Introduction.Intestinal obstruction has been shown to induce bacterial translocation and in turn, would be associated with an increased risk of sepsis. Such a condition would be affecting the achievement of peristaltic and ultimately increased morbidity and mortality. In addition, nosocomial infections that threaten neonates cause sepsis also will affect the achievement of a peristaltic. Thus, the aim of this study was to investigate the relationship between sepsis with timing achievement of peristaltic postoperatively. Method. This is a cross-sectional study with data obtained from medical records of patients with duodenal obstruction without congenital abnormalities (gastroschisis, omphalocele, and another intestinal atresia) that underwent operations in RSCM during the period of January 2010 to July 2016. Subjects were grouped into sepsis and without sepsis. The association between sepsis and timing achievement of peristaltic, and confounding variables (gestational age, birth weight, congenital abnormalities, conditions of hypoxia and electrolyte imbalance) were analyzed. Data analyzed using univariate, bivariate (Mann Whitney, Chi-Square or Fischer) and multivariate (linear regression) with the significance of <0.05. Results. The study enrolled a total of 31 subjects. Period to achieve peristaltic (median value) was 12.5 days in subjects with sepsis and 5 days in those without sepsis. Bivariate analysis between timing achievement of peristaltic were sepsis (p <0.0001), gestational age (p = 0.004) and hypoxic conditions (p = 0.02). The multivariate analysis showed an association between sepsis and timing achievement of peristaltic (p = 0.011, R 2 = 35.8%). Conclusion. In this study, sepsis was a major factor affecting the achievement of a peristaltic. The time difference to achieved peristaltic between sepsis and without sepsis was significance. Thus, it is necessary to control and prevent sepsis preoperatively and postoperatively that in turn, reducing morbidity and mortality.
In this era of COVID-19, suspected breast cancer patients experience delay in diagnosis due to the fear of contracting the virus and reduction of non-COVID-19 health services. Furthermore, it may lead to potential increase in the incidence of advanced cancers in the future. Ultrasound-guided (US-guided) percutaneous core needle biopsy (CNB) is a great option for the diagnosis of cancer but it is poorly utilized. This study aimed to prove that the US-guided CNBis accurate when performed in a local setting and a potential solution for diagnosing breast cancer patients in this pandemic. In addition, it was a single health center cross-sectional study, and the participants were all breast cancer patients that had US-guided CNB from 2013-2019. The pathology results from US-guided CNB were compared to specimens from post-CNB surgeries. The data were collected from medical records and the immunohistochemistry (IHC) examinations were carried out for malignancy. There were 163 patients who were included in this study, 86 had malignancies and 77 had benign tumor reported in their CNB results. The US-guided CNB had 100% sensitivity and specificity compared to surgery. With its lower cost, time usage, and patient exposure to the hospital environment, US-guided CNB should replace open surgery biopsy for diagnosing suspicious breast cancers during the pandemic in Indonesia.
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