Wahidin Sudirohusodo General Hospital Research Articles

ANALISIS KING'S SCORE DI PENYAKIT HATI KRONIS BERDASARKAN FIBROSCAN

Chronic liver disease is a commonly found disease in Indonesia and remains a serious health problem. Chronic liver disease oftenprogresses to hepatic cirrhosis or hepatoma initiated by fibrotic process in liver. Liver biopsy result is a gold standard in determining theliver fibrosis degree, but it has some limitations. King's Score is a non-invasive method that uses routine laboratory predictors relatedto liver fibrosis. Therefore, it is necessary to know the diagnostic value of King's Score in determining the fibrosis degree of liver chronicdisease by using fibro scan as the gold standard in stead of biopsy. This study was a retrospective study with data collected from themedical records from the Medical Record Installation at the Dr. Wahidin Sudirohusodo General Hospital between January 2011 up toDecember 2013. The study results derived from 99 samples with Spearman correlation test showed a significant relationship between theKing's Score and fibrosis degree of chronic liver disease (p=0.000 and r=0.651). The analysis of the receiver operating characteristics(ROC) indicated that in mild and moderate fibrosis the AUC value was too weak, whereas in heavy fibrosis the AUC value was 0.860,which was statistically very strong with a cut-off value of 7.15 and with a 80.6% sensitivity, and a 75.0% specificity, Positive PredictiveValue59.5%, Negative Predictive Value 89.5%. This meant that the King's Score value of >7.15 could be used as a heavy fibrosis degreepredictor in chronic liver patients. Further studies are needed to analyze the King's Score based on chronic liver disease etiology and usea liver biopsy as the gold standard in determining the degree of liver fibrosis.

PERMINTAAN DARAH PERSIAPAN TINDAKAN BEDAH DI RSUP DR. WAHIDIN SUDIROHUSODO

Surgical procedures frequently need blood transfusion. However, the blood demand is frequently excessive without an appropriateneed analysis. The high percentage of canceled and returned blood indicates the ineffective use of blood transfusion. To know theappropriateness of blood demand for surgery preparation at the Dr. Wahidin Sudirohusodo General Hospital the researchers analyzedhis matter. This study was an observational study with cross sectional approach. The data of the blood demand for surgery preparationwere obtained from the blood bank of the Dr. Wahidin Sudirohusodo General Hospital, Makassar during August up to November 2013.The data were grouped based on the number of blood demand and the quantity of canceled and returned blood, these were then analyzedby SPSS software. The total of samples which were identified was about 1599 with 3829 blood demands. The quantity of canceled bloodwas1915 and the returned blood was 730. The demand of blood products indicated that whole blood was 2340 (61.3%), PRC 1392(36.4%), platelets 83 (2.2%) and FFP 5 (0.1%). The highest blood demand was observed in the General Surgery Department 797(20.9%). The difference between blood demand and the returned blood quantity (for whole blood and PRC) was analyzed statisticallyand indicated a significant result (p=0.000), this meant that there was a mismatch between blood demand number and the returnedblood quantity. This matter could reflect the ineffective use of blood transfusion.

DETECTION OF MALASSEZIA SPECIES IN PATIENTS OF PITYRIASIS VERSICOLOR AND SEBORRHEIC DERMATITIS USING NESTED-PCR IN DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL AND ITS NETWORK HOSPITAL MAKASSAR IN 2018

Introduction Malassezia is a lipophilic dimorphic fungus belonging to the normal flora of human skin which might cause superficial mycosis on humans in the form of pityriasis versicolor and may accompany seborrheic dermatitis. Seborrheic dermatitis may affect adults and infants at the rich in sebaceous glands areas such as face, chest, back and head area. Aim This study aims to describe the species of Malassezia species found in pityriasis versicolor and seborrheic dermatitis in Dr. Wahidin Sudirohusodo general hospital and its network hospitals Makassar in 2018. Method Cross-sectional study was performed on 29 patients of pityriasis versicolor and 40 patients with seborrheic dermatitis who came for treatment at Dr. Wahidin Sudirohusodo general hospital and its network hospital in Makassar by Nested PCR examination of scale specimens scraped from both groups of patients with each primer to identify species of Malassezia species. Frequency distribution test was then conducted by fisher's exact test. Results The results showed 29 patients pityriasis versicolor and 40 patients seborrheic dermatitis. Of the 3 species of Malassezia (M.globosa, M.furfur, M.restricta), with Nested PCR examination only 14 cases of M. restricta were found in pityriasis versicolor patients (48.3%) and 31 cases of seborrheic dermatitis (77.5 %). M. furfur and M.globosa were not found in both groups of patients. Conclusions and Recommendations M.restricta was found on seborrheic dermatitis and its prevalence is greater than its finding on pityriasis versicolor. Therefore, antifungals should be considered to be given to patients with seborrheic dermatitis.

Procalcitonin and C-Reactive Protein as a Predictor of Organ Dysfunction and Outcome of Sepsis and Septic Shock Patients in Intensive Care Unit

BACKGROUND & OBJECTIVE: Sepsis is a potentially life-threatening disorder in ICU. The worst complication is organ dysfunction and mortality. Procalcitonin (PCT) and C-Reactive Protein (CRP) had been proposed as biomarker and predictor for diagnosis, prognosis, and patient deterioration in sepsis and septic shock patients. To know whether PCT and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients in ICU.MATERIALS & METHODS: Data were cohort retrospectively analyzed in 35 sepsis (45.5%) and 42 septic shock patients (54.5%) admitted to ICU Dr. Wahidin Sudirohusodo General Hospital (January 2014 – December 2015). Data were analyzed using Chi-Square test, Pearson Correlation, and Spearman-Rho Correlation test.RESULTS: Total of 77 patients met the inclusion criteria. Cut-off point in predicting organ dysfunction in sepsis and septic shock was significantly higher in PCT (45.7ng/mL) with 76.6% sensitivity and 70.0% specificity, while CRP was 145.75 mg/mL with 70.2% sensitivity and 56.7% specificity. There was a positive correlation of PCT (0.492 [p=0.000]) and CRP (0.336 [p=0.003]) to organ dysfunction reflected on SOFA score using the Pearson Correlation test (p<0.01 statistically significant). Based on Spearman-Rho Correlation test, correlation of PCT (0.191 [p=0.097]) and CRP (0.110 [p=0.340]) to outcome in day-7 was positive but not statistically significant (p≥0.01). While in day-28, there was positive correlation 0.553 (p=0.001) for PCT, 0.460 (p=0.006) for CRP, and statistically significant (p<0.01).CONCLUSIONS: Procalcitonin and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients.

Application Design of Dengue Hemorrhagic Fever Patients Screening Using Naive Bayes Method

Dengue Hemorrhagic Fever is a disease which is endemic in most districts / cities still becomes a public health problem in Indonesia. The awareness of people to the dengue viral infection and its symptoms are needed to decrease the fatality of this disease. The community need to be known the symptoms thereby they could intervened and prevent from falling in to worse condition. This study was conducted to design system which could diagnose the onset of the disease with 3 levels of possibilities namely Grade 1 Dengue Hemorrhagic Fever, Grade 2 Dengue Hemorrhagic Fever, and Non Dengue Hemorrhagic Fever. The system is build based on patient medical records of Dr. Wahidin Sudiro Husodo General Hospital, Mojokerto, East Java using the Naive Bayes method. The method of this study including several steps such as collecting data, preprocessing data, designing database, interface design, calculation and processing data, classification and analyzing data and evaluating application. Determining the results of the application diagnose requires posterior calculation which searches the highest values in three degrees as the results of the initial diagnose. The application as a device for an early diagnosis of dengue hemorrhagic fever has a high accuracy value of 97% out of the 30 tested data. The homogenization of the training data and the test data by sex and age can be considered in future research.

Comparison of The Means of Argyrophilic Nucleolar Organizer Region (mAgNOR) Pre- and Post-Therapy in Nasopharyngeal Carcinoma Patients at Wahidin Sudirohusodo General Hospital Makassar

BACKGROUND: Nasopharyngeal carcinoma (NPC) is malignant tumor growing in nasopharynx with a predilection in fossa Rossenmuller and nasopharyngeal roof. This research aimed to prove whether the means of argyrophilic nucleolar organizer region (mAgNOR) can predict the success of treatment in nasopharyngeal carcinoma patients.METHODS: We used diagnostic test method with longitudinal design and purposive sampling technique. Endoscopic biopsy examination was performed on 15 nasopharyngeal carcinoma patients before and after therapy, 13 patients underwent chemotherapy and other two underwent chemoradiotherapy. Tumor tissues were stained and AgNOR was calculated.RESULTS: Based on the tumor stage, sample characteristic showed 3 patients (20%) were in stage II, 3 patients (20%) in stage III, and 9 patients (60%) in stage IV, with pre- and post-therapy mAgNOR were 1.610±0.988 and 1.000±0.000, respectively in stage II, 1.100±0.092 and 1.000±0.000, respectively in stage III, 1.226±0.265 and 1.107±0.164, respectively in stage IV patients. Based on histopathology type, 4 patients (26.7%) had non keratinizing squamous cell carcinoma with pre- and post-therapy mAgNOR were 1.117±0.134 and 1.060±0.120, respectively, while 11 patients (73.3%) had undifferentiated squamous cell carcinoma with pre- and post-therapy mAgNOR were 1.335±0.528 and 1.065±0.146, respectively. Overall the pre-therapy were significantly higher than post-therapy mAgNOR. In subgroups there are significant differences in stage IV and type 3.CONCLUSION: The values of AgNOR were decreased in all NPC stages and significantly decreased in undifferentiated squamous cell carcinoma. AgNOR can be used to predict the successfulness of therapy in NPC.KEYWORDS: nasopharyngeal carcinoma, therapy, proliferation, mAgNOR

Effectivity of Preovulation Phase Autologous Serum Application on Moderate-Severe Acne Vulgaris Patients

Acne vulgaris (AV) is the most common skin disease, including in Indonesia. This research aims to determine the effectivity of preovulation phase autologous serum application in patients with moderate-severe AV. This research was conducted in Makassar, South Sulawesi. Thirteen patient samples with moderate-severe AV who have met the inclusion criteria were taken from Dr. Wahidin Sudirohusodo General Hospital, Public Senior High School, and Medical Faculty of Hasanuddin University Laboratory. The method used is clinical trial. The examination was done by observing the clinical manifestations, sebum level using 815 sebumeter, and estradiol level examination. All patiens were given the same autologous serum treatment which is applied once a day every night and followed-up on day 21 and day 42. The data were processed using paired t test and Fisher’s exact test. The result showed that there were improvements in clinical manifestation and decreased sebum level after autologous serum application (p < 0.05) on day 21 compared to day 1, on day 42 compared to day 21, and day 42 compared to day 1. Preovulation estradiol level were higher than the estradiol level on menstruation or in lutheal phase (p < 0.05). There were no significant relationship between routine activity, familial history, peanuts, chocolate, spicy and oily food consumption, wearing cosmetics, stress, and squeezing pimples (trauma) with number of acne lesion and sebum level (p < 0.05).

The Analysis of the Mycobacterium Leprae Resistance Against Ofloxacin After the Rifampicin Ofloxacin Minocycline (ROM) Therapy

Background: This reserach aimed to determine the correlation between the morphology index and IgM anti PGL-1, and the mutations in gyrA genes in order to detect ofloxacin resistance in the patients with multibacillary (MB) leprosy. Methods: This research was conducted in Dr. Wahidin Sudirohusodo General Hospital and its network hospitals in Makassar using the cohort retrospective design. The research sample comprised 21 patients with MB leprosy who had completed the ROM treatment regimens, and whose bacterial index (BI), morphology index (MI), IgM anti PGL-1 antibody, PCR, and sequencing, skin lesion number, and treatment regularity had been examined. Result: The research revealed that all the samples did not undergo any mutations of the gyrA genes which was responsible for the ofloxacin resistance; however, there was a correlation between BI and the IgM anti PGL-1 antibody, and between IgM anti PGL-1 antibody and the number of the skin lesions. Conclusions: There was no samples found to undergo the mutations of gyrA genes, this could be used as the reference to assess the correlation between the morphology index and the IgM anti PGL-1 antibody with the mutations of the gyrA genes.

Relationship between newborn mid-upper-arm circumference and birth weight

Background Recording an accurate birth weight by primaryhealth care workers has been a problem in rural areas, leadingto a search for an alternative, inexpensive, age independent andnoninvasive method to predict neonatal well being. Mid-upper-armcircumference (MUAC) might be an alternative anthropometricmeasurement useful to estimate the state of nutrition.Objective To evaluate the relationship between MUAC andbirth weight in low birth weight (LBW) and normal birth weight(NBW) infants.Methods We measured birth weight and MUAC of newbornbabies of various gestational ages at Siti Fatimah Maternity andChildren's Hospital and Dr. Wahidin Sudirohusodo GeneralHospital, Makassar, South Sulawesi, Indonesia. Correlationtests and diagnostic accuracy using different cut-off points wereperformedResults There were 892 live birth newborns (117 LBW and 775NBW) included in the study. The sensitivity, specificity, positivepredictive value, and negative value for MUACs of&lt; 10.3 em were94.9 %, 99.9%, 99.1%, and 99.2%, respectively. The sensitivity,specificity, positive predictive value, and negative value for MUAC&lt; 10.4 em were 99.1 %, 99.6%, 97.5%, and 99.9%, respectively.The sensitivity, specificity, positive predictive value, and negativevalue for MUAC &lt; 10.5 em were 100%,99.4%, 95.9%, and 100%,respectively.Conclusion There is a strong correlation between MUAC andbirth weight. Birth weight can be predicted with the followingequation: Birth weight= -1776.383 + (416.95 newborn MUACvalue). The optimal cut-off point for the newborn MUAC value forLBW infants is&lt; 10.5 em.