E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
Not a member yet
1208 research outputs found
Sort by
Methicillin-Resistant Staphylococcus aureus (MRSA) Patterns and Antibiotic Susceptibility in Surgical and Non-Surgical Patients in a Tertiary Hospital in Indonesia
Get PDFMethicillin-Resistant Staphylococcus aureus (MRSA) in the hospital is found mainly in surgical patients, which increases morbidity and mortality. Currently, vancomycin is the drug of choice for the treatment of MRSA infections. The increasing use of vancomycin and its inappropriate administration may increase the resistance of S. aureus to vancomycin. This study aimed to describe the distribution of MRSA and types of antibiotics that are still sensitive to MRSA in surgical and non-surgical patients. This cross-sectional, observational, retrospective descriptive study was conducted at the Microbiology Laboratory, Dr. Hasan Sadikin General Hospital, in 2019 using secondary data on the results of culture examination and antibiotic susceptibility of positive S. aureus culture isolates from all types of isolates from surgical and non-surgical patients. All specimens were cultured in appropriate media. Identification of S. aureus was performed by Gram staining to identify bacterial morphology, and automatic tools. Antibiotic susceptibility test was performed using an automatic machine. Seventy-five isolates (17%) were identified to be MRSA with 46 (53%) of them retrieved from surgical patients. Most of the MRSA isolates came from pus and were mostly due to skin infections. Antibiotic susceptibility results showed two Vancomycin-Resistant Staphylococcus aureus (VRSA) isolates from surgical patients. The positive culture of the MRSA and VRSA was dominated by surgical patients with pus coming from surgical wound infection, burn, and other skin infection as the most common sources. Thus, the proportion of MRSA isolates in the hospital in 2019 is 17% and two VRSA isolates are identified in the same year. The surgical ward was the primary origin of most MRSA isolates. Further studies are necessary to identify the MRSA incidence rate, evaluation and periodic monitoring of antibiotic use, and active surveillance in the surgical patient rooms
Characteristics of Brain Imaging in Intracranial Tumor Patients at Neurology Ward Dr. Hasan Sadikin General Hospital Bandung 2017–2019
Get PDFBackground: Brain imaging is the main modality in establishing the diagnosis of intracranial tumors. Therefore, by using appropriate imaging modalities, lesions can be identified and this is useful in determining management and monitoring of the therapeutic process. This study aimed to describe the use of imaging modalities and the characteristics of imaging findings in diagnosing intracranial tumor patients.Methods: This cross-sectional descriptive study obtained data from medical resumes at the Neurology Ward of Dr. Hasan Sadikin General Hospital Bandung, collected by total sampling method. Data on patients with intracranial tumors who underwent imaging examinations in January 2017–December 2019 were taken, including demographical and imaging characteristics data, divided by tumor type.Results: Of 206 data, the imaging modalities used were contrast CT scan (45.6%), non-contrast CT scan (34.5%), multimodality imaging (13.6%), contrast magnetic resonance imaging (MRI) (3.9%), non-contrast MRI (2.4%), and magnetic resonance spectroscopy (MRS) (0.5%). The most common primary tumor was a solitary lesion (89.4%) located in the right hemisphere in 38.1% of subjects. Metastatic tumors were found mostly as multiple lesions (63.4%) located in both supratentorial and infratentorial in 25.8% of the subjects. Perifocal edema was found in 75% of patients in both tumor types.Conclusions: Contrast CT scan is the most frequently used imaging modality. The most common radiological finding is perifocal edema. Primary tumors are commonly found in solitary numbers, and are located in supratentorial on the right hemisphere. Metastatic tumors are commonly found in multiple numbers and are located both in supratentorial and infratentorial
Global Longitudinal Strain of Chronic Granulocytic Leukemia Patients treated with Imatinib and Nilotinib
Get PDFObjective: To determine left ventricular function of patients with Chronic Granulocytic Leukemia in Chronic Phase (CGL-CP) who received imatinib and nilotinib by using Global Longitudinal Strain (GLS) examination.Methods: This was a descriptive study involving 46 CGL-CP patients who received imatinib and nilotinib therapy at the Hemato-Oncology Clinic of the Internal Medicine Departement of Dr. Hasan Sadikin General Hospital,, Bandung, Indonesia. Sampling was performed consecutively during the period of October to December 2019. Variables assessed in this study were age, gender, BMI, length of treatment, hemoglobin level, Left Ventricular Ejection Fraction (LVEF) value, and Global Longitudinal Strain (GLS). Primary data were tested for normality using the Saphiro-Wilk test. Statistical analysis was performed using SPSS software version 25.0.Results: Thirty-nine patients (seventeen males and twenty-two females with a mean age of 42±11) who had been in therapy for about 8 to 179 months at the time of the study were included as subjects. On average, the GLS results for both treatment groups indicated a normal value based on the classification of the American Society of Echocardiography. The imatinib group gained a score of -22.4% (average range = -16.4% to (-28.1%)), while the nilotinib group gained a score of -21.6% (average range = -18.0% to (-25.9%)). Conclusion: This study described the left ventricular function based on results of GLS in CGL-CP patients receiving imatinib and nilotinib
Parental Knowledge, Attitude, and Behavior towards Basic Immunization
Get PDFImmunization, which is usually done by giving vaccinations, is the process of forming immunity in individuals against infectious diseases. The target in the Strategic Plan of the Ministry of Healht of the Republic of Indonesia in 2015-2019 aimed for 93 % of coverage. However, according to the report of the Indonesian Basic Health Survey (IBHR), there is actually a decrease in basic immunization coverage for the period of 2012–2015 when compared to the previous period. This study aimed to determine the correlation between parental knowledge, attitudes, and behavior towards complete course of basic immunization among parents of an elementary school in North Jakarta, Indonesia, in 2018 and 2019. This was a cross-sectional analytical descriptive study involving 110 respondents. Data were obtained through a questionnaire that was distributed to parents that included questions on knowledge, attitude, and behavior towards complete basic immunization. Out of 110 respondents, 70% stated that their child received the full basic immunization course while the remaining 30% stated that their child only received some of the vaccines required in the basic immunization course. There was no correlation, based on the bivariate analytical test, between parental behavior (p = 0.868), parental attitude (p = 0.647), and full course of basic immunization. In contrast, parental knowledge influences whether the child will receive the full course of basic immunization or not (p=0.000)
Correlation between Head Computed Tomography Scan, Pre-operative Blood Lactate, and Pre-operative Glucose Level in Acute Traumatic Subdural Hematoma
Get PDFAcute traumatic subdural hematoma (SDH) is a focal brain injury resulting in alteration of cerebral perfusion and glucose metabolism, which would also results in hyperglicemia-induced-hyperlactatemia. A cross-sectional study was performed to analyze acute traumatic SDH patients by head CT scan and observe the effect on pre-operative blood lactate and blood glucose levels in 40 acute traumatic SDH patients at Dr. Hasan Sadikin Hospital, Bandung, Indonesia during the period of July-September 2013. Somers' D correlation were used in the analysis with a p-value of ≤0.05 considered as significant with 95% confidence interval. The mean values of pre-operative blood lactate and blood glucose levels were 3.16±1.49 mmol/L and 155.85±32.95 mg/dl, respectively with a strong positive correlation between the hematoma thickness and the increase in blood lactate (r= 0.656; p= 0.021) and a moderate positive correlation with increased blood glucose (r= 0.556; p= 0.025). In addition, the compressed cistern also had a very weak positive correlation with increase in blood lactate (r =0.156; p=0.043) and very weak positive correlation with increase in blood glucose (r= 0.139; p=0.056) while the midline shift had a weak positive correlation with increased blood lactate (r=0.353; p= 0.041) and a weak positive correlation with increased blood glucose (r = 0.333; p= 0.046). In conclusion, increased hematoma thickness, compressed cistern, and midline shift seen on head CT scan correlate with increasing blood lactate and glucose levels in acute traumatic SDH. Head CT scan, blood lactate level, and blood glucose level can be considered as one of the routine examinations to determine acute traumatic SDH severity at the macroscopic and cellular level
Anesthesia Management of Oculocardiac Reflex in Strabismus Surgery: A Case Study
Get PDFThere are various types of eye surgery with each requires special attention in anesthesia management. Strabismus surgery has several risks that need to be considered; one of which is oculocardiac reflex. The oculocardiac reflex is a condition characterized by decreased heart rate caused by the pressure on the globe or by traction on the extraocular muscles and conjunctiva or the orbital structures. This reflex can manifest as an asystole if left untreated. This is a case report of a 19-year-old male with ASA classification 1 presented with esotropia of left and right eyes. General anesthesia was used for anesthesia with 100 mcg fentanyl, 100 mg propofol, and 25 mg atracurium for induction and, for airway management, LMA size 3 was used. Sevoflurane 2–3 vol% with oxygen and nitrous oxide was given as maintenance. During the surgery, the heart rate dropped to 35 beats per minute when the operator pulled the medial rectus muscle in the first eye. The surgery was then paused and the heart rate was incrementally increased to 65 beats per minute without any other intervention. Then, as the operator pulled the medial rectus muscle in the second eye, the heart rate decreased to 55 beats per minute and the surgery continued with the heart rate slowly increased without any intervention. The remaining surgery time was uneventful. Knowledge and early intervention of oculocardiac reflex conditions should be well understood by all anesthesiologist to avoid more catastrophic conditions. Manajemen Anestesi untuk Reflek Okulokardiak pada Operasi Strabismus: Laporan KasusTerdapat banyak jenis operasi pada mata, setiap operasi membutuhkan penanganan anestesi yang khusus. Operasi strabismus memiliki beberapa risiko yang perlu menjadi perhatian, salah satunya adalah refleks okulokardiak. Refleks okulokardiak merupakan konisi yang ditandai dengan penurunan denyut jantung disebabkan oleh tekanan pada bola mata atau penarikan pada otot-otot ekstraokular pada konjungtiva atau strukur orbita. Tanpa penanganan refleks ini dapat menyebabkan asistol. Sebuah laporan kasus mengenai laki-laki 19 tahun dengan klasifikasi ASA 1, dengan esotropi pada kedua mata yang akan dilaksanakan operasi strabismus. Anestesi umum dilaksanakan dengan obat-obat induksi fentanil 100 mcg, propofol 100 mg, dan atrakurium 25 mg, LMA ukuran 3 digunakan untuk managemen jalan napas. Sevofluran 2–3% dengan oxygen dan nitrous oxide digunakan untuk rumatan. Sewaktu operasi denyut nadi menurun sampai 35 kali per menit ketika operator menarik otot medial rektus pada mata pertama, kemudian operasi diminta dihentikan sementara, kemudian denyut nadi meningkat perlahan kembali ke 65 kali per menit tanpa pemberian intervensi lain. Kemudian, ketika operatot menarik otot medial rektus pada mata kedua denyut jantung menurun ke 55 kali per menit, operasi dilanjutkan dan denyut jantung meningkat tanpa intervensi lain. Operasi berlangsung tanpa kejadian lain. Pengetahuan dan penanganan awal kondisi refleks okulokardiak perlu diketahui oleh dokter anestesi untuk mencegah kondisi yang lebih berbahaya
Patient Satisfaction on Surgical Service Decision Time in Emergency Department of A Tertiary Hospital in Indonesia
Get PDFBackground: Patient satisfaction survey is essential for evaluating and developing plans to improve health services' quality. One of the emergency department service quality indicators is decision time. Overcrowding of the emergency room as a result of long decision time may cause dissatisfaction among patients. This study aimed to evaluate the satisfaction level of patients receiving surgical services and the correlation between the satisfaction level and surgical service decision time.Methods: A cross-sectional descriptive analytical study was conducted from September to November 2019 at the emergency department of Dr. Hasan Sadikin General Hospital. The consecutive sampling method was applied and a total of 110 patients met the inclusion and exclusion criteria. Patient satisfaction was assessed using a validated questionnaire and data on decision time was obtained from the patient’s medical record. Spearman correlation test was used to analyze the data.Results: This study discovered that most of the respondents were satisfied with the service (92.7%) and that decision was mostly made in less than 2 hours (79.1%). A weak negative correlation (ρ = - 0.144), was identified between decision time and patient satisfaction, albeit insignificant (p = 0.067), with a confidence interval of 95% (α = 5%).Conclusion: This study suggested that there is no correlation between patient satisfaction and decision time. Thus, decision time is not the main factor that determines patient satisfaction
Knowledge and Severity of Female Urinary Incontinence and Reasons for Not Seeking Treatment
Get PDFUrinary incontinence (UI) is a commonly overlooked problem in women, particularly women of post-menopausal age. Despite the medical, social, and hygiene burdens conferred by UI to its sufferers, past studies have shown that only a few among women afflicted with UI sought treatment. This may be due to various reasons: lack of knowledge and awareness of UI or a wrong belief of UI as a natural part of aging. This study aimed to investigate the association between knowledge and severity of UI and reasons for not seeking treatment among post-menopausal women in Bandung, Indonesia. This was an analytic cross-sectional study conducted at the Geriatric and Gynecology Clinic, Dr. Hasan Sadikin General Hospital, in September 2013. Ninety-one women who met the inclusion criteria were interviewed to assess their knowledge of UI. The severity of UI was assessed using Urinary Distress Inventory 6 (UDI-6). Data were analyzed using the chi-square test. Sixty-five respondents (70.7%) had poor knowledge of UI. Knowledge of UI was not associated with awareness of UI as a medical condition (p=0.633). The difference in UI severity was associated with the perception of UI as a normal part of aging (p=0.008). Post-menopausal women are poorly informed regarding urinary incontinence. However, knowledge alone might not be adequate to encourage women to seek treatment. Further studies are needed to investigate women’s reasons for not seeking treatment for UI
Glioblastoma following Hemorrhagic Stroke: A Case Report
Get PDFObjective: To report a glioblastoma (GBM) case preceded by a hemorrhagic stroke.Methods: This case reported a 53-year-old male presenting at at Murni Teguh Memorial Hospital, Medan, Indonesia, with a chief complaint of an altered mental state. The condition had been worsened for two weeks. On anamnesis, he was identified to have experienced intracerebral hemorrhage in January 2020. A follow-up head computed tomography scan was conducted in September 2020, showing a normal condition of the brain. Other oncogenic risk factors were not found. Due to convulsion in October 2020, the patient underwent a magnetic resonance imaging examination showing a cystic right temporoparietooccipital lesion and cerebral edema. Craniotomy tumor removal surgery was performed while the tumor was further examined for histopathological findings. The tumor was diagnosed as glioblastoma with microvascular proliferation and palisading necrosis.Results: There was some associations between hemorrhagic stroke and glioblastoma development.Conclusion: GBM preceded by hemorrhagic stroke is a rare case that can be diagnosed thoroughly by complete clinical and adjunct examinations
perbandingan excessive daytime sleepiness dengan normal daytime sleepiness terhadap fungsi kognitif serta waktu reaksi peserta ppds anestesiologi dan terapi intensif
Get PDFExcessive daytime sleepiness (EDS) adalah ketidakmampuan untuk tetap terjaga pada siang hari yang menghasilkan rasa kantuk berlebih dan tertidur pada waktu yang tidak tepat. Prevalensi EDS yang tinggi ditemukan pada tenaga medis seperti peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif. Kondisi EDS dapat memengaruhi fungsi kognitif dan waktu reaksi. Tujuan penelitian ini adalah membandingkan EDS dengan normal daytime sleepiness (NDS) terhadap fungsi kognitif serta waktu reaksi peserta PPDS Anestesiologi. Penelitian ini merupakan penelitian analitik komparatif numerik dengan rancangan potong lintang yang dilakukan pada peserta PPDS Anestesiologi Fakultas Kedokteran Universitas Padjadjaran di bulan November 2020. Seluruh PPDS Anestesiologi mengisi kuisioner Epworth Sleepiness Scale (ESS) agar terbagi menjadi dua kelompok, kelompok EDS (n=23) dan kelompok NDS (n=23). Fungsi kognitif diukur menggunakan tes Montreal Cognitive Assessment versi Bahasa Indonesia dan waktu reaksi menggunakan perangkat lunak Personal Computer-Psychomotor Vigilance Task. Hasil penelitian menunjukkan fungsi kognitif lebih rendah pada kelompok EDS (26,74±1,096) dibanding dengan kelompok NDS (28,65±1,191) dan waktu reaksi lebih lambat pada kelompok EDS (337,38±62,021) dibanding dengan kelompok NDS (298,81±34,225). Simpulan penelitian adalah peserta PPDS Anestesiologi kelompok EDS memiliki fungsi kognitif lebih rendah dan waktu reaksi lebih lambat dibanding dengan peserta PPDS Anestesiologi kelompok NDS. Comparison between Excessive Daytime Sleepiness and Normal Daytime Sleepiness on Cognitive Function and Reaction Time of Anesthesiology and Intensive Care Residents Excessive daytime sleepiness (EDS) is the inability to stay alert during the day due to sleepiness during daytime, often associated with the tendency of falling asleep during inappropriate times. High prevalence of EDS was found among medical workers, such as anesthesiology residents. The condition is associated with increased secretion of cathecholamines, cortisol, and inflammatory mediators that may affect the prefrontal cortex, area of the brain that acts as a center for cognitive function and reaction time. The study aimed to compare EDS with normal daytime sleepiness (NDS) on cognitive function and reaction time of anesthesiology residents. The research was a numerical comparative analytic study with a cross-sectional design performed on anesthesiology residents of Faculty of Medicine Universitas Padjadjaran in November 2020. All residents in the department were instructed to complete the Epworth Sleepiness Scale (ESS) questionnaire. After completion, the respondents were randomized using simple random sampling into two groups: the EDS group (n=23) and NDS group (n=23). Each group was assessed for cognitive function using the Indonesian version of the Montreal Cognitive Assessment and reaction time using the Personal Computer-Psychomotor Vigilance Task software. Lower cognitive function scores were found in EDS group (26.74±1.096) compared to NDS group (28.65±1.191); slower reaction time were found in EDS group (337.38±62.021) compared to NDS group (298,81±34.225). Both variables had shown significant differences between both groups (p<0.05). The study had concluded that anesthesiology residents with EDS have lower cognitive scores and slower reaction time compared to anesthesiology residents with NDS. Excessive Daytime Sleepiness (EDS) adalah ketidakmampuan untuk tetap terjaga pada siang hari yang menghasilkan rasa kantuk berlebih dan tertidur pada waktu yang tidak tepat. Kondisi EDS memiliki tingkat prevalensi tinggi pada tenaga medis seperti peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif. Kondisi EDS dapat memengaruhi fungsi kognitif dan waktu reaksi. Tujuan penelitian ini adalah untuk membandingkan EDS dengan normal daytime sleepiness (NDS) terhadap fungsi kognitif serta PPDS Anestesiologi. Penelitian ini merupakan penelitian analitik komparatif numerik dengan rancangan crosssectional yang dilakukan pada peserta PPDS Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran di bulan November 2020. Seluruh PPDS Anestesiologi diminta untuk mengisi kuisioner Epworth Sleepiness Scale (ESS). Berdasarkan nilai ESS, subjek penelitian dipilih menggunakan simple random sampling menjadi dua kelompok, kelompok EDS (n=23) dan kelompok NDS (n=23). Setiap kelompok dilakukan pemeriksaan fungsi kognitif menggunakan tes Montreal Cognitive Assessment versi Bahasa Indonesia dan waktu reaksi menggunakan perangkat lunak Personal Computer-Psychomotor Vigilance Task (PC-PVT). Hasil penelitian didapatkan fungsi kognitif lebih rendah pada kelompok EDS (26,74±1,096) dibandingkan dengan kelompok NDS (28,65±1,191) dan waktu reaksi lebih lambat pada kelompok EDS (337,38±62,021) dibandingkan dengan kelompok NDS (298,81±34,225). Kedua variabel menunjukkan perbedaan yang signifikan dengan nilai p<0,05. Kesimpulan penelitian adalah peserta PPDS Anestesiologi kelompok EDS memiliki fungsi kognitif lebih rendah dan waktu reaksi lebih lambat dibandingkan dengan peserta PPDS Anestesiologi kelompok NDS