E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Perbandingan Angka Keberhasilan, Waktu Dan Kenyamanan Intubasi Endotrakea Antara Operator Posisi Berdiri Dan Duduk Pada Pasien Posisi Sniffing
Get PDFKemampuan untuk visualisasi glotis saat melakukan tindakan laringoskopi direk merupakan kunci untuk melakukan tindakan intubasi endotrakea. Posisi sniffing dan ketinggian meja berpengaruh pada visualisasi glotis dan kenyamanan operator saat intubasi endotrakea. Namun, meja operasi sering ditemukan tidak berfungsi dengan baik. Ketersediaan kursi ergonomis diharapkan sebagai alternatif untuk menjawab permasalahan yang terjadi. Tujuan penelitian ini mengetahui perbandingan keberhasilan, waktu, dan kenyamanan operator pada intubasi endotrakea dengan pasien posisi sniffing menggunakan bantal kepala antara operator posisi berdiri dan duduk. Penelitian ini merupakan penelitian prospective randomized paralel trial, dilakukan pada 44 pasien yang menjalani operasi elektif dan emergensi dengan anestesi umum yang memenuhi kriteria inklusi dan tidak termasuk kriteria eksklusi. Penelitian dilakukan di ruang operasi elektif dan emergensi RSUP Dr. Hasan Sadikin pada bulan Oktober 2020. Analisis statistik menggunakan t independent test untuk lama intubasi dan kenyamanan pasien, sedangkan untuk data kategorik dengan uji chi-square. Keberhasilan dan lama waktu intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk tidak terdapat perbedaan yang signifikan (p>0,05). Pada variabel skor kenyamanan intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk terdapat perbedaan rerata yang sangat signifikan (p0.05) in intubation time and success rate of endotracheal intubation on patients in sniffing position using a head cushion between sitting and standing position of the operator. There was a significant mean difference (p0,05) pada variabel keberhasilan dan waktu intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk. Terdapat perbedaan rerata yang sangat signifikan (p<0,01) pada variabel skor kenyamanan intubasi endotrakea pada pasien posisi sniffing menggunakan bantal dengan operator posisi berdiri dan duduk. Skor kenyamanan intubasi endotrakea posisi duduk lebih baik dibandingkan posisi berdir
Coping Stress of the COVID-19 Pandemic among Medical and Non-Medical Undergraduate Students at Universitas Padjadjaran, Bandung, Indonesia
Get PDFBackground: Coping stress is an act of dealing with stress by adapting to the problems of the thought process. The ‘Distance Learning’ policy is a stress factor during the COVID-19 pandemic which may have an impact on psychological conditions and coping stress. This study aimed to determine differences in stress levels and coping stress among medical and non-medical undergraduate students against the global COVID-19 pandemic.Methods: Cross-sectional analytical methods were used. Stratified random sampling recruiting undergraduate students, including from medical students (n=80) and non-medical students (n=84) at Universitas Padjadjaran class 2017–2019. The distributed questionnaire contained 25 questions adapted from the Depression Anxiety Stress Scale (DASS 42) and the Cope Inventory. Validity and reliability tests were carried out previously, and statistical analysis was performed using SPSS v.26.Results: The median age of both groups was 21 years and most of the respondents were female. There was no significant difference in stress and coping stress. At the time of coping, the medical students focused more on emotions and the non-medical students focused more on the problems.Conclusion: There is no difference in the levels of stress and coping stress with emotional and problems focus in the medical and non-medical students
Effects of Ethanol Extract from Sunkist (Citrus sinensis L. Osbeck) Peels on Rat’s Estrus Cycle
Get PDFKuhnle et al. has reported that Sunkist peels contain 36 µg/100 g wet weight of phytoesterogen. This study was designed to explore Sunkist peels' potential to recover the infertility due to ovulation failure. This study was performed in June 2020 at the Pharmacology Laboratory, Universitas Prima Indonesia, on 25 rats. These rats were divided into five groups: Control, Standard, and Sunkist Peels Extract-I, II, and III that received 1 ml of 0.5% Sodium Carboxymethyl cellulose suspension, ethinyl estradiol 50 g/kgBW, 300 mg/kgBW, 450 mg/k BW, and 600 mg/kgBW of ethanol extract from Sunkist peel, respectively. Every 8-12 hours, the rat’s vagina were swabbed and smear into on object glass to be stained by 10% Giemsa and viewed at 40x and 100x magnifications. The leucocytes, especially neutrophils, epithelial cells, cornified and epithelial cells as well as the density of cells in vaginal swab were evaluated to determine the estrus cycle of the rats. The length of estrus phases was express as median (IQR) and analyzed using the Kruskall-Wallis test. The result of this study showed that the standard and highest dosage extract showed a significant extending of estrus and metestrus phases compared to the control group and significantly shortened diestrus phases. Hence, the highest dosage of Sunkist extract can prevent infertility by increasing the period of estrus cycle (ovulation) at the same level as the standard group
Comparison of Diagnostic Accuracy of Tuberculosis Spondylitis between Genexpert and Histopathological Examination
Get PDFTuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Spinal TB is associated with poor functional outcomes. Histopathological examination requires a long waiting times to obtain the results thus impractical for screening and may delay diagnosis. GeneXpert offers rapid tests for prompt screening and diagnosis. This study aimed to assess the diagnostic accuracy of GeneXpert in patients with spinal TB when compared to the histopathology test as the gold standard. This study was performed on patients in the Spine Clinic of the Department of Orthopedic and Traumatology, Dr. Hasan Sadikin General Hospital Bandung who were diagnosed with spinal TB during the period of May 2019–May 2020. Blood samples were collected from the patients and tested using GeneXpert and histopathological assessment. Results demonstrated 34 patients with a positive result and 6 patients with negative results on both diagnostic methods. Twenty nine out of 40 patients (72.5%) had rifampin-sensitive TB. Diagnostic accuracy of GeneXpert, when compared to histopathological examination, is represented by the sensitivity of 88.2%, specificity of 33.3%, positive predictive value of 88.2%, and negative predictive value of 33.3%. High sensitivity results forpatients with spinal TB on GeneXpert suggests that the test is appropriate to be used as a screening method and as a high-yield rapid diagnostic test for patients suspected for spinal TB
Infective Endocarditis with Multiple Valvar Vegetation in Uncorrected Tetralogy Fallot: A Case Report of Rare Condition
Get PDFObjective: To describe a case of an adult patient with uncorrected Tetralogy of Fallot (TOF) who suffered from Infective Endocarditis (IE) that involved the tricuspid and aortic valves.Methods: On October 2019, a-twenty-year-old male with uncorrected TOF was admitted to the emergency department of Dr. Hasan Sadikin General Hospital with a chief complaint of fever. The echocardiography showed the presence of vegetation on the tricuspid valve and aortic valve. The patient was given empirical antibiotics therapy for IE treatment. The serial blood cultures did not yield any organism growth and the transthoracic echocardiography evaluation showed healed vegetation after 21 days of antibiotics treatment.Results: A high turbulence in small VSD and valvular stenosis, as found in TOF, can injure the endocardial surface. While bacterial adherence to the injured endocardial surface can cause IE, no specific criteria available for diagnosing IE in congenital heart disease (CHD) patients compared to other population. In CHD patients, it is necessary to consider the diagnosis of IE presenting with signs of infection or fever. Our patient was known to have uncorrected TOF and was admitted to the hospital with a chief complaint of fever. The uncorrected TOF was complicated by an unusual form of aggressive vegetation involving multiple valves.Conclusion: The incidence of IE in uncorrected TOF is around 4%. Patient is advised to receive a corrective surgery for the cardiac anomaly. Surgical repair of CHD with no residual lesion reduces the risk of IE
Relationship between Nutritional Status and School Achievement of 10-13 Years Old Elementary School Students in Penjaringan 2019
No full textBackground: School achievement is a crucial element in determining the students’ success. Nutritional status is one of the factors that influence school achievements. This study aimed to analyze the relationship between nutritional status and school achievements among elementary school students.Methods: The cross-sectional analytic observation was conducted during April–November 2019 using a total sampling approach. Four elementary schools in Penjaringan, North Jakarta were chosen and students aged >10 years were selected. The data collected were gender, age, weight, height, and midterm test scores recorded in the school report, including mathematics, science, and Indonesian language. The nutritional status was assessed by body mass index (BMI) and classified upon Permenkes 2 Tahun 2020, which were deficient, sufficient, and overnutrition. Assessment of school achievement based on midterm test scores, categorized according to the 2016 Assessment Guidelines for Elementary Schools (Panduan Penilaian untuk Sekolah Dasar), into three classifications of good, fair, and poor. Data were analyzed using Chi-square. Results: Of the 436 students, 21.8% (n=95) of students were considered good, 28.2% (n=123) were fair, and 50% (n=218) were poor. The nutrition level was deficient in 9.6% (n=42) students, whereas 54.8% (n=239) students had sufficient nutrition, and 35.6% (n=155) students had overnutrition. Bivariate analysis test showed a statistically insignificant relationship between nutritional status and school achievement (p>0.05).Conclusion: This study indicates that nutritional status does not affect school achievement. Further study is needed to determine other factors such as health, intelligence, anxiety, motivation, family, and living environment that may influence school achievement
Perbandingan Kombinasi Parasetamol dan Deksametason dengan Deksametason Praoperasi untuk mengurangi angka kejadian nyeri tenggorok pasca operasi anestesi umum di RSUP Dr. Hasan Sadikin Bandung
No full textPostoperative sore throat (POST) setelah anestesi umum dengan pemasangan pipa endotrakea merupakan komplikasi yang sering terjadi dan tidak diinginkan. Angka kejadian nyeri tenggorok pascaoperasi setelah pemasangan pipa endotrakea adalah 6–76%. Penelitian ini bertujuan membandingkan efek kombinasi parasetamol dan deksametason dengan deksametason tunggal untuk mengurangi angka kejadian POST pada pasien setelah anestesi umum. Penelitian ini merupakan eksperimental dengan melakukan uji klinis rancangan acak lengkap terkontrol buta ganda. Penelitian dilakukan di RSUP Dr. Hasan Sadikin bulan Januari–April 2021. Total 92 pasien yang dijadwalkan operasi elektif dibagi secara acak menjadi 2 kelompok. Kelompok deksametason dan parasetamol (n=46) diberikan deksametason 10 mg dan parasetamol 1.000 mg intravena. Kelompok deksametason (n=46) diberikan deksametason 10 mg intravena dan plasebo. Pada penelitian ini, derajat POST dipantau. Angka kejadian POST didapatkan lebih rendah pada kelompok kombinasi deksametason dan parasetamol dibanding dengan kelompok deksametason dan plasebo pada jam ke-0, 1, dan 6 (p=0,0001, p=0,001, dan p=0,0001). Simpulan penelitian ini adalah kombinasi deksametason parasetamol lebih baik dibanding dengan deksametason tunggal dalam menurunkan angka kejadian POST anestesi umum.Comparison of Combined Paracetamol and Dexamethasone with Preoperative Dexamethasone for Reducing Sore Throat Post General AnesthesiaPostoperative sore throat (POST) following general anesthesia with endotracheal tube insertion is a common and undesirable complication. The incidence of postoperative sore throat after insertion of an endotracheal tube is 6–76%. This study aimed to compare the effect of combined paracetamol and dexamethasone with single-dose dexamethasone to reduce POST incidence in patients after general anesthesia. This experimental study conducted a double-blind, complete randomized controlled clinical trial at RSUP Dr. Hasan Sadikin Bandung during January–April 2021 Ninety-two patients scheduled for elective surgery were randomly assigned to two groups. The dexamethasone and aracetamol group (n=46) were given dexamethasone 10 mg and paracetamol 1000 mg intravenously. Dexamethasone group (n=46) was given dexamethasone 10 mg intravenously and placebo. In this study, the degree of POST was monitored. Results showed that the incidence of POST was lower in the dexamethasone and paracetamol combination group than in the dexamethasone and placebo group at 0, 1, and 6 hours (p=0.0001, p=0.001, and p=0.0001). This study concludes that the combination of dexamethasone paracetamol is better than single-dose dexamethasone in reducing the incidence of POST general anesthesia.Postoperative sore throat (POST) setelah anestesi umum dengan pemasangan pipa endotrakea merupakan komplikasi yang sering terjadi dan tidak diinginkan. Angka kejadian nyeri tenggorok pascaoperasi setelah pemasangan pipa endotrakea antara 6 – 76%. Pada penelitian ini, dilakukan perbandingan efek kombinasi parasetamol dan deksametason dengan deksametason tunggal untuk mengurangi angka kejadian POST pada pasien setelah anestesi umum. Penelitian ini merupakan eksperimental dengan melakukan uji klinis rancangan acak lengkap terkontrol buta ganda. Total 92 pasien yang dijadwalkan operasi elektif dibagi secara acak menjadi 2 kelompok. Kelompok Deksametason dan Parasetamol (n=46) diberikan Deksametason 10 mg dan Parasetamol 1000 mg intravena. Kelompok Deksametason (n=46) diberikan Deksametason 10 mg intravena dan plasebo. Derajat POST dipantau, selain itu sebagai tambahan skala nyeri luka operasi pascaoperasi dan penggunaan opioid pascaoperasi dibandingkan. Didapatkan hasil angka kejadian POST lebih rendah pada kelompok kombinasi Deksametason dan Parasetamol dibandingkan Deksametason dan placebo pada jam ke 0, 1 dan 6 (p=0,0001, p=0,001, dan p=0,0001). Mekanisme POST disebabkan adanya inflamasi pada faring dan trakea saat tindakan intubasi endotrakea. Deksametason dan parasetamol memiliki efek antiinflamasi dan penghambatan cyclooxygenase (COX) sebelum dilakukan tindakan intubasi endotrakea. Dari penelitian ini dapat disimpulkan bahwa kombinasi deksametason parasetamol lebih baik dibandingkan deksametason tunggal dalam menurunkan angka kejadian POST anestesi umum
Effects of Low-level Laser Therapy on Fibroblast Density in Achilles Tendon Rupture Healing
Get PDFObjective: To investigate the effect of low-level laser therapy (LLLT) on fibroblast proliferation as a part of the tendon healing cascade. Methods: This was an unpaired comparative experimental animal laboratory study with one control groups and two experimental groups, each consisted of 10 Sprague Dawley rats. The experimental groups 1 and 2 were given infrared irradiation for 15 minutes and 30 minutes per day, respectively, after having their achilles tendon partially cut. Histological assessment was carried out to assess the fibroblast density in healing site after three weeks on intervention. Results: The median values of fibroblast density in group 1, group 2, and control group were 1, 2, and 1, respectively, with a p-value of 0.014. No significant difference (p = 0.123) was identified on Mann-Whitney test between the fibroblast density of group 1 and group 2. The same was also true forgroup 1 and control group (p = 0.315). A significant difference was found between group 2 and control group (p = 0.005). Conclusions: A regime of LLLT irradiation of 30 min/day for two weeks (1080 J cm-2) improves the fibroblast proliferation amidst tendon healing in a partially injured achilles tendon in a rat model, which is not seen in the regime with a 15 min/day duration. This emphasizes the significance of irradiation time to improve tendon healing, despite the deficient understanding of the mechanism
Correlation Between Serum Ferritin and Testosterone Level in Adolescent Male with Transfusion Dependent Thalassemia
Get PDFTransfusion-dependent thalassemia (TDT) is a type of beta-thalassemia that needs regular and long-term blood transfusions. Complications can occur due to the deposition of iron in TDT patients, including endocrine complications causing deficiency of testosterone that plays a role in the secondary sexual development in males. The objective of this study was to understand the correlation between ferritin and testosterone level in male adolescences with transfusion-dependent thalassemia. This cross-sectional observational correlative study was conducted from April to August 2019 on 74 males aged 12-18 years old who were presented to the Thalassemia Outpatient clinic, Dr. Hasan Sadikin General Hospital, Bandung. Blood was collected using phlebotomy for ferritin and total testosterone serum examination. Data were then analyzed using SPSS version 17.0. Low testosterone level (<3.0 ng/mL) was found in 63.5% of subjects. Results of the Spearmen correlation test demonstrated a negative correlation with r: -0,699 and p-value <0.001, showing a negative, strong, and significant correlation among those variables. The higher ferritin level in TDT patients indicates a high level of the free iron level in the body that can destroy the endocrine organs and cause deprivation of testosterone secretion, leading to hypogonadism in transfusion dependent thalassemia patients
Accuracy of Urine Cytology In Detecting Bladder Cancer
Get PDFOne of the most prevalent and deadly cancers in men is bladder cancer. To achieve the best possible outcome, physicians need to diagnose it promptly. The gold standard for diagnosis is tissue biopsy, but this method is invasive. There is another option for non-invasive diagnostic using urine cytology. The purpose of this study was to measure the accuracy of urine cytology in diagnosed bladder cancer patients. This study extracted data from patients medical records in a tertiary hospital in Indonesia from 2009–2019. The diagnostic accuracy was then compared between urine cytology and biopsy as the gold standard. Data on subjects’ baseline characteristics and diagnostic accuracy (sensitivity, specificity, PPV, and NPV) were collected. Results were then stratified according to the American Joint Committee on Cancer pathology staging for bladder cancer. Of 124 study subjects, male was more dominant (male,88% versus female, 12%) Seventy-five patients had a T1-tumor stage. Overall, the diagnostic accuracy was as follows:sensitivity, 47.8%; specificity, 90.9%; PPV, 98.2%; and NPV, 14.5%. High-grade tumors were shown to have a higher sensitivity. The highest accuracy was found in the MIBC grade T3, which was 90.68%. For diagnostic accuracy, urine cytology offered high specificity, but low sensitivity. The exploration of other markers is needed to establish a non-invasive but accurate method to diagnose bladder cancer