Hospital Surabaya Research Articles

The Dominant Personality Trait in Type 2 Diabetes Mellitus Patients at Dr. Soetomo General Hospital Surabaya

Introduction: Diabetes mellitus (DM) is a chronic disease characterized by elevated blood sugar levels above the normal range. The global prevalence of DM increased, with over 90% of cases being Type 2 Diabetes Mellitus (T2DM). People attempted various physical therapies, including adopting a healthy lifestyle through dietary adjustments, physical activity, and pharmacological interventions. However, we have not extensively explored non-physical therapies related to personality traits, and the incidence of DM remains high. The Big Five Personality Theory encompasses openness, conscientiousness, extraversion, agreeableness, and neuroticism. Each personality trait is believed to have specific tendencies toward diseases, emphasizing the importance of identifying the dominant personality traits in T2DM patients. This study aims to identify the dominant personality type in T2DM patients based on the Big Five Personality Theory at Dr. Soetomo General Hospital Surabaya. Methods: We employed a cross-sectional approach for data collection, using Big Five personality questionnaires as the primary data sources. Results: Among the 68 T2DM patients who participated in this study at Dr. Soetomo General Hospital Surabaya, from October 2022 to May 2023, the mean age of patients was 51-60 years, with a majority of female participants (63.2%) and male participants (37.8%). The questionnaire results indicated that the dominant personality trait was agreeableness (85.3%). Conclusion: The dominant personality type in T2DM patients, according to the Big Five Personality Theory at Dr. Soetomo General Academic Hospital Surabaya, was agreeableness (85.3%).

Clinical Symptoms of Patients with Early-Stage and Advanced-Stage Ovarian Cancer

Background: Ovarian cancer is a malignant neoplasm originating from ovarian cells with different histological types depending on the subtype. It can affect women of all ages. Ovarian cancer ranks third in terms of incidence among diagnosed female cancer patients, following breast and cervical cancer. Ovarian cancer often doesn’t present specific/clear symptoms. As a result, only a small number of patients are diagnosed at an early stage (20%). The study aimed to analyze the clinical complaints experienced by ovarian cancer patients, both in early and advanced stages before diagnosis. Methods: This descriptive cross-sectional study analyzes clinical complaints before the diagnosis of early and advanced-stage ovarian cancer patients. The study was conducted in the Gynecology-Oncology inpatient ward at Dr. Soetomo Regional General Hospital in 2021, utilizing medical record data. Results: A total of 98 patients (21 patients with early-stage, and 77 patients with advanced-stage) were analyzed. The majority of the patients are aged 45-58 years (49%), work as homemakers (32.7%), and are married (63.3%). The three most common complaints experienced by subjects with early-stage ovarian cancer were abdominal/pelvic pain (23.8%), abdominal/pelvic pressure (28.6%), and abdominal distension (42.9%), while in patients with advanced-stage ovarian cancer were abdominal/ pelvic pain (32.7%), abdominal distension (42.9%), and abdominal discomfort (bloating, early satiety, feeling of fullness, frequent belching, heartburn, nausea and vomiting) (44.2%). Conclusions: The three most common clinical complaints among patients before being diagnosed with early and advanced-stage ovarian cancer in the inpatient ward of Dr. Soetomo Regional General Hospital Surabaya in 2021 were similar. The recognition of these complaints and several risk factors are expected to assist in the earlier diagnosis of ovarian cancer.

Efficacy of Picosecond Laser in Clinical, Histopathology, and Immunohistochemistry Examination in Indonesian Wrinkled Skin.

Introduction: The elderly population wants to improve skin function and maintain a youthful appearance without wrinkles. Laser is one of the highly developed and widely used therapeutic modalities of skin aging by stimulating dermal collagen formation. Picosecond laser therapy is performed on skin with wrinkles to determine the mechanism of wrinkle improvement with a picosecond laser through an increasing in tissue inhibitor of metalloproteinases 1 (TIMP-1), and a decrease in matrix metalloproteinase-1 (MMP-1), which was confirmed by collagen density. Methods: The study was started from March 2021 to July 2021 at URJ Dr. Soetomo Hospital Surabaya and Surabaya Skin Centre. Twenty patients meeting the inclusion criteria of being 36-55 years of age and having a wrinkle in the forearm were enrolled by random sampling. Each sample data was recorded, the average TIMP-1, MMP-1, collagen density, and clinical wrinkles were calculated, and the laser was performed by using a picosecond 755 nm laser. Results: All patients showed a moderate pre-test wrinkle scale. The figure for TIMP-1 and MMP-1 after therapy was higher. The MMP-1/TIMP-1 ratio in wrinkles treated by using a picosecond laser was lower but insignificant than before. The picture of collagen density indicates that collagen density after laser therapy was higher than before. Conclusion: The result of clinical examination, histopathology, and immunohistochemistry in this research explained that a picosecond 755 nm laser with DLA is an effective therapy for wrinkles in Indonesian patients without any adverse effects.

Predictive Positive Value Xpert MTB/RIF in Detecting Mycobacterium tuberculosis on Adult Pulmonary Tuberculosis Patients in Dr. Soetomo Referral Hospital Surabaya Indonesia

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Mtb) and transmitted via droplets. Southeast Asia is the largest contributor of TB, and Indonesia itself has the second-highest number in the world with an incidence of approximately 824000 cases. The most common symptoms of active TB are cough, fever, weight loss, and night sweats. The diagnosis can be established upon the confirmation that one of the specimens contains M. tuberculosis. Xpert MTB/RIF provides results in less than 2 hours, whereas culture takes approximately 2-6 weeks. This research aims to evaluate the characteristics and determine the Predictive Positive Value (PPV) percentage of GeneXpert MTB/RIF, utilizing parameters derived from the gold standard examination results, namely culture. This research method is descriptive- analytic based on secondary data extracted from medical records of patients receiving care at the multi-drug resistant TB (MDR-TB) Outpatient Management at Dr. Soetomo Referral Hospital Surabaya from the period January 2019 – April 2022. The results showed that the PPV level of GeneXpert MTB/RIF in detecting the presence of M. tuberculosis is 90%. The diagnosis of pulmonary TB is also supported by the chest X-ray infiltrate's appearance and clinical symptoms of cough, weight loss, fever, and night sweats. Smoking and diabetes are the most common comorbid and risk factors in TB. The conclusion of this study is that the PPV for diagnosing adult pulmonary TB using the Xpert MTB/RIF is relatively high. This suggests the potential use of this method as a diagnosing tool for accurately diagnosing pulmonary tuberculosis.

Management Of Hazardous And Toxic Waste at PKU Muhammadiyah Hospital Surabaya in 2024

Hospitals, as healthcare service facilities, generate hazardous and toxic waste. Inadequate management can cause health problems both within the hospital environment and in the surrounding community. This study aims to examine the management of hazardous and toxic waste generated by PKU Muhammadiyah Hospital Surabaya.This research uses a descriptive method by collecting primary and secondary data. The subjects in this study are those responsible for the management of hazardous and toxic waste. The data obtained are then analyzed descriptively using the CIPP evaluation method.The context evaluation of hazardous and toxic waste management based on interviews and observations falls into the good category, while the input, process, and product evaluations based on interviews also fall into the good category. However, based on observations, they fall into the sufficient category. This is because several CIPP evaluation variables have not fully met the assessment criteria. It is hoped that the results of this evaluation can be used as feedback to improve the quality of hazardous and toxic waste management at PKU Muhammadiyah Hospital Surabaya.Based on the research results, it can be concluded that the management of hazardous and toxic waste at PKU Muhammadiyah Hospital Surabaya generally complies with Ministry of Health Regulation Number. 2 of 2023. However, its implementation is not yet optimal, as it is adjusted to the hospital's conditions and capabilities. It is recommended that the hospital improve and upgrade the facilities and infrastructure for hazardous and toxic waste management.

Profiles of Patients with Low Back Pain Caused by Disc Herniation in the Neurology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya during the Period of 2021

Profiles of Patients with Low Back Pain Caused by Disc Herniation in the Neurology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya during the Period of 2021

Profile Patients based on Risk Factors for Ischemic Stroke in the Neurology Inpatient Ward of Dr. Soetomo General Academic Hospital Surabaya during the Period of January to June 2022

Profile Patients based on Risk Factors for Ischemic Stroke in the Neurology Inpatient Ward of Dr. Soetomo General Academic Hospital Surabaya during the Period of January to June 2022

Factors that Influence The Onset of Acne Vulgaris :Retrospective Study

Background: Acne vulgaris (AV) is a skin condition that mostly occurs in adolescents, although it can occur at any age. Most occur during adolescence, with a prevalence of around 85%. Acne vulgaris is a multifactorial disease triggered by many factors, namely, genetics, environment, hormonal and emotional stress, food, trauma, cosmetics, and medications. Purpose: This study identifies the precipitating factors of acne vulgaris. Methods: This study was retrospective based on medical record data at the Dermatology and Venereology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya in the period January 2018–December 2019. Results: The number of AV patients within 2 years from January 2018 to December 2019 obtained 517 cases of acne vulgaris patients with complete data. There were female AV patients (80.7%) and male AV patients (19.3%). The most common age of AV patients was 15–24 years old (60.5%), the most common occupation of AV patients was student (59.8%), and patients suffered from AV for >12 months (18.6%). The most precipitating factors for AV are hormonal (69.6%) and cosmetic (50.1%); the most common type of AV is mild AV (64.2%); and the most common AV therapy is the combination of topical tretinoin, benzoyl peroxide (BPO), and topical clindamycin. Conclusion: The results of this study showed that hormonal and cosmetic precipitating factors caused most AV patients in women.

Relationship between Consumption of Vitamin D Food Sources, Sun Exposure, and Consumption of Vitamin D Supplements with Intrauterine Growth Restriction at Airlangga University Hospital Surabaya

Relationship between Consumption of Vitamin D Food Sources, Sun Exposure, and Consumption of Vitamin D Supplements with Intrauterine Growth Restriction at Airlangga University Hospital Surabaya

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.

Enhancing self-care in elderly patients: the impact of WhatsApp reminder messages at the Heart and Vascular Center

The importance of reminder messages lies in improving self-care among heart disease patients. At the Heart and Vascular Center, many patients, both those under ongoing care and those recently treated, do not consistently engage in self-care activities. Reminder messages can encourage adherence to medication regimens. This study aimed to investigate the effectiveness of WhatsApp reminder messages on the self-care of elderly patients at the Heart and Vascular Center. The research employed a quasi-experimental design with a two-group pre- and post-test control design. Using a probability sampling technique with simple random sampling, the study required 16 new patients in each group. The instrument used was the Self-Care Heart Failure Index (SCHFI) questionnaire, consisting of 22 questions. Data analysis was performed using the Mann-Whitney test. The results indicated that WhatsApp reminder messages are effective in enhancing patient self-care at the Heart and Vascular Center at Premier Hospital Surabaya (p-value<0.001). The Mann-Whitney test results post-intervention showed a p-value of 0.013, confirming the effectiveness of WhatsApp reminder messages in improving self-care among patients. This study demonstrated a significant positive influence of WhatsApp reminder messages on the self-care of elderly patients at the Heart and Vascular Center. These messages are an effective tool for improving patient self-care practices at Premier Hospital Surabaya.

How a Servant-Leadership Attitude Affects Discharge Planning Efficiency

Background: Discharge planning is one way in which leadership styles can motivate nurses to up their game and provide better care to patients. Examining how a servant leadership style affects the success of discharge planning initiatives is the primary goal of this study. Methods: The initial part of this mixed-method study involved doing qualitative research using an exploratory descriptive methodology with seven participants at Surabaya's Bhakti Dharma Husada Hospital. Research using quantitative methods and a quasi-experimental design is the second phase. Using a purposeful sampling technique, 114 nurses from the inpatient population at Bhakti Dharma Husada Hospital Surabaya participated in the study. Of this, 57 were assigned to the intervention group and 57 to the control group. Results: The first stage of the study produced a servant leadership module for the head of the room. In the second stage, based on the paired sample t-test, there was an effect after the intervention was given while entering the hospital (ρ = 0.000), during treatment (ρ = 0.000), and before leaving the hospital (ρ = 0.000). In the independent sample t-test, there was a significant difference in the post-test mean between the intervention and control groups during entering the hospital (ρ = 0.000), during treatment (ρ = 0.000), and before leaving the hospital (ρ = 0.000) on the performance results of the discharge plan. Conclusion: The ward head at Bhakti Dharma Husada Hospital Surabaya can use the servant leadership module and intervention to improve the performance of discharge planning from the time a patient enters the hospital to the time they leave.

Analysis of determinants of infertility among women at <i>in vitro</i> fertilization clinic in Surabaya

In social life and global health, infertility is common. History of abdominal surgery, body mass index (BMI), endometriosis, menstrual history, and polycystic ovarian syndrome (PCOS) have not been fully explained as female infertility factors. This study examined infertility causes at ASHA in vitro fertilization Primasatya Husada Citra (PHC) Hospital Surabaya. This quantitative study was cross-sectional. In May-July 2023, 82 childbearing-age women with infertility issues visited the hospital and completed questionnaires. Description and analysis were performed using the Wilcoxon rank test to evaluate menstrual history, BMI, PCOS, endometriosis, and abdominal surgery history in relation to infertility. Infertility was statistically associated with abdominal surgery history (P=0.008), BMI (P=0.000), endometriosis diagnosis (P=0.000), and PCOS (P=0.000). Women with abdominal surgery, endometriosis, and PCOS had significant infertility. Women’s infertility can be caused by ovulation disorders, tubal and pelvic disorders, or uterine disorders, but one-third of cases are unexplained. Infertility treatment may benefit from addressing abdominal surgery history, BMI, endometriosis, and PCOS. Early intervention and targeted care based on these determinants may improve fertility outcomes and reduce unexplained infertility.

Interprofessional collaboration practices: Health worker’s perceptions in private hospital Surabaya

Background: The quality of services provided by hospitals is the responsibility of a group of multi-professional teams working with different professional backgrounds, resulting in inter-professional conflicts that cause losses. To produce quality services, building Interprofessional Collaboration (IPC) among health workers is very important. One of the challenges that prevents the implementation of IPC from working efficiently is the varying opinions of health workers regarding interprofessional collaboration activities. Objective: The goal of this study was to investigate the attitudes of health workers concerning the practice of IPC in hospitals. Method: This research was an observational study employing a cross-sectional strategy. Health workers' impressions of interprofessional cooperation practices were analysed using the Collaborative Practice Assessment Tool for health workers. Result: This study involved 105 health professional respondents. The findings of the questionnaire analysis indicated significant differences in the domain of Relationship among Team Members (p 0.027), Team Relationship with the Community (p 0.012), Leadership (p 0.009), and Mission, Goals, and Objectives (p 0.001). Conclusion: Based on research findings, there are differences in perceptions among health workers because each professional competency domain is different. Therefore, interprofessional education is necessary to illustrate the implementation of collaborative practices across various professions.

Antihypertensive profile in COVID-19 patients at emergency field hospital Surabaya, Indonesia

Background: Case fatality rates for COVID-19 patients with hypertension have reached up to 14%. Using ACEi and ARB reduces ACE and increases ACE2 expression, which theoretically can mediate SARS-CoV-2 invasion and infection. Objective: This study examines the profile of hypertension therapy, time to reduce blood pressure, and length of stay. Method: A retrospective cross-sectional observational study was undertaken. Data were collected from patients' medical records using a consecutive and time-limited sampling method. Result: 222 patients were involved in this study. The most widely used antihypertensive monotherapy is oral amlodipine (1x5 mg) 51.35%, and combination therapy with oral amlodipine (1x10 mg) plus candesartan (1x8 mg) 8.11%. The mean time to reduce blood pressure was 5.96 and 6.67 days, and the mean length of stay was 5.99 and 6.67 days. Correlation analysis on the rate of decrease in blood pressure with length of stay showed significance (p = 0.000 < 0.05) with a positive Spearman correlation (0.992), which showed a very strong correlation. Conclusion: Antihypertensive therapy in this study was following existing guidelines. The time to reduce blood pressure was proportional to the length of stay, so hypertension is vital to control to support the improvement of the patient's clinical condition.

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.

Relationship Between Personality and Relapse of Breast Cancer Patients at The Oncology Polyclinic Dr. Soetomo Academic General Hospital Surabaya

Introductions: Breast cancer is a major health problem that affects the lives of millions of women. Some patients have tried treatment, but cancer recurrence is still present. It is suspected that growth factors play a role in the occurrence of relapse. However, until now, it has been controversial. Finding out whether there is a relation between personality and the incidence of relapse in breast cancer and comparing the personalities of patients with relapsed breast cancer with those with non-relapsed breast cancer. Methods: Analytical research is an observational case-control study. The number of respondents is 56 patients who meet the criteria. It consists of 28 relapsed patients and 28 non-relapsed patients. The research was conducted at the Oncology Polyclinic of Dr. Soetomo General Hospital. Using an instrument to measure personality types that have been validated, namely the OCEAN—Big Five Questionnaire Inventory 44 and Demographic Questionnaire. Results: There is no relationship between personality and the incidence of relapse in breast cancer (p > 0.05). The type of personality in relapse with the most neuroticism (29%) and non-relapse with the most openness (32%), extraversion (36%). Conclusions: The incidence of relapse in breast cancer is not only caused by personality factors; it is possible that other factors play a role. However, the personality of neuroticism is quite prominent in relapse patients.

Association between chest X-ray score and clinical outcome in COVID-19 patients: A study on modified radiographic assessment of lung edema score (mRALE) in Indonesia.

Radiological examinations such as chest X-rays (CXR) play a crucial role in the early diagnosis and determining disease severity in coronavirus disease 2019 (COVID-19). Various CXR scoring systems have been developed to quantitively assess lung abnormalities in COVID-19 patients, including CXR modified radiographic assessment of lung edema (mRALE). The aim of this study was to determine the relationship between mRALE scores and clinical outcome (mortality), as well as to identify the correlation between mRALE score and the severity of hypoxia (PaO2/FiO2 ratio). A retrospective cohort study was conducted among hospitalized COVID-19 patients at Dr. Soetomo General Academic Hospital Surabaya, Indonesia, from February to April 2022. All CXR data at initial admission were scored using the mRALE scoring system, and the clinical outcomes at the end of hospitalization were recorded. Of the total 178 COVID-19 patients, 62.9% survived after completing the treatment. Patients within non-survived had significantly higher quick sequential organ failure assessment (qSOFA) score (p<0.001), lower PaO2/FiO2 ratio (p=0.004), and higher blood urea nitrogen (p<0.001), serum creatinine (p<0.008) and serum glutamic oxaloacetic transaminase (p=0.001) levels. There was a significant relationship between mRALE score and clinical outcome (survived vs deceased) (p=0.024; contingency coefficient of 0.184); and mRALE score of ≥2.5 served as a risk factor for mortality among COVID-19 patients (relative risk of 1.624). There was a significant negative correlation between the mRALE score and PaO2/FiO2 ratio based on the Spearman correlation test (r=-0.346; p<0.001). The findings highlight that the initial mRALE score may serve as an independent predictor of mortality among hospitalized COVID-19 patients as well as proves its potential prognostic role in the management of COVID-19.

Platelet count and platelet indices in early life of infant with retinopathy of prematurity

Background and objectives. Retinopathy of prematurity (ROP) is a complication of prematurity. Early detection of ROP is important because its management depends on prevention of severe ROP and its complications. Pro- and anti-angiogenic factors are involved in ROP pathogenesis. Platelet store and release these factors, but its role as predictor of ROP is still obscure. This study aimed to compare platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet mass index (PMI) value between two age groups in early life of infant diagnosed with ROP. Materials and methods. This study was retrospective study of medical record data of infants born at “dr. Soetomo” General Academic Hospital Surabaya during 2021-2023. The infants were divided into two groups, they who have complete blood count result (CBC) in 0-7 days old (group 1) and 8-28 days old (group 2). We evaluated platelet count, MPV, PDW, and PMI value from CBC data. These data were analyzed using suitable statistical test. Results. Total of 126 infants were involved in this study. It consisted of 62 infants in group 1 and 64 infants on group 2. Platelet count was significantly different between groups (230.460±102.040/μL vs 313.664±182.890/μL, p=0,002). Value of MPV, PDW, and PMI were also significantly higher in group 2 (p&lt;0.001). Frequency of thrombocytosis (&gt;500.000/μL), high MPV (&gt;10.05 fL), and high PMI (3640 fL/nL) were also significantly higher in group 2 (p&lt;0.05). Conclusions. Higher platelet count, MPV, PDW, and PMI value were observed in 8-28 days old infant with ROP. They also more likely to experienced thrombocytosis, high MPV, and high PMI value.

Premier Hospital Surabaya Score: COVID-19 Mortality Score Model Based on Blood Levels of Neutrofil-Lymphocite Ratio, C-Reactive Protein, D-dimer, and Interleukin-6

Premier Hospital Surabaya Score: COVID-19 Mortality Score Model Based on Blood Levels of Neutrofil-Lymphocite Ratio, C-Reactive Protein, D-dimer, and Interleukin-6