Soetomo Surabaya Research Articles

Risk Factors of Acute and Chronic Erythema Nodosum Leprosum in Dr. Soetomo General Academic Hospital Surabaya

Background: Leprosy is a chronic granulomatous infection and is one of the neglected diseases caused by Mycobacterium leprae. ENL is a complex syndrome, that caused inflammation of the skin, nerves, and other organs due to an inflammatory immune response to Mycobacterium leprae antigens. Acute ENL was defined as the first episode of ENL with a duration of less than 24 weeks. Chronic ENL was defined as ENL that persisted for more than 24 weeks. These types of ENL can have different risk factors and require different therapeutic interventions. Purpose: The onset of ENL is acute, but may progress to a chronic or recurrent phase and require long-term therapy. Early detection of leprosy is very important, because the infection is curable and prompt treatment can reduce nerve damage and associated stigma. Chronic ENL patients require prolonged high doses of corticosteroids to control inflammation in ENL and cause severe complications and side effects associated with morbidity and mortality. Methods: This retrospective study was conducted using a non-probability sampling technique consecutively using a casecontrol formula in leprosy patients with ENL in the Leprosy Division of the Outpatient Dermatology and Venereology Unit RSUD Dr. Soetomo Surabaya for the period 2015 – 2020, using secondary data in the form of medical record data. Result: The results of this study obtained leprosy patients with ENL as many as 234 patients, 56 patients with acute ENL and 89 patients with chronic ENL. 45 patients with acute ENL and 45 patients with chronic ENL were obtained from the case-control minimal sample size formula. Conclusion: The results of the bivariate analysis test showed that there was a relationship between risk factors for coinfection and steroid therapy with the type of ENL. The presence of coinfection and steroid therapy showed that patients tend to be chronic ENL, conversely, in the absence of coinfection and without steroid therapy, patients tend to be acute ENL. The multivariate logistic regression analysis test showed a significant association between risk factors for ENL onset before MDT and the presence of coinfection with chronic ENL, whereas ENL onset after MDT and absence of coinfection were associated with acute ENL.

Vitamin D and cathelicidin assessment in children with pneumonia

Introduction: Pneumonia is a lung infection that becoming one of the most causes of death in children in developing countries. A deficiency of vitamin D has been suggested in several research had a potential role in reducing cathelicidin production. It is a peptide that could act as an anti-microbial agent. Thus this research aimed to analyze the effect of vitamin D supplementation on serum cathelicidin levels. Method: This study was a quasi-experimental, pretest-posttest control group double-blinded design conducted in the pediatric inpatient ward of General Hospital Dr. Soetomo Surabaya. The inclusion criteria of the sample were children that have been diagnosed with pneumonia clinically, and the ages must range from 1 month up to 5 years old. An oral single dose of 100,000 IU of vitamin D (cholecalciferol) has been administered to the participant, on the day of enrolment after the collection of the blood samples. Cathelicidin and calcidiol (25-hydroxyvitamin D) levels were obtained. Supplementation with oral vitamin D3 (cholecalciferol) at 100,000 IU single dose and placebo was given. At 8 days, all subjects had repeat serum cathelicidin and vitamin D levels. All of the data were annyalsis in SPSS ver 25. We analyze the data descriptively and analytically. For the analytic analysis, we analyze the data by man-witney and paired t-test. Results: Forty-six subjects were consisting in this study consisting of 23 cases and 23 controls, 30/46 were males and 16/46 were females. The median age in the study was 24 months. The mean levels of cathelicidin in the post-supplementation treatment group were 11.80 + 11.40 with p value= 1.00. Meanwhile, the mean level of cathelicidin in the placebo group after giving the placebo was 8.81 + 6.46 with p val ue= 0.29. Conclusion: Enhancement of vitamin D in children with pneumonia after giving the supplementation has been established. Meanwhile, only calcidiol serum level was to be significant in difference when comparing the pre and post-examination of the vitamin D supplementation group.

A Retrospective Study on the Factors Affecting Patients Length of Stay at the Burn Center RSUD Dr. Soetomo Surabaya During 2017-2019

Background: Length of stay (LOS) is one of contributor in hospital costs, and attention has been paid to reducing LOS without compromising the quality of care for patients. Hospitals with a burn center have a longer average LOS than hospitals without a burn center, which can result in higher hospitalization costs. This study aims to identify the epidemological and clinical factors that affect LOS in burn patients. Methods: We conducted a retrospective cross-sectional study in design included all patients admitted to the Burn Center Soetomo General Hospital Surabaya between January 2017 - December 2019 who arrived within 48 hours after injury and survived till discharge. Patients who arrived after 48 hours following the injury, death during treatment and discharge against medical advice are excluded. Epidemiological and clinical data, such as age, gender, pre-existing co-morbidities, total body surface area (TBSA) burn wound, depth of burn, inhalation trauma, burn etiology, hospital acquired pneumonia (HAP), sepsis, anemia and hypoalbuminemia collected and subjected to statistical analysis. Results: Of all 249 patients admitted, 136 patients are eligible in the inclusion criteria. Median LOS in the total population was 17 days. The population most often treated for more than 28 days is a patient with a burn area of 30.5-40%, experiencing HAP and hypoalbuminemia. LOS significantly increased with TBSA, inhalation trauma, comorbidities, HAP, sepsis, anemia and hypoalbuminemia. Conclusion: There are several factors associated with the increased LOS observed in burn patients. This study confirmed and identified new factors that were significantly associated with LOS and were not previously discussed in the literature which allows better prediction of LOS and management of patients with burn injuries.

Comparison of Autolytic Debridement Treatment Using Hydrogel and Silver Sulfadiazine Cream Combined With Hyaluronic Acid in Pressure Ulcer Patients with COVID-19 at Dr. Soetomo Hospital

Pressure ulcer is a lesion obtained due to pressure on the body area with bone protrusion. Prolonged pressure on the surface area of the protruding bone may result in localized soft tissue damage. This study was conducted to compare autolytic debridement treatment using hydrogel and silver sulfadiazine-hyaluronic acid cream in pressure ulcer patients with COVID-19 at Dr. Soetomo Hospital. The aim of this study is to analyze autolytic debridement treatment using hydrogel compared to silver sulfadiazine - hyaluronic acid cream in pressure ulcer patients with COVID-19 at RSUD Dr. Soetomo. This study is a retrospective study with an observational analytic design with the source of research data using secondary data by looking at research variables recorded in the medical records at Dr. Soetomo Surabaya Hospital for the period April 2020 - March 2021. Research subjects were selected using the total sampling method that met the inclusion and exclusion criteria. The data obtained will be assessed using the perdanakusuma score II before treatment and 4 weeks after treatment. The number of research samples was 28 patients with 18 patients treated using hydrogel and 5 patients treated with silver sulfadiazine - hyaluronic acid cream. There was a significant decrease in perdanakusuma score II after wound treatment using hydrogel and silver sulfadiazine - hyaluronic acid cream in pressure ulcer patients with COVID-19 at Dr. Soetomo Hospital. There is no significant difference between treatment using hydrogel compared to silver sulfadiazine - hyaluronic acid cream in pressure ulcer patients with COVID-19 at RSUD Dr. Soetomo.

Factors Associated with the Incidence of Stress Urinary Incontinence in Uterine Prolapse Cases at RSUD Dr. Soetomo Surabaya

<div class="WordSection1"><p><strong>Background:</strong> Urinary incontinence (UI) is the involuntary leakage of urine, which can cause problems and have a negative impact on quality of life. Stress urinary incontinence is one of the subtypes of urinary incontinence which is defined as the involuntary expulsion of urine during exertion or physical activity, or sneezing, or coughing. The purpose of this study was to explain the relationship between age, type of delivery, parity, and body mass index with the incidence of stress urinary incontinence in cases of uterine prolapse at RSUD Dr Soetomo Surabaya.</p><p><strong>Method:</strong> This type of research is a quantitative research using analytical observational method, with a cross sectional approach. The sampling technique in this study was total sampling that met all inclusion and exclusion criteria. The independent variables of this study were age, type of delivery, parity, and body mass index. The dependent variable of this study is stress urinary incontinence.</p><p><strong>Result:</strong> Fisher's Exact test results on age, type of delivery, parity, and body mass index obtained p-values of 0.004, 0.021, 0.021, 0.014, 0,014 respectively. Because the p value of the five variables > 0.05, it can be concluded that H1 is accepted.</p><p><strong>Conclusion: </strong>There is a relationship between age, type of delivery, parity, body mass index, and degree of uterine prolapse. The results of the logistic regression test showed that most related variable to the incidence of stress urinary incontinence was age.</p></div><div class="WordSection2"> </div><strong><br clear="all" /></strong>

THE PROFILE OF HIV INFECTED PREGNANT WOMAN IN TERTIARY HOSPITAL

Introduction. In Indonesia, HIV infection is one of the main health problems. Mother or baby with HIV / AIDS have a great opportunity to contribute in maternal and infant mortality. Besides, maternal and infant mortality rates determine the public health quality of a country. This research was conducted based on the negative impact caused by HIV infection and the lack of data on infected pregnant HIV women in Surabaya. This research also expected to find out the main challenges in providing care services, both in terms of health and HIV education for health workers. Method. This research was a descriptive retrospective study to find out the characteristics of HIV infected pregnant women in Regional Public Hospital Dr. Soetomo Surabaya from January-December 2019. There were 36 HIV pregnant women included as a research subject. Results & Analysis. This study shows that the characteristics of HIV infected pregnant women who gave birth in Regional Public Hospital Dr. Soetomo Surabaya has the majority aged of 31-35 years (33.3%), who working as private employees (44.4%), with the latest education is high school (55.6%), married (97.2%), and multigravida (80.6%). Regarding their HIV, most patients (55.6%) had taken ARV for more than 6 months without viral load results (63,8%), and gave birth by C-section (88, 8%). Discussion. Early diagnosis and follow-up of therapy implemented by HIV infected pregnant women and their babies is important to reduce the mother-to-child transmission rate.

Behavioral Problems Among Type 1 Diabetes Mellitus Children with Good and Poor Metabolic Control During COVID-19 Pandemic

Background: Children with type-1 diabetes mellitus (T1DM) often experience emotional and behavioral problems such as anxiety and depression. Social restrictions during the COVID-19 pandemic caused social restrictions and limited access to healthcare facilities, which may have worsened the metabolic control. Objectives: This study aimed to analyze the behavioral problems among type 1 diabetes mellitus children with good and poor metabolic control during COVID-19 pandemic. Methods: This cross-sectional study was conducted in January - August 2021 in the Endocrine Outpatient Clinic of General Hospital Dr. Soetomo Surabaya. Type-1-DM children who fulfilled the inclusion criteria were divided into two groups based on metabolic control, including good (HbA1C ≤ 8) and poor (HbA1C > 8). The Pediatric Symptom Checklist-17 (PSC-17) was used as a screening tool with the domain internalizing problems (IP), externalizing problems (EP), and attention problems (AP). The data were analyzed using Pearson or Spearman test with Statistical Product and Service Solution (SPSS) version 18.0. Results: In this study, 27 subjects (17 boys and 10 girls, aged 12.63 ± 3.39 years) were investigated. Of all subjects, only 8 subjects had good metabolic control during the COVID-19 pandemic. Furthermore, 33.3% of the participants had behavioral problems (14.8% IP; 18.5% EP). The frequencies of IP, EP, and AP in the good metabolic control group were 12.5%, 37.5%, and 0%, respectively; while those in the poor metabolic group were 15.8%, 10.5%, and 0%, respectively. There was no significant difference between the good and poor metabolic control groups in terms of behavior problems (P = 1.00, IP; P = 0.14, EP). Conclusions: No significant difference was found between good and poor metabolic control groups (P = 1.00, IP; P = 0.14, EP). However, the frequency of EP was higher in good metabolic control, and the frequency of IP was higher in poor metabolic control.

Relationship of Testic Volume Towards Semen Analysis in Male Patients in Andrology Poly, RSUD Dr. Soetomo Surabaya

Examination of semen / ejaculates / sperm is the first screening examination that a subfertile / infertile couple needs to undertake in an attempt to find out the cause of infertility that may come from his side. Besides spermanalysis, it is also necessary to do physical examination, especially about internal and external genital tool because as it is known abnormal result of sperm analysis can be caused by anatomical abnormalities and or testis function. To determine the relationship of testicular volume to semen analysis on male patients in Andrology clinic RSUD Dr. Soetomo Surabaya. The research is a kind of observational analytic research to find out the correlation of testicular volume to semen analysis on male patients in Andrology clinic RSUD Dr. Soetomo Surabaya by using secondary data. Based on the results of statistical tests of 64 samples by using chi square test can be seen that the value of significance or p-value 0.005 <0.05. So it can be concluded that there is a relationship between testicular volume with morphology, motility and sperm concentration. Data were analyzed using chi square test to determine the relationship between testicular volume and semen analysis. Testicular volume is one of the risk factors of decreased semen analysis results

Relationship of Nutritional Status with Tuberculosis Lungs of Children Aged 0-5 Years in Surabaya

Background: Tuberculosis or TB is an infectious disease caused by Mycobacterium Tuberculosis, the tenth leading cause of mortality worldwide affecting both children and adults. Indonesia is the third country with the highest case of TB after China and India. Risk factors of this disease such as host immunity, nutritional status, hygiene, humidity, and population density. Objective: To analyze the correlation between nutritional status and the incidence of pulmonary tuberculosis at RSUD Dr. Soetomo Surabaya. Methods: This study is a retrospective analytical observational design with a case-control design. Sampling was taken using purposive sampling and then analyzed using the lambda coefficient contingency test. Results: A total sample of 130 patients was taken then analyzed. The result showed there is a correlation between a child with underweight (p=0,019) and standard (p=0,015) nutritional status and TB incidence. However, there is no correlation between overweight (p=0,259) and obesity (p=0,153) nutritional status and TB incidence. Conclusion: TB is correlated with underweight and standard nutritional status among children under five years.

Profile of Patients with Maxillofacial Fracture in Emergency Department, Head-Neck Surgery Division, Dr. Soetomo Public Hospital Surabaya in 2020

Maxillofacial fracture is the most common form of injury in trauma patients, especially in patients with motor vehicle accidents. The COVID-19 pandemic has affected various sectors, including restrictions on people's mobility. This study aims to determine the profile of patients with maxillofacial fractures during the COVID-19 pandemic. A descriptive observational study was conducted to evaluate maxillofacial fracture patients who came to the Emergency Department of the Head-Neck Surgery Division of the Dr. Soetomo Surabaya Hospital in 2020. Subjects were grouped according to sex, age, month of visit and the mechanism of trauma. The ratio between men and women was 4.92:1. The largest age distribution is in the 11-20 years range, as much as 39.2%. The most distribution based on the month of visit was in February as much as 16.9%. Most trauma mechanisms were due to traffic accidents (90.1%). Most locations in single maxillofacial fractures in maxillary bone were 37.8% and multiple maxillofacial fractures in zygoma bones were 79.4%. Accompanying trauma was found in 73.2% of subjects, with the highest pattern of intracranial trauma as much as 80.8%. The incidence of single maxillofacial fractures was 47.9% and multiple maxillofacial fractures were 52.1%, with concomitant trauma occurring in 73.2% of subjects.

Description of Blood Pressure of Intracerebral Hemorrhage Patients in Tertiary Hospitals in Indonesia

Background: Stroke is one of the serious health problems that has a high mortality rate and is the leading cause of death worldwide. Intracerebral hemorrhage (ICH) is a subtype of stroke that often causes severe disability or death and is associated with greater morbidity and mortality than ischemic stroke. The main risk factor for intracerebral hemorrhage is hypertension. Objective: This study aims to identify the description of the blood pressure of ICH stroke patients in RSUD Dr. Soetomo Surabaya as tertiary hospital in Indonesia. Methods: This study is a retrospective descriptive study, using medical record data of ICH stroke patients at RSUD Dr. Soetomo Surabaya during the period of January 2019 to December 2019 involving 206 patients. Result: Research shows that the number of hemorrhagic stroke patients in RSUD Dr. Soetomo Surabaya is 206 patients. The majority of hemorrhagic stroke patients are female (52.9%) with an age range of over 35 years old (98.5%). A total of 109 patients (59,2%) did not work, as many as patients (58.7%) with a GCS score of 13-15. A total of patients (69.4%) had a history of hypertension, and 59.2% were in stage 2 hypertension. Conclusion: ICH stroke patients in Dr. Soetomo Surabaya in 2019 mostly occured in women aged over 35 years, not working, with a GCS score of 13-15, and has a history of hypertension. The highest blood pressure is in category of stage 2 hypertension.

Self-Assessment for Building Creativity in Writing Essay about ‘Entrepreneurial Mindset’

One of the biggest problems faced by developed countries in the world is concerned with the increase of unemployment from day to day. Lacks of building the entrepreneurial mindset among people in society may support the existing problem which can exacerbate the economic conditions in the developed countries nowadays. This study investigated the students’ entrepreneurial mindset seen from their opinions written down in their essay. A quantitative approach within a survey design was applied in the study. 50 students from English department of the Faculty of Letters, Universitas Negeri Malang (UM) and Universitas Dr. Soetomo Surabaya (Unitomo) were chosen to be the participants in the study. The study also used a questionnaire and a depth-interview as the instruments. The results showed that students’ creativities in writing essay about building the entrepreneurial mindset were low. It could be seen from the creativity aspects including curiosity, flexibility, and originality in finding and developing new ideas in their writings. And also, the students’ lacks of creativity were also influenced by their unwillingness to build and to do business due to some obstacles such as having no parents’ permissions, business skills and experiences, business relations, and having other plans of working referring to their background knowledge and titles gained. The study implies that entrepreneurial mindset actually can be the alternative topic to build the students’ creativities in writing essay which are beneficial not only for their writing skill improvement, but also for their thinking development in solving the problems about unemployment through being entrepreneurs in the future.

Characteristics of Vaginal Swab Examination Related to Demography, Host, Enviromental Factors, and Diagnostic Results in RSUD Dr. Soetomo 2020

Background: Indonesia is a tropical country that has high humidity, which causes bacteria to develop easily and one of them can cause infections in the female reproductive organs, namely vaginal discharge. The study aimed to characterized to analyze the characteristics of vaginal swab examination related to demographic, host, environmental factors, and diagnosis results at RSUD Dr. Soetomo, Surabaya. Methods: This study was a descriptive study, using secondary data in the form of medical records of patients who performed vaginal swabs at RSUD Dr. Soetomo Surabaya. Results: The number of patients who performed vaginal swabs at Dr. Soetomo Surabaya Hospital in 2020 was 56 patients. The highest age range was 31-45 years old which was a productive age. A total of 29 patients (51.7%) had graduated from high school / equivalent, 45 patients (80.3%) were working women. There were 46 patients (82.1%) who were married. The most reproductive state of 40 patients (71.4%) was menstruation. Thirty two patients (57.1%) did not use contraceptive methods. The highest number of sexual partners was one partner as many as 36 patients (64.2%). The diagnosis of bacterial vaginosis was 48 patients (85.7%) others are Candidiasis vaginalis and Trichomoniasis were not found, and 8 patients (14.2%) were found. Conclusion: The characteristics of patients who take vaginal swabs at Dr. Soetomo Hospital were women of productive age with the latest high school education, and were married. The most reproductive state was menstruation and mostly is experienced by patients who do not use contraception with sexual partners totaling one with the most diagnosis results caused by bacterial vaginosis, 48 patients (85.7%) were diagnosed with Bacterial Vaginosis.

Profile Of Type 2 Diabetes Mellitus Patients With Hypoglycemia Events In RSUD Dr. Soetomo Hospital, Surabaya from January 2019 - March 2021

Background: Hypoglycemia is a decrease in blood glucose levels which is the most common side effect of diabetes mellitus due to its treatment and is rarely a concern for patients and health workers. However, because the patient neglects the mild hypoglycemia symptoms, they cannot be immediately identified and treated. Each Type 2 diabetes mellitus (T2DM) patient with hypoglycemia has a different profile and manifestations. Objective: This study aims to identify the demography, clinical, and laboratory profiles of T2DM patients who experience hypoglycemia in the inpatient unit of RSUD Dr. Soetomo Surabaya from January 2019 - March 2021. Material and method: This study is a retrospective descriptive study. Medical record data were collected through total sampling, then processed descriptively, and presented as a frequency distribution table. Results: The samples of this study were 83 T2DM patients with hypoglycemia. The most age group was > 65 years, with 33 (39.8%) patients. The most gender group was female in 55 (66.3%) patients, the most common chief complaint was decreased consciousness in 47 (56.6%) patients, and the most common results of head physical examination were anemic conjunctiva in 43 (51.8%) patients. Extremity examination results 13 (15.7%) patients had wounds, and 10 (12.0%) patients had edema. The results of the random plasma glucose (RPG) examination <40 mg/dl in 62 (74.7%) patients, low Hb in 66 (79.5%) patients, high leukocytes in 47 (56.6%) patients, and high BUN in 52 (62.7%) patients. SK was high in 42 (50.6%) patients, and albumin was low in 56 (67.5%) patients. Conclusion: From this study, T2DM patients with hypoglycemia events were highly female and primarily found in patients over 65 years with severe hypoglycemia. The most common chief complaint was decreased consciousness, and the most common laboratory result was anemia, leukocytosis, high BUN, high SK, and hypoalbuminemia.

Effect of Sexually Transmitted Disease Services in Type B Hospitals on Patient Self-Treatment

Background: Self-treatment is still a problem in disease treatment (Rakhmawati and Anggraini, 2010). This is supported by the large availability of drugs that are sold over the counter (Hadi, et. Al., 2010). However, there is not much research data regarding self-treatment by patients with sexually transmitted diseases (STD) and its relationship to hospital services. This study aimed to examine the effect of sexually transmitted disease ambulatory units services at Type B Hospital on patients self-treatment. Methods : The study was an analytic cross-sectional study. A total of 60 patients had their disease checked at the Sexually Transmitted Infectious Diseases Unit at the Dermatology and Venereology Department of the Regional General Hospital Dr. Soetomo Surabaya were selected consecutively and were interviewed about their experience with STD ambulatory services at type B hospitals and self-treatment. Simple and multiple logistic regression analyses were performed to prove the effect of the services on self-treatment at a significance level of 0.05. Results : Self-treatment was performed by 71.7% of the respondents. The distance to STD services of type B hospital that more than 8 km increased self-treatment (p = 0.042 OR = 4.043 95% CI = 1.050 - 15.568), while age (p = 0.063), gender (p = 0.126), treatment staff (p = 0.197), satisfaction (p = 0.298), type of disease (p = 0.967), duration of illness (p = 0.201) had no effect on self-treatment. Conclusions : Sexually transmitted disease services in type B hospitals did not affect the patients self-treatment behavior, but the distance of more than 8 km to the service increased patients self-treatment. STD services need to be expanded in such a way that the distance to the service is less than 8 kilometers.

AN OVERVIEW OF KNOWLEDGE LEVEL REGARDING THE SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IN PEOPLE WITH LUPUS (ODAPUS)

Introduction: Systemic Lupus Erythematosus (SLE) is lay disease in Indonesia. People with lupus must undergo lifelong treatment because the manifestations vary with high mortality rate. The aim of this study is to measure the level of knowledge of ODAPUS about SLE. Methods: This study was an observational descriptive with a cross-sectional approach. One hundred respondents were selected consecutively according to inclusion criteria from SLE patients who attended outpatients of Rheumatology Polyclinic in RSUD (Regional Public Hospital) Dr. Soetomo Surabaya from September 2019 to January 2020. The variable was knowledge level of ODAPUS about SLE and ODAPUS characteristics. Data analysis used descriptive statistical analysis. Data were obtained using LKQ-R questionnaires. Result: The result showed that majority of respondents are female (95%), aged 17-25 years (34%), had Senior High School (SHS) as their highest educational background (60%), do not work (53%), got the information about SLE only from health services (71%), and had lack knowledge about SLE (68%). There is no difference between knowledge about SLE in gender (p-value 0.123), a significant relationship between knowledge and educational background (p-value 0.005), and differences in the level of knowledge in group of information sources (p-value 0,000). Conclusion: In conclusion, most of the SLE patients have lack of knowledge about SLE, especially those who have SHS educational background and only depend on the health service as the source of information. Special interventions are needed as health promotion, especially in childbearing age women who likely suffer from the disease.

THE RELATIONSHIP OF STRESS LEVEL WITH MENSTRUAL CYCLE IN MIDWIFE AT RSUD DR. SOETOMO DURING THE COVID-19 PANDEMIC

Background: An interrupted menstrual cycle can indicate reproductive system problems. However, there are several factors that can affect the length of the menstrual cycle such as nutritional status, diet, stress, hormonal drugs, smoking, and sleep quality. The current COVID-19 pandemic has had a major impact, one of which is an increase in stress, especially for health workers who serve COVID-19 problems. This study aims to analyze the relationship between stress levels with the length of the midwife's menstrual cycle during the COVID-19 pandemic. Methods: The type of research that will be used is an observational analytic study using a cross sectional design. The number of samples used were 47 midwives who work in RSUD Dr. Soetomo Surabaya during the COVID-19 pandemic. Bivariate analysis using Spearman tests. Results: There were 63.8% of midwives who had moderate stress levels and 88.2% of midwives with normal menstrual cycle length. The results of the analysis showed that there was no relationship between the midwife's stress level with the length of her menstrual cycle with p=0,660 and p = 0.568. Conclusion: Based on the results of this study, it can be concluded that there is no relationship between stress levels with the length of the menstrual cycle in midwives during the COVID-19 pandemic, so education and information about stress handling mechanisms are needed so that stress does not increase. Keywords: Stress level, menstrual cycle length, COVID-19 pandemic

An Overview of Candidemia Patients in Tertiary Hospital, Surabaya, Indonesia

Candidaemia is a bloodstream infection (BSIs) caused by Candida spp. common in hospitalized patients. Candidemia has a high mortality and morbidity. This study aimed to give an idea about incidence, patient characteristics, species and patterns of candida susceptibility, and risk factors in candidaemia patients at Dr. Soetomo Hospital from January to December 2020. This is descriptive research using an observational research design. This study used a medical record instrument for candidemia patients in the inpatient ward of Dr. Soetomo and data in the form of records of blood culture results at the Clinical Microbiology Unit of RSUD Dr. Soetomo Surabaya for the period January-December 2020. The observed variables include incidence, sex, age, the origin of hospitalization, species distribution, frequency of antifungal sensitivity testing, and risk factors for candidemia. In 12 months, 53 candidemia patients were treated at Dr. Soetomo Hospital. The incidence of candidemia is 1.58 cases per 1000 person-years. Most of them are male (64.15%) and aged less than <1 year (28,30). Most of the medical units at the time of the diagnosis were intensive care units and pediatric wards (28.30%). Candida albicans was the most commonly found species (33.96%), then Candida tropicalis (26.41%) and Candida parapsilosis (24.53%). Two Candida glabrata isolates (40%) were susceptible to caspofungin, and all isolates (100%) of Candida albicans, Candida parapsilosis, Candida rugosa, Candida lusitaniae, Candida tropicalis, Candida dubliniensis, and were susceptible to the antifungals tested. Patients who use the Central Venous Catheter (CVC) have the highest level of risk factor, followed by patients with diabetes mellitus.

Concordance of Proteinuria Examination Results using Dipstick Urine, Albumin-Creatinine Ratio, and Immunoassay in Diabetes Mellitus Type-2

Periodic examination of proteinuria for DM patients is important for the prevention of diabetic nephropathy complications. The most commonly used methods for checking proteinuria today are urine dipstick, albumin-creatinine ratio, and immunoassays. To analyze the suitability of proteinuria examination using a urine Dipstick, Albumin-Creatinine Ratio, and immunoassay. An observational analytic study, cross sectional, conducted in July 2020 - October 2020 at the Dr. Soetomo Surabaya, using urine samples (n = 57) that met the inclusion and exclusion criterias. The suitability test was carried out between the AIM urine dipstick, urine sysmex dipstick, AIM immunoassay and the Sysmex UC 3500 AC Ratio which were analyzed by the Cohen's kappa test. Immunoassay detected the highest proteinuria in 85.96% of type 2 DM patients, followed by AC Ratio (68.42%), AIM Dipstick (52.6%), and Sysmex Dipstick (49.12%). There was a very strong agreement between the AIM Dipstick and the Sysmex Dipstick, κ = 0.86 (p&lt;0.05), a weak agreement between AIM immunoassay examination and Sysmex AC ratio, κ = 0.37 (p&lt;0.05). There is no agreement between the Sysmex urine disptick and AIM immunoassay. There is a low agreement between the AIM Dipstick and the Sysmex AC Ratio. The AIM immunoassay detected microalbuminuria in 10(55.6%) of 18 subjects with negative results on Sysmex. Most immunoassay examinations detect proteinuria in type 2 DM patients. It is advisable to screen proteinuria using an immunoassay examination in type 2 DM patients1. Immunoassay examination can be relied on in screening proteinuria in DM patients. The results showed a very strong agreement using the AIM and the Sysmex dipstick examination. However, there was a weak agreement between the immunoassay examination and the AC ratio.

N-Acetyl Cysteine in combination with vancomycin or linezolid for biofilm eradication of methicillin-resistant Staphylococcus aureus (MRSA)

Antibiotics are challenging to deliver because MRSA can build biofilms. In Indonesia, the major parenteral antibiotics for treating MRSA infections are Vancomycin and Linezolid. Because NAC can degrade the biofilm matrix, it is believed that combining it with antibiotics will improve its capacity to destroy MRSA biofilms. An experiment was done at RSUD Dr. Soetomo Surabaya's Clinical Microbiology Laboratory in June 2022. The biofilm-forming bacteria studied were MRSA clinical isolates. The antibiotics utilized were Vancomycin (2 g/mL), Linezolid (4 g/mL), and NAC (8 mg/mL). A biofilm assay microtiter test was also carried out to see how drug exposure affected the biofilm that had grown. Biofilm eradication was observed when comparing the mass yield and biofilm metabolism after treatment to the control. According to the study's findings, using a combination of NAC with Vancomycin or Linezolid was superior to using NAC, Vancomycin, or Linezolid alone. There was no apparent difference between the two combinations, however. The combination of NAC and Vancomycin had the same effect on eliminating MRSA biofilms as the combination of NAC and Linezolid.