This project aimed to assess the Online National Board of Urology Objective Structured Clinical Examination (OSCE) feasibility in evaluating candidates simultaneously from five urology training centers in Indonesia during the COVID-19 pandemic. Data were collected from two online OSCE simulation trials and the Online National Board of Urology OSCE. A self-administered questionnaire was used to assess examiners and candidates’ perception. The average final score of the Online OSCE was compared to previous face-to-face OSCE results. All candidates and examiners (100%) heard and saw clearly the audio-visual in both OSCE simulation trials. None of the candidates had a failing score on the mock exam from all stations. There was a statistically significant difference between the online OSCE and December 2019 face-to-face OSCE. The Online National Board Urology OSCE was feasible and comparable to face-to-face OSCE in evaluating urology candidates. It may be beneficial for the future OSCE method in the medical education system. Objective Structured Clinical Examination (OSCE) which assesses a broad range of urology candidates’ high-level clinical skills, is a more valid and reliable assessment instrument than the traditional oral examination The Online National Board of Urology OSCE method can help evaluate urology candidates, especially during the unprecedented COVID-19 pandemic
Objective: This study was aimed to analyze the survival rate on End Stage Renal Disease (ESRD) patients and underwent Continuous Ambulatory Peritoneal Dialysis (CAPD) insertion surgery. Materials & Methods: The subjects of this study were 58 people diagnosed as chronic renal failure and underwent CAPD insertion surgery. This type of research is retrospective, using medical record data in Sardjito Hospital, and then we performed patient survival analysis with CAPD procedure performed on end stage renal disease patient. Results: In survival test performed on patients who underwent CAPD insertion without considering other factors, the mean survival rate was 40.26 months. Kaplan Meier curve obtained 3 and 5 years survival rate of 62% and 45% respectively. Furthermore, the survival test is done by dividing into two group diabetes mellitus (DM) and non-diabetes mellitus (non-DM). In CAPD-attached patients with DM, has a lower mean survival time compared to non-DM. Mean survival time of CAPD patients with comorbid of DM 36.05 months while non-DM 43.43 months. In this study, the Hazard Ratio was 1.44 (0.69-2.99) DM: Non DM. In the survival test by dividing into two age groups, age group ≥ 55 years and <55 years. The results obtained mean survival time for age group ≥ 55 years 36.02 months and for age group <55 years 43.08 months. Conclusion: Patients with kidney failure who underwent CAPD with comorbid DM had lower survival compared with non-DM. The younger the age of the patient that underwent CAPD insertion, the survival rate increase.
Objective To explore the impact of the coronavirus disease 2019 (COVID-19) pandemic on the training experience of urology residents in Indonesia. Methods A cross-sectional study using a web-based questionnaire (SurveyMonkey) involved all registered urology residents in Indonesia. The questionnaire was structured in Bahasa Indonesia, consisted of 28 questions, and divided into three sections: Demographic characteristics, current daily activities, and opinions regarding training experiences during the COVID-19 outbreak. The survey was distributed to all respondents via chief of residents in each urology center from May 26, 2020 to Jun 2, 2020. Results Of the total 247 registered urology residents, 243 were eligible for the study. The response and completeness rate for this study were 243/243 (100%). The median age of respondents was 30 (24–38) years old, and 92.2% of them were male. Among them, 6 (2.5%) respondents were confirmed as COVID-19 positive. A decrease in residents’ involvement in clinical and surgical activities was distinguishable in endourological and open procedures. Most educational activities were switched to web-based video conferences (WVC), while others opted for the in-person method. Smart learning methods, such as joining a national/international speaker webinar or watching a recorded video, were used by 93.8% and 80.7% of the respondents, respectively. The respondents thought that educational activities using WVC and smart learning methods were effective methods of learning. Overall, the respondents felt unsure whether training experience during the COVID-19 pandemic was comparable to before the respective period. Conclusions The COVID-19 pandemic negatively affected urology residents’ training experience. However, it also opened up new possibilities for incorporating new learning methodologies in the future.
Objective: The aim of this study was to determine the prognostic parameters for the recovery of renal function in patients with obstructive uropathy after the release of obstruction. Material & methods: This is a retrospective cohort study. Secondary data from the patient's medical record was used to determine whether the ratio of blood urea nitrogen (BUN)/creatinine, hemoglobin, hyperkalemia, blood glucose, renal parenchymal thickness, and obstruction etiology are prognostic parameters for recovery of renal function in patients with obstructive uropathy after release of obstruction. Bivariate was used to analyze the data using Chi-square and Fisher's exact test with significance level of p<0.05 to evaluate the significance. Results: Based on total of 66 research samples, it was found that renal parenchymal thickness was ≥10 mm (p=0.001), hemoglobin level was ≥10 mg/dL (p=0.001), and BUN/creatinine ratio was ≥10 (p=0.003), it had significant correlation with the recovery of renal function, meanwhile, obstruction etiology variable (p=0.566), and hyperkalemia (p=0.792) did not provide significant recovery of renal function. Conclusion: Renal parenchymal thickness, hemoglobin level, and BUN/Creatinin ratio are the prognostic parameters for recovery of renal function after release of obstruction.
RECK), programmed cell death protein 4 (PDCD4), Sprouty homolog 1/2 (Spry 1/2), phosphatase and tensin homologue deleted on chromosome 10 (PTEN), tissue inhibitor of metalloproteinases 3 (TIMP3), acidic nuclear phosphoprotein 32 family member (ANP32A), tropomyosin 1 (TPM1), forkhead box 01 (FOXO1), RhoB,
Objective: We evaluated the value of urinary cytology, and presence of hydronephrosis to predict muscle invasive bladder cancer. Material & methods: We retrospectively analyzed data of 167 patients that diagnosed bladder cancer from medical record at Sardjito General Hospital Yogyakarta, between 2004-2011. Preoperative parameters were evaluated including age, gender, number and location of bladder cancer, urinary cytology, as well as presence of hydronephrosis. The outcome was muscle invasive bladder cancer. Results: A total of 96 (57.5%) patients had positive urinary cytology, 80 (47.9%) had hydronephrosis, most location of tumor were in trigone 43 (25.7%). The youngest patient was 26 years and the oldest was 84 years old, male was most affected in 145 (86.8%). On bivariate analysis, positive urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer (OR 0.08 CI 0.038–0.167; OR 30.24 CI 12.72–71.89, respectively, each p < 0.05). Combination urinary cytology and hydronephrosis incrementally improved prediction of muscle invasive bladder cancer with positive and negative predictive value were 93.9% and 71.4%, respectively. Presence of hydronephrosis was associated with tumor location in trigone (p < 0.05). Conclusion: Urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer, and can be used to predict muscle invasive bladder cancer.
Objective: To study factors that influence signs and symptoms related to stented ureter. Material & methods: This was a prospective-cross sectional study, from March 2014 to August 2014, to know factors that influence signs and symptoms of patients with ureteral stent. All patients were inserted ureteral stent participated in this study. Exclusion criteria were patients with malignancy, patients who had history of DJ stent placement previously, patients with bilateral DJ stents and patients with urinary tract infection. All patients completed IPSS questionnaire before inserted stents. After 1 month, when removal DJ stents performed, all patients completed IPSS, USSQ and VAS. All data was analyzed with Chi-square/fisher exact test, Pearson/Spearman correlation and Mann Whitney. Results: Fourty patients consisted of 23 man (57.5%) and 17 women (42.5%) completed this study. The mean age was 44.92 years old and length of stented ureter was 38.22 days. There was significance correlation between IPSS of DJ stent pre-insertion and post insertion (p < 0.001; r = 0.628). Of the patients reported dysuria (62.5%), frequency (55%), nocturia (52.5%), incomplete emptying (47.5%), hematuria (35%) and urgency (15%). On bivariate analysis, there was significance correlation between DJ stent position and frequency (p < 0.001), nocturia (< 0.001), urgency (p = 0.002), incomplete emptying (p = 0.049), dysuria (p = 0.030), hematuria (p = 0.026) and pain (p < 0.001). Conclusion: Previous urinary symptoms and DJ stent position were factors that influenced sign and symptoms related to ureteral stent insertion.
Objective: This study aims to determine the effect of diabetes mellitus (DM) and body mass index (BMI) on the risk of prostate cancer and high grade prostate cancer. Materials & method: This study is a retrospective observational study with cross-sectional design, using secondary data to determine the relationship of diabetes mellitus, body mass index and HbA1c levels with the degree of differentiation histopathologic prostate cancer. Data were analyzed using Chi-Square test, T-test and Man Whitney test with a confidence level of p<0.05 and a=0.05. Results: There are 78 samples diagnosed with prostate cancer. A total of 12 (15.4%) samples are diabetes mellitus, 18 (22.9%) samples classified as body mass index more than 23.4 (5.1%) samples have elevated levels of HbA1c levels >6.5. On histopathologic examination, it was found as many as 45 (57.7%) samples with high grade prostate cancer, as much as 9 (11.5%) samples with moderate grade prostate cancer, and as many as 24 (30.8%) samples with low grade prostate cancer. In bivariate analysis diabetes mellitus, BMI>23, and HbA1c level relationship with high grade prostate cancer is not statistically significant with p>0.05. Conclusion: There were no statistically significant relationship between diabetes, BMI and increased levels of HbA1c with high grade prostate cancer.
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