Kariadi Hospital Research Articles

Difference Between BMI At Admission and Discharge and NIHSS at Admission and Discharge In Iscemic Stroke Patients at Dr.Kariadi Horpital

BACKGROUND : Hospitalized patients are at risk for malnutrition. Decreased BMI (Body Mass Index) in stroke patients is negatively correlated with patient outcomes. Studies on differences in BMI and NIHSS (National Institutes of Health Stroke Scale) at admission and discharge in stroke patients have not been conducted in Indonesia. OBJECTIVE: To describe the difference between BMI and NIHSS at admission and discharge in ischemic stroke patients at Dr. Kariadi hospital METHOD : An observational study on 49 hospitalized ischemic stroke patients at the Stroke Unit of dr. Kariadi hospital. Outcomes were measured using the National Institutes of Stroke Scale (NIHSS). Data was collected from the patient's medical record and analyzed using Paired Sample t Test. RESULT : There was no significant difference between BMI at admission and discharge (p = 0.161). There was a significant difference between the NIHSS at the time of admission and at the time of discharge (p= 0.014). CONCLUSION : There is no significant difference between BMI at admission and discharge. There is functional improvement in ischemic stroke patients during treatment

Correlation Between Portal Venous Dimensions And Liver Stiffness In Patients Of Child Pugh A Cirrhosis

BACKGROUND: Liver cirrhosis is an end-stage liver disease characterized by pathologic fibrosis and regenerative nodules with resultant liver dysfunction. The diagnostic hallmark of portal hypertension is slow flow velocities in addition to the increased caliber of the mean portal vein. That is, the diagnosis of portal hypertension requires the measurement of mean portal velocity and portal diameter, and the correlation between cirrhosis and mean portal velocity and port diameter is the correlation between liver cirrhosis and its complications.OBJECTIVE: To analyze the correlation between portal vein dimensions and liver stiffness in patients of Child-Pugh A cirrhosis.METHOD: This study was a cross-sectional study on 30 subjects with Child-Pugh A liver cirrhosis. The subjects of this research are patients who come to the Radiology Department of the Dr. Kariadi Hospital in Semarang for point shear wave elastography and abdominal ultrasound examination from January to December 2022. Spearman test correlation was used for the analysis.RESULT: Spearman test showed no correlation between liver stiffness and portal vein diameter (p=0.250, r= -0.217), liver stiffness and mean portal vein velocity (p=0.883, r= -0.028), and portal vein diameter with mean venous velocity in Child-Pugh A liver cirrhosis (p = 0.979, r = 0.005)

Relationship Between Pre-Operative Clinical Characteristics With Changes In Post-Operative Memory Scores On Temporal Lobe Epilepsy Patient

Background: Most temporal lobe epilepsy (TLE) will become seizure-free after anterior temporal lobectomy (ATL) surgery but often result in cognitive decline, specifically in verbal or visual memory. Objective: This study examined the relationship between several demographic characteristics and pre-operative clinical conditions with changes in pre-post surgical memory of TLE patients. Methods: This study used a retrospective cohort in which the subjects were TLE patients who had undergone ATL surgery at Kariadi Hospital or Telogorejo Hospital, Semarang. Demographic variables include the age of onset, duration of illness, level of education, and clinical variables include seizure frequency, EEG waveform, number of AED, lesion site, and IQ score. Results: Memory re-examination was conducted on TLE patients who had undergone surgery between 2018 and 2021, with 55 subjects who fulfilled the criteria. Characteristics of the subjects were male 31(56%) males, 38% Senior High School education, the mean age of onset was 13,87±6,899, age at surgery was 27,67±9,802, 21 (39%) normal pres-surgical EEG waveform, 31 (56%) lesion on the left and the most frequent seizures occurred in 36 subjects (65%). Statistical test results showed a significant relationship between age of onset and changes in verbal memory recognition scores (p 0.044), lesion side with changes in verbal memory task scores (p 0.018), recall (p 0.005), recognition (0.008), and IQ scores with changes in visual memory construction recall (p 0.041) Conclusion: Age of onset, lesion side, and IQ score characteristics were related to the changes in memory scores between pre- and post-operative anterior temporal lobectomy in TLE patients.

Pain Improvement Among Chronic Lumbar Disc Herniation Patients Underwent Epidural Triamcinolone With Or Without Hyaluronidase Injection Within 3 Months Of Follow-Up: A Prospective Study

Background Chronic lumbar disc herniation (CLDH) will accompany by chronic inflammation, so the fibrosis tissues formed in the epidural space and adjacent nerve roots, and lead to mixed pain syndrome. Objectives To compare between triamcinolone only and hyaluronidase 1500 international unit (IU) administration epidural injection for treating bulged or protrusion CLDH. Methods This prospective study involved CLDH patients visiting the outpatient department of Neurology at Dr. Kariadi Hospital Semarang Indonesia from November 2021 until August 2022. They divided: triamcinolone (Group 1) and hyaluronidase 1500 IU and triamcinolone epidural injection (Group 2) with 3 days of hospitalization. Neurotrophic was prescribed during 3 months of follow-up and ordered for personal physical treatment. They analyzed pain improvements (NRS and Pain DETECT), and the Oswestry Disability Index (ODI) scores. Results The 37 subjects were recruited but 1 female dropped out cause of re-injection, so 13 males and 23 females aged between 24 to 72 years old (mean 48+2) were followed. They significantly improved (Wilcoxon test p=.000), as the NRS score was 47.9% (Group 1) and 55.4% (Group 2). ODI scores without significance (Mann-Whitney p> .005), such at 2 weeks (group 1= 20.4%, group 2= 23.6%) and 3 months (group 1= 58.1%, group 2= 53.7%). They observed nociceptive and neuropathic improvement even though needed more time for the healing process. Conclussions This study proved hyaluronidase administration before triamcinolone epidural injection with better improvements for treating bulged or protrusion CLDH patients.

The relationship between nutritional status before chemotherapy with nutritional status after chemotherapy in locoregionally advanced nasopharyngeal carcinoma patients

Background: Malnutrition in nasopharyngeal carcinoma (NPC) patients is caused by various factors such as tumor localization, metabolic derangement, and side effects of therapy. Poor nutritional status in cancer patients is associated with serious clinical consequences such as poor quality of life, higher treatment toxicity, and poor prognosis. The purpose of this study was to determine the effect of nutritional status before chemotherapy on the nutritional status after chemotherapy in non-metastatic advance-stage NPC patients. Methods: This study was an observational study with a cross sectional design using secondary data involving non-metastatic advanced-stage NPC patients undergoing chemotherapy at dr. Kariadi Hospital Semarang in January 2020 – June 2022. The sampling technique used was consecutive sampling. Nutritional status was measured by malnutrition criteria according to the American Society for Parenteral and Enteral Nutrition (ASPEN). Statistical analysis was performed with Chi-Square and McNemar analysis test. Results: Total sample of this study was 55 subjects. The results of this study were there was a relationship between nutritional status before chemotherapy and nutritional status after chemotherapy in non-metastatic advanced-stage NPC patients (P<0.05). All subjects were malnourished before chemotherapy, with 12.7% moderately malnourished and 87.3% severely malnourished. All subjects were malnourished after chemotherapy, with 41.8% moderately malnourished and 58.2% severely malnourished, decreased nutritional status of post-chemotherapy non-metastatic advanced NPC patients was related to the length of chemotherapy (p<0.05), but not related to comorbidities, age, and stage of chemotherapy (p>0.05). Conclusion: There is a relationship between nutritional status before chemotherapy and nutritional status after chemotherapy in non-metastatic advanced-stage NPC patients.

Effects of virtual music therapy on Burnout Syndrome in health workers in Tertiary Hospitals

Background: Health workers are vulnerable to experiencing psychological and physiological stress, including burnout syndrome (BOS). BOS can be measured using the Maslach Burnout Inventory (MBI) assessment. BOS can also affect heart rate variability (HRV). Music therapy is one of the BOS therapies in the recovery phase. This study aims to evaluate the effects of virtual music therapy on "Burnout Syndrome" in health workers in Tertiary Hospitals Methods: This research is a qualitative study and a randomized control trial using a pre-and post-test control group study design on healthcare workers at Dr. Kariadi Hospital and Dr. Cipto Mangunkusumo Hospital for three months. Subjects were divided into two groups, namely the intervention group and the control group, each consisting of 20 people. The instruments used were the MBI-HSS questionnaire and heart rate variability measuring devices for the pretest and posttest. Depending on the data distribution analysis performed using the Shapiro-Wilk test, data analysis was performed using either the Mann-Whitney test or the independent T-test. Data were analyzed using SPSS version 21.0 for Windows. Results: This study shows significant differences in the MBI-HSS scores between the intervention and control groups (p<0.05). In the HRV-SDNN scores, there were only significant differences in the control group (p<0.05), although there was an increase in the mean values in the intervention group. Conclusion: The use of music therapy according to culture and individual preferences can significantly affect the MBI-HSS score, which indicates burnout and increases the HRV value.

Correlation of Brain-Derived Neurotrophin Factor Levels in Epilepsy Patients Treated with Valproic Acid and Phenytoin with Cognitive Function

BACKGROUND: Epilepsy cases requiring OAE multitherapy are found in 40% of total epilepsy cases. Many epilepsy patients are referred to Dr. Kariadi Hospital Semarang because of the occurrence of intractable epilepsy. Valproic acid is one of the OAEs that are widely used in the BPJS era in Indonesia as a combination of phenytoin. Seizures increase the expression of BDNF mRNA and protein. METHODS: This study is a cross-sectional study that took place from January to May 2022. The subjects of this study were epilepsy patients who used a combination of phenytoin-valproic acid who met the inclusion criteria. Patient data were obtained from medical records and filling out questionnaires. Patients were asked to fast for ± 8−10 h. Furthermore, blood sampling (±5 ml) of BDNF was carried out at 08.00−10.00 WIB. Cognitive function assessments were performed using MoCA-Ina and the Hamilton depression rating scale at the same time. Data were analyzed by Spearman correlation test and partial correlation test. The results are said to be meaningful if p < 0.05. RESULTS: Thirty-two study subjects used a combination of phenytoin-valproic acid. The Spearman correlation test between the relationship between BDNF levels and cognitive function in epilepsy patients treated with valproic acid and phenytoin showed a significant relationship with the direction and strength of which was strongly positive (r = 0.676 and p ≤ 0.001). The partial correlation test between the relationship between BDNF levels and cognitive function after controlling for age (r = 0.692), seizure frequency (r = 0.641), duration of combination therapy (r = 0.700), and age of seizure onset (r = 0.693) remained the same, while after controlling for the level of education (r = 0.812) and the type of seizure (r = 0.747) increased. CONCLUSION: There is a strong correlation between BDNF levels and cognitive function in epilepsy patients treated with valproic acid and phenytoin. The relationship between BDNF levels and cognitive function remained the same after controlling for age, frequency of seizures, duration of combination therapy, and age of onset of epilepsy.

Factors related to mortality in geriatric patients after elective surgery: a retrospective cohort study

Introduction: The increased number of surgery on the elderly is often followed by an increased risk of mortality rate. Identifying the risk factors of surgical death in elderly patients will be mandatory before making a decision. This study aimed to determine mortality-associated factors in older people who underwent inpatient elective surgery. Methods: This cohort retrospective study analyzed secondary data from the medical records of geriatric patients hospitalized at Dr. Kariadi Hospital Semarang in 2020. Patients aged ≥ 60 years and who have undergone elective surgery were included. Patients with incomplete medical records, who had undergone outpatient surgery, more than one surgery, and emergency surgery, Covid-19, were excluded. A total of 382 patients met the criteria. In this study, independent variables analyzed were age, sex, nutritional status based on body mass index, functional status by Barthel, marital status, residence status, number of comorbidities according to Charlson Comorbidity Index, albumin levels, electrocardiogram (ECG) abnormalities, surgery type, and American Society of Anesthesiologists (ASA) status. The dependent variable was in-hospital mortality. In the logistic regression analysis, we identified the five most significant variables to allow for the prediction of in-hospital mortality. Results: Residence status (p= 0.003), ECG (p= 0.001), comorbidity (p <0.0001), albumin status (p< 0.0001), and ASA status (p< 0.0001) were identified as factors that affect postoperative mortality after multivariate analysis. Conclusion: In this study, mortality-associated factors were living alone, ECG abnormality, comorbidity > 2, hypoalbumin, and ASA > 2.

Haematopoietic stem cell transplantation in RSUP Kariadi Semarang

In Indonesia, bone marrow transplantation is a treatment which not known yet to some people. Kariadi Hospital is the one hospital that do it first. On 1987, it was successful for acute myeloid leukemia case. Bone marrow transplantation is one of therapy used to treat patients with leukemia, severe aplastic anemia, Hodgkin's disease, non-Hodgkin's lymphoma, myeloma multiple, many blood disorder and solid tumor. This study described the patients characteristics who did hematopoietic stem cell transplantation during 2017-2021 at Kariadi General Hospital Semarang. This study is a quantitative research non-experiment with design retrospective analysis. Data was taken with a total sampling are 20 patients. Data analysis by describing the criteria. The results describe the sex of patients consist are 60% male and 40% female. Most range age at 35-44 years amount 30%. The diagnosis is 40% in the case of Myeloma Multiple. Most of transplantation doing an autologous transplant are 80%. It is indicated 90% of malignancy cases. All patient got 100% engraftment, all patients happen neutropenia, thrombocytopenia, oral mucositis, gut disorder, and electrolyte imbalance. Amount 15% are hematuria and 10% are urticaria, Veno Occlusive Disease, sepsis, brain infection and brain hemorrhage. The conclusion is patients who did hematopoietic stem cell transplantation have various adverse events and complications depending on many factors or comorbids. These are age, sex, diagnosis, stage of disease, state of remission, regiment conditioning. Health professionals should upgrade knowledge and skill for treatment of hematopoietic stem cell transplantation.

PREDICTIVE VALUE OF PLATELET COUNT AND PLATELET INDICES IN CERVICAL CANCER PATIENTS WITH EXTERNAL RADIATION THERAPY.

The aim: This study aims to assess the role of platelets and platelet indices as a cost-effective predictive marker of the cervical cancer patient's response before, 15th, and 25th external radiation. Materials and methods: A total of 54 cervical cancer patients at Dr. Kariadi Hospital were divided into good and poor therapeutic response groups. Measurements of platelet count and indices including PDW, P-LCR, and PCT were carried out before, 15th, and 25th external radiation. Results: There was no difference in platelet counts, MPV, PDW, P-LCR, and PCT in both groups, but patients with decreased MPV and P-LCR values on 15th-25th external radiation had a better therapeutic response (p= 0.005 and 0.007). Conclusions: MPV and P-LCR values at 15th to 25th external radiation appeared to decrease further in the group that responded better to therapy.

Parameter estimation of Weibull distribution on type III censored survival data by maximum likelihood estimator method: Case study of lung cancer patient data at Dr. Kariadi Hospital Semarang

Research on survival data is quite important. Many modeling problems can be made related to survival data. One of the survival data methods is the Type III Censored method, which is a type of censoring that is limited by time, with individuals entering the study at different times during a certain period of time. In this study, the research focus is to obtain point estimates of the Weibull distribution parameters using the Maximum Likelihood Estimator method. The method is used to examine the survival data of Weibull distribution censored type III on secondary data of patients with lung cancer at Dr. Kariadi Hospital Semarang. Based on the results of the analysis, the Weibull distribution with a point estimator for the scale parameter is α̂ = 94.875997 and the shape parameter is β̂ = 1.638958.

Factors Associated With Recurrence Of Epithelial Ovarian Cancer In RSUP Dr. Kariadi Semarang

Introductions: Epithelial ovarian cancer accounts for 90% of all ovarian malignancies. More than 70% of patients will experience a relapse even after receiving operative therapy and chemotherapy. There are several prognostic factors that influence the recurrence of ovarian cancer. In Indonesia, especially at Dr. Kariadi Hospital, Semarang, the data as mentioned above is still very limited.objective: Knowing the disease-free survival rate, optimizing surgery and factors related to the incidence of recurrence in epithelial ovarian cancer patients at Dr. Kariadi Hospital SemarangMethods: This study is a retrospective cohort study with survival analysis. Data were collected through medical records, with the study population are patients with a diagnosis of epithelial ovarian cancer who were treated at Dr. Kariadi Hospital Semarang in period January 2018-December 2019. Furthermore, patients who had been remission were observed for signs of disease recurrence for 2 years period.Results: There were 361 patients with epithelial ovarian cancer who underwent primary treatment at Dr. Kariadi Hospital, Semarang in 2018-2019. Furthermore, there were observations of recurrence in 148 patients who achieved remission. Of these 76 patients (51.4%) experienced recurrence, while 72 patients not relapse. From 148 epithelial ovarian cancer patients who underwent cytoreduction surgery at Dr. Kariadi Hospital, Semarang, 113 patients (76.4%) achieved optimal operation with a residu less than 2 cm, while 35 patients (23.6%) were not optimal with a residu more than 2 cm. FIGO stage (HR 2.44) and tumor residu (HR 2.15) were shown to be significant factors associated with the recurrence of epithelial ovarian cancer.Conclusion: Overall disease-free survival in epithelial ovarian cancer at Dr. Kariadi Semarang were 74.8% (6 months), 57.1% (1 year), 42.5% (18 months), and 37.4% (2 years). Tumor residual factors and FIGO stage were shown to be significant prognostic factors influencing the recurrence of epithelial ovarian cancer.

Ceftolozane/Tazobactam In-Vitro Activity against Clinical Isolates from Complicated Intra-Abdominal Infection Patients in Three Indonesian Referral Hospitals.

Complicated intra-abdominal infections (cIAIs) lead to high morbidity and mortality, especially if poorly managed. However, Indonesia's microbial pattern and susceptibility data are limited, especially for new antibiotics. Ceftolozane/tazobactam (C/T) is reported to be a new potent antibiotic against various pathogens. Thus, we aim to investigate C/T in vitro activity against clinical isolates from cIAI patients. This prospective cross-sectional study was conducted in three major referral hospitals in Indonesia, including Dr. Cipto Mangunkusumo Hospital (Jakarta), Dr. Kariadi Hospital (Semarang), and Dr. Soetomo Hospital (Surabaya), enrolling those diagnosed with cIAIs. Blood specimens were collected before or after at least 72 h of the last antibiotic administration. Meanwhile, tissue biopsy/aspirate specimens were collected intraoperatively. These specimens were cultured, followed by a susceptibility test for specific pathogens. The minimum inhibitory concentration (MIC) of isolates was determined according to CLSI M100. Two-hundred-and-eighty-four patients were enrolled from 2019-2021. Blood culture was dominated by Gram-positive bacteria (GPB, n = 25, 52.1%), whereas abdominal tissue culture was dominated by Gram-negative bacteria (GNB, n = 268, 79.5%). The three most common organisms were GNB, including E. coli, K. pneumoniae, and P. aeruginosa. C/T was susceptible in 96.7%, 70.2%, and 94.1% of the E. coli, K. pneumoniae, and P. aeruginosa isolates, respectively. In addition, C/T also remained active against ESBL Enterobacterales and carbapenem-non-susceptible P. aeruginosa. Overall, C/T demonstrates a high potency against GNB isolates and can be considered an agent for carbapenem-sparing strategy for cIAI patients as the susceptibility is proven.

Correlation Between Body Mass Index, Gender, and Age With Cholelithiasis

BACKGROUND : Gallstones are formed due to deposit or hypersaturation of one or more of the bile components, namely cholesterol, bilirubin, bile salts, calcium, protein, fatty acids, and phospholipids. BMI, gender, and age are the factors that can trigger the formation of gallstones. In Indonesia, cholelithiasis cases have received less attention because they are often asymptomatic, making it difficult to detect and often misdiagnosed, resulting in a lack of official publication about the incidence of gallstones in Indonesia. AIM : To determine the correlation between BMI, Gender, and Age with cholelitiasis in Dr. Kariadi Hospital. METHOD : This was an observational study using cross-sectional design. Data were taken from medical records of patients in Digestive Surgery Department Dr. Kariadi Hospital from January 2018 until March 2020. A total of 100 patients were selected as subjects (50 patients with cholethiasis and 50 patienst without cholelithiasis). Pearson Chi-Square correlation was used for statistical analysis. RESULTS : Pearson Chi-Square test of BMI (p = 0.001) and Age (p = 0.041) was statistically significant for cholelithiasis risk (p < 0.05). While Gender (p = 0.224) was not statistically significant for cholelithiasis risk. CONCLUSION : There wa a significant correlation between BMI and Age with Cholelithiasis and there was no significant correlation between Gender with Cholelithiasis. KEYWORDS : Body Mass Index (BMI), Gender, Age, Cholelithiasis.

The Correlation Between Bullous Concha Volume and Type of Nasal Septal Deviation with Lund-Mackay CT Score in Chronic Rhinosinusitis

BACKGROUND: Chronic rhinosinusitis is inflammation of the mucoperiosteum lining of the nose and paranasal sinuses for more than 12 weeks. Computed Tomography (CT scan) of the paranasal sinuses is the gold standard for diagnosing chronic rhinosinusitis. Nasal septal deviation and bullous concha are anatomical variation that often found in CT scan of chronic rhinosinusitis patients. The severity of chronic rhinosinusitis can be evaluated with Lund Mackay CT score. AIM: To analyse the correlation between bullous concha volume and type of nasal septum deviation with Lund-Mackay CT Score in chronic rhinosinusitis METHOD: This was an observational study with a cross sectional design. This study was conducted from March-May 2019. Subjects were CRS patients whom underwent paranasal sinuses CT scan in Dr. Kariadi Hospital Semarang whom met the criteria. The inclusion criteria were chronic rhinosinusitis patients more than 17 years old with deviated nasal septum and conchae bullosa. RESULT: There were 50 CRS patients, the age average is 18 – 67 years. The mean volume of the bullous concha was 0.534 cm3. The highest deviation of the nasal septum is to the right (53.2%) and the highest total Lund-Mackay CT Score was 4 (56%). The correlation between septal type and bullous concha volume with Lund-Mackay CT Score CONCLUSION: Lund Mackay CT score didn't correlate with septal type and bullous concha volume. KEYWORDS: Bullous Concha, Chronic Rhinosinusitis, Lund Mackay CT score, Nasal Septum Deviation

A study of efficacy, safety, and acceptance of two combined oral contraceptive pills containing 150 mcg Levonorgestrel and 30 mcg Ethinyl Estradiol at Dr. Kariadi Hospital, Semarang, Indonesia

Background: Combine Oral Contraceptives (COCs) pills is one of the many popular contraceptives worldwide, with 100 million women who use contraceptive pills. To increase the choice of oral contraceptives, COCs Novadiol® (Pill A) domestic production, which has the same dosage as Microgynon® (Pill B), are still imported drugs. This study aims to determine Pill A's efficacy, safety and acceptance level compared to Pill B for 3 months. Methods: The study was a randomized control clinical trial, an open-label trial in 200 women of childbearing age who met the inclusion and exclusion criteria from July to November 2015. Data were analyzed using SPSS version 20 for Windows. Results: About 300 participants were selected and 200 met the inclusion and exclusion criteria who participated study from the beginning to the end of the study period. In the first month of observation, 1 complaint of dizziness in pill A and 2 from pill B. One nausea complaint was found in the participant from Pill A. These differences were not statistically significant (p>0.05). In the second month of observation, 1 complained of dizziness from pill B and 1 nausea from Pill A. In the third month, observation found no complaints about using Pill A and pill B. There were changes in menstrual patterns in both pills and bleeding outside the cycle during the use of 3 months, but they were not statistically significant (p>0.05). Conclusion: Pills A has the same efficacy, safety and acceptance when compared to the use of birth control pills B for 3 months.

Influence of Epidemiological Risk Factors for Occurrence of Hepatitis B Virus (HBV) Co-Infection in HIV/AIDS Patients: (Study in dr. Kariadi Hospital, Semarang, Indonesia)

Background: Chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma are all have a major cause which is Hepatitis B virus (HBV). Given the fact that HIV and HBV are all transmitted through the same routes, co-infection is common. The objective of this research is to identify several risk factors which influence the occurrence of Hepatitis B virus infection in HIV/AIDS patients at Kariadi, Semarang, Indonesia. Method: This research is analytical observational with a case control study design, a sample of 68(34 cases and 34 controls) For all HIV patients involved in the study, samples were determined by a positive HBsAg test, The dependent variable is HBV occurrence in HIV/AIDS individuals and dependent variable were CD4≤100, Age>30,gender,marital status ,level of education ,male who have sex with other male(MSM),Analysis of data was done through univariate, bivariate and multivariate analysis with logistic regression.Result: Variables that were proven to influence the occurrence HBV infection in HIV/AIDS individuals, after analysis were CD4≤100(p= 0.003 OR=7.535, 95% CI=(2.029-27.990 ) , being male who do sex with male( MSM) (P=0.027 ,OR=3.544 ,95%CI=( 1.158-10.848) . The probability for HIV/AIDS patients to be infected by HBVirus when they have both these risk factors is equal to 88.18%.Conclusion: The factors that were proven to affect the influence of occurrence Hepatitis B virus in HIV/AIDS patients were, CD4≤100 and being male who do sex with other male (MSM).

The Analysis of Research Center Establishment Preparation at dr. Kariadi Hospital, Semarang

Background: A good preparation is required to set up a research center. Management support, planning, infrastructures, human resources, and funding are factors that are closely related to the requirements of the establishment of a research center.Objective: To analyze the preparation of the research center establishment at dr. Kariadi Hospital, Semarang.Method: This study was using analytic descriptive. As many as 180 respondents consisting of : hospital directors, heads of medical staff unit, specialists, general practitioners, paramedics, and interns, were involved in this study. Data collection was done through structured questionnaires. The data analysis including univariate analysis, bivariate analysis using chi-square, and multivariate analysis using logistic regression.Results: Factors that are significantly related to the preparation of the research center establishment are management support (p value 0.005; probability level of 39.66%), infrastructure (p value 0.020; probability level 35.97%), organizational system (p value 0.041; probability level 35.02%). Other factors that are not directly related to the preparation of a research center establishment are research personnel, quality criteria, research startups, achievement progress and constraints.Conclusion: Preparation for the establishment of a research center requires a full support of hospital management, both internal and external support.

Correlation between Hematologic Parameters and Asymptomatic Bacteriuria in the Full-Term Pregnant Patients in Dr. Kariadi Hospital, Semarang, Indonesia

Objective: We investigated the role of hematologic parameter such as hemoglobin, white blood cells, platelet, hemoglobin platelet ratio (HPR), hemoglobin white blood cells ratio (HWR) in full-term pregnant patients and correlate the result with their urine culture following delivery. Methods: Between 2019-2020, a total number of 95 pregnant patients were retrospectively evaluated at the maternal ward.Results: The average age of the subjects was 29.15 (SD ± 5.95), median of parity of 2 (range 1- 4) and mean of gestational age was 37.5 (SD ± 1.67). There is no difference between groups on the surgery types and comorbidities condition. Among the patients, 14 urine cultures produced growth of 105 CFU/ml bacteria. Pearson’s correlation test showed that leukocyte inversely correlated with bacteriuria, meanwhile hemoglobin white blood cell ratio (HWR) is positively correlated with urinary culture result. In the diagnostic performance, HWR had AUC of 0.765 with sensitivity and specificity of 78.6% and 64.2% respectively at the cut off of 11.92.Conclusions: Prediction of asymptomatic bacteriuria in pregnant patient by simple calculation of HWR might be helpful in significantly reducing workload and costs of urine culture. It is a great advantage that the parameters we use in our work are easily accessible and can be performed in emergency conditions.

Preliminary study of hypoxia markers in diffuse large B-cell lymphoma.

While the association of hypoxia has been established in various types of solid cancers, little is known about its presence and existence in diffuse large B-cell lymphoma (DLBCL). The purpose of the present study was to evaluate the expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor A (VEGF-A) in DLBCL and to analyze the association of these factors with several clinical and pathological characteristics. The immunohistochemical protein expression of HIF-1α and VEGF-A was investigated in 34 de novo DLBCL tumor samples from January 2017 to December 2017 from the Department of Hematology/Medical Oncology and Anatomical Pathology at Dr Kariadi Hospital (Semarang, Indonesia). The present study revealed by using immunohistochemistry (IHC), that hypoxic markers were overexpressed (88.2% for both HIF-1α and VEGF-A) in the vast majority of patients with DLBCL. Only in 4 tumors, was HIF-1α expression normal, and interestingly VEGF-A was negative as well. There was a significant correlation in the intensity of staining of HIF-1α and VEGF-A using our custom scoring system in surgically resected tissues (r=0.475; P=0.005). Both HIF-1α and VEGF-A were also associated to serum LDH and tumor diameter. Collectively, HIF-1α and VEGF-A were predominantly expressed in the majority of DLBCL tumor cells. The findings of the present study indicate the existence of hypoxia in DLBCL tumors similar to numerous solid cancers, and thus warrants further investigation to clarify its role as a potential pathogenic or prognostic marker in this type of hematological cancer.