Hasan Sadikin General Hospital Research Articles

55. The Duration of Hypertension does not Affect Left Atrial Volume Index and Left Ventricular Mass Index in Hypertensive patients at Regional Referral Hospital

Background: Increased left atrial size and volume and left ventricular hypertrophy can be used as prognostic indicators of cardiovascular morbidity and mortality. Enlargement of left atrium and hypertrophied of LV are already known associated with several factors, but many of them studied in mild-hypertension case in primary/secondary health care. The objective of this study was to evaluate the effect of hypertension duration on Left Atrial Volume Index (LAVi) and Left Ventricular Mass Index (LVMi) in hypertensive patient at Regional Referral Hospital. Methods: Data from hypertension registry at Dr Hasan Sadikin General Hospital, Bandung, from March to December 2022 were collected. Patients with reduced left ventricular systolic function, moderate to severe valvular heart disease, professional athlete, pregnancy, congenital heart disease, pulmonary arterial hypertension were excluded. Patients’ hypertension duration, gender, age, echocardiographic measurement was collected. Linear regression analysis was conducted to evaluate effects of hypertension duration on LAVi and LVMi from echocardiographic evaluation. Results: A total of 94 patient's was studied with median age: 60.5 (22–75) years old and male: 50%. The median duration of hypertension was 5 (0.08–44) years. The median value of LAVi was 20.9 (10.1–56.4) ml/m2, The median LVMi was 124.65 (52.9–281.8) g/m2. There was no significant association between duration of hypertension and LAVi, R2 = .009, P = .482, F = .370, CI (19.389, 24.456). There was no significant association between duration of hypertension and LVMi: R2 = .006, P = .446, F .58, CI (120.06, 138.72) Conclusion: Hypertension duration doesn’t significantly affect Left Atrial Volume Index and Left Ventricular Mass Index in Hypertensive patients at Regional Referral Hospital.

49. The Differences of Clinical Characteristics between Coronary Artery Disease Patients with and without Hypertension

Background: Hypertension may appear concomitantly and share the same pathophysiology with other comorbidities of coronary artery disease (CAD), which may indicate a relation between the two. This study aims to compare the differences between CAD patients with and without hypertension. Methods: This retrospective study includes subjects from the CAD registry in Dr. Hasan Sadikin General Hospital Bandung, from March-September 2022. Hypertension was defined as blood pressure $140/90 mmHg, known history of hypertension, or routinely consumed hypertension medication. Salt intake, history of smoking, low physical activity, body mass index (BMI), heart failure (HF), stroke, type-2 diabetes mellitus (T2DM), chronic kidney disease (CKD), obstructive sleep apnea (OSA), dyslipidemia, and chronic obstructive pulmonary disease (COPD) were compared between CAD patients with and without hypertension. Results: From 173 subjects included in this study, 124 (71.7%) subjects had hypertension, consist of 66.7% of male population and 93.8% of female population. The mean age in CAD patients with hypertension were higher than without hypertension (59.8 ± 8.3 vs 56.4 ± 8.8 years). There was no significant difference (p-value >0.05) regarding salt intake, history of smoking, low physical activity, BMI, diabetes, CKD, OSA, dyslipidemia, and COPD. Significant difference was found with age, female, HF, and stroke (p-value < 0.05). Multivariate analysis showed that hypertension was only independently associated with age [OR 1.04 (1–1.08, p-value 0.045)], female [OR 6.97 (1.57–30.86 p-value 0.01)], and HF [OR 3.5 (1.01–12.82, p-value 0.048)]. Conclusion: CAD patients with hypertension was higher in female, older population, and those who have heart failure compared to CAD patients without hypertension.

52. The Association of Cardiovascular Risk Factors and Blood Pressure Changes after Exercise in Coronary Artery Disease Patients

Background: Changes in blood pressure after exercise and factors affecting it specifically in CAD patients were poorly studied. This study aimed at investigating the association of cardiovascular risk factors and changes of blood pressure among CAD patients after exercise. Methods: This retrospective study includes 87 CAD patients from cardiac rehabilitation center Dr. Hasan Sadikin General Hospital Bandung that have completed 12 sessions of moderate intensity exercise from December 2021 to November 2022. Blood pressure measured before and immediately after their training session. The change in blood pressure calculated as the mean of it during 12 sessions. Results: Among 86 patients (95.3% men; mean age 55.93 + 9.9) included in this study, 57% had hypertension, 29.1% had diabetes mellitus (DM), 9.3% had dyslipidemia, and 82.6% had history of smoking. All patients have received at least one antihypertensive therapy. From 970 blood pressure data, the mean SBP and DBP changes after exercise were decreased 8.13mmHg and 3.54mmHg, respectively. Most patients has decreased both SBP and DBP (66 patients; 77%); decreased SBP increased DBP (12.6%); increased both SBP and DBP (5.7%); and increased SBP decreased DBP (4.6%), Sex is the only factor that has association with category of blood pressure changes (p 0.007), while the others (age, hypertension, dyslipidemia, DM, history of smoking) were not. Conclusion: This study shows that most patients experience a decrease in blood pressure immediately after exercise. Men tend to have increasing blood pressure compared to women. However, other classic cardiovascular risk factors were not associated with the changes.

Association Between Maternal Hemoglobin Level and Incomplete Abortion At RSUP Dr. Hasan Sadikin Bandung 2017-2019

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

Autoantibody Profile and Lung HRCT Scan in Systemic Sclerosis with Restrictive Lung Disease

Objective: To identify auto-antibodies in systemic sclerosis with interstitial lung disease (ILD). Method: This was a descriptive categorical study on auto-antibody profile in systemic sclerosis patients visiting the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital, West Java, and Bandung during the period of January 2018 to December 2019 who were registered in the West Java Systemic Sclerosis Registry. Auto-antibody identification was performed using the Euroline immunoblot assays.Results: Thirty six cases were identified during the study period with most of the cases involved women (n=35, 97.2%). The average age of patients participating in this study was 40 years, with an average duration of disease of 18 months. Diffuse cutaneous systemic sclerosis was found in 22 (61.1%) cases and limited cutaneous systemic sclerosis was observed in 14 (38.9%) cases. Specific autoantibodies were positive in 33 (91.6%) cases, with anti-topoisomerase I as the largest group, positive in 22 (52.9.3%) cases. This was followed by anti-Th/To in eight (15.7%) cases; anti-Ro52 in four (7.8%) cases; anti-centromere in three (5.9%) cases; anti-RNA polymerase in three (5.9%) cases; anti-fibrillarin in three (5.9%) cases; anti-Ku in two (3.9%) cases; and anti-PDGF in one (2.0%) case. High-resolution computed tomography of the lung showed 34 (94.4%) cases with ILD and 22 (61.1%) cases with severe lung fibrosis. Usual interstitial pneumonia was seen in 19 (52.8%) cases and non-specific interstitial pneumonia in 15 (41.7%) cases.Conclusion: Anti-topoisomerase I, anti-Th/To, and anti-Ro52 are the most common autoantibodies observed in systemic sclerosis patients with ILD as the most prevalent feature detected with lung HRCT.

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

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

Risk Factors for Patients with Gonococcal Urethritis at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2013–2019

Background: Gonorrhea is the second most common sexually transmitted infection in Southeast Asia. Many factors cause gonococcal urethritis, and each region has its characteristics. This study aimed to determine the risk factors among patients with gonococcal urethritis at Dr. Hasan Sadikin General Hospital Bandung. Methods: This was a descriptive study with a retrospective and total sampling method, reviewing the gonococcal urethritis patient medical records obtained from Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2019. Sociodemographic, clinical manifestations, and sexual or risky behaviors data were collected.Results: Among 97 males with gonococcal urethritis, unmarried males (54.6%) and the age category of 20–24 years (35.1%) were predominant, with high school education/equivalent (58.8%). Based on their sexual behavior, the majority had more than one sexual partner in the past month (63.9%) and had never used a condom when having sex (55.7%). Additionally, there was also a group of man who had sex with man (MSM) (14.4%) and illicit drug users (19.5%).Conclusions: Males in the young adult age group, single, have a high education level, have multiple sexual partners, and never used a condom during having sex, have a higher risk of having gonococcal urethritis. Identifying these most reported risk factors may help health care providers design effective prevention strategies. Unmarried young adults should be a primary focus in receiving educational programs. They should be informed regarding the impact of multiple sexual partners, condom usage, and illicit drug on gonococcal urethritis infection among men.

Lipid Profile in Early and Late Stage among Patients with Nephrotic Syndrome-Related Chronic Kidney Disease in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2016−2019

Background: Chronic kidney disease (CKD) is a major health problem in children with an increased prevalence globally. CKD is strongly associated with Nephrotic Syndrome (NS) and dyslipidemia, which become a progressive factor of CKD. This study aimed to describe the lipid profile of children with CKD and NS in Dr. Hasan Sadikin General Hospital Bandung, Indonesia.Methods: An observational-retrospective study was conducted with a cross-sectional design involving 150 medical records of children aged 1−18 years who were diagnosed with CKD with NS. Lipid profile data, including total cholesterol, triglycerides, LDL, and HDL, were collected from 2016−2019 using the total sampling method. Subjects with incomplete lipid profile data were excluded from the study.Results: Among the fifty-two children that were eligible and fulfilled the inclusion criteria, 88.5% were diagnosed with stage 1 CKD, and 32.7% were aged between 6−11 years and boys were predominant (67.3%). Lipid profile changes were found in the LDL, HDL, and total cholesterol serum levels between CKD stage I and II–V.Conclusions: Lipid profile of CKD pediatric patients with NS in Dr. Hasan Sadikin General Hospital Bandung in 2016−2019 showed hypertriglyceridemia and hypercholesterolemia. Most subjects were in stage I of CKD and Steroid-Resistant Nephrotic Syndrome, and comparison between stages of CKD and types of nephrotic syndrome is lacking. A prospective analytical study would be more reliable in proofing its significance.

Correlation Analysis of Lactic Acid Level as A Predictor of Severity of Patients with Acute Appendicitis

Perforated appendicitis is a leading cause of morbidity and mortality in all appendicitis cases, both for adults and children. Delay in preoperative diagnosis is the main reason for perforation. In previous studies, it was revealed that diagnostic modalities such as radiological examination and the current scoring system have not been able to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The increase in the serological value of lactic acid in perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) according to a previous study. This study aimed to determine the correlation between lactic acid level and the severity of appendicitis in patients visiting Dr. Hasan Sadikin General Hospital. This was a cross-sectional prospective analytic observational study on adult patients diagnosed with appendicitis who were admitted to the emergency room of Dr. Hasan Sadikin General Hospital from January 1, 2021 to June 1, 2021. Data analysis was performed using bivariate analysis and correlation tests of difference. This study involved 54 subjects with a mean lactic acid level of 2,5093 mmol/L (0.9 mmol/L - 11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) was found to experience an increase in lactic acid (OR 1.07; 95% CI: -0.03-0.22; p=0.14). The correlation analysis showed the direction of negative correlation. Thus, it is concluded that there is no significant correlation between lactic acid level and the severity of appendicitis in patients with appendicitis.

Association of Lower Urinary Tract Symptoms and Benign Prostatic Enlargement in Patients with Hypertension

Development of hyperplastic nodules in the transition zone of the prostate is the characteristic of Benign prostatic enlargement (BPE). Men with hypertension have a high risk of severe lower urinary tract syndrome (LUTS). This restrospective cohort analytic study investigated the association between LUTS and BPE in hypertension patients. Subjects were BPE patients with primary hypertension who visited the urology clinic of Dr. Hasan Sadikin General Hospital Bandung that were sampled consecutively from 2017 to 2020. Three hundred and twenty-four patients from the urology department participated in the study. These patients were categorized into mild LUTS (IPSS 1-7) (n=37, 11.4%), moderate LUTS (IPSS 8-19) (n=169, 52.2%), and severe LUTS (IPSS 20-35) (n=118, 36.4%). A positive correlation (r = 0.761, p = 0.000) and weak positive correlation (r = 0.152, p = 0.006) were found between systolic blood pressure and prostate volume and between LUTS and systolic blood pressure, respectively. In addition, there was also a weak positive correlation between diastolic blood pressure and prostate volume (r = 0.065, p = 0.245) and LUTS (r = 0.015, p = 0.784). Thus, there is an association between hypertension and prostate enlargement and the severity of lower urinary tract symptoms

Age, Gender, and Preoperative LVEF Influence on ICU Length of Stay After CABG

Coronary artery bypass graft (CABG) surgery is a surgical therapy for coronary artery disease (CAD) patients who cannot be solely treated using pharmacological therapy. Patients undergoing CABG surgery require careful postoperative monitoring in the intensive care unit (ICU). This leads to the need for careful selection of patients due to the limited number of ICU beds available. A prolonged stay in ICU could delay surgery for other patients. This retrospective study analyzed how preoperative factors such as age, gender, and preoperative left ventricular ejection fraction (LVEF) may influence patient's length of stay (LOS) in the ICU. For this study, subjects were patients undergoing isolated CABG in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of January 2019- December 2020 who were selected using the simple random sampling method. The subjects were categorized into <65 years old and ≥65 years old age groups; man and woman gender; preoperative LVEF of <40% and ≥40%; and prolonged ICU LOS (>96 hours) and non-prolonged ICU LOS (<96 hours). Deceased patients in the ICU were excluded. Results of the bivariate and multivariate analyses showed that age was the only factor (p-value of 0.017) that increased the risk of prolonged ICU LOS (OR of 3.34) after CABG surgery that was statistically significant. This study concluded that patient of old age (>65 years old) is at a higher risk of having prolonged ICU LOS after CABG; thus, a careful scheduling of patients for CABG surgery by age is important to prevent prolonged ICU LOS after CABG.

Orthognathic Surgery as Class III Skeletal Treatment in a 31-Year-Old Female with Mandible Prognathism: A Case Report.

Mandible prognathism or malocclusion skeletal class III is facial deformities. These deformities can affect orofacial function, such as mastication, speech, and function of the temporomandibular joint. Besides the physical effects of these deformities, the psychosocial impact on the individual is often essential, and such deformities can affect the quality of life and self-confidence. Orthognathic surgery is designed to correct these deformities because these deformities could not have been corrected by only orthodontic treatment. Therefore, at Hasan Sadikin General Hospital, orthognathic surgery is the treatment choice for mandibular prognathism or malocclusion skeletal class III. In this case report, we present a 31-year-old female with mandibular prognathism, difficulty in closing her mouth and anterior open bite. Surgery was performed by Le Fort 1 osteotomy for advancing maxilla and bilateral sagittal split osteotomy for setback mandible. Two weeks after surgery, patient came back to the orthodontic department for occlusion treatment.

Comparison of Accuracy Scores between CLOC and RSCLO Scoring Systems in Predicting the Risk of Preoperative Laparoscopic Cholecystectomy Conversion at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Background: Cholecystectomy is a surgical therapy for cholelithiasis which can be performed by open cholecystectomy or laparoscopic cholecystectomy. Not all laparoscopic cholecystectomy procedures work properly. Sometimes it requires conversion from laparoscopic cholecystectomy to open cholecystectomy. A risk factor scoring system has been developed and validated using a large prospective cholecystectomy database and can accurately predict the likelihood of conversion with the conversion from laparoscopic to open cholecystectomy (CLOC) score and risk score for conversion from laparoscopic to open cholecystectomy (RSCLO). This study aimed to compare the accuracy value between CLOC and RSCLO in predicting the risk of preoperative laparoscopic cholecystectomy conversion at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
 Methods: This study was an observational study with a cross-sectional approach. A total of 183 research subjects participated in this study. Observation of CLOC and RSCLO scores was carried out in this study. Univariate and bivariate data analysis was carried out using SPSS. The analysis of the value of sensitivity, specificity, positive predictive value, and negative predictive value were carried out using Medcalc software.
 Results: A CLOC score > 5.5 has a greater conversion risk than a CLOC score ≤ 5.5. Meanwhile, an RSCLO score >-2 has a greater conversion risk than an RSCLO score ≤ -2. Sensitivity value CLOC for the prediction of preoperative conversion from laparoscopic cholecystectomy to open cholecystectomy obtained 75% and a specificity of 74.85%, with value negative predictive value, which is higher than a positive predictive value and 74.86% accuracy. The sensitivity value RSCLO for the prediction of preoperative conversion from laparoscopic cholecystectomy to open cholecystectomy was obtained at 75% and a specificity of 77.78%. With value negative predictive value, which is higher than the positive predictive value and 74.86% accuracy.
 Conclusion: The CLOC and RSCLO scores were equally accurate in predicting preoperative conversion from laparoscopic cholecystectomy to open cholecystectomy.

Howell-Jolly Body-Like Inclusions in Coronavirus Disease 2019 (COVID-19): Possible Novel Findings.

During COVID-19 pandemic, it is difficult to distinguish febrile patient infected by SARS-CoV-2 or bacterial causes. Howell-Jolly bodies are a well-known entity found in red blood cells. They are nuclear fragments, composed of deoxyribonucleic acid, commonly observed in the peripheral blood smears of hyposplenic or asplenic patients. Recently, similar inclusions often referred to as Howell-Jolly body-like inclusions (HJBLIs) have been reported in the neutrophils of patients with acquired immune deficiency syndrome (AIDS) and COVID-19 patient. To explore whether HJBLIs in peripheral blood smear could differentiate between patients with confirmed SARS-CoV-2 and bacterial pneumonia. We performed cross-sectional study using secondary data from COVID-19 database and re-evaluated peripheral blood smears to identify HJBLIs. We included confirmed COVID-19 adults age >18 years who were hospitalized in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from March 1st 2020-May 31st 2020. We also examined peripheral blood smears in patients with confirmed bacterial pneumonia as a control group. Clinical characteristics including disease severity, CURB-65 score, comorbidity, and the present of HJBLIs in peripheral blood smears were evaluated. Overall, 33 patients were included: 22 were confirmed COVID-19 and 11 were confirmed bacterial pneumonia. The median (interquartile range) age in COVID-19 and patients with bacterial pneumonia were 53 years (40-64) vs 57 years (53-71), respectively. Compared with patients with bacterial pneumonia, HJBLIs were significantly higher in COVID-19 patients [21/22 (80.8%) vs 5/11 (45.5%), p 0.001]. Howell-Jolly body-like inclusions could be a potential feature to help differentiate between COVID-19 and bacterial pneumonia.

Risk factors of COVID-19 clinical worsening: A retrospective cohort study in COVID-19 referral hospital in west Java, Indonesia

Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is marked as one of the highly pathogenic viruses, resulting in millions of deaths worldwide. Management of COVID-19 in limited resources requires appropriate decisions. Clinical considerations along with simple laboratory parameters that can predict the worsening are needed to determine which patients should be treated more intensively. Methods: This is a retrospective cohort study based on the Research Electronic Data Capture (REDCap) registry of COVID-19 patients in Hasan Sadikin General Hospital from April to December 2020. Patients were divided into worsening and non-worsening groups within a 14-day follow-up. Factors affecting these conditions were analyzed. Results: A total of 537 patients were included in this study, of which 72 patients suffered deterioration. Multivariate analysis showed the significant factors affecting the worsening of COVID-19 patients were age > 60 years (aOR 4.207, 95% CI 2.13-8.32), heart disease (aOR 2.802, 95% CI 1.12-6.99), diabetes mellitus (aOR 3.107, 95% CI 1.43-6.74), respiratory rate > 23x/minute (aOR 3.71, 95% CI 1.87-7.38), and NLR > 3.8 (aOR 2.51, 95% CI 1.21-5.21). Conclusions: Older age, chronic heart disease, diabetes mellitus, tachypnea, and higher neutrophil-to-lymphocyte ratio (NLR) are risk factors for the clinical worsening of COVID-19 and can be useful to predict the worsening outcome and poor prognosis.

FAMILY PERCEPTION OF LIFE-SUSTAINING TREATMENT WITHDRAWAL IN PATIENT WITH SEVERE BRAIN INJURY: A QUALITATIVE STUDY IN BANDUNG-INDONESIA

Background: The decision-making process for withdrawing life-sustaining treatment (LST) in patients with severe brain injury can potentially become a problem between doctor and family because of different opinions. Objective: Explore the family consideration in withdrawing LST in patients with severe brain injury. Methods: This qualitative descriptive study with phenomenological approach conducted using semi-structured in-depth interview. Subjects were family members of coma patients due to severe brain injury and were admitted to the Intensive Care Unit in Hasan Sadikin General Hospital during January 2019 - December 2020. Results: The results of the five-participant interview showed that the considerations for withdrawing LST include: (1) the patient's condition, (2) family psychology, (3) resources, and (4) family beliefs. Conclusion: Doctors need to understand the family's considerations in terminating LST to bridge the inner conflicts that occur in the patient's family.

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Increase of blood glucose level In pregnant woman correlated with increased risk of maternal morbidity, and problems in labour also affect child outcome. This phenomena cause by physiological changes occur in pregnancy such as placental factor and inflammation factor in circulation. Changes in inflammation factor like tumor nerosis factor (TNF-α) and beta-cell correlated gene disfunction (potassium voltage-gated channel KQT-like 1 (Kcnq1) and glucokinase (Gck)) could affect blood glucose level. Blood glucose control in pregnant woman known to be effective to decrease and prevent complication in mother and fetus, such as preeclampsia, prematurity, low birth weight, and asphyxia baby. This research wish to know correlation of maternal blood glucose level to maternal delivery and fetal outcome. This research use seconder data from medical records as retrospective cohort study. Subject of this study are pregnant mother which given birth in Hasan Sadikin Hospital (RSHS) sbetween January 2018 – December 2021 and has been performed blood glucose test when first time administered in Hasan Sadikin Hospital. Analitic statistic was performed with contingency correlation test, association test with chi-square and continued with multivariate logistic regression. From 8996 subjects, positive correlation was founded between high random blood glucose with preeclampsia (r=0.154, p<0.001), premature labour (r=0.020, p=0.052), and low birth weight (r= -0.034, p=0.003). Correlation between random blood glucose and asphyxia was unfounded (r=0.003, p=0.809). There’s weak positive correlation between random blood glucose to preeclampsia and prematurity incidence. There’s also weak negative correlation between random blood glucose and baby birth weight. Correlation between blood glucose and APGAR score was unfounded.

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Mother’s Pregnancy Trimester Does Not Affect the Differences of IgG SARS-COV-2 Antibody Levels in Pregnant Women after mRNA and Inactivated Coronavirus Disease 2019 Vaccination

BACKGROUND: Since pregnancy increases the risk of coronavirus disease 2019 (COVID-19) and its morbidity in pregnant women, it is necessary and recommended to prevent COVID-19 in pregnant women by vaccination such as by messenger RNA (mRNA) and inactivated vaccines. SARS-CoV-2 antibodies produced from vaccination have different results according to the type of vaccine given. The previous studies showed that IgG SARS-CoV-2 antibody levels were influenced by various factors such as gestational weeks at the time when vaccines were given. Moreover, there have been no previous studies on the effect of gestational age on quantitative IgG levels after the second dose of the vaccine especially in Indonesia during this pandemic due to some restrictions on daily activities. AIM: The aim of this study is to see the effect of giving the COVID-19 vaccine based on maternal gestational age (in trimester units) on maternal immunity (IgG SARS-CoV-2) in Dr. Hasan Sadikin General Hospital Bandung, Bandung Kiwari Hospital and Dr. Slamet Hospital, Garut. METHODS: This was a retrospective and cohort study by taking secondary data using consecutive sampling from the previous tests on the levels of SARS-CoV-2 IgG antibodies after two doses of inactivated vaccine and mRNA. Healthy pregnant women 14–34 weeks at the Department of Obstetrics and Gynecology, Dr. Hasan Sadikin (RSHS) Bandung, Bandung Kiwari Hospital, and Dr. Slamet Hospital for the period October 2021 to January 2022 were the target population of this study. Based on inclusion and exclusion criteria, 103 samples met the criteria. Examination of Maternal SARS-CoV-2 IgG Antibody Levels procedures was carried out using Chemiluminescent Microparticle Immunoassay. Statistical analysis was done using IBM SPSS 28.00 and p < 0.05 was considered statistically significant. RESULTS: There was no significant difference (p = 0.236, p > 0.05) between the mean maternal age in the mRNA and inactivated vaccine groups. The mRNA and inactivated vaccine groups also had no significant difference in the gestational age category (0.70). There was a significant difference (p = 0.0001) between the levels of SARS-CoV-2 IgG antibodies after the vaccine in the mRNA and inactivated vaccine groups. There was no significant difference in the levels of SARS-CoV-2 IgG antibodies in the gestational age group after the mRNA vaccine (p = 0.426) and after the inactivated vaccine (p = 0.293). There was a significant difference (p < 0.05) in the subgroup analysis in each gestational age group (second trimester and third trimester) between SARS-CoV-2 IgG antibody levels after the mRNA vaccine compared to inactivated vaccine. DISCUSSIONS: The mRNA vaccine is based on the principle that mRNA is an intermediate messenger to be translated to an antigen after delivery to the host cell via various routes. However, inactivated vaccines contain viruses whose genetic material has been destroyed by heat, chemicals, or radiation, so they cannot infect cells and replicate but can still trigger an immune response. The administration of the vaccine in the second and third trimesters of pregnancy has the same results in increasing levels of SARS-CoV-2 IgG antibodies after mRNA and inactivated vaccination in this study. CONCLUSIONS: mRNA vaccination in pregnant women is better than inactivated vaccines based on the levels of IgG SARS-CoV-2 antibodies after vaccination. The maternal trimester of pregnancy was not a factor influencing the levels of SARS-CoV-2 IgG antibodies after either mRNA or inactivated COVID-19 vaccinations in this study.

Characteristics of Patients with Neglected Fractures Who Seek Treatment at the Bone Setter before Going to the Hasan Sadikin General Hospital Bandung In 2021

Introduction: Neglected fracture is a fracture that is not treated or treated improperly, resulting in a delay in treatment, or a worse condition and even disability. Until now, people still believe in the treatment of fractures by bone setter. More than 50% of complications occur in fracture treatment performed by bone setter. This study aims to determine the characteristics of patients with neglected fractures to a bone setter at the Hasan Sadikin General Hospital, Bandung in 2021. Method: This study is descriptive, the data were taken from the medical records of patients with neglected fractures who previously went to a bone setter before being treated at Hasan Sadikin Hospital in Bandung in 2021. Sampling used total sampling according to the inclusion and exclusion criteria. Results: The socioeconomic status of neglected fracture patients were obtained with high income (39.81%), very high (26.85%), low (18.52%), and moderate (14.81%). The confidence of neglected fracture patients in bone setter dominated the cases, that is 96.3%, and only 3.7% did not believe in the treatment carried out by a bone setter. The patient’s trust in medical treatment in cases of neglected fracture to a bone setter is quite high (71.3%). A total of 90.75% of neglected fracture patients who were brought to a bone setter previously had easy access to health facilities, while the other 9.25% experienced difficulties in accessing health facilities. Conclusion: This study concludes that trust in bone setters in the case of Neglected Fractures is not influenced by socioeconomic status.