Volume 7 Issue 2, July - December 2022

Introduction: Maternal mortality remains a critical issue in achieving optimal health status. Evaluation through near-miss cases provides valuable data about morbidity to monitor the quality of obstetric services, which can be used to estimate the incidence of life-threatening obstetric complications. A study reported that the incidence of near-miss in pregnant women had a significant relationship with various non-medical factors, included sociodemographic factors. Therefore, this study aims to examine the relationship of sociodemographic factors with near-miss and missed cases. Methods:   This analytic retrospective study conducted in Educational and affiliated hospitals in Makassar. Data were retrieved from the obstetric referral registry from 2019 to 2020. Sociodemographic factors of interest include diagnosis, gestational age, maternal age, referral status, maternal parity, and economics. Results:  A total of 156 near-miss and missed cases were obtained from January 1, 2019, to December 31, 2020. There was no significant relationship between maternal age (p=0.675), gestational age (p=0.38), parity (p=0.24), economic status (p=0.73), educational background (p=0.85), and referral status (p=0.16) with maternal near-miss and missed cases. Conclusions: There was no significant relationship between sociodemographic characteristics and maternal near-miss and missed cases in Educational and affiliated hospitals in Makassar from 2019 to 2020. More studies are needed to evaluate other factors associated with near-miss and missed cases.

Introduction: Sinonasal tumors are rarely found. The protected nature of the sinuses makes early detection of tumors growing in these areas difficult. The Epstein-Barr virus is one of the most common viruses found in humans; which expresses Latent Membrane Protein-1 (LMP-1) that can transform cell lines and alter cell phenotype due to its oncogenic potential. Objective: To investigate the relationship between immunohistochemical expression of Latent Membrane Protein-1 (LMP-1) from Epstein-Barr virus and clinical stages of sinonasal carcinoma. Methods: This cross-sectional study was carried out in DR. Wahidin Sudirohusodo General Hospital and anatomic pathology of Hasanuddin University Hospital, Makassar, South Sulawesi, Indonesia, from October 2016 to March 2017. Histopathological samples from biopsy specimen of all subjects diagnosed with sinonasal carcinoma in Otorhinolaryngology-Head and Neck Surgery outpatient clinic were taken and examined for LMP-1 expression using immunohistochemical staining. The samples were taken from paraffin block from patients. Result: There were 33 males (67.3%) and 16 females (32.7%) with sinonasal carcinoma who participated in this study. The majority of participants aged ≥50 years (25 people, 51.0%) and worked as farmers (27 people, 55.1%). A significant correlation between LMP-1 expression and sinonasal carcinoma clinical stages was found (Spearman’s correlation r = 0.355 and p <0.001). Conclusion: Higher LMP-1 expression correlates with higher sinonasal carcinoma clinical stage in patients aged <50 years.

Introduction: Fluid management in sepsis patients is crucial, especially in the first three hours after sepsis diagnosis is established. However, excessive fluid administration will increase patient mortality. This study’s purpose is to determine the correlation among cumulative fluid balance and mortality in patients with sepsis and/or septic shock admitted to the Intensive Care Unit (ICU) of Dr. Wahidin Sudirohusodo Central Hospital, Makassar. Methods: This comes about as an analytical observational study with a retrospective method. The population involved in this study was patients diagnosed with sepsis and septic shock who were treated in the ICU of Dr. Wahidin Sudirohusodo Central Hospital, Makassar from January to December 2021 with a total sample of 56 people. Data were analyzed using Mann-Whitney and Chi-Square statistical tests with a significance level of α=0.05. Data were studied using SPSS 25.0 (SPSS, Inc. Chicago, IL). Results: The mean cumulative fluid balance in septic patients was -1299.51±5228.34 ml. Based on the fluid balance category, 24 people (42.9%) had a positive balance and 32 people (57.1%) had a negative balance. There was a correlation among cumulative fluid balance and mortality in sepsis patients hospitalized in the ICU of Dr. Wahidin Sudirohusodo Central Hospital (p < 0.001), out of 24 patients with a positive balance, the non-survivors percentage was 66.7% and 33.3% of patients survived, while out of 32 patients with a negative balance, the percentage of non-survivors was 18.7% and 81.3% of patients survived. Conclusions: There is a correlation among cumulative fluid balance and mortality of septic patients in the ICU. A positive cumulative fluid balance will cause a higher mortality rate or risk of death compared to a negative cumulative fluid balance.

Introduction: Urinary tract infections (UTIs) are common in the community, including among pregnant women. This study investigates turbidity, urine pH, and direct gram as predictors of symptomatic urinary tract infection in pregnant women. Methods:  A total of 177 pregnant women with suspected UTIs based on clinical and laboratories at the community health center in Makassar were collected from September to December 2021. The Urine sample was assessed for turbidity, urine pH, direct gram, and urine culture. Results: Urine turbidity was found in 108 (75.5%) patients who had positive cultures and PPV of 94.7%. The mean pH of the urine from UTI patients was 6.42 and without UTIs was 6.45. Urine that grows Gram-positive bacteria showed the most alkaline pH (mean pH=6.71) and was significantly less acidic than urine with UTI negative. In contrast, urine with Gram-negative bacteria had the most acidic pH (mean PH=6.30). The gram direct test shows a significant association with UTIs.  Conclusions: Turbid urine can predict urinary tract infections in pregnant women that provide clinical symptoms. In addition, leukocytes esterase test further selected the samples. Urine pH showed no significant correlation with UTI. Less acidic urine pH is particularly associated with Gram-positive bacterial infections. Furthermore, direct gram can predict the event of UTI.

Conclusion: There was a decline in maternal referral cases in Education Network hospitals before and during the COVID-19 pandemic.

Background: Cellular angiofibroma is a rare benign tumor in the distal genitalia introduced by Nucci et al in 1997 that can occur in both women and men with an age range of 46 – 54 years. In women it usually occurs in the vulva and vagina. These tumors are often diagnosed as Bartholin cysts, vulvar cysts, myomas, and unspecified complex tumors.

Objective: Report a case of cellular angiofibroma previously diagnosed with cervical myoma

Case: A 51-year-old female patient para 5 abortion 0 with complaints of lumps that have been felt to come in and out since 4 months but since 1 week it feels enlarged and cannot be inserted again, and diagnosed as cervical tumor. History of menopause since 1 year ago. The general condition of the patient is good with vital signs within normal limits. On physical examination of the abdomen, there was no tumor mass, tenderness or flux. On inspection, there was a reddish mass coming out of the vaginal introitus with some blackish necrotic appearance. On vaginal examination, a mass with a solid consistency was found with the impression of the cervix with a border of the tumor stalk that was not palpable. In this patient, Total Abdominal Hysterectomy and Bilateral Salpingoophorectomy were performed and the tissue was examined for anatomical pathology with cervical angiofibroma results with non-specific chronic inflammation and atypical complex endometrial gland hyperplasia. 

Conclusion : Cellular angiofibroma is a rare tumor that usually occur in the vulva and vagina, which is often diagnosed as Bartholin's cyst, vulvar cyst, myoma and unspecified complex tumor. Action in the form of total excision of tumor tissue gives a low recurrence.

Keywords : Cervical angiofibroma, cervical tumor

Introduction: By relying on polymorphonuclear (PMN) cells, stromal vascular fraction (SVF) and platelet-rich plasma (PRP) contribute significantly in the healing process. Through anal trauma model, this study examined the effect of SVF and PRP combination on PMN counts in vivo. Method: Three groups of twenty-eight eligible Wistar rats anal trauma model randomly assigned to receive SVF and PRP combination (Group A), normal saline (Group B), or healthy controls (Group C). On days 1, 7, and 14, we examined at PMN cell counts in Groups A and B. Group C were sacrificed early to acquire baseline data on PMN cells. Results:  On the first day, Group A had more PMN cells than Group B, but this difference faded by days 7 and 14. On day 1, the test revealed a significant increase in PMN cells (p=0.002). Conclusion:  Combining SVF and PRP can improve PMN cells' acute phase of anal damage repair in vivo