Soetomo Surabaya Research Articles

Effect Of Cognitive-Behavioral Therapy on Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis

Introduction: Depression is the most common psychiatric disorder suffered by patients with chronic kidney disease who are undergoing hemodialis. Depression can lead to decreased quality of life and increase the economic burden on the health system. CBT is a validated treatment for depression, and there has been no research yet on CBT in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. To prove the effect of CBT on the improvement of depression in patients with chronic kidney disease undergoing hemodialysis in RSUD, Dr. Soetomo Surabaya. Methods: Experimental study with use of randomized, pretest-posttest control group design. Respondents meeting the criteria were divided by random allocation, treatment by CBT for as many as 17 respondents, and even as much control as 20 respondents. The mean age of the treatment group was 37.24 and the control group was 44.45, with a range of 21–60 years old, who experienced mild and moderate depression without antidepressants. Treatment consists of 4 sessions, 45 minutes each session, once a week. Effectiveness was measured using BDI instruments. Results: There were significant differences in pre- and post-depression scores in the treatment group (p = 0.007), and there were significant differences in depression improvement between the treatment and control groups (p = 0.006). Depression improvement in the treatment group was 64.7% compared to the control group’s 25.0%. Conclusion: CBT can improve mild and moderate depression without antidepressants (NNT = 3) in patients with chronic kidney disease undergoing hemodialysis treatment at RSUD Dr. Soetomo Surabaya.

Implementation of the Family-Centered Care Model During Invasive Actions of Giving Injections and Installing Infusions Children's Nurses

The aim of implementing Community Service is the implementation of the Family Centered Care Model in the Children's Inpatient Room using invasive injections and infusions at Dr Soetomo Hospital, Surabaya. This community service was carried out at the Children's Inpatient Installation at Dr. RSUD. Soetomo Surabaya consists of 4 rooms. The rooms are the sleeping room, Nakula Sadewa room, Bona 1 room, and Bona 2 room with a total of 92 nurses. The four rooms are children's inpatient rooms that provide low-care nursing care so services with an integrated family-oriented care (FCC) system have not yet been established. The method used in this community service is to involve the family, each nurse will carry out invasive procedures on children with stages of preparation, implementation, and reporting. Implementation results Almost all patient respondents received family-centered care in the good category, 85 people (92.4%). Meanwhile, there were only 7 patients who underwent family-centered care in the sufficient category (7.6%). This shows that patients and nurses at IRNA Children's Hospital Dr. Soetomo Surabaya have implemented a family-centered care system in nursing care and health services.

GWO-SVM: AN APPROACH TO IMPROVING SVM PERFORMANCE USING GREY WOLF OPTIMIZER IN INTELLECTUAL DISABILITY CLASSIFICATION

Intellectual disability (ID) is a neurodevelopmental disorder that requires early and accurate diagnosis. This study aims to improve the efficiency of ID diagnosis using a machine learning approach. A Support Vector Machine (SVM) model optimized with Grey Wolf Optimizer (GWO) was developed and trained using data from questionnaires completed by 101 families/guardians of ID patients at RSUD Dr. Soetomo Surabaya. The features used include family history, cognitive abilities, and adaptive behaviors. The results showed that the GWO-SVM model achieved an accuracy of 95% in classifying ID patients, an improvement of 5% compared to the conventional SVM. The GWO algorithm successfully optimized the parameters in SVM, resulting in a model with the best performance. These findings indicate the potential of GWO-SVM as an effective and efficient tool for assisting in the diagnosis of ID.

Effect of low-intensity aerobic cycling ergometer on ability to perform activity of daily living of patients with myasthenia gravis in RSUD Dr. Soetomo Surabaya

Background and objectives. Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction causing fluctuating skeletal muscle weakness and fatigue that result in increased restrictions on physical activity, affecting the patient's ability to perform daily activities in the family, social, and work environment. The MG-ADL scale is an assessment of the ability of the daily activities of MG patients that does not require equipment or special skills for the examiner and can be done in a short time. This study analyzes the effect of low intensity aerobic exercise cycle ergometer on the ability to perform daily activities of MG patients. Materials and methods. Twenty-two MG patients, MGFA class IIa and IIb, aged 18–59, participated in this study. The subjects were randomly divided into a treatment group and a control group. The treatment group received aerobic cycle ergometer exercise for 30 minutes, three times per week, for eight weeks. Both groups were educated to continue medication from neurology, perform physical activity as usual, and breathing exercises. Assessment of MG-ADL performed before and after intervention. Results. There was an improvement in scores on breathing and lower limb function in the treatment group. There was significant decrease in MG-ADL scores at the intervention group (p = 0.000) with large effect size (1.09). The comparison of MG-ADL scores between groups showed a significant value (p = 0.009) with a large effect size (1.24). Conclusion. Low intensity aerobic exercise cycle ergometer for 8 weeks improves the ability to perform ADL in MG patient.

Event Profile of Ankle Sprain Injury at Athletes in East Java Puslatda

Background: Ankle injuries are the most common injuries in sports and often cause chronic pain, swelling, and functional instability. Ankle injuries (sprains) are acute injuries that athletes often experience. This acute injury is caused by a pressure force, for example, when making a sudden turning motion. Sprains can affect the ankle's side and damage the outside (lateral) ligament; ankle injuries were reported at the Sports Clinic RSUD Dr. Soetomo Surabaya . Aims: To understand the profile of ankle injuries suffered by East Java Puslatda athletes and investigate the risk factors for these injuries. Material and methods: The study was conducted using a retrospective approach with an analytic observational design in the form of a cross-sectional study because the researchers did not provide intervention to the research subjects and only made observations and secondary data profiling. Result: The data collection and analysis found that ankle injuries in East Java Puslatda athletes most often occur in the late adolescent age range (17-23 years), which is as high as 35.8%. Conclusions: There is no relationship between extrinsic and intrinsic factors on the risk of ankle injury for Puslatda East Java athletes.

The Relationship Between Expression of HIF-1α and Clinical Response in Cervical Cancer Patients with Neoadjuvant Chemotherapy at Dr. Soetomo Surabaya Hospital

This investigation aims to analyze the relationship between expression of Hypoxia Inducible factors-1 αlfa (HIF-1α) to assess the response to neoadjuvant chemotherapy in cervical cancer patients. This research is a Quast Experimental Non-Randomized Before and After with no control design with a sample size of 30 stage IIIB cervical cancer patients by inclusion and exclusion criteria, with pretest and posttest treatment, namely biopsy for immunohistochemical examination and abdominal ultrasound to evaluate lesion diameter cervix after three cycles of chemotherapy. This study showed a decrease in HIF-1α expression before and after chemotherapy (p=0,003) and a decrease in the diameter of cervical lesions before and after chemotherapy (p=0,000). Correlation between decreased HIF-1α expression and decreased diameter of cervical lesions (p=<0,05). Response to neoadjuvant chemotherapy: 25 patients (83,3 %) showed a negative response and 5 patients (16,7 %) showed a positive response. Strong HIF-1α expression before chemotherapy gave a negative response 23 and 25 subjects with a negative response after neoadjuvant chemotherapy. This study found a relationship between high HIF-α expression before chemotherapy with a negative chemotherapy response and low HIF-1α expression after neoadjuvant chemotherapy with a positive chemotherapy response in cervical cancer patients at Dr Soetomo Hospital, Surabaya

Unique Profile of Post Mastectomy Pain Syndrome in Breast Cancer Patient in an Oncologic Center Surabaya, Indonesia

Background: Post Mastectomy Pain Syndrome (PMPS) is chronic neurophatic pain that is localized around the surgical site and can occur immediately or some time after surgery and lasts up to more than three months. Breast cancer is the most malignancy in women worldwide. Mastectomy is one of the treatment options for breast cancer that is often performed. Goal: This research aims to provide an overview of the profile of breast cancer patients who experience PMPS at the Oncology Clinic at RSUD dr. Soetomo Surabaya in Desember 2023. Method: This research uses a cross sectional to all breast cancer patients who experience PMPS. Samples were taken by consecutive sampling based on inclusion and exclusion criteria. We present our data descriptively in the tabulation of diagrams and tables. Results: Based on the quality of pain, most patients complained of radiating pain (52.7%), followed by stinging (33.33%), and dullness (14%). Pain was mainly felt at the surgical area (94%) with the remaining 6% feeling pain in ipsilateral arm. A total 108 samples (60%) answered that they felt pain continously, and most of samples (86.7%) had a history of taking anti-pain medication to reduce complaints. Only about 36% of the samples said that pain improved over time. Conclusion: At the Tertiary Oncologic Centre in Surabaya, most post-mastectomy pain syndrome patients were older, with luminal A type, and at higher TNM stages. The majority reported pain radiating from the surgery site, typically manifesting more than six months after the surgery.

HUSBANDS' PERCEPTIONS AND EXPERIENCES IN CARING FOR WIFE WITH CERVICAL CANCER: A QUALITATIVE PHENOMENOLOGICAL STUDY

Background: Cervical cancer ranks fourth for cancer that is often experienced by women worldwide and all ages with an estimated 604,127 new cases (6.5%), 342,000 deaths and about 90% of these cases occurred in low- and middle-income countries in 2020. In terms of psychoneuroimmunology, physical and emotional stress can have an impact on the immune system. Husband support with anxiety levels in cervical cancer patients undergoing chemotherapy, data was obtained that 7 out of 12 cervical cancer patients experience lower levels of anxiety when getting support from their husbands because patients feel more comfortable, calm and happy. This study aims to explore the perceptions and experiences of husbands while caring for their wives suffering from cervical cancer. Method: This research was conducted using qualitative methods with a phenomenological approach. The research subjects or informants in this study are husbands who treat wives with cervical cancer at Dr. Soetomo Surabaya Hospital who meet the inclusion and exclusion criteria From the results of semi-structured interviews, the researcher took the following steps, organizing and preparing the data to be analyzed, reading and viewing all the data, coding all the data, using the coding as material for creating descriptions, connecting between themes, and providing interpretation and meaning about the theme.Result: In this study, researchers found four dominant perceptions of husbands caring for their wives who had cervical cancer. These perceptions are most participants did not know about cervical cancer, all participants felt negative emotions when they learned about the complaints experienced by wives, various forms of support were given by participants to wives, all participants hoped for the recovery of wives. In the section on husbands' experiences in caring for wives with cervical cancer, researchers found five experiences experienced by husbands. These experiences include: all participants' wives experienced bleeding complaints, all participants experienced changes in terms of conjugal sexual relations, most participants had bad concerns about wife disease, the majority of participants never used poly palliative or pain-free services, most participants hoped that administrative services at Dr. Soetomo Surabaya Hospital would be faster. Conclusion: Cervical cancer affects and changes all aspects of women's lives and their families including for husbands of patients, therefore the care given to cervical cancer patients should be carried out holistically

Comparison of Quality of Life in Children with Chronic Kidney Disease Undergoing Peritoneal Dialysis Versus Hemodialysis at Regional Public Hospital Dr. Soetomo Surabaya

Comparison of Quality of Life in Children with Chronic Kidney Disease Undergoing Peritoneal Dialysis Versus Hemodialysis at Regional Public Hospital Dr. Soetomo Surabaya

Clinical and Epidemiological Characteristics of Severe and Very Severe Pneumonia in Infants

Background: Childhood pneumonia is a leading cause of mortality and morbidity in developing countries. World Health Organization (WHO) stated that pneumonia is the cause of mortality of around 1.2 million children under 5 years per year. The high incidence of very severe pneumonia cases with preventable risk factors become the background of this study.Purpose: The aim of our study was to describe clinical and epidemiological characteristics of severe and very severe pneumonia in infants and children.Methods: This is a descriptive cross-sectional study. The study were conducted from January 2017 to December 2018. We obtained clinical and demographic data of each patient based on medical records.The diagnosis of pneumonia was made clinically based on the Indonesian Ministry of Health criteria. Prematurity was defined as babies born with gestational age less than 37 weeks, low birth weight was defined as babies with birth weight less than 2500 grams. The nutritional status of children is clinically and anthropometrically evaluated using 2006 WHO curve of weight-by-age. Results: A total of 465 patients were diagnosed with pneumonia during 48 months study. 212 patients were excluded and 253 pneumonia patients met the inclusion criteria, 140 patients with very severe pneumonia and 113 patients with severe pneumonia. Among 253 patients, 141 were boys. 125 patients were 2-5 months of age. 71 patients were born with low birth weight and 62 patients had history of preterm birth. There were 86 patients receiving exclusive breastfeeding and 138 patients with complete immunization status. There were 131 patients with moderate and severe malnutrition, and 127 patients with comorbidity factors. 94 patients developed pneumonia with suspected bacterial causative agents.Conclusion: Lower age, prematurity, low birth weight, poor nutritional status, exclusive breastfeeding, comorbidities, and suspected bacterial causative agents are common characteristics of severe and very severe pneumonia in infants and children in Dr. Soetomo Surabaya.

Fast Food Consumption Patterns Relationship and Physical Activity with Nutritional status in Adolescents at SMA Dr. Soetomo Surabaya City

Teenagers need increasing nutritional intake due to experiencing physical changes and transitioning from childhood to adolescence. One of the factors influencing this is their dietary habits and physical activities. The researches objective is to understand the relationship between fast food consumption patterns,physical activities,and Nutritional status among 11th-grade students at SMA Dr. Soetomo in Surabaya City. The research methodology used was an analytical survey design with a cross-sectional approach.The sample consists of 60 respondents.The statistical analysis used in this research was the Spearman's rank correlation.The results of this research,shows that the majority of respondents were 17 years old and categorized as having excessive or overweight Nutritional status. They had poor dietary habits and engaged in very light physical activities. There’s a significant relationship between fast food consumption patterns and Nutritional status (p=0.000),as well as between physical activities and Nutritional status (p=0.042) among 11th-grade students at SMA Dr. Soetomo in Surabaya City.In conclusion,this research reveals a connection between fast food consumption patterns, physical activities, and Nutritional status among 11th-grade students at SMA Dr. Soetomo in Surabaya City,should be made to limit fast food consumption and increase physical activities to reduce overweight and obesity

The Administration of Intradialytic Parenteral Nutrition Does Not Affect the Anemia Status of Chronic Kidney Disease Patients Undergoing Hemodialysis

Background: Hemodialysis (HD) patients are susceptible to malnutrition, and there is a close relationship between malnutrition and the incidence of anemia. Parenteral nutrition plays a role in treating malnutrition. Objective: This study aims to determine the effect of parenteral nutrition on anemia in HD patients. Methods: Quasi-experimental research which is part of the nutritional research tree at the Hemodialysis Unit of RSUP Dr. Soetomo Surabaya for 3 months. A total of 45 malnourished CKD patients (SGA B & C) undergoing routine HD were included in this study (n=26 received regular diet & education, n=17 received regular diet, education and intradialytic parenteral nutrition, and n=2 dropped out of school due to blood transfusion). Measurements of body mass index (BMI), hemoglobin (Hb), serum iron (SI), and total iron binding capacity (TIBC) were carried out before and 8 weeks after therapy. Between groups used the Mann-Whitney test, while pre and post used the Wilcoxon matched-pairs sign rank test. Results: The treatment group was older than the control group. There was no difference in duration of HD between groups. Intradialytic parenteral nutrition had no effect on BMI (24.71±3.939 vs 24.71±4.026; p=0.3802), Hb (9.746±1.309 vs 9.162±1.960; p= 0.3525), SI (62.33±34.74 vs. 53.78±24.89; p=0.3594), and TIBC (242.8±119.0 vs. 197.3±43, 65; p=0.4258). Conclusion: In HD patients, intradialytic parenteral nutrition for 8 weeks did not affect Hb, SI and TIBC levels. Long-term observations with larger samples are needed to confirm these findings.

Differences in Glutamate Dehydrogenase (GLDH) and Other Liver Biochemistry Levels before and after Remdesivir Treatment in COVID-19

Background: Remdesivir (RDV) is a broad-spectrum antiviral approved by the Food and Drug Administration (FDA) for the treatment of Covid-19 patients, known to have the potential to cause toxic effects on the liver. Routine monitoring of liver biochemical parameters such as AST, ALT, bilirubin, ALP and GGT, can help detect liver injury. Drug-induced liver injury, according to Hy's law, is characterized by an increase in ALT > 5x ULN, or ALP > 2x ULN, or an increase in ALT > 3x and total bilirubin > 2x ULN, simultaneously. Glutamate dehydrogenase (GLDH) is a sensitive and specific hepatic marker, which can detect liver injury and loss of mitochondrial integrity earlier than other liver biochemical parameters. This study aimed to analyze GLDH levels and liver biochemical parameters before and after RDV therapy in patients with Covid-19. We also analyze several factors that affect liver function and suggest renal function. Methods: This study used an observational analytical with a prospective cohort design, in a population of Covid-19 patients receiving RDV therapy at the infectious emergency department and isolation ward Dr. Soetomo Surabaya for September-November. Consecutive sampling was taken. The subject had drawn blood twice; once before therapy and 5 days after receiving intravenous RDV. GLDH examination is using sandwich ELISA method, while ALT, AST, ALP, GGT, direct and total bilirubin were determined spectrophotometrically. Mann-whitney, the Wilcoxon rank test and Spearman correlation test were used to analyze the data. Results: The number of samples was 34 participants with an average age of 52.47+15.21 years. Concomitant medications were dominated by n-acetylcysteine (94.1%), antioxidants (91.2%) and immunomodulators (82.4%). None of the subjects suffered liver injury induced by RDV according to Hy’s Law. Median GLDH serum levels before RDV treatment 1,14 U/L and after 5 days RDV administration 0,85 U/L (p=0,945), AST (36,4 U/L; 34, 00U/L; p=0,140), ALT (30,43 U/L; 30,20 U/L; p=0,301), DBI (0,15mg/dL; 0,24mg/dL; p=0,090), TBI (0,49mg/dL; 0,50mg/dL; p=0,567), ALP (85,0U/L; 87, 5 U/L; p=0,313) dan GGT (64,5U/L; 71,0U/L; p=0,871). The use of concomitant medication was thought to have protective properties against hepatocytes. Conclusion: After 5 days of RDV treatment, there is no evidence of liver injury. There are no significant differences in GLDH levels and other liver biomarker parameters compared to baseline. There is no difference in delta GLDH levels between groups with and without renal impairment.

Transcatheter versus surgical closure of atrial septal defect: comparison of early result and complication

Background. Surgical therapy for closure of atrial septal defect with cardiopulmonary bypass is the gold standard. Transcatheter closure has become an alternative for the treatment of atrial septal defect because 80-90% of atrial septal defects can be resolved without surgery. The success of transcatheter closure of atrial septal defect is almost 80% of all patients with atrial septal defect. Objective. To analyze the differences in the results of transcatheter and surgical closure of atrial septal defects. Method. The type of research is observational analytic with a cross-sectional design. The sample is medical record data from pediatric patients with atrial septal defect who underwent transcatheter and surgical closure of the atrial septal defect between January 1, 2019 and June 30, 2023 at Dr. Soetomo Surabaya. All subjects with incomplete data will be excluded. Results. The total research subjects were 81 subjects, divided into 2 groups: transcatheter 41/81 (50.6%) and surgical 40/81 (49.6%). Transcatheter and surgical procedures had similar success rates (100% vs 92.5%, p=1.116). Transcatheter procedures had a longer ICU stay (0.07 day vs 3 days, p<0.001) and longer hospital stay (4,8 days vs 7,3 days, p<0.001) than surgical procedures. The total procedure cost of transcatheter procedures was also cheaper than surgical procedures (61 million vs 91 million, p<0.001). Complications of transcatheter procedures were also lower than surgical procedures (12.2% vs 52.5%, p<0.001). Conclusion. Transcatheter closure of atrial septal defects showed excellent result, shorter ICU and hospital stay, lower costs, and fewer complications.

The Correlation between the Level of Physical Activity and the Incidence of Breast Cancer in RSUD Dr. Soetomo Surabaya

Breast cancer is one of the most common cancers worldwide. This study aims to investigate and analyze the relationship between the level of physical activity and the occurrence of breast cancer at Dr. Soetomo Hospital Surabaya. The research method employed in this study is correlation analysis. The sample population was obtained from the Cancer Service Development Center (PPLK) at Dr. Soetomo Hospital Surabaya. The results of this study indicate that the majority of the 53 research subjects suffering from breast cancer had low-intensity physical activity since childhood to adolescence, with 41.5% of the total subjects (22 patients). In contrast, only 24.5% (13 patients) and 34% (18 patients) had moderate and high-intensity physical activity, respectively. Statistical analysis using Microsoft Excel version 2019 and SPSS showed that the calculated Chi-square value was greater than the tabulated Chi-square value, thus rejecting the null hypothesis (H0). This indicates a significant relationship between the intensity of physical activity during childhood to adolescence and the occurrence of breast cancer in the research subjects. This study implicates the importance of awareness regarding the significance of physical activity in maintaining breast health, especially from a young age. The practical implication of this research is the necessity of a preventive approach to breast cancer involving the promotion of a healthy lifestyle and regular physical activity, particularly during childhood and adolescence.

The Relationship between Characteristics and Underlying Eye Disorders with Optical Aid Selection and Visual Acuity Status Differences in Children with Low Vision Before and After Optical Aid Selection

Background: Low vision is a vision disorder that can have a significant impact on a person's independence, especially in children. According to WHO data from 2019, 246 million people suffer from low vision. Ophthalmologists must prioritize low-vision services such as refractive correction and low-vision assessment. This study aims to learn more about the relationship between characteristics and underlying eye disorders with optical aid selection, as well as differences in visual acuity status in children with low vision before and after optical aid selection.
 Methods: This study was an analytic observational retrospective cohort using medical records of children with low vision in RSUD Dr. Soetomo Surabaya. This study analyzed the relationship between characteristics (gender, age, education level, intervention history) and underlying eye disorders with optical aid selection using the Chi-Square test, while visual acuity status differences before and after optical aid selection were analyzed using the Wilcoxon test.
 Results: There were no relationships between characteristics (gender, age, education level, intervention history) and underlying eye disorders with optical aid selection (p > 0.05). There were differences in visual acuity status before and after optical aid selection (p < 0.05) with a minimum decrease of 0.1 logMAR which means an increase in visual acuity in all 72 samples of children with low vision after optical aid selection.
 Conclusion: These data provide new evidence of essential links between visual acuity status before and after optical aid selection. However, characteristics (gender, age, education level, intervention history) and underlying eye disorders were not associated with optical aid selection.

Relationship Between Multimorbidity, Nutritional Status and Duration of ARV Treatment to Major Signs of HIV at RSUD Dr. Soetomo Surabaya

People living with HIV/AIDS (PLWHA) can have better health outcomes with early identification of the AIDS phase. In the first three years, PLWHA may progress to the AIDS stage. This cross-sectional study aimed to determine the relationship between multimorbidity, nutritional status and duration of Antiretroviral (ARV) treatment on major signs of PLWHA. This study was conducted in the Intermediate and Infectious Disease Treatment Unit (UPIPI) at regional public hospital (RSUD) Dr. Soetomo Surabaya from January to February 2023. As many as 52 PLWHA who started HIV treatment at RSUD Dr. Soetomo in 2020 to 2021 were sampled in this study, which was obtained from medical records. The dependent variable in this study was the major sign of HIV. Independent variables in this study were multimorbidity, nutritional status, and the duration of ARV treatment. This study found that 76.9% of PLWHA experienced major signs. Multimorbidity and duration of ARV treatment did not have an association with major signs of HIV (<em>p</em>-value > 0.05). Nutritional status has a significant association with major clinical symptoms of HIV (<em>p</em>-value < 0.05). PLWHA with underweight had higher odds of having a major sign (<em>p</em>-value = 0.017; PR = 1.507; 95% CI 1.131-2.008) than PLWHA with normal nutritional status. Thereby, it is hoped that the hospital will be assisted in determining health promotion needs such as screening and evaluation of nutritional status to monitor the nutritional status of patients, which will improve their health outcomes.

PROFILE OF CHARACTERISTIC, RISK FACTOR, AND CLINICAL SEVERITY OF ISCHEMIC STROKE PATIENTS

Background: Ischemic strokes account for 87% of all strokes, making them the second leading cause of disability and one of the leading causes of mortality worldwide. Using the National Institutes of Health Stroke Scale (NIHSS), the clinical severity of an ischemic stroke can be assessed. Objective: The objective of this study is to ascertain the clinical severity, risk factors, and characteristics of patients with ischemic stroke at the neurology department of RSUD Dr. Soetomo Surabaya. Methods: The participants in this descriptive observational study comprise individuals who sought medical attention at the neurology department of RSUD Dr. Soetomo between January 2019 and December 2020 due to an ischemic stroke. The observed profile comprises the following factors: age, gender, obesity, smoking status, alcohol consumption, physical inactivity, family history of vascular disease, form of infarction, dyslipidemia, hypertension, cholesterol, and diabetes. Results: In the medical record data collection of 89 ischemic stroke patients, 36 patients were excluded when they first entered the hospital. So a total of 53 ischemic stroke patients were collected. 29 (54.72%) patients are male. The age range is dominated by 48 - 62 years from 29 (54.72%) patients. 44 (83.02%) patients are Javanese. 18 (33.96%) patients had a history of smoking, 1 (1.89%) patient consumed alcohol, and 1 (1.89%) patients were inactive physically. 13 (24.53%) patients have a family history of vascular disease, 45 (84.91%) patients have hypertension, 26 (49.06%) patients have dyslipidemia, and 19 (35.85%) patients have diabetes. 34 (64.15%) patients had moderate strokes, 15 (28.30%) patients had mild strokes, 2 (3.77%) patients had moderate-severe strokes, and 2 (3.77%) patients had severe strokes according to the results of the NIHSS assessment on the first admission. Conclusion: Ischemic stroke patients were mostly in the age range of 48 – 62 years. Comorbidities such as hypertension, dyslipidemia, hypertriglyceridemia, and diabetes are present in the majority of patients. The NIHSS scoring identified moderate stroke patients as having the most frequent outcomes, followed by patients with mild stroke.

The relationship of complete blood count on the outcome of childhood patients with Dengue Shock Syndrome (DSS) in the Pediatric Intensive Care Unit (PICU) Dr. Soetomo General Hospital

Dengue Hemorrhagic Fever (DHF) is an acute infectious disease caused by the dengue virus which is spread through the bite of female mosquitoes of the Aedes Aegypti and Aedes Albopictus species. DHF cases often attack children under 15 years of age and if not treated properly it will turn into Dengue Shock Syndrome (DSS). Supporting examinations are needed to diagnose and monitor the condition of DSS patients, one of which is a complete blood test. This study aims to determine the relationship between a complete blood profile and the parameters: platelet count, leukocyte count, hematocrit value, and hemoglobin level on the outcome of pediatric patients with DSS in the Pediatric Intensive Care Unit (PICU) at the Regional General Hospital (RSUD) Dr. Soetomo. This research is a descriptive analytical observational study with a cross sectional approach using medical record data from pediatric patients with DSS in the PICU of Dr. RSUD. Soetomo Surabaya for the 2015-2022 period. The sample consisted of 40 samples in accordance with the inclusion and exclusion criteria taken using total sampling technique. In this study, a significant relationship was found between age, hemoglobin and leukocytes and the mortality outcome of pediatric DSS patients. The values obtained were <0.05 (age), 0.048 (hemoglobin), and 0.048 (leukocytes). Apart from that, there is also a significant relationship between platelets and the outcome of treatment duration for pediatric DSS patients.

Analisis Pemborosan Waktu Pelayanan Dengan Metode Lean Healthcare Dan Failure Mode And Effects Analysis Di RSUD Dr. Soetomo Surabaya

Dr. Hospital Soetomo Surabaya with minimum service standard data that must be met is customer satisfaction ≥ 90% and waiting time ≤ 60 minutes in accordance with Ministry of Health (Kemenkes) decree no. 129 of 2008. Therefore, the problems faced by the Outpatient Institution Children's Polyclinic include service time Administration takes too long and quality must be improved. The most critical slowness of services at the Children's Polyclinic is in the registration administration section, namely the number of double registrations, disruptions in facilities and nurses who are still lacking in discipline. Applying Lean Healthcare and Failure Mode and Effects Analysis to improve service quality and prevent failures, such as slow service and lack of facilities will help find recommendations for improving these problems, namely reducing double registration of patients by improving data management and registration, repairing and improving maintenance of computer facilities for reducing waiting time due to disturbances and tightening discipline according to SOP.