Universitas Sumatera Utara Hospital Research Articles

Susbstance P Levels in Children with Atopic Dermatitis

Background: Atopic dermatitis (AD) is the most common skin disease in infants and children. AD is influenced by hereditary and environmental factors, and it is characterized by an inflammatory reaction in the skin. In developing countries, children suffering from AD are estimated around 10–20%, of which 60% of the cases persist into adulthood. Substance P is a cutaneous neuropeptide that contributes to the pathogenesis of AD. Substance P promotes the production of nerve growth factors from keratinocytes, and the release of histamine, leukotriene, or tumor necrosis factor from mast cells, which cause the growth of sensory nerve fibers, augmentation of skin inflammation, and are considered pruritogenic factors. Purpose: This study aims to determine the description of substance P in children with atopic dermatitis using a descriptive observational study with a cross-sectional approach. Methods: This is a destructive observational study with a crossectional approach samples were selected from AD patients at the Universitas Sumatera Utara Hospital. Result: The largest group of subjects were childhood (2–12 years old), there was 60%, followed by the adolescent group (12–18 years old) and the infant group (<2 years old). In the childhood group, the highest level of substance P was found in girls with a mean of 349.03 ± 146.7. On the other hand, the highest levels of substance P in the adolescent were found in males with a mean of 243.73 ± 64.57 ng/L. Conclusion: In this study, we found that the level of substance p was higher in the childhood group.

Learning Achievement Level in Children with Helicobacter Pylori Gastritis

Most children with H.pylori gastritis suffered from recurrent abdominal pain (RAP) that disrupted their activities. RAP has become 10 ? 20% cause of non-attendance at school and disrupted leaning process in children resulted in lower learning achievement level. This research aims to assess learning achievement level in children with H. pylori gastritis. It was an observational analytical study with a cross-sectional approach in Gastroenterology Polyclinic Haji Adam Malik general hospital, Universitas Sumatera Utara hospital, and the network hospitals from October 2019 to July 2020. Research subjects who met the inclusion and exclusion criteria underwent physical examination, and gastroscopy and CLO tests. Interviews were carried out to obtain basic characteristic data that was relevant to children?s learning achievement level. Fisher?s exact statistical test and multivariate analysis were carried out to assess learning achievement level in children with H. pylori gastritis. There was a significant relationship (p=0.015) between H. pylori gastritis and learning achievement level with OR value 5.992 (95% CI: 1.307 ? 26.837).

Outcome benefits to transurethral resection of the prostate in patients with benign prostatic hyperplasia at Medan regional hospital

Background: Benign prostatic hyperplasia (BPH) is a pathologic process that cause of lower urinary tract symptoms (LUTS) in aging men. Transurethral resection of the prostate (TURP) is still the current gold standard of BPH treatment. International Prostate Symptoms Score (IPSS) and the quality of life (QoL) index are used for assessing the TURP results.Objective: This study would like to show the benefits outcome of TURP in patients with BPH evaluated with IPSS score and QoL index in Medan regional hospital.Methods: This research is a retrospective study of BPH patients that is treated with TURP at Universitas Sumatera Utara Hospital from September 2019 – August 2020. Patients will be divided into 2 groups, group 1 with patients who have a prostate size <80 grams and the second group with a prostate size> 80 grams. All patients who were included in this study were assessed for their complaints using the IPSS and QoL index before and after taking an operation. Statistical analysis was performed using independent t test and Mann Whitney test. The data were significant if the p value < 0.05. Results: There are 60 patients enrolled in this study that treated with TURP. The mean age of patients in the group 1 was 69.57 ± 7.698 years and 69.84 ± 5.893 years in the group 2. There is no significant difference between group 1 and group 2 in postoperative IPSS and QoL results (p >0.05). Conclusion: TURP procedure is preferable option of BPH for patients in any prostate size.

Differences of Lower Urinary Tract Symptoms Degree In Benign Prostatic Hyperplasia Patients With and Without Diabetes Mellitus

Background. Benign Prostatic Hyperplasia (BPH) is a benign tumor that most often occurs in men. Many risk factors could cause BPH, one of which is diabetes mellitus (DM). Diabetes mellitus (DM) is a metabolic disease, characterized by hyperglycemia. Method. This study was conducted at the Urology Polyclinic of the Universitas Sumatera Utara Hospital from August to September 2019. A total of 102 patients diagnosed with BPH were registered by cross-sectional study approach. Detailed medical history and physical examination were performed for all patients to diagnose BPH. While the diagnosis of DM was according to patient history or diabetic-medicine use. International Prostate Symptom Score (IPSS) were completed by all patients to obtain a LUTS degree. Result. From a total of 102 patients diagnosed with BPH there were 97 patients were selected. The mean age of patients was 70.43 ± 7.52 year (range 50-88 year) and the total IPSS score was 17.55 ± 6.55. DM patients were more likely to report severe LUTS and the symptom score evaluated with IPSS was significantly higher than in non non-DM group: 21.69 ± 5.41 vs 16.70 ± 6.41 (p=0.005). For the IPSS subscores, the DM group also show higher storage: 8.38 ± 4.57 vs 5.88 ± 3.72 (p = 0.02), voiding: 9.69 ± 2.47 vs 8.14 ± 3.21, (p= 0.039) and post micturition: 3.63 ± 1.26 vs 2.69 ± 1.744, (p= 0.045) symptoms significantly. Conclusion: Benign Prostatic Hyperplasia patients with DM manifested more severe lower urinary tract symptoms. Storage, voiding, post micturition, and urgency symptoms were also greater.

The Role of Early Initiation of Breastfeeding in the Duration of the Third Stage of Delivery and the Amount of Blood Loss in the Fourth Stage in Spontaneous Vaginal Delivery

Aims: To determine the effect of Early Initiation of Breastfeeding (EIBF) in the third stage of labor and the amount of blood loss in the forth stage of delivery.
 Methods: An experimental study comparing the duration of 3rd stage and the amount of blood loss in 4th stage in Early Initiation of Breastfeeding (EIBF), oxytocin administration, and Early Initiation of Breastfeeding (IBF) given oxytocin at spontaneous vaginal delivery in delivery room of H. Adam Malik General Hospital, Dr. Pirngadi Hospital, Sundari Hospital and Universitas Sumatera Utara Hospital starting from March 2019 until the minimum sample was met.
 Results: The data analysis results of the comparison of duration demonstrated p-value of 0.001The comparison among groups with post hoc analysis showed a meaningful comparison in this analysis with p value of 0.001, while duration of the3rd stage in group B compared to group C statistically did not show any significant difference with p value of 1.00. The mean of amount of blood loss among groups A, B, and C respectively were 139 ± 11.8, 141.8 ± 12.4 and 132.1 ± 14.4 with p value 0.048.
 Conclusions: It is concluded that the amount of blood loss in the fourth stage among the groups was not significantly different in each group. Comparisons of the amount of bleeding in group A vs. B, A vs. C and B vs. C are indicated by the p value of each group i.e. 1.0; 0184 and 0.059.

Identification of the type of Human Papilloma Virus (HPV) in condyloma acuminata in the genital and/or anal areas in men who have sex with men (MSM)

Background: Condyloma acuminata is a sexually transmitted infection (STI) caused by the Human Papilloma Virus (HPV), marked by mucosal and skin hyperplasia, especially in the anogenital areas. HPV is transmitted by sexual intercourse. The incidence of condyloma acuminata in men who sex with men (MSM) increases due to the variations in genito-anal sexual intercourse. This study determined the type of HPV in condyloma acuminata in the genital and/or anal area in MSM.Methods: This study was a descriptive observational study with a cross sectional approach in 25 MSM subjects with condyloma acuminata at the Dermatology and Venereology outpatient clinic of Haji Adam Malik General Hospital Medan and Universitas Sumatera Utara Hospital from June 2020 to February 2021. Subjects were selected by consecutive sampling. The samples of condyloma acuminata were collected by a shave biopsy technique, followed by examining the DNA type of HPV using the PCR method. We collected the demographic data (age, education level, employment, condyloma acuminata location, and condyloma acuminata lesion shaped) and then presented it in the descriptive.Results: From 25 men who had condyloma acuminata in this study, most of them (14 people or 56%) were 19-26 years old and unmarried with homosexual orientation. Fifteen people (60%) graduated from high school, and 21 respondents (84%) worked as employees. The most locations of condyloma acuminata on the anal area as many as 16 people (64%), the most common characteristic of the lesion was acuminatum, found in 16 people (64%), and the most common type of HPV was HPV type 11 in 13 people (52%). In the genital areas and anal areas, the most common type of HPV was HPV type 11 in 4 people (44,4%) and nine people (56,2%). The most characteristic lesions in the genital area were papule in 7 people (77,8%), and in the anal area were acuminatum in 14 people (87,5%).Conclusion: The most common type of HPV in condyloma acuminata in the genital area and anal area in MSM were HPV type 11. The characteristic of condyloma acuminata lesions in the genital area in MSM was mostly papule, whereas in the anal area was acuminatum.

Assessment of Healthcare Professional’s Knowledge, Skills, Motivation, and Commitment to Clinical Pathways Implementation

BACKGROUND: Healthcare providers are facing challenges to deliver qualified and efficient health services in response to the current health system. Clinical pathways (CPs) are a tool to achieve the best clinical outcomes at the lowest cost. The implementation should be supported by healthcare professional’s capacity involved in the process. AIM: The aim of the study was to assess healthcare professionals’ knowledge, skills, motivation, and commitment to clinical pathways (CPs) implementation in Universitas Sumatera Utara (USU) Hospital. METHODS: This cross-sectional study was conducted at USU Hospital with 65 healthcare professionals as participants who consist of 10 specialist doctors, 50 nurses, and 5 pharmacists. These participants were selected using quota sampling and interviewed using a developed and structured questionnaire. This questionnaire was tested for its validity and reliability with r > 0.5 and Cronbach’s Alpha > 0.6. Pearson correlation test with p < 0.05 was used for analyzing the relationship among variables on CPs implementation. RESULTS: The healthcare professionals in USU Hospital had high knowledge, motivation, and commitment, but moderate skills in CPs implementation. There were positive correlations between knowledge and skill (p = 0.039), motivation and skill (p = 0.001), commitment and skill (p = 0.001), and motivation and commitment (p = 0.001) on CPs implementation. CONCLUSION: USU Hospital healthcare professional’s knowledge, motivation, and commitment to CPs implementation were adequate, but their skills were moderate. The motivation is substantially related to the healthcare professional’s commitment to CPs implementation. This study recommended the hospital explore and grow skills in communication, coordination, and affective commitment among individuals, teamwork, and leaders for the sake of willingness to achieve the values or goals of the CP implementation in their organization.

Analysis implementation of code blue service towards early warning system in Universitas Sumatera Utara Hospital, Medan-Indonesia

Introduction: Since its operation in 2016, the Universitas Sumatera Utara Hospital (USU Hospital) has implemented Medical Services for patients with cardiac arrest conditions by forming a Code Blue team. Based on data in 2018, the number of patients who received the Code Blue emergency was 240 patients. There are still many cardiac arrest events at USU Hospital, it is necessary to evaluate the implementation of the Code Blue services and create an early warning system (EWS) for patients who are potentially in cardiac arrest to prevent high cardiac arrest cases that will economically harm USU Hospital.Method: We analyze the secondary data from the Medical Record, an interview with the code blue team, and an analysis of the resuscitation form that has been completed.Result: The results of the study (n=30) which experienced the most stop breathing and cardiac arrest before the implementation of EWS were chronic diseases with 63.3% (n=19) and after the implementation of EWS there were still chronic diseases with 56.7% (n=17). A paired t-test was conducted with the result that code blue services on the numeric response time parameter was different in response time of 0.266 minutes after the implementation of EWS services (p=0.354). Meanwhile related to the length of time for cardiopulmonary resuscitation(CPR) there is a time difference of 10,767 minutes after the implementation of EWS services, (p=0.000).Conclusion: Interpretation of EWS implementation can affect the time of the CPR performed because the worsening condition of the patient has been monitored before respiratory and cardiac arrest occurred. The conclusion of making an early warning system (EWS) at USU Hospital can be immediately implemented as stated in the guidelines as a form of service in medical and nursing services.

Impacts of Pharmacy Intervention on Appropriateness of Antibiotics Use in Pneumonia Patients

AIM: This study analyzed the impact of pharmacy intervention on appropriateness of antibiotics use in the treatment of inpatients with pneumonia admitted to Universitas Sumatera Utara (USU) Hospital, Medan, Indonesia. METHODS: This cohort study analyzed appropriateness of antibiotic use in the treatment of in-patients with pneumonia without interventions or baseline group (n = 33) admitted to USU Hospital year 2018 and 3-month period admission with pharmacy intervention (n = 42) year 2019. Characteristics of the patients and antibiotics provided to both groups were descriptively analyzed. The appropriateness of antibiotics use in both groups was analyzed based on their medical conditions, culture and sensitivity tests, and trustable literatures, and then categorized applying Gyssens method regarding dose, intervals, routes, length of provision, effectivity, and costs. The significant difference in inappropriate use of antibiotics between groups with and without interventions was analyzed applying unpaired t-test (p < 0.05 was considered statistically significant). RESULTS: Most of the pneumonia patients in both groups were male. Mean age of the patients (years) in group: without intervention, 60.20 ± 15.48; with intervention, 60.48 ± 14.76. The three most widely provided antibiotics were ceftriaxone, meropenem, and ciprofloxacin. Incidence of inappropriate use of antibiotics per patient in group: without intervention, 0.66; with intervention, 0.33. The inappropriate use of antibiotics reduced significantly in group with intervention, p = 0.049. CONCLUSIONS: Pharmacy intervention is crucial to reduce the inappropriate use of antibiotics in the treatment of pneumonia.

The Relationship between Glycated Hemoglobin Levels and the Quality of Life among Type 1 Diabetes Mellitus in Children

BACKGROUND: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia that occurs due to impaired both in insulin secretion and insulin action. Children with type 1 diabetes mellitus should be targeted to achieve a glycated hemoglobin (HbA1C) level ≤7.0% to reduce the risk of complications and improve quality of life. The majority of children with type 1 diabetes mellitus exhibit poor self-care and Health-related Quality of life behavior. AIM: The objective of the study was to determine the relationship between HbA1C level and the quality of life among type 1 diabetes mellitus in children. METHODS: A cross-sectional study was conducted among 30 children with type 1 diabetes mellitus who attended at pediatric endocrine clinic Haji Adam Malik general hospital and Universitas Sumatera Utara hospital Medan. Sampling was carried out in April 2020–July 2020. HbA1C level and self-administered questionnaire were used to assess the quality of life. Spearman correlation test was conducted to assess the correlation between HbA1C levels and the quality of life. RESULTS: The mean of HbA1C level was 10.35 ± 2.68. No significant correlation between HbA1C level and the quality of life of children with type 1 diabetes mellitus (r = 0.264, p > 0.05) CONCLUSIONS: There was no significant correlation between HbA1C levels and the quality of life of children with type 1 diabetes mellitus.

Prolonged Indwelling Foley Catheter Use in Post-operative Gynecology Patient Associated with an Increased Incidence of Urinary Tract Infections

BACKGROUND: Urinary tract infection (UTI) is one of the common conditions and significantly contributes to expensive health treatment and associated with gynecological surgery which increases the cases up to 50% in women undergoing specific reconstructive procedures. Besides that, one indicator of surgical quality was post-operative UTI occurrence. AIM: This study aims to assess the relationship between Foley catheter usage and UTIs after gynecological surgery with a urinary catheter. METHODS: A total of 48 subjects examined at the Department of Obstetrics and Gynecology, Universitas Sumatera Utara Hospital, and Haji Adam Malik General Hospital, Medan, from June to September 2020. Subjects were performed urinalysis 8 days after surgery, or earlier if UTI symptoms occur. Personal data and illness data were taken from medical records. Statistical analysis was done using the Chi-square-based test. RESULTS: There was a significant difference of urine leukocytes in subjects with indwelled catheter for 24–36 h compared to subjects with 36–48 h of catheterization (p = 0.01). The 36–48 h group has a 2.15 odds of developing UTI compared to 24–36 h group (p = 0.01). CONCLUSION: This study found that prolonged indwelling Foley catheter usage may increase the risk of UTI after gynecology surgery.

Factors Related to Anxiety Scores in Diabetes Mellitus Outpatients at the Universitas Sumatera Utara Hospital

Background: Diabetes mellitus (DM) is a serious chronic disease, caused by the inability of the pancreas to produce enough insulin. It is estimated that people with diabetic are at twice the risk of anxiety compared to the general population. Diabetic patients with anxiety has been related to increasing risk of comorbidities, which can interfere with daily living activities, and life quality, increased health costs, and many other complication when compared with the general population.
 Method: This study is a predictive type multivariate study, with a cross-sectional approach to 111 subjects in the outpatient clinic of Universitas Sumatera Utara hospital. The tests carried out in this study were the bivariate test, multivariate linear regression test to determine what factors are related to anxiety scores in DM patients, using the Hospital Anxiety and Depression Scale (HADS-A) as measurement tool.
 Results: After conducting the multivariate analysis test, it was found that the variables associated with anxiety scores in people with DM were length of education (p <0.001), Body Mass Index (p <0.001), duration of illness (p <0.001), work status (p <0.001), comorbidity (p = 0.021).
 Conclusion: By knowing the factors that influence anxiety scores in people with DM, it is hoped that clinicians will pay more attention to the symptoms of anxiety in people with DM, especially in the early days of diagnosis so that intervention can be carried out.

Female Caregivers Stress in Caring for Hospitalized Elderly with Chronic Disease at Universitas Sumatera Utara Hospital: A Phenomenology Study

The elderly is prone to suffer from physical illness and experience hospitalization due to physiological decline. Researches showed that the majority of the family caregivers are females, who are responsible for the caregiving delivery.This study aims to explore the female caregiver stress caring for hospitalized elderly with chronic illness at USU Hospital, Medan. This research is a qualitative study with a phenomenological approach. The sampling technique was the purposive sampling method with several criteria; female with mild to high stress level, the prominent caregivers in the family, and had been caring the elderly for more than 1 year. The female caregivers would be assessed for stress levels with the Zarit Burden Inventory instrument, which is commonly used to assess the stress burden of caregivers caring for the elderly. The data collection is conducted through in-depth interview. The data are transcribed and analysis for sub-theme and theme. The research result found nine participants with an age range of 32-67 years. All participants are the elderly daughter’s and spouses. The stress score is 15-25 which means that the participants are experiencing mild-moderate to severe stress ranges. The thematic analysis revealed four main themes namely; (1) Financing elderly, (2) Caregiver fatigue, (3) Experiencing negative relationship, and (4) Indonesian culture associated with female gender. According to the research result, it should be a basis data for further research related to the elderly caregivers. Therefore, the need for the specific interventions is provided for the elderly and the caregivers who are vulnerable to stressful conditions.

The relationship between solid medical waste knowledge with attitudes and behaviors of students in Medical Professional Education Program (P3D) Faculty of Medicine, Universitas Sumatera Utara

Healthcare workers in hospitals are vulnerable to risks associated with solid medical waste, such as used unsterile needles. This study aims to explain the relationship between knowledge with attitudes and behavior of students and solid medical waste knowledge. This was a descriptive-analytic study with consecutive sampling method, conducted from June to December 2018 on students of the medical professional education program at the Universitas Sumatera Utara Hospital. A questionnaire was performed to test the data validity and reliability, whereas the data was statistically analyzed using the Fisher Exact test. A total of 50 students consisting of 31 women (62%) and 19 men (38%), the majority were aged 22-23 years as many as 40 students (80%). On average, 26 students (52%) had a moderate level of knowledge, but more students had good attitudes and behaviors, that is 39 people (78%) and 33 people (66%), respectively. There is no relationship between knowledge about solid medical waste with the attitudes and behavior of students in the medical professional education program, with p-values = 0.227 (p> 0.05) and p-values = 0.217 (p> 0.05), respectively.

Trabeculectomy in Staphyloma Eye with High Intraocular Pressure Following Ocular Trauma – A Case Report

BACKGROUND: Ocular trauma may alter the anterior segment condition that may lead to secondary glaucomas such as inflammation, hyphema, angle recession, and lens subluxation. One of the most common procedures to decrease intraocular pressure (IOP) is trabeculectomy by creating pathways that allow aqueous humor to flow out of the anterior chamber. Scleral tissue destruction can cause damage in thin areas (such as posterior to the rectus muscle insertions) as in case of scleritis. CASE REPORT: An 11-year-old boy presented to the Ophthalmology Department of Universitas Sumatera Utara Hospital with a bigger white grayish mass and blurry vision. There was a history of the left ocular trauma 6 years ago, followed by redness of the eye, but not treated properly. On the general examination, the patient’s left eyes looked cloudy. On ocular examination, the left eye visual acuity was 1/300 and IOP was 28 mmHg. Segment anterior examination showed staphyloma from 9 to 12 o’clock, conjunctival injection, corneal scar, shallow anterior chamber, and cloudy lens. We could not asses the posterior segment due to cloudy media. We gave anti-glaucoma medication for 1 month, but the IOP did not decrease. We performed a trabeculectomy to control IOP and to prevent staphyloma from getting bigger. CONCLUSION: Trabeculectomy was an effective procedure to control IOP in a staphyloma eye following ocular trauma.

Analysis of Glycemic Control and Low-Density Lipoprotein Cholesterol with Glaucomatous Optic Neuropathy as a Microvascular Complication in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study in North Sumatera, Indonesia

BACKGROUND: Diabetes mellitus (DM) is an important health problem that induces microvascular complication such as retinopathy, nephropathy, and neuropathy. Ocular complications associated with type 2 DM are progressive and rapidly becoming the world’s most significant cause of morbidity and preventable with early detection and timely treatment. AIM: This study to analyze of glycemic control and low-density lipoprotein cholesterol (LDL-C) with glaucomatous optic neuropathy as a microvascular complication in patients with type 2 DM. MATERIALS AND METHODS: A prospective, analytical observational with cross-sectional study was conducted in Universitas Sumatera Utara Hospital and Satellite Hospital, Medan, Indonesia, from April 2020 to August 2020. The study included 66 participants with type 2 DM. The patients were investigated for hemoglobin A1c (HbA1c) level, LDL-C level, and ophthalmology examination including visual acuity (VA), intraocular pressure (IOP) measurement by Goldmann Applanation Tonometer, retinal nerve fiber layer (RNFL) thickness with spectral domain Optovue optical coherence tomography, and visual field defect with Octopus Perimeter. RESULTS: This study showed a significant correlation between HbA1c with VA (p = 0.030), IOP (p = 0.035), RNFL thickness (p = 0.002), visual field defect (p = 0.032), and duration of DM (p = 0.003) and showed significant correlation between LDL-C with VA (p = 0.048), IOP (p = 0.006), and duration of DM (p = 0.042). CONCLUSION: Higher HbA1c and LDL-C correlated with Glaucomatous Optic Neuropathy as a microvascular complication in type 2 DM. Advantage of research is still rarely studied.

A Rare Case of Waardenburg-Shah Syndrome without Family History

BACKGROUND: Waardenburg syndrome (WS) is an uncommon genetic disorder that is most often characterized by pigmentary disturbance and lateral displacement of inner iris with variety of sensorineural deafness. The prevalence of this syndrome is about 1/42.000–1/50.000 on population. There are approximately 48 cases of WS with Hirschsprung disease (HD) which were being reported up to 2002. CASE REPORTS: A 7-year-old, Asian boy, routine patient of Pediatric-Surgery Department with HD was transferred from Pediatric-Surgery Department of Haji Adam Malik Hospital Medan to Ophthalmology Department of Universitas Sumatera Utara Hospital Medan with progressive abdominal distance and first ophthalmic evaluation. The patient is accompanied by a history of Hirschsprung disease, malnutrition, and sensorineural hearing loss. There was no family history being discovered. He is responding to visual command. Anterior segment examination showed that there were two different colors of iris – blue colored of the whole left iris and partial right iris. Fundoscopy showed pale retina on both eyes. CONCLUSION: This patient is diagnosed with Waardenburg-Shah syndrome type IV. It is directly reality with a kind of other congenital disease like HD and no further treatment is needed.

Correlation between the stress scale with cortisol levels in leprosy patients

Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae) that causes a complex problem. Stress can trigger several physiological responses, including the endocrine, nervous, and immune systems. In leprosy patients, stimulation in the form of infection and cytokine secretion lasts a long time, causing adrenal exhaustion, resulting in decreased serum cortisol production. This study aims to determine the correlation between the stress scale and cortisol levels in leprosy patients.Methods: This was a cross-sectional analytic correlation study with a consecutive sampling method. The research subjects were obtained from the Dermatology and Venereology Polyclinic of Universitas Sumatera Utara Hospital and the Dermatology and Venereology Polyclinic of Dr. Pirngadi Hospital Medan from March until November 2020. The research variables consisted of a stress scale and cortisol levels. Data analysis using the Spearman test. P-value <0.05 was significant. The study was conducted after approval from the Ethics Committee Faculty of Medicine, Universitas Sumatra Utara.Result: A total of 35 patients enrolled in the study, the majority had characteristics of the male gender, multibacillary type of leprosy, duration of leprosy in the group > 12 months, with a median age of 36 (19 - 79) years. The mean stress scale was 15.17 ± 6.3, with the mild stress scale was the most common. The median cortisol levels were 9.5 (4 – 20,8) g/dl, which was still in the low category. The lowest median cortisol levels were found in the multibacillary type of leprosy, duration of leprosy in the group > 12 months, and severe stress scale. There was a significant moderate negative correlation between the stress scale and cortisol levels in leprosy patients (p = 0.017; r = -0.402).Conclusion: The heavier the stress scale, the lower the cortisol levels in leprosy patients.

Correlations of Maternal Serum Zinc Levels with Cord Blood Procollagen Type 1-N Terminal Propeptide Levels and Anthropometric Measurements of Newborns

Background: Zinc is an important micronutrient that is required for optimal fetal growth and development. Zinc deficiency during pregnancy may interfere with intrauterine fetal ossification. Fetal ossification can be measured with specific bone growth markers, such as procollagen type 1-N terminal propeptide (P1NP). This study aimed to investigate the mean maternal serum zinc levels and assess the correlations of maternal serum zinc levels with cord blood P1NP levels and anthropometric measurements of newborns. Methods: This cross-sectional study was conducted at Universitas Sumatera Utara Hospital and other hospitals in Medan, Indonesia, from April to October 2019. The statistical populations were pregnant mothers and their newborns who met the inclusion criteria. The participants were selected using a consecutive sampling technique. Maternal serum zinc levels and cord blood P1NP levels were measured before delivery; moreover, anthropometric measurements were conducted in this study. Results: A total of 42 subjects were included in this study with a mean maternal serum zinc level of 52.0±9.0 µg/dL. The proportion of pregnant mothers with low serum zinc levels was high (54.8%). According to the results, there was a significant correlation between maternal serum zinc levels and newborn birth weight (r=0.648) and length (r=0.656), as well as head circumference (r=0.578; P=0.001). There was also a significant and positive linear correlation between maternal serum zinc levels and cord blood P1NP levels (r=0.469; P=0.002). Conclusion: The mean maternal serum zinc levels during pregnancy were below normal. There were positive significant correlations between maternal serum zinc levels and cord blood P1NP levels with anthropometric measurements of newborns.

The role of cholelithiasis risk factors in stone types in cholelithiasis patients at Universitas Sumatera Utara Hospital

Introduction: Cholelithiasis is the most common disease in the biliary tract. Several risk factors have been known as risk factors of cholelithiasis, such as obesity and female gender. Meanwhile, only few studies evaluate correlation between clinical characteristics and stone type in cholelithiasis. The study aims to evaluate correlation between clinical characteristics and stone type in cholelithiasis patients at Universitas Sumatera Utara Hospital.Method: The study design was cross sectional. The sample of this study was 35 people with cholelithiasis patients who underwent cholecystectomy either by open or laparoscopic cholecystectomy at Universitas Sumatera Utara Hospital. Gallstones will be examined by a laboratory. Risk factors assessed were age, gender, body mass index, hemoglobin bilirubin, cholesterol levels. Data analysis will use the Kruskal Wallis test.Result: From 35 study samples was found the most types of stones were mixed stones with 17 (48.6%). Based on the Kruskal Wallis test found a significant relationship between the type of stone with gender, body mass index, total bilirubin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).Conclusion: Factors related to the type of cholelithiasis stone are gender, body mass index, bilirubin levels, total cholesterol levels, HDL-C, and LDL-C.