Wahidin Sudirohusodo Hospital Research Articles

PENGARUH VOLUME URIN TERHADAP PEMERIKSAAN SEDIMEN URIN PADA PASIEN INFEKSI SALURAN KEMIH (ISK)

The research about effect of urine volume to urine sediment examination in patient with Urinary Tract Infection (UTI) at Wahidin Sudirohusodo hospital was performed. This research aimed to find out the volume urine effect to urine sediment examination in Urinary Tract Infection (UTI) so as to improve the diagnostic a laboratory. This research used laboratorial eksperimental method with total samples are 30 consist of 13 male (43,3%) and 17 female (56,7%). Microscopically sample examination used Shih-Yung method with during urine with comparative volume 12 ml, 10 ml, and 8 ml. This research showed mean total urine sediment in volume 12 ml (leukocyte 37,75/μL; erythrocyte 7,77/μL; epithelial cells 7,96/lfv; bacteria 5,15/lfv) in volume 10 ml (leukocyte 22,67/ μL; erythrocyte 4,48/ μL; epithelial cells 4,35/lfv; bacteri 3,88/lfv) in volume 8 ml (leukocyte 12,20/μL; erythrocyte 2,16/μL; epithelial cells 2,50/lfv; bacteria 2,08/lfv) from One Way Anova statistic test get P value = 0,000 (<0,05) showed there is significant different between urine sediment used volume 12 ml, 10 ml, and 8 ml. From the result can be concluded that there is an effect of urine volume to urine sediment test in patient with UTI and volume 10 ml as smallest urine volume can give an accurate result.

THE ROLE OF A1166C ANGIOTENSIN II TYPE-1 RECEPTOR GENE POLYMORPHISM IN URINARY ALBUMIN EXCRETION RATE ON HYPERTENSIVE SUBJECTS

Background: Expression of angiotensin-II type 1 receptor (AT1R) play a role in angiotensin-II (Ang-II) mechanism of action. Angiotensin-II also have a role on urinary albumin excretion (UAE) incidence in hypertensive subjects. Objective: Understanding the role of A1166C AT1R gene polymorphism on UAE rate in hypertensive subjects. Method: This is an observational study with cross-sectional approach, conducted in 2014 at Dr. Wahidin Sudirohusodo Hospital Makassar. We included both hypertensive and controlled hypertensive subjects, eGFRMDRD ≥60 ml/menit/.73 m2, no evidence of urinary tract infection, no diabetes mellitus, not on period of menstruation or hematuria. Based on ACR, subjects were classified into A1 (ACR <30 mg/g), A2 (ACR 30–300 mg/g) and A3 (ACR >300 mg/g). A1 group was categorized as normal, while A2 and A3 group as abnormal. A1166C AT1R gene polymorphism detected by PCR examination if we found genotype: AT1R 1166AA, AT1R 1166AC and AT1R 1166CC. Non-AA genotype are AT1R 1166AC and AT1R 1166CC, and AA genotype is AT1R 1166AA. Result: From 71 subjects, 20 subjects (28.2%) are non-AA genotype and 51 subjects (71.8%) are AA genotype. From 20 non-AA genotype subjects, 4 subjects (20%) with abnormal UAE rate and 16 subjects (80%) with normal UAE rate. While from 51 subjects with AA genotype, 6 subjects (11,8%) with abnormal UAE rate and 45 subjects (88.2%) with normal UAE rate. The risk of non-AA genotype to have UAE rate increment is 1.9 times compared with AA genotype, but statistically not significant (CI: 0,47–7,51; p = 0.452). Conclusion: We found that C allele of the A1166C AT1R gene polymorphism is not a risk factor for UAE rate increment in hypertensive subjects.

Correlation of Sex and Remission of Acute Lymphoblastic Leukemia-L1 (ALL-L1) in Children

Introduction: Acute Lymphoblastic Leukemia (ALL) is a malignancy often found in children with peak incidence of 2-5 years. The symptoms and biological factors affect the ALL prognosis; age, leukocyte count, sex, nutritional state, ALL phenotype, CNS infiltration, chromosome abnormalities, and early response to chemotherapy. Objective: The aim of this study was to determine the role of sex on the patient’s remission with ALL-L1. Methods: The retrospective cohort study was conducted to determine the role of sex on the patient’s remission with ALL-L1. The study was conducted in the pediatric ward of Dr. Wahidin Sudirohusodo hospital in Makassar from March until November 2014. The cases were taken from the pediatric ward that met both the inclusion and exclusion criteria. The data were taken from the patient’s medical records related to the study. Results: Revealed of 70 cases that met the criteria was consisted of 42 males and 28 females. Frequency of remission in male group was 41 (97.6%) and in female group was 27 (96.4%). The statistical analysis revealed that there was no significant difference between sex and remission, as it was shown by p = 0.643 (p>0.05). Conclusion: Sex did not have any effects on the frequency of remission in children with ALL-L1 in Dr. Wahidin Sudirohusodo hospital. The frequency of remission in male group was 97.6%, and in female group was 96.4%.

Relationship Between Severity Levels of Diseases in Children with Maternal Anxiety at Pediatric Intensive Care Unit

Background: PICU (pediatric intensive care unit) is child care units that require intensive surveillance and invasive action. A state of anxious disorder is characterized by feelings of fear which accompanied by somatic complaints shown with hyperactivities of autonomic nervous system and non-specific symptom and normal emotion. Objective: This study identified the factors associated with the occurrence of anxiety in mothers whose child was treated in a PICU suffered degrees of severity of disease. Methods: A cross-sectional studies have been conducted since April to September 2014 at Dr .Wahidin Sudirohusodo Hospital, Makassar. Samples were children aged 1 month to 18 years old who experienced the severity of the disease based on the PRISM III scores treated at PICU. Results: Of the 151 samples of children, there were 88 male and 63 female. Bivariate analyzes mothers who have children with PRISM III score ≥15 had a greater occurrence frequency of severe anxiety disorders compared with mothers whose children have PRISM III score <15, with a value of p= 0.000 (p<0.01). There is a correlation between the PRISM III scores in children with maternal HARS scores, which is a higher PRISM III score will also make the HARS scores higher with p<0.001, correlation value of 0.296. Conclusion: There is a correlation between PRISM III score in children and the score of HARS in the mother, which is the highest of PRISM III score, the HARS score will also be higher.

The Risk Factors of Early Onset Neonatal Sepsis

Introduction: Neonatal sepsis is one of the major causes of morbidity and mortality in newborn. Early onset neonatal sepsis (EONS) is a severe disease and has high mortality rate. The clinical signs of EONS are nonspecific and the confirmation of diagnosis may consuming time. Therefore, the diagnostic approach is necessary by considering the risk factors. Objective: The aims of this study are to identify the risk factors of newborn infants whose mother has risk factors of sepsis affecting the occurrence of EONS. Methods: This is a cohort retrospective study, conducted from January 2013 to June 2014 in Neonatology Installation of Dr. Wahidin Sudirohusodo hospital, Makassar. The sample population included newborn infants whose mother has risk factors of sepsis. The information of the risk factors from infant and diagnoses of EONS was obtained from their medical record. Multivariate analysis and logistic regression formula were performed to predict the occurrence of EONS. There were 221 samples: 62 cases of EONS and 159 of control. Results: The results of multivariate analysis revealed 3 risk factors from infant which were associated to EONS: APGAR score <7 (p= 0.000, AOR 14.05 with 95% CI 5.48-35.98), gestational age <37 week (p= 0.000, AOR 13.45 with 95% CI 3.91-46.26), birth weight <1500 gram (p= 0.04, AOR 4.9 with 95% CI 1.08-22.25). Conclusion: Based on this study, it concluded that the risk factors of EOS were: APGAR score, gestational age and birth weight.

Relationship Between Seizures in Children with Maternal Anxious Levels at Pediatrics Intensive Care Unit

Introduction: Seizure is an emergency condition that makes mother or the care taker being anxious. The anxious of parents frequently denied where as psychological problems both acute and chronic could be happened intervention as a holistic approach to the patient and her family. Objective: To analize the correlation between seizure in children hospitalization in Pediatrics Intensive Care Unit (PICU) with the maternal anxious levels. Methods: A cross-sectional study was done and the data were collected from the 29-day-old to 18 years children treated in PICU of Dr. Wahidin Sudirohusodo Hospital, Makassar from April through September 2014. Total of samples comprised 133 children were devided into two groups: 58 children in the seizure group and 75 other in the not seizure group. The maternals anxious levels are based on the HARS (Hamilton anxious rating scale) score. Results: The study revealed there is a significant correlation between the seizure in children with maternal anxious levels as shown by the Odds Ratio (OR) value of 6.286 CI95% = 2.912 – 13.569 with p value of 0.000 (p <0.01), and the mean, median, maximum and minimum values of HARS score were higher in seizure group: the values being 31.5: 26.02, 30.5: 26, and 20–50: 18–24 respectively with p= 0.000 (p<0.01). Conclusion: Severe anxious frequency evidences in maternals with children who had seizure were higher than in children without seizure, either of the HARS score of maternals.

The Relationship of Salivary Free Testosterone Concentration with Acne Vulgaris

Background: Acne Vulgaris (AV) is a chronic inflammatory and multifactorial disease involving the pilosebaceous unit. Androgen hormone plays an important role in the pathogenesis of acne. Objective: This study aims to determine the relationship of free testosterone concentration with the severity of acne vulgaris. Methods: This is an observational study using cross sectional design. This study conducted in Dr. Wahidin Sudirohusodo hospital, Hasanuddin University hospital, and other hospital networks and Prodia laboratory in Makassar starting from January until February 2015. The study samples are 42 patients who met the study criteria. There are 32 patients with AV who have been diagnosed clinically and 10 patients with non AV as a control group. Results: The free testosterone concentration and sebum levels in the AV group are higher compared to the control group (p 0.005), but there is a correlation between the free testosterone concentration with the increased of sebum levels. It is mean that even the free testosterone concentration and sebum levels are increased, the acne vulgaris is not necessarily severe, but the increased of free testosterone concentration makes the sebum levels increased. Conclusions: The free testosterone concentration and sebum levels are higher in the acne vulgaris group than the control group. There is no significant relationship of free testosterone concentration with acne vulgaris with p>0.05.

The Effect of Dexamethasone on the Dynamics of Inflammation, Cortisol and analgesia in Lower Limb Surgery

Background: Dexamethasone is currently used as a part of multimodal analgesia on postoperative pain management. Dexamethasone considered providing effective analgesia as a steroid anti-inflammatory. This study aimed to examine the effects of preoperative single dose of intravenous dexamethasone to the inflammation, cortisol response and analgesia in lower limb surgery. Methods: This is a clinical experimental study conducted in randomized double-blind trial performed at Wahidin Sudirohusodo Hospital, Makassar Indonesia. Thirty patients with lower limb surgery under spinal anesthesia meet the inclusion criteria were randomly divided into 2 groups: (1) group received 8 mg dexamethasone intravenous preoperatively and perioperative analgesia with paracetamol and PCA morphine (dexamethasone group) and (2) group received perioperative analgesia paracetamol and PCA morphine (control group). Blood samples were taken at the time before anesthesia, immediately post-surgery, 4 and 24 hours after surgery to measure plasma levels of CRP and Cortisol with the ELISA test. We recorded the intensity of rest pain and morphine requirement in 4 and 24 hours after surgery. Results: Both of groups found increase in CRP plasma levels at the 24 hours after surgery (p<0.05). Cortisol in the dexamethasone group decreased significantly at the 24 hours after surgery while in the control group did not change (p<0.05). Rest pain intensity and morphine requirement in the dexamethasone group was lower in the 24 hours after surgery than the control group (p<0.05). No differences changes in blood pressure, heart rate, respiration and the side effects between the two groups. Conclusion: The addition of single dose dexamethasone preoperatively on the combination of paracetamol and morphine did not abolish inflammation process but decrease cortisol response after surgery with sufficient analgesia and minimal side effect.

Evaluation of Dri-Dot OMPs Salmonella Typhi in Suspected Typhoid Fever Patients as an Immunodiagnostic Kit

Background. Several studies have identified a protein of OMP S. Typhi. The protein is highly immunogenic and can be recognize whole cells of S. Typhi. The aims of the study was to evaluate the Dri-dot OMPs immunoreactivity in typhoid fever suspected patients. Method. Samples obtained from Dr. Wahidin Sudirohusodo Hospital, lbnu Sina Hospital, and Haji Hospital of Makassar from February to November 2014. Their sensitivity and specificity were evaluated against blood culture method as the gold standard. For each of the two tests, sensitivity, specificity, positive and negative predictive values were calculated using standard formulae. Results. A total of 15 of suspected typhoid fever samples examined for culture, lateral flow and Dri-dot OMPs. Examination of blood culture method showed that 3 of 15 (20%) patients had a blood culture positive for S. typhi. Dri-dot OMPs were positive in 13 (86.7%) serum samples. Fourteen (93.3%) serum samples were positive for lateral flow examination. Thirteen samples were positive for both Dri-dot and lateral flow. One sample was negative for both lateral flow and Dri-dot. One sample was positive for Dri-dot but negative for lateral flow. Conclusion. We conclude that there was no difference between Dri-dot OMPs, lateral flow and widal tests. Dri-dot could be of use for the diagnosis of typhoid fever in patients who have clinical typhoid fever

Age as a Risk Factor of Relapse Occurrence in Acute Lymphoblastic Leukemia-L1 (All-L1) in Children

Introduction: Relapse in children with leukemia is a phase appearing the leukemia cells after complete remission; this situation can impact the children itself, parents and also the support system. Objective: To identify the factors related of relapse incidence in children with leukemia. Methods: This study was conducted by using a retrospective cohort study design based on medical record data from Dr. Wahidin Sudirohusodo Hospital, Makassar from December 2013 until August 2014. Study samples were children of 0 month – 18 years old diagnosed of having Acute Lymphoblastic Leukemia-L1. They are treated with chemotherapy and divided into relapse and non-relapse samples. Results: From 42 relapse and non-relapse samples, there were 35.7% (15) relapse samples and 64.3% (27) non relapse samples. Bivariate analyses revealed that among 1-10 year, there were 31.4% (11) with relapse and 68.6% (24) without relapse. Among the samples aged more than 10 years old, there were 57.1% (4) samples with relapse and 42.9% (3) samples without relapse, with p=0.225 (p>0.05). In terms of interval time from first diagnosis until the occurrence of relapse, the median value was 1.80 in 1-10 year-old group. In the group of >10 years old, the median value was 0.84 and p=0.207 (p>0.05). Conclusion: Age did not give any influence in the incidence of relapse in children with ALL-L1 and the interval time when the first diagnosed until relapse.

Serum Mannose Binding Lectin Levels in Early Onset Neonatal Sepsis

Introduction: Early Onset Neonatal Sepsis (EONS) is still the most cause of neonatal morbidity and mortality. The diagnosis is difficult to establish because of nonspecific clinical features and laboratory findings. Mannose binding lectin (MBL) is one of the acute phase proteins that can show progressing infection process. Objective: To determine the serum MBL levels of neonates with EONS and not EONS. Methods: This study was conducted as a cross sectional study from September to November 2014. The population included 92 neonates baby whose mother has risk factors of sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital and joined hospital. The subjects were divided into two groups, EONS and Not EONS group based on clinical features and laboratory findings. The MBL serum level was measured on each group. Results: Statistical analyses showed median value of serum MBL of EONS group (0.88 μg/mL) was significant lower compare with Not EONS group (0.93 μg/mL), with p= 0.00 (p<0.05). The cutoff point of ≤0.93 µg/mL is the best levels to distinguish between EONS and Not EONS (p=0.01, sensitivity 76%, specificity 56%, positive predictive value 60%, negative predictive value 67%, COR 3.182, 95%CI 1.306-7.752). Conclusion: MBL serum levels on EONS group were lower than Not EONS group.

The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever

Introduction: The incidence of myocarditis on Dengue Hemorrhagic Fever (DHF) is still controversial because the disease was asymptomatic and definitive diagnosis only with endocardial biopsy. More specific and sensitive examination to detect the cardiac disorder is cardiac enzyme likes the level of troponin T. Objective: This study aims to evaluate the level of troponin T in patients with dengue shock syndrome (DSS) and dengue hemorrhagic fever without shock. Methods: The research conducted a cross-sectional study at Child Health Department of Dr. Wahidin Sudirohusodo Hospital, Makassar, from July to October 2012. The population included children with DHF admitted to the hospital of Dr. Wahidin Sudirohusodo, Ibnu Sina and Faisal Islamic. Diagnosis of DHF was established based on history taking, physical and laboratory examination. Results: There were 70 samples who met the criteria, including 35 patients of DSS and 35 patients of dengue hemorrhagic fever without shock. The level of troponin T was higher on DSS group than DHF group with the cut off point of ≥0.007 ng/ml is the best level to distinguish between dengue shock syndrome and dengue hemorrhagic fever without shock (p=0.000, sensitivity 97.1%, specificity 88.6%, positive predictive value 89.5%, negative predictive value 96.9%,OR 18.7; 95% CI 15.3–1417.5). Conclusion: The level of troponin T was higher on DSS group than dengue hemorrhagic fever without shock group because on DSS occurs to stress caused by hypoperfusion. But the level of troponin T between two groups within normal limits, not found cardiac disorder such as myocarditis on DHF.

Absolute Neutrophil Count as Predictor of Early Onset Sepsis

Background: Infant mortality rate (IMR) was found to increase in the newborn. The most frequent causes of death are infection, prematurity, low birth weight (LBW), neonatal asphyxia and birth trauma, respectively. Absolute neutrophil count (ANC) can be used as a marker of infection because of its faster, easier, simpler and cheaper nature. Objective: The study aims to identify the influence of an increase and decline in ANC on newborns from mothers with risk factors for early onset sepsis. Methods: This study was conducted as a a prospective cohort study from December 2013 to July 2014. The population included 120 newborns whose mother has risk factors of early onset sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital, and joined hospital. The subjects were divided into three groups, ANC 5400/mm3. Results: Newborn from mother with risk factor of infection with ANC >5400/mm3 and ANC 1800-5399/mm3 shows a significant difference with p = 0.000 (p 5400/mm3 group with sensitivity and specificity 89.47% and 80.95% respectively; PPV (Positive predictive value) 80.95%; NPV (Negative predictive value) 89.47%; p=0.000; OR 36.125; IC 95% 5.820 – 224.224. Conclusions: Absolute neutrophil count >10.710/mm3 in a term newborn from mother with infection risk factors can be used as predictor for early onset sepsis 36 fold higher than the ANC <10.710/mm3.

Absolute Neutrophil Count as a Septic Shock Predictor in Pediatric Emergency Room

Introduction: The Absolute Neutrophil Count (ANC) is a neutrophil percentage multiplied by the total leukocytes in blood. Its use as a prognostic indicator has been studied in a variety of circumstances, especially sepsis in the neonates and children. Objective: This research aims to investigate the roles of the ANC as the predictor of the septic shock. Methods: It was a prospective cohort study. The data were collected when the patients were brought into the Pediatric Emergency Room (PER) of Dr. Wahidin Sudirohusodo Hospital, Makassar in September through December 2012. The ANC total of the treated patients was counted and then the patients were put into two groups: the group with ANC < 1500/mm3 and the group with ANC ≥ 1500/mm3. The individual health condition of each ANC group was observed carefully in order to determine whether the patients suffered from the septic shock or not. Results: The incidence of the septic shock in the ANC group of < 1500/mm3 was greater compared to that of ≥ 1500/mm3 with the p value = 0.015 (p < 0.05). Besides, it was found that the odds ratio = 6.333, CI = 95% (1.523 – 26.335). No significant differences of septic shock incidence were found between age, nutritional status, sex and infectious/non infectious disease. Conclusion: The mean value of the ANC in patients with septic shock is lower compared with non septic shock. The incidence of septic shock in patients with ANC ≥ 1500/ mm3 group; ANC can be used as predictor of impending the septic shock.

Prognostic Factor of Ureum and Creatinine Serum of Acute Post Streptococcal Glomerulonephritis in Children

Introduction: Acute post streptococcal glomerulonephritis is one of the commonest causes of glomerular disease in developing countries. Ureum and creatinine examination not only can be used to support the diagnosis but also to identify and detect early organs disturbances and predict the patient prognosis. Objective: This study aims to observe the ureum and creatinine serum level in APSGN children and its relationship with the outcomes. Methods: A retrospective cohort design regarding the prognostic value of serum ureum and creatinine levels for APSGN children outcomes. The data was collected from medical records of APSGN children treated at Dr. Wahidin Sudirohusodo Hospital Makassar from 2009-2013. Results: There is no significant correlation between the outcome and sex (p=0.961), nutritional status (p=1.000), and age (p=0.108). There is a significant difference both in early ureum levels to outcome with p=0.003 and in early creatinine levels to outcome with p=0.020. There is tendency to decreased levels of ureum and creatinine serum of survival group (p=0.000) while hospitalization and trend of increased or stagnan levels of ureum and creatinine serum of non survival group while hospitalization. Multivariate analyses indicated that serum ureum levels <119 mg/dl is an independent prognostic factor for APSGN outcomes in children with p=0.032, OR 1.021, and CI 95% 1.002-1.041. Conclusion: It seems that serum ureum is an independent prognostic factor for APSGN, where serum ureum levels <119 mg/dl and creatinine levels <1.3 mg/dl have a good prognosis. Out of the 95 patients as sampled, there were 90 (94.7%) cured, and 5 (5.2%) patients died.

Manifestasi klinis tipe kandidiasis oral pada penderita AIDS di Rumah Sakit Dr Wahidin Sudirohusodo, Makassar (Clinical manifestations of oral candidiasis types in AIDS patients at Dr Wahidin Sudirohusodo Hospital, Makassar)

Oral candidiasis is one of clinical manifestations in aquired immune deficiency syndrome (AIDS) patients. This conditionis a common opportunistic infection of the oral cavity caused by an overgrowth of Candida spesies. The clinical types oforal candidiasis are erythematous or atropic, pseudomembranous, hyperplastic or chronic, and angular cheilitis. AIDS isgroup of symptoms that resulting from infection of human immunodeficiency virus (HIV). This case is associated with thedecreasing of CD4 count. The aimof this study was to know the types of oral candidiasis on AIDS patients at Dr WahidinSudirohusodo Hospital. This observational studywith a cross-sectional design examined 30 patients with AIDS whosuffered fromoral candidiasis, to determine its type after the diagnosis had confirmed by culture test. Their CD4 cellcount taken fromtheir medical records. The result showed that Pseudomembranous candidiasis were found to be higher(76.7%), that was followed by angular cheilitis (23.3%), hyperplastic (16.7%), and erythematous (6.7%). They wereshowed showed CD4 T cell count &lt;200 cells/mm3 (63.3%). From this study, it was concluded that pseudomembranous candidiasis is the most common type and showed that CD4 T cell count &lt;200cells/mmfrom the AIDS patients.

Expression Collagen I and III in Anterior Vaginal Women with and without Pelvic Organ Prolapse

Objective: To find out the expression of collagen [ and III in the anterior vaginal wall of women with and without pelvic organ prolapse (POP).&#x0D; Method: The research was a cross sect ional study, conducted in Dr. Wahidin Sudiro Husodo hospital and its networks from January 1, 2011 to April 1, 2012. The case group consisted of 35 women with POPlevel III and IV.The contro l group consisted of35 women without POP. The expression of collagen I and III were examined by immunohistochemical test with the stain ing of antibody of collagen I (mouse monoclonal collagen lab 90395 ) and the antibody collagen III (Mu167 4i).The data was then analyzed by using a computer statistic program with a significance level of 0.05.&#x0D; Result: It was found that in the group of women with POP, there were 28 cases of expression collagen III (84%), which is significantly higher than in women without POP, found in only 20 cases (58.8%), with p=0.02. Meanwhile, in the group of POP, 9.1% of subjects showed moderate expre ssion of collagen I, significantly less compared to the expressio n in the contro l group (35.3%), with p=0.007. For the ratio of collagen I and III, the result was weak in women with POP(58.5% ) while in the control group, the result was high (85.7%).&#x0D; Conclu sion: In terms of collagen I and III expression, there was no significant difference between the two groups.&#x0D; Keywords: collagen I, collagen III, pelvic organ prolapse, vaginal wall

Primipara Undergoing Episiotomy had Lower Postpartum Sexual Function

Objective: To compare postpartum sexual functions between primipara with episiotomy and without episiotomy.&#x0D; Method: The research was conducted in public service section of Dr. Wahidin Sudiro Husodo hospital and a number of educational hospitals obstetrics and gynecology of Faculty of Medicine of Hasanuddin University, started from February to May 2012. The research evaluated the sexual function of postpartum with episiotomy in 171 primipara, and 150 primipara postpartum without episiotomy. Sexual function was measured by Female Sexual Function Index (FSFI) questionnaire which had been validated in various countries. The research was conducted with cross sectional approach. Samples were withdrawn with consecutive sampling method. The data was processed with SPSS version 17, with chi-square test, and significant level of 0.05.&#x0D; Result: Indicated that either the episiotomy or non-episiotomy group has undisturbed sexual function score (&gt;28.5), however, higher score was indicated in non-episiotomy group (65.477) compared to the episiotomy group (59.70), (p&lt;0.05).&#x0D; Conclusion: Primipara with episiotomy and breastfeeding has lower sexual functions compared to the non-breastfeeding group, however, it was statistically insignificant (p&gt;0.05).&#x0D; Keywords: episiotomy, FSFI, primipara, sexual functions

Hospital malnutrition at pediatric ward Dr. Wahidin Sudirohusodo Hospital Makassar

Methods A prospective study was conducted in January until December 2011 period. The initial measurement were made by residents in charge. The nutritional status was defined according to CDC 2000 guidelines. Exclusion criteria including children with fluid retention, organomegaly, obesity, and tumours. HM was defined as weight decreased ≥ 2% for LOS (length of stay) less than 7 days, ≥ 5% for LOS 7 to 30 days and ≥ 10% for LOS 1 to 6 months. Data were analyzed using SPSS for Windows.

Endoglin concentration in peritoneal fluid of patients with endometriosis

Background: Endoglin is a specific angiogenic factor suspected to involve in the pathogenesis of endometriosis. The aim of this study was to evaluate the significance of endoglin concentration in the peritoneal fluid of patients with endometriosis. Methods: This pilot study was performed between March 2011 and July 2012 at Dr. Wahidin Sudirohusodo Hospital and another private hospital in Makassar, Indonesia. This was an observational, cross-sectional study. All patients undergoing laparoscopy for infertility and other cases with suitable inclusion criteria were asked to answer a questionnaire and had a 5 cc peritoneal fluid sample taken for measurement of peritoneal endoglin concentration using ELISA. Endometriosis stage was classified using ASRM criteria and divided into two groups, mild and severe. All data were analyed using Excel and Spearman correlation analysis. Results: In the endometriosis group peritoneal endoglin concentration ranged between 14.43- 15.65 ng/mL (median 15.04 ng/mL) which is higher than control group 7.42-10.26 ng/mL (median 8.84 ng/mL). A peritoneal endoglin concentration equal to or higher than 11 ng/mL could be used to predict endometriosis. Conclusion: Endoglin concentrations increased proportionally with the severity of endometriosis, and many be used as predictive factor of endometriosis cases. (Med J Indones. 2013;22:88-91)