The Quality Test for Postoperative Pain Management using the American Pain Society Patient Outcome Questionnaire Revisied (APS-POQ-R) version Indonesia at Mohammad Hoesin Hospital in Palembang (A study of the quality level of postoperative pain management

A B S T R A C TPain is an unpleasant sensory and emotional experience associated with actual orpotential tissue damage, or described in terms of such damage. APS-POQ-R (RevisedAmerican Pain Society Patient Outcome Questionnaire) is a measuring tool for assessingthe quality of postoperative pain management by exploring patient experiences andoutcomes. This research aims to assess the quality of postoperative pain managementat Mohammad Hoesin Hospital Palembang and to determine the factors that influenceit. The Cross-sectional observational analytic study was conducted toward 51respondents. Data was collected primarily by using questionnares and interview. Datawas analyzed by using chi-square. The study showed that the quality of postoperativepain management at RSUP Mohammad Hoesin General Hospital Palembang has goodquality with a total of 27 patients (52.9%). From statistical analysis there wassignificant relationship between the quality of post-operative pain management withage (p=0,037), gender (p=0,027), ethnicity (p=0,039), education level (p=0,039), andeconomic level (p=0,005). So it can be concluded that was a significant relationshipbetween the quality of post-operative pain management with age, gender, ethnicity,education level, and economic level.

Gastric Neuroendocrine Neoplasm : WHO Classification 2019

A B S T R A C TNeuroendocrine neoplasm (NEN) of gastric is a term that includes all tumour types withneuroendocrine differentiation of gastric, well differentiated or poorly differentiatedtumour. NEN is a new term in 2019 World Health Organization (WHO) classification ofdigestive system tumours. In WHO 2019 had many updates, one of them isneuroendocrine tumours (NET) grade 3 have been included in tumour category of welldifferentiated tumour or NET. Previously, NET G3 in WHO 2010 are included as poorlydifferentiated tumour or neuroendocrine carcinoma (NEC). This neoplasm is geneticallywell differentiated and because of that, WHO 2019 classification included them as a welldifferentiated tumour. For NEC, WHO 2019 subdivided them as NEC with small cells(SCNEC) and NEC with large cells (LCNEC). In WHO 2010, mixed type neuroendocrineneoplasms with other components of carcinoma are called mixed adenoneuroendocrinecarcinoma (MANEC). But, not all of non-neuroendocrine components areadenocarcinoma and it is possible that one of the components in not carcinoma. Becauseof that, in WHO 2019 the term has been changed to mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN).

Maternal And Neonatal Management In The Cases Of HIV / AIDS Infected Pregnant Women In Jambi City

A B S T R A C TBackgrounds: HIV/AIDS is a disease that still becoming a global health problem, andalso became a disease that given special attention by Sustainable Development Goals(SDGs) in 2016 points number 3. In Jambi Province recorded that in the year of 2014the number of cumulative cases of HIV and AIDS is 145 cases of HIV and AIDS 59.Vertical transmission can occur from a mother who is infected by HIV/AIDS to theirbabies. To increase epidemiological knowledge of perinatal outcome from pregnantmother with HIV/AIDS infection, because in Indonesia this type of information is notmuch known, In Jambi This kind of information doesn’t exist. Methods:This is adescriptive research. The data are taken from 41 registers by total sampling. The dataanalysis is using proportion descriptive method. Results: According to 41 datarecorded. 35 neonates (85,4 %) delivered with weight around 2500 gram or more, 41neonates (100 %) delivered with APGAR score (neonatal asthfixia) APGAR 7-9, 32neonates (78,1 %) delivered by Sectio Caesarean, 40 neonates (97.6 %) born at 36weeks, and 25 neonates (60,1 %) delivered from mothers infected by HIV/AIDS withCD 4 counts above 350 cell/ml 41 neonates (100%) born without HIV/AIDS infection.Conclusions: Neoanatal outcome from HIV / AIDS infected mothers in Raden Mattaherthe state hospital of Jambi Province were delivered with normal weight, APGAR score7-9 (normal), delivered by Sectio Caesarea, at the age of 36 weeks or above from motherwith CD4 counts over 350 cell/ml without HIV/AIDS infection.

Insulinoma

A B S T R A C TInsulinoma is a functional neuroendocrine neoplasm consisting of insulin-producingcells, which produce insulin uncontrollably, causing a hypoglycemic syndrome. TheHypoglycemic syndrome is a result of hyperinsulinemia which causes adrenergicsymptoms and neuroglycopenia. The clinical diagnosis is based on the Whipple triad,insulin, and C peptide levels in a 72-hour fasting state. Generally, insulinoma is abenign neoplasm with a proliferation index of Ki-67 <2%. On histological features, thegrowth pattern of the insulinoma is usually trabecular or solid. Some insulinomas showa tubuloacinar growth pattern with psammoma bodies. We reported one case ofinsulinoma in a 65-year-old woman, who had experienced fainting, cold sweats for 3years, especially when the patient ate late or at midnight while sleeping. A CT scanshowed a tumor mass in the pancreas possibly an insulinoma and a pancreatectomywas performed. The results of the histopathological examination are bu following peerunder Insulinoma.

Evidence-based case report: Coinfection of COVID-19 in children and administration of antibiotics

A B S T R A C TBackground. COVID-19 in childrenalthoughmostly mild,but can also cause seriousillness and even death. Coinfection, especially bacterialcan increase the severity of thedisease. There is yet sufficient evidence about the role of antibiotics in childhoodCOVID-19 with coinfection.Objective. To review the available evidence on thecoinfection in childhood COVID-19 and the role of antibiotic administration.Method.Online literature search using Pubmed database, google scholar dan Cohcranelibrary Results.No study was found that directly evaluate the efficacy of antibiotic inchildhood COVID-19 with coinfection. Three meta-analyses found rates of coinfectionof 5.6%-14% and one case series identified a very high rate (94.2%). Most frequentpathogens included Mycoplasma pneumonia, Streptococcus pneumonia,andinfluenza/parainfluenza viruses. Two RCTsandone case series on antibioticadministration, but all three studies did not address coinfection status.All threestudies evaluated the combination of azithromycin and hydroxychloroquine. Nochanges in illness severity or mortality attributed to the medications, one studyindicated more rapid viral load clearance associated with azithromycin. ConclusionThere is a lack of evidence on the role of antibiotics in the management of childhoodCOVID-19with coinfection. Azithromycin can be considered in some cases.

Superficial mycosis profile in the Tertiary Hospital Dr. Moh. Hoesin Palembang: retrospective research

Background Superficial mycoses is a fungal infection of the skin, nails and hair thatcaused by dematophytes, yeast and mold. Superficial mycoses infections are commonlyfound in high temperature and humidity area such as Indonesia. Palembang is one ofregions in Indonesia has a high temperature and humidity, considered the incidenceof this disease is high. A retrospective study of new cases of superficial mycoses, datataken from medical records and register book at Policlinic of Dermatology andVenereology Dr. Moh. Hoesin Palembang during 5 years from January 2014-December2018. There were 1,236 (17.1%) new cases of superficial mycoses. Incidence ofsuperficial mycoses varies with range 6.9%-23%. The most common superficialmycoses is dermatophytes (38,3%). Microsporum canis, Trichophyton rubrum danTricophyton hmentagrophytes are frequent isolates in this study. The most age groupis 36-45 years (17.6%) with male more than female. Superficial mycoses are often foundin students (26.9%), followed by unskilled workers (20.8%). Of the 1,236 new cases,125 patients had comorbidities, such as malignancy 21 (16.8%) patients,cerebrovascular disease and diabetes mellitus each 16 patients (7.4%). Inguinal andabdomen are the most commonly infected regions. 656 (53.1%) patients was giventopical antifungal. The most common topical antifungal was ketoconazole 2% cream(62%) and systemic antifungal was itraconazole (55,3%).Conclusion: Cases ofsuperficial mycoses, especially dermatophytosis and Malassezia were still commonlyfound, especially in Palembang.

Role of Cathelicidin (Ll-37) and Human Β-Defensin In Atopic Dermatitis And Psoriasis

The Human epithelium, including the epidermis produces antimicrobial peptide (AMP)as part of innate immunity. Cathelicidin and human β-defensins are the most AMPfound on the skin. This antimicrobial peptide has a role in the response of the naturalimmune system by becoming the front line of the defense system against infection. Thediscussion of this literature review will focus on cathelicidin and human β-defensin-1which are the main AMPs that affect atopic dermatitis and psoriasis. Antimicrobialpeptides are excessively produced in lesional psoriatic scales or rosacea in contrast tothe atopic skin that shows lower AMP levels when compared with psoriasis. Despitethe impaired skin barrier which facilitates potentially pathogenic microbes to colonizethe epidermis, patients with psoriasis surprisingly present a low frequency of skininfections, whereas patients with atopic dermatitis are predominantly susceptible toparticular cutaneous bacterial, fungal and viral infections. One possible explanation ofthe fact is the difference in the expression of AMPs. DA patients have fewer AMPexpression characteristics, especially cathelicidins LL-37 and HBD-2. Research onantimicrobial use can help reduce pathogen colonization so that clinical improvementof AD occurs. In the case of psoriasis, AMP expression increases, especially LL-37 andHBD-2, showing synergistic antimicrobial activity that is effective in eradicatingmicrobial colonization, so there is no strong evidence to support antibiotic use intreating psoriasis or in preventing disease.

Stromal Tumors in the Prostate

Stromal tumors of the prostate are rare mesenchymal tumors of the prostate stroma,in the form of spindle cell tumors, which are differentiated by cellularity, mitotic index,cellular atypia, and necrosis. These tumors are classified into two; prostatic stromaltumors of uncertain malignant potential (STUMP) and prostatic stromal sarcomas (PSS).The incidence is about 0.1-0.2% of the total incidence of prostate cancer. Thepathogenesis of prostate stromal tumors is based on origin, clonal and chromosomalabnormalities. Clinical symptoms of complaints lead to lower urinary tract obstruction,dysuria and pollakiuria as well as abnormalities in the rectal toucher (RT) examination.Macroscopically, brownish-white masses were found showing a solid or solid-cysticpattern. Radiological examination can use transrectal ultrasound (TRUS), CT Scan andMRI. Histopathologically, prostate STUMP has five different patterns, namely thedegenerative atypia pattern, hypercellular stroma pattern, phyllodes-type growthpattern, myxoid pattern, and epithelioid stromal pattern. Meanwhile, in PSS, there arehistological patterns of storiform, epithelioid, fibrosarcomatous, and patternless growthpatterns. Then PSS was subclassified into two, namely low grade and high gradetumors. Immunohistochemical examination showed immunoreactivity for CD34, PR,smooth muscle actin (SMA), desmin, HHF35, smooth muscle actin, vimentin andandrogen receptors and negative for estrogen receptors, CD117 and S-100. Thedifferential diagnosis is rhabdomyosarcoma, leiomyosarcoma, inflammatorymyofibroblastic tumor, sarcomatoid carcinoma, benign prostate hyperplasia, smoothmuscle tumor, gastrointestinal stromal tumor, and solitary fibrous tumor. Prognosis ofprostate STUMP is better than that of PSS. Treatment of STUMP is currently unknown.Definitive resection can be performed taking into account the patient's age, treatmentpreference, and the size or size of the lesion. Treatment for PSS radical prostatectomy,cystoprostatectomy, or pelvic exenteration for local aggressive tumors.

Black Dot Type Capitis Tinea Appreciates Bacterial Foliculitis

Tinea capitis is a superficial fungal infection of the scalp and hair, which is seenpredominantly in children. In adults, it is usually related to immunocompromisedpatients and have an atypical features. In patients with end stage renal disease (ESRD),uremia is associated with immune suppression due to the impact of uremic milieu. Allspecimens of tinea capitis should be examined for microscopy, wood’s lamp andculture. Reported a case of 50–year-old male, animal husbandry, presented with itchypapules, pustules, patch alopecia and a hair loss for 6 months. Dermatologic featuresshowed papules, pustules, patch alopecia and black dot. The patient treated withketoconazole shampoo for 3 weeks without any improvement. He had an ESRD for 2years. Gram stain examination and culture showed no bacteri. Wood’s lampexamination showed no fluorescent. Potassium hydroxide (KOH) 10% from scalpscrapings and KOH 20% from hair showed a fungal elements, which support diagnosisof black dot tinea capitis. The patient treated with griseofulvin tablet 500 mg twice aday for 8 weeks, cetirizine tablet 10 mg once daily and 3x/week of ketoconazoleshampoo 2% showed improvement in clinical features and microscopic evaluation.

Effectiveness Of Ranitidine Providing Compared With Omeprazol In Children With Gastroesofageal Reflux Disease

Background. The drugs that are often given to children with GERD are stomach acidsuppressants, namely the H2 receptor antagonist and proton pump inhibitor (PPI) classof drugs, but the effectiveness of the two drugs is still controversial. Objective. Toevaluate the use of PPIs and H2 RA in children with GERD through evidence-basedcase studies. Methods. Systematic search for literature using the search instrumentPUBMED, Cochrane, Google Scholar, Pediatrica Indonesiana, and Sari Pediatri.Searches included systematic review articles, randomized controlled clinical trials andcohort studies. Abstract only studies, non-clinical evaluation results, and case reportswere excluded. Results. The study was obtained from three RCT studies comparingthe effectiveness of omeprazole and ranitidine in the treatment of GERD, all of whichhave differences. Azizollahi et al demonstrated that after 2 weeks of standard doses ofomeprazole or ranitidine there was a comparable significant improvement. Ummarinoet al demonstrated that omeprazole was significantly better than high-dose ranitidine.Cucchiara et al (1993) showed that high doses of ranitidine were as good as omeprazole.Another study by Pfefferkorn et al showed no significant effect on the addition ofomeprazole therapy combined with ranitidine in preventing the incidence of NAB. Astudy by Boccia et al comparing omeprazole, ranitidine, and non-therapy, found verylow relapse rates. Conclusion. Evidence regarding the use of ranitidine versusomeprazole in infants and children is lacking. Based on one study specifically in theinfant age group, omeprazole and ranitidine were of comparable effectiveness. A higherdose of ranitidine may have a better effect. In terms of complete symptom relief,omeprazole is likely to be superior to ranitidine.