Patient Medical Record Research Articles

LUARAN VISUAL ANTARA VITREKTOMI YANG DILAKUKAN SECARA DINI DAN TERTUNDA PADA PASIEN ENDOFTALMITIS YANG DIOPERASI DI RUMAH SAKIT KARIADI SEMARANG : STUDI DESKRIPTIF SELAMA DUA TAHUN

Introduction : Endophthalmitis is a medical emergency caused by infection of tissue or fluids inside the eyeball. Vitrectomy for endophthalmitis is one of the treatment choice and leads to VA gains in some cases. Timing of surgery and visual outcome after surgery are vital to acknowledge. This study aims to analyze the difference of visual outcome between early and delayed vitrectomy in endophthalmitis patients operated in Dr. Kariadi General Hospital Methods : A Retrospective study held from medical record of patients with endophthalmitis underwent vitrectomy surgery from January 2021 – January 2023 in Dr. Kariadi General Hospital, Semarang. Endophthalmitis patients caused by trauma were excluded. All of the patients had immediate vitrectomy, and based on the onset, the patients were divided into two groups, early vitrectomy (onset ? 7 days) and delayed vitrectomy (onset > 7 days). Independent t- test method was used to analyze the data (significant if p<0.05) Result : Totally 30 endophthalmitis patients (30 eyes) were obtained. There were 18 patients (60%) had early vitrectomy and 12 patients (40%) had delayed vitrectomy. Postoperative examination showed 13 (72%) patients with early vitrectomy had improved VA, and 5 (28%) had constant VA. On the other hand, patients with delayed vitrectomy showed 5 (42%) had improved VA, 6 (50%) had constant VA, and 1 (8%) had decreased VA. The difference between two groups was significant (p=0.014) Conclusion : This study found endophthalmitis patients with early vitrectomy had significant better visual outcome than delayed vitrectomy.

Successful Rate of Glaucoma Surgery in Secondary Glaucoma after Vitrectomy in Kariadi General Hospital Semarang 2020-2022

Introduction & ObjectivesGlaucoma is one of the most frequent complications of vitrectomy surgery. It can cause a significantrise in intraocular pressure (IOP). Glaucoma surgery can be planned in medically uncontrolledglaucoma. Trabeculectomy and Glaucoma Drainage Device (GDD) implantation are the mostfrequent filtering surgeries used in these cases. This study aims to define the success rate ofglaucoma surgery in secondary glaucoma after vitrectomy.
 MethodsThis study is an analytical observational study with retrospective data collection held from medicalrecords of patients with secondary glaucoma after vitrectomy who underwent glaucoma surgery inKariadi General Hospital Semarang from 2020-2022. Surgical success defined by postoperative IOPreduced by>20% from baseline, with or without anti-glaucoma medication.
 ResultsThere were 16 eyes of trabeculectomy with 5-fluorouracil (5-FU), and 8 eyes of GDD implants. Themean preoperative IOP was 43.76+6.77 mmhg for trabeculectomy 5-FU, and 42.43+4.02 mmhg forGDD implant. IOP levels in both groups varied significantly after one day, one week, one month, andthree months after surgery (p<0.05). The success rate for the trabeculectomy 5-FU group was81.25% and the GDD implant group was 87.5% in 3 months. There was no statistically significantdifference in the success rate between the trabeculectomy 5-FU and GDD implant groups (p=0.839).The complication for the GDD implant group was 25%. No complications were found in thetrabeculectomy 5-FU group.
 ConclusionThere was no significant difference in the success rate between trabeculectomy 5-FU and the GDDimplant group. Both groups are viable for glaucoma surgery in secondary glaucoma after vitrectomysurgery.

Strabismus Surgery for Traumatic Ocular Misalignment: Twelve Cases in Five Years

Introduction : Trauma can cause an ocular misalignment due to damage of extraocular muscles, nerves and orbital tissue around the eye. Direct trauma causing extraocular muscle rupture needs immediate surgery, meanwhile indirect trauma resulting in traumatic sixth nerve palsy or other reversible ocular misalignment without orbital floor fracture can be observed for six months. This study describe the characteristic of patients undergo single-step strabismus surgery for traumatic ocular misalignment, mechanism of injury, eye alignment, amount of ocular deviation before and after strabismus surgery.
 Case Illustration : This was a case series based on medical record of patients underwent strabismus surgery secondary to head or eye injury from 2017 until 2022.
 Discussion : Twelve individuals with post-traumatic strabismus correction participated in this study. All subjects were male age ranging from 18-51 years. Direct trauma was observed in 6 (50%) patients causing medial rectus muscle rupture in 4 patients and inferior rectus muscle rupture in 2 patients. Indirect trauma was observed in 6 (50%) patients caused by sixth nerve palsy on 4 patients The misalignment was exotropia, esotropia, and hypertropia with amount of 5, 4, and 3 respectively. The deviation was between 30-90 prism dioptre (PD) and 7 (58%) patients had deviation less than 65 PD. Strabismus surgery performed was muscle transposition with or without recession of the antagonist muscle.
 Conclusion : Single step surgery for traumatic ocular misalignment can provide good result in cases of deviation less than 65 PD

Prevalence and determinants of adverse perinatal outcomes of preeclampsia with severe features at two selected public hospitals in Addis Ababa, Ethiopia.

Preeclampsia is a new onset of hypertension and either proteinuria or end-organ failure after 20 weeks of gestation. It is a prevalent cause of perinatal mortality, morbidity, and neonatal complications in developing nations including Ethiopia. Thus, the aimed to assess the prevalence and determinants of adverse perinatal outcomes among women with preeclampsia with severity features (PEWSF) at two selected public hospitals in Addis Ababa, Ethiopia, 2023. A cross-sectional study was carried out among 348 mothers between January 1, 2023, and July 1, 2023. A structured, pre-tested questionnaire was used to gather data from in-person interviews and a review of the patient's medical record. The statistical program Epi-Data version 4.6 was used to enter the data, and SPSS version 26.0 was used for analysis. Binary logistic regression analysis was used to find factors that were associated with unfavorable perinatal outcomes. A p-value of less than 0.05 was used to declare the significance level. The overall prevalence of unfavorable perinatal outcomes was 59.2% (95% CI: 54.0-63.8). Among the complications, low birth weight, prematurity, NICU admission, and a low fifth-minute APGAR score, encompass 48.9%, 39.4%, 20.4%, and 14.7%, respectively. No formal education [OR = 5.14, 95% CI: (1.93-13.63)], unemployment [OR = 0.42, 95% CI: (0.24-0.73)], referral cases [OR = 2.03, 95% CI: (1.08-4.06), inadequate antenatal care (ANC) contact [OR = 3.63, 95% CI: (1.22-10.71)], and family history of hypertension [OR = 1.99, 95% CI: (1.03-3.85)] have shown a statistically significant association with unfavorable perinatal outcomes. In this study, the prevalence of unfavorable perinatal outcomes was high compared to other studies in Ethiopia. Level of education, occupation, mode of admission, ANC contact, and family history of hypertension were significant predictors of unfavorable perinatal outcomes. Socio-economic development, improving referral systems, and adequate antenatal care contact are needed to improve unfavorable outcomes. Additionally, antenatal screening and specialized care for high-risk mothers, e.g., those with a family history of hypertension are recommended.

Acthar Gel in African Americans versus Non-African Americans with Symptomatic Sarcoidosis: Physician Assessment of Patient Medical Records.

Sarcoidosis is common among African Americans in the United States. Acthar® Gel is a viable option for the treatment of advanced symptomatic sarcoidosis. This study examined patient characteristics, Acthar Gel utilization, co-medication use, and treatment response based on physicians' assessments among African Americans versus non-African Americans with advanced symptomatic sarcoidosis. Data from the medical charts of patients were used. During data collection, patients had either completed ≥1 course or received treatment with Acthar Gel for ≥6 months. This study comprised 168 African Americans and 104 non-African Americans. On average, the time since the first diagnosis of sarcoidosis was slightly longer among African Americans than non-African Americans (5.2 versus 4.3 years). Skin, heart, eyes, and joints were the most common extrapulmonary sites involved among both race groups. Shortness of breath, fatigue, bone and joint pain, and wheezing/coughing were the most frequent symptoms among both race groups. A higher proportion of African Americans versus non-African Americans were first-time Acthar Gel users and had not completed treatment during data collection. Patients in both race groups with higher starting doses of Acthar Gel therapy had a shorter treatment duration and vice-versa. A significantly lower proportion of patients among both race groups were on any co-medication after Acthar Gel initiation (p<0.0001). Further, a higher proportion of African Americans versus non-African Americans had a reduction in any co-medication use after Acthar Gel initiation. The mean daily dose of prednisone decreased among African Americans (18.5 to 10.1 mg) and non-African Americans (17.6 to 10.0 mg) after Acthar Gel initiation. Improvement in patient health status and overall symptoms was similar for both race groups. Findings suggest that Acthar Gel improves health outcomes for patients with sarcoidosis, which could help to alleviate health disparities among African Americans, who are disproportionately affected by this disease.

Design of EMR (Electronic Medical Record) Applications Using RFID Cards to Record Patient Medical Record Data at The Sukajadi Bandung Health Center

One of the supports for health services is required to be better, one of which is by making EMR (electronic medical record) applications using RFID cards as a substitute for patient medical record cards. In this case this RFID card can function as patient history data, when the patient taps the RFID card, then all the history data appears entirely. Problem Identification at this stage the author identifies the problems that occur and looks for solutions needed at the Sukajadi Community Health Center in Bandung which requires a medical record application system to assist in processing patient data, medical record data and drug data at the Sukajadi Community Health Center. This research resulted in the design of a Medical Record application at the Sukajadi Health Center, Bandung City using an RFID card. b. With the record application can help activities in managing data both patients and drug data and more efficient and safer so that doctors can add or view the patient's medical record history.

Medical records information system based on prototyping model using automatic identifier NFC card

Radio Frequency Identification is a compact wireless technology that is superior and has been developed in the commercial and educational for example in automatic identification in the hospital patient registration. This research aims to improve patient registration services to be more practical during outpatient registration at hospitals. Currently, hospital outpatient registration is still carried out semi-computerized where patients come to the reception desk and then register by filling in a registration form. Next, the reception staff performs data entry from the registration form that has been filled in by the patient. If a lot of patients come, there will be a queue of patients because it takes quite a long time for the registration process. Based on the problems faced, this research carried out the development of a patient data management system using NFC cards which contain patient medical record number data. When a patient visits the hospital, the patient taps the medical record card and inputs the complaint and the doctor they are going to, then the patient gets a queue number for consultation, until the patient consults with a doctor and gets the medicine prescribed by the doctor through the use of the system. Testing the system by reading and writing data on the NFC card on the card reader/writer unit, the test results showed that the maximum reading distance for the NFC card was 7 cm with a reading angle relative to the NFC reader/writer with 300 can read the NFC card.

Clinical Issues - February 2024.

Retaining count sheets in the patient's medical record Key words: count sheet, medical record, procedural risk factor, retained surgical item, surgical count. Counting instruments during cavity closure Key words: uterine cavity, abdominal cavity, fetal procedure, cesarean delivery, instrument count. Surgical wound classification of procedures involving cancer removal Key words: cancer, contamination, infection, surgical wound classification, decision making. Placing an electrosurgical unit dispersive electrode over a tattoo Key words: dispersive electrode placement, metallic pigment, burn, tattoo, electrosurgical unit (ESU).

Risk Factors of Coronary Heart Disease in North Sulawesi Indonesia

Coronary heart disease (CHD) is caused by multifactorial such as age, gender, blood pressure, blood sugar, and lipid profiles. This study aims to analyze the description of risk factors for CHD at the North Sulawesi, Indonesia. This is a descriptive research conducted at the Cardio Vascular and Brain Center Cardiology Polyclinic, General Hospital Prof. Dr. R. D. Kandou Manado in December 2021 to January 2022. The respondents of this study were CHD patients, totaling 100 people. The variables in this study were age, gender, blood pressure, blood sugar, and lipid profiles. The data was obtained from the patient's medical record data. Data analysis performed univariately. The results showed that the respondents are most distributed in the age group ≥40 years as many as 99 people (99%), and male sex as many as 73 people (73%). Respondents who do not suffer from hypertension are 56 people (56%) more than those who suffer from hypertension, namely 44 people (44%). Respondents with GDP &gt;126 mg/dL were 57 people (57%) more than those with GDP &lt; the same as 126 mg/dL, namely 43 people (43%). Respondents whose total cholesterol level was &lt; equal to 240 mg/dL were more than 60 people (60%) compared to patients with cholesterol levels &gt; 240 mg/dL which were 40 people (40%). It can be concluded that the risk factors for CHD at the North Sulawesi, Indonesia was ≥40 years old, male, more patients with blood pressure &lt;140/90 mmHg, more patients with GDP &gt;126 mg/dL and more patient with total cholesterol level &lt;240 mg/dL

P1189 Clinical features and surgical necessity rate of fistulising perianal disease in newly diagnosed patients with Crohn's disease: Interim analysis of inception cohort registry study of patients with Crohn's disease (iCREST-CD)

Abstract Background Fistulising perianal diseases (FPD) are common in patients with Crohn's disease (CD) in Asia, but the treatment pattern and the proportion of patients who develop new FPD after diagnosis are not clear. An interim analysis of a large registry study was performed to evaluate the difference in prognosis between patients with and without FPD at diagnosis of CD and the incidence and timing of onset of FPD in patients without FPD at diagnosis of CD. Methods iCREST-CD is a prospective, non-interventional, longitudinal, observational registry study conducted at 19 tertiary centres in Japan. Patients newly diagnosed with CD from June 2016 to June 2020 based on the diagnostic criteria of the Japanese Guidelines, aged ≥16 years at the time of informed consent with no prior exposure to biologics were enrolled. Patient demographics, clinical data, disease activity and medical treatment record up to June 2022 were used. FPD were defined as a perianal abscess and/ or perianal fistula. Results Of the 662 patients with newly diagnosed CD for whom with or without FPD were recorded, 236 patients [35.6%] had FPD at diagnosis (Group A). Of the 426 patients who did not have FPD at the time of diagnosis, 32 patients developed FPD during the observation period (Group B), and 394 patients did not develop it (Group C). The mean age [SD] at the time of CD diagnosis in Groups A, B, and C was 25.0 [8.6], 31.6 [15.5], and 31.7 [14.4] years, respectively. The proportion of female was 21.2%, 34.4% and 37.8%, respectively; L2 disease location was 14.6%, 23.3%, and 18.0%, respectively; and B2+B3 disease behaviour was 27.5%, 53.1%, and 40.6%, respectively. The mean CRP (mg/L [SD]) was 28.5 [33.8], 42.4 [43.6], and 27.1 [36.3], respectively. For disease activity based on HBI score, the proportion with moderate (8≦HBI≦16) and severe (16&amp;lt;HBI) activity was 17.6%, 36.8%, and 24.0%, respectively (Table). The rate of patients who developed FPD was 4.5% (19 patients) by 12 months and 6.5% (28 patients) by 24 months, respectively (Figure). In Group A with a mean observation period (month [SD]) of 27.9 [8.8], 12.3% and 17.3% of patients needed perianal surgery at 12 and 24 months, respectively. In Group B with a mean observation period of 29.7 [7.7], 7 FPD patients [21.9%] subsequently underwent perianal surgery, all within 12 months of FPD onset. Conclusion Patients who did not have a perianal abscess or fistula at the time of their CD diagnosis but later developed these problems tended to have numerically higher CD activity at the time of diagnosis and were more likely to require perianal surgery. These results suggest that patients with highly active CD are at risk of developing new FPD and should be carefully monitored.

The Impact of Socioeconomic Status on the Presence of Advance Care Planning Documents in Patients With Acute Cervical Spinal Cord Injury.

Patients presenting with spinal cord injury (SCI) often times have notable deficits or polytrauma and may require urgent decision making for early management. However, their presentation may affect decision-making ability. Although advance care planning (ACP) may help guide spine surgeons as to patient preferences, the rate at which they are available and disparities in ACP completion are still not understood. The objective of this study was to evaluate disparities in the completion of ACP among patients with acute SCI. All patients presenting with cervical SCI to the emergency department at an urban, tertiary level I trauma center from 2010 to 2021 were identified from a prospective database of all consults evaluated by the spine service. Each patient's medical record was reviewed to assess for the presence of ACP documents such as living will, power of attorney, or advance directive. Community-level socioeconomic status was assessed using the Distressed Communities Index. Bivariable and multivariable analyses were performed. We identified 424 patients: 104 (24.5%) of whom had ACP. Patients with ACP were older (64.8 versus 56.5 years, P = 0.001), more likely White (78.8% versus 71.9%, P = 0.057), and present with ASIA Impairment Scale grade A SCI (21.2% versus 12.8%, P = 0.054), although the latter two did not reach statistical significance. On multivariable logistic regression, patients residing in at-risk communities were significantly less likely to have ACP documents compared with those in prosperous communities (odds ratio [OR]: 0.29, P = 0.03). Although patients living in distressed communities were less likely to complete ACP compared with those in prosperous communities (OR 0.50, P = 0.066), this did not meet statistical significance. Female patients were also less likely to have ACP (OR: 0.43, P = 0.005). Female patients and those from at-risk communities are markedly less likely to complete ACP. Attention to possible disparities during admission and ACP discussions may help ensure that patients of all backgrounds have treatment goals documented.

Case Series Study on Recovery of Left Ventricle Systolic Function After Percutaneous Coronary Intervention In ST-Segment Elevation Myocardial Infarction Patients at FMIC Hospital in Kabul, Afghanistan.

Background Left ventricle dysfunction is the most recurrent consequence of ST-elevated myocardial infarction, and still, it is a powerful predictor of mortality. The percutaneous coronary intervention of the culprit artery disease in acute coronary syndrome is related to a significant improvement of left ventricle segmental function. It is a retrospective case series study on a patient population with the diagnosis of ST-elevated myocardial infarction patients who presented to the hospital within 12 hours and underwent percutaneous coronary intervention at the French Medical Institute of Mother and Children Hospital. Data was collected retrospectively from the patient's medical record files and analyzed. We took the patients with Left ventricle dysfunction on echocardiography on the first presentation before percutaneous coronary intervention and saw the left ventricle function after three months of follow-up. We reviewed the charts of 102 patients (78.4% male and 21.6% female) with a diagnosis of St-elevated myocardial infarction who presented within 12 hours of chest pain. Of 102 patients, 55.9% had hypertension, 21.6% diabetes, 22.5% dyslipidemia, and 19.6% history of smoking, and their mean age was 58.11 ± 11.993 years. We noticed that percutaneous coronary intervention led to significant left ventricle dysfunction improvement in the patient population with ST-elevated myocardial infarction who presented within 12 hours of chest pain.

Barriers and facilitators to the implementation of family cancer history collection tools in oncology clinical practices.

This study aimed to identify barriers and facilitators to the implementation of family cancer history (FCH) collection tools in clinical practices and community settings by assessing clinicians' perceptions of implementing a chatbot interface to collect FCH information and provide personalized results to patients and providers. By identifying design and implementation features that facilitate tool adoption and integration into clinical workflows, this study can inform future FCH tool development and adoption in healthcare settings. Quantitative data were collected using survey to evaluate the implementation outcomes of acceptability, adoption, appropriateness, feasibility, and sustainability of the chatbot tool for collecting FCH. Semistructured interviews were conducted to gather qualitative data on respondents' experiences using the tool and recommendations for enhancements. We completed data collection with 19 providers (n = 9, 47%), clinical staff (n = 5, 26%), administrators (n = 4, 21%), and other staff (n = 1, 5%) affiliated with the NCI Community Oncology Research Program. FCH was systematically collected using a wide range of tools at sites, with information being inserted into the patient's medical record. Participants found the chatbot tool to be highly acceptable, with the tool aligning with existing workflows, and were open to adopting the tool into their practice. We further the evidence base about the appropriateness of scripted chatbots to support FCH collection. Although the tool had strong support, the varying clinical workflows across clinic sites necessitate that future FCH tool development accommodates customizable implementation strategies. Implementation support is necessary to overcome technical and logistical barriers to enhance the uptake of FCH tools in clinical practices and community settings.

Legal Analysis of the Doctor's Responsibility Towards the Completeness of Patient Medical Records in the Framework of Fulfilling Patient Rights in the Hospital

Doctors have a legal responsibility to ensure that patient medical records are complete and accurate. A legal analysis of the doctor's responsibility for the completeness of patient medical records in order to fulfill patient rights in hospitals is an important study to ensure that patient rights are fulfilled in accordance with the standards set by applicable laws and regulations. A comprehensive analysis of the doctor's responsibility and the importance of complete medical records is expected to create a better health care system that respects and fulfills patient rights optimally. This study uses a normative legal method. The conclusions of this study are: 1) The doctor's legal responsibility for fulfilling the patient's right to obtain complete Medical Records as a form of the patient's right to information in health services. This right is protected and regulated in a number of legal regulations. Fulfillment of the method of obtaining the contents of Medical Records to patients must also pay attention to and follow the procedures as stipulated in the laws and regulations. 2) The legal consequences of the doctor's legal responsibility if they violate the fulfillment of the patient's right to complete Medical Records, including: 1) criminal sanctions, namely imprisonment for a maximum of 1 (one) year and a maximum fine of Rp. 50,000,000.00 (fifty million rupiah) (Article 79 point b of the Medical Practice Law Law No. 29 of 2004), 2) civil sanctions in the form of compensation by the Hospital or the doctor to the patient (Article 1365 of the Civil Code) and 3) administrative sanctions in the form of written warnings and/or recommendations for revocation or revocation of accreditation status. (Minister of Health Regulation 24 of 2022 concerning Medical Records).

Exploring Drug Utilization Patterns and Adverse Drug Reactions in the Management of Osteoarthritis: A Prospective Study

Aim/Background Osteoarthritis (OA) is a degenerative joint disease characterized by pain and functional impairment, leading to significant healthcare challenges. Pharmacological management, including NSAIDs, analgesics, disease-modifying osteoarthritis drugs (DMOADs), and corticosteroids, is commonly used. However, limited data exist on drug utilization patterns and adverse drug reactions (ADRs) in OA treatment. This study aimed to evaluate these patterns and identify potential ADRs in patients with OA. Methods This prospective study included OA patients from diverse backgrounds. Baseline demographic data, disease severity, and treatment history were recorded. Drug utilization was monitored, focusing on NSAIDs, analgesics, DMOADs, corticosteroids, and alternative therapies. ADRs were identified through patient self-reports, clinician observations, and medical record reviews. Statistical analysis examined drug prescription trends, ADR frequency, severity, and associated risk factors. Results NSAIDs were the most frequently prescribed drugs (44.45%), followed by analgesics and DMOADs. Gastrointestinal discomfort was the most commonly reported ADR, particularly among NSAID users. Corticosteroids were linked to systemic side effects in a minority of patients. Advanced age, longer treatment duration, and existing gastrointestinal conditions were significant risk factors for ADRs. Conclusion The study underscores the widespread use of NSAIDs in OA treatment and highlights the need for careful monitoring due to potential ADRs, especially gastrointestinal issues. Identifying risk factors helps clinicians make informed prescribing decisions, improving patient outcomes and minimizing ADRs. Future research should focus on optimizing drug therapies to ensure better safety and efficacy in OA management.

Investigation on Preserving Privacy of Electronic Medical Record using Split Learning

Artificial Intelligence is deployed in multiple areas, including healthcare. Utmost research is done in AI enabled healthcare industry because of the demands like accurate result, data security, exact prediction, huge volume of data, etc. In conventional deep learning models, the training happens with the dataset that are stored in a single device. This requires a huge storage space and highly efficient machines to train the data. Usage of big data, demands for innovative models that can be deployed and used in confined storage. Split learning is one such collaborative distributed deep learning model that allows the data to be stored in a split fashion. Split learning supports desirable features like less storage, more privacy to raw data, ability to work with resource constraints, etc., making it suitable for storing electronic medical record of patients. This paper discusses the advantages of using split learning for healthcare, the possible configurations of split learning that supports data privacy in healthcare and finally discusses the open research challenges in implementing split learning for healthcare.

In-hospital mortality and associated factors among patients admitted with venous thromboembolism at selected public hospitals of Harar Town, Eastern Ethiopia.

Venous thromboembolism is the third most common cause of cardiovascular death and is responsible for more than 3 million deaths annually worldwide. Despite high rates of morbidity and mortality associated with venous thromboembolism, limited studies have been conducted on in-hospital mortality and its associated factors in Ethiopia, particularly in study settings. To assess in-hospital mortality and associated factors among patients admitted with venous thromboembolism at selected public hospitals of Harar town, Eastern Ethiopia, from 10 March 2018 to 8 March 2022. A retrospective cohort study design was conducted among 502 patients admitted with venous thromboembolism at Hiwot Fana Comprehensive Specialized Hospital and Jugal General Hospital using a simple random sampling technique. Data extraction formats were used to collect data from patient medical record cards. Then data were coded and entered into EpiData version 3.1 computer programs and exported to SPSS version 26 for analysis. Bivariate and multivariate backward Cox regression analysis was used to verify the associated factors of in-hospital mortality among venous thromboembolism patients. A p-value of less than 0.05 at a 95% confidence interval was used to establish a statistically significant association. A total of 502 patient medical record cards with outcome variables were included in the study. More than half of the patients 350 (69.7%) were females. Among the 502 patients who were admitted with venous thromboembolism, 8.2% (95% CI: 5.6-10.6) of patients had in-hospital mortality. DM (AHR = 4.28, 95% CI: 1.80-10.15, p = 0.001) and unfractionated heparin duration (AHR = 10.26, 95% CI: 2.45-43.01, p = 0.001) were statistically significant association with venous thromboembolism mortality. Approximately 8.2% of venous thromboembolism patients died in the hospital. Diabetes and heparin were independently associated with higher mortality. Therefore, it is better to give more attention to the patients co-morbid with diabetes mellitus and for unfractionated heparin treatment duration to reduce venous thromboembolism mortality.

Evaluation of Cutoff Point Prostate Specific Antigen (PSA) and Prostate Specific Antigen Density (PSAD) in Patients with Suspected Prostate Cancer.

Prostate cancer is the second leading cause of cancer death in men worldwide. There is no national standard for PSA cut-off levels even through the transrectal prostate biopsy procedure causes many serious complications such as bleeding, infection, and sepsis. Therefore, determining cut-off levels for PSA and PSAD is essential to avoid unnecessary biopsies. This study aims to determine the Prostate Specific Antigen (PSA) and Prostate Specific Antigen Density (PSAD) cut-off points in patients with suspected prostate cancer. A retrospective study was conducted from January 2018 until March 2021 in Saiful Anwar General Hospital Malang Indonesia. Inclusion criterias were patients with suspected prostate cancer; > 50 years old; underwent PSA, PSAD, and prostate biopsy. Exclusion criterias were patients refuse to participate in the study and incomplete patient medical record data. Medical records from 53 patients who underwent transrectal ultrasonography (TRUS)-guided prostate biopsy were reviewed. Statistical analysis was performed using Mann-Whitney U, Chi-Square, Fisher's Exact, and Receiver Operator Characteristic (ROC) curves. Medical records conducted 53 patients who met inclusion criteria and underwent transrectal ultrasonography (TRUS)-guided prostate biopsy were reviewed. PSA cut off level for prostate biopsy was 19.71 ng/ml with a sensitivity of 69.23% and a specificity of 72.5%. The positive predictive value is 45% and the negative predictive value is 87.87%. PSAD cut off level for prostate biopsy was 0.4113 with a sensitivity of 61.54% and a specificity of 63.16%. The positive predictive value is 36.36% and the negative predictive value is 82.76%. Results from this study, the cut off levels of PSA and PSAD in prostate disease patients is higher than the recommended cut off; prostate cancer is the largest malignancy in men worldwide and has a higher incidence in the older age and high serum PSA levels group.

THE RELATIONSHIP ANALYSIS OF INTERPERSONAL CARE AND CONTINUITY OF CARE WITH THE PATIENT SATISFACTION INDEX IN THE OUTPATIENT POLYCLINIC OF TGK.CHIK DITIRO PIDIE REGIONAL HOSPITAL

Patient satisfaction is an important indicator in evaluating health care quality. Outpatient care are one type of hospital service that requires quality assessment aspects, and nursing services are an integral part of hospital services. This research was conducted to determine the relationship between interpersonal care and continuity of care with patient satisfaction index in outpatient polyclinics. This study is quantitative research with a cross-sectional design. The respondents in this study were patients who received outpatient services at the Polyclinic of Tgk. Chik Ditiro Pidie Regional Hospital, totaling 209 respondents selected by Probability sampling. The study was conducted in October 2023. The Spearman test showed a relationship between interpersonal care (p=0,000; r=0.490) with patient satisfaction index, interpersonal communication (p=0.000; r=0.498) with patient satisfaction index, interpersonal style (p=0.000; r=0.509) with patient satisfaction index, decision making p=0.000; r=0.482) with patient satisfaction index. The relationship between continuity of care (p=0,000; r=0,478) with patient satisfaction index, long-term patient and medical partnerships (p=0.000; r=0.508) with patient satisfaction index, doctor and nurse information of patient medical record (p=0.000; r=0.338) with patient satisfaction index and service facilities (p=0.000; r=0.545) with patient satisfaction index at the outpatient polyclinic of Tgk.Chik Ditiro Pidie Regional Hospital. The results of the linear regression test of the service facilities are the most related to the patient satisfaction index (coeff=-0,662; p=0,000). Service facilities are the variables most related to the patient satisfaction index at the outpatient polyclinic of RSUD Tgk. Chik Ditiro Pidie.

Medication Adherence and Physical Activity in Relation to Blood Pressure in Hypertension Patients

In the 21st century, it is estimated that there will be a rapid increase in the incidence and prevalence of NCDs. It is estimated that the countries that will feel the impact the most are developing countries, including Indonesia. One of the NCDs that is currently a very serious health problem is hypertension. This study aims to determine the relationship between medication adherence and physical activity on blood pressure in hypertension patients. This research is an analytical study with a cross-sectional design. Data collection was carried out by conducting interviews with patients, filling out questionnaires by the patient, viewing the patient's medical record data and carrying out blood pressure checks in September 2023 to October 2023. Bivariate analysis showed that there was an influence of medication attendance (p value = 0.0001; PR = 7.667) and physical activity (p value = 0.0001; PR = 26.156) on blood pressure. Multivariate analysis showed that physical activity (p value = 0.0001; aPR = 23.726) had more influence on blood pressure than medication adherence (p value = 0.007; aPR = 6.622). It is important for health workers to always educate patients regarding medication compliance and increase physical activity in an effort to achieve normal blood pressure.