Hospital Denpasar Research Articles

Correlation of Total Protein in Cerebrospinal Fluid with the Type of Guillain-Barre Syndrome based on the Electrodiagnostic Examination at Prof. Dr. IGNG Ngoerah General Hospital Denpasar

Introduction: Guillain-Barre syndrome (GBS) is an autoimmune disease of the peripheral nervous system with an incidence of around 0.6 to 2.4 cases per 100,000 population. GBS pathogenesis is related to inflammatory factors, cytokines, chemokines, and complement. Protein levels in the cerebrospinal fluid of GBS patients will increase due to damage or increased permeability of the blood-nerve barrier and blood-cerebrospinal fluid (CSF) barrier. However, there are still pros and cons to the relationship between the amount of CSF protein and the subtype of GBS. Objective: To determine the most common GBS subtype and the characteristics of electrodiagnostic examination at Prof Dr IGNG Ngoerah General Hospital and the relationship between the GBS subtype characteristics on electrodiagnostic examination and CSF protein levels. Methods: This study used an analytic observational study with a cross-sectional study design with consecutive sampling. The sample of this study is 42 GBS patients (21 patients with normal total protein and 21 patients with increased total protein) at Prof Dr IGNG Ngoerah General Hospital, Denpasar-Bali. Data is collected through medical records and analyzed by Chi-Square test. Results: There is no correlation between the increase in total CSF protein in GBS patients and the GBS subtype on electrodiagnostic examination (p=0.215). Discussion: The most common GBS subtype is the AIDP type. Although the average amount of CSF protein was higher in the AIDP, AMAN and AMSAN subtypes respectively, the increase in total CSF protein did not have a significant relationship to the GBS subtype in Prof Dr IGNG Ngoerah General Hospital, Denpasar-Bali. Keywords: Guillain-Barre syndrome, autoimmune, total protein, cerebrospinal fluid, AIDP, AMAN, AMSAN

Psycho-Social Impact of Stigmatization against Pregnant Women with HIV

Background: Stigmatization, discrimination, and poor social support are challenges faced by people living with HIV, and the stigmatization of pregnant women with HIV is still very frequent, which can have a profound negative impact on patient's health. This can have a psychosocial impact on the sufferer. Objective: To study and determine the psychosocial impact of discriminatory behavior towards pregnant patients with HIV. Methods: This is a case report of two cases of pregnant women with HIV at the Voluntary Counseling and Testing (VCT) Polyclinic of RSUP Prof. Dr. I.G.N.G. Go to Denpasar. In-depth interviews were conducted with them regarding their views on openness to their families and communities about their condition. Results and Discussion: It was reported that two cases of pregnant women with HIV who were carrying out antenatal care in the Obstetrics and Gynecology Polyclinic Room, Prof. dr. I.G.N.G Ngoerah Central General Hospital Denpasar. In both cases, discriminatory treatment and stigma still strongly haunt the sufferers even though the form and source are slightly different. In the first case, the patient was afraid of getting discriminatory treatment and stigmatization that came from the family environment and the wider environment. Meanwhile, in the second case, it shows that the discriminatory treatment that causes stigma does not only come from far away but also comes from the people themselves. Both have a psychosocial impact that creates a sense of social discomfort, even though the race is slowly diminishing with the assistance of a counselor. There is a need for a wide range of active education by health workers to the patient's family and the community in reducing the stigma and discrimination against pregnant women with HIV. Conclusion: Women with HIV, especially those who are pregnant, are still full of negative judgments, and discriminatory behavior towards them. This can cause psychosocial impacts on patients. The disparity between knowledge about unknown patterns of HIV transmission on the one hand and risky sexual behavior, on the other hand, can be one of the risk factors for contracting HIV. This also contributes to stigma and discrimination against pregnant women with HIV.

The association between achieve of full feeding with mortality in children at sanglah hospital

Background: For pediatric patients who are hospitalized, full feeding nutritional needs is not only to improve BMI but also very useful for accelerating the healing process, shortening the treatment period, reducing complications, reducing morbidity and mortality, and preventing malnutrition due to treatment or medical action. This study aimed to describe the association between the achievement of full feeding with mortality in children. Method: The retrospective study was conducted in Pediatric Ward at Sanglah General Hospital, Denpasar Bali period January to December 2021. The inclusion criteria in this study were all pediatric patients who were hospitalized at pediatric wards Sanglah Hospital Denpasar. Inclusion criteria were children aged 1 month-18 years old. Samples were taken by total sampling. Quantitative variables were tested using variables that scale categorical data will be displayed in the form of absolute numbers and percent. The results of the descriptive analysis are presented using a chi-square test used to analyze all indirect variables (depending on whether the assumptions were met). The results of multivariate analysis were with logistic regression. The results were considered statistically significant at p < 0.05. Result: Total 258 subjects who met the inclusion criteria. Multivariate analysis with logistic regression shows full feeding (Exp B 0.24; 95% CI 0.032-0.27; P 0.006), nutritional status (Exp B 0.23; 95% CI 0.31-1.55; P 0,004) was statistically significant for mortality. Conclusion: Full feeding and nutritional status were associated with an increase in child mortality.

Quality of Life in End-Stage Renal Disease Patients Undergoing Hemodialysis and Its Affecting Factors in a Hemodialysis Unit of General Hospital Denpasar

End-stage renal disease (ESRD) patients undergoing hemodialysis (HD) repeatedly can affect their quality of life (QOL). Its QOL value can vary according to the patient's characteristics amid health conditions that may make it difficult for them. This study aimed to analyze the QOL of ESRD patients undergoing HD and its affecting factors. This cross-sectional study was conducted in a Hemodialysis Outpatient Unit of General Hospital, Denpasar, Bali, from April to May 2021. A sample of 103 respondents was obtained by using the purposive sampling technique. Inclusion criteria were ESRD patients undergoing HD aged ≥8 years old, completing questionnaires thoroughly, and communicating well. Data was collected through the KDQOL-36 questionnaire to measure the QOL and medical records for completeness of patient identities. Data were analyzed using Spearman's ρ, η, Mann-Whitney, and an Independent sample t-test (CI 95%). Findings showed the majority of respondents were aged <60 years (75.7%), had secondary education (41.7%), were working (50.5%), were diagnosed with ESRD, and undergoing HD <3 Years (81.6%), the duration of each HD >4 hours (85.4%), three times a week (91.3%), having a BMI >29 kg/m2 (89.3%), and hypertension (42.7%). The respondents experienced major problems in their QOL on the burden of ESRD (33.50±24.64), physical (39.57±8.94), and mental component summary (52.62±10.39) dimensions. Respondent's characteristics, including education level, duration of each HD, and diagnosis with ESRD undergoing HD, contributed to their QOL (p <0.05). The patient's QOL needs to be improved through the family and health worker's support.

Survival rate of children acute lymphoblastic leukemia at the end of therapy protocol with minimal residual disease (MRD) in Prof I G.N.G. Ngoerah General Hospital Denpasar

Link of Video Abstract: https://youtu.be/5DFCQHg86rU Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Although the survival rate of pediatric patients with ALL is currently improving, cases of relapse still occur. Minimal residual disease (MRD) status is a prognostic factor that plays an important role in recurrence of ALL patients who have been through induction therapy. Aim: To determine the survival rate in pediatric patients with ALL based on negative MRD examination is better than positive MRD at the end of therapy. Method: A retrospective cohort study with inclusion criteria including pediatric patients aged 1 to 18 years who were diagnosed with ALL in the period of 2017-2019 at Sanglah General Hospital, Denpasar. Subject’s recruitment was initiated when the minimum number of subjects was fulfilled. Result: From 32 research subjects, the mean age was 5.1 years, the majority obtained MRD+ results, the dominant sex was male, the average leukocyte was 28.33 thousand, most of the subjects had no mediastinal masses, and generally experienced remissions. MRD levels were found to be significantly lower in remitting patients than patients who did not achieve remission (p value <0.05). The Kaplan-Meier estimates for event-free survival on MRD status (negative versus positive) were 84.6% and 42.1% (P = 0.030). Conclusion: There was a significant relation between MRD levels and the survival rate to achieve remission and MRD levels are significantly lower in remitting patients than patients who do not achieve remission.

Risk factors and characteristics of cervical cancer patients under 40 years old at Prof Dr I.G.N.G. Ngoerah Hospital Denpasar, Bali from January until December 2022

Risk factors and characteristics of cervical cancer patients under 40 years old at Prof Dr I.G.N.G. Ngoerah Hospital Denpasar, Bali from January until December 2022

PROFILE OF INCOMPATIBLE REACTIONS TO PACKED RED CELL TRANSFUSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AT SANGLAH HOSPITAL

Background: Since the prevalence of chronic renal failure disease has increased. Packed Red Cell (PRC) transfusions were a common way to replace the kidneys' function in filtration. However, the reaction caused was not widely reported. Purpose: To assess the profile of incompatible reactions in PRC transfusions of chronic kidney disease patients at Sanglah Hospital, Denpasar. Method: A descriptive observational study with a cross-sectional design was employed to identify incompatibility reactions in 210 patients using medical records from July–December 2021 at Sanglah Hospital in Denpasar. Sample determination using saturated sampling techniques and data analysis were carried out descriptively. Result: Incompatible reactions in patients with chronic renal failure at Sanglah Hospital Denpasar still affected 57 people (27.14%) out of 210 people with chronic renal failure. This condition could increase fatalities in various health services if not appropriately handled. Incompatible reactions could occur, and the higher risk was in patients of the male sex who were elderly (45–65 years), had blood type O, had hemoglobin (Hb) levels ranging from 6.1–9.0 g/dL, and had conducted PRC transfusions above three pouches with a frequency of more than three times. Conclusion: People with chronic kidney failure still had a high chance of having an incompatible reaction after a PRC transfusion. Many different things caused these reactions. Incompatibility reactions in people with chronic kidney failure should happen less often in the future if they were evaluated and found early.

Pengaruh Tingkat Pelanggaran Terhadap Cedera Kepala Pada Kasus Kecelakaan Lalu Lintas Di Kota Denpasar

Traffic accident is an unexpected event that occurs on the highway usually at a productive age. Traffic accidents occur due to the level of violations committed by the driver. The severity of head injury patients was assessed from the GCS score, namely mild, moderate, and severe head injuries. This study aims to determine the effect of the violations on head injuries in traffic accidents cases in Denpasar City based on age, gender, GCS score, classification of head injuries based on GCS score dan morphology, Mechanism of Injury to assess the level of violations. This research is analytic with cross sectional approach. The data used is secondary data of patients head injuries due to traffic accidents registered in the Medical Records Installation of Sanglah Hospital Denpasar in 2020. The data collection technique by total sampling with the result that 68 data matched inclusion criteria. The results show that most common patient found in the age group 15-24 years(38.2%), male (83.8%), GCS Score 13-15(48.6%), minor violations(33.8%), mild head injury(48.5%) with bleeding morphology(79.4%), and a chi-square test result 0.024 in severe head injuries caused by violation. The conclusion is the most head injury patient due to traffic accidents in Denpasar City are aged 15-24 years, male, GCS score 13-15, commits minor level violations, caused minor head injury with bleeding morphology, and result of chi-square test show that level of violation affect head injury. The result of this study can be developed and become the basis for the other research with more varied variables.
 Keywords : Traffic Accident, Violation Rate, Head Injury

Correlation Between Type 2 Diabetes Mellitus with the Risk of Obstructive Sleep Apnea in Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar

Background: Obstructive Sleep Apnea (OSA) is part of a complex sleep disordered breathing syndrome. OSA is defined by periods of respiratory events such as apneas, hypopneas, or respiratory effort related arousals during sleep, leading to hypoxia, waking during the night, excessive daytime sleepiness and hindering daily activities. In addition, OSA can also cause various systemic complications and even death. The occurrence of OSA is associated with the presence of metabolic disorders that cause type 2 diabetes mellitus (DM), with as many as 30% patients with OSA also have type 2 DM. The occurence of OSA are often underdiagnosed, especially in high-risk population. Therefore, the purpose of this study is to find out the relationship between type 2 DM with the risk of OSA. Methods: A cross sectional analytic study was conducted from June to August 2022 at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar with a total of 80 respondents. The risk of OSA in the respondents was recorded using the Berlin questionnaire. Results: Of the 80 respondents, there were 33 people with a high risk of OSA and 47 people with a low risk of OSA. Respondents with a high risk of OSA were mostly male (78.6%), with the most ages between 51-60 years (53.6%), had type 2 DM (78.6%), and with nutritional status obese I (60.7%). There is a significant relationship between OSA and type 2 DM with a p-value of 0.019 (<0.05), a prevalence ratio of 3.3 with a 95% confidence interval (1.2-9.0), and a correlation coefficient of 0.254. Conclusion: There is a significant relationship between type 2 DM and OSA and is positively correlated. Type 2 DM is a risk factor of OSA, with 3.3 times the risk to develop a high risk OSA compared to patients without type 2 DM.

Relationship between saliva 17 beta-estradiol levels with anxiety and depression in menopause paramedic at Prof I.G.N.G Ngoerah Hospital Denpasar

Background: Hospital Services rely on Medical and Paramedics at the Hospital, Hospital Paramedic services, especially women, are greatly influenced by mood, in women it is especially influenced by hormonal balance, including menstruation and menopause. The drop in estrogen levels after menopause causes many physical and emotional changes. Estradiol is the largest estrogen. It is estimated that the number of women who have menopause will experience a very significant increase of estradiol. Methods: An analytic observational study with a cross-sectional study design on 85 menopausal paramedics at Prof I.G.N.G Ngoerah Hospital Denpasar using a Hospital Anxiety and Depression Scale (HADS) questionnaire and examined salivary levels of 17? estradiol and looked for its relationship with anxiety and depression. Results: Based on the low salivary 17? estradiol level of the sample aged above 50 years (76.5%). Outpatient (75%), underweight (100%), married status (74.4%), and sample >5 years (76.5%). It is also a significant result where the salivary 17? estradiol level is lower in the sample compared to anxiety and depression complaints, with the chi-square test (p-value = <0.001). Conclusion: There is a significant relationship between low salivary 17? estradiol levels and complaints of anxiety and depression in menopausal paramedics.

High Apoptotic Index in Amniotic Membrane of Pregnant Women is A Risk Factor for Preterm Labor

This study aims to prove a high apoptotic index in the amniotic membrane as a risk factor for preterm Labor. Case-control study, comparing preterm and term groups (n=54) who underwent labor in Obstetrics Emergency Room, Sanglah Central General Hospital Denpasar, Bali. Apoptotic index is a method of identifying and assessing the quantity of tissue undergoing apoptosis, which in this study was the amniotic membrane tissue, calculated and stained using the TUNEL method. Data collected was subjected to further statistical tests. Normality test with Shapiro Wilk test, followed by parametric independent T-test and Mann Whitney test was performed. Cut off apoptotic index was determined using the Receiver Operating Characteristic (ROC) curve. Bivariate analysis with Chi-square test and calculation of odds ratio was performed to assess the high apoptotic index to the risk of preterm Labor. Statistical significance was obtained with p value <0.05. Based on the cut-off value of ROC, the apoptotic index was classified into high (≥37.5%) and low (<37.5%) apoptotic index. A high apoptotic index is a risk factor for preterm Labor and increases the risk 6 times greater than the group with a low apoptotic index (p=0.003; OR 5.714; 95% CI 1.764–18.507). High apoptotic index in the amniotic membranes of pregnant women is a risk factor for preterm Labor.

Septic abortion in incomplete abortion case report and literature review

In the last 10 to 15 years, nearly 12% of all pregnancies ended in abortion in the first trimester (12 weeks of gestation), and recent data show that 80% of first trimester abortions occur before 10 weeks of gestation. Septic abortion is the result of an unsafe abortion. According to the World Health Organization (WHO), septic abortion occurs due to the termination of an unwanted pregnancy by an unfit person or the handling of an abortion in an environment that does not meet medical standards, or both. We report the case of a 21-year-old woman with G3P2002 with septic abortion + observation of decreased consciousness + acute kidney injury + electrolyte imbalance + transaminitis. The patient was brought by her family to the emergency department of Wangaya Hospital Denpasar with the main complaint of decreased consciousness, fever and weakness. The patient was diagnosed with incomplete abortion at 6 weeks gestation by an obstetrician but the patient did not seek medical treatment to evacuate the remaining tissue. The patient was dilated and curetted with oxytocin protection and antibiotics meropenem and levofloxacin. Postoperatively the patient was admitted to the intensive care unit for general improvement and continued electrolyte correction. after 2 days of treatment the patient experienced a decline in condition and was later declared dead. Treatment of septic abortion begins with rapid and accurate recognition of infection of the placenta and remaining conceptions, genital and blood cultures, administration of fluids and antibiotics, and immediate evacuation of infected products of conception.

Clinical profile of patients with pseudoexfoliation glaucoma in Bali Mandara Eye Hospital from January to December 2022: a descriptive retrospective Study

Background: Pseudoexfoliative glaucoma (PEX glaucoma) is a type of secondary either open or closed-angle glaucoma that is characterized by the accumulation of flaky, whitish material on the surface of the eye. This material, known as pseudoexfoliative material (PEX), can clog the eye's drainage system, leading to increased intraocular pressure and eventual optic nerve damage if left untreated. This study aimed to describe the characteristic and management of PEXG in the Bali Mandara Eye Hospital Denpasar. Methods: A descriptive retrospective study was conducted in March-April 2023 using electronic medical records of PEXG patients in the Bali Mandara Eye Hospital Denpasar from January–December 2022. Results: There were 26 patients (37 eyes) diagnosed as PEXG; most of them were male (88.4%), aged 60-69 years old (34.4%), and followed by those in the range of age 70–79 years old (42.3%). Most of the cases were bilateral (59.5%) with a decrease of visual acuity of less than 3/60 (54%), an increase of intraocular pressure (IOP) with the majority in the range of 20-29 mmHg (35.1%), and 10-19 mmHg (29.8%), and followed by those who have a history of metabolic disease with Hypertension found on ten patients (38.4%) and Diabetes Mellitus on three patients (11.5%). The treatment combined several types of antiglaucoma medication and glaucoma surgery with patients who had undergone surgery in 19 eyes (51.3%). And the post-operative visual acuity was measured and showed the most favorable results, with normal eyes found in 14 eyes (73.6%). Conclusion: PEX Glaucoma is commonly found in elderly patients. At the same time, most patients come with high IOP and late stage of the disease. The most frequent treatment is triple procedure surgery which produces a significant visual acuity improvement.

HUBUNGAN CITA RASA DENGAN SISA MAKANAN BIASA PADA PASIEN RAWAT INAP DI RUMAH SAKIT TK II UDAYANA DENPASAR

Food maintenance is the responsibility of Nutrition Installation at Tk. II Udayana Hospital Denpasar, but often find problems in the form of patient food waste that exceeds the standard. This study aims to analyze the relationship of taste with ordinary food waste in the hospitalization at Tk. II Udayana Hospital Denpasar, as one of the scientific evaluation steps in reducing food waste. The data in this study were collected by questionnaire and observation methods. The results of this study showed that the results showed that, of the 47 samples studied that had a large sample food waste is 18 people (38.3%), which is classified as a small number of 29 people (61.7%) and averaged the sample regular food waste of 18.4%. The sample that stated the taste of good food was 42 people (89.4%) and stated the taste of food is not good ie 5 people (10.6%).Keywords: Flavor,Food wasted

Comparison of quality of life in chronic rhinosinusitis patients based on SNOT-22 before and after administration of saline nasal irrigation at Sanglah General Hospital Denpasar

Introduction: Rhinosinusitis is an inflammation of the mucosa nasal cavity and paranasal sinuses and still a health problem in both developing and developed countries with a high prevalence and impacts in various aspects including quality of life and socioeconomics. Chronic rhinosinusitis occurs in 12.5% of the US population or 31 million patients per year.2 Saline nasal irrigation is a conservative treatment that can be used in patients with rhinosinusitis. Currently, SNOT-22 questionnaire is the best specific questionnaire that can be applied to assess the quality of life of chronic rhinosinusitis patients. Objective: To determine the impact of nasal saline irrigation on the quality of life of patients with chronic rhinosinusitis. Methods: This research is an observational study of the one-group test posttest design (before-after study). The selection of samples from all patients chronic rhinosinusitis who come to the ENT-KL polyclinic at Sanglah General Hospital Denpasar from October 2019 to December 2020 Result: In this study, the total sample that met the inclusion criteria was 52 people. In this research, it was found that the majority of the research subjects were male as many as 28 sufferers or 53,8%. Based on age, the majority of subjects were aged 25–44 years, namely 24 (46.1%). Based on the characteristics of comorbid diagnoses, there were 22 (42.3%) subjects with turbinate hypertrophy and septal deviation. The mean difference in improvement of SNOT-22 score was found to be 22.4 with a p value of <0.001. Conclusion: From this study, it was found that the most characteristics of research subjects were male, aged 25-44 years, with concomitant diagnoses of turbinate hypertrophy and septal deviation. There was a significant improvement in quality of life based on the SNOT-22 score in patients with chronic rhinosinusitis after administration of saline nasal irrigation.

Comparison of quality of life in chronic rhinosinusitis patients based on SNOT-22 before and after administration of saline nasal irrigation at Sanglah General Hospital Denpasar

Comparison of quality of life in chronic rhinosinusitis patients based on SNOT-22 before and after administration of saline nasal irrigation at Sanglah General Hospital Denpasar

Severe Falciparum Malaria with Multiple Complications in Sanglah Hospital Denpasar

Malaria is caused by Plasmodium, which is transmitted through the bite of infected female Anopheles mosquitoes. Plasmodium falciparum causes the most severe form of malaria and can be life-threatening. A 63-year-old male with decreased consciousness, fever, chills, vomiting, and joint pain. The patient works in the Ivory Coast, malaria-endemic areas. Physical examination found clouding of consciousness and jaundice. Laboratory examination results are leukocytosis with eosinophilia and thrombocytopenia, increased of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin, direct and indirect bilirubin, Blood Urea Nitrogen (BUN), creatinine, decreased of estimated Glomerular Filtration Rate (e-GFR), decreased random plasma glucose. Urinalysis showed macroscopic hematuria, positive blood, and protein are found, and erythrocyte sediment is increased. A blood gas analysis examination revealed metabolic acidosis. Rapid Diagnostic Test (RDT) showed positive for Plasmodium falciparum. The blood smear showed leukocytosis with eosinophilia and thrombocytopenia and the ring-form trophozoites stage of Plasmodium falciparum. The definitive diagnosis of falciparum malaria is confirmed by microscopic peripheral blood smear and malaria RDT for antigen detection. An overall investigation concluded the patient diagnosed is severe falciparum malaria with various complications including hypoglycemia, jaundice, and acute kidney failure. The patient died on the first day after being treated in Sanglah Hospital, Denpasar.

Characteristics of the rectosigmoid index in pediatric patients with definitive Hirschsprung’s disease in radiology installation of Sanglah General Hospital, Denpasar from January 2018 to December 2019

Background: Hirschsprung's disease is a developmental disorder of the enteric nervous system of the distal intestines. Colon in-loop examination is used as a spearhead in the diagnosis of Hirschsprung's disease, and according to previous studies, it was found that the presence of transitional zone and rectosigmoid index of less than 1 were correlated with positive pathology results in 79%-87% of cases. The purpose of this study was to provide an overview of the rectosigmoid index of patients suspected of having Hirchsprung's disease as illustrated by a colon in-loop examination. Methods: The research method is cross-sectional descriptive from January 2018 to December 2019 at Prof. Dr. dr. I. G. N. G. Ngoerah Hospital Denpasar. Data collected from colon in-loop examination in patients suspected of having Hirschsprung's disease included gender, age, RSI, and pathology results in patients who underwent biopsy. Data were analyzed using SPSS version 20 for Windows. Results: The results found from 49 samples were that Hirschsprung was dominant in males (63.27%). Patients aged less than 1 month were the most common, with a percentage of 44.9%. The second most common was at the age of 1 to 12 months at 30.6%, while the incidence rate with the least number was at the age of more than 12 months, namely 24.5%. RSI data found that of the patients suspected of having Hirschsprung's disease, 40 samples, or 81.6%, had an RSI < 1, and it was found that of the 40 samples with RSI < 1, 82.9% confirmed Hirschsprung's with an aganglionic pathology result. In contrast, in patients with aganglionic PA, the proportion of patients with RSI < 1 was more than 80%. Conclusion: The data obtained in this study are in accordance with those described in previous studies and support the role of RSI in strengthening the diagnosis of Hirschsprung's disease.

High C-Reactive Protein (CRP) Levels as Risk Factors for Poor Sleep Quality in Patients with Nasopharyngeal Cancer with Radiotherapy

Background/aim: Good sleep quality affects the body's metabolism, which impacts a person's physical and psychological condition. Patients with nasopharyngeal cancer who receive radiotherapy are reported to experience a lot of poor sleep quality, which will affect the success of treatment, increase treatment costs and decrease quality of life, which will cause social problems in the community future. Rate C-Reactive Protein (CRP) serum in nasopharyngeal cancer patients with radiotherapy increased significantly after radiotherapy. This study to Proving rate of CRP is a risk factor for poor sleep quality in nasopharyngeal cancer patients with radiotherapy Method: This is a statistical analytical study with a case-control design in nasopharyngeal cancer patients with radiotherapy at Prof. Dr. IGNG Ngoerah Hospital Denpasar, Bali, from December 2020 to April 2021. Data analysis using SPSS for Windows. Results: There were 120 respondents, 77.5% male, mean age ± SD 52.85 ± 6.35, high CRP levels on average with poor sleep quality 16.95 ± 6.95 mg/L. Bivariate analysis using Chi-square obtained OR = 9.33 (95% CI 2.18-39.9; p = 0.003). The results of multivariate analysis showed that the CRP level variable had p=0.003. There is a significant relationship between high CRP levels and poor sleep quality. Conclusion: High CRP levels increase the risk of poor sleep quality nine times in nasopharyngeal cancer patients with radiotherapy Keywords: poor sleep quality, CRP, nasopharyngeal cancer, radiotherapy

Characteristics of Mother with Neonatal Jaundice at Wangaya Regional Hospital Denpasar in the Period January - December 2022

Introduction: Maternal and child health problems are issues that need more attention because they have a major impact on development in the health sector and improve the quality of human resources. Although jaundice is not the highest cause of Infant Mortality Rate (IMR), jaundice is one of the contributors to infant morbidity in Indonesia because it can cause the baby's body to become weak and unwilling to suck, increased muscle tone, stiff neck, muscle spasms, seizures, sensory disturbances, mental retardation, disability, even death. Methods: This study is a descriptive design of all maternal patients who have jaundice babies. This research was conducted by collecting data from patient registers and electronic medical records at the Pediatric Polyclinic and Child Care Ward at Wangaya Regional Hospital Denpasar for the period January until December 2022. Results: There were 77 mothers with neonatal jaundice in this study. Researchers compared the characteristics of the mother with neonatal jaundice based on the mother’s age, gestational age, parity, education level, and the delivery method. Conclusion: Majority of mothers with neonatal jaundice are in the age group of 20-35 years, high school graduates, multigravida parity, gestational age 37-41 weeks and the method of delivery is sectio caesarea. Keywords: Jaundice, neonatal, risk factor, mother, icterus