Althea Medical Journal
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Clinical Manifestations and Laboratory Examination Findings of Hepatocellular Carcinoma at a Tertiary Care Facility in Bandung: An Annual Observation Study
Get PDFBackground: Hepatocellular Carcinoma (HCC) is the most prevalent liver cancer with high mortality. Early detection is important for better patient outcomes. The aim of this study was to explore clinical manifestations and laboratory examinations among HCC patients in a tertiary care facility.Methods: This was a cross-sectional descriptive study with a total sampling method, reviewing the medical record of patients with HCC in the Outpatient Clinic of Dr. Hasan Sadikin General Hospital between January to December 2019. Clinical manifestations, laboratory findings, and imaging results data were collected.Results: Of the 112 HCC patients included in this study, the HCC findings among new patients at the outpatient clinic were 8.4%, with hepatitis B (80.8%) as the major etiology. Complaints of abdominal pain (65.2%) was frequent. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were increased in 89.8% and 67% of patients, as well as total bilirubin levels in 58.8% of patients. In contrast, hemoglobin and albumin levels decreased in 55.3% and 78.1% of patients, respectively. The characteristics of tumor were mainly multinodular, with a size of 3-10 cm.Conclusions: The annual proportion of HCC in Dr. Hasan Sadikin General Hospital in 2019 is 8.4% among all outpatient gastrointestinal and hepatology cases, with hepatitis B as the most common etiology. Abdominal pain is the predominantly prevalent clinical manifestation with increased ALT and AST levels
Proportion of Traumatic Avascular Necrosis on Hip Joint at Dr. Hasan Sadikin General Hospital Bandung in 2016–2020
Get PDFBackground: Traumatic factors affecting the femur such as fractures and dislocations can cause complications in the form of avascular necrosis (AVN), if not treated immediately, AVN is one of the contributors to total hip arthroplasty (THA) usage and disability which will have an impact on productivity and quality of life. Hence, it is necessary to understand the epidemiology of AVN caused by traumatic factors. This study aimed to determine the proportion of traumatic AVN on the hip joint at Dr. Hasan Sadikin General Hospital. Methods: A Descriptive-observational study with a cross-sectional study design was conducted on all patients registered in the medical record database, with a diagnosis of AVN on the hip joint at Dr. Hasan Sadikin General Hospital Bandung in 2016–2020. Traumatic AVN was included and patients with incomplete medical record data were excluded.Results: In total, 210 patients were registered in the medical records and only 56 had complete medical records, and 10.5% (22 of 210) were diagnosed with traumatic AVN of the hip joint, consisting of 14 male with most of the trauma (n=11) caused by AVN were femoral neck fractures and 20 patients were of productive age (18–64 years old). Most of the patients underwent surgical therapy with a THA (n=20).Conclusion: The proportion of AVN on the hip joint caused by trauma is 10.5%. However, this disease should not be underestimated because AVN has the potential to cause disability and impact the quality of life
Neutrophil-to-Lymphocyte Ratio and Covid-19 Symptom-based Severity at Admission
Get PDFBackground: Increased Neutrophil-to-Lymphocyte Ratio (NLR) is an independent risk factor for mortality in Covid-19 patients and is considered as an early warning sign of Covid-19 severity. This study aimed to observe the differences in NLR at admission between patients with mild, moderate, and severe symptoms of Covid-19 treated in a referral hospital in Banda Aceh, Indonesia.Methods: A total of 114 patients with Covid-19 admitted to a referral hospital in Banda Aceh, Indonesia, during March–September 2020 were included in this study. Demographic information and baseline laboratory data, including the NLR, were collected. Descriptive and inferential statistics were used to analyze the data. Results: The median NLR at admission was higher among patients with moderate to severe symptoms than those with mild symptoms [6.54 (2.80–97.00, IQR 4.81–9.44) vs 2.27 (0.79–5.07, IQR 1.43-2.98), p <0.001]. Covid-19 patients who died had a higher NLR than those who survived [10.88 (4.17–47.50, IQR 7.00–15.17) vs 6.15 (2.80–97.00, IQR 4.63–8.50), p 0.02]. Patients with moderate-severe symptoms had an initial NLR of 4.63–8.50 and decreased to 2.75–5.43 at the end of the treatment had a greater chance of survival. There was an increased probability of death in patients with moderate-severe symptoms whose initial NLR was 7.00–15.17, which was then elevated to 14.33–23.25.Conclusion: Different NLR at admission is seen among Covid-19 patients with mild and moderate-severe symptoms, leading to significantly different outcomes. The NLR can be used as a simple parameter to determine the severity of the disease and predict the outcome of Covid-19 patients
Clinical Manifestation and Hematologic Interpretation of Pediatric Systematic Lupus Erythematosus at Initial Presentation: 2-Years Observation
Get PDFBackground: Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by a spectrum of clinical manifestations, immunological abnormalities, and varied laboratories results. In children, SLE manifestation is particularly more severe, involving more organs. Hematological manifestation has been known as the most common manifestation. The purpose of this study was to describe the clinical manifestations and hematologic interpretation of pediatric SLE at initial presentation.Methods: This retrospective data collection study was conducted at the Department of Child Health Dr. Hasan Sadikin General Hospital Bandung on medical records from a two-year period of 2017–2018. The clinical manifestations were categorized into malar rash, discoid rash, photosensitivity, oral ulcers, arthritis, renal disorders, and neurological disorders. The hematologic interpretations were categorized into anemia, leukopenia, neutropenia, lymphopenia, and thrombocytopenia. Clinical manifestations and hematological interpretations were presented as occurrence percentages and stratified into three age-group of pre-pubertal, peri-pubertal, and post-pubertal.Results: Among 79 pediatric SLE patients (median age 14 years old; IQR 11–16), female gender was predominant. Abnormalities hematologic interpretation occurs in more than half of the patients (83.5%). Malar rash and anemia were the commonest findings among all age groups. Increased occurrence of neuropsychiatric and renal disorders were observed in all age-groups.Conclusions: Malar rash and anemia are important findings among pediatric SLE patients. Furthermore, the occurrences of the neuropsychiatric and renal disorders are also important
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
Readiness of Health Workers to Provide Pregnancy Planning Program for Women Infected with Human Immunodeficiency Virus: A Case Study in Surabaya, East Java, Indonesia
Get PDFBackground: The prevalence of human immunodeficiency virus (HIV) mother-to-child infection, or vertical transmission of HIV, in Indonesia is about 90%. Ministry of Health of the Republic of Indonesia Regulation No. 21 of 2013 stated that HIV infection in sexual productive age needs integrative professional help to lower the transmissions, including voluntary counseling and testing for pregnant women as well as all people at risk. This study aimed to determine the readiness of health workers to provide pregnancy planning program service for women with HIV.Methods: This study was a descriptive study involving 30 obstetricians and 30 residents of Obstetrics and Gynecology specialist education in Surabaya, Indonesia. The respondents’ knowledge on pregnancy planning for HIV-infected women based on based on guidance released by the Ministry of Health of Indonesia in 2017 and Regulation of Ministry of Health no. 52 the year 2017, as well as their attitude and readiness to provide pregnancy planning services, was explored. Questionnaires were distributed from August to December 2019 and the data collected were analyzed using Statistical Package for the Social Science (SPSS) version 17.0 and results were described in percentage.Results: Most health workers (80%) had good knowledge on providing pregnancy planning program for HIV positive women; however, only 63.3% had good attitude towards it. The majority of respondents (90%) were ready to help HIV patients in planning their pregnancy. Conclusion: Health workers in Surabaya are ready to provide services related to pregnancy planning for women infected with HIV
Relationship between Narcissism, Self-Esteem, and Social Media Addiction in Preclinical Medical Students
Get PDFBackground: Narcissism is a condition in which people have a constant demand to be complimented and prioritized. Self-esteem is a subjective evaluation of one's worth. Several studies have linked narcissism and low self-esteem as a risk factor of social media addiction, a disorder where individuals displayed an unhealthy compulsion to access social media until it disrupts other activities. This study aimed to discover the relationship between narcissism, self-esteem, and social media addiction in preclinical medical students. Methods: This study was a cross-sectional observational analytical study on 211 preclinical medical students at the Atma Jaya Catholic University of Indonesia. Instruments used in this study were Narcissistic Personality Inventory-16 (NPI-16), Rosenberg Self-Esteem Scale (RSES), and Bergen Social Media Addiction Scale (BSMAS). Data were analyzed statistically using Chi-square in STATA analytic program.Results: Of all respondents, 6.6% were narcissistic, 19.9% had low self-esteem, and 34.6% had social media addiction. There was a significant relationship between narcissism and social media addiction (p=0.021) and between self-esteem and social media addiction (p=0.002).Conclusion: There is a relationship between narcissism, self-esteem, and social media addiction in university students. This indicates the importance of preliminary psychological screening in students, especially regarding self-esteem, narcissism, and social media addiction, to develop approaches that will ensure good academic achievements and physical health among students
Visualization of Carotid Doppler in Patients with Ischemic Stroke at Dr. Hasan Sadikin General Hospital Bandung Year 2016-2019
Get PDFBackground: Various pathological changes in both the intra and extracranial arteries that supply the brain can cause disturbance of cerebral blood flow and perfusion leading to cerebral dysfunction. Doppler ultrasound is able to assess these changes. This study was performed to evaluate the anatomical and physiological changes found in the carotid arteries of patients with ischemic stroke using Doppler ultrasound.Methods: The cross-sectional descriptive study design with total sampling method was conducted on the medical records of ischemic stroke patients who had carotid Doppler ultrasound at the Department of Cardiology and Vascular Medicine Dr. Hasan Sadikin General Hospital Bandung from 2016 to 2019. Demographic data, such as stroke diagnoses and plaque characteristics recorded in the Doppler reports were collected.Results: There were 38 data sets collected. The distribution and characteristics of atherosclerotic plaques were similar between the two carotid systems, with the same percentage of plaque being found in the right (31.6%) and left (36.8%) carotid system. The most common type of plaque found was type III and was located in the common carotid artery. Thrombus was absent in all patients. Intimal media thickening was found in 13.2% right system and 15.8% left system. Stenosis was present in 34.2% of patients, and most had 125 cm/s) in 5.3% of the right system and 7.9% of the left system of the internal carotid artery.Conclusions: Most of the atherothrombotic and thromboembolic type of ischemic stroke patients in this study have normal carotid Doppler ultrasound features. Further study on the presence of plaque in ischemic stroke patients in Indonesia is needed
Histopathological Findings in Sudden Cardiac Death: 5-years Autopsy Experience in a Tertiary Hospital in Bandung, Indonesia
Get PDFBackground: Sudden death (SD) is a sudden and unexpected death with an unknown cause. However, it has been assummed that the most common causes of sudden deaths are cardiovascular or non-cardiovascular causes such as gastrointestinal disease, respiratory disease, genitourinary disease, epilepsy, and trauma. This study aimed to portray histopathological findings and causes of sudden cardiac death (SCD) cases based on 5 year autopsy experience in a tertiary hospital in Bandung, Indonesia. Methods: This study was a descriptive cross-sectional study exploring causes of SCD from 2015 to 2019 at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. All medical records with SCD and histopathology findings were retrieved from September to December 2020. Only cases with histopathological examination results were included.Results: SCD was found in 7 of 16 patients with sudden death. Coronary atherosclerosis was the most common (n=4), followed by myocardial infarction (n=2) and ruptured aortic aneurysm (n=1). Myocarditis and calcific aortic valve diseases were not found.Conclusions: In this study, the most common cause of SCD is coronary atherosclerosis, which is identified mainly in older and male patients
Vascular Endothelial Growth Factor Expression in Correlation with Stage Juvenile Nasopharyngeal Angiofibroma
Get PDFBackground: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign tumor of mesenchymal tissue, originating from the stromal and blood vessels with dense collagen. However, JNA has a malignant tumor-like property because it can cause erosion of surrounding bone. Vascular Endothelial Growth Factor (VEGF) plays a role in the angiogenesis process. The expression of VEGF is the best marker to determine the occurrence of angiogenesis in JNA. This study aimed to determine the correlation between VEGF expression and JNA clinical stage. Methods: This was a cross-sectional correlational analytic observational study on medical records and paraffin blocks of all patients with JNA at Dr. Hasan Sadikin General Hospital Bandung during the period of 2016 to 2019. Immunohistochemistry examination of VEGF expressions was performed and VEGF expression was rated based on staining intensity, percentage distribution, and histoscore. Data were then analyzed using the Spearman correlation test.Results: Of 24 patients, 23 males and 1 female, 58% demonstrated a strong intensity of staining. The positivity of VEGF cell percentage was identified as 26–50% (n=6 patients), 51–75% (n=11), and >75% (n=7). The median VEGF histoscores were 2.5, 6.5, and 12 in JNA stage I, stage II, and stage 3, respectively, with the greater VEGF histoscore had a higher clinical stage with a correlation coefficient of (rs) 0.723 (p=0.002). Conclusions: There is a strong correlation between increased VEGF expression and JNA clinical stage. VEGF expression can be used as a prognostic factor of JNA