Mohammad Hoesin Research Articles

Risk Factors for HIV-positive Status In Condyloma Acuminata

Background: Condyloma acuminata (CA) is a sexually transmitted infection (STI) caused by human papillomavirus (HPV), especially types 6 and 11. The number of HPV infections increases in immunosuppressed conditions, such as human immunodeficiency virus (HIV) infection. Risk factors in CA patients such as gender, sexual partner, sexual orientation, and sexual intercourse can increase HIV status. Methods: This is a descriptive-analytic study with a cohort retrospective design. The subjects are all CA patients who visited the polyclinic STI Dr. Mohammad Hoesin, General Hospital, Palembang, Indonesia, between 2016-2020. The number of CA patients included in the study were 115 patients aged 14 to 71 years old. Chi-square and multivariate logistic regression were used to analyze the independent variables. Results: The total number of HIV-positive CA patients was 31 (26.8%) out of 115. There were more males than females, and the mean age was 29±9.90, with a range of 14-71 years old. The most common location was the genital (58.3%). Gender, marital status, number of partners, sexual orientation, sexual intercourse, location, and type of lesions had p Conclusion: Risk factors for HIV in CA patients are age, marital status, sexual partner, sexual orientation, and location of lesions. CA patients who were MSM had a 22-fold higher risk for HIV-positive status.

PHYSICAL COMORBIDITIES IN CHILDREN WITH AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorders (ASD) is a neurodevelopmental disorder characterized by two core symptoms; impairments in social communication and restricted or repetitive behavior. ASD is a broad group of conditions where patients have a variety of abilities and needs. Their ASD related-physical and psychological comorbidities also affect their mortality risk. This study wished to investigate physical comorbidities associated with ASD in the national reference hospital in Indonesia. This is a descriptive study with a cross-sectional approach on children with ASD who visited RSUP Dr. Mohammad Hoesin, Palembang, during 2014-2018. Data were obtained from the medical records and telephone interviews with the parents. Of all the 60 participants included in the study, most are male (n=52;86,7%). The most prevalent ASD-related physical comorbidities were gastrointestinal disorders (n=27;45%), followed by nervous system disorders (n=35;58,3%), and immune system disorders (n=11;18,3%). Despite the small sample size, the prevalence of ASD-related physical comorbidities in children with ASD is profoundly high, implying the need to do early detection from both parents and health professionals to prevent morbidity and complications that may occur. Children with autism can benefit from various therapies start in early childhood and continue throughout their lives to improve their development, and quality of life.

The Quality Characteristics of Distal Radius Fractures in Patients Admitted to Emergency Department Dr. Moh. Hoesin Hospital Palembang during January-December 2020

Fracture cases increases in globalization era. The 8-15% reported cases were distal radius fracture (DRF). The epidemiology data is the foundation of diagnostic and management for DRF patients. However, this has not been studied in Indonesian patients. As a result, the authors decided to study the picture of DRF patients in the Indonesian subpopulation, especially in the Central General Hospital Dr. Mohammad Hoesin (RSMH) Palembang. This research is a descriptive observational study at RSMH Palembang in January-December 2020 with variables of age, sex, mechanism of injury, types of fractures, radial inclination and volar tilt as the parameter of DRF severity. All of these variables are components of the assessment on the medical record. The data in this study were 29 cases and described with the age, sex, mechanism of injury, types of fractures, radial inclination and volar tilt. The most common DRF occurred at the youth age between less 13-25 years (41.4%). DRF happened more in male (75,9%) patients than the female (24.1%) ones. The most common type of fracture is Colles (44.8%). Motorcycle crash (58.6%) is the most common mechanism of injury in DRF. The abnormal radial inclination occurred in 82% cases. Severe volar tilt counted 85% of DRF in this study. DRF happened mostly in youth, male, and motorcycle crash. Colles fracture is the most commonly type of DRF case.

Sensitivity and Specificity of Vascular Endothelial Growth Factor A (VEGF-A) against Endometriosis

Background. Endometriosis is a benign disorder defined by the presence of endometrial glands and stroma outside the uterus. Endometriosis occurs in 10-15% of women during their reproductive years. Angiogenesis and the inflammatory response are important factors in the development of endometriosis. The formation of a new blood supply is a crucial step in the formation of endometrial lesions. Angiogenesis is induced by a growth factor peptide, namely vascular endothelial growth factor A (VEGF-A). VEGF-A is known as a vascular permeability factor that plays an important role in the pathological angiogenesis process and is a more specific and prominent angiogenesis factor among the VEGF family. The purpose of this study was to determine the sensitivity and specificity of examination VEGF-A of menstrual blood in diagnosing endometriosis compared to laparoscopy. Methods. This diagnostic test research has been carried out at the gynecology polyclinic, especially the division of Fertility, Endocrinology and Reproduction, Faculty of Medicine, Sriwijaya University- Dr. Central General Hospital. Mohammad Hoesin from August to November 2018, there were 45 patients who met the inclusion criteria. VEGF-A examination in instrumental blood based on ELISA examination. Data analysis to measure sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy using Medcalc statistics. Results. From the results of this study, it is known that the majority of the study samples were aged 31.69 years (24-38 years) 75.6%, body mass index (BMI) 51.1% with normal BMI, experienced infertility by 82.2% of the sample, most of the samples did not smoke (95.6%) and most experienced mild pain 55.6% using the VAS pain scale. From this study, it is known that 84.4% or 38 of the study samples had endometriosis with a cut off point value of VEGF-A > 347 pg/mL. From the results of this study, it is known that the sensitivity of VEGF-A in diagnosing endometriosis is 84.2%, specificity is 85.7%, positive predictive value is 97%, negative predictive value is 50% and accuracy is 84%. Conclusion. VEGF-A menstrual blood can be used as a diagnostic tool for endometriosis.

Performance Measurement of Comprehensive Emergency Neonatal Obstetric Servant (PONEK) in Dr. Moh. Hoesin Palembang with a Balanced Scorecard to Improve the Quality of Midwifery Services

A B S T R A C TIntroduction Maternal Mortality Rate (MMR) and Neonatal Mortality Rate (IMR)in Indonesia are the highest among ASEAN countries, namely 307 / 100.000 livebirths for MMR and 20/1000 live births for IMR. This situation can actually beprevented through early detection approaches and appropriate management ofmothers and babies through the Comprehensive Obstetric Neonatal EmergencyServices (PONEK) program as one of the important elements of good hospitalservice performance. The performance of a hospital is of course determined by theperformance of each unit and team which requires relevant multi-dimensionalmeasurement standards. Basic Score Card (BSC) is a method developed byKaplan and Norton (1996) to measure performance comprehensively, so it ishoped that this method can help improve the quality of obstetric emergencyservices, especially in Palembang. Methods: This descriptive analytic study wasconducted at Dr. Mohammad Hoesin (RSMH) Palembang by looking for factorsthat affect the quality of emergency obstetric care and analyzing the performanceof the PONEK team in providing PONEK services. Primary data is obtainedthrough questionnaires with direct interviews with respondents or by directobservation in the field to see the real obstacles that occur during service. Thedata were analyzed qualitatively and quantitatively. Results: During the periodOctober 2014 - March 2015 there were 1219 total hospitalized patients. Based onthe Financial Perspective, the effectiveness ratio for achieving the performance ofthe RSMH PONEK team still meets the target of 1.3 for vaginal and has not metthe target of 0.5 for SC with a financial perspective score of +2. Based on theCustomer Perspective, the total score is +2 with the patient satisfaction index is5957 (satisfied) and the Gross Death Rate (GDR) figure for PONEK RSMH servicesis 14 (meets GDS MOH standards). Based on the Internal Business Perspectivethe total score is +1, with the level of compliance with the clinical pathwaystandard = 92%, the level of compliance for the National Fornas PONEK = 100%,while the response time is > 1 hour. Based on the perspective of learning andgrowth, the total score = +1, with the number of PONEK trained personnel <50%,neonatal resuscitation and lactation management <10%, employee workmotivation is very high, and facilities and infrastructure are classified as good.Based on these four perspectives, the BSC score for RSMH PONEK performanceis +0.6 with an interval scale of -1 to +1. Conclusion: Based on the BSCmeasurement results of the PONEK team at RSMH Palembang, it can beconcluded that the PONEK team's performance is good.

Association Between Clinicopathologic Characteristics and WHO Prognostic Group in Gastrointestinal Stromal Tumor Patients at RSUP Dr. Mohammad Hoesin, Palembang

BackgroundGastrointestinal stromal tumors are the most common mesenchymal tumors in the gastrointestinal tract. Based on tumor size andmitotic index, WHO classified GIST into three prognostic groups which were benign, uncertain malignant potential, and malignant.Some studies revealed that there was variation in association between age, gender, tumor location, histopathologic type and prognosisof GIST patients. This study aimed to identify and analyze the association between clinicopathologic characteristics and WHOprognostic group in GIST patients at RSUP Dr. Mohammad Hoesin Palembang.MethodsThis study used 30 medical records of GIST patients during 01 January 2014 to 27 December 2018 in the Department of AnatomicPathology RSUP Dr. Mohammad Hoesin. Clinicopathologic characteristics and WHO prognostic group data were collected. Theassociation between clinicopathologic characteristics (age, gender, tumor location, histopathologic type) and WHO prognostic groupwere analyzed by chi-square test.ResultsFrom 30 subjects, 40% of the patients aged 52-58 years.There was no gender predilection. A total of 33.3% of the GISTs were locatedin the small intestine. Majority of histopathologic type was spindle cell type (93.3%). Bivariate analysis showed there were no significantassociation between clinicopathologic characteristics: age (p=0.811), gender (p=0.682), tumor location (p=1.000), histopathologic type(p=0.469) and WHO prognostic group.ConclusionThere was no significant association between clinicopathologic characteristics and WHO prognostic group in GIST patients at RSUPDr. Mohammad Hoesin Palembang. We suggest doing a cohort study about association between clinicopathologic characteristics andsurvival rate in GIST patients.

Non-structural Preparedness Analysis At RSUP Dr. Mohammad Hoesin In Disaster Based On The Hospital Safety Index

Disasters are one of the most challenging cases for health institutions that can disrupt health services’ functioning. However, as essential and primary care providers in society, health institutions and especially hospitals must be prepared for disasters and emergencies. This study analyzes the hospital’s non-structural preparedness in facing disasters based on the Hospital Safety Index in RSUP (Central General Hospital) Dr. Mohammad Hoesin. This research is a mixed-methods study with a sequential explanatory design. The research subjects were four people. The key informants consisted of Occupational Health and Safety Staff and Non-Medical Facilities Maintenance Staff. The triangulation informant was the Occupational Safety and Health Committee. The non-structural preparedness of RSUP Dr. Mohammad Hoesin, based on the Hospital Safety Index is 0.84. The results of the in-depth interviews show that the obstacles for hospitals in implementing disaster preparedness are budgetary funds and the focus of the hospital in improving structural preparedness and health services. RSUP Dr. Mohammad Hoesin is at a high level of non-structural preparedness. Overall, the hospital can function in emergencies and disasters. However, it is recommended to continue with steps to improve crisis and disaster management's security and capacity. Abstrak: Bencana adalah salah satu kasus paling sulit bagi institusi kesehatan yang dapat mengganggu fungsi layanan kesehatan. Namun, sebagai dasar dan penyedia perawatan primer dalam masyarakat, institusi kesehatan dan khususnya rumah sakit harus siap menghadapi bencana dan keadaan darurat. Penelitian ini bertujuan untuk menganalisis kesiapsiagaan nonstruktural rumah sakit dalam menghadapi bencana berdasarkan Hospital Safety Index di RSUP Dr. Mohammad Hoesin. Penelitian ini merupakan penelitian mix methods dengan jenis sequential explanatory design. Subjek penelitian berjumlah empat orang. Informan kunci terdiri dari Staf Keselamatan dan Kesehatan Kerja dan Staf Instalasi Pemeliharaan Sarana Non-Medik (IPSNM). Informan triangulasi yaitu Komite Keselamatan dan Kesehatan Kerja. Kesiapsiagaan nonstruktural RSUP Dr. Mohammad Hoesin berdasarkan Hospital Safety Index sebesar 0,84. Hasil wawancara mendalam menunjukkan bahwa kendala rumah sakit dalam menerapkan kesiapsiagaan bencana yaitu anggaran dana, serta fokus rumah sakit dalam tahap peningkatan kesiapsiagaan struktural dan pelayanan kesehatan. RSUP Dr. Mohammad Hoesin berada pada level kesiapsiagaan nonstruktural tinggi. Secara keseluruhan rumah sakit dapat berfungsi dalam keadaan darurat dan bencana. Namun, direkomendasikan untuk melanjutkan langkah-langkah dalam memperbaiki tingkat keamanan dan kapasitas penanganan darurat dan bencana.

Outcome of Combined Neoadjuvant Chemotherapy and Vitamin A in Advanced Cervical Carcinoma: A Randomized Double-Blind Clinical Trial.

Background:The latest World Health Organization (WHO) inquiry on the epidemiology of cervical cancers indicate there are approximately 528,000 new cases per year, ranking fourth after breast, colorectal and lung cancer. The validity of neoadjuvant chemotherapy (NAC) alone in advanced cervical cancer is still being debated. NAC induces tumor shrinkage prior to pursuing surgery. NAC also has the benefit of sterilizing the lymph nodes and parametria, thereby lowering the need for adjuvant therapy after surgery. This research aims to determine the impact on the treatment of advanced cervical carcinoma with NAC, with the additional provision of Vitamin A during treatment to assess the factors that could affect the outcome of clinical treatment. Methodology:The research methodology and design of this study is a randomized double-blind clinical trial to compare the effects of treatment with NAC and treatment with NAC + Vitamin A, in advanced cervical carcinoma. Both study groups received treatments consisting of a regime of cisplatin and paclitaxel. The study was conducted at the General Hospital of Dr. Mohammad Hoesin. The total number of patients recruited for the trial was 30 with 15 patients per treatment arm. One group received NAC consisting of cisplatin and paclitaxel and the remaining 15 patients received NAC + Vitamin A. Results:The addition of Vitamin A was found to be much better in influencing the clinical response in the treatment of advanced cervical carcinoma, although this was not statistically significant. However, a larger sample size with the reported proportion of higher positive outcome for NAC + Vitamin A may be statistically significant. Conclusion:Based on the results, Vitamin A supplementation in the treatment of advanced cervical carcinoma with neoadjuvant chemotherapy may play a crucial role in the treatment of cervical carcinoma.

Relationship between Knowledge, Attitude and Behavior of Postnatal Woman Toward Participation in Permanent Contraception

Objective: To investigate the association between knowledge,attitude, and behavior towards participation in permanentcontraception and describe factors that could affectparticipation of permanent contraception in women inRSMH Palembang.Methods: This case control study was conducted at the Departmentof Obstetrics and Gynecology, Dr. Mohammad Hoesin Hospital/Faculty of Medicine, Universitas Sriwijaya, Palembang, during theperiod of June 2016 to December 2016. Sample of the cases groupwas woman who agreed to use permanent contraception whilecontrol sample was women who refuse to use permanent contraception.Data were collected using a questionnaire. Statisticalanalysis was performed using SPSS.Results: There was a significant association between attitude,behavior, husband support, and disease complications withparticipation of permanent contraception. Factors that influencedparticipation of permanent contraception in woman in RSMHPalembang include husband support and behavior.Conclusion: Factors that influence the participation of women inRSMH safe contraception Palembang include support for herhusband and behavior.[Indones J Obstet Gynecol 2018; 6-1: 39-44]Keywords: family planning, participation, permanent contraception

Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children

Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive.Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children.Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC) area under the curve (AUC).Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382), cough (OR 3.500; 95%CI 1.788 to 6.582), and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797). A scoring system was constructed based on the parameters: male (score of 1), cough (score of 2), and yellow-greenish stool (score of 3). From ROC analysis, the AUC was 0.755. Using a cut-off score of > 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%.Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.

Hubungan antara Kepercayaan dan Keterpaparan Informasi dengan Pengetahuan dan Sikap terhadap Perawatan Metode Kanguru pada Bidan di Kabupaten Musi Rawas Sumatera Selatan Tahun 2016

Background: Infant and Neonatal mortality in Musi Rawas District is the highest in Southern Sumatera in 2014. Implementation of kangaroo mother care as Low Birth Weight treatment is still limited in the provincial general hospital Dr. Mohammad Hoesin, Palembang. At the present time, midwives as maternal and child health service provider, can access many information including Kangaroo Mother Care from various media.Objectives: This study aimed to analyze the relationship between belief in the myth of LBW care and exposure information with the knowledge and attitudes toward kangaroo mother care on midwives in Musi Rawas District of Southern Sumatra 2016.Method: Cross sectional study design used on 197 midwives with purposive sampling.Result and Discussion: The results showed that midwives who have relatifely good knowledge about KMC As much as 50,8% and having relatively positive attitude towards KMC as much as 40.1%. There are a significant relationship between belief of LBW care (ρ=0,001; OR: 3,1; 95% CI: 1,6 – 5,8), exposure information from scientific media (ρ=0,039; OR: 2,4; 95% CI: 1,0 – 5,4), training (ρ=0,001; OR: 3.5; 95% CI: 1.7 – 7,5) with knowledge about KMC on midwives.Conclusion: A significant relationship also demonstrated between exposure information from training with attitude towards KMC on midwives (ρ=0,003; OR: 2,8; 95% CI: 1,4 – 5,6). Improving quality of the midwives in Kangaroo Mother Care is very important so midwives can provide counseling, information, and education to mother since detected with LBW.Keywords: Kangaroo Mother Care, Midwife, Belief, Attitude, Knowledge of KMC