Background: Pre-eclampsia is a common condition that causes significant morbidity and mortality in pregnant women; the occurrence of cardiovascular complications aggravates the disease. Efforts have been made to predict the complications of pre-eclampsia, but some modalities, such as echocardiography and biomarkers, are neither available nor widely feasible for use by healthcare providers, especially in developing countries. On the other hand, ECG is cheap, noninvasive, widely available, and already routinely performed for pre-eclampsia. The role of ECG in predicting cardiovascular complications in pre-eclampsia patients is not known. Objective: This study aimed to investigate the role of ECG in pre-eclampsia diagnostics and simple clinical parameters in pre-eclampsia patients with and without cardiovascular complications. Methods: This cross-sectional, analytical study used retrospective data from medical records of patients with pre-eclampsia from the Dr Kariadi General Hospital, Semarang, Indonesia, from January 2016–July 2017. Bivariate association between demographic, clinical, laboratory, and ECG results with the occurrence of cardiovascular complications was tested; this continued with logistic regression. Results: Sixty-eight pre-eclampsia patients were identified, with a mean age of 30.2 years. Cardiovascular complications occurred in 16 patients (23.5%), with 14 patients exhibiting pulmonary oedema. In univariate analysis, haemoglobin level and heart rate showed a significant association with the occurrence of cardiovascular complications (p=0.035 and 0.033, respectively). No significant independent predictor was found in multivariate analysis. Conclusion: This study showed that ECG parameters were not able to predict cardiovascular complications in pre-eclampsia patients. Nevertheless, there was a significant association between heart rate and haemoglobin level with cardiovascular complications in pre-eclampsia.

Aims KARIADI risk score is a 0-to-9 point scoring system based on Killip class, final TIMI flow, total ischemic time, creatinine level, blood glucose, systolic blood pressure, and age. This score was developed to predict the risk of in-hospital major adverse cardiovascular events (MACE) (composite of death, stroke, urgent revascularization, cardiogenic shock, acute pulmonary edema, or arrhythmia) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI). KARIADI risk score was claimed to be able to predict MACE with a rate of 1.2% at lowest score until 99.9% at highest score, but its performance has never been validated externally. This study aims to perform external validation on KARIADI risk score. Methods and Results This study was a prospective cohort study on 109 STEMI patients undergoing PPCI in Dr. Kariadi General Hospital during January-November 2020. Each sample underwent KARIADI risk score assessment and follow-up for in-hospital MACE. The risk score validation was performed by assessing calibration [measured with calibration-in-the-large (alpha), calibration slope (beta), and calibration plot] and discrimination performance [measured with c-statistic and receiver operating characteristic (ROC) curve). Eighteen patients (16.5%) had MACE. The calibration plot of KARIADI risk score demonstrated moderate calibration with alpha -0.39, beta 0.71, and reasonably close calibration to line of identity; meanwhile the ROC curve demonstrated moderate discrimination with c-statistic 0.75, 95% CI 0.62-0.87. Conclusion KARIADI risk score has moderate external validation in predicting in-hospital MACE in patients with STEMI undergoing PPCI.

LATAR BELAKANG: Skor risiko KARIADI merupakan sistem skor dengan rentang skor 0-9; komponennya meliputi kelas Killip, final TIMI flow, total ischemic time, kadar kreatinin darah, kadar glukosa darah, tekanan darah sistolik, dan usia. Skor tersebut dikembangkan untuk memprediksi risiko kejadian kardiovaskular mayor (KKvM) selama rawat inap (gabungan kematian, stroke, urgent revascularization, syok kardiogenik, edema paru akut, atau aritmia) pada penderita infark miokard akut dengan elevasi segmen ST (IMA-EST) yang menjalani intervensi koroner perkutan (IKP) primer, namun performa skor risiko tersebut belum pernah divalidasi secara eksternal. TUJUAN: Melakukan validasi eksternal terhadap skor risiko KARIADI. METODE: Penelitian ini merupakan penelitian kohort prospektif pada 109 penderita IMA-EST yang menjalani IKP primer di RSUP Dr. Kariadi dari Januari-November 2020. Sampel penelitian menjalani penilaian skor risiko KARIADI dan follow-up selama rawat inap untuk menentukan ada/tidaknya KKvM. Validasi dilakukan dengan menguji performa kalibrasi [dinilai dengan calibration-in-the-large (alfa), calibration slope (beta), serta plot kalibrasi] dan diskriminasi (dinilai dengan c-statistic dan kurva receiver operating characteristic). HASIL:  Delapan belas pasien (16,5%) mengalami KKvM. Skor risiko KARIADI menunjukkan performa kalibrasi yang kurang baik (alfa -0,39; beta 0,71; plot kalibrasi kurang sesuai) dan performa diskriminasi sedang (c-statistic 0,75; IK95% 0,62-0,87). KESIMPULAN: Skor risiko KARIADI belum valid dalam memprediksi KKvM selama rawat inap pada penderita IMA-EST yang menjalani IKP primer.   Kata Kunci    : Infark miokard akut dengan elevasi segmen ST, intervensi koroner perkutan primer, kejadian kardiovaskular mayor, skor risiko KARIADI, validasi eksternal

BackgroundThe aim of this study was to describe the diagnosis and treatment patterns of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and evaluate their appropriateness in an area without an urologist and with limited resources, such as the area covered by Murjani General Hospital, Sampit, Indonesia.MethodsThis descriptive study used data collected from medical records of patients who were diagnosed with LUTS suggestive of BPH in Murjani General Hospital between September 2013 and August 2015.ResultsThere were 89 patients. Their mean age was 64.5 years. The most common chief complaint was inability to void (59.6%), followed by frequency (10.1%). Diagnostic evaluations such as symptom scoring (1.1%), frequency–volume chart (0%), digital rectal examination (3.4%), urinalysis (5.6%), and prostate-specific antigen (0%) were used rarely or never, while renal function assessment (37.1%) and imaging of the prostate (68.5%) and upper urinary tract (65.2%) were used more often. Overall, the treatment that was administered most often was indwelling catheterization (25.8%); only 19.1% visited a urologist following a referral by the physician, although 41.6% were referred to a urologist. There were 40.4% of patients with an indication for surgery, mostly in the form of recurrent or refractory urinary retention (83.3%). In this group of patients, only 38.9% received appropriate treatment in the form of open prostatectomy by a general surgeon (16.7%) or were referred to a urologist (22.2%), while 50% of them were managed with chronic indwelling catheterization.ConclusionAll patients received substandard diagnostic evaluations, with a pattern of preference toward imaging studies over more basic examinations for LUTS–BPH. The high frequency of indwelling catheterization in overall and inappropriate treatment in the group of patients with an indication for surgery showed that patients received suboptimal treatment. Improvements in various aspects are required to optimize the management of LUTS suggestive of BPH in Murjani General Hospital.