Soebandi Hospital Research Articles

Association between Platelet-Lymphocyte Ratio and Proteinuria in T2DM Patient

Diabetes Mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia and glucose intolerance. Type 2 DM (T2DM) covers over 90% of DM cases. Diabetic nephropathy is a microvascular complication of DM. Proteinuria is as a marker of diabetic nephropathy in DM patients, which reflects disturbances of glomerular filtration and protein reabsorption. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation and predictor of various medical conditions that is cheap and easy to access through a complete blood count. The pathophysiology of diabetic nephropathy has been reported to be related to chronic inflammation, hypercoagulation, and oxidative stress, which can affect the increase in the number of platelets and decrease in the number of lymphocytes. This study aimed to determine the correlation between PLR and proteinuria in T2DM patients. This cross-sectional study design used medical records data and involved patients presenting T2DM at dr. Soebandi Hospital, Jember from April 2021 to March 2023. The correlation between variables was analyzed using the Spearman correlation test (p <0.05). Based on the result with a subject of 98 T2DM patients, statistical analysis showed a significant correlation between PLR and proteinuria (p=0.000) with moderate strength of correlation (r=0.468). The average PLR value in T2DM patients with proteinuria was higher (255.41) than in T2DM patients without proteinuria (139.85).

The Impact of Rewards and Punishments on Employee Performance in the Hospital Industry

Currently, competition in the hospital industry is increasingly sharp. The existence of private hospitals has increased significantly in line with the health needs of the community. This research aims to determine and analyze the influence of rewards and punishment on employee performance of employees at RSD dr. Soebandi Jember. The population in this study was administrative staff at RSD dr. Soebandi as many as 123 people. The sampling technique was carried out using saturated samples (census). Analysis to find out the ins and outs of respondents uses descriptive analysis. Tests for measuring instruments are validity tests and reliability tests. Hypothesis testing is used to determine the impact of exogenous variables on endogenous variables in this research. The research results prove that rewards have a positive but not significant effect on employee performance at RSD Dr Soebandi. Punishment has a positive and significant effect on employee performance at Dr Soebandi Hospital.

The Effect of Distraction Therapy on Pain Levels in Patients with Multiple Lumbar Fractures and Nerve Root Injuries in the Seruni Room at Dr Soebandi Hospital, Jember

The Effect of Distraction Therapy on Pain Levels in Patients with Multiple Lumbar Fractures and Nerve Root Injuries in the Seruni Room at Dr Soebandi Hospital, Jember

Application of Diabetes Foot Exercise to Mr. A With Type 2 Diabetes Mellitus as an Improvement of Leg Blood Circulation in the Anturium Room of dr. Soebandi Hospital: Case Study

Application of Diabetes Foot Exercise to Mr. A With Type 2 Diabetes Mellitus as an Improvement of Leg Blood Circulation in the Anturium Room of dr. Soebandi Hospital: Case Study

Progressive Muscle Relaxation for Anxiety and Hyperglycemia in Diabetes Mellitus Type 2 Patient: A Case-Study

Hyperglycemia is the main symptom in patients with diabetes mellitus. One of the risk factors that can increase blood sugar levels in diabetes mellitus (DM) patients is anxiety and stress, as a result of diabetes mellitus sufferers who experience anxiety, their physical condition does not improve, and their blood sugar levels are always high. Progressive muscle relaxation therapy (PMR) is a therapy that aims to focus the patient's attention so that they can differentiate the feelings that occur when the muscles are relaxed or relaxed from when they are contracting so that the patient can manage their body condition against their anxiety. This study aims to analyze the provision of progressive muscle relaxation therapy to control anxiety levels and blood sugar levels in patients with type 2 diabetes mellitus in the Gardena medical ward of Dr. Soebandi Hospital Jember. This research uses descriptive methods in the form of case studies on a patient with Type 2 DM. Therapy was given once a day for 20-30 minutes. Anxiety levels were measured using the DASS questionnaire, and blood sugar measurements were made using a blood sugar stick. After being given PMR therapy for 3 x 24 hours, the patients experienced a decrease in anxiety levels and blood sugar levels. Providing PMR therapy is effective in treating unstable blood glucose levels and anxiety for patient with Type 2 DM.

The Degree of COVID-19 and Preeclampsia at Dr. Soebandi Hospital, Jember

Introduction: The risk of preeclampsia increases due to COVID-19. COVID-19 was the leading cause of Indonesia's high maternal mortality rate in 2021, with 2,982 cases. COVID-19 cases affected the maternal mortality rate in East Java, reaching 234.7 per 100,000 live births. Jember ranks first with the highest number of deaths of pregnant women in East Java. This study aimed to examine the relationship between the severity of COVID-19 and the degree of preeclampsia at Dr. Soebandi Hospital, Jember. Methods: This was an analytic observational study with a cross-sectional design. This study was conducted from March to April 2023. A total of 27 samples of pregnant women with COVID-19 were taken using the total sampling method in 2020-2022 at Dr. Soebandi Hospital, Jember, and analyzed using SPSS with the Spearman statistical test. Results: This study found that pregnant women with mild cases of COVID-19 were 9 cases, 16 cases were moderate, and 2 cases were severe. There were 15 cases of pregnant women with no preeclampsia and 12 cases with severe preeclampsia. Conclusion: There was no relationship between the severity of COVID-19 and the degree of preeclampsia at Dr. Soebandi Hospital, Jember.

Validity and Reliability of Basic Life Support Intention Questionnaire for Nurses at Dr. Soebandi Hospital Jember

Based On the Theory of Planned Behaviour perspective, basic life support intention is determined by attitudes, perception of a social norm, perceived self-efficacy, and control ability in performing basic life support. This study analyzed the validity and reliability of the basic life support intention questionnaire, designed to measure basic life support intention among nurses. A total of 48 items were developed based on literature reviews encompassing four main constructs: attitude, social norms, self-efficacy, and control ability. The questionnaire then underwent a validation process, including construct and content validity (CVI) and reliability analysis. This study was conducted on nurses in Dr. Soebandi Hospital Jember. The questionnaire was distributed to 160 nurses, of whom only 80 questionnaires were returned. The results of the CVI test on 36 questionnaire statements found that the CVI value was in the range 0,85-1. In comparison, the results of the construct validity test on 48 questionnaire statements were found to be valid and obtained 21 statement items. Reliability test-retest results obtained a coefficient correlation value of 0,75 and an alpha value of 0,669, which means it is reliable. The final set of basic life support intentions consisted of 21 items measuring attitude (four items), social norms (seven items), self-efficacy (six items), and control ability (four items) of practicing basic life support intention. The basic life support intention questionnaire was shown to be valid and reliable.

Relation of NLR Value and Mortality Rate in Neonatal Sepsis

<p><strong>Introduction</strong>: Neonatal sepsis is a significant issue for newborns everywhere and causes a large amount of morbidity and mortality. Various indicators of newborn sepsis are expensive and occasionally unavailable in peripheral hospitals. The neutrophil-lymphocyte ratio (NLR), which is affordable, is a component of complete blood counts and does not call for further testing. This study intended to investigate the neutrophil-to-lymphocyte ratio (NLR) as a predictor of neonatal mortality rate in the local hospital in rural locations.</p><p><strong>Methods</strong>: This study sampled newborns with sepsis in the perinatal room of dr. Soebandi Hospital Jember for this cross-sectional study, from January 2021 to June 2022. NLR is calculated by manually dividing the number of neutrophils by the actual number of lymphocytes. Our neutrophil and lymphocyte data were obtained from the patient's lab results. This study analyzed neonatal sepsis NLR data using Spearman analysis to find the relation between NLR value and mortality rate of neonatal sepsis.</p><p><strong>Results</strong>: This study obtained 43 data on neonatal sepsis in the perinatology ward during this period. The data found to show that 37 neonatal sepsis survived and 6 died. The collected data analysis found that the lowest NLR neonatal sepsis is 0.4, the highest NLR neonatal sepsis is 25.6 and the mean value for NLR neonatal sepsis in perinatology was 3.88. This study found no correlation between the NLR value of the sepsis neonate and the neonatal mortality rate Sig. (2-tailed) 0.662.<strong></strong></p><p><strong>Conclusion</strong>: In this study demonstrated no correlation between the NLR value of the sepsis neonates and the neonatal mortality rate.</p>

Correlation between Platelets Count and C-reactive Protein in COVID-19 Patient in Jember Regency

The laboratory test for Coronavirus disease 2019 (COVID-19) is very important for initial treatment and predicting the prognosis of the patients, but there have been reports of false negative COVID-19 diagnostic test results. Another study reported changes in COVID-19 patient biomarkers, namely platelets count and C-Reactive Protein (CRP) levels. This study investigated the correlation between platelet count and CRP in COVID-19 patients. This study was conducted using a cross-sectional analytic observational method, through secondary data analysis of COVID-19 patients who hospitalized between June – August 2021 at Dr. Soebandi Hospital and Jember Klinik Hospital. Of 30 patients, there were 16 male patients (53%) and 14 female patients (47%); 18 patients in the 46-59 years old age group (60%) and 12 patients in ≤ 4 years old (40%) age group; and there were 8 patients admitted to ICU (26.67%). There was a negative correlation between platelet count and CRP in COVID-19 patients (r = -0.733; p<0.001). A strong correlation between platelet count and CRP is related to prognostic and predictive factors of severity in COVID-19 patients. Further studies about the analysis of other biomarkers in COVID-19 are needed to obtain more prognostic and predictive factors of severity in patient.

Correlation between Vertebral Slippage in Spondylolisthesis with Ligamentum Flavum Thickening in Dr. Soebandi Hospital, Jember, East Java, Indonesia

Background: Spondylolisthesis is a vertebral slip condition that compromises the body’s axial alignment and structures such as ligamentum flavum. The ligamentum flavum thickening may play a role in spondylolisthesis. The purpose of this study was to investigate the correlation between the slippage of vertebral body (spondylolisthesis) with ligamentum flavum thickening as a tissue response regarding increased mechanical stress.Methods: An analytical retrospective radiological observational was used a cross-sectional study from the results of MRI examination in Dr. Soebandi Hospital, Jember, Indonesia, collected from 2018-2021 using the simple random sampling method. Ligamentum flavum thickness and the degree of vertebral slip were measured using T2-weighted MR imaging and the correlation was analyzed using Fisher’s exact test. Results: Of 102 spondylolisthesis data records, 34 were taken, being female was the most prevalent cases in the age group above 60 years, with the most vertebral segment shift occurring at the L4–L5 level. There was a significant correlation. (p = 0.02; RR = 4.8) between ligamentum flavum thickening and vertebral slip in spondylolisthesis. Conclusion: The significant correlation between ligamentum flavum thickening and vertebral slip in spondylolisthesis suggest that mechanical stress has caused spondylolisthesis, by inducing chronic inflammation that results in hypertrophy of ligamentum flavum. Lumbar segmental instability due to spondylolisthesis is a factor contributing to the development of ligamentum flavum hypertrophy.

Prediction of Coronary Heart Disease on Civil Servants in Jember by Framingham Risk Score

Coronary heart disease is one of the biggest causes of death in developing countries. Civil servants (PNS) are a group of people who are susceptible to the disease because of their busy lives. Framingham risk score (FRS) can predict the occurrence of coronary heart disease in the next 10 years. The purpose of this study was to determine the prediction of coronary heart disease for the next 10 years in civil servants in Jember Regency. This type of research is descriptive observational with a cross sectional design. The data was taken from the medical records of patients with echelon II and III civil servants who did a medical sheck up at Dr. Soebandi Hospital in December 2013. Prediction of coronary heart disease for the next 10 years using the FRS method. From 63 medical record data, the prediction results of coronary heart disease in civil servants were 76.2% low risk, 17.5% moderate risk, and 6.3% high risk.
 Keywords: coronary heart disease, civil servants, framingham risk score

Immunization Stress-Related Response (ISSR) from Covid-19 Vaccination First-Dose among Medical Clerkship Students in dr. Soebandi Hospital Jember

Vaccination is one of the recommended way to eradicate Covid-19 pandemic. Unfortunately, there are still many people who refuse to get vaccinated. One of the causes is anxiety about the side effects that occur after vaccination. With this misinformation about vaccines, public anxiety is getting higher, so that more and more people are hesitant to get vaccinated. The purpose of this study was to determine the level of anxiety related to vaccines in medical students who have more knowledge about vaccines than the general public society. The anxiety assessment method used was the Hamilton Rating Scale for Anxiety (HARS) questionnaire. There were 108 medical clerkship students in this study, consisting of 25 male respondents and 83 female respondents, aged between 21-27 years. Based on the HARS-score obtained, it showed that all respondents were in the low or minimal anxiety range. Aspects of anxiety predominately appeared in the pre-vaccination phase. The differences between men and women were influenced by hormonal fluctuations and conditions before vaccination, such as stress, workload, knowledge capacity, and information obtained related to vaccination.
 Keywords: Anxiety, Covid-19, HARS-score, ISRR, Vaccines

Antibiotic Sensitivity Against Klebsiella spp. in the Post Debridement Culture an Open Fracture in Emergency Department of dr. Soebandi Hospital Jember

Surgical site infection (SSI) in open fracture is often caused by bacterial contamination in the management of open fracture. Because of that, one of the most important thing in handling open fracture is debridement. Prophylactic antibiotics given are Cephalosporin and Aminoglycosides. Post-debridement culture is important in predicting the incidence of infection. One of the bacteria that is often found in post-debridement culture is Klebsiella spp. which can produce ESBL to fight β-lactam class of antibiotics. The purpose of this study was to determine antibiotic sensitivity against Klebsiella spp. in the post-debridement culture of cases of open fractures in the emergency department of dr. Soebandi hospital Jember. This study uses a laboratory exploratory research design. The sample of this study was the isolate of Klebsiella spp. which amounts to 5 from post debridement culture of open fracture patients in the emergency department of dr. Soebandi hospital Jember from March to May 2019.The method used is diffusion (Kirby Baurer) by matching using the CLSI standard table to determine sensitive, intermediate, or resistant. The results of this study showed that most antibiotics had resistance to Klebsiella spp., including β-lactam antibiotics, such as Amoxicillin, Ceftriaxone, Cefixime, Penicilin, Meropenem, and Cefadroxil. Vancomycin antibiotics are still sensitive to Klebsiella spp. in all patients. Gentamicin, Ciprofloxacin, Tetracycline, and Chloramphenicol antibiotics were sensitive in 1 patient. Erythromycin intermediates antibiotics against Klebsiella spp.. The conclusion of this study is that all β-lactam group antibiotics are resistant to Klebsiella spp while the most sensitive antibiotic is Vancomycin.

Effectivity of Pyridoxine as Adjuvant Therapy of Phenytoin in Patients with Epilepsy at Soebandi Regional Hospital Jember

Phenytoin is an antiepileptic drug used as monotherapy for partial and generalized tonic-clonic seizures for more than 50 years. Pyridoxine is a water-soluble vitamin widely used for seizure patients unresponsive to standard treatment regimens. This study was conducted to determine the effect of pyridoxine as adjuvant therapy in epilepsy patients receiving phenytoin and to determine the relationship between age, gender, type of epilepsy, and duration of therapy on the incidence of seizures in epilepsy patients at Soebandi Regional Hospital Jember. This research is an observational analytic study with a cross sectional design. The data was taken from the patient's medical record at Soebandi Hospital Jember. The number of samples in each treatment group was 18 samples so the total number of samples in this study was 36 samples. Samples were taken using total sampling technique. Data analysis was performed using Chi-Square test on bivariate analysis and The Logistic test on multivariate analysis. The sample in this study was dominated by male patients (52.8%), aged 19-59 years (52.8%), had epilepsy with generalized seizure type (86.1%), and received therapy for < 3 years (77.8%). The results of bivariate and multivariate analysis showed correlation between the administration of pyridoxine and the incidence of seizures, indicating that phenytoin therapy with pyridoxine adjuvants was more effective than monotherapy phenytoin. Other factors such as gender, age, type of epilepsy, and duration of therapy were not proven to have a correlation with the incidence of seizures in epilepsy patients at Soebandi Hospital Jember.

Clinical Profile of Children Hospitalized with COVID-19 in Indonesia’s District Hospital : A First Year Pandemic Wave Single Centre Study

<p><strong>Background:</strong><strong> </strong>Children are known to be less infected by Coronavirus disease 2019 (COVID-19) rather than adults. However, children are still a vulnerable group and the incidence of patients admitted to hospital continues to increase. As Indonesia’s district has limited resources during pandemic wave, the data on pandemic cases was still underreported especially cases of children.</p><p><strong>Methods:</strong> This retrospective observational study collected data on pediatric case aged 0 – 18 years old, who were hospitalized at dr. Soebandi Hospital, Jember, Indonesia and confirmed to have COVID-19, from March 2020 to the end of March 2021.</p><p><strong>Results:</strong><strong> </strong>40 children were hospitalized and confirmed COVID-19 during the study period, the majority aged 15 – 18 years (40%), male (65%), and had a history of contact (67.5%). The most common symptoms were cough (85%), fever (67.5%), and shortness of breath (40%). Laboratory results showed that the majority had decreased neutrophils and increased lymphocytes, while most of the patient had normal chest X-rays (52.5%). From 5 pediatric patients who had multimorbidity, 4 patients died. All four had common underweight clinical morbidity, while acute respiratory distress syndrome was dominated the cause of death. The mortality rate in this study reached 10%.</p><p><strong>Conclusion:</strong><strong> </strong>The majority of pediatric patients were found to have mild to moderate symptoms with good outcomes. Case mortality rate in this study was lower than national data. Meanwhile, the underweight comorbid in children with COVID-19 was worsening the outcome in this study.</p>

Evaluation of Building Vulnerability to Earthquake Using Rapid Visual Screening (RVS) Method

Indonesia is one of the countries prone to earthquakes. One of the earthquake disasters that occurred several years ago hit Palu and Donggala on September 28, 2018. It caused severe damage to infrastructure. Therefore, it is necessary to evaluate buildings vulnerable to earthquakes as a form of prevention. One of the buildings in Jember, the dr. Soebandi hospital, experienced cracks in the walls during an earthquake measuring 6.0 on the Richter scale in Nusa Dua Bali on July 16, 2019. This study carried out the risk assessment of the vulnerability of buildings to earthquakes using the Rapid Visual Screening (RVS) method from FEMA P-154. RVS is a method to identify a building that is potentially vulnerable to earthquake hazards based on visual observations from the exterior and interior of the building. The results of the evaluation using the RVS method showed that the dr. Soebandi hospital is categorized as safe and not prone to earthquakes, with a potential vulnerability percentage of 0.0126%. Based on these results, the building does not require special treatment to anticipate earthquakes; however, maintaining the occupants' safety and extending the building's life requires routine maintenance.

PROFILE AND PATIENT ACUTE HEPATITIS CHILDREN OUTPUT IN DR SOEBANDI JEMBER HOSPITAL

Background: Indonesia is an endemic area for Hepatitis akut. District of Jember determines the status of extraordinary event Hepatitis akut at the end of 2019. The purpose of this study was the profile and patient acute hepatitis children output in dr Soebandi Jember Hospital in December 2019 until January 2020. Methods: This study was retrospective descriptive. The material was taken of the medical records Hepatitis akut patient at the pediatric departement of the dr. Soebandi Hospital in Jember. Results: In this study, patients most often occurred in male, age ranged between 7 – 14 years, and lived on the villages. The most common of clinical manifestation are anorexia, jaundice, fever, hepatomegaly, dark urine, vomiting and abdominal pain. The result of laboratory examination showed that Hepatitis acut patient had elevated of SGOT , SGPT, direct and total bilirubin. Conclusions: The combination of curcuma with SNMC (Stronger Neo-Minophagen C) reductly significant SGOT and SGPT serum levels (p < 0,001).

The Correlation Between Human Immunodeficiency Virus (HIV) Infections in Pregnancy and Low Birth Weight Infants

Background: The prevalence of Human Immunodeficiency Virus (HIV) infection in pregnancy were increase in developing countries. The existence of infection interferes with the absorption of nutrients due to accumulation of inflammatory cells in the placenta can cause the infant born with low birth weight.
 Objective: The purpose of this study was to determine the correlation of HIV infections in pregnancy and low birth weight infant.
 Methods: This research used an observational analytic design with a retrospective approach. The samples were positive and negative HIV mother with their infants that hospitalized at dr. Soebandi Hospital, Jember, from August 2014 - July 2017. The data were analysed by Fisher's Exact.
 Results: This study was found 52 positive HIV mother with their infants and 52 negative HIV mother with their infants. Nine from 52 infants (17.3%) who born from positive HIV mother were low birth weight. Only 3 from 52 infants (5.8%) who born from negative HIV mother were low birth weight. Data analysis using Fisher’s Exact was obtained p value = 0.06.
 Conclusion: There was no significant correlation of HIV infections in pregnancy and low birth weight infant.

The Relationship Between Moral Distress With Level of Burnout on Nurses in Intensive Care Room at the dr. Soebandi Hospital Jember

Moral distress is defined as psychological disequilibrium and negative feelings that results from recognizing an ethically appropriate action, yet not taking it because of such barriers. This causes an increase workload of nurses in the intensive care room, resulting burnout that affects nurses, patients and health care providers. This study aimed to analyze the relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember. This study used a quantitative descriptive observational analytic with the approach cross sectional design selected 47 nurses as respondents used total sampling. Data collected by Measure of Moral Distress Scale - Healthcare Professionals (MMD-HP) and Maslach Burnout Inventory (MBI). The results revealed that most respondents experienced low moral distress (85.1%) and low burnout (61.7%). The bivariate analysis showed with spearman test that p-value was < 0.001 (α = 0.05; r = 0.531). There was a relationship between moral distress and the level of burnout in intensive care room nurses at the dr. Soebandi Hospital Jember with moderate and positive relationship strength. A healthy work environment plays an important role in the low level of moral distress and burnout, if there are staff skilled in communication, good collaboration between people or professions, effective decision making, proper staffing, recognition and leadership.

Postoperative Orthopedic Surgical Site Infection Antibiogram of dr. Soebandi Hospital, Jember in 2019

<span>Surgical site infection (SSI) is a microbial infection of the surgical wound within 30 days of operation or one year after surgery if an implant is placed in a patient. The incidence level of postoperative orthopedic SSI range to 71%. An increase in antibiotic-resistant bacteria causes the treatment of postoperative orthopedic surgical wound infections to be less effective, so there is an increase in morbidity, mortality, length of stay, and economic burden on hospital resources.</span><span lang="EN-ID">A</span><span lang="IN">ntibiogram</span><span lang="EN-ID"> were used to guide</span><span>the clinician and pharmacis</span><span lang="IN">t </span><span lang="EN-ID">selected</span><span>the best empiric antimicrobial treatment in the event of pending microbiology culture and susceptibility results</span><span lang="IN"> to overcome the disadvantages of antibotic-resistant bacteria</span><span>.</span><span> This study aimed to form a postoperative orthopedic SSI antibiogram of dr. Soebandi Hospital in</span><span lang="IN"> Jember City, East Java, Indonesia</span><span> which can be used as a reference to rational therapy</span><span lang="IN">. </span><span>This study used a descriptive observational study research design with medical records</span><span lang="IN"> from January – December 2019</span><span>.</span><span>A total of 34 isolates were found from 33 patients who did a culture examination. Of the 34 isolates, 25 were found to be positive for bacterial growth, while nine were negative. Twenty-two bacteria were Gram-negative and others were Gram-positive. The bacteria were tested against beta-lactam and non</span><span lang="IN">-</span><span>beta lactam antibiotics.</span><span>From antibiogram, showed that Gram-negative bacteria sensitive to the meropenem and resistant to cefotaxime. While, gram-positive bacteria showed sensitivity to doxycycline and resistant to erythromycin and penicillin.</span>