Jurnal RSMH Palembang

Evaluation of the operation scheduling application (SIJO) in an effort to reduce the number of cancellation of operations at Dr. Mohammad Hoesin Hospital Palembang

Masdahlena — 2024-06-21

The high rate of surgical cancellation has an impact on the low hospital performance assessment. Based on the results of the first semester achievement of 8.75% with a score of 0.5, it shows that it is far from the target achievement < 1%. This study aims to evaluate the application of the SIJO application in an effort to reduce the cancellation rate at Dr. Mohammad Hoesin Palembang Hospital using mixed methods with a quantitative research design using cross-sectional and qualitative research design using Miles and Huberman. The results of quantitative research showed that there was a significant relationship between the number of cancelled operations with laboratory results (COVID-19) (p-value 0.0001); did not get anesthesiologist approval (p-value 0.0001); ICU room availability (p-value 0.017); and blood availability (p-value 0.0001), and there was an insignificant relationship between the number of cancelled operations and the unavailability of pharmaceutical equipment (p-value 0.227). From the results of qualitative analysis conducted by in-depth interviews with research respondents, it is known that the Operation Scheduling Application (SIJO) is useful in the regularity of scheduling operations, effective in reducing the number of canceled operations. The most common obstacles encountered in using the SIJO application are swab results that sometimes do not appear automatically which have an impact on the operation scheduling process, the passwords of all users are the same so that misuse of SIJO accounts can occur and the slow RSMH internet network.

Correlation between the Pre-Analytical Stage and Quality of Breast Histopathology Specimen

Nyiayu Fauziah Kurniawaty — 2024-06-21

The histopathology preparations procedure in the Anatomic Pathology Laboratory consists of three stages: pre-analytic, analytical and post-analytic. Errors in the pre-analytic process can affect the quality of histopathology preparations, thereby affecting diagnosis and patient management. The length of fixation and the large size of tissue lamellae are variables in the pre-analytic process that influence the quality of histopathological preparations. The aim of this study is to determine the relationship between the length of fixation and the size of large tissue lamellae on the quality of histopathological preparation. A cross-sectional study was conducted on medical record data of histopathological examination of breast tissue examined at the Barokah Palembang Anatomical Pathology Laboratory between January - December 2022. There were 37 cases of histopathological specimens that met the inclusion criteria, of which 3 cases were underfixed, 13 cases were overfixed and the rest were normal. One case from the underfixation, 20 cases from the normal fixation and 3 from the overfixation group were included in the good specimen quality category. The Spearman test showed that there was a significant relationship between normal fixation and good specimen quality (p=0.00217). Of the 37 research subjects, there were 18 subjects who were categorized as good lamellation. When related to specimen quality, good lamellation is associated with good specimen quality (p=0.02161). The correct fixation and lamellation during the pre-analytic phase are associated with good specimen quality.

Impact of Particulate Matter 2.5 in Acne Vulgaris: A Literature Review

Afren I — 2024-06-21

Air pollution is the contamination of any chemical, physical or biological agent that alters the characteristics of the atmosphere. The main environmental pollutants consist of nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), heavy metals, particulate matter (PM)10 and PM2.5. Particulate matter is a heterogeneous mixture of small particles and liquids consisting of organic chemicals, acids, metals, soil or dust particles. Hair has a diameter of 50-70 µm, while PM10 is 2.5-10 µm and PM2.5 is < 2.5 µm. Air pollution can induce or aggravate skin diseases including acne vulgaris. Particulate matter2.5 triggers skin inflammation and stimulates inflammatory acne lesions through lipid peroxidation and Aryl hydrocarbon receptor (AhR) signaling. Interleukin (IL)-1α and IL-8 are elevated in inflammatory lesions of acne compared to normal skin, showing their role in the exacerbation of acne. The main preventive and therapeutic strategies against air pollution-induced skin damage consist of preventing the penetration of air pollutants through the skin and hair follicles, removing pollutants, improving skin barrier function, increasing skin hydration, and reducing inflammation, as well as preventing collagen and elastin degradation.

Effect of Autologous Serum Therapy (AST) as Adjuvant Management in Morphea: A Pilot Study

Nopriyati — 2024-06-21

Morphea, or localized scleroderma, is a chronic autoimmune disease characterized by sclerosis of the skin, subcutaneous tissue, and bones. Morphea therapy targets the inflammatory component, cytokine release and collagen activation and deposition. The mechanism of action of autologous serum therapy (AST) is based on the principle of induction of desensitization or tolerance to pro-inflammatory signals. The patient's clinical improvement criteria were calculated using the localized scleroderma cutaneous assessment tool (LoSCAT) based on physical examination. This study used a one group pre-test – post-test experimental design on morphea patients at the Dermatology, Venereology, and Aesthetics (DVE) Polyclinic, Allergy and Immunology Subdivision in Dr. Mohammad Hoesin General Hosptial (RSMH) Palembang in May-October 2023. This study included 7 morphea patients who met the inclusion criteria for AST injection in 8 weeks duration. The Dermatology Life Quality Index (DLQI) assessment carried out before the AST and after the 8^th AST showed that all patients experienced improvements in quality of life after 8 weeks. There was a decrease in LoSCAT scores in 5 patients (71.4%), while there was no change in LoSCAT scores in 2 patients (28.6%). Side effects of pain at the AST injection site in 3 patients (42.8%) were tolerable without painkillers, while other patients did not experience any side effects. The paired T-test statistical test on patients before AST and after AST treatment for 8 weeks showed that there was a significant difference in the mean DLQI and LoSCAT with p-value respectively 0.003 and 0.032. There is a significant difference in the mean DLQI and LoSCAT in study patients before AST and after AST for 8 weeks. There were side effects in the form of local pain at the AST injection area in 3 patients which were well tolerated without painkillers.

Resistance Patterns in Drug-Resistant Pulmonary Tuberculosis Patients at Dr. Mohammad Hoesin Palembang Hospital

Muhammad Novran Chalik — 2024-06-21

Tuberculosis (TB) is a contagious infectious disease caused by acid-resistant bacteria, Mycobacterium Tuberculosis (MTb). Based on immunity, there are two types of pulmonary TB infection: drug-sensitive and drug-resistant. Based on ATD sensitization tests, MTb resistance types consist of TB that is monoresistant, polyresistant, multidrug resistance (MDR), pre-extensively drug resistant (Pre-XDR), extensively drug-resistant (XDR). Globally, in 2022, there will be an estimated 450,000 cases of DR-TB, but only 161,000 treated. In Indonesia, in 2022, there were an estimated 24,000 cases of DR-TB; only 8,268 were notified and 5,082 cases had started therapy. In this study, conducted with a retrospective descriptive method, during the period 2022 at RSMH Palembang, 92 patients with DR-TB were obtained who received treatment at RSMH Palembang. Of the 92 subjects, the mean age of diagnosis of DR-TB was 44.47 ± 16.5. The most common gender was male 62 subjects (67.4%) and 30 subjects were female (32.6%). Of the 92 rifampicin-resistant patients, there were a total of 39 patients (42.4%) with isoniazid resistance. Among these 39 patients, 21 patients (54%) were primary resistance cases and 18 patients (46%) were secondary resistance cases. The most common type of therapy regimen used was a long-term regimen as many as 68 subjects (74%) and short-term as many as 24 subjects (26%)Primary resistance patterns were obtained in 43 subjects (46.8%) and secondary resistance in 49 subjects (53.2%). Of the 49 secondary resistance subjects, 52 subjects (56.5%) had TB-RR, 33 subjects (35.8%) had MDR-TB, 6 subjects (6.5%) had pre-XDR TB, and 1 subject (1.2%) had XDR-TB. The researcher concluded that the dominant resistance pattern of pulmonary TB cases was secondary resistance, with the results of the drug sensitivity test being TB-RR. However, it should be noted that DR-TB with a primary resistance pattern also has a higher percentage.