E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Risk Factor of Stillbirth among Pregnant Women at Dr. Hasan Sadikin General Hospital Bandung from 2017–2020
Get PDFBackground: Stillbirth is one of the most devastating pregnancy outcomes that affects approximately 2.6 million pregnancies worldwide. Several factors have been identified to be associated with stillbirth, and grouped based on the pathophysiological aspects, such as maternal, placental, fetal, and unknown or unexplained factors. This study aimed to describe the prevalence, along with the baseline and risk factor characteristics of stillbirth among singleton pregnancies at Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive, cross-sectional study design was conducted, including all stillbirth medical records from 2017 to 2020 obtained from the Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital Bandung. Medical records with complete baseline data, 2nd–3rd trimester pregnancies, and singleton pregnancies were collected.Results: The prevalence of stillbirth cases in this study was 2.2%. Most of the cases occurred in the age range of 20–35 years old (64.4%) with the gestational age of >28 weeks (65.8%). Of all risk factors observed, hypertensive disorders were the most common medical conditions found (45.6%), followed by unknown factors (17.8%), and congenital abnormalities (14.2%).Conclusions: The majority of stillbirth patients are at their optimal reproductive age, nulliparity, and have hypertensive disorders during pregnancy, specifically the superimposed preeclampsia subtype. Although the prevalence is considerably low, early management of the risk factors, particularly hypertensive disorder, is important to prevent its occurrence
Impact of Instagram Usage Intensity on Self-Esteem among Preclinical Medical Students
Get PDFBackground: Instagram is one of the social media that is growing rapidly in Indonesia. However, the impact of Instagram usage intensity, especially on the users’ emotional well-being, is still unclear. This study aimed to explore the impact of the intensity of using Instagram on the self-esteem among preclinical medical students in Jakarta.Methods: This study was an observational analytic study with a cross-sectional approach in preclinical medical students in Jakarta, Indonesia, conducted from January 2020 to January 2021. Sampling was performed by stratified random sampling followed by simple random sampling. Instagram usage intensity and self-esteem were measured using the Instagram Intensity Scale Questionnaire (IISQ) and the Rosenberg Self-Esteem Scale (RSES). Data were analyzed using the Chi-Square test.Results: Of the108 students, 45.4% had used Instagram above the usage intensity average (average 3.01), of whom 30.6% had low self-esteem (15 out of 49). There was a significant relationship between Instagram usage intensity and self-esteem (p=0.031).Conclusion: Instagram usage intensity has an impact on the self-esteem of preclinical medical students. Further studies are needed to explore this issue, as to see other contributing factors and a larger population with different characteristics.
Efektivitas Penambahan Sodium Bikarbonat 1 mEq pada Lidokain 2% dalam Balon ETT untuk Pencegahan Nyeri Tenggorokan Paska Intubasi
Get PDFPemberian lidokain dalam balon selang endotrakeal dapat berdifusi menyebar menembus dinding membran semipermeabel selang endotrakeal dan merangsang efek anestesi pada trakea. Alkalinisasi lidokain menggunakan natrium bikarbonat (NaHCO3) diprediksi dapat meningkatkan presentasi fraksi obat tidak terionisasi sehingga diharapkan dapat lebih efektif. Penelitian ini bertujuan mengetahui efektivitas penambahan natrium bikarbonat 1 mEq pada lidokain 2% dalam balon ETT untuk pencegahan nyeri tenggorokan pascaintubasi. Penelitian ini menggunakan metode double-blind randomized controlled trial dari Juli–September 2020 di Rumah Sakit Moewardi Surakarta. Teknik pengambilan sampel dilakukan dengan non-probability sampling dengan metode consecutive sampling yang berjumlah 36 pasien ASA I–II. Sesaat setelah intubasi, balon selang endotrakeal dikembangkan dengan lidokain 2% dan lidokain 2% ditambah NaHCO3 1 mEq pada tiap-tiap kelompok hingga tekanan 20–30 cmH2O. Pasien yang telah menjalani operasi dinilai skala nyeri tenggorokan pascaoperasi dan dievaluasi komplikasi yang terjadi selama 24 jam. Data demografik dan durasi anestesi pada kedua kelompok tidak berbeda bermakna secara statistik (p>0,05). Skor nyeri tenggorokan pada waktu 30–60 menit, 6–8 jam, dan 24 jam pascaoperasi, kelompok lidokain 2% ditambah NaHCO3 1 mEq (LN) lebih rendah dibanding dengan kelompok lidokain 2% murni (L). Berbeda bermakna secara statistik (p0,05) pada jam ke-24. Tidak didapatkan komplikasi berkaitan dengan overdosis. Simpulan, pada grup LN lebih efektif dibanding dengan grup L untuk pencegahan nyeri tenggorokan pascaintubasi. Sodium Bicarbonate Efficacy to Lidocaine in Prevention of Sore Throat Post ETT Balloon Intubation When lidocaine is injected into the ETT cuff, it spreads through the semi-permeable membrane wall and induces anesthesia in the trachea. Alkalinization of lidocaine with sodium bicarbonate (NaHCO3) to increase the non-ionized lidocaine is expected to be more effective. This study aimed to determine the effectiveness of adding one mEq NaHCO3 to lidocaine into the ETT cuff to prevent sore throat post-intubation. This study used a double-blind, randomized controlled trial from July to September 2020 at the Moewardi Regional General Hospital Surakarta. The method used was non-probability sampling with consecutive sampling, totaling 36 ASA I-II patients. Shortly after intubation, the ETT cuff was inflated with 2% lidocaine and 2% lidocaine plus one mEq NaHCO3 in each group. Patients who had undergone surgery were assessed on the postoperative sore throat scale and observed for complications for 24 hours. Both groups' demographic data and anesthesia duration were not statistically significant (p>0.05). Sore throat scores at 30-60 minutes, 6-8 hours, and 24 hours after surgery were lower in the 2% lidocaine plus one mEq NaHCO3 (LN) group than in the 2% lidocaine (L) group. It was statistically significant (p0.05) at 24 hours. No complications were associated with lidocaine overdose, systemic toxicity, or ETT balloon rupture. In conclusion, the LN group is more effective than the L group in reducing the incidence of postoperative sore throat.Nyeri tenggorokan paska operasi sering terjadi setelah anestesi umum menggunakan intubasi endotrakeal. Pemberian lidokain dalam balon selang endotrakeal dapat berdifusi menyebar menembus dinding membran semipermeabel selang endotrakeal dan merangsang terjadinya efek anestesi pada trakea. Hanya bentuk obat basa tidak terionisasi yang dapat berdifusi melintasi dinding klorida polivinil hidrofobik dari manset selang endotrakeal. Dengan alkalinisasi lidokain menggunakan sodium bikarbonat (NaHCO3) diprediksi dapat meningkatkan presentasi fraksi obat tidak terionisasi sehingga diharapkan dapat lebih efektif mencegah nyeri tenggorokan paska operasi. Penelitian ini bertujuan untuk mengetahui efektivitas penambahan sodium bikarbonat 1 mEq pada lidokain 2% dalam balon ETT untuk pencegahan nyeri tenggorokan paska intubasi. Penelitian ini menggunakan metode double-blind randomized controlled trial dari Juli hingga September 2020 di Rumah Sakit Moewardi Surakarta. Teknik pengambilan sampel dilakukan dengan non-probability sampling dengan metode consecutive sampling yang berjumlah 36 pasien ASA I-II. Sesaat setelah intubasi, balon selang endotrakeal dikembangkan dengan lidokain 2% dan lidokain 2% ditambah sodium bikarbonat 1 mEq pada masing-masing kelompok hingga tekanan 20-30 cmH2O. Pasien yang telah menjalani operasi dinilai skala nyeri tenggorokan paska operasi (skor 0-3) dan dievaluasi komplikasi yang terjadi selama 24 jam. Data demografik dan durasi anestesi pada kedua kelompok tidak berbeda bermakna secara statistik (p>0,05). Skor nyeri tenggorokan pada waktu 30-60 menit, 6-8 jam, dan 24 jam paska operasi, kelompok lidokain 2% ditambah sodium bikarbonat 1 mEq (LN) lebih rendah dibanding kelompok lidokain 2% murni (L). Berbeda bermakna secara statistik (p0,05) pada jam ke-24. Tidak didapatkan komplikasi berkaitan dengan overdosis. Penambahan sodium bikarbonat 1 mEq pada lidokain 2% dalam balon ETT lebih efektif dibandingkan lidokain 2% untuk pencegahan nyeri tenggorokan paska intubasi
Association of Maternal Obesity and Pregnancy Outcomes
Get PDFBackground: The prevalence of obesity is increasing globally, causing various possible disorders and complications. Maternal and perinatal morbidity and mortality might potentially be affected by maternal obesity. This study aimed to evaluate the association between maternal obesity and pregnancy outcomes.Methods: This retrospective cohort study was part of a larger cohort study performed from July 2016 to July 2017 in West Java, including 223 pregnant women with normal fetuses, who were obese or non-obese pre-pregnancy. Underweight women were excluded. Data on pregnancy outcomes consisting of Caesarean section, preeclampsia, premature rupture of membrane (PROM), preterm birth, post-term birth, small for gestational age (SGA), and large for gestational age (LGA) were collected. The association with maternal obesity was analyzed using the Fisher’s Exact Test to determine the association with a 95% confidence interval, and a p-value <0.05 was considered significant.Results: There was an association between maternal obesity and Caesarean section, with an increased risk in obese mothers compared to non-obese mothers (RR 2.398 CI 1.328-4.329). There was no significant association between maternal obesity and preeclampsia, PROM, preterm birth, post-term birth, SGA, and LGA.Conclusion: Maternal obesity is associated with Caesarean section. A more comprehensive approach is essential for obese pregnant women to ensure the health of both the mother and the infant
Association Between Maternal Mid-Upper Arm Circumference and Baby's Birth Weight
Get PDFBirth weight can be a potential predictor for short-term and long-term health outcomes. Low birth weight can be an output from maternal malnutrition. Mothers' chronic energy malnutrition risk is detected by measuring maternal mid-upper arm circumference (MUAC). This study aimed to analyze the correlation of maternal MUAC with a baby's birth weight. This study was an analytic observational study that used secondary data from October 2021 to January 2022. Data were obtained from Tanjungsari Intergenerational Study Nutrition Working Group from 2014 to 2016. Subjects were 124 pairs of mother and baby who were recruited using total sampling. Data were analyzed using t-test and logistic regression. A significant association of maternal MUAC and the baby's birth weight (t (122) = 3.75, 95% CI 174.5, 564.0, p=0.000) was detected. Underweight (OR 23.3, 95% CI 2.6, 209.0, p=0.005), overweight, and obese (OR 0.05, 95% CI 0.01, 0.42, p=0.006) status was shown to have an association with MUAC. Education level and occupation status had no associations with MUAC. In conclusion, maternal MUAC is associated with baby's birth weight. The determinant factors of maternal MUAC were underweight, overweight, and obese status
Influence of Pesticide Intoxication Education on Farmer Knowledge and Attitude in Kalidoni District, Palembang City, Indonesia
Get PDFKnowledge and attitude of farmers are among factors that influence pesticide intoxication in farms. They are influenced by several variables, including education. Farmers’ knowledge and attitude on pesticide intoxication may change after they receive interventions, such as education about pesticides. This study aimed to determine the level of knowledge and attitude of farmers on pesticide intoxication before and after an education session on pesticides in Sei Selincah Sub-district, Kalidoni District. This was a quasi-experimental observational analysis with a two-group pretest posttest design with a control group. This study used primary data from farmers in Sei Selincah Sub-district, Kalidoni District. Sampling was performed using the purposive sampling method and seventy-six respondents who met the inclusion and exclusion criteria were recruited. Results of the statistical tests using the Wilcoxon test showed that there was no difference in the level of knowledge and attitude of farmers before and after education, both fort the intervention group and the control group (p>0.05). Thus, education does not influence the level of knowledge and attitude on pesticides and pesticide intoxication among farmers
ANESTESI KAUDAL PADA NEONATUS DENGAN SUSPEK SINDORM DOWN DAN HIPOTIROID KONGENITAL YANG DILAKUKAN TINDAKAN ANOPLASTI
No full textDokter anestesi menghadapi beberapa tantangan dalam manajemen anestesi untuk neonatus yang menjalani operasi di bawah anestesi umum karena ketidakmatangan berbagai organ, toleransi terhadap agen anestesi, dan cadangan oksigen rendah. Tindakan regional neuroaksial kaudal dapat digunakan sebagai alternatif yang aman pada neonatus yang dilakukan tindakan anoplasti. Laporan kasus ini bertujuan memaparkan keberhasilan penatalaksanaan anestesi pada neonatus yang menjalani operasi anoplasti dengan anestesi kaudal. Seorang bayi baru lahir aterm dengan usia 3 hari dan BB 2.800 gram disertai dengan suspek sindrom Down dan hipotiroid kongenital dikonsulkan untuk menjalani anoplasti. Pada pemeriksaan fisis didapatkan wajah tampak mongolid dengan abdomen yang distensi dan produksi orogastric tube kehijauan sebanyak 10 mL. Pada preoperatif, pasien dipuasakan dan diberikan maintenance cairan. Operasi dilakukan dengan tindakan regional kaudal menggunakan bupivakain 0,25% sebanyak 0,5 mL/kgBB. Untuk menjaga pasien tetap tenang saat intraoperatif, pasien diberikan dot. Efektivitas blok diperiksa menggunakan tes pinprick di bawah umbilikal. Tidak diberikan sedasi saat intraoperasi. Saat intaoperasi didapatkan bayi tenang dan operasi dapat diselesaikan dengan baik. Tindakan kaudal anestesi pada anoplasti dapat dilakukan dengan aman terutma pada pasien neonatus yang memiliki risiko tinggi untuk dilakukan tindakan general anestesi. Caudal Anesthesia for Anoplasty in Neonates with Suspected Down Syndrome and Congenital HypothyroidAnesthesiologists face several challenges in anesthetic management for neonates undergoing surgery under general anesthesia due to the immaturity of various organs, tolerance to anesthetic agents, and low oxygen reserves. Caudal anesthesia can be used as a safe alternative in neonates undergoing anoplasty. This case report aimed to describe the success of anesthetic management in neonates who underwent anoplasty surgery under caudal anesthesia. A term newborn baby aged three days and weighing 2800 grams with suspected Down syndrome and congenital hypothyroidism was consulted for anoplasty. On physical examination, the face appeared Mongolian, with a distended abdomen and ten ccs of greenish orogastric tube production. Preoperatively, the patient fasted and was given fluid maintenance. The operation was performed by caudal regional action using 0.25% bupivacaine as much as 0.5 mL/kgBW. The patient needed to be calm intraoperatively, so the patient was given a pacifier. The effectiveness of the block was checked using the pinprick test below the umbilical. No intraoperative sedation was given. At the intraoperative time, the baby was calm, and the operation was completed. Caudal anesthesia in anoplasty can be performed safely, especially in neonates who are at high risk for general anesthesia.Dokter anestesi menghadapi beberapa tantangan dalam manajemen anestesi untuk neonatus yang menjalani operasi di bawah anestesi umum karena ketidakmatangan berbagai organ, toleransi terhadap agen anestesi, dan cadangan oksigen rendah. Tindakan regional neuroaksial kaudal dapat digunakan sebagai alternatif yang aman pada neonatus yang dilakukan tindakan anoplasti. Laporan kasus ini bertujuan untuk memaparkan keberhasilan penatalaksanaan anestesi pada neonatus yang menjalani operasi anoplasti dengan anestesi kaudal. Seorang bayi baru lahir aterm dengan usia 3 hari dan BB 2800 gram disertai dengan suspek sindrom down dan hipotiroid kongenital dikonsulkan untuk menjalani anoplasti. Pada pemeriksaan fisik didapatkan wajah tampak mongolid dengan abdomen yang distensi dan produksi orogastric tube kehijauan sebanyak 10 cc. Pada preoperatif, pasien dipuasakan dan diberikan maintenance cairan. Operasi dilakukan dengan tindakan regional kaudal menggunakan bupivakain 0,25% sebanyak 0,5 cc/kgBB. Untuk menjaga pasien tetap tenang saat intraoperatif, pasien diberikan dot. Efektifitas blok diperiksa menggunakan tes pinprick di bawah umbilical. Tidak diberikan sedasi saat intraoperasi. Saat intaoperasi didapatkan bayi tenang dan operasi dapat diselesaikan dengan baik. Tindakan kaudal anestesi pada anoplasti dapat dilakukan dengan aman terutma pada pasien neonatus yang memiliki risiko tinggi untuk dilakukan tindakan general anestes
Perbandingan Adductor Canal Block Dan Femoral Nerve Block Terhadap Kekuatan Otot Quadriceps Femoris Pascaoperasi Total Knee Replacement
No full textAbstrak Blokade saraf femoral telah digunakan terlebih dahulu dalam penatalaksanaan nyeri pascaoperasi total knee replacement (TKR). Penelitian ini bertujuan mengetahui perbedaan kekuatan otot paha pascaoperasi TKR antara femoral nerve block (FNB) dan adductor canal block ACB dengan mengukur nilai manual muscle test (MMT), selain itu penelitian ini membandingkan nilai numeric rating scale (NRS) dengan total kebutuhan patient controlled anlagesia (PCA) morfin yang digunakan pascaoperasi TKR. Penelitian dilakukan pada periode Oktober–November 2020 di RS Santosa Bandung. Penelitian ini menggunakan metode uji klinis acak terkontrol buta tunggal melibatkan 18 pasien yang menjalani operasi TKR. Pasien dibagi menjadi dua kelompok, kelompok kelompok ACB, n=9 dan kelompok FNB, n=9. Pemeriksaan MMT otot kuadrisep femoris dilakukan pada jam ke-24 pascaoperasi TKR. Analisis data numerik dengan uji T tidak berpasangan dan Mann Whitney. Data kategorik dengan uji chi square. Nilai NRS ACB lebih tinggi pada jam ke- 24 saat diam dan bergerak serta total kebutuhan PCA morfin lebih tinggi pada kelompok ACB, namun tidak bermakna secara statistik (p>0,05). Nilai MMT pascaoperasi TKR pada jam ke-24 pada kelompok ACB lebih tinggi dibanding dengan kelompok FNB dengan perbedaan bermakna (p0,05). Nilai MMT pascaoperasi TKR pada jam ke-24 pada kelompok ACB lebih tinggi dibandingkan kelompok FNB dengan perbedaan bermakna (p<0,05)
Efektivitas Spray Lidokain pada Pipa Endotrakea terhadap Kejadian Nyeri Tenggorok Pascaoperasi yang Dihubungkan dengan Lama Anestesi/Intubasi
Get PDFPostoperative sore throat (POST) merupakan salah satu komplikasi anestesi yang mengurangi kenyamanan pasien dengan angka kejadian yang cukup tinggi. Lidokain merupakan salah satu medika mentosa yang dapat digunakan untuk mencegah POST. Penelitian ini bertujuan menilai efektivitas spray lidokain pada endotracheal tube (ETT) yang dihubungkan dengan lama anestesi/intubasi pada periode Desember 2020–Februari 2021 di RSUP Dr. Hasan Sadikin Bandung. Uji klinis dilakukan terhadap 113 subjek yang terbagi menjadi 3 kelompok, yaitu dengan lama operasi 2 jam (kelompok 3). Penilaian dilakukan pada jam ke-0, 1, 6, dan 24 pascaoperasi. Analisis statistik nonparametrik menggunakan uji Kruskal Wallis dan analisis post-hoc menggunakan uji Mann Whitney. Terdapat perbedaan POST yang signifikan pada perbandingan kelompok 1 dengan 3, serta kelompok 2 dengan 3 (p0,05). Pemberian lidokain pada ETT untuk mencegah POST efektif pada lama anestesi/intubasi kurang dari 2 jam. Diperlukan modalitas lain untuk mencegah POST pada operasi dengan durasi lebih dari 2 jam.Effectiveness of Lidocaine Spray for Preventing Postoperative Sore Throat in Several Durations of AnesthesiaPostoperative sore throat (POST) is a common postoperative complaint after general anesthesia, which can cause dissatisfaction and discomfort after surgery. Lidocaine is one of the drugs used to reduce or prevent POST. This study aimed to determine the effectiveness of lidocaine in preventing POST at various durations of anesthesia/intubation. The study was conducted from December 2020 to February 2021 at Dr. Hospital. Hasan Sadikin Bandung. This study enrolled 113 subjects who were divided into three groups, namely the group with a duration of anesthesia/intubation of less than 1 hour (group 1), between 1–2 hours (group 2), and the group with a duration of more than 2 hours (group 3). The postoperative sore throat was assessed immediately after the patient was extubated, 1, 6, and 24 hours post-extubation. Nonparametric statistical analysis was performed with the Kruskal Wallis test. The results showed that the severity of POST was statistically different between the groups (p0.05). Administration of a lidocaine spray for preventing POST is effective in an anesthetic duration of fewer than 2 hours. Other modalities may be required for an anesthesia duration of more than 2 hours. Postoperative sore throat (POST) merupakan salah satu komplikasi anestesi yang mengurangi kenyamanan pasien dengan angka kejadian yang cukup tinggi. Lidokain merupakan salah satu medika mentosa yang dapat digunakan untuk mencegah POST. Penelitian ini bertujuan menilai efektivitas spray lidokain pada endotracheal tube (ETT) yang dihubungkan dengan lama anestesi/intubasi pada periode Desember 2020–Februari 2021 di RSUP Dr. Hasan Sadikin Bandung. Uji klinis dilakukan terhadap 113 subjek yang terbagi menjadi 3 kelompok, yaitu dengan lama operasi 2 jam (kelompok 3). Penilaian dilakukan pada jam ke-0, 1, 6, dan 24 pascaoperasi. Analisis statistik nonparametrik menggunakan uji Kruskal Wallis dan analisis post-hoc menggunakan uji Mann Whitney. Terdapat perbedaan POST yang signifikan pada perbandingan kelompok 1 dengan 3, serta kelompok 2 dengan 3 (p0,05). Pemberian lidokain pada ETT untuk mencegah POST efektif pada lama anestesi/intubasi kurang dari 2 jam. Diperlukan modalitas lain untuk mencegah POST pada operasi dengan durasi lebih dari 2 jam
