E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
Not a member yet
1208 research outputs found
Sort by
Correlation between Serum Interleukin-6 Level and Modified Rodnan Skin Score in Systemic Sclerosis Patients
Get PDFObjective: To determine the correlation between serum levels of IL-6 and MRSS in systemic sclerosis patients.Methods: This was a crossectional observational study on patients with SSc visiting the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia from January 2019 to December 2020. Registered SSc patients, with validated MMRS by a rheumatologist, and available biological materials for IL-6 measurement were included. Patients with other autoimmune diseases, acute infection, diabetes mellitus, and obesity were excluded from this studyResults: Of the 51 SSc patients, 42 patients met the inclusion criteria. Women comprised the majority of these patients (95.2%), while patients’ mean age was 43±12 years. The mean duration of disease was 20 months, with diffuse SSc (78.6%) as the most frequent type. Bivariate analysis showed that IL-6 was positively correlated with MRSS (100-scale) with r=0.397 and p=0.005.Conclusion: There is a medium positive correlation between MRSS and interleukin-6 serum among systemic sclerosis patients visiting Dr. Hasan Sadikin General Hospital Bandung, Indonesia.
Review on Acute Cardio-Cerebral Infarction: a Case Report
Get PDFObjective: To describe a case of a Cardio-Cerebral Infarction (CCI) male patient presented with a history of chest pain recognized using electrocardiography, brain computed tomography, and Percutaneous Coronary Intervention (PCI).Methods: A 69 years old man came with history of chest pain since 13 hours before to the emergency room. Electrocardiography, brain computed tomography, and PCI were performed, leading to the diagnosis of CCI.Results: The electrocardiography showed ST Elevation in Antero-lateral, atrial fibrillation and left-sided hemipharesis, which occurred on the second day. Brain computed tomography demonstrated acute infarct stroke, while the Percutaneous Coronary Intervention (PCI) showed one vessel disease with severe stenosis in LAD and implanted stent in proximal-mid LAD. Therapy prescribed was providing antiplatelet and anticoagulation.Discussion: Acute Myocardial Infarction (AMI) and Acute Infarct Stroke (AIS) have a narrow therapeutic time-window and a delayed intervention may results in morbidity and death. Antiplatelet and anticoagulant used in PCI for AMI increase the risk for hemorrhagic, and AIS with thrombolytic increase the risk of cardiac wall rupture in AMI. Direct Oral Anticoagulant (DOAC) treatment should reduce ischaemia and lower bleeding. The optimal time point to start anticoagulant treatment might be between 4-14 days after the onset of stroke. Duration of post-PCI triple therapy should be minimized depending on bleeding and risks of ischemia
gambaran prokalsitonin, skor sofa dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di rsup hasan sadikin
Get PDFSepsis masih menjadi penyebab utama kematian pada luka bakar berat karena dampak luka bakar yang luas pada sistem organ. Prokalsitonin dan skor sequential organ failure assessment (SOFA) memiliki kemampuan yang sama dalam menilai prognosis pada pasien sepsis untuk indikator mortalitas, terapi yang lebih awal dan mengevaluasi terapi yang diberikan, agar angka mortalitas dapat menurun. Penggunaan antibiotik yang tepat dan akurat juga dapat dianggap sebagai faktor penting dalam meningkatkan prognosis. Tujuan penelitian ini melihat gambaran prokalsitonin, skor SOFA, dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di RSUP Dr Hasan Sadikin Bandung. Penelitian ini merupakan penelitian observasional analitik yang dilakukan pada 38 pasien yang dirawat di ULB dan ICU RSUP Dr. Hasan Sadikin Bandung Februari–Agustus 2021. Penelitian ini diperoleh hasil bahwa nilai prokalsitonin yang didukung skor SOFA dapat dijadikan acuan untuk mempertimbangkan keberhasilan pemberian antibiotik dan penghentian antibiotik pada pasien luka bakar berat. Pemberian antibiotik pada seluruh pasien luka bakar berat di RSUP Dr. Hasan Sadikin tidak rasional dikarenakan tidak didasari pemeriksaan kultur dan prokalsitonin pada hari pertama pasien terpapar. Pemberian antibiotik profilaksis secara rasional harus didukung oleh tanda-tanda infeksi yang jelas dilihat dari nilai prokalsitonin, skor SOFA, dan kultur untuk menghindari resistensi antibiotikOverview of Procalcitonin, SOFA Score, and Rationality of Antibiotics Administration to Patients with Severe Burns at Dr. Hasan Sadikin General Hospital Bandung, February–August 2021Sepsis is currently the leading cause of death in severe burns due to its wide-ranging effects on organ systems. Procalcitonin and sequential organ failure assessment (SOFA) scores can determine the prognosis of septic patients in terms of mortality indicators, early therapy, and evaluation of the therapy given to reduce mortality and morbidity. Correct and accurate use of antibiotics is also essential in improving the patient's prognosis. This study aimed to determine the procalcitonin, SOFA scores, and the rationality of antibiotics administration to patients with severe burns at Dr. Hasan Sadikin General Hospital Bandung. This analytic observational study was conducted on 38 patients hospitalized in the Burn Unit and ICU of Dr. Hasan Sadikin General Hospital Bandung during February–August in 2021. Procalcitonin values supported by SOFA scores may refer to successful antibiotic administration and ceasing therapy in severe burn injury patients. Antibiotic administration to all patients with severe burns in Dr. Hasan Sadikin General Hospital was irrational as it was not based on cultural examination and procalcitonin on the first day of exposure. Clear signs of infection seen from the procalcitonin value, SOFA score, and culture to avoid antibiotic resistance must support rational prophylactic antibiotic administration.Latar Belakang: Saat ini sepsis masih menjadi penyebab utama kematian pada luka bakar berat karena dampak luka bakar yang luas pada sistem organ. Prokalsitonin dan skor SOFA memiliki kemampuan yang sama dalam menilai prognosis pada pasien sepsis untuk indikator mortalitas, terapi yang lebih awal dan mengevaluasi terapi yang diberikan, agar angka mortalitas dan morbiditas dapat menurun. Penggunaan antibiotik yang tepat dan akurat juga dapat dianggap sebagai faktor penting dalam meningkatkan prognosis pasien. Tujuan penelitian ini untuk melihat gambaran prokalsitonin, skor SOFA dan rasionalitas pemberian antibiotik pada pasien luka bakar berat di RSUP DR Hasan Sadikin BandungMetode: Penelitian ini merupakan penelitian observasional analitik yang dilakukan pada 38 pasien yang dirawat di unit luka bakar dan ICU RSUP dr. Hasan Sadikin Bandung tahun 2021.Hasil: Penelitian ini diperoleh hasil bahwa pasien dengan prokalsitonin ³ 2 yang mengalami penurunan sebanyak 9 atau sebesar 81,8% dengan antibiotik yang diberikan pada hari ke-3 yaitu ceftriaxon sebanyak 5 atau sebesar 45.5% dan meropenem sebanyak 5 atau sebesar 45.5%.Kesimpulan: Nilai prokalsitonin yang didukung skor SOFA dapat dijadikan acuan untuk mempertimbangkan keberhasilan pemberian antibiotik dan penghentian terapi antibiotik pada pasien luka bakar berat. Pemberian antibiotik pada seluruh pasien luka bakar berat di RS Hasan Sadikin tidak rasional dikarenakan tidak didasari pemeriksaan kultur dan prokalsitonin pada hari pertama pasien terpapar. Pemberian antibiotik profilaksis secara rasional harus didukung oleh tanda-tanda infeksi yang jelas dilihat dari nilai prokalsitonin, skor SOFA dan kultur untuk menghindari resistensi antibiotik
Premedikasi Lidokain dengan Torniket Lebih Baik Dibanding dengan Kombinasi Lidokain dan Propofol untuk Mencegah Nyeri Injeksi Propofol
Get PDFPropofol merupakan jenis obat induksi intravena yang paling sering digunakan dalam pembiusan umum, namun dapat menimbulkan rasa nyeri pada lokasi injeksi. Tujuan penelitian ini adalah mengetahui perbandingan persentase nyeri pascainjeksi propofol setelah premedikasi lidokain dengan perlakuan torniket selama satu menit dan teknik campuran lidokain fropofol. Penelitian ini merupakan uji klinis tersamar tunggal bersifat eksperimental. Penelitian dilaksanakan di RSUD Dr. Saiful Anwar pada April–Mei 2013. Subjek penelitian adalah 50 pasien yang dibagi menjadi dua kelompok secara acak. Kelompok A (n=25) mendapat perlakuan campuran 40 mg lidokain dalam propofol intravena (i.v.). Kelompok B (n=25) mendapat perlakuan lidokain 40 mg (i.v.) dengan perlakuan torniket selama satu menit, diikuti injeksi propofol. Derajat nyeri diukur menggunakan Verbal Rating Score. Hasil pengukuran dianalisis statistik dengan uji normalitas, homogenitas, dan Mann Whitney menggunakan software SPSS (versi 18, IBM Statistic, USA). Pemberian lidokain dengan perlakuan torniket signifikan dapat merunkan detajat nyeri lebih baik (24/25 tidak nyeri, 1/25 nyeri) dibanding dengan kelompok campuran lodokain dan propofol (10/25 tidak nyeri, 11/25 nyeri ringan, 4/25 nyeri sedang) (p=0,000). Premedikasi lidokain dengan perlakuan torniket lebih baik dalam menurunkan derajat nyeri dibanding dengan pemberian campuran lidokain dan propofol.Premedication Using Lidocaine with Tourniquet Technique is Superior to Combining Lidocaine and Propofol to Prevent Propofol Injection PainPropofol is one of the most used intravenous induction drugs in general anesthesia, but it produces pain at the injection site. This study aimed to compare the post-propofol injection pain after premedication using lidocaine with the tourniquet technique and a mixture of lidocaine in propofol. This study was a single-blind, experimental clinical trial conducted from April to May 2013. The study's subject was 50 patients divided into two groups. Group A (n=25) received a mixture of 40 mg lidocaine in propofol intravenously (i.v.). Group B (n=25) received 40 mg lidocaine (i.v) with a tourniquet technique for one minute, followed by propofol injection. The degree of pain is measured using the Verbal Rating Score. The results were statistically analyzed using the normality, homogeneity, Mann-Whitney test using SPSS (version 18, IBM Statistic, USA) software. The administration of lidocaine with the tourniquet technique was significantly better in reducing the pain levels (24/25 painless, 1/25 mild pain) compared to the mixture of lidocaine in the propofol group (10/25painless, 11/25 mild pain, 4/25 moderate pain) (p= 0,000). The premedication of lidocaine with the tourniquet technique significantly produces lower pain levels than the mixture of lidocaine in propofol. Premedication of lidocaine with a tourniquet technique can prevent pain after injecting propofol
FLOTAC Technique for Soil-Transmitted Helminth Infection Diagnosis
Get PDFHuman helmintiasis is a neglected disease with significant economic impacts caused by its effects on performance and cognition. The burden of many helminth infections is not well understood due to the lack of progress in detecting low-intensity infection in elimination programs. Furthermore, the decision for individual and community treatments, as well as the community-based control program evaluation, obviously depends on the technics used for parasitological diagnostic. A well-established diagnostic technic will be beneficial to detect and eliminate the disease. Therefore, this study aimed to compare the performance of FLOTAC and FECT technics for detecting helminth infections in human stool. A total of 149 fecal specimens were collected from schoolchildren in Nangapanda village, Ende District, East Nusa Tenggara Province in 2012. The sensitivity of both technics was analyzed using the kappa analysis. Positive results from both technics were used as the gold standard. The sensitivity of FLOTAC for diagnosing T. Trichiura, A. lumbricoides and hookworm infections were 100%, 100%, and 82%, respectively, while the sensitivity of FECT was 80%, 7%, and 18%, respectively. FLOTAC yielded considerably higher mean faecal egg counts (11,452, 1,038, and 19 eggs per gram stool (EPG) for A. lumbricoides, T. Trichiura, and hookworm). FLOTAC technique was considerably more sensitive than FECT in diagnosing soil-transmitted helminth infections. In conclusion, FLOTAC can be used as a diagnosis tool for future helminth control programs
IGF-1 levels in Patients with Type 2 Diabetes Mellitus
Get PDFType 2 Diabetes Mellitus (Type 2 DM) is a metabolic disorder group with mechanisms that include hyperglycemia, insulin resistance and hyperinsulinemia. Type 2 DM has a close association with IGF-1, where the active form of the IGF-1 becomes elevated by reason of the fact that hyperinsulinemia inhibits the production of IGF-binding proteins (IGFBP) 1/IGFBP 2. The active form of IGF-1 has the ability to promote cell proliferation and inhibit apoptosis, hence becomes one of the risk factors for cancer cell growth. This was an analytical study conducted in August at the Harapan Bunda Clinic, Medan, Indonesia to determine the difference between the IGF-1 level and blood glucose level in type 2 DM patients in different age groups. Twenty subjects with Type 2 DM participated in this study and were divided based on their age into 35-50 years old or Group 1 and 51-65 year old group or Group 2. The IGF-1 levels in both groups were compared and analyzed using the T-test dependent method. Results showed that the IGF-1 and blood glucose levels were higher in Group 1 (35-50 years old) when compared to Group 2 and the difference was significant. The change in the IGF-1 level in diabetic patients cannot be determined only by the blood sugar level
Validity of Serum Uromodulin as Early Diagnosis Marker of Diabetic Nephropathy in T2DM
Get PDFIncreased prevalence of DM is accompanied by increased in its various complications include diabetic nephropathy, which can lead to end stage renal disease (ESRD). Urinary albumin-creatinine ratio (uACR) is the gold standard for diabetic nephropathy; however, it has several limitations, including the inability to early diagnose due to the absence of increased level in uACR. Uromodulin is produced by thick ascending limb (TAL) at Henle’s loop and early distal tubule of nephron. Uromodulin will decrease when tubular atrophy occurs in early stage of renal impairment with normoalbuminuria. The aim of this study was to determine the validity of serum uromodulin in type 2 diabetes mellitus (T2DM) in identifying diabetic nephropathy by comparing it with uACR as gold standard. This study was a cross-sectional analytical observational study at Dr. Hasan Sadikin (RSHS) Bandung from June to August 2020. Subjects consisted of 62 patiens with T2DM. Results showed that the serum uromodulin level had a sensitivity of 93.3%, a specificity of 88.2%, a positive predictive value of 95.5%, a negative predictive value of 83.3%, and an accuracy of 91,9% and an AUC value of 0.975. The cut-off point of serum uromodulin in this study was 47.195 ng/mL. In conclusion, serum uromodulin, when compared to the uACR as the gold standard, has good sensitivity and specificity for identifying diabetic nephropathy
Vascular Endothelial Growth Factor Expression in Correlation with Stage Juvenile Nasopharyngeal Angiofibroma
Get PDFBackground: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor of mesenchymal tissue, originating from the stromal and blood vessels with dense collagen. However, JNA has a malignant tumor-like property because it can cause erosion of surrounding bone. Vascular Endothelial Growth Factor (VEGF) plays a role in the angiogenesis process. The expression of VEGF is the best marker to determine the occurrence of angiogenesis in JNA. This study aimed to determine the correlation between VEGF expression and JNA clinical stage. Methods: This was a cross-sectional correlational analytic observational study on medical records and paraffin blocks of all patients with JNA at Dr. Hasan Sadikin General Hospital Bandung during the period of 2016 to 2019. Immunohistochemistry examination of VEGF expressions was performed and VEGF expression was rated based on staining intensity, percentage distribution, and histoscore. Data were then analyzed using the Spearman correlation test.Results: Of 24 patients, 23 males and 1 female, 58% demonstrated a strong intensity of staining. The positivity of VEGF cell percentage was identified as 26–50% (n=6 patients), 51–75% (n=11), and >75% (n=7). The median VEGF histoscores were 2.5, 6.5, and 12 in JNA stage I, stage II, and stage 3, respectively, with the greater VEGF histoscore had a higher clinical stage with a correlation coefficient of (rs) 0.723 (p=0.002). Conclusions: There is a strong correlation between increased VEGF expression and JNA clinical stage. VEGF expression can be used as a prognostic factor of JNA
Knowledge, Attitude, and Practices towards the COVID-19 Pandemic among Undergraduate Students
Get PDFBackground: Coronavirus disease-2019 (COVID-19) has caused serious implications and has received a lot of international attention, especially in public health sector. The main strategy for containing the COVID-19 pandemic includes preventive methods such as wearing masks, which requires individual awareness and initiative to adhere to the protocol. This study described the level of knowledge, attitude, and practices towards the COVID-19 pandemic among undergraduate students who were selected due to their high mobility and rate of activity.Methods: This study used a descriptive design and a cross-sectional approach, conducted from October to November 2020. Undergraduate students from all faculties of Universitas Padjadjaran Year 2017– 2019 were invited to participate, using an online questionnaire to assess the knowledge, attitude, and practices towards the COVID 19 pandemic. The result was given numeric values and scored. The mean value of the scores was used as a reference value to describe the level of knowledge, attitude, and practices.Results: From a total of 483 students, 99.5% had good knowledge, 87.9% had good attitude, and 67% had a good practices towards COVID-19.Conclusions: The overall levels of knowledge, attitudes, and practices towards COVID-19 among undergraduate students are good, as well as the adherence to government health protocols and initiatives in seeking information regarding COVID-19. Several specific areas such as transmission through dead bodies, exercise and vitamin supplementation, and anxiety when reading information about COVID-19 are areas of interest for the improvement of education
IgG levels in Human Papillomavirus Infection Associated with Clinical Stage of Head and Neck Squamous Cell Carcinoma
Get PDFBackground: Head and neck squamous cell carcinoma (HNSCC) is an invasive neoplasm of epithelial tissue in the head and neck and one of the etiologies of HNSCC is human papillomavirus (HPV) which maybe associated with the clinical stage of HNSCC. HPV infection in squamous cell epithelium produces specific IgG antibodies against HPV. IgG titer of HPV can help identify patients who are at risk for HPV-related cancers. This study aimed to explore the association between IgG titer of HPV with the clinical stages of HNSCC.Methods: The design of this study was analytic cross sectional, conducted at the Outpatient Clinic of Otorhinolaryngology-Head and Neck Surgery, Division of Oncology, Dr. Hasan Sadikin General Hospital Bandung period September-December 2017. Patients with HNSCC were recruited, and history was taken. Furthermore, histopathologic examination and HPV IgG serology examination was performed using the ELISA method. The HPV IgG levels were compared by stage and data were analyzed using the Shapiro Wilks test and Unpaired T test.Result: The HPV IgG was high in 75% (n=21) of HNSCC patients in the advanced stage and low in 25% (n=7) of patients in the early stage. There was a significant relationship between HPV IgG titer and early and advanced stage of HNSCC (p=0.001).Conclusion: The HPV IgG titer is related to the clinical stage of HNSCC indicating that the higher the HPV IgG level, the more advanced the clinical stage. Further study is needed to explore HPV IgG levels as a prognostic marker in HNSCC