Wahidin Sudirohusodo Hospital Research Articles

Deficiency of serum l-arginine levels in severe preeclampsia; a consideration for supplementation

The purpose of this study was to compare serum levels of l-arginine in normal pregnant women, severe preeclampsia, and severe preeclampsia with complications. It was an observational study with a cross-sectional design, 88 third trimester of pregnancy became the sample which consisted of 46 normal pregnant women, 30 severe preeclampsia, and 12 severe preeclampsia with complication. This study conducted in four hospitals in the city of Makassar: Dr. Wahidin Sudirohusodo hospital, education Hospital of Hasanuddin University, Fatimah, and Sitti Khadijah 1 Mothers and Children hospital. Serum blood samples were taken from the antecubital venous blood Assessment of serum l-arginine levels was carried out using the Human l-Arginine Assay Kit. There were significant mean differences between normal, severe preeclampsia and severe preeclampsia with complications. The lowest serum levels of l-arginine were severe preeclampsia with complications (28.33ng/mL), then severe preeclampsia group (34.66ng/mL), and the highest was normal pregnant woman (60.91ng/mL). Severe preeclampsia with complications had the lowest l-arginine level. Role l-arginine level should be considered in the prevention and treatment of severe preeclampsia.

Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", "MTB detected”, and "MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of "MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.

Analysis on Relationship between Bacillus and Enterobacter Bacteria in Air with Hospital Acquired Infections Potential in Intensive Care Unit of Dr. Wahidin Sudirohusodo Hospital

Introduction: Poor hospital building environment quality is due to presence of potential sources of airborne microbial and may lead to HAIs (Hospital Acquired Infections). The research aimed to find out the relationship between the Bacillus sp. and Enterobacter sp. in the air with HAIs incident potential. Material and Method: This research was conducted in Dr. Wahidin Sudirohusodo hospital. This was an analytic observational research with the cross-sectional study design. Samples taken were human samples based on the criteria of the research as many as 61 patients, and the environmental samples were as many as 8 ICU rooms. The data were analyzed using the Chi-square test. Findings and Discussion: The research result indicates that the air quality related to the microbial pollution in the air in intensive care unit room does not qualify. The result of the microorganism culture and identification is found the HAIs causing bacteria namely Bacillus sp. and Enterobacter sp. Based on the statistic test, the value of p=0.014 (95% confidence intervals) is obtained, so there is the relationship between Bacillus sp. with HAIs incident potential. The Enterobacter sp. bacterium indicates the value of p=0.437 (95% confidence intervals), so there is not have the relationship between the Enterobacter sp. bacterium with HAIs incident potential. Conclusion: Bacillus in the air has the potential to cause HAIs in the ICU. Aspects of hygiene and sanitation appeared to be important factor in maintaining low microbial load in the air and further research is needed related to fungi and viruses in the air because of the potential source of HAIs.

THE RELATIONSHIP BETWEEN TRIPLE TUMOR MARKER (CEA, CA 19-9, AND CA 125) AND COLORECTAL CANCER METASTASES AT MAKASSAR, INDONESIA

Introduction: Tumor markers combination (CEA, CA19-9, and CA125) can increase sensitivity due to interactions between several epitopes and tumor cells, especially in colorectal cancer (CRC) diagnosis. Therefore, this study aimed to assess the relationship between triple tumor markers (CEA, CA 19-9, CA 125) and CRC metastases. Materials and Methods: The research samples were CRC patients at Dr. Wahidin Sudirohusodo Hospital, Makassar from November 2019 to April 2020. The histopathology data were collected through endoscopic or anal biopsy, CEA, CA 19-9, CA 125, Thorax X-Ray, Abdomen CT Scan, Surgery, and data processing. Furthermore, statistical tests were performed with the Mann Whitney difference test (significance = p

A Cautionary Note to Hepatitis B <i>e</i> ANTIGEN (HBeAg)-Negative Status of Pregnant Women

Background: Hepatitis B e Antigen (HBeAg) positive has been known as a risk factor for mother-to-child-transmission (MTCT) in addition to the high levels of hepatitis B virus (HBV) DNA. The World Health Organization (WHO) in 2020 recommends HBeAg testing as an alternative to determine eligibility for tenofovir prophylaxis, where molecular measurement is unavailable. However, high prevalence of HBeAg-negative chronic hepatitis B (e-CHB) in many countries should not be ignored. This study aimed to evaluate the viral characteristics in HBeAg-negative pregnant women and its association with the risk of intrauterine exposure to HBV. Methods: Antenatal screening of 1,348 pregnant women showed 81 (6·0%) HBsAg positivity. These HBsAg-positive mothers were examined for HBeAg status, HBsAg levels, viral load, and HBV DNA presence in corresponding cord blood. HBeAg-negative subjects were classified into inactive and ‘non-inactive’ carriers. Sequencing was performed to identify basal core promoter (BCP) and precore (PC) mutations in ‘non-inactive’ carriers. Findings: A total of 65 (80·2 %) of 81 HBsAg-positive subjects were HBeAg-negative. The risk for intrauterine exposure to HBV was higher at HBsAg levels ≥4 log 10 IU/mL (odds ratio [OR]=6·43; p =0·008), but comparable among the different HBeAg status. Higher risk of intrauterine exposure was found at HBV DNA levels ≥5·3 log 10 IU/mL (OR=22·32; p <0·001), with different risks for HBeAg-positive (OR=0·42; p =0·069) and HBeAg-negative (OR=12·6; p =0·010) groups. Of 65 HBeAg-negative women, 8 (13·8%) were inactive carriers and 57 (87·7%) were ‘non-inactive’ carriers. Ten of 12 HBV DNA sequences had BCP (A1762T/G1764A with or without T1753A/C), PC (A1814C or G1896A), or combined BCP/PC mutations, with higher proportion in genotype C than in genotype B. Interpretation: This study provided a cautionary note that HBeAg-negative status should be interpreted carefully, particularly for HBsAg-positive pregnant women who had high viral load. Funding Statement: Indonesia Science Fund and Educational Fund Management Institution (RISPRO/B1/TKL/5/6023/1/2017). Declaration of Interests: All authors declare to have nothing to disclose and have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest Ethics Approval Statement: This study was approved by the Research Ethics Committees of Hasanuddin University – Faculty of Medicine, Wahidin Sudirohusodo Hospital, and Hasanuddin University Hospital (Authorization No. 0942/H4.8.4.5.31/PP36-KOMETIK/2017).

LYMPHOCYTE LEVEL IN VARIOUS CLINICAL MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS

Backround: Systemic Lupus Erythematosus (SLE) is an autoimmune rheumatic disease characterized by inflammation that affects the organs or systems in the body. This disease is associated with the deposit of autoantibodies and immune complexes which caused a tissue damage. Clinical manifestations of SLE are very vast, including the involvement of skin and mucosa, joints, blood, heart, lung, kidney, central nervous system (CNS), and the immune system. Lymphocytes is one type of white blood cell (leucocyte) which play a role in the pathogenesis of SLE through the role of B cells and T cells. Lymphocyte levels are also included in hematologic criteria of SLE patients, and are also used as a parameter to measure the activity degree of SLE disease. Lymphopenia in patients with SLE is associated with the increase of organ damage index. Objective: To determine the level of lymphocyte in various clinical manifestations of patients with SLE. Methods: This study was an analytic research with cross-sectional design. The study subjects were all newly diagnosed patients with SLE. The study was conducted at Wahidin Sudirohusodo Hospital and its network during February until June 2018. Results: Subjects who met the study criteria were 37 who were all female. The lowest lymphocyte level was 133μl and the highest was 3978μl with an average level 1244.6μl. The most comon clinical manifestations were mucocutaneous with 26 subjects (97.3%). Clinical manifestations of renal disorders (p

Albumin excretion rate among patients with diabetic retinopathy.

Background:Chronic microvascular complications consist of diabetic nephropathy (DN), diabetic retinopathy (DR), and diabetic neuropathy. Diabetic nephropathy is assessed through albuminuria, and diabetic retinopathy is assessed through fundoscopy. Several studies have assessed the albuminuria in diabetic retinopathy but have found inconclusive results. This study aims to investigate the albumin excretion rate in patients with diabetic retinopathy.Methods:A cross sectional design was applied in this study. The diagnosis of type 2 diabetes mellitus was determined based on the anamnesis and laboratory examinations. The study was conducted at Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital in Makassar during November 2018 until April 2019. The stages of diabetic retinopathy were based on funduscopic examinations. In addition, the blood pressure, BMI, albumin excretion rate, lipid profile, and HbA1C were also examined. Chi Square and Kappa tests were performed in the statistical analysis.Results:120 subjects with type 2 diabetes mellitus were observed. Of the total subjects, the number of females within the age of 36-79 years made up the biggest fraction. There was a significant relation between hypertension comorbidity with the albumin excretion rate and grading diabetic retinopathy where the A3 and proliferative diabetic retinopathy (PDR) percentages were higher in the hypertension group at 68.8% and 54.5%. There was also a significant correlation between incidence of albuminuria with diabetic retinopathy. Particularly, proliferative diabetic retinopathy (PDR) remained associated with albuminuria, while non-proliferative diabetic retinopathy (NPDR) was related to non-albuminuria.Conclusion:Albuminuria incidence confirms association with diabetic retinopathy grading.

A Three-Years Survival Rates of Chronic Myeloid Leukemia Patients with Targeted Therapy

Introduction: Chronic myeloid leukemia (CML) is a hematopoietic stem cell cancer driven by the BCRABL fusion protein that arises from the translocation of chromosomes 9 and 22. Since the found of the Tyrosine Kinase Inhibitor (TKI) as a targeted therapy, the relative survival rate of 5 years has significantly increased compared to the era of the use of previous agents. As a successful leukemia treatment, it can be seen based on the survival rate. Several factors have been known to influence the survival and prognosis of CML patients, including the age of the patient at diagnosis, gender, and response to therapy and treatment. This study aims to determine how many a three-year survival rates for CML patients with targeted therapy in Makassar and the factors that affect survival. Method: This study used a retrospective cohort using secondary data (medical records) of CML subjects who had been outpatient or inpatient followed in the same time period. The study was conducted in January 2015 to December 2017 at Dr. Wahidin Sudirohusodo Hospital, Makassar. The samples consisted of 108 subjects who met the inclusion criteria. Gender, age, BCR-ABL transcript, targeted therapy and status were taken from medical records. Data were analyzed with SPSS 22.0 version and survival analysis, Meier Kapplan curves, survival median, log-rank and test statistic. Results: There were 108 subjects of CML patients who received targeted therapy, 58 male (53.7%), 30-39 years old 32 subjects (29.6%), b3a2 transcript 67 subjects (73.6%), Imanitib 62 subjects (57.4%) and status for 36 months was followed during the targeted treatment of dead 19 subjects (17.6%) and alive 89 (82.4%). The survival rate of a three years CML subjects who received targeted therapy of 51%, found no significant relationship between gender, age, and targeted therapy. Conclusion: The survival rate of three years of CML patients at Wahidin Sudirohusodo Makassar Hospital is 51% and factors related to age, gender, and targeted therapy tend to influence even though statistically not significant,

Comparison between short segment pedicle screw fixation and long segment pedicle screw fixation for treatment of neglected single level thoracolumbar burst fracture

BackgroundIn contrast with acute cases, the treatment for thoracolumbar burst fracture remains controversial between short segment and long segment pedicle screw in neglected cases, in which only little investigation is done about the proper treatment. MethodsUsing cross-sectional study, we assessed all patients with neglected single level thoracolumbar burst fracture underwent short segment or long segment pedicle screw fixation from January 2016 to June 2019 in Wahidin Sudirohusodo Hospital Makassar. We analysed the data for neurological status, radiological kyphotic angle correction, hospital length of stay, and postoperative patients’ satisfaction. ResultsTwenty-one samples were analysed. The mean age of patients was 35 ± 13 years old, consisted of 15 males (71,4%) and 6 females (28,6%). The first lumbar vertebra was the most frequently affected site of a burst fracture (71,4%). Based on ASIA Impairment Scale, the difference was insignificant (p = 0,918). Kyphotic angle correction of less than three degrees, were achieved in 20% of patients treated with short segment fixation, while the long segment counterpart achieved only 12,5%, with p = 0,579. Six out of sixteen patients (37,5%) underwent long segment fixation had poor hospital length of stay (>14 days), while none of the short segments had it, but the difference was insignificant (p = 0,246). Patients’ complain of pain was significant (p = 0,047) in fair category (VAS 3–7). ConclusionThere were no significant differences in outcome between short segment and long segment pedicle screw fixation for treatment of patient with neglected single level thoracolumbar burst fracture.

THE ASSOCIATION OF BRAF V600E MUTATIONS IN THE FECES OF COLORECTAL CANCER PATIENTS WITH LOCATION, HISTOPATHOLOGY, AND TUMOR DIFFERENTIATION DEGREE IN MAKASSAR, INDONESIA

Introduction: BRAF mutations (v-RAF murine sarcoma homogeneous viral oncogene B1) has been associated with aggressive phenotypes and are the main prognostic biomarkers for poor outcomes, especially in late-stage colorectal cancer (CRC). Faecal DNA testing has become a valid and reliable non-invasive procedure for the detection of CRC. This study aims to determine the relationship of the BRAF V600E mutation in CRC patients' faecal with the location, histopathology, and degree of tumour differentiation. Material and Methods: This study used data from 43 stool samples of CRC patients at Wahidin Sudirohusodo Hospital Makassar from July to December 2019. We collected data such as age, sex, CRC location, histopathological results, degree of differentiation, and BRAF mutations. Statistical tests were performed with a Chi-squared test. The test results are significant if the P-value

The Role of Matrix Metalloproteinase‑9 (MMP‑9) and Tissue Inhibitor Metalloproteinase‑1 (TIMP‑1) Level in Dengue Hemorrhagic Fever

Introduction: Vascular leakage is a hallmark of Dengue Hemorrhagic Fever (DHF), due to changes in interactions between cells and extracellular matrix in endothelial basement. It major components is type IV collagen that can be destaged by MMP‑9. However, MMP‑9 has an endogenous regulator, TIMP‑1.This study aimed to evaluate between MMP‑9 and TIMP‑1 serum levels in children with DHF. Method: A cross‑sectional study, conducted in Wahidin Sudirohusodo Hospital Makassar, Indonesia. Population of children aged 1 to 18 years from September 2014 to March 2015. Results: Out of 38 subjects, DHF stage I (34,2%), stage II (39,5%), stage III (26,3%) and no stage IV. No significant different levels of MMP‑9 and DHF (P&gt;0.05). There was difference levels of TIMP‑1 in stage I and II (P&lt;0,05). Level of MMP‑9/TIMP‑1 ratio is higher in stage I than II (P&lt;0.05). Positive correlation between MMP‑9 and TIMP‑1 levels in stage II (P&lt;0.05). Conclusion: The levels of MMP‑9 serum could not represent vascular condition in DHF. However, TIMP‑1 serum, MMP‑9/TIMP‑1 ratio, and correlation between the levels of MMP‑9 and TIMP‑1 in DHF describe the vascular state instage I and II.

Karakteristik Pasangan Infertil di BLU RS Dr. Wahidin Sudirohusodo Makassar

Background: Infertility is the inability to conceive after 12 months of frequent sexual intercourse without contraception. Where infertility can be influenced by the characteristics of both partners.&#x0D; Objective: To analyze the characteristics of infertile couples in BLU Dr. Wahidin Sudirohusodo Hospital Makassar.&#x0D; Place: BLU Dr. Wahidin Sudirohusodo Hospital Makassar.&#x0D; Study design: This study is an analytic survey with a retrospective approach. The variables were age, occupation, education, and referral place. Data from patient samples were processed and analyzed with the help of computerization.&#x0D; Results: There were 90 (91.8%) cases of primary infertile couples and 8 (8.2%) cases of secondary infertile couples. The most common diagnoses following infertility were uterine tumors (35.7%) and endometriosis (29.6%). The age, occupation, and education variables are significant in the case of infertility with a p value &lt;0.05. The result stated that the referral place was not significant with a value of p = 0.096. The range of infertility risk is wide in occupational variables, where the wife (OR 3.012; 95% CI = 1.639 - 5.536) and husband (OR 36.00; 95% CI = 8.628 - 150.216).&#x0D; Conclusion: Characteristic analysis shows that working infertile couples have the biggest risk factor for infertility.

Evaluation of Pleura Efusion Determination by Light's and Heffner's Cciteria

EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT'S DAN HEFFNER'S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital Makassar ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation in the pleural cavity due to excessive transudation or exudation. Light's criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications so several alternative criteria are developed, one of which is Heffner's criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner's criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light's criteria obtained 3 misclassifications and Heffner's criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light's criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner's criteria has sensitivity of 100 % and specificity of 86,7 %. Conclusion : Heffner's criteria offers better sensitivity and specificity than Light's criteria. Heffner's criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner's criteria, Light's criteria, transudate, exudate, pleural effusion

Analysisi Platelet Indices in Patient Type 2 Diabetes Mellitus with Vascular Complication

ANALYSIS PLATELET INDICES IN PATIENT TYPE 2 DIABETES MELLITUS WITH VASCULAR COMPLICATION Nelly1, Suci Aprianti2 ,Darmawaty ER31Medical Doctor Specialist Education Program of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo hospital, Makassar2Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University3Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University /Dr. Wahidin Sudirohusodo Hospital, Makassar ABSTRACT Introduction :Type 2 Diabetes Mellitus(T2DM) is an endocrin disease that is marked by hyperglycemic condition due to a decrease increase in insulin secretion and insulin resistance or both. Indonesia is the 7th country with the highest incidence of diabetes mellitus in the world. Progression of the disease is slow and cause vascular endothelial damage. The increase of platelet indices is suspected to be an indications of vascular complicationsObjective :To evaluate the platelet indices in diabetics patients with complication and correlate these indices with GDP and HbA1c. Materials and methods :We analyzed platelet indices and biochemical data of patients seen in outpatients by clinicans of wahidin soedirohusodo hospitals. 120 patients with type 2 diabetes mellitus were included with 64 patients vascular complication and 56 patients without complication.Result :We observed an increase in mean platelet volume (MPV): 9,96 + 1.99vs 8.87 + 1.35(p-value: 0,001) ;in platelet distribution width (PDW): 15.29 + 3.45 vs 12.36 + 2.819(p-value: 0,000; without increase plateletcrit (PCT); 0.28 + 0.14 vs 0.25 + 0.12 (p-value: 0.168). we observed a correlation between FBG with PDW (P=0.044).Conclusion :The study findings point to the significant differences in platelet indices (MPV and PDW) in patients with T2DM with complication and without complication, suggesting the presence of platelet in diabetics type 2 patients more reactive and aggregatable in this group of individuals. These suggest that platelet evaluation may be useful in the early detection of long term complication in diabetics patients.Keyword :T2DM, platelet indices, complication vascular

The Compatibility Analysis of Serum Ascites Albumin Gradient and Ascitic Fluid Evaluation to Clinical Diagnosis of the Patient

Ascites is a condition of abnormal fluid accumulation in the peritoneal cavity that can be caused by many underlying diseases. Some studies conclude that ascitic fluid evaluation with transudate-exudate concept has been replaced by greater indicator, known as Serum Ascites Albumin Gradient (SAAG). This study aims to analyze the compatibility of SAAG and ascitic fluid evaluation to the clinical diagnosis of patients in Dr. Wahidin Sudirohusodo Hospital Makassar. The retrospective cross-sectional study was conducted by taking data from all patients with ascites condition examining both ascitic fluid and serum albumin simultaneously or within 3 days at the Dr. Wahidin Sudirohusodo Hospital Makassar from January – August 2018. The statistical analysis was performed for frequency distribution and Kappa statistical test to assess the compatibility of SAAG and ascitic fluid evaluation to clinical diagnosis of the patient. The study was conducted on 68 subjects and found that both ascitic fluid examination and SAAG were significantly compatible to the clinical diagnosis, 25.8% (p &lt;0.05), 42.5% (p &lt;0.001), respectively. SAAG and ascitic fluid evaluation were significantly in accordance with the clinical diagnosis of the patient. The compatibility value of SAAG is greater than ascitic fluid evaluation so that SAAG is more recommended for ascites examination.

Genotype and Serotype Identification of Hepatitis B Virus in Chronic Hepatitis B Patients Treated with Telbivudine

Hepatitis B is an inflammatory liver disease caused by hepatitis B virus (HBV). In Indonesia, the prevalence of Hepatitis B Surface Antigen (HBsAg) is 9.4%, categorizing the country as endemic hepatitis B. HBV has been classified into at least ten genotypes and four serotypes. Each genotype has different clinical significance and virologic characteristics, which can be an independent risk factor of Hepatocellular Carcinoma in addition to the male sex, older age, and positive Hepatitis B Envelope Antigen status. Telbivudine antiviral therapy suppressed the virus, but in case of resistance mutations, the mutant might grow continuously due to drugs inefficiency. This study aimed to detect the genotypes and serotypes of HBV in hepatitis B chronic patients after 12 weeks of telbivudine treatment. The subject of this study involved 26 patients with chronic hepatitis B, receiving 12 weeks treatment of telbivudine in the gastrohepatology division of the RSUP Wahidin Sudirohusodo hospital. The HBV genotype was identified by analyzing the HBV P gene, while the serotype was detected by deducing the nucleotide of the HBV S gene that overlapped with the P gene. Nine samples (75%) were genotype b, and three samples (25%) were genotype c. for serotype, six (50.0%), three (25.0%), and three (25.0%) samples were ayw, adw, and adr, respectively. genotype b is generally associated with less progressive liver disease than genotype c. genotypes b and c are prevalent in highly endemic areas in which the perinatal or vertical transmission play an important role in spreading the virus.

Maternal Death Risk Factors in Wahidin Sudirohusodo Hospital and Its Affiliates

Abstract&#x0D; Objectives : To identify maternal death risk factors in Wahidin Sudirohusodo Hospitals and its affiliates between 01 January - 31 December 2017&#x0D; Methods: This study is an observational case control study that includes all cases of maternal death and considerable numbers of pregnancy without complications that occured in Wahidin Sudirohusodo Hospital and its affiliates between 01 January 2016 and 31 December 2017. Data were then be analysed using chi square and logistic regression test to know the correlations between risk factors and maternal death.&#x0D; Results :There are 28 cases of maternal death in Wahidin Sudirohusodo Hospital and its affiliates which mostly occured at age 20-35 years old (60.7%) and antenatal care in in primary health care (71,4%). Hypertension (39,3%) and hemorrhage (35,7%) were the most frequent complicaitons of maternal death. Age under 20 years old and older than 35 years old (odds ratio 3.882; 95% CI, 1.056-14.276; P&lt;0.05), education level less than 9 years (odds ratio 3.178; 95% CI, 0.987-10.228; P&lt;0.05), Age and education level did not seem to affect incidence of maternal death when analysed simultaneously (odds ratio 1.842; 95% CI, P&gt; 0.05).&#x0D; Conclusions: Hypertension and hemorrhage were the most frequent causes of maternal death. Age under 20 years old and older than 35 years old as well as education level less than 9 yearsincreased the risk of maternal deaths independently. Parity, frequency of antenatal care, and location of antenatal care did not show any significant role in maternal death occurence.&#x0D; Keywords : Maternal death, risk factors, hypertension, hemorrhage, age&#x0D; &#x0D; Abstrak&#x0D; Tujuan: Untuk mengetahui faktor-faktor risiko kematian maternal di Rumah Sakit Umum Pusat Wahidin Sudirohusodo dan jejaringnya dalam periode 01 Januari – 31 Desember 2016.&#x0D; Metode : Penelitian ini penelitian studi observasional case control dengan mengambil seluruh data kematian maternal yang terjadi di Rumah Sakit Umum Pusat Wahidin Sudirohusodo dan jejaringnya dalam periode 01 Januari – 31 Desember 2016. Data dianalisis dengan Uji chi square dan regresi logistik untuk melihat faktor risiko yang diteliti dengan terjadinya kematian maternal.&#x0D; Hasil : Ada 28 kasus kematian maternal di Rumah Sakit Umum Wahidin Sudirohusodo dan jejarignya yang sebagian besar terjadi pada kelompok umur 20-35 tahun (60,7%) dan lokasi asuhan antenatal di Puskesmas (71,4%). Komplikasi kehamilan terbanyak ialah hipertensi (39,3%) dan perdarahan (35,7%). Kelompok umur kurang dari 20 tahun dan lebih dari 35 tahun (odds ratio 3.882; 95% CI, 1.056-14.276; P &lt;0.05) dan pendidikan kurang dari 9 tahun (odds ratio 3.178; 95% CI, 0.987-10.228; P&lt;0.05) memiliki pengaruh signifikan terhadap terjadinya kematian maternal . Umur dan tingkat pendidikan secara simultan tidak mempengaruhi terjadinya angka kematian maternal (odds ratio 1.842; 95% CI; P &gt; 0.05).&#x0D; Kesimpulan : Hipertensi dan perdarahan merupakan penyebab utama terjadinya kematian maternal. Kelompok umur kurang dari 20 dan lebih dari 35 tahun serta tingkat pendidikan &lt; 9 tahun secara independen berisiko meningkatkan jumlah kematian maternal. Paritas, frekuensi asuhan antenatal, dan lokasi asuhan antenatal tidak memiliki peran signifikan dalam terjadinya kematian maternal.&#x0D; Kata kunci : Kematian maternal, faktor risiko, hipertensi, perdarahan, umur

A case evaluation of traumatic brain injury in Wahidin Sudirohusodo Hospital, Makassar during January 2016 - December 2017

Introduction: Traumatic Brain Injury is a case that is often encountered in emergency care installation and is one of the leading causes of death in the productive age range. Globally, the Traumatic Brain Injury incident increased sharply, mainly due to the increase in motorized vehicle use. In 2020, the WHO estimated that traffic accidents would be the third-largest cause of disease and trauma in the world. In Indonesia, at Cipto Mangunkusumo Hospital Jakarta shows that the mortality rate is high in patients with severe head injuries with a percentage of 35% -50%. This figure is higher than the international literature standard. This study aims to describe the traumatic brain injury case in Wahidin Sudirohusodo Hospital from January 2016 - December 2017.Methods: This descriptive study report the evaluation of cases of traumatic brain injury patients at Wahidin Sudirohusodo Hospital Makassar, from January 2016 - December 2017. The population and sample are 1217 patients (total sampling).Result: From 1217 samples, most are men (70%), and 30% are women, with age 11-20 years are the most (30%). The most common causes of traumatic brain injury are caused by traffic accidents (89%). The largest group of patients (50%) had a mild head injury (GCS 14-15). From a Head CT scan, the most lesion was epidural hemorrhage (EDH) (26-34%) followed by intracerebral hemorrhage (ICH) (23-28%). About 36% patients were treated by operations and the rest were conservative. Based on the outcomes, about 77% were discharged from a hospital in life and 23% died.  Conclusion: The highest mortality was in severe head injury, about 87% was died (161 of 186 patients with a severe head injury). From the Head CT Scan, about 95% (19 of 20 patients) with IVH lesions were died and followed by ICH lesions as 39% (122 died from 309 patients). Based on the therapy given both surgery and conservative, patients who were discharged from the hospital in life at 77-79% and died 21-23%.

PROFILE IGA (VCA-P18+EBNA1) AND VIRAL LOAD EBV DNA AS A RISK FACTOR AMONG RELATIVES OF NASOPHARYNX CARCINOMA PATIENT WITH EBV POSITIVE AT DR. WAHIDIN SUDIROHUSODO HOSPITAL IN MAKASSAR

Introduction:&#x0D; Nasopharyngeal carcinoma (NPC) is closely associated to viral infection, i.e. Epstein-Barr virus (EBV), about 90 % of the worldwide are infected with EBV at same point of their lives. This virus is highly oncogenic and easily transmitted via saliva. The high level of biomarker for EBV infection can become a risk factor for NPC in relative’s NPC patients. Therefore, EBV related biomarkers is needed to enable screening and detecting early diagnosis of NPC in endemic area.&#x0D; Objective:&#x0D; This study aims to analyze the role of IgA (VCA-p18+EBNA1) levels and viral load (VL) as screening tools for early detection in relatives of positive EBV NPC patients. Therefore, it can be used as predicted risk factor for NPC.&#x0D; Method:&#x0D; The method used in this study is cross-sectional with consecutive sampling of 50 relatives of NPC patients treated at the Dr. Wahidin Sudirohusodo Hospital from August 2012 to May 2013. Univariate and bivariate analysis and t-test are used to measure and to show the correlation of Ig A (VCA-p18+EBNA1) level and VL.&#x0D; Result:&#x0D; Results showed that 28 % of the NPC patients are female with an average age of 31.12±11.91. Sixty-eight percent of the relatives are siblings, and most of them are Buginese tribe (58%). According to the risk distribution of NPC, the sampling is grouped in 3 categories i.e. high risk, intermediate risk, and low risk to NPC. There is 50% of the relatives of the NPC patients categorized to the intermediate risk. The IgA (VCA-p18+EBNA1) level is significant (p=0.000) compared with the VL level (p=0.337). Sixteen percent of the high-risk group have a normal pattern, but it still needs high awareness. Statistically, the Pearson correlation analysis showed a relationship but not significant.&#x0D; Conclusion:&#x0D; It could be concluded that IgA (VCA-p18+EBNA1) and VL level could be used as a screening method and early detection in relatives of NPC patients and become a predicted risk factor for NPC

Vascular endothelial growth factor (VEGF) expression in induction phase chemotherapy of acute lymphoblastic leukemia

Background Leukemia is a hematolymphoid malignancy originating from bone marrow. The progression of hematolymphoid malignancies depends on new formation of vasculature, called angiogenesis. Angiogenesis is regulated by vascular endothelial growth factor (VEGF), which is secreted by paracrine and autocrine signaling mechanisms.&#x0D; Objective To evaluate VEGF expression in induction phase chemotherapy of acute lymphoblastic leukemia (ALL) patients. &#x0D; Methods This prospective, cohort study was conducted in ALL patients admitted to Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi, from October 2016 to October 2017. Subjects’ VEGF levels were measured at diagnosis and at the end of induction chemotherapy.&#x0D; Results VEGF levels were analyzed in 59 patients, 29 of whom were diagnosed with standard risk ALL and 30 patients with high risk ALL. VEGF levels were significantly decreased after induction phase chemotherapy in standard risk ALL and in high risk ALL subjects. There was no significant difference in VEGF levels before induction phase chemotherapy between the standard and high risk groups (P=0.405). There was also no significant difference in VEGF levels after induction phase chemotherapy between the two risk groups (P=0.094).&#x0D; Conclusion The VEGF level is significantly lower after ALL induction phase chemotherapy in both the standard risk and high risk ALL groups. However, there are no significant differences in VEGF levels between the standard and high risk groups before as well as after induction phase chemotherapy.