Test Chi Square Research Articles

COMMUNITY ACCESS TO HEALTH SERVICES DURING THE COVID-19 PANDEMIC

During the current Covid-19 pandemic, public visits to health facilities such as hospitals, health centers and clinics have decreased. People are increasingly worried about visiting health facilities for fear of contracting it. The purpose of this study was to measure the level of public concern about visiting a health facility during a pandemic when experiencing health problems. This research is a quantitative research using an analytical approach and study designcross sectional. The population in this study were all Indonesian people and the number of samples in this study were 118 people. The analytical method used is univariate about the respondent's identity (gender, age, occupation, and education) and bivariate to determine the correlation of the independent variables with the dependent variable using the test chi square. The sampling technique uses the technique accidental sampling. The results of the study showed that there was no relationship between the level of knowledge and the level of public concern about visiting health facilities p-value 0.421.

The Main Casual Factors Associated with The Incidence of Asphyxia Neonatorum

Background: Asphyxia is the second most common cause of neonatal death after babies with low birth weight (LBW). The factors that can cause asphyxia include preeclampsia, premature birth, prenatal anemia, antepartum bleeding and premature rupture of membranes. Purpose: This study aimed to determine the main causative factors associated with the incidence of asphyxia neonatorum at RSUP Dr. M. Djamil Padang in 2021. Methods: This research was a quantitative research with an analytic approach with a cross sectional design, was conducted in the Medical Record Sub-Division of RSUP Dr. M. Djamil Padang in December 2022. The sample in this study were babies who were diagnosed with asphyxia totaling 132 people obtained by total sampling technique. Collection data were taken from patient medical records and analyzed univariately, bivariately (test chi square), and multivariate (logistic regression analysis) with 95% CI. Results: The result showed that 77.3% of patients had moderate asphyxia. The result of this study showed that majority of patients with severe asphyxia with preeclampsia mothers 60.0% (p=0.001), premature birth 76,7% (p=0.044), anemia mothers 53,3% (p=0.035), did not experience antepartum hemorrhage 83,3% (p=0.390), and premature rupture of membranes 73,3% (p=0.000). The most dominant factor was premature rupture of membranes with OR=34.988). Conclusion: It was concluded that there was a relationship between preeclampsia, premature birth, prenatal anemia, premature rupture of membranes, and there was no relationship between antepartum bleeding and neonatal asphyxia. The factor that has the most dominant influence on the incidence of neonatal asphyxia is premature rupture of membranes. Suggestions for health workers to maintain and improve services to patients, especially asphyxia neonatorum.

Overweight might Affect the Live Birth Rate after Frozen Thawed Embryo Transfer Cycles in Chinese Women

Background: Overweight affects about 34.3% of Chinese adults, especially women of childbearing age. The purpose of this study was to investigate whether overweight affect the live birth rate of frozen-thawed embryo transfer (FET) cycles in Chinese mothers. Methods: This retrospective case-control study was conducted in all patients undergoing FET cycles from May 2016 to October 2020 at a single center. A total of 969 FET cycles performed in 632 patients were included in the analysis. Patients were divided into the four groups based on the mother’s body mass index (BMI): Group 1: BMI <18.5 kg/m2; Group 2: 18.5 kg/m2 ≤ BMI <24 kg/m2; Group 3: 24 kg/m2 ≤ BMI <28 kg/m2; Group 4: BMI ≥28 kg/m2. The main outcome indicator was the live birth rate per FET cycle. The secondary endpoints included rates of biochemical clinical pregnancy, clinical pregnancy, implantation, multiple pregnancy and miscarriage. Results: Ovarian reserve parameters were similar among the four groups (p = 0.382 for anti-Müllerian hormone and p = 0.195 for antral follicle count). Additionally, the rates of chemical pregnancy, clinical pregnancy, implantation and live birth were comparable in the four groups. Pregnancy outcomes were similar among the four groups using logistic regression analysis adjusting for age, anti-Müllerian hormone (AMH), antral follicle count (AFC), endometrial thickness, indication combined with polycystic ovarian syndrome (PCOS), duration of infertility (years), stage of embryos transferred, previous attempts, protocol of endometrial preparation, number of embryos transferred, and BMI. A decreasing tendency in the rates of clinical pregnancy (p = 0.032) and live birth (p = 0.011) with BMI change was observed through Chi Square for Trend test. Conclusions: Overweight might reduce the possibility of live birth after FET cycles in Chinese mothers.

HUBUNGAN EFIKASI DIRI DENGAN KECEMASAN AKADEMIK SISWA SEKOLAH MENENGAH ATAS DALAM MENJALANI PEMBELAJARAN DARING

Academic anxiety can have a negative impact on the quality of student learning. One of the things that effect the quality of student learning is self-efficacy. This study aims to determine the relationship between self-efficacy and academic anxiety of high school students in undergoing online learning. This study used a descriptive correlative design and aapproach cross sectional. The instrument used was a questionnaire containing questions about self-efficacy and academic anxiety that were valid and reliable. The research sample was 208 students at SMAN 8 Pekanbaru. Sampling using probability sampling technique, namely stratified non-random sampling. The analysis used is bivariate analysis using test chi-square. The results of this study indicate that most of the students very high self-efficacy were 111 students (53,4%) and students who had moderate academic anxiety were 139 students (66,8%). The results of statistical tests showed that there was a significant relationship between self-efficacy and academic anxiety of high school students in undergoing online learning with p value (0,000) < (0,05).

Factors related to compliance of Covid-19 health protocols among restaurant employees, Mandonga District, Kendari City, Indonesia

The restaurant is one of the places that was given a permit to continue to run its business activities in the midst of the Covid-19 pandemic. Restaurant employees can act as spreaders or contracting diseases, this can be through contact between food brought by employees and when interacting with visiting consumers. Therefore, it is important to implement health protocols as an effort to prevent the transmission of Covid-19. The general purpose of this study was to determine the factors related to compliance with the Covid-19 health protocol in restaurant employees, Mandonga District, Kendari City. This study was an analytical study with a cross sectional. The sample in this study amounted to 120 people who were taken using the technique of incidental sampling. Statistical test used test Chi-square with independent variables namely knowledge, education, belief, availability of infrastructure, and economic status with measuring tools in the form of questionnaire sheets and interview methods. The results showed that 106 respondents (88.3%) did not comply with the Covid-19 health protocol and 14 (11.7%) complied with the Covid-19 health protocol. Knowledge variable (p-value =0.000), education (p-value = 0.038), confidence (p-value =0.000), the availability of infrastructure (p-value =0.000) indicates that there was a relationship with Covid-19 health protocol compliance, while the economic status variable (p-value =0.196) showed that there was no relationship with Covid-19 health protocol compliance. The conclusion of the study showed that the variables of knowledge, education, belief, availability of infrastructure have a relationship with Covid-19 health protocol compliance, while the economic status variable has no relationship.

Faktor-Faktor yang Berhubungan dengan Keikutsertaan Kelas Ibu Hamil di Wilayah Kerja Puskesmas Muaro Tembesi

Pregnant Women Class is a study group for pregnant women with a gestational age between 20 weeks to 32 weeks (before delivery) with a maximum number of 10 participants. The purpose of this study was to determine the factors related to the participation of pregnant women in the working area ofthe Muaro Tembesi Health Center.This research is a type of analytical research with a cross sectional design. The variables studied were age, occupation, availability of information, family support and knowledge, on class participation of pregnant women, population 44 people and the sampling technik uses total sampling so that the research sample 44 people. Sources of data in this study through primary data, data obtained through questionnaires adobted which been tested for validity and reliability, Bivariate and Univariate analysts uses statistic test Chi-Square. The results showed that there was a relationship between age and class participation of pregnant women with (p-value = 0.101>0.05), availability of information (p-value = 0.002>0.05), family support (p-value = 1.00> 0.05), and there is no relationship between work and class participation of pregnant women with (p-value = 0.000>0.05), knowledge (p-value = 0.000>0.05). It is hoped that the results of this research can be an input for health workers, especially midwives to improve the provision of health care, especially in the implementation of guidance, coaching and counseling activities in an effort to increase pregnant women in carrying out class activities for pregnant women.

The Relationship Between Mother's Age and Duration Of Placental Devotion in the 3rd Stage Of Delivery in Midwife Practices Yulis Aktriani,S.Tr,Keb

The Maternal Mortality Rate (MMR) in Indonesia is still the highest in Southeast Asia and is still far from the global target of the SDGs (Sustainable Development Goals). One of the highest contributors to death is bleeding during childbirth. Stage III is a stage of labor that has a relatively short duration, can endanger the mother's life because of the increased risk of bleeding and lead to maternal death. This study aims to determine the relationship between maternal age and the duration of placental separation in the third stage of labor. This research method uses a correlational study research design with a retrospective approach. The sample of this study was 138 mothers who met the inclusion criteria. Using a purposive sampling technique. The data collection method used secondary data from medical records and partograph sheets, then the data were analyzed using Chi Square. The results of this study were almost all (77.5 percent) of the mother's age were 20 until 35 years old, while almost all of the time (82.6 percent) of the placenta was detached was not long. Statistical test chi square obtained a value of p more than 0.05 that H0 is rejected, meaning that there is a relationship between maternal age and the incidence of prolonged placental detachment in the third stage with an OR of 5.7, the maternal age at risk will cause the incidence of prolonged placental detachment 5 , 7 times more than the age of mothers who are not at risk. It is hoped that mothers, especially mothers who are at risk of age, understand the importance of planning for childbirth so as to prevent complications during delivery, especially the problem of the length of time the placenta is released.

Hubungan Pengetahuan, Sikap, Dan Dukungan Suami Dengan Pemilihan KB IUD Pasca Persalinan DI RSUD Budhi Asih Jakarta Tahun 2022

Introduction: Postpartum family planning services are still low, even though they have high effectiveness. This can be seen in the City of East Jakarta, only 6.81%. Budhi Asih Hospital, Jakarta, in 2021 from 820 births, post-delivery IUD users were found to be 564 people with an average of 31 to 32 people per month. There are several factors that do not support the use of the IUD contraceptive method including the mother's knowledge, attitude, and husband's support. The purpose of the study was to determine the relationship between knowledge, attitude, and husband's support with the use of the IUD Postpartum KB at Budhi Asih Hospital, Jakarta in 2022. Methods: Quantitative analytic research method with a cross-sectional design, the number of samples was 52 respondents, the sampling technique was accidental sampling, and the data analysis used the test chi-square. Results: The results of the study mostly did not choose the IUD after childbirth 61,5%; with low knowledge 67,3%; negative attitude 53,8%; and a supporting husband 48,1%. The results of the bivariate analysis showed that there was a relationship between knowledge (p-value = 0,000), attitude (p-value = 0,000), and husband's support (p-value = 0,019) with the choice of postnatal IUD KB. Discussion: The conclusion of the research is that there is a relationship between knowledge, attitude, and husband's support with the selection of post-delivery IUD family planning. It is hoped that pregnant women will be more diligent in consulting health facilities and seek more health information through the media, the internet, and health workers about the goals and benefits of post-delivery IUD contraception so that mothers are more motivated to use the IUD after delivery.

Soil contamination with intestinal parasites eggs in public parks and playgrounds in Kirkuk city

Intestinal parasites eggs are the most soil contaminated which can cause many health problems after ingestion. The aim of this study was to estimate the presence of intestinal parasites eggs in the soil samples collected from public parks and playgrounds in Kirkuk city.
 A total of Fifty-six (56) soil samples were collected from 14 areas (7 public parks and 7 playgrounds) through a period from 1st of March 2016 to 1st of October 2016, samples were examined microscopically using wet mount and zinc sulphate flotation methods for detecting intestinal parasitic eggs.
 Ninety-seven (78.6%) of soil sample were positive for presence eggs, include Toxocara Spp. (22.2%), Ascaris lumbricoides (19.4%), Hymenolepis diminuta (16.7%), Ancylostoma duodenale (13.9%), Taenia saginata (11.1%), Trichuris trichiura (8.3%) and Trichostrongylus Spp. (8.3%).
 The collected data was analyzed using statistical test Chi-square; this study shows the high rate of eggs of parasites which could be a potential source of parasitic infection.

Single spot albumin to creatinine ratio as an independent predictor of 12 years follow-up mortality in acute coronary syndromes without ST-segment elevation.

Background: Up to date there is no evidence of the association between microalbuminuria, measured as single spot urine albumin to creatinine ratio (ACR), with very long-term mortality in patients with non-ST segment Elevation Acute Coronary Syndromes (NSTE-ACS). Aim: To evaluate the association between admission ACR and very long-term all-cause mortality in an unselected cohort of NSTE-ACS patients. Methods: A prospective cohort study was conducted, including patients with NSTE- ACS admitted in the Intensive Care Unit. The ACR was determined in spontaneous urine samples during the first 24 hours after admission and analyzed by immunoturbidimetry. The primary endpoint was all-cause mortality during the follow-up. Actuarial survival curves were compared by log rank test and a logistical Cox regression analysis was performed to identify variables independently associated with mortality in the follow-up. Statistics were calculated using the IBM Statistics program SPSS version 26. Results: 600 patients were analyzed. The overall average ACR value was 7 mg/gr (95% CI 4-26). 76% had normoalbuminuria (ACR 0-30 mg/gr), 22% had microalbuminuria (ACR 30-300 mg/gr), and 1.5% had macroalbuminuria (ACR > 300 mg/gr). The median and interquartile range of follow-up was 12 years (95% IC 11-14). The average IAC among those who met the primary endpoint was 59.15 mg/gr (95% CI 52-66) and among the survivors, 27.66 mg/gr (95 % CI 63-77), p 0,003. ACR terciles were defined by 33th and 66th percentiles: tercile 1: patients with IAC of 0 to 4 mg/gr, tercile 2: IAC from 4 to 17 mg/g and tercile 3 values greater than 17mg/gr. Strong associations were observed between ACR with age, hypertension, stroke and history of COPD, previous use of angiotensin II converter/blocking enzyme inhibitors, systolic blood pressure at admission, ST segment deviation, left ventricle ejection fraction and elevation of serum Troponin T and CPK MB. All cause-mortality during the follow-up was 14% (CI 95% 11-17). Elevation of ACR was significantly associated with long term mortality risk: log rank test chi square: 133.936, p = 0.0001. By multivariate Cox regression analysis adjusted by age, gender, diabetes, hypertension, serum creatinine, troponin T elevation, ST segment deviation, previous AMI, prior use of aspirin, statins and percutaneous coronary intervention after hospitalization, the ACR was independently associated with a 12-year follow-up mortality: OR 13 (95% IC 5-35; p 0.0001). Conclusion: Single spot urine ACR at admission is a strong predictor of 12-year follow- up mortality in an unselected cohort of patients with NSTE-ACS.

EXCLUSIVE BREASTFEEDING: Indonesian Mothers Awareness in Providing Exclusive Breastfeed

The awareness of a mother in giving milk to her child is the main capital. Because then, he will try as much as possible, in order to produce milk. On the other hand, giving milk is an effort of a mother's love for her child, with the hope that her child can live healthy and grow perfectly. Therefore, awareness of giving exclusive breast milk is important. This research was conducted to look at the various factors that influence a mother's awareness of giving exclusive breastfeeding to her baby. The subjects of this study were mothers who were breastfeeding their babies, aged between 1 month to 12 months, in Kampar district, Indonesia. The research method was carried out using descriptive quantitative and test tests Chi-square. The research sample was carried out in a simple random manner with a total of 50 respondents. The results showed that the sensitivity of a mother in giving exclusive breast milk to her baby was greatly influenced by several fundamental factors, especially knowledge. This is a motivation in itself, how can a mother who has a baby try to do various things so that she can provide breast milk naturally. So that there is hope, his child will grow into a healthy child.

Nutritional status among pregnant adolescents at maternity teaching hospital

Background: Adolescent pregnancy increases nutritional requirements and the risk of pregnancy complications. There are few studies about anthropometric measurements as predictors of the nutritional status of pregnancy. Objective: The study consisted of an assessment of nutritional status by studying the association of anthropometric index and biochemical tests with adolescent pregnancy outcomes. Materials and Methods: A descriptive study included 116 convenient samples of pregnant adolescents. An interview questionnaire was used for collecting the following data: socio-demographic, body mass index (BMI), height, mid-upper arm circumference (MUAC), hemoglobin levels, and proteinuria. Pregnancy complications included; anemia, urinary tract infection, mode of delivery, preterm birth, and low birth weight. Descriptive statistics, Pearson's R test chi-square, and logistic regression were all used in statistical analysis. Results: The majority of study subjects were of late age of adolescence (≥ 17 years), housewives with primary education, and had normal obstetric history. Multigravida was only in late age of adolescence. Most 46.9% were overweight. Primigravida decrease in overweight subjects (odds ratio [OR] 0.2*; 95% confidence interval [CI] 0.03-0.88). The highest percentage had normal stature, 12.1% had short stature, 46.6 % had MUAC ˃28cm, and 3.4 % had undernutrition. Short stature increased at age 17 years and the risk of multipara increased in short stature (OR 4.2*; 95% CI 1.2-14.4). The majority had normal pregnancy outcomes. Anemia risk decreased in the normal height group (OR=0.08*: 95% CI 0.01-0.73), and in MUAC ≥ 28 cm (OR 0.77*; 95% CI 0.64-0,93). The risk of low birth weight increased not significantly in late age, among MUAC 24-28 cm, and significantly in anemia (OR=2.5*, 95% 1.1-5.5). Conclusion: This study concluded that the majority of the adolescents with primigravid/para status had normal nutritional status and pregnancy outcomes, as a result of growth in height, MUAC, and weight gain. malnutrition among overweight older adolescents with multigravida status affects growth, causes shorter stature, and anemia consequently increases the risk of low birth weight, preterm birth, and cesarian section. Because its effects manifest as teenage age increases in multigravida, this study supports the prevention of adolescent pregnancy. MUAC can be used to assess adolescent pregnancy complications.

A risk score for the prognosis prediction of the muscle-invasive bladder cancer patients who received gemcitabine plus cisplatin chemotherapy.

To develop an individualized gene-based risk score to predict the prognosis of muscle-invasive bladder cancer (MIBC) patients who received GC regimens. We downloaded transcriptome profiling data and clinical information from the Cancer Genome Atlas (TCGA) database. We identified 1854 survival-associated genes and then constructed the risk score based on six special genes selected from the survival-associated genes. We divided patients into high-risk and low-risk groups according to the median risk score. High-risk patients have significantly poorer overall survival than low-risk patients (log-rank test chi-square = 38.08, p = 7e-10, C-index = 0.785, se = 0.032). The risk score was evaluated by Kaplan-Meier survival curve, time-dependent ROC curves, and C-index. Multivariate Cox regression and nomogram suggested that the risk score was an independent prognostic indicator. Gene set enrichment analysis indicated that the survival-associated genes were significantly enriched in immune-related terms. Among six special genes, CHPF2, TRAV26-2, and BTF3P12 were found to be immune-related genes. In conclusion, our risk score provided an indicator to predict the prognosis of MIBC patients who received GC regimens and potential immunotherapeutic targets for MIBC.

Relationship between Body Image and Anxiety Level during Menopause at Pintu Padang District Health Center Angkola Trunk 2022

Menopause is the last menstruation, one of the psychological aspects of changebody imageDuring menopause, it is certain that menopausal women become anxious about their bodies and form a body image about how their bodies are. The purpose of this study was to determine the relationship between body image and anxiety levels during menopause at the Pintu Padang Health Center, Batang Angkola District in 2022. This type of research uses descriptive correlation and the design of this study uses a cross sectional design, the population in this study isall postmenopausal women visiting the PuskesmasPintu Padang, Batang Angkola District from January to July onin 2022 as many as 300 people.The sampling technique was purposive sampling, the number of samples was 75 people. The instrument used was a body image questionnaire sheet and an anxiety level. Data analysis was carried out with univariate and bivariate using testchi square. The results showed that the body image of the majority of respondents was high as many as 42 people (56%), the anxiety level of the majority of respondents was not anxious as many as 53 people (70.7%). The results of statistical tests with chi square values obtained. As much as 0.000 <0.05, it means that there is a relationship between body image and anxiety levels during menopause at the Pintu Padang Health Center, Batang Angkola District in 2022. The conclusion of the study is that there is a relationship between body image and anxiety levels during menopause at the Pintu Padang Health Center, Batang Angkola District in 2022. It is recommended for health workers to play an active role in increasing the knowledge of menopausal women in order to know and be aware of the changes that occur.

Clinical Outcomes of Patients with TP53-Mutated AML after First Relapse or with Primary Refractory Disease: Results from Consortium on Myeloid Malignancies and Neoplastic Diseases (COMMAND)

BackgroundTP53-mutated (m) acute myeloid leukemia (AML) is a high-risk disease with sub-optimal response to conventional therapies and portends a particularly worse outcome in patients with relapsed or refractory disease. In this study we analyzed the outcomes of patients with TP53m AML after first relapse or after primary induction failure. Methods We conducted this retrospective study through COMMAND (Consortium on Myeloid Malignancies and Neoplastic Diseases), a collaboration involving 10 US academic institutions. 366 patients with TP53m AML diagnosed between 2012-2021 were evaluated with 151 patients who had either primary refractory (87 [58%]) or relapsed (64 [42%]) disease and received further care, were the subject of this study. Continuous variables were summarized as median (range), while categorical variables were reported as frequency (percentage). Predictors of treatment response were assessed by Chi-square or Fisher's exact test for nominal data and Wilcoxon rank-sum test for continuous variables. Event free survival (EFS) was estimated from time of diagnosis to progression or death. Overall survival (OS) from the date of first salvage until last follow up or death was evaluated by the Kaplan-Meier method with differences compared by the log-rank test. Cox proportional hazards regression models were used to find the univariate and multivariate predictors of OS. Multivariable models included all significant univariate predictors with p value <0.1. Results Baseline characteristics Baseline characteristics and treatment outcome are summarized in Table 1. The median age of the patients was 64 (range [R], 18-84) years and 59 (39%) patients were > 65 years of age. 21% of patients had therapy-related AML, 86% had complex cytogenetics (CG) and 9% of these patients had erythroid leukemia. Twenty-one (14%) patients relapsed after allogeneic stem cell transplantation (alloHCT). Co-mutations were observed in 45% of patients with the most frequently occurring (≥ 5% of patients) being ASXL1 (5%), TET2 (7%), DNMT3A (8%), RUNX1 (7%), RAS (7%), and JAK2 (8%) mutations. Salvage therapies were venetoclax-based (with hypomethylating agent [HMA] or low dose cytarabine [LDAC]) (46%), HMA +/- investigational agent (20.5%), intensive chemotherapy (IC; excluding CPX-351) (17%), other low intensity +/- investigational agent (11%) and CPX-351 (6%). Responses The rate of complete remission (CR) with or without count recovery (CRi) was 24% (n= 35) and 13% (n=20) were able to receive alloHCT after achieving response. We evaluated predictors of response (CR/CRi) using baseline variables. Age > 65 yrs (23% vs 77%, p=0.03) and secondary AML (15% vs 85%, p= 0.02) were significantly associated with an inferior response rate. Remaining variables were not significantly associated with response to salvage therapy. Survival The median EFS was 3.97 months (95% CI: 31.5-4.78) and median OS was 4.37 months (95% confidence interval [CI]: 3.58-5.15) (Figure 1a). In sub-group analysis, median OS (in months) based on salvage therapy was 3.23, 5.20, 3.93, 3.37 and 2.83 with venetoclax based, HMA +/- investigational agent, IC, other low intensity +/- investigational agent and CPX-351, respectively (p= 0.16) (Figure 1b). We did multivariate analysis (MVA) for OS, utilizing univariate predictors with p value <0.1. Achievement of CR/CRi (hazard ratio [HR]=0.57, 95% CI: 0.36-0.91; p=0.01) and alloHCT after salvage therapy (HR=0.45, 95% CI: 0.24-0.75; p= 0.03) retained significance for better OS. Complex CG (HR=1.83, 95% CI: 1.05-3.17; p= 0.03) and diagnosis of erythroid leukemia (HR=2.25, 95% CI: 1.22-4.17; p= 0.009) retained significance for inferior OS in MVA. Conclusion As expected, our study confirms the dismal outcome of patients with TP53m AML progressing on first line therapy, however alloHCT can significantly improve outcome even after salvage therapy in a subset of patients who achieve response and are eligible for alloHCT. Effective therapies are urgently needed to improve outcome of patients with TP53m AML. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

EPIDEMIOLOGY, PREDISPOSING FACTORS AND OUTCOME OF STAPHYLOCOCCUS AUREUS BACTEREMIA IN NEUTROPENIC PATIENTS

Staphylococcus aureus is a common cause of bloodstream infection in neutropenic patients. We analyzed trends in incidence, epidemiology, predisposing factors and outcome of S. aureus bacteremia (SAB) in febrile neutropenic patients. We reviewed a database of febrile neutropenia at a single institution in Brazil in a 30-year period (January 1991 to December 2020). We divided in 3 periods: 1991-1994 (period 1), 2001-2010 (period 2) and 2011-2020 (period 3), and looked at incidence rates, risk factors and mortality. Risk factors and prognostic factors were evaluated by univariate (Fisher or Chi-square for categorical variables and Wilcoxon test for continuous variables) and multivariate (logistic regression) analysis. We diagnosed 62 (3%) episodes of SAB in 2,243 episodes of febrile neutropenia, 23 (38%) of which were caused by methicillin-resistant S. aureus (MRSA). The incidence of SAB per 1,000 days of neutropenia was 1.57, 2.53 and 1.50 in periods 1, 2 and 3, respectively (p > 0.05), and of MRSA was 0.49, 0.84 and 1.07, respectively (p > 0.05). Most infections (70%) were diagnosed in the first day of fever and the clinical presentation were skin infection (19%), catheter-related infection (14%) and pneumonia (3%). Complications like endocarditis or osteomyelitis were not observed. The only factor associated with S. aureus bacteremia by multivariate analysis was cellulitis at site of catheter exit site or tunnel on day 1 of fever (odds ratio [OR] 4.34, 95% confidence interval [CI] 2.05 – 9.16), whereas quinolone prophylaxis was protective (OR 0.37, 95% CI 0.18 - 0.74). The crude mortality of SAB was 30.6%, compared 13.8% in patients without this infection (p < 0.001). However, early mortality (within 3 days of start of empiric antibiotic therapy) was not significantly different (4.8% vs. 1.9%, p = 0.08). The mortality with MRSA was higher than with methicillin-susceptible S. aureus (47.8% vs. 13.9%, p < 0.001), but no difference was found regarding early mortality (5.0 vs 1.7%, p = 0.27). Among various predictors of death during febrile neutropenia MRSA bacteremia (but not methicillin-sensitive) was associated with an increased risk of death by multivariate analysis. The median time from febrile neutropenia to death in MRSA episodes was 19 days. The incidence of SAB over the period remained stable. Complication of SAB were not common. Although the crude mortality was higher with SAB (including MRSA), it was not associated with early deaths, thus not demanding anti-staphylococcal coverage in the first day of febrile neutropenia. MRSA bacteremia was associated with increased risk of death, with most deaths occurring after 2 weeks of febrile neutropenia.

Risks of Hemorrhage and Poor Clinical Outcome in SLE with Thrombocytopenia at Dr. Sardjito Hospital

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that affects various body organs and causes chronic inflammation. Thrombocytopenia is common in SLE, and there is a risk of causing bleeding, which can result in death. This study aimed to analyze the relationship of thrombocytopenia with bleeding and poor clinical outcomes in SLE patients at Dr. Sardjito Hospital. The design of this study was retrospective observational analytic. The research subjects were patients diagnosed with SLE at Dr. Sardjito Hospital from January 2016-December 2019 who conducted ANA and anti-dsDNA examinations. Statistical analysis using MedCalc version 13.0. Receiver operating characteristic curve analysis to determine the cut-off value of the platelet count for the occurrence of bleeding. Chi-Square for trend test to determine the relationship between the degree of thrombocytopenia and the degree of bleeding. Kaplan-Meier test to determine the six months survival analysis for SLE patients. There were 61 SLE patients at Dr. Sardjito Hospital. Thirty-two patients (52.5%) had thrombocytopenia. The AUC of the platelet count for the occurrence of hemorrhage was 0.988 (95% CI=0.918-1, p &lt; 0.0001), the cut-off value was 146x103/L, sensitivity 100%, specificity 90.6%, and LR+ 10.33. The AUC of the platelet count for grade 3 hemorrhage was 0.929 (95% CI=0.833-0.979, p &lt; 0.0001), cut-off value 91x103/L, sensitivity 100%, specificity 89.3%, and LR+ 9.33. Hemorrhage was seen in 29 subjects with thrombocytopenia. Five subjects (8.2%) died, with a significant difference in the mortality of SLE patients with and without thrombocytopenia in the six months survival analysis (p=0.028). The risk of hemorrhage and poor clinical outcome (death) were significantly higher in SLE patients with thrombocytopenia and increased with the thrombocytopenia grade.

Factors Related To The Implementation Of Communication With The Sisbar Method ( Salam Introduction Situation Background Assessment Recommendation ) At Medical-Surgical Wards In Santosa Hospital Bandung Central

This study focus on is there any connection between factors ( age , gender , length of work and origin room ) with implementation communication with the SISBAR (Salam Introduction Situation Background Assessment Recommendation) method. This Study use cross sectional design. Sample of this study is the total sample nurse in charge who implementation SISBAR communication (West Safir , East Safir , West Berlian and Mutiara wards) in Santosa Hospital Bandung Central that fulfills inclusion criteria sample totaling 44 nurses.The method used total sampling technique that whole population made sample on this research. Analysis bivariate used for seeing connection between 2 variables (independent and dependent). Analysis is conducted for see meaningful relationship by statistics, use statistical test Chi Square with level 95% confidence (?=0.05).Analysis test results statistics using the Chi Square test obtained p-Value: 0.048 (variable age ), 0.004 (variable education ) and 0.011 (variable length of work ), while the other two factors are not connection with p value for each of these factors is 1,000 (variable type gender ) and 0.791 ( original variable room ). It means there is connection between the variables of age , education and length of work, whereas variable gender and origin room is no relationship with implementation communication effective with SISBAR method between nurses and doctors.SISBAR communication can be developed and enhanced for effective communication between nurses and doctors in other hospitals in Indonesia with pay attention to the factors that influence it.

Hubungan Tingkat Pengetahuan dan Sikap dengan Praktik Penggunaan Masker pada Lansia

Background: The trend of Covid-19 in Indonesia continues showing positive result, the government then starting to change the status from pandemic to endemic. The Indoensian government made a policy of easing the use of masks for the community not including vulnerable groups like elderly. However, there are elderly who still do not wear masks. The purpose of this study was analyzing the relation between individual characteristics, level of knowledge, and attitudes with the practice of using masks in the elderly in Wonogiri District.Methods: This research is an analytic observational research with a cross sectional study design. The research subjects were 105 elderly respondents from 15 sub-districts in Wonogiri District. The sampling technique is quota sampling. Data collection using questionnaire with interview method. Test data analysis using test chi-square.Result: The outcome of this study show indicate that there is a significant relation between level of knowledge (p=0.001) and attitude (p=0.005) with the practice of using face mask among elderly.Conclusion : It can be concluded that individual, level of knowledge, and attitude are related with the practice of using face mask among elderly. Increased socialization related to the policy of easing masks and educating people on how to use masks properly.

RELATIONSHIP BETWEEN NUMBER AND REGION OF TOOTH LOSS WITH THE QUALITY OF LIFE IN THE ELDERLY.

Background: Prevalence of tooth loss due to extraction is highest in the elderly aged 65 years and over. Tooth loss means loss of tooth function therefore it affects the quality of life. It seems a reflection of a person's comfort and disability in terms of limited physical, psychological, and social functions. The aim of this study was to determine the relationship between number and region of tooth loss with the quality of life in the elderly at the Margo Mukti Elderly Social Service Home, Rembang. Method: Research design was observational study with cross sectional approach. Sample size was 58 elderly people taken from the total population of 300 elderly who live at social services home. Data was collected by examining the number and region of tooth loss followed by interviews using the Oral Health Impact Profile (OHIP-14) questionnaire. Data analysis was performed by univariate and bivariate analysis, using the test chi square and Kolmogorov Spirnov to determine the relationship between independent and dependent variables. Result: The results showed significance of statistical was found at relation number and region of tooth loss with quality of life (0.006). The highest number of tooth loss was in the range of 6-23 teeth. Anterior region was the most tooth lost. Most of elderly (67.2%) have good quality of life. Conclusion: There is relationship between number and region of tooth loss with quality of life related to oral health