JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga

Success Rate of Coronary Artery Bypass Grafting on Elderly Patients in Dr. Soetomo General Academic Hospital, Surabaya

Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

CABG is the most performed cardiac surgery in Indonesia, and most patients undergoing this surgery are above 60 years old.
CABG success rate is not significantly influenced solely by the patient's age but also by several perioperative characteristics such as gender, comorbidities, and other variables included in the calculation of EuroSCORE II.

Abstract

Introduction: Coronary artery disease (CAD) has caused more than a quarter of deaths in Indonesia and is found to be more prevalent in elderlies (â‰¥60 years old). Treatment options include coronary artery bypass grafting (CABG), the most-performed cardiac surgery in Indonesia. This study aimed to determine the short-term and one-year postoperative success, morbidity, and mortality rates with their causes in Dr. Soetomo General Academic Hospital, Surabaya.

Methods: This was a cross-sectional retrospective study using secondary data obtained from 85 medical records of CABG patients aged â‰¥60 years old in the Department of Thoracic, Cardiac, and Vascular Surgery Dr. Soetomo General Academic Hospital, Surabaya, from January 2018 to December 2020. Aside from descriptive statistics, logistic regression was conducted to assess the relationship between EuroSCORE II and the success of CABG in elderly patients. A probability (p) value < 0.05 was considered significant.

Results: Patients were mostly male in their sixties with a mean of 65.5 ± 4.9 years old, had three-vessel disease, and predicted mortality of 1.6%. The average number of grafts used was 3.3 ± 0.7, and the average length of hospital stay was 7.4 ± 2.4 days. The morbidity rate was 71.8%, with bleeding as the most common complication, a 17.6% mortality rate, and a success rate of 82.4% (short-term) and 80% (one-year postoperative). Higher EuroSCORE II was found to significantly decrease the probability of both short-term (prevalence ratio [PR], 0.766; 95% CI, 0.604-0.971; p = .028) and one-year postoperative success (PR, 0.787; 95% CI, 0.624-0.993; p = .044).

Conclusion: Surgical success in elderly patients is influenced by many factors, and old age should not deter physicians from referring patients for CABG. Despite the ability of EuroSCORE II to predict surgical success, both short-term and one-year survival, on elderly patients, there is a need for holistic and locally validated scoring systems to both evaluate and predict surgical success due to the unique healthcare context of Indonesia.

Risk Factor Profile of Amputation in Diabetic Foot Patients in Dr. Soetomo General Academic Hospital, Surabaya, from 2019 to 2020

Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

Certain variables are known to be risk factors associated with the outcome of lower extremity amputation among diabetic foot patients.
The patient population was observed to be slightly female-biased, with a high prevalence of older age, abnormally high blood sugar and HbA1c, and a history of nephropathy, dyslipidemia, and hypertension. Prior history of vascular diseases, prior amputation history, and heavy smoking were observed but not as prevalent.

Abstract

Introduction: This study aimed to find the general distribution of certain variables as risk factors for lower extremity amputation among diabetic foot patients at the Inpatient Ward of the Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Surabaya, from 2019 to 2020.

Methods: This was a descriptive-retrospective study using data from medical records. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26 was used to calculate the distribution.

Results: The mean ± SD of age was 55.38 ± 7.503 years old and was slightly female-biased. The median (min-max) blood sugar level was 212.00 (85–446) mg/dL. Fifteen out of 16 patients had an HbA1c beyond 7.0%. The body mass index (BMI) of most patients was between normal and overweight, with a mean ± SD of 24.018 ± 4.1827. Fifteen percent of patients were smokers. Strokes were present in 3.9% of patients, cardiovascular diseases were present in 13.73% of patients, prior lower extremity amputation (LEA) history was present in 15.7% of patients, hypertension was present in 49% of patients, and dyslipidemia was present in 13 of 15 patients. The mean estimated glomerular filtration rate (eGFR) was 70.15 ± 34.498 mL/min/1.732.

Conclusion: Older age, high blood sugar, high HbA1c levels, nephropathy, dyslipidemia, and hypertension had a high prevalence. Smoking, cardiovascular diseases, strokes, and prior amputation had a low prevalence. Gram-negative bacterial infection was observed in almost all reported patients. ABI results were either mostly not assessable or abnormally high. Most of the patients' Wagner gradings were in the worst category.

Trauma Profile of Homicide Victims at Dr. Soetomo General Academic Hospital, Surabaya, during the COVID-19 Pandemic

Ichsan Syarif, Ahmad Yudianto, Tania Ardiani Saleh, Nily Sulistyorini — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

Most homicide victims were predominantly in the productive age range of 21-40 years old.
Males were more likely to be homicide victims than females.

Abstract

Introduction: The injuries of homicide victims are clues in forensic medicine to uncover a possible crime. In Indonesia, there are not many studies on trauma profiles, specifically in homicide cases. This study aimed to provide an overview of the trauma profile of homicide victims at Dr. Soetomo General Academic Hospital, Surabaya, from January 2020 until December 2021.

Methods: This was a descriptive study. Secondary data was collected from 34 forensic examination reports at Dr. Soetomo General Academic Hospital, Surabaya. Data such as age, sex, type of injury, sites of injury, number of injuries, cause of death, and mechanism of death were analyzed statistically.

Results: Most victims were between 21 and 30 years old and 31 and 40 years old (26.47%). Sex was dominated by men (76.47%). The most common type of injury was abrasion (25.71%). The most common injury sites were head-neck (34.34%) and chest-upper back (34.34%). The most common number of injuries was â‰¥10 (44.12%). The most common cause of death was sharp-force trauma (54.54%), and the most common mechanism of death was exsanguination (54.54%).

Conclusion: Males predominated in the age ranges of 21 to 30 years old and 31 to 40 years old. The most common type of injury was abrasion. The most common sites of injury were the head, neck, and chest upper back. The most common number of injuries was â‰¥10. Most victims died of sharp-force trauma. Exsanguination was the most common mechanism of death.

Food Intake, Infectious Disease, and Environmental Sanitation in Toddlers Aged 6-24 Months in Cibatu Health Center, Garut

Dinna Yusigania, Linda Dewanti, Ahmad Suryawan — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

This study found a significant relationship between food intake, environmental sanitation, and the incidence of infectious diseases in toddlers with stunting.
Each variable (food intake, infectious diseases, and environmental sanitation) demonstrated a significant association with the stunting category, indicating their importance in addressing stunting in the target population.

Abstract

Introduction: Indonesia is a developing nation with complex issues, particularly regarding nutrition. Stunting is a nutrient deficiency that persists over time as a result of being fed food that is not sufficient to meet nutritional requirements. This study aimed to analyze the relationship between food intake, illness, and environmental sanitation in the stunting category in toddlers aged 6-24 months at Cibatu Health Center, Garut, in 2022.

Methods: This was a correlational analytical study with a cross-sectional design. The population in this study was all toddlers with stunting (aged 6-24 months) at Cibatu Health Center, Garut, with a total sample of 99 people. The sampling technique used was total sampling. The analysis techniques used were univariate, bivariate, and multiple correlation analyses with a significance level of p < 0.05.

Results: There was a significant relationship between food intake, environmental sanitation, and the incidence of infectious diseases in the stunting category, where the p-value (each) was <0.05. Food intake (X1), infectious diseases (X2), and environmental sanitation (X3) had a significant relationship with the stunting category (Y), where the p-value was < 0.05.

Conclusion: Food intake, environmental sanitation, and the incidence of infectious diseases had a significant relationship with the stunting category at Cibatu Health Center, Garut.

Difference of Dietary Habit on Type 2 Diabetes Mellitus Patients at Perumnas I Public Health Center, West Pontianak

Agatha Silaban, Eka Ardiani Putri, Agustina Arundina Triharja Tejoyuwono — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

Good eating habits can control the blood sugar levels and BMI of type 2 DM patients.
Good dietary control includes the schedule, amount, and type of food consumed.
The schedule recommendation for type 2 DM consists of six meals a day, divided into three large meals and three times breaks.

Abstract

Introduction: In 2019, type 2 diabetes mellitus (DM) at Perumnas I Public Health Center was sixth-placed among the top ten diseases with 1,118 cases. This study aimed to determine the dietary habits of type 2 DM patients based on body mass index (BMI) and fasting blood glucose at Perumnas I Public Health Center, West Pontianak.

Methods: This was an observational analysis study with a cross-sectional design. A total of 78 type 2 DM patients who were treated from January to July 2021 at Perumnas I Public Health Center were involved in this study. This study used a three-day food record questionnaire to get patients' food dishes and the Wilcoxon test for correlation between variables.

Results: Most of the respondents had a calorie deficit for three days straight (70.5% on the first day, 76.9% on the second day, and 71.8% on the third day), a normal BMI (51.3%), and above-normal fasting blood glucose (88.5%). The p-value of the Wilcoxon test that showed dietary habits on the first day, the second day, and the third day with BMI was 0.000. The p-value of the Wilcoxon test that showed dietary habits on the first day, the second day, and the third day with fasting blood glucose was 0.000. This showed a significant distinction between patients' three-day dietary habits and their BMI and fasting blood glucose.

Conclusion: There was a significant difference between nutritional status and fasting blood glucose in three-day dietary habits in type 2 DM patients at Perumnas I Public Health Center, West Pontianak.

Age-Associated with Worsening of Neurological Deficits in Ischemic Stroke Patients in Abdoel Wahab Sjahranie Regional Hospital, Samarinda

Muhamad Dino Indria, Eva Rachmi, Yetty Octavia Hutahaean — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

The worsening of neurological deficits in ischemic stroke patients is associated with the patient's age, with those over 45 years old having a higher risk.
The worsening of neurological deficits in ischemic stroke patients does not correlate with hemoglobin level, hematocrit value, gender, smoking history, blood pressure, or hyperglycemic state.

Abstract

Introduction: Treatment of impairment is an important step to prevent advanced neurological deficits in ischemic stroke medicine. Ischemic stroke patients with likely worsening neurological deficits should receive appropriate interventions. Therefore, this study aimed to examine predictors that can identify worsening neurological deficits.

Methods: This study used a cross-sectional design on 74 hospitalized ischemic stroke patients at Abdoel Wahab Sjahranie Regional Hospital, Samarinda, in 2019. The worsening of neurological deficits was based on the progression of the National Institutes of Health Stroke Scale (NIHSS) scores at hospital admission and discharge. Age, hemoglobin level, hematocrit value, gender, smoking history, blood pressure, and hyperglycemic state were based on patient data at the beginning of hospital admission. The Chi-Square and Fisher's exact tests were used in bivariate analysis.

Results: The results showed that age had a significant association with the worsening of neurological deficits in ischemic stroke patients (p = 0.024). Hemoglobin level, hematocrit value, gender, smoking history, blood pressure, and hyperglycemic state showed no relationship with worsening neurological deficits in ischemic stroke patients (p > 0.05).

Conclusion: Age can serve as a predictor of worsening neurological deficits in ischemic stroke patients, with those aged over 45 years old having a higher risk. Meanwhile, the other factors were not associated with a worsening neurological deficit in ischemic stroke patients.

Primary Open-Angle Glaucoma Patients in the Ophthalmology Outpatient Clinic Dr. Soetomo General Academic Hospital, Surabaya, in 2013–2015

Risnanda Putri Rasyda, Indri Wahyuni, Dewi Ratna Sari — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

POAG is a common type of glaucoma.
POAG patients were predominantly >60 years old, with males being more dominant than females.

Abstract

Introduction: Primary open-angle glaucoma (POAG) is a progressive, chronic optic neuropathy characterized by distinct optic nerve atrophy and impairment of the visual field. The purpose of this study was to describe the characteristics of primary open-angle glaucoma patients in the ophthalmology outpatient clinic of Dr. Soetomo General Academic Hospital, Surabaya, in 2013–2015.

Methods: This was a descriptive-retrospective study. Samples were patients with a primary open-angle glaucoma (POAG) diagnosis in the ophthalmology outpatient clinic at Dr. Soetomo General Academic Hospital, Surabaya, in 2013–2015.

Results: There were 88 samples of POAG patients in the ophthalmology outpatient clinic at Dr. Soetomo General Academic Hospital, Surabaya, in 2013–2015. POAG was dominated in the age group 60–69 years old, with a percentage of 37.50%. Males were more dominant than females, with a percentage of 55.70%. Many POAG patients were unemployed, with a percentage of 56.82%. Most patients with POAG did not have a history of hypertension or diabetes mellitus, with a percentage of 73.86%. Patients who had a history of hypertension were 11.36%, those with diabetes mellitus were 9.09%, and those who had a history of both hypertension and diabetes mellitus were 5.68%.

Conclusion: POAG was a higher risk in older adults, with males being more dominant than females. Most patients did not have a history of either hypertension or diabetes mellitus.

The Impact of COVID-19 Pandemic on the Epidemiology of Hip and Knee Arthroplasty: A Two-Year Look into the Pandemic from A Single Tertiary Referral General Hospital in Indonesia

Hanan Hanif, Indrayuni Lukitra Wardhani, Lukas Widhiyanto, Mohammad Zaim Chilmi — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

Arthroplasty surgeries were reduced significantly during the COVID-19 pandemic.
The number of operations gradually increased between the first and second year of the pandemic.
Patients' median age and hospital stays were reduced during the pandemic.

Abstract

Introduction: The COVID-19 pandemic has had significant effects on arthroplasty surgeries worldwide. Various studies have described decreased arthroplasty procedures among the most common orthopedic surgeries. This study aimed to analyze the effects of the pandemic on the epidemiology and demography of hip and knee arthroplasty in a tertiary referral general hospital in Indonesia.

Methods: This was a retrospective study of medical records data conducted on hip and knee arthroplasty cases from the pre-pandemic (April 2019–March 2020), first-year pandemic (April 2020–March 2021), and second-year pandemic (April 2021–March 2022) periods. Each period was compared for epidemiology and demography data, which included the annual number of arthroplasties, female-to-male ratio, age, duration of hospitalization, and in-hospital post-operative rehabilitation participation. All statistical data calculations were performed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26.

Results: This study observed a statistically significant decrease of 232.00% for hip and 371.43% for knee arthroplasty performed during the first-year pandemic and an increase of 41.86% for hip and 74.07% for knee arthroplasty in the second-year pandemic. A decrease in median age and fluctuation of the female-to-male ratio were observed. The median duration of hospitalization was 80.00% shorter between the pre-pandemic and first-year pandemics and 11.11% shorter between the first and second-year pandemics. Participation in rehabilitation fluctuated during each period. There were four positive cases of COVID-19 and two cases of mortality during the first- and second-year pandemics.

Conclusion: The COVID-19 pandemic caused a significant reduction in arthroplasties performed during the first year and a slight increase during the second year. Several changes to the demographics of the patients were also observed between the pre-pandemic and the pandemic periods.

Type 2 Diabetes Mellitus Status with Ankle-Brachial Index among Patients with Diabetic Foot Ulcer at Universitas Airlangga Hospital, Surabaya

Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

ABI was not influenced by diabetic status due to potential confounders.
A more severe form of diabetic ulcer was associated with a lower ABI value.

Abstract

Introduction: Diabetic foot ulcer (DFU) is one of the most significant complications of uncontrolled type 2 diabetes mellitus (T2DM) that may affect a patient's prognosis and quality of life. This study aimed to identify the association between diabetic status, DFU severity, and other clinical factors with ankle-brachial index (ABI) score and category.

Methods: This was a cross-sectional study under a consecutive sampling frame conducted from 1 November 2022 to 31 January 2023 at Universitas Airlangga Hospital, Surabaya. Primary data for ABl were measured from T2DM patients with DFU in the Thoracic and Cardiovascular Polyclinic. Meanwhile, secondary clinical data were collected from the Department of Internal Medicine based on the inclusion and exclusion criteria specified in the patient's medical records. The International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26 was utilized for the statistical analysis.

Results: Out of 30 included patients, 63.33% had uncontrolled diabetic status, and the average ABI score was 0.999 ± 0.19. DFU severity was significantly associated with the ABI score and ABI category. Patients indicated with angioplasty exhibited a markedly lower ABI score than those without (mean 0.32 vs 1.01; p < 0.001). Indication of angioplasty was the only clinical factor significantly associated with a lower ABI score (p < 0.001).

Conclusion: The status of T2DM was unrelated to ABI. Future research is recommended to advance the understanding of peripheral artery disease in diabetic foot ulcer patients.

In vitro Antimicrobial Activity Test of Zingiber officinale var. rubrum Rhizome Extract against Methicillin-Sensitive Staphylococcus aureus (MSSA) and Methicillin-Resistant Staphylococcus aureus (MRSA)

Alden Jieputra, Marijam Purwanta, Arifa Mustika, Wiwin Retnowati — Wed, 10 Jan 2024 00:00:00 +0000

Highlights:

Staphylococcus aureus, particularly MRSA, had developed rapid resistance against antibiotics like beta-lactams.
Red ginger is believed to be antibacterial against MSSA and MRSA in vitro.
Red ginger rhizome extracts displayed weak activity against MSSA and MRSA.

Abstract

Introduction: Red ginger (Zingiber officinale var. rubrum) is a traditional herb that is believed to possess antibacterial properties. Throughout the years, Staphylococcus aureus has developed resistance to a broad range of antibiotics, including beta-lactams, particularly in the form of Methicillin-Resistant Staphylococcus aureus (MRSA). As treatment options dwindle, it is urgent to formulate novel antibiotics. This study aimed to examine the antibacterial activity of the ginger rhizome ethanol extract against Methicillin-Sensitive Staphylococcus aureus (MSSA) and MRSA.

Methods: This study was performed according to the post-test-only control group design. Through a good diffusion assay, the anti-MSSA and anti-MRSA activity of the red ginger extract concentrations (100%, 50%, 25%, 12.5%, and 6.25%) was observed by measuring the diameter of the clear inhibition zones. Dimethyl sulfoxide (DMSO) and an antibiotic disc were added as control groups.

Results: The red ginger extracts produced inhibition zones on both MSSA and MRSA. However, the antibacterial activity was considered weak (<12 mm). The concentration of the extract appeared to linearly affect its antibacterial activity against MSSA and MRSA. On MSSA, the 12.5% extract results differed significantly from those of the 100% and 50% extracts. Meanwhile, on MRSA, the extracts seemed to yield significantly different outcomes when compared to each other, except for the comparisons between 50%-25% and 12.5%-6.25%.

Conclusion:Zingiber officinale var. rubrum rhizome extracts showed weak antibacterial activity against MSSA and MRSA.

Back Matter Vol 15 No 1, 2024

Back Matter — Wed, 10 Jan 2024 00:00:00 +0000

Front Matter Vol 15 No 1, 2024

Front Matter — Wed, 10 Jan 2024 00:00:00 +0000