Mohammad Hoesin General Hospital Palembang Research Articles

Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis

Background: Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy. While nerve conduction studies (NCS) remain the gold standard for diagnosis, ultrasound (USG) offers a non-invasive alternative. This study aimed to compare the diagnostic accuracy of USG and NCS in CTS at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Methods: A cross-sectional study was conducted on patients presenting with CTS symptoms. Demographic and clinical data were collected. NCS and USG assessments were performed, blinded to each other's results. USG measurements included the cross-sectional area at the carpal tunnel inlet (CSAc), proximal to the carpal tunnel (CSAp), and the difference between them (∆CSA). Diagnostic accuracy was calculated, and agreement was assessed using Cohen's kappa. Results: A total of 86 wrists from 49 patients were included. The mean age was 52 ± 11 years, with a female predominance (86%). The majority had mild CTS based on NCS (55.8%). USG measurements showed mean CSAc of 13.1 ± 3.5 mm², CSAp of 10.6 ± 3.0 mm², and ∆CSA of 2.5 ± 0.9 mm². ∆CSA had the highest sensitivity (92.2%), specificity (88.9%), and accuracy (91.9%), with substantial agreement with NCS (Kappa = 0.65). Conclusion: USG, particularly using ∆CSA, demonstrates high diagnostic accuracy in CTS, comparable to NCS. It can serve as a valuable tool, especially in settings with limited NCS availability.

Analysis of the Role of Age Factors on Hemoglobin, Leukocyte and Platelet Levels in Breast Cancer Patients Post Chemotherapy 3 Cycles at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Introduction: Breast cancer is one of the most common cancers in women. Chemotherapy is one of the main modalities in the treatment of breast cancer, but it can cause hematological side effects such as anemia, leukopenia, and thrombocytopenia. Age is one factor that is thought to influence these side effects.
 Methods: This study used an analytical observational design with data collected from medical records of breast cancer patients who had undergone 3 cycles of chemotherapy at Dr. Mohammad Hoesin General Hospital Palembang. Data on hemoglobin, leukocyte, and platelet levels before and after chemotherapy were analyzed using the t-test and ANOVA.
 Results: A significant decrease in hemoglobin levels was observed in patients aged > 60 years after chemotherapy (p < 0.05). Leukocyte levels showed fluctuations, especially in patients aged <40 years, while platelet levels fluctuated more in patients aged <40 years and decreased in the age group 40-60 years after chemotherapy.
 Conclusion: Age does not significantly influence the decrease in hemoglobin, leukocyte, and platelet levels in breast cancer patients after chemotherapy.

Perineural Injection of Mecobalamin Versus Dextrose 5% Against Clinical Changes and Electrophysiological Features of Carpal Tunnel Syndrome Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Background: Carpal tunnel syndrome (CTS) is a common compression neuropathy with symptoms of pain, tingling, and numbness in the hands. Perineural injections of steroids and mecobalamin have been shown to be effective in relieving CTS symptoms. This study aims to compare the effectiveness of the perineural injection of mecobalamin and 5% dextrose on clinical changes and electrophysiological features in CTS sufferers.
 Methods: This research is a pilot study open-label randomized controlled trial conducted at Dr. Mohammad Hoesin General Hospital Palembang. A total of 24 CTS patients were randomly divided into two groups: the mecobalamin group (n=12) and the 5% dextrose group (n=12). Patients in both groups received a single perineural injection.
 Results: In the mecobalamin group, there were significant improvements in pain scores (NPRS), Boston carpal tunnel questionnaire (BCTQ) - symptom severity scale (SSS) and functional status scale (FSS), as well as median nerve motor and sensory conduction after 2 weeks. In the 5% dextrose group, there were significant improvements in pain scores and BCTQ-SSS but not in BCTQ-FSS and nerve conduction. Comparison between groups showed significant differences in BCTQ-SSS and sensory conduction amplitude.
 Conclusion: Perineural injection of mecobalamin and 5% dextrose is effective in improving clinical symptoms of CTS. Mecobalamin showed better effects on BCTQ-SSS and sensory conduction amplitude than 5% dextrose.

Correlation of Soluble Programmed Death Ligand-1 (sPD-L1) with Alpha-Fetoprotein Levels as a Predictor of Prognosis in Hepatocellular Carcinoma Patients

Background: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and one of the leading causes of cancer death worldwide. Chronic hepatitis B virus infection is the most common etiology of HCC. Programmed death ligand-1 (PD-L1) is a protein that is overexpressed on the surface of tumor cells, which can be detected in serum (sPD-L1). Elevated sPD-L1 concentrations in the plasma of cancer patients are associated with poor prognosis in HCC patients, as indicated by increased AFP levels. There have been no previous studies examining the correlation of sPD-L1 levels with AFP in HCC patients. The aim of the study was to determine the correlation of sPD-L1 and AFP as predictors of prognosis in HCC patients.
 Methods: The research is an observational study with a cross-sectional design to see the correlation of sPD-L 1 with serum alpha-fetoprotein levels in HCC patients at Dr. Mohammad Hoesin General Hospital Palembang starts from April to July 2023. Measurement of sPD-L1 levels and serum AFP levels is carried out using ELISA examination.
 Results: Of the 28 subjects studied, HCC patients were more commonly found in men (89.29%) aged 18-60 years (75%). sPD-L1 and AFP values were found to be increased in the advanced stages of HCC. The sPD-L1 value is directly proportional to the serum AFP value.
 Conclusion: There is a strong positive correlation between sPD-L1 levels and serum AFP levels caused by hepatitis B in HCC patients, so the higher the sPD-L1, the higher the serum AFP levels.

Analysis of Morphometric Variations in the Thickness of the Mandibular Symphysis in Patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia

Introduction. Accurate knowledge of mandibular thickness is necessary for performing surgical treatments on the mandible. The Champy procedure has become the predominant approach for treating fractures of the mandible. Placing plates along these lines is believed to offer the best possible fixing and stability. The objective of this study is to analyze and compare the thickness of the mandible in patients, specifically depending on their gender. The purpose is to gain a more comprehensive understanding of the differences in mandibular architecture across various populations in South Sumatra, Indonesia.
 Methods. This study is a cross-sectional analytical-observational study. The Department of Radiology of Dr. Mohammad Hoesin Central General Hospital, located in Palembang, conducted the study. We included a total of 103 research participants in this study, all of whom met the specified inclusion criteria.
 Results. There is a notable difference in the thickness of the lower jawbone in the front part (A and B) that runs parallel to Champy's line, depending on the person's gender. Males have a greater morphometric thickness of the mandibular symphysis in comparison to females. The thickness of the mandibular symphysis closely links to gender disparities.
 Conclusion. The thickness of symphysis A in men was substantially greater than in females, while the thickness of symphysis B in males was also significantly greater than in females, with a P value less than 0.001.

Correlation Between the Severity of Dry Eye Disease and Fluorescein Break-Up Patterns (FBUP)

Dry eye disease is a disorder of the eye surface characterized by instability of the tear film. The FBUP examination is one of the examinations used to determine the stability of the tear film. The various symptoms that occur in each type of dry eye indicate differences in break-up patterns (BUP). This study aims to determine the correlation between the severity of dry eye disease and the appearance of FBUP at RSUP dr. Mohammad Hoesin Palembang. A correlative analytical cross-sectional study was undertaken at the Eye Polyclinic, Infection- Immunology Subdivision, Dr. Mohammad Hoesin General Hospital Palembang from January to June 2022. There were 32 patient samples with 60 dry eye samples that met the inclusion criteria. The correlation between the Schirmer Test, TBUT and the severity of dry eye disease with the appearance FBUP was analyzed using the Spearman Rho's test. All data were analyzed with SPPS version 23.0. In this study, the results showed that there was a moderate and significant positive correlation between the degree of the Schirmer test and the appearance FBUP (r = 0.482; p = 0.000) and a moderate and significant positive correlation between the TBUT degree and the appearance FBUP (r = 0.435; p = 0.001) . In addition, the results showed that there was a moderate and significant positive correlation between the severity of dry eye disease and the appearance of FBUP (r = 0.478; p = 0.000). Using the multivariate test, it was concluded that the degree of dry eye was statistically significantly related to age (p = 0.001) and gender (p = 0.001). There is a correlation between the severity of the disease and the appearance FBUP of patients with dry eye disease.

Effectiveness of Nigella sativa Addition against TNF-Alpha in Stage III and IV Breast Cancer Undergoing Doxorubicin and Cyclophosphamide Chemotherapy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Background: Breast cancer is a malignancy caused by the continuous uncontrolled growth of the component cells of the ducts or lobules of the breast gland. Globally, breast cancer is the second leading cause of death in women. Nigella sativa contains substances thymoquinone. Thymoquinone can inhibit the progression of cancer through anti-inflammatory, anti-oxidant mechanisms, inhibit proliferation, trigger apoptosis, and prevent angiogenesis. Chronic inflammation in breast cancer is mediated by one of them is TNF-alpha tumors. Elevated levels of TNF-α have a significant association with poor prognosis and progression of breast cancer. This study aims to determine the effectiveness of the additional Nigella sativa in declining TNF-α levels in breast cancer patients at Dr. Mohammad Hoesin General Hospital Palembang.
 Methods: This research used a randomized, open clinical trial design, which was carried out at the internal medicine hematology-oncology medical polyclinic and the surgical oncology polyclinic of Dr. Mohammad Hoesin General Hospital Palembang from January 2023 to October 2023. Data processing for data analysis used SPSS version 26 for Windows.
 Results: There were 36 research subjects followed during the study period and received Doxorubicin chemotherapy and cyclophosphamide (AC), which were divided into treatment groups of 18 people (chemotherapy with the addition of Nigella sativa @600 mg 2x2 capsule/ day and a control group of 18 people. A TNF-alpha examination was carried out before and after to assess the comparison before and after. From the results, it was found that TNF-alpha levels in the treatment group showed a decrease in TNF-alpha with a p-value <0.001.
 Conclusion: The addition of Nigella sativa has the effect of reducing TNF-alpha in breast cancer patients receiving AC chemotherapy at Dr. Mohammad Hoesin General Hospital, Palembang.

Correlation of Platelet-Derived Growth Factor-BB Levels as a Biomarker of Liver Fibrosis with the Degree of Fibrosis Based on Fibroscan in Chronic Hepatitis B Patients

Background: Liver fibrosis is scar tissue that forms due to excessive accumulation of ECM proteins due to chronic liver injury, mediated by cytokines involving complex cellular interactions, such as platelet-derived growth factor-BB (PDGF-BB). In Indonesia, no research has been conducted to determine the correlation between PDGF-BB levels and the degree of liver fibrosis based on fibroscan. The aim of this study is to assess the correlation between PGDF-BB levels and the degree of liver fibrosis based on fibroscan in chronic hepatitis B.
 Methods: A cross-sectional study was conducted on the chronic hepatitis B population at the internal medicine clinic of Dr. Mohammad Hoesin General Hospital Palembang from January to Agustus 2023. The assessment uses fibroscan to determine the degree of liver fibrosis, measured in kilopascals (kPa). PDGF-BB levels measured by ELISA.
 Results: From 40 subjects, the majority of chronic hepatitis B patients were women (57,5%). The lowest PDGF-BB level was found in chronic hepatitis B patients with fibroscan F0, and the highest PDGF-BB level in fibroscan F4. Fibroscan results are directly proportional to PDGF-BB level.
 Conclusion: PDGF-BB has a strong positive correlation with the degree of fibroscan in chronic hepatitis B patients in Dr. Mohammad Hoesin General Hospital. The higher the range of PDGF-BB levels, the higher the degree of fibroscan in chronic hepatitis B patients.

Association Between Sebum, Total Cholesterol, and Low-Density Lipoprotein (LDL) Cholesterol Levels With Post-acne Keloids.

Background Prolonged acne inflammation causes scar formation, one of which is post-acne keloids. Sebum, total cholesterol, and low-density lipoprotein (LDL) level can influence post-acne keloids. This study aims to determine the association between sebum, total cholesterol, and LDL levels with post-acne keloids to better define the predisposing factors for this condition. Methods This study used primary data involving sociodemographics, clinical features, keloid classification, sebum levels, total cholesterol levels, and LDL levels in post-acne keloid patients at the Dermatology, Venereology, and Aesthetics Outpatient Clinics of Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Study samples were patients who fulfilled the inclusion and exclusion criteria by consecutive sampling. The data then underwent univariate and bivariate analyses to show the association between variables. Result A total of 22 patients with post-acne keloids participated. The subjects presented mostly with major keloids based on the classification (59.1%). The patients were predominantly 21-30 years old (50%) and male (90.9%). The keloids had onsets >six months to one year (45.5%), durations of one to five years (77.3%), and multiple presentations (68.2%). Vancouver Scar Scale (VSS) assessment showed mainly red vascularity (40.9%), mixed pigmentation (68.2%), >5 mm keloid height (59.1%), and firm pliability (40.9%). Most patients presented with pruritus (86.4%) but without pain (54.5%). Most had low levels of sebum (50%), normal total cholesterol (90.9%), and near-optimal LDL level (40.9%). There were no significant association between sebum (p = 1.000), total cholesterol (p = 1.000), and LDL (p = 0.376) levels with post-acne keloids. However, LDL levels above normal were most found in this study (68.2%). Conclusions There is no association between sebum, total cholesterol, and LDL levels with post-acne keloids. Despite the fact that LDL level was not statistically significant, there has been a rise in LDL level in the research subjects. Further research with a larger number of subjects and consideration of multicenter study through retrospective/prospective methods and complete lipid profile examinations is still required to provide a more representative study.

Diagnosis of Osteogenesis Imperfecta in 23 Years Old Man: A Case Report

Osteogenesis imperfecta is a disorder of the formation of collagen tissue that functions as connective tissue and is caused by a gene mutation that causes disturbances in the formation of type 1 collagen. This study aimed to describe the diagnosis of osteogenesis imperfecta. A 23-year-old man came to the rheumatology polyclinic of Dr. Mohammad Hoesin General Hospital Palembang with a complaint of recurrent fractures since ± 17 years ago. The patient also complained that the hearing in the left ear was slowly decreasing. The patient's right thigh was still pinned 2 years ago, but after being controlled by orthopedics, it was said that the bones were still not fused. Then the patient was referred to the rheumatology polyclinic for further examination and management. On examination, the patient was 145 cm tall and weighed 40 kg. He had blue-gray sclera, triangular facial appearance, right leg length 86 cm, left leg length 78 cm, blue sclera, and scoliosis, while secondary sex growth was within normal limits. From the examinations of bone survey and bone age, it was found osteoporotic bone structure, scoliosis, plate-screw in the middle 1/3 of the right femur, fracture union of the femur, bowing of the left femur, BMD Z-Score -3.0 means very low compared to the same age and gender. Management is more focused on supportive therapy with the aim of minimizing the occurrence of fractures, minimizing disability, and helping people with osteogenesis imperfecta to be independent and maintain overall health. The goal of orthopedic management is to treat osteogenesis imperfecta with fractures and prevent or correct bone deformity. In conclusion, osteogenesis imperfecta is a complex hereditary disease characterized by striking clinical variability necessitating a logical classification system. Disease management requires multidisciplinary experts and further research on therapeutic approaches such as bisphosphonates.

The Characteristics of Deviated Nasal Septum Patients and Computed Tomography Findings at Dr. Mohammad Hoesin General Hospital Palembang

Introduction. The deviated nasal septum is found in 80% of people in the world either with or without specific symptoms. Mladina has divided the classification of deviation of the septum nasi into seven parts based on the findings of the deviation to facilitate the determination of diagnosis, therapy, and which type often appears. This study aims to determine the characteristics of patients with a deviated nasal septum at Dr. Mohammad Hoesin General Hospital Palembang from January to December 2021. Methods. Data was obtained from medical records of patients with a deviated nasal septum at Dr. Mohammad Hoesin General Hospital Palembang from January to December 2021. Results. The majority of patients were in the age range of 16-25 years (37.8%) and male gender (64.9%). The most common etiology was congenital (86.5%). Clinical manifestation mainly is nasal obstruction (94.6%), and the most common secondary diagnoses found are concha hypertrophy (54%) and allergic rhinitis (16.2%). The most common pathological condition was narrowed cavum nasal (91.9%). The majority of patients had type III deviation (51.4%). All patients were treated with septoplasty (100%). Conclusion. Most patients are predominantly male aged between 16-25 years. Congenital factors primarily caused this condition, leading to complaints of nasal obstruction. Secondary diagnoses included concha hypertrophy and allergic rhinitis. Physical examinations often revealed a narrowed nasal cavity. Most patients exhibited type III septal deviation and all patients were treated with septoplasty

Comparison of antiphenolic glycolipid-1 antibody levels in seropositive contacts of leprosy after 2 years of single-dose rifampicin as postexposure prophylaxis.

Leprosy is still a global problem, especially in developing countries, including Indonesia. Ineffective prevention of leprosy leads to active transmission of the disease. World Health Organization (WHO) recommend post-exposure prophylaxis (PEP) with single dose of rifampicin (SDR) for leprosy patients. Previous study showed protective effect of SDR against leprosy, especially for the first 2 years. Hence, the use of PEP and IgM anti PGL-1 examination are required to suspend the chain of leprosy transmission. This study evaluated the effectiveness of SDR administration by comparing IgM anti-PGL-1 antibody levels in seropositive household contacts before and after 2 years of SDR administration. Analytical observational laboratory study comparing IgM anti PGL-1 antibody levels before and after 2 years of SDR administration in leprosy contacts, with a prospective follow-up study design. We conducted this study from December 2022 to January 2023 at Dr. Mohammad Hoesin General Hospital Palembang. All seropositive household contacts of leprosy who had been administrated SDR 2 years ago were included, then PGL-1 antibody levels were examined. The use of SDR showed significant improvement in leprosy contacts after 2 years (P=0.000). The median antibody level before SDR administration was 1,209.20 (615.81 - 4,353.60), which decrease to 146.03 (0 - 2,487.80) U/mL after 2 years. There was statistically significant relationship between history of BCG vaccination (P=0.003) and IgM PGL-1 antibody levels after 2 years of SDR administration. There is a significant decrease in IgM anti PGL-1 antibody levels among leprosy contacts after 2 years of SDR chemoprophylaxis administration.

The Characteristics of Primary Open Angle Glaucoma Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Introduction. Many people in Indonesia are unfamiliar with glaucoma, even though it causes blindness. This fact is because the damage process of glaucoma occurs slowly. If glaucoma is not treated immediately, it can cause irreversible vision loss and blindness. This study aims to present the characteristics of primary open-angle glaucoma patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia.
 Methods. This study is a descriptive observational study. A total of 33 subjects participated in this study. Data analysis was carried out with SPSS for Windows.
 Results. Most participants were men aged 40-69 years old with a history of high school education. Most patients had clinical symptoms with a mild cup-to-disc ratio with early degrees of visual field defects and intraocular pressure less than 21 mmHg with therapy. Most patients had no history of hypertension, no history of diabetes mellitus and no family history of similar disorders. Most patients have refractive disorders and received medical therapy.
 Conclusion. The characteristics of primary open-angle glaucoma patients at Dr. Mohammad Hoesin General Hospital have a clinical form of a mild cup-to-disc ratio, refractive disorders and receive medical therapy to control increased intraocular pressure.

Risk Factors for Progressive Chronic Kidney Disease in Children with Idiopathic Nephrotic Syndrome at Dr. Mohammad Hoesin General Hospital Palembang

Nephrotic syndrome (NS) is a kidney disease that is often found in children. NS can cause infectious and non-infectious complications, such as upper respiratory tract infections, urinary tract infections, edema, acute kidney injury (AKI), and hypertension. This study aimed to determine the risk factors of age, gender, nutritional status, hypertension, hematuria, AKI, hyperfiltration, and steroid sensitivity to the progression of chronic kidney disease (CKD) in children with the initial idiopathic NS in the pediatric ward of Dr. Mohammad Hoesin General Hospital Palembang. This study was an analytic observational study with a cross-sectional design. A total of 72 secondary data of research subjects were included in this study. Risk factor analysis was carried out with the help of SPSS version 24 software in univariate, bivariate, and multivariate ways. The most common risk factor for children with the initial idiopathic NS is age ≥10 years, males and females gender obtained the same number, and the nutritional status of obesity, hematuria, AKI, and hyperfiltration have quite low rates. However, hypertension and SRNS have high rates in children with initial idiopathic NS. In conclusion, hypertension and hyperfiltration are risk factors that play a role in initiating the progression of idiopathic NS to CKD in the pediatric ward of Dr. Mohammad Hoesin General Hospital, Palembang.

Overall Survival for Stage III Breast Cancer Patients at DR. Mohammad Hoesin General Hospital Palembang and the Influencing Factors

Background: There is still a limited number of studies related to overall survival in breast cancer patients in Indonesia. This study determines the overall survival and the factor which can affect the survival of stage III breast cancer patients.Methods: This study was a retrospective study. Patients first diagnosed with stage III breast cancer from January 1 to August 31, 2018, at DR. Mohammad Hoesin General Hospital Palembang had been studied. The primary outcome of this study was overall survival. The sociodemographic, clinicopathology, and treatment factors were analyzed to identify the independent variables associated with overall survival using Kaplan-Meier and Cox proportional hazard regression.Results: In this study, 78 samples were included. The 3-year overall survival for stage III breast cancer was 71%. In the bivariate analysis, several factors including older age (> 40) (HR = 2.795, 95% CI 1.223–6.387), higher stages for IIIB (HR = 7.155, 95% CI 0.960–53.334), and IIIC (HR = (HR = 33.450, 95% CI 3.013-371.354), history of not undergoing surgical intervention (HR = 3.999, 95% CI 1.684–9.495), and adjuvant chemotherapy (HR = 2.768, 95% CI 1.211–6.327) have been associated significantly to lower overall survival. Multivariate analysis showed IIIC breast cancer stage as an independent factor and had a significantly increased probability of mortality (HR = 14.677, 95% CI 1.268–169.948).Conclusions: The stage at diagnosis was the only significant predictor for the survival outcome, indicating that early diagnosis may need more attention.

Characteristics of Breast Cancer in Young Female Patients in Dr. Mohammad Hoesin General Hospital Palembang

Background: Breast cancer has had the highest mortality and morbidity globally in recent years. Breast cancer in young women presents with biological characteristics of more aggressive cancer, generally detected at advanced stage and a poorer prognosis. This study aimed to determine the characteristics of the incidence of breast cancer in young female patients at Dr. Mohammad Hoesin General Hospital Palembang in 2019–2020.Methods: This study is descriptive observational study conducted in October–November 2021. After having ethical approval from the Institutional Review Committee, research data were obtained from the medical records of young female patients diagnosed with breast cancer from January 1, 2019 to December 31, 2020. Samples were collected by using total sampling with the patient’s young age limit of fewer than 40 years.Results: The incidence of breast cancer was 20.9% (169 patients). The number of samples in this study was 120. Sociodemographic characteristics include the age range of 35–39 years around 63.3% (76 people), the highest education level of senior high school around 35% (42 people), not working around 73.3% (88 people), and living in the Palembang City area around 47.5% (57 people). Clinicopathological characteristics include the stage at the first diagnosis of stage IIIB about 46.7% (56 people), luminal B clinical subtype about 60% (72 people), and most histopathological type of invasive carcinoma of no special type about 88.3% (106 people).Conclusions: The incidence of breast cancer in young women is less than in older women but has worse cancer characteristics

Antibiotic Susceptibility of Staphylococcus sp. in Diabetic Ulcer Patients at Dr. Mohammad Hoesin General Hospital, Palembang

The high prevalence of diabetic ulcers and the resistance of Staphylococcus sp. to antibiotics can complicate the treatment of diabetic ulcer patients with Staphylococcus sp. This study aimed to determine the pattern of susceptibility of Staphylococcus sp. in patients with diabetic ulcer at Dr. Mohammad Hoesin General Hospital Palembang in January 2019-August 2022. This research was an observational descriptive study using total sampling conducted in September-November 2022 at Dr. Mohammad Hoesin General Hospital Palembang. Data was obtained from patient medical records and laboratory results of patients with diabetic ulcer disease infected with Staphylococcus sp. from January 2019 to August 2022. Prevalence of Staphylococcus sp. infection in diabetic ulcer patients was low (15 of 77 diabetic ulcer patients, 19.5%). There were 19 bacterial isolates from 15 diabetic ulcer patients. A total of 8 coagulase-negative Staphylococcus sp. (CoNS) and 11 coagulase-positive Staphylococcus sp. (CoPS) isolates were tested for their susceptibility to antibiotics. Both CoPS and CoNS bacteria in diabetic ulcer patients were most susceptible to linezolid (90.9% for CoPS and 100% for CoNS) and most resistant to benzylpenicillin (81.8% for CoPS and 87.5% for CoNS).

Correlation of IL-17 Serum Levels with Carotid Intima-Media Thickness and Degree of Disease Activity in Rheumatoid Arthritis Patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia

Background: Rheumatoid arthritis (AR) is an autoimmune disease characterized by chronic and progressive systemic inflammation, in which the joints are the main target. AR has long been associated with increased cardiovascular risk. Vascular inflammation plays an important role in atherosclerosis. In AR, there is an increase in IL-17, which accelerate the formation of atherosclerosis. In Indonesia alone, there is no data that publishes the correlation between IL-17 levels with carotid IMT and the severity of AR.
 Methods: This type of research is a descriptive observational study with a correlation test approach. A total of 31 subjects participated in this study who were AR patients and calculated a DAS score of 28. Carotid IMT was measured by high-resolution carotid Doppler ultrasound B-mode ultrasound machine (PHILIPS, iE33) equipped with an 11 MHz linear array transducer. IL-17 was measured by the ELISA method. Data analysis was performed with a correlation test with SPSS software version 25.
 Results: There was a strong positive correlation between IL-17 and the degree of disease activity in AR (DAS28 score) with r = 0.657; p = 0.0001; n=31. There was no significant correlation between carotid IMT and IL-17 levels (r= 0,207; p=0,264; n=31).
 Conclusion: There is a strong positive correlation between IL-17 and the degree of AR disease activity. There was no significant correlation between carotid IMT and IL-17 levels.

Secukinumab Therapy on Psoriasis at Dr. Mohammad Hoesin General Hospital Palembang

Background: Psoriasis is a chronic inflammatory skin disease mediated by T lymphocytes. IL-17 or IL-22 plays an important role in the chronic inflammatory process. Secukinumab is an effective biological agent therapy with a molecular target, IL-17A. This study aimed to describe PASI improvement and safety of using secukinumab in psoriasis patients at the Dermatology and Venereology Clinic Dr. Mohammad Hoesin General Hospital Palembang.
 Methods: This study was a retrospective, descriptive-analytic study. The inclusion criteria of this study were all medical record data of patients diagnosed with cutaneous psoriasis through anamnesis, clinical and histopathology examination, treated with secukinumab from January 2018 to December 2020.
 Results: Psoriasis patients with secukinumab therapy were 15 people. The number of male patients was 8 people, the mean age (+ SD) was 40.4, + 12.34 years, and the age range was 19-64 years. A family history of psoriasis was present in 2 patients (13.4%). Psoriasis vulgaris was the most prevalent type of psoriasis and was treated with secukinumab in 8 patients (53.3%). Another type was pustular psoriasis (20%) and erythrodermic psoriasis (26,7%). The triggers of exacerbations obtained in this study include occupation, hypertension, diabetes mellitus, obesity, smoking, and infections. PASI 75 was achieved by 13 patients (86.7%) at week 12, and all patients achieved DLQI<5. There were no adverse events during the use of secukinumab.
 Conclusion: The improvement of PASI and DLQI scores were achieved at week 12 in accordance with previous studies. Risk factors do not reduce the therapeutic effect of secukinumab in achieving PASI 75.

Adverse Skin Reaction to Hand Hygiene and Personal Protective Equipment among Health-Care Workers during COVID-19 Pandemic in Dr. Mohammad Hoesin General Hospital Palembang

Background: Indonesian health-care workers (HCWs) are at the front liners battling against the Coronavirus-2019 disease (COVID-19) pandemic since March 2020 and must protect themselves by hand hygiene and using personal protective equipment (PPE). Hand hygiene and the use of PPE are associated with an adverse skin reactions. This study aimed to find out the prevalence, characteristics, and risk factors for adverse skin reactions to hand hygiene and PPE among HCWs in Indonesia during the COVID-19 pandemic.
 Methods: A cross-sectional online questionnaire-based survey among HCWs in Dr. Mohammad Hoesin General Hospital Palembang on April 1-30, 2022. The data were collected, including demographic characteristics, occupational-related characteristics, and adverse skin reactions.
 Results: The study included 134 respondents, the majority of the respondents were female (57,5%), with a mean age was 31,18 ± 4,89 years old. Adverse skin reactions were reported only on 16,4% of respondents. Hands (40,9%) were the most common site affected. The highest symptom and lesion were itch (54,5%), erythema (59,1%) and scales (59,1%). There was a significant association between adverse skin reactions to hand hygiene (p <0,001) and PPE (p = 0,001) before and during the pandemic. However, adverse skin reactions were not associated with increased frequency of hand hygiene and duration of PPE worn. History of pre-existing inflammatory skin condition is the risk factor for adverse skin reactions to hand hygiene and PPE.
 Conclusion: Adverse skin reactions to hand hygiene and PPE are increasing among Indonesian HCWs during the COVID-19 pandemic.