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Relationship between interleukin-6 (IL-6) levels and chest X-ray severity scoring in COVID-19 patients Kardiasyah, Alzi; Syarani, Fajrinur; Bihar, Syamsul; Lubis, Netty D.; Mutiara, Erna; Syahputra, Hafid
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.690

Abstract

The severity of coronavirus disease 2019 (COVID-19) may be measured by interleukin-6 (IL-6) and chest X-rays. Brixia score of the chest radiographs is usually used to monitor COVID-19 patients’ lung problems. The aim of this study was to demonstrate the relationship between IL-6 levels and chest radiographs (Brixia score) that represent COVID-19 severity. A retrospective cohort study was conducted among COVID-19 patients who had a chest X-ray and examination of IL-6 levels at H. Adam Malik General Hospital, Medan, Indonesia. A multinomial logistic regression analysis was conducted to evaluate the association between IL-6 levels and the severity of the chest radiograph. A total of 76 COVID-19 patients were included in the study and 39.5% of them were 60–69 years old, with more than half were female (52.6%). A total of 17.1%, 48.7%, and 34.2% had IL-6 level of <7 pg/mL, 7–50 pg/mL and >50 pg/mL, respectively. There were 39.5%, 36.8% and 23.7% of the patients had mild, moderate and severe chest X-rays based on Brixia score, respectively. Statistics analysis revealed that moderate (OR: 1.77; 95% CI: 1.05–3.32) and severe (OR: 1.33; 95% CI: 1.03–3.35) lung conditions in the chest X-rays were significantly associated with IL-6 levels of 7–50 pg/mL. IL-6 more than 50 pg/mL was associated with severe chest X-ray condition (OR: 1.97; 95% CI: 1.15–3.34). In conclusion, high IL-6 levels significantly reflected COVID-19 severity through chest X-rays in COVID-19 patients.
Correlation of Bronchoscopy Visualization With Cell Type in Lung Cancer Patients at Haji Adam Malik Hospital Medan 2023 Fachrina, Intan; Bihar, Syamsul; Syarani, Fajrinur
Journal of Society Medicine Vol. 3 No. 10 (2024): Oktober
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i10.167

Abstract

Introduction: Lung cancer is defined as a tumor that originates in the lung parenchyma or is located around the bronchi. The two main types are Non Small Cell Lung Carcinoma (NSCLC) and Small Cell Lung Carcinoma (SCLC). When carrying out the procedure, several bronchoscopy visualizations are assessed, such as the bronchial lumen, bronchial mucosa, secretions and bronchial anatomy. Timely bronchoscopic intervention is important for rapid and accurate diagnosis. To determine the relationship between bronchoscopic visualization and carcinoma cell type characteristics from histopathology. Method: This study was conducted with an observational analytic design conducted in a cross-sectional manner, from October 2023 to May 2024. The subjects of this study were taken from the population of lung cancer patients who were hospitalized and outpatient in the hospital, were found to be 67 samples of Non Small Cell Lung Carcinoma (NSCLC). Data included bronchoscopic visualization with lung carcinoma cell type from histopathology, were analyzed univariately and bivariately to assess the relationship between bronchoscopy visualization and lung carcinoma cell type. Results: All patients had Non Small Cell Lung Cancer (100%) are Adenocarcinoma as much as 63% and Squamous Cell Carcinoma as much as 37%. Bronchoscopy visualization shows a central location (62%), partially closed lumen (65%), smooth mucosa (64.5%), mucoid secretion (83.8%), and most often in the right main bronchus (32.2%). Conclusion: There was a significant relationship between bronchoscopy location and type of lung cancer cell (P value 0.001), as well as between mucosa and cell type (P value 0.001).
Correlation Between Neutrophil to Lymphocyte Ratio (NLR) and Procalcitonin Levels in Sepsis Pneumonia Patients Purba, Angela Yurika; Bihar, Syamsul; Sinaga, Bintang Y.M.
Journal of Society Medicine Vol. 3 No. 11 (2024): November
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i11.175

Abstract

Introduction: According to the World Health Organization's global health estimates, lower respiratory infections are the fourth leading global cause of deaths and the deadliest communicable disease, causative for three million deaths worldwide in 2016. Despite the introduction of antibiotic therapies in the 1950s, pneumonia mortality has not decreased substantially, and sepsis, septic shock or acute pulmonary failure (eg acute respiratory distress syndrome, ARDS) are frequent secondary complications. To improve management and treatment of pneumonia, supporting microbiological and virological tests from throat swabs, sputum or blood cultures might be indicated to identify the responsible pathogen(s) and to allow targeted antimicrobial or antiviral therapy. To determine the relationship between procalcitonin level and neutrophil to lymphocyte ratio in sepsis pneumonia patients. Method: This study was conducted with an observational analytic design conducted in a cross-sectional manner, from January 2023 to December 2023. The subjects of this study were taken from the population of sepsis pneumonia patients who were hospitalized at intensive care unit, were found to be 132 samples. Data included procalcitonin level and neutrophil to lymphocyte ratio from laboratory findings, were analyzed with univariate and bivariate method to assess the relationship between procalcitonin level and neutrophil to lymphocyte ratio. Results: In this study, white blood cell, neutrophil and neutrophil/lymphocyte ratio values were found to be significantly higher in patients with elevated procalcitonin. Among the 132 samples, the mean of procalcitonin level was between ≥ 2 to 10 (39,39%) and neutrophil to lymphocyte ratio was between ≥ 11 to 17 (50%). Conclusion: There was no significant relationship between procalcitonin level and neutrophil to lymphocyte ratio in sepsis pneumonia patient at intensive care unit in Adam Malik Hospital Medan (P value 0.816).
Pentingnya Layanan Kesehatan Menggabungkan Metode Online dan Offline Guna Tetap Terjadinya Perlindungan Hukum Bagi Pasien dan Dokter Putri, Radhita Sylvia; Yuyut, Prayuti; Jie, Elvin Shon; Bihar, Syamsul; Pantja P, Emilia Saminoe; Lany, Arman
Jurnal Ilmiah Wahana Pendidikan Vol 10 No 20 (2024): Jurnal Ilmiah Wahana Pendidikan
Publisher : Peneliti.net

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.5281/zenodo.14455119

Abstract

Pelayanan kesehatan online, atau yang umumnya dikenal sebagai telekonsultasi, merupakan bagian integral dari kemajuan teknologi dalam bidang kesehatan. Peningkatan inovasi ini mulai menyebar di Indonesia bersamaan dengan dorongan inovasi data, terutama di masa merebaknya virus Corona yang membatasi kerja sama yang erat dan personal. Manfaat dari pengadopsian inovasi ini melibatkan keleluasaan dalam pengaturan waktu, penurunan biaya pertemuan, jangkauan yang lebih luas, serta peningkatan dalam pelayanan kesehatan. Akan tetapi, penerapan layanan konsultasi kesehatan online dapat menimbulkan permasalahan etika dan hukum di Indonesia, seperti kekhawatiran mengenai kerahasiaan dan keamanan data pasien serta legalitas lokasi praktik, izin praktik, dan transaksi terapeutik. Konsultasi kesehatan online saat ini tidak diatur secara spesifik di Indonesia. Oleh karena itu, pedoman yang tegas diharapkan dapat menjamin pemanfaatan inovasi tersebut sesuai dengan moral dan peraturan materiil. Selain itu, penyempurnaan pedoman dan penggunaan peralatan klinis juga perlu terus dilakukan untuk membantu terlaksananya penyelenggaraan pertemuan kesehatan berbasis internet ini. Hal ini penting guna memastikan bahwa pelayanan tersebut tetap memenuhi standar keamanan dan kualitas yang dibutuhkan dalam konteks kesehatan masyarakat.
Hubungan Antara Pola Kuman dengan Mortalitas pada Pasien Pneumonia di IPI RS. HAM Medan Nadia, Agnes; Bihar, Syamsul; Syarani, Fajrinur
Public Health and Safety International Journal Vol. 5 No. 01 (2025): Public Health and Safety International Journal (PHASIJ)
Publisher : YCMM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55642/phasij.v5i01.990

Abstract

Pneumonia is one of the leading causes of morbidity and mortality, partIPIlarly in hospital settings. Identifying bacterial patterns and antibiotic resistance is essential to determine appropriate therapy and reduce mortality rates. This study aimed to examine the association between bacterial patterns, antibiotic resistance, and mortality in pneumonia patients. A retrospective design was used by analyzing medical record data of pneumonia patients treated in 2022. A total of 66 patients who met the inclusion criteria were included in the analysis. Data included sputum culture results, antibiotic resistance profiles, and patient mortality status. The results showed that the most commonly found bacteria were Klebsiella pneumoniae (31.8%), followed by Acinetobacter baumannii (25.8%) and Pseudomonas aeruginosa (16.7%). The highest resistance rates were observed for meropenem (31.8%) and levofloxacin (28.8%). Statistical analysis revealed a significant association between antibiotic resistance and patient mortality (p = 0.017). However, no significant association was found between the type of causative bacteria and mortality (p = 0.414). These findings indicate that antibiotic resistance plays a major role in clinical outcomes of pneumonia patients. Therefore, regular monitoring of bacterial and resistance patterns and the implementation of rational antibiotic use policies are essential to reduce pneumonia-related mortality in hospitals.
Profile Of Pleural Fluid Adenosine Deaminase And Protein Levels In Tuberculous Pleural Effusion At Adam Malik Hospital Indonesia Sihite, Marisi Ester Nova; Bihar, Syamsul
Jurnal Impresi Indonesia Vol. 4 No. 7 (2025): Indonesian Impression Journal (JII)
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i7.6873

Abstract

Tuberculosis remains one of the most prevalent infectious diseases worldwide. In addition to affecting the lungs, Mycobacterium tuberculosis infection can also cause extrapulmonary tuberculosis, including pleural effusion. Tuberculous pleural effusion is a relatively common condition, with an incidence ranging from three to thirty percent of total tuberculosis cases. Diagnosing tuberculous pleural effusion presents a clinical challenge due to nonspecific symptoms and limitations of conventional diagnostic methods. Biomarker testing, such as measuring Adenosine Deaminase levels in pleural fluid, has been widely used as a diagnostic method due to its high sensitivity and specificity in distinguishing tuberculous pleural effusion from other causes. Method: This study aims to analyze Adenosine Deaminase levels and pleural fluid protein levels in patients with pleural effusion. A descriptive study with a cross-sectional approach was conducted on thirty-five samples that met the inclusion criteria. Result: The results showed that the mean Adenosine Deaminase level was sixty-one point nine seven grams per liter, with a standard deviation of fifty-eight point three one four and a median value of forty-one grams per liter. The mean pleural fluid protein level was four point five grams per deciliter, with a standard deviation of one point five six and a median value of four point three one grams per deciliter. Conclusion: The analysis revealed significant differences in Adenosine Deaminase and pleural fluid protein levels based on nutritional status, comorbid diseases, and bacteriological examination results. Furthermore, a positive and significant correlation was found between Adenosine Deaminase and pleural fluid protein levels, where an increase in Adenosine Deaminase levels was associated with higher pleural fluid protein levels. Clinical factors such as nutritional status, comorbid diseases, and bacteriological examination results play a role in determining the levels of these biomarkers.
Optimizing Diagnosis and Antibiotic Therapy in Ventilator-Associated Pneumonia: A Comparative Study of Tracheal Secretion Cultures in Critically III Patients Assilmy Lubis, Muhammad Rizky; Bihar, Syamsul
Jurnal Impresi Indonesia Vol. 4 No. 7 (2025): Indonesian Impression Journal (JII)
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i7.6875

Abstract

Invasive mechanical ventilation in pneumonia patients often leads to complications, including ventilator-associated pneumonia (VAP), which is associated with specific bacterial pathogens and antibiotic resistance. Tracheal secretion cultures are essential for identifying bacterial patterns and assessing antibiotic resistance in these patients. This study aims to analyze the bacterial patterns and antibiotic resistance in tracheal secretion cultures of pneumonia patients undergoing invasive mechanical ventilation in a hospital setting. This cross-sectional study involved 95 samples from patients receiving care in the intensive care unit (ICU) who met predefined inclusion and exclusion criteria. Samples were collected through endotracheal aspiration or bronchoalveolar lavage procedures. Bacterial identification was conducted using both conventional and automated methods, while antibiotic resistance was assessed using the disk diffusion method. The study found that Gram-negative bacteria, primarily Acinetobacter baumannii and Pseudomonas aeruginosa, dominated the bacterial cultures. These pathogens are known for their high adaptability in hospital environments and their association with prolonged hospitalization and increased mortality. High resistance to ?-lactam antibiotics and fluoroquinolones was observed, although antibiotics like amikacin and meropenem remained effective. Chi-square analysis showed a significant correlation between bacterial species and antibiotic resistance patterns. The findings highlight the importance of accurate microbiological diagnosis to guide appropriate empirical therapy and emphasize the need for strict antibiotic stewardship programs and continuous resistance surveillance in ICU settings. Further studies are necessary to optimize infection control and antibiotic therapy protocols for patients requiring prolonged mechanical ventilation.
Legal Aspects of Informed Consent for Patients Requiring Emergency Treatment Putri, Junia; Bihar, Syamsul; Jamaludin, Ahmad
Research Horizon Vol. 5 No. 4 (2025): Research Horizon - August 2025
Publisher : LifeSciFi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54518/rh.5.4.2025.747

Abstract

In the medical field, doctors are required to have a permit before performing medical procedures. However, doctors often encounter patients in emergency situations who cannot give consent and are not accompanied by family. This study aims to examine the implementation of informed consent in Indonesia to identify challenges and possible solutions. Through a literature review, this study uses a normative legal approach. Therefore, Law Number 17 of 2023, Article 293(9) exempts doctors from the obligation to obtain medical consent in emergencies. The result shows According to Article 275 paragraphs (1) and (2), doctors are also legally protected from payment demands after providing first aid to save lives or prevent disability. Because they offer an agreement on efforts and are exempt from legal responsibility if the patient’s goal is to be helped, doctors should not hesitate to act quickly in emergencies. This study found that Law Number 17 of 2023 provides doctors with legal protection to act without consent in emergencies, thereby reducing the risk of legal liability. The conclusion is that clear guidelines and ongoing legal education for medical personnel are essential to ensure safe and legal emergency care.