Clinical Spectrum of Neurological Complaints in COVID-19: Experiences from a COVID-19 Referral Hospital in Indonesia

<p><strong>Background: </strong>The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in confirmed COVID-19 patients in Indonesia is still lacking</p><p><strong>Aim: </strong>To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.</p><p><strong>Methods: </strong>This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.</p><p><strong>Results: </strong>There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.</p><p><strong>Conclusion: </strong>The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.</p>

Association Between Quality Of Sleep With Primary Headache In Siloam Hospital Karawaci

<p>A primary headache is the most common neurological complaint and is experienced by almost everyone throughout life. The most common type of primary headache is TTH (Tension-Type Headache) and Migraine. Quality of sleep is associated with life satisfaction and data shows that one-third of adults are affected by poor sleep. Many studies have mentioned that there is a relationship between quality of sleep and primary headache, but no study has ever been conducted in Siloam Hospital Karawaci. We did a case-control study in Siloam Hospital Karawaci using purposive sampling, with a total of 50 patients as the subjects. Data were collected using the PSQI questionnaire and DASS 42 between January 2019 – March 2019. It was found that there was a significant relationship between sleep quality and primary headache (p= &lt;0,001).</p>

Use Of Panty Liner As A Risk Factor The Occurration Of Abnormal Vaginal Discharge

<p>Vaginal discharge or fluor albus is a problem that is often found in women. Daily use of panty liner is a predisposing factor of pathological/abnormal vaginal discharge. This paper reviews the correlation between the use of panty liner and vaginal discharge. The aims of this study were to analyze the effect of daily panty liner use as a risk factor of vaginal discharge. This research is done by using the cross-sectional method. The study population is students of the University of Pelita Harapan in the Faculty of Nursery. Sample size calculation was done using the categorical comparative analytical formula and a result of 46 samples were obtained for each population. A questionnaire was used in this research. Statistical analysis is done by using the SPSS 22.0 program with the Chi-Square method. Bivariate analysis on 92 respondents revealed that there is a significant association between the usage of a panty liner and abnormal vaginal discharge (p-value &lt;0.05). Based on bivariate analysis panty liner material is not related to abnormal vaginal discharge (p-value &gt;0.05).</p>

Functional Endoscopic Orbital Decompression Surgery in Acute Rhinosinusitis with Orbital Complication : A Case Report

<div class="WordSection1"><p><strong>Introduction: </strong>Orbital complications secondary to acute rhinosinusitis can cause permanent vision loss and death if not treated promptly and appropriately. The prevalence of orbital complications due to rhinosinusitis is more common in children than adults, occurring in 3-4% of children with acute rhinosinusitis. Lamina papyracea in children has many dehiscences, the nasal cavity tends to be narrower and the mucosa is softer than in adults, therefore causing the spread of infection more easily from the sinuses to the eyes. Clinical presentation: a 4-year-old child presented with eye swelling and pus discharge in the right eye for 5 days before being admitted to the hospital, for which she was treated with medication and did not improve. On physical examination, there is a narrow nasal cavity, inferior turbinate edema, and hyperemia, mucopurulent discharge. CT scan and MRI revealed contrast enhancement in intraorbital with suspected intraorbital abscess with orbital cellulitis, right pansinusitis, and buccal abscess. Functional endoscopic orbital decompression was done immediately.</p><p><strong>Conclusion: </strong>Orbital complications due to acute rhinosinusitis are uncommon but potentially lead to more fatal complications. Early diagnosis and aggressive treatment of immediate functional endoscopic sinus surgery and antimicrobial therapy have a good outcome.</p></div>

Association Between Cigarette Smoking And Cognitive Function In Stroke Patients Of Siloam Lippo Karawaci Hospital

<div class="WordSection1"><p>Stroke is cerebrovascular disease, causing deterioration of brain function as a result of cerebral blood flow disruption. Stroke is the third leading cause of death in the world and is considered an important cause of long-term disability and cognitive impairment. Risk factors of stroke are further divided into unmodifiable risk factors and modifiable risk factors, with one of the most common modifiable risk factors of stroke, is cigarette smoking. Besides being one of the risk factors that cause stroke, cigarette smoking is believed to have a role in cognitive impairment. This study aims to obtain information regarding the association between cigarette smoking and cognitive function in stroke patients of Siloam Lippo Karawaci Hospital. This research is an unpaired comparative analytical study with a cross-sectional design. Data sampling was taken by consecutive sampling on 56 stroke patients of Siloam Lippo Karawaci Hospital. Cognitive function was made based on the Montreal Cognitive Assessment version Indonesia (MoCA-INA). All data were analyzed by Chi-Square test using SPSS version 25 and the result is considered significant if the p-value &lt; 0,05. From the result of this study. There is a significant association between cigarette smoking and cognitive function (p-value 0,004 and OR 5,343).</p></div>

Correlation Between Aphasia in Stroke Patients and Severe Depression of Family Members as Primary Caregivers.

<p><strong>Background and Objective: </strong>Stroke is a disease with an increasing annual prevalence. One of the most frequent clinical manifestation seen in stroke patients is aphasia which greatly affects the patient’s ability to communicate. The burden and the pressure of taking care of the patient placed on the family members often results in psychological impacts such as depression. We intend to know the association between aphasia in stroke patients with severe depression on family members. </p><p><strong>Methodology:</strong> This was a cross sectional study, using an unpaired categorical comparative analysis. Inclusion criteria were family members of patients with and without aphasia. Patients and caregivers who gave their consent verbally were guided to fill in the Hamilton Depression Rating Scale questionnaire. The association between aphasia status and the depression scale was analyzed using Chi-Square.</p><p><strong>Results: </strong>Out of 54 respondents included in the study, there were 25 caregivers (46,3%) taking care stroke patients without aphasia, and 29 caregivers (53,7) taking care stroke patients with aphasia. As much as35 (64.8%) were categorized as normal- moderate level of depression and 19 (35.2%) categorized as major depression. From those with major depression, 14 (73.7%) were found in the aphasic group and 5 were in the non-aphasia group. Chi-Square analysis shows a significant correlation [P=0.03; OR=3.73 (1.1-12.7)] between aphasia in stroke patients and severe depression of the caregivers.</p><p><strong>Conclusion: </strong>There is a significant association between aphasia in stroke patients and the incidence of severe depression on their caregivers.</p>

Profile and Factors Associated with Depression, Anxiety, and Stress in Indonesian People During COVID-19 Pandemic

<div class="WordSection1"><p><strong>Background : </strong>As a result of the COVID-19 pandemic, Indonesia implemented various policies to break the chain of transmission of COVID-19, starting from large-scale social restrictions, quarantines, and even lockdowns. Without exception, schools were also closed. These conditions affect people psychologically, including levels of depression, anxiety, and stress in students. The aim of this study is to determine profile and factors associated with depression, anxiety, and stress in Indonesian people during the COVID-19 pandemic.</p><p><strong>Methods : </strong>A cross-sectional study among students in Indonesia was conducted to determine depression, anxiety, and stress levels in adolescents based on their sociodemographic characters. The DASS-21 questionnaire was distributed online.</p><p><strong>Results : </strong>A total of 913 people participated from all provinces in Indonesia. Depression, anxiety, and stress were found in 43.5%, 43.3%, 25.2%, respectively. The severity of depression was significantly associated with age (p&lt;0.001), gender(p=0.003), and region(p=0.039). Adults (25-55) are 4.6 times odds more likely to have depression than adolescent during pandemic (OR=4.641, 95% CI=2.053-10.491). The severity of anxiety was significantly associated with age (p=0.002), gender(p&lt;0.001), education (p=0.004) and region(p=0.004). The severity of stress was significantly associated with gender (p&lt;0.001) and education (p=0.018).</p><p><strong>Conclusion : </strong>Depression, anxiety and stress quite common found in Indonesian during COVID-19 pandemic. Several sociodemographic factors were associated with depression, anxiety and stress among Indonesia</p></div><strong><br clear="all" /> </strong>

Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice

<p>Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.</p>

Development and Validation of a “Pelita Harapan” Questionnaire Assessing Knowledge, Attitude, and Practice Toward Coronavirus Disease 2019 Among Young People in Indonesia

<p><strong>Introduction:</strong> Coronavirus Disease 2019 (COVID-19) has become a pandemic. Much false information was circulating especially through social media and affected individual’s knowledge, attitude, practice (KAP) towards COVID-19. Currently, there is lack of validated questionnaires to assess KAP about COVID-19 especially in Indonesian young people.</p><p><strong>Aim:</strong> To develop and validate a new COVID-19 KAP questionnaire for young people population in Indonesian language.</p><p><strong>Methods:</strong> Some literature review was done to look for the concept to generate a new questionnaire. Open-ended questions were generated to know the baseline knowledge. Then, close-ended questions were formulized for knowledge, attitude, and practice area. The experts and several respondents were asked to give their opinions about the contents of the questionnaire. The validity was examined using Cronbach's alpha coefficient. For reliability, internal consistency was examined by using Pearson or Spearmen correlation test.</p><p><strong>Results:</strong> A total of 59 subjects with median ages 21 (16-24) years old of non-medical individuals were included in this validation process. More than half were male, mostly held bachelor’s degree/diploma, and were dominated with students. This Indonesian COVID-19 KAP questionnaire for young people consists of 10 knowledge, 8 attitude, and 7 practice questions. The Cronbach’s alpha coefficient of knowledge, attitude, and practice areas were 0.87, 0.82, and 0.91, respectively.</p><p><strong>Conclusions:</strong> A questionnaire of KAP towards COVID-19 in Indonesian language had been developed and the results showed good validity.</p>

Incidence And Characteristics Of Double Lumen Induced Central Venous Catheter-Related Thromboembolism In Hemodialytic Patients

<p><strong>Background: </strong>Central venous catheters (CVCs) are frequently used in patients for several indications such as cancer treatment, diagnostic monitoring, parenteral nutrition, hemodialysis, and administration of fluids, blood products or medication. Double lumen catheter induced CVCs thrombosis has not been paid into proper attention in developing countries such as Indonesia.</p><p><strong>Aims:</strong> The aim of this study is to identify the incidence and characteristic of double lumen catheter induced CVCs thrombosis in patients undergoing hemodialysis.</p><p><strong>Methods: </strong>This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool.<strong> </strong></p><p><strong>Results: </strong>A total of 408 patients were included in our study. There were 192 (47.1%) male patients. The double lumen catheter was mostly placed in the jugular vein (60%), followed by subclavian vein (25%) and femoral vein (15%). Four (1.1%) patients had deep vein thrombosis after about one month of double lumen catheter placement. All these four patients, the double lumen catheter was inserted in the femoral vein. Any other significant risk factors for thrombosis other than double lumen catheter insertion not found. Out of these four patients, one of them passed away. All patients were treated using heparin.</p><p><strong>Conclusion: </strong>The incidence of double lumen catheter induced thrombosis is low (1.1%) in patients undergoing hemodialysis. However, further larger study is needed to confirm and find the associating factors.</p>