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61	Clinical Practice in Pandemic Era	ABS-134
CORRELATION OF TOTAL CHOLESTEROL LEVELS WITH THE PROPORTION OF FAT MASS IN ROUTINE HEMODIALYSIS PATIENTS Hendri Priyadi FK Unjani Abstract Keywords: CKD, hemodialysis, cholesterol, fat mass proportion, BIA Share Link | Plain Format | Corresponding Author (Hendri Priyadi)

62	Clinical Practice in Pandemic Era	ABS-135
SOCIALIZATION OF PROPER HAND WASHING ACCORDING TO WHO RECCOMENDATION DURING THE COVID-19 PANDEMIC IN CIMAHI CITY ORPHANAGE Elly Noer R. Fransiska Ambarukmi P, Een Taryana, Handoko Rusiana Iskandar, M.Reza Hidayat FK dan FT Unjani Abstract Since the end of 2019, Corona Virus (COVID-19) disease began to be known as an infectious disease and spread rapidly across continents. In March 2020, WHO announced the Global Pandemic Covid-19, then Indonesia through the Presidential Decree No. 11 of 2020 established the Corona Virus Disease Public Health Emergency 2019. The disease can hit all human organs, especially respiratory tract. The symptoms of Covid-19 vary greatly, ranging from non-symptomatic to symptoms that can lead to death. The orphanage is one of the institutions that performs the functions of families and communities in the development and personality of children to adolescents. Institute of Research and Community Service, Universitas Jenderal Achmad Yani (LPPM UNJANI), has the task of facilitating research activities and community service. In order to develop sensitivity and concern to the paradigm of life, LPPM UNJANI involving the Faculty of Medicine and the Faculty of Electrical Engineering held community service activities in the form of teaching and training of proper hand washing using soap, in accordance with WHO recommendations, in addition to helping the provision of hand washing facilities, so that it is expected to help break the chain of transmission of COVID-19. The results of this community service obtained the sufficient pre test scores, and good post test scores. By providing training to orphanage children, it is expected to make knowledge and understanding of proper hand washing in accordance with WHO recommendations during the pandemic, especially to children living in orphanages, thus helping to break the chain of infection transmission. Keywords: Handwashing, WHO, Covid-19, Orphanages Share Link | Plain Format | Corresponding Author (Elly Noer Rochmah)

63	Clinical Practice in Pandemic Era	ABS-139
NEUROCOGNITIVE COMPLICATIONS IN COVID 19 Yustiani Dikot Medical Faculty of Universitas Jenderal Achmad Yani Abstract Keywords: COVID-19, Respiratory viral infection, Neuroinvasion, Acute and chronic neurocognitive complication Share Link | Plain Format | Corresponding Author (M Helmi)

64	Clinical Practice in Pandemic Era	ABS-140
Leukocyte Count and Absolute Lymphocyte Count Results in Covid-19 Confirmed Case Susanti Ratunanda1, Emilia R Putri2, Herfina H Putri2 1)Clinical Pathology Department, Faculty of Medicine - Universitas Jenderal Achmad Yani 2)Faculty of Medicine-Universitas Jenderal Achmad Yani Abstract Indonesia is the first rank country in Southeast Asia and 19th in the world with the highest number of Covid-19 cases. Examination of leukocyte count and absolute lymphocyte count can support the diagnosis of COVID-19 cases, especially as in predictor, prognosis and monitoring aspects. The aim of this study is to determine the results of leukocyte count and absolute lymphocyte count in confirmed COVID-19 cases, based on age, gender and comorbidities at Kasih Bunda Hospital, Cimahi. This descriptive study using medical record of 35 confirmed COVID-19 patients with simple random sampling technique. The results showed 31 patients (88.6%) had normal leukocyte count and 4 (11.4%) had leukocytosis. Lymphopenia was found in 16 patients (45.7%) and 19 (54.3%) had normal absolute lymphocyte counts. Most patients in all ages had normal leukocyte count and none had leukopenia with leukocytosis was more prevalent in elderly group (1 patient, 33,3%). Lymphopenia mostly found in late elderly (6 patients, 17, 1%) and no lymphocytosis was found in all age group. Almost all patients in all gender had normal leukocyte count and none had leukopenia, and leukocytosis was more prevalent in men (2 patients, 16,7%). Most of male (8 patients, 66.7%) had lymphopenia and (15 patients, 54.3%) female had normal absolute lymphocyte count. Most patients with or without comorbid had normal leukocyte count and none had leukopenia and 3 patients (12%) with no comorbid had leukocytosis. Normal absolute lymphocyte count was found in 7 patients (50%) and lymphopenia in 7 patients (50%) in comorbid patients, 12 patients (57.1%) with no comorbid had normal absolute lymphocyte count and 9 (42.9%) had lymphopenia. Elderly more likely had leukocytosis and lymphopenia due to decrease immune response. Male had leukocytosis and lymphopenia due to higher prevalence of active smoking. Comorbid patients had normal leukocyte count might be related to previous medication. Keywords: COVID-19, leukocyte count, absolute lymphocyte count, age, gender, comorbid Share Link | Plain Format | Corresponding Author (Susanti Ratunanda)

65	Clinical Practice in Pandemic Era	ABS-141
Disaster Psychiatry Irwanto Ichlas Departemen Psikiatri Fakultas Kedokteran Universitas Jenderal Achmad Yani Abstract The current Covid 19 pandemic has had a tremendous impact on the lives of mankind in the world, as well as in Indonesia. It can be said that this pandemic is a disaster, or rather a disaster for the continuity of human life. So a disaster is a critical situation, where daily life is suddenly disrupted and many people fall into a helpless state, suffer and as a result there is a need for medication, treatment, protection, food, clothing and other necessities of life. As we know that a disaster can be caused by natural causes (for example earthquakes, hurricanes, floods), or a result of human actions and or the result of a technology-related event (for example, an airplane crash, a power plant exploration), or it is purely due to human activity (mass shooting or terrorism). In connection with the current Covid-19 pandemic, there is still debate as to whether this disaster was purely a made of disaster, or a natural disaster. From the results of observations at the hospital, cases of psychiatric problems or disorders that often arise are adjustment disorders, anxiety reactions, depression and panic attacks. In contrast to previous years, it seems that developments regarding the role of psychiatry in disaster management are felt to be getting better, more complete and comprehensive. Usually starting from the planning stage /preparedness stage, implementation in the acute phase /disaster event to the post-disaster stage everything can be carried out properly. The communication system has also not been neglected, with the role of the team leader coordinated to the field where this is not the obstacle that has often been worried about. Likewise, what must be done after the disaster period is over, can be planned more comprehensively. Triage system difficulties can gradually be overcome until the first aid (Psychological First Aids-PFA) for victims according to the enrichment and triage system which is getting better. Keywords: disaster psychiatry , covid-19 pandemic , mental-health problem/disorder Share Link | Plain Format | Corresponding Author (M Helmi)

66	Clinical Practice in Pandemic Era	ABS-142
PANIC DISORDER Chatidjah Satriyo Wibowo Medical Faculty of Universitas Jenderal Achmad Yani Abstract Panic Disorder is an anxiety disorder characterized by reoccurring unexpected panic attack. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past. Keywords: Panic Attack-, symptoms-, therapy Share Link | Plain Format | Corresponding Author (M Helmi)

67	Covid 19 in Emergency	ABS-8
TULI MENDADAK PADA PASIEN PASKA COVID-19, LAPORAN KASUS Yanti Nurrokhmawati RS Dustira/ FK Unjani Abstract SUDDEN DEAFFNESS IN PATIENTS POST COVID-19 CASE REPORT Yanti Nurrokhmawati Abstract Sudden deafness or Sudden sensorineural hearing loss (SSNHL) is case that is quite often found in ENT clinics. The exact pathophysiology of the disease is still unknown, one of the most frequent causative factors is post viral infection. COVID-19 infection can cause blood coagulation that cause blood clog, involve the inner ear vascularization. This can cause hair cell ischemia and lead to sensorineural hearing loss. During the pandemic there have been several reported cases of hearing loss related to COVID-19 infection around the world. So that sudden deafness is stated as a rare symptom of COVID-19. This paper presents a case of sudden deafness following COVID-19 infection at Dustira Cimahi Hospital. The patient is a 62 year old male with hearing loss and tinnitus after leaving the COVID-19 isolation room. Physical examination, tympanometry and audiometry done to exclude other causes of hearing loss. The patient received steroid therapy following to the management of sudden deafness and experienced improvement within two weeks of therapy. Hearing loss can be overlooked when a patient experiences severe symptoms of COVID-19, but in mild and moderate cases, evaluation of hearing loss must always be done. Diagnosing and screening for sudden deafness after COVID-19 allows for initial therapy and has a greater chance for hearing recovery. Keywords: covid-19, patient, sudden deafness Keywords: covid-19, patient, sudden deafness Share Link | Plain Format | Corresponding Author (Yanti Nurrokhmawati)

68	Covid 19 in Emergency	ABS-9
OLFACTORY DISORDER IN COVID 19 PATIENTS at DUSTIRA CIMAHI HOSPITAL Yanti Nurrokhmawati, Evy Shavilla RS Dustira/ FK Unjani Abstract GImpaired function of smell is one of the most common symptoms of Covid 19. Many studies have shown various evidence of increased cases of anosmia and dysgeusia during a pandemic, Olfactory disorders in the form of anosmia or hyposmia are even mentioned as an early symptom before other symptoms appear on COVID-19. Research evidence regarding olfactory disorders in COVID-19 can be used as an early warning to diagnose COVID-19 before other symptoms appear. Dustira Hospital is as a reference hospital for COVID-19 in the West Java region since March 2020. This study aims to describe the olfactory disorder of COVID-19 patients who were hospitalized at Dustira Hospital from March to December 2020. This research method was descriptive study of COVID-19 patients at Dustira Hospital who meet the inclusion and exclusion criteria. Data collection techniques from medical record data collection and interviews. Of the 763 COVID-19 patients, 61 patients (18.2%) experienced olfactory disorders, female sex was found at 50.82% subjects, most age was 18-50 years (72%), olfactory disorders in the form of anosmia was 95.1% subjects., Other symptoms experienced were fever (86.89%) and cough (57.38%). The most recovery time was 6-9 days (56%). Conclusion:Olfactory disorder is a symptom that often happen in COVID-19 patient at Dustira hospital and can recover. Keywords: covid 19, olfactory disorder, patient Share Link | Plain Format | Corresponding Author (Yanti Nurrokhmawati)

69	Covid 19 in Emergency	ABS-10
Types of Vaccines and the Latest Development of the COVID-19 Vaccine Lia Siti Halimah Lab of Microbiology, Faculty of Medicine, Universitas Jenderal Achmad Yani Abstract The 2019 coronavirus disease pandemic (COVID-19) caused by coronavirus 2 (SARS-CoV-2) is the most formidable challenge for humanity in this century. This situation has prompted many companies and public research institutions to focus their efforts on effective therapeutic and vaccine research to find the proper answers to controlling SARS-CoV-2. Because COVID-19 is new to humanity and the nature of the protective immune response is poorly understood, it is not clear which vaccine strategy will work most. Therefore, it is imperative to develop multiple vaccine platforms and strategies in parallel. Generally, vaccine platforms are apart into six categories: live attenuated viruses, recombinant viral vector vaccines, inactivated viruses, protein subunit vaccines, virus-like particles (VLP), and nucleic acids DNA or mRNA-based vaccines. A successful COVID-19 vaccine will require careful validation of its efficacy and adverse reactivity in the vaccine target population including high-risk individuals over the age of 60, those with chronic comorbidities, frontline healthcare workers, and those involved.. in an important industry. Vaccine design concerns antigen selection, vaccine platform, and vaccination route and regimen. The choice of vaccine platform determines the relative immunogenic strength of the vaccine-derived viral antigen, whether adjuvants are required, and the nature of protective immunity. This review is aimed at providing an overview of the efforts dedicated to an effective vaccine for this novel coronavirus which has crippled the world in terms of economy, human health, and life. Keywords: COVID-19, SARS-CoV-2, Vaccine, Platform Share Link | Plain Format | Corresponding Author (Lia Siti Halimah)

70	Covid 19 in Emergency	ABS-14
CODE BLUE IMPLEMENTATION IN PANDEMIC COVID-19 dr Nizamuddin Ubaidillah Sp.JP FIHA Udayana Army Hospital Dustira Army Hospital Faculty of Medicine Jenderal Ahmad Yani University Abstract Pandemic COVID-19 has a bruthless strength which highly emphasize of all dimension in human life. It made a high turnover in all approach to achieve a better way to minimize the catastrophe. In emergency response the approach for cardiopulmonary arrest are highly debate for ethics and better prognosis and the utmost is safety for medical personnel. COVID-19 is caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is highly contagious. Out of Hospital Cardiac Arrest (OHCA) from French Registry (French National Cardiac Arrest Registry) between march 1st and april 31st 2020 revealed ROSC rate was reduction by six point (ROSC 19.5% vs 25.3%) and D30 survival rate (2.8% vs 6.4%) was halved compared to non COVID 19 period. Health workers are the profession with the highest risk of contracting this disease. There are 3 concern from ILCOR (International Liaison Committee on Resuscitation) regarding systematic review: first, are chest compression and defibrillation generating aerosol- second, all CPR intervention increase infection transmission, and the last what kind of protective equipment was suitable for preventing the infection. The changing approach for CPR in COVID 19 should be warrant for healthcare safety to do a best result for managing the cardiac arrest. Healthcare professional should be pay a close attention to the use of Personal Protective Equipment in dealing cardiac arrest in patient COVID 19 Keywords: COVID-19, CPR, Healthcare Share Link | Plain Format | Corresponding Author (Nizamuddin Ubaidillah)

71	Covid 19 in Emergency	ABS-15
Antiviral therapy for COVID-19 critical patients with respiratory distress syndrome Deasy Wirasiti RS Dustira Faculty of Medicine, UNJANI Abstract Corona virus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), a newly emergent corona virus that was first recognized in Wuhan, Hubei province, China in Desember 2019. Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a positive-sense single stranded RNA virus that is contagious in humans, and also the successor to SARS-CoV-1, the strain that caused the 2002 until 2004 SARS outbreak. Corona virus disease 2019 (COVID-19) can develop into critical disease with complications such as respiratory failure, an acute respiratory distress syndrome about 5% of all cases. Some antivirals currently used are oseltamivir, favipiravir, lopinavir/ritonavir and remdesivir. The guidelines from World Health of Organization (WHO) contains strong recommendation against the use of hydroxycholoroquine and lopinavir/ritonavir in patients with COVID-19, regardless of disease severity. A conditional recommendation against remdesivir in hospitalized patients with COVID-19. Both favipiravir and remdesivir can give better improvement to early COVID-19 patients. Keywords: covid-19, antiviral, respiratory distress Share Link | Plain Format | Corresponding Author (Deasy Wirasiti)

72	Covid 19 in Emergency	ABS-29
SURVIVAL ANALYSIS OF COVID 19 PATIENTS FROM TWO HOSPITALS IN CIMAHI, INDONESIA Desy Linasari Department of Community Health Science Medicine Faculty, Universitas Jenderal Achmad Yani, Indonesia Correspondence email : desy.linasari[at]lecture.unjani.ac.id Abstract Abstract - In December 2019 in Wuhan, a mysterious and highly infectious pneumonia case with unknown cause was reported. In February 2020 WHO named the new virus for the cause of the mysterious pneumonia as SARS cov, and the disease was called CoronaVirus disease 2019 (COVID 2019). Nearly all the countries in the world cannot avoid the transmission of covid 19, and covid 19 caused lots of deaths especially in the elderly and in those with the history of comorbidities. This study was conducted to find out the survival probability of patients suffering from covid after the patients were hospitalized for one month in Dustira hospital and RSUD Cibabat. The study design used retrospective cohort study, with data analysis using survival analysis employing life table and Kaplan Meier. From the clinical symptoms it was found that the most complaints were among others fever, cough, throat pain, throws up, and anosmia with 88,1%, 85,1%, 50,6%, 56,5% and 26,2 % respectively. Survival probability of males and females was 49% and 33% respectively. The covid patients with comorbid factors had a lower survival probability than those without comorbid ones. The covid patients hospitalized in Dustira Hospital and RSUD Cibabat were those showing the symptoms from the beginning of the disease, and the dead patients were those with comorbid factors. Keywords: Survival analysis- Covid 19- Life table - Kaplan Meier. Share Link | Plain Format | Corresponding Author (Desy Linasari)

73	Covid 19 in Emergency	ABS-43
POTENTIAL ZOONOSES IN SARS-CoV 2 Sayu Putu Yuni Paryati Universitas Jenderal Achmad Yani Abstract Zoonotic diseases are infections that are transmitted from animals to humans. The World Health Organization defines a zoonosis as any infection naturally transmissible from vertebrate animals to humans. COVID-19 caused by SARS-CoV-2 most likely originated in bats and transmitted to humans through a possible intermediate host, however, no animal reservoir has yet been found. Phylogenetic analysis of the &#946--coronavirus genera indicated that SARS-CoV-2 is similar to some viruses identified in bats in a group described as SARS/SARS-like CoV. Members of the virus species SARSrelated coronavirus that includes both SARS-CoV and SARS-CoV-2 as well as multiple genetically highly diversified bat-associated strains can infect different hosts belonging to four different mammalian orders, including bats, carnivores, pangolins and primates. In the tropics, direct contact between humans and bats potentially facilitating human infection is more frequent than in temperate climates. Human-to-animal transmission events during the COVID-19 pandemic have been documented in several countries. Case reports on cats Felis catus) living in the same household with COVID-19 patients, revealed that these animals can be infected with SARSCoV-2, showing either no or mild respiratory illness. Case report on two separate SARS-CoV-2-infected dogs (Canis lupus familiaris), whose owners were COVID-19 patients. Animal experimental infections can demonstrate the susceptibility of different animal species to SARS-CoV-2. A new structure-based approach has identified of potential intermediate hosts of SARS-CoV-2 by modeling the binding affinity between the SARS-CoV-2 Spike receptor-binding domain and the ACE2 protein of host animals. We conclusion that SARS-CoV-2 is a zoonotic disease. Keywords: COVID-19- SARS-CoV-2- zoonotic diseases- zoonosis Share Link | Plain Format | Corresponding Author (Sayu Putu Yuni Paryati)

74	Covid 19 in Emergency	ABS-45
PROGNOSTIC VALUE OF NEUTROFIL LIMFOSITE RATIO, D DIMER LEVELS AND SCORING OF LUNG LESSION ON CHEST X-RAY ON MORTALITY OF COVID-19 PATIENTS Yudith Yunia Kusmala (a), Jusron Iriawan(a), Fariz Albarri(b), Tersia Viradanti(b), Sunnatul Mufarrohah(b) (a). Internal Medicine Dept. Medical Faculty Universitas Jenderal Achmad Yani (b). Programme of Bacheclor Degree Medical Faculty Universitas Jenderal Achmad Yani Abstract Acute Respiratory Distress Syndrome (ARDS) plays an important role that increase mortality in Covid-19 patients. Several parameters have been tried to predict the patient^s condition for worsening and even death. The objective of this study was to determine the prognostic value of the neutrophil lymphocyte ratio (NLR), D Dimer levels and the degree of severity of lung lesions on chest X-rays on patient mortality. A cross sectional study was conducted on 53 patients with positive PCR at Kebon Jati Hospital Bandung for the period September-December 2020. Each patient who was admitted, carried out routine examinations of NLR, D Dimer and chest X ray. There were 40 (75.5%) survival patients and 13 (24.5%) patients were died. The mean NLR, D Dimer, score of lung lesions on chest X-rays of patients who died was higher than those of the survival. NLR (8.59 vs 4.10- P = 0.002), D Dimer (3,285.08 vs 1,489.33- P = 0.000) and scoring for lung lesions on the chest X-ray (11.00 vs 6.82- P = 0.001). The prognostic value of these parameters above shown by the Area Under Curve (AUC), with the largest value represented by the AUC NLR of 0.0840, P = 0.000. The NLR value> 5.07 has a sensitivity of 92.3% and a specificity of 79.5% in predicting the occurrence of death due to Covid-19. The results showed that the NLR, D Dimer and thoracic lesion scoring at the time of admission to the hospital have prognostic values for the mortality of Covid-19 patients. Keywords: Prognostic Value, Neurofil Limfosit Ratio, D Dimer, Chest X-ray Scoring, Covid 19 Share Link | Plain Format | Corresponding Author (Yudith Yunia Kusmala)

75	Covid 19 in Emergency	ABS-85
Coronavirus Emergence & Trajectory: Where and How did COVID-19 Start, and Where has It Spread? Eka Noneng Nawangsih1, Sayu Putu Yuni Paryati2, Siska Tely Pratiwi3 Department of Microbiology, Faculty of Medicine, Universitas Jenderal Achmad Yani Abstract Coronaviruses are a group of viruses that can cause disease in both animals and humans. The new strain of coronavirus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus causes coronavirus disease 19 (COVID-19) and detected in China at the end of December 2019. From the outbreak in Wuhan, the virus took different times to reach the borders of different countries. The sequences of SARS-CoV-2 are mutating and have many variants, both in nucleotides and amino acids. Mutations of SARS-CoV-2 that cause COVID-19 have been observed globally.The D614G mutation, which is increasing in prevalence worldwide and seems to increase infectivity. To date, three key SARS-CoV-2 variants have been identified that are of potential concern. The variant (B.1.1.7 lineage) was first detected in the United Kingdom (UK) in September 2020- the variant (B.1.351 lineage) was first detected in October 2020 in the Republic of South Africa (RSA)- and the variant (P.1 lineage) was first detected in Brazil in December 2020. All mutations, are likely to induce variations in immune responses, which will need to be investigated in potential vaccines or new tests. in addition, these variants are more contagious and some are suspected to cause more severe diseases. A greater number of sequences covering longer periods of evolution, with a more exhaustive representation of different human populations, countries and continents, will make it possible to study these mutations in terms of selection pressure, convergence, adaptation to the human host, virulence, severity and pandemic risk. Further viral genomic tracing and experimental virological analyses are required to characterize SARS-CoV-2. Keywords: COVID-19, emerged, trajectory, spread Share Link | Plain Format | Corresponding Author (Eka Noneng Nawangsih)

76	Covid 19 in Emergency	ABS-138
Kesiapan Rumah Sakit sebagai Rujukan Pandemi Covid-19 M. Helmi Wisma Atlet Jakarta Abstract Pandemi adalah keadaan darurat di mana terjadi penyebaran penyakit menular secara cepat dan luas bahkan ke seluruh dunia. Indonesia mengumumkan secara resmi kasus pertama Covid 19 pada hari Senin 2 Maret 2020 oleh Presiden Joko Widodo. Maka sejak itu masuklah era perawatan Covid-19 di Indonesia. Pemerintah secara resmi menunjuk 3 rumah sakit sebagai rujukan utama Covid-19 yaitu RS Persahabatan, RSPI Sulianti Saroso dan RSPAD Gatot Soebroto ketiganya ada di Jakarta. Namun demikian dalam perkembangan ternyata dengan cepat penyakit Covid-19 menyebar ke seluruh propinsi dan kota di Indonesia, walau ada beberapa Propinsi melaporkan jumlah kasus di bawah angka Nasional. Khusus untuk 5 Propinsi di Jawa dan Bali memiliki angka yang cukup tinggi. Maka disamping 3 Rumah Sakit rujukan Nasional, di tiap-tiap daerah juga ditunjuk rujukan daerah. Rumah Sakit sebagai benteng terakhir dalam menghadapi pandemi harus menyiapkan mulai sejak di emergensi, Poliklinik, ruang perawatan, kamar operasi, icu, penunjang seperti laboratorium, radiologi, laundry, kamar jenazah dll. Sebagian besar Rumah Sakit kita adalah Rumah Sakit Umum yang melayani pasien non infeksi khusus, maka yang pertama dilakukan adalah memisahkan ruang Rumah Sakit menjadi 2. Yaitu pelayanan Rumah Sakit Umum / biasa dan pelayanan infeksi khusus / pandemi. Jadi kita seolah olah melayani dua Rumah Sakit, karena kedua pelayanan ini tidak bisa disatukan untuk menghindari penyebaran. Kemudian penyiapan sumber daya manusia yang akan mengawaki dalam perawatan pasien, mulai tenaga dokter, perawat, pembantu perawat, petugas lab, radiologi, petugas loundry, petugas kesling, kamar jenazah dll. Tidak kalah penting adalah kesiapan sarana prasarana seperti ruang isolasi khusus dengan hepa filter dan tekanan negatif, APD, pembuangan limbah / material terkontaminasi, sarana dekontaminasi dan pembuatan jalur pasien yang terpisah. Kesiapan Rumah Sakit sebagai rujukan pandemi yang baik akan menentukan hasil dari kualitas pelayanan. Keywords: Pandemi, Isolasi Share Link | Plain Format | Corresponding Author (M Helmi)

77	Covid 19 in Emergency	ABS-144
CUTANEOUS MANIFESTATION OF CORONAVIRUS DISEASES 2019 (COVID-19) Lina Damayanti Department of Dermatovenereology, Faculty of Medicine, Universitas Jenderal Achmad Yani Department of Dermatovenereology, Dustira Hospital Cimahi, Indonesia Abstract Patients with COVID-19 most commonly present with respiratory symptoms, but multiorgan involvement can occur, including skin manifestations. Dermatologic findings may include a maculopapular eruption (morbiliform rash), urticarial, vesicular rash (varicella-like), petechiae, purpura, pseudochilblains, livedo racemosa, and distal ischemia. Most of these skin rashes are not any correlation with disease^s severity and fully recovered without any treatment. But some eruptions can be a marker of poor prognosis and should be treated intensively. Keywords: COVID-19, cutaneous manifestations Share Link | Plain Format | Corresponding Author (Lina Damayanti)

78	Covid 19 in Emergency	ABS-145
Response to COVID-19 Pandemic in Indonesia Bagus Tjahjono, Agus Suryono, Riyanto, Fadillah Amin Faculty of Medicine Universitas Jenderal Ahmad Yani Cimahi, Indonesia Abstract The COVID-19 pandemic has hit and is attacking Indonesia. This pandemic is very difficult to eradicate, causing very high mortality and detrimental to various aspect of life. It takes an active role from all components of the nation in order to cope with this pandemic. For this reason, the Indonesian government has formed a task force for handling the COVID-19 pandemic. The duties and functions of this task force are to coordinate and lead the six main components in the collaborative mechanism for handling the COVID-19 pandemic. This study used a descriptive analytical method using data derived from the data on handling this pandemic. The results obtained indicate that Indonesia is implementing a collaborative governance approach in the effort to tackle the COVID-19 pandemic. Keywords: collaborative governance, COVID-19 pandemic, task force Share Link | Plain Format | Corresponding Author (Bagus Tjahjono)

79	Covid 19 in Emergency	ABS-146
The Relation Between D-dimer Level and Chest X-Ray (CXR) Scoring in COVID-19 Patients, What we can learn from? Tersia Viradanti, Yudith Yunia Kusmala Internal Medicine Department, Jenderal Achmad Yani University Faculty of Medicine, Cimahi, Indonesia Abstract Coronavirus disease is a kind of pneumonia cause by infection of SARS-CoV-2. In most cases, patients only get mild manifestation or even asymptomatic. Some patient can get severe disease, especially elderly people or someone with comorbid, leading to cytokines storm that triggers SIRS and induce coagulation dysregulation (marked by D-dimer elevation) so that increasing risk to get thrombosis. Recent pathology finding suggest that micro-thrombosis has contribution to ARDS due to lung^s fibrosis. We use a CXR scoring system to assess lung parenchyma involvement in COVID-19 patients and D-dimer level to see coagulopathy then performing an analysis to investigate the relationship between both. Based on the Spearman test, we find that there is a significant relationship between D-dimer level and CXR scores of COVID-19 patients describe as a positive correlation (p=0.023- r=0.358). Keywords: D-dimer, CRX SCORE, COVID-19 Share Link | Plain Format | Corresponding Author (Yudith Yunia Kusmala)

80	Covid 19 in Emergency	ABS-147
OPTIMIZING ENT PATIENTS MANAGEMENT GUIDELINES DURING COVID-19 PANDEMIC Asti Kristianti ENT Departement of Dustira Hospital-Cimahi Fakulty of Medicine, Jenderal Achmad Yani University-Cimahi Abstract An ENT specialist have a higher risk transmission of contracting COVID-19 due to procedures in the nasal cavity, nasopharynx, oral cavity, and oropharynx. This risk of transmission does not only affect the ENT specialist caring for the patient, but all staff in the room has potential for infection. Clinical and organizational guidelines is necessary for reducing contact. Patient, staff, and personal safety should been given the highest priority with strategy to provide high quality care. Aim of our study was to review the available recommendations published by Perhimpunan Dokter Spesialis Telinga Hidung Tenggorok Bedah Kepala dan Leher (PERHATI-KL) Indonesia on May 2020 for first edition and July 2020 for second edition and evaluate the underlying literature. Clinical and organizational guidelines for the management of a ENT department during COVID-19 pandemic set the appropriate standard for personal protective equipment, management for ENT patients with the new normal adaptation, and modify the assessment room. During the COVID-19 pandemic, ENT departments were forced to re-schedule their activity giving priority to urgent procedures and non-COVID cases. There is a lack of evidence-based literature providing. It is of paramount importance to face the emergency in the most effective and efficient manner, retrieving resources from non-essential settings and, at the same time, providing care to high priority non-COVID-19 related diseases. Keywords: ENT patient, COVID-19 pandemic, guidelines Share Link | Plain Format | Corresponding Author (Asti Kristianti)

81	Disaster Management	ABS-126
Case Report: End Point Resuscitation of Severe Burn Injury with Inhalational Trauma in Intensive Care Unit Andie Muhari B, Nurita Dian, Moch Hasyim, Basuki Rachmad Departement of Anesthesiology and Intensive Care Dr. Hasan Sadikin Central General Hospital/Faculty of Medicine Universitas Padjadjaran, Bandung Abstract Severe burn injury involved wound area > 25% of total body surface area, which is often required management in Intensive Care Unit (ICU), especially if inhalation trauma is suspected. The diagnosis of inhalation trauma needs to be established immediately to avoid life-threatening airway obstruction. In severe burns, physiological changes occur involving multiple organs. Handling must involve multidisciplinary science. Coagulopathy occurs immediately after a burn, causing a microvascular reaction around the dermis which results in the expansion of the injury. Burns activate systemic responses caused by loss of skin barrier, release of vasoactive mediators from wounds and infections that follow. The result of this process is interstitial edema in organs and soft tissues. This process requires handling resuscitation that is individualized, depending on the parameters of each patient. For this reason, it is necessary to concern more about end point resuscitation target of burn injury to prevent complications due to over or under resuscitation. Keywords: burn injury, inhalational trauma, end point resuscitation Share Link | Plain Format | Corresponding Author (Andie Muhari)

82	Disaster Management	ABS-127
THE CORRELATION BETWEEN PERCEPTION OF TRAINING BENEFITS WITH THE LEVEL OF CONFIDENCE OF UNJANI CAMPUS RESIDENTS IN APPLYING KNOWLEDGE AND SKILLS ABOUT DISASTER MITIGATION Fransiska Ambarukmi Pontjosudargo Fakultas Kedokteran Universitas Jenderal Achmad Yani, Cimahi Abstract The disaster mitigation socialization and training program for the Unjani campus residents aims to improve the knowledge, and skills, so they understand how to behave in saving themselves, friends, and communities around in the event of a disaster. The knowledge and skills regarding disaster mitigation is an important factor that determines attitudes and behaviors that affect the preparedness ability of campus residents in the face of disasters. The purpose of this study is to assess the correlation of educational benefits and training provided, with confidence in applying the knowledge of campus citizens about disaster mitigation. A total of 56 participants answered a questionnaire assessing the perception of benefits and confidence of participants. The data analyzed with Spearman^s test, with a 95% degree of confidence. Spearman^s test results showed that p=0.000 (p<0.05), which meant there a significant correlation between perception of educational and training benefits with participants^ confidence in applying knowledge about disaster mitigation, with an R-value of 0.710, which indicates the strong correlation. The conclusion is, the better the perception of the benefits of education and training programs, the higher the confidence levels. Keywords: Level Of Confidence, Benefits, Disaster Mitigation, Unjani Campus Residents Share Link | Plain Format | Corresponding Author (Fransiska Ambarukmi Pontjosudargo)

83	Disaster Management	ABS-148
The Role of Indonesian National Armed Forces (TNI) in Disaster Management Dr.dr. Tugas Ratmono, Sp.S., MARS, M.H. INAF Surgeon General Office, INAF HQ Cilangkap, East Jakarta Abstract Natural and nonnaural disasters that occurred in many areas in our country nowadays the intensity have dramatically increased both quantity and quality. Loss of life, property and infrastructure damage are avoidable if the natural disasters such as earthquakes tsunami and volcanic Merapi happens. Since year of 2007, in order to anticipate the threat of disaster, the government has established a policy with the publication of law No. 24 Provincial and Regency/ Municipality.The effort of disaster relief are not only the responsibility of BNPB/BPBD, but also are require the involvement of all government institutions, private sector and all components of society, including the involvement of Indonesian National Armed Forces (TNI) a network that spread throught out the Republic of Indonesia. Indonesian Republic which have many area which vulnerable to natural hazards is Indonesia that geographically is a region with a long history of disaster. The involvement of TNI in natural disaster management became very urgent in this area, because when disasters happen, beside as disaster victims, TNI is also as a national guard command and must ready, to assist the disaster victims. As specialy in emergency respon. Keywords: management disasters, Indonesian National Armed Forces, role, emrgency response. Share Link | Plain Format | Corresponding Author (Tugas Ratmono)

84	Epidemology	ABS-26
CHARACTERISTICS OF INPATIENTS SUSPECTED COVID-19 BASED ON SWAB RESULTS RT-PCR IN DUSTIRA ARMY HOSPITAL (PERIOD ON AUGUST, 15 th - NOVEMBER, 15th 2020) Sasongko S 1 Dept. ENT of RSPAD Gatot Soebroto Jakarta, Indonesia sieragolftht@yahoo.com Nurrokhmawati Y 2 Dept. ENT of Medical Faculty of UNJANI Cimahi, West Java, Indonesia yantinurrokhmawati@gmail.com Rahayu D.F 3 Medical staff of Dustira Army Hospital Cimahi, West Java, Indonesia Darafr25@gmail.com Medical faculty of General Achmad Yani University Abstract Coronavirus Disease 2019 (Covid-19) is an infectious viral disease of a new type of betacoronavirus and is named 2019 novel Coronavirus (2019-nCoV). WHO recommends diagnostic tests for patients with suspected Covid-19, with molecular detection / NAAT (Nucleic Acid Amplification Test) such as RT-PCR using the naso-oropharyngeal swab method. This research discuss about the characteristic of inpatients suspected Covid-19 based on the result of the RT-PCR swab at the Dustira Army Hospital so that is useful for epidemiological data. This research is a descriptive study with a cross sectional design. The study sample was a total sampling of inpatients with suspected Covid-19 who were tested by RT-PCR. The results of RT-PCR were positive if the CT value was <41. The results of the data were analyzed using statistical tests that were in accordance with the significance if p <0.001 with the odds ratio (OR) based on the Confidential interval (CI) 95%. The results showed that the mean CT value of positive RT-PCR was 30,345 (20.17-40.52). The characteristics of the most inpatients suspected Covid-19 with positive RT-PCR were male (65.01%), aged 25-50 years (40.35%), TNI / Polri occupation (45.17%) with the rank of non-commissioned officers / group II (51.02%) and units outside Kodam III / Slw (86.22%). Male patients confirmed of Covid-19 with positive PCR results were significantly at risk 2.3 times greater, while those aged 25-50 years had a 1.39 times greater risk and occupation of the TNI / Polri had a 4.78 times greater risk. Inpatients suspected Covid-19 were significantly dominant at the age of 25-50 years. with the main symptoms of the airway system. Inpatients suspected Covid-19 with positive RT-PCR results had an average CT value of 30,345, with the most significant characteristics being male, aged 25-50 years, occupation of the TNI / Polri, as well as the main symptoms of the respiratory system. Keywords: Characteristics, Covid-19, , RT-PCR. Share Link | Plain Format | Corresponding Author (Sigit Sasongko)

85	Epidemology	ABS-58
INTEGRATED VECTOR MANAGEMENT DI MASA PANDEMI COVID 19 Emma Mardliyah Hidayat, Lutfhi Nurlaela Laboratorium Parasitologi Fakultas Kedokteran Universitas Jenderal Achmad Yani Cimahi Abstract Pandemi coronavirus disease 2019 (COVID-19) yang disebabkan oleh SARS-CoV-2, sekarang menjadi krisis kesehatan mayor. Pada Juli 2020, terdapat 14 juta kasus dan lebih dari 600.000 kematian di seluruh dunia, dan menyebabkan disrupsi ekonomi dan sosial yang hebat. Meskipun pandemi ini menjadi perhatian utama, masih banyak penyakit infeksius lain yang terus meningkat jumlahnya. World Health Organization (WHO) telah menekankan pentingnya meneruskan usaha dalam mencegah, mendeteksi, dan mengobati malaria dalam masa pandemi ini. Pendekatan serupa sebaiknya diadopsi untuk pengendalian penyakit arboviral lain seperti dengue, Zika, chikungunya, dan demam kuning, sebagaimana dicantumkan Pan-American Health Organization (PAHO) dalam panduan interim mereka mengenai pengendalian nyamuk Aedes aegypti di masa pandemi COVID-19. Intervensi kesehatan masyarakat yang diinisiasikan guna menghentikan penyebaran COVID-19 sangat mempengaruhi aktivitas pemantauan dan pengendalian vektor. Kombinasi dampak COVID-19 dengan epidemi dengue atau (Vector Borne Disease) VBD lainnya berkonsekuensi berat pada populasi berisiko. Bersirkulasinya dengue bersamaan dengan COVID-19 mungkin menghasilkan berbagai luaran yang tidak diinginkan seperti ko-infeksi- lambatnya diagnosis, tatalaksana, dan usaha mitigasi- sistem kesehatan yang kewalahan- kurangnya pelaporan kasus- penurunan pemantauan dan intervensi pengendalian- dan eksaserbasi kesenjangan sosial. Jelas, lockdown sangat membahayakan efektivitas pengendalian vektor, khususnya kampanye mobilisasi sosial dan penyemprotan insektisida preventif. Oleh karena itu, kegagalan dalam implementasi usaha pengendalian vektor secara maksimal dapat berujung pada pengurangan efektivitasnya secara keseluruhan dan meningkatkan risiko sirkulasi VBD. Komunitas kesehatan dan pembuat kebijakan perlu mengembangkan kebijakan proaktif dan mengalokasikan sumber daya yang adekuat guna mencegah dan menangani munculnya dengue dan VBD lain dalam era baru COVID-19. Keywords: Aedes aegypti, COVID-19, integrated vektor management Share Link | Plain Format | Corresponding Author (Lutfhi Nurlaela)

86	Epidemology	ABS-71
CHARACTERISTICS AND DEGREE OF DYSPNEU THAT HAPPEND IN COPD PATIENTS USING MODIFIED MEDICAL RESEARCH COUNCIL (mMRC) METHODE AT DUSTIRA CIMAHI HOSPITAL I Wayan Agus Putra, Novita Kumala, Irwanto Ichlas, Raynisa Budhy Pratiwi Jenderal Achmad Yani University Abstract Chonic Obstructive Pulmonary Disease characterized by persistent air flow resistance. The degree of breathless in each patient can be measured by Modified Medical Research Counsil (mMRC) questionnaire. This study as a descriptive by doing an interview to the COPS^s Patient. This study has been done on 45 patients at Dustira Hospital Pulmonary clinic and ward on December 2018. The data obtained from questionnaires and medical record that presented in the descriptive form and arranged in table from using SPSS application. In the pulmonary clinic, there are 13 patients (52%) in mMRC grade 0,10 patients (40%) in mMRC grade 1,2 patients (8%) in mMRC grade 2, and no patient in mMRC grade 3 and 4. While in the pulmonary ward, most patients are in mMRC grade 2 and 3 there are 8 patients(40%), no patient in mMRC grade 0, 2 patients(10%) in mMRC grade 1, and 2 patients (10%) in mMRC grade 4. Based on the characteristics,there are 15patients (33,3%) up to 70 years old, 29 patients (64,4%) are male,18 patients (72%) are hadlast educatedonhighschool, and 31 patients (68,9%)didn^twork.The result of this study concluded that the characteristics of COPD^s patients consisted of age, gender,occupation, and degree of smoking which were risk factors for COPD. The degree of breathlessness measured using the mMRC method is different for each patient. This result occurs because the breathless is qualitatively different in each COPD^s patient. Keywords: degree of breathless, chronic obstructive pulmonary disease, modified medical research council Share Link | Plain Format | Corresponding Author (Wayan Agus)

87	Epidemology	ABS-79
Characteristic description of patients with bipolar affective disorder which hospitalized in psychiatric hospital of West Java Province Muhammad Adam Zulqarnain, Lukas Kabul Budianto, Chatidjah Satrijo Wibowo Medical Faculty, Universitas Jenderal Achmad Yani Abstract Bipolar disorder was a severe mental disorder which had a quite high prevalence around 1-2%. Most patients had a chronic symptom of bipolar disorder. The chronicty of symptom caused comorbidities that could eventually caused malfunction and death. This study aimed to described the characteristics description of patients with bipolar affective disorder which hospitalized in psychiatric hospital of West Java Province. The research method was descriptive with sample of 375 data from 499 medical record. Data were collected through medical record section in psychiatric hospital of West Java Province and the results were presented in the form of a frequency distribution table. From the result of this study found that the count of bipolar affective disorder patients which hospitalized in psychiatric hospital of West Java Province were mostly in the age of 20-29 years as much as 117 people (31,2%), with male gender as much as 212 people (56,5%), and did not have a family history of mental disorder as much as 261 people (69,6%), marital status more in patients who were single as much as 170 people (45,3%), for the homeland were more from rural people as much as 268 people (71,5%), while the most job were in patients who unemployed as much as 272 people (72,5%), and in level of education most cases were at high school as much as 128 people (34,1%). Keywords: Affective disorder, bipolar disorder, characteristics Share Link | Plain Format | Corresponding Author (Muhammad Adam Zulqarnain)

88	Epidemology	ABS-81
Overview of Low Birth Weight Infants with Incidence of Neonatal Jaundice in Perinatology Ward at Dustira Hospital Yoke Ayukarningsih, Wahyudin, Siska Telly Pratiwi, Nadhilah Lailani Medical Faculty, Universitas Jendral Achmad Yani Abstract Low Birth Weight (LBW) is an indicator of public health. The morbidity and mortality risk of LBW is 4 times greater than non-LBW. Low birth weight (LBW) both in pre-term and term gestational age infants often occurs jaundice. This study aims to determine the distribution of LBW with neonatal jaundice based on gestational age in Perinatology Ward at Dustira Hospital. This quantitative descriptive study uses data sources from medical records in the Perinatology Ward from January to December 2019. The results of this study showed there were 51 (87.9%) pre-term LBW and 7 (12,1%) term LBW and none post-term LBW infant. There are 42 (72,8%) cases of LBW with neonatal jaundice with 35 (83,3%) pre-term LBW and 7 (16,7%) term LBW. Neonatal jaundice occurrs more often in pre-term LBW than term LBW as done by other studies. The incidence of LBW with neonatal jaundice is not only affected by gestational age, but also by ABO blood group incompatibility, maternal age during pregnancy, the gender of the infants, and asphyxia. Keywords: Low Birth Weight (LBW) Infants, Gestation Age, Neonatal Jaundice Share Link | Plain Format | Corresponding Author (Siska Telly Pratiwi)

89	Epidemology	ABS-83
Description and Hystopatology Type of Nevus Pigmentosus in Dustira Hospital and Cibabat Hospital Cimahi Aditya Yudha Pratama, Pisi Lukitto, Lina Damayanti Medical Faculty, Universitas Jenderal Achmad Yani Abstract Nevus pigmentosus is benign skin tumor which is the most common disease that has been found in many clinics. It comes from nevus cells that can produce melanin. Some types of nevus, such as junctional and compound nevus, can cause malignant melanoma which is a life-threatening skin cancer. Some risk factors that can cause nevus pigmentosus are age, genetic factors, and the exposure of UV light. The objection of this research is to describe the patients of nevus pigmentosus based on some risk factors such as age, sex, the location of nevus, and histopathology type. Descriptive method was used and the objects of this research are medical records from nevus pigmentosus patients that has been treated by excisional surgery and has been examined by histopathology test from the 1st of January 2011 until the 31st of December 2015. The medical records are obtained from Dustira Hospital and Cibabat Hospital, Cimahi. The results of this research showed that there were 55 cases of nevus pigmentosus found in 2011 - 2015 with 21 cases found in Dustira Hospital and 35 cases found in Cibabat Hospital, nevus pigmentosus mostly found in individuals aged 21-30 (25,45%), mostly found in female patients (65,45%), mostly located in the face and scalp (90,90%), and the most common histopathological type was intradermal nevus (94,55%). Keywords: Nevus Pigmentosus, Histophatological Type Share Link | Plain Format | Corresponding Author (Aditya Yudha Pratama)

90	Epidemology	ABS-92
The Relationship Between Low Fiber Consumption and The Incidence of Haemorrhoids Patients in The Surgical Department of Dustira Hospital Cimahi Lukmana Lokarjana, Trianda Kanserina, Rini Roslaeni, Aditya Yudha Pratama Medical Faculty, Universitas Jenderal Achmad Yani Abstract One of risk factors for the accurence of hemorrhoids is a low fiber consumption habit. Hemorrhoids are widening and inflammation of the veins in the anal area that originate from the hemorrhoidal plexus. This study aims to determine the relationship between low fiber consumption and the incidence of hemorrhoids patients in the surgical department of Dustira Hospital Cimahi. This study is used an analytical design with cross sectional design. The data of this study were analyzed using the chi square test. The results of the study: from 92 people, there were 38 patients with hemorrhoids and 54 people without hemorrhoids were taken with the total sampling method. Research shows that the number of hemorrhoids cases is found in the age of 41-50 years with percentage 31.6% and in women at percentage 68.4%. Hemorrhoid patients who consumed lower fiber who consumed high fiber at percentage 73.7%. Hemorrhoid patients who consumed the most low fiber at the age of 41-50 years at percentage 28.6%. Women consume more low fiber at percentage 67.9%. Analytical test results showed a significant relationship between low fiber consumption and hemorrhoids incidence in patients in Surgery Department (95% Cl-p = 0.016). Based on the results, there was an effect of fiber consumption with hemorrhoids events in patients at the Surgery Department of Dustira Cimahi Hospital. Keywords: hemorrhoids, low fiber consumption Share Link | Plain Format | Corresponding Author (Lukmana Lokarjana)

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