International Journal of Integrated Health Sciences
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Maternal Mortality Risk Factors in Dr. Hasan Sadikin General Hospital, Bandung in 2009−2013
Get PDFObjective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR) in Indonesia is still a common problem which needs urgent solution.Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001), delivery complication (p<0.001), puerpural complication (p=0.022), age (p=0.030), parity (p=0.427), prior medical history (p<0.001), antenatal care (p=0.007), maternal education (p=0.527), and area of residence (p=0.049).Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence. Keywords: Complication, maternal deaths, risk factors DOI: 10.15850/ijihs.v5n2.99
Correlations between Muscle Mass, Muscle Strength, Physical Performance, and Muscle Fatigue Resistance in Community-Dwelling Elderly Subjects
Get PDFObjective: To determine the correlations between muscle mass, muscle strength, physical performance, and muscle fatigue resistance in community-dwelling elderly people in order to elucidate factors which contribute to elderly’s performance of daily activities.Methods: A cross-sectional study was conducted on community-dwelling elderly in Bandung from September to December 2014. One hundred and thirty elderly, 60 years old or above, were evaluated using bioelectrical impedance analysis to measure muscle mass; grip strength to measure muscle strength and muscle fatigue resistance; habitual gait speed to measure physical performance; and Global Physical Activity Questionnaire (GPAQ) to assess physical activity. Results: There were significant positive correlations between muscle mass (r=0,27, p=0,0019), muscle strength (r=0,26, p=0,0024), and physical performance (r=0,32, p=0,0002) with muscle fatigue resistance. Physical performance has the highest correlation based on multiple regression test (p=0,0025). In association with muscle mass, the physical activity showed a significant positive correlation (r=0,42, p=0,0000). Sarcopenia was identified in 19 (14.61%) of 130 subjects. Conclusions: It is suggested that muscle mass, muscle strength, and physical performance influence muscle fatigue resistance. Keywords: Community-dwelling, elderly, muscle fatigue resistance, muscle mass, sarcopenia DOI: 10.15850/ijihs.v4n1.68
Comparison of the Effectiveness of Phosphorus 32 Application and 10 Mg/Cc Triamcinolone Acetonide Intralesional Injection on Keloid
Get PDFObjective: To analyze the effectiveness of phosphorus 32 (32P) application compared to 10 mg/cc triamcinolone acetonide (TA) intralesional injection in keloid.Methods: A single blind (evaluator blind) randomized clinical trial on 52 keloids was conducted during the period of May – August 2014 in Tumor and Skin Surgery Clinic, Department of Dermatovenereology and Department of Nuclear Medicine and Molecular Imaging, Dr. Hasan Sadikin General Hospital Bandung.Results: Lesions were divided into two groups with each group consisted of 26 lesions. Group A was treated with 32P application whereas group B was treated with 10 mg/cc TA intralesional injection. Flattening of the lesion of more than 50% was higher in the group treated with 32P application (76.9%) compared to the group that was treated with 10 mg/cc TA intralesional injection (57.7%) on the 8th week, but the difference was not statistically significant (p>0.05).Conclusions: Based on the statistical analysis, the application of 32P was as effective as the intralesional injection of 10 mg/cc TA for keloid lesions.Keywords: Flattening, keloid, phosphorus 32, triamcinolone acetonide DOI: 10.15850/ijihs.v4n1.68
Loaded and Unloaded Sit-to-Stand Strengthening Exercises Effect to Gross Motor Function Measure in Spastic Diplegia Cerebral Palsy Patients
Get PDFObjective: To examine sit-to-stand and loaded sit-to-stand exercises effect in standing, walking, and running dimensions of gross motor function measure (GMFM) in spastic diplegia cerebral palsy (SDCP) patients.Methods: This study was conducted in the period of May to October 2014 and included 24 children with SDCP as the subjects. The methods used in the study were interventional study with randomized controlled trial, and investigation of CP before and after the exercise intervention. The subjects were divided into two groups, sit-to-stand exercise group and loaded sit-to-stand exercise group. Results: The results showed that the increase of standing, walking, and running dimension scores of GMFM in the loaded group were higher (standing dimension score 12.00 vs 11.08 and walking and running dimensions 13.58 vs 13.42) compared to the unloaded group.Conclusions: Both sit-to-stand and loaded sit-to-stand exercise groups do not show significant differences in improving motor skills in standing, walking, and running dimensions of GMFM. Children with SDCP may receive the exercise to improve their motor skills in mobility aspects, such as standing, walking, and running. Keywords: Cerebral palsy, gross motor function measure, rehabilitation, sit-to-stand exercise DOI: 10.15850/ijihs.v4n1.68
Handgrip Strength Prediction Formula Using Aneroid Sphygmomanometer in Elderly
Get PDFObjective: To examine the prediction formula used to measure handgrip strength using aneroid sphygmomanometer in elderly.Methods: This study was a cross-sectional study performed at the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital from March to April 2015. Thirty five elderly subjects aged 60–74 years were included in the study. The subject handgrip strength was measured using an aneroid sphygmomanometer and a Jamar dynamometer. Results: All data were analyzed statistically using Pearson correlation test to examine the distributed data and Spearman test to examine the non distributed data. A significant correlation was found between hand width, age, and sex and the handgrip strength values using Jamar dynamometer (p<0.01) using multiple linear regression (p<0.01). A normality test using the Shapiro-Wilk test resulted normal residue with p value 0.000. The results showed that the regression analysis could be used to predict the handgrip strength using aneroid sphygmomanometer.Conclusions: Aneroid sphygmomanometer can be used to predict handgrip strength in elderly using conversion formula. Keywords: Aneroid sphygmomanometer, elderly, handgrip strength, Jamar dynamometer DOI: 10.15850/ijihs.v4n2.83
Peripheral and Intracranial Compartment Serum Level of Selenium in Pediatric Patients with Intracranial Tumor in Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran–Dr. Hasan Sadikin Hospital, Bandung, Indonesia: a Preliminary Study and Literature Review
Get PDFObjective: To determine the level of Selenium (Se) in peripheral and intracranial serum in pediatric patients with intracranial tumor. Selenium has chemopreventive potentials and acts as neuromodulator.Methods: This study was conducted on 13 pediatric patients with intracranial tumors who were treated in Dr. Hasan Sadikin Hospital, Bandung in the period of February 2014 to February 2015. Samples were taken from peripheral and intracranial serum. The results were analyzed with independent t-test and Pearson correlation test. Significance is defined as p≤0.05 with 95% confidence interval.Results: The results showed that the average Se concentration in peripheral serum was significantly higher than the Se concentration in intracranial serum (95.92±20.95 μg/L and 66.62±22.37 μg/L, respectively). After classifying the subjects into groups based on sex, age, tumor location, and grades, the difference between Se concentrations were still statistically significant (p≤0.05), with the exception of the supratentorial group (p=0.0053). Pearson correlation test showed very-low to medium strength correlations between peripheral and intracranial serum Se concentration in all groups (r=0.16–0.59, p>0.05).Conclusions: A significant difference is seen between the peripheral and intracranial serum Se concentration means in pediatric patients with intracranial tumors, with higher concentrations observed in the peripheral serum. Further studies are required to investigate the roles of Se in the management of pediatric patients with intracranial tumors.Keywords: Pediatric intracranial tumor patients, selenium concentration in peripheral and intracranial serum DOI: 10.15850/ijihs.v4n2.83
Rare Distal Anterior Choroidal Artery Aneurysm
Get PDFObjective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting.Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia.Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery.Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed.Keywords: Aneurysm, distal anterior choroidal artery, neuronavigation DOI: 10.15850/ijihs.v4n2.83
Anterior Interhemispheric Approach for Olfactory Groove Meningioma
Get PDFObjective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM). Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT) scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma.Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively.Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.Keywords: Anterior interhemispheric approach, olfactory groove meningioma DOI: 10.15850/ijihs.v4n2.83
Serum Selenium Concentration in Cervical Cancer Patients: Preliminary Study and Literature Review
Get PDFObjective: To analyze the role of selenium and glutathione peroxidase (GPx) in cervical cancer.Methods: Serum selenium concentrations and GPx activities of 19 women with cervical cancer along with their healthy counterparts (control group) were obtained. Selenium concentration were measured fluorometrically and GPx activities were measured spectrophotometrically based on the quantity of NADPH used in the reduction of glutathione. Results: The mean of serum selenium concentrations in cervical cancer group was significantly lower than that in the control group, 67.24±15 ng/mL and 77.05±12 ng/mL (p=0.03), respectively. The mean GPx activity in the cervical cancer group was also significantly lower than that in the control group, 128.18±38 ∆mmol NADPH/min/L and 148.9±23 ∆mmol NADPH/min/L (p=0.04), respectively. Multivariate analysis in the cervical cancer patients showed that the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) staging score (early vs. advanced) was inversely correlated with serum selenium concentration (p=0.027).Conclusions: Serum selenium concentration and GPx activity was significantly lower in the cervical cancer patients. Our results demonstrate that selenium and GPx activity may have an important role in the carcinogenesis of cervical cancer. Keywords: Cervical cancer, glutathione peroxidase activity, selenium DOI: 10.15850/ijihs.v4n2.83
Discharge against Medical Advice in Pediatric Intensive Care Unit and Subsequent Events
Get PDFObjective: The occurence of discharge against medical advice (DAMA) has impacted globally. Decisions of DAMA in pediatric patients are not made by the patients, but pose life-threatening consequences, especially for children treated in Pediatrics Intensive Care Unit (PICU). The present study aimed to identify the occurence of DAMA and subsequent events to the DAMA patients after treated in PICU of Dr. Hasan Sadikin General Hospital Bandung, Indonesia.Methods: A retrospective study from medical records of DAMA patients from PICU of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between April 2011 and April 2012. Results: A total of 195 children aged 1–5 years were admitted. Of this number, 12 (6.2%) were DAMA. Financial problems were the most common reason for DAMA, followed by parents’ perception about their child’s terminal condition. The majority of parents were laborer. Last parents’ education level was mostly elementary school. Most patients who DAMA from PICU died in less than 24 hours.Conclusions: A considerable number of DAMA was found in our PICU. High mortality occured after patients asked for DAMA from PICU.Keywords: Discharge against medical advice (DAMA), pediatric, pediatrics intensive care unit (PICU) DOI: 10.15850/ijihs.v3n1.40