E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
Not a member yet
1208 research outputs found
Sort by
Hubungan Rasio Neutrofil Limfosit terhadap Mortalitas di General Intensive Care Unit RSUP Dr. Mohammad Hoesin Palembang
No full textRasio neutrofil limfosit adalah metode yang cepat dan sederhana untuk mengevaluasi stres peradangan dan memprediksi mortalitas di ruangan intensif. Penelitian ini bertujuan mengetahui hubungan rasio neutrofil-limfosit dengan mortalitas ≤28 hari di ruangan rawat intensif. Penelitian ini menggunakan desain penelitian cross sectional berdasarkan data sekunder rekam medis dengan sampel semua pasien yang dirawat di ICU RSUP Dr. Mohammad Hoesin Palembang dari Januari–Desember 2018. Didapatkan total sampel sebanyak 562 sampel, dan sebanyak 347 yang memenuhi kriteria inklusi. Pada uji analisis regresi diagnosis, kelompok usia, jenis kelamin dan terapi terhadap nilai rasio neutrofil limfosit, didapatkan bahwa diagnosis merupakan faktor risiko yang dapat memengaruhi nilai rasio neutrofil limfosit (p=0,001). Pada distribusi subjek berdasarkan rasio neutrofil limfosit terhadap mortalitas terdapat rerata rasio neutrofil limfosit pada kelompok yang meninggal adalah 17,75±15,06 dan rerata rasio neutrofil limfosit subjek pada kelompok yang hidup adalah 13,63±10,71. Dilakukan Uji Mann-Whitney dan didapatkan bahwa terdapat perbedaan rerata antara rasio neutrofil limfosit antara kelompok yang hidup dan meninggal dengan nilai p=0,009. Simpulan, rasio neutrofil limfosit merupakan salah satu biomarker yang dapat memprediksi mortalitas pada pasien di ICU RSUP Dr. Moh. Hoesin Palembang. Relation between Neutrophil-to-Lympocyte Ratio and ≤28 day Mortality in General Intensive Care Unit of Dr. Mohammad Hoesin General Hospital PalembangNeutrophil lymphocyte ratio is a fast and simple method for evaluating inflammatory stress and predicting mortality in intensive care. The purpose of this study was to determine the relationship between the ratio of neutrophils to lymphocytes to ≤28 day mortality in the intensive care unit. This was a crosssectional study on secondary data collected from medical records of all patients treated at the ICU of Dr. Mohammad Hoesin General Hospital Palembang during the period of January–December 2018. A total sample of 562 samples was obtained and 347 of them met the inclusion criteria. When diagnosis, age group, gender, and therapy for neutrophil-lymphocyte ratio value were subjected to regression analysis, it was revealed that diagnosis was a risk factor that could affect the neutrophil-lymphocyte ratio value (p=0,001). When subject distribution was assessed based on neutrophil lymphocyte ratio to mortality, an average neutrophil lymphocyte ratio of 17.75±15.06 was observed in the deceased group while the average ratio in survived patients was 13.63±10.71. Mann-Whitney test was then performed and a difference in the neutrophil to lymphocyte ratio was found between the survived and deceased groups with a p value of 0.009. In conclusion, neutrophil to lymphocyte ratio can be used as one of the biomarkers that can predict mortality in patients treated in intensive care unit.Latar Belakang/Tujuan. Angka mortalitas di Intensive Care Unit (ICU) dapat diprediksi dengan berbagai cara. Pada pasien dengan penyakit kritis, inflamasi sistemik merupakan bagian dari proses perjalanan penyakit. Rasio neutrofil limfosit adalah metode yang dapat diandalkan, cepat, dan sederhana untuk mengevaluasi sejauh mana stres peradangan dan memprediksi mortalitas di ruangan intensif.Metode. Penelitian ini menggunakan desain penelitian cross sectional berdasarkan data sekunder rekam medis dengan sampel dalam penelitian ini adalah semua pasien yang dirawat di ICU RSUP Dr.Mohammad Hoesin Palembang dari bulan Januari 2018 sampai Desember 2018 dan memenuhi kriteria penyertaan penelitian yaitu pasien memiliki data rekam medis lengkap dan berusia > 18 tahun.Hasil. Didapatkan total sampel sebanyak 562 sampel, dan sebanyak 347 yang memenuhi kriteria inklusi. Pada uji analisis regresi diagnosis, kelompok usia, jenis kelamin dan terapi terhadap nilai rasio neutrofil limfosit, didapatkan bahwa diagnosis merupakan faktor risiko yang dapat memengaruhi nilai rasio neutrofil limfosit (p=0,001). Pada distribusi subjek berdasarkan rasio neutrofil limfosit terhadap mortalitas terdapat rerata rasio neutrofil limfosit pada kelompok yang mati adalah 17,75±15,06 dan rerata rasio neutrofil limfosit subjek pada kelompok yang hidup adalah 13,63 ± 10,71. Dilakukan uji analisis Mann-Whitney dan didapatkan bahwa terdapat perbedaan rerata antara rasio neutrofil limfosit antara kelompok yang hidup dan mati dengan nilai p=0,009.Kesimpulan. Rasio neutrofil limfosit merupakan salah satu biomarker yang dapat memprediksi mortalitas pada pasien di ICU RSUP Dr. Moh. Hoesin Palembang
Gambaran Suhu Inti Tubuh Preanestesi dan Pascaanestesi pada Pasien Sectio Caesarea di Rumah Sakit Dr. Hasan Sadikin Bandung
Get PDFPerubahan suhu inti tubuh dapat terjadi pada pasien perioperatif dan disebabkan oleh beberapa faktor seperti jenis operasi, jenis anestesi yang diberikan, durasi operasi, dan tata laksana yang dilakukan pascaoperasi, begitu pula pada kondisi pemulihan suhu inti tubuh. Penelitian ini bertujuan mengetahui gambaran umum suhu inti tubuh preanestesi dan pascaanestesi pada pasien sectio caesarea di Rumah Sakit Dr. Hasan Sadikin Bandung.Penelitian ini dilakukan kepada pasien peripartum yang menjalani operasi sectio caesarea pada September hingga Oktober 2018 di Central Operation Theater dan Ruang Pemulihan Rumah Sakit Dr. Hasan Sadikin Bandung menggunakan metode observasional dengan pendekatan potong lintang secara total sampling, jumlah sampel didapatkan 47 orang. Suhu inti tubuh diukur sebelum preanestesi dan pascaanestesi menggunakan termometer timpanik. Data yang terkumpul dianalisis secara deskriptif dengan hasil berupa frekuensi dan persentase yang disajikan dalam bentuk tabel atau grafik. Hasil penelitian ini menunjukkan bahwa terdapat perubahan suhu inti tubuh dengan rerata penurunan 0,15˚C, yakni terdapat penurunan sebanyak 63,8% dan peningkatan sebanyak 36,2%. Simpulan, semua pasien pada penelitian ini mengalami perubahan suhu inti tubuh. Lebih banyak pasien yang mengalami penurunan suhu inti tubuh dibanding dengan peningkatan suhu inti tubuh. Pengendalian faktor eksternal mengurangi risiko penurunan suhu inti tubuh berlebih. Pre-Anesthesia and Post-Anesthesia Core Body Temperature of Patients Underwent Caesarean Section in Dr. Hasan Sadikin General Hospital BandungChanges in core body temperature can occur to anyone, especially to perioperative patients. Perioperative patient’s core body temperature change is caused by various factors such as the type of surgery, type of anesthesia used, duration of surgery, postoperative management, and core temperature recovery process. This study was conducted to describe pre-anesthesia and post-anesthesia core body temperature of patients underwent caesarean section in Dr. Hasan Sadikin General Hospital Bandung. This was a cross-sectional observational study on peripartum patients underwent caesarean section during the period between the third week of September to the third week of October 2018 at the Central Operation Theater and Recovery Room of Dr. Hasan Sadikin General Hospital. Sampling was performed using total sampling approach, resulting in 47 subjects. The core body temperature was measured with tympanic thermometer before anesthesia and after anesthesia. Data analysis was carried out descriptively in the form of tables and graphs of frequencies and percentages. Results showed that the core body temperature change with a decrease of 0.15˚C, decreased core body temperature was seen in 63.8% of the subjects with the remaining 36.2% experienced an increase in core body temperature. In conclusion, the all subjects in this study experienced changes in core body temperature with a decrease in temperature as the more likely change. Controlling the external factors can reduce the risk of excessive core body temperature decline.Perubahan suhu inti tubuh dapat terjadi pada pasien perioperatif dan disebabkan oleh beberapa faktor seperti jenis operasi, jenis anestesi yang diberikan, durasi operasi, dan tatalaksana yang dilakukan pascaoperasi, begitu pula pada kondisi pemulihan suhu inti tubuh. Penelitian ini dilakukan untuk mengetahui gambaran umum suhu inti tubuh preanestesi dan pascaanestesi pada pasien sectio caesarea di Rumah Sakit Dr. Hasan Sadikin Bandung dan dilakukan kepada pasien peripartum yang menjalani operasi sectio caesarea pada minggu ke-3 bulan September hingga minggu ke-3 bulan Oktober 2018 di Rumah Sakit Dr. Hasan Sadikin. Metode penelitian bersifat observasional potong lintang secara total sampling (n=47). Suhu inti tubuh diukur preanestesi dan pascaanestesi dengan termometer timpanik. Data yang terkumpul dianalisis secara deskriptif dengan hasil frekuensi dan persentase yang disajikan dalam bentuk tabel. Hasil penelitian ini menunjukkan bahwa rata-rata suhu inti tubuh pasien preanestesi adalah 35,95˚C, pascaanestesi 35,80˚C, preanestesi umum 36,01˚C, pascaanestesi 35,83˚C, preanestesi regional spinal 35,94˚C, pascaanestesi regional spinal 35,83˚C. Terdapat perubahan suhu inti tubuh dengan rata-rata penurunan 0,15˚C. Terdapat 63,8% penurunan dan 36,2% peningkatan. Semua pasien mengalami perubahan suhu inti tubuh. Lebih banyak pasien yang mengalami penurunan suhu inti tubuh dibanding dengan peningkatan suhu inti tubuh. Pengendalian faktor eksternal dapat mengurangi risiko penurunan suhu inti tubuh berlebih
Malnutrition in Non-Hodgkin Lymphoma Patients at Dr. Hasan Sadikin General Hospital Bandung
Get PDFBackground: Non-hodgkin lymphoma (NHL) has the highest prevalence among hematologic malignancies. The prognosis and response to therapy in NHL patients may worsen in the presence of malnutrition. The aim of the study was to describe the malnutrition status in NHL patients. Methods: This was a cross-sectional descriptive study. Nutritional status was assessed using Subjective Global Assessment (SGA) obtained from the medical records of all NHL patients at Dr. Hasan Sadikin General Hospital registered in 2017.Results: In total, there were 78 medical records of NHL patients that fulfilled the inclusion criteria. All NHL patients had experienced malnutrition, categorized as mild-moderate malnutrition (70.5%) and severe malnutrition (29.5%). In NHL patients with mild-moderate malnutrition, 29% had 5–10% weight loss; 60% had suboptimal solid diet; 56.4% experienced anorexia; and 50.9% had subcutaneous fat loss. In NHL patients with severe malnutrition, 78.3% had more than 10% weight loss; 73.9% had suboptimal solid diet; 78.3% experienced anorexia; and 100% had subcutaneous fat loss.Conclusions: Based on subjective assessment, all NHL patients were malnourished and experienced change of food intake and loss of subcutaneous fat, therefore, a better nutritional support scheme are crucial for NHL patients
Pharmacological Treatment Pattern and Comorbidities in Parkinson’s Disease Outpatients at Dr. Hasan Sadikin General Hospital Bandung in 2013–2018
Get PDFBackground: Parkinson’s disease (PD) is one of many neurodegenerative diseases with symptomatic management, and with the correct pattern of pharmacological treatment PD may have an improved quality of life for a minimum of three years. This study aimed to illustrate treatment patterns and comorbidities in PD patients at Dr. Hasan Sadikin General Hospital, Bandung.Methods: This study was a cross-sectional descriptive study by using total medical records of the period of 2013 to 2018. PD patients receiving pharmacological treatments such as levodopa, anticholinergics, dopamine agonists, or combined therapy were included. Patients with incomplete data and with the previous history of other neurological diseases before PD were excluded from this study.Results: In total, there were 57 patients with PD, of whom most of them were males (79%). Age-wise, PD was most common in 60 to 69-year-olds (32%). The most commonly used treatment pattern was the administration of levodopa (33%). Patients aged younger than 30 years were administered anticholinergics, whereas the older patients (>60 years old) mostly were given levodopa. Comorbidities after PD diagnosis were mostly stroke, dementia, and epilepsy.Conclusions: Males are most affected by PD, and the most commonly used treatment pattern is levodopa monotherapy. PD is most commonly found in patients aged 60 to 69 years. Patients aged below 30 years are administered anticholinergics. The most common comorbidities found are a stroke, followed by dementia and epilepsy. By recognizing the patterns and comorbidities of this disease, the study may provide some insights into choosing the most effective pharmacological therapy for PD.
The Distribution of Meningioma in Dr. Hasan Sadikin General Hospital Bandung Period 2010–2013
Get PDFBackground: In neurological diseases, brain tumor is the second leading cause of death after stroke, of which the most common types of brain tumor is meningioma. There are many factors affect the prognosis of meningioma patient, including age, gender, location, and histopathological type of tumor. This study aimed to explore the distribution of meningioma based on age, gender, location of the tumor, and its histopathological type during the period of 2010–2013 in Dr. Hasan Sadikin General Hospital Bandung.Methods: This study was a quantitative descriptive study and data were collected from medical records of Department of Pathology between January 2010-December 2013. Age, gender, location, and histopathological type of meningioma were acquired. Results: There were 277 eligible cases of meningioma with an average number of cases per year were 69 cases. The ratio of men to women was 1:6.4. Meningioma was most commonly found in the age group 4150 years (38.9%), and mostly located in convexity (55.96%). The most common histopathological type of meningioma was meningotheliomatous meningioma (70%).Conclusions: The frequency of meningioma is 6 times higher in women, predominantly around the age of 50 years old. Meningioma is most commonly found in convexity, and meningotheliomatous meningioma is the most common histopathological type.
Correlation between Serum Uric Acid and HbA1c Levels in Patients with Type 2 Diabetes Mellitus
Get PDFBackground: Indonesia ranks fourth among countries with the highest number of diabetics. Increasing evidence suggests that hyperuricemia is an independent risk factor for impaired fasting glucose (IFG) and type 2 diabetes. Some observational studies have identified elevated uric acid concentration as a risk factor for diabetes, while others have found an inverse relationship. The present study was conducted to discover the strength and the direction of the correlation. Methods: This study was an analytical cross-sectional study conducted from May to October 2014. The study subjects were 56 medical records of new outpatients diagnosed with T2DM in the Internal Medicine Polyclinic who underwent laboratory examination at the Clinical Pathology Unit of Dr. Hasan Sadikin General Hospital, January-December 2013. Result: The correlation between HbA1c and uric acid levels on the whole subject revealed a weak but significant negative correlation (r=-0.354, p=0.007). There was an insignificant negative correlation in male subjects (r=-0.405, p=0.120); in female subjects (r=-0.319, p=0.05), the correlation was a weak but insignificant negative correlation.Conclusions: There is a weak correlation between HbA1c and uric acid levels in patients with Diabetes Mellitus type 2.
Generalized Seizure Due To Acute Hyperosmolar Hyponatremıa Followıng Coronary Angıography: A Lesson Learned From A Case Report
Get PDFHyponatremia is a common electrolyte disorder, but symptomatic hyponatremia following coronary angiography is rare. Although patients with hyponatremia are generally asymptomatic, neurological manifestations may result in lethal complications.Here we presented a 69-year-old female, admitted for elective coronary angiography due to exertional chest pain. Seven hours later after coronary angiography, however, the patient had a headache, temporary mental confusion and her speech was slurring. A brain magnetic resonance imaging (MRI) test, arterial blood gas analysis, and the neurological examination were carried out. The neurological examination showed no focality and brain diffusion MRI was normal. Arterial blood gas analysis revealed sodium of 110 mmol/L and potassium of2.8 mmol/L. The patient was treated with hypertonic saline (3% NaCl) and vasopressin antagonist tolvaptan 15 mg at first and isotonic saline (0,09 NaCl) with a gradual normalization of electrolytes. Diagnosis of acute hyperosmolar hyponatremia should be considered in patients with developing mental or behavioral abnormalities following coronary angiography
Chula Formula sebagai Prediktor Ketepatan Kedalaman Endotracheal Tube pada Intubasi Nasotracheal
Get PDFIntubasi nasotrakeal adalah salah satu metode yang umum digunakan pada operasi intraoral dan maksilofasial yang memiliki keunggulan untuk menyediakan akses yang lebih baik. Hal yang menjadi perhatian utama ketika memasukkan endotracheal tube (ETT) adalah penempatan yang tepat dan sesuai sehingga menghindari komplikasi akibat malposisi ETT. Fiberoptic bronchoscope (FOB) adalah cara yang paling pasti untuk menilai penempatan ujung ETT karena menyediakan visualisasi secara langsung sehingga dapat mengukur penempatan ETT yang ideal, tetapi FOB tidak selalu tersedia di rumah sakit. Penelitian ini bermaksud menilai kesesuaian Chula formula, yaitu rumus yang menggunakan tinggi badan untuk menempatkan ETT pada posisi yang tepat. Penelitian ini merupakan penelitian analitik yang dilakukan secara prospektif pada 59 subjek penelitian di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli sampai Agustus 2018. Subjek diintubasi nasotrakeal dengan kedalaman ETT dihitung menggunakan Chula formula, kemudian jarak ujung ETT ke carina dinilai menggunakan FOB. Hasil uji statistik dengan Guilford dan Spearman didapatkan nilai r 0,933 dan p 0,0001 yang menunjukkan kesesuaian yang sangat kuat pada Chula formula untuk menempatkan ETT pada kedalaman yang tepat. Simpulan, Chula formula dapat memprediksi kedalaman ETT dengan tepat pada intubasi nasotrakeal.Chula Formula as a Predictor for Correct Endotracheal Tube Placement for Nasotracheal IntubationNasotracheal intubation is a common method which provides better access for intraoral and maxillofacial operations. The main concern when inserting an endotracheal tube (ETT) is the correct and appropriate placement as there are many complications develop due to ETT malposition. A Fiberoptic Bronchoscope (FOB) is the best way to assess the placement of the tip of the ETT for it provides a direct visualization to measure the ideal ETT placement; however, it is not always readily available in hospitals. This study aims to assess the compatibility of Chula formula, a formula that utilizes height to determine the correct ETT placement. This study was a prospective analytical study on 59 research subjects in Dr. Hasan Sadikin General Hospital Bandung from July to August 2018. The subjects were nasotracheally intubated with the ETT depth measured using the Chula formula, afterwards the distance from the tip of the ETT to the carina was assessed using an FOB. The results from Guilford and Spearman’s were an r value of 0.933 and a p value of 0.0001, showing a statistically significant conformation of the Chula formula in correct ETT placement. It is concluded that Chula formula can be used as a predictor for correct ETT placement in nasotracheal intubation.Intubasi nasotrakeal adalah salah satu metode yang umum digunakan pada operasi intraoral dan maksilofasial yang memiliki keunggulan untuk menyediakan akses yang lebih baik. Hal yang menjadi perhatian utama ketika memasukkan endotracheal tube (ETT) adalah penempatan yang tepat dan sesuai sehingga menghindari komplikasi akibat malposisi ETT. Fiberoptic bronchoscope (FOB) adalah cara yang paling pasti untuk menilai penempatan ujung ETT karena menyediakan visualisasi secara langsung sehingga dapat mengukur penempatan ETT yang ideal, tetapi FOB tidak selalu tersedia di rumah sakit. Penelitian ini bermaksud menilai kesesuaian Chula formula, yaitu rumus yang menggunakan tinggi badan untuk menempatkan ETT pada posisi yang tepat. Penelitian ini merupakan penelitian analitik yang dilakukan secara prospektif pada 59 subjek penelitian di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli sampai Agustus 2018. Subjek diintubasi nasotrakeal dengan kedalaman ETT dihitung menggunakan Chula formula, kemudian jarak ujung ETT ke carina dinilai menggunakan FOB. Hasil uji statistik dengan Guilford dan Spearman didapatkan nilai r 0,933 dan p 0,0001 yang menunjukkan kesesuaian yang sangat kuat pada Chula formula untuk menempatkan ETT pada kedalaman yang tepat. Simpulan, Chula formula dapat memprediksi kedalaman ETT dengan tepat pada intubasi nasotrakeal. Kata kunci: Chula formula, fiberoptic bronchoscope, intubasi nasotrakeal, kedalaman endotracheal tub
Health-Seeking Behavior of Dengue Hemorrhagic Fever Patients in Several Hospitals in Bandung West Java Indonesia
Get PDFBackground: Dengue hemorrhagic fever is one of the major global public health problems. Secondary prevention of dengue fever must be conducted to prevent high mortality rate by giving appropriate diagnosis and early management. This study was conducted to identify health-seeking behavior in dengue hemorrhagic patients and its related factors.Methods: This study involved 98 dengue hemorrhagic patients from four hospitals in Bandung region during July until November 2014. The hospitals were 2 public hospitals and 2 private hospitals. A questionnaire and in depth interview were used to collect the data.Results: Among 98 patients, 54 patients (55%) sought a right medical treatment timely, whereas 44 patients (45%) delayed. The first seeking behaviour to treat the disease was using over-the-counter drugs, followed by visiting a private clinic doctor. The second choice to seek health care was going to a private clinic doctor and hospital.Conclusions: Health-seeking behavior in dengue hemorrhagic patients in Bandung is inappropriate which can cause delay in treatment.
Effects of Ageratum conyzoides Leaf Decoction on Glucose Absorption in Rat’s Small Intestine
Get PDFBackground: Obesity is one of the health problems caused by excessive glucose intake which exceeds normal body requirement. To prevent health problems, Indonesian natives used traditional herbs, such as Ageratum conyzoides (billygoat weeds). The study aimed to discover the effect of Ageratum conyzoides leaf decoction on glucose absorption in the small intestine of rats.Methods: An experimental study was conducted at the Biochemical Laboratory of Faculty of Medicine, Universitas Padjadjaran. Two groups of six rats were given Ageratum conyzoides leaf decoction with dosages 0.89 and 1.33 g/kgbw respectively. Each rat was given glucose solution as a control, decoction administration along with the glucose solution, and glucose solution again to discover the effect of decoction in the absorption function after the administration of decoction was discontinued. Glucose absorbed by the intestine was measured every 15 minutes in 1 hour after the administrationof the solution.Results: Glucose absorption was impeded in dosage 1 and 2 with a mean of the gap between glucose absorbed concentration before given decoction and after given decoction were 73.97 and 45.09 mg/dl respectively. Analysis using paired t-test resulted in insignificant meaning (p-value of dosage 0.89 g/kgbw=0.08; p-value of dosage 1.33 g/kgbw=0.06). In the last glucose perfusion, absorption increased in both dosages after administration of decoction was discontinued.Conclusions: Ageratum conyzoides leaf decoctioncan inhibit the glucose absorption in the small intestine but is not statistically significant. Further investigation may be needed by using a higher concentration of Ageratum conyzoides and/or other filtration methods