Ramelan Navy Hospital Research Articles

The effect of hypertonic dextrose prolotherapy on knee osteoarthritis outpatients in Dr. Ramelan Navy Hospital Surabaya: case series

Background: The high use and pressure on the knee cause osteoarthritis to occur frequently. Prolotherapy is a non-surgical injection therapy used to treat chronic pain in musculoskeletal conditions, including knee OA. This solution can create local irritation, inflammation, and tissue regeneration, thereby increasing the strength of damaged ligaments, tendons, and intra-articular structures. Therefore, the aim of this research is to assess the changes in VAS and WOMAC scores, as well as plain radiographs of knee OA patients after hypertonic dextrose prolotherapy. Methods: This experimental case series was done at the Physical Medicine and Rehabilitation Polyclinic of dr. Ramelan Navy Hospital Surabaya from December 2021 to April 2022, by giving hypertonic dextrose prolotherapy injection intraarticularly to 3 knee OA subjects using a 22G or 23G needle. This procedure was performed 3 times on each subject, with an interval of 4 weeks each. The assessments were carried out with VAS and WOMAC scores, as well as plain radiographs of the knees before the procedure and 1 month after the third injection for evaluation. Results: In all 3 subjects, the knee joint spaces were slightly widened on plain radiographs, as well as decreased VAS and WOMAC scores after injection. Conclusion: Hypertonic dextrose prolotherapy here had minimal side effects, affordable prices, and a fast process. It also causes a reduction in pain and joint stiffness and causes functional improvement. Prolotherapy may be considered a therapy for knee OA patients.

E-Knowledge Module Development with Sprint Method in Dr. Ramelan Navy Hospital

Background: Hospitals need to manage document systems well. Dr Ramelan Navy hospital only 15% of the training materials have been documented. Knowledge of basic infection control programs only reached 57.2% and effective communication reached 56%. Objective: The purpose of this study is to analyze the factors causing the documentation of training materials under the standard, to determine solutions to improve the documentation of training materials to reach the standard and to develop an activity plan in overcoming the problem of documentation of training materials that have not reached the standard. Methods: This study uses the analytical observational method. The method used is the Problem Solving Cycle (PSC) approach. Data obtained through interviews, observations, and documentation in several departments and work units, then processed through a number of stages in overcoming the problem of documentation of training materials. Problems are solved by using a problem solving cycle approach with five stages of problem analysis, strategy design, development strategy, implementation, monitoring, evaluation and feedback. Solution of problems with the development of knowledge modules in hospital management information system. Results: The results at the strategy development stage of the development of the module named E-Knowledge was developed using the Sprint method with five stages of map, sketch, divide, prototype and test. Conclusion: E Knowledge increase knowledge and improve personnel performance.

Brain Derived Neurotrophic Factor as a Non-invasive Biomarker for Detection of Endometriosis.

Endometriosis is an estrogen-dependent chronic progressive gynecological disease that affects around 10% of women of reproductive age. A recent study shows that brain-derived neurotrophic factor (BDNF) has the potential as a clinical marker in the diagnosis of endometriosis. We aimed to determine whether BDNF levels are correlated with pain scores associated with endometriosis. Fifty women who underwent laparoscopy surgery at Dr. Soetomo General Hospital and Dr. Ramelan Navy Hospital were prospectively recruited from October 2017 until August 2018. A blood sample was obtained before surgery and BDNF was measured using the Human BDNF Quantakine® kit. The relationship of BDNF levels in serum with the diseases's level of pain and stages was compared between cases and controls. BDNF validity as an endometriosis diagnosis biomarker was assessed using receiver operating characteristic (ROC) analysis. Serum concentrations of BDNF were significantly greater in women with endometriosis (30.42±7.41 pg/ml), compared to controls (25.66±3.30 pg/ml). Serum concentrations of BDNF were moderately correlated with the patient's reported pain scores (r=0.44, p=0.01). Receiver operating characteristic curve analysis confirmed the potential of BDNF in the diagnosis of endometriosis. Using a cut-off value of 27.06 pg/ml, the sensitivity and specificity were reported to be 66.7% and 64.3%, respectively. BDNF serum levels in endometriosis women are significantly higher than in women without the disorder. BDNF serum level seems to have low accuracy and predictive value as a diagnostic marker for endometriosis. However, there was a moderate relationship between BDNF serum level and the degree of pain.

Clinical Characteristics and Profile of Heart Failure Patients at dr. Ramelan Navy Hospital in 2020

Background: Heart failure (HF) is a global pandemic affecting at least 26 million people worldwide and is increasing in prevalence. It has been associated with a high rate of readmissions and prolonged hospitalizations. There were few publications in Indonesia that described the characteristics and length of hospital stay of heart failure patients.Aims: To obtain data and describe the clinical characteristics and profile of heart failure patients hospitalized at dr. Ramelan Navy Hospital in 2020.Methods and Results: A cross sectional study was done using secondary data from patients’ medical records in dr. Ramelan Navy Hospital admitted during 2020. Data were then calculated and presented further. Based on the medical records, 121 heart failure patients were included in the study. Median age was 56 years old, 58,7% were men. Median length of stay was 6 days for all patients. 51.2% patients admitted to hospital with NYHA FC III. When patients were admitted to hospital, median systolic blood pressure was 124 mmHg and pulse was 91 beats per minute. Peripheral edema was shown in 67,8% of patients, hypertension in 49,6%, diabetes mellitus in 24,8%, ischemic heart disease in 52,9%. 6.6% of total patients treated in hospital died.Conclusion: Median length of stay for heart failure patients at dr. Ramelan Navy Hospital was 6 days. Most patients were men with median age of 56 years old.Keywords: clinical characteristic; demographic; heart failure

Analysis of Antibiotic Usage in Critical COVID-19 Patients with Secondary Infections

Background: Infrequent data exist on the frequency of bacterial co-infections and secondary infection among COVID-19-infected patients admitted to intensive care units (ICU). Objective: To describe the quantity and the quality of antimicrobial usage in COVID-19 with secondary infection, multiple drug resistance organisms and the outcome of antimicrobial treatment. Methods: This study applies observational design with a cross sectional approach. All the patients with laboratory-confirmed severe COVID-19 pneumonia who were discharged from the Intensive Care Unit (ICU) Dr. Ramelan Navy Hospital from February 1st to June 30th 2022 included. The quantity of antibiotics usage was assessed by counting the Defined Daily Dose (DDD). Result: During the study period, 126 patients were referred to the ICU for COVID-19 with severe pneumonia. There were 70.6% (89 patients) treated with antibiotics and 29.4% (37 patients) untreated with antibiotics. Quantitative analysis of 89 patients revealed that levofloxacin was the most common antibiotic prescribed with 43 DDD, followed by Meropenem and Cefoperazone-Sulbactam, which were 17.76 DDD and 16.87 DDD, respectively. Meanwhile, qualitative analysis resulted in 81 antibiotics (43.55%) being used appropriately. No indications of the use of antibiotics were found in 53 antibiotics (28.49%). Klebsiella pneumonia was the main pathogen identified in the blood, sputum. While E. Coli was found to be the main pathogen in urine. Conclusion: A high death rate in patients treated with antibiotics compared to patients not treated with antibiotics.

EFEKTIVITAS PERENCANAAN KEBUTUHAN OBAT DENGAN METODE MORBIDITAS TERHADAP KETERSEDIAAN OBAT KEMOTERAPI

One cycle of chemotherapy does not eliminate all cancer cells, therefore it takes a repeated cycle (Williams, et al, 2016), so the guarantee the availability of chemotherapy drugs is needed. An effective drug requirement planning is required to ensure the availability of chemotherapy drug. This study was intended to determine the effectiveness of planning the need for chemotherapy drugs using the morbidity method on the availability of chemotherapy drugs in Dr. Ramelan Navy Hospital. This study was an observational study with a cross sectional study design. The instrument used in this study was the data collection sheet with data sources prescription sheets and sheets of chemotherapy drug reconstitution during 2015-2017. Descriptive data analysis and to determine effective planning methods using indicators of drug availability. The results showed that the planning of drug needs with the morbidity method can better guarantee the availability of chemotherapy drugs and can minimize drug shortages compared to the consumption method that has been done so far in Dr. Ramelan Navy Hosptal. So it can be concluded that in this study, the morbidity method is effective in meeting the needs of chemotherapy drugs.

The Role of Pressure and Duration of Dive on Lung Physiology in Professional and Non-Professional Divers

Backgrounds: Professional divers have a greater lung volume than non-professional divers in higher force vital capacity (FVC) and force expiratory flow in 1 second (FEV1) values. The purpose of this study is to analyse the effect of pressure and duration of diving on changes in lung physiology in professional divers and non-professional divers.
 Methods: This is a cross sectional study on the personnel of the Indonesian Navy Dislambair Koarmada II Surabaya and RSAL personnel of dr. Ramelan Navy Hospital in Lakesla Surabaya in March-April 2019. Samples was collected with purposive sampling. This study used unpaired subjects with the independent t-test statistic analysis if the data is normally distributed and the Mann-Whitney U test if the data is not normally distributed
 Results: There was a significant difference in the professional divers group compared to non-professional divers group in the values of FVC (P=0.042) and FEV1 (P=0.040) at 1.3 ATA for 10 minutes and the FEV1 (P=0.049) for 20 minutes. No significant differences in FVC (P=0.092) at 1.3 ATA pressure for 20 minutes. There were no significant differences in FVC (P=0.865), FEV1 (P=0.659) at 1.5 ATA pressure for 10 minutes and FVC (P=0.858) and FEV1 (P=0.857) for 20 minutes.
 Conclusions: The different pressure in non-professional group could reduce the FEV1 value. There was a difference in the FVC value of the professional diver group and non-professional divers at a pressure of 1.5 ATA for 10 minutes. (J Respir Indo. 2020; 40(2): 103-12)

The relapse of coronary artery disease in patients with diabetes mellitus at Dr. Ramelan Navy Hospital, Surabaya, Indonesia

The patients with coronary artery disease are susceptible to experience the relapse so that the control towards the risk factors of coronary artery disease is needed such as a history of hypertension, dyslipidemia, suffering from diabetes mellitus, medication adherence, and history of obesity. This study aimed at knowing the relationship between the risk factor of diabetes mellitus and the relapse of coronary artery disease. This study was an analytical observation by using retrospective cohort. The total respondent was 189 people taken by using purposive sampling technique. The finding showed that nearly all patients (82.5%) did not suffer from diabetes mellitus, and most of them (72.5%) experienced the relapse of CAD. The result of the chi-square analysis showed that the p-value of 0.009 < α = 0.05, indicating a significant relationship between Diabetes Mellitus and the relapse of coronary artery disease. The patient with diabetes mellitus has a higher risk of experiencing the relapse of CAD. The nurse should concern and control the risk factors of coronary artery disease that affects the relapse.

HUBUNGAN ANTARA NAFSU MAKAN DENGAN ASUPAN ENERGI DAN PROTEIN PADA PASIEN KANKER PAYUDARA POST KEMOTERAPI<br><i>[Correlation between Appetite with Energy and Protein Intake of Post Chemotherapy Breast Cancer Patients]</i><br>

Chemotherapy drugs used to kill or inhibit proliferation of cancer cell that are cytotoxic and causing side effect for breast cancer patients. The side effect of chemotherapy drugs is decreasing the appetite which causing decrease in energy and protein intake, and could affect nutritional status. This study aim to determine the relationship between appetite with energy and protein intake of post chemotherapy breast cancer patients. This research was an analytic observational research using cross sectional design and purposive sampling conducted at Dr. Ramelan Navy Hospital Surabaya with a sample size of 50 patients. Correlation between appetite with energy and protein intake were analyzed using Pearson correlation. The average of energy and protein intake were 976.3±304.2 kcal and 29.4±12.9 g. Pearson correlation test showed signifi cant correlation between appetite as chemoteraphy side effect with energy intake (p=0.000; r=-0.558) and protein intake (p=0.000; r=-0.504). Decreasing of appetite due to chemoterapy reduce the energy and protein intake of breast cancer patient. Patient are suggest to consume foods in small portion but often to maintain adequate energy and protein intake.

Supraclavicular Approach on Thoracic Outlet Syndrome

Background: Thoracic Outlet Syndrome (TOS) is a clinical syndrome that refers to abnormal compression of the neurovascular in the neck and axilla with signs and symptoms manifesting in the shoulders, neck, arms, hands and sometimes fingers. It may be underdiagnosed because this syndrome is poorly understood. The compression is primarily neurogenic, vascular, or both. As the number of patients undergoing successful treatment increases, TOS is becoming a common diagnosis. In those patients in whom pain is refractory to conservative care, surgery should be considered. The aim of this study is to evaluate the outcome of a supraclavicular approach to treat the thoracic outlet syndrome patients in Dr. Ramelan Navy Hospital Surabaya.Materials and methods: This study is a case series of 16 patients (10 females and 6 males) of 19-50 years old, who underwent neurovascular compression with the supraclavicular approach. Symptoms were evaluated with medical records based on peri-operative anamnesis and physical examination.Results: The follow-up with 16 patients showed excellent results such as decreasing pain, decreasing sensory or motoric symptoms, and complications like pneumothorax hematothorax, and injury of artery, vein or plexus brachialis were not found.Conclusion: Supraclavicular approach is relatively effective and safe for neurovascular decompression of TOS. Excellent outcomes were observed with a small incision, safe and minimal complications.

Supraclavicular Approach on Thoracic Outlet Syndrome

Background: Thoracic Outlet Syndrome (TOS) is a clinical syndrome that refers to abnormal compression of the neurovascular in the neck and axilla with signs and symptoms manifesting in the shoulders, neck, arms, hands and sometimes fingers. It may be underdiagnosed because this syndrome is poorly understood. The compression is primarily neurogenic, vascular, or both. As the number of patients undergoing successful treatment increases, TOS is becoming a common diagnosis. In those patients in whom pain is refractory to conservative care, surgery should be considered. The aim of this study is to evaluate the outcome of a supraclavicular approach to treat the thoracic outlet syndrome patients in Dr. Ramelan Navy Hospital Surabaya.Materials and methods: This study is a case series of 16 patients (10 females and 6 males) of 19-50 years old, who underwent neurovascular compression with the supraclavicular approach. Symptoms were evaluated with medical records based on peri-operative anamnesis and physical examination.Results: The follow-up with 16 patients showed excellent results such as decreasing pain, decreasing sensory or motoric symptoms, and complications like pneumothorax hematothorax, and injury of artery, vein or plexus brachialis were not found.Conclusion: Supraclavicular approach is relatively effective and safe for neurovascular decompression of TOS. Excellent outcomes were observed with a small incision, safe and minimal complications.

TINGKAT PENGETAHUAN TENTANG TB PARU MEMPENGARUHI PENGGUNAAN MASKER DI RUANG PARU RUMKITAL Dr. RAMELAN SURABAYA

Number of patients with pulmonary TB increased annually in Surabaya, on of the measures to prevent TB infections is by using a mask. In TB care room a lot of visitors (family) who did not wear a mask. The purpose of this study to determine the relationship of the level of knowledge with the use of masks to visitors (family).This study used correlational analytic designwith cross sectional approach. independent variable in the study is the level of knowledge about Tuberculose anddependent variable is the use of masks. Samples were taken by using purposive sampling technique earned by 28 respondents visitors in Pulmonary Wards,Dr. Ramelan Navy Hospital, Surabaya, date 11 – 20 June 2013. Data collection was undertaken using questionnaire about Pulmonary Tuberculose and observation sheet of the use of mask. Data were analyzed with Spearman's Rho test with a significance level Corellation ρ <0.05.Results showed that the level of knowledge about Tuberculose less 14 respondents (50%) and 16 respondents (57.1%) did not wear a mask. Spearman's Rho test showed that there is a relationship between the level of knowledge about Pulmonary Tuberculosewith the use of masks in in Pulmonary Wards,Dr. Ramelan Navy Hospital, Surabaya (ρ = 0.000).

TINGKAT PENGETAHUAN TB PARU MEMPENGARUHI PENGGUNAAN MASKER PADA PENDERITA TB PARU

Number of patients with pulmonary TB increased annually in Surabaya, on of the measures to prevent TB infections is by using a mask. In TB care room a lot of visitors (family) who did not wear a mask. The purpose of this study to determine the relationship between the knowledge level of Tuberculose with the masks using among visitors (family). This study used correlational analytic design with cross sectional approach. independent variable in the study is the level of knowledge about Tuberculose and dependent variable is the using of masks. Samples were taken by using simple random sampling technique earned by 28 respondents. Data collection was undertaken using questionnaire about Pulmonary Tuberculose and observation sheet of the using of mask. Data were analyzed with Spearman's Rho test with a significance level Corellation ρ <0.05. Results showed that the level of knowledge about Tuberculose less 14 respondents (50%) and 16 respondents (57.1%) did not wear a mask. Spearman's Rho test showed that there is a relationship between the level of knowledge about Pulmonary Tuberculose with the using of masks in Pulmonary Wards, Dr. Ramelan Navy Hospital, Surabaya (ρ = 0.000). The implications of this study is the level of knowledge about Tuberculosis associated with using of a mask, which is expected for nurses in the room can provide health education about and prevention of pulmonary Tuberculose transmission by using a mask.

Semen Analysis Profile on Varicocele Patients at Dr. Ramelan Navy Hospital Surabaya during Period 2015

<p><strong>ABSTRACT</strong></p><p><strong>Background</strong>: Infertility has affected about 10–15 percent married couples. Almost half of infertility cases have been attributed to men with low sperm motility (asthenozoospermia), low sperm count (oligozoospermia) and abnormal sperm morphology (teratozoospermia). Sperm motility is one of the major determinants of male fertility and is required for successful fertilization. Semen analysis is a method to know the quality of semen. Semen analysis consists of macroscopic and microscopic examination of sperm cells, which are concentration, motility and morphology of sperm cells. </p><p><strong>Objective</strong>:<strong> </strong>This study aimed to obtain the semen analysis profile on varicocele patients at DR. Ramelan Navy Hospital Surabaya during period 2015.</p><strong>Method</strong>: This study used descriptive research design and quantitative method, by using the secondary data were collected from medical records during January – December 2015. <strong>Result</strong>: In this study the semen analysis of 36 patients with varicocele, 3 patients (8,33%) with oligozoospermia, 10 patients (27,78%) with asthenozoospermia, 20 patients (55,55%) with oligoasthenozoospermia, 3 patients (8,33%) with extreme oligoasthenozoospermia. <strong>Conclusion</strong>: This study has concluded that all varicocele patients have abnormalities in semen analysis (none of the sperm quality results within normal limits).

The Relationship Between Child Nurturing Pattern, Family Support, and Language Competence in Children Aged 5-6 Years with Auditory Disorder

Background: Hearing is one of the important senses for human that functions as a communication tool and education. Lack of hearing ability in children may hinder development and lead to problem in language and speaking ability. In turn it may affect academic achievement. Hearing disorder therefore needs to be detected early. This study aimed to determine the relationship between child nurturing pattern, family support, and language competence in children aged 5-6 years with auditory disorder. Subjects and Method: This was an analytic and observational study with cross sectional design. It was carried out at “Jala Puspa” Children Observation Garden (Taman Observasi Anak “Jala Puspa”) Dr. Ramelan Navy Hospital, Surabaya, East Java. A total sample of 40 children aged 5-6 years with their parents were selected for this study by simple random sampling. The dependent variable was language competence. The independent variables were child nurturing pattern and family support. The data were collected by a set of questionnaire, and were analyzed by logistic regression. Results: There were positive relationship between nurturing pattern (OR= 10.05; 95% CI= 1.85-54.73; p= 0.008), family support (OR= 6.76; 95% CI= 1.36-33.51; p= 0.019), and language competence. Conclusion: Nurturing pattern and family support have positive relationship with language competence. Keywords: child nurturing pattern, family support, language competence, auditory disorder Correspondence: Dewi Tirtawati. School of Health Polytechnics, Surakarta. Email: tirta.dewi@yahoo.co.id Journal of Maternal and Child Health (2016), 1(3): 188-194 https://doi.org/10.26911/thejmch.2016.01.03.06