Accreditation
SINTA 2Nationally Accredited Journal
Vol. 7 No. 7 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
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Correlation of the Adverse Event Following Immunization with the Severity of COVID-19 Infection in Health Care Workers in Padang
Views: 591Downloads: 339Background: Effective countermeasures to control the current COVID-19 pandemic are the implementation of health protocols and vaccinations. The problem that must be a concern after vaccination is post-immunization co-occurrence (AEFI), including COVID-19 vaccination. Another issue that is also a concern after vaccination is the incidence of being infected with COVID-19. The purpose of this study was to determine the incidence of post-vaccination COVID-19 infection in health workers in the city of Padang and its association with the incidence of COVID-19 vaccine AEFIs.
Methods: The study used a descriptive-analytic design with a retrospective cohort method. The research will be carried out in all hospitals in Padang, and sampling will be carried out for 2 months, from November to December 2021. Officers who are confirmed to have COVID-19 after vaccination and meet the inclusion criteria are healthcare workers who have received at least 2 vaccines and are willing to fill out a Google form.
Results: The characteristics of health workers in Padang who were confirmed to have COVID-19 after 2 vaccinations were mostly (68.1%) early adults (26-35 years), the sex was mostly female as much as 77.3%, and most professions were workers. Paramedics (nurses or midwives) as much as 57.0%. The most comorbid obesity is as much as 3.4%. Nutritional status assessed by BMI showed that obesity (37.7%) and normal nutritional status (32.9%) had almost the same proportion. Almost all health workers with or without AEFI experience mild COVID-19, as many as 98%, and experience COVID-19 infection 28 days after vaccination.
Conclusion: The incidence of AEFI is not related to the severity of post-vaccination COVID-19 infection in health workers in Padang.
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Prevalence of Sexually Transmitted Infections in Premarital Age Adolescents at Siloam Hospital Semarang Period 2019 – 2022
Views: 526Downloads: 499Background: Sexually transmitted infection (STI) is an infectious disease that is transmitted through sex. Changing times and views on sexuality are thought to have caused major shifts in sexual habits and lifestyles. Adolescents are uniquely at risk for STIs from a behavioral and biological perspective.
Methods: This study is a descriptive study by collecting secondary data in the form of medical records at dermatology and venereology clinics at Siloam Hospital Semarang for the period 2019 - 2022 to see the number of STI cases in premarital adolescents, namely ages ≤24 years in males and ≤20 years in females.
Results: The number of STI cases in premarital adolescent boys in 2019 was 28 people (36.4%). In 2020 there were 50 people (25.9%). In 2021 there will be 93 people (29.1%). And in 2022, there will be 112 people (27.7%). Then in premarital adolescent girls, in 2019, there was 1 case of STI (1.3%), 2 people (1%) in 2020, 7 people (2.2%) in 2021, and 8 people (2%) in 2022. Even though the percentage has fluctuated, the number of cases has continued to increase.
Conclusion: The number of STI cases in premarital adolescents, age ≤24 years for males and ≤20 years for females, in the 2019 - 2022 period at Siloam Hospital Semarang continues to increase every year. Many factors are thought to influence this phenomenon.
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Intensive Management of Postoperative Septic Shock in Patient with Secundum Atrial Septal Defect: A Case Report
Views: 941Downloads: 423Background: Sepsis is a life-threatening organ dysfunction caused by an abnormal inflammatory response to infection. This study aimed to describe the intensive management of postoperative septic shock in secundum atrial septal defect patients.
Case presentation: A 28-year-old woman complaining of pus discharge and reddish swelling in the scar after a cesarean section operation. The patient has a history of pulmonary hypertension and secundum ASD. While in the ICU, examination of vital signs found the patient was weak, compost mentis conscious, blood pressure 80/55 mmHG (MAP 63), Respiration 28 times per minute, pulse 114 times per minute, temperature 38.6°C with 98% oxygen saturation with NRM 10 L/ and laboratory examinations obtained hemoglobin 8.6, leukocytes 14.870, platelets 236.000, hematocrit 24, albumin 2.4 and procalcitonin > 100.
Conclusion: This study reported that septic shock is a life-threatening condition, especially in patients with congenital heart disease. Appropriate, rapid, and comprehensive treatment and addressing the source of infection are essential in managing sepsis shock.
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Intensive Management of A 21-Year-Old Male Patient with Acute Respiratory Failure Due to Near Drowning: A Case Report
Views: 1,207Downloads: 712Background: The mechanism of near drowning involves decreased lung compliance and aspiration of water into the lungs, which damages surfactants and disrupts alveolar capillary membranes. This leads to the development of alveolar oedema, and ventilation-perfusion mismatch, which causes hypoxemia leading to acute respiratory distress syndrome (ARDS) and cause other organ dysfunction and death.
Case presentation: The patient was found drowned by his friends while on vacation and swimming in the river. Initial physical examination in the ED obtained a Glasglow coma scale (GCS) score of 14/15 (E3-V5-M6), blood pressure 124/70 mmHg, and pulse 124 beats/min. The patient breathed spontaneously 25 breaths/min with oxygen saturation (SpO2) of 90% on room air. The patient was initially managed with oxygenation using a non-rebreathing mask (NRM semi-fowler positioning and peripheral access. Chest X-ray and other radiologic examinations, including a brain CT scan, were performed before the patient was immediately transferred to the ICU, and there was no evidence of other trauma. During the 9 days of intensive management in the ICU, there was a good improvement from GCS 14 to 15.
Conclusion: Intensive management of a 21-year-old male patient with acute respiratory failure due to near drowning.
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Analysis of Patient Safety Culture at Semen Padang Hospital Indonesia
Views: 562Downloads: 383Background: Hospitals have a role and function to provide integrated health services for patients as consumers of health services. When providing services to patients, hospitals must pay attention to quality and safety. This study aimed to find out the patient safety culture that has been built at Semen Padang Hospital in 2022.
Methods: This study uses an approach mixed methods research with a design sequential explanatory, namely research that uses a combination of quantitative and qualitative methods simultaneously (quantitative-qualitative). The subjects of this study were employees of Semen Padang Hospital, with as many as 81 respondents for quantitative data and 11 respondents for qualitative data. Measurement of patient safety culture using the MaPSaF instrument (Manchester patient safety framework) in the form of filling out the MaPSCAT questionnaire (Manchester patient safety culture assessment tool). This questionnaire consists of 10 dimensions with a total of 24 questions and is equipped with in-depth interview data.
Results: Data collection was carried out using the MaPSCAT instrument on 10 dimensions of patient safety culture, 6 dominant dimensions were at the proactive level, namely the dimension of overall commitment to continuous improvement (1st dimension), the dimension of system error and individual responsibility (3rd dimension), the dimension of incident evaluation and best practices (5th dimension), effective learning and change (6th dimension), communication about patient safety issues (7th dimension) and staff education and training dimension (9th dimension).
Conclusion: The safety culture at Semen Padang Hospital is generally at a proactive level. This indicates that the hospital places priority on improving patient safety and is carried out on an ongoing basis. A system that is integrated and comprehensive has a wide scale, involved stakeholders, and an evidence-based approach.
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Neuraxial Anesthesia for Cesarean Section in Pregnant Women with Ruptured Arteriovenous Malformation
Views: 550Downloads: 314Background: Maternal stroke as a result of ruptured arteriovenous malformation (AVM) in pregnancy is rare. However, AVM rupture can result in high morbidity during pregnancy and the puerperium. In its management, several special considerations are needed to ensure the welfare of the mother and fetus. This article will discuss anesthesia in pregnant patients after hemorrhagic stroke due to AVM rupture under neuraxial anesthesia.
Case presentation: A 25-year-old patient with a second pregnancy with twins at 33 weeks came with complaints of water coming out of the birth canal 1.5 hours before admission to the hospital. The patient was diagnosed with G2P0010 33 Weeks 3 days Gemelli H/H head presentation, buttocks presentation, intracerebral hemorrhage (ICH) et cause suspected AVM rupture, premature rupture of membranes, and first-day febrile observation and planned to undergo cito cesarean section.
Conclusion: Neuraxial anesthesia is one of the safe options for pregnant patients after a hemorrhagic stroke with controlled intracranial pressure.
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Male Breast Cancer in Dr. Hasan Sadikin General Hospital: A Serial Case
Views: 511Downloads: 449Background: Male breast cancer is a rare case. It accounts for 1% of all breast cancer cases. Both female and male breast cancers were influenced by the same risk factors. Male breast cancer patients are typically associated with advanced stages, higher grades, higher prevalence of hormone receptor-positive, and a worse prognosis. Many factors can explain the late diagnosis in men: absence of screening programs, lack of awareness about the condition by the male population, embarrassment due to a stigmatization of the disease, and misjudgment by primary care physicians. The aim of study is to improve the knowledge about the biology tumor and characteristics, risk factor, and management of male breast cancer.
Case presentation: Two patients who were studied were a man with 50 years old, without malignancy on their family and testicles disease. First patients was diagnosed with mucinous adenocarsinoma grade II on right breast luminal A subtype T4bN0M0 and second patient was diagnosed with Ductal carcinoma in situ on right breast luminal B Her2 negative subtype TisN0M0 as preoperative diagnosis and Invasive solid papillary carcinoma grade III on right breast T2N0M0 as post operative diagnosis. Both of them were operated with modified radical mastectomy. First patient was given neoadjuvant chemotherapy, adjuvant chemotherapy and tamoxifen as endocrine therapy. Second patient was given adjuvant chemotherapy and tamoxifen as endocrine therapy.
Conclusion: Both of patients on serial cases are male breast cancer with hormone receptor positive and they were given endocrine therapy. The majority characteristic of male breast cancer was hormone receptor-positive. Management of male breast cancer is similar overall to management of female breast cancer in modality surgery, chemotherapy, endocrine therapy, and radiotherapy.
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Bartter Syndrome: A Case Report
Views: 985Downloads: 947Background: Bartter's syndrome refers to a group of genetic disorders that affect the renal tubular system, which is responsible for reabsorbing various substances such as sodium, potassium, and chloride from the urine into the blood. This study aimed to present a clinical case related to Bartter syndrome.
Case presentation: A 52-year-old male patient in the internal medicine department of Dr. M. Djamil General Hospital Padang with the main complaint of weakness in both legs increasing since 1 day ago. On laboratory examination, the patient found potassium 1.7 mmol/L, indicating hypokalemia. Renal function examination showed normal kidney function. Examination of blood gas analysis showed results of metabolic alkalosis. Examination of urine potassium obtained potassium levels of 22 mmol/day, urine osmolarity of 140 mOsm/kgH2O at serum osmolarity of 274 mOsm/kgH2O, with TTKG (transtubular potassium gradient) = 28. The patient was diagnosed with Bartter syndrome. Treatment is carried out by administering KSR tablets 3x600 mg orally while monitoring electrolytes regularly.
Conclusion: This patient has hypokalemia, metabolic alkalosis, normal magnesium and calcium, and hypercalciuria. This patient is diagnosed with Bartter syndrome.
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Infiltration Between Popliteal Artery and Capsule of the Knee Combined with Adductor Canal Block as Analgesic Adjuvant During and Postoperative in Total Knee Replacement Surgery
Views: 698Downloads: 345Background: Infiltration between the popliteal artery and capsule of the knee (iPACK) is one method that has been proposed in recent years as a potential alternative to peripheral nerve block as analgesia in total knee replacement (TKR) procedures. This study presents anesthetic management using spinal anesthesia combined with iPACK and adductor canal block (ACB) in patients with grade IV osteoarthritis who underwent TKR of the right knee.
Case presentation: A woman, a housewife aged 50 years, was planning to undergo TKR surgery. The patient came with complaints of pain in the right knee 1 year before entering the hospital. The patient was given supplemental oxygen with a nasal cannula at 3 liters per minute. Prior to spinal anesthesia, the patient was given fentanyl 25 mcg iv, ketamine 10 mg iv, and midazolam 1.5 mg IV as premedication. The patient was positioned on the right side, and a 27G Quincke needle was inserted at the level of L3-L4 and given bupivacaine heavy 0.5% 7.5 mg, then lateralized for 15 minutes. After lateralization, the patient was positioned supine and used ultrasound to direct ACB action with a regimen of ropivacaine 0.25% + dexamethasone 5 mg a volume of 20 ml, then iPACK was performed with a regimen of Ropivacaine 0.375% + dexamethasone 5 mg a volume of 20 ml. After surgery, the patient is treated in the recovery room for 1 hour until bromage score is 0. The patient received the PCA Morphine analgesic demand only 1 mg/mL, 1 mg per dose, max 5 mg over 4 hours, lockout interval 6 minutes; Paracetamol 500 mg every 6 hours PO; Ibuprofen 400 mg every 8 hours PO.
Conclusion: TKR patients who were given analgesia using the ACB peripheral nerve block technique combined with iPACK experienced a decrease in pain levels and lower use of postoperative morphine so that patient mobilization was faster and reduced the patient's length of stay.
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Free Opioid Anesthesia in Cancer Patient Undergoing Total Thyroidectomy and Functional Neck Dissection Dextra: A Case Report
Views: 623Downloads: 385Background: The use of large doses of opioids perioperatively has been found to be associated with early recurrence in patients undergoing surgery for primary cancer. This study aimed to describe the use of opioid free anesthesia in cancer patients.
Case presentation: A 72-year-old man with a diagnosis of papillary adenocarcinoma thyroid underwent total thyroidectomy and dextra functional neck dissection. The results of the preoperative assessment stated that the patient had ASA III physical status and would undergo general anesthesia (GA-OTT) and regional anesthesia peripheral nerve block (RA-PNB BPSS).
Conclusion: Nonopioid regimens are recommended for pain control in the perioperative and postoperative periods in some cases. The application of free opioids can reduce opioid dependence in patients who routinely receive opioid prescriptions after discharge.
