JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga

Profile of Patients with Decreased Bone Density Aged Over 50 Years Old with Cases of Femoral Neck Fracture, Thoracic Vertebral Compression Fracture, Lumbar Vertebral Compression Fracture, and Distal Radius Fracture in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, in 2019-2020

Arlingga Pratama, Gadis Meinar Sari, Dwikora Novembri Utomo — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Decreased bone density often progresses to osteoporosis, where osteoporosis is a degenerative disease characterized by low bone mass, bone tissue damage, and bone microarchitecture disorders that can lead to an increased risk of bone fracture.
Fractures often found in low bone density consist of fractures of the femoral neck, the thoracic and lumbar vertebrae, and distal radius fractures.

Abstract

Introduction: Human life expectancy will increase over time, as will various chronic degenerative diseases, one of which is fracture caused by decreased bone mass density. This study described fracture features associated with decreased bone mass density in patients over 50 years old.

Methods: This study took place at the Polyclinic of Orthopaedics and Traumatology Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, using a quantitative design with a cross-sectional approach. The sample in this study consisted of 56 medical records collected using a questionnaire processed with Microsoft Excel.

Results: This study used 56 samples. Femoral neck fractures had the highest number of decreased bone mass density fractures (69.7%). The most common body mass index (BMI) found with fractures was obese patients (32.2%). Most fractures were experienced by females (64.3%). The location of the highest incidence of fractures was found in domestic accidents (66.1%) with low-energy trauma (67.9%).

Conclusion: Most of the fractures caused by decreased bone density in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, were femoral neck fractures, with females being the most common gender. These fractures were also the most common in obese patients, and the highest incidence was found in domestic accidents with low-energy trauma.

Profile of Elderly COVID-19 Patients at Indrapura Field Hospital, Surabaya

Haidar Mahdian, Erwin Astha Triyono, Noor Idha Handajani, Leny Kartina — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Elderly patients with comorbidities are more vulnerable to coronavirus disease (COVID-19) because it can cause a higher mortality rate and a poor prognosis.
Most of the elderly COVID-19 patients who were given symptomatic treatment were cured.

Abstract

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a pathogen that causes coronavirus disease (COVID-19). The elderly, especially those with comorbidities, are vulnerable to COVID-19. This study aimed to determine the profile of elderly patients with COVID-19 and to provide valuable data for further research.

Methods: This was a retrospective descriptive study of 132 (n=132) elderly COVID-19 patients at Indrapura Field Hospital, Surabaya, between April and October 2021. The clinical profile was determined by collecting medical record data from Indrapura Field Hospital, Surabaya. All statistical data analyses were conducted using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) for Macintosh version 25.0.

Results: This study indicated that among 132 (n=132) elderly patients, the predominated age range was 61–63 years old (37.12%), and most of the patients were males (57.6%). The majority of the patients' occupations were private employees, and hypertension was the main comorbidity in elderly patients (52.3%). Most patients experienced mild symptoms (46.2%), with the most common complaint being a productive cough (42.4%). All of the patients had no antiviral, antibacterial, or corticosteroid therapy. There were 73 patients (55.3%) who had been hospitalized for less than 10 days, with most of the patients (78.79%) cured and allowed to go home.

Conclusion: The majority of patients at Indrapura Field Hospital, Surabaya, were elderly male patients, with hypertension being the most common comorbidity. Most patients exhibited mild symptoms, mainly a productive cough, and showed significant improvement with symptomatic, isolation, relaxation, nutrition, and observation (SIRNO) therapy, resulting in a high recovery and discharge rate.

Risk Factors of Death in Chronic Obstructive Pulmonary Disease (COPD) Patients at Dr. Soetomo General Academic Hospital, Surabaya, in 2019

Hilmy Indra Wedhana, Arief Bakhtiar, Edward Kusuma, Alfian Nur Rosyid — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

The highest distribution of chronic obstructive pulmonary disease (COPD) patients’ age and gender was over 60 years old and males.
The highest distribution of COPD patients’ comorbidity was infection, with pneumonia being the most common infection.

Abstract

Introduction: The distribution of death and risk factors in chronic obstructive pulmonary disease (COPD) patients varies according to disease severity. This study aimed to determine the risk factors of mortality in COPD patients.

Methods: This was a retrospective descriptive study with a total sampling method using inclusion and exclusion criteria. Data collection was performed on patients' medical records throughout 2019. The inclusion criteria for this study sample were patients diagnosed with COPD who died in 2019, aged over 25 years old (adults), both male and female. The exclusion criteria were COPD patients with incomplete medical record data.

Results: The total number of samples obtained and included in this study was 31 COPD patients (n=31). The characteristics of the patients showed a predominance of males over females, with a ratio of 9:1. Seventeen samples (58.0%) out of 31 were patients aged >66 years old. Comorbidities accounted for 96.8% of the study population. The most prevalent comorbidity was infection (77.41%), with pneumonia accounting for 38.7% of all deaths. Eighteen patients (58.1%) reported having two or more comorbidities, whilst 28 patients (90.3%) scored 0-7 on the Modified Sequential Organ Failure Assessment (mSOFA) when admitted to the hospital.

Conclusion: This study found that the group of patients with the mSOFA score of 0-7 with the characteristics of being aged >60 years old, males, and having pneumonia infection had the highest mortality rate among other COPD patients who died.

Description of Medical Career Choices during the COVID-19 Pandemic for Students of the Medical Profession Study Program, Faculty of Medicine, Tanjungpura University

Zahlah Ninanda, Iit Fitrianingrum, Sari Eka Pratiwi — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

The most sought-after medical career choices and institutions were specialist doctors and hospitals.
The most sought-after medical career choices were obstetrics and gynecology specialists.

Abstract

Introduction: Government policies during the coronavirus disease (COVID-19) pandemic have limited the clinical rotation learning system of the Medical Faculty at Tanjungpura University. This study examined the description of medical career choices during the COVID-19 pandemic for students of the Medical Profession Study Program, Faculty of Medicine, Tanjungpura University.

Methods: This was a descriptive study using a quantitative method in the form of a questionnaire. A total of 138 students were selected through the purposive sampling technique (n=138). The variables were then measured using a medical career choice questionnaire. The obtained data were further processed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) for Windows version 23.0 and Microsoft Excel 2013.

Results: Study results showed that from 138 samples (n=138), students chose careers as general practitioners (male=17.5%; female=16%), specialist doctors (male=70%; female=73%), lecturers (female=2%), structural doctors (male=5%; female=6%), and non-medical careers (male=7.5%; female=2%). Regarding their preferred workplace, students chose the government hospital (male=40%; female=47%), private hospital (male=37%; female=32%), public health center (male=7%; female=9%), private clinic (male=5%; female=4%), state-owned clinic (male=3%, female=1%), military (male=5%, female=2%), ministry (male=3%; female=1%), educational institution (female=3%), and police (female=1%).

Conclusion: The most sought-after medical career choices and institutions were obstetrics and gynecology specialists and hospitals. Factors that influenced the selection of a medical career were personal and professional characteristics, employment conditions, personal life, preclinical and clinical rotation phase, demands of postgraduate education, and family roles. Conducting further research to determine the factors that influence the choice of a medical career by using mixed-method research or qualitative interviewing is recommended.

Academic Motivation and Achievement in Undergraduate Students of the Medical Program, Faculty of Medicine, Tanjungpura University, during the COVID-19 Pandemic

Imanda Yandion, Iit Fitrianingrum, Sari Eka Pratiwi — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Most students had very high academic motivation and achievement in the very satisfactory category.
No correlation between academic motivation and achievement in undergraduate students.

Abstract

Introduction: Academic motivation is said to be correlated to academic achievement. The coronavirus disease (COVID-19) pandemic has led to a distance learning policy allowing students to continue their education. Distance learning has several impacts that can result in students' academic motivation. Therefore, it affects academic achievement. This study examined the relationship between academic motivation and achievement in undergraduate students of the Medical Study Program, Faculty of Medicine, Tanjungpura University, during the COVID-19 Pandemic.

Methods: This was an observational analytic study with a cross-sectional approach. A total of 169 students (n=169) were selected through a stratified random sampling technique. Data was processed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 24.0. The variables were measured using the Academic Motivation Scale (AMS)—Short Indonesian Language Version questionnaire and the student's Grade Point Average (GPA). The Spearman Rank correlation test showed a significance value of 0.096 (Sig>0.05; r=0.128).

Results: The results showed that most of the samples had very high academic motivation (71.6%) and academic achievement in the very satisfactory category (51.5%). Spearman Rank correlation test showed a significance value of 0.096 (Sig>0.05; r=0.128).

Conclusion: There was no correlation between academic motivation and achievement in undergraduate students of the Medical Program, Faculty of Medicine, Tanjungpura University, during the COVID-19 pandemic.

Duration of Gadget Use and Severity of Dry Eye Syndrome based on the Ocular Surface Disease Index (OSDI) Questionnaire in Final-Year Students of the Faculty of Medicine, Universitas Airlangga

Arya Agung Hari Subagiono, Evelyn Komaratih, Pirlina Umiastuti, Rozalina Loebis — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Screen time is one of the risk factors for dry eye disease (DED). Therefore, students are at high risk for DED.
The ocular surface disease index (OSDI) is one method used to assess dry eye disease based on subjective symptoms. However, the correlation between screen time and the incidence of dry eye and/or its severity based on OSDI produces varying results.
The majority of respondents had dry eyes based on OSDI. There was no correlation between screen time and dry eye incidence or severity based on OSDI parameters. Females had higher mean OSDI scores than males.

Abstract

Introduction: People’s screen time surged during and after the COVID-19 pandemic. Screen time was a risk factor for dry eye disease (DED). This study examined the correlation between screen time and DED severity based on an ocular surface disease index (OSDI) questionnaire in final-year undergraduate students of the Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Methods: This was a cross-sectional study. Respondents were recruited via a total sampling method. One hundred eight students participated in this study. Independent variables were sex, average duration of device use per day, and degree of daily gadget usage time. Dependent variables were OSDI score, degree of dry eye based on OSDI score, and dry eye incidence. Chi-Square, Spearman, Kruskal-Wallis, and Mann-Whitney tests were used in data analysis.

Results: There was no significant relationship between daily gadget use duration and OSDI score (p=0.497; r=-0.066) and between the degree of daily gadget usage time and dry eye severity (p=0.609; r=0.050). Sex was unrelated to dry eye incidence (p=0.072) nor severity (p=0.125). There were no significant differences in daily gadget use duration between dry eye vs non-dry eye respondents (p=0.926) and across dry eye severity (p=0.934). There were no significant differences in OSDI scores between degrees of screen time (p=0.978). There was no significant correlation between the incidence of dry eye and the degree of daily gadget usage time (p=0.640). Female respondents had higher mean OSDI scores than males (p=0.009).

Conclusion: Screen time was not related to the incidence and severity of dry eye based on OSDI. However, many respondents had dry eyes based on OSDI.

Profile of Primary Arteriovenous Fistula Failure in End-Stage Renal Disease Patients on Hemodialysis at Dr. Soetomo General Academic Hospital, Surabaya

Moses Orvin Reviano, Yan Efrata Sembiring, Widodo Widodo, Heroe Soebroto — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Arteriovenous fistula is preferred for dialysis vascular access.
Twenty-eight (4.8%) cases had primary arteriovenous fistula failure.

Abstract

Introduction: Primary arteriovenous fistula failure in Indonesia is still relatively high, and end-stage renal disease patients are prioritized to have arteriovenous fistula as their main vascular access for hemodialysis. This study aimed to determine the primary arteriovenous fistula failure profile in end-stage renal disease patients on hemodialysis at Dr. Soetomo General Academic Hospital, Surabaya.

Methods: This was a descriptive retrospective study. The population was primary arteriovenous fistula failure patients. A total sampling method was used from the medical records of Dr. Soetomo General Academic Hospital, Surabaya, from January 2021 until January 2023. The research variables were gender, age, diabetes mellitus (DM) history, hypertension (HTN) history, duration of catheter double-lumen (CDL) usage before arteriovenous fistula placement, incidence of early thrombosis, and incidence of maturation failure. Data was analyzed with Microsoft Excel 2018.

Results: There were 28 primary arteriovenous fistula failure cases from 580 surgical procedures performed in the research period (4.8%). The dominant results were: 15 female patients (54%), 25 non-elderly patients (89%), 16 non-DM patients (57%), 14 patients in both HTN and non-HTN (50%), 20 prolonged CDL patients (71%), followed by 7 patients that did not use CDL (25%), 28 maturation failure patients (100%), and 18 non-early thrombosis patients (64%).

Conclusion: Female gender, duration of CDL usage, and maturation failure were the more prominent characteristics in this research profile. Meanwhile, the less prominent characteristics were old age, DM history, HTN history, and early thrombosis.

Profile of Rhinosinusitis Patients with Orbital Complications at the Ear, Nose, and Throat (ENT) Outpatient Unit, Dr. Soetomo General Academic Hospital, Surabaya, from January 2015 to April 2022

Made Ayu Rheina Putri, Budi Sutikno, Yulia Primitasari, Puguh Setyo Nugroho — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Most rhinosinusitis patients with orbital complications were diagnosed as chronic rhinosinusitis.
Orbital cellulitis (Chandler II) was the most common orbital complication degree.
Rhinosinusitis patients with orbital complications commonly experience eye pain, swollen eyes, and persistent runny noses.

Abstract

Introduction:Rhinosinusitis is an inflammation of the mucosa of the nasal cavity and/or paranasal sinuses. The most common complication is orbital. The limited data available does not account for the high number of cases of rhinosinusitis. This study examined the profile of rhinosinusitis patients with orbital complications.

Methods: This was an observational descriptive study with a retrospective design. It used secondary data from medical records of patients with rhinosinusitis and orbital complications at the Ear, Nose, and Throat (ENT) Outpatient Unit, Dr. Soetomo General Academic Hospital, Surabaya, from January 2015 to April 2022.

Results: There were 40 samples that met the inclusion and exclusion criteria (n=40). As many as 80% of cases were chronic rhinosinusitis, and 20% were acute. The average age of chronic rhinosinusitis was in 6^th decade, while acute rhinosinusitis (ARS) was in 3^rd decade. The majority of patients were males and reside outside Surabaya. Signs and symptoms that ARS patients often experienced were eye pain and swelling, nasal congestion, persistent runny nose, and decreased vision. Meanwhile, chronic rhinosinusitis included eye swelling and pain, persistent runny nose, and facial pain. The most common Chandler’s degree was orbital cellulitis (Chandler II). The most common treatment for ARS was a combination of medicamentosa and non-medicamentosa or medicamentosa and surgery, while chronic rhinosinusitis was a combination of medicamentosa, non-medicamentosa, and surgery.

Conclusion: There were outcome differences between patients with acute and chronic rhinosinusitis regarding age, manifestations, and treatments, but there were similarities in sex, domicile, and Chandler’s degree predominance.

Predictors of Success in Horizontal Strabismus Surgery: Insights from a Prospective Study

Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

The younger age and shorter duration of misalignment are significant predictors of success in horizontal strabismus surgery. Younger patients tend to have higher success rates, and shorter durations of misalignment correlate with better surgical outcomes.
Despite variations in population and surgical methods, the overall success rate of 82.3% for horizontal strabismus surgeries aligns with previous studies. This consistency underscores the reliability of surgical outcomes in different settings.

Abstract

Introduction: Strabismus is an eye disorder characterized by misalignment of the eyes, which can occur in individuals of any age. This study explored the surgical outcomes of horizontal strabismus correction in patients, aiming to provide insights into the factors influencing success.

Methods: A prospective study was conducted with 17 patients (n=17) who underwent surgery at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Preoperative factors, including age, duration of misalignment, and preoperative angle of strabismus, were analyzed for their impact on surgical success. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) for Macintosh version 27.0 was used for data analysis.

Results: This study reviewed the medical records of 17 research samples (n=17). A significant change in the median angle of deviation prism diopters (PD) preoperatively was indicated by the median Postoperative Deviation (PD) (p<0.001). A significant difference in median age at surgery was observed between successful and unsuccessful cases (p=0.035), with younger individuals exhibiting a higher success rate. The duration of misalignment emerged as a crucial factor, with a shorter duration correlating positively with a higher probability of surgical success (p<0.001). Notably, successful outcomes were achieved by all children (100%), suggesting a potential trend indicating age as a predictor of success. While the preoperative angle of strabismus did not significantly impact success, a trend emerged (p=1), indicating a potential threshold effect for more significant angles.

Conclusion: Knowing the significance of age and duration of misalignment on the success rate of strabismus surgery allows for enhanced preoperative assessments, optimized timing of surgery, and developed predictive models to assist in clinical decision-making, ultimately leading to more efficient and successful surgical outcomes.

The Role of Vitamin C Supplementation in Preventing Severity Progression in Mild and Moderate COVID-19 Patients at Universitas Airlangga Hospital

Yoga Akbar Arifandi, Alfian Nur Rosyid, Danti Nur Indiastuti, Wiwin Is Effendi — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

The administration of different dosages of vitamin C significantly yields different outcomes in preventing the progression of disease severity.
Most patients with mild and moderate coronavirus disease (COVID-19) did not demonstrate an escalation in disease severity.

Abstract

Introduction:Coronavirus disease (COVID-19) is an infectious disease that increases pro-oxidant elements and decreases antioxidants. Vitamin C functions as a potent antioxidant in humans due to its electron-donating properties. This study aimed to explain the impact of three distinct vitamin C supplementation dosages in preventing disease severity progression among mild and moderate COVID-19 patients.

Methods:This retrospective study used secondary data from 100 medical records (n=100). The subjects were classified into three categories based on the vitamin C dosage. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26.0 for Windows.

Results:Most of mild and moderate COVID-19 patients (78%) did not experience increased disease severity. Vitamin C supplementation significantly demonstrated a different outcome in preventing disease severity progression among the three groups (p=0.018). However, it did not significantly show any difference in reducing the duration of hospital stay (p=0.680).

Conclusion:The impact of vitamin C supplementation on COVID-19 severity appeared to vary depending on the dosage administered. However, it did not affect the duration of the hospital stay.

Obesity and Clinical Outcomes of Acute Decompensated Heart Failure

Alviyatul Ainin Nuvus, Andrianto Andrianto, Sony Wibisono Mudjanarko — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Clinical outcomes in obese acute decompensated heart failure patients were found to be better than those of non-obese patients but not statistically significant.
Acute decompensated heart failure patients were dominated by males.

Abstract

Introduction: Obesity is an independent risk factor that raises the prevalence of heart failure, but it is paradoxically associated with a better prognosis. This study examined the relationship between obesity and clinical outcomes of acute decompensated heart failure at Dr. Soetomo General Academic Hospital, Surabaya.

Methods: This was an analytic observational study using a prospective cohort design. Patients with acute decompensated heart failure who were admitted to the inpatient care unit of Dr. Soetomo General Academic Hospital, Surabaya, from December 2021 to July 2022 were chosen using a purposive sample technique. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26.0.

Results: There were 58 patients (n=58) representing different categories, with an average age of 55 years old, and were predominately males (58.6%). This study found that clinical outcomes in obese acute decompensated heart failure patients were better than those of non-obese patients in terms of shorter lengths of stay (p=0.825), lower rates of rehospitalization (p=0.458), and lower rates of all-cause mortality (p=0.673).

Conclusion: The difference between the clinical outcomes in obese acute decompensated heart failure patients and non-obese patients was not statistically significant.

Knowledge of Teenagers in Surabaya about COVID-19 and Prevention Behavior

Amara Destania Armyne, Nining Febriyana, Wiwin Retnowati, Azimatul Karimah — Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

Most respondents had good knowledge and prevention behavior.
No significant relationship was found between knowledge and behavior to prevent COVID-19.

Abstract

Introduction: Coronavirus disease (COVID-19) is a newly discovered infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which can affect individuals of all ages. The high positive number of COVID-19 cases in Surabaya and the proportion of teenagers in society is quite large. This study examined the knowledge of teenagers in Surabaya about COVID-19 and prevention behavior.

Methods: This descriptive study used a cross-sectional design and an online questionnaire (Google Forms). The target sample was teenagers aged 10-19 years old who live in Surabaya. A total of 122 respondents were involved (n=122). Sampling was performed using the consecutive sampling method, and the data was processed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 19.0 using univariate and bivariate analysis (p=0.367).

Results: The results showed that most respondents had good knowledge (72.1%) and good behavior (89.3%) regarding COVID-19. No significant relationship was found between knowledge and behavior to prevent COVID-19 among adolescents who live in Surabaya (p=0.367).

Conclusion: This study revealed that most respondents had good knowledge and prevention behavior. Due to a limited number of samples, a larger sample would have provided a more thorough representation of the population and resulted in more accurate outcomes.

BCG Vaccination and Spinal Tuberculosis in Non-Malnourished and/or Non-HIV Infected Children at Dr. Soetomo General Academic Hospital, Surabaya

Fri, 10 Jan 2025 00:00:00 +0700

Highlights:

The Bacillus Calmette-Guérin (BCG) vaccination has been widely implemented in Indonesia, but cases of spinal tuberculosis (TB) in children can still be found.
There are significant and moderate relationships between BCG vaccination and the occurrence of spinal TB in children.

Abstract

Introduction: Spinal tuberculosis (TB) is an extrapulmonary form of TB that affects the spine. The Bacillus Calmette-Guérin (BCG) vaccination program, which has been implemented to prevent TB, should have prevented this type of TB. However, cases of this disease in children can still be found. This study aimed to determine whether there was a relationship between BCG vaccination and the occurrence of spinal TB in children.

Methods: This case-control analytic observational study was performed based on medical record data. The study subjects of each group, both case and control, were taken from pediatric TB patients at Dr. Soetomo General Academic Hospital, Surabaya, from 2017 to 2021. Patients with malnutrition and/or human immunodeficiency virus (HIV) infection were excluded. Statistical analyses were performed using Fisher’s exact test.

Results: There were 9 patients in total within each group. Most were 12-17 years old, and the ratio of male by female was 1.25:1. There were 4 out of 9 (44%) spinal TB patients and 9 of 9 (100%) patients with no spinal TB who all received BCG vaccination. The statistical test indicated a significant (p=0.029) and moderate (C=0.527) relationship between BCG vaccination and the occurrence of spinal TB in children.

Conclusion: The Bacillus Calmette-Guérin vaccination should be able to prevent the new occurrence of spinal TB in children.