Majalah Kedokteran Bandung
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Correlation of Nutritional Status, HbA1c, and Duration of Diabetes Mellitus with Amputation Incidence in Patients with Diabetic Foot Ulcers
Full text linkDiabetic foot ulcer (DFU) is a severe complication of diabetes that significantly impairs quality of life and may often lead to amputation, particularly when infections become extensive. This study investigated the correlation of nutritional status, HbA1c levels, and duration of diabetes exposure with the incidence of amputation in DFU patients. Using an observational analytic study with a retrospective cohort design, data from 47 DFU patients treated at the Vascular and Endovascular Surgery clinic and Emergency Room of a hospital from 2019-2024 were analyzed. The majority of subjects were men aged 40-60 years (59.57%). Among the amputee group, 55.31% experienced neuropathy, primarily classified as Wagner's degree 4. Patients requiring amputation had significantly higher levels of urea, creatinine, and leukocytes compared to those who did not. A significant correlation was observed between the incidence of amputation and nutritional status—specifically, serum albumin (r=-0.616) and Body Mass Index (BMI) (r=0.823)—as well as HbA1c levels (r=0.806) and duration of diabetes exposure (r=0.445) (p<0.05). However, the Subjective Global Assessment (SGA) did not show a significant relationship with amputation incidence. The findings of this study suggest that nutritional status, HbA1c levels, and duration of diabetes exposure are significantly correlated with the likelihood of amputation in patients with diabetic foot ulcers (DFU)
Prognostic Nutritional Index (PNI) at Admission Predicts In-Hospital Mortality of COVID-19-Infected Patients
Full text linkCorona Virus Disease-2019 (COVID-19) was declared a pandemic in March 2020 and caused considerable deaths in all parts of the world. Mortality is influenced by the immune system status and increased vulnerability to infection, both related to nutritional status. The Prognostic Nutritional Index (PNI), calculated using lymphocyte count and albumin levels, may have the ability to more accurately characterize the nutritional and inflammatory conditions of COVID-19 patients. This retrospective study analyzed 967 COVID-19 patients at Ulin Hospital Banjarmasin, Indonesia, by examining demographic data, laboratory results, and PNI in relation to survival outcomes. The study revealed that factors such as age, sex, comorbidities (including hypertension, diabetes mellitus/DM, obesity, etc.), number of comorbidities, and disease severity correlated with mortality. Leucocyte count, lymphocyte count, albumin levels, and PNI all showed significant correlations with survival (p<0.001), suggesting that these factors may serve as useful prognostic indicators for COVID-19 patient’s survival. The PNI was associated with an increased risk of mortality, with a univariate odds ratio (OR) of 0.923. Receiver operating characteristic (ROC) analysis demonstrated that a PNI cut-off value of p<41.9 had a sensitivity of 44.9% and a specificity of 82.4%, with an area under the curve (AUC) of 0.666 (p<0.001). Hence, PNI at admission, which reflects patients' immune system and nutritional status upon hospital admission, can be used as a simple, cost-effective, and reliable predictor of mortality in COVID-19 patients
Functional Outcome of Biportal Endoscopy Spine Surgery for Lumbar Disc Herniation Diseases
Full text linkBiportal endoscopic spine surgery (BESS) is an innovative, minimally invasive technique to treat lumbar disc herniation (LDH). BESS provides superior surgical visualization with minimal tissue dissection. However, its application requires a thorough understanding of endoscopic anatomy and adaptation of endoscopy equipment, which are key factors in achieving optimal functional outcomes post-surgery. This study aimed to evaluate the functional outcomes and complications of BESS performed on 49 patients between 2020 and 2022 at Dr. Kariadi Hospital, Semarang, Indonesia. The majority of patients (53%) had herniation at the L4-5 level, followed by L5-S1. Pain assessment using the Visual Analog Scale (VAS) demonstrated a significant reduction in pain, from 4.26 to 1.5, post-surgery. Functional outcomes, as evaluated using MacNab’s Criteria, revealed that 93.8% of patients achieved a satisfactory condition, with 36.7% reporting no pain and 57.1% experiencing occasional pain that did not affect their daily activities. Complications were minimal, with two cases of dural tears and intraoperative bleeding. The study concludes that BESS is a safe and effective procedure for LDH, resulting in significant pain relief and functional improvement, although certain technical challenges persist
Maternal Anemia in Patients with Preterm Delivery in Indonesia
Full text linkPreterm delivery remains one of the leading causes of fetomaternal morbidity and mortality worldwide. Anemia during pregnancy is also a significant concern, and may contribute to adverse pregnancy outcomes including preterm birth, intrauterine growth restriction (IUGR), and postpartum hemorrhage (PPH). This study aimed to assess the prevalence of maternal anemia in women with preterm delivery and to evaluate its association with preterm-related complications. A retrospective cross-sectional study was conducted at the Obstetrics and Gynecology Department of Arifin Achmad Hospital, Pekanbaru, Indonesia. Anemia was defined according to the CDC criteria as hemoglobin levels below 11 g/dL in the first and third trimesters or below 10.5 g/dL in the second trimester. Data were collected from medical records of 654 preterm deliveries, of which 359 met the inclusion criteria. Among these, 204 women (56.82%) had anemia, while 155 women (43.18%) had normal hemoglobin levels. A significant association was found between anemia and preterm delivery (p=0.010). Maternal anemia was associated with preterm premature rupture of membranes (PPROM) (p=0.035, contingency coefficient=0.110, 95% CI). These findings suggest that maternal anemia is significantly correlated with preterm birth and its complications, particularly PPROM. Screening and early management of anemia in pregnancy may help reduce the risk of preterm delivery and improve maternal and neonatal outcomes
Correlation Between Anemia, Sexually Transmitted Infections, and Low Birth Weight Among Pregnant Women
Full text linkAnemia in pregnancy and sexually transmitted infections (STIs) are global health issues linked to low birth weight. This study explored the correlation between these factors and low birth weight at the General Hospital of Scholoo Keyen, South Sorong, Southwest Papua, Indonesia. A cross-sectional observational analytic study was conducted from September 2022 to March 2023, involving pregnant women who gave birth at the General Hospital of Scholoo Keyen. The correlation between risk factors and low birth weight was analyzed using the chi-square test with a significance threshold of p0.05). The incidences of HIV, syphilis, and hepatitis B were 3.1%, 13.6%, and 7.4%, respectively. A significant association was identified between HIV infection and low birth weight (p=0.000), while no such association was found for syphilis (p=0.160) or hepatitis B infection (p=0.852). In conclusion, HIV infection is associated with low-birth-weight newborns, but there are no apparent relationships between anemia, syphilis, or hepatitis B infection and low-birth-weight newborns, This study implies the importance of nutritional support among pregnant mothers with HIV and delaying pregnancy in HIV-positive women to until their immune system improve
Tummy Time and Development of 6- to 12-Month-Old Infants
Full text linkEarly childhood development, particularly within the first 1,000 days of life, is a critical period. Globally, 5–16% of children experience developmental delays. This figure is higher in Indonesia with approximately 13–18% of children under five are facing growth and developmental issues. Adequate stimulation, including activities like tummy time, plays a vital role in a child's growth and development. This study aimed to investigate the correlation between tummy time and the developmental outcomes of infants aged 6–12 months. An analytical descriptive design with a cross-sectional approach was employed in this study that was conducted at Public Health Centers in North Sulawesi Province, Indonesia. Data collection involved questionnaires assessing the onset, frequency, and duration of tummy time, alongside the use of the Child Development Pre-Screening Questionnaire. With a minimum sample size of 96 respondents, data were analyzed using Spearman’s correlation. Findings indicated that performing tummy time more than 1–2 times per week, with each session lasting 6–20 minutes, was significantly associated with better developmental outcomes. However, no significant relationship was observed between early initiation of tummy time or the number of daily sessions with infant development. The study concluded that engaging in tummy time more than 1-2 times per week for 6-20 minutes per session can promote optimal infant development
Local Tumor Control Affects Survival of Patients with Osteosarcoma and Ewing Sarcoma
Full text linkOsteosarcoma and Ewing sarcoma are the most common primary malignant bone tumors in children. This study aimed to analyze the characteristics of osteosarcoma and Ewing sarcoma patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from 2020 to 2023 and compare the one-year survival rates between patients who underwent complete treatment (surgery for local tumor control and chemotherapy) and those who received chemotherapy alone. This study used a descriptive-analytical observational design with a retrospective approach by reviewing electronic medical records from the Indonesian Pediatric Cancer Registry (IPCAR). A total of 44 osteosarcoma patients and 14 Ewing sarcoma patients who met the inclusion criteria were included. The majority of patients were boys (osteosarcoma=61.36%; Ewing sarcoma=64.29%), with a mean age of 13.5 years for osteosarcoma and 9.1 years for Ewing sarcoma. Osteosarcoma was most commonly found in the femur and tibia (90.92%), whereas Ewing sarcoma was primarily located in the axial region (71.43%). Most patients underwent chemotherapy without local tumor control (osteosarcoma=61.36%; Ewing sarcoma=57.14%). The analysis revealed a significant difference in one-year survival between patients who received local tumor control combined with chemotherapy and those who underwent chemotherapy alone (osteosarcoma p=0.000; Ewing sarcoma p=0.010). In conclusion, local tumor control significantly improves one-year survival in both tumor types
Characteristics of Patients with Anterior Cruciate Ligament Injury at Ulin Hospital Banjarmasin, Indonesia
Full text linkKnee injuries are one of the common injuries, especially among athletes. Many studies have concluded that the main cause of these injuries were sudden movements while doing sports. The incidence of the knee joint injury in Indonesia was 38 to 78 per 100,000 patients with the prevalence of Anterior Cruciate Ligament (ACL) injuries of 16%. Recently, an increasing number of ACL injury patients was observed to be treated at the Ulin Hospital, Banjarmasin, Indonesia, when compared to the number of the previous years, making it important to understand the characteristics of patients experiencing these injuries. This study aimed to explore the characteristics of patients with ACL injuries in the hospital. Data for this retrospective descriptive study were collected from medical records during the period of March 2022 to June 2023 from Ulin Hospital, Banjarmasin. The inclusion criteria were patients diagnosed with an ACL injury with or without meniscus tear. From a total of 95 patients with ACL injuries, 30 (32%) were below 20 years old, 42 (44%) were 20-30 years old, 18 (19%) were 31-40 years old, 3 (3%) were 41-50 years old, and 2 (2%) were above 50 years old. The ratio between men and women was 11:1. There were 74 patients who had sports-related injuries while the remaining 21 patients experienced the injury due to other activities. Of the total 95 cases, 59 (62%) were treated nonoperatively and 36 (38%) received arthroscopy surgery. The arthroscopy was mostly performed to patients who also experienced a meniscus injury and in the chronic phase, with an average length of stay at the hospital of 2.6 days
A Case Study of Psoriasis Vulgaris After COVID-19 Vaccination in Saudi Arabia
Full text linkSince the COVID-19 vaccines have been approved, worldwide reports of adverse events have been reported. Although a few cases of Psoriasis vulgaris have been reported after COVID-10 vaccination, there is currently limited evidence to establish a direct relationship between the vaccine and this condition. A 27-year-old Saudi woman, previously healthy and had no medical issues, reported skin lesions on her lower legs, which she noticed ten (10) days after receiving the first dose of the Pfizer COVID-19 vaccine. The patient had no prior history of such lesions or any family history of psoriasis. Joint pain was not observed. A diagnosis of psoriasis vulgaris was made, and the patient was treated with Daivobet® cream, urea cream 10%, and full-body NB-UVB light therapy three times a week for up to two months. The patient's condition improved partially. This report presents the first known case of psoriasis vulgaris after the COVID-19 vaccine in the Middle East. Further research is needed to fully understand this connection. The study emphasizes the significance of a thorough medical history and evaluation for precise diagnosis and treatment
Clinical Features of Drug Eruption in An Indonesian Tertiary Hospital
Full text linkDrug eruption is a response to drugs undergoing sensitization, which is mediated by the immune system. Clinical features of drug eruptions, such as maculopapular drug eruption, Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS), are known as common drug reactions. This study aimed to explore the characteristics and clinical features of patients with drug eruptions at the Department of Dermatology and Venereology of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. This retrospective descriptive study used data from the department from patients treated between January 1, 2014 and December 31, 2018. Data were analyzed using Excel and SPSS software. In this study, 200 subjects were included, mainly consisting of female subjects (50.5%) and aged between 19 and 65 (89%). Maculopapular drug eruption (45%) was the most typical clinical presentation, followed by SJS/TEN (37.5%), and DRESS (3%). The analgesics and non-steroidal anti-inflammatory drugs (NSAID) group was the most commonly suspected causative drug (36.91%), with paracetamol (29.18% of total drugs consumed) as the most frequent NSAID causing the eruption. This was followed by the antibiotic-type drugs group (36.48%), with cotrimoxazole (9.87% of total drugs consumed) as the most common one. So, maculopapular drug eruption is the most common clinical presentation of drug eruption, with analgesics and non-steroidal anti-inflammatory drugs (NSAID) class as the most suspected causative drug. Further investigations are needed to get the accurate result