Relationship of gallbladder histopathology towards types of stones in cholelithiasis patients at Universitas Sumatera Utara Hospital, Medan, Indonesia

Background: Cholelithiasis is a common disease of the gall bladder. It is estimated that around 10-15% of the population in western countries suffer from cholelithiasis. Types of gall bladder stones can be classified into cholesterol stones (containing cholesterol> 50%), mixed stones (containing 20-50% cholesterol), and pigment stones (containing cholesterol <20%). Cholelithiasis causes various histopathological changes in the gallbladder mucosa such as acute and chronic inflammation, Cholelithiasis, hyperplasia and carcinoma. The general objective of this study was to determine the histopathological relationship of the gallbladder to the type of stone in cholelithiasis patients at USU Hospital.

Method: The design in this study was cross-sectional. The sample of this study was 49 samples of patients with cholelithiasis who underwent cholecystectomy either by open cholecystectomy or per-laparoscopic cholecystectomy at Universitas Sumatera Utara (USU) Hospital. Gallstones and gall bladder will be examined in the laboratory. Data analysis will use the chi-square test.

Result: From 49 research samples found the most types of stones were mixed stones with 24 (49%) and histopathological results showed 18 examples (36.7%) were chronic inflammation. Based on the Chi-Square test found a significant relationship between the types of stones with histopathology of the gallbladder with a p-value of 0.001.

Conclusion: There is a significant relationship between the type of stone with histopathology in patients with cholelithiasis.

Mean pulmonary artery diameter in chest CT scan in the Thai population

Introduction: Pulmonary hypertension has been associated with a significant increase in morbidity and mortality. The pulmonary artery diameter measurement from a CT scan is routinely used to predict possible evidence of pulmonary hypertension. However, no data available as a reference for the normal range, especially in the Thai Population. The primary purpose of this study was to determine the normal diameter of the main pulmonary artery (MPA) and ascending aorta (AAo) and the ratio between MPA and AAo diameter in the Thai population.

Methods: Patients who met the inclusion criteria and had a chest CT performed in Songklanagarind hospital between 1 January 2014 and 14 July 2014 were enrolled. Measurement of the MPA diameter at the level of its bifurcation and the AAo from an axial-view contrast-enhanced CT chest (venous phase) image was done. The ratio between the diameter of MPA and AAo was then calculated.

Results: 2395 patients were included in this study (male = 1271 patients, female = 1124 patients, aged between 20-96 years; mean = 57 years old). The mean diameter of the MPA was 25.21 mm, and the mean diameter of the AAo was 30.78 mm. The mean MPA/ AAo ratio was 0.83. The sex-specific mean diameters of the MPA were 25.4 mm in men and 25.0 mm in women. The mean diameters of the AAo in men and women were 31 mm and 30 mm, respectively.

Conclusion: The mean MPA diameter obtained from chest CT scans in this study was about 25.4 mm in men and 25.0 mm in women. These values are easily obtained from chest CT scans and are highly reproducible. Therefore, it may be used as a reference value for a healthy Thai population.

A 3-days old infant with neonatal soft tissue sarcoma: a case report

Background :The incidence of sarcomas occurs in less than 1% of all malignant tumors but sarcoma is the cause of 2% of total cancer deaths. Based on the National Registry the incidence of neonatal sarcomas is 2.6 per million live births.

Case Description : A baby girl aged 3 days, complaining of a mass on the patient's left thigh since birth. the mass was large from birth and there was only one on the left thigh. In the prenatal history, the mother and baby with routine ANC history to the midwife, and never having a control with an obstetrician, the mother was not sick during pregnancy and took medication during pregnancy outside of a doctor's prescription. In the perinatal history, the baby was born to mother G1P1A0, gestational age at term, was born by cesarean section, with birth weight 2800 grams, was born crying, active movement, reddish color, vomiting (-) genitalia (+) anus (+)

Conclusion : Soft tissue sarcomas (STS) require proper diagnosis and management. The results of rhomboid flap in the tumor resection area are better than skin grafts of similar shape and location and provide cosmetic advantages with very few complications.

Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report

Background: Single umbilical artery (SUA) is a rare presentation in obstetrics practice, yet it comprises most of the umbilical anomaly. Despite its rare occurrence, a proper prenatal diagnosis needs to be established timely in order to prevent morbidity and mortality from commonly coexisting abnormalities. This case report presents a delayed diagnosis of SUA by prenatal sonography diagnosis and vascular imaging features postnatal cord at the third trimester of pregnancy and discusses the proper diagnosis and management of such cases.

Case Presentation: We reported a case of a 37 year old pregnant woman who found to have one artery one vein in her umbilical cord on ultrasound. This is very rare case and precise concern for us. Unfortunately we found this case in the third trimester of pregnancy (37w5d), therefore we have slightly to evaluate. Female baby was born by elective C-section. The baby cried immediately, with an Apgar score of 8-9. We didn’t find major abnormalities in the baby. Birth weight 3700 grams. There were not sign of heart diseases and kidney’s abnormality. Baby was monitoring for one weeks and the baby has good growth and development.

Conclusion: This report is expected to increase the awareness of this disease entity as a fundamental basis for developing its screening and management protocols.      

The relationship between self-esteem and husband support with body image perception in post-vaginal delivery primiparous mother in independent Delima midwife practice in Denpasar

Background: Childbirth is a big, happy event for a mother. In post-partum mothers, physical changes and psychological changes can occur. It is reported that 50% to 70% of post-partum mothers experience psychological disorders, such as a mother can feel uncomfortable with body image perception changes, which result in feelings of lack of husband support. Body image perception itself can cause an effect on self-esteem. This study aimed to analyze the relationship between self-esteem and husband's support with body image perception among primiparous mothers after vaginal delivery.

Methods: An observational analytic study was conducted among 30 post-vaginal delivery primiparous mothers in independent Delima midwife practice in Denpasar. Data regarding respondents’ characteristics, self-esteem, husband’s support and body image perception were obtained using the Rosenberg self-esteem questionnaire, the Revised Dyadic Adjustment Scale (R-DAS) questionnaire Multidimensional Body-Self Relations Questionnaire Appearance Scales (MBSRQ-AS). The relationship between self-esteem and husband's support with body image perception was analyzed using SPSS version 23 for Windows.

Results: The average age of the respondents were 24.73 years old, and most of them were graduated from high school (50%), employed (53.3%) and have no conflict in their marriage (80%), have normal self-esteem (96.6%), didn’t get enough husband’s support (56.7%) and have positive perception regarding the evaluation of physical appearance (96.6%). We found a significant relationship between self-esteem and body image perception (p = 0.001), husband's support and body image perception (p = 0.001) and husband's support and self-esteem (p = 0.010) in post-vaginal delivery primiparous mother in independent Delima midwife practice in Denpasar.

Conclusion: Self-esteem, husband's support and body image perception were essentials factors that contributed to post-partum woman mental health stability that should be understood by family and health workers to avoid psychological disorder in post-partum woman.