Hasan Sadikin General Hospital Research Articles

Characteristic of Intratemporal Complication in Chronic Suppurative Otitis Media Patient with and without Cholesteatoma at Hasan Sadikin General Hospital Bandung

Otitis media supuratif kronis (OMSK) merupakan penyakit telinga umum di negara-negara berkembang. Kasus OMSK dengan kolesteatoma sering disebut sebagai tipe bahaya. Tujuan penelitian ini untuk mengetahui karakteristik komplikasi intratemporal pada pasien OMSK dengan dan tanpa kolesteatoma di Poliklinik Telinga Hidung Tenggorok Bedah Kepala Leher (THT-KL) Rumah Sakit Hasan Sadikin (RSHS) Bandung. Penelitian ini merupakan penelitian deskriptif retrospektif dari pasien yang datang ke poliklinik THT-KL RSHS Bandung periode 2014-2017. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan penunjang radiologi. Didapatkan 791 kasus baru OMSK; pria (51,20%), sebanyak 30,59% kasus berada di rentang usia 21-30. Gejala dan tanda klinis yang paling sering terjadi adalah telinga berair (70,92) %, tipe gangguan dengar yang paling sering terjadi adalah tuli konduktif (83,94%). Pada proyeksi foto Schuller, 64,72 % menunjukkan gambaran mastoiditis kronis dengan kolesteatoma. Dari hasil kultur dijumpai 19,97 % kasus disebabkan oleh Pseudomonas aeroginosa. Komplikasi mastoiditis didapatkan pada 86,34%. Pada operasi Canal Wall Down ditemukan kolesteatoma pada 60, 42% kasus. Komplikasi terbanyak intratemporal pasien OMSK dengan dan tanpa kolesteatoma adalah mastoiditis kronis. Simpulan, komplikasi terbanyak intratemporal pasien OMSK dengan dan tanpa kolesteatoma adalah mastoiditis kronis. Profil penderita OMSK tipe bahaya dengan komplikasi intratemporal di RSUP Dr. Hasan Sadikin masih tinggi.
 
 Kata kunci: karakteristik; kolesteatoma; mastoiditis kronis; otitis media supuratif kronik

Time to Hospital Admission of Stroke Patients in Department of Neurology Hasan Sadikin General Hospital Bandung

Stroke merupakan penyebab kematian terbesar di dunia dalam 15 tahun terakhir. Tujuan penelitian ini adalah untuk mengetahui gambaran waktu kedatangan pasien stroke ke rumah sakit yang dirawat di Departemen Neurologi Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan studi desain deskriptif analitik yang dilakukan dari Juli-Agustus 2018. Sampel didapat dari seluruh rekam medis pasien stroke iskemik dan hemoragik di Departemen Neurologi RSUP Dr. Hasan Sadikin Bandung dari Mei 2017-Desember 2017. Dari penelitian didapatkan median waktu kedatangan pasien stroke adalah 16,50 jam (0,5-336 jam). Sebanyak 65,93% pasien stroke datang ke rumah sakit di atas delapan jam setelah mengalami gejala. 9,26% pasien stroke datang ke rumah sakit dalam jangka waktu 6-8 jam, 11,48% pasien stroke datang ke rumah sakit dalam jangka waktu 4,5 -6 jam, 9,63% pasien datang ke rumah sakit dalam jangka waktu 3- 4,5 jam dan hanya 3,70% pasien stroke yang datang ke rumah sakit dibawah 3 jam setelah mengalami gejala. Dari penelitian dapat disimpulkan terdapat perbedaan signifikan waktu kedatangan pasien berdasarkan jenis stroke, cara kedatangan dan hasil terapi pasien.
 
 Kata kunci: stroke iskemik; stroke hemoragik; waktu kedatangan

Comparison of Menstrual Effluent Vascular Endothelial Growth Factor Immunocytochemistry Expression Between Endometriosis and Non-Endometriosis Patients

Objectives: This study aimed to measure the vascular endothelial growth factor (VEGF) expression in menstrual effluent from patients with endometriosis compared to non-endometriosis through immunocytochemical methods. We also measured the degree of pain level, endometrioma cyst size, and infertility status whether it is affected by VEGF expression. Materials and Methods: The present case-control study was conducted in Hasan Sadikin General Hospital, Bandung. Thirty productive-age women diagnosed with endometrioma and 30 productive-age women without endometriosis as the control group were included in this study. Menstrual effluent was taken from the posterior fornix on the second day of menstruation and stained using immunocytochemistry staining for VEGF. Results: The results demonstrated a significant difference between the two study groups in terms of VEGF intensity and histoscore although no difference was found in VEGF distributions between the study groups. The subjects in the endometriosis group had significantly higher VEGF intensity and significantly higher VEGF histoscore compared to the control group. Women with VEGF histoscore more than 6 has 9.33 times risk of developing endometriosis compared to those with lower histoscore. There were no significant correlations between VEGF and pain scale, infertility, and the cyst size. Finally, the cyst size was proportionally related to pain. Conclusions: VEGF distribution and expression in endometriosis women were significantly higher than VEGF levels in non-endometriosis women. Women with menstrual effluent containing higher VEGF levels had more chances of developing endometriosis compared to those with lower VEGF levels. Eventually, larger endometrioma size was proportionally related to higher pain levels in subjects with endometrioma.

Analisis Risiko Kerja Petugas Filling Rawat Inap Dengan Menggunakan Severity Assessment di RSUP Dr. Hasan Sadikin Bandung

Risk is the possibilities of an unwanted, or unexpected, adverse loss in an activity. Risk can occur as a form of thepossibility of something bad happening in the future which can not be predicted when it comes. These risks can beresulted as negative impacts for the existing officers in several activities. We have observed the examples of risks thatoccur in the filling room of Dr. Hasan Sadikin General Hospital, Bandung. There are several risks of occupationalaccidents experienced by officers such as fingers affected by stapler attached to the medical record files, officers feelaches and pain in their hands and back when retrieving files, and the possibility of officers being hit by files. Thisresearch was aimed to analyze the risks that occur in filling inpatients. This risk assessment uses severity assessmentand a hierarchy of risk control to overcome the risks that occur. The type of research uses qualitative research with 4respondents. The results of this study produced 7 risks with 4 high injury risks and 3 moderate injury risks. Handling inrisk prevention is needed by making work safety SOPs, mandatory of Personal Protective Equipment (PPE) usage, theuse of tools to lift heavy loads, the use of chairs and stairs with strong materials, giving warning signs, paying attentionto ventilation to regulate proper lighting, and installing thermometers in inpatient filling rooms.

Correlation between Alpha Fetoprotein (AFP) Levels and Characteristics of Liver Lesions Using Computed Tomography (CT) scan in Hepatocellular Carcinoma: a Study at Dr. Hasan Sadikin Central General Hospital Bandung 2019

Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver which is about 75% - 85%. The diagnosis of HCC is determined based on several factors, including the background of chronic liver disease, tumor markers, and imaging diagnosis. There are three main growth patterns of HCC that can be seen on computed tomography (CT) scan : massive, nodular, and diffuse infiltrative. HCC is locally invasive and tends to invade the portal vein, inferior vena cava and bile duct. Alpha fetoprotein (AFP) is one of the tumor markers used for early diagnosis of KSH and plays an important role in the development and progression of HCC. Objective : To determine the correlation between alpha fetoprotein levels with characteristics of liver lesions using CT scan examination in HCC patients. Methods : This study was an observational analytic study with a cross-sectional design. Sampling was done retrospectively by collecting medical record data and the results of abdominal CT scan readings from January to December 2019. The study was conducted at the Department of Radiology, Department of Clinical Pathology and Installation of Medical Records-SIRS Hospital Dr. Hasan Sadikin Bandung in February - April 2020. Univariable analysis was carried out to see the description of the proportion of each variable to be presented descriptively, which could be explained into descriptive analysis and hypothesis testing. Results : There were 63 subjects, 48 men (76.2%), 15 women (23.8%), with the youngest age of 21 years, the oldest 86 years with an average age of 53.44 years. The highest average AFP levels were found in the group of patients with diffuse infiltrative growth patterns 93064.84 ± 177486,301 and the presence of a thrombus in the portal vein of 78770.98 ± 88358,791. The results of statistical tests using the Mann Whitney Test showed that there were significant differences between the levels of AFP and the growth pattern of liver lesions in HCC patients based on the results of the CT scan with a value of p = 0.040 (p?0.05) and there were significant differences between the levels of AFP and portal vein thrombus in HCC patients based on the results of CT scan examination with a value of p = 0.040 (p?0.05). Conclusion : There is a significant correlation between AFP levels with the characteristics of liver lesions specifically the form of growth patterns and the presence of portal venous thrombus using CT scan examination of HCC patients in dr. Hasan Sadikin General Hospital. Keywords : Hepatocellular carcinoma, Alpha fetoprotein, CT scan

4-7CORONARY ARTERY DISEASE ALTER ON NOVEL CLASSIFICATION LEFT VENTRICULAR GEMOMETRY IN HYPERTENSIVE PATIENTS IN HASAN SADIKIN GENERAL HOSPITAL BANDUNG

Background: Coronary artery disease (CAD) was known to cause an increase in left ventricular mass and changes in cardiac dimensions in hypertensive patients. There is a novel classification of left ventricular (LV) geometry. Objective: To evaluate the impact of CAD on LV geometry (LV dilatation, hypertrophy, and concetricity) in hypertensive patients at the Hasan Sadikin General Hospital Bandung. Method: Between September and December 2019, 115 consecutive patients underwent trans-thoracal echocardiography examination in Hasan Sadikin General Hospital Bandung, who had suffered from hypertension. Hypertension was defined as resting systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg or on antihypertensive therapy routinely. CAD was defined as the patients have a known history of CAD in the medical record. Patients were divided based on LV dilation (end-diastolic volume[EDV]/body surface area[BSA]>75 ml/m2), LV hypertrophy (LVM/BSA>115 and >95 g/m2 on men and women respectively), and concentricity (RWT>0.42;0.32–0.42;or<0.32). Results: One-hundred-ten patients were included after excluding patients with incomplete data. Sixty patients (54.55%) were females, mean age was 56.95±11.54 years old. Forty patients was diagnosed CAD (36.36%), 70 patients non-CAD (63.63%). Dilation LV was found in 23 patients (20.9%); CAD vs non-CAD (15/40 (37,5%) vs 8/70 (11,8%)); p = 0,001. Hypertrophic LV was found in 70 patients (63.6%); CAD vs non-CAD (32/40 (80%) vs 38/70 (54.3%)); p = 0,008. Concentricity RWT > 0,42 (60%), RWT 0,32–0,42 (31.8%), RWT < 0,32 (8.2%). In CAD vs non-CAD (26/7/7 vs 40/28/2); p = 0,04. Conclusion: In hypertensive patients, CAD group has significant difference in LV dilatation, hypertrophy, and concentricity compared to it counterparts. Based on this novel classification, CAD in hypertensive patients might have an impact on its prognosis.

Expression of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Endometriosis Menstrual Blood.

Endometriosis is a gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Remodeling of the extracellular matrix (ECM) is a prerequisite for tissue implantation. The presence of matrix metalloproteinase (MMP) and its inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), in shed endometrium cells has a significant role in ECM degradation. A case–control study was performed to find other diagnostic markers using menstrual blood. We examined a sample of 68 women who visited the gynecology clinic in Dr Hasan Sadikin General Hospital, 40% of whom were confirmed to have endometriosis, and the rest tested negative by histopathological examination. All endometriotic cases presented MMP-9 and TIMP-1 expression with different cell distribution. MMP-9 expression in endometriosis patients was increased compared to the controls (p = 0.002). Expression of MMP-9 in >80% of endometrial cells was associated with a higher risk for endometriosis (OR 4.44 95% CI 1.31 to 15.56) compared to MMP-9 expression in 50%–80% of cells. TIMP-1 cell expression in women with endometriosis was lower than in the control group (p = 0.030). Subjects with TIMP-1 expression in 20%–50% of endometrial cells had a higher risk for endometriosis (OR 4.5, 95%CI 1.21–17.42) compared those with TIMP-1 expression in 50%–80% of cells. These expressions levels can be useful to predict endometriosis.

Forced Expiratory Volume in 1 Second and Forced Vital Capacity in Bronchial Asthma Patients in Relation with Asthma Exercise

Background : Aerobic physical activity is one of the non-pharmacology management approaches of asthma. The Asthma Foundation of Indonesia ( Yayasan Asma Indonesia , YAI) has designed an aerobic physical activity for people with asthma, known as Asthma Exercise. Asthma exercise is expected to increase the overall functional capacity of the lungs. One way to measure lung function is by measuring the score of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). The objective of the study was to explore the difference in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Methods : This study involved asthma patients from the Bandung Asthma Association ( Perhimpunan Asma Bandung , PAB) who did asthma exercise (n=28), and as control patients from the Pulmonology Clinic in Dr. Hasan Sadikin General Hospital were selected who did not do asthma exercise. The research data used were primary data from the spirogram examination. Asthma patients were selected based on inclusion and exclusion criteria. This research used unpaired numerical comparative analytical hypothetical tests with a cross-sectional design. Results : The study showed the mean of FEV1 and FVC in the group with asthma exercise (1.6107±0.3780L and 2.0396±0.3465L) was higher than the group without asthma exercise (1.3750±0.4702L and 1.7164±0.4632L). Statistical difference test using independent t-test indicated a score of p=0.044 for FEV1 and p=0.005 for FVC between the two groups. Conclusions : There are significant differences in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Furthermore, asthma exercise is recommended for asthma patients to improve their lung function.

Spirometric Values of Patients with Chronic Obstructive Pulmonary Disease in Dr. Hasan Sadikin General Hospital Bandung

Background : Chronic obstructive pulmonary disease (COPD) is a frequently underdiagnosed disease. Definitive COPD has been diagnosed using spirometry to evaluate pulmonary function. This study aimed to explore the spirometric values of COPD patients to aid in the diagnosis of COPD. Methods : A descriptive study was conducted in Dr. Hasan Sadikin General Hospital Bandung from October to November 2015. Data on patients diagnosed with COPD, aged 40 to 60 years old, were collected during the year 2014 prior to ethical clearance. Spirometry values consisted of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were taken from the medical records. Results : Sixty-eight COPD patients, consisting of 48 males and 20 females, were included of with most were classified as moderate COPD. The FEV1 was 49.72±17.79, whereas the FVC was 55.90 (range 22.80–96.03), and the FEV1/FVC ratio was 0.70±0.12. Most patients were classified into moderate COPD who had FEV1 between 50 and 80% of normal as GOLD 2 standard. Conclusions : Even though patients seem to have no symptoms, spirometric values may show a silent insufficient lung function affecting patients’ daily life.

Relationship between Calcification on Mammography and Human Epidermal Growth Factor Receptor 2 (HER-2) Expression in Breast Carcinoma

Background : Breast carcinoma shows over-expression of Human Epidermal Growth Factor Receptor 2 (HER-2) in 18 to 20% of the cases. This type of cancer is very progressive and has a poor prognosis. This study aimed to determine the association between the calcification on mammography with HER-2 expression in breast carcinoma as a marker of breast carcinoma aggressiveness. Methods : This was an analytic observational study with a case-control design. Patients with breast carcinoma at the Department of Radiology and Department of Anatomical Pathology of Dr. Hasan Sadikin General Hospital Bandung from July–September 2019 were enrolled in this study. Samples were consecutively collected. The association of calcification on mammography and HER2 expression was analyzed using the Chi-square test. Result : In total, 40 patients were included, consisting of 20 individuals with HER-2 positive and 20 individuals with HER-2 negative. The youngest was 40 years old and the oldest was 73 years old. Statistical test results showed that there was a significant association between calcifications in mammography and HER-2 expression (p-value = 0.0001, OR 13.22; 95% CI 2.7–62.6). Conclusions : There is a significant association between calcification on mammography and HER-2 expression in breast carcinoma, suggesting that positive calcification mammography was 13.22 times higher in patients with HER-2 positive compared to patients with negative calcifications.

Cerebral Palsy Parents’ Knowledge, Attitude, and Behavior at Dr. Hasan Sadikin General Hospital Bandung 2014

Background : Cerebral palsy (CP) as a non-progressive syndrome of motor function and posture disturbance is caused by the abnormality or damage on the brain during its development. Children with CP usually have motor, sensory, communication, and intellectual disturbances. Medical rehabilitation is important; however, the environmental aspect is also crucial for their development. Parents as their caregivers may have good knowledge to assist their children during rehabilitation. This study aimed to explore the knowledge, attitude, and behavior among parents with CP children. Methods : This study was descriptive quantitative study and conducted at the Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital Bandung during September to October 2014. Parents of CP children were asked to complete a questionnaire that was specifically designed for this study after their consent was obtained. Results : From a total of 31 parents, 51.6% had good knowledge about CP; 58.1% had good attitude toward CP children, and 51.6% had good behavior while taking care of their children. Conclusions : The majority of parents with CP children have good knowledge, attitude, and behavior towards CP children. The knowledge of risk factors of cerebral palsy are poor, therefore, it is necessary for doctors and therapists to provide more education sessions on the risk factors and other related topics about cerebral palsy.

PREVALENCE OF NASOPHARYNGEAL CARCINOMA PATIENTS IN DEPARTEMENT OF ORL-HNS HASAN SADIKIN GENERAL HOSPITAL 2010 -2017

Introduction:
 Nasopharingeal Carcinoma starting from Rosenmuller fossa and intracranial or local spread as a mass in the head area. Nasopharyngeal carcinoma is also associated with hearing problems, serous otitis media, tinnitus, nasal congestion, anosmia, nose bleeding, difficulty swallowing, and dysphonia. Nasopharyngeal carcinoma is a disease that spreads globally and divides races around the world. The purpose of this study is to determine the prevalence of nasopharyngeal disease in Otorhinolaringology-Head and Neck Department, Dr. Hasan Sadikin General Hospital Bandung in 2010-2017.
 Methods:
 Medical record method description of Nasopharyngeal Carcinoma at Departement of Otorhinolaringology- Head and Neck Surgery, Dr. Hasan Sadikin General Hospital Bandung in 2010-2017 that used sampling method.
 Results:
 There were 1378 patients nasopharyngeal carcinoma, 976 people that included, 657 were men and 319 were women. Obtain most elementary school education (54.9 %) the majority of male patients (67.3 %) with various job background, whereas female patients were housewives (28.1%), and those aged 41-50 years (34%). Most histopathology are undifferentiated carcinoma (58.3 %).
 Conclusion:
 Nasopharyngeal Carcinoma patients at the Otorhinolaringology-Head and Neck Surgery Departement. Dr. Hasan Sadikin General Hospital Bandung are 1378 cases. There was higher instance in middle age, and older men and elementary school educated with major histopathology finding was undifferentiated carcinoma

A Prospective Cohort Study of Outcome In Total Knee Arthroplasty With Or Without Drainage At Dr. Hasan Sadikin General Hospital From January 2017 To January 2018

The use of postoperative drainage after total knee arthroplasty (TKA) in osteoarthritis patients was believed effective in decreasing hematoma, swelling, infection, and postoperative pain. However, the drainage can also cause infection due to retrograde migration of bacteria and impair early postoperative rehabilitation. The aim of the study was to compare pain intensity (VAS), hemoglobin level (Hb), range of motion (ROM), clinical results (KSS and WOMAC) in TKA patients with and without postoperative drainage.This study was a prospective cohort study with samples of 98 patients at Dr. Hasan Sadikin Hospital from January 2017-January 2018. Simple random sampling with closed envelopes was used to determine TKA patients who undergone postoperative drainage and without drainage. The drainage group (K1) was 46 knees, the without drainage group (K2) was 52 knees. Both groups were compared based on VAS, Hb, ROM, KSS and WOMAC score on preoperative, 1st, 3rd, 5th day, 1st, 6th month, and 1 year postoperative.VAS score on K1 group showed better results (3rd day VAS K2 1.77; K1 1.32; p-value 0.070; 5th day K2 1.46; K1 1.22; p-value 0.090; p-value < 0.1). Based on postoperative Hb, K2 group was better (K2: 11.74;K1: 10.835; p-value 0.06). ROM on K2 is better than K1 (1st day ROM K2 52.50; K1 42.85; p-value 0.64;3rd day K2 53.70; K1 47.24; p-value 0.832; 5th day K2 54, 60; K1 45.85; p-value 0.73). Based on the KSS and WOMAC score there were no significant differences between K2 and K1.Our study concluded that there are several advantages for not using drainage after TKA in terms Hb, ROM on 1st, 3rd, and 5th day postoperative and early mobilization with weight bearing using walker at 3rd day postoperative. There is no rationale for the use of drain after primary TKA.

Outcomes of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis at Hasan Sadikin General Hospital Bandung

Peripheral joints involvement in Ankylosing spondylitis (AS) has been reported in 73% of these cases, with the hip being the most commonly affected diarthrodial joint. The reported prevalence of hip involvement in AS varies from 19 to 36%. Total Hip Arthroplasty (THA) is often required to manage pain and restore function and mobility. The aim of this study was to retrospectively analyze outcomes related to performing THA on patients with AS.Methods:We evaluated the oncologic, functional outcome and complications of a patient 27 years old with Ewing sarcoma Data of 19 AS patients who underwent 29 THAs between 2014 and 2018 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical outcomes.Results:There were 14 males and 5 females with 29 affected hips (53% bilateral, 47% unilateral). The average patient at surgery was 31.7 years old (range, 17-47 years). After surgeries, overall inclinations and anteversions of acetabular cups were 44.9°±0.3° (range, 30°–50°) and 18.42°±0.30° (range, 0°–25°) respectively. Mean Visual Analogue Scale (VAS) score decreased from 7.4±0.14 (range, 4–10) preoperatively to 3.21±0.09 (range, 0–4) at final follow-up. Mean Harris Hip Score (HHS) improved from 24.36±2.6 (range, 15–45) to 92±1.66 (range, 80–95) at final follow-up. Postoperative Range of Motion (ROM) was improved from 10.26°±2.61° (range, 0°–50°) preoperatively to 84.26°±0.76° (range, 70°–100°) at final follow-up. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, which shows the activity of disease, was 7.6±0.17, and it decreased to 3.5±0.15 at last follow-up. There were post-operative complications in 8 hips (27.6%). Superficial wound infection was documented in 3 hips (10.3%), sciatic nerve injury in 1 hip (3.4%), implant loosening in 2 hip (6.9%), and heterotopic ossification was documented in 2 hips (6.9%) at final follow-up.Conclusion:Surgical outcomes of THA for AS patients with hip involvement are satisfactory.

Subclinical hypothyroidism in pediatric nephrotic syndrome: the correlations with albumin, globulin, and proteinuria

Background Nephrotic syndrome causes loss of medium-sized plasma proteins and binding proteins, resulting in thyroid hormone deficiency.&#x0D; Objective To assess for potential correlations between subclinical hypothyroidism in pediatric nephrotic syndrome with albumin, globulin, and proteinuria.&#x0D; Methods This cross-sectional study was conducted in the Department of Pediatrics, Hasan Sadikin General Hospital, Bandung, West Java. All types of nephrotic syndrome patients aged 1 month to &lt; 18 years were included. Blood and urine specimens were collected from the patients for albumin, globulin, thyroid function (T3, fT4 and TSH), and proteinuria tests and analyzed with standard techniques.&#x0D; Results There were 26 subjects, 20 males and 6 females. Ten subjects developed subclinical hypothyroidism, with mean albumin and thyroid-stimulating hormone (TSH) levels of 0.92 g/dL and 6.9 mIU/L, respectively. There was a negative correlation between albumin level and subclinical hypothyroidism (rpb=-0.702; P&lt;0.001) and a positive correlation between proteinuria and subclinical hypothyroidism (r=0.573; P=0.003). Univariate logistic regression analysis revealed that globulin had no impact on the presence of subclinical hypothyroidism, but albumin and proteinuria did have such an impact. The odds ratios of albumin and proteinuria with subclinical hypothyroidism were 27.00 (95%CI 1.69 to 17.7) and 19.80 (95%CI 1.94 to 201.63), respectively.&#x0D; Conclusion Subclinical hypothyroidism correlates with serum albumin level and proteinuria in nephrotic syndrome patients. Tha low serum albumin level has a high likelihood of subclinical hypothyroidism.

Subclinical hypothyroidism in pediatric nephrotic syndrome: the correlations with albumin, globulin, and proteinuria

Background Nephrotic syndrome causes loss of medium-sized plasma proteins and binding proteins, resulting in thyroid hormone deficiency.&#x0D; Objective To assess for potential correlations between subclinical hypothyroidism in pediatric nephrotic syndrome with albumin, globulin, and proteinuria.&#x0D; Methods This cross-sectional study was conducted in the Department of Pediatrics, Hasan Sadikin General Hospital, Bandung, West Java. All types of nephrotic syndrome patients aged 1 month to &lt; 18 years were included. Blood and urine specimens were collected from the patients for albumin, globulin, thyroid function (T3, fT4 and TSH), and proteinuria tests and analyzed with standard techniques.&#x0D; Results There were 26 subjects, 20 males and 6 females. Ten subjects developed subclinical hypothyroidism, with mean albumin and thyroid-stimulating hormone (TSH) levels of 0.92 g/dL and 6.9 mIU/L, respectively. There was a negative correlation between albumin level and subclinical hypothyroidism (rpb=-0.702; P&lt;0.001) and a positive correlation between proteinuria and subclinical hypothyroidism (r=0.573; P=0.003). Univariate logistic regression analysis revealed that globulin had no impact on the presence of subclinical hypothyroidism, but albumin and proteinuria did have such an impact. The odds ratios of albumin and proteinuria with subclinical hypothyroidism were 27.00 (95%CI 1.69 to 17.7) and 19.80 (95%CI 1.94 to 201.63), respectively.&#x0D; Conclusion Subclinical hypothyroidism correlates with serum albumin level and proteinuria in nephrotic syndrome patients. Tha low serum albumin level has a high likelihood of subclinical hypothyroidism.

Persepsi Pasien DM Tipe 2 Terhadap Penggunaan Obat Antidiabetes Oral di RSUP Dr. Hasan Sadikin Bandung

Type 2 Diabetes Mellitus (T2DM) is a lifelong metabolic disorder characterized by hyperglycemia, which requires continuous therapy. Oral antidiabetic drugs (OAD) become the main line in T2DM therapy. There are several factors influencing drug compliance and consumption, one of them is perception. Perception is a process of processing sensory information to form a meaning that will make T2DM patient take a decision to take the medication regularly and continously. The purpose of the study is to determine the perception of T2DM patients about the use of OAD in the Endocrine Polyclinic, Dr. Hasan Sadikin General Hospital, Bandung. This study uses categorical descriptive method with cross-sectional design. Data is collected using a questionnaire that has been through the process of validity and reliability tests. Sampling was done by convenience sampling method to 46 respondents. The variables in this study are respondents' characteristics and perceptions, which is grouped into four categories. The data was processed using the Rasch Model to be categorized into positive and negative perceptions based on the mean logit respondent value. The results showed positive perception of treatment benefits is 73.91%, positive perception of drug consumption procedures is 78.26%, positive perception of treatment side effects is 82.61%, and positive perception of drug consumption encouragement is 67.39%. Overall, the perception of T2DM patients about the use of OAD in RSHS is a positive perception. This is a good foundation for patients for doing the therapy regularly and continuously.

BURNOUT OF SOCIAL WORKERS AT Dr. HASAN SADIKIN BANDUNG CENTRAL HOSPITAL

The high workload can cause burnout. Burnout makes the worker not pay attention to the person he helped, thus reducing the quality of service. The research method used is descriptive research method with qualitative approach. The informant consisted of 11 people, two medical social workers, three medical social worker partners, and six medical social worker patients. The result of the research showed that: a) medical social workers experiencing burnout with the most emerging aspect of emotional exhaustion, b) depersonalization aspects, medical social workers showed apathetically and acting callous at work, c) medical social worker feel they can't work optimally but in the reality, they have good performance based on Indeks Kinerja Individu (IKI), d) Medical social worker can keep working with good performance because of their love to the profession, e) The burnout shown by medical social workers has no effect to the helping process to the patient in Dr. Hasan Sadikin General Hospital. The main factors of burnout of medical social workers is a barrier in their career, which leads the medical social worker can't get their rights based on their performance and education.

Resistive Index Value of Superior Mesenteric Artery In Preterm Infants With Necrotizing Enterocolitis

Aims: to find out the comparison of RI values of superior mesenteric artery inpremature infants with NEC and without NEC.Material and methods: This study was an observational analytic study, with acase-control study design, where the sampling method was using consecutive samplingin the NICU Room, Anturium and Radiology Department Dr. Hasan Sadikin GeneralHospital Bandung from September to October 2019. Data processing uses unpairedT-test.Results: The total sample was 22 subjects, consisting of 11 with positive NEC and11 negative NEC, with an average gestational age of 31.36 weeks and an average birthweight of 1490.45 grams. In the positive NEC group, the average RI value was 0.90and in the negative NEC group, the average RI value was 0.70. Statistical test resultswith unpaired T-test showed that there was a statistically significant increase in thevalue of superior mesenteric artery RI in premature infants with NEC compared topremature infants without NEC with a p-value = 0.0001 (p-value < 0.05).Conclusion: There was an increase in the value of superior mesenteric artery RIin premature infants with NEC compared to premature infants without NEC with avalue of p = 0.0001 (p-value <0.05).Key words: Necrotizing Enterocolitis–Superior Mesenteric Artery–Ultrasonography

Profile of Upper Extremities Function among Stroke Outpatients in Dr. Hasan Sadikin General Hospital, Bandung

Background: Stroke is one of the leading causes of death and disabilities worldwide. Among all types of disabilities, disturbance in upper extremities functions is at the highest percentage. This study aimed to determine the profile of upper extremities function among stroke outpatients in Dr. Hasan Sadikin General Hospital as an initial step to provide a better follow up and management. Methods: The design of this study was a descriptive study, conducted from April to October 2014 among stroke outpatients in the Department of Physical Medicine and Rehabilitation Dr Hasan Sadikin General Hospital, Bandung based on a consecutive sampling method. The function of upper extremities was tested by Chedoke Arm and Hand Integrated version 9 (CAHAI-9). Result: In total, 42 patients were included, consisting of a male (n=25) and a female (n=17). Nine tasks were performed with dependently by the patients such as open the coffee jar (n22; 52%), call 118 (n24;57%), draw a line with a ruler (n22;52%), pour a glass of water (n33;79%), wring out washed cloth (n26;62%) do up five-button (n31;74%), dry back with the towel (n25;60%), put toothpaste on a toothbrush (n25;60%), and cut medium resistance putty(n32;76%). Conclusions: The majority of stroke outpatients in the sub-acute phase still have a dependent function of upper extremities. Better patient management and interventions focusing on this function need to be enhanced for a better outcome.