Charasteristics of COVID-19 Patients Treated At Santa Elisabeth Medan Hospital 2020

Corona Virus Disease (COVID-19) is a disease caused by a new type of coronavirus (SARS-CoV-2). This virus was first discovered in Wuhan, China for the first time and has infected 90,308 people as of March 2, 2020. Infection is transmitted by large droplets or droplets within 1 - 2 m, which are generated during coughing and sneezing by symptomatic patients and people without symptoms. This infection is acquired by inhaling these droplets or touching a contaminated surface and then touching the nose, mouth and eyes.  To see the characteristics of COVID-19 patients who are treated at the Santa Elisabeth Hospital Medan in 2020.  Type of research is a descriptive study with a cross-sectional study design with a retrospective approach using total sampling technique. This type of research data is secondary data obtained from the medical record data of positive COVID-19 patients confirmed to be hospitalized in several Medan city hospitals in 2020.Of the 230 study samples, 147 confirmed positive COVID-19 patients were found, dominated by the age range 46-55 years. The sex most common is male. The most common clinical symptoms are respiratory disorders such as coughing, shortness of breath and fever.The number of confirmed positive patients at the hospital. Santa Elisabeth in March to October 2020 is 147 people (51.1%)

Correlation Between Carbon Monoxide Level In Exhaled Air and Pulmonary Function On Grill Street-Vendors In Medan City

Background. Air pollution is the result of household waste responsible for 3.8 million death and 7.7% of all mortality over the world. One air pollutant which tends to increase year by year is carbon monoxide (CO). CO is produced as the result of the imperfect combustion of machines and the combustion of charcoal. The purpose of this study is to assess the correlation between CO level in exhaled air and pulmonary function on grill street-vendors in Medan city. Method: This study is an observational analytic with a cross-sectional approach. The subjects were grill in Medan city who fulfilled certain inclusion and exclusion criteria with the consecutive sampling method. This study data is primary data which is collected using a questionnaire, smokerlyzer, and spirometry. Result: The subjects of this study are 25 grill street-vendors. Most subjects in this study have red (40%) and green (32%) zone in CO exhaled test and as in pulmonary function test, restrictive (56%) and mixed-type (40%) are the most. The Spearman correlation result between CO level in exhaled air and pulmonary function  FEV1 and FVC are not significant (p=0.068 and p=0.251). Conclusion: There is no significant correlation between CO levels in exhaled air and pulmonary functio

The Characteristic of Secondary Lung Tumours in Medan

BACKGROUND: Metastatic malignant neoplasms are the most commonly known as secondary lung tumour. Any cancer could have the ability to spread to the lung. The secondary tumour most typically appears on radiologic findings are multiple nodules pleural effusion, etc. AIM: To observe the characteristic of secondary lung tumours patients in Haji Adam Malik General Hospital. MATERIAL AND METHODS: Research design is a cross-sectional with consecutive sampling to 53 patients that are diagnosed with secondary lung tumours. The data was taken from the medical record of secondary lung tumours diagnoses in Haji Adam Malik General Hospital medical record department. RESULTS: From the study, most cases are found in < 40-year-old age group with a percentage of 34%. The highest secondary lung tumour was ovarian carcinoma (13.2%) and multiple nodules (52.8%) from radiology images. Adenocarcinoma is the most found cytology/histopathology type which is around 69.8%. CONCLUSION: Female ages < 40 years are the group with the most cases of secondary lung tumours. Primary tumour from the ovarian is the main cause of secondary lung tumour

Analysis of Concordance of Medication-Taking Behaviour in Tuberculosis Patients in Medan, Indonesia

AIM: This study aimed to analyse tuberculosis (TB) medication-taking behaviour based on the concept of concordance between health workers and TB patients in Medan, Indonesia. METHODS: This study was an analytical study with a cross-sectional design. A total of 100 patients undergoing TB treatment at several public health centres in Medan City participated in the study. RESULTS: The results showed that there was a relationship between the concordance behaviour of the health workers with the attitude and medication-taking behaviour of the patients (p < 0.05). However, there was no relationship found between concordance and knowledge of the patients (p > 0.05). CONCLUSION: The results showed that most of the concordance behaviour, knowledge, attitude, and behaviour in the sample were good

RELATIONSHIP OF ATTITUDES AND PERCEPTIONS WITH ADHERENCE IN TREATMENT OF PULMONARY TUBERCULOSIS PATIENTS IN MEDAN, INDONESIA

  Objective: This study aimed to analyze the relationship of attitudes and perceptions about tuberculosis (TB) with adherence to the treatment of TB patients in Medan.Methods: A quantitative cross-sectional design. The target population was all patients who admitted to seven primary health centers (PHCs) in Medan. Samples were new TB patients aged >18 years old, with the result of acid-fast bacilli (+) (n=100). Assessment of behavioral adherence, attitudes, and perceptions of treatment were done based on treatment behavior instruments that had been validated and analyzed by the Chi-square test and logistic regression.Results: The results showed that 55% of the patients adhered to their medication. There was a relationship between attitude and adherence of TB treatment (p<0.05). However, there is no wrong perception correlation with treatment adherence (p>0.05). A good attitude increased 3.7 (95% confidence interval 1624; 8549) times for adherence to TB treatment.Conclusions: The positive attitude of the TB patients improved TB treatment behavior. Structured education provided by doctors and TB officers in PHC should be done to improve the knowledge and attitude of TB patients

Clinical Profile of Male Patients with Non-Small Cell Lung Cancer in Adam Malik General Hospital, Medan, Indonesia

BACKGROUND: Lung cancer is the most frequently found cancer among men around the world and is is the main cause of cancer deaths. The occurrence of lung cancer is particularly associated with smoking habit around men, along with environmental tobacco smoke in the workplace. It is diagnosed in patients with the varied clinical and demographical profile. AIM: We aimed to determine the clinical profile of men with non-small cell lung cancer in Adam Malik Hospital Medan based on age, smoking habits, occupation, clinical symptoms, clinical stage, and type of lung cancer histopathology MATERIAL AND METHODS: This is a descriptive study using medical record from 2012 to 2015 of all men with non-small cell lung cancer at Adam Malik Hospital Medan, Indonesia RESULTS: Most men with lung cancer are aged 51-60 years old (43.5%) and work like entrepreneurs. More than 80% of men with lung cancer are heavy smokers. Adenocarcinoma is the most common type of lung cancer, and 2/3 of lung cancer patients are diagnosed at an advanced stage. CONCLUSION: Lung cancer occurs most often in active smokers in the age group above 50 years. The most dominant type of histopathology is adenocarcinoma and is frequently diagnosed in the late stages

The role of oncogenes and tumor suppressor genes in determining survival rates of lung cancer patients in the population of North Sumatra, Indonesia [version 2; peer review: 2 approved]

Background: Gaining a better understanding of molecular alterations in the pathogenesis of lung cancer reveals a significant change in approach to the management and prognosis of lung cancer. Several oncogenes and tumor suppressor genes have been identified and have different roles related to survival rates in lung cancer patients. This study aims to determine the role of KRAS, EGFR, and TP53 mutations in the survival rate of lung cancer patients in the population of North Sumatra. Methods: This is a retrospective cohort study involving 108 subjects diagnosed with lung cancer from histopathology specimens. DNA extractions were performed using FFPE followed by PCR examinations for assessing the expressions of EGFR, RAS, and TP53 protein. Sequencing analysis was carried out to determine the mutations of EGFR exon 19 and 21, RAS protein exon 2, and TP53 exon 5-6 and 8-9. Data input and analysis were conducted using statistical analysis software for Windows. The survival rate analysis was presented with Kaplan Meier. Results: 52 subjects completed all procedures in this study. Most of the subjects are male (75%), above 60 years old (53.8%), heavy smokers (75%), and suffer from adenocarcinoma type of lung cancer (69.2%). No subjects showed KRAS exon 2 mutations. Overall survival rates increased in patients with EGFR mutations (15 months compared to 8 months; p=0.001) and decreased in patients with TP53 mutations (7 months compared to 9 months; p=0.148). Also, there was increasing Progression-Free Survival in patients with EGFR mutations (6 months compared to 3 months) (p=0.19) and decreasing PFS in patients with TP53 mutations (3 months compared to 6 months) (p=0.07). Conclusions: There were no KRAS mutations in this study. EGFR mutations showed a higher survival rate, while TP53 mutations showed a lower survival rate in overall survival and progression-free survival

Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment

Introduction: Patients with adenocarcinoma of the lung that have a common EGFR mutation, the Exon 19 Del mutation, survive better than those with the Exon 21 L858R mutation. This study examined whether there is a significant difference in prognosis between two common EGFR mutations, namely exon 19 Del and 21 L858R. This study compared OS (overall survival) and PFS (progression-free survival) in NSCLC patients with Exon 19 Del and Exon 21 L858R mutations who received EGFR-TKI targeted therapy at H. Adam Malik Hospital Medan. Methods: This analysis study used a retrospective cohort design to evaluate the OS and PFS of NSCLC patients who underwent EGFR-TKI precision medicine at H. Adam Hospital Malik Medan between January 1, 2017, and December 31, 2020 and also had Exon 19 Del and Exon 21 L858R alterations. Results: A total of 88 people were sampled. The majority of research subjects were male (60.2%). Median OS was eleven months (95 percent CI:9.594-12,406). According to the study's data, eight people (9.1%) survived until the study's ending. The median OS of Exon 19 Del Common Mutation was 11 months (95%CI 9,064-12,936). While Exon 21 L858R group had ten months (95%CI 4,546-15,454). The log-rank test identified no statistical difference in median OS between mutation types (p=0.562). Conclusion: The findings of this study revealed that subjects with Exon 19 Del mutations had a longer median OS and PFS than those with Exon 21 L858R variants. Nevertheless, there was no significant difference in median OS and PFS between study subjects with mutation of Exon 19 Del and Exon 21 L858R, which received the targeted medication

The Role of CYP2A6 Genetic Polymorphism in Nicotine Dependence and Tobacco Consumption among Bataknese Male Smokers

AIM: This research aimed to analyse the relationship between CYP2A6 gene polymorphism with nicotine dependence and its relation to the number of cigarette consumption among Bataknese smokers.METHOD: This study was a cross-sectional study involving 140 research subjects in Medan, Indonesia.RESULTS: Nicotine dependence rates were found to be significantly associated with the number of cigarette consumption expressed in the Brinkman Index.CONCLUSION: The *1A wild-type alleles have a greater risk of high-very high dependence rate compared to the other variants

Deciphering the Coagulation Factors in Pulmonary Embolism Incident-Based Thorax Enhanced Chest CT in COVID-19 Patient

Introduction: Pulmonary embolism is associated with coagulopathy in COVID-19. It is one of the causes of death in COVID-19 cases and is often underdiagnosed in Indonesia because computed tomography-pulmonary angiography (CTPA) is not used as the gold standard. T Methods: This study used a prospective analytical design with a cross-sectional approach. The study participants were 45 COVID-19 patients admitted to Santa Elisabeth Hospital, Medan, from January to March 2021. Patients were identified with moderate to severe degrees of COVID-19 and elevated D-dimer and subsequently instructed to undergo a thorax CT scan with IV contrast. The data was analyzed using dependent t-test statistical analysis. The p-value < 0.05 was noted as significant. Results: Moderate to severe coagulation factor values in COVID-19 patients with mean + SD PT, APTT, D-dimer, fibrinogen, and platelets were 14.11; 30.65; 1172.14; 423.56 and 215.822, respectively. In this study, 22 (48.9%) patients experienced a pulmonary embolism, while the other 23 (51.1%) did not. No significant correlation was found between all coagulation factors and embolism (p > 0.05). The mean + SD well score for pulmonary embolism was 0.23 + 0.57. Conclusion: Pulmonary embolism was detected in 22 patients (48.49%) with moderate to severe COVID-19 who developed hypercoagulation as indicated by the thorax CT scan with IV contrast. This case was quite common. In resource-constrained situations, a thorax CT scan with IV contrast may replace CTPA in diagnosing/detecting the presence of pulmonary embolism