Siloam Hospital Research Articles

Risk factors of speech and language disorders in children

Background Speech and language problems are developmental disorders often observed in children. Risk factors for speech and language disorders can occur prenatally, perinatally, or postnatally. Recognizing the risk factors for speech and language problems is essential for early diagnosis and intervention. Objective To identify risk and protective factors of speech and language disorders in children. Methods This case-control study was conducted in the Growth and Development Clinic at Dr. Soetomo Hospital, Siloam Hospital, Kendangsari Merr Hospital, and Darmo Hospital, Surabaya, East Java. Subjects with normal development were included in the control group, subjects with speech-language development disorders with no additional problems were included in the primary case group, and subjects with speech-language disorders and additional problems were included in the secondary case group. Subjects underwent history-taking and developmental examinations to assess for risk factors and types of speech-language disorders. Results During March – July 2023, 162 subjects aged 2-6 years met the inclusion criteria. The significant risk factors in the primary group were male sex (P=0.000), age 2-3 years (P=0.01), and maternal age 19-35 years (P=0.018). The protective factor identified was not bilingual (P=0.046). In the secondary group, the significant risk factor was male gender (P=0.002). The protective factors obtained were absence of seizures (P=0.028) and not being bilingual (P=0.045). Conclusion Male gender is a risk factor while non-bilingual is protective for speech-language disorders in children.

Performance Analysis Measured by Key Performance

Humans are the main asset in an organization, so human resources (HR) must be managed and utilized in a balanced and humane manner. A private hospital is a health institution owned by a non-profit and private company whose operational activities are financed through payments for medical services by the patients themselves. Siloam Hospital Bali is located at Jl. Sunset Road No. 818, Kuta, Kec. Kuta, Badung Regency, Bali with a total of 73 employees as respondents. This research aims to determine performance analysis as measured by key performance (financial and profitability, customer satisfaction, internal processes, learning and growth and company performance). The research data is secondary data obtained from Siloam Hospitals Bali. Testing the research hypothesis used SPSS (Statistical Product and Service Solution) analysis techniques. The research results show that financial and profitability (X1), customer satisfaction (X2), internal processes (X3), learning and growth both partially and simultaneously have a positive and significant influence on company performance (Y). It is hoped that in future research other variables that influence company performance can be examined.

Relationship Between Breast Milk Feeding and COVID-19 Incidence in Children Aged 0-2 Years at Siloam Hospital Kelapa Dua During The Pandemic

<p><strong>Background:</strong> The COVID-19 pandemic has claimed more than 6 million lives worldwide, and children are not spared from its danger. Breast milk is known to protect babies from various kinds of infections. Until now there are few data regarding the relationship between breastfeeding and the incidence of COVID-19 in children aged 0-2 years in Indonesia. This study aims to further examine the relationship between breastfeeding and the incidence of COVID-19 in children aged 0-2 years. Siloam Hospitals Kelapa Dua (SHKD) was chosen as a location because it was one of the referral hospitals for treating COVID-19 for pediatric patients in Tangerang that can be accessed by the researcher.</p><p><strong>Methods:</strong> This study was conducted using a cross-sectional study method on a sample of children aged 0-2 years from the medical record database of Siloam Hospitals Kelapa Dua for the period 2020 to 2022.</p><p><strong>Result:</strong> Upon calculation, it was found that the p-value is 0,154 (p>0,05). From 61 sample, 37,7% of the samples were breastfed and 44,3% was COVID-19 positive.</p><p><strong>Conclusions:</strong> No significant relationship was found between breastfeeding and COVID-19 infection among children aged 0-2 years old in SHKD.</p>

Age, Onset, and Tumor Size Differences in Newly Diagnosed Breast Cancer Patients Before and During the SARS-CoV-2 Pandemic at Siloam Hospital Lippo Village (April 2019 – December 2020)

<p><strong>Background:</strong> The current pandemic condition has caused delays in cancer treatment therefore surveillance should be increased.</p><p><strong>Methods:</strong> By total sampling, this retrospective cross-sectional study enrolled 108 samples, who were newly diagnosed breast cancer patients at the outpatient department of Siloam Hospital Lippo Village (April 2019 - December 2020). Data obtained from medical records and interviews from December 2020 – February 2021.</p><p><strong>Result:</strong> From the total of 108 samples which consisted of 54 samples before the pandemic (April 2019 – February 2020) and 54 samples during the pandemic (March 2020 – December 2020), accompanied by an increasing trend. The age during pandemic was younger than before pandemic (51,167 years old ± 11,255 vs 47,537 years old ± 9,824, p value=0,038), the tumor size during pandemic was bigger than before pandemic (3,403 cm ± 3,024 vs 4,262cm ± 4,212, p value=0,046) but the onset of patient during pandemic was not longer than before pandemic (281,69 days ± 401,387 vs 178,09 days ± 292,563, p value=0,036).</p><p><strong>Conclusions:</strong> Newly diagnosed patients have younger age and larger tumor size during pandemic when we compare to before pandemic period, but no difference in onset term. Surveillance to society is needed to ensure older people with smaller tumor size to seek medical attention.</p>

Evaluation of Prophylactic Antibiotic Use in The Surgical Action of Urinary Tract in Siloam Hospital Bali from January-June 2019

Inappropriate use of antibiotics raises various problems to health, especially bacterial resistance to .antibiotics. One of them is surgery with prophylactic antibiotics. The purpose of this study is to observe the accuracy of the usage of antibiotics in the surgical action of urinary tract. The method used is descriptive method with retrospective data collection from January to June 2019. The analyses used are the Gyssens method and the 2016 Indonesian Ministry of Health Guidelines for Antibiotics Usage. The biggest patient profile are aged 41-50 years (51 patients-43%), with 80% male and 20% female patients. Gyssens method is used to gain evaluation result; IVA Category (there is more effective alternative )(100%) and I Category (inappropriate timing) (99,92%). Evaluation using the 2011 Indonesia Ministry of Health method, namely accurate patient 100%, accurate doses 100%, and time of prophylactic antibiotics is 100%. This retrospective study concluded that the use of third-generation cephalosporin as prophylactic antibiotics for the urinary tract surgical action used is not accordance to the guideline Prophylactic antibiotics used for urinary tract surgical action is third-generation cephalosporin; cefoperazone (85%), cefotaxime (10%) and ceftriaxone (5%)

Unit Cost Analysis of Haemodialysis Services By Activity Based Costing Approach as a Strategy For Increasing Hospital Profits

One of the catastrophic diseases that is the focus of health insurance financing is kidney failure. Haemodialysis is a type of kidney replacement therapy for chronic kidney disease using special equipment. One method of financing haemodialysis procedures is the National Health Insurance Program. Hospitals, as health service providers for JKN participants, have an interest in the INACBG rates. Based on the Regulation of the Minister of Health of the Republic of Indonesia Number 3 of 2023 concerning Health Service Tariff Standards in the Implementation of the Health Insurance Program, there are changes to tariffs for haemodialysis services. With the current tariff changes, single-use and re-use services are divided into two different tariffs. The research was conducted at Siloam Hospital Bali. The data taken is secondary data originating from the Financial Division of Siloam Hospital Bali, the Medical Records Department of Siloam Hospital Bali, and the Haemodialysis Department of Siloam Hospital Bali during the period January–April 2023. The data collected and the hypothesis formulated in this research will be tested using the MANOVA (Multivariate Analysis of Variance) test method, using SPSS software. The research results show that there is a significant difference in total costs for re-use and single-use haemodialysis services; there is a significant difference in the total INACBG rates per patient for re-use and single-use haemodialysis services and there is no significant difference in the difference between INACBG rates and total costs in re-use and single-use haemodialysis services.

Detail Engineering Design (DED) pada Struktur New Siloam Hospital Surabaya

The construction of health facilities is part of national development. Therefore, many health facility development projects, such as hospitals, continue to be carried out in various regions. One of them is the construction of the New Siloam Hospital in Surabaya. This article aims to understand the concept of detail engineering design on the building structure of New Siloam Hospital. Field surveys and data collection are the methods used to obtain information related to hospital construction projects. There are several differences between field data and work drawing data that has been created. Some of these differences include details on the reinforcement and casting volume. Therefore, it is necessary to carry out further evaluation of field data with work drawing data so that the project can proceed according to initial planning.

PENGARUH TARIF RAWAT INAP DAN STANDAR PELAYANAN MINIMAL TERHADAP KEPUASAN PASIEN BPJS DI RUMAH SAKIT SILOAM PURWAKARTA

Effect of Inpatient Rates and Minimum Service Standards on BPJS Patient Satisfaction at Siloam Hospital Purwakarta.Based on optimal Service delivery, a health Service institution provides an impetus for the government to make a regulation regarding equitable standards in the health Service system. This study aims to determine how the influence of minimum Service rates and standards in Siloam Purwakarta hospitals in accordance with existing regulations.The analytical framework used is the inpatient tariff framework and minimum Service standards for patient satisfaction evaluating comfort, patient relationships, staff technical competencies and costs. The analytical method used is descriptive analysis with a quantitative approach.The results of the analysis show (1) Effect of Inpatient Rates on Patient Satisfaction partially has a significant influence on patient satisfaction (2) Effect of Minimum Service Standards on Patient Satisfaction partially has a significant effect on patient satisfaction (3) Effect of Inpatient Rates and Standards Minimal Service to patient satisfaction simultaneously has a significant effect on patient satisfaction and has an influence of 90.6% and the remaining 9.4%> is influenced by other factors not examined. The suggestions given by the authors include: (1) It should be noted again about BPJS hospitalization rates and re-socialization about class promotion programs, namely by analyzing the making of hospitalization rates and making special fields for Information on Service rates. (2) Need to continuously provide an explanation or understanding to patients of the minimum Standard of hospitalization. (3) Due to the simultaneous influence between inpatient rates and minimum Service standards on patient satisfaction, the quality of the two variables must be reviewed.

Level of Distress Experienced by Glioblastoma Multiforme Patients and Caregivers in Relation to their Medical Education Background: A Qualitative Study

BACKGROUND: Glioblastoma multiforme (GBM) is a primary brain tumor with extensive infiltration of surrounding brain tissue and a high rate of recurrence, with an average survival of 13–16 months. Due to the rapid course of the disease, multimodality treatment, and poor prognosis, both the patients and their caregivers will face significant psychological distress. Identification of the types and severity of distress is crucial to control morbidity during treatment. AIM: This study aims to define the level of distress experienced by patients and their caregivers during the treatment period by considering their medical education background. At the time of publication, this type of study is unique and has never been done before. MATERIALS AND METHODS: This study was conducted at the Neurosurgery Outpatient Department of Mochtar Riady Comprehensive Cancer Center Siloam Hospital Jakarta. Patients with GBM and their caregivers were recruited during the early stages of radiation treatment (T1) and the follow-up chemotherapy (T2) and were assessed using the distress thermometer (DT) and National Comprehensive Cancer Network (NCCN) problem checklist followed by in-depth interviews. Participants were divided into two groups based on medical education background. Significant distress is defined as DT score >4. RESULTS: Data from four pairs of patient-caregivers are collected during the early stages of T1. Two pairs of Patient-Caregivers without medical educational background (P-C non-D) are included later during T2. From T1, patients and caregivers with medical education (P-D) are higher than those without medical education (P-D > P-non D; C-D > C-non D). Another comparison shows that P-D is higher than C-D. In contrast, P-non D is lower than C-non D. Based on the time data collected, it shows DT: P-non D T2 > P-non D T1, but there is no difference between T2 and T1 in the caregiver’s group: C-non D T1 = C- non D T2. From the NCCN problem checklist, it is known that they attribute their distress mostly to physical problems. CONCLUSION: The physical and mental changes experienced by patients cause distress for patients and their caregivers. Knowledge of disease and treatment possessed by patients or caregivers helps them deal with GBM and the entire course of treatment.

Dermatomyositis with multiple organ involvement: a case report and literature review

Background: Dermatomyositis (DM) is a chronic autoimmune disorder characterized by muscle and skin inflammation, a part of the idiopathic inflammatory myositis (IIM). Even though the disease is idiopathic, there are multifactorial factors related to dermatomyositis. This care report aimed to describe a DM case in a male patient to increase the knowledge and management of DM patients. Case description: A 44-year-old Filipino male was referred to the emergency department (ED) of Siloam Hospital Mataram complaining of muscle pain and weakness with skin rashes 3 weeks before admission. Before the skin rash started, he had enlarged femoral lymph nodes in both thighs. The patient was afebrile with normal vital signs and was prescribed ibuprofen and amoxicillin. After that, he experienced skin rashes around his neck and the back of his ears with minimal pruritus. The symptoms worsened, making him unable to open his mouth and hard to breathe. In the ED, he also threw up dark-colored blood twice. Supporting examination showed elevated transaminase, increased LDH, and creatinine kinase. Biopsy results showed a histologic pattern of dermatomyositis. During hospitalization, he received a high-dose systemic steroid, antibiotic, and symptomatic treatment. He was discharged with a good outcome and planned to continue medical treatment in his country. Conclusion: Dermatomyositis is an idiopathic autoimmune disease involving skin and internal organs. It is a multifactorial disease yet with unclear etiopathogenesis. Specific treatment guidelines for DM are not yet established, but initial systemic corticosteroid and additional steroid-sparring agents may exhibit good outcomes.

IMPROVING THE SKILLS OF MIDWIVES IN OVERCOMING PREGNANCY DISCOMFORT WITH EARLY POSTPARTUM AND PREGNANCY EXERCISES

Pregnancy is a process that a woman looks forward to, but during pregnancy, there are various complaints that are felt due to physical and psychological changes and cause discomfort. Changes that occur due to changes in hormones and the psychology of pregnant women Increasing gestational age results in increasingly diverse complaints in pregnant women, especially in the third trimester. The complaints that are often experienced are back pain caused by excessive bending, walking without rest, and lifting weights. Midwives have an important role in improving the health of pregnant and postpartum women to overcome discomfort during pregnancy, childbirth, and the early postpartum period. This community service is carried out so that midwives can reduce discomfort for pregnant women, so they need to receive training in pregnancy and early postpartum exercises to improve their skills. There were 18 participants in the course, all of whom are currently employed as midwives for the Siloam Hospital Group. The course was considered successful after receiving an improving score from all participants.

Relationship of CK-MB Levels with Troponin T in Patient with Coronary Heart Disease at Siloam Hospital Jambi

Background: Coronary heart disease (CHD) is one of the cardiovascular diseases which is the highest cause of death in the world. CHD occurs due to the build-up of cholesterol plaque which causes narrowing of the arteries. CHD is characterized by an increase in biomarkers, especially cardiac troponin and Creatine Kinase enzyme activity. The aim of this research is to determine the relationship between CK-MB and Troponin T in CHD patients.
 Method: The type of this research is descriptive study with a cross sectional approach. The population of this study was all patients who had been clinically diagnosed with CHD by doctors at Siloam Jambi Hospital according to their medical records. The sampling technique used was a total sample technique that met the inclusion and exclusion criteria. To analyze the relationship between variables, a parametric statistical test is used, namely the Pearson correlation test.
 Result: The results of the study show the average value of CK-MB activity = 46.12 IU/L and Troponin T = 359.53 ng/L. The Pearson correlation test analysis showed that there was a significant relationship between CK-MB and Troponin T (p <0.00001), and the correlation coefficient (r) is 0.636.
 Conclusion: The activity of the CK-MB enzyme and the levels of Troponin T enzymes have a strong relationship in CHD patients at Siloam Hospital Jambi.

The Development Of The Use Of Social Media Marketing Rs: How Far Has It Been?

The use of hospital social media marketing has become a necessity and a common thing, needed, to be a trend in the current marketing era even though not all hospitals are ready to use it effectively and efficiently. All hospitals are developing these relatively new and fast-growing marketing "tools" trying to find suitable marketing patterns and forms. This article seeks to review how far the development of the use of social media marketing in several hospitals simply, namely Adi Husada Undaan Wetan Hospital Surabaya, Siloam Hospital Surabaya, Mount Elizabeth Group Hospital; based on data that can be obtained, reviews and observations and also know more about the reasons for the use and development of social media marketing by one of the hospitals in Surabaya, namely Adi Husada Undaan Wetan Hospital Surabaya

Recurrent Stroke in Young Adult as a Manifestation of Moyamoya Disease: Case Report

Background: Moyamoya disease is a chronic cerebrovascular disorder characterized by progressive narrowing of the intracranial portions of the distal internal carotid artery, the initial proximal components of the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery. Moyamoya disease can manifest as a stroke in young adult. Methods: This report presents a young female patient with Moyamoya disease in Siloam Hospital Denpasar, Bali, Indonesia, diagnosed using MRI and Digital Subtraction Angiography. Case Report: A 29-year-old woman with recurrent stroke, presented with right-side hemiparesis, urinary incontinence, disinhibition syndrome, hypertension, and a history of left hemiparesis from a previous stroke. The MRI brain showed hyperintensity throughout the sulci (ivy sign) in the bilateral frontoparietal with acute infarct in the left frontomedial region, chronic infarct in right frontomedial, occlusion of bilateral carotid arteries (supraclinoid segment), bilateral MCA and ACA. The cerebral DSA study showed stenosis in the right ICA, stenosis in the M1-M2 junction with poor collateral to ACA territory with a puff of smoke appearance, occlusion in the left ICA (supraclinoid segment), and severe stenosis in M1. The patient had undergone direct bypass in the right MCA and right superficial temporal artery. Unfortunately, the bypass did not succeed because of infection of the bypass site and the patient got oral medication with a single antiplatelet (asetosal) and angiotensin receptor blocker (valsartan). Discussion: Moyamoya disease is a rare chronic cerebrovascular disorder that can manifest as an ischaemic stroke in young adult. This patient had a recurrent ischaemic stroke due to Moyamoya disease. According to a global multicenter stroke database, 90% of Moyamoya disease patients initially presented with an ischemic stroke, 7.5% with a transient ischemic attack, and 2.5% with a hemorrhagic stroke. DSA showed that the intracranial collateral system failed to fulfill the demand for brain circulation when the stroke occurred. The patient had failure to grow collateral after direct bypass surgery from the right superficial temporal artery to MCA and single oral antiplatelet as a secondary prevention for ischaemic stroke. Conclusion: Moyamoya disease is a rare disease that needs further studies for its treatment to halt the progression and prevent secondary complications. Young patients with ischaemic stroke needed to be asses with brain MRI, MRA, and DSA to evaluate the etiology of ischaemic stroke. Keywords: Moyamoya disease, Digital Substraction Angiography,ischaemic stroke

VISITOR RESPONSE AS THE IMPACT OF SERVICE QUALITY IN PRIVATE HOSPITAL

Lately, there have been a lot of complaints from patients and their families who go to the hospital because they are not satisfied with the services provided by the hospital. Hospitals are a service industry that is starting to become competitive because many private hospitals are competing. This study aims to determine the effect of the response of hospital visitors on the quality of hospital services. The research sample was the introduction of patients in three middle-class private hospitals in Surabaya, namely Adi Husada Hospital, Siloam Hospital and Premier Hospital. A total of 405 samples were divided into 2 groups, namely group 1 with 30 respondents and group 2 with 375 respondents. Data analysis of group 1 with Cronbach's Alpha aims to test the quality of the questionnaire before it is used to produce data analysis. To answer the research objectives, Structural Equation Model (SEM) analysis was carried out on the data in group 2. In this test, 5 data were detected as outliers so that the remaining 370 data were analyzed. The results show that the loyalty of patients and their families to visit the same hospital is influenced by the expectations and satisfaction of patients and their families and is influenced by the quality of hospital services they feel. Service quality has the greatest influence on patient and family loyalty.

THREE YEARS FOLLOW UP REPLANTATION IN HEAVY SMOKER PATIENT: CASE REPORT

Tooth avulsion is different from all other dental injuries due to the extracorporeal situation with varying duration and degree of contamination of the teeth and the patient's systemic conditions. In a heavy-smoker patient, wound healing could be interrupted. Extra-alveolar handling, good replantation, and educating the patient could be the key to successful treatment of tooth avulsion, especially in a heavy smoker. The aim of this study is to discuss an avulsed tooth case that has been successfully treated by replantation in a heavy smoker. A 39-year-old female patient was refered to Siloam Hospital due to a dental trauma injury. The patient was in good general health, but she was a heavy smoker. Intraoral examination revealed that the maxillary left permanent central incisor was avulsed after the patient fell off in her bathroom. Replantation is a treatment of choice in this case. The avulsed tooth was stored in a saline solution. On one visit, root canal treatment was done on the avulsed tooth extra orally soon after the patient was refered to the AE department at Siloam Hospital. The avulsed tooth was replanted and fixed using an Erich arch bar to the previous position by finger pressure. Fix the Erich bar as far as possible to the distal and mesial of the avulsed tooth using circumferential wire in every single tooth. We decided to put the Erich bar from 15 to 25. The following oral hygiene cleaning, dietary instructions, and education to reduce or stop smoking during the healing process were given. Extra-alveolar handling, good replantation, good fixation, and adequate oral hygiene education are the keys to treating a tooth avulsion, even in a heavy smoker.

GAMBARAN PERILAKU PROSOSIAL PERAWAT DI RUMAH SAKIT SILOAM BALIKPAPAN TAHUN 2021

n the field of nursing, there is an act of helping or what is known as prosocial. However, the lack of development of altruism or motivation in nurses' prosocial behavior can lead to behaviors that lack care for patients. As a result, patients' needs are not addressed immediately, and nurses can be rude and fierce, which causes patients' needs not to be met and can affect the image of the hospital. This study aims to determine the relationship between spiritual intelligence and prosocial behavior at Siloam Hospital Balikpapan. The research method used is descriptive correlation with cross sectional approach. This research was conducted at Siloam Hospital Balikpapan, Jl. MT. Haryono Dalam No 23, Sungai Nangka Village, South Balikpapan District. This study covers three rooms namely Surgery, Internist, and Intensive Care rooms. The population in this study is all nurses in Siloam Hospital Balikpapan which amounted to 282 people, and the sample of 146 people was selected using Simple Random Sampling technique. The results showed the demographic data of respondents based on the majority characteristics as follows: female as many as 116 people (80%), the average age of respondents is 26-35 years old as many as 85 people (57.8%), 0-5 years of service as many as 70 people (45.5%), Catholic religion as many as 80 people (51.1%), and the majority tribe is Toba Batak as many as 120 people (80%). The level of prosocial behavior of nurses at Siloam Hospital Balikpapan in 2021 is included in the good category as many as 120 people (89.8%).

Pengaruh Price Dan Social Media Marketing Activities (SMMA) Terhadap Healthcare Apps Purchase Intention Dimediasi Oleh Consumption Values

The increasing use of social media in Indonesia opens up opportunities for entrepreneurs especially in the health sector on COVID-19 pandemic era. During the COVID-19 pandemic, the need for online health services has soared. According to data from the Global Web Index (GWI) social media users in Indonesia in 2022 increased by 12.6% in the past year. The number of rivalries between health facilities is getting tougher, so a specific strategy is needed in marketing techniques in the field of health services in Indonesia. Market price competition is also one of the problems in the business sector. In this study, 163 samples collected had purchased health care products on the MySiloam application belonging to Siloam Hospital Group. The sample was obtained by purposive sampling method and then the data was processed using the PLS-SEM analysis method with the SmartPLS ver 3.2.9 application. The results obtained from data processing, there are several hypotheses that do not show a relationship between research variables, but social media marketing activities (SMMA) have the strongest influence on epistemic value which then increases healthcare apps purchase intention. Suggestions for further research should be done with a wider number of samples and tighten the criteria for respondents so that the data obtained is more significant and accurate.

Relationship Between Clinical Factors of Lymphoma DLBCL GCB and Non-GCB Subtype with Ki-67 Proliferation Index in Siloam Karawaci Hospital 2014 - 2018

<p><strong>Background:</strong> Non-Hodgkin large cell B-lymphoma (DLBCL: Diffuse Large B-cell Lymphoma) were classified into two subtypes of Germinal Center B-Cell Like (GCB) and non-Germinal Center B-Cell Like (non-GCB), which GCB has a better prognosis. The Ki-67 antigen is one of the most reliable markers of cell proliferation. This research aims to establish the relationship between proliferation index Ki-67 with DLBCL subtypes and to evaluate the utility of Ki-67 proliferative index as a predictive marker for predicting stages of lymphoma.</p><p><strong>Methods: </strong>We obtained 60 cases of patient samples DLBCL in Siloam Hospital Lippo Karawaci in 2014-2018. Clinical and pathological data were obtained from medical records. Chi-square methods were used to analyze data.</p><p><strong>Result:</strong> There were more ≤60 years compared to >60 years. In this study, there were more male patients than female patients. lymphoma provided in extranodal were higher than lymphoma in nodal form.</p><p><strong>Conclusions:</strong> There is a relationship between Ki-67 proliferation index with lymphoma GCB and non-GCB subtypes and stage of lymphoma, which can be used as a predictive factor in predicting the stage of lymphoma.</p>

Comparison of Post-Operative Pain Score Between Open Appendectomy and Laparoscopic Appendectomy on Acute Appendicitis Patient in Siloam Hospital Lippo Village

<div class="WordSection1"><p><strong>Background:</strong> Appendicitis is inflammation of vermiform appendix which can be caused by luminal obstruction. Appendicitis is one of the most common causes of emergency abdominal surgery, with 11 cases per 10.000 person per year. Until today, open appendectomy is still the gold standard for appendicitis treatment although laparoscopic appendectomy has significantly lower post-operative pain.</p><p><strong>Methods:</strong> This study uses cross-sectional study design with post-open appendectomy and laparoscopic appendectomy patients in Siloam Hospital Lippo Village as the sample population. The Visual Analogue Scale (VAS) is taken from patient’s medical record and processed using Mann-U-Whitney test.</p><p><strong>Result:</strong> From 70 acute appendicitis patients, 36 underwent open appendectomy and 34 underwent laparoscopic appendectomy. The result showed the median score of VAS 1 day post open appendectomy surgery (median = 3, min/max = 2/6 [95% CI = 2,55 – 3,14]) is higher than post laparoscopic appendectomy (median = 2,25, min/max = 0/4, [95% CI = 1,97 – 2,59]), with adjusted p value against age and surgery duration is 0,024. In pediatric patients, median score of VAS 1 day post open appendectomy surgery is the same with laparoscopic appendectomy (median = 3, p value = 0,863). Multivariate analysis showed that surgery duration affects VAS 1 day post appendectomy surgery in pediatric patients (p value = 0,042).</p><p><strong>Conclusions: </strong>This study shows that the median score of VAS 1 day post open appendectomy surgery is higher than laparoscopic appendectomy. This result is statistically significant. However, in pediatric patients the median score of VAS 1 day post open appendectomy surgery and laparoscopic appendectomy is the same. VAS 1 day post appendectomy surgery in pediatric patients is affected by surgery duration.</p></div>