Saiful Anwar General Hospital Research Articles

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.

Exploring the Predictive Value of Inflammatory Biomarkers in COVID-19 Patients: A Prospective Cohort Study in Malang, Indonesia

The objective of this study was to assess the predictive value of inflammatory biomarkers in COVID-19 patients, namely the CRP/albumin ratio (CAR), interleukin 6 (IL-6), IL-6/lymphocyte ratio (IL-6/LY), and neutrophil/lymphocyte ratio (NLR). A prospective cohort study was conducted between January to June 2021 at Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia. CRP and albumin levels were measured using COBAS C6000. IL-6 was measured using the enzymatic chemiluminescence immunoassay (ECLIA) method and NLR was calculated based on flow cytometry evaluation of neutrophil and lymphocyte. Patient outcomes were obtained from medical records. Out of the 102 COVID-19 patients, 60 were non-survivors. The findings revealed that the area under the receiver (AUC) for CAR, IL-6, IL-6/LY, and NLR were 0.71, 0.77, 0.75, and 0.65, respectively. Kaplan-Meier curve analysis demonstrated significant differences between the groups stratified by these cut-off values. Notably, CAR and IL-6 exhibited the most accurate predictive values for mortality in COVID-19 patients. These findings suggest that CAR and IL-6 may serve as valuable biomarkers for predicting mortality in COVID-19 patients. Importantly, CAR offers an advantage over IL-6 as it is relatively more affordable, making it a viable option even if COVID-19 becomes endemic.

Clinicopathological profile of Non-Hodgkin and Hodgkin Lymphoma at the Anatomical Pathology Laboratory of Saiful Anwar General Hospital Malang from January 2018 until May 2023

Lymphomas are a lymphocyte-driven malignancy that comprise up to 10% of cancers diagnosed in individuals < 20 years of age globally. Malignant lymphomas are divided into Hodgkin Lymphoma (HL) and Non Hodgkin Lymphoma (NHL). In 2019 at United States, more than 82.000 new patients diagnosed with lymphoma. Since the epidemiology of Lymphoma is different across regions and may have change over time, its global distribution pattern, risk factors, and temporal trends need to be assessed for developing preventive measures. The purpose of this study was to determine the frequency of NHL and HL based on histopathological type, age, and gender. This research is a descriptive analytic study. Data were obtained from patients who underwent histopathological and immunohistochemistry examinations at the Anatomical Pathology laboratory of Saiful Anwar General Hospital Malang from January 2018 until May 2023. There are 408 cases of Lymphoma consisting of 56 HL and 352 NHL. In HL, the percentage higher in men, and occurred mostly during 21 – 30 years old age group. The most common histopathological type of HL is Classical Hodgkin Lymphoma, with mostly Nodular Sclerosis subtype. In NHL, the percentage higher in men, and occurred mostly during 51 – 60 years old age group. The most common histopathological type of Non Hodgkin Lymphoma is B cell type.

Diagnostic Test for Estimation of Plasma Volume on Assessment of Congestive Status in Acute Heart Failure Patients at Saiful Anwar General Hospital

Background: Heart failure is a health issue with high mortality and morbidity rates globally, including in Indonesia. Congestion is the main symptom of acute heart failure. B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-pro BNP) are well-known markers to confirm the condition. Plasma volume estimation (ePVS) is one of the procedures currently being developed to assess a patient's congestive status at a lower cost. Objective: This study aims to evaluate the sensitivity and specificity value of ePVS to assess the congestive status in acute heart failure patients Methods: This is a descriptive observational research with a cross-sectional study method that included all patients with dyspneu that come to emergency room between May 2018-February 2023. Baseline characteristics, medication history, and echocardiography were also included in the statistical analysis. We used univariate and bivariate analysis to assess the effect of each variable on the patient's congestive condition. A diagnostic test of plasma volume estimation was carried out using Receiver Operating Characteristics (ROC) Analysis compared to NT pro-BNP as a diagnostic tool of congestive in acute heart failure based on guideline. Plasma volume estimation calculated using Strauss-Duarte formula. Result: A total of 506 subjects with dyspnea at ER Dr. Saiful Anwar Malang Hospital, who met the inclusion and exclusion criteria. The mean age was older in congestive patients with 51.3% being male. Patients with congestive conditions have a lower ejection fraction with a higher estimated right atrial pressure from echocardiography. The estimation plasma volume status was also higher in congestive conditions (4.90 vs 3.5). The ePVS from ROC analysis has a good diagnostic value at the reduced and mildly reduced EF. Conclusion: The estimation of plasma volume status has a good sensitivity and specificity value to assess congestive status in patients with acute heart failure who are fluid-overloaded. Keyword: Acute Heart Failure, Congestive, Plasma Volume Status.

The Relationship Between Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV) Value to the Clinical Degree of Dengue Hemorrhaging Fever (DHF) in Haji Saiful Anwar General Hospital, Subang District, West Java, Indonesia

Abstract: Background: Dengue Hemorrhagic Fever (DHF) remains a significant health concern in various tropical countries, including Indonesia. Caused by the dengue virus transmitted through Aedes aegypti mosquitoes, DF can progress to severe conditions, particularly in cases with complications like bleeding or shock. Addressing this burden necessitates research into identifying factors guiding diagnosis, severity assessment, and patient management. Hematological parameters, especially Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV), have gained attention in this context. Methods: This analytical observational cross-sectional study was conducted at Haji Saiful Anwar General Hospital in West Java, Indonesia, from March to June 2023. The study enrolled 60 patients diagnosed with DHF based on WHO criteria. Clinical and demographic data were collected from medical records. Complete blood count tests were performed to obtain PDW and MPV values. Statistical analyses, including Pearson or Spearman correlation tests, were used to explore the relationship between PDW, MPV, and DF severity.

Relationship of Breast Volume and Breast Malignancy Risk Based on BI-RADS Classification Categories In Mammography

Breast cancer is a major global public health problem and the most common type of cancer. The incidence of cases in Indonesia was about 42.1 per 100.000 population in 2019. Multiple risk factors underlie breast cancer malignancy. However, breast volume has not yet been included as a risk factor for breast cancer. This study aims to analyze the association between breast volume and breast malignancy. This cross-sectional study obtains breast volume and BI-RADS score by performing a mammography assessment at Dr. Saiful Anwar General Hospital, Malang. The inclusion criteria were women aged > 40 years and excluded those who have mammography contraindications such as pregnancy and breastfeeding. The parameters for calculating breast volume were the width, height, and compression thickness. The malignancy determination was use the BI-RADS category. There was no significant association using the Kruskal-Wallis test (p = 0.273, p > 0.05). The conclusion is there was no association between breast volume and the risk of malignancy based on BI-RADS mammography.

The Extract Of Ophiocephalus Striatus Affect Levels Of TNF-Α, TGF-Β1, IL-17 And SuPAR, Pulmonary Diffusing Capacity For Carbon Monoxide, And Health-Related Quality Of Life In Stable COPD Patients With Muscle Wasting

Objective — This study aimed to evaluate the effect of Ophiocephalus striatus extract on body composition, levels of TNF-α, TGF-β1, IL-17, suPAR and neutrophils, diffusing capacity of the lungs for carbon monoxide (DLCO) and health-related quality of life (HRQoL) in stable COPD patients with muscle wasting. Methods — Clinical pre- and post- quasi-experimental study of 32 stable COPD patients with muscle wasting from the Pulmonary Outpatient Clinic of Saiful Anwar General Hospital Malang, determined in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016 and bioelectrical impedance analysis (BIA) measurements (FFM <14.6 kg/m; BMI <18.5 kg/m2). Measurements of the following health-related parameters for the QoL due to COPD were performed before and after the nutritional intervention of 3,000 mg of O. striatus extract daily for 12 weeks: TNF-α, TGF-β1, IL-17 and suPAR levels (by ELISA), neutrophils (by blood test), DLCO (by body plethysmography), and CAT score. Results — A non-significant reduction of TNF-α (p=0.302), IL-17 (p=0.275), neutrophil (p=0.619), and suPAR (p=0.674) levels, along with an increase in DLCO (p=0.369), occurred after 12 weeks of O. striatus extract administration. However, the level of TGF-β1 declined significantly (p=0.022), followed by an increase in QoL as assessed by the CAT score (p=0.000). There was no significant correlation between inflammatory cytokines and DLCO, nor with the CAT score. Conclusion — The study results demonstrated a potential role of oral nutritional supplementation in the management of COPD patients with muscle wasting.

Profil Klinikopatologi Meningioma di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang Periode Tahun 2016-2020

Background. The most common intracranial neoplasms worldwide is meningioma. It has been classified into three grades by World Health Organization (WHO) in which each grade has several histological variants. The prognosis of meningioma is affected by many factors including histopathological type of tumor, age, and gender.
 Objective. The aim of this study is to determine the frequency of meningioma based on histopathological type, age, and gender from 2016 to 2020 in Saiful Anwar General Hospital Malang.
 Methods. This study was a quantitative descriptive study and data was collected from medical records from 2016 to 2020 in Department of Anatomic Pathology, Medical Faculty, Brawijaya University, Saiful Anwar General Hospital Malang. Histopathological type of meningioma, age, and gender were acquired.
 Results and Discussion. From 2016 to 2020, there were 96 eligible cases of meningioma. Ratio of men to women was 1:12.7. Meningioma was most commonly found in age group 41­50 years old (43.75%). The most common histopathological type of meningioma was meningotheliomatous meningioma (37.5%). The average of meningioma cases was 19 per year. In this study, there was an increase in incidence rate of meningioma in 2017, and decreased in 2020. It may happen because The government has a better referral system to provide health care, thus meningioma can be detected earlier.
 Conclusion. Frequency of meningioma is higher in women than men, and increases with age until 50 years, which then decreases. Meningotheliomatous meningioma is the most common histopathological type in this study.
 

Increase in Serum Ferritin Level as a Marker of Disease Activity in Pediatric Sys-temic Lupus Erythematosus (pSLE) Patients

Ferritin is an acute-phase reactant that is elevated in autoimmune disorders, including systemic lupus erythematosus (SLE). However, their correlation with disease activity scores has not been confirmed. Pandemic Covid-19 makes children visitation to hospital to get the treatment of SLE were delayed. This study aimed to evaluate correlation between serum ferritin and disease activity and its role in screening for flare in pediatric SLE (pSLE) patients during pandemic Covid-19. This is a cross-sectional study conducted in Saiful Anwar General Hospital Malang. Sampling was carried out sequentially on pediatric patients who met the criteria for Systemic Lupus International Collaborating Clinics (SLICC) and were recorded between July 2021-May 2022. All patients were interviewed and assessed for disease activity using SLE Disease Activity Index 2000 (SLEDAI-2k). A score <4 was categorized as inactive disease. Biochemical, serological tests including markers of disease activity and ferritin level were measured by standard laboratory procedure. Comparison, correlation and ROC curve analyses were performed with SPSS software. There were 38 females pSLE participated in this study. The mean age of the patients were 12.6 ± 3.02 years. Serum ferritin significantly higher in active disease compared to inactive disease 84.50 ng/mL (68.00-151.75 ng/mL) ng/mL and 815.00 ng/mL (451.25-1570.00 ng/mL), a value of p<0.05 was determined to be statistically significant. A significant correlation was found between serum ferritin with SLEDAI 2K (r = 0.890, p = 0.000). Correlation was also found between serum ferritin and IgM anti-double stranded-DNA (r = 0.325, p = 0.046), but not with other laboratory and serological parameters. In ROC curve analysis, we found that Area Under The Curve (AUC) 0.989, 95%CI 0.964-1.014, p value 0,000, with cut off value 297.50 with sensitivity 85% and specificity 94.4%. Ferritin was increased in active disease as compared to inactive disease and correlated with SLEDAI score and IgM-dsDNA. Thus, ferritin may be potential as an affordable and available marker of disease activity in pSLE during pandemic Covid-19.

Comparison of Methanolic Extract of Piper Betle to Amikacin against the Growth of Pseudomonas aeruginosa

Pseudomonas aeruginosa is one of the most common pathogens that cause Healthcare-Associated Infections (HAIs). A previous study stated that Piper betle L. extract has antibacterial activity against certain bacteria, including Pseudomonas aeruginosa. This study has the objective of comparing antibacterial activity of the methanolic extract of Piper betle L. and amikacin on the growth of Pseudomonas aeruginosa. This study used the tube dilution method with a sample of Pseudomonas aeruginosa from Microbiology Laboratory Dr. Saiful Anwar General Hospital, Malang. The results of this study showed that the value of MIC and MBC from the methanolic extract of the Piper betle L. treatment was 4800μg/mL. Meanwhile, the amikacin treatment resulted in 0.4μg/mL for MIC and 0.45μg/mL for MBC. From linear regression, it was found that the methanolic extract of Piper betle L. had a β-coefficient value closer to -1 compared to amikacin. Therefore, it can be concluded that the methanolic extract of Piper betle L. has a greater inhibiting effect on the growth of Pseudomonas aeruginosa.

Infected Urachal Cyst in Adult

Infected urachal cyst is one of urachal spectrum abnormalities. It usually presents in children because obliteration normally happened at early infancy. Rare case occurs in adult either can be small incidence or unrecognized symptoms until adulthood. Only small numbers of literature reported. The urachus is a tube extending from the anterior roof of the vesica urinaria to the umbilicus along the midline. The urachus is a vestigial fibromuscular structure located anterior to the fascia transversalis and posterior to the peritoneum. The presence of an embryonic urachal remnant can result in a variety of clinical complications. Due to the rarity of urachal residual disorders and the possibility of vague stomach or urinary symptoms, it is difficult to make a firm preoperative diagnosis. A 32-year-old female was referred to Saiful Anwar General Hospital after suffering abdominal pain for two months; the perineum felt the pain. There was a history of dysuria and nausea since the previous month, but no history of fever or change in bowel habits. Abdominal ultrasound showed an abscess at the anterior bladder and MRI showed an infected cyst mass in the suprapubic pointing to the left umbilical. Partial cystectomy and uterus biopsy were performed. The histopathologic result showed chronic inflammation tissue, and no malignancy was found. Misdiagnosis may lead to many complications such as progressive infection until malignancy therefore early detection of this case is important.

EXPERIENCE OF BILATERAL SYNCHRONOUS PERCUTANEOUS NEPHROLITHOLAPAXY (PCNL)

Objective: This case report will present bilateral synchronous percutaneous nephrolitholapaxy (PCNL) that was performed in Saiful Anwar General Hospital Malang for the first time. Case(s) Presentation: 49 years old male with flank pain on both sides continuously. Non contrast abdominal Computed Tomography (CT) scan showed bilateral pyelum stone and bilateral hydronephrosis. From blood analysis, the creatinine serum was 1.5 mg/dL and ureum serum was level 69.8 mg/dL. Discussion: Bilateral synchronous PCNL was performed in prone position, and stone fragmentation was done with pneumatic lithotripter, the operation last for about 2 hours with minimal amount of bleeding. After 3 months of follow-up, urology ultrasound and abdominal X-ray shows no residual stone, and normal ureum-creatinine level (0.77mg/dL; 43.7mg/dL). Conclusion: Bilateral synchronous PCNL is a safe choice to be done in order to treat bilateral pyelum stone, it can decrease length of stay , total cost therapy, and morbidity of the patient.

Survival Rate of Lung Adenocarcinoma Patients Receiving EGFR - Tyrosine Kinase Inhibitor Targeted Therapy

Globally, lung cancer is by far the leading cause of death by cancer-which contribute to 2.094 million death-with the highest toll from cancer being 1.8 million. Currently, lung cancer therapy has developed from chemotherapy to targeted therapy, such as Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI). This study aimed to assess the survival rate of adenocarcinoma cell lung cancer patients who received EGFR-TKI therapy at the Pulmonary Clinic of Dr. Saiful Anwar General Hospital Malang. This study was a retrospective study using patient medical records between 2017 and 2020. The data were processed and analyzed using the Chi-Square test. The number of samples was 117 patients consisting of 63 patients receiving Gefitinib therapy, 36 patients receiving Afatinib therapy, and 18 patients receiving Erlotinib therapy. There were no significant differences between variables of age, sex, smoking history, stage, and exon mutations with 1-year survival. Gefitinib therapy has a higher average survival time than Afatinib and Erlotinib. However, the 1-year survival rate (YSR) was highest on Afatinib. The Middle Survival (MS) of the three regimens is almost the same, about 300 days. Statistical data showed no relationship between survival and the treatment regimen given (p=0.187). The most common side effect of TKI is skin rash. This research should be carried out with a larger sample to minimize bias.

Maternal Comorbidities with Full-Term Pregnancy Who Gave Birth to Low Birth Weight Babies at Dr. Saiful Anwar Malang General Hospital

Introduction: Stunting is a challenge for children's growth and development in the future, which has long-term impacts in the form of reduced cognitive abilities, decreased productivity, and increased risk of infection and non-communicable diseases. Low birth weight (LBW) is a major determinant of stunting in Indonesia. Various multidimensional factors contribute to low birth weight, including maternal factors. Material and Methods: Quantitative descriptive research was conducted at Dr. Saiful Anwar general hospital from July 2021 to September 2022. The variables studied were age, education, occupation, parity status, medical history, number of antenatal care controls, height, mother's body mass index, and baby's birth weight. Results: Of the 54 full-term pregnant women, the majority who delivered LBW babies were nulliparous (42.6%), aged 20-35 years during pregnancy (79.6%), had a history of hypertension during pregnancy (25.9%), antenatal care visits 1-5 times (48.1%), high school degree (48.1%), housewives (75.9%), height ranging between 151-160 cm (64.8%), and BMI 18.5 to 25 kg/m 2 (51.9%). Conclusion: Maternal factors that contribute to the birth of LBW babies include low parities, age 20 to 35 years during pregnancy, hypertension in pregnancy, infrequent antenatal care visits, high school degree, work as a housewife, height ranging between 151 -160 cm, and had a normal BMI. The representation of the mother's BMI and educational level in this study differs from that in previous studies.

The Visual Rehabilitation of Bilateral Posterior Lens Luxation In Children: A Case Report

Introduction: Dislocated lens can be subluxated (partial) or luxated (complete), which can cause visual impairment in children. Conservative visual rehabilitation is an option for luxated lens treatment. Purpose: This study reports the possibility for visual rehabilitation of bilateral of bilateral luxated lens in children. Case Report: A 3-year-old boy came to the outpatient clinic of Dr. Saiful Anwar General Hospital with complaints of blurred vision on both eyes. The child would always bring objects close to his eyes since the past year. There was no history of ocular injury nor development disorder. Uncorrected visual acuities with LEA symbol on both right and left eyes were 6/114. The best-corrected visual acuity (BCVA) of the right eye was 6/45 and left eye was 6/9 with both S+11.00. Iridodonesis and aphakic lenses were found during slit-lamp examination of both eyes. The intraocular pressures were 14.2 mmHg on the right eye and 17.3 mmHg on the left eye. The lenses were seen in the vitreous cavities during funduscopy and ultrasonography examination. After 1 month of using spectacles, the BCVA of the right eye was 6/18 and that of the left eye was 6/18 with the binocular BCVA was 6/15. Lensectomy with pars plana vitrectomy was planned to prevent complication. Conclusion: Conservative visual rehabilitation is important to prevent amblyopia in children with luxated lenses and surgical treatment is needed to prevent complication. In this patient, aphakic spectacles were given for visual rehabilitation pending operative treatment.

FACTORS AFFECTING THE FUNCTIONAL STATUS OF PATIENT WITH MENINGIOMA IN DR. SAIFUL ANWAR GENERAL HOSPITAL MALANG

Background: Meningioma is one of the most commonly reported primary central nervous system (CNS) tumors, originating from arachnoid meningeal cells and including intracranial extra-axial neoplasms. Although meningioma is considerably benign, the patient conditions are reported to be diverse resulting in severe and life-threatening neurological deficits. Hence the assessment regarding functional status is deemed pivotal to provide a prognostic perspective as patient presentation exhibits disability due to lesions and other factors. Objective: This research aims to analyze factors affecting the functional status of patients with meningioma in Dr. Saiful Anwar General Hospital Malang. Methods: An analytic retrospective study was conducted with cross-sectional study involving 62 samples from patients visits with meningioma brain tumor in RSUD dr. Saiful Anwar General Hospital Malang from January 2017 to December 2020. The data was selected through non-probability sampling, generating sampling type from brain tumor register data Neurology. Results: Data obtained from 62 meningioma patients in RSUD dr. Saiful Anwar General Hospital Malang met the inclusion criteria from January 2017 to December 2020, based on demographic characteristics such as age of <50 in 38 patients (61.3%) and age of >50 in 24 patients (38.7%). Clinically, it was found that 58 patients (93.5%) experienced headache, 28 patients (45.2%) experienced decreasing consciousness, 15 patients (24.2%) had hemiplegia, and 17 patients (27.4%) had hemiparesis, 17 people had hemiparesis. 17 patients (27.4%) experienced visual disturbances, and 24 patients (38.7%) are with seizures. Based on the radiology screening sites, 46 patients (74.2%) were screened in Convexity sphere, 9 patients (14.5%) were screened at Cranial base, 3 patients (4.8%) were screened at Parasagittal, and 4 patients (6.5%) were screene at Falx, from which the 41 patients (66.1%) exhibited herniation. Based on comorbidities, 12 patients (19.4%) had sepsis, and 1 patient (1.6%) had pneumonia. From the analysis test results, it was found that decreasing consciousness (GCS) was significantly correlated with functional status, referred to Karnofsky Performance Scale of <70 (p: 0.013, p <0.05). Seizures were reported to be correlated significantly with functional status, referred to Karnofsky Performance Scale of > 70 (p: 0.015, p<0.05). Tumor location was significantly correlated with functional status, reffered to Karnofsky Performance Scale of > 70 (p: 0.027, p<0.05). Conclusion: The factors affecting the functional status based on the Karnofsky Performance Scale (KPS) of a patient with meningioma at Dr. Saiful Anwar General Hospital Malang included: decreasing consciousness (GCS), and seizures, and tumor location.

PS-P05-2: THE CORRELATION OF HYPERTENSION WITH LENGTH OF STAY OF ADHF IN CVCU OF SAIFUL ANWAR GENERAL HOSPITAL, MALANG, INDONESIA

Background: Long-term hypertension eventually leads to heart failure (HF), and therefore, most patients with HF have a history of hypertension. Conversely, the absence of hypertension in midlife was associated with a lower risk of new-onset heart failure later in life. Cardiac remodeling with major pressure overload includes diastolic dysfunction and concentric left ventricular (LV) hypertrophy. If pressure overload persists, diastolic dysfunction progresses and concentrically remodeled left ventricular filling decreases, followed by heart failure with preserved ejection fraction. Objectives: The aim of this study was to ascertain the correlation of pre-existence hypertension with the length of stay (LOS) of acute decompensated heart failure (ADHF) patients admitted in CVCU of Dr. Saiful Anwar General Hospital, Malang. Method: The study was a retrospective analytic in ADHF patients in CVCU of Dr. Saiful Anwar General Hospital Malang in August 2021 to April 2022. The presence of pre-existence hypertension in admission were compared with non-hypertensive group. Result: A total of 86 patients met study criteria in August 2021 to April 2022, respectively. The prevalence of hypertensive group ADHF patients was 61.6% (53 of 86), with comparable rates for men (74.4% [64 of 86]) and women (25.6% [22 of 86]). The LOS rate was higher in hypertensive group (11 days in average) than non-hypertensive group ADHF patients (8 days in average). Conclusion: The prevalence of hypertension as comorbid of heart failure patients is higher than the non-hypertensive heart failure group in CVCU of Dr. Saiful Anwar Malang in August 2021 to April 2022. Based on admission vital signs, patients with longer LOS have hypertension as pre-exsistence comorbid.

Risk Factors for Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Background Acute Kidney Injury (AKI) is a prominent complication of ACS, is more prevalent in STEMI, and can be a predictive indicator of long-term death. The frequency of AKI in patients with STEMI ranges between 10 and 20 percent, and the presence of AKI has a significant impact on in-hospital clinical results and long-term outcomes. Aim Form the basis for clinical considerations for the cost-effectiveness of treating STEMI with Acute Kidney Injury after undergoing primary percutaneous coronary intervention (PCI). Methods This cohort retrospective study of 597 STEMI patients who underwent Primary PCI from 2017 to July 2022 at Saiful Anwar General Hospital Malang. There were 568 patients included, 29 patients were excluded. We conducted both univariate and multivariate studies to determine AKI risk factors. By comparing the area under the curve, the receiver operating characteristic curves were compared (AUC). The number of positive variables for which the sensitivity and specificity were established. Using SPSS 26.0, data were examined. Results In terms of familial CAD risk factors, there was a statistically significant difference between the two patient groups with p= 0.020. In the clinical condition of shock (p = 0.000); IMA location p = 0.019; Killip classification (p = 0.000). The laboratory parameters that are significant between the two groups to be a risk factor for incidence of acute kidney injury include Random Blood Sugar (RBS) with p value = 0.000. The results of cardiac catheterization in culprit lesions showed significant results for the incidence of AKI in STEMI patients undergoing primary PCI with p-value = 0.000; TIMI flow (p = 0.000); and total volume contrasts (p = 0.000). This variable, with p value < 0.05, is an independent risk factor for the incidence of AKI in STEMI patients undergoing primary PCI. Furthermore, multivariate analysis with logistic regression was performed on these variables. From multivariate analysis with logistic regression, result of the odds ratio value (OR) of each variable was obtained for the incidence of AKI. The OR values for each were as follows: Shock condition (OR = 1.41; 95% CI 1.18 – 1.92); Killip 3 (OR = 3.54; 95% CI 2.14 – 4.26); LAD culprit lesions (OR = 0.34; 95% CI 0.27 – 0.68); and total volume contrast > 145 ml (OR = 1.61; 95% CI 1.13 – 1.92). Based on the ROC curve above, the total volume contrast > 145 ml is independent risk factor with an Area under curve (AUC) of 0.75 (95% CI 0.65-0.85); a sensitivity of 0.71 (95% CI 0.0.65-0.76) and a specificity of 0.66 (95% CI 0.61 – 0.71 ).

Chronic Rhinosinusitis Epidemiology Study in Those Who Need a Surgical Intervention at Saiful Anwar General Hospital Ward January 1st, 2018 – December 31th 2021

Chronic Rhinosinusitis Epidemiology Study in Those Who Need a Surgical Intervention at Saiful Anwar General Hospital Ward January 1st, 2018 – December 31th 2021

THE RELATIONSHIP BETWEEN BREAST VOLUME AND BREAST MALIGNANCY IN MAMMOGRAPHY

Breast cancer is a major global public health problem and the most common type of cancer. The incidence of cases in Indonesia are about 42.1 per 100.000 population in 2019. There are multiple risk factors that underlie breast cancer malignancy. However, breast volume has not been yet included as a risk factor for breast cancer. The aim of this study is to analyze the association between breast volume and breast malignancy. This study is a cross-sectional study obtaining breast volume and BI-RADS score by performing mammography assessment at dr. Saiful Anwar General Hospital, Malang. The inclusion criteria were women aged > 40 years and excluded those who have mammography contraindications such as pregnancy and breast-feeding. The parameters for calculating breast volume were the width, height, and compression thickness, and the BI-RADS category (0 – 6) was used to determine the malignancy. There is no significant association using the non-parametric analytic test Kruskal Wallis analytic test (p = 0.273 , p < 0.05) and a very weak negative correlation based on the correlation test Spearmanis correlation test (-0.127). There is no association between breast volume and the risk of malignancy based on BI-RADS mammography.