Korelasi antara Modification of Diet in Renal Disease (MDRD) dan Cystatin C Serum pada Usia 40–70 Tahun

Pelaporan estimasi laju filtrasi glomerulus (eLFG) pada setiap hasil pemeriksaan kreatinin dianjurkan, walaupun saat ini tidak semua laboratorium mencantumkan pada hasil pemeriksaan. Modification of Diet in Renal Disease (MDRD) merupakan formula yang digunakan untuk mengestimasi laju filtrasi glomerulus menggunakan kreatinin serum. Cystatin C serum merupakan pemeriksaan yang relatif baru dan petanda yang baik untuk menilai fungsi ginjal. Penelitian ini bertujuan mengetahui korelasi antara MDRD dan cystatin C serum. Penelitian ini menggunakan data sekunder dari 260 subjek penelitian usia 40–70 tahun yang memeriksakan kreatinin serum dan cystatin C serum selama periode Januari 2013–September 2014 di laboratorium klinik swasta di Jakarta Barat dengan desain potong lintang. Hasil penelitian menunjukkan bahwa usia rata-rata subjek 55,7+7,8 tahun. Kadar cystatin C serum rata-rata 0,99 + 0,6 mg/L, MDRD 80,24±28,1 mL/min/1,73m2. Terdapat korelasi negatif antara MDRD dan cystatin C serum dengan r=-0,767, p=0,001 (uji Pearson). Disimpulkan bahwa semakin tinggi nilai MDRD, nilai cystatin C serum semakin rendah. MDRD dapat digunakan sebagai alternatif uji fungsi ginjal bila pemeriksaan cystatin C serum tidak tersedia

The Air Quality and Detection of Streptococcus pneumoniae in the Pediatric Ward of Dr. Hasan Sadikin Hospital Bandung

Background: Nosocomial infection can be acquired by inhalation of droplets from contaminated air. In children, nosocomial pneumonia is mainly caused by Streptococcus pneumoniae. This study aimed to explore the air quality level and to detect Streptococcus pneumonia in the air of the Pediatric Ward of Dr. Hasan Sadikin Hospital, Bandung. Methods: This was an observational descriptive study conducted in the Pediatric Ward of Dr. Hasan Sadikin Hospital in November 2012. The different number of modified tryptic soy agar (TSA) plates with 4% blood were exposed and placed in various rooms of the ward for 30 minutes between 12.00 pm to 1.00 pm at heights between 1.0m to 1.5m and according to the respectively room air volume. After exposure, these plates were then incubated for 48 hours at 35°C. The Colony Forming Units (CFU) on each plate was counted per Replicate Organism Detection and Counting (RODACTM). Detection of Streptococcus pneumonia was performed by detecting any round α-hemolytic colonies on the TSA plate, confirmed by Gram staining, optochin susceptibility test, and the bile solubility test. Result: The air quality in 13 rooms of the Pediatric Ward was generally poor ranging from 27.5 to 232.0 CFU/30 min, however, the concentration of microorganisms per cubic meter air was from 0.198 to 4.296 CFU/m3. Moreover, Streptococcus pneumoniae was not present in the air of the ward.Conclusions: Although Streptococcus pneumoniae has not been detected, the air quality in the Pediatric Ward of Dr. Hasan Sadikin Hospital, Bandung is generally poor. General precautions need to be enhanced to increase the air quality in the hospital. 

Factors Influencing the Cervical Cancer Screening uptake among Medical Lecturers at Faculty of Medicine Universitas Padjadjaran

Background: Cancer is the leading cause of death worldwide. In Indonesia, cervical cancer is one of the most occurring types of cancer. It is acknowledged that early screening can prevent cervical cancer. This study aimed to explore what factors influenced the screening uptake and to correlate characteristics, perceived susceptibility, and self-efficacy of Pap smear uptake among medical faculty lecturers.Methods: This was a cross-sectional analytical study conducted among female lecturers in the Faculty of Medicine, Universitas Padjadjaran from October to November 2013. The questionnaire was used to collect data using a purposive sampling method. Data collected were tabulated into frequency and percentage and the correlation was performed using Pearson chi-square. Results: From a total of 79 respondents who participated, only 55.7% of medical lecturers had ever taken Pap smear. Reasons for not taking Pap smear were time (77.1%) and the perception of not being at risk (22.9%). However, most of the respondents (84.8%) were willing to have a screening test for cervical cancer routinely. There was a significant correlation between age (p=0.001), level of education (p=0.003) and duration of marriage (p=0.001) with the uptake of Pap smear.Conclusions: The factors that are influencing the uptake of screening are not having the time to take the test and the perception of not being at risk of the disease. There is a correlation between age, level of education and duration of marriage with screening uptake. Awareness of the importance of screening should also be promoted among female doctors

Neutrophil to Lymphocyte Ratio within Clinical Staging of Head and Neck Squamous Cell Carcinoma

Background: Neutrophil to lymphocyte ratio (NLR) is one of the inflammatory markers, associated with malignancies progression and metastasis, including head and neck squamous cell carcinoma (HNSCC). Neutrophil to lymphocyte ratio is presenting the activity index of protumor and antitumor. It is easy to perform in daily clinical practice, obtained from blood examination. The aim of this study was to assess the prognostic value of NLR in HNSCC patients, associated with the clinical staging.Methods: This study was an analytic design to explore the relationship between NLR and clinical staging. The sample was collected from pre-treatment HNSCC patients who came to the Head and Neck Oncology Clinic, Dr.Hasan Sadikin General Hospital. The data consisted of disease history, ENT examination, staging determination, and blood sample examination for NLR count.Results: In total, data on 92 HNSCC patients were collected. There was a statistically significant association between NLR with clinical staging in HNSCC (p<0.001). The higher the NLR, the higher the clinical stage, whereas the lower the NLR, (OR14.1; 95% CI 3.4–59.0).Conclusions: There is a significant association between NLR with clinical staging in HNSCC. Further study is needed to explore NLR as a prognostic marker in HNSCC patient

Propolis of Trigona spp. Protects Mucosa from Aspirin-Induced Gastric Mucosal Damage in Rats

Background: Helicobacter pylori and non-steroid anti-inflammatory drugs are the major causes of peptic ulcer in the world. Indonesian native stingless bee species, Trigona spp., produces propolis that might be effective to protect mucosal damage. The aim of the study was to determine the protective effect of Trigona spp. propolis on aspirin-induced gastric mucosal damage in rats.Methods: This experimental study was conducted from September–November 2013 at Animal Laboratory of Department of Pharmacology and Therapy Faculty of Medicine Universitas Padjadjaran. Healthy male Wistar rats (n=24) aged 2–3 months old and weighed 200–250 grams were randomly divided into three groups. The first group was control negative, the second group was given 100 mg/kg body weight of aspirin, and the third group was given 200 mg/kg body weight of Trigona spp. propolis, one hour before administration of 100 mg/kg body weight of aspirin. After two weeks of treatment, rats were sacrificed by laparotomy to obtain gastric tissues, followed by processing for the paraffin section for histopathological analysis. The grade of gastric mucosal damage was determined under a light microscope. Data were then compared between groups using the Mann-Whitney test.Results: Oral administration of aspirin-induced gastric mucosal damage ranging from grade 0 to grade IV; whereas administration of propolis showed a reduction of gastric mucosal damage’s grade when compared to the aspirin group (p<0.05).Conclusions: Trigona spp. propolis has a protective effect on aspirin-induced gastric mucosal damage. Further study is encouraged to study an optimal dose of aspirin after propolis administration.

Effect of Preoperative Anti Tuberculosis Drug Administration Duration on Tuberculous Spondylitis Surgical Treatment Outcomes

Preoperative anti-tuberculosis (TB) drugs play a role in surgery of TB spondylitis patients to prevent transmission in the operating room, reduce inflammatory processes and prevent relapse. Currently, there is no study on effects of preoperative anti TB drugs administration duration on the spinal TB patients surgical outcome at Dr. Hasan Sadikin Hospital (RSHS). This study used retrospective method by analyzing medical record data of TB spondylitis patients operated at RSHS, January 2014–May 2018. Based on the preoperative TB drugs duration, patients were divided into 2 groups: preoperative TB drugs group <2 and 2–4 weeks. Data analyzed were identity, duration of preoperative TB drugs administration, preoperative neurologic grade, preoperative CRP and ESR level, and postoperative data at 2 month follow up consisted of neurologic grade, postoperative CRP and ESR levels. The 58 patients consisted of 25 males and 33 females, Kolmogorov-Smirnov test showed a significant difference (p<0.05) in postoperative neurologic grade between preoperative TB drugs administration <2 vs 2-4 weeks. Unpaired T-Test showed postoperative CRP and ESR levels were significant (p<0.05). Postoperative neurologic grade in the preoperative TB drugs <2 weeks group was better vs the 2–4 week group. Operative procedure is more important in TB spondylitis patients treatment compared to a prolonged preoperative TB drugs administration. Pengaruh Lama Pemberian Obat Anti Tuberkulosis Preoperatif Terhadap Hasil Pengobatan Spondilitis Tuberkulosis yang Mengalami Tindakan OperatifObat anti tuberkulosis (OAT) preoperatif memiliki peranan penting dalam pembedahan pasien spondilitis tuberkulosis sebagai pencegahan penularan di kamar operasi, menurunkan proses inflamasi, dan mencegah relaps. Sampai saat ini belum terdapat penelitian mengenai pengaruh lama pemberian OAT preoperatif terhadap hasil pembedahan pasien spondilitis tuberkulosis di Rumah Sakit Dr. Hasan Sadikin Bandung (RSHS). Penelitian ini menggunakan metode retrospektif dengan menganalisisa data rekam medis pasien spondilitis tuberkulosis yang dioperasi di RSHS periode Januari 2014–Mei 2018. Berdasar atas lama pemberian OAT preoperatif, sampel dibagi menjadi 2 kelompok, yaitu kelompok pemberian OAT preoperatif <2 dan 2–4 minggu. Data yang dianalisis berupa identitas, lama pemberian OAT preoperatif, tingkat neurologis preoperatif, kadar CRP dan LED preoperatif, dan data post-operatif saat follow up 2 bulan berupa tingkat neurologis, kadar CRP, dan kadar LED. Terdapat 58 pasien terdiri 25 laki-laki dan 33 perempuan, uji Kolmogorov-Smirnov menunjukkan bahwa terdapat perbedaan yang signifikan (p<0,05) pada tingkat neurologis post-operatif antara kelompok OAT <2 vs. 2–4 minggu. Uji-t tidak berpasangan memperlihatkan bahwa kadar CRP dan LED post-operatif ditemukan bermakna secara signifikan (p<0,05). Tingkat neurologis postoperatif pada kelompok pemberian OAT preoperatif <2 minggu lebih baik bila dibandingkan dengan kelompok 2–4 minggu. Tindakan operasi lebih berperan penting terhadap hasil pengobatan pasien spondilitis tuberkulosis jika dibanding dengan lama pemberian OAT preoperatif

Comparison of Cognitive Functions between Paroxysmal and Persistent Atrial Fibrillation Patients without Clinical Stroke

Objective: To compare cognitive functions between paroxysmal and persistent atrial fibrillation patients without clinical stroke, in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores. Methods: A comparative study that compared MoCA-Ina scores between paroxysmal and persistent AF patients without clinical stroke, who came for treatment at the Cardiology Clinic Dr. Hasan Sadikin General Hospital, Bandung and Dustira Hospital, Cimahi from September 2018–January 2019. Results: Sixty four subjects were recruited, consisted of 24 paroxysmal and 40 persistent AF patients. There were no difference in clinical characteristics between two groups, except that there were more subjects in the persistent AF group using anticoagulants therapy: 97.5% vs 62.5% (p=0.005) and more prevalence of type 2 Diabetes Mellitus in the paroxysmal AF group: 25% vs 2.5% (p=0.009). Cognitive impairment (MoCA-Ina score 0.05).Conclusion: There were no differences in cognitive functions between paroxysmal and persistent AF patients, both in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores, although in both groups had cognitive decline

Anti-migration Effect of Aaptos suberitoides Fraction in HCT-116 Colorectal Cancer Cell Line

Background: Colorectal cancer is the second leading cause of mortality and the most prevalent cancer worldwide. Most patients, who come with late-stage, have ineffective treatments and some side effects in chemotherapy. Aaptos suberitoides has potential anti-cancer effects due to its bioactive compounds such as aptamine. This study aimed to evaluate the migration inhibition effect of Aaptos suberitoides fraction in HCT-116 cell line.Methods: This study was an experimental study. Aaptos suberitoides specimen was taken in Tinjil Island and fractionated with ethyl acetate. HCT-116 cell line was added with Aaptos suberitoides fraction and cellular migration activity was observed in 48 hours of which the scratch assay was performed. The gap closure area was determined with ImageJ software.Results: The data showed that a low concentration of Aaptos suberitoides fraction inhibited migration activity in HCT-116 cell line as follow; 1 and 5 mg/L Aaptos suberitoides fraction inhibit 3-4 % cancer cell migration in 24 hours, and 10-11% inhibition in 48 hours, respectively. However, 10 mg/L fraction concentration only inhibited 7-14% of the migration effect.Conclusion: Aaptos suberitoides fraction suggests insignificant migration inhibition in colorectal cancer cells and only inhibits less than 15 % HCT-116 cell line

Relationship between the Quality of Informed Consent at Surgical Procedure in Terms of Ethics and Medicolegal with Satisfaction of Patient Health Service in dr. Zainoel Abidin Hospital

Objective: To determine the relationship between the quality of informed consent in terms of ethics and medicolegal with patient health service satisfaction at the dr. Zainoel Abidin Hospital (ZAH) Banda Aceh.Method: This study is an observational analytic with a cross-sectional method. Subject selection through a total sampling method. This study involved patients who were treated at dr. Zainoel Abidin Hospital (ZAH) Banda Aceh and a total of patients were 100 (52 men and 48 women) who met the inclusion criteria carried out on 16 December 2019 to 31 December 2019.Results: As many as 90% of respondents rated informed consent made at ZAH as good quality and 85% expressed the satisfaction with health services at ZAH. An ethical and medicolegal review of informed consent emphasizes the basic principles of bioethics. As many as 84% of respondents stated that their autonomy rights had been fulfilled, 92.50% thought that the doctor had done beneficence, nonmaleficence, and justice well in the process of informed consent and 92.33% of respondents rated the three elements of informed consent as being well implemented. Based on the results of the chi-square statistical test showed a significant relationship between the quality of informed consent in terms of ethics and medicolegal with patient health service satisfaction under the value of p = 0.001 (p≤0.05).Conclusion: Good quality of informed consent in terms of ethics and medicolegal has an important role in increasing patient satisfaction with health services at the dr. Zainoel Abidin Hospital of Banda Aceh

Length of Stay Children Hospitalized with Chronic Kidney Disease Based on Etiology and Stage in Dr. Hasan Sadikin Hospital Bandung

Objectives: This study aims to describe the LOS children hospitalized with CKD based on the etiology and stage at Dr. Hasan Sadikin General Hospital, Bandung in 2016–2018.Methods: This was a retrospective study with a cross-sectional design from June–October 2019. The inclusion were all medical records of pediatric inpatient diagnosed with CKD and exclusion criteria were incomplete medical record data and hospital readmission patients. The variables studied were CKD etiology, CKD stage, and length of stayResults: From 103 patients, the etiologies found were steroid-resistant nephrotic syndrome (SRNS) (58.25%), congenital anomalies of kidney and urinary tract (9.71%), urinary tract infection (5.83%), and chronic glomerulonephritis (21.36%). The mean LOS was 19 days. The longest LOS found in CKD stage 5 patients caused by SRNS (141 days). Meanwhile, the shortest LOS was found in CKD stage 2 patients caused by chronic glomerulonephritis and CKD stage 5 patients were caused by SRNS who died (1  day). Conclusion: Pediatric patients with CKD stage 5 with SRNS has the potential to have a longer LOS than other etiologies