Hasan Sadikin Hospital Bandung Research Articles

C-Reactive Protein (CRP) Value and Platelet Counts in Pediatric Dengue Patients at RSUP Dr. Hasan Sadikin Bandung

Plasma leakage, thrombocytopenia, and cytokines play roles in pathogenesis of dengue infection. Thrombocytopenia correlates with severity of the disease. Dengue virus infection produces cytokines that stimulate C-Reactive Protein (CRP). This study aims to describe the results of CRP and platelet counts with severity of dengue infection in paediatric inpatient at Hasan Sadikin Hospital Bandung. This is a descriptive observational study with retrospective, cross-sectional data collection in January 1-December 31, 2021 at Hasan Sadikin Hospital. From 32 total subjects, there were 24(75%) non-severe dengue infections compared to severe dengue 8(25%). Non-severe dengue 19(79.2%), had the most platelet counts of 50,000-150,000/L, while platelets count 20,000-50,000/µL was mostly in severe dengue 4/8(50%). CRP value was mostly normal (<0.3mg/dl) as many as 18/24(75%) in mild dengue, whereas in severe dengue CRP was mostly high as many as 6/8(75%). CRP examination is mostly done in critical phase, both in severe and non-severe dengue. Severe dengue infection was found mostly in platelet counts of 50,000-150,000/µL and normal CRP level as many as 14(58.3%). In severe dengue infection, platelet counts was found mostly in 20,000-50,000/µL and high CRP (≥0.3mg/dl) as many as 3(37.5%). Most cases of dengue fever infections in children at Hasan Sadikin General Hospital in 2021 were of mild severity, with platelet counts ranging from 50,000 to 150,000/µL and normal CRP levels. Examinations were typically carried out during the critical phase.

A Comparison of Pain Before and After Transfusion in Adult transfusion-dependent thalassemia (TDT) Using BPI-SF.

Background Pain is a complication in patients with transfusion-dependent thalassemia (TDT). There are several mechanisms underlying pain in people with thalassemia and low hemoglobin at the end of the transfusion cycle was the most etiology. Pain can develop into chronic pain and interfere with the quality of life. The Brief Pain Inventory Short Form (BPI-SF) can help identify pain in people with TDT. The present study aimed to compare pain before and after transfusion in adult TDT patients. Methods It was an analytical observational study using a cross-sectional design on adult TDT patients with pain who came to the Haemato-Oncology Clinic of Dr. Hasan Sadikin Hospital Bandung. This study was conducted from December 2020 to July 2021. All subjects were assisted in filling out the Indonesian version of the BPI-SF questionnaire hemoglobin levels were examined and before and after transfusion, then paired test analysis was performed using the Wilcoxon Test. Results This study is conducted on 60 adult TDT patients with symptoms of pain. The median value of pain intensity and pain interferes with life obtained from the Indonesian version of the BPI-SF score after transfusion decreased significantly compared to before transfusion (NRS 5 vs. 0 and 2.8 vs. 0; p=0.0001). Conclusion There is a significant difference in pain intensity and pain interfere with life in adults with TDT before and after transfusion. It is necessary to carry out pain assessments for thalassemia patients.

Prevalence of Squamous Cell Carcinoma of The Tongue In Dr. Hasan Sadikin General Hospital During 2017 – 2022

Introduction: Squamous cell carcinoma is the most common malignant neoplasm in the oral cavity, accounting for 90% of all malignancies in the oral cavity. Exposure of the oral epithelium to carcinogenic substances can cause squamous cell carcinoma. This study was show the prevalence of squamous cell carcinoma of the tongue in West Java which is used as education for the prevention of squamous cell carcinoma of the tongue. Purpose: This research is a descriptive study and carried out using purposive sampling method. The sample in this study were patients with a diagnosis of squamous cell carcinoma of the tongue at Dr. Hasan Sadikin Hospital Bandung during January 2017 - January 2022 who had been confirmed by histopathological examination results. Data analysis will be carried out on secondary data from collected medical records and the results of the pathologist's interpretation, then the results of the data analysis will be arranged and presented in tabular and percentage form. Methods: The data obtained were 218 cases. Based on age, the most patients were in the age group above 48 years (58%). Based on gender criteria, it shows more women (57%). Based on domicile criteria, the highest domicile was in Bandung (38%). Based on family history criteria, there were 215 patients with no family history or 99%. Based on the predisposing factor criteria, it shows more patients with a history of chronic irritation (48%). Based on the mass size criteria, it shows more patients with mass size T4 (60%). Based on KGB criteria, it shows more patient showed N1 lymph nodes involvement (63%). Based on tumor metastasis criteria, it shows more patients with Mx tumor metastasis (50%). Based on the therapy status criteria, it shows more patients with combined therapy (32%). Results: Type the result of your research, including statistical analysis. Conclusion: Patients suffering from squamous cell carcinoma in the tongue are mostly patients over 48 years old with female gender who live in Bandung City, West Java, and have no family history but have predilection factors such as irritation and infection. The size of the tumor mass in patients with squamous cell carcinoma mostly has a mass size > 3 cm, with lymph node involvement mostly on the ipsilateral with a size < 3 cm and metastasis to other organs is difficult to assess due to lack of supporting modalities. The therapy received was mostly combined therapy (surgery and chemotherapy or radiotherapy) Keywords: Squamous cell carcinoma of the tongue, prevalence, patient characteristics

Patterns of contraception utilization among reproductive-aged women with thyroid cancer undergoing radioiodine ablation: A study at Hasan Sadikin Hospital.

The incidence of new cases of thyroid cancer worldwide is around 10.1/100.000 in woman dan 3.1/100.000 in men. Women with thyroid cancer are advised to avoid pregnancy while undergoing radioablation due to teratogenicity. Therefore, it is crucial to utilize contraception to avoid pregnancy during treatment. The purpose of this study was to determine the characteristics of contraceptive use patterns in women with thyroid cancer of reproductive age who underwent radioablation at Hasan Sadikin Hospital Bandung.Cross-sectional study conducted at Hasan Sadikin Hospital Bandung in May 2023. The research sample was all female thyroid cancer of reproductive age who underwent radioablation at the Nuclear Medicine polyclinic of Dr. Hasan Sadikin Bandung in January-December 2022 by purposive sampling. Data obtained from patient medical records and primary data from patients. A total of 450 patients fulfilled inclusion criteria, but only 329 analyzed with complete data. Majority of the patient was in age group 35-49 years (58.1%), parity >1 (55.9%), last education high school (39.2%), married (81.8%), type of papillary thyroid carcinoma (79.9%), sources of information about contraception from doctors (71.7%), and 75.4% use contraception. The most widely used type of contraception was intrauterine device (IUD), accounting for 28.6% patients. Approximately 75.4% patient use contraception. The most widely used type of contraception is the IUD. Contraception counselling is important for increasing contraceptive use rates among women with thyroid cancer. Further research in the form of analytical research is needed to assess the factors that influence contraceptive use in women with thyroid cancer of reproductive age.

Characteristics of Middle 1/3 Facture Fractures Assessed with the Facial Injury Severity Scale at the Oral Surgery Policy of Dr Hasan Sadikin Hospital Bandung Period June 2019 - June 2021

Maxillofacial trauma is damage that affects the face and surrounding tissue, where traffic accidents are the main cause of trauma. The location of facial fractures can occur in the upper third, middle third and lower third of the face. The position of the maxilla which is located in the middle third of the face causes it to be protected by the prominent bones of the mandible, zygoma, nasalis and frontalis, so that maxillary fractures are rarely found compared to mandibular fractures. The prevalence of fractures in the middle third of the face is higher than fractures in other areas of the face (upper third and lower third). Keywords: MISS, FISS

Steiner cephalometric analysis in orthognathic surgery patients treated at Department of Oral and Maxillofacial Surgery, Hasan Sadikin General Hospital, Bandung

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible. Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Cephalometric radiography was utilized for assessment, employing the Steiner method to analyze various angles. Patient characteristics, including gender and age, were also observed. Parameters such as the average angle of SNA, SNB, and ANB were examined, alongside diagnoses, the number of corrected jaws, and the type of orthognathic surgery. Results: The findings indicated a predominance of male orthognathic surgery patients (63.3%), with the majority falling within the age range of 19 to 20 years (40%). Grade III malocclusion was the most prevalent diagnosis (96.7%), with double jaw correction being the most common procedure performed (90%). Bilateral sagittal split osteotomy was utilized in 93% of cases, followed by Le Fort I osteotomy in 96.7% of cases and chinplasty in 16.7% of patients. The average SNA, SNB and ANB was 83.8o, 90.6o, and -6.8o, respectively. Conclusion: The findings indicated a higher frequency of orthognathic surgery among patients diagnosed with class III malocclusion. Additionally, a notable proportion of patients underwent simultaneous orthognathic surgery on both the maxilla and mandible.

Steiner Analysis of Cephalometric in Orthognathic Surgery Patients of Department Oral and Maxillofacial Surgery Hasan Sadikin General Hospital Bandung of Period April 2017 – April 2022

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Attention was carried out using cephalometric radiography and analyzed using the stainer method by observing angles also observing patient characteristics such as gender and age, average angle of SNA, SNB, ANB, diagnosis, number of corrected jaws and type of orthognathic surgery. Results: The results of this study showed that orthognathic surgery patients were more male (63.3%), most aged between 19 - 20 years (40%), diagnosis of grade III malocclusion (96.7%), double jaw correction action (90%), bilateral sagittal split osteotomy (93%), osteotomy le fort I (96.7%), chinplasty (16.7%), mean angle SNA (83.8), angle SNB (90.6), angle ANB (-6.8). Conclusion: The results showed that more patients underwent orthognathic surgery with class III malocclusion and underwent orthognathic surgery on the maxilla and mandible simultaneously Keywords: Orthognathic surgery, cephalometry, Steiner analysis, malocclusion

Clinical Significance of D-dimer Level and Numeric Rating Scale with Amount of Sinus Involvement in Cerebral Sinus Thrombosis Patients.

Cerebral venous sinus thrombosis (CVST) is a cerebral vascular disorder that currently occurs quite often and has very varied clinical symptoms. Headache is the main symptom most commonly found in patients with CVST and multiple sinus involvement often have a more severe prognosis and poor clinical outcome. This study aimed to learn the relationship between D-dimer level, numeric rating scale (NRS), and amount of sinus involvement in CVST patients. This study was a retrospective observational analytic study with a cross-sectional approach using medical records and supporting data (D-dimer level and imaging finding) on patients diagnosed with CVST at Dr Hasan Sadikin Hospital Bandung. Sixty-five CVST patients met the study criteria with mean age of 47 years and mostly female (76.9%). Patients with single sinus involvement had a median initial NRS of 4 (range 2-6) and multiple sinus involvement was higher at 8 (range 5-9). Statistical test results showed a significant difference between D-dimer level, NRS and amount of sinus involvement (P<0.001). D-dimer level, NRS, and amount of sinus involvement are associated with amount of sinus involvement in CVST patients. Involvement of multiple sinus will cause higher NRS with higher D-dimer level.

Accuracy of Kampala Trauma Score as a Predictor in Assessing the Prognostic Value of Multiple Trauma

Determining a trauma scoring system appropriate for certain conditions will help in predicting mortality and morbidity, and can determine the need for treatment in patients. Kampala Trauma Score (KTS) is a trauma scoring system that uses a decent number of assessment variables and can be used in all general groups. This study was a retrospective prognostic test conducted in Dr. Hasan Sadikin Hospital Bandung, Indonesia, from December 2021 to July 2022. Data obtained was processed using Microsoft Excel and SPSS spreadsheets. The respondents were 66 people with multiple trauma. Results showed that this study was dominated by patients with blunt trauma (n=63, 95.45%). The mean KTS score in this study was 13.08±1.03. In 49 (74.24%) patients who survived, the mean KTS score was 13.41±0.89 and in 17 (25.76%) patients who died, the mean KTS score was 12.12±0.79. The greatest mortality accuracy was at the cutoff point of the KTS score &gt;12 (81.82% accuracy; 70.59% sensitivity; 85.71% specificity). The accuracy value of the KTS score is in line with the ROC where the optimal KTS score is &gt;12 (85.77%). In conclusion, the Kampala trauma score can be used as a predictor in assessing the prognostic value of multiple trauma patients with the obtained cut-point value as it has high accuracy, sensitivity, and specificity values.

A Comparison of Pain Before and After Transfusion in Adult transfusion-dependent thalassemia (TDT) Using BPI-SF

Background Pain is a complication in patients with transfusion-dependent thalassemia (TDT). There are several mechanisms underlying pain in people with thalassemia and low hemoglobin at the end of the transfusion cycle was the most etiology. Pain can develop into chronic pain and interfere with the quality of life. The Brief Pain Inventory Short Form (BPI-SF) can help identify pain in people with TDT. The present study aimed to compare pain before and after transfusion in adult TDT patients. Methods It was an analytical observational study using a cross-sectional design on adult TDT patients with pain who came to the Haemato-Oncology Clinic of Dr. Hasan Sadikin Hospital Bandung. This study was conducted from December 2020 to July 2021. All subjects were assisted in filling out the Indonesian version of the BPI-SF questionnaire hemoglobin levels were examined and before and after transfusion, then paired test analysis was performed using the Wilcoxon Test. Results This study is conducted on 60 adult TDT patients with symptoms of pain. The median value of pain intensity and pain interferes with life obtained from the Indonesian version of the BPI-SF score after transfusion decreased significantly compared to before transfusion (NRS 5 vs. 0 and 2.8 vs. 0; p=0.0001). Conclusion There is a significant difference in pain intensity and pain interfere with life in adults with TDT before and after transfusion. It is necessary to carry out pain assessments for thalassemia patients.

Prevalence of Squamous Cell Carcinoma of Oral Cavity at Oral and Maxillofacial Surgery Department Dr. Hasan Sadikin Hospital Period of 2019-2020

Background: International Agency Data for Research on Cancer (IARC) in 2018 showed that cancer of the lips and oral cavity was ranked the 17th most common cancer in the world, there were 354,864 new cases of oral cancer in the world and cases of death from oral cancer were 177,384. case. New cases of oral cancer in Indonesia in 2018 were 5,078 cases and cases of death caused by oral cancer were 2,326 cases. Research on the characteristics of squamous cell carcinoma in the oral cavity in Indonesia is still relatively low. Objective: To analyze the prevalence of squamous cell carcinoma patients in the oral cavity at the Department of Oral and Maxillofacial Surgery, Dr. Hasan Sadikin Hospital Bandung from January 2019 to December 2020. Methods: Retrospective observational study by taking medical record data of patients with oral squamous cell carcinoma which had been clarified from histopathological results at the Oral Surgery Clinic, Dr. Hasan Sadikin Bandung. The sampling process was carried out using a purposive sampling method. The variables in this study were age, gender, location of the lesion, histopathological features, duration of the lesion and the complications caused. Data analysis using Microsoft Excel program. Results: The number of respondents aged 25-36 years as many as 4 people or 14%, ages 37-48 years as many as 7 people or 24%, and ages over 48 years as many as 18 people or 62%. There were 12 male patients or 41% and 17 female patients or 59%. Patients with a history of smoking as many as 10 people or 33%, a history of chronic irritation as many as 6 people or 20% and others as many as 14 people or 20%. The results of anatomical pathology showed that patients with poorly differentiated were 0 people or 0%, moderately differentiated were 9 people or 41%, well differentiated were 12 people or 55%, and others were 1 person or 4%. Conclusion: The age criteria of patients with the most squamous cell carcinoma are over 48 years old as many as 18 people or 62%. Based on the gender criteria, the patients with the highest incidence of squamous cell carcinoma tumors were 17 people or 59% female. anatomical pathology well differentiated as many as 12 people or 55%. Keywords: squamous cell carcinoma, oral cancer, patient characteristics

Prosedur Penggunaan Alat Fiksasi Masker Termoplastik Pada Terapi Radiasi Kasus Kanker Payudara Di Instalasi Radioterapi RSUP Dr. Hasan Sadikin Bandung

Breast cancer is a type of cancer that often occurs in women, in the treatment of breast cancer is radiotherapy and fixation tools used, namely breast boards and thermoplastic masks which are aids for patients not to move during radiation therapy. The purpose of the study was to determine the procedure and reasons for using thermoplastic mask fixation devices in radiation therapy cases of breast cancer. This research is qualitative with a case study approach, the research time is from June 7 to July 15, 2023 and the research location at the Radiotherapy Installation of Dr. Hasan Sadikin Hospital Bandung. The subjects of the study were Radiation Oncology Doctors, Medical Physicists, Radiotherapists and Patients. By collecting data, making interview transcripts and reducing data and processed with open coding, given in the form of quotations and then drawing conclusions.The results showed that the procedure for using a thermoplastic mask fixation device was inserted into a waterbath with a temperature of 65.50C until the thermoplastic mask became flexible, the reason for using fixation was a shift in smaller objects at the time of irradiation, and better aesthetic value, because concentration marks and field boundaries did not need to be drawn directly on the patient's body but were drawn on the thermoplastic mask. Using a mask does not need to be marked on the patient's chest so that by using a thermoplastic mask the shift towards the target object is smaller during irradiation.

Characteristics of Middle Third Facial Fractures in the Emergency Departement of Hasan Sadikin Hospital Bandung

Characteristics of Middle Third Facial Fractures in the Emergency Departement of Hasan Sadikin Hospital Bandung

Characteristics of Maxilllofacial Trauma Patiens before and during the Covid-19 Pandemic in Oral and Maxilllofacial Surgery Department of Dr. Hasan Sadikin Hospital Bandung

Introduction: Prior to the COVID-19 pandemic, motor vehicle accidents, falls, physical assaults, and sports injuries were the main causes of maxillofacial trauma. The existence of interventions to prevent the COVID-19 pandemic resulted in home-centered social activities in the community. This also contributes to alterations in the aetiology of maxillofacial trauma that occur worldwide and may affect other characteristics of this entity. Methods:This is a retrospective study conducted at the Hasan Sadikin Hospital, Bandung, West Java, Indonesia, and was carried out in September–December 2022. The population of this study were maxillofacial trauma patients with diagnoses of vulnus (laceratum, schissum, punctum, and morsum), frontal, mandibular, maxillary fractures, orbit, naso-orbito-ethmoid (NOE), zygomaticus, and dentoalveolar fractures before the 2018–2019 pandemic period and during the 2020–2021 pandemic period at the Oral and Maxillofacial Surgery Department at RSUP Dr. Hasan Sadikin Bandung through the emergency department.The variables studied included age, gender, type of trauma, etiology, alcohol involvement, and management.The data are presented as frequency distribution and percentage in tabular and diagram. Results: During the 2018–2021 periods, there were 504 patients who experienced maxillofacial trauma before the COVID-19 pandemic, and this number has decreased to 216 patients during the COVID-19 pandemic. The majority of maxillofacial trauma experienced both before (n = 314; [62%]) and during (n = 166; [77%]) the COVID-19 pandemic was caused by motor vehicle accidents. Most of patients before the COVID-19 pandemic were aged 0–19 years (n = 230; [46%]), meanwhile, during the COVID-19 pandemic most patients were aged 20–39 years (n = 88; [41%]).Overall, there were no differences in sex characteristics, alcohol involvement, type of maxillofacial trauma, or treatment given before and during the COVID-19 pandemic. Conclusion: The existence of interventions to prevent the COVID-19 pandemic by imposing Large-Scale Social Restrictions (PSBB) has resulted in modifications to community social activities that are centered in the home. This factor contributed to some differences in the characteristics of maxillofacial trauma patients at the Oral and Maxillofacial Surgery Department in Hasan Sadikin Hospital before and during the COVID-19 pandemic. Keywords: Maxillofacial trauma, Characteristics, COVID-19

Comparison of granisetron 10 µg/kg vs 40 µg/kg intravenous for prophylaxis of shivering after spinal anesthesia for lower abdominal surgery

Background &amp; Objective: Postanesthetic shivering is one of the many complications during recovery that is marked by vasoconstriction and involuntary movements in several muscle groups and psychologically is an incredibly uncomfortable experience for the patient. The 5-HT3 receptor antagonist granisetron can potentially be used to manage postanesthetic shivering through the thermoregulation neurotransmission system. This study aims to compare the effects of administering 10 µg/kg or 40 µg/kg of granisetron intravenously on the grade of shivering post spinal anesthesia in lower abdominal surgeries. Methodology: This study was a single-blind experimental study conducted on 30 patients who underwent spinal anesthesia for lower abdominal surgeries in Dr. Hasan Sadikin Hospital Bandung. There were no statistical differences of age, weight, height, BMI, core temperature before anesthesia, block height, room temperature, total bleeding, input volume, duration of surgery, and use of ephedrine between the two intervention groups. Results: Administration of 40 µg/kg intravenous granisetron could maintain the body temperature above 36.56 °C , better than the 10 µg/kg intravenous granisetron with the lowest temperature at 35.31 °C. Regarding the grade of shivering, administration of 40 µg/kg granisetron IV was able to improve postanesthetic shivering up to grade 2 in 3 (20%) patients, while 10 µg/kg intravenous granisetron improved grade of shivering to grade 3 in 5 (33%) patients, these results were statistically significant (P &lt; 0.05). Conclusion: In conclusion, administration of granisetron 40 µg/kg IV reduces the incidence and severity of shivering post spinal anesthesia, and maintains a better core temperature compared to granisetron 10 µg/kg IV.Keywords: 5-Ht3 Receptor Antagonist; Granisetron; Postanesthetic Shivering; Prophylaxis&#x0D; Citation: Wahid WR, Pradian E, Prihartono MA. Comparison of granisetron 10 µg/kg vs 40 µg/kg intravenous for prophylaxis of shivering after spinal anesthesia for lower abdominal surgery. Anaesth. pain intensive care 2023;27(4):553−557; DOI: 10.35975/apic.v27i4.2265&#x0D; Received: October 20, 2021; Reviewed: March 19, 2023; Accepted: June 22, 2023

Analysis of Completeness of Filling in Medical Records in Inpatients of Orthopedic Surgery to Improve Quality Services at Hasan Sadikin Hospital Bandung, Indonesia

Analysis of Completeness of Filling in Medical Records in Inpatients of Orthopedic Surgery to Improve Quality Services at Hasan Sadikin Hospital Bandung, Indonesia

Myeloid Cell Leukemia-1 (MCL-1) and Its Correlation with the Prognostic Scoring System in Chronic Myeloid Leukemia

The prognostic scoring system is used to assess the prognosis of Chronic Myeloid Leukemia (CML) patients to get the right treatment strategy. Poor prognosis, treatment resistance, and tumorigenesis have been associated with the overexpression of Myeloid Cell Leukemia-1 (MCL-1), an anti-apoptotic protein in several hematologic malignancies, including CML. Research on the correlation between MCL-1 levels and the scoring system prognostic in patients with CML is still limited. This study aims to evaluate the correlation between MCL-1 levels and the prognostic scoring system in chronic phase CML patients. This research was conducted on chronic phase CML patients who came to the Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Hasan Sadikin Hospital Bandung, Indonesia. Data is collected from medical records of patients examined for MCL-1 protein levels from previous studies and results of prognostic scoring systems (Sokal, Hasford, and EUTOS. Data were analyzed to evaluate the correlation between the MCL-1 level and the prognostic scoring system. Forty patients had a male-female ratio of 1.5. The average age is 40±11 years, with an age range of 19 to 61 years. The median MCL-1 protein level was 0.27 (min 0.02-max 4.1). Statistical analysis showed no significant correlation between MCL-1 levels and Sokal, Hasford, and EUTOS scores in chronic phase CML patients (p=0.285; p=0.923 and p=0.663, respectively).

Characteristics of Patients with Morbidly Adherent Placenta at Dr. Hasan Sadikin Hospital Bandung

Abstract Objective: Morbidly adherent placenta (MAP) is one of the causes of postpartum haemorrhage that impacts morbidity, hysterectomy, and mortality. This study reviewed patient characteristics and disease features in tertiary referral hospital patients with MAP. Methods: This is a quantitative descriptive study conducted on patients with MAP in September 2019–September 2020. Patient data were sourced from medical records. The characteristics described in this study include sociodemographic characteristics, obstetric history (gestation, parity, and abortion), history of caesarean section (CS), history of curettage, comorbidities, and current disease description and outcomes (bleeding, infant outcome, length of stay, death). Result: A total of 24 patients were diagnosed post-operatively as MAP in this study. Most of the patients were multi-parity, had a history of CS or curettage, and had comorbid placenta previa. Most of the patients came for CS plans or went with the chief complaint of bleeding. All patients were managed by hysterectomy. There was one case of maternal death and one case of fetal death. Conclusion: The characteristics of the patients in this study reflect the risk factors and general features of MAP. Karakteristik Pasien MAP di RSUP Dr. Hasan Sadikin Bandung Abstrak Tujuan: Morbidly adherent placenta (MAP) merupakan salah satu penyebab perdarahan pasca-salin yang berdampak pada morbiditas, tindakan histerektomi, dan mortalitas. Penelitian ini dilakukan untuk meninjau karakteristik pasien dan gambaran penyakit pada pasien dengan MAP di rumah sakit rujukan tersier. Metode: Penelitian ini merupakan deskriptif kuantitatif yang dilakukan pada pasien dengan MAP pada September 2019–September 2020. Data pasien bersumber dari rekam medik. Karakteristik yang dideskripsikan pada penelitian ini meliputi karakteristik sosiodemografi, riwayat obstetrik (gestasi, paritas, dan abortus), riwayat seksio caesarea (SC), riwayat kuretase, komorbid, dan gambaran penyakit terkini serta luarannya (perdarahan, luaran bayi, lama perawatan, kematian). Hasil: Sebanyak 24 pasien yang terdiagnosis pasca-bedah sebagai MAP pada penelitian ini. Sebagian besar pasien multi paritas, memiliki riwayat SC ataupun kuretase, dan memiliki komorbid plasenta previa. Sebagian besar pasien datang untuk rencana SC ataupun datang dengan keluhan utama perdarahan. Semua pasien ditatalaksana dengan histerektomi. Kematian pada ibu terjadi sebanyak satu kasus dan anak terjadi sebanyak satu kasus. Kesimpulan: Karakteristik pasien pada penelitian ini merefleksikan faktor risiko dan gambaran umum MAP. Kata kunci: morbidly adherent placenta, plasenta akreta, plasenta inkreta, plasenta perkreta.

Characteristics of Patients with Morbidly Adherent Placenta at Dr. Hasan Sadikin Hospital Bandung

AbstractObjective: Morbidly adherent placenta (MAP) is one of the causes of postpartum haemorrhage that impacts morbidity, hysterectomy, and mortality. This study reviewed patient characteristics and disease features in tertiary referral hospital patients with MAP.Methods: This is a quantitative descriptive study conducted on patients with MAP in September 2019–September 2020. Patient data were sourced from medical records. The characteristics described in this study include sociodemographic characteristics, obstetric history (gestation, parity, and abortion), history of caesarean section (CS), history of curettage, comorbidities, and current disease description and outcomes (bleeding, infant outcome, length of stay, death).Result: A total of 24 patients were diagnosed post-operatively as MAP in this study. Most of the patients were multi-parity, had a history of CS or curettage, and had comorbid placenta previa. Most of the patients came for CS plans or went with the chief complaint of bleeding. All patients were managed by hysterectomy. There was one case of maternal death and one case of fetal death.Conclusion: The characteristics of the patients in this study reflect the risk factors and general features of MAP.Karakteristik Pasien MAP di RSUP Dr. Hasan Sadikin BandungAbstrakTujuan: Morbidly adherent placenta (MAP) merupakan salah satu penyebab perdarahan pasca-salin yang berdampak pada morbiditas, tindakan histerektomi, dan mortalitas. Penelitian ini dilakukan untuk meninjau karakteristik pasien dan gambaran penyakit pada pasien dengan MAP di rumah sakit rujukan tersier.Metode: Penelitian ini merupakan deskriptif kuantitatif yang dilakukan pada pasien dengan MAP pada September 2019–September 2020. Data pasien bersumber dari rekam medik. Karakteristik yang dideskripsikan pada penelitian ini meliputi karakteristik sosiodemografi, riwayat obstetrik (gestasi, paritas, dan abortus), riwayat seksio caesarea (SC), riwayat kuretase, komorbid, dan gambaran penyakit terkini serta luarannya (perdarahan, luaran bayi, lama perawatan, kematian).Hasil: Sebanyak 24 pasien yang terdiagnosis pasca-bedah sebagai MAP pada penelitian ini. Sebagian besar pasien multi paritas, memiliki riwayat SC ataupun kuretase, dan memiliki komorbid plasenta previa. Sebagian besar pasien datang untuk rencana SC ataupun datang dengan keluhan utama perdarahan. Semua pasien ditatalaksana dengan histerektomi. Kematian pada ibu terjadi sebanyak satu kasus dan anak terjadi sebanyak satu kasus.Kesimpulan: Karakteristik pasien pada penelitian ini merefleksikan faktor risiko dan gambaran umum MAP. Kata kunci: morbidly adherent placenta, plasenta akreta, plasenta inkreta, plasenta perkreta.

Characteristic of Acute Ischemic Stroke Patients Based on TOAST Classification During COVID-19 Pandemic Era: A Single Centre Study.

The categorization system used in the Trial Org 10172 classification in Acute Stroke Treatment (TOAST) provided more insight into the causal process. The aims of this study were to characterize individuals with acute ischemic stroke using the TOAST criteria and to determine risk variables for patients with acute ischemic stroke during the COVID-19 pandemic. A cross-sectional study was done on the medical records of acute ischemic stroke patients at Hasan Sadikin Hospital (RSHS) Bandung, Indonesia, who were hospitalized in the Neurology Department of Hasan Sadikin Hospital from January to December 2021. Eligible patients were divided into 2 groups, with and without COVID-19 infection. There were 136 participants with acute ischemic stroke. Thirty-one percent of strokes were caused by atherosclerosis in the large arteries (LAA), followed by small-vessel occlusion (SVO) (25%), cardioembolism (CE) (22.1%), an undetermined cause (21.3%), and an other etiology (1.5%). CE risk factor was atrial fibrillation (p < 0.001), while hypertension, diabetes, and smoking were significant for LAA (p < 0.05). However, in patients with COVID-19 who had an acute ischemic stroke, most of the subtypes were stroke of undetermined etiology (76%), and hypercoagulation was the main risk factor (p < 0.001). Patients with and without COVID-19 show varied distributions of stroke subtypes according to the TOAST categorization. Hypercoagulation is a major risk factor for stroke of undetermined etiology in individuals with COVID-19 who suffer from acute ischemic stroke. Increased viral-mediated endothelial inflammation leading to aberrant coagulopathy may explain the correlation between COVID-19 and acute ischemic stroke.