AST to Platelet Ratio Index (APRI), Fib-4 Score, and Pregnancy Outcome of Pregnant Women with Hepatitis B

Hepatitis B virus infection in pregnancy has become a major concern in many developing countries,. The relationship between hepatitis B virus infection and pregnancy is complex and puzzling. This study aimed to investigate the relationship between hepatitis B virus infection and pregnancy outcomes with the insights into the AST to Platelet Ratio Index (APRI) and Fib-4 score. This was a cross-sectional study on pregnant women with hepatitis B virus infections who underwent labor at dr. Zainal Abidin Hospital General Hospital, Aceh, Indonesia. Data were collected from the obstetric ward patient medical records from 2017 to 2019 and 77 pregnant women was identified to be infected with hepatitis B virus, of which 44 had complete medical record data and were included in the analysis. The median APRI in this study was 0.30 (0.1-1.2) while the median FIB-4 score was 0.74 (0.3-1.9). Delivery with live births was identified in 42 (95.5%) women. Term pregnancy and vaginal delivery were observed in 39 (88.6%) and 10 (22.7%) women, respectively, Complicated pregnancy was seen in 14 (31.8%) of pregnancies that included complications such as oligohydramnios, HELLP, severe preeclampsia, placenta previa, and premature rupture of membranes. APRI was higher in the stillbirth group (0.5 [0.2-0.8] p = 0.682) and preterm birth group (0.4 [0.2-0.6], p = 0.502). FIB-4 scores were higher in the stillbirth group (1.2 [0.5-1.8], p = 0.517) and preterm birth group (0.9 [0.4-1.9], p = 0.529). Hence, pregnancy does not always worsen liver function and is not related to the natural course of hepatitis B infection. Pregnancy with hepatitis B without fibrosis is not associated with poor pregnancy outcomes. Routine liver function examination is needed in pregnant mothers with hepatitis B virus infections

Effect of Hypervirulent Strains, Antibiotic Resistance, and Host Characteristics on Mortality of Klebsiella pneumoniae Bacteremia Patients at a Tertiary Referral Hospital in Denpasar, Indonesia

Klebsiella pneumoniae bacteremia is one of the leading causes of sepsis that has a high mortality rate. The effect of multidrug resistance and different virulence of Klebsiella pneumoniae on mortality is still controversial. This study aimed to determine the impact of hypervirulent K. pneumoniae (hvKp), MDR, and clinical characteristics on mortality of K. pneumoniae bacteremia patients. A retrospective cross-sectional study was conducted on  K.  pneumoniae bacteremia cases of patients hospitalized at Professor dr. I.G.N.G Ngoerah General Hospital from December 1, 2020, to May 31, 2021. A positive PCR of rmpA, iucA genes, and/or a positive string test was identified as hvKp. The mortality rate of 51 K. pneumoniae bacteremia patients samples (aged 0-74 years) was 72.5%, in which 9.8% (5/51) of them were hvKp and 51% of the isolates (26/51) produced the Extended Spectrum Beta Lactamase (ESBL). Furthermore, 9.8% (5/51) of the cases were carbapenem-resistant. Thus, hvKp, MDR, gender characteristics, and comorbidities do not significantly affect the mortality of K. pneumoniae bacteremia patients. Multivariate logistic regression analysis showed that sepsis (odds ratio (OR) 4.29; p=0.038) and adult age group (mean 50 years) (OR 3.75; p=0.039) are independent predictors with a significant effect on mortality of  K. pneumoniae bacteremia patients. Careful and integrated management of K. pneumoniae bacteremia patients is essential for better outcomes, especially in sepsis and elderly patients. Although hvKp prevalence is low, emerging MDR-hvKp in health facilities is a severe concern for further actions and research

Pola Bakteri dari Jam Tangan dan Kacamata yang Dibawa ke Instalasi Bedah Sentral Rumah Sakit Dr. Moewardi Surakarta

Ruang bedah berperan sebagai penyebab infeksi nosokomial terutama akibat luka bedah. Transmisi patogen oleh tenaga kesehatan berperan penting dalam rute infeksi silang. Penelitian ini bertujuan mengetahui pola bakteri jam tangan dan kacamata tenaga kesehatan yang dibawa ke kamar operasi di Rumah Sakit Dr. Moewardi Surakarta. Penelitian menggnakan metode kuantitatif dengan pendekatan deskriptif laboratorik di Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta pada Juni–Juli 2018. Sampel adalah seluruh hardware yang dibawa masuk ke ruang bedah umum dan memenuhi kriteria inklusi. Hasil penelitian terhadap 40 hardware, yaitu 19 jam tangan dan 21 kacamata yang dipakai dan dibawa ke kamar operasi Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta. Hardware yang dibawa dan mengandung bakteri patogen sebanyak 33 hardware (83%). Hardware yang terkontaminasi patogen paling banyak adalah kacamata. Jenis bakteri yang paling banyak ditemukan adalah Staphylococcus hominis sebanyak 16 hardware (40%). Staphylococcus haemolyticus ditemukan pada 7 hardware (17%). Staphylococcus epidermidis ditemukan pada 4 hardware (10%). Simpulan penelitian ini adalah hardware yang diteliti mayoritas terdapat patogen (83%).Jenis bakteri yang paling banyak ditemukan adalah staphylococcus hominis pada 40% hardware.Ruang bedah berperan sebagai penyebab infeksi nosokomial terutama akibat luka bedah. Transmisi patogen oleh tangan petugas kesehatan berperan penting dalam rute infeksi silang. Beberapa jam tangan mengandung bakteri patogen, namun efeknya sebagaipembawa bakteri belum dapat dijelaskan. Penelitian ini bertujuan untuk mengetahui pola bakteri jam tangan dan kacamata yang dibawa ke kamar operasi di Rumah Sakit Dr. Moewardi Surakarta. Penelitian menggunakan metode kuantitatif dengan pendekatan deskriptif laboratorik di Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta pada Juni - Juli 2018. Sampel adalah seluruh hardware yang dibawa masuk ke ruang bedah umum dan memenuhi kriteria inklusi. Pengambilan sampel menggunakan metode swab dan dibawa ke Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Sebelas Maret untuk diidentifikasi. Data dianalisis dengan Uji Fhiser Exact Test. Hasil penelitian terhadap 40 hardware yaitu 19 jam tangan dan 21 kacamata yang dipakai dan dibawa ke kamar operasi Instalasi Bedah Sentral RS Dr. Moewardi Surakarta. Hardware yang dibawa dan mengandung bakteri patogen sebanyak 33 hardware (82,5%). Hardware yang terkontaminasi patogen paling banyak adalah kacamata, (p= 0,040). Jenis bakteri yang paling banyak ditemukan adalah Staphylococcus            hominis sebanyak 16 hardware (40,0%). Staphylococcus haemolyticus ditemukan pada 7 hardware (17,5%). Staphylococcus epidermidis ditemukan pada 4 hardware (10,0%). Kesimpulan dari penelitian ini adalah hardware yang diteliti dan terdapat pathogen ada 33 hardware (82,5%).Jenis bakteri yang paling banyak ditemukan adalah Staphylococcus hominis pada 40,0% hardware

Antibacterial Activity of Terminalia mantaly Stem Ethanol Extract as Hand Sanitizer Gel

Background: Hand sanitizers generally contain alcohol. However, it can cause dry and irritated skin. Therefore, it is necessary to find antibacterial alternatives that are safe for the skin. One of the plants that has antibacterial activity is Terminalia mantaly (T. mantaly). This study aimed to investigate the antibacterial activity of ethanol extract and hand sanitizer gel of T. mantaly.Methods: The antibacterial activity test against gram-positive (Staphylococcus aureus and Streptococcus pyogenes) and gram-negative bacteria (Escherichia coli and Shigella dysenteriae) was carried out using the liquid micro dilution method. The phytochemical tests were also performed. This study was conducted at the Chemistry Laboratory, Faculty of Sains and Informatics, Universitas Jenderal Achmad Yani in April-June 2022.Results: The ethanol extract of T. mantaly stem contained secondary metabolites of alkaloids, tannins, quinones, saponins, steroids, and flavonoids. The minimum inhibitory concentration (MIC) values of T. mantaly stem ethanol extract against Escherichia coli, Shigella dysenteriae, Staphylococcus aureus, Streptococcus pyogenes were 0.63%, 0.63%, 0.16%, and 0.16%, whereas the hand sanitizer gel gave MIC values of 0.63%; 0.31%; 0.16%; and 0.16% respectively. The minimum bactericidal concentration (MBC) values of T. mantaly stem ethanol extract and hand sanitizer gel had the same results, namely 2.50%, 0.16%, 1.25%, and 1.25%. The physical stability of the hand sanitizer gel from the ethanol extract of T. mantaly stem met the physical stability standards of the gel. Conclusions: The ethanol extract of the T. mantaly stems has stronger antibacterial activity against gram-positive bacteria than against gram- negative bacteria.     

Hepatoprotective Potentials of Dates Extract (Phoenix dactylifera) in Acetaminophen-Induced Mice

Dates (Phoenix dactylifera) are considered as a well-known fruit consumed by many people in various countries. This study aimed to examine potential effects of dates as a hepatoprotective agent in mice. This study was conducted at the Iratco Group’s eLRosa Laboratory Research Facility, Indonesia, starting from June 2022 to July 2022. Mice from ddY strain were randomly divided into 5 groups (n=5 per group) of positive and negative control groups, and treatment groups 1, 2, and 3. The negative control group as the normal baseline did not receive acetaminophen and date extract. In treatment groups, 30 µL/30 gr BW, 60 µL/30 gr BW,  and 100 µL/30 gr BW extract was given per oral to Treatment Group 1, Group 2, and Group 3, respectively for 20 days. On day 21, all  treatment groups were induced with 300mg/KgBW acetaminophen for 3 days via the intraperitoneal route. Blood tests were performed on day 24 to measure the serum transaminase level as the parameter of liver damage. The lowest level of transaminase serum was found in group 3 with the highest volume of dates extract, which was 100 µL, followed by group 2 (60 µL), and group 1 (30 µL). There was a significant difference between the positive control group and treatment groups with  no significant difference was seen between negative and the treatment groups. This study concludes that dates extract has the potential of being a hepatoprotective agent

Association between Maternal Hemoglobin Level and Incomplete Abortion in A West Java Tertiary Hospital, Indonesia

Objective: To evaluate the association between maternal hemoglobin concentrations and incomplete abortion.Methods: An analytic, cross-sectional study with consecutive sampling method was conducted using medical records of 45 pregnant women aged 18 – 35 years old visiting the Obstetrics and Gynecology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 1, 2017 to December 31, 2019. Participants were grouped into incomplete abortion and non-abortion groups.Results: Maternal characteristics in the incomplete abortion group showed that the majority of pregnant women in this group were 25.58 years of age, non-anemic (n=37, 82.22%), had no previous spontaneous abortion (n=40, 88.89%), and were nulliparous (n=25, 55.55%) with a mean interpregnancy interval of 4.03 years. The characteristics in both incomplete abortion group and non-abortion group were homogenous in the level of anemia (p-value=0.380), previous spontaneous abortion (p-value=1.00), and interpregnancy intervals (p-value=0.667). The mean hemoglobin concentration for the incomplete abortion group was 11.81 gr/dL (95% CI, 11.30 to 12.26). Heterogenous data was found in age (p-value=<0.001) and parity (p-value=0.002). Parity was a strong confounder, causing the hemoglobin concentration insignificantly associated to incomplete abortion (p-value=0.884).Conclusion: No statistically significant association is found between hemoglobin concentration and incomplete abortion. Most women with incomplete abortion are around 25 years old, nulliparous, non-anemic with a mean hemoglobin concentration of 11.81 gr/dL with no history of previous abortion, and a rather secure interpregnancy intervals

Perbandingan Morfin Dosis 0,05 Mg dengan 0,1 Mg Sebagai Adjuvan Bupivakain 0,5% 10 Mg Intratekal Terhadap Skala Nyeri dan Durasi Analgesia Pascaseksio Sesarea

Masalah pascaoperasi yang paling dikeluhkan oleh pasien yang menjalani seksio sesarea adalah nyeri akut pascaoperasi. Salah satu metode yang direkomendasikan dalam protokol Enhanced Recovery After Cesarean Section (ERACS) untuk mencegah nyeri akut pascaoperasi adalah penggunaan opioid long-acting intratekal dengan morfin intratekal sebagai baku standar. Penelitian dilakukan di RSUP Dr. Hasan Sadikin selama bulan Juli–Oktober 2022 Penelitian ini bertujuan menilai perbandingan intensitas nyeri dan durasi analgesia antara pemberian morfin 0,05 mg dan 0,1 mg sebagai adjuvan bupivakain 0,5% 10 mg intratekal pada pasien yang menjalani prosedur seksio sesarea. Penelitian ini merupakan penelitian eksperimental dengan rancangan double blind randomized controlled trial. Penilaian intensitas nyeri dan durasi analgesia pada pasien dihitung setiap 1 jam sejak operasi selesai (T0) hingga jam ke-24 (T24) pascaoperasi. Analisis statistik data numerik menggunakan uji t tidak berpasangan pada data berdistribusi normal serta uji Mann Whitney pada data tidak berdistribusi normal. Analisis statistik data kategorik menggunakan uji chi-square dan alternatif uji Eksak Fisher. Intensitas nyeri NRS jam ke-2, -3, -4, -5, - 6, dan -7 pada kelompok morfin 0,1 mg lebih rendah dibanding dengan kelompok morfin 0,05 mg dengan perbedaan yang bermakna secara statistik (p<0,05). Simpulan. durasi analgesia pascaseksio sesarea pada pemberian morfin secara intratekal dosis 0,1 mg lebih lama dibanding dengan dosis 0,05 mg. Masalah pascaoperasi yang paling dikeluhkan dan ditakuti oleh pasien yang menjalani seksio sesarea adalah nyeri akut pascaoperasi. Salah satu metode yang direkomendasikan dalam protokol Enhanced Recovery After Cesarean Section (ERACS) untuk mencegah nyeri akut pascaoperasi adalah penggunaan opioid long-acting intratekal, dengan morfin intratekal sebagai baku standar. Penelitian ini bertujuan untuk menilai perbandingan skala nyeri dan durasi analgesia antara pemberian morfin dosis 0,05 mg dengan 0,1 mg sebagai adjuvan bupivakain 0,5% 10 mg intratekal pada pasien yang menjalani prosedur seksio sesarea. Penelitian ini merupakan penelitian eksperimental dengan rancangan double blind randomized controlled trial terhadap kedua kelompok penelitian. Penilaian skala nyeri dan durasi analgesia pada pasien dihitung setiap 1 jam sejak operasi selesai (T0) hingga jam ke-24 (T24) pascaoperasi. Analisis statistik data numerik menggunakan uji t tidak berpasangan pada data berdistribusi normal serta uji Mann Whitney pada data tidak berdistribusi normal. Analisis statistik data kategorik menggunakan Uji Chi-Square dan alternatif Uji Exact Fisher. Terdapat perbedaan skala nyeri NRS jam ke-2, 3, 4, 5, 6, dan 7 yang bermakna secara statistik (p<0,05), dan perbedaan durasi analgesia yang bermakna (p<0,05) pada kedua kelompok. Skala nyeri pascaseksio sesarea pada pemberian morfin secara intratekal dosis 0,1 mg lebih rendah dibandingkan dengan dosis 0,05 mg. Durasi analgesia pascaseksio sesarea pada pemberian morfin secara intratekal dosis 0,1 mg lebih lama dibandingkan dengan dosis 0,05 mg

Perbandingan Terapi Albumin dari Ekstrak Channa Micropeltes Dan Channa Striata Terhadap Peningkatan Kadar Albumin pada Pasien Hipoalbuminemia

Suplemen albumin yang selama ini sering digunakan adalah ekstrak ikan gabus (Channa striata). Ikan toman (channa micropeltes) diduga memiliki protein yang lebih tinggi dari pada ikan gabus. Tujuan penelitian ini adalah membandingkan peningkatan kadar albumin dari ekstrak ikan toman dan ikan gabus dengan peningkatan kadar albumin darah pada pasien hipoalbuminemia. Penelitian ini dilakukan di ICU RSUD Dr. Muwardi Surakarta pada bulan November 2019–Januari 2020. Penelitian menggunakan uji klinis acak tersamar tunggal pada 30 pasien yang menjalani perawatan intensif dengan hipoalbuminemia yang telah memenuhi kriteria inklusi dan tidak termasuk eksklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok dengan pemberian albumin ekstrak ikan toman (A) dan kelompok pemberian albumin ekstrak ikan gabus (B). Kedua kelompok diberikan albumin dengan dosis 5 gram tiap 12 jam selama tiga hari berturut-turut. Dilakukan pencatatan kadar albumin darah sebelum perlakuan dan tiga hari berturut-turut sejak pemberian ekstrak albumin. Penelitian menunjukan hasil bahwa selisih perubahan kadar albumin hari ke 1-baseline kelompok A mengalami peningkatan rerata 0,17+0,12, sedangkan kelompok B 0,11+0,08 (p=0,163). Pada hari ke-2 baseline kelompok A mengalami peningkatan rerata 0,41+0,15, sedangkan kelompok B 0,39+0,21 (p=0,785); pada hari ke-3 baseline kelompok A mengalami peningkatan rerata 0,74+0,35, sedangkan kelompok B 0,55+0,23 (p=0,785). Simpulan, ekstrak ikan toman memberikan peningkatan albumin yang lebih baik dibanding dengan ikan gabus, meskipun tidak berbeda secara statistik. Hipoalbuminemia adalah kadar albumin darah kurang dari 3,5 g/dL. Pemberian suplemen peroral albumin selama ini menggunakan ekstrak dari ikan gabus (Channa striata). Ikan Toman (Channa micropeltes) diduga memiliki protein yang lebih tinggi dari ikan gabus. Tujuan ini adalah membandingkan peningkatan kadar albumin pada pemberian albumin teknologi nano dari ekstrak ikan toman dengan ekstrak ikan gabus pada penderita hypoalbuminemia. Penelitian menggunakan uji klinis acak tersamar tunggal pada 30 pasien yang menjalani perawatan intensif dengan hipoalbuminemia yang telah memenuhi kriteria inklusi dan ekslusi. Sampel dibagi menjadi 2 kelompok masing-masing 15 pasien, yaitu kelompok dengan pemberian albumin ekstrak Ikan Toman dan kelompok pemberian albumin ekstrak Ikan Gabus. Kedua kelompok diberikan albumin dengan dosis 5 gram tiap 12 jam selama tiga hari berturut-turut. Dilakukan pencatatan kadar albumin darah sebelum perlakuan dan tiga hari berturut-turut, serta efek samping dari pemberian ekstrak albumin. Penelitian menunjukan hasil bahwa selisih perubahan kadar albumin hari ke 1-Baseline kelompok A mengalami peningkatan rata-rata 0,17 +0,12, sedangkan kelompok B 0,11 +0,08 (p=0,163); pada hari ke 2 - Baseline kelompok A mengalami peningkatan rata-rata 0,41 +0,15, sedangkan kelompok B 0,39 +0,21 (p=0,785); pada hari ke 3 - Baseline kelompok A mengalami peningkatan rata-rata 0,74 +0,35, sedangkan kelompok B 0,55 +0,23 (p=0,785). Efek samping albumin hanya ditemukan keluhan mual muntah pada Kelompok A (2 pasien) dan Kelompok B (3 pasien). Simpulan, Albumin teknologi Nano Ekstrak Ikan Toman memberikan hasil peningkatan albumin yang lebih baik dibanding Ikan Gabus meskipun tidak berbeda signifikan secara statisti

Characteristics of Nasal Foreign Body Cases in Dr. Hasan Sadikin General Hospital Bandung

Background: Nasal foreign bodies are caused by the insertion of an extraneous substance into the nasal cavity. These cases frequently occur in children. Nasal foreign bodies are easily diagnosed, yet the treatment may be burdensome with possible complications and costly management. The study aimed to evaluate the characteristics of nasal foreign body cases.Methods: The study was descriptive and cross-sectional, using secondary data taken from all medical records of the Emergency Room in Dr. Hasan Sadikin General Hospital, Bandung, from 2018 to 2021. Data were presented in tables.Results: Of the 57 cases, most of the patients (64.9%) were aged 3-5 years, with boys as the most prevalent cases (59.7%) and the most common complaint was pain (31.7%). Inorganic foreign bodies (61.4%) were more commonly found, and being frequently found in the right nasal cavity (49.1%). The duration of the foreign body in the nasal cavity and the treatment conducted on the patients were mostly not written in the medical records, however, no complications were found.Conclusions: A higher incidence of nasal foreign bodies can be found in boys aged 3-5 years. Inorganic objects and pain are the most common manifestations, although the condition of all patients has been improved. Raising awareness about foreign body cases to the community, especially the parents, is the key to preventing these cases from occurring

Level of Knowledge, Attitude, and Behavior among Specialists of Otorhinolaryngology-Head and Neck Surgery in West Java Towards Cochlear Implants

Background: Hearing loss and deafness are still an issue in Indonesia, especially in West Java, with a prevalence of 2.5% and 0.06%, respectively. Cochlear implants are intended for patients with severe sensorineural hearing loss to stimulate the remaining auditory nerves. Based on their competency standards, Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Specialists are expected to be able to inform patients and families about the cochlear implantation procedures. This study aimed to explore the level of knowledge, attitudes, and behavior of ORL-HNS Specialists in West Java towards cochlear implants.Methods: This study was a descriptive study with a cross-sectional approach. Primary data were collected through a questionnaire filled out by ORL-HNS Specialists who were actively working in West Java in 2021–2022.Results: Data from 157 specialists showed that 41.4% (n=65) had good knowledge about cochlear implants, and 43.9% (n=69) had adequate knowledge, however, 62.4% (n=98) showed a negative attitude. In addition, 99.3% (n=156) showed good behavior.Conclusions: ORL-HNS Specialists in West Java have a sufficient level of knowledge, negative attitude, and good behavior towards cochlear Implants. The negative attitude of the specialists need to be bettered, updating their knowledge about how cochlear implants work and their effectiveness for patients with hearing impairments might give them a new perspective and hopefully change their attitude towards cochlear implants