Pub Date : 2023-03-31DOI: 10.47353/jsocmed.v2i3.37
A. Sitepu, D. Lindarto, M. S. Nasution
Introduction: Diabetes can cause secondary hyperlipidemia. In COVID-19, dyslipidemia is thought to be the result of biological and pathological processes triggered by SARS-CoV-2. Altered lipid profiles have been reported since the beginning of the COVID-19 pandemic, where the alteration of lipid profile and the severity of SARS-CoV-2 infection were positively correlated. This study aims to analyze the lipid profile in confirmed COVID-19 patients with T2DM at H. Adam Malik General Hospital Medan. Method: This was a descriptive study with a cross-sectional design using a total sampling technique by collecting secondary data on inpatients with confirmed COVID-19 with T2DM at H. Adam Malik General Hospital from 2020 to 2021 which was then analyzed using the SPSS version 25 application. Results: Of the 372 subjects, the most common sex was male (57.3%), 193 people had a BMI of 18.5 - 24.9kg/m2 (51.9%), the mean overall age was 57.5 ± 10.4 years, and the median length of stay was 8 days. The most common comorbid was hypertension (n=189, 50.8%), 176 people had severe COVID-19 (47.3%), and 225 patients were discharged (60.5%). Based on laboratory data, 327 people had dyslipidemia (87.9%), 31 people had mild acute liver impairments (8.3%), the average of HbA1c was 9.0±2.5%, the average fasting blood glucose was 221.7±122.2 mg/L, the average 2 hours post-prandial blood glucose was 261.7±125.8 mg/L, an average of total cholesterol was 151.2±52.2 mg/L, an average of triglycerides was 147.5±99.1 mg/L, an average of HDL was 33.1±14.6 mg/L, an average of LDL was 97.4±44.5 mg/L, the median of ALT was 25 μ/L, and an average of AST was 30.45±27.42 μ/L. Conclusion: Total cholesterol, triglyceride, and LDL were lower in T2DM patients with a critical illness of COVID-19 and patients who died.
{"title":"Lipid Profile in Confirmed Covid-19 Patients with Type 2 Diabetes Mellitus At Haji Adam Malik General Hospital Medan from March 2020 to December 2021","authors":"A. Sitepu, D. Lindarto, M. S. Nasution","doi":"10.47353/jsocmed.v2i3.37","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i3.37","url":null,"abstract":"Introduction: Diabetes can cause secondary hyperlipidemia. In COVID-19, dyslipidemia is thought to be the result of biological and pathological processes triggered by SARS-CoV-2. Altered lipid profiles have been reported since the beginning of the COVID-19 pandemic, where the alteration of lipid profile and the severity of SARS-CoV-2 infection were positively correlated. This study aims to analyze the lipid profile in confirmed COVID-19 patients with T2DM at H. Adam Malik General Hospital Medan.\u0000Method: This was a descriptive study with a cross-sectional design using a total sampling technique by collecting secondary data on inpatients with confirmed COVID-19 with T2DM at H. Adam Malik General Hospital from 2020 to 2021 which was then analyzed using the SPSS version 25 application.\u0000Results: Of the 372 subjects, the most common sex was male (57.3%), 193 people had a BMI of 18.5 - 24.9kg/m2 (51.9%), the mean overall age was 57.5 ± 10.4 years, and the median length of stay was 8 days. The most common comorbid was hypertension (n=189, 50.8%), 176 people had severe COVID-19 (47.3%), and 225 patients were discharged (60.5%). Based on laboratory data, 327 people had dyslipidemia (87.9%), 31 people had mild acute liver impairments (8.3%), the average of HbA1c was 9.0±2.5%, the average fasting blood glucose was 221.7±122.2 mg/L, the average 2 hours post-prandial blood glucose was 261.7±125.8 mg/L, an average of total cholesterol was 151.2±52.2 mg/L, an average of triglycerides was 147.5±99.1 mg/L, an average of HDL was 33.1±14.6 mg/L, an average of LDL was 97.4±44.5 mg/L, the median of ALT was 25 μ/L, and an average of AST was 30.45±27.42 μ/L.\u0000Conclusion: Total cholesterol, triglyceride, and LDL were lower in T2DM patients with a critical illness of COVID-19 and patients who died.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"179 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114008819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.47353/jsocmed.v2i3.39
Introduction: CT is widely used to evaluate patients with aneurysm or aortic dissection. Therefore, it is very important to assess accurate aortic size in detecting aneurysm and dissection. The thoracic aortic diameter varies depending on the measurement level. Several demographic factors affect the thoracic aorta diameter such as age and gender. Risk factors for cardiovascular disease such as hypertension also have a relationship with the diameter of the thoracic aorta. To determine the difference of thoracic aorta diameter based on age, sex, and history of hypertension in patients with contrast-enhanced CT chest. Method: A case-control study in 140 patients with contrast-enhanced CT chest without signs or symptoms of car¬diovascular diseases. Thoracic aortic diameters were measured at seven predetermined levels on CT images. Analysis of data was performed with regard to age, sex, and hypertension. Results: The mean diameters of the thoracic aorta at the level of the aortic valve sinus is 3.06 ± 0.39 cm, ascending aorta 2.90 ± 0.39 cm, proximal to innominate artery 2.73 ± 0.39 cm, transverse aortic arch 2.53 ± 0.38, distal transverse aortic arch 2.37 ± 0.35, aortic isthmus 2.17 ± 0.33, and descending aorta at the level of diaphragm 1.91 ± 0.33 cm. There is a significant difference in all thoracic aortic diameters based on age and gender on statistical analysis (p<0.001). There is a significant difference in all thoracic aortic diameters between subjects with history of hypertension and without history of hypertension, except at the level of transverse aortic arch (p<0.051). Conclusion: There is a difference in the mean thoracic aortic diameter at each level of measurement based on age, sex, and history of hypertension in patients with contrast-enhanced CT chest.
{"title":"Measurement of Thoracic Aortic Diameter Using Contrast-Enhanced CT Chest Based on Age, Gender, and Hypertension","authors":"","doi":"10.47353/jsocmed.v2i3.39","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i3.39","url":null,"abstract":"Introduction: CT is widely used to evaluate patients with aneurysm or aortic dissection. Therefore, it is very important to assess accurate aortic size in detecting aneurysm and dissection. The thoracic aortic diameter varies depending on the measurement level. Several demographic factors affect the thoracic aorta diameter such as age and gender. Risk factors for cardiovascular disease such as hypertension also have a relationship with the diameter of the thoracic aorta. To determine the difference of thoracic aorta diameter based on age, sex, and history of hypertension in patients with contrast-enhanced CT chest.\u0000Method: A case-control study in 140 patients with contrast-enhanced CT chest without signs or symptoms of car¬diovascular diseases. Thoracic aortic diameters were measured at seven predetermined levels on CT images. Analysis of data was performed with regard to age, sex, and hypertension.\u0000Results: The mean diameters of the thoracic aorta at the level of the aortic valve sinus is 3.06 ± 0.39 cm, ascending aorta 2.90 ± 0.39 cm, proximal to innominate artery 2.73 ± 0.39 cm, transverse aortic arch 2.53 ± 0.38, distal transverse aortic arch 2.37 ± 0.35, aortic isthmus 2.17 ± 0.33, and descending aorta at the level of diaphragm 1.91 ± 0.33 cm. There is a significant difference in all thoracic aortic diameters based on age and gender on statistical analysis (p<0.001). There is a significant difference in all thoracic aortic diameters between subjects with history of hypertension and without history of hypertension, except at the level of transverse aortic arch (p<0.051).\u0000Conclusion: There is a difference in the mean thoracic aortic diameter at each level of measurement based on age, sex, and history of hypertension in patients with contrast-enhanced CT chest.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123933398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.47353/jsocmed.v2i3.38
Rizka Farahin Assania, E. R. Daulay, Refli Hasan
Introduction: Coronary Artery Disease (CAD) is the one of manifestation for cardiovascular disease and a cause of death and disability. Abdominal aortic calcification (AAC) has been shown to be strongly associated with atherosclerosis and CAD events. This study to investigated the association of risk factors for CAD with the incidence of AAC on abdominal CT Scan. Method: This study was an observational analytic study with a cross-sectional design on 105 patients who underwent abdominal CT scans with/without intravenous contrast at Radiology Department of H. Adam Malik General Hospital. AAC score was identified calcification on the abdominal aorta (from 1 cm above the origin of the celiac trunk to 1 cm below the iliac bifurcation) use the Agatston method. Analyzing the association CAD risk factors such as gender, age, diabetes mellitus, hypertension, smoking, and alcohol and AAC score. Results: The results of the analysis using the Chi Square comparative test showed that there was a significant relationship between age (p=0.000), hypertension (p=0.017), diabetes (p=0.006), in othe words there is no significant relationship between gender (p = 0.613), smoking (p=0.22) and alcohol (p=0.28) with AAC score. Conclusion: There is a significant relationship between age, hypertension and diabetes with the AAC score.
冠状动脉疾病(CAD)是心血管疾病的表现之一，也是导致死亡和残疾的主要原因之一。腹主动脉钙化(AAC)已被证明与动脉粥样硬化和冠心病事件密切相关。本研究旨在探讨腹部CT扫描中冠心病危险因素与AAC发生率的关系。方法:本研究是一项观察性分析研究，采用横断面设计，对在H. Adam Malik总医院放射科进行腹部CT扫描的105例患者进行了静脉造影剂扫描。采用Agatston法确定腹主动脉钙化(从腹腔干起点上方1cm到髂分叉下方1cm)。分析性别、年龄、糖尿病、高血压、吸烟、饮酒等冠心病危险因素与AAC评分的关系。结果:卡方比较检验分析结果显示，年龄(p=0.000)、高血压(p=0.017)、糖尿病(p=0.006)与AAC评分有显著相关，即性别(p= 0.613)、吸烟(p=0.22)、饮酒(p=0.28)与AAC评分无显著相关。结论:年龄、高血压、糖尿病与AAC评分有显著相关性。
{"title":"Association of Risk Factors for Coronary Artery Disease with The Incidence of Abdominal Aortic Calcification On Abdominal CT-Scan Imaging in H. Adam Malik General Hospital","authors":"Rizka Farahin Assania, E. R. Daulay, Refli Hasan","doi":"10.47353/jsocmed.v2i3.38","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i3.38","url":null,"abstract":"Introduction: Coronary Artery Disease (CAD) is the one of manifestation for cardiovascular disease and a cause of death and disability. Abdominal aortic calcification (AAC) has been shown to be strongly associated with atherosclerosis and CAD events. This study to investigated the association of risk factors for CAD with the incidence of AAC on abdominal CT Scan.\u0000Method: This study was an observational analytic study with a cross-sectional design on 105 patients who underwent abdominal CT scans with/without intravenous contrast at Radiology Department of H. Adam Malik General Hospital. AAC score was identified calcification on the abdominal aorta (from 1 cm above the origin of the celiac trunk to 1 cm below the iliac bifurcation) use the Agatston method. Analyzing the association CAD risk factors such as gender, age, diabetes mellitus, hypertension, smoking, and alcohol and AAC score.\u0000Results: The results of the analysis using the Chi Square comparative test showed that there was a significant relationship between age (p=0.000), hypertension (p=0.017), diabetes (p=0.006), in othe words there is no significant relationship between gender (p = 0.613), smoking (p=0.22) and alcohol (p=0.28) with AAC score.\u0000Conclusion: There is a significant relationship between age, hypertension and diabetes with the AAC score.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127890869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-31DOI: 10.47353/jsocmed.v2i3.40
U. H. Surbakti, R.A. Dwi Pujiastuti, Kiking Ritarwan
Introduction: Sleep disorders are common in stroke patients and can affect 20% - 78% of patients. Stroke patients also often experience depression and anxiety associated with a decrease in the patient's sleep quality. The purpose of this study was to determine the relationship between depression and anxiety with sleep quality in post-stroke patients. Method: This study used a cross-sectional design. The research subjects were post-stroke patients at the neuro polyclinic at H. Adam Malik General Hospital Medan and Satellite Hospital during July - December 2022 who met the inclusion criteria. Assessment of depression, anxiety and sleep quality used Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Pittsburgh Sleep Quality Index (PSQI) Questionnaires, respectively. Data were analyzed using Spearman's correlation test. Results: Bivariate analysis found that there was a strong relationship between the HDRS score and the PSQI score (r = 0.708; p <0.001), and the HARS score and PSQI (r = 0.650; p <0.001). Conclusion: There was strong correlation between depression and anxiety with sleep quality in post-stroke patients.
{"title":"Associations between Depression and Anxiety with Sleep Quality in Post Stroke Patients","authors":"U. H. Surbakti, R.A. Dwi Pujiastuti, Kiking Ritarwan","doi":"10.47353/jsocmed.v2i3.40","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i3.40","url":null,"abstract":"Introduction: Sleep disorders are common in stroke patients and can affect 20% - 78% of patients. Stroke patients also often experience depression and anxiety associated with a decrease in the patient's sleep quality. The purpose of this study was to determine the relationship between depression and anxiety with sleep quality in post-stroke patients.\u0000Method: This study used a cross-sectional design. The research subjects were post-stroke patients at the neuro polyclinic at H. Adam Malik General Hospital Medan and Satellite Hospital during July - December 2022 who met the inclusion criteria. Assessment of depression, anxiety and sleep quality used Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and Pittsburgh Sleep Quality Index (PSQI) Questionnaires, respectively. Data were analyzed using Spearman's correlation test.\u0000Results: Bivariate analysis found that there was a strong relationship between the HDRS score and the PSQI score (r = 0.708; p <0.001), and the HARS score and PSQI (r = 0.650; p <0.001).\u0000Conclusion: There was strong correlation between depression and anxiety with sleep quality in post-stroke patients.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124834251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-28DOI: 10.47353/jsocmed.v2i2.29
Primta Bangun, Suwarman Suwarman
Introduction: End Stage Renal Disease (ESRD) 5D patient have potential to respiratory failure due to excess fluid, thus increasing the incidence of repeated hospital admissions. Deaths were reported in about 15%– 30% cases, where 50%–60% of patients needed respiratory support with mechanical ventilation. About 30%– 40% of patients had complications in the weaning process from mechanical ventilation. Prolonged mechanical ventilation increased mortality and morbidity, the length of stay periods and costs. Case Report: This case report will discuss the difficult weaning from mechanical ventilation in patients with ESRD 5D who have respiratory failure due to edema pulmonary and pneumonia who were hospitalized at the Intensive Care Unit (ICU) of Hasan Sadikin Hospital - Bandung for 20 days Conclusion: Weaning difficulty due to accumulation positive fluid balance during hospitalization lead to longer use of mechanical ventilation and pulmonary infection get heavier. A positive cumulative fluid balance could be one factor of weaning difficulty
{"title":"Weaning Difficulty in Patient with End Stage Renal Disease Acute with Respiratory Failure due to Pulmonary Edema and Pneumonia","authors":"Primta Bangun, Suwarman Suwarman","doi":"10.47353/jsocmed.v2i2.29","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i2.29","url":null,"abstract":"Introduction: End Stage Renal Disease (ESRD) 5D patient have potential to respiratory failure due to excess fluid, thus increasing the incidence of repeated hospital admissions. Deaths were reported in about 15%– 30% cases, where 50%–60% of patients needed respiratory support with mechanical ventilation. About 30%– 40% of patients had complications in the weaning process from mechanical ventilation. Prolonged mechanical ventilation increased mortality and morbidity, the length of stay periods and costs.\u0000Case Report: This case report will discuss the difficult weaning from mechanical ventilation in patients with ESRD 5D who have respiratory failure due to edema pulmonary and pneumonia who were hospitalized at the Intensive Care Unit (ICU) of Hasan Sadikin Hospital - Bandung for 20 days\u0000Conclusion: Weaning difficulty due to accumulation positive fluid balance during hospitalization lead to longer use of mechanical ventilation and pulmonary infection get heavier. A positive cumulative fluid balance could be one factor of weaning difficulty","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127132865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-30DOI: 10.47353/jsocmed.v2i1.20
Perdana Liansyah Sihite, Abdullah Hambali, Muhammad Firdaus Kamil, Muhsin Muhsin, A. Gani, Muhammad Diah
The thyroid gland produces thyroid hormones that affect all tissue's metabolic processes, including the heart. Disorders of thyroid hormones, both increasing and decreasing thyroid hormones, can cause similar symptoms to primary heart disease. Thyroid heart disease (THD) is a heart disease that occurs due to increasing (hyperthyroid) or decreasing (hypothyroid) thyroid hormones in the circulation. Hyperthyroidism can cause several types of heart disease, including mitral regurgitation, tricuspid regurgitation, cardiomyopathy, heart failure, mitral valve prolapses, atrial fibrillation, or sinus tachycardia. Almost all cases of THD occur in middle-aged women. Here we presented a 32-year-old male patient diagnosed with THD caused by graves' disease. The patient was admitted to the emergency department due to shortness of breath. Medical and non-medical treatments were administered to the patients, and patients experienced improvement after several days of hospitalization. The progression of hyperthyroidism is characterized by remission and long-term exacerbations. Although some patients can remain euthyroid for a long time after therapy, many eventually get into hypothyroidism. Therefore, lifetime follow-up is an indication for all patients with hyperthyroidism.
{"title":"Thyroid Heart Disease in Young Male, a Case Report","authors":"Perdana Liansyah Sihite, Abdullah Hambali, Muhammad Firdaus Kamil, Muhsin Muhsin, A. Gani, Muhammad Diah","doi":"10.47353/jsocmed.v2i1.20","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i1.20","url":null,"abstract":"The thyroid gland produces thyroid hormones that affect all tissue's metabolic processes, including the heart. Disorders of thyroid hormones, both increasing and decreasing thyroid hormones, can cause similar symptoms to primary heart disease. Thyroid heart disease (THD) is a heart disease that occurs due to increasing (hyperthyroid) or decreasing (hypothyroid) thyroid hormones in the circulation. Hyperthyroidism can cause several types of heart disease, including mitral regurgitation, tricuspid regurgitation, cardiomyopathy, heart failure, mitral valve prolapses, atrial fibrillation, or sinus tachycardia. Almost all cases of THD occur in middle-aged women. Here we presented a 32-year-old male patient diagnosed with THD caused by graves' disease. The patient was admitted to the emergency department due to shortness of breath. Medical and non-medical treatments were administered to the patients, and patients experienced improvement after several days of hospitalization. The progression of hyperthyroidism is characterized by remission and long-term exacerbations. Although some patients can remain euthyroid for a long time after therapy, many eventually get into hypothyroidism. Therefore, lifetime follow-up is an indication for all patients with hyperthyroidism.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125630467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-30DOI: 10.47353/jsocmed.v2i1.59
Tasrif Hamdi
Introduction: Various factors including surgical, psychological, amount of acute pain relief have been proposed as risk factors for developing CPSP. Different treatment modalities like nerve and plane blocks, psychiatric counselling have been described to counter this pain. Case: The patient was a 30-year-old female with complaints of severe pain in the right lower quadrant of the abdomen and found a surgical scar with hyperalgesia and a history of open appendicectomy surgery, two times section caesarean section surgery. The patient experienced pain after section caesarean section surgery 6 months ago. Because the pain was also felt in the right hypochondrium, the patient was unable to move his body, unable to sit and stand. The patient was diagnosed as a case of chronic post surgical pain syndrome (CPSP). We performed transversus abdominis plane block (TAP) with ultrasound guidance and lidocaine 15 ml combined with 40mg methylprednisolone. VAS scores showed significant improvement from 8/10 and 2/10 during the 10-day follow-up. We conclude that ultrasound-guided TAP block can be a treatment option for CPSP cases. Conclusion: Chronic post surgical pain (CPSP) is a definite clinical entity after laparatomy. We report a successful management of such a case with ultrasound guided transversus abdominis plane block. The patient had very significant pain relief after procedure follow up continue until today without any side effects.
{"title":"Transversus Abdominis Plane (TAP) Steroid Block for Chronic Abdominal Pain Caused by Chronic Postoperative Pain","authors":"Tasrif Hamdi","doi":"10.47353/jsocmed.v2i1.59","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i1.59","url":null,"abstract":"Introduction: Various factors including surgical, psychological, amount of acute pain relief have been proposed as risk factors for developing CPSP. Different treatment modalities like nerve and plane blocks, psychiatric counselling have been described to counter this pain. Case: The patient was a 30-year-old female with complaints of severe pain in the right lower quadrant of the abdomen and found a surgical scar with hyperalgesia and a history of open appendicectomy surgery, two times section caesarean section surgery. The patient experienced pain after section caesarean section surgery 6 months ago. Because the pain was also felt in the right hypochondrium, the patient was unable to move his body, unable to sit and stand. The patient was diagnosed as a case of chronic post surgical pain syndrome (CPSP). We performed transversus abdominis plane block (TAP) with ultrasound guidance and lidocaine 15 ml combined with 40mg methylprednisolone. VAS scores showed significant improvement from 8/10 and 2/10 during the 10-day follow-up. We conclude that ultrasound-guided TAP block can be a treatment option for CPSP cases. Conclusion: Chronic post surgical pain (CPSP) is a definite clinical entity after laparatomy. We report a successful management of such a case with ultrasound guided transversus abdominis plane block. The patient had very significant pain relief after procedure follow up continue until today without any side effects.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"8 20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130307772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-12DOI: 10.47353/jsocmed.v2i1.26
Siti Alimahtun Sodiah Chaniago, I. Nasution, I. Nasution
Introduction: Stroke is a sudden-onset neurologic deficit and having a type 2 diabetes increases the risk of stroke twice as much. In addition to affecting physical and mental abilities, stroke can also lead to a decline in nutritional status. Malnutrition is associated with poor functional outcomes in all stroke subtypes. The Controlling Nutritional Status (CONUT) score is an objective nutritional marker and could reflects malnutrition due to its comprehensive assessment of nutritional status. This study aims to find the association between nutritional status towards the outcome of acute ischemic stroke patients with type 2 diabetes. Method: This was an observational analytic study with prospective cohort design using primary data collected consecutively from patients with both acute ischemic stroke and type 2 diabetes mellitus who were hospitalized in the Stroke Corner Room, Intensive Care Unit (ICU) and inpatient ward of Haji Adam Malik General Hospital who met the inclusion criteria. The nutritional statuses of patients were measured using the CONUT score and patients outcomes were measured by mRS score. Spearman correlation test was used to assess the association between nutritional status and outcome of acute ischemic stroke patients with type 2 diabetes mellitus. Results: There were 43 patients who met the inclusion criteria where the majority of patients were male 22 people (51.2%), in the age group 51-65 years 23 people (53.5%) with a mean age of 57.93 + 10.01, was a housewife 15 people (34.9%) and Bataknese 27 people (62.8%). The majority of patients in this study had mild malnutrition with a total of 15 people (34.9%) and a median CONUT score of 3 (0-11) and poor outcome as many as 29 people (67.4%) with mRS score median 4 (0-6). The result of Spearman correlation test showed a significant correlation between nutritional status and the outcome of acute ischemic stroke patients with type 2 diabetes mellitus with a moderate correlation. Conclusion: There was a significant correlation between nutritional status and the outcome of acute ischemic stroke patients with type 2 diabetes mellitus with a moderate correlation
{"title":"The Association of Nutrition Status Towards The Outcome of Acute Ischemic Stroke Patients with Type-2 Diabetes Mellitus","authors":"Siti Alimahtun Sodiah Chaniago, I. Nasution, I. Nasution","doi":"10.47353/jsocmed.v2i1.26","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i1.26","url":null,"abstract":"Introduction: Stroke is a sudden-onset neurologic deficit and having a type 2 diabetes increases the risk of stroke twice as much. In addition to affecting physical and mental abilities, stroke can also lead to a decline in nutritional status. Malnutrition is associated with poor functional outcomes in all stroke subtypes. The Controlling Nutritional Status (CONUT) score is an objective nutritional marker and could reflects malnutrition due to its comprehensive assessment of nutritional status. This study aims to find the association between nutritional status towards the outcome of acute ischemic stroke patients with type 2 diabetes.\u0000Method: This was an observational analytic study with prospective cohort design using primary data collected consecutively from patients with both acute ischemic stroke and type 2 diabetes mellitus who were hospitalized in the Stroke Corner Room, Intensive Care Unit (ICU) and inpatient ward of Haji Adam Malik General Hospital who met the inclusion criteria. The nutritional statuses of patients were measured using the CONUT score and patients outcomes were measured by mRS score. Spearman correlation test was used to assess the association between nutritional status and outcome of acute ischemic stroke patients with type 2 diabetes mellitus.\u0000Results: There were 43 patients who met the inclusion criteria where the majority of patients were male 22 people (51.2%), in the age group 51-65 years 23 people (53.5%) with a mean age of 57.93 + 10.01, was a housewife 15 people (34.9%) and Bataknese 27 people (62.8%). The majority of patients in this study\u0000had mild malnutrition with a total of 15 people (34.9%) and a median CONUT score of 3 (0-11) and poor outcome as many as 29 people (67.4%) with mRS score median 4 (0-6). The result of Spearman correlation test showed a significant correlation between nutritional status and the outcome of acute ischemic stroke patients with type 2 diabetes mellitus with a moderate correlation.\u0000Conclusion: There was a significant correlation between nutritional status and the outcome of acute ischemic stroke patients with type 2 diabetes mellitus with a moderate correlation","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124147620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-11DOI: 10.47353/jsocmed.v2i1.23
Abdurrahman Asysyarif, E. R. Daulay, K. Ritarwan
Introduction: Stroke is the main cause of mortality and morbidity in Indonesia. Dysarthria is a symptom that can be seen from stroke. These symptoms occur in 15% of stroke events. Dysarthria is a motor speech disorder. Atypical lacunar stroke (ALS) is a stroke subtype that rarely occurs in one in 14 lacunar strokes or occurs in 6.8% of lacunar strokes, where isolated dysarthria or dysarthria facial paresis is the most common form of presentation. Method: This study is an observational analytic study with a case-control type of research with the aim of knowing the relationship between CT scan images of lacunar infarcts and dysarthria in ischemic stroke patients. The population in this study were all medical records of stroke patients who went to the Department of Neurology at the Haji Adam Malik General Hospital (RSUPHAM) Medan for a period of one year from January 1, 2019 to December 31, 2019 who underwent a head CT scan for 18 patients. Results: The subjects on the CT scan results of lacunar infarction with dysarthria 18 people (72%), and 7 people (28%) on the CT scan results there is no lacunar infarction. The same number and percentage were also found in the non-chivalrous control group. The test results obtained p value = 1,000 and odd ratio = 1.00, in other words there is no significant relationship between lacunar infarct and dysarthria. Conclusion: No significant relationship was found between the incidence of lacunar infarction and the incidence of dysarthria. The population with the most lacunar infarcts is men, hypertension, obesity, hypercholesterolemia, smoking and diabetes.
{"title":"Correlation of Lacunar Infarct on Head Ct Scan with Dysarthria in Haji Adam Malik General Hospital in 2019","authors":"Abdurrahman Asysyarif, E. R. Daulay, K. Ritarwan","doi":"10.47353/jsocmed.v2i1.23","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i1.23","url":null,"abstract":"Introduction: Stroke is the main cause of mortality and morbidity in Indonesia. Dysarthria is a symptom that can be seen from stroke. These symptoms occur in 15% of stroke events. Dysarthria is a motor speech disorder. Atypical lacunar stroke (ALS) is a stroke subtype that rarely occurs in one in 14 lacunar strokes or occurs in 6.8% of lacunar strokes, where isolated dysarthria or dysarthria facial paresis is the most common form of presentation. Method: This study is an observational analytic study with a case-control type of research with the aim of knowing the relationship between CT scan images of lacunar infarcts and dysarthria in ischemic stroke patients. The population in this study were all medical records of stroke patients who went to the Department of Neurology at the Haji Adam Malik General Hospital (RSUPHAM) Medan for a period of one year from January 1, 2019 to December 31, 2019 who underwent a head CT scan for 18 patients. Results: The subjects on the CT scan results of lacunar infarction with dysarthria 18 people (72%), and 7 people (28%) on the CT scan results there is no lacunar infarction. The same number and percentage were also found in the non-chivalrous control group. The test results obtained p value = 1,000 and odd ratio = 1.00, in other words there is no significant relationship between lacunar infarct and dysarthria. Conclusion: No significant relationship was found between the incidence of lacunar infarction and the incidence of dysarthria. The population with the most lacunar infarcts is men, hypertension, obesity, hypercholesterolemia, smoking and diabetes.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126109566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-11DOI: 10.47353/jsocmed.v2i1.27
T. Karim, Luwih Bisono, D. W. Wijaya, Rr. Sinta Irina
Introduction: Trauma is currently the most common cause of death in the first four decades of life and is still a major public health problem in every country. Arterial blood gas analysis (AGDA) is known to be an important marker for poor patient outcomes and occult or compensatory hypoperfusion. This study also evaluated the relationship and influence of AGDA scores on the outcome and prognosis of patients with multiple trauma. The results of this study will be able to assist in the rapid triage of acute trauma patients, which will also help identify high-risk patients who develop severe complications. Method: This study assessed the relationship between initial arterial blood gas and initial hemostatic function in acute trauma patients who came to the emergency department at H. Adam Malik General Hospital Medan. This type of research is a retrospective analytic where data is taken from medical records to see the relationship between AGDA and coagulation profile in multiple trauma patients at H. Adam Malik General Hospital Medan. After recruiting research samples at Adam Malik Haji Center General Hospital Medan, it was found that 141 multiple trauma patients who underwent surgery at H. Adam Malik General Hospital Medan met the inclusion criteria and were not included in the exclusion criteria Results: In this study, there were significant results between the pH and the three hemostatic physiology, there were no significant results between pCO2 and the three hemostatic physiology, and there were significant results between the HCO3 value and the PT and INR values, but no significant results were obtained with the APTT. Some authors believe that arterial PCO2 at admission is a significant prognostic factor in patients with traumatic head injury, but several studies dispute the arterial blood gas (ABG) parameter as a reliable indicator of short-term outcome in these patients. The main goal of the management of critically ill patients is the maintenance and optimization of cellular (and organ) health. Conclusion: This goal can be achieved by maintaining oxygenation, perfusion, fluid, electrolyte, and acid-base balance. Acid-base and oxygenation disorders are also critical, especially when these disorders develop rapidly.
简介:目前，创伤是生命头40年最常见的死亡原因，并且仍然是每个国家的一个主要公共卫生问题。已知动脉血气分析(AGDA)是不良患者预后和隐蔽性或代偿性灌注不足的重要标志。本研究还评估了AGDA评分与多发创伤患者预后的关系及影响。这项研究的结果将有助于急性创伤患者的快速分诊，这也将有助于识别出现严重并发症的高危患者。方法:本研究评估在棉兰亚当马利克总医院急诊科就诊的急性创伤患者初始动脉血气与初始止血功能的关系。这种类型的研究是一种回顾性分析，从医疗记录中获取数据，以了解棉兰H. Adam Malik综合医院多名创伤患者的AGDA与凝血特征之间的关系。在棉兰Adam Malik Haji中心总医院招募研究样本后，发现在棉兰H. Adam Malik总医院接受手术的141例多发创伤患者符合纳入标准，未被纳入排除标准。在本研究中，pH值与三种止血生理指标之间有显著性差异，pCO2值与三种止血生理指标之间无显著性差异，HCO3值与PT、INR值之间有显著性差异，而APTT无显著性差异。一些作者认为，入院时动脉PCO2是创伤性颅脑损伤患者的一个重要预后因素，但一些研究对动脉血气(ABG)参数作为这些患者短期预后的可靠指标存在争议。危重病人管理的主要目标是维持和优化细胞(和器官)健康。结论:通过维持氧合、灌注、体液、电解质和酸碱平衡可以达到这一目的。酸碱和氧合障碍也很重要，特别是当这些障碍发展迅速时。
{"title":"Relationship Blood Gas Analysis And Hemostasis Physics In Multiple Trauma Patients In Adam Malik Hospital Medan","authors":"T. Karim, Luwih Bisono, D. W. Wijaya, Rr. Sinta Irina","doi":"10.47353/jsocmed.v2i1.27","DOIUrl":"https://doi.org/10.47353/jsocmed.v2i1.27","url":null,"abstract":"Introduction: Trauma is currently the most common cause of death in the first four decades of life and is still a major public health problem in every country. Arterial blood gas analysis (AGDA) is known to be an important marker for poor patient outcomes and occult or compensatory hypoperfusion. This study also evaluated the relationship and influence of AGDA scores on the outcome and prognosis of patients with multiple trauma. The results of this study will be able to assist in the rapid triage of acute trauma patients, which will also help identify high-risk patients who develop severe complications. \u0000Method: This study assessed the relationship between initial arterial blood gas and initial hemostatic function in acute trauma patients who came to the emergency department at H. Adam Malik General Hospital Medan. This type of research is a retrospective analytic where data is taken from medical records to see the relationship between AGDA and coagulation profile in multiple trauma patients at H. Adam Malik General Hospital Medan. After recruiting research samples at Adam Malik Haji Center General Hospital Medan, it was found that 141 multiple trauma patients who underwent surgery at H. Adam Malik General Hospital Medan met the inclusion criteria and were not included in the exclusion criteria \u0000Results: In this study, there were significant results between the pH and the three hemostatic physiology, there were no significant results between pCO2 and the three hemostatic physiology, and there were significant results between the HCO3 value and the PT and INR values, but no significant results were obtained with the APTT. Some authors believe that arterial PCO2 at admission is a significant prognostic factor in patients with traumatic head injury, but several studies dispute the arterial blood gas (ABG) parameter as a reliable indicator of short-term outcome in these patients. The main goal of the management of critically ill patients is the maintenance and optimization of cellular (and organ) health. \u0000Conclusion: This goal can be achieved by maintaining oxygenation, perfusion, fluid, electrolyte, and acid-base balance. Acid-base and oxygenation disorders are also critical, especially when these disorders develop rapidly.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132983394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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