E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Correlation between serum KL-6 level and severity of SARD-related ILD
Get PDFObjective: To understand the correlation between serum KL-6 level and severity of SARD-related ILD in Indonesia.Method: This was a cross-sectional study to evaluate the correlation between serum KL-6 level and Interstitial Lung Disease (ILD) severity based on Chest High-Resolution Computed Tomography (Chest HCRT) among patients with Systemic Autoimmune Rheumatic Disorders (SARD) who visited the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital during the period of January 2019 to February 2020. Secondary data were retrieved from a study on the Effects of Ciplukan Herbs on Organ Fibrosis. KL-6 serum concentration was measured from stored biological material and the correlation between the serum KL-6 level and ILD severity was analyzed by Rank Spearman's test.Results: Thirty-four patients participated in this study with a median age of 37 years-old. Most of the participants were female (94.1%), Sundanese (64.7%), and had systemic sclerosis as an underlying disease (48.5). The median serum KL-6 level was 57.1 U/ml (21.6-444.1). Most participants belonged to severe ILD group (58.8%) with a mean serum KL-6 level of 65.1±48.9 U/ml. The highest mean serum KL-6 level (111.6±121.8) was observed in the moderate ILD group comprising of 32.4% of the participants. The remaining 11.8% participants belonged to mild ILD group with a mean serum KL-6 level of 61.1±24.9 U/ml. Serum KL-6 level was demonstrated to have a weak correlation with ILD severity (r=-0.229, p=0.193).Conclusion. There is an insignificant weak correlation between serum KL-6 level and ILD severity based on chest HRCT in SARD patients
Indications and Complications of Orthopedic Hardware Removal in an Indonesian Tertiary Hospital: A Descriptive Study
Get PDFObjective: To acquire clinical data regarding indications of implant removal and complications in orthopedic metal implant removal. Methods: This was a cross-sectional observational descriptive study using patient medical records. The inclusion criterion was all patients who underwent orthopedic metal implant removal during 2018-2020 while the exclusion criterion was unintentional implant removal due to subsequent injury or loosening. Data regarding anatomic regions, indications, and complications were collected and presented in tables.Results: In 112 patients participated in this study consisting of 75 (67%) men and 37 (33%) women, the implants were mainly located in thigh, lower leg, and ankle (53% combined). The most common indication for metal implant removal was conversion (31%), followed by infection (25%) and patient's request (20%). The only complication observed in orthopedic metal implant removal in this study was disturbed wound healing in a small percentage of the patients (16%). Most patients (84%) did not experience any complication due to metal implant removal.Conclusions: Indications for metal implant removal may vary, with or without symptoms. Disturbed wound healing is a complication observed in metal implant removal. Despite the advantages of removal, further analysis and guidelines are needed to avoid unnecessary hardware removal considering the risk of complications
Level of Knowledge and Attitude towards COVID-19 among High School students in Depok
Get PDFBackground: Depok is the city with the largest COVID-19 cases in West Java, Indonesia. The application of health protocol for high school student as the second-largest age group,’s depends on the level of knowledge and attitudes that can be affected by gender. This study aimed to determine the level of knowledge and attitudes based on the gender of high school students towards COVID-19 in Depok.Methods: This study was a cross-sectional analytic study, conducted from June 2020 to June 2021. The data was collected using a Google form application with a validated questionnaire and the research subjects were high school students in Depok. Knowledge of COVID-19 was assessed with 18 questions, true or false questions. Correct answer was assigned 1 point. Points were summed for a total knowledge score of Poor, Moderate, or Good. Attitude was assessed with 6 questions. For each answer given, subjects with a total score of >18 were assessed as a positive attitude.Results: Of a total of 273 respondents, 238 had met the inclusion criteria. Most of the respondents had a moderate level of knowledge (60.5%) and most of the respondents (89%) had a positive attitude towards COVID-19. No significant differences in level of knowledge or attitude between males and females (p>0.05).Conclusions: High school students in Depok have a moderate level of knowledge and have a positive attitude in dealing with COVID-19 which is not influenced by gender. The lack of information regarding the timing of vaccine administration and examination of COVID-19 needs to be a concern for high school students in Depok
Aspartate Aminotransferase to Platelet Ratio Index Score in Correlation with Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio to Predict Hepatic Cirrhosis in Hepatitis C Patients
Get PDFBackground: Tissue biopsy examination which is an invasive procedure has become the mainstay for hepatic cirrhosis identification in patients with hepatitis. Alternatively, noninvasive method using the aspartate aminotransferase (AST) to platelet ratio index (APRI) score has been developed to predict hepatic cirrhosis. Furthermore, the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) have been used to predict the severity of hepatitis C. This study aimed to analyze the relationship between APRI scores and NLR and PLR in chronic hepatitis C patients.Methods: This correlative cross-sectional observational study used secondary data of complete blood counts such as neutrophil, lymphocyte, and platelet values, as well as AST values of patients with hepatitis C in the outpatient and inpatient installation of Dr. Hasan Sadikin General Hospital during 2019. The inclusion criteria were patients aged ≥18 years, male and female, who were diagnosed as hepatitis C patients, patients who had AST examination data, leukocytes, count type, and platelets. Data were analyzed using the Spearman rank correlation test.Results: The 123 subjects were dominantly male with an age range of 46–55 years. There was no correlation between the APRI and NLR scores (p=0.229). However, there was a moderate and significant negative correlation between APRI and PLR scores with a correlation coefficient of -0.468 (p=0.000).Conclusion: There is a significant negative correlation between APRI and PLR scores to predict the occurrence of hepatic cirrhosis in patients with Hepatitis C
Distribution of Rifampicin-Resistant Tuberculosis Patients based on Presumptive Drug-Resistant Tuberculosis Criteria at Dr. Hasan Sadikin Hospital 2016–2019
Get PDFBackground: Diagnosis of drug-resistant tuberculosis (DR-TB) begins with identifying presumptive DR-TB patients using Xpert MTB/RIF, as a diagnostic test to detect resistance to rifampicin. The study aimed to identify the distribution of rifampicin-resistant tuberculosis (RR-TB) patients based on presumptive DR-TB criteria at Dr. Hasan Sadikin General Hospital Bandung. Moreover, this study also explored the Xpert MTB/RIF Ct values.Methods: This was a descriptive-retrospective study from 570 medical records of DR-TB patients collected at the Multidrug-resistant tuberculosis (MDR-TB) clinic of Dr. Hasan Sadikin General Hospital from 2016 to 2019. The inclusion criteria were suspected patients with the Xpert MTB/RIF Ct values in the very low-low and medium-high categories. Data were analyzed using frequency distribution. Results: The most common presumptive DR-TB criteria among DR-TB patients were relapse cases (52.3%). Presumptive DR-TB criteria, with a high percentage result of medium-high Ct values, were category II treatment failure (80.9%).Conclusion: Relapse case and category II treatment failure are presumptive DR-TB criteria, which need more attention from clinicians
Gambaran Respons Peserta PPDS Anestesi FK Unpad Terhadap Pernyataan Seputar COVID-19 dan Tatalaksana Jalan Napas Pasien COVID-19
Get PDFPeserta Program Pendidikan Dokter Spesialis (PPDS) Anestesi adalah salah satu tenaga kesehatan yang rentan terinfeksi Coronavirus disease 2019 (COVID-19) yang disebabkan oleh paparan droplet dan aerosol saat mereka mengerjakan prosedur tata laksana jalan napas pasien. Tujuan penelitian ini adalah menggambarkan bagaimana respons peserta PPDS anestesi Fakultas Kedokteran Universitas Padjadjaran (FK Unpad) terhadap pernyataan seputar COVID-19 dan tata laksana jalan napas pada pasien COVID-19. Penelitian ini adalah sebuah studi deskriptif dengan desain potong lintang. Pengambilan data secara survei daring yang dilakukan kepada sebanyak 98 peserta PPDS Anestesi bulan Oktober 2021. Data penelitian terdiri atas karakteristik partisipan, respons terhadap pernyataan seputar COVID-19, dan tata laksana jalan napas pasien COVID-19. Data kemudian dianalisis dengan metode statistika deskriptif dengan aplikasi SPSS versi 26. Hasil penelitian ini adalah mayoritas peserta PPDS anestesi FK Unpad menunjukkan respons yang sesuai dengan referensi yang ada kecuali respons terhadap pernyataan mengenai periode inkubasi, lokasi pemeriksaan praoperatif, karantina setelah intubasi, dan masker laring sebagai pilihan pertama pembukaan jalan napas, dan pemberiaan pra-medikasi bagi pasien COVID-19 yang akan dianestesi. Simpulan penelitian ini adalah walaupun mayoritas peserta PPDS Anestesi FK Unpad sudah memberikan respons yang sesuai, namun masih diperlukan peningkatan literasi mengenai COVID-19, dan tata laksana jalan napas pasien COVID-19 agar mereka semakin aman dalam pekerjaannya. Responses of Universitas Padjadjaran Anesthesiology Residents to COVID-19 and Airway Handling for COVID-19 PatientsAnesthesiologists are healthcare workers vulnerable to COVID-19 infection as they are exposed to droplets and aerosols when working with patients' airways. This study aimed to describe how anesthesiology residents of the Faculty of Medicine, Universitas Padjadjaran responded to statements about COVID-19 and airway management in COVID-19 patients. This research was a descriptive study with a cross-sectional design. Data were collected through an online survey of 98 anesthesiology resident participants in October 2021. The data collected consisted of participant characteristics, responses to statements about COVID-19, and airway management of COVID-19 patients. Data analysis used descriptive statistical methods using the SPSS version 26 application. Study results were: most of the participants showed an appropriate response according to existing references except for responses to statements regarding the incubation period, preoperative examination location, quarantine after intubation, and laryngeal mask as the first choice to establish an airway, and providing premedication for COVID-19 patients who would be anesthetized. This study concludes that although most participants have responded appropriately, they must increase literacy about COVID-19 and the airway management of COVID-19 patients to remain secure at work. Peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesi adalah salah satu tenaga kesehatan yang rentan terinfeksi Coronavirus Disease 2019 (COVID-19) yang disebabkan oleh paparan droplet dan aerosol saat mereka mengerjakan prosedur tatalaksana jalan napas pasien. Tujuan penelitian ini adalah menggambarkan bagaimana respons peserta PPDS anestesi Fakultas Kedokteran Universitas Padjadjaran (FK UNPAD) terhadap pernyataan seputar COVID-19 dan tatalaksana jalan napas pada pasien COVID-19. Penelitian ini adalah sebuah studi deskriptif dengan desain potong lintang. Pengambilan data secara survei daring yang dilakukan kepada sebanyak 98 peserta PPDS Anestesi bulan Oktober 2021. Data penelitian terdiri atas karakteristik partisipan, respons terhadap pernyataan seputar COVID-19 dan tatalaksana jalan napas pasien COVID-19. Data kemudian dianalisis dengan metode statistika deskriptif dengan aplikasi SPSS versi 26. Hasil penelitian ini adalah mayoritas peserta PPDS anestesi FK UNPAD menunjukkan respons yang sesuai dengan referensi yang ada kecuali respons terhadap pernyataan mengenai periode inkubasi, lokasi pemeriksaan pra-operatif, karantina setelah intubasi, dan masker laring sebagai pilihan pertama pembukaan jalan napas, dan pemberiaan pra-medikasi bagi pasien COVID-19 yang akan dianestesi. Simpulan penelitian ini adalah walaupun mayoritas peserta PPDS Anestesi FK UNPAD sudah memberikan respons yang sesuai namun masih diperlukan peningkatan literasi mengenai COVID-19 dan tatalaksana jalan napas pasien COVID-19 agar mereka semakin aman dalam pekerjaannya
Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation Use in Refractory Glaucoma Patients
Get PDFGlaucoma is the leading cause of irreversible blindness worldwide. Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) is a new method for treatment for refractory glaucoma with lesser complications than coventional TSCPC. This study aimed to evaluate the effectiveness and safety of MP-TSCPC (IRIDEX IQ810 Laser systems, CA) for refractory glaucoma treatment. This was a retrospective study using data obtained from the medical records of patients who underwent a MP-TSCPC procedure at Cicendo National Eye Hospital from July 2018 to September 2019. The outcomes measured were success rate (IOP decreased ≥30% from baseline with or without anti glaucoma medication at first month follow up) and post-operative complications. Fifty-seven eyes from 56 patients with a mean age of 57 years old underwent MP-TSCPC with 3 month follow up. The mean pre-operative intraocular pressure (IOP) dropped from 51.8 mmHg to 36.0 mmHg at 1 month follow up and 36.8 mmHg at the final follow up, representing an IOP decrease of 31% (1 month) and 28% (3 month). There was also a decrease of anti glaucoma medication usage from 2.51 to 2.16. The overall success rate at 1 month follow up was 49% and only 5% complication were found in this study. MP-TSCPC is safe and effective for lowering IOP and decreasing the need of anti glaucoma -medications in refractory glaucoma case. Further long-term evaluation and comparison to conventional TSCPC are still necessary
Effectiveness of Basil, Lime, Honey, Candlenut, and Tiwai Onion Herbs Combination as Analgesics and Stamina Stimulator
Get PDFTraditional medicine is generally considered to be safer than modern medicine because it has lower incidence of side effects and also relatively easy to obtain. The purpose of this study was to examine the analgesic effect of herbs made of basil, lime, honey, candlenut, and Tiwai onions as well as to evaluate the potential of these herbs as a stamina stimulator. This study was conducted at the Laboratory of Animal Management Unit, Faculty of Veterinary Medicine, IPB University, from January–February 2022. Mice were divided into four groups based on the treatment dose with each group consisted of five mice. An analgesic test was conducted using hot water immersion tail-flick test method and the stamina test was performed with swimming endurance test. Data obtained were analyzed using Microsoft Excel 2019 and Minitab 19. Significant differences of the average of each group were shown statistically using the one-way ANOVA and confirmed with Tukey test. Results showed that mice given the combination herbal medicine infusion of with a dose of 4 g/kg body weight had the highest average tail lift time compared to the controls (p<0.05). Mice with a treatment dose of 1 g/kg body weight had the highest analgesic power compared to the other treatment doses. The highest swimming duration was observed in group that received a dose of 1 g/kg body weight. It is concluded that this herbal combination can be used as an analgesic and a stamina stimulator
Initial TLC, NLR, LDH, CRP, D-Dimer, and Procalcitonin in Intubated vs Non Intubated COVID-19 Patients
Get PDFCOVID-19 is an acute respiratory disease caused by the SARS-CoV-2 virus that has caused a pandemic with symptoms of upper respiratory infection, respiratory failure, and even mortality. Several asymptomatic patients, with no shortness of breath, were found to experience impaired oxygenation in examination for objective data (happy hypoxia). Thus, objective data are needed, including data on inflammatory parameters (TLC, NLR, LDH, CRP, D-dimer and PCT) to monitor the severity and prognosis of COVID-19 patients. This study aimed to evaluate the inflammatory parameters in the initial days of treatment for COVID-19 patients between intubated and non-intubated patients during hospitalization. The study was conducted in the COVID isolation ward of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from July 2020 to July 2021. This was a retrospective cross-sectional comparative analytical observational study that involved patients’ first laboratory examination results. The statistical analysis was performed using Mann Whitney test for numerical data and Chi Square test for categorical data. There were significant differences in inflammatory parameters values in both groups (p<0.01). The TLC values of intubated patients were lower than those of non-intubated patients, while the NLR, LDH, CRP, D-dimer and PCT values of intubated COVID-19 patients were higher than those of non-intubated patients
Profile and Frequency of One Hundred Ankle Osteoarthritis Cases in an Indonesian Tertiary Hospital
Get PDFOsteoarthritis is one of the most common cases in orthopedics and traumatology clinic. Ankle osteoarthritis is less common than osteoarthritis of hip and knee. Limited data and literature resulted in suboptimal treatment strategy. The purpose of this study was to describe the profile and frequency of ankle osteoarthritis at Dr. Hasan Sadikin General Hospital Bandung, a tertiary referral hospital in Indonesia. A cross-sectional descriptive observational study was conducted on all patients diagnosed with ankle osteoarthritis enrolled in the medical record database at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in November 2020–November 2021. Results showed that the majority of the patients were female (52%), aged ≥60 years old (44%), graduated from senior high school education (56%), and housewives (30%). The 100 patients were proportionally distributed with most of them were categorized as suffering from secondary osteoarthritis with post-trauma predominance. From the perspective of body mass index, 85% patients were classified as above normal. As many as 76% of patients presented to the hospital in an advanced stage. With the high rate of posttraumatic ankle osteoarthritis, concerns should be given more to the ankle trauma management, as well as to the population with high body mass index. Increased health promotion for general population and health care providers is also needed to reduce the tendency of late presentation at the health care facility