Arifin Achmad General Hospital Research Articles

Neutrophil Lymphocytes Ratio (NLR) of One-Step and Multi-Step Procedure for Hirschsprung Disease Patients At Arifin Achmad General Hospital

Hirschsprung disease (HD) is a congenital anomaly due to intestinal aganglionosis starting from the internal anal sphincter and spreading to the proximal area with varies extension of the segment. Definitive treatment for this abnormality is to perform surgery to remove the aganglionic bowel and can be carried out in one-step and multi-step procedure. In the process of wound healing after surgery, it involves inflammatory mediators as a marker of whether there is a stress response from the endocrine system such as neutrophil-lymphocyte ratio (NLR). This study aims to compare NLR as an inflammatory biomarker in one-step and multi-step procedure of hirschsprung disease patients at Arifin Achmad Hospital. The design of this study was cross-sectional using medical records and using total sampling for number of samples. Age, gender, and method of surgery were evaluated by univariate and bivariate to determine whether there were statistical differences. Seven HD patient taken from Mei-October at Arifin Achmad Hospital taken for evaluated. The results showed that the most samples were in < 1-month-old (42.9%) and male (71,4%) for gender. The average number of NLR was in 7.33 after one-step procedure and 2.77 for multi-step procedure. This number of NLR both not statistically different neither for the post-operative examination nor the comparison between procedure.

Efek Steroid Terhadap Kadar Troponin I dan CRP Pada Pasien Bedah Jantung Koroner di RSUD Arifin Achmad Provinsi Riau

Steroids can diminish inflammation and forestall cardiac impairment in cardiac surgery cases, encompassing coronary heart surgery; however, this approach remains a topic of ongoing discussion. The present study investigated the ramifications of administering steroids in coronary heart surgery patients, focusing on the variations in CRP and Troponin I level at Arifin Achmad General Hospital in Riau Province. Employing a cross-sectional design, the study retrospectively reviewed medical records of individuals who had undergone coronary heart surgery between January 2018 and September 2020 at Arifin Achmad Hospital in Riau Province. Comparisons between Troponin I and C-Reactive Protein (CRP) levels were drawn contingent on the specific administered steroid (methylprednisolone or dexamethasone). The study further examined secondary outcomes, encompassing myocardial contractility, duration of ventilator employment, and Intensive Care Unit (ICU) length of stay, distinguishing patterns based on the steroid type. Among the 42 analyzed patients, the methylprednisolone and dexamethasone groups exhibited significant increases in troponin I and CRP levels (p<0.05). In contrast, changes in myocardial contractility pre- and post-surgery remained consistent across both groups—similarly, no substantial difference in ventilator or ICU stay duration. As the conclusion, dexamethasone and methylprednisolone have not given any effect in preventing increases in troponin I, CRP levels and myocardial contractility early after coronary heart surgery.

Lung Cancer In Former Tuberculosis Patients at Arifin Achmad General Hospital, Riau Province

Background: There is ongoing discussion over the connection between lung cancer and pulmonary tuberculosis (TB). Future lung cancer cases in Indonesia, which has the second-highest TB case burden, are a cause for concern. The purpose of this study is to ascertain the connection between TB and LC at Arifin Achmad General Hospital in the province of Riau. Method: From 2015 to 2018, we looked back on lung cancer patients at Arifin Achmad General Hospital in Riau Province who had received pulmonary tuberculosis and anti-tuberculosis treatment (ATT). Results: From 203 patients, 24 patients (11.8%) had histories of TB. The patients' ages were from 41 years to 60 years. The most prevalent pathological findings were adenocarcinoma in 13 patients (54.0%). The most common cancer stage was advanced stage IIIB in 7 patients (29.2%) Conclusion: The cases of TB infections were apparent in lung cancer patients, approximately around 11% of lung cancer cases. Therefore, it is necessary to assess the history of TB in lung cancer patients.

Lung Abscess Located in Lesion of Lung Tumor and Multiple Cavities due to Pulmonary Tuberculosis: A Case Report

Introduction: People with tuberculosis (TB) have an increased risk of pulmonary cancer. They are also disproportionately affected by risk factors like immune suppression, smoking, and alcohol misuse. A lung tumor is reported to have occurred after an episode of TB, but we reported a patient with a lung tumor with co-infection TB and lung abscess at the same time. Case: A 73-year-old man was hospitalized at Arifin Achmad General Hospital, Pekanbaru, with a 3-day history of bloody cough 2-3 times a day, 1-2 tablespoons estimated by the patient for blood from the cough. The patient had a cough with white phlegm in the last 4 months before the bloody cough. The patient also had a fever, night sweats, a limp body, decreased appetite for 6 months, and decreased body weight by 15 kg in the last year. Heterogenic consolidation on the superior lobe of the lung with prominence compression and irregular boundaries in the apex was found. We found an air bronchogram and multiple cavities with air-fluid levels inside the lesion. We also found a satellite nodule in the inferior lung and a mass connected with the chest wall. GeneXpert showed low detection for Mycobacterium tuberculosis. The patient was diagnosed with a left lung abscess, pulmonary TB, left lung tumor T4N2M1a, unspecified type of tumor stage IVA PS2, and osteoporosis. Conclusion: Lung tumors could also be diagnosed with co-infection TB. Proper diagnosis to make sure cancer and TB are co-infected is necessary. Therefore, it will not be just a single disease that is treated.

The Relationship between COVID-19 Vaccination and the Severity of COVID-19 in Patients Treated for the Period August 2021 – August 2022 at Arifin Achmad General Hospital, Riau Province, Indonesia

Background: The use of the COVID-19 vaccine is very effective in controlling the pandemic, but it is important to know that no vaccine is 100% effective in preventing the COVID-19 pandemic. Vaccination can make the disease milder so that the risk of infection, hospitalization, and death is lower in people who have been vaccinated compared to those who have not been vaccinated. This study aims to determine the relationship between COVID-19 vaccination and the severity of COVID-19 infection in patients treated at Arifin Achmad General Hospital, Riau Province, for the period August 2021 to August 2022.
 Methods: This study is an analytical observational research with a cross-sectional approach. A total of 403 research subjects were included in this study. Data analysis using Chi-square by looking for the relationship between the dependent variable and the independent variable. Ineligible bivariate data will be performed using the Fisher test with a p-value < 0.05 considered significant based on statistical tests.
 Results: The percentage of mild and moderate severity patients was generally the highest in the group who did not receive vaccination, with the percentage being 45.8%, followed by those who received booster (30.4%). Of the 54 cases of patients with severe-critical severity, 27 cases were dominated by patients who had no vaccination status at all, with a percentage of 50.0%. Subjects who did not receive vaccination had a 3.37 times higher chance of developing severe COVID-19 than those who were vaccinated (odds ratio = 3,37; 95% confidence interval [THERE] = 1,95-4,80).
 Conclusion: The relationship between COVID-19 vaccination and the severity of COVID-19 infection in patients treated at Arifin Achmad General Hospital, Riau Province, for the period August 2021 to August 2022.

Implementation of MRI (Magnetic resonance imaging) information system to improve service quality in radiology room Arifin Achmad general hospital

Implementation of MRI (Magnetic resonance imaging) information system to improve service quality in radiology room Arifin Achmad general hospital

The susceptibility pattern and distribution of blaOXA-23 genes of clinical isolate Acinetobacter baumannii in a tertiary hospital, Indonesia.

Acinetobacter baumannii, a pathogen of concern in hospitals worldwide, has diverse antimicrobial resistance mechanisms leading to limiting the antibiotic options and carbapenemase enzyme production is one of the common mechanisms in carbapenem resistance. The epidemiology and resistance pattern of clinical isolates are critical in developing a prevention and treatment strategy. The aim of this was to determine the prevalence and resistance pattern of carbapenem non-susceptible strains (CNS) A. baumannii at Arifin Achmad General Hospital, Pekanbaru, Indonesia. Data were retrieved from the culture and susceptibility test results from various clinical specimens from January 2015 to December 2019. A susceptibility test was conducted using Vitek 2 Compact following the manufacturer's protocol. To explore the genetic profile of CNS A. baumannii, we amplified the blaOXA-23 and blaOXA-51 genes, carbapenemase producing genes, using a duplex polymerase chain reaction (PCR) among 24 isolates Chi-squared was used to assess the factors associated with the presence of CNS A. baumannii. Between 2015-2019, 1.263 A. baumannii isolates were tested and the prevalence of CNS A. baumannii was 50%. The trend decreased from 53% in 2016 to 45% in 2019. The proportion of CNS A. baumannii was higher among samples from patients treated in the Intensive Care Unit (ICU) compared to non-ICU (p < 0.001). The CNS A. baumannii was also more frequently detected from sputum than from non-sputum samples (p = 0.009). CNS A. baumannii were highly resistant to almost all antibiotics and the highest susceptibility was to amikacin, tigecycline, and trimethoprim/sulfamethoxazole with 64%, 53%, and 43%, respectively. The blaOXA-23 gene was detected in 92% of tested CNS A. baumannii isolates. The prevalence of CNS A. baumannii is high at Arifin Achmad Hospital Riau, Indonesia. This is also supported by the high prevalence of the blaOXA-23 gene among tested isolates. Based on the antibiotic susceptibility pattern there are limited antibiotic choices for CNS A. baummannii urging the strengthening of antimicrobial stewardship programs in the country.

The outcome of hypospadias surgery and it’s advanced treatment in Arifin Achmad General Hospital in January 2019 – December 2020

Introduction: Hypospadias, the most common congenital genital anomaly, is defined as the abnormal ventral opening of the urethral meatus extent from the proximal tip of the glans penis, penis rod, scrotum until perineum. The incidence of Hypospadias continued to increase from time to time. Urethroplasty and orthoplasty is the only possible treatment for Hypospadias until this time. Surgical reconstruction cannot always be done in one step, many cases need more than one reconstruction even though an experienced surgeon did it. This study aims to describe patients’ characteristics in Arifin Achmad General Hospital. Methods: This is a descriptive retrospective study using a total sampling method and carried out 28 hypospadias patients at Pediatric Surgery of Arifin Achmad General Hospital from January 2019 until December 2020. Data were analyzed descriptively to describe the patient’s characteristics including age, hypospadias type, frequency of surgery based on Hypospadias type, day of hospitalization based on surgical procedure, complication after surgery based on Hypospadias type, and advanced treatment for the complication. Results: From 28 patients with hypospadias, it could be concluded that the highest number of hypospadias patients found in the 0-5 years age group (50%) with the most common type was penoscrotal as many as 12 cases (43%). One stage procedure was predominant and attributed to 75% more than multistage procedure (25%). Chordectomy procedure got hospitalized for 3 days and multi procedure (cordectomy + urethroplasty + scrotoplasty) got hospitalized for 7 days. Fistula urethrocutaneous majority found in shaft penile type as a complication after surgery (78%) and had cutaneous fistula closure as an advanced treatment for the complication. From the 28 cases, 23 cases were successful without complication (82%) and 5 cases had fistula as a complication after surgery (18%). Conclusion: Hypospadias treatment in Pediatric Surgery division at Arifin Achmad General Hospital such as Characteristics of hypospadias patient and surgical outcome majority had satisfied outcome and advanced treatment for complication after surgery is fistula urethrocutaneous closure.

Quality of defecation in patients with anorectal malformation following posterior sagittal anorectoplasty (PSARP) in Arifin Achmad General Hospital of Riau Province, Indonesia

Background: Anorectal malformation is a congenital abnormality that shows imperfect anus or absence of anus. The most common complication in patients with anorectal malformations after posterior sagittal anorectoplasty (PSARP) are disorders in defecation, especially constipation. Method: The purpose of this study was to determine the correlation of quality of defecation measured with the presence of constipation with the type of PSARP surgery in Arifin Achmad Hospital of Riau Province. This study used an analytical retrospective method from November 2018 to March 2019. Total sampling was the sampling method used in this study, which accounted for a total of 28 subjects. The population of this study was all patients with anorectal malformation and fistula in the Pediatric Surgery Division of Arifin Achmad General Hospital. Result: This study showed that among 28 cases found, there were 19 female patients (68%) and 9 male patients (32%). Based on the lesion level, there were 17 cases (60,7%) of intermediate lesions and 11 cases (39,3%) of high lesions. In this study, rectovestibular fistula had the highest incidence among other types of fistula (53,6%). Constipation were found in 53.6% patients with p-value of 0.025 (OR 6.40, 95% CI 1.183-34.613). Conclusion: There was a significant correlation between the PSARP method and constipation in patients who underwent anorectal malformation surgery, which constipation was a sign of the quality of defecation.

The Description of Infectious Waste Management by Nurses Stationed at Inpatient Room of Arifin Achmad General Hospital of Riau Province

Hospital activities produce various kinds of hospital waste, one of which is infectious waste. Infectious waste management that is not good can cause health and environmental problems. This study aims to see an overview of infectious waste management by nurses in class III inpatient rooms (Dahlia, Edelweis, Kenanga, Krisan) Arifin Achmad Regional General Hospital, Riau Province. This study uses a simple descriptive design with the number of respondents 66 nurses using a total sampling technique. The data collection method in this study used a questionnaire. The analysis used is univariate analysis. The results of this study explained that as many as 48 nurses carried out infectious waste management well (72.7%). a total of 50 nurses have good knowledge of waste management (75.8%). The type of infectious waste in the treatment room is the majority of waste contaminated with patients in the isolation ward such as gauze, swab bandages, and other contaminated waste. a total of 50 nurses performed the waste sorting method well (75.8%) and 51 nurses performed the waste collection method well (77.3%). Overall, the nurses in the ward have performed the infectious waste management well. This research is expected so that nurses can further improve the quality of waste management in the inpatient room so that it will be even better in the future. Keywords: Infectious waste; Waste management;Nurses

Prevalence Oncogenic Human Papillomavirus in Cervical Cancer Patients in Riau Province Indonesia.

Cervical cancer is the fourth most deadly cancer in the world, and it is caused by infection of high-risk subtypes of Human PapillomaVirus (HPV) in most cases. The aims of this study were to determine the prevalence oncogenic HPV in cervical cancer patients in Riau Province Indonesia and to determine the clinical manifestation of HPV in cervical cancer patients in Riau Province Indonesia. This research was a descriptive study conducted at Arifin Achmad General Hospital Riau from February to August 2018 which aimed to analyze HPV genotype prevalence oncogenic of cervical cancer patients. This study showed out 86 of 110 women (78.1%) were found HPV positive, and the most common genotype of HPV was HPV 16 (38.2%). The average age of cervical cancer patient was 50 years old, and the average number of parities was 4 times. The majority of participants were married at the age before 20 years (77.3%) and had low educational background (64.5%). Vaginal bleeding happened in more than half of the participant as major clinical manifestation (72.7%), followed by fluor albus (72.7%), pelvic pain (60.2%) and fatigue (65.9%). The most common HPV genotype in Riau Province was HPV type 16 and the most common clinical symptoms of cervical cancer patient were vaginal bleeding, fluor albus, pelvic pain and fatigue.

P7‐59: Relationship between stable chronic obstructive pulmonary disease with the incidence of heart failure and its influencing factors in the lung polyclinic at Arifin Achmad General Hospital, Riau Province

P7‐59: Relationship between stable chronic obstructive pulmonary disease with the incidence of heart failure and its influencing factors in the lung polyclinic at Arifin Achmad General Hospital, Riau Province

P5‐82: The correlation of cycle threshold value with severity of COVID‐19 at the isolation of new emerging and re‐emerging infectious diseases room Arifin Achmad General Hospital Riau Province Indonesia

P5‐82: The correlation of cycle threshold value with severity of COVID‐19 at the isolation of new emerging and re‐emerging infectious diseases room Arifin Achmad General Hospital Riau Province Indonesia

P5‐83: The correlation between cycle threshold polymerase chain reaction COVID‐19 with the extent of chest X‐ray abnormalities and D‐dimer in COVID‐19 patients at Arifin Achmad General Hospital Riau Province

P5‐83: The correlation between cycle threshold polymerase chain reaction COVID‐19 with the extent of chest X‐ray abnormalities and D‐dimer in COVID‐19 patients at Arifin Achmad General Hospital Riau Province

P5‐81: Correlation of serum ferritin level with disease severity of COVID‐19 at Arifin Achmad General Hospital Riau Province

P5‐81: Correlation of serum ferritin level with disease severity of COVID‐19 at Arifin Achmad General Hospital Riau Province

The Relationship of Chest X-Ray in COVID-19 Patients and Disease Severity in Arifin Achmad General Hospital Riau

Introduction: Coronavirus Disease 2019 (COVID-19) pandemic is caused by SARS-CoV-2 which spreads rapidly throughout the world and causes clinical manifestations in various organs, especially in the lungs. Clinical symptoms arise from asymptomatic, mild, moderate, severe, and critical symptoms in patients with or without comorbid disease. Chest X-ray examination is one of the modalities in the management of COVID-19 which is cheap and easy to do.Methods: This study was performed by analyzing medical record data of confirmed COVID-19 patients from March to December 2020. This study aimed to examine the relationship between chest X-ray and the degree of disease severity.Results: The results showed that from the examined 542 total samples, the highest number was found in the age group of 40-49 years old (23.6%), women (53%), mild degree of COVID-19 (67.9%), normal chest X-ray (54.6%), predominance on the lower zone of the lung, peripheral and bilateral on abnormal chest X-ray, no comorbid (56.3%), hypertensive in comorbid disease (26.6%). There was a significant relationship between chest X-ray and comorbidity towards COVID-19 severity (p = 0.000).Conclusion:Chest X-ray can determine disease severity, therefore it can be used as the first modality for triage and treatment evaluation in COVID-19 patients.

Sensitivity and Specificity of a COVID-19 Lateral Flow Immunoassay Compared to RT-PCR in Pregnant Womenat Arifin Achmad General Hospital Pekanbaru, Indonesia

Coronavirus disease 2019 (COVID-19) is significant global treat including to pregnant woman in Indonesia.A point-of-care diagnostic tool that is able to early diagnose and hasa good sensitivity and specificity iscritical during the pandemic. The aim of this study was to describe the clinical, laboratory and outcomesof pregnant women with presumptive COVID-19 and to compare the sensitivity and specificity betweenCOVID-19 rapid test (lateral flow immunoassay) and real-time reverse transcription polymerase chainreaction (RT-PCR). Pregnant women with presumptive COVID-19 symptoms were recruited at ArifinAchmad General Hospital between April 2020 and December 2020. Demographic and clinical data werecollected and patients were tested with COVID-19 rapid test as well as RT-PCR. Analyze was conducted todetermine the sensitivity and specificity. We included 120 patients with presumptive COVID-19 of which48 (40%) and 72 (60%) of patients were reactive for IgM and IgG antibody anti severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2), respectively and 51 (42.5%) were reactive for both IgM and IgG.The sensitivity and the specificity of rapid test was 64.0% and 33.3%, respectively. The positive and negativepredictive value was 61.5% and 35.7%, respectively. In conclusion, lateral flow immunoassay-based rapidtest has relatively low sensitivity and specificity in diagnosing COVID-19 in pregnant women.

Hubungan Onset Keluhan Nyeri Perut dan Jumlah Leukosit dengan Tingkat Keparahan Apendisitis Akut pada Anak

Acute appendicitis always need surgical treatment. If appendectomy is not performed immediately, perforation of appendix and peritoneal contamination will complicate the disease. The highest incidence of appendicitis is in late teen, with 5% incidence in children under 5 years old. The aim of this study was to determine the correlation between onset of abdominal pain with the severity of pediatric acute appendicitis and to know the different of average leukocyte count of pediatric acute appendicitis between appendicitis and appendicitis complication. This study was analytical comparative and analytical correlative with retrospective approach. About 68 medical records of pediatric acute appendicitis patient in Arifin Achmad General Hospital Riau Province period January 2018 – December 2019 were analyzed. The result showed appendicitis case in children was same affected girls and boys mostly in group age 6-12 years old. Onset of abdominal pain was mostly after 48 hours of the disease. About 69.1% patient was suffering of appendicitis complication. Leukocytosis was found in 76.5% patients. Statistics analysis using unpaired t test showed p=0.00, it meant a significant different of average leukocyte count between appendicitis and appendicitis complication. IC95%=4015.7-6683.1. Statistics analysis using Somers’d correlative test show p=0.00. From this study, it can be concluded that there was a significant different of average leukocyte count between appendicitis and appendicitis complication also there was a significant correlation between onset of abdominal pain with severity of pediatric acute appendicitis with strong power correlation.

PENGARUH KENAIKAN BERAT BADAN BAYI BERAT LAHIR RENDAH YANG MENDAPAT KOMBINASI ASI-PASI

Low Birth Weight Infant was the problem in all over world until nowdays because it causes illness and death on infant. The result of Indonesia Riskesdas in 2013 stated that presentage of toodlers (0-59 month) with low birth weight was the tenth sequence. This research aimed to know the influence of low birth weight infant increase that getting combination ASI-PASI in Arifin Achmad Genaral Hospital Pekanbaru. The type of research used analytic description that was quantitative, that conducted in Arifin Achmad General Hospital Pekanbaru on November 2015 until October 2016. The sample of research was 47 respondences, the instrument of research was scale of infant weight, the technique of collecting sample was by designing accidental sampling. The data was managed by computerization. The analysis of data used univariate and bivariate by using statistic nonparametric wilcoxon test. It was gained the distribution univariate result of female about 57.4 % and male was about 42.6 %, average of gestation age (34,5 weeks). The youngest gestation (28 weeks) and the oldest gestation (40 weeks). The result of statistic test was gained p=0,000 there was the significant difference between birth weight and wiegth after 14 days at the first caring on low birht weight baby that getting combination ASI-PASI with increase average of weight was amount 136,1 grams. It is suggested in order to raise exclusive ASI in fulfilling the nutrition need of baby especially low birth weight baby.&#x0D;

ANALISIS MANAJEMEN LAUNDRY DI RUMAH SAKIT UMUM DAERAH (RSUD) ARIFIN ACHMAD PROVINSI RIAU TAHUN 2019

ABSTRACT&#x0D; Hospital laundry service is an important part of a hospital operation. Prelimenary survey conducted at Arifin Achmad General Hospital of Riau Province show thata lack of space.There are two sepate room washing room dan drying room and one room for ironing, pelipatan, distributing room. There are also too many broken laundry equipment. This study purposeis to analysis laundry management at Arifin Achmad General Hospital of Riau Province &#x0D; This study uses the deep interview, observation and document review methode with a qualitative approach and data validity of triangulation. There are six informant : laundry officer, Head of laundry, Head of medical instalation, Chief of monitoring and evaluation, Chief of Nurserry and vice director of medik and nursery at Arifin Achmad General Hospital of Riau Province .&#x0D; This studyresult show that there are many themes appear as the finding of the studyof laundry management. As for themes in the area of Human Resousches Quality. Less of training officer, less internal teknision, the provision of facilities and laundry equipmentProvision for supply of waterand the implemantation of the house in the form of disharging SOP, there are no wet for dirty linen, provision of identity not include the name of hospital, size an No, ID. There needs improvement to Laundry manajement become Sentral Linen conforming with established standart.&#x0D; Keywords : Laundry, Manajemen, Hospital Bibliography&#x0D; Literature : 40 (2004 - 2017)