Hospital In Surabaya Research Articles

The Relationship Between TSH and Indirect Bilirubin Levels in Neonates Suspected of Having Jaundice

Background: Congenital hypothyroidism (CH) is a condition of thyroid hormone deficiency that occurs at birth. The TSH (thyroid-stimulating hormone) test is crucial for diagnosing hypothyroidism. CH is known to cause prolonged unconjugated hyperbilirubinemia. Therefore, this study aimed to analyze the relationship between TSH and indirect bilirubin levels in neonates suspected of having jaundice. Methods: This is a non-experimental, retrospective study conducted at Lombok Dua Dua Lontar Mother and Child Hospital in Surabaya. The study involved data collection on neonates aged 2–7 days suspected of jaundice, whose TSH and indirect bilirubin levels were measured between November 2022 to April 2024. Results: Among 100 neonates, 62% were aged 2-4 days, while 38% were aged 5-7 days. The majority were male (56%), with female comprising 44%. Of the 100 neonates, only 1 (1%) had borderline TSH levels, while 99% had normal TSH levels. Hyperbilirubinemia was observed in 94% of the neonates, while 6% had normal indirect bilirubin levels. Statistical analysis using the Spearman correlation showed no significant link between TSH and indirect bilirubin levels (p = 0.802). Conclusions: While this study did not find a clear connection between TSH and indirect bilirubin levels in neonates suspected of having jaundice, one case of borderline TSH was identified. This neonate required referral to pediatric endocrinology, as untreated congenital hypothyroidism can lead to mental retardation. Despite limited research linking TSH and bilirubin levels in jaundiced neonates, routine screening for congenital hypothyroidism using TSH testing should be reconsidered. Future studies could benefit from focusing on specific causes of neonatal jaundice to help narrow down research questions in this area.

Spline Estimator in Nonparametric Ordinal Logistic Regression Model for Predicting Heart Attack Risk

In Indonesia, one of the main causes of death for both young and elderly people is heart attacks, and the main cause of heart attacks is non-communicable diseases such as hypertension. Deaths due to heart attacks caused by non-communicable diseases, namely hypertension, rank first in Indonesia. Therefore, predictions of the risk of having a heart attack caused by hypertension need serious attention. Further, for determining whether a patient is experiencing a heart attack, an effective method of prediction is required. One efficient approach is to use statistical models. This study discusses predicting risk of heart attack via modeling and classifying hypertension risk based on factors that influence it, namely, age, cholesterol levels, and triglyceride levels by using the spline estimator of the Nonparametric Ordinal Logistic Regression (NOLR) model. In this study, we assume an ordinal scale response variable with q categories to have an asymmetric distribution, namely, a multinomial distribution. The data used in this study are secondary data from medical records of cardiac poly patients at the Haji General Hospital in Surabaya, Indonesia. The results show that the proposed model approach has the greatest classification accuracy and sensitivity values compared to NOLR model approach using GAM, and the classical model approach, namely the Parametric Ordinal Logistic Regression (POLR) model. This means that the NOLR model approach is suitable for predicting hypertension and heart attack risks. Also, the NOLR model estimated using the LS-Spline estimator obtained is valid for predicting the risk of heart attack with accuracy value of 85% and sensitivity value of 100%.

Sex and sexual orientation as potential risk factors for co-infection with sexually transmitted infections in Surabaya, Indonesia: a single-center cross-sectional study

Objective: Sexually transmitted diseases (STDs) are infections that are transmitted from an infected person to an uninfected person through sexual contact. We conducted this study to evaluate the prevalence and the risk factors of co-infection because there hasn't been any research that thoroughly demonstrates its occurrence in Indonesia, particularly at the Dr. Soetomo General Academic Hospital in Surabaya. Methods: This research is a retrospective analytical study at Dr. Soetomo General Academic Hospital in a period of 2019-2021 primarily to assess risk factors associated with co-infection events. Patient’s data included sex, age, occupation, marital status, comorbid factors, the patient's number of sexual partners, sexual orientation, and the patient's nonsexual behavior were taken from the secondary medical records for analysis. The Chi-square test was used to analyze the correlations between variables. Results: There was a statistically significant difference in the presence of co-infections according to sex and sexual orientation (P < 0.001, P < 0.001, respectively), however, there was no statistically significant association of age, patient's occupation, marital status, commorbidity and sexual partner with co-infection in STDs. Conclusion: The incidence of co-infection is positively associated with both sex and sexual orientation in Surabaya, Indonesia.

Efektivitas Pelayanan Publik Bagi Pasien Pengguna BPJS di RSUD dr. M. Soewandhie Kota Surabaya

A survey conducted by the Ombudsman of the Republic of Indonesia indicates that public services in Indonesia are still unsatisfactory, particularly in the healthcare sector, which is one of the basic rights of the community. Through the Social Security Administering Body (BPJS) program, the government strives to provide social security to the public, including access to quality healthcare services. However, there are still challenges in the effectiveness of public services, especially in the context of hospitals. A surprise inspection by the Mayor of Surabaya at the Dr. Mohamad Soewandhie Regional General Hospital revealed several deficiencies in service, which were subsequently addressed by the hospital with various improvements, including increased efficiency and the use of technology. Therefore, this study aims to explore the effectiveness of public services for BPJS patients at Dr. Mohamad Soewandhie Regional General Hospital in Surabaya, with the hope of providing deeper insights into the performance of public services in government institutions. This research uses qualitative research techniques with a descriptive strategy. The location of the study is Dr. Soewandhie Regional General Hospital in Surabaya. Based on our observations and interviews with various parties, we determined that the services provided by Dr. Soewandhie Regional General Hospital to BPJS Kesehatan patients have successfully achieved the main goals of the program, namely providing adequate and quality infrastructure, facilities, and healthcare services for patients. However, there are challenges such as the renewal of BPJS accounts that have expired.

Comparison of success rates in early stages of in vitro fertilization (IVF) in women with and without endometriosis

Endometriosis remains a significant challenge for reproductive-aged women and is frequently associated with infertility. Although in vitro fertilization (IVF) is used to address infertility in women with endometriosis, its effectiveness in this context is still debated, particularly in developing countries such as Indonesia, where IVF remains a major challenge. The aim of this study was to investigate the success rates of early stages of IVF in women with and without endometriosis. A retrospective cohort study was conducted at the Graha Amerta Fertility Clinic, located within Dr. Soetomo Academic General Hospital in Surabaya, Indonesia. The quantity and quality of oocytes (the number of oocytes obtained by ovum pick-up (OPU) and the number of metaphase II (MII) oocytes), fertilization quality (the number of two-pronuclei oocytes and fertilization rate), embryo development quality (cleavage rate and blastocyst rate), biochemical pregnancy, clinical pregnancy, and live birth rate were collected from IVF patients between 2017−2022. Independent Student’s t-test or Mann-Whitney test was used accordingly for comparison analysis. A total of 410 IVF patients were included in the study; 93 had endometriosis, while 317 had no endometriosis. Oocyte quantity obtained by OPU (p=0.016) and oocyte quality (p=0.045), as measured by the number of MII oocytes, were significantly lower in the endometriosis group compared to the non-endometriosis group. However, there were no significant differences between the two groups in terms of the number of two-pronuclei oocytes (p=0.105), fertilization rate (p=0.987), cleavage rate (p=0.467), blastocyst rate (p=0.128), biological pregnancy rates (OR: 0.98; 95%CI: 0.60–1.60; p=0.940), clinical pregnancy rate (OR: 0.69; 95%CI: 0.39–1.24, p=0.219), or live birth rate (p=0.609). These findings suggest that while endometriosis may reduce oocyte quantity and quality, it does not significantly impact the success rates of IVF.

Low-intensity aerobic cycle ergometer effects on lung function of myasthenia gravis patients: A randomized controlled trial

Patients with generalized myasthenia gravis (MG) often show restrictive spirometry results. Although regular exercise and physical fitness are linked to better respiratory function, there is limited research assessing the effects of aerobic exercise on lung function in MG patients. The aim of this study was to analyze the effect of low-intensity aerobic exercise using a cycle ergometer on lung function parameters in MG patients. A randomized controlled trial with pre- and post-test was conducted at the Medical Rehabilitation Outpatient Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, in 2023. MG patients classified as I−IIb based on the Myasthenia Gravis Foundation of America (MGFA) classification were recruited and randomly divided into treatment and control groups. The treatment group was given low-intensity aerobic exercise using a cycle ergometer, education on lifestyle changes, and breathing exercises (deep and pursed lip breathing). Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume ratio (FEVR), were then measured. Measurements were conducted before and after eight weeks of low-intensity aerobic cycle ergometer exercise and compared with those of a control group. A total of 17 MG patients were included in this study. The results showed a significant increase in FVC in the treatment group (p=0.003), whereas no significant change in the control group (p=0.068). A significant increase in FEV1 was observed both in the treatment (p=0.029) and the control group (p=0.016). There was no improvement in FEVR in either group. After the intervention, significant differences were observed in FVC (p=0.009) and FEV1 (p=0.029) between the treatment and control groups. There was no significant difference in FEVR values after the intervention between both groups (p=0.491). In conclusion, eight weeks of low-intensity aerobic cycle ergometer exercise led to significant improvements in FVC and FEV1 among MG patients.

The Resilience of Healthcare Workers in Hospital During Covid-19 Crisis

The outbreak of the COVID-19 pandemic in all corners of the world has made all activities from various sectors difficult and even experience complete paralysis. As a result of the COVID-19 pandemic, a crisis emerged in various organizations engaged in the medical and non-medical fields. With the crisis due to the COVID-19 pandemic, a transformational leadership role is needed as a form to overcome feelings of worry, fear, and anxiety that arise in healthcare workers. The purpose of this review is to examine the resilience of healthcare workers amid the outbreak of the COVID-19 pandemic. Through well-established adopted questionnaires, data were collected from healthcare workers (N=134) treating COVID-19 patients in the Islamic Hospital in Surabaya, Indonesia. This type of research uses a quantitative approach, a sampling method with census technicalities, and the Partial Least Square (PLS) analysis method. The results showed that transformational Leadership had a positive effect on health workers. Then, there was no significant influence of transformational Leadership on negative effects on health workers. At the same time, from positive effects, it was found to have a significant influence on the resilience of health workers of Islamic Hospital during the COVID-19 crisis.

Pregnancy Exercise Shorten the Duration of the Second Stage of Labor

Background : There are several factors that contribute to duration of labor, which are power, passage, and passenger. Pregnancy exercise is one of many interventions that can be done in favor of increasing power during labor.Aim : The purpose of this study was to investigate the correlation between pregnancy exercise and second stage of labor duration.Material and Methods: This was an analytic observational study using cross sectional design conducted in Al-Irsyad Hospital in Surabaya. The total sample was 48 pregnant women who followed pregnancy exercise program and did not follow pregnancy exercise program that met sample criteria. Medical records data on duration of second stage of labor and pregnancy exercise program data were collected then analyzed by mann-whitney test.Results: The mean second stage of labor in pregnancy exercise group was 25.88±13.21 minutes, while in non-pregnancy group was 11.46±4.77 minutes. The analysis using mann-whitney test showed a significant correlation between pregnancy exercise and second stage of labor (p=0.000).Conclusion: There was a significant correlation between pregnancy exercise and second stage of labor. Pregnancy exercise shorten the duration of second stage of labor.

The prognostic role of mitosis index, stage and grade of endometrial cancer in Dr. Soetomo General Academic Hospital Surabaya, Indonesia, in 2018-2020

HIGHLIGHTS 1. Mitotic index and grade are prognostic factors for endometrial cancer, but both are independent.2. Stage and mitotic index associated with cell proliferation affect the prognosis of endometrial cancer. ABSTRACT Objective: This study aimed to analyze the correlation between the mitotic index and the stage and grade of endometrial cancer. Materials and Methods: We collected pathology reports of endometrial cancer from the Pathology Laboratory at Dr. Soetomo General Hospital in Surabaya, Indonesia, covering cases diagnosed between 2018 and 2020. A total of 106 cases of endometrial cancer were included in this study. For each case, detailed records of the cancer stage, grade, and mitotic index were recorded. The mitotic index, an indicator of cell proliferation, was quantified, and its correlation with cancer stage and grade was assessed. To determine the strength and direction of these relationships, we performed a Spearman rank correlation statistical analysis for non-parametric data. Results: Our findings indicated a significant positive correlation between the mitotic index and the stage of endometrial cancer. An increase in the mitotic index, reflecting a higher proliferation rate of cancer cells, was associated with a more advanced cancer stage, suggesting that the mitotic index could potentially serve as a prognostic marker for assessing tumor progression in endometrial cancer. However, our analysis revealed no significant correlation between the mitotic index and the histological grade of endometrial cancer, implying that the grade, which typically reflects the differentiation status and morphological characteristics of the tumor cells, is independent of the proliferation rate as measured by the mitotic index. Conclusion: The mitotic index is positively correlated with the stage of endometrial cancer but does not show a correlation with the histological grade. These findings highlight the potential use of the mitotic index in staging endometrial cancer.

Surgical Profile of Osteosarcoma Patients in a Tertiary Referral Hospital in Surabaya, Indonesia

Osteosarcoma is a rare malignant bone disease with unclear etiology. It is primarily a disease of childhood with rapid bone growth in periods of rapid bone proliferation [such as in puberty]. Before the 1970s, prognosis for this malignancy is very grim with the only available form of treatment are limb ablation [amputation]. The advent of modern chemotherapy, in addition to the development of modern limb salvage surgery [LSS] techniques, mortality has decreased and quality of life of surviors have increased. Indonesia is a developing country with unequal distribution of adequate health facilities. Studies have shown that unlike western countries, most osteosarcoma patients in Indonesia are still treated with limb ablation procedures. A retrospective descriptive study is done on Dr. Soetomo General Hospital to discover the surgical profile of patients undergoing chemotherapy during the period of 2014-2020. Results have shown that the majority [26] underwent amputation, 17 underwent no surgical treatment, and the rest [9] LSS. The results of this research shows that the clinical reality of developing nations like Indonesia is still far from the ideal clinical situation in developed western nations where these studies originate.

Determinants of Bacterial Vaginosis: A Retrospective Study

Background: Among women who can have children, bacterial vaginosis (BV) is the most common cause ofabnormal vaginal discharge. Due to its high prevalence and morbidity, it is crucial to prevent BV by addressing its risk factors. Objective: This study aimed to determine the incidence and determinants of BV in the sexually transmitted infection (STI) division of the Dermatovenereology Department at Dr. Soetomo Hospital in Surabaya. Methods: This retrospective analytical observational study was conducted using a cross-sectional approach. Electronic data from 56 patients were included in the study, covering the period from 2019 to 2022. The patients were divided into two groups: BV patients and controls. BV patients were diagnosed with BV by fulfilling three out of four Amsel criteria, while controls with typical vaginal discharge. Results: The study included 34 BV patients and 22 control patients. Bivariate analysis showed a significant correlation between the incidence of BV and the number of sexual partners (p = 0.009) and the use of intrauterine devices (IUD) (p = 0.002). Multivariate analysis confirmed that both factors were determinants of BV incidence, with IUD use being the most dominant determinant (95% CI 1.86~135.02, p = 0.01). Conclusion: The study found that the use of IUDs and the number of sexual partners significantly determined BV incidence.

THE OCCURRENCE OF CONTRACTURE AND THE SEVERITY OF BURN INJURIES AMONG BURN PATIENTS TREATED AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA (2020-20220)

Highlights: A robust association was observed between total body surface area (TBSA) and burn injuries, except in the case of elderly individuals. The duration of hospitalization is significantly associated with the occurrence of contracture. Abstract: Introduction: Burn injuries are a worldwide issue and can happen for many reasons, often causing skin damage that leads to deformities and movement difficulties. Many burn patients, up to 50%, experience contractures, which limit movement in areas such as the shoulders, wrists, and torso. Proper management through medicine, surgery, and therapy is crucial for helping these patients. Research at Dr. Soetomo General Academic Hospital is focused on studying the frequency of contractures after burn injuries to improve treatment and prevention methods. Methods: The research used descriptive analytics and gathered data from the Burn Unit at Gedung Bedah Pusat Terpadu (GBPT) and the Plastic Surgery Polyclinic at Dr. Soetomo General Academic Hospital in Surabaya. The study examined 40 eligible patients and assessed variables including burn severity, affected body area, and hospitalization duration. Results: The results showed that the average age of patients was 26.30 years, with 70% of them being male. Only 5% of patients had other health problems, mainly related to hormones. Most burns were caused by fire (37.5%), and many were second-degree burns (42.5%). The percentage of the body affected by burns varied by age: children had around 9.86%, adolescents had around 15.96%, and adults had around 5.25%. Most injuries were on the left arm (67.5%), and many patients stayed in the hospital for a long time (67.5%). Conclusion: All patients developed contractures following burns, irrespective of burn severity. There was a correlation between burn size and severity, except among older patients. Additionally, a notable association was observed between contracture occurrence and prolonged hospitalization.

PROGNOSIS OF INHALATION INJURY MORTALITY RATE WITH REVISED BAUX SCORE AT DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA (2019-2021)

Highlights: Fire is the most frequent cause of burns, while thermal contact is the least common. Mortality rate with revised Baux score in burn patients with inhalation injury showed a significant relationship. Abstract: Introduction: Burn trauma has quite a high mortality rate in Indonesia. One of the scoring systems that is straightforward to apply is the revised Baux score. However, there is no standardised scoring system that is currently in use in our institution. Therefore, the purpose is to determine the feasibility of using this scoring system in our population's features. Methods: This research is a retrospective study with research design case control design using secondary data in the form of medical record data from patients with acute burn trauma that were admitted to Burn Unit of Dr. Soetomo General Academic Hospital in Surabaya between January 2019 and December 2021. All the data will be divided by their group and analysed with SPSS software. Results: The study found significant relationships between several factors and mortality rates among burn patients. Age, total burn surface area percentage, presence of inhalation injury, and the revised Baux Score all showed significant correlations with mortality rate (p < 0.005). Specifically, among burn patients with inhalation injury, the correlation between mortality rate and revised Baux score remained significant (p=0.002). Conclusions:The study revealed that age, the percentage of total burn surface area, and the presence of inhalation injury are significantly associated with mortality rate among burn patients. Additionally, the revised Baux Score was identified as a useful tool for predicting the prognosis of burn patients with inhalation injury. These findings emphasize the importance of these factors in assessing and managing outcomes for burn patients, particularly those with inhalation injury.

Postoperative outcome analysis of isolated ventricular septal defect at Dr Soetomo General Academic Hospital in Surabaya, Indonesia

Postoperative outcome analysis of isolated ventricular septal defect at Dr Soetomo General Academic Hospital in Surabaya, Indonesia

Analisis Faktor-Faktor Pengambilan Keputusan Masyarakat Dalam Memilih Jasa Pelayanan Kesehatan Di Rumah Sakit Umum Daerah (RSUD) Dr. Mohammad Soewandhie Kota Surabaya

Patient satisfaction is a competitive advantage for every hospital to retain its customers and enable the hospital to continue to compete and grow every day. This study examines patient satisfaction as a significant competitive advantage for hospitals, focusing on Dr. Mohamad Soewandhie Hospital in Surabaya. This study uses qualitative descriptive method with literature review approach to assess the quality of hospital services based on five main indicators: physical evidence (tangibles), reliability, responsiveness, empathy, and assurance. This study concluded that the quality of service at Dr. Mohamad Soewandhie Hospital has met these indicators, so as to increase patient satisfaction and compete in the health industry.

Correlation of High-Grade Osteosarcoma Response to Chemotherapy with Enhanced Tissue Immunological Response: Analysis of CD95R, IFN-γ, Catalase, Hsp70, and VEGF

High-grade osteosarcoma, a primary malignant bone tumour, is experiencing a global increase in reported incidence with varied prevalence. Despite advances in management, which include surgery and neoadjuvant chemotherapy often an unsatisfactory outcome is found due to poor or heterogeneous response to chemotherapy. Our study delved into chemotherapy responses in osteosarcoma patients and associated molecular expressions, focusing on CD95 receptor (CD95R), interferon (IFN)-γ, catalase, heat-shock protein (Hsp)70, and vascular endothelial growth factor (VEGF). Employing immunohistochemistry and Huvos grading of post-chemo specimens, we analysed formalin-fixed paraffin-embedded (FFPE) osteosarcoma tissue of resected post-chemotherapy specimens from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia (DSGAH), spanning from 2016 to 2020. Results revealed varied responses (poor 40.38%, moderate 48.08%, good 11.54%) and distinct patterns in CD95R, IFN-γ, catalase, Hsp70, and VEGF expression. Significant differences among response groups were observed in CD95R and IFN-γ expression in tumour-infiltrating lymphocytes. The trend of diminishing CD95R expression from poor to good responses, accompanied by an increase in IFN-γ, implied a reduction in the count of viable osteosarcoma cells with the progression of Huvos grading. Catalase expression in osteosarcoma cells was consistently elevated in the poor response group, while Hsp70 expression was highest. VEGF expression in macrophages was significantly higher in the good response group. In conclusion, this study enhances our understanding of immune-chemotherapy interactions in osteosarcoma and identifies potential biomarkers for targeted interventions.

Competency analysis of health workers: Interprofessional collaboration practices in a tertiary referral hospital in Surabaya

Background: There is a rising need for high-quality, efficient healthcare. Implementing interprofessional cooperation (IPC) between healthcare professionals is one of the initiatives that has raised the standard of treatment in hospitals. The disparity in competence amongst health professionals is one of several elements that affect the requirements for the successful implementation of cooperation. Objective: To examine the attitudes, abilities, teamwork, and positive roles implemented by health workers in interprofessional collaboration practices. Method: Cross-sectional research methodology was used in this observational study. The Chiba Interprofessional Competency Scale (CICS29) instrument, which has 29 verified items, was used to evaluate the proficiency of health workers. The value of five (always) until one (never) was used to distinguish between the various categories. Result: A very good Cronbach alpha score of 0.921 was used to verify the questionnaire. Exactly 109 health professionals, including 21 physicians, 34 pharmacists, 50 nurses, and four nutritionists, participated in the study as respondents. Conclusion: Based on the study's findings, it was determined that health professionals, including physicians, pharmacists, nurses, and nutritionists, possess a high level of competence or capacity regarding interprofessional collaboration in hospitals.

The readiness and acceptance of patients with tuberculosis to use telecare

Background: Tuberculosis (TB) has been a global health burden and a leading infectious killer. The evolving healthcare technology allows telecare services to improve treatment support for TB patients. However, patient readiness and acceptance to use the service still need to be discovered. Objective: To evaluate the readiness and acceptance of TB patients in using telecare services. Methods: A cross-sectional survey involving patients at a respiratory hospital in Surabaya, Indonesia, was conducted using an accidental sampling technique from April to June 2023. A validated questionnaire was developed from the technology readiness index (TRI) and technology acceptance model (TAM) framework. Data were analysed using partial least squares-structural equation modelling (PLS-SEM). Results: A total of 188 respondents participated. Respondents had low to medium-range attitudes towards a readiness to use the telecare service. Nevertheless, the majority of the respondents accepted the idea of telecare service. Optimism and innovativeness were two significant factors influencing patient readiness to use telecare services. Respondents had a positive perception of the perceived ease of use and perceived usefulness of the service. Conclusion: Not all patients were ready to use telecare despite their high acceptance towards the service. However, the positive perception towards the benefits of the service can be the leveraging factor for gradually adopting the service.

Characteristics of Nonunion Fractures in Patients with Antebrachial Fractures at dr. Mohamad Soewandhie General Hospital Surabaya 2021-2022: A Retrospective Study

Background: Nonunion, a complication of fracture healing, can lead to patient morbidity. Contributing factors include age, gender, fracture type, multiple fractures, infection, prolonged nonsteroidal anti-inflammatory drug (NSAID) use, smoking, nutritional status, and history of chronic disease. This study aims to determine the prevalence and characteristics of nonunion antebrachial fractures at dr. Mohamad Soewandhie General Hospital Surabaya. Methods: This retrospective descriptive study involved 111 patients. Data was gathered from medical records treated at dr. Mohamad Soewandhie General Hospital Surabaya for antebrachial fracture during 2021-2022. The study protocol obtained approvals from two local ethical committees. Data included demographics, fracture characteristics, fracture type, multiple fractures, infection, NSAID use, hypertension and diabetes history, smoking habits, and nutritional status by BMI calculation. Results: This study found a 24.3% prevalence of antebrachial nonunion fractures at dr. Mohamad Soewandhie General Hospital Surabaya in 2021-2022, mostly in males (66.7%) aged 17-25 years (22.2%). Nonunion in antebrachial fractures is marked by high rates in closed (92.6%) and single fractures (92.6%). Notably, infections (22.2%), smoking (7.4%), and hypertension history (7.4%) are common contributors. Despite ideal BMI in many cases (44.4%), nonunion still occurred. Conclusions: The study conducted at Dr. Mohamad Soewandhie General Hospital in Surabaya revealed a high prevalence of antebrachial nonunion fractures at 24.3%, particularly among young males. It was found that closed, single fractures were the most common type, with infections, smoking, and a history of hypertension being significant contributing factors. Interestingly, even individuals with an ideal BMI were still at risk for nonunion.

Detail Engineering Design (DED) pada Struktur New Siloam Hospital Surabaya

The construction of health facilities is part of national development. Therefore, many health facility development projects, such as hospitals, continue to be carried out in various regions. One of them is the construction of the New Siloam Hospital in Surabaya. This article aims to understand the concept of detail engineering design on the building structure of New Siloam Hospital. Field surveys and data collection are the methods used to obtain information related to hospital construction projects. There are several differences between field data and work drawing data that has been created. Some of these differences include details on the reinforcement and casting volume. Therefore, it is necessary to carry out further evaluation of field data with work drawing data so that the project can proceed according to initial planning.