- Current Issue
12th Bali Cardiology Update Proceeding Abstract
Agung SuwiryaOnline First: Aug 23, 2023
- Abstract
12th Bali Cardiology Update Proceeding Abstract
As the COVID-19 pandemic has been resolved, we are glad to welcome our colleagues to visit the paradise island, Bali, while joining our annual meeting, the 12th Bali Cardiology update that will be held offline. We organises workshops, symposiums, plenary talks, lectures with international and national keynote speakers, and interactive gatherings from throughout regions to discuss cutting-edge discoveries to advance the profession and medications specializing in cardiovascular disease managements, providing an absolutely superb framework for professionals in cardiovascular health, researchers, scientists, healthcare specialists, academicians, and individuals with interest in cardiology. This is your best opportunity to network with the most individuals from hospitals, academic institutions, heart associations, and research facilities because there are people from all over the world interested in finding a few solutions in the field of cardiology. The opportunity to network with colleagues and hear from renowned cardiologists and cardiovascular researchers at this cardiology summit is unmatched.
Sinusitis maksilaris jamur invasif: laporan kasus
Pandu Dewa Natha, Anak Agung Dewi AdnyaniOnline First: Jul 12, 2023
- Abstract
Sinusitis maksilaris jamur invasif: laporan kasus
Background: Acute Infection Fungal Rhinosinusitis (AIFRS) is an uncommon inflammation of the paranasal sinus mucosa. Although the incidence of fungal sinusitis is still rare, there has been an increase in cases over the past few decades. Invasive fungal sinusitis occurs more frequently in patients with weakened immune systems. Diagnosis of fungal sinusitis involves a medical history assessment, physical examination, and supportive tests such as CT-scan. CT-scan to aid in confirming the diagnosis of invasive fungal sinusitis and help in planning appropriate management. Surgery, such as the Luc-Caldwell (LCW) procedure. Through this article, the authors aim to describe cases of fungal invasive maxillary sinusitis and diagnostic approaches with CT-Scan and Luc-Caldwell's treatment (LCW).
Case Presentation: A 61-year-old male complained of swelling, pus, and pain in his right eye. He had a history of sinus surgery. Physical examination revealed swelling in the right eye, and anterior rhinoscopy showed sinuses filled with greenish secretions. A CT scan showed extensive sinus inflammation involving the right eye area. The patient was diagnosed with maxillary, ethmoid, and frontal fungal sinusitis. A Luc-Caldwell (LCW) surgery was performed in collaboration with an ophthalmologist. Following the surgery, the swelling and pus in the eye decreased, and the pain in the cheek resolved.
Conclusion: Early diagnosis is crucial in cases of suspected AIFRS to improve patient outcomes and reduce morbidity. Diagnosing this condition can be challenging due to its non-specific clinical presentation. Initial diagnostic investigations that can be performed include computed tomography (CT).
Latar Belakang: Acute Infection Fungal Rhinosinusitis (AIFRS) adalah peradangan jamur pada mukosa sinus paranasal yang jarang ditemukan. Meskipun insiden sinusitis jamur masih jarang, saat ini terjadi peningkatan kasus dalam beberapa dekade terakhir. AIFRS lebih sering terjadi pada pasien dengan sistem kekebalan tubuh yang lemah. Diagnosis AIFRS melibatkan penilaian riwayat penyakit, pemeriksaan fisik, dan penunjang seperti CT-Scan. CT-Scan membantu dalam mengonfirmasi diagnosis AIFRS dan dapat digunakan sebagai panduan tindakan bedah. Melalui artikel ini, penulis bertujuan untuk mendeskripsikan kasus mengenai sinusitis maksilaris jamur invasif dan pendekatan diagnosis dengan CT-Scan dan tatalaksana Luc-Caldwell (LCW).
Persentasi Kasus: Seorang pria berusia 61 tahun mengeluh pembengkakan, keluar nanah, dan nyeri pada mata kanannya. Pada pemeriksaan fisik didapatkan pembengkakan pada mata kanan, dan rhinoskopi anterior menunjukkan sinus yang terisi dengan sekret berwarna hijau. CT-Scan menunjukkan peradangan sinus yang luas yang melibatkan area mata kanan. Kemudian, pasien didiagnosis dengan sinusitis jamur maksila, etmoid, dan frontal. Pasien kemudian dilakukan tindakan Luc-Caldwell (LCW) oleh dokter spesialis THT-KL bekerjasama dengan seorang oftalmologis. Setelah operasi, pembengkakan dan nanah pada mata berkurang, dan nyeri pada pipi hilang.
Kesimpulan: Diagnosis dini sangat penting dalam kasus kecurigaan AIFRS untuk meningkatkan outcome pasien dan mengurangi morbiditas. Untuk mendiagnosis kasus ini bisa menjadi tantangan karena gambaran klinisnya yang tidak spesifik. Pemeriksaan diagnostik awal yang dapat dilakukan meliputi computed tomography (CT).
Manajemen fisioterapi untuk meningkatkan performa olahraga boccia pada anak dengan cerebral palsy diplegia: sebuah laporan kasus
Syarif Maulana Fauzi, Suryo Saputra Perdana, Salma Muazarroh, Retno Setianing, Yuni Sandra Repisalta, Ahmad Fatih FauziOnline First: Jul 13, 2023
- Abstract
Manajemen fisioterapi untuk meningkatkan performa olahraga boccia pada anak dengan cerebral palsy diplegia: sebuah laporan kasus
Background: Cerebral palsy (CP) diplegia is a neurological condition that occurs in infancy or early childhood, and permanently affects muscle control and coordination, with lower limb conditions more severe than upper limb. Symptoms can be an increase in muscle tone that causes spasticity in the feet. The arm muscles are generally less affected or not affected at all. Symptoms in addition to motor disorders can be accompanied by sensory and cognitive disorders. Management of physiotherapy with passive stretching (PS), peripheral joint mobilization (PJM), myofascial release technique (MRT), neurodevelopmental technique (NDT), boccia rehabilitation program (BRP) and aquatic exercise increase boccia sports performance in children with cerebral palsy diplegia.
Case Report: A 16-year-old male patients with complaints of unable to stand upright, both legs experience stiffness, and hunchbacked body posture (kyphosis) and forward head. Complaints in patients cause limitations and disorders of motion and function, such as stiffness in both feet, decreased balance capability, decreased gross motor skills and decreased precision ability in throwing. The physiotherapy program was conducted in four meetings in four weeks and patients get physiotherapy programs in the form of PS, PJM, MRT, NDT, BRP and aquatic exercise. Physiotherapy programs get the results of an increase in functional abilities of balance and increase precision capabilities in the throw.
Conclusion: Provision of PS, PJM, MRT, NDT, BRP and aquatic exercise programs increases the ability of functional balance and increase precision capabilities in throwing.
Latar Belakang: Cerebral palsy (CP) diplegia merupakan suatu kondisi neurologis yang terjadi pada masa bayi atau anak usia dini, dan secara permanen mempengaruhi kontrol dan koordinasi otot, dengan kondisi ekstremitas bawah lebih berat daripada ekstremitas atas. Gejalanya bisa berupa peningkatan tonus otot yang menyebabkan spastisitas di kaki. Otot lengan umumnya kurang terpengaruh atau tidak terpengaruh sama sekali. Gejala selain gangguan motorik bisa disertai gangguan sensori maupun kognitif. Penanganan fisioterapi dengan passive stretching (PS), peripheral joint mobilization (PJM), myofascial release technique (MRT), neurodevelopmental technique (NDT), boccia rehabilitation program (BRP) dan aquatic exercise meningkatkan performa olahraga boccia pada anak dengan diagnosa CP diplegia.
Laporan Kasus: Pasien laki-laki berusia 16 tahun dengan keluhan belum bisa berdiri dengan tegak, kedua kaki mengalami kekakuan, dan postur tubuh bungkuk (kifosis) serta forward head. Keluhan pada pasien menyebabkan timbulnya keterbatasan dan gangguan gerak dan fungsi antara lain seperti kekakuan pada kedua kaki, penurunan kemampuan keseimbangan, penurunan kemampuan motorik kasar serta penurunan kemampuan presisi dalam lemparan. Program fisioterapi dilakukan sebanyak empat kali pertemuan dalam empat minggu dan pasien mendapatkan program fisioterapi berupa PS, PJM, MRT, NDT, BRP dan aquatic exercise. Program fisioterapi mendapatkan hasil adanya peningkatan kemampuan fungsional keseimbangan dan peningkatan kemampuan presisi dalam lemparan.
Kesimpulan: Pemberian program PS, PJM, MRT, NDT, BRP dan aquatic exercise meningkatkan kemampuan keseimbangan fungsional serta meningkatkan kemampuan presisi dalam lemparan.
Profile of psoriasis vulgaris patients receiving secukinumab therapy in 2019-2021
Prima Sanjiwani Saraswati Sudarsa, Luh Made Mas Rusyati, Nyoman Suryawati, Michael Hostiadi, Nyoman Indra Karunia MurtiOnline First: Aug 14, 2023
- Abstract
Profile of psoriasis vulgaris patients receiving secukinumab therapy in 2019-2021
Introduction: Psoriasis vulgaris can affect patients' quality of life due to its clinical appearance, expensive treatment costs, and side effects of therapy. Effective long-term treatment with secukinumab injection can help improve this condition. This study aims to identify psoriasis vulgaris conditions with secukinumab injection based on disease severity and quality of life.
Methods: This study is a cross-sectional descriptive study. Data were taken from patients' medical records at the Dermatology and Venerology Polyclinic of Prof. dr. I G. N. G. Ngoerah Hospital, Denpasar, Bali, from January 2019-December 2021. Demographic characteristics variables were age, gender and history of comorbidities. Variables that reflect disease severity and quality of life were body surface area (BSA), Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). The distribution of BSA, PASI and DLQI scores is shown in a box plot. In comparison, the distribution of the number of cases based on each category of BSA, PASI and DLQI is presented in a proportion table.
Results: There were 17 patients, mostly men, with a mean age of 38. Patients' Diagnoses were divided into psoriasis vulgaris (52.9%) and psoriasis vulgaris with psoriatic arthritis (47.1%). Based on BSA, clinical improvement was seen two weeks after initiation of therapy, while the BSA grade category improved when entering the maintenance phase. Based on the PASI score, were decreased after an average of 1 week since initiation, and the PASI grade category improved after an average of 2 weeks. Finally, based on the DLQI score, the patient's quality of life improved after an average of 4 weeks since initiation.
Conclusions: There was an improvement in the severity of psoriasis vulgaris according to BSA, PASI score and overall DLQI after two cycles of initial dosing of secukinumab injection.
A rare case of Elizabethkingia meningoseptica infection in a neonate
Felicia Anita Wijaya, I Wayan Gustawan, I Made Gede Dwi Lingga Utama, Made Sukmawati, I Made Kardana, I Wayan Dharma Artana, Putu Junara PutraOnline First: Aug 26, 2023
- Abstract
A rare case of Elizabethkingia meningoseptica infection in a neonate
Background: Elizabethkingia infections were reportedly rare, but if it was found, it had been known to cause neonatal meningitis, bloodstream infections and respiratory infections. Elizabethkingia meningoseptica had a unique antibiotic susceptibility pattern, usually resistant to most antibiotics. Elizabethkingia infections were associated with a high mortality rate because of the lack of effective therapeutic regimens, antibiotic resistance and virulence.
Case Presentation: Fourteen days old boy patient came with the chief complaint of seizure, which occurred twice. Before the seizure, the patient had a fever with the highest temperature was 39°C. The patient looked lethargic, tended to sleep more often, cried occasionally and was not as active as previously. Septic marker revealed an Immature to Total neutrophil (IT) ratio of 0.2 and C-Reactive Protein (CRP) 49.30 mg/dL. A blood smear examination showed toxic granules, vacuolization of the leucocyte and reactive thrombocytosis. Cerebrospinal fluid analysis revealed a cell number of 2520 cell/uL, polymorphonuclear (PMN) cell 80%, mononuclear (MN) cell 20%, Nonne and Pandy was positive, protein level at 300 mg/dL and cerebrospinal fluid glucose level below 20 mg/dL. The patient was initially diagnosed with sepsis and meningitis and was given ampicillin and gentamicin. Blood and cerebrospinal fluid culture isolated Elizabethkingia meningoseptica and significantly as the infection-causing agent. The antibiotic sensitivity of the blood culture was ciprofloxacin and levofloxacin. The antibiotic sensitivity of the cerebrospinal fluid culture was levofloxacin. During the treatment, there were several inappropriate results between clinical manifestation and laboratory results; the antibiotic was changed to levofloxacin according to the sensitivity of the blood and cerebrospinal fluid culture.
Conclusion: Elizabethkingia meningoseptica was a rare case, and the nature of this bacteria was resistant to multiple antibiotics. Treatment should be considered carefully.
Gene similarity examination Pseudomonas aeruginosa in Intensive Care Unit (ICU) at Prof. Dr. dr. I.G.N.G Ngoerah hospital using the ERIC-PCR method: case reports
I Gede Wahyu Toya Pratama, Agus Eka Darwinata, Ni Made Adi TariniOnline First: Jul 12, 2023
- Abstract
Gene similarity examination Pseudomonas aeruginosa in Intensive Care Unit (ICU) at Prof. Dr. dr. I.G.N.G Ngoerah hospital using the ERIC-PCR method: case reports
Background: Pseudomonas aeruginosa is an opportunistic pathogen that has the potential to cause severe degrees of healthcare-associated infections, especially in immunocompromised patients who have AIDS, cancer, burns, and respiratory tract infections. Antibiotic resistance genes by genetic elements are increased so that it becomes a worldwide concern and also causes the evolution of resistant strains (MDR) ERIC-PCR technique is a PCR-based method in which the location and number of different ERIC sequences in bacteria are used as genetic markers of bacterial diversity.
Case Presentation: We presented three patients with Pseudomonas aeruginosa infection treated in the ICU (Intensive Care Unit) room of Prof. dr. I. G. N. G Ngoerah Hospital. While being treated in the ICU, the three patients' beds were located side by side in one room. Three patients, in this case, reports were treated in the same room where the beds were side by side and experienced a worsening of their condition. After examination, it was found that the bacteria that caused the infection was Pseudomonas aeruginosa. However, after conducting molecular analysis using the ERIC-PCR method, there was no gene similarity between the three isolates examined. This might have happened because the patient had been treated in a different room before being admitted to the ICU.
Conclusion: We presented a discrepancy between Pseudomonas aeruginosa infection in three patients treated in the same ICU room. However, the ERIC-PCR results found no gene similarity between the three isolates examined.
Small bowel volvulus (SBV) due to multiple adhesion in the small intestine: A case report
Pradnya Gunadi Pranata, Made Kurniawan ASOnline First: Sep 4, 2023
- Abstract
Small bowel volvulus (SBV) due to multiple adhesion in the small intestine: A case report
Introduction: Small bowel volvulus (SBV) is a rare but significant cause of small intestinal obstruction. Ischemia or even infarction is frequently the result. Morbidity and death rates rise when surgical intervention and diagnosis are delayed. Volvulus is a special form of mechanical intestinal obstruction. It happens when a loop of small intestine twists abnormally around the axis of its mesentery. An acute abdomen is a clinical presentation. The bowel itself may become constricted, strangulation of the blood supply, or both may be the source of the symptoms.
Case Description: A-49-year old female patient was delivered to the emergency department because of severe pain around her abdomen that lasted for one day with a bloated abdomen. Other symptoms she complained of were nausea, vomiting, fever and constipation since one day before hospitalization. She was transferred to the medical ward and initially diagnosed with abdominal pain due to severe dyspepsia. After four days, her complaints were not improved, and she was diagnosed with intraabdominal obstruction and decided to undergo an emergency laparotomy. During surgery, there was a small bowel volvulus due to multiple adhesion in the small intestine, which caused all of her symptoms. After total 8 days of hospitalization, the patient was finally discharged.
Conclusion: Diagnosing SBV can be difficult, especially if the sign of ileus obstruction is not yet fully developed. Early diagnosis and suspicion are pivotal in SBV because a delay in the surgical treatment can be disastrous.
Laringomalasia: sebuah laporan kasus dan telaah pustaka
Hendradi Surjotomo, Solita Vasya SiregarOnline First: Aug 17, 2023
- Abstract
Laringomalasia: sebuah laporan kasus dan telaah pustaka
Background: Laryngomalacia is a congenital disorder caused by collapse of the supraglottis structure that causes stridor in neonates and infants. The cause of laryngomalacia is still under further research but currently there are 3 theories that can cause laryngomalacia, namely neurological disorders, GERD and anatomical abnormalities. This case report aims to evaluate the laryngomalacia case in a child.
Case reports: A toddler aged 2 months with complaints of choking every time he eats and drinks followed by wheezing. The patient had previously been treated with the same complaint by the Pediatric Surgery Department and was diagnosed with pyloric stenosis, was given therapy and the complaint disappeared but reappeared so that a CT scan was carried out and found hydrocephalus and medulloblastoma. Then, on supporting examination, flexible laryngoscopy found an omega-shaped larynx, with a wide airway and an NGT tube.
Conclusion: In infant and toddler patients with complaints of frequent choking while eating and drinking can still be a clinical sign of laryngomalacia that needs to be proven by flexible laryngoscopy examination and periodic evaluation of clinical complaints and symptoms which are very important in determining further therapy
Latar Belakang: Laringomalasia adalah sebuah kelainan kongenital yang diakibatkan oleh kolaps dari struktur supraglotis, menyebabkan stridor pada neonatus dan bayi. Penyebab terjadinya laringomalasia masih dalam penelitian lanjutan, namun saat ini didapati 3 teori yang menyebabkan terjadinya laringomalasia yaitu gangguan neurologis, adanya GERD serta kelainan anatomis. Laporan kasus ini bertujuan untuk mengevaluasi kasus laringomalasia pada anak.
Presentasi Kasus: Seorang balita usia 2 bulan dengan keluhan tersedak setiap kali makan dan minum diikuti dengan nafas berbunyi. Pasien sebelumnya telah dirawat dengan keluhan yang sama oleh Bagian Bedah Anak dan didiagnosis dengan stenosis pylorus, diberikan terapi dan keluhan menghilang namun muncul kembali sehingga dilakukan pemeriksaan penunjang CT Scan ditemukan adanya hydrosephalus dan medulablastoma. Kemudian pada pemeriksaan penunjang laringoskopi fleksibel didapati gambaran laring berbentuk omega, dengan airway lapang dan tampak pipa NGT.
Kesimpulan: Pada pasien bayi dan balita dengan keluhan sering tersedak pada saat makan dan minum masih merupakan satu tanda klinis laringomalasia yang perlu dibuktikan dengan pemeriksaan laringoskopi fleksibel serta evaluasi berkala terhadap keluhan dan gejala klinis yang sangat penting dalam menentukan terapi lanjutan
Endometriosis of the appendix mimicking appendicitis: Histomorphology and case report
Histomorphology and case report Ida Bagus Ari Sudewa, Luh Dewi Rahayu, Ida Bagus Caka Gunantara, Ni Luh Gde Sagita DewiOnline First: Aug 28, 2023
- Abstract
Endometriosis of the appendix mimicking appendicitis: Histomorphology and case report
Introduction: Even though endometriosis is relatively common among women of reproductive age, endometriosis of the appendix is rare. It has various clinical presentations and sometimes mimics appendicitis. Diagnosis is made from microscopic examination.
Case Description: Here, we report a case of a 42-year-old woman with severe right lower abdominal pain. An appendectomy was performed, and the tissue specimen was analyzed. Endometrial glands and stroma were found in the muscularis propria and serosa. The diagnosis of appendiceal endometriosis was established histologically.
Conclusion: Endometriosis of the appendix is a rare case. It can mimic appendicitis and is hard to detect preoperatively. A histopathology examination was recommended to confirm the diagnosis.
Morbus hansen tipe borderline lepromatous pada seorang anak dengan riwayat narakontak erat kusta tipe mulibasiler: laporan kasus
Ni Luh Putu Ratih Vibriyanti Karna, I Gusti Ngurah Ariwangsa Asbita, I Gusti Ayu Agung Dwi Karmila, Luh Made Mas Rusyati, Ni Putu Ayu Riska Yunita SariOnline First: Aug 29, 2023
- Abstract
Morbus hansen tipe borderline lepromatous pada seorang anak dengan riwayat narakontak erat kusta tipe mulibasiler: laporan kasus
Background: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae and Mycobaterium lepromatosis. Children are one of the populations at risk of M. leprae transmission. Prompt treatment is needed to avoid complications of disability in children with leprosy. Therefore, this study aims to describe a pediatric patient who had borderline lepromatous morbus hansen with a history of close contact multibacillary leprosy.
Case: A 16 years old girl, complained red spots on the right and left legs that are numb. Dermatological examination found multiple erythema macules-patches, firm boundaries, rounded to geographic shapes, discrete distribution on the face and right and left anterior and posterior extremities. Thickening of the right ulnar nerve, right and left common peronial nerve, decreased sensation of touch, pain and temperature were found. Histopathological examination found a non-caseating granulomata lesion, consistent with borderline tuberculoid leprosy type. Slit skin smear found acid fast bacilli (AFB) in the right earlobe 25-30 AFB/1 visual field (VF) (bacterial index (IB): +4)) fragmented, in the left earlobe>100 smear/1 VF (IB: +5) fragmented, and morphological index (IM): 0. The patient was diagnosed with borderline lepromatous (BL) leprosy and given multidrug therapy (MDT) for multibacillary (MB) leprosy. After 6th package of MDT, leprosy reactions or side effects of treatment were not found.
Conclusion: The highest risk of transmission of leprosy is close contact with leprosy patients, especially the multibacillary type of leprosy. In this case, a child with BL type leprosy was treated with an adult dose of MDT MB according to the patient's age and body weight.
Latar belakang: Morbus hansen (MH) merupakan penyakit granulomatosa kronis yang disebabkan oleh Mycobacterium leprae dan Mycobaterium lepromatosis. Anak-anak merupakan salah satu populasi berisiko terhadap transmisi M. leprae. Terapi lebih dini diperlukan untuk menghindari komplikasi kecacatan pada anak dengan morbus hansen. Untuk itu, tujuan dari studi ini adalah memaparkan seorang pasien anak anak yang mengalami morbus hansen tipe borderline lepromatous dengan riwayat narakontak erat kusta tipe multibasiler.
Kasus: Seorang anak perempuan, 16 tahun, dengan keluhan utama bercak kemerahan pada kaki kanan dan kiri yang mati rasa. Pemeriksaan status dermatologis ditemukan makula hingga patch eritema multipel, batas tegas, bentuk bulat hingga geografika, tersebar diskret di lokasi wajah dan ekstremitas anterior et superior dextra et sinistra serta penebalan nervus ulnaris dekstra dan nervus peronius komunis dekstra et sinistra dan penurunan sensasi raba, nyeri dan suhu. Pemeriksaan histopatologi ditemukan kesan non-caseating granulomata lesion. Pemeriksaan bakteriologis dengan pengecatan Ziehl-Neelsen ditemukan basil tahan asam (BTA) pada cuping telinga kanan 25-30 BTA/1 lapang pandang (LP) (indeks bakteri (IB): +4)) fragmented, pada cuping telinga kiri >100 BTA/1 LP (IB: +5) fragmented, dan indeks morfologi (IM): 0. Pasien didiagnosis dengan MH tipe borderline lepromatous (BL) dan diberikan multidrug theraphy (MDT) untuk MH tipe multibasiler (MB). Evaluasi pada konsumsi MDT paket ke-VI tidak menunjukkan adanya reaksi kusta ataupun efek samping pengobatan.
Simpulan: Risiko tertinggi penularan kusta adalah kontak erat dengan pasien kusta terutama kusta tipe multibasiler. Pada kasus ini didapatkan anak dengan kusta tipe BL dan diterapi dengan MDT MB dosis dewasa menyesuaikan usia dan berat badan pasien.
Gambaran Radiologis Sindroma Fahr pada Pasien Post Tiroidektomi : Sebuah Laporan Kasus
Luh Dindi Ayu Surya Kanti, Ni Kadek Antari DarmasihOnline First: Aug 28, 2023
- Abstract
Gambaran Radiologis Sindroma Fahr pada Pasien Post Tiroidektomi : Sebuah Laporan Kasus
Introduction: Fahr's syndrome is a rare disorder characterized by bilateral abnormal calcium deposits in the cerebral cortex and basal ganglia. This condition is often asymptomatic but can also cause symptoms of neurological dysfunction, movement disorders, and psychiatric symptoms. Radiological imaging, such as a CT scan, can be used to confirm the diagnosis. This case report discusses the clinical manifestations and radiological features of Fahr's syndrome in a 45-year-old female patient with a history of thyroidectomy.
Case Report: A 45-year-old woman was referred with complaints of weakness, fever, and pain in the chest, lower abdomen, right thighs, and right upper back after being exposed to hot water. The patient was found suddenly unconscious while carrying a pot of hot water. The patient has a history of enlargement of the thyroid gland, has undergone thyroid removal surgery 10 years ago, and has had epilepsy since 2 years ago. Physical examination showed low blood pressure, fever, and burns in the right chest area, right lower abdomen, right thigh, and right upper back. Neurologic examination within normal limits. A laboratory examination found leukocytosis, hyponatremia, and hypokalemia. A CT scan of the head without contrast showed multiple symmetrical calcifications in the cerebellum, caudate nucleus, thalamus, lentiform nucleus, and white and gray matter of the frontal lobes, parietal lobes, and occipital lobes.
Conclusion: Radiological examinations such as CT scans can be performed in patients with neurological symptoms and a history of total thyroidectomy to establish the diagnosis of Fahr's syndrome.
Pendahuluan: Sindrom Fahr merupakan kelainan langka yang ditandai dengan adanya deposit kalsium abnormal bilateral pada korteks serebral dan ganglia basalis. Kondisi ini seringkali tanpa gejala, namun juga dapat menyebabkan gejala disfungsi neurologis, gangguan gerakan dan gejala psikiatri. Pencitraan radiologi seperti CT scan dapat digunakan untuk menegakkan diagnosis. Laporan kasus ini membahas tentang manifestasi klinis dan gambaran radiologis sindroma Fahr pasien perempuan usia 45 tahun dengan riwayat tiroidektomi.
Laporan Kasus: Wanita berusia 45 tahun dirujuk dengan keluhan lemas, demam, nyeri pada dada, perut bawah, paha, dan punggung atas sebelah kanan setelah terkena air panas. Pasien ditemukan tiba-tiba tidak sadarkan diri ketika sedang membawa panci berisi air panas. Pasien memiliki riwayat epilepsi sejak 2 tahun yang lalu serta memiliki riwayat pembesaran kelenjar tiroid dan sudah menjalani operasi pengangkatan tiroid. Pemeriksaan fisik menunjukkan tekanan darah rendah, demam, dan luka bakar pada daerah dada kanan, perut bawah kanan, paha kanan, dan punggung atas sebelah kanan. Pemeriksaan neurologis dalam batas normal. Pada pemeriksaan laboratorium ditemukan leukositosis, hiponatremia dan hipokalemia. Pemeriksaan CT scan kepala tanpa kontras menunjukkan kalsifikasi multiple simetris pada daerah cerebellum, nukleus kaudatus, talamus, nukleus lentiformis, dan white serta gray matters lobus frontalis, lobus parietalis, dan lobus occipitalis.
Kesimpulan: Pemeriksaan radiologis seperti CT scan dapat dilakukan pada pasien dengan gejala neurologis dan riwayat total tiroidektomi untuk menegakkan diagnosis sindrom Fahr.
Dyke-Davidoff-Masson syndrome: an unusual cause of epilepsy
I Gusti Amanda Jaya, I Gusti Ngurah Made Suwarba, Dewi Sutriani Mahalini, Ni Nyoman MargianiOnline First: Aug 6, 2023
- Abstract
Dyke-Davidoff-Masson syndrome: an unusual cause of epilepsy
Background: Dyke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown global prevalence and incidence. The characteristic clinical features include facial asymmetry, seizures, and contralateral hemiplegia. Signature neuroimaging findings include unilateral brain volume loss, ventriculomegaly, compensatory bone hypertrophy resulting in cerebral hemiatrophy, calvarial thickening and hyperpneumatization of paranasal and frontal sinuses neuroimaging.
Case Presentation: 4-year-old girl patient presented seizures (diagnosed as epilepsy) and complained of left-sided hemiplegia since 1 year ago. Neurological examination revealed left-sided spastic hemiplegia with brisk tendon reflexes and extensor planter response on the left side, increased reflexes physiology in the left limb, and positive Babinski on the left leg. MRI showed right cerebral hemiatrophy with ex vacuo dilatation of the right lateral, III and IV ventricles, with hyper pneumatization of the right ethmoid sinus and right left mastoid Aircell and elevation of the right petrous ridge, and falcine displacement to the right as far as +/- 7mm and blurring right hippocampus, suspected atrophy. Therapy, she got multiple anti-epileptic drugs.
Conclusion: Diagnosis of DDMS is made by a triad of hemiplegia, contralateral hemiatrophy, seizures, and classical radiological features. Imaging is important in diagnosing this rare entity and differentiating it from other causes of cerebral hemiatrophy. The long-term prognosis is good, provided the clinical entity is recognized early and managed appropriately.
Bladder stone in a 1-year infant with recurrent urinary tract infections: a rare case report
I Gede Reza Sanjaya, Agustin Junior Nanda De Niro, Anak Agung Putri Nadia ParamithaOnline First: Jul 10, 2023
- Abstract
Bladder stone in a 1-year infant with recurrent urinary tract infections: a rare case report
Background: Bladder stone is a rare disease accounting for 5% of all urinary calculi. It is more common in middle- and low-income countries due to nutritional obstacles, water sanitation, and warm climates. Primary bladder calculi are most common in children younger than 10 years old, with a peak incidence at 2 to 4 years. There have been no reports of bladder stones in children under 2 years of age. This case study aims to evaluate the bladder stone in a 1-year infant with recurrent urinary tract infections.
Case Presentation: An infant boy 1 year and 2 months presented with a 6-month history of complaints of pain on micturition presented with pulling the penis, cloudy urine, and recurrent fever in our clinic. During the 6 months before admission, he visited several pediatric clinics and was diagnosed with and treated for UTI. On ultrasonography, we found a bladder stone 1,9 x 1,3 cm in size. Then we performed open cystolithotomy under general anesthesia. One day after surgery, the patient was discharged from the hospital.
Conclusion: Children who live in endemic areas are more likely to develop bladder stones due to dietary issues. Preventing dehydration, treating urinary tract infections effectively, and securing metabolic abnormalities are the methods for reducing the prevalence of pediatric bladder stones. Pediatric bladder stones must be diagnosed and treated to avoid the stones' recurrence and improve quality of life.
Efusi pleura pada tuberkulosis ekstra paru dengan riwayat lupus eritematosus sistemik di Puskesmas Sukasada II: sebuah laporan kasus
Dewa Ayu Citra HendrawardaniOnline First: Jun 8, 2023
- Abstract
Efusi pleura pada tuberkulosis ekstra paru dengan riwayat lupus eritematosus sistemik di Puskesmas Sukasada II: sebuah laporan kasus
Background: Infection is a complication that contributes to morbidity and mortality in SLE patients. Tuberculosis (TB) is an infection that is of particular concern, especially for those living in endemic areas such as Indonesia. Pleural TB is the second most common form of extrapulmonary tuberculosis after lymphatic involvement and is the most common cause of pleural effusion. This case report describes a case of pleural effusion in extrapulmonary tuberculosis with a history of systemic lupus erythematosus for the purpose of determining appropriate management.
Case presentation: A 42-year-old woman complained of fever for 2 weeks, non-productive cough, lower right chest pain when coughing, and shortness of breath. The patient has a history of controlled SLE disease with medication since one year ago. On physical examination found decreased vocal fremitus right chest, dull percussion on the right chest, decreased vesicular breath sounds in the lower right lung. Complete blood count and blood chemistry showed normal results, chest X-ray showed right pleural effusion with pulmonary infiltrate on the ipsilateral pleural effusion, pleural fluid analysis showed an exudate, and adenosine deaminase levels were more than laboratory reference values. This patient was diagnosed with right pleural effusion et causa pleural TB. Management includes evacuation of pleural fluid, administering rivastar therapy at the hospital followed by 2RHZE/4RH anti-tuberculosis drugs at the Sukasada II Health Center. Significant improvement was evident by the reduced number of pleural effusions and pulmonary infiltrates on the chest X-rays of the patients in the second and final month of treatment.
Conclusion: Pleural effusion in extrapulmonary TB patients with a history of SLE can be diagnosed through history, physical examination and supporting examinations such as radiography, pleural fluid analysis and histology. Treatment and monitoring of TB in SLE patients is in line with national guidelines for TB patients without SLE.
Latar Belakang: Infeksi merupakan komplikasi yang berkontribusi terhadap morbiditas dan mortalitas pada pasien SLE. Tuberkulosis (TB) merupakan salah satu infeksi yang menjadi perhatian khusus terutama bagi mereka yang tinggal didaerah endemik seperti di Indonesia. TB pleura adalah bentuk paling umum kedua dari tuberkulosis ekstra paru setelah keterlibatan limfatik dan merupakan penyebab paling umum dari efusi pleura. Laporan kasus ini mendeskripsikan kasus efusi pleura pada tuberkulosis ekstra paru dengan riwayat lupus eritematosus sistemik agar tepat dalam menentukan tatalaksana yang tepat.
Presentasi kasus: Perempuan 42 tahun mengeluh demam selama 2 minggu, batuk non produktif, nyeri dada kanan bawah jika batuk, dan sesak. Pasien memiliki riwayat penyakit SLE terkontrol dengan pengobatan sejak satu tahun yang lalu. Pada pemeriksaan fisik ditemukan vokal fremitus dada kanan menurun, perkusi redup pada dada kanan, suara napas vesikuler menurun pada paru kanan bawah. Pemeriksaan darah lengkap dan kimia darah menunjukkan hasil normal, foto toraks menunjukkan efusi pleura kanan dengan gambaran infiltrat paru di ipsilateral efusi pleura, analisis cairan pleura menunjukkan suatu eksudat, dan kadar adenosine deaminase lebih dari nilai rujukan laboratorium. Pasien ini didiagnosis dengan efusi pleura dekstra et causa TB pleura. Tatalaksana meliputi evakuasi cairan pleura, pemberian terapi rivastar di rumah sakit dilanjutkan obat anti tuberkulosis 2RHZE/4RH di Puskesmas Sukasada II. Perbaikan yang signifikan terbukti dengan berkurangnya jumlah efusi pleura dan infiltrate paru pada foto toraks pasien bulan kedua dan akhir pengobatan.
Simpulan: Efusi pleura pada pasien TB ekstra paru dengan riwayat SLE dapat ditegakkan diagnosisnya melalui anamnesis, pemeriksaan fisik dan pemeriksaan penunjang seperti radiografi, pemeriksaan analisis cairan pleura dan histologi. Pengobatan dan monitoring TB pada pasien SLE sejalan dengan pedoman nasional pasien TB tanpa SLE.
Satu kasus sarkoma Kaposi pada seorang laki-laki biseksual dengan infeksi human immunodeficiency virus stadium IV
Ni Made Dwi Puspawati, I Gusti Ayu Agung Elis Indira, Putu Ayu Dewita GaneswariOnline First: Sep 6, 2023
- Abstract
Satu kasus sarkoma Kaposi pada seorang laki-laki biseksual dengan infeksi human immunodeficiency virus stadium IV
Background: A disorder that manifests on the skin and can be a marker of acquired immunodeficiency syndrome (AIDS) is Kaposi sarcoma (KS). Kaposi sarcoma is a vascular and lymphatic neoplasm caused by human herpesvirus-8 (HHV-8). AIDS-related Kaposi sarcoma is common in homosexuals, bisexuals, and intravenous drug users. This case report will discuss a case of KS in a patient with stage IV human immunodeficiency virus (HIV) infection.
Case description: A male, 25 years old, with a chief complaint of lumps on the face and body since 7 months ago. Initially, the lumps were few and small, but they have increased in number and size in the last 2 months. Some lumps are purplish red, but there are also skin-colored lumps. There is a history of fever with diarrhea since the previous 6 months and a drastic weight loss in the last 7 months. Dermatological status in the fascial region, anterior and posterior thorax, efflorescences were found multiple nodules, purplish red to skin color, varying in size. Histopathologic examination showed a picture consistent with KS. There was no specific therapy for this patient from the Department of Dermatology and Venereology. Gradually, the patient continued treatment for HIV infection and tracing of other opportunistic infections.
Conclusion: Kaposi sarcoma is a vascular and lymphatic neoplasm sign of AIDS. Treatment in KS focuses more on antiretrovirals for HIV infection.
Latar belakang: Salah satu kelainan yang bermanifestasi pada kulit dan dapat menjadi penanda acquired immunodeficiency syndrome (AIDS) adalah sarkoma Kaposi (SK). Sarkoma Kaposi merupakan neoplasma vaskular dan limfatik yang disebabkan human herpesvirus-8 (HHV-8). Sarkoma Kaposi terkait AIDS paling sering ditemukan pada kelompok homoseksual, biseksual, dan pengguna obat-obatan intravena. Laporan kasus ini akan membahas kasus SK pada pasien dengan infeksi human immunodeficiency virus (HIV) stadium IV.
Deskripsi kasus: Seorang laki-laki, 25 tahun, dengan keluhan utama benjolan di wajah dan badan sejak 7 bulan yang lalu. Awalnya benjolan berjumlah sedikit dan berukuran kecil, namun makin lama makin banyak dan bertambah besar dalam 2 bulan terakhir. Beberapa benjolan berwarna merah keunguan, namun terdapat juga yang sewarna kulit. Terdapat riwayat demam hilang timbul disertai diare sejak 6 bulan terakhir dan penurunan berat badan drastis dalam 7 bulan terakhir. Status dermatologis pada regio fasialis, toraks anterior et posterior didapatkan efloresensi nodul multipel, berwarna merah keunguan hingga sewarna kulit, ukuran bervariasi. Pada pemeriksaan histopatologi didapatkan gambaran sesuai dengan sarkoma Kaposi. Tidak ada terapi spesifik untuk pasien ini dari Departemen Dermatologi dam Venereologi. Secara bertahap, pasien melanjutkan terapi untuk infeksi HIV dan penelusuran infeksi oportunistik lain.
Simpulan: Sarkoma kaposi merupakan neoplasma vaskular dan limfatik yang menjadi penanda kondisi AIDS. Terapi pada SK lebih menitikberatkan pada terapi penyakit dasar yaitu pemberian antiretroviral untuk infeksi HIV.
Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female: a case report
Michelin Mathonie, Grace Claudia, Angel Benny WisanOnline First: Jul 12, 2023
- Abstract
Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female: a case report
Background: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) is a dermatologic emergency characterized by extensive epidermal detachments. The most frequent etiology is drug reaction within an interval of the last 8 weeks. SJS/TEN may occur in any age, race, and gender; however, there is an increased risk in patients over 65. SJS and TEN are differentiated based on the extent of epidermal detachments, which is <10% in SJS, 10-30% in SJS-TEN overlap, and >30% in TEN. This case study aims to evaluate the Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female.
Case Presentation: A 34-year-old woman presented with a pruritic and burning rash on almost all body parts. The suspected causative drug was lamotrigine, which she consumed within the last 2 weeks. Mucosal involvement was also found on the lips and genital mucosal. The affected body surface area was approximately 20%, with a positive Nikolsky sign. Laboratory studies showed elevated liver function tests. Based on the history, physical examination, and biopsy, the patient was diagnosed with SJS/TEN overlap. The suspected causative drug was immediately stopped, and supportive and systemic corticosteroid treatments were provided. The SCORTEN was 2, with a mortality rate of 12.1%. After a few days, the patient's condition had improved, the liver function test was normal, and there was no significant complication.
Conclusion: SJS-TEN is a part of epidermal necrolysis, characterized by an extensive epidermal detachment. The management of SJS/TEN includes early detection, immediately stopping the suspected drugs, administering systemic corticosteroids, and other supportive treatments.
Peranan Magnetic Resonance Imaging (MRI) payudara pada kasus benign late peri- implant effusion pasca breast augmentation: laporan kasus
Perina Enri Lisniawan, Putu Utami Dewi, Ni Nyoman MargianiOnline First: Aug 6, 2023
- Abstract
Peranan Magnetic Resonance Imaging (MRI) payudara pada kasus benign late peri- implant effusion pasca breast augmentation: laporan kasus
Background: Breast augmentation is a surgical procedure performed to increase breast size by implanting implants or through fat transfer. MRI is the gold standard for evaluating the integrity of breast implants, with a sensitivity of 80–90% and a specificity of 80–90% for detecting implant rupture. In this case report, we will discuss the role of breast MRI in cases of benign late peri-implant effusion after breast augmentation.
Case Presentation: A 49-year-old female patient has complained of a lump in her left breast since 2017. The patient had surgery to insert right and left breast implants in 2004. The patient underwent ultrasound and MRI examinations at Prof. I.G.N.G Ngoerah Hospital and obtained results in the form of an anechoic area, with internal echo and a solid component in it in the submamary of the left breast, susp. infectious process, and multiple non-suspicious left axillary lymphadenopathy. Meanwhile, no nodules, masses, or cysts were found in the right breast, and no enlarged lymph nodes in the right axilla were found. The patient was diagnosed with benign late peri-implant effusion after breast augmentation and underwent implant removal and capsulectomy after seeing the results of the MRI examination.
Conclusion: An MRI examination can help identify an implant effusion after a breast augmentation procedure.
Latar belakang: Breast augmentation merupakan prosedur pembedahan yang dikerjakan untuk meningkatkan ukuran payudara melalui penanaman implan maupun melalui transfer lemak. MRI merupakan baku emas standar untuk mengevaluasi integritas dari implan payudara, dengan sensitivitas mencapai 80-90%, dan spesifisitas 80-90% untuk mendeteksi adanya ruptur implan. Pada laporan kasus ini akan dibahas mengenai peranan MRI payudara pada kasus benign late peri- implant effusion pasca breast augmentation.
Presentasi Kasus: Pasien perempuan 49 tahun datang dengan keluhan benjolan pada payudara kiri sejak tahun 2017. Pasien pernah melakukan operasi pemasangan implant payudara kanan kiri pada tahun 2004. Pada pasien dilakukan pemeriksaan ultrasonografi dan MRI di RSUP Prof. I.G.N.G Ngoerah didapatkan hasil berupa area anechoic, dengan internal echo dan komponen solid didalamnya pada submamary payudara kiri, susp. proses infeksi dan multiple non suspicious lymphadenopathy axilla kiri. Sedangkan tidak ditemukan adanya nodul, massa, maupun kista pada payudara kanan serta tidak ditemukan adanya pembesaran kelenjar getah bening pada axilla kanan. Pasien didiagnosis dengan benign late peri- implant effusion pasca breast augmentation dan dilakukan tindakan implant removal dan kapsulektomi setelah melihat hasil dari pemeriksaan MRI.
Simpulan: Pemeriksaan MRI dapat membantu mengidentifikasi suati efusi perimplan pasca tindakan breast augmentation.
Case report: corticosteroid as an alternative therapy for Kawasaki disease
Elok Izawati, Sandhi Parwata, Pande Tiara MaharaniOnline First: May 22, 2023
- Abstract
Case report: corticosteroid as an alternative therapy for Kawasaki disease
Background: Kawasaki disease is an acute febrile illness with systemic vasculitis and predominantly causes acquired heart disease. The etiology is still unknown, and there is no specific diagnostic test. The diagnosis was made using clinical criteria, laboratory and echocardiographic findings. It is characterized by fever, bilateral non-exudative conjunctivitis, erythema of lips and oral mucosa, rash, cervical lymphadenopathy, edema and erythema of the hand and foot. The initial treatment for both complete and incomplete Kawasaki disease is a single high dose of intravenous immunoglobulin (IVIG) and aspirin. The place of corticosteroids in the initial therapy is still controversial.
Case Description: A 3-year-old boy presented with a 7-day history of high fever and not relieved by antipyretic, which was followed by a maculopapular rash on his trunk and extremities, vomiting, reduced appetite, red on her lips and eyes who aspirin, IVIG and corticosteroid treated as initial therapy. He showed clinical improvement and did not have cardiovascular complications.
Conclusion: We report a case of Kawasaki disease in a 3-year-old boy. This case highlighted that adding corticosteroids to IVIG and aspirin as initial therapy might improve outcomes in Kawasaki disease and could be selected as a treatment modality to treat Kawasaki disease.
Preventing mother-to-child transmission of human immunodeficiency virus (HIV), syphilis and hepatitis B: a secondary hospital approach in North Bali, Indonesia
Aditya Prabawa, Putu Sudarsana, Komang Hendra SetiawanOnline First: Jul 13, 2023
- Abstract
Preventing mother-to-child transmission of human immunodeficiency virus (HIV), syphilis and hepatitis B: a secondary hospital approach in North Bali, Indonesia
Background Mother-to-child transmission (MTCT) of human immune virus (HIV), syphilis, and hepatitis B can lead to significant health burdens and even mortality in children. This study aimed to evaluate the effectiveness of triple elimination of MTCT in a secondary hospital in Buleleng, North Bali
Method: This study conducted a retrospective review of 345 pregnancy case in Buleleng General Hospital from January to December 2022
Result: In this study, 98.5% of the 345 pregnant women seeking antenatal care were tested for HIV, syphilis, and hepatitis B. Among the tested patients, 100%, 99.7%, and 98.8% were tested for HIV and hepatitis B, HIV and syphilis, and syphilis and hepatitis B, respectively. The prevalence of HIV, syphilis, and hepatitis B was 1.4%, 2.1%, and 4.3 %, respectively. Antiretroviral therapy was administered to 80 % of HIV-positive patients, and 71.4 % of syphilis patients received benzathine penicillin G. Only 6.6% of hepatitis B patients received hepatitis B virus deoxyribonucleic acid (HBV DNA) & hepatitis B envelope antigen (HBeAg) examination followed by Lamivudine administration.
Conclusion: Early detection of HIV, syphilis, and hepatitis B in pregnant women is important for preventing MTCT. Coverage of triple elimination screening is in accordance with WHO targets, but further management of hepatitis B needs to be improved
Vertebrae compression fracture due to osteonecrosis as initial sign of childhood acute lymphoblastic leukemia: A case report
Michelle Husin, Ketut Ariawati, AANKP Widnyana, I Made Arimbawa, Kadek Ayu Yani Lastariana, I Made Darma YudaOnline First: Sep 6, 2023
- Abstract
Vertebrae compression fracture due to osteonecrosis as initial sign of childhood acute lymphoblastic leukemia: A case report
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common cancer in children. Manifestations of ALL vary from pallor, organomegaly, fever, and pancytopenia. Bone pain caused by vertebrae fracture is an uncommon manifestation of ALL, approximately only 16% of all bone pain occurrences. Fractures in ALL could occur at diagnosis and following treatment initiation. This case report described vertebrae compression fracture due to osteonecrosis as the initial sign of childhood acute lymphoblastic leukemia.
CASE: An 8-year-10-month girl was referred to an orthopedic because of worsened low back pain since 1 month before, with no history of trauma. The pain was throbbing and radiated to the lower extremities. The patient was non-ambulant due to the pain. Physical examination revealed the visual analog scale was 8, tenderness in the spine, decreased strength, and range of movement in the lower extremities. There was no organomegaly in this patient. Serial laboratory examination revealed mild pancytopenia (leukopenia, mild normochromic normocytic anemia, mild thrombocytopenia) with dominancy of lymphocytes (68.1-81.9%). No blast was found in the peripheral blood smear. Magnetic Resonance Imaging of the spine revealed compression of the vertebral corpus with a pincer fracture and bone infarction. Bone marrow aspiration showed ALL-L2 with lymphoblast 50%. The patient started chemotherapy with ALL standard risk protocols and got zoledronic acid during the treatment. The patient's condition gradually improved, and able to undergo chemotherapy protocol. No side effects of zoledronic acid occurred.
CONCLUSION: Vertebrae compression fracture without trauma and pancytopenia can be an early symptom of ALL. Zoledronic acid can be given concurrently with chemotherapy for bone mineralization.
Anestesi general pada pasien gravida di ruang operasi gawat darurat: sebuah laporan kasus
Achmad Munif, Pontisomaya ParamiOnline First: Aug 28, 2023
- Abstract
Anestesi general pada pasien gravida di ruang operasi gawat darurat: sebuah laporan kasus
Background: The choice of anesthesia technique in pregnant women is determined by several factors, such as maternal safety considerations (airway evaluation and aspiration risk), technical issues, and anesthesiologist experience. Superimposed preeclampsia is chronic hypertension in pregnant women under gestational age >20 weeks. This disease can become an emergency if neurological symptoms arise and require immediate termination of pregnancy with the option of a section caesarian. This case report discusses general anesthesia in a pregnant patient with a history of hypertension.
Case: Female, 42 years old, 38-39 weeks of pregnancy with a history of hypertension and acute decompensated heart failure (ADHF) profile B, in an intubated state, underwent green code caesarean section under general anesthesia using propofol 200 mg, fentanyl 100 mcg and rocuronium 50 mg. The operation lasted for 50 minutes with stable hemodynamics, no desaturation, and a total bleeding of 300 ml. A Born male baby immediately cried with appearance, pulse, grimace, activity, and respiration (APGAR) score 8-9 and a birth weight of 2,410 grams. Post-cesarean section and anesthesia, the patient were in good condition without persistent complications.
Conclusion: The general anesthesia technique of caesarean section is preferred in patients with superimposed preeclampsia with neurological complications because it has rapid induction, optimal airway control, and lower risk of hypotension and cardiovascular instability.
Latar belakang: Pilihan teknik anestesi pada ibu hamil ditentukan beberapa faktor seperti pertimbangan keselamatan ibu (evaluasi jalan napas dan risiko aspirasi), masalah teknik, dan pengalaman ahli anestesi. Superiomposed preeclampsia adalah hipertensi kronik yang terjadi pada ibu hamil dengan usia kehamilan >20 minggu. Penyakit ini dapat menjadi suatu kondisi kegawatan apabila timbul gejala neurologis dan membutuhkan tindakan terminasi kehamilan dengan sesegera mungkin dengan pilihan operasi cesar. Laporan kasus ini membahas anestesi general pada pasien gravida dengan riwayat hipertensi.
Kasus: Perempuan, 42 tahun, gravida 38-39 minggu dengan riwayat penyakit hipertensi dan acute decompensated heart failure (ADHF) profil B, dalam keadaan sudah terintubasi telah menjalani bedah cesar green code dengan anestesi general menggunakan propofol 200 mg, fentanil 100 mcg dan rokuronium 50 mg. Operasi berlangsung selama 50 menit dengan hemodinamik stabil, tidak terjadi desaturasi dengan total perdarahan 300 ml. Lahir bayi laki-laki langsung menangis dengan skor appearance, pulse, grimace, activity, and respiration (APGAR) 8-9 dan berat badan lahir 2.410 gram. Pasca operasi pasien masih dalam pengaruh obat dan dirawat di ruang terapi intensif. Pasca operasi cesar dan anestesi, pasien didapatkan dalam kondisi baik dan tidak didapatkan komplikasi menetap.
Simpulan: Teknik anestesi general pada bedah cesar lebih dipilih pada pasien superimposed preeclampsia dengan komplikasi neurologis karena memiliki induksi yang cepat, pengendalian jalan nafas yang optimal, dan risiko hipotensi dan instabilitas kardiovaskular lebih rendah.
Bradycardia symptomatic causes headache associated with frontal diffuse astrocytoma: a case report
Cyndiana Widia Dewi Sinardja, Kumara Tini, Dewa Putu Wisnu Wardhana, Putu Utami Dewi, Ni Luh Putu Rustiari DewiOnline First: Aug 27, 2023
- Abstract
Bradycardia symptomatic causes headache associated with frontal diffuse astrocytoma: a case report
Background: Headache is the most common symptom in patients with brain tumors, whereas a developing brain tumor generally increases intracranial pressure and brain edema. Brain tumors have symptoms including nausea, vomiting, seizures, neurological deficits, and mental status or consciousness changes. Heart rhythm disturbances can occur, including bradycardia (heart rate below 60x/minute), a common symptom in brain tumor patients.
Case Presentation: In this case report, a young adult male patient was found with headache symptoms, a previous history of syncope, and sinus bradycardia on the EKG examination, but on physical examination, there were no symptoms of neurological deficits. Head CT scan with contrast found a tumor in the left frontal lobe associated with high intracranial pressure and brain edema that explained the symptoms.
Conclusion: The relationship between headache and bradycardia, accompanied by a history of syncope, is close and can be regarded as an early sign of a brain tumor. In this case, a brain tumor found based on pathological examination is diffuse astrocytoma.
Bifurcated rib as major diagnostic criteria of Gorlin syndrome in paediatric patient: a rare case report
Kenny Gozal, Komang Septian SandiwidayatOnline First: Jun 7, 2023
- Abstract
Bifurcated rib as major diagnostic criteria of Gorlin syndrome in paediatric patient: a rare case report
Background: Bifurcated rib or Bifid rib is considered to be an anatomical overgrowth anomaly of the chest wall, forming a forked sternal end. Diagnosis of this condition is generally an incidental finding on imaging or post-mortem examination. Most of the cases were asymptomatic and established as part of Gorlin syndrome. Here we describe a rare case of chest wall deformity in a paediatric patient, and our approach for this case with limited cost and resources.
Case Presentation: A 5-year-old boy, presented at orthopedic outpatient clinic with complaint of a painless lump in his upper left chest. No significant history of infection, malignancy or any congenital syndromes. Chest imaging revealed a bifid left 4th rib at the sternal end.
Conclusion: There is currently no data on the best approach to managing bifid ribs. In addition, genetic testing for susceptible genes should be strongly considered. In this situation with limited cost and resources, we suggest close monitoring with regular follow-ups for the patient as the best approach, including detection of any other diagnostic criteria of Gorlin syndrome, to ensure better prognosis and quality of life for this patient.
The pentalogy of cantrell in limited resources: A case report
Kadek Maharini, Eka Gunawijaya, Ni Putu Veny Kartika Yantie, I Made Kardana, Wayan SudarmaOnline First: Jun 24, 2023
- Abstract
The pentalogy of cantrell in limited resources: A case report
Background: Pentalogy of Cantrell (PC) is a rare anomaly, and the incidence varies from 5.5 to 7.9 per million live births. The components are defined as a defect of the lower sternum, a midline supraumbilical thoracoabdominal wall defect, a deficiency of the diaphragmatic pericardium, a deficiency of the anterior diaphragm, and congenital cardiac anomalies. The pathognomonic characteristic of this syndrome is the coexistence of omphalocele and ectopia cordis. Diagnosis is possible by antenatal or physical examination, and other tests should be performed to detect other anomalies, including the heart's anomaly. Surgical treatment is complex, and various operative techniques often require a staged approach. The mortality rate is quite high, with a survival rate of less than 5%.
Case presentation: Two-day-old male infant was complained that his heart had been outside his chest wall since birth without covering by skin or sternum. He was born on aterm through section cesarean with a vigorous baby condition. Section cesarean was chosen because his mother has Human Immunodeficiency Virus (HIV)—no family history with similar symptoms. While pregnant, the mother regularly checks with the midwife and fetal ultrasonography only once during the third trimester but did not find the defect, no history of drug abuse, teratogen exposure, smoking, alcohol, or consanguinity. The midline defect extended from the lower part of the sternum completely. Echocardiography found defects such as classic Tetralogy of Fallot, mild atrial regurgitation, mild mitral regurgitation, mild tricuspid regurgitation, and suspect mass at left atrium (LA). The patients underwent surgery by covering the heart with a silo bag. Three days after the procedure, the patient's condition worsened and death because of the sepsis.
Conclusion: Prenatal diagnosis is important in guiding the surgical team to estimate the prognosis and reduce a postnatal management strategy. Early management can provide the basic care necessary to keep the patients until definitive management can be provided.
Laporan kasus: bayi usia 4 bulan dengan kecurigaan hemofagositik limfohistiositosis (HLH) di RSUP Prof. Dr. I.G.N.G. Ngoerah
Anak Agung Istri Rani Gacchanti, Ida Ayu Putri WirawatiOnline First: Aug 29, 2023
- Abstract
Laporan kasus: bayi usia 4 bulan dengan kecurigaan hemofagositik limfohistiositosis (HLH) di RSUP Prof. Dr. I.G.N.G. Ngoerah
-Background: Hemophagocytic lymphohistiocytosis (HLH) is a disease characterized by immune dysregulation. The incidence of this disease is approximately 1.2 cases per one million people each year. HLH is a life-threatening hyperinflammatory syndrome and can be divided into primary and secondary groups. Familial HLH (primary HLH) can be diagnosed under 1 year of age in 70-80% of cases. Patients with mutations in this gene resulting in complete loss of protein function, develop primary HLH in childhood. This study aims to report a case of an infant with suspicion of HLH at Prof. Dr. I.G.N.G. Ngoerah General Hospital.
Case report: A 4-month-old male infant patient came to the health facility with a chief complaint of fever. The fever has been fluctuating since August 1, 2020 and in the last 24 hours the patient has had a fever that has fluctuated 3 times. Other complaints such as cough, runny nose, shortness of breath, nosebleeds, bleeding gums, and red spots on the patient's body were denied by the patient's parents. On physical examination, schuffner III splenomegaly was found. Laboratory examination of hematology and femostasis faeces showed that there was a picture of hypocellular bone marrow with suspicion of metabolic disease, X-ray examination results showed suspected splenomegaly. The patient was diagnosed with observation of bicytopenia with splenomegaly et causa suspected HLH with differential diagnosis of Gaucher disease. The patient was finally given supportive therapy in the form of fluids, zinc peroral, and paracetamol if fever appeared.
Conclusion: This study reports a case of a 4-month-old male patient with suspicion of HLH. Examination showed that this patient met 5 of the 8 criteria based on the HLH-2004 guidelines.
Pendahuluan: Hemofagositik limfohistiositosis (HLH) adalah penyakit yang ditandai dengan disregulasi imun. Insiden dari penyakit ini sekitar 1,2 kasus per satu juta orang setiap tahunnya. HLH merupakan sindrom hiperinflamasi yang dapat membahayakan nyawa dan dapat dibagi menjadi kelompok primer dan sekunder. HLH familial (HLH primer) dapat didiagnosa pada usia dibawah 1 tahun pada 70-80% kasus. Pasien dengan mutasi pada gen ini yang mengakibatkan hilangnya fungsi protein secara total, berkembang menjadi HLH primer di masa anak-anak. Studi ini bertujuan untuk melaporkan sebuah kasus bayi dengan kecurigaan HLH di RSUP Prof. Dr. I.G.N.G. Ngoerah.
Laporan Kasus: Pasien bayi laki-laki berusia 4 bulan datang ke fasilitas kesehatan dengan keluhan utama demam. Demam naik turun sejak tanggal 1 Agustus 2020 dan dalam 24 jam terakhir pasien mengalami demam yang naik turun sebanyak 3 kali. Keluhan lain seperti batuk, pilek, sesak, mimisan, gusi berdarah, dan bintik merah pada tubuh pasien disangkal oleh orang tua pasien. Pada pemeriksaan fisik ditemukan splenomegali schuffner III. Pemeriksaan laboratorium hematologi dan faal femostasis menunjukkan bahwa terdapat gambaran sumsum tulang hiposeluler dengan kecurigaan penyakit metabolik, hasil pemeriksaan rontgen menunjukkan adanya suspek splenomegali. Pasien terdiagnosis dengan observasi bisitopenia dengan splenomegali et causa suspek HLH dengan diagnosis banding penyakit Gaucher. Pasien akhirnya diberikan terapi suportif berupa cairan, zinc peroral, dan parasetamol jika demam muncul.
Simpulan: Studi ini melaporkan satu kasus pasien laki-laki berusia 4 bulan dengan kecurigaan HLH. Pemeriksaan yang telah dilakukan menunjukkan bahwa pasien ini memenuhi 5 dari 8 kriteria berdasarkan pedoman HLH-2004.
Management of blowout fracture with iliac bone graft
Cokorda Agung Dalem Pemayun, Putu Yuliawati, Ni Made Laksmi Utari, AAA Sukartini Djelantik, Agus Roy Rusly Hariantana HamidOnline First: May 25, 2023
- Abstract
Management of blowout fracture with iliac bone graft
Introduction: Blowout fracture is a traumatic deformity of the orbital wall and the repair is indicated when enophthalmos is troublesome to the patient, or when diplopia interferes patient’s activities. Iliac bone has been reported in the immediate and secondary repair of orbital wall deformities following blowout fracture. This case is to report blowout fracture management using iliac bone graft.
Case Illustration: A 35 years old man complains pain on his left eye when moving his eye and diplopia in upgazed since 4 months after fell down from stairs. Eye position is orthophoria, visual acuity 6/6 on both eye, anterior and posterior segments are normal, restricted movement to superior on left eye, Hertel exophthalmometry examination on right eye 15 mm and left eye 10 mm (base 90). On CT-scan examination, it was found that an orbital floor fracture was characterized by herniation of the orbital tissue. The patient was diagnosed with left eye enophthalmos, suspect inferior rectus muscle and adnexal entrapment and neglected blow out fracture. LE Repair Orbital Floor Fracture, Release Muscle Rectus Inferior, Exploration (join op with Plastic Reconstructive and Aesthetic Surgery Department) is done to this patient.
Conclusion: Iliac bone graft can be used as an alternative in orbital floor reconstruction, since it easy to harvest, low risk to rejected or extruded and can be used in large defect. Optimal outcome of blowout fracture repair can be achieved if the surgical management is done before two weeks after the incidence.
Depresi yang diinduksi insulin dan nyeri kronis pada pasien neuropati diabetik dengan paraparesis tipe lower motor neuron: sebuah laporan kasus
Petrus Agustinus Seda Sega, Ida Ayu Sri Indrayani, Anak Ayu Sri WahyuniOnline First: Jun 29, 2023
- Abstract
Depresi yang diinduksi insulin dan nyeri kronis pada pasien neuropati diabetik dengan paraparesis tipe lower motor neuron: sebuah laporan kasus
Background: Indonesia ranks 4th in terms of the number of people with diabetes mellitus in the world, and chronic complications in DM include disorders of the nerves (neuropathy). Paraparesis causes disturbances in mobility and disturbances to the person, namely the perception of his disability which can lead to reactions of disappointment, low self-esteem and ends in despair and depression. This case report aims to describe insulin-induced depression and chronic pain in diabetic neuropathy patient with lower motor neuron paraparesis.
Case Presentation: A 36-year-old Balinese woman could not walk, she had been complaining of sadness for a long time, since she was told she had diabetes, thus limiting her daily activities. The patient has a history of diabetic disease since childhood and was definitely diagnosed at the age of 15 around 18 years ago, and started a history of back pain since December 2021 and worsened with cramps and weakness in both legs since January 2022. Vital signs were good, on waist is attached plate metal as high as vertebrae L3–L4, extremities: edema +/- warm +/+, cruris dextra: edema (+), clinical neurology: lower motor neuron type paraparesis, motor weakness, atrophy of musculus gastrocnemius dextra et sinistra and musculus tibialis dextra et sinistra paresthesia of the glove and stocking type. Psychiatric status: reasonable appearance of consciousness: clear, affective. Mood affect: sad/depressive/ appropriate. Thought process: logical realist/coherent/preoccupation with back pain and weak legs. Mixed-type insomnia exists; history of raptus and hypobulia is present. Impulse control: poor.
Conclusion: Patients with diabetes on insulin treatment were associated with the prevalence of depressive syndromes.
Latar belakang: Indonesia menempati urutan ke-4 terbesar dalam jumlah penderita diabetes melitus di dunia, dan komplikasi kronis pada diabetes antara lain kelainan pada saraf (neuropati). Paraparese menyebabkan gangguan dalam mobilitas serta gangguan terhadap pribadinya yaitu persepsi kecacatannya yang dapat menimbulkan reaksi kecewa, rendah diri dan berakhir pada keadaan putus asa dan depresi. Laporan kasus ini bertujuan mendeskripsikan depresi yang diinduksi insulin dan nyeri kronis pada pasien neuropati diabetik dengan paraparesis tipe lower motor neuron.
Presentasi Kasus: Perempuan 36 tahun suku Bali, tidak bisa berjalan, keluhan sedih sudah lama, semenjak dikatakan mempunyai penyakit diabetes, sehingga membatasi aktivitasnya sehari hari. Pasien memiliki riwayat penyakit diabetes dari kecil dan terdiagnosis pasti pada umur 15 tahun sekitar 18 tahun yang lalu, dan mulai riwayat nyeri punggung sejak bulan desember 2021 dan memberat dengan kram dan lemah pada kedua kaki sejak Januari 2022. Tanda vital baik, pada pinggang terpasang: plat logam setinggi vertebra L3–L4, ekstremitas: edema +/- hangat +/+, kruris dekstra: edema (+). Klinis neurologis: paraparesis tipe lower motor neuron, kelemahan motorik, atrofi musculus gastrocnemius dekstra et sinistra dan musculus tibialis dekstra et sinistra, parestesia tipe gloves and stocking. Status psikiatri: penampilan wajar kesadaran: jernih. Mood afek: sedih/depresif/appropriate. Proses pikir: logis realis/koheren/preokupasi nyeri punggung dan lemah kaki. Insomnia tipe campuran ada; raptus ada riwayat dan hipobulia ada. Pengendalian impuls: kurang baik.
Simpulan: Diabetes pada pengobatan insulin dikaitkan dengan prevalensi sindrom depresi, menunjukkan hubungan yang permanen dan signifikan.
Psoriasis vulgaris dengan anti-HCV reaktif yang diterapi injeksi secukinumab
Luh Nyoman Arya Wisma Ariani, Prima Sanjiwani Saraswati Sudarsa, Ni Putu Ayu Riska Yunita Sari, Nyoman Indra Karunia Murti, Desak Nyoman Trisepti UtamiOnline First: Jul 4, 2023
- Abstract
Psoriasis vulgaris dengan anti-HCV reaktif yang diterapi injeksi secukinumab
Background: Psoriasis vulgaris is an inflammatory skin disease characterized by epidermal hyperplasia, and Hepatitis C Virus (HCV) is reported to be one of the infections that can trigger psoriasis. Treatment safety is a particular concern, especially in patients with comorbidities. This case report describes an asymptomatic hepatitis C condition that can trigger psoriasis and is an important concern in administering biological agent therapy, especially secukinumab.
Case: A 42-year-old man, with the main complaint of reddish spots accompanied by scales on the body, arms and legs that have been worsening since 1 month ago. The patient was diagnosed with psoriasis vulgaris 6 years ago from history and physical examination with methotrexate treatment for 3 years. During therapy, the patient complained of yellowing of the body and tired easily found an increase in liver function 3 times the normal value during monitoring and found reactive anti-HCV and an increase in HCV RNA titer (diagnosed with chronic hepatitis C infection). The therapy was given as direct-acting antiviral (DAA) for 3 months and only topical steroids for skin lesions. After DAA therapy, the patient started subcutaneous injections of secukinumab 150 mg for 6 cycles when the PASI score was 11 and found clinical improvement and markers of hepatitis C infection.
Conclusion: There are not much data regarding the efficacy of using secukinumab in psoriasis with reactive anti-HCV, which hepatitis C is suspected as the trigger of psoriasis. Evaluation after DAA therapy and injection of 6 cycles of secukinumab found improvement of the lesion and undetectable HCV RNA titers.
Latar belakang: Psoriasis vulgaris adalah penyakit inflamasi kulit yang ditandai dengan hiperplasia epidermal dan hepatitis C virus (HCV) dilaporkan menjadi salah satu infeksi yang dapat mencetuskan psoriasis. Keamanan terapi menjadi perhatian khusus terutama pada kondisi pasien dengan komorbiditas. Laporan kasus ini menjelaskan kondisi hepatitis C asimptomatis dapat mencetuskan psoriasis dan menjadi perhatian penting pada pemberian terapi agen biologis, khususnya secukinumab.
Kasus: Seorang laki-laki berumur 42 tahun, dengan keluhan utama berupa bercak kemerahan disertai sisik di badan, lengan dan tungkai yang memberat sejak 1 bulan yang lalu. Pasien didiagnosa psoriasis vulgaris sejak 6 tahun lalu dari anamnesis dan pemeriksaan fisik dengan pengobatan metotrexat selama 3 tahun. Selama terapi pasien mengeluhkan tubuh menguning dan mudah lelah serta ditemukan peningkatan fungsi hati 3 kali nilai normal saat monitoring dan ditemukan anti-HCV reaktif, serta peningkatan titer RNA HCV (didiagnosis dengan infeksi hepatitis c kronis). Terapi yang diberikan berupa direct acting antiviral (DAA) selama 3 bulan dan hanya topikal steroid untuk lesi kulit. Pasca terapi DAA pasien memulai injeksi secukinumab 150 mg subkutan sebanyak 6 siklus saat skor PASI 11 dan ditemukan perbaikan klinis serta marker infeksi hepatitis C.
Simpulan: Belum terdapat banyak data mengenai efikasi penggunaan secukinumab pada psoriasis dengan anti-HCV reaktif, dengan adanya kecurigaan hepatitis C sebagai pencetus psoriasis. Evaluasi pasca terapi DAA dan injeksi 6 siklus secukinumab ditemukan perbaikan lesi dan titer HCV RNA tidak terdeteksi.
Septic arthritis of the temporomandibular joint: a systematic review
Luh Putu Mettary Yasoda Gera, Anak Agung Istri Yulan Permatasari, Anak Agung Gde Ngurah AsmarajayaOnline First: Aug 28, 2023
- Abstract
Septic arthritis of the temporomandibular joint: a systematic review
Introduction: This study aimed to describe the history, clinical presentation, laboratory examination, treatment, and long-term functional characteristics of patients with septic arthritis of the temporomandibular joint (SATMJ).
Methods: All articles in the English literature on SATMJ were queried using PubMed, Science Direct, and Google Scholar (2013 to 8 March 2023), and the keywords "temporomandibular OR TMJ AND septic arthritis". Articles are included if related to the SATMJ in patients of all ages, using case reports, case series, and cohort studies. The Newcastle-Ottawa Scale was applied to all included investigations. Article selection followed PRISMA’s guidelines for measuring the quality of systematic reviews.
Results: A preliminary literature search yielded 220 results, of which 25 matched the inclusion requirements, and one more came via reference checking. There were 25 cases with a mean age of 26.7 years (0.1 to 85). Symptoms mainly consisted of TMJ/preauricular pain (n=17, 42.5%), trismus (n=20, 50%), and facial/preauricular swelling (n=24, 60%). Most patients had no systemic symptoms (n=16, 40%). The average mouth opening measured 16.3 mm (5 to 36). The diagnosis was made using the following imaging techniques: X-ray (n=6, 15%), CT scan (n=33, 82.5%), MRI (n=16, 40%), and ultrasound (n=1, 2.5%). Staphylococcus aureus (n = 10, 25%) was the most frequently isolated. Approximately 40 patients (100%) received antibiotics, 26 (65%) patients underwent surgery (e.g., joint aspiration, arthroscopy, etc.), of which two patients (5%) required further surgical intervention. In general, long-term results were positive. In 10 of the 40 patients (25%) who had documented follow-up, sequelae occurred.
Conclusion: In the event of trismus, jaw pain, or preauricular edema, SATMJ should be considered. Quick examination and broad-spectrum antibiotic treatment are part of management. Although surgery is not always necessary, it can be life-saving in serious circumstances.
The impact between peritoneal closure and non-closure on the risk of adhesion in caesarean section: a systematic review
Thomas Yohan Junardi, Taura AvensiaOnline First: Aug 28, 2023
- Abstract
The impact between peritoneal closure and non-closure on the risk of adhesion in caesarean section: a systematic review
Background: Caesarean section is one of the most frequently performed major surgical procedures worldwide. Peritoneal sutures in the cesarean section are performed via absorbable or delayed sutures. There is controversy over the choice of technique (continuous or interrupted) to close this layer, even among surgeons who believe in closing this layer. Overall, there are still differing opinions regarding the closure of this layer. This study examines how the study of the impact of peritoneal closure with no closure at the cesarean section on the risk of adhesions.
Methods: Systematic Literature Review Research is the method selected by researchers in this study. Researchers will describe facts, data and information obtained from literature studies such as books and journals to research results related to the research topic. The quality of the articles was reviewed based on PRISMA and PICO guidelines so that as many as 7 articles were synthesized in the final review report from the literature.
Results: It is known that the incidence of births worldwide by Caesarean section (CS) is increasing. Many births after CS have previously been performed by repeat surgery, either with elective CS or after an unsuccessful delivery attempt. The formation of these adhesions is associated with increased maternal morbidity in patients with recurrent CS. In studies, non-closure of the peritoneum appears to save time and costs and therefore lacks the adhesions that cause infertility. However, not closing the parietal peritoneum will cause adhesions without causing infertility. These adhesions can cause long operating times, recovery, and increased postoperative pain in the second cesarean section.
Conclusion: Caesarean section is a very common surgical procedure worldwide. Suturing the peritoneal lining in the cesarean section can provide benefits or not. Therefore it is necessary to evaluate whether this step should be omitted.
Effect Sacubitril/Valsartan in patients with Acute Myocardial Infarction (AMI): a systematic review and meta-analysis
Fernanda Savitri Mega Pratistha, I Wayan Surya ArdianaOnline First: Jul 12, 2023
- Abstract
Effect Sacubitril/Valsartan in patients with Acute Myocardial Infarction (AMI): a systematic review and meta-analysis
Background: Acute Myocardial Infarction (AMI) is a type of coronary heart disease with high morbidity and mortality. The renin-angiotensin-aldosterone system (RAAS) is an important endocrine system in controlling blood pressure and cardiovascular homeostasis and is responsible for AMI. In patients with AMI or a heart attack, sacubitril/valsartan has been shown to reduce the risk of heart failure and death. This study aims to evaluate the effect of sacubitril/valsartan in AMI patients.
Methods: In order to evaluate the effects of sacubitril/valsartan in patients with AMI, three databases, including PubMed, Cochrane Library, and the ClinicalTrials website, were searched. The final search was performed in January 2023. The meta‑analysis was subsequently performed with Revman 5.4 software and a total of three studies were included.
Results: The results of the main outcomes showed that sacubitril/valsartan has no significant reduction in major adverse cardiovascular and cerebrovascular events (MACCEs) odds ratio (OR), 0.70; 95% confidence interval (CI), 0.38‑1.30; P=0.26] and incidence of acute heart failure (AHF) (OR, 0.52; 95% CI, 0.24‑1.15; P=0.11). The secondary outcomes showed no effect of sacubitril/valsartan to increase left ventricular remodeling.
Conclusion: In conclusion, the present meta‑analysis revealed that sacubitril/valsartan could not effectively reduce the incidence of MACCEs and AHF in patients with AMI. In the future, a meta‑analysis study will be designed with many studies to reduce the incidence of MACCEs and AHF effectively.
Urgent-start peritoneal dialysis (USPD): A Literature Review
Gede Resha Wisadianta, Ni Wayan Anantika RianiOnline First: Sep 4, 2023
- Abstract
Urgent-start peritoneal dialysis (USPD): A Literature Review
Peritoneal dialysis can be a treatment for kidney replacement therapy, and the lining of the abdomen can be used as the filter for dialysis. The dialysate is inserted into the abdomen through a peritoneal dialysis catheter. Conventionally, people would wait two weeks after getting a catheter insertion before starting dialysis. This period was to give enough time for the wound to heal correctly. But some studies found that chronic kidney disease patients who need to begin dialysis immediately after having a catheter insert (urgent-start peritoneal dialysis) had similar results to those who started dialysis more than two weeks after inserting the catheter (conventional-start peritoneal dialysis). Peritoneal dialysis is a significant method of kidney replacement therapy. Most patients who need dialysis right away are given hemodialysis instead of peritoneal dialysis, which means that peritoneal dialysis is not used as much as it could be. Urgent-start peritoneal dialysis is an effective and cost-effective option instead of starting conventional dialysis. There is not enough evidence to help guide the treatment, but involvement of the knowledge with this technique is required. This article overviews why urgent-start peritoneal dialysis is important and how it can be used in practice.
Peran rehabilitasi medik pada pasien pasca infeksi COVID-19: tinjauan kepustakaan
I Made Dwi Dananjaya, Dedi SilakarmaOnline First: Jul 24, 2023
- Abstract
Peran rehabilitasi medik pada pasien pasca infeksi COVID-19: tinjauan kepustakaan
Background: Coronavirus Disease 2019 (COVID-19) is a highly contagious disease and has become a worldwide pandemic due to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection. In post-COVID-19 patients, about 10% of patients remain symptomatic for more than three weeks, and less than 10% of patients experience sequelae for months. Patients who have sequelae, known as long COVID syndrome, can experience various impairments in structure and function. Not only in the respiratory tract, but sequelae can also occur in some organs such as the cardiovascular system, musculoskeletal, and even psychological nervous system.
Literature review: Medical rehabilitation has a role in improving functional abilities and improving the quality of life of patients after COVID-19 infection. To find out the impairment that occurs in patients after COVID-19 infection, screening and assessment are needed to determine the severity experienced in COVID-19 survivors. Rehabilitation services are provided in accordance with the severity of patients after COVID-19 infection. There are three levels of recommended rehabilitation service models, such as specialist multidisciplinary team (MDT) services, community-based therapy teams, and self-management.
Conclusion: The rehabilitation program for post-COVID-19 patients is given specifically and differently for each individual, depending on the severity and functional impairment experienced. For this reason, screening and assessment of COVID-19 survivors is needed, especially those at high risk of experiencing long COVID syndrome.
Latar belakang: Coronavirus Disease 2019 (COVID-19) merupakan penyakit yang sangat menular dan menjadi pandemi di seluruh dunia akibat infeksi Severe Acute Respiratory Syndrome Coronavirus (SARS-COV2). Pada pasien pasca infeksi COVID-19 sekitar 10% pasien tetap mengalami gejala hingga lebih dari tiga minggu dan kurang dari 10% pasien mengalami gejala sisa hingga berbulan-bulan. Pasien yang memiliki gejala sisa atau yang dikenal dengan sindrom long COVID dapat mengalami berbagai gangguan struktur dan fungsi tubuh. Tidak hanya pada saluran pernapasan, gejala sisa juga dapat terjadi pada beberapa organ seperti sistem kardiovaskular, muskuloskeletal dan sistem saraf bahkan psikologis.
Tinjauan kepustakaan: Rehabilitasi medik memiliki peran dalam meningkatkan kemampuan fungsional dan meningkatkan kualitas hidup pasien pasca infeksi COVID 19. Untuk mengetahui gangguan yang terjadi pada pasien pasca infeksi COVID-19 maka dibutuhkan screening dan assessment untuk menentukan tingkat keparahan yang dialami pada penyintas COVID-19. Pelayanan rehabilitasi yang diberikan sesuai dengan tingkat keparahan pasien pasca infeksi COVID 19. Terdapat tiga tingkatan model pelayanan rehabilitasi yang direkomendasikan yaitu pelayanan specialist multidisciplinary team (MDT), tim terapi berbasis komunitas, dan self-management.
Simpulan: Program rehabilitasi pada pasien pasca COVID 19 diberikan secara spesifik dan berbeda pada setiap individu tergantung dari tingkat keparahan dan gangguan fungsi yang dialami. Untuk itu diperlukan screening dan assessment pada penyintas COVID-19 terutama yang berisko tinggi mengalami sindrom long COVID.
Analisis potensi fraud dalam pelaksanaan jaminan kesehatan nasional pada pelayanan kesehatan di Indonesia: tinjauan sistematis
I Ketut Muliarta, I Gusti Agung Mas Rwa Jayantiari, Sagung Putri M.E. Purwani, I Wayan ParsaOnline First: Sep 6, 2023
- Abstract
Analisis potensi fraud dalam pelaksanaan jaminan kesehatan nasional pada pelayanan kesehatan di Indonesia: tinjauan sistematis
Background: Fraud is an action taken to gain financial benefits from a health insurance program. The development of fraud cases continues to increase from year to year. The purpose of this study is to identify the dangers associated with upcoding fraud episodes in the JKN era so that health policymakers can make informed decisions regarding national fraud prevention policies.
Methods: This study is a systematic study compiled using the PRISMA guidelines. Articles found using academic journals and Google Scholar. According to a survey of research studies, upcoding is one of the possible frauds committed by officers in healthcare facilities. Upcoding incidents are often associated with the roles of coders and supervisors.
Results: The opportunity factor, namely the lack of internal and external audits at the Puskesmas, is one of the triggering factors for fraud. It was found on the pressure factor that situational pressure and work can lead to errors in referring patients and patient complaints. Acceptance of patients who entrust treatment, as well as delays in payment of claims, have an impact on the income of the Puskesmas. The capability component, particularly the training provided to employees, was insufficient, and the leader's assertive policies had a significant impact on the position on the job.
Conclusion: Based on the research findings, it can be determined that the possibility of fraud occurs when there are four things that influence it. Healthcare providers need to adopt potential fraud management, quality control, and cost control, as well as improve internal audit systems.
Latar Belakang: Fraud merupakan tindakan yang dilakukan untuk mendapatkan keuntungan finansial dari program jaminan kesehatan. Perkembangan kasus Fraud terus meningkat dari tahun ke tahun. Tujuan dari penelitian ini adalah untuk mengidentifikasi bahaya yang terkait dengan upcoding episode fraud di era JKN sehingga pembuat kebijakan kesehatan dapat membuat keputusan yang tepat mengenai kebijakan pencegahan fraud nasional.
Metode: Kajian ini merupakan kajian sistematis yang disusun dengan menggunakan pedoman PRISMA. Artikel ditemukan menggunakan jurnal akademik dan Google Scholar. Menurut survei studi penelitian, upcoding adalah salah satu kemungkinan fraud yang dilakukan oleh petugas di fasilitas pelayanan kesehatan; Insiden upcoding sering dikaitkan dengan peran pembuat kode dan pengawas.
Hasil: Faktor peluang yaitu kurangnya audit internal dan eksternal di Puskesmas menjadi salah satu faktor pemicu terjadinya fraud. Ditemukan pada faktor tekanan bahwa tekanan situasional dan pekerjaan dapat menyebabkan kesalahan dalam merujuk pasien dan keluhan pasien. Penerimaan pasien yang menitipkan pengobatan, serta keterlambatan pembayaran klaim berdampak pada pendapatan Puskesmas. Komponen kemampuan, khususnya pelatihan yang diberikan kepada karyawan, tidak mencukupi, dan kebijakan tegas pemimpin memiliki dampak yang signifikan terhadap posisi dalam pekerjaan.
Simpulan: Berdasarkan temuan penelitian, dapat ditentukan bahwa kemungkinan terjadinya fraud terjadi apabila ada empat hal mempengaruhinya. Penyedia layanan kesehatan perlu mengadopsi potensi manajemen fraud, kontrol kualitas, dan kontrol biaya, serta meningkatkan sistem audit internal
Pre-exposure prophylaxis (PrEP) pada pencegahan human immunodeficiency virus (HIV) dan dampaknya terhadap infeksi menular seksual
Pande Agung Mahariski, Ni Made Dwi Puspawati, I Gusti Ayu Agung Elis Indira, I Gusti Ayu Agung Praharsini, Aditya PermanaOnline First: Aug 17, 2023
- Abstract
Pre-exposure prophylaxis (PrEP) pada pencegahan human immunodeficiency virus (HIV) dan dampaknya terhadap infeksi menular seksual
As part of a comprehensive strategy to prevent human immunodeficiency virus (HIV) infection, pre-exposure prophylaxis (PrEP), safe sex practices, routine HIV testing, HIV risk reduction counseling, and consistent and correct use of condoms are largely effective in HIV prevention. Pre-exposure prophylaxis is intended for people who engage in high-risk sexual behavior and do not use condoms consistently. The use of PrEP is widely promoted in the man who have sex with men (MSM) community, including MSM who wish to practice safer sex in sexual relationships with casual partners who have difficulty sharing HIV status and sexually transmitted infections (STIs) with sexual partners. However, due to the inconsistent practice of using condoms when using PrEP, there is an impact, namely an increase in the incidence of other sexually transmitted infections. In addition to the increased transmission of disease, especially bacterial infections, PrEP also has a protective effect against the herpes simplex virus (HSV). This literature review discusses PrEP and its impact on sexually transmitted infections.
Sebagai bagian dari strategi pencegahan komprehensif infeksi human immunodeficiency virus (HIV), penggunaan pre-exposure prophylaxis (PrEP) disertai praktik seks aman, tes HIV rutin, konseling pengurangan risiko HIV, dan penggunaan kondom yang konsisten dan benar sebagian besar efektif terhadap pencegahan HIV. Pre-exposure prophylaxis ditujukan untuk orang yang melakukan perilaku seksual berisiko tinggi dan tidak menggunakan kondom secara konsisten. Penggunaan PrEP dipromosikan secara luas pada komunitas laki-laki suka dengan laki-laki (LSL), termasuk LSL yang ingin mempraktekkan seks yang lebih aman pada hubungan seksual dengan pasangan tidak tetap yang sulit berbagi status HIV dan infeksi menular seksual (IMS) pada pasangan seksual tersebut. Namun, oleh karena praktik penggunaan kondom yang tidak konsisten saat menggunakan PrEP, terdapat dampak yang timbul yaitu adanya peningkatan kejadian infeksi menular seksual lainnya. Selain adanya transmisi penyakit terutama infeksi bakteri yang meningkat, penggunaan PrEP ternyata juga memiliki dampak efek protektif terhadap herpes simplex virus (HSV). Tinjauan pustaka ini membahas mengenai PrEP dan dampaknya pada infeksi menular seksual.
Unique problems of pneumonia in obese children: a literature review
Ayu Setyorini Mestika MayangsariOnline First: Aug 6, 2023
- Abstract
Unique problems of pneumonia in obese children: a literature review
Background: Obesity in children has its impact when the child experiences infectious conditions common in childhood, such as pneumonia. The increasing incidence of obesity in children in the last three decades forms the basis for compiling this review article. This review article aims to provide current insights about the impact of obesity on respiratory physiology, inflammatory conditions in pneumonia, and drug pharmacodynamics.
Methods: This literature review uses the latest literature relevant to matters affecting pneumonia management and clinical approach in children with obesity. This literature was obtained from various sources of other scientific literature.
Results: Obesity affects the respiratory physiology of children to collapse more easily, energy use becomes less efficient, children become tired, and hypoxemia occurs easily. Obesity also increases the degree and ease of inflammation in pneumonia and affects the pharmacodynamics of several drugs commonly used to manage pneumonia.
Conclusion: Management of pneumonia in children with obesity requires vigilance and more stringent monitoring and adjustment of drug doses.
Penggunaan klonidin sebagai terapi shivering pasca anestesi spinal: sebuah tinjauan sistematis
I Nyoman Dwi Ari ArthanaOnline First: Jul 13, 2023
- Abstract
Penggunaan klonidin sebagai terapi shivering pasca anestesi spinal: sebuah tinjauan sistematis
Background: Shivering can increase oxygen use, the risk of hypoxemia, and post-operative sequelae. The many properties of clonidine make this medication versatile enough to be employed not just to avoid shivering, but also to treat additional spinal anesthesia adverse effects.
Methods: Researchers combed the PubMed database for randomized clinical trials (RCTs) conducted between 2012 and 2022. Each study must be accessible and written in English. Individuals older than 18 who received spinal anesthesia operations.
Results: A total of 41 article abstracts and 12 full-length studies were evaluated, and seven papers met the inclusion criteria. The studied clinical outcome was the frequency of post-spinal anesthesia shivering. The majority of prior investigations found no significant difference in the shivering impact between the clonidine and midazolam groups. Shivering was much less common after tramadol treatment than after clonidine administration. Dexmedetomidine is known to be more effective than clonidine in controlling post-spinal blockade shivering.
Conclusion: Clonidine is beneficial in lowering the occurrence of post-spinal anesthesia shivering.
Latar Belakang: Shivering dapat meningkatkan konsumsi oksigen, meningkatkan risiko hipoksemia, dan meningkatkan komplikasi setelah operasi. Berbagai efek klonidin membuat agen ini cukup potensial untuk digunakan tidak hanya sebagai pencegahan shivering tetapi juga untuk mengatasi efek samping lain dari anestesi spinal.
Metode: Peneliti mencari database PubMed untuk uji coba terkontrol acak/randomized clinical trial (RCT) dalam periode 2012-2022. Setiap studi harus dalam bahasa Inggris dan dapat diakses untuk full review. Subjek berusia >18 tahun yang menjalani prosedur anestesi spinal.
Hasil: Total 41 abstrak artikel yang ditelaah, 12 studi full paper ditelaah dan 7 studi yang memenuhi kriteria inklusi. Keluaran klinis yang dievaluasi adalah kejadian shivering pasca anestesi spinal. Hasil sebagian besar studi sebelumnya menunjukkan bahwa tidak terdapat perbedaan bermakna efek shivering pada kelompok klonidin dan midazolam. Insiden shivering pasca pemberian tramadol secara bermakna lebih rendah dibandingkan kelompok klonidin. Pemberian dexmedetomidine diketahui lebih efisien dibandingkan klonidin untuk mengontrol post spinal blockade shivering
Kesimpulan: Klonidin efektif mengurangi kejadian shivering pasca anestesi spinal.
Perbandingan penanganan operatif dengan non operatif pada tatalaksana dislokasi bahu anterior terhadap rekurensi: systematic review
Made Sabrina Prativa Prasaditya Ardhaswari, Putu Astawa, Anak Agung Gde Yuda AsmaraOnline First: Aug 23, 2023
- Abstract
Perbandingan penanganan operatif dengan non operatif pada tatalaksana dislokasi bahu anterior terhadap rekurensi: systematic review
Background: Shoulder dislocations are very prone to recurrent shoulder dislocations, the best treatment for reducing recurrence is controversial in several studies. Thus, the aim of this study was to compare operative and nonoperative management of anterior dislocation of the shoulder against recurrence.
Method: The literature search used PubMed and Google Scholar databases and met the inclusion criteria from 2010-2020 regarding the comparison of operative and non-operative treatment on anterior shoulder dislocation on recurrence. This systematic review was prepared by using the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes).
Result: Five studies were reviewed with a total sample size of 635 samples. Three studies stated that the recurrence rate for operative was 10-13% and non-operative was 41-71% and there was a significant difference. Meanwhile, two other studies stated that there was no significant difference between operative and non-operative on recurrence rates.
Conclusion: Studies suggest that non-operative management recurs more frequently in shoulder dislocation than operative management.
Pendahuluan: Dislokasi bahu sangat rentan untuk terjadi dislokasi bahu berulang (recurrent). Hingga saat ini, penanganan yang terbaik dalam menurunkan rekurensi masih bersifat kontroversial dalam beberapa studi. Untuk itu, tujuan dari studi ini adalah untuk membandingan penanganan operatif dengan non operatif pada tatalaksana dislokasi bahu anterior terhadap rekurensi
Metode: Pencarian literatur menggunakan database PubMed dan Google Scholar, serta memenuhi kriteria inklusi dari tahun 2010-2020 mengenai perbandingan operatif dan non operatif pada dislokasi bahu anterior terhadap rekurensi. Penulian systematic review ini disusun menggunakan protocol PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Hasil: Lima studi yang diulas dengan jumlah sampel sebanyak 635 sampel. Tiga studi menyebutkan recurrence rate pada operatif sebesar 10-13% dan non operatif sebesar 41-71% dan terjadi perbedaan yang signifikan. Sedangkan, dua studi lainnya menyebutkan recurrence rate pada operatif dan non operatif menunjukkan tidak ada perbedaan yang signifikan.
Kesimpulan: Keseluruhan studi menyebutkan bahwa penanganan non operatif lebih sering mengalami rekurensi pada dislokasi bahu dibandingkan dengan penanganan operatif.
Diagnosis dan penatalaksanaan osteosarkopenia pada penderita sistemik lupus eritematosus
Dewa Ayu Kartika Tejawati, I Wayan Hendra Gunadi, Gede Kambayana, Ida Bagus Putu Putrawan, Pande Ketut KurniariOnline First: May 6, 2023
- Abstract
Diagnosis dan penatalaksanaan osteosarkopenia pada penderita sistemik lupus eritematosus
The term osteosarcopenia has been coined to describe the concomitant occurrence of osteopenia/osteoporosis and sarcopenia. Osteosarcopenia can occur in patients with SLE due to the inflammatory process and long-term use of glucocorticoids which play a role in the pathophysiology of osteosarcopenia. Until now there is no definite recommendation regarding when to carry out early detection of osteosarcopenia in patients with SLE, but there is a recommendation to carry out screening after 3 months of long-term glucocorticoid use to determine the incidence of glucocorticoid-induced osteoporosis. The gold standard for assessing bone mass is dual X-ray absorptiometry (DXA). For prevention of osteosarcopenia, identification and treatment of modifiable risk factors such as endocrine disorders is essential. In addition, the risk of developing sarcopenia and osteopenia can be reduced through healthy lifestyle changes that optimize stem bone mass and maintain musculoskeletal health throughout life, including regular physical activity and adequate nutrition (intake of calcium, vitamin D and protein).
Istilah osteosarkopenia telah diciptakan untuk menggambarkan kejadian bersamaan dari osteopenia/osteoporosis dan sarkopenia. Osteosarkopenia dapat terjadi pada pasien SLE akibat proses inflamasi dan penggunaan glukokortikoid jangka panjang yang berperan dalam patofisiologi osteosarkopenia. Sampai saat ini belum ada anjuran pasti mengenai kapan harus dilakukan deteksi dini osteosarkopenia pada pasien SLE, namun ada anjuran untuk melakukan skrining setelah 3 bulan penggunaan glukokortikoid jangka panjang untuk mengetahui kejadian osteoporosis akibat glukokortikoid. Standar emas untuk menilai massa tulang adalah dual X-ray absorptiometry (DXA). Untuk pencegahan osteosarkopenia, identifikasi dan pengobatan faktor risiko yang dapat dimodifikasi seperti gangguan endokrin sangat penting. Selain itu, risiko terjadinya sarkopenia dan osteopenia dapat dikurangi melalui perubahan gaya hidup sehat yang mengoptimalkan massa tulang induk dan menjaga kesehatan muskuloskeletal sepanjang hidup, termasuk aktivitas fisik secara teratur dan nutrisi yang cukup (asupan kalsium, vitamin D, dan protein).
Strategi penatalaksanaan dan pencegahan Transfusion-Associated Circulatory Overload (TACO): tinjauan pustaka
Dentiama JayaprawiraOnline First: Jul 4, 2023
- Abstract
Strategi penatalaksanaan dan pencegahan Transfusion-Associated Circulatory Overload (TACO): tinjauan pustaka
Background: Transfusion-associated circulatory overload (TACO) is a serious complication after blood transfusion. Although the incidence of TACO ranges from 0.1% to 10% of all blood transfusions, the mortality rate is quite high, up to 11 cases per 100,000 transfusions. This literature review aims to identify strategies for managing and preventing TACO in daily clinical practice.
Methods: This literature review was conducted by searching studies on online databases in the form of PubMed, Cochrane Library, and Google Scholar using the keywords “Transfusion-Associated Circulatory Overload” (TACO)”, “blood transfusion”, “pathophysiology”, “management”, “prevention”. Appropriate studies then carried out a narrative synthesis analysis.
Results: In TACO, excess fluid causes pulmonary edema, which can lead to respiratory distress. The main mechanism of TACO is hydrostatic pulmonary edema, in which the accumulation of fluid in the pulmonary capillaries then causes an increase in hydrostatic pressure. The management of TACO includes immediately stopping the administration of transfusion products and supportive therapy in the form of supplemental oxygen administration and administration of diuretics such as furosemide. In contrast, prevention of TACO can be done with a restrictive transfusion strategy, rules for using single-dose red blood cell transfusions, identification of high-risk patients using algorithms or checklists, intensive monitoring of at-risk patients, administration of blood product infusions at a slow rate, and use of diuretic drugs preemptive in at-risk patients.
Conclusion: The main key to the management of TACO is to prevent the further formation of pulmonary edema by stopping the administration of transfusions and giving oxygen and diuretics. Meanwhile, preventive measures can be taken by restricting blood product administration, identifying high-risk patients and pre-emptive diuretic administration.
Latar belakang: Transfusion-associated circulatory overload (TACO) merupakan salah satu komplikasi serius pasca transfusi darah. Meskipun insiden TACO berkisar antara 0,1% hingga 10% dari semua transfusi darah., angka mortalitasnya tergolong cukup tinggi yakni hingga 11 kasus per 100.000 transfusi. Tinjauan pustaka ini bertujuan untuk mengetahui strategi penatalaksanaan dan pencegahan TACO dalam praktik klinis sehari-hari.
Metode: Tinjauan pustaka ini dilakukan dengan pencarian studi pada basis data online berupa PubMed, Cochrane library, dan Google Scholar dengan menggunakan kata kunci “Transfusion-Associated Circulatory Overload” “(TACO)”, “blood transfusion”, “pathophysiology”, “management”, “prevention”. Studi yang sesuai kemudian dilakukan analisis sintesis secara naratif.
Hasil: Pada TACO terjadi kelebihan cairan yang menimbulkan edema paru yang dapat berujung pada distres nafas. Mekanisme utama terjadinya TACO adalah edema pulmoner hidrostatik, dimana akumulasi cairan pada kapiler pulmoner kemudian menyebabkan peningkatan tekanan hidrostatik. Penatalaksanaan TACO meliputi pengehentian pemberian produk transfusi dengan segera dan terapi suportif berupa pemberian oksigen supplemental serta pemberian diuretik seperti furosemide. Sedangkan pencegahan TACO dapat dilakukan dengan strategi transfusi yang restriktif, aturan penggunaan transfusi sel darah merah dosis tunggal, identifikasi pasien berisiko tinggi dengan menggunakan algoritma atau ceklist, monitoring intensif pada pasien berisiko, pemberian infus produk darah dengan kecepatan lambat, dan penggunaan obat-obatan diuretik preemtif pada pasien berisiko.
Simpulan: Kunci utama penatalaksanaan TACO adalah mencegah terbentuknya edema paru lebih lanjut dengan menghentikan pemberian transfusi dan pemberian oksigen serta diuretik. Sedangkan tindakan pencegahan dapat dilakukan dengan restriksi pemberian produk darah, identifikasi pasien berisiko tinggi hingga pemberian diuretik preemtif.
Potensi efek Nano-Oleanolic Acid- Lactoferrin (NOAL) dalam menurunkan kadar glukosa darah: : sebuah literatur review
Kadek Tresna Yuwana, I Putu Hendri Aryadi, I Nyoman Tri PramarthaOnline First: Aug 27, 2023
- Abstract
Potensi efek Nano-Oleanolic Acid- Lactoferrin (NOAL) dalam menurunkan kadar glukosa darah: : sebuah literatur review
Diabetes mellitus (DM) is a major cause of death and disability worldwide where insulin resistance is a fundamental etiological factor of the pathogenesis of Type 2 DM (T2DM). The global prevalence of DM reached 425 million sufferers in 2017 and it is estimated that in 2040 it will reach 615 million people. Efforts to manage diabetes are by controlling blood sugar levels and preventing complications in this disease. Management modalities based on herbal medicine as an alternative have been extensively researched and analyzed. One of them is the use of the Syzygium cumini plant, because it has various bioactive compounds that are antihyperglycemic, anti-diabetic, anti-inflammatory, and antioxidant such as oleanolic acid (OA). The aim of the study was to discuss the potential of Nano-Oleanolic Acid-Lactoferrin (NOAL) in its ability to reduce blood glucose levels in the management of T2DM. The construction mechanism for NOAL using the Nanoparticle Albumin-Bound (NAB) method includes the preparation and construction stages of a combination of OA and lactoferrin (Lf) nanoparticles while the administration mechanism uses the oral route. The mechanism of action of NOAL is through postprandial blood sugar regulation, revitalization and regeneration of pancreatic β cells and increased sensitivity to insulin receptors. OA is known to inhibit PTP1B (Protein Thyrosine Phosphatase 1B) which increases insulin sensitivity through inhibition of PTP1B-mediated negative regulation of bypass insulin signaling. Reasoning creative ideas in this paper, requires an assessment and further research on the potential of NOAL in the management of T2DM.
Diabetes mellitus (DM) merupakan penyebab utama kematian dan kecacatan di seluruh dunia dimana resistensi insulin merupakan faktor etiologi mendasar dari patogenesis DM Tipe 2 (DMT2). Prevalensi global DM mencapai 425 juta penderita pada tahun 2017 dan diperkirakan pada tahun 2040 mencapai 615 juta orang. Upaya penatalaksanaan DM adalah dengan pengendalian kadar gula darah dan pencegahan komplikasi pada penyakit ini. Modalitas penatalaksanaan berbasis pengobatan herbal sebagai alternatif telah banyak diteliti dan dianalisis. Salah satunya adalah pemanfaatan tumbuhan Syzygium cumini, karena memiliki berbagai senyawa bioaktif yang bersifat antihiperglikemia, antidiabetes, antiinflamasi, dan antioksidan seperti oleanolic acid (OA). Tujuan kajian adalah untuk membahas potensi Nano-Oleanolic Acid- Lactoferrin (NOAL) dalam kemampuannya menurunkan kadar glukosa darah dalam penatalaksanaan DMT2. Mekanisme konstruksi NOAL menggunakan metode Nanoparticle Albumin-Bound (NAB) meliputi tahap preparasi dan konstruksi dari kombinasi OA dan nanopartikel lactoferrin (Lf) sedangkan mekanisme adminitrasinya menggunakan jalur oral. Mekanisme kerja NOAL yakni melalui regulasi gula darah postprandial, revitalisasi dan regenerasi sel β pankreas serta peningkatan sensitivitas reseptor insulin. OA diketahui menghambat PTP1B (Protein Thyrosine Phosphatase 1B) yang meningkatkan sensitivitas insulin melalui penghambatan regulasi negatif termediasi PTP1B dari pintasan persinyalan insulin. Penalaran ide kreatif dalam karya tulis ini, memerlukan suatu pengkajian dan penelitian lebih lanjut mengenai potensi NOAL dalam penatalaksaan DMT2.
Aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) meningkatkan kadar tissue inhibitors of matrix metalloproteinase-1 dan menurunkan kadar matrix metalloproteinase-2 pada tikus wistar (Rattus norvegicus) yang terpapar sinar ultraviolet B
Ni Putu Ayu Riska Yunita Sari, Ketut Kwartantaya Winaya, I Gusti Ayu Agung Dwi Karmila, Luh Made Mas Rusyati, I Gusti Agung Ayu Praharsini, Ni Luh Putu Ratih Vibriyanti KarnaOnline First: Sep 1, 2023
- Abstract
Aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) meningkatkan kadar tissue inhibitors of matrix metalloproteinase-1 dan menurunkan kadar matrix metalloproteinase-2 pada tikus wistar (Rattus norvegicus) yang terpapar sinar ultraviolet B
Introduction: UV radiation stimulates the production of ROS. UVB produces higher levels of ROS. TIMP-1 protects against photodamage by reducing UVB-induced collagen breakdown. ROS stimulates increased expression of MMP-2 and causes chronic photoaging. Sugar apple plants are known to protect against inflammation and contain antioxidant compounds. The purpose of this research was to determine the topical application of sugar apple leaf cream extract (Annona squamosa L.) to increase TIMP-1 levels and decrease MMP-2 levels in mice models of chronic skin inflammation exposed to UVB.
Methods: This post-test-only experimental study with a control group design was conducted in March–June 2023. The samples were Wistar rats. ELISA examined TIMP-1 and MMP-2 levels.
Results: The phytochemical test of sugar apple leaf extract showed total flavonoid levels of 3583.77 mg QE/100 mL; total phenol content was 5244.98 mg GAE/100 mL, IC50 value was 226.53 ppm and positive alkaloids. In experimental animals given 5%, 10%, and 20% sugar apple leaf extract, TIMP-1 levels were found to be 6.36 ± 1.001, respectively; 8.56 ± 1.004; and 10.89 ± 0.932. Meanwhile, MMP-2 levels were found to be 41.57 ± 3.897; 38.52 ± 4.620; and 26.03 ± 5.912 in experimental animals given 5%, 10%, and 20% sugar apple leaf extract. The results showed that there were significant differences in TIMP-1 and MMP-2 levels between treatment groups (p<0.05).
Conclusion: Cream extract from Annona Squamosa L. leaves with a concentration of 5%, 10%, and 15% was found to significantly increase TIMP-1 and decrease MMP-2 levels in rats exposed to UVB light.
Pendahuluan: Radiasi ultraviolet (UV) merangsang produksi reactive oxygen species (ROS). Sinar UVB menghasilkan ROS dengan tingkat yang lebih tinggi. TIMP-1 telah dibuktikan dapat menjadi pelindung terhadap photodamage dengan menghambat degradasi kolagen yang diinduksi UVB. ROS menstimulasi peningkatan ekspresi MMP-2 dan menyebabkan photoaging kronis. Tanaman srikaya diketahui berefek protektif terhadap inflamasi dan memiliki kandungan senyawa antioksidan. Penelitian ini dilakukan dengan tujuan untuk mengetahui aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) terhadap peningkatan kadar TIMP-1 dan penurunan kadar MMP-2 pada tikus model inflamasi kronis kulit yang terpapar UVB.
Metode: Penelitian eksperimen post-test only with control group design ini dilakukan pada bulan Maret–Juni 2023. Penelitian ini menggunakan hewan coba berupa tikus strain wistar. Kadar TIMP-1 dan MMP-2 diperiksa dengan ELISA.
Hasil: Uji fitokimia ekstrak krim daun srikaya menunjukkan kadar total flavonoid sebanyak 3583,77 mg QE/100 mL; kadar total fenol 5244,98 mg GAE/100 mL, nilai IC50 226,53 ppm, dan alkaloid positif. Pada hewan coba yang diberikan ekstrak daun srikaya 5%, 10%, dan 20% ditemukan kadar TIMP-1 masing-masing adalah 6,36 ± 1,001; 8,56 ± 1,004; dan 10,89 ± 0,932. Sementara itu, kadar MMP-2 ditemukan masing-masing 41,57 ± 3,897; 38,52 ± 4,620; dan 26,03 ± 5,912 pada hewan coba yang diberikan ekstrak daun srikaya 5%, 10%, dan 20%. Hasil analisis menunjukkan adanya perbedaan kadar TIMP-1 dan MMP-2 yang signifikan antar kelompok perlakuan (p<0,05).
Simpulan: Ekstrak krim dari daun srikaya (Annona Squamosa L.) dengan konsentrasi 5%, 10%, dan 15% ditemukan secara signifikan meningkatkan kadar TIMP-1 dan menurunkan kadar MMP-2 pada tikus yang terpapar sinar UVB.
Kejadian Infeksi Saluran Pernapasan Akut (ISPA) pada bayi usia 0-12 bulan yang memperoleh Air Susu Ibu (ASI) eksklusif di wilayah Desa Kedewatan, Kecamatan Ubud, Bali, Indonesia
Ni Kadek Diah Armayukti, I Nyoman Budi Hartawan, Dyah Kanya Wati, Dewi Sutriani MahaliniOnline First: Aug 6, 2023
- Abstract
Kejadian Infeksi Saluran Pernapasan Akut (ISPA) pada bayi usia 0-12 bulan yang memperoleh Air Susu Ibu (ASI) eksklusif di wilayah Desa Kedewatan, Kecamatan Ubud, Bali, Indonesia
Background: Acute Respiratory Infection (ARI) is the main cause of morbidity and mortality from infectious diseases in the world. Nearly four million people die from ARI each year, 98% of which are caused by lower respiratory tract infections. ARI is the most common disease in children. Incidence by age group under five is estimated to be 0.29 episodes per child/year in developing countries and 0.05 episodes per child/year in developed countries. One of the risk factors that contribute to the incidence of ARI is the low level of exclusive breastfeeding. This study aims to determine the incidence of ARI in infants who have been exclusively breastfed.
Methods: The research design was cross-sectional descriptive. Sampling was carried out using the non-probability sampling method of consecutive sampling. Subjects came sequentially and those who met the selection criteria were included in the study until the required number of subjects was met. In this study, subjects who met the research criteria were infants aged 0-12 months who were exclusively breastfed. Data were analyzed using SPSS version 20.0 for Windows.
Result: Based on the results of bivariate analysis of 100 samples consisting of 53 women and 47 men and 53 women, 43 babies or 43% of the samples had experienced ARI, namely 21 babies or 21% of the samples with mild ARI, 12 babies or 12% of the sample with moderate ARI and 10 infants or 10% of the sample with severe ARI.
Conclusion: As many as 43% had experienced ARI. This is caused by several factors, one of which is the mother's education level and mother's occupation. This is directly related to the mother's mindset in fulfilling baby nutrition through exclusive breastfeeding as an effort to form the baby's immune system in preventing babies from getting sick.
Latar belakang: Infeksi Saluran Pernapasan Akut (ISPA) adalah penyebab utama morbiditas dan mortalitas penyakit menular di dunia. Hampir empat juta orang meninggal akibat ISPA setiap tahun, 98% disebabkan oleh infeksi saluran pernapasan bawah. ISPA merupakan penyakit yang paling sering terjadi pada anak. Insiden menurut kelompok umur balita diperkirakan 0,29 episode per anak/tahun di negara berkembang dan 0,05 episode per anak/tahun di negara maju. Salah satu faktor risiko yang berkontribusi terhadap insiden ISPA adalah masih rendahnya peberian ASI eksklusif. Penelitian ini bertujuan untuk mengetahui angka kejadian ISPA pada bayi yang telah memperoleh ASI eksklusif.
Metode: Desain penelitian cross-sectional deskriptif Pengambilan sampel dilakukan dengan metode non-probability sampling jenis consecutive sampling, subjek datang secara berurutan dan yang memenuhi kriteria pemilihan dimasukkan dalam penelitian sampai jumlah subjek yang diperlukan terpenuhi. Dalam penelitian ini subjek yang memenuhi kriteria penelitian adalah bayi usia 0-12 bulan yang memperoleh ASI Eksklusif. Data dianalisis dengan SPSS versi 20.0 untuk Windows.
Hasil: Berdasarkan hasil analisis secara bivariat dari 100 sampel yang terdiri dari 53 perempuan dan 47 laki-laki dan 53 perempuan diperoleh sebanyak 43 bayi atau 43% sampel pernah mengalami ISPA, yaitu 21 bayi atau 21% sampel dengan ISPA ringan, 12 bayi atau 12% sampel dengan ISPA sedang dan 10 bayi atau 10% sampel dengan ISPA berat.
Simpulan: Sebanyak 43% pernah mengalami ISPA. Hal ini disebabkan oleh beberapa faktor salah satunya adalah tingkat Pendidikan ibu dan pekerjaan ibu. Hal ini berhubungan langsung terhadap pola pikir ibu dalam pemenuhan nutrisi bayi melalui pemberian ASI Eksklusif sebagai usaha pembentukan sistem imun bayi dalam mencegah bayi terserang penyakit.
Hubungan aktivitas fisik dan tingkat konsumsi energi dengan kejadian kurang energi kronis pada remaja putri di Desa Pemecutan Klod, Denpasar Barat
Ni Putu Trisna Widyanthi, I Wayan Ambartana, Ni Made DewantariOnline First: Jul 10, 2023
- Abstract
Hubungan aktivitas fisik dan tingkat konsumsi energi dengan kejadian kurang energi kronis pada remaja putri di Desa Pemecutan Klod, Denpasar Barat
Background: Based on data from Basic Health Research for Bali province in 2018, Denpasar is a city that has the highest prevalence of chronic energy deficiency (CED) among young women in the Bali province. The purpose of this research is to determine the relationship between physical activity and energy consumption levels with CED in young women in Pemecutan Klod Village, West Denpasar.
Method: This research is an analytical research with a cross-sectional survey design. The sample of this research is 92 samples. The sample determination method used is Cluster Sampling by selecting five banjars. Data about CED status was carried out by measuring the circumference of the upper arm. Data about physical activity was collected using a physical activity questionnaire. Energy consumption level data was collected using the SQ-FFQ questionnaire. Analysis of the data used is Rank Spearman correlation test with α = 0.05.
Results: Most of the samples have a strenuous level of physical activity as many as 13% moderate physical activity level as many as 66,3% and light physical activity level as many as 20,7%. Based on the level of energy consumption it was found that 52,2% have a deficit energy consumption level, 2,2% have a good energy consumption level, and 45,7% have a low energy consumption level. Most of the samples were in CED conditions as many as 56,5% while the rest were not in CED conditions as many ad 43,5%
Conclusion: There is a significant relationship between physical activity and the level of energy consumption with CED in young women in Pemecutan Klod Village, West Denpasar District.
Latar Belakang: Berdasarkan data Riset Kesehatan Dasar Provinsi Bali tahun 2018, Kota Denpasar merupakan kota yang memiliki prevalensi remaja putri dengan kondisi kekurangan energi kronis (KEK) tertinggi di Provinsi Bali. Penelitian ini bertujuan untuk mengetahui hubungan aktivitas fisik dan tingkat konsumsi energi dengan kejadian kurang energi kronis pada remaja putri di Desa Pemecutan Klod Kecamatan Denpasar Barat.
Metode: Penelitian ini merupakan penelitian analitik dengan rancangan survei cross-sectional. Sampel penelitian ini berjumlah 92 sampel. Metode penentuan sampel yang digunakan yaitu cluster sampling dengan memilih lima banjar. Data status KEK dikumpulkan dengan pengukuran lingkar lengan atas. Data aktivitas fisik dikumpulkan menggunakan kuisioner aktivitas fisik. Data tingkat konsumsi energi dikumpulkan menggunakan kuesioner Semi Quantitative Food Frequency Questionnaire (SQ-FFQ). Data dianalisis dengan uji korelasi Rank Spearman dengan α = 0,05.
Hasil: Sebagian besar sampel memiliki tingkat aktivitas fisik yang berat yaitu sebanyak 13%, tingkat aktivitas fisik sedang sebanyak 66,3% serta tingkat aktivitas fisik ringan sebanyak 20,7%. Tingkat konsumsi energi sampel sebanyak 52,2% memiliki tingkat konsumsi energi defisit, tingkat konsumsi energi baik sebanyak 2,2% serta tingkat konsumsi energi kurang sebanyak 45,7%. Sebagian besar sampel dalam kondisi KEK sebanyak 56,5% sedangkan tidak dalam kondisi KEK sebanyak 43,5%.
Simpulan: Terdapat hubungan yang signifikan antara aktivitas fisik dan tingkat konsumsi energi dengan kejadian KEK pada remaja putri di Desa Pemecutan Klod Kecamatan Denpasar Barat.
Hubungan pendapatan keluarga pada masa pandemi Covid-19 terhadap status gizi bayi usia 0-2 tahun di Puskesmas Dawan I, Kecamatan Dawan, Kabupaten Klungkung
Ni Putu Stephanie Putri Fernando, I Gusti Ayu Trisna Windiani, Anak Agung Ngurah Ketut Putra Widnyana, Dyah Kanya WatiOnline First: Aug 30, 2023
- Abstract
Hubungan pendapatan keluarga pada masa pandemi Covid-19 terhadap status gizi bayi usia 0-2 tahun di Puskesmas Dawan I, Kecamatan Dawan, Kabupaten Klungkung
Background: The Covid-19 pandemic has reportedly resulted in increased layoffs in Indonesia, which has affected people's income. This can lead to a decrease in food purchasing ability, decreasing children's nutritional intake. Furthermore, the first thousand days of life is a critical period that determines the health and welfare of children. This study aimed to determine the relationship between family income during the Covid-19 pandemic and the nutritional status of infants aged 0-2 years at the Dawan I Community Health Center, Dawan District, Klungkung Regency.
Method: This cross-sectional study used infants aged 0-24 months as study subjects, with the respondents being housewives with toddlers aged 0-24 months who were selected according to the study inclusion criteria. Nutritional status and family income were obtained using secondary data, interviews and filling out questionnaires. Data analysis was performed with SPSS v.21 with a p-value ≤0.05.
Results: A total of 80 respondents were obtained as study subjects. Most of the parents were >25 years old (61 respondents; 76.3%) with senior high school education (46 respondents; 57.5%). Most respondents did not work (34 respondents; 42.5%) with family income < Rp. 2,538,000.00 (53 respondents; 66.3%). Most babies have good nutritional status (38 respondents; 47.5%). Based on bivariate analysis, a significant relationship exists between family income and infant nutritional status (chi-square; p=0.008; two-tailed).
Conclusion: There is a significant relationship between family income during the Covid-19 pandemic and the nutritional status of infants aged 0-2 years at the Dawan I Health Center, Dawan District, Klungkung Regency.
Latar Belakang: Pandemi Covid-19 dilaporkan telah mengakibatkan peningkatan angka pemutusan hubungan kerja (PHK) di Indonesia, khususnya di Bali yang berpengaruh terhadap pendapatan masyarakat. Hal ini dapat menyebabkan penurunan daya beli pangan yang berakibat pada penurunan asupan gizi anak. Terlebih lagi, seribu hari pertama kehidupan (1000 HPK) merupakan masa kritis yang menentukan kesehatan dan kesejahteraan anak. Penelitian ini bertujuan untuk mengetahui hubungan antara pendapatan keluarga pada masa pandemi Covid-19 terhadap status gizi bayi usia 0-2 tahun di Puskesmas Dawan I Kecamatan Dawan Kabupaten Klungkung.
Metode: Penelitian ini merupakan studi observasional analitik dengan desain potong lintang. Subjek penelitian adalah bayi usia 0-24 bulan yang tercatat pada Laporan Bulanan Gizi Puskesmas Dawan I Kecamatan Dawan, Kabupaten Klungkung, dengan responden penelitian ini adalah ibu rumah tangga anak balita usia 0-24 bulan sesuai kriteria penelitian. Status gizi dan pendapatan keluarga diperoleh menggunakan data sekunder, wawancara, dan pengisian kuesioner. Analisis data dilakukan dengan SPSS v.21 dengan nilai p≤0,05 dianggap signifikan secara statistik.
Hasil: Sebanyak 80 responden diperoleh sebagai subjek penelitian. Sebagian besar orang tua berusia >25 tahun (61 responden; 76,3%) dengan pendidikan terakhir SMA (46 responden; 57,5%). Sebagian besar responden tidak bekerja (34 responden; 42,5%) dengan pendapatan keluarga < Rp. 2.538.000,00 (53 responden; 66,3%). Sebagian besar bayi memiliki status gizi baik (38 responden; 47,5%). Berdasarkan analisis bivariat, terdapat hubungan signifikan antara pendapatan keluarga dan status gizi bayi (chi-square; p=0,008; two-tailed).
Simpulan: Terdapat hubungan signifikan antara pendapatan keluarga pada masa pandemi Covid-19 terhadap status gizi bayi usia 0-2 tahun di Puskesmas Dawan I Kecamatan Dawan Kabupaten Klungkung.
Nanoenkapsulasi senyawa bioaktif daun salam (Syzygium polyanthum) menggunakan surfaktan tween 80 di dalam ruang berbentuk tabung berdiameter 500 μm
Angel Sri Diendra Waruwu , Horasdia SaragihOnline First: May 22, 2023
- Abstract
Nanoenkapsulasi senyawa bioaktif daun salam (Syzygium polyanthum) menggunakan surfaktan tween 80 di dalam ruang berbentuk tabung berdiameter 500 μm
Background: The bioactive compounds found in bay leaves have an abundance of potential to be used in the future, particularly as pharmaceutical ingredients as they consist of several beneficial characteristics, such the ability to reduce cholesterol and act as antioxidants, anti-inflammatory, and antibacterial. These bioactive compounds also have characteristics that make it very difficult for them to dissolve in water, evaporate easily, and decay easily, leading to numerous difficulties for their utilization. This problem has been solved using the nanoencapsulation method.
Objective: This study aimed to nanoencapsulate bioactive compounds in bay leaves using a surfactant in a 500 μm diameter tube.
Method: Tween 80 surfactant was used to perform nanoencapsulation in a tubular chamber with a diameter of 500 μm. A very small and constant amount of the liquid precursor mixture can be used in a tubular chamber with a very small diameter to produce nanoparticles with a tiny size. Precursor mixing occurs very quickly because of the immense mass movement in the tube.
Results: The average diameter of nanoparticles produced through nanoencapsulation ranges from 16.6 nm to 20.3 nm. There were four distinct mass concentrations of the bioactive compounds found in bay leaves used: 8 mg, 10 mg, 12 mg, and 14 mg. It was discovered that the average diameter of the produced nanoparticles and their polydispersity index rose as the mass of the utilized bioactive compounds concentrate increased.
Conclusions: According to the results of this study, bay leaf bioactive compound nanoparticles were successfully encapsulated in nanometers utilizing a 500 μm diameter tube-shaped chamber. The resulting nanoparticles have a single distribution and average sizes that are relatively small.
Latar Belakang: Senyawa bioaktif daun salam memiliki potensi yang sangat besar untuk dikembangkan ke depan terutama sebagai bahan obat-obatan karena memiliki sifat-sifat yang sangat berguna, seperti: dapat menurunkan kolesterol, bersifat antioksidan, antiinflamasi, dan antibakteri. Namun senyawa bioaktif ini juga memiliki sifat yang sangat sulit larut di dalam air, mudah menguap dan mudah terdegradasi sehingga pemanfaatannya mengalami banyak hambatan. Untuk mengatasi hal tersebut pendekatan nanoenkapsulasi dilakukan.
Tujuan: Penelitian ini bertujuan untuk menanoenkapsulasi senyawa bioaktif daun salam menggunakan suatu surfaktan di dalam ruang berbentuk tabung berdiameter 500 μm.
Metode: Nanoenkapsulasi dilakukan di dalam ruang berbentuk tabung berdiameter 500 μm menggunakan surfaktan tween 80. Di dalam ruang berbentuk tabung dan berdiameter sangat kecil, volume cairan campuran prekursor yang digunakan dapat diatur sangat kecil dan teratur sehingga nanopartikel yang diperoleh dapat berukuran sangat kecil. Proses pencampuran prekursornya sangat cepat karena transport massa di dalam tabung sangat tinggi.
Hasil: Nanopartikel yang dihasilkan dari nanoenkapsulasi memiliki diameter rata-rata dari 16,6 nm – 20,3 nm. Empat ragam massa konsentrat senyawa bioaktif daun salam digunakan, yaitu 8 mg, 10 mg, 12 mg, dan 14 mg. Diperoleh bahwa ketika massa konsentrat senyawa bioaktif yang digunakan ditambah, diameter rata-rata nanopartikel yang dihasilkan dan indeks polidispersitasnya bertambah.
Simpulan: Nanopartikel senyawa bioaktif daun salam telah berhasil dienkapsulasi berukuran nanometer dengan menggunakan ruang berbentuk tabung berdiameter 500 μm. Ukuran diameter rata-rata nanopartikel yang dihasilkan pun sangat kecil dan berdistribusi tunggal.
Pola transmisi dan komorbid COVID-19 pada anak di RSUD Ulin Banjarmasin
Edi Hartoyo, Jade Irene LinardiOnline First: Jul 4, 2023
- Abstract
Pola transmisi dan komorbid COVID-19 pada anak di RSUD Ulin Banjarmasin
Background: COVID-19 is a disease caused by the SARS-CoV-2 virus. Until now, the current understanding of the COVID-19 transmission pattern in the pediatric population is still limited. Data regarding the comorbid presented in the pediatric population is also limited, despite its importance as a determinant of COVID-19 severity. The aim of this study is to know the transmission pattern and comorbid in confirmed COVID-19 cases in pediatrics so that prevention can be made in children at risk of the virus transmission.
Methods: Observational, cross-sectional study was conducted in children aged 0-18 years with confirmed COVID-19 cases based on RT-PCR between March 2020-2022 in the Department of Child Health/Ulin Hospital Banjarmasin. There were 92 patients hospitalized with confirmed COVID-19. Parents were interviewed to know the source of the virus transmission. Comorbid that were present were also recorded.
Results: There were 53% confirmed COVID-19 cases in the age group 0-5 years. Out of 92 samples, 67% presented with comorbid, mostly with haemato-oncology disease. There were only 10% of cases classified as severe cases. Based on an interview with the parents, the primary source of the virus transmission depends on the age group. Parents (71.3%) were the primary source within the age group 0-5 years, while school and community were the primary sources within the age group >5 – 10 years and >10 – 18 years, respectively 66% and 32%.
Conclusion: COVID-19 transmission in the pediatric population has different primary sources of infection depending on the age group. The most comorbid that were presented in COVID-19 cases is haemato-oncology disease which can be classified as immunocompromised patients.
Latar Belakang: COVID-19 merupakan penyakit yang disebabkan oleh virus SARS-CoV-2. Hingga saat ini, pola transmisi COVID-19 maupun data terkait komorbid pada populasi pediatri masih terbatas, meskipun hal tersebut sangat penting sebagai salah satu faktor penentu derajat keparahan COVID-19. Tujuan penelitian ini adalah mengetahui pola transmisi serta ada terkait komorbid pada kasus COVID-19 terkonfirmasi pada pediatri, agar pencegahan penularan dapat dilakukan terutama pada anak yang berisiko tertular virus tersebut.
Metode: Studi observasional dengan metode potong lintang ini dilakukan pada anak berusia 0-18 tahun yang terkonfirmasi COVID-19 berdasarkan pemeriksaaan RT-PCR selama periode Maret 2020-2022 pada departemen Ilmu Kesehatan Anak/Rumah Sakit Ulin Banjarmasin. Total anak yang dirawat dengan diagnose COVID-19 terkonfirmasi adalah 92 pasien. Data terkait komorbid yang ada juga dicatat dan dianalisa.
Hasil: Terdapat 53% kasus COVID-19 terkonfirmasi pada kelompok usia 0-5 tahun. Dari total 92 sampel penelitian, 67% pasien memiliki komorbid, dengan yang terbesar adalah penyakit hemato-onkologi. Hanya terdapat 10% kasus yang tergolong kasus COVID-19 derajat berat. Berdasarkan hasil wawancara orangtua sampel, sumber penularan primer transmisi virus berbeda-beda tiap kelompok umur. Orangtua (71,3%) merupakan sumber penularan primer transmisi virus pada kelompok usia 0-5 tahun, sedangkan sekolah dan komunitas menjadi sumber utama pada kelompok usia >5 -10 tahun dan usia >10-18 tahun, berturut-turut 66% dan 32%.
Kesimpulan: Transmisi COVID-19 pada populasi pediatri memiliki perbedaan sumber penularan primer virus tergantung kelompok usia. Komorbid terbanyak yang ditemui pada kasus COVID-19 terkonfirmasi adalah penyakit hemato-onkologi, yang termasuk kedalam pasien dengan imunokompromais.
Correlation between nutritional status and side effects of covid-19 vaccination in students of Senior High School 1 Namorambe, Sumatra, Indonesia
Safarna Lavia, Inke Nadia Diniyanti Lubis, Rini Savitri DaulayOnline First: Jul 13, 2023
- Abstract
Correlation between nutritional status and side effects of covid-19 vaccination in students of Senior High School 1 Namorambe, Sumatra, Indonesia
Introduction: The global pandemic caused by the Coronavirus Disease 2019 (COVID-19) is currently causing havoc in various sectors of global life, such as public health, the economy, and life. Vaccines are biological agents that can provide active protection against specific infectious diseases. The side effects that can be caused by the COVID-19 vaccine are very wide, and the most common side effects are pain, fatigue, and headaches. This study aimed to determine the relationship between the occurrence of side effects of the COVID-19 vaccine and the nutritional status of Senior High School 1 Namorambe students, Deli Serdang Regency, North Sumatera Province.
Method: This research is an observational study with a cross-sectional study design. The population in this study were all Senior High School 1 Namorambe students who were participants in the COVID-19 vaccination, namely 657 students, the sample in the study was 196 students.
Result: The results of the study, namely the most common side effects experienced by research subjects were colds (15.8%), headaches (15.1%), nasal congestion (10.3%), coughs (9.8%), and fever (8.0%). The results of the bivariate analysis found that there was no significant relationship between gender, age group, and nutritional status with the incidence of COVID-19 vaccine side effects (H0, H28, and H60) in Senior High School 1 Namorambe students (p-value >0.05).
Conclusion: It is necessary to carry out further research on the relationship between nutritional status and the incidence of side effects of the COVID-19 vaccine in adolescents using a larger and heterogeneous population to reduce bias factors.
Karakteristik tajam penglihatan, tekanan bola mata dan penyakit mata masyarakat Desa Celuk, Gianyar Provinsi Bali di era pandemi COVID 19
Ni Kadek Puspa Mega Putri Sudibia, Ni Made Ari Suryathi, Ni Made Suryanadi, I Wayan Eka Sutyawan, Ni Made Laksmi Utari, I Gusti Ayu Ratna SuryaningrumOnline First: Jul 3, 2023
- Abstract
Karakteristik tajam penglihatan, tekanan bola mata dan penyakit mata masyarakat Desa Celuk, Gianyar Provinsi Bali di era pandemi COVID 19
Background: It is an important effort to do a visual and intraocular pressure by conducting examination directly to the community due to support the Indonesian Ministry of Health to reduce the prevalence of blindness by 2030. This examination will produce epidemiological data.
Aim: To find out the characteristics of visual acuity, intraocular pressure and eye disease in the people of Celuk Village, Gianyar, Bali in the Era of Covid 19 pandemic.
Methods: Observational descriptive of the people of Celuk Village, Gianyar Regency, Bali
Results: Visual examination results in the right and left eyes were mostly normal. The results of tonometry showed that most people still have normal eye pressure. The data obtained from the examination results to the public can be used as a reference value in the normal population. Strategies that can be taken to prevent the transmission of COVID-19 during external examinations are choosing a large location, adjusting the seat distance, setting the time of patient arrival, officers must be vaccinated, antigen swabs are carried out, and use PPE.
Conclusion: In this study, the most common visual disturbance was age-related presbyopia.
Latar belakang: Pemeriksaan visus dan tekanan bola mata dengan turun langsung ke masyarakat sangat penting untuk dilakukan karena menunjang harapan Kemenkes RI menurunkan prevalensi kebutaaan tahun 2030. Pemeriksaan ini akan menghasilkan data epidemiologis.
Tujuan: Untuk mengetahui karakteristik tajam penglihatan, tekanan bola mata dan penyakit mata masyarakat Desa Celuk, Gianyar Provinsi Bali di era pandemi COVID 19
Metode: Deskriptif observasional pada masyarakat Desa Celuk, Kabupaten Gianyar, Provinsi Bali.
Hasil: Visus mata kanan dan kiri sebagian besar normal. Hasil tonometri mendapatkan sebagian besar masyarakat masih memiliki tekanan bola mata normal. Data yang diperoleh dari hasil pemeriksaan tersebut ke masyarakat dapat digunakan sebagai referensi nilai normal di populasi. Strategi yang dapat dilakukan untuk pencegahan transmisi COVID-19 selama skrining dan pemeriksaan luar adalah memilih lokasi yang luas, mengatur jarak kursi tunggu, mengatur waktu kedatangan pasien, seluruh petugas wajib divaksinasi, dilakukan swab antigen, dan menggunakan APD.
Simpulan: Pada penelitian ini gangguan penglihatan yang paling banyak adalah presbiopia terkait dengan usia.
Gambaran karakteristik pasien balita dan faktor resiko merokok di pkm manggar periode bulan februari sampai maret 2022
Made Nindya Prahasari Wismawan, Isdiawati, Ida KurniatiOnline First: Aug 23, 2023
- Abstract
Gambaran karakteristik pasien balita dan faktor resiko merokok di pkm manggar periode bulan februari sampai maret 2022
Introduction: Acute respiratory infection (ARI) is still a major health problem in Indonesia. Parents' smoking habit is a risk factor for the incidence of ARI in children under five. This study aims to assess the relationship between the incidence of ISPA in toddlers and the smoking habits of parents who come to the Manggar Health Center.
Methods: This descriptive observational study was conducted using a cross-sectional method in the period February - March 2022 at PKM Manggar. The independent variable includes the degree of parental smoking behavior. While the dependent variable is the visit of pediatric patients with a diagnosis of ISPA.
Results: Fifty visits of toddler patients during the study period were dominated by ARI patients (52%). As many as 64% of patients were passive smokers with 62% getting exposure to cigarette smoke of more than 5 cigarettes per day. Most of the patients were males with normal birth weight and aged between 2-5 years.
Conclusion: Further analytical exploration to determine the relationship between parents' smoking habits and the incidence of ARI in toddlers is needed.
Pendahuluan: Infeksi saluran pernapasan akut (ISPA) masih menjadi masalah kesehatan besar di Indonesia. Kebiasaan merokok orang tua merupakan faktor risiko kejadian ISPA pada balita. Penelitian ini bertujuan untuk menilai hubungan kejadian ISPA pada balita dengan kebiasaan merokok orang tua yang datang ke Puskesmas Manggar .
Metode: Penelitian observasional deskriptif ini dilakukan menggunakan metode potong lintang pada periode Februari - Maret 2022 di PKM Manggar. Variabel bebas meliputi derajat perilaku merokok orang tua. Sementara variabel terikat adalah kunjungan pasien anak dengan diagnosis ISPA.
Hasil: Lima puluh kunjungan pasien balita selama periode penelitian didominasi oleh pasien ISPA (52%). Sebanyak 64% pasien merupakan perokok pasif dengan 62% mendapatkan pajanan asap rokok lebih dari 5 batang per hari. Sebagian besar pasien adalah laki-laki dengan berat badan lahir normal dan berusia antara 2-5 tahun.
Kesimpulan: Eksplorasi lebih lanjut secara analitik untuk mengetahui hubungan antara kebiasaan merokok orang tua dan kejadian ISPA pada balita diperlukan.
Faktor risiko kejadian dengue shock syndrome pada anak di RSUD Sanjiwani Gianyar periode Januari 2021 sampai September 2022
Anak Agung Puteri Indira Rajani, Romy WindiyantoOnline First: Aug 18, 2023
- Abstract
Faktor risiko kejadian dengue shock syndrome pada anak di RSUD Sanjiwani Gianyar periode Januari 2021 sampai September 2022
Background: Early detection and proper management are crucial to prevent rapid mortality caused by severe dengue, particularly in children, and it is essential to identify potential risk factors that may lead to dengue shock syndrome (DSS) to anticipate and manage potential worsening in pediatric patients. This study aims to evaluate the factors associated with the development of DSS in children with dengue.
Methods: Between January 2021 and September 2022, a cross-sectional study was conducted at the Sanjiwani Regional General Hospital in Gianyar City. The study involved the use of secondary data from medical records of pediatric patients aged 0-18 years, who were diagnosed with dengue during the period under investigation. The variables of age, gender, nutritional status, abdominal pain, persistent vomiting, bleeding, leukocyte levels, hemoglobin, hematocrit, platelets, and hemoconcentration were analyzed for their association with the prevalence of DSS.
Results: The study subjects were 62 children who met the criteria. A total of 31 (50%) patients were diagnosed with DSS. The results of this study indicate that the factors that have an association with the incidence of DSS in children at Sanjiwani Gianyar Hospital are age (p=0.038; prevalence ratio [PR]=0.359), nutritional status (p=0.020; PR=1.897), abdominal pain (p=0.038; PR=2.154), platelet levels (p=0.046; PR=1.672), and the presence of hemoconcentration (p=0.002; PR=2.122).
Conclusion: Age, nutritional status, abdominal pain, platelet levels, and hemoconcentration factors were found to be associated with the incidence of DSS.
Latar belakang: Severe dengue dapat menyebabkan kematian yang cepat terutama pada anak-anak jika tidak terdeteksi sejak dini dan dikelola dengan baik. Mengidentifikasi faktor-faktor risiko yang berpotensi mempengaruhi dengue shock syndrome (DSS) penting untuk mengantisipasi dan mengelola potensi perburukan pada pasien anak. Penelitian ini bertujuan mengevaluasi faktor-faktor yang berkontribusi dalam perkembangan DSS pada anak-anak dengan dengue.
Metode: Penelitian cross-sectional dilakukan menggunakan data sekunder dari rekam medik di Rumah Sakit Umum Daerah (RSUD) Sanjiwani Gianyar, pada pasien anak berusia 0-18 tahun yang terinfeksi dengue dan dirawat pada periode Januari 2021-September 2022. Variabel usia, jenis kelamin, status gizi, nyeri perut, muntah persisten, perdarahan, kadar leukosit, hemoglobin, hematokrit, trombosit, dan hemokonsentrasi dianalisis hubungannya dengan kejadian DSS.
Hasil: Subyek penelitian sebanyak 62 sampel yang memenuhi kriteria. Sebanyak 31 (50%) pasien terdiagnosis DSS. Hasil penelitian ini menunjukkan bahwa faktor-faktor yang memiliki hubungan dengan kejadian DSS pada anak di RSUD Sanjiwani Gianyar yaitu usia (p=0,038; prevalence ratio [PR]=0,359), status gizi (p=0,020; PR=1,897), nyeri perut (p=0,038; PR=2,154), kadar trombosit (p=0,046; PR=1,672), dan adanya hemokonsentrasi (p=0,002; PR=2,122).
Kesimpulan: Faktor risiko yang ditemukan berhubungan dengan kejadian DSS meliputi usia, status gizi, nyeri perut, kadar trombosit, dan kejadian hemokonsentrasi.
Association of Neutrophil-lymphocyte ratio and platelet lymphocyte ratio with GRACE risk score and high-sensitivity Troponin T in acute coronary syndrome patient
Gede Dehandra Dipastraya Wikananda, Achmad Yusri Rachmani DiartoputraOnline First: Jun 7, 2023
- Abstract
Association of Neutrophil-lymphocyte ratio and platelet lymphocyte ratio with GRACE risk score and high-sensitivity Troponin T in acute coronary syndrome patient
Background: Inflammatory indicators such as alterations in neutrophils, platelets, and lymphocytes are linked to the acute coronary syndrome. This research seeks to understand the association of the Platelet Lymphocyte Ratio (PLR) and Neutrophil-Lymphocyte Ratio (NLR) with the Grace score as well as the association between NLR and PLR with High Sensitivity Troponin T (hs-cTnT) as a serum biomarker that aids in ACS diagnosis.
Methods: The 99 patients who met the inclusion criteria for this study were the subject of an analytical investigation with a retrospective cross-sectional design. Based on the ratio of lymphocytes to neutrophils, NLR is determined. Based on the ratio of platelets to lymphocytes, PLR is determined. hs-cTnT laboratory samples were collected more than three hours after the ischemia complaint first manifested, using the Grace risk score as a predictor of mortality. Using SPSS program 25.0, data were examined.
Results: Bivariate analysis using the Spearman correlation test. There is a correlation between NLR and GRACE risk scores (r=0.348; p<0.001), PLR and GRACE risk scores (r=0.434; p<0.001), NLR and hs-cTnT (r=0.343; p=0.001), PLR and hs-cTnT (r=0.284; p=0.004). ROC curve analysis, NLR cut-off value 4.45 (sensitivity 73.3%; specificity 72.6%), and PLR cut-off value 139.77 (sensitivity 66.7%; specificity 59.5 %) to detect High grace score. NLR cut-off value 2.17 (sensitivity 62.9%; specificity 60 %), and PLR cut-off value 108.38 (sensitivity 60.7%; specificity 60 %) to detect High hs-cTnT.
Conclusion: In this study, there was a relationship between NLR and PLR with the Grace risk score as well as a relationship between NLR and PLR with hs-cTnT.
Incidence and outcomes of persistent pulmonary hypertension of the newborn in a tertiary referral center, Indonesia
Maria Angela Yustina Fernandez, Eka Gunawijaya, Ni Putu Veny Kartika Yantie, Made SukmawatiOnline First: Aug 28, 2023
- Abstract
Incidence and outcomes of persistent pulmonary hypertension of the newborn in a tertiary referral center, Indonesia
Background: Persistent pulmonary hypertension of the newborn (PPHN), also known as persistent fetal circulation, is a failure of the transition/adaptation process from fetal to extrauterine life with significant morbidity and mortality rates. This study determined the incidence and outcome of PPHN in infants.
Methods: From January 2017 to March 2022, an observational study was conducted on newborns with PPHN who were hospitalized in the second and third-level neonatology wards of Prof. Dr. I.G.N.G. Ngoerah Hospital. Based on a clinical and echocardiographic examination, PPHN was confirmed. Missing data on infants were excluded. PPHN incidence and outcomes were the main outcomes. The clinical profile of newborns with PPHN was one of the secondary outcomes.
Results: There were 42 neonates, with a median age of 1 (range 0-5 days) day at diagnosis. PPHN occurred in 2.5 cases per 1000 neonates admitted, with 60% male and 40% female. Referrals accounted for 74% of all PPHN cases. The majority of cases were born cesarean delivery (83%), at term (74%), and with birth weights of more than 2500 grams (65%). In 55% of cases, asphyxia history was discovered. The median oxygen index (OI) was 5.3 (range 1.90-57.30), with pneumonia/sepsis accounting for 95% of the causes. The median length of stay was 9.50 days (range 1-89), and 20 (48%) of the 42 cases had death.
Conclusion: The incidence of PPHN in a tertiary referral center in Indonesia is 2.5 cases per 1000 patients treated with a 48% mortality rate.
Hubungan antara pola asuh dengan kejadian Gangguan Stres Pasca Trauma (GSPT) pada penyintas kekerasan seksual yang terjadi saat usia anak
Jacqueline Nicole, Anak Ayu Sri Wahyuni, I Gusti Ayu Indah Ardani, Lely Setyawati KurniawanOnline First: Aug 6, 2023
- Abstract
Hubungan antara pola asuh dengan kejadian Gangguan Stres Pasca Trauma (GSPT) pada penyintas kekerasan seksual yang terjadi saat usia anak
Background: The number of sexual violence cases against children under the age of 18 in Indonesia has shown an upwards trend every year. Sexual violence also has a serious impact on the psychological well-being of children. However, disclosure rates of sexual violence in Indonesia is still very low. One of the factors that determine the occurrence of psychological disorders after traumatic events is the parenting style experienced by the individual. This study aims to identify the characteristics of survivors of sexual violence that occurred during childhood and to investigate the relationship between parenting style and the occurrence of PTSD in survivors.
Methods: The study sample was taken from the list of sexual violence reports at LBH APIK and UPTD PPA Denpasar, Bali. Parenting style was assessed using the Parental Authority Questionnaire (PAQ) and the PTSD score was measured using the PTSD checklist for DSM-V (PCL-5) questionnaire. Data were analyzed using SPSS version 26.0 for Windows.
Results: It was found that 62.5% of the sample experienced GSPT. The distribution of parenting styles experienced by the sample is as follows: 54.2% are authoritarian, 33.3% are democratic, and 12.5% are permissive. In the sample group with authoritarian parenting, 76.9% experienced GSPT. In the group with democratic parenting, 50% experienced GSPT, whereas in the group with permissive parenting, 33.3% experienced GSPT. However, the differences between the three groups were not significant based on the Chi-square test due to the limited number of samples. Survivors of sexual violence with authoritarian parenting styles have a higher OR = 4.00 of experiencing GSPT than samples with democratic and permissive parenting styles.
Conclusion: Authoritarian parenting has a greater correlation with the incidence of GSPT than permissive and democratic parenting. However, the chi-square test indicated that there was no significant difference in the findings.
Latar Belakang: Angka kekerasan seksual pada anak berumur di bawah 18 tahun di Indonesia menunjukkan tren terus meningkat setiap tahunnya. Kekerasan seksual juga berdampak berat terhadap keadaan psikis anak, namun tingkat pelaporan kekerasan seksual di Indonesia sayangnya masih rendah. Salah satu faktor yang menentukan terjadinya gangguan psikis setelah kejadian traumatis adalah pola asuh orangtua. Penelitian ini bertujuan untuk mencari karakteristik penyintas kekerasan seksual yang terjadi saat usia anak dan mencari hubungan pola asuh dan kejadian GSPT pada penyintas.
Metode: Sampel penelitian diambil dari daftar laporan kekerasan seksual pada LBH APIK dan UPTD PPA Denpasar, Bali. Pola Asuh anak dinilai dari Parental Authority Questionnaire (PAQ) dan skor GSPT diukur dengan kuesioner PTSD checklist for DSM-V (PCL-5). Data dianalisis dengan SPSS versi 26.0 untuk Windows.
Hasil: Ditemukan bahwa 62,5% sampel mengalami GSPT. Distribusi pola asuh yang dialami sampel adalah sebagai berikut: 54,2% otoriter, 33,3% demokratis, dan 12,5% permisif. Kelompok sampel dengan pola asuh otoriter, 76,9% mengalami GSPT. Pada kelompok dengan pola asuh demokratis, 50% mengalami GSPT, sedangkan pada kelompok dengan pola asuh permisif, 33,3% mengalami GSPT. Namun, perbedaan antara ketiga kelompok tidak signifikan berdasarkan uji Chi-square karena jumlah sampel yang terbatas. Penyintas kekerasan seksual dengan pola asuh otoriter memiliki OR = 4,00 lebih tinggi mengalami GSPT daripada sampel dengan pola asuh demokratis dan permisif.
Kesimpulan: Pola asuh otoriter memiliki korelasi lebih besar dengan kejadian GSPT daripada pola asuh permisif dan demokratis. Namun, uji chi-square menunjukkan bahwa tidak ada perbedaan signifikan dalam temuan tersebut.
Hubungan kebiasaan menginang dengan kejadian gingivitis pada lansia di wilayah kerja Puskesmas Kintamani VI
Desak Ayu Dhyana Nitha Dewi, I Made Subrata, Ni Wayan Arya UtamiOnline First: Jul 20, 2023
- Abstract
Hubungan kebiasaan menginang dengan kejadian gingivitis pada lansia di wilayah kerja Puskesmas Kintamani VI
Background: Elderly is one of the risk groups for periodontal disease, one of which is gingivitis. This study aimed to identify the relationship between betel chewing habits and the incidence of gingivitis among elderly in the Kintamani VI Health Center.
Methods: A quantitative analytical research design with a cross-sectional approach was used in this study, involving about 134 elderly respondents aged 55 years and over in the Kintamani VI Public Health Center. The variabels measured in this study included the characteristics of the elderly (age, gender, occupation, and income), the incidence of gingivitis, betel chewing habits, the habit of brushing teeth and rinsing with antiseptiks, and knowledge related to gingivitis.
Results: The results of the analysis showed that most of the incidence of gingivitis was found in the male group, aged between 75 to 90 years, worked as traders/entrepreneurs, earned more than the regional minimum wage Bangli Regency (IDR 2,516,917), had betel chewing habits, had less knowledge, not regularly brushing teeth every day, and not gargling with antiseptik liquid. The proportion of respondents who had betel chewing habit was 43.3% and 61.9% had gingivitis. In addition, the betel chewing habit can increase the risk of gingivitis up to 3,269 times and earning more than the regional minimum wage is at risk of experiencing gingivitis by 3,618 times.
Conclusion: Health promotion to the elderly group and their families is very important to increase awareness that brushing teeth properly and correctly can prevent gingivitis and good for oral and dental health.
Latar Belakang: Lansia merupakan salah satu kelompok berisiko untuk terkena penyakit periodontal, salah satunya adalah gingivitis. Penelitian ini bertujuan untuk mengidentifikasi hubungan kebiasaan menginang dengan kejadian gingivitis pada lansia di wilayah kerja Puskesmas Kintamani VI.
Metode: Rancangan penelitian analitik kuantitatif dengan pendekatan crosssectional digunakan dalam penelitian ini, dengan melibatkan 134 responden lansia yang berusia 55 tahun ke atas di wilayah kerja Puskesmas Kintamani VI. Variabel yang diukur pada penelitian ini meliputi karakteristik lansia (usia, jenis kelamin, pekerjaan, dan penghasilan), kejadian gingivitis, kebiasaan menginang, kebiasaan gosok gigi dan berkumur dengan antiseptik, dan pengetahuan terkait gingivitis.
Hasil: Hasil analisis menunjukkan bahwa sebagian besar kejadian gingivitis ditemukan pada kelompok laki-laki, berusia antara 75 hingga 90 tahun, bekerja sebagai pedagang/wiraswasta, berpenghasilan lebih dari UMK Kabupaten Bangli (Rp. 2.516.917), memiliki kebiasaan menginang, memiliki pengetahuan yang kurang, tidak rutin gosok gigi setiap hari, dan tidak berkumur dengan cairan antiseptik. Proporsi responden yang menginang adalah 43,3% dan sebanyak 61,9% mengalami gingivitis. Selain itu, kebiasaan menginang dapat meningkatkan risiko terkena gingivitis hingga 3,269 kali serta berpenghasilan lebih dari UMK berisiko mengalami gingivitis sebesar 3,618 kali.
Kesimpulan: Promosi kesehatan kepada kelompok lansia dan keluarganya sangat penting dilakukan untuk meningkatkan kesadaran bahwa gosok gigi yang baik dan benar dapat mencegah terjadinya gingivitis serta bermanfaat untuk menjaga kesehatan gigi dan mulut.
Association between T2DM with high resting heart rate and abnormal heart rate recovery within one minute after treadmill exercise test in CHD patients
I Gede Bagus Gita Pranata Putra, Ida Bagus Budha Dharma Kusuma, Ni Wayan Armerinayanti, Ketut Erna Bagiari, Eka Sriayu WulandariOnline First: Aug 30, 2023
- Abstract
Association between T2DM with high resting heart rate and abnormal heart rate recovery within one minute after treadmill exercise test in CHD patients
Background: Diabetes mellitus and coronary heart disease are chronic diseases that are very closely related. It has long been known that diabetes mellitus is a significant risk factor for coronary heart disease. The incidence of diabetes mellitus is increasing, according to data taken from the PERKENI consensus, WHO predicts an increase in the number of people with DM in Indonesia from 8.4 million in 2000 to around 21.3 million in 2030. The purpose of this study was to determine whether diabetes mellitus is related to cardiovascular autonomic neuropathy.
Methods: This research method is helpful to know that diabetes mellitus is directly related to cardiovascular autonomic neuropathy so that it will affect a person's hemodynamic quality functionally. In addition, to functionally affecting a person's hemodynamic capacity, determining that a patient with cardiovascular autonomic neuropathy is determined from the high resting heart rate and abnormal recovery heart rate variables after the treadmill exercise test, we can provide information and education to patients regarding the importance of a cardiac rehabilitation program in patients with coronary heart disease.
Results: A total of 45 people according to the calculation of the number of samples by type, male sex numbered 30 and female numbered 15 people. The number of patients who experienced impaired recovery of the 1-minute heart rate in this study was 25 people (55.5%) with the majority being male. And the number of sufferers who experience high heart rates at rest is 22 people (48.9%). In a bivariate analysis, patients with type 2 diabetes mellitus and without type 2 diabetes mellitus significantly worsened recovery heart rate (P value <0.05).
Conclusion: There is a significant relationship between diabetes mellitus on high resting heart rate and diabetes mellitus on poor heart rate recovery in 1 minute in patients with coronary heart disease.
Presepsin as diagnostic test in neonatal sepsis
Luh Made Diah Wulandari Artana, Putu Junara Putra, I Nyoman Budi Hartawan, Ni Putu Siadi Purniti, I Gusti Lanang Sidiartha, Ayu Setyorini Mestika MayangsariOnline First: Sep 4, 2023
- Abstract
Presepsin as diagnostic test in neonatal sepsis
Background: Sepsis is clinical syndrome characterized by hemodynamic, respiratory and metabolic changes resulting from infectious processes that trigger systemic inflammatory response syndrome. The latest diagnosis enforcement of neonatal sepsis in the form of biomarker, presepsin. This research was established to estimate the accuracy of presepsin in diagnosing neonatal sepsis in preterm
Methods: This study is cross-sectional study with diagnostic test design to determine the accuracy of presepsin examination in diagnosing neonatal sepsis with gold standard used double-sided blood culture. Sample size was 62 samples. Data analysis including sensitivity, specificity, positive predictive value, negative predictive value and accuracy of presepsin as diagnostic test calculated by using 2x2 table.
Results: This study involved 62 subjects. Subjects were dominated by median age 3, male 66.1%, birth weight 1500-<2500 grams 53.2%, vigorous baby 51.6%, caesarean section 67.7%, median leukocytes 4.8, median platelets 101.4, median IT-ratio 0.33, procalcitonin 2.21 and positive blood culture 77.4%. The AUC value is 85% and ROC curve showed 2 cut off values, namely 150 pg/mL, 44 subjects suffer neonatal sepsis with sensitivity 91.7%, specificity 78.57%, positive predictive value 93.62%, negative predictive value 73.3%, positive trend ratio 4.28, prevalence 77% and accuracy 88.71%. Cut off 243 pg/mL sensitivity 75%, specificity 85.7%, positive predictive value 94.6%, negative predictive value 50.6%, positive trend ratio 5.25, prevalence 77% and accuracy 77.46%.
Conclusion: A cut off value 150 pg/mL, sensitivity 91.67% presepsin can be used as screening tool and cut off 243 pg/mL with specificity 85.7% as high specificity diagnostic test.
Efek ekstrak umbi ubi jalar ungu (Ipomoea batatas) terhadap peningkatan ekspresi ABCA1 pada tikus model dislipidemia
I Ketut Rama Ardiana, Gede Setula Narayana, I Nyoman Tri Pramartha, Gde Ngurah Indraguna Pinatih, Dya Pradnyaparamita DuarsaOnline First: Aug 21, 2023
- Abstract
Efek ekstrak umbi ubi jalar ungu (Ipomoea batatas) terhadap peningkatan ekspresi ABCA1 pada tikus model dislipidemia
Background: Maintaining the homeostasis of body fat levels is an important thing. ABCA1 is an important protein in cholesterol efflux function, which can maintain lipid profile homeostasis. Purple sweet potato (potato ipomoea batatas) is a Convolvulaceae plant with various biological functions, one of which is anthocyanin content known to prevent hyperlipidemia through ABCA1 synthesis. This study aims to examine the effect of purple sweet potato tuber extract on increasing levels of ABCA1.
Methods: Post-test-only study design with a control group using 50 male Wistar rats divided into 5 groups (n = 10). The negative treatment group (P0) was given standard feed, while the positive group (P4), treatment 1 (P1), treatment 2 (P2) and treatment 3 (P3) were given a hyperlipidemic diet for 8 weeks. The treatment group was then given purple sweet potato tuber extract with 3 doses, including 200mg/kg (P1), 400mg/kg (P2), and 800mg/kg (P3) for 2 weeks, and the food was returned to standard food.
Results: There was a significant increase in ABCA1 levels in P2 and P3 compared to negative controls (P <0.05), but the increase in ABCA1 in P3 was not different from positive controls.
Latar Belakang : Menjaga homeostasis kadar lemak tubuh merupakan hal yang penting. ABCA1 merupakan protein yang penting dalam fungsi efluks kolestrol yang dapat menjaga homeostasis profil lipid. Ubi ungu (Ipomoea batatas) merupakan tanaman Convolvulaceae yang memiliki berbagai fungsi biologis, salah satunya kandungan Antosianin yang diketahui dapat mencegah hiperlipidemia melalui sintesis ABCA1. Penelitian ini bertujuan untuk menguji efek ekstrak umbi ubi jalar ungu terhadap peningkatan kadar ABCA1
Metode : Desain penelitian post test only dengan kontrol grup menggunakan 50 ekor tikus wistar jantan yang dibagi menjadi 5 kelompok (n=10). Kelompok perlakuan negatif (P0) diberikan pakan standar sedangkan kelompok positif (P4), perlakuan 1(P1), perlakuan 2(P2) dan perlakuan 3(P3) diberikan diet hiperlipidemia selama 8 minggu. Kelompok perlakuan kemudian diberikan ekstrak umbi ubi jalar ungu dengan 3 dosis, antara lain 200mg/kg(P1), 400mg/kg(P2), 800mg/kg(P3) selama 2 minggu dan makanannya dikembalikan ke makanan standar.
Hasil : Terdapat peningkatan kadar ABCA1 yang signifikan pada P2 dan P3 dibandingkan dengan kontrol negatif (P<0,05) tetapi peningkatan ABCA1 pada P3 tidak berbeda dengan kontrol positif.
Karakteristik pasien glaukoma sekunder di RSUP Prof Ngoerah periode 2018-2020
Angelo Doniho, I Gusti Ayu Ratna Suryaningrum, I Made Agus Kusumadjaja, Anak Agung Mas Putrawati Triningrat, Ida Bagus Putra Manuaba, Ni Kompyang Rahayu, Deasy Sucicahyati MendalaOnline First: May 3, 2023
- Abstract
Karakteristik pasien glaukoma sekunder di RSUP Prof Ngoerah periode 2018-2020
Introduction: Secondary glaucoma refers to any form of glaucoma in which there is identifiable cause of increased eye pressure, resulting in optic nerve damage and vision loss. Secondary glaucoma can be caused by lens, diabetes (neovascular glaucoma), trauma, post-operation of vitrectomy, corneal abnormality, uveitis and many more. Glaucoma is a condition presents in 80 million people worldwide, in which 6 million of them had secondary glaucoma. Causes of secondary glaucoma may differ from place to place. This study aims to determine the characteristics of secondary glaucoma patients at the eye polyclinic Prof Dr IGNG Ngoerah Hospital Denpasar in 2018-2022.
Patients and methods: This research is a descriptive analytical study with retrospective data. Study were done by collecting data based on observations of the medical records of patients who visited Eye Polyclinic at Prof Ngoerah General Hospital in the period of 2018-2020. A total of 55 people (67 eyes) who met the inclusion and exclusion criteria were analysed using SPSS for windows version 23.0
Results: The majority of subjects aged > 60 years (41.8%), male (71.6%), came with chief complaints of blurry vision (97%), unilateral (64.2%), open-angle (67.2%) and mostly had chronic onset (97%). There was significant improvement of visual acuity and intraocular pressure after surgery. The amount of drug used also decreased significantly after having surgery. There is significant improvement in visual acuity in patients after surgery from logmar 1.61 to logmar 0.85. Average intraocular pressure in patients receiving therapy decreased from 30.93 to 17.39. Considering drugs usage, it decreased from average of 1.64 to 0.68. Paired T-test analysis were used, resulting in statistically meaningful results.
Conclusion: Treatment for patients with secondary glaucoma in our hospital results in better visual acuity, decreased intraocular pressure, and decreased of anti-glaucoma drugs usage.
Latar Belakang: Glaukoma sekunder mengacu pada kondisi glaukoma dimana penyebab peningkatan tekanan mata telah diketahui, dimana hal ini menyebabkan kerusakan saraf optik dan kehilangan penglihatan. Penyebab glaukoma sekunder bervariasi meliputi lensa, diabetes (glaukoma neovaskuler), trauma, post-operasi vitrektomi, kelainan kornea, uveitis, dan lain-lain. Glaukoma diderita 80 juta orang di seluruh dunia, dimana 6 juta diantaranya dengan glaukoma sekunder. Penelitian bertujuan mengetahui karakteristik pasien glaukoma sekunder yang datang ke poliklinik mata di RSUP Prof Dr IGNG Ngoerah Denpasar pada tahun 2018-2020.
Metode: Penelitian ini merupakan penelitian deskriptif analitik. Data dikumpulkan secara retrospektif berdasarkan catatan medis pasien yang berkunjung ke Poliklinik Mata RSUP Prof Ngoerah periode 2018-2020. Sebanyak 55 orang (67 mata) subjek penelitian yang memenuhi kriteria inklusi dan eksklusi dianalisis menggunakan SPSS for windows versi 23.0
Hasil: Total 55 pasien (67 mata) dengan mayoritas subjek berusia > 60 tahun (41,8%), berjenis kelamin laki-laki (71,6%), datang dengan keluhan pandangan buram (97%). Sebagian besar glaukoma pada penelitian ini terjadi unilateral (64,2%) dengan onset kronis (97%) dan sebesar 67,2% diantaranya merupakan glaukoma sudut terbuka. Terdapat perbaikan signifikan rerata tajam penglihatan pasien yang telah dioperasi logmar 1.61 menjadi logmar 0.85. Untuk rerata tekanan intraokular pasien yang mendapatkan terapi mengalami penurunan dari 30.93 mmHg menjadi 17,39 mmHg. Dilihat dari jumlah obat glaukoma yang digunakan setelah operasi mengalami penurunan dari 1,64 menjadi 0,68. Analisa statistik menggunakan uji T-berpasangan dimana didapatkan hasil yang bermakna secara statistik.
Kesimpulan: Pasien glaukoma sekunder yang mendapatkan pengobatan, didapatkan perbaikan tajam penglihatan, penurunan tekanan intraokuler, serta penurunan jumlah obat antiglaukoma.
Analisis faktor-faktor yang mempengaruhi produktivitas kerja perawat pelaksana di ruang rawat inap RSUP Ratatotok Buyat di era adaptasi kebiasaan baru COVID-19
Stefany Jemmi Junaidy Waani, Starry Homenta Rampengan, Aaltje Ellen ManampiringOnline First: Aug 20, 2023
- Abstract
Analisis faktor-faktor yang mempengaruhi produktivitas kerja perawat pelaksana di ruang rawat inap RSUP Ratatotok Buyat di era adaptasi kebiasaan baru COVID-19
Introduction: The performance of nurses, especially inpatient nurses who have a considerable impact on the quality of hospital services, is a good indicator of the standard of healthcare provided in hospitals. Nurses must increase productivity to improve work quality in order to improve hospital performance. Numerous aspects, such as work motivation, work discipline, education, skills, work environment, and leadership management, have an impact on employee productivity. In the era of adjusting to new COVID-19 behaviors, this study aims to investigate the elements that affect the job productivity of nurses implementing in the inpatient ward of Ratatotok Buyat General Hospital.
Methods: This study used a cross-sectional, observational, analytical, quantitative research design. A sample of 39 nurses participated in the study at RSUP Ratatotok Buyat from January to July 2023. A trustworthy and tested questionnaire served as the research tool. Using questionnaires that were distributed and returned, the research data was collected. univariate, bivariate, and multivariate approaches were used to analyze the data. While multivariate analysis used logistic regression, bivariate analysis used the Chi-square statistical test.
Results: With a p-value of 0.014, the analysis's findings showed a significant correlation between job motivation and productivity. With a p-value of 0.001, the analysis also revealed a strong link between leadership management and job productivity. The results of the multivariate study showed that leadership management had the biggest impact on job productivity, with good leadership having a 2.0 times greater likelihood of raising nurses' output.
Conclusion: Workplace motivation and leadership management have an impact on productivity. The relationship between variables including work discipline, education, skills, and work environment, however, was not discovered to exist. When RSUP Ratatotok Buyat was adjusting to the new standard of Covid-19, leadership management had the most impact on improving nurses' work productivity.
Latar belakang: Kualitas kerja perawat menjadi cerminan pelayanan kesehatan pada rumah sakit, terutama perawat rawat inap menghasilkan dampak yang sangat esensial dalam menentukan mutu dari suatu rumah sakit. Untuk meningkatkan performa rumah sakit, para perawat harus memiliki kualitas kerja yang baik dengan cara membuat tingkat produktivitas kerja semakin baik. Beberapa faktor antara lain yang mempengaruhi kualitas rumah sakit adalah manajemen kepemimpinan, motivasi kerja, keterampilan kerja, lingkungan kerja, disiplin kerja, pendidikan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi produktivitas kerja perawat pelaksana di ruang rawat inap RSUP Ratatotok Buyat di era adaptasi kebiasaan baru COVID-19.
Metode: Penelitian termasuk dalam penelitian observasional analitik kuantitatif dengan desain cross sectional. Penelitian ini bertempat di RSUP Ratatotok Buyat pada bulan Januari-Juli 2023. Sampel yang digunakan sebanyak 39 perawat. Instrumen penelitian berupa kuesioner yang telah diuji validitas dan reliabilitas. Data penelitian diperoleh melalui pembagian dan jawaban kuesioner. Data yang diperoleh dianalisis secara univariat, analisis bivariat menggunakan uji statistik Chi-square, dan analisis multivariat dengan uji regresi logistic.
Hasil: Hasil analisis menunjukkan bahwa terdapat hubungan yang signifikan secara statistik antara variabel motivasi kerja dengan produktivitas kerja (p = 0,014), serta hubungan yang bermakna antara variabel manajemen kepemimpinan dengan produktivitas kerja (p = 0,001). Hasil analisis multivariat memperoleh bahwa variabel manajemen kepemimpinan yang paling berpengaruh terhadap produktivitas kerja, di mana kepemimpinan yang baik memiliki peluang sebesar 2,0 kali dalam meningkatkan produktivitas kerja perawat.
Kesimpulan: Adanya hubungan yang bermakna secara statistik antara motivasi kerja, dan manajemen kepemimpinan dengan produktivitas kerja, sedangkan beberapa faktor seperti disiplin kerja, pendidikan, keterampilan kerja dan lingkungan kerja tidak berhubungan. Faktor manajemen kepemimpinan merupakan faktor yang paling berpengaruh dalam meningkatkan produktivitas kerja perawat di RSUP Ratatotok Buyat di era adaptasi kebiasaan baru COVID-19.
Omicron tidak meningkatkan Neutrophil to Lymphocyte Ratio (NLR) di Rumah Sakit Darurat Covid-19 (RSDC) Wisma Atlet Kemayoran: studi pendahuluan
Winda Amelia, Jemimah Kezia Lee, Silvia Yanita Karina, Karolin Dwi Setiowati SidhartaOnline First: Jul 6, 2023
- Abstract
Omicron tidak meningkatkan Neutrophil to Lymphocyte Ratio (NLR) di Rumah Sakit Darurat Covid-19 (RSDC) Wisma Atlet Kemayoran: studi pendahuluan
Background: Neutrophil Lymphocyte Ratio (NLR), which is the sum of neutrophils divided by lymphocytes, has an important role in determining the inflammatory state in the patient. RNL is one of the markers of inflammation that is simple, rapid, and can be performed on routine blood tests.
Methods: This research is a retrospective descriptive study that examined NLR levels in patients confirmed with the Omicron variant of COVID-19 infection at the Wisma Atlet COVID-19 Hospital, Kemayoran, Jakarta. Data were analyzed using SPSS version 20.0 for Windows.
Results: From 331 samples, 187 samples were found to be female and 144 samples were male. A total of 300 samples had no increase in NLR (NLR <3.13), while the other 31 samples had an increase in NLR (NLR >3.13). Cytokine storm associated with immune dysregulation occurs less in women than in men. Almost all patients with confirmed Omicron variant COVID-19 at the Wisma Atlet Kemayoran Hospital did not experience an increase in NLR.
Conclusion: The cytokine storm associated with immune dysregulation occurs less frequently in women than in men. Almost all patients confirmed with the Omicron variant of COVID-19 at Wisma Atlet Hospital Kemayoran did not experience an increase in NLR.
Latar Belakang: Rasio Limfosit Neutrofil (RNL), yang merupakan jumlah neutrofil dibagi dengan limfosit, memiliki peran penting dalam menentukan keadaan inflamasi pada pasien. RNL merupakan salah satu penanda inflamasi yang sederhana, cepat, dan dapat dilakukan pada pemeriksaan darah rutin.
Metode: Penelitian ini merupakan studi deskriptif retrospektif yang meneliti kadar RNL pada pasien terkonfirmasi infeksi COVID-19 varian Omicron di Rumah Sakit COVID-19 Wisma Atlet, Kemayoran, Jakarta. Data dianalisis dengan SPSS versi 20.0 untuk Windows.
Hasil: Dari 331 sampel, ditemukan 187 sampel berjenis kelamin perempuan dan 144 sampel berjenis kelamin laki-laki. Sebanyak 300 sampel tidak mengalami peningkatan NLR (NLR <3,13), sedangkan 31 sampel lainnya mengalami peningkatan NLR (NLR >3,13). Badai sitokin yang terkait dengan disregulasi imun terjadi lebih sedikit pada wanita dibandingkan pada pria. Hampir seluruh pasien terkonfirmasi varian Omicron COVID-19 di RS Wisma Atlet Kemayoran tidak mengalami peningkatan NLR.
Simpulan: Badai sitokin terkait dengan disregulasi imun, terjadi lebih sedikit pada wanita dibandingkan dengan laki-laki.hampir seluruh pasien terkonfirmasi COVID-19 varian Omicron di RSDC Wisma Atlet Kemayoran tidak mengalami peningkatan RNL.
Clinical profile of patients with pseudoexfoliation glaucoma in Bali Mandara Eye Hospital from January to December 2022: a descriptive retrospective Study
Priscilla Christina Natan, Yinvill, Ni Kompyang RahayuOnline First: Jun 26, 2023
- Abstract
Clinical profile of patients with pseudoexfoliation glaucoma in Bali Mandara Eye Hospital from January to December 2022: a descriptive retrospective Study
Background: Pseudoexfoliative glaucoma (PEX glaucoma) is a type of secondary either open or closed-angle glaucoma that is characterized by the accumulation of flaky, whitish material on the surface of the eye. This material, known as pseudoexfoliative material (PEX), can clog the eye's drainage system, leading to increased intraocular pressure and eventual optic nerve damage if left untreated. This study aimed to describe the characteristic and management of PEXG in the Bali Mandara Eye Hospital Denpasar.
Methods: A descriptive retrospective study was conducted in March-April 2023 using electronic medical records of PEXG patients in the Bali Mandara Eye Hospital Denpasar from January–December 2022.
Results: There were 26 patients (37 eyes) diagnosed as PEXG; most of them were male (88.4%), aged 60-69 years old (34.4%), and followed by those in the range of age 70–79 years old (42.3%). Most of the cases were bilateral (59.5%) with a decrease of visual acuity of less than 3/60 (54%), an increase of intraocular pressure (IOP) with the majority in the range of 20-29 mmHg (35.1%), and 10-19 mmHg (29.8%), and followed by those who have a history of metabolic disease with Hypertension found on ten patients (38.4%) and Diabetes Mellitus on three patients (11.5%). The treatment combined several types of antiglaucoma medication and glaucoma surgery with patients who had undergone surgery in 19 eyes (51.3%). And the post-operative visual acuity was measured and showed the most favorable results, with normal eyes found in 14 eyes (73.6%).
Conclusion: PEX Glaucoma is commonly found in elderly patients. At the same time, most patients come with high IOP and late stage of the disease. The most frequent treatment is triple procedure surgery which produces a significant visual acuity improvement.
Bacterial patterns and antibiotic susceptibility among neonatal sepsis in Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia
I Gusti Amanda Jaya, I Wayan Gustawan, Made Sukmawati, Ni Nengah Dwi FatmawatiOnline First: Aug 6, 2023
- Abstract
Bacterial patterns and antibiotic susceptibility among neonatal sepsis in Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, Indonesia
Background: Neonatal sepsis has the main cause of mortality and morbidity in neonates worldwide; the most frequent cause is bacteria. This study examined the bacterial patterns and antibiotic susceptibility in neonatal sepsis at Prof Ngoerah Hospital, Bali.
Methods: This observational, descriptive study was conducted in Prof Ngoerah Hospital, Bali, Indonesia involving neonatal sepsis confirmed with blood culture. Data on antibiotic susceptibility and bacterial patterns were collected retrospectively from the registry of neonates patients with neonatal sepsis from January 2021 to August 2022.
Results: The predominance of gram-negative bacteria was Acinetobacter baumannii (29.17%), Klebsiella pneumonia (10.42%), and the predominance of gram-positive bacteria was Staphylococcus haemolyticus (14.58%), Staphylococcus epidermidis (8.35%). The susceptibility was Gentamicin (57.29%), Ciprofloxacin (56.84%), Levofloxacin (55.21%), Trimethoprim/sulfamethoxazole (54.17%), Amikacin (50%), Meropenem (39.58%), Ampicilin/sulbactam (34.38%), Cefepim (32.29%), Piperacillin/Tazobactam (28.13%), Cefoperazone sulbactam (25%), Tigecycline (25%), Ceftriaxone (23.96%), and Vancomycin (22.92%).
Conclusion: Gram-negative bacteria were a common infection. This study suggests that the reconsideration of gentamicin still can be an option as an empirical antibiotic, but ampicillin has low sensitivity; another broad-spectrum antibiotic with better sensitivity is another option due to its significantly higher susceptibility.
The association between achieve of full feeding with mortality in children at sanglah hospital
Rina Margareth Sihombing, I Gusti Lanang Sidiartha, I Gusti Ayu Eka PratiwiOnline First: Aug 30, 2023
- Abstract
The association between achieve of full feeding with mortality in children at sanglah hospital
Background: For pediatric patients who are hospitalized, full feeding nutritional needs is not only to improve BMI but also very useful for accelerating the healing process, shortening the treatment period, reducing complications, reducing morbidity and mortality, and preventing malnutrition due to treatment or medical action. This study aimed to describe the association between the achievement of full feeding with mortality in children.
Method: The retrospective study was conducted in Pediatric Ward at Sanglah General Hospital, Denpasar Bali period January to December 2021. The inclusion criteria in this study were all pediatric patients who were hospitalized at pediatric wards Sanglah Hospital Denpasar. Inclusion criteria were children aged 1 month-18 years old. Samples were taken by total sampling. Quantitative variables were tested using variables that scale categorical data will be displayed in the form of absolute numbers and percent. The results of the descriptive analysis are presented using a chi-square test used to analyze all indirect variables (depending on whether the assumptions were met). The results of multivariate analysis were with logistic regression. The results were considered statistically significant at p < 0.05.
Result: Total 258 subjects who met the inclusion criteria. Multivariate analysis with logistic regression shows full feeding (Exp B 0.24; 95% CI 0.032-0.27; P 0.006), nutritional status (Exp B 0.23; 95% CI 0.31-1.55; P 0,004) was statistically significant for mortality.
Conclusion: Full feeding and nutritional status were associated with an increase in child mortality.
Gambaran karakteristik pasien stroke hemoragik di RSUP Prof. Dr. I.G.N.G Ngoerah Bali, Indonesia, tahun 2019-2021
Made Hery Jayadi Natha, Sri Maliawan, I Wayan Niryana, Gede Febby Pratama KusumaOnline First: Jul 13, 2023
- Abstract
Gambaran karakteristik pasien stroke hemoragik di RSUP Prof. Dr. I.G.N.G Ngoerah Bali, Indonesia, tahun 2019-2021
Background: Stroke is the third most common disease after cancer and heart disease. According to the South East Asian Medical Information Centre (SEAMIC), Indonesia has the highest death rate from stroke in Southeast Asia. A hemorrhage stroke occurs when a blood artery in the brain ruptures or leaks, so bleeding can occur around the organ and reduce blood supply to part of the brain.
Methods: This research is a retrospective descriptive study using a cross-sectional design. Data were taken from the patient's medical records using a consecutive sampling technique. This study aims to describe the characteristics of hemorrhagic stroke patients at Prof. Dr. I.G.N.G Ngoerah from January 2019 to January 2021. Data were analyzed using SPSS version 20.0 for Windows.
Results: In this study, the characteristics of the patients observed included the percentage of age between 30 to 60 years of 53,1%, male patients as much as 68,8%, the type of work reached 52.1%, CT-scan examination of the head found intracerebral hemorrhage as much as 50%, the last level of education in high school reached 65,6%, the history of the disease reached 81,2%, the initial diagnosis when entering the hospital with suspected hemorrhage stroke was 32,2%, and patients who did not experience complications were 77,1%. As many as 43.8% of patients died.
Conclusion: Characteristics of hemorrhagic stroke patients at Prof. Dr. dr. I.G.N.G Ngoerah Hospital in the period January 2019–January 2021 mostly had an age range of 30–60 years, were male, had a last high school education, had a job, had an intracerebral hemorrhage, had a history of previous illness, and most of the patients did not experience complications.
Latar Belakang: Setelah kanker dan penyakit jantung, stroke menjadi penyakit paling umum ketiga. Menurut South East Asian Medical Information Centre (SEAMIC), Indonesia memiliki tingkat kematian tertinggi akibat stroke di Asia Tenggara. Stroke hemoragik terjadi ketika arteri darah di otak pecah atau bocor, sehingga perdarahan dapat terjadi di sekitar organ dan mengurangi suplai darah ke sebagian otak.
Metode: Penelitian ini merupakan penelitian deskriptif retrospektif yang menggunakan desain potongan melintang (cross-sectional). Data diambil dari rekam medis pasien dengan teknik pengambilan sampel secara consecutive sampling. Penelitian ini bertujuan untuk mendeskripsikan karakteristik penderita stroke hemoragik di RSUP Prof. Dr. I.G.N.G Ngoerah selama periode Januari 2019 hingga Januari 2021. Data dianalisis dengan SPSS versi 20.0 untuk Windows.
Hasil: Dalam penelitian ini, ciri-ciri pasien yang diamati meliputi persentase usia antara 30 hingga 60 tahun sebesar 53,1%, pasien laki-laki sebanyak 68,8%, pasien yang memiliki pekerjaan mencapai 52,1%, pemeriksaan CT-Scan kepala didapat pendarahan intraserebral sebanyak 50%, tingkat pendidikan terakhir di sekolah menengah atas mencapai 65,6%, pasien yang memiliki riwayat penyakit mencapai 81,2%, diagnosis awal ketika masuk rumah sakit dengan suspek stroke hemoragik sebanyak 32,2%, dan pasien yang tidak mengalami komplikasi sebanyak 77,1%. Sebanyak 43,8% pasien meninggal dunia.
Kesimpulan: Karakteristik pasien stroke hemoragik di RSUP Prof. Dr. I.G.N.G Ngoerah pada periode Januari 2019 – Januari 2021 sebagian besar memiliki rentang usia dari 30-60 tahun, laki-laki, pendidikan terakhir SMA, memiliki pekerjaan, intracerebral hemorrhage. memiliki riwayat penyakit sebelumnya, dan sebagian besar pasien tidak memiliki komplikasi.
Pengaruh program rehabilitasi kardiovaskular terhadap tingkat ansietas dan depresi pada pasien infark miokard akut
Anak Agung Ayu Dwi Adelia Yasmin, I Nyoman Wiryawan, I Wayan WitaOnline First: Aug 28, 2023
- Abstract
Pengaruh program rehabilitasi kardiovaskular terhadap tingkat ansietas dan depresi pada pasien infark miokard akut
Introduction: Anxiety and depression are psychological problems that are commonly found in patients after episode of acute myocardial infarction (AMI). The presence of anxiety and depression may reduce the patient’s quality of life, increase disability, cardiovascular events, and mortality. One simple way to screen for anxiety and depression is to use Hospital Anxiety and Depression Scale (HADS) questionnaire. Active participation of AMI patients in cardiovascular rehabilitation program could improve psychological outcomes in patients. This study is a one group Pre Test-Post Test Design that aimed to determine the impact of cardiovascular rehabilitation program on anxiety and depression level as measured by HADS. This study included 29 AMI patients who were treated at Prof IGNG Ngoerah Hospital.
Method: The cardiovascular rehabilitation program provided were phase I (inpatient) cardiovascular rehabilitation which was given while the patient still in hospital, followed by phase II (outpatient) cardiovascular rehabilitation which was given for 12 sessions within 4-6 weeks after discharge.
Result: Based on Wilcoxon Signed Rank Test, there were improvements in anxiety and depression as indicated by decrease in HADS-A (p<0.001) and HADS-D scores (p=0.021) after participating in cardiovascular rehabilitation program in AMI patients who undergone treatment at Prof IGNG Ngoerah Hospital.
Conclusion: Cardiovascular rehabilitation programs can reduce anxiety and depression levels indicated by HADS-A and HADS-D scores in post AMI patients
Pendahuluan: Ansietas dan depresi merupakan masalah psikologis yang sering ditemukan pada pasien-pasien pasca perawatan akibat infark miokard akut (IMA). Adanya ansietas dan depresi dapat menurunkan kualitas hidup pasien, meningkatkan disabilitas, kejadian kardiovaskular, dan mortalitas. Salah satu cara yang sederhana untuk skrining kondisi ansietas dan depresi pada pasien adalah menggunakan kuisioner Hospital Anxiety and Depression Scale (HADS). Partisipasi aktif pasien pasca IMA dalam program rehabilitasi kardiovaskular dapat memperbaiki luaran psikologis pada pasien.
Metode: Penelitian ini merupakan suatu one group Pre Test-Post Test Design yang bertujuan untuk mengetahui pengaruh program rehabilitasi kardiovaskular terhadap tingkat ansietas dan depresi pada pasien IMA yang diukur menggunakan HADS. Penelitian ini mengikutsertakan 29 pasien IMA yang dirawat di RSUP Prof IGNG Ngoerah. Program rehabilitasi kardiovaskular yang diberikan adalah rehabilitasi kardiovaskular fase I (fase rawat inap) yang diberikan selama pasien masih dalam perawatan di Rumah Sakit, dilanjutkan dengan rehabilitasi kardiovaskular fase II (fase rawat jalan) yang diberikan selama 12 sesi dalam waktu 4-6 minggu pasca perawatan di Rumah Sakit.
Hasil: Berdasarkan uji Wilcoxon Signed Rank Test, terdapat perbaikan kondisi ansietas dan depresi yang ditunjukkan oleh penurunan skor HADS-A (p<0,001) dan HADS D (p=0,021) setelah mengikuti program rehabilitasi kardiovaskular pada pasien IMA yang menjalani perawatan di RSUP Prof IGNG Ngoerah.
Simpulan: program rehabilitasi kardiovaskular dapat menurunkan tingkat ansietas dan depresi yang ditunjukkan dengan skor HADS-A dan HADS-D pada pasien IMA.
Daya hambat ekstrak daun Dewandaru (Eugenia uniflora L) terhadap bakteri Gram Positif (Staphylococcus aureus) dan Gram Negatif (Pseudomonas aeruginosa) penyebab infeksi pada daerah sinonasal
I Wayan Lolik Lesmana, Ni Putu Oktaviani Rinika PranitasariOnline First: Jul 12, 2023
- Abstract
Daya hambat ekstrak daun Dewandaru (Eugenia uniflora L) terhadap bakteri Gram Positif (Staphylococcus aureus) dan Gram Negatif (Pseudomonas aeruginosa) penyebab infeksi pada daerah sinonasal
Background: Research and utilization of natural materials from the leaf extract of the Dewandaru plant (Eugenia uniflora L) in the Ear, Nose and Throat (ENT) field as an alternative therapy for bacterial infections in the nose and sinus area has never been studied before. This study aims to determine the inhibitory power of Dewandaru leaf extract (Eugenia uniflora L) against Gram Positive (Staphylococcus aureus) and Gram Negative (Pseudomonas aeruginosa) bacteria that cause infection in the sinonasal area.
Methods: This study took an approach in identifying the leaves of the Dewandaru plant (Eugenia uniflora L), identifying the active antibacterial compounds in the leaves of Dewandaru, and processing the leaves of Dewandaru into pure extracts in several concentrations through standard processing of the Udayana University Pharmacy Laboratory. To determine the effectiveness of Dewandaru leaves against Pseudomonas aeruginosa and Staphylococcus aureus bacteria as the most common causes of sinonasal infection, an in-vitro test was carried out on Dewandaru leaf extract at concentrations of 100%, 90% and 80%, compared to 1% Chloramphenicol drops on agar media. Data were analyzed using SPSS version 23.0 for Windows.
Results: The average inhibition results at 80 percent of Dewandaru leaf extract was 13.60 mm, at 90 percent concentration was 13.60 mm and at 100 percent concentration was 12.60 mm for Staphylococcus aureus. Meanwhile, the average inhibition at 80 percent of Dewandaru leaf extract was 7.20 mm, 7.20 mm at 90 percent concentration and 7.20 mm at 100 percent concentration for Pseudomonas aeruginosa bacteria.
Conclusion: The results of this study indicate that there is an inhibitory power from the antibacterial test results of Dewandaru leaf extract (Eugenia uniflora L) with concentrations of 80%, 90% and 100% respectively against Staphylococcus aureus and Pseudomonas aeruginosa.
Latar Belakang: Penelitian dan pemanfaatan bahan alam dari ekstrak daun tanaman Dewandaru (Eugenia uniflora L) pada bidang Telinga Hidung dan Tenggorok (THT) sebagai terapi alternatif infeksi bakteri pada daerah hidung dan sinus belum pernah diteliti sebelumnya. Penelitian ini bertujuan untuk mengetahui daya hambat ekstrak daun Dewandaru (Eugenia uniflora L) terhadap bakteri Gram Positif (Staphylococcus aureus) dan Gram Negatif (Pseudomonas aeruginosa) penyebab infeksi pada daerah sinonasal
Metode: Penelitian ini melakukan pendekatan dalam identifikasi daun tanaman Dewandaru (Eugenia uniflora L), identifikasi senyawa aktif antibakteri daun dewandaru, serta upaya pengolahan daun Dewandaru menjadi ekstrak murni dalam beberapa konsentrasi melalui standar pengolahan laboratorium Farmasi Universitas Udayana. Untuk mengetahui efektivitas daun Dewandaru terhadap bakteri Pseudomonas aeruginosa dan Staphylococcus aureus sebagai penyebab tersering infeksi daerah sinonasal, dilakukan uji secara in-vitro dari ekstrak daun Dewandaru pada konsentrasi 100%, 90% dan 80%, dibandingkan dengan obat tetes Chloramphenicol 1% pada media agar. Data dianalisis dengan SPSS versi 23.0 untuk Windows.
Hasil: Hasil rerata daya hambat pada konsentrasi ekstrak daun Dewandaru 80 persen sebesar 13,60 mm, pada konsentrasi 90 persen sebesar 13,60 mm dan pada konsentrasi 100 persen sebesar 12,60 mm pada Staphylococcus aureus. Sedangkan hasil rerata daya hambat pada konsentrasi ekstrak daun Dewandaru 80 persen sebesar 7,20 mm, pada konsentrasi 90 persen sebesar 7,20 mm dan pada konsentrasi 100 persen sebesar 7,20 mm terhadap bakteri Pseudomonas aeruginosa.
Kesimpulan: Hasil penelitian ini menunjukkan bahwa terdapat daya hambat dari hasil uji antibakteri sediaan Ekstrak daun Dewandaru (Eugenia uniflora L) dengan konsentrasi masing-masing 80%, 90% dan 100% terhadap bakteri Staphylococcus aureus maupun Pseudomonas aeruginosa.
Aplikasi topikal krim ekstrak ubi jalar ungu (Ipomoea batatas l.) meningkatkan kadar superoxide dismutase (SOD) dan menurunkan kadar caspase-3 pada tikus (Rattus norvegicus) dengan photoaging akibat paparan sinar ultraviolet B
Andrew Yoshihiro Wirya, Ketut Kwartantaya Winaya, I Gusti Ngurah Darmaputra, Nyoman Suryawati, I Gusti Ayu Agung Dwi Karmila, Ni Made Dwi PuspawatiOnline First: Jun 26, 2023
- Abstract
Aplikasi topikal krim ekstrak ubi jalar ungu (Ipomoea batatas l.) meningkatkan kadar superoxide dismutase (SOD) dan menurunkan kadar caspase-3 pada tikus (Rattus norvegicus) dengan photoaging akibat paparan sinar ultraviolet B
Introduction: The aging process can occur due to oxidative stress from free radicals, which triggers an inflammatory process. SOD expresses the body's ability to fight free radicals, while Caspase-3 is a marker of cell apoptosis due to an inflammatory response. Ipomoea batatas L. is known to have antioxidant compounds that can increase SOD and suppress Caspase-3. Researchers wanted to see the ability of purple sweet potato extract to increase SOD levels and decrease Caspase-3 levels in rats with chronic skin inflammation models exposed to UV-B.
Methods: This research is an experimental study using a post-test only with a control group design that shows descriptive and analytic data divided into six groups. The exposure procedure was carried out for 4 weeks with a total 840 mJ/cm2 dose. The purple sweet potato cream concentration was 4%, 8% and 16%. A rat skin biopsy was taken to determine SOD and Caspase-3 levels using an ELISA kit. In addition, an anthocyanin examination was carried out on purple sweet potatoes. This study describes a descriptive and analytic analysis using SPSS 26.0
Results: The anthocyanin content in purple sweet potato extract was 7.1669 mg/100g. The highest SOD level in the treatment group was 3162±17.801ng/mL (16% concentration), and the lowest Caspase-3 level was in the P3 group (0.456±0.066ng/mL). Based on the normality and homogeneity tests, it was found that the data were normally distributed and not homogeneous, so a comparability test was carried out with the Kruskal-Wallis analysis. The results of the Kruskal-Wallis test showed that each treatment had significantly different mean SOD levels and caspase-3 levels (p<0.05). The post-hoc test showed significant differences in SOD and Caspase-3 levels between all control groups (K-, K1+, K2+) and the treatment group (P1, P2, P3).
Conclusion: Administration of purple sweet potato cream extract can increase SOD levels as a marker of the aging process due to UVB exposure and decrease Caspase-3 levels as a marker of inflammation due to UVB exposure
Pendahuluan: Proses penuaan dapat terjadi sebagai akibat stress oksidatif dari radikal bebas yang memicu proses inflamasi. SOD merupakan cerminan dari kemampuan tubuh dalam melawan radikal bebas, sedangkan Caspase-3 merupakan penanda apoptosis sel sebagai akibat respon inflamasi. Ipomoea batatas L. diketahui mampu memiliki senyawa antioksidan yang mampu meningkatkan SOD dan menekan caspase-3. Peneliti hendak mengetahui kemampuan ekstrak ubi jalar ungu dalam meningkatkan kadar SOD dan menurunkan kadar caspase-3 pada tikus model inflamasi kronis kulit yang terpapar UV-B.
Metode : Penelitian ini merupakan penelitian eksperimental rancangan post-test only dengan kelompok kontrol dan terbagi menjadi enam kelompok. Penyinaran dilakukan selama 4 minggu dengan total dosis penyinaran sebesar 840 mJ/cm2. Konsentrasi krim ubi jalar ungu yang diberikan yaitu 4%, 8% dan 16%. Biopsi kulit tikus diambil untuk dilakukan pengecekan kadar SOD dan caspase-3 menggunakan kit ELISA. Selain itu, dilakukan pemeriksaan antosianin pada ubi jalar ungu. Penelitian ini memaparkan analisis deskriptif dan analitik menggunakan SPSS 26.0
Hasil : Kadar antosianin yang terkandung pada ekstrak ubi jalar ungu yaitu 7,1669 mg/100g. Kadar SOD kelompok perlakuan paling tinggi yaitu 3162±17,801 ng/mL (konsentrasi 16%), begitu juga dengan kadar Caspase-3 terendah pada kelompok P3 (0,456±0,066 ng/mL). Berdasarkan uji normalitas dan homogenitas ditemukan bahwa data berdistribusi normal dan tidak homogen sehingga dilakukan uji komparabilitas dengan analisis Kruskal-Wallis yang menunjukkan masing-masing perlakuan memiliki rerata kadar SOD dan kadar caspase-3 yang berbeda secara signifikan (p<0,05). Uji post-hoc menunjukkan perbedaan bermakna kadar SOD dan caspase-3 antara semua kelompok kontrol (K-, K1+, K2+) dengan kelompok perlakuan (P1, P2, P3).
Simpulan: Pemberian ekstrak krim ubi jalar ungu dapat meningkatkan kadar SOD sebagai penanda proses penuaan akibat paparan sinar UVB dan menurunkan kadar Caspase-3 sebagai penanda inflamasi akibat paparan sinar UVB
Hubungan antara kekuatan genggaman tangan dengan kadar gula darah sewaktu pada lansia di Desa Melinggih, Kecamatan Payangan, Kabupaten Gianyar
Komang Ayu Vitriana Gamayanti, I Gusti Putu Suka Aryana, Wira GoteraOnline First: Jun 7, 2023
- Abstract
Hubungan antara kekuatan genggaman tangan dengan kadar gula darah sewaktu pada lansia di Desa Melinggih, Kecamatan Payangan, Kabupaten Gianyar
Introduction: Type 2 diabetes mellitus in the elderly causes various complications, including sarcopenia, characterized by a decrease in skeletal muscle mass and function. Several previous studies have shown that type 2 diabetes, or high plasma glucose levels cause a reduction in hand grip strength in the elderly. Therefore, this study aims to evaluate the relationship between hand grip strength and blood sugar levels in the elderly in Melinggih Village, Payangan District, Gianyar.
Methods: The study used an analytical method with a cross-sectional approach to 88 elderly people in Melinggih Village, Payangan District, Gianyar. The variables assessed included hand grip strength as the dependent variable and blood sugar levels as the independent variable. Gender, age, education level, body mass index, blood pressure, comorbidities, smoking, and medical history were considered confounding variables. The Asian Working Group guides the criteria for determining hand grip strength for Sarcopenia (AWGS) 2019. Data analysis used the chi-square test and multivariate logistic regression.
Results: Bivariate analysis showed a significant relationship between patients with high plasma glucose levels and weak hand grip strength (p=0.037; OR: 5.938; 95%CI: 1.07-32.75). However, this study found no significant relationship between plasma glucose levels with age, gender, BMI, history of comorbid diseases, smoking, and long-term drug use (p>0.05).
Conclusion: High plasma glucose levels are associated with weak hand grip strength.
Pendahuluan: Diabetes Melitus (DM) tipe 2 pada lansia menyebabkan berbagai macam komplikasi, salah satunya adalah sarkopenia yang ditandai dengan penurunan massa dan fungsi otot rangka tubuh. Beberapa penelitian sebelumnya menunjukkan bahwa DM tipe 2 atau kadar glukosa plasma yang tinggi menyebabkan penurunan kekuatan genggaman tangan pada lansia. Penelitian ini bertujuan untuk mengetahui hubungan antara kekuatan genggaman tangan dengan kadar gula darah sewaktu pada lansia di Desa Melinggih, Kecamatan Payangan Gianyar.
Metode: Penelitian menggunakan metode analitik dengan pendekatan potong lintang terhadap 88 lansia di Desa Melinggih, Kecamatan Payangan, Gianyar. Variabel yang dinilai meliputi kekuatan genggaman tangan sebagai variabel terikat dan kadar gula darah sewaktu sebagai variabel bebas. Jenis kelamin, usia, tingkat pendidikan, indeks massa tubuh, tekanan darah, penyakit penyerta, merokok, dan riwayat pengobatan dianggap sebagai variabel pengganggu. Kriteria untuk menentukan kekuatan genggaman tangan berpedoman pada Asian Working Group for Sarcopenia (AWGS) 2019. Analisis data menggunakan uji chi-square dan regresi logistik multivariat.
Hasil: Analisis bivariat menunjukkan adanya hubungan yang signifikan antara pasien dengan kadar gula darah sewaktu yang tinggi dengan kekuatan genggaman tangan yang lemah (p=0,037; OR: 5,938; 95%CI: 1,07-32,75). Namun dalam penelitian ini tidak ditemukan hubungan yang signifikan antara kadar gula darah sewaktu dengan usia, jenis kelamin, IMT, riwayat penyakit komorbid, merokok, dan penggunaan obat dalam jangka waktu lama (p>0,05).
Simpulan: Kadar gula darah sewaktu yang tinggi berhubungan dengan kekuatan genggaman tangan yang lemah.
Hubungan stadium klinis awal dan lanjut dengan kejadian depresi pada penderita Karsinoma Nasofaring (KNF) sebelum terapi di Poliklinik THT – KL RSUP Prof. Dr. IGNG Ngoerah, Bali, Indonesia
Ketut Wahyudiana Sudana, I Ketut Suanda, Sari Wulan Dwi SutanegaraOnline First: Aug 28, 2023
- Abstract
Hubungan stadium klinis awal dan lanjut dengan kejadian depresi pada penderita Karsinoma Nasofaring (KNF) sebelum terapi di Poliklinik THT – KL RSUP Prof. Dr. IGNG Ngoerah, Bali, Indonesia
Background: Nasopharyngeal Carcinoma (NPC) is a tumor or malignancy that manifests in the nasopharynx, in the upper throat and back of the nose. When someone is diagnosed with cancer, many of them experience mental disorders, such as one example of depression. This study aimed to determine the relationship between early and advanced clinical stages with the incidence of depression in nasopharyngeal carcinoma patients before therapy.
Methods: An observational cross sectional comparative study design was conducted. Fifty-four research subjects were obtained with consecutive sampling techniques. The data obtained were analyzed descriptively, followed by the Chi-Square test and ended with the Logistic Regression test by SPSS version 26.0 for Windows.
Results: Based on bivariate analysis, three variables are significantly related to the level of depression in NPC patients, such as age, level of education and stage of cancer (p<0.05). Based on multivariate analysis using Logistic Regression, only one variable had a statistically significant relationship with the level of depression in NPC patients, namely the cancer stadium variable (p=0.001).
Conclusion: These findings suggest a significant relationship between the stage of cancer and the level of depression in NPC patients.
Latar Belakang: Karsinoma Nasofaring (KNF) adalah tumor atau keganasan yang bermanifestasi pada daerah nasofaring yaitu pada daerah atas tenggorokan dan belakang hidung. Ketika seseorang didiagnosa menderita kanker,banyak yang mengalami gangguan mental seperti salah satu contohnya depresi. Tujuan penelitian ini adalah untuk mengetahui hubungan stadium klinis awal dan lanjut dengan kejadian depresi pada pasien karsinoma nasofaring sebelum terapi.
Metode: observasional dengan rancangan cross sectional comparative study. Didapatkan 54 subjek penelitian dengan tehnik consecutive sampling. Data yang diperoleh dianalisis secara deskriptif, dilanjutkan dengan uji Chi-Square dan diakhiri uji Regresi Logistik menggunakan SPSS versi 26.0 untuk Windows.
Hasil: Berdasarkan analisis bivariat, terdapat tiga variabel yang berhubungan secara bermakna dengan tingkat deprersi pada pasien KNF yakni usia, tingkat pendidikan terakhir dan stadium kanker (p<0.05). Berdasarkan analisis multivariat dengan menggunakan Regresi Logistik hanya terdapat satu variabel yang secara statistik memiliki hubungan bermakna dengan tingkat depresi pada pasien KNF yaitu variabel stadium kanker (p=0.001).
Kesimpulan: Hasil penelitian ini menunjukkan bahwa terdapat hubungan yang bermakna antara stadium kanker dengan tingkat depresi pada pasien KNF.
Prevalensi dan karakteristik penderita kusta di Kabupaten Klungkung, Bali kurun pandemi COVID-19
Dewa Ayu Devi Anjaswari Putera, I Putu ArtanaOnline First: Aug 30, 2023
- Abstract
Prevalensi dan karakteristik penderita kusta di Kabupaten Klungkung, Bali kurun pandemi COVID-19
Background: Leprosy as one of the neglected tropical diseases which can attack various parts of body causing disability. Indonesia ranks 3rd in the highest leprosy cases in the world, with six provinces yet to achieve leprosy elimination. Bali Province has achieved leprosy elimination but has yet to achieve free leprosy. Klungkung Regency is included in the top three regencies in Bali, with the highest prevalence of leprosy. In the Pandemic, COVID-19 has impacted efforts to control leprosy. This study aims to determine the prevalence and characteristics of leprosy patients in Klungkung Regency during the COVID-19 pandemic
Methods: A cross-sectional study was conducted using secondary data from Klungkung District Health Office for 2019-2021. The data will be obtained from July-September 2022. The research sample of 22 leprosy patients was obtained by purposive sampling technique.
Results: Leprosy prevalence of 0.95/10,000 population in 2019 (pre-pandemic), 0.1/10,000 population in 2020 (first-year pandemic), and 0.28/10,000 population in 2021 (second-year pandemic). The distribution of leprosy patients is dominant aged 15-64 years (86.4%), male (59.1%), last education SD/equivalent (68.2%), farmer occupation (40.9%), from Nusa Penida sub-district (54.5%), registered in primary health facilities (100%), multibacillary leprosy type (100%), and COVID-19 status is not infected (100%).
Conclusion: The prevalence of leprosy fluctuated in the Klungkung Regency during the COVID-19 pandemic. Has achieved the leprosy elimination target but is categorized as areas with a high burden of leprosy. Leprosy patient in this regency has variant characteristics.
Latar belakang: Kusta sebagai salah satu penyakit tropis terabaikan yang menyerang berbagai bagian tubuh serta dapat menimbulkan kecacatan. Indonesia menempati peringkat ketiga kasus tertinggi di dunia, dengan 6 provinsi belum mencapai eliminasi kusta. Provinsi Bali telah mencapai eleminasi kusta namun belum bebas kusta. Kabupaten Klungkung termasuk dalam 3 besar kabupaten/kota di Bali dengan prevalensi tertinggi. Pandemi COVID-19 membawa dampak pada upaya penanggulangan kusta. Penelitian ini bertujuan untuk mengetahui prevalensi dan karakteristik penderita kusta di Kabupaten Klungkung kurun pandemi COVID-19.
Metode: Penelitian ini menggunakan rancangan cross-sectional dari data sekunder Dinas Kesehatan Kabupaten Klungkung periode tahun 2019-2021. Penarikan data dilakukan selama bulan Juli-September 2022. Sampel penelitian sejumlah 22 penderita kusta didapat dengan teknik purposive sampling.
Hasil: Prevalensi kusta 0,95/10.000 penduduk tahun 2019 (pra pandemi), 0,1/10.000 penduduk tahun 2020 (pandemi tahun pertama), dan 0,28/10.000 penduduk tahun 2021 (pandemi tahun kedua). Distribusi penderita dominan berusia 15-64 tahun (86,4%), laki-laki (59,1%), pendidikan terakhir SD/sederajat (68,2%), pekerjaan petani (40,9%), asal daerah Kecamatan Nusa Penida (54,5%), terdaftar di faskes primer (100%), tipe kusta Multibasiler (100%), dan status COVID-19 tidak terinfeksi (100%).
Simpulan: Prevalensi kusta di Kabupaten Klungkung kurun pandemi COVID-19 berfluktuasi. Telah mencapai target eleminasi kusta namun termasuk daerah dengan beban kusta tinggi (high burden). Karakteristik penderita kusta pada daerah ini beragam.
Profil pasien tinea kapitis di poliklinik kulit dan kelamin RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar periode 2014-2019: sebuah studi potong lintang retrospektif
Ni Putu Ayu Riska Yunita Sari, Luh Made Mas RusyatiOnline First: Jul 18, 2023
- Abstract
Profil pasien tinea kapitis di poliklinik kulit dan kelamin RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar periode 2014-2019: sebuah studi potong lintang retrospektif
Background: Indonesia is a tropical country with numerous cases of infectious diseases, and one of the causes is fungal infections. Fungal infections on the hair and scalp are known as tinea capitis. Up-to-date epidemiological data is essential for guiding diagnosis and therapy. Therefore, regular reports from each healthcare center are necessary.
Method: This study is a retrospective cross-sectional study that utilizes secondary data from all patients with tinea capitis in the Skin and Venereal Disease Clinic during the period of January 2014 to 2019. Data analysis was conducted using SPSS version 25.0 to perform univariate analysis.
Results: There were 42 cases of tinea capitis during the study period. The cases were predominantly found in males (61.9%) and the age group of 6-18 years (59.5%). The most commonly encountered type of tinea capitis was gray patch (78.6%) with negative Wood's lamp findings (90.5%) and ectothrix spores (54.8%). The common pathogens identified were Trichophyton tonsurans, Trichophyton mentagrophyte, and Microsporum audouinii.
Conclusion: There was fluctuation in the number of cases from 2014 to 2019, with a tendency towards an increase. The majority of tinea capitis patients were males in the age group of 6-18 years. Gray patch was the most common type of tinea capitis, and the most prevalent pathogens were Trichophyton tonsurans, Trichophyton mentagrophyte, and Microsporum audouinii, respectively.
Latar Belakang: Indonesia merupakan negara tropis yang memiliki banyak kasus penyakit infeksi dan jamur merupakan salah satu penyebabnya. Infeksi jamur pada rambut dan kulit kepala dikenal sebagai tinea kapitis. Data epidemiologi terkini sangat bermanfaat untuk mengarahkan diagnosis serta terapi. Oleh sebab itu, dibutuhkan laporan secara berkala dari masing-masing pusat layanan kesehatan.
Metode: Studi ini merupakan studi retrospektif cross sectional yang menggunakan data sekunder dari seluruh pasien tinea kapitis di Poliklinik Kulit dan Kelamin pada periode Januari 2014-2019. Analisis data menggunakan SPSS versi 25.0 untuk melakukan analisis univariat.
Hasil: Terdapat 42 kasus tinea kapitis selama periode penelitian. Kasus didominasi oleh laki-laki (61,9%) dan kelompok usia 6 – 18 tahun (59,5%). Tipe tinea kapitis yang paling banyak dijumpai adalah gray patch (78,6%) dengan hasil temuan lampu Wood negatif (90,5%), dan spora ektotrik (54,8%). Patogen yang umum dijumpai adalah Trichophyton tonsurans, Trichophyton mentagrophyte, serta Microsporum audouinii.
Kesimpulan: Terjadi fluktuasi pada tahun 2014 hingga 2019 dengan kecenderungan peningkatan kasus. Sebagian besar pasien tinea kapitis adalah laki-laki dan kelompok usia 6 – 18 tahun. Gray patch merupakan tipe tinea kapitis yang paling umum dan patogen terbanyak adalah Trichophyton tonsurans, Trichophyton mentagrophyte, serta Microsporum audouinii, secara berurutan.
Correlation of delta shock index and lactate clearance in shock patients treated in pediatric intensive care unit at Prof Dr. I.G.N.G Ngoerah Hospital
Dyah Kanya Wati, Putu Ayunda Trisnia, I Wayan Bikin Suryawan, I Gusti Ayu Trisna Windiani, I Gusti Ngurah Suwarba, I Wayan GustawanOnline First: May 10, 2023
- Abstract
Correlation of delta shock index and lactate clearance in shock patients treated in pediatric intensive care unit at Prof Dr. I.G.N.G Ngoerah Hospital
Introduction: Lactate was an examination done in patients with shock as a predictor of mortality. The delta shock index (DSI) is one of the parameters that are easy to do but very limited studies related to the benefits of DSI have been found. This study aimed at determining the correlation of DSI and lactate clearance levels in pediatric shock patients treated at the Pediatric Intensive Care Unit (PICU) of Prof Dr. I.G.N.G Ngoerah Hospital.
Method: This was a prospective cohort study of children diagnosed with shock in a pediatric emergency ward or PICU Prof Dr. I.G.N.G Ngoerah Hospital. A Spearman correlation test was done since the data distribution was abnormal. Multivariate analysis with multiple regression tests was carried out to assess the pure effect of lactate clearance with DSI. The level of significance was determined based on p <0.05. The general linear model analysis is done on variables that are repeated measurements.
Result: There were 39 subjects obtained in this study, with 34 subjects surviving and 5 subjects not surviving. The median lactate clearance was 28.5 (-95 - 77.7), with a median DSI of 0.45 (0.04-1.3). There were significant differences in the decrease of shock index over time (p = 0.034). The correlation test results showed a weak positive between lactate clearance with DSI (r = +0.351) and p = 0.028. Multivariate analysis test results obtained a value of â 0.002 with p = 0.071.
Conclusion: There was a weak positive correlation between lactate clearance and DSI. There were significant differences in the decrease of shock index over time between survivors and non-survivors.
Karakteristik penderita hernia inguinalis yang di rawat inap pada Rumah Sakit Bayukarta Karawang periode 2022
Bob Fernando Maruba SihombingOnline First: Jul 4, 2023
- Abstract
Karakteristik penderita hernia inguinalis yang di rawat inap pada Rumah Sakit Bayukarta Karawang periode 2022
Background: Inguinal hernia is when intra-abdominal fat or part of the small intestine protrudes through a weak area in the lower abdominal muscles. Emergency cases can occur if the inguinal hernia is strangulated (irreponible accompanied by an impaired passage) and incarcerated (irreponible accompanied by inadequate vascularization). This study aims to determine the characteristics of inguinal hernia patients hospitalized at Bayukarta Hospital, Karawang, in 2022.
Methods: This descriptive study used a cross-sectional method with secondary data from medical records. The subjects studied were 90 inguinal hernia patients who were hospitalized. The variable assessed in this study was age (years), type of work, gender, classification of organ discharge, and classification of hernia characteristics. Data were analyzed using SPSS version 20.0 for Windows.
Results: The results showed two age groups with the highest inguinal hernia were the age group 46-55 years and 56-65 years, with 20 people (22.2%) each; the most jobs were laborers, as many as 34 people (37.8 %), the majority of patients were men with 83 people (92.2%). Inguinal hernia lateralis dextra in 53 people (58.9 %) and inguinal hernia reponible in 75 people (83.3%).
Conclusion: The characteristics of inguinal hernia patients hospitalized at Bayukarta Hospital, Karawang, in 2022 were age group 46-65 years, laborers, men, inguinal hernia lateralis dextra and inguinal hernia reponible.
Latar Belakang: Hernia inguinalis merupakan kondisi dimana lemak intra-abdominal atau bagian dari usus halus menonjol melalui area lemah di otot perut bagian bawah. Kasus kegawatdaruratan dapat terjadi apabila hernia inguinalis bersifat strangulasi (ireponibel disertai gangguan pasase) dan inkarserasi (ireponibel disertai gangguan vascularisasi). Penelitian ini bertujuan untuk mengetahui karakteristik penderita hernia inguinalis yang dirawat inap di Rumah Sakit Bayukarta, Karawang periode 2022.
Metode: Penelitian deskriptif ini menggunakan metode potong lintang dengan data sekunder rekam medik. Subjek yang diteliti yaitu penderita hernia inguinalis yang dirawat inap, sebanyak 90 orang. Variabel yang dinilai pada penelitian ini adalah usia (tahun), jenis pekerjaan, jenis kelamin, klasifikasi jalur keluarnnya organ, dan klasifikasi sifat dari hernia. Data dianalisis dengan SPSS versi 20.0 untuk Windows.
Hasil: Hasil penelitian diperoleh dua kelompok usia penderita hernia inguinalis tertinggi adalah kelompok usia 46-55 tahun dan 56-65 tahun masing-masing sebanyak 20 orang (22,2%), pekerjaan terbanyak yaitu buruh sebanyak 34 orang (37,8 %), jenis kelamin terbanyak yaitu laki-laki sebanyak 83 orang (92,2%). Hernia inguinalis lateralis dextra sebanyak 53 orang (58,9%) dan hernia inguinalis reponibel sebanyak 75 orang (83,3 %).
Kesimpulan: Karakteristik penderita hernia inguinalis yang dirawat inap di Rumah Sakit Bayukarta periode 2022 berupa kelompok usia 46-65 tahun, pekerjaan buruh, jenis kelamin laki-laki, dengan hernia inguinalis lateralis dextra dan hernia inguinalis reponibel.
Aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) meningkatkan kadar tissue inhibitors of matrix metalloproteinase-1 dan menurunkan kadar matrix metalloproteinase-9 pada tikus wistar (Rattus norvegicus) yang terpapar sinar ultraviolet B
Luh Nyoman Arya Wisma Ariani, Ketut Kwartantaya Winaya, I Gusti Agung Ayu Elis Indira, I Gusti Agung Ayu Praharsini, I Gusti Nyoman Darmaputra, Ni Made Dwi PuspawatiOnline First: Aug 29, 2023
- Abstract
Aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) meningkatkan kadar tissue inhibitors of matrix metalloproteinase-1 dan menurunkan kadar matrix metalloproteinase-9 pada tikus wistar (Rattus norvegicus) yang terpapar sinar ultraviolet B
Introduction: Skin aging is a biological process that cannot be avoided. Repeated UVB exposure increases collagen degradation by increasing MMP-9 levels. Little is known about TIMP-1's potential role in skin protection or recovery from skin damage caused by photoaging. Sugar apple leaf extract increases cell proliferation, levels and collagen deposition. This study aims to determine the topical application of sugar apple leaf cream extract (Annona squamosa L.) to increase TIMP-1 levels and decrease MMP-9 levels in Wistar rats (Rattus norvegicus) exposed to UVB light.
Methods: Experimental study with a post-test-only design with a control group design using 35 male Wistar rats. There were five groups: negative control, positive control, and treatment (5%, 10%, and 20% sugar apple leaf extract cream). Skin biopsies were taken to measure TIMP-1 and MMP-9 levels using the ELISA method. Data analysis was performed using the SPSS 25.0 application.
Results: The phytochemical test showed total flavonoid levels of 3583.77 mg QE/100 mL, phenol 5244.98 mg GAE/100 mL, IC50 value 226.53 ppm, and alkaloids. The highest mean TIMP-1 level in the treatment group was 38.95 ± 3.31 ng/mL, and the lowest mean MMP-9 level was 2.94 ± 1.66 ng/mL (20% concentration). One Way ANOVA showed that there were significant differences in TIMP-1 and MMP-9 levels between the test groups with a p<0.001. Post hoc LSD analysis showed significantly higher TIMP-1 and lower MMP-9 levels (p<0.05) than the control.
Conclusion: Administration of sugar apple leaf cream extract increased TIMP-1 levels and significantly decreased MMP-9 levels in Wistar rats exposed to UVB light.
Pendahuluan: Penuaan kulit merupakan proses biologis yang tidak dapat dihindari. Paparan UVB berulang meningkatkan degradasi kolagen dengan meningkatkan kadar MMP-9. Potensi keterlibatan TIMP-1 dalam perlindungan kulit atau pemulihan dari adanya kerusakan kulit akibat photoaging masih belum banyak diketahui. Ekstrak daun srikaya diketahui dapat meningkatkan proliferasi sel, kadar dan deposisi kolagen. Tujuan penelitian ini adalah untuk mengetahui aplikasi topikal ekstrak krim daun srikaya (Annona squamosa L.) dalam meningkatkan kadar TIMP-1 dan menurunkan kadar MMP-9 pada tikus wistar (Rattus norvegicus) yang terpapar sinar UVB.
Metode: Penelitian eksperimental dengan rancangan post-test-only with control group design ini menggunakan 35 tikus wistar jantan. Terdapat lima kelompok, yaitu kontrol negatif, kontrol positif, dan perlakuan (krim ekstrak daun srikaya 5%, 10%, dan 20%). Biopsi kulit diambil untuk pengukuran kadar TIMP-1 dan MMP-9 dengan metode ELISA. Analisis data dilakukan dengan menggunakan aplikasi SPSS 25.0.
Hasil: Uji fitokimia menunjukkan kadar total flavonoid sebanyak 3583,77 mg QE/100 mL; fenol 5244,98 mg GAE/100 mL, nilai IC50 226,53 ppm, dan alkaloid positif. Rerata kadar TIMP-1 tertinggi pada kelompok perlakuan adalah 38,95 ± 3,31 ng/mL dan rerata kadar MMP-9 terendah yaitu 2,94 ± 1,66 ng/mL (konsentrasi 20%). Analisis One Way ANOVA menunjukkan terdapat perbedaan kadar TIMP-1 dan MMP-9 yang signifikan antara kelompok uji dengan nilai p<0,001. Analisis post hoc LSD menunjukkan kadar TIMP-1 lebih tinggi dan kadar MMP-9 lebih rendah secara signifikan (p<0,05) dibandingkan kontrol.
Simpulan: Pemberian ekstrak krim daun srikaya dapat meningkatkan kadar TIMP-1 dan menurunkan kadar MMP-9 secara signifikan pada tikus wistar yang terpapar sinar UVB.
Hubungan subtipe molekuler kanker payudara dengan grading histopatologi di RSUD M Yunus Bengkulu
Galuh Setyorini, Lia Sasmithae, Panji Irani Fianza, Dian KurniaOnline First: Jun 26, 2023
- Abstract
Hubungan subtipe molekuler kanker payudara dengan grading histopatologi di RSUD M Yunus Bengkulu
Introduction. Breast cancer is a disease with complex and heterogeneous condition which can be assessed from its morphology, molecular subtypes, and patient response to treatment. Treatment is individualized based on predictive and prognostic factors. Based on this, molecular examination is very important and the Muhammad Yunus Bengkulu Hospital opened cancer patient services and continues to improve its services, especially for breast cancer. It has been recorded since mid-2021 that were 77 patients who underwent immunohistochemical examinations independently. The purpose of this study was to determine the distribution of various molecular subtypes of breast cancer at M Yunus Hospital Bengkulu and their relationship with histopathological grading in breast cancer patients.
Method. A cross-sectional study was conducted on breast cancer patients who went to the Surgical Oncology Polyclinic at M Yunus Bengkulu Hospital. In this study, we used medical record data in the form of laboratory results as research subjects, which were then analyzed using SPSS 25 for windows. The relationship between variables is stated to significant if the p-value <0.05.
Results. From 77 breast cancer patients whose molecular subtypes were examined, the average age was 50 (standard deviation of 12) years. Most of the histopathological grades were grade 3 (41.60%), then grade 2 (23.40%), at least grade 1 (5.20%), and could not be determined quite a lot, namely 29.9%. ER status was mostly positive (67.50%), then PR status was more positive (53.20%), HER2 was mostly negative (61.00%), and triple-negative was 13.00%. For Ki67, mostly >20% (75.30%). According to the findings of statistical analyses using the Chi-Square test, p>0.05, indicates that there is no correlation between the histopathological grade and the molecular subtype of breast cancer patients (p=0.199).
Conclusion. Histopathological grading and molecular subtype do not significantly correlate.
Pendahuluan. Kanker pada payudara merupakan suatu penyakit dengan kondisi yang komplek dan heterogen yang dapat dinilai dari bentuk morfologi, subtipe molekuler nya, respon pasien terhadap pengobatan karena pengobatan bersifat individual yang berdasarkan faktor prediktif dan prognostik. Berdasarkan hal tersebut maka pemeriksaan molekuler sangatlah penting, dan di Rumah Sakit Muhammad Yunus Bengkulu membuka layanan pasien kanker dan terus meningkatkan pelayanannya terutama pada kanker payudara dan sudah tercatat sejak pertengahan 2021 terdapat 77 pasien yang dilakukan pemeriksaan immunohistokimia secara mandiri. Tujuan pada penelitian ini adalah untuk mengetahui distribusi pada berbagai subtipe molekuler kanker payudara di RSUD M Yunus Bengkulu dan hubungan nya dengan grading histopatologinya pada penderita kanker payudara.
Metode. Studi potong lintang dilakukan pada penderita kanker payudara yang berobat rutin ke Poliklinik Bedah Onkologi di RSUD M Yunus Bengkulu. Pada penelitian ini menggunakan data rekam medik yang berupa hasil laboratorium sebagai subjek penelitiannya yang selanjutnya di analisis menggunakan SPSS 25 for windows. Hubungan antar variabel dinyatakan bermakna apabila nilai p<0,05.
Hasil. Dari total 77 subjek pasien kanker payudara yang di periksa subtipe molekulernya didapatkan rerata usia 50 (simpang baku 12) tahun. Didapatkan grade histopatologis paling banyak grade 3 (41,60%), kemudian grade 2 (23,40%), yang paling sedikit grade 1 (5,20%), dan tidak dapat ditentukan cukup banyak yaitu 29,90%. Status ER sebagian besar positif (67,50%), kemudian status PR lebih banyak positif (53,20%), sedangkan HER2 sebagian besar negatif (61,00%), Triple negatif ada sebesar 13,00%. Ki67 sebagian besar >20% (75,30%). Dari hasil uji statistik dengan Uji Chi-Square p>0.05 yang artinya subtipe molekuler pada pasien kanker payudara tidak memiliki hubungan dengan grading histopatologinya (p=0.199).
Simpulan. Tidak ada hubungan bermakna antara subtipe molekuler dengan grading histopatologis nya.
Level of 8-Hydroxy-2'Deoxyguanosine (8-OHdG) in children with acute lymphoblastic leukemia post-chemotherapy induction phase and post-chemotherapy maintenance phase
Anak Agung Ngurah Ketut Putra Widnyana, Ni Kadek Wiwik Agustini, GAP Nilawati, I Made Gede Dwi Lingga, Wayan Dharma Artana, I Made Arimbawa, Ni Nyoman Metriani NesaOnline First: May 10, 2023
- Abstract
Level of 8-Hydroxy-2'Deoxyguanosine (8-OHdG) in children with acute lymphoblastic leukemia post-chemotherapy induction phase and post-chemotherapy maintenance phase
Introduction: Chemotherapy is an important curative therapy modality in ALL patients. 8-Hydroxy-2'-Deoxyguanosine (8-OHdG) has been studied as a biomarker of oxidative stress as a trigger for DNA damage, which is statistically significantly increased in ALL patients after chemotherapy compared to healthy children. This study aims to prove that 8-OHdG levels in children with ALL post-chemotherapy induction phases were higher than in the post-chemotherapy maintenance phase.
Methods: This study used a cross-sectional design. The subjects were children aged 1-18 years, with ALL who received treatment at Prof Dr. I.G.N.G Ngoerah Hospital from September 2019-January 2021. The Mann-Whitney test assessed the 8-OHdG levels in children with ALL post-chemotherapy induction and post-chemotherapy maintenance phase. Logistic regression multivariate analysis was used to evaluate the factors that influence 8-OHdG levels in pediatric patients with ALL. The value of p<0,05 determined the level of significance.
Results: A total of 27 subjects who underwent the post-chemotherapy induction phase and 19 subjects who underwent the post-chemotherapy maintenance phase were analyzed in this study. In the post-chemotherapy induction group, the median 8-OHdG level was 0.163 (0.104-1.864), and the median 8-OHdG level in the post-chemotherapy maintenance phase group was 0.158 (0.094-0.512). There was no significant difference in 8-OHdG levels between the two groups. Logistic regression multivariate analysis found that the post-chemotherapy induction phase was a prognostic factor at risk of increasing 8-OHdG levels (RO 16.55; 95% CI 1.118-245.277).
Conclusion: This study concluded that 8-OHdG levels were higher in children post-chemotherapy induction phase than in children post-chemotherapy maintenance phase.
Pemanfaatan informasi medis dan obat secara online di kalangan mahasiswa kedokteran
Komang Denisa Dimi Paramitha, Ida Ayu Alit Widhiarthini, I Gusti Made Aman, I Made JawiOnline First: Jun 26, 2023
- Abstract
Pemanfaatan informasi medis dan obat secara online di kalangan mahasiswa kedokteran
Introduction: Currently the Internet is an important part of student learning. The internet provides information that is one of the main sources of reference in understanding medical science. The information available on the internet varies over a wide area. Not all of this information can be used as a reference. This study aimed to describe the use of online medical and drug information among university students.
Method: This study used a descriptive cross-sectional research design. Data was collected through a questionnaire conducted online with active students of the Undergraduate Medicine Study Program, Faculty of Medicine, Udayana University, Class of 2019-2022 during the January-March 2023 period.
Results: The number of students who became respondents included 301 people. Most of the respondents (86.14%) have known the internet as a source of medical and drug information for more than 1 year and the devices that are widely used are laptops and mobile phones (85,72% and 87.38%). The frequency is at most once a week (56.82%), and the duration is less than 2 hours (57.81%). Almost all respondents feel that digital information plays a very influential role in medical practice and have utilized electronic journal databases (89,04%). The most frequently used journals are Google Scholar (87,05%) and Pubmed (84.72%). The largest drug database is the official BPOM website (64.46%). Lecturer recommendations are the most common source (55.82%). Most of the reasons were lecture assignments (90,04%) with the most searched topics being information about management (86.72%) and drug dosages (86,05%).
Conclusion: Utilization of online medical and drug information has a big role in student learning activities. Based on this, the availability of access to information in reputable scientific journals will be needed.
Pendahuluan: Saat ini internet menjadi bagian penting dalam pembelajaran mahasiswa. Internet menyediakan informasi yang menjadi salah satu sumber referensi utama dalam memahami ilmu kedokteran. Informasi yang tersedia dalam internet beragam dengan area yang luas. Tidak semua informasi dapat dimanfaatkan sebagai referensi. Penelitian ini bertujuan untuk mendeskripsikan pemanfaatan informasi medis dan obat secara online di kalangan mahasiswa kedokteran.
Metode: Penelitian ini menggunakan rancangan penelitian potong lintas dengan deskriptif analitik. Data dikumpulkan melalui kuesioner yang dilakukan secara daring terhadap mahasiswa aktif Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana Angkatan 2019-2022 selama periode Januari-Maret 2023.
Hasil: Jumlah mahasiswa yang menjadi responden mencakup 301 orang. Sebagian besar responden (86,14%) sudah mengenal internet sebagai sumber informasi medis dan obat lebih dari 1 tahun serta perangkat yang banyak digunakan adalah laptop dan mobile phone (85,72% dan 87,38%). Frekuensi paling banyak satu kali seminggu (56,82%), dan durasi yang dihabiskan selama kurang dari 2 jam (57,81%). Hampir keseluruhan responden merasakan peran informasi digital sangat berpengaruh dalam praktik kedokteran dan sudah memanfaatkan database jurnal elektronik (89,04%). Jurnal paling sering digunakan adalah Google Scholar (87,05%) dan Pubmed (84,72%). Basis data obat terbanyak adalah situs resmi BPOM (64,46%). Rekomendasi dosen adalah sumber terbanyak (55,82%). Alasan terbanyak adalah tugas perkuliahan (90,04%) dengan topik yang paling banyak ditelusuri adalah informasi mengenai manajemen (86,72%) dan dosis obat (86,05%).
Simpulan: Pemanfaatan informasi medis dan obat secara online memiliki peran besar dalam kegiatan pembelajaran mahasiswa. Didasari hal tersebut, ketersediaan akses informasi jurnal-jurnal ilmiah bereputasi akan sangat dibutuhkan.
Perbedaan kadar rasio neutrofil dan limfosit terhadap kejadian kejang demam sederhana dengan kejang demam kompleks pada anak di RSUD Sanjiwani
Dewa Ayu Dwi Megantari Putri, Romy WindiyantoOnline First: Aug 17, 2023
- Abstract
Perbedaan kadar rasio neutrofil dan limfosit terhadap kejadian kejang demam sederhana dengan kejang demam kompleks pada anak di RSUD Sanjiwani
Background: The characteristics of febrile seizures are generally reported by parents subjectively. The neutrophil-to-lymphocyte ratio (NLR) is proposed as an objective parameter that can distinguish simple and complex febrile seizures. This study aims to assess the difference in NLR in children with simple and complex febrile seizures.
Methods: A cross-sectional study was conducted using secondary data from medical records, at the Sanjiwani Regional General Hospital, Gianyar City, on pediatric patients aged six months to five years diagnosed with febrile seizures and treated in the period January-October 2022. The dependent variable in this study was the classification of febrile seizures, so the sample was divided into simple and complex febrile seizure groups. The NLR value was obtained by calculating the ratio of neutrophil and lymphocyte counts from the complete blood count results. The Mann-Whitney test assessed the difference in NLR value in the two groups.
Results: There were 52 children included as research subjects. The majority of the samples were ≥1 year old (94.2%), female (53.8%), and diagnosed with simple febrile seizure (71.2%). The samples' median (minimum-maximum) NLR was 4.54 (0.4-16.4). This study found no significant difference in NLR values between the simple and complex febrile seizure groups (p = 0.976).
Conclusion: There was no significant difference in NLR values between the groups of simple and complex febrile seizures. Further research is needed to determine NLR's cut-off point and correlation with simple and complex febrile seizures.
Latar belakang: Karakteristik kejang demam umumnya dilaporkan oleh orang tua secara subyektif. Rasio neutrofil dan limfosit (NLR) diusulkan sebagai parameter objektif yang dapat membedakan kejang demam sederhana (KDS) dan kompleks (KDK). Studi ini bertujuan untuk menilai perbedaan NLR pada anak dengan KDS dan KDK.
Metode: Penelitian cross-sectional dilakukan menggunakan data sekunder dari rekam medik di Rumah Sakit Umum Daerah (RSUD) Sanjiwani Gianyar, pada pasien anak berusia enam bulan hingga lima tahun didiagnosis dengan kejang demam dan dirawat pada periode Januari-Oktober 2022. Variabel terikat pada penelitian ini adalah klasifikasi kejang demam, sehingga sampel dibagi menjadi kelompok KDS dan KDK. Nilai NLR diperoleh dengan menghitung rasio jumlah neutrofil dan limfosit dari hasil pemeriksaan darah lengkap. Uji Mann-Whitney digunakan untuk menilai perbedaan nilai NLR pada dua kelompok.
Hasil: Terdapat 52 anak yang diikutkan sebagai subyek penelitian. Mayoritas sampel berusia ≥1 tahun (94,2%), perempuan (53,8%), dan di diagnosis dengan KDS (71,2%). Median (minimum-maksimum) NLR sampel adalah 4,54 (0,4-16,4). Tidak terdapat perbedaan nilai NLR bermakna ditemukan antara kelompok KDS dan KDK pada penelitian ini (p = 0,976).
Kesimpulan: Tidak terdapat perbedaan nilai NLR yang bermakna antara kelompok KDS dan KDK. Penelitian selanjutnya diperlukan untuk menentukan cut off point dan kuat korelasi NLR dengan KDS dan KDK.
Prevalensi dan faktor yang berhubungan dengan kecurigaan keterlambatan perkembangan pada bayi risiko tinggi
Siska Permanasari Sinardja, I Gusti Ayu Trisna Windiani, Made Kardana, I Gusti Agung Ngurah Sugitha Adnyana, SoetjiningisihOnline First: Aug 29, 2023
- Abstract
Prevalensi dan faktor yang berhubungan dengan kecurigaan keterlambatan perkembangan pada bayi risiko tinggi
Background: Developmental delay was still a challenging issue especially in high risk infants. Multifactorial reasoning in neonatal history has led to the screening test as an important step to detect suspicion of any developmental delay. The suspicion was made based on the Denver II screening test, that could lead us to such conditions earlier. Determined prevalence and associated factors of developmental delay suspicion in high risk infants were needed to be investigated further. This study aimed to determine prevalence and associated factors of developmental delay suspicion based on the Denver II screening test in high risk infants.
Methods: This was an observational analytic study using a cross-sectional design. Data were collected from the Denver II screening test of infants aged below 12 months whose history of being treated in level II and III neonatal units, who visited outpatient clinics in July 2015 until June 2017.
Results: A total of 197 subjects were conducted in this study. It was dominated by male (58.9%), aged below 6 months (82.7%) with mean age was 77 days, term babies (56.8%), and spontaneous vaginal delivery (55.8%). Prevalence developmental delay suspicion in high risk infants was 46.2%. Significant associated factors were asphyxia and neonatal sepsis [OR=6.88 (CI 95% 3.39-13.94), p=0.00], [OR=2.36 (CI 95% 1.13-4.95), p=0.02].
Conclusion: Almost half of subjects had developmental delay suspicion based on Denver II screening test, with asphyxia and neonatal sepsis were significant associated factors. Further investigation and periodic evaluation were needed to confirm developmental issues in high risk infants.
Latar belakang: Gangguan perkembangan masih sering ditemui terutama pada bayi dengan risiko tinggi. Bayi tersebut memiliki alasan rawat yang bersifat multifaktorial, sehingga uji tapis keterlambatan perkembangan menjadi langkah awal yang penting. Kecurigaan keterlambatan tersebut dinilai menggunakan uji tapis Denver II yang dapat mengarahkan kecurigaan gangguan tersebut lebih awal. Prevalens kecurigaan keterlambatan perkembangan dan faktor yang berhubungan dengan hasil tersebut pada bayi risiko tinggi perlu dinilai lebih lanjut. Penelitian ini bertujuan untuk mengetahui prevalensi serta menilai faktor yang berhubungan dengan kecurigaan keterlambatan perkembangan pada bayi risiko tinggi.
Metode: Penelitian ini merupakan penelitian analitik observasional menggunakan rancangan potong lintang. Data diambil dari hasil uji tapis Denver II terhadap bayi berusia di bawah 12 bulan yang memiliki riwayat perawatan neonatus level II dan III, yang melakukan kontrol poliklinik pada Juli 2015 hingga Juni 2017.
Hasil: Sebanyak 197 subjek yang diikutsertakan dalam penelitian ini. Subjek didominasi oleh jenis kelamin lelaki (58,9%), berusia di bawah 6 bulan (82,7%) dengan rerata usia 77 hari, usia gestasi cukup bulan (56,8%), dan persalinan spontan (55,8%). Prevalens kecurigaan keterlambatan perkembangan pada bayi risiko tinggi adalah 46,2%. Faktor yang berhubungan secara signifikan adalah asfiksia dan sepsis neonatorum dengan nilai [OR=6,88 (IK 95% 3,39-13,94), p=0,00], [OR=2,36 (IK 95% 1,13-4,95), p=0,02].
Simpulan: Hampir separuh subjek dicurigai mengalami keterlambatan perkembangan pada uji tapis Denver II, dengan asfiksia dan sepsis neonatorum sebagai faktor yang berhubungan secara signifikan. Penelitian lebih lanjut dan pengamatan berkala diperlukan untuk memastikan gangguan perkembangan pada bayi dengan risiko tinggi.
Faktor risiko perburukan pada pasien trauma tumpul thorax di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah
Putu Agus Sukarna, I Ketut Sudiasa, Tjok Gde Bagus Mahadewa, I Wayan Sudarsa, I Wayan NiryanaOnline First: Jul 31, 2023
- Abstract
Faktor risiko perburukan pada pasien trauma tumpul thorax di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah
Background: Thoracic trauma it often causes ventilation perfusion disorders resulting in tissue oxygenation disorders that cause death. Rapid and systematic evaluation of the patient in the identification and treatment of injuries is essential for immediate recovery of the soul and further definitive treatment. Several factors have been studied to see arrest in increasing the risk of worsening of the condition in cases of blunt thoracic trauma.
Methods: A cross-sectional study with a prospective cohort design conducted by taking secondary data from questionnaire extraction data. Sampling was carried out at the Emergency Room (ER), Prof. Dr. I.G.N.G.Ngoerah Central General Hospital from April 2021 to April 2022. The independent variables studied included risk factors for worsening. The dependent variable includes a worsening of the condition characterized by the presence of ARDS (PaO2/FiO2 ≤ 300 mmHg), or PaO2/FiO2 ≤ 200 mmHg in patients who present with ARDS. Control variables include diabetes mellitus, coronary heart disease, chronic obstructive pulmonary disease, and cancer
Results: The study subjects were 69 children who met the criteria. Age more than or equal to 45 years, sex, oxygen saturation, changes in pH, contusions, bone fractures, infection, hemothorax, and pneumothorax are not risk factors for worsening in patients with blunt thoracic trauma at Prof. Dr. I.G.N.G.Ngoerah Central General Hospital. Only ARDS conditions and worsening of conditions had a meaningful relationship. The condition of ARDS when in the ER for worsening resulted in a relative risk value (RR) of 18.750 (p=0.001; 95% CI: 5.400-65.101).
Conclusion: Risk factors for aggravation in patients with blunt thoracic trauma ARDS
Latar belakang: Pada trauma thorax sering menyebabkan gangguan ventilasi perfusi sehingga terjadinya gangguan oksigenasi jaringan yang menyebabkan kematian. Evaluasi yang cepat dan sistematis pada pasien dalam mengidentifikasi dan penanganan cedera sangat penting untuk penyelamatan jiwa secara langsung dan penanganan definitif lebih lanjut. Beberapa faktor telah dipelajari untuk melihat perannya dalam meningkatkan risiko perburukan kondisi pada kasus trauma tumpul thorax.
Metode: Penelitian cross-sectional dengan desain kohort prospektif yang dilakukan dengan mengambil data sekunder dari kuisioner ekstrasi data. Pengambilan sampel dilakukan di Instalasi Gawat Darurat (IGD), Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G.Ngoerah pada Bulan April 2021 sampai dengan bulan April 2022. Variabel bebas yang diteliti meliputi faktor-faktor risiko perburukan. Variabel terikat meliputi perburukan kondisi yang ditandai oleh munculnya ARDS (PaO2/FiO2 ≤ 300 mmHg), atau PaO2/FiO2 ≤ 200 mmHg pada pasien yang datang dengan ARDS. Variabel kendali meliputi diabetes melitus, penyakit jantung coroner, penyakit paru obstruktif kronis, dan kanker
Hasil: Subyek penelitian sebanyak 79 sampel yang memenuhi kriteria. Usia lebih dari atau sama dengan 45 tahun, jenis kelamin, saturasi oksigen, perubahan pH, kontusio, fraktur kosta, infeksi, hemothorax, dan pneumothorax tidak merupakan faktor risiko terjadinya perburukan pada penderita trauma tumpul thorax di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G.Ngoerah. Hanya kondisi ARDS dan perburukan kondisi yang memiliki hubungan bermakna. Kondisi ARDS saat di UGD terhadap terjadinya perburukan menghasilkan nilai relative risk (RR) 18,750 (p=0,001;95%CI:5,400-65,101).
Kesimpulan: Faktor risiko terjadinya perburukan pada penderita trauma tumpul thorax meliputi ARDS
Hubungan antara tipe fraktur zygomaticomaxillary complex dengan gangguan fungsi bola mata, fraktur orbital floor dan tindakan bone graft di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar
Lucretya Yeniwati Tanuwijaya, Agus Roy Rusly Hariantana Hamid, I Gusti Putu Hendra Sanjaya, I Made Suka Adnyana, Tjokorda Gde Bagus MahadewaOnline First: Aug 27, 2023
- Abstract
Hubungan antara tipe fraktur zygomaticomaxillary complex dengan gangguan fungsi bola mata, fraktur orbital floor dan tindakan bone graft di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar
Introduction: A zygomaticomaxillary complex fracture is the most common facial fracture after a nose fracture. Serious eye injuries most often complicate these fractures and are almost always associated with fractures of the orbital floor. This study aims to determine the relationship between the types of zygomaticomaxillary complex fractures and impaired ocular function, orbital floor fractures, and bone graft procedures.
Methods: This cross-sectional analytic observational study was conducted at Prof. Hospital. Dr. I.G.N.G. Ngoerah Denpasar. Data were obtained from patient medical records from January 2020 – December 2021 with a sample size of 85 subjects. Data analysis used the SPSS chi-square test for bivariate analysis.
Results: The majority of the 107 study subjects were male (75.7%) and aged ≥28 years (58.9%). Subjects who experienced type A1, A2, A3, B, and C fractures were 10 people (9.3%), 1 person (0.9%), 16 (15.0%), 68 people (63, 6%), and 12 people (11.2%). Fractures in the orbital area were experienced by most of the subjects in this study (51.4%). There was a significant positive relationship between fractures of the zygomaticomaxillary complex and impaired eyeball function (p<0.05) and a positive relationship between fractures of the orbital floor and bone grafting (p<0.05). The relationship between orbital floor fracture and bone graft based on the types of zygomaticomaxillary complex fractures showed a significant positive relationship in type A3 and in type B (p=0.036;0.006).
Conclusion: Fractures of the zygomaticomaxillary complex are associated with impaired eyeball function, fractures of the orbital floor, and bone grafting. Orbital floor fractures accompanying zygomaticomaxillary complex fractures in types A3 and B are significantly associated with bone grafting.
Pendahuluan: Fraktur zygomaticomaxillary complex merupakan fraktur pada wajah yang paling sering terjadi setelah fraktur hidung. Fraktur ini paling sering disertai dengan komplikasi cedera mata yang serius dan hampir selalu dikaitkan dengan fraktur orbital floor. Penelitian ini bertujuan untuk mengetahui hubungan antara tipe fraktur zygomaticomaxillary complex dengan gangguan fungsi bola mata, fraktur orbital floor, dan tindakan bone graft.
Metode: Penelitian observasional analitik dengan desain potong lintang ini dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Data diperoleh dari rekam medis pasien mulai Januari 2020 – Desember 2021 dengan besar sampel 85 subjek. Analisis data menggunakan SPSS uji chi square untuk analisis bivariat.
Hasil: Mayoritas dari 107 subjek penelitian berjenis kelamin laki-laki (75,7%) dan berusia ≥28 tahun (58,9%). Subjek yang mengalami fraktur tipe A1, A2, A3, B, dan C masing-masing sebanyak 10 orang (9,3 %), 1 orang (0,9%), 16 (15,0%), 68 orang (63,6%), dan 12 orang (11,2%). Fraktur di daerah orbita dialami oleh sebagian besar subjek pada penelitian ini (51,4%). Terdapat hubungan yang bermakna positif antara fraktur zygomaticomaxillary complex dengan gangguan fungsi bola mata (p<0.05), dan hubungan positif antara fraktur orbital floor dengan tindakan bone graft (p<0,05). Hubungan fraktur orbital floor dengan bone graft berdasarkan tipe-tipe fraktur zygomaticomaxillary complex menunjukkan hubungan yang bermakna positif pada tipe A3 dan pada tipe B (p=0,036;0,006).
Simpulan: Tipe fraktur zygomaticomaxillary complex berhubungan dengan terjadinya gangguan fungsi bola mata, fraktur orbital floor, tindakan bone graft. Fraktur orbital floor yang menyertai fraktur zygomaticomaxillary complex pada tipe A3 dan B berhubungan secara bermakna dengan tindakan bone graft.
Gambaran kelainan neuro oftalmologi akibat lesi intrakranial (Chiasma Optikum) di poliklinik mata RSUP Prof. Dr. IGNG Ngoerah tahun 2021-2022
I Gusti Agung Ratna Noviantari, Anak Agung Mas Putrawati Triningrat, Made Paramita Wijayati, Ida Bagus Putra ManuabaOnline First: Jun 29, 2023
- Abstract
Gambaran kelainan neuro oftalmologi akibat lesi intrakranial (Chiasma Optikum) di poliklinik mata RSUP Prof. Dr. IGNG Ngoerah tahun 2021-2022
Background: Intracranial lesions can cause neuroophthalmological disorders in patients. This study aims to describe neuroophthalmological disorders due to intracranial lesions (optic chiasma) at the Optic Hospital of Prof. Dr. IGNG Ngoerah 2021-2022.
Methods: This type of research is a retrospective descriptive using medical record data in 2021 - 2022. The parameters assessed in this study were age, sex, hemianopsia, visual acuity, color vision impairment, optic nerve papillae atrophy, contrast sensitivity, cupping, and Relative Afferent Pupillary Defect (RAPD). Data were analyzed with SPSS version 23.0 for Windows.
Results: There were 22 patients with intracranial lesions in the Neuro-Ophthalmology Division, Ophthalmic Hospital, Prof. Dr. IGNG Ngoerah, during the study period. Most of the research subjects were male and were in the age group of 41-50 years. The most common complaint is blurred vision without other complaints. The most common type of visual field loss is bitemporal hemianopsia. The most visual acuity is 6/6-6/18, as much as 54.5%, while 25% of eyes have visual acuity <6-60. Nearly half of the eye samples (45.5%) had atrophic papillae and 8 eyes (18.2%) had cupping. A total of 9 eyes (20.5%) had impaired color vision, 28 eyes (63.6%) had impaired contrast sensitivity, and 2 eyes (4.5%) had positive RAPD.
Conclusion: There is a significant relationship between visual acuity, color vision impairment, and contrast sensitivity. There is no relationship between complaints of pain and the type of hemianopsia.
Latar Belakang: Lesi intrakranial dapat menyebabkan kelainan neuro oftalmologi pada pasien. Penelitian ini bertujuan untuk mengetahui gambaran kelainan neuro oftalmologi akibat lesi intrakranial (chiasma optikum) di Poliklinik Mata RSUP Prof. Dr. IGNG Ngoerah tahun 2021-2022.
Metode: Jenis penelitian adalah deskriptif retrospektif dengan menggunakan data rekam medik pada tahun 2021 - 2022. Parameter yang dinilai pada penelitian ini adalah usia, jenis kelamin, hemianopsia, tajam penglihatan, gangguan penglihatan warna, atrofi papil nervus optikus, sensitivitas kontras, cupping, dan Relative Afferent Pupillary Defect (RAPD). Data dianalisis dengan SPSS versi 23.0 untuk Windows.
Hasil: Terdapat 22 pasien Lesi Intrakranial di Divisi Neuro Oftalmologi Poli Mata RSUP Prof. Dr. IGNG Ngoerah selama periode penelitian. Subjek penelitian lebih banyak berjenis kelamin laki-laki dan berada pada kelompok usia 41-50 tahun. Keluhan yang paling sering terjadi adalah penglihatan kabur tanpa keluhan lainnya. Jenis gangguan lapang pandang yang paling sering dialami adalah hemianopsia bitemporal. Tajam penglihatan terbanyak adalah 6/6-6/18 sebanyak 54,5% sedangkan 25% mata memiliki tajam penglihatan <6-60. Hampir setengah sampel mata (45,5%) mengalami papil atrofi dan 8 mata (18,2%) mengalami cupping. Sebanyak 9 mata (20,5%) mengalami gangguan penglihatan warna, 28 mata (63,6%) mengalami gangguan sensitivitas kontras, dan 2 mata (4,5%) memiliki RAPD positif.
Kesimpulan: Terdapat hubungan bermakna antara tajam penglihatan dengan gangguan penglihatan warna dan sensitivitas kontras. Tidak terdapat hubungan antara keluhan nyeri dan jenis hemianopsia.
Daya hambat ekstrak daun binahong (Anredera cordifolia) terhadap Bakteri Gram Negatif (Pseudomonas aeruginosa) dan Gram Positif (Staphylococcus aureus) penyebab otitis eksterna difusa
Ni Putu Oktaviani Rinika Pranitasari, I Wayan Lolik LesmanaOnline First: Aug 23, 2023
- Abstract
Daya hambat ekstrak daun binahong (Anredera cordifolia) terhadap Bakteri Gram Negatif (Pseudomonas aeruginosa) dan Gram Positif (Staphylococcus aureus) penyebab otitis eksterna difusa
Background: Diffused otitis externa is an external ear infection in the form of ear pain and swelling of the ear canal with or without ear fluid. The most common bacteria that cause this infection are Staphylococcus aureus and Pseudomonas aeruginosa. Research using natural ingredients to treat infectious diseases has been done a lot. The binahong plant (Anredera cordifolia) is one of the interesting natural ingredients to study because of its potential as an antibacterial. This study aims to determine the antibacterial activity and active compounds of the ethanol extract of binahong leaves (Anredera cordifolia) against Staphylococcus aureus and Pseudomonas aeruginosa.
Methods: The method of this study was to test the antibacterial activity of alkaloids, flavonoids and saponins from binahong leaf extract against ATCC 9027 (Pseudomonas aeruginosa) and ATCC 25923 (Staphylococcus aureus) bacteria as the most common causes of diffuse otitis externa. Antibacterial activity was assessed using the Thin Layer Chromatography-Bioautography (TLC-Bioautography) immersion method using a clear area on a purple background on the TLC plate. This data was analyzed with SPSS version 23.0 for Windows.
Results: The mean measurement results of the Inhibitory Diameter Zone (IDZ) of binahong leaf extract (Anredera cordifolia) concentrations of 80%, 90% and 100% against ATCC 25923 bacteria were 7.80 mm, 8.00 mm and 9.60 mm respectively. In contrast, the mean diameter of inhibition (DDH) of binahong leaf extract (Anredera cordifolia) concentrations of 80%, 90% and 100% against ATCC 9027 bacteria was 0.00 mm. Thin Layer Chromatography (TLC)-Bioautography test MTT method of binahong leaf extract on Staphylococcus aureus (ATCC 25923) showed clear areas with a purple background in alkaloids and saponins.
Conclusion: The active compounds of binahong leaf extract (Anredera cordifolia), which inhibit the growth of Staphylococcus aureus bacteria, are alkaloids and saponins.
Latar Belakang: Otitis eksterna difusa adalah infeksi telinga luar berupa nyeri telinga dan pembengkakan liang telinga dengan atau tanpa disertai cairan telinga. Bakteri tersering penyebab infeksi ini adalah Staphylococcus aureus dan Pseudomonas aeruginosa. Penelitian menggunakan bahan alam untuk mengatasi penyakit infeksi telah banyak dilakukan. Tanaman binahong (Anredera cordifolia) menjadi salah satu bahan alam yang menarik untuk diteliti karena potensinya sebagai antibakteri. Penelitian ini bertujuan mengetahui aktivitas antibakteri dan senyawa aktif ekstrak etanol daun binahong (Anredera cordifolia) terhadap Staphylococcus aureus dan Pseudomonas aeruginosa.
Metode: Metode penelitian ini adalah pengujian aktivitas antibakteri golongan senyawa alkaloid, flavonoid dan saponin dari ekstrak daun binahong terhadap bakteri ATCC 9027 (Pseudomonas aeruginosa) dan ATCC 25923 (Staphylococus aureus) sebagai penyebab tersering otitis eksterna difusa. Aktivitas antibakteri dinilai berdasarkan uji Kromatografi Lapis Tipis- Bioautografi (KLT-Bioautografi) metode imersi berupa adanya daerah bening diatas latar belakang ungu pada plat KLT. Data ini dianalisis dengan SPSS versi 23.0 untuk Windows.
Hasil: Hasil pengukuran rerata Diameter Daya Hambat (DDH) ekstrak daun binahong (Anredera cordifolia) konsentrasi 80%, 90% dan 100% terhadap bakteri ATCC 25923 berturut-turut adalah 7,80 mm, 8,00 mm dan 9,60 mm. Sedangkan rerata diameter daya hambat (DDH) ekstrak daun binahong (Anredera cordifolia) konsentrasi 80%, 90% dan 100% terhadap bakteri ATCC 9027 adalah 0,00 mm. Uji Kromatografi Lapis Tipis (KLT)-Bioautografi metode MTT ekstrak daun binahong pada bakteri Staphylococcus aureus (ATCC 25923) menunjukkan adanya daerah bening dengan latar belakang ungu pada senyawa alkaloid dan saponin.
Kesimpulan: Senyawa aktif ekstrak daun binahong (Anredera cordifolia) yang berperan dalam mengahmbat pertumbuhan bakteri Staphylococcus aureus adalah senyawa alkaloid dan saponin.
Reaksi neointimal hyperplasia pada pemasangan kateter tunnelled dan non tunnelled pasien penyakit ginjal kronis di RSUP Prof DR. I.G.N.G Ngoerah Denpasar dengan melihat nilai rasio monosit limfosit, rasio neutrofil limfosit, dan rasio trombosit limfosit
Andri Jaya Atmaja, I Nyoman Semadi, I Wayan NiryanaOnline First: Jun 26, 2023
- Abstract
Reaksi neointimal hyperplasia pada pemasangan kateter tunnelled dan non tunnelled pasien penyakit ginjal kronis di RSUP Prof DR. I.G.N.G Ngoerah Denpasar dengan melihat nilai rasio monosit limfosit, rasio neutrofil limfosit, dan rasio trombosit limfosit
Introduction: Vascular access with non-tunneled and tunneled hemodialysis catheters in patients with chronic kidney disease can cause complications such as neointimal hyperplasia. Creating vascular access will cause injury to the endothelium and its underlying layer, which in turn will cause a series of inflammatory reactions. This study was conducted to determine the initial response of neointimal hyperplasia in blood vessels after vascular access in chronic kidney disease by increasing the monocyte lymphocyte ratio, neutrophil lymphocyte ratio, and platelet lymphocyte ratio after insertion of tunneled and non-tunneled catheters.
Methods: The research method is observational analysis with a retrospective cohort design. Sampling was taken using the consecutive sampling method in adult patients with chronic kidney failure who were inserted with tunneled and non-tunneled hemodialysis catheters at Prof. Dr. General Hospital, I.G.N.G. Ngoerah Denpasar. The statistical test uses paired T-test and unpaired T-test with a significance level of 0.05.
Results: A significant difference was found in the value of the neutrophil-lymphocyte ratio in tunneled hemodialysis catheters (mean difference: 0.51; 95% CI: -0.89–(-0.13); p value: 0.01) and non-tunneled (mean difference: 0.04; 95% CI: -0.08–(-0.001); p-value: 0.043). There was no significant difference in the monocyte-lymphocyte ratio after and before insertion of the tunneled hemodialysis catheter (mean difference: 0.04; 95% CI: -0.003–0.81; p value: 0.07) or non-tunneled (median difference: 0.06; p: 0.925). There was a statistically significant difference in the mean platelet-lymphocyte ratio after and before insertion of the tunneled hemodialysis catheter (mean difference: 32.24; 95% CI: -54.11–(-10.38); p-value: 0.005), but no significant difference was found in the placement of non-tunnelled hemodialysis catheters (mean difference: 26.24; 95% CI: -61.47–9.0; p value: 0.14).
Conclusion: There were differences in the inflammatory response after and before the insertion of tunneled and non-tunneled hemodialysis catheters, especially in the value of the neutrophil-lymphocyte ratio.
Pendahuluan: Akses vaskular dengan pemasangan kateter hemodialisa non tunnelled dan tunnelled pada pasien penyakit ginjal kronis dapat menimbulkan komplikasi seperti neointimal hiperplasia. Tindakan pembuatan akses vaskuler akan menyebabkan cedera pada endotel dan lapisan dibawahnya yang selanjutnya akan menyebabkan rangkaian reaksi inflamasi. Penelitian ini dilakukan untuk mengetahui respon awal neointimal hiperplasia pada pembuluh darah yang dilakukan pemasangan akses vaskuler pada penyakit ginjal kronis melalui peningkatan nilai rasio monosit limfosit, rasio neutrofil limfosit, dan rasio trombosit limfosit setelah pemasangan kateter tunnelled dan non tunnelled.
Metode: Metode penelitian berupa analitik observasional dengan rancangan kohort retrospektif. Pengambilan sampel dengan metode consecutive sampling, pada pasien dewasa dengan gagal ginjal kronis yang dilakukan insersi kateter hemodialisis tunnelled dan non-tunnelled di RSUP Prof Dr. I.G.N.G Ngoerah Denpasar. Uji statistic menggunakan Uji T-berpasangan dan Uji T-tidak berpasangan dengan tingkat kemaknaan α=0.05.
Hasil: Ditemukan perbedaan yang signifikan dari nilai rasio neutrofil-limfosit pada pemasangan kateter hemodialisis tunnelled (selisih rerata:0,51; IK95%: -0,89 – (-0,13); nilai p: 0,01) dan non-tunnelled (selisih rerata: 0,04; IK95%: -0,08 – (-0,001); nilai p: 0,043). Tidak terdapat perbedaan yang bermakna dari rasio monosit-limfosit setelah dan sebelum pemasangan kateter hemodialisa tunnelled (selisih rerata: 0,04; IK95%: -0,003 – 0,81 ; nilai p: 0,07) maupun non- tunnelled (selisih median: 0,06; p: 0,925). Adanya perbedaan yang bermakna secara statistik dari rerata rasio trombosit limfosit setelah dan sebelum pemasangan kateter hemodialisa tunnelled (selisih rerata: 32,24; IK95%: -54,11 – (-10,38); nilai p: 0,005), namun tidak ditemukan perbedaan yang bermakna pada pemasangan kateter hemodialisa non-tunnelled (selisih rerata: 26,24; IK95%: -61,47 – 9,0; nilai p: 0,14).
Simpulan: Terdapat perbedaan respon inflamasi setelah dan sebelum pemasangan kateter hemodialsis tunnelled dan non-tunnelled, khususnya pada nilai rasio neutrofil-limfosit.
The outcome of oxygen therapy on desaturated patient with moderate to severe symptoms in Kogabwilhan II Indrapura Field Hospital
Hafizh Rizky Prasetya, Erwin Astha Triyono, Paulus Budiono Notopuro, Leny KartinaOnline First: Aug 30, 2023
- Abstract
The outcome of oxygen therapy on desaturated patient with moderate to severe symptoms in Kogabwilhan II Indrapura Field Hospital
Background: Since the first outbreak of Coronavirus Disease 2019 (COVID-19) in late 2019 in Wuhan, the SARS-CoV virus has grown rapidly and spread around the globe. The virus invades respiratory epithelium, causing inflammation and damage to lung cells, which causes impaired gas exchange and leads to a desaturated state. Kogabwilhan II Indrapura Field Hospital in Surabaya was an initial emergency hospital for asymptomatic and mild-symptomatic COVID-19 patients. Due to the massive surge of COVID-19 cases in East Java, it had to treat moderate and severe symptomatic patients.
Aim: The study aims to report clinical prognosis post-COVID-19 infection.
Method: This is a retrospective descriptive study in Kogabwilhan II Indrapura Field Hospital with desaturated COVID-19 patients from March 2020 to October 2021 as samples.
Results: Of 471 admitted COVID-19 patients with desaturation, 36.9% were moderate-symptomatic, and 63.9% had severe ones. All patients received oxygen therapy and multivitamins. Then, 29.7% of patients were cured, while 70.3% were referred. 48.4% of referred patients were bonam, 10.2% were pronounced deceased, and 11.7% were unknown.
Conclusion: Most patients declared cured after being referred to another center.
Hubungan antara rasio limfosit monosit preoperatif dengan performance status pasien karsinoma buli
Andre Ferryandri Susantio, Anak Agung Gde Oka, I Gede Raka WidianaOnline First: Aug 24, 2023
- Abstract
Hubungan antara rasio limfosit monosit preoperatif dengan performance status pasien karsinoma buli
Introduction: Bladder carcinoma is a common malignancy in women and is the fourth most common malignancy in men. LMR (Lymphocyte monocyte ratio) is an inexpensive and practical inflammatory biomarker that has been introduced to determine prognosis in the field of urology. The aim of this study was to determine the relationship between preoperative LMR (lymphocyte monocyte ratio) and performance status in bladder cancer patients.
Methods: This study is observational with an analytic cross-sectional study approach. This research was conducted at Sanglah Hospital in Denpasar to collect secondary data in the form of medical records from 2018 to 2022. This study used primary and secondary data derived from questionnaires and medical records.
Results: Based on this study, the mean age of the research sample was 60.56 ± 7.606 years. The LMR cut point value for Performance Status is 2.474. In the ROC curve analysis, the area under the curve was found to be 0.917, with a sensitivity value of 86.36% and a specificity of 95.45%. The results of the bivariate analysis showed that based on the results of the analysis it was found that LMR had a significant relationship to performance status (p <0.001) with a PR value of 133.00 (95% CI = 20.510-86.473). The results of the logistic regression test show that LMR (categorized based on the cut point of 2.474) is significantly related to Performance Status.
Conclusion: Based on the research results show that the LMR value is related to Performance Status as measured using the Karnofsky Score.
Pendahuluan: Karsinoma buli adalah keganasan yang umum pada wanita dan merupakan keganasan keempat yang paling umum pada pria. Banyak pemeriksaan biomarker terkait keganasan yang berdasarkan pada gambaran patologis dan marker molecular, namun mahal dan tidak selalu rutin dilakukan sehari-hari. LMR (Lymphocyte monocyte ratio) merupakan salah satu biomarker inflamasi yang murah dan praktis ini mulai diperkenalkan untuk menentukan prognosis di bidang urologi. Tujuan penelitian adalah untuk mengetahui hubungan LMR (lymphocyte monocyte ratio) pre operatif dengan performance status pada pasien karsinoma buli.
Metode: Penelitian ini adalah suatu penelitian observasional dengan pendekatan studi potong lintang analitik. Penelitian ini dilaksanakan di RSUP Sanglah Denpasar untuk melakukan pengambilan data sekunder berupa rekam medis, mulai dari tahun 2018 sampai dengan tahun 2022. Penelitian ini menggunakan data primer dan sekunder berasal dari kuesioner dan rekam medis.
Hasil: Berdasarkan penelitian ini, rerata usia sampel penelitian adalah sebesar 60,56 ± 7,606 tahun. Nilai titik potong LMR terhadap Performance Status adalah sebesar 2,474. Pada analisis kurva ROC ditemukan nilai area di bawah kurva sebesar 0,917 dengan nilai sensitivitas sebesar 86,36% dan spesifisitas sebesar 95,45%. Hasil analisis bivariat menunjukkan bahwa Berdasarkan hasil analisis ditemukan bahwa LMR memiliki hubungan yang signifikan terhadap performance status (p<0,001) dengan nilai PR sebesar 133,00 (IK 95% = 20,510-86,473). Hasil uji regresi logistik menunjukkan bahwa LMR (dikategorikan berdasarkan titik potong 2,474) berhubungan secara signifikan dengan Performance Status.
Simpulan: Berdasarkan hasil penelitian menunjukkan bahwa nilai LMR berhubungan dengan Performance Status yang diukur dengan menggunakan Karnofsky Score.
Karakteristik pasien sphenoid wing meningioma di poliklinik mata divisi rekonstruksi, okuloplasti, dan onkologi (ROO) Rumah Sakit Umum Pusat Sanglah Denpasar Tahun 2018 – 2020
Putu Yuliawati, Ni Made Laksmi Utari, I Gusti Ayu Dian RatnasariOnline First: Jun 16, 2023
- Abstract
Karakteristik pasien sphenoid wing meningioma di poliklinik mata divisi rekonstruksi, okuloplasti, dan onkologi (ROO) Rumah Sakit Umum Pusat Sanglah Denpasar Tahun 2018 – 2020
Background: Meningiomas are invasive tumors originating from the arachnoidal villi. Sphenoid wing meningiomas (SWM) constitute 15%-20% of all meningiomas. The incidence of meningiomas is about 0.4 per 100,000 in the population under 34 years of age and 18.86 per 100,000 in the population over 85 years of age, occurring more frequently in women than in men. Classic symptoms caused by SWM include unilateral proptosis which is sometimes painless, decreased visual acuity to 20/40 or less and ocular paresis. The aim of the study is to determine the characteristics of patients with shpenoid wing meningioma at Sanglah Hospital Denpasar from 2018 to 2020.
Method: This research is an observational study with a cross sectional study approach. Data were collected retrospectively by recording the characteristics and examination data of patients with SWM at the ROO division outpatient eye clinics of Sanglah General Hospital Denpasar based on medical records from 2018 to 2020.
Result: Patients with sphenoid wing meningioma who came to the Eye Polyclinic of the ROO Division of Sanglah Hospital in 2018-2020 who met the inclusion and exclusion criteria in this study amounted to 23 people. Subjects with male sex were obtained as many as 1 person (4.35%), while female subjects were 22 people (95.65%). The mean age ± SB in patients was 43.35 ± 5,228 years. Most of the patients, which amounted to 19 patients (82.60%) had a history of using family planning and 4 patients (17.39%) had no history of using family planning. With duration of use of family planning < 1 year, there were 8 patients (42.10%) and duration of use of family planning > 1 year totaled 11 patients (57.89%). Most of the patients were only able to identify Ishihara 0 plate (78.26%). In visual field examination, most of them could not be evaluated (78.26%), only 3 patients had normal visual fields (13.04%), and 2 patients had temporal defects (8.69%).
Conclusion: Patients with SWM are more common in women than men. The mean age of patients with SWM is 43.35 with initial symptoms in the form of proptosis. In this study, a significant relationship was found between the contraception and duration use contraception with sphenoid wing meningiomas.
Latar Belakang: Meningioma merupakan tumor invasif yang berasal dari arachnoidal villi. Sphenoid wing meningioma (SWM) merupakan 15%-20% dari keseluruhan meningioma. Insiden meningioma sekitar 0.4 per 100.000 pada populasi dengan usia kurang dari 34 tahun dan sebesar 18,86 per 100.000 pada populasi dengan usia lebih dari 85 tahun, lebih sering terjadi pada wanita dibandingkan dengan pria. Gejala klasik yang ditimbulkan oleh SWM diantaranya adalah unilateral proptosis yang terkadang tidak menimbulkan rasa nyeri, penurunan tajam penglihatan hingga 20/40 atau kurang dan adanya paresis okular. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik pasien dengan SWM di Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar pada tahun 2018 - 2020.
Metode: Penelitian ini merupakan suatu penelitian observasional dengan pendekatan studi potong lintang (cross sectional). Data dikumpulkan secara restrospektif dilakukan dengan mencatat karakteristik dan data pemeriksaan pasien dengan sphenoid wing meningioma di Poliklinik Mata divisi ROO RSUP Sanglah Denpasar berdasarkan rekam medis pada periode 2018- 2020.
Hasil: Pasien dengan SWM yang datang ke Poliklinik Mata Divisi ROO RSUP Sanglah pada tahun 2018-2020 yang memenuhi kriteria inklusi dan eksklusi pada penelitian ini berjumlah 23 orang. Subjek dengan jenis kelamin laki-laki di dapatkan sebanyak 1 orang (4,35%), sementara subjek berjenis kelamin perempuan sebanyak 22 orang (95,65%). Rerata umur ± SB pada pasien adalah 43,35 ± 5,228 tahun. Sebagian besar penderita yang berjumlah 19 pasien (82,60%) memiliki riwayat pemakaian kontrasepsi berencana (KB) dan 4 pasien (17,39%) tidak memiliki riwayat pemakaian KB. Dengan durasi pemakaian KB < 1 tahun berjumlah 8 pasien (42,10%) dan durasi pemakaian KB > 1 tahun berjumlah 11 pasien (57,89%). Sebagian besar pasien hanya mampu mengidentifikasi ishihara 0 plate (78,26%). Pada pemeriksaan lapang pandang, sebagian besar tidak dapat dievaluasi (78,26%), hanya 3 pasien yang memiliki lapang pandang normal (13,04%), dan 2 pasien memiliki defek di temporal (8,69%).
Simpulan: Pasien dengan SWM lebih sering terjadi pada perempuan dibandingkan laki-laki . Rerata usia pasien dengan SWM adalah 43.35 dengan gejala awal berupa proptosis. Pada penelitian ini didapatkannya hubungan yang bermakna antara penggunaan KB dan Durasi penggunaan KB dengan Sphenoid Wing Meningioma.
Korelasi kolestasis intrahepatik dan ekstrahepatik dengan tes fungsi hati
I Gusti Ngurah Sanjaya Putra, I Putu Gede Karyana, Ni Nyoman Metriani Nesa, Jessica IrawanOnline First: Aug 30, 2023
- Abstract
Korelasi kolestasis intrahepatik dan ekstrahepatik dengan tes fungsi hati
Background: Newborn babies experience jaundice in about 60% to 80% of cases. Differentiating between intrahepatic and extrahepatic cholestasis may require invasive examinations such as cholangiography and liver biopsy. Liver function tests are used to diagnose early cholestasis, distinguish between intrahepatic and extrahepatic cholestasis, monitor treatment response, and predict prognosis.
Objective: To understand the relationship between liver function tests and intrahepatic and extrahepatic cholestasis.
Methods: An observational analytical study was conducted cross-sectionally, using medical records of cholestasis patients treated at RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, from January 2015 to May 2023. The study population comprised infants aged 0-3 months with cholestasis who met the inclusion and exclusion criteria. The diagnosis of intrahepatic and extrahepatic cholestasis was confirmed by liver biopsy.
Results: Among 52 cholestasis patients, 34 had extrahepatic cholestasis (biliary atresia), and 18 had intrahepatic cholestasis. The median AST in the intrahepatic group was 231.0 [31.7 – 790.7], p-value=0.744. The median ALT in the intrahepatic group was 161.6 [10.1 – 408.1], p-value=0.46. The mean ALP in the extrahepatic group was 458.32±152.56, p-value=0.3. The median GGT in the extrahepatic group was 654 [67 – 3568], p-value=0.002. The median total bilirubin in the intrahepatic group was 9.2 [0.19 – 29.35], p-value=0.281. The median conjugated bilirubin in the extrahepatic group was 7.78 [2.07 – 22.9], p-value=0.331.
Conclusion: Laboratory results for liver function tests in patients with intrahepatic and extrahepatic cholestasis did not differ significantly except for GGT, which was higher in patients with extrahepatic cholestasis. GGT showed the best diagnostic ability compared to other liver function test results.
Latar belakang: Bayi baru lahir mengalami penyakit kuning sekitar 60% sampai 80%. Kesulitan dalam membedakan kolestasis intra dan ekstrahepatal memerlukan pemeriksaan invasif seperti kolangiografi dan biopsi hati. Tes fungsi hati digunakan untuk menegakkan diagnosis dini kolestasis, untuk membedakan kolestasis intra dari ekstrahepatik, untuk menindaklanjuti respon pada pengobatan, dan untuk memprediksi prognosis.
Tujuan: Mengetahui hubungan antara tes fungsi hati dengan kolestasis intrahepatik dan ekstrahepatik.
Metode : Penelitian analitik observasional dilakukan secara potong lintang, menggunakan rekam medis pasien kolestasis yang dirawat di RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar sejak Januari 2015 hingga Mei 2023. Populasi penelitian ini adalah bayi 0-3 bulan dengan kolestasis yang memenuhi kriteria inklusi dan eksklusi. Diagnosis kolestasis intrahepatik dan ekstrahepatik dikonfirmasi oleh biopsi hati.
Hasil: Pada 52 anak kolestasis, 34 anak dengan kolestasis ekstrahepatik (atresia bilier) dan 18 anak dengan kolestasis intrahepatik. Median AST pada kelompok intrahepatal 231,0 [31,7 – 790,7], nilai p=0,744. Median ALT pada intrahepatal 161,6 [10,1 – 408,1], nilai p=0,46. Rerata ALP kelompok ekstrahepatal 458,32±152,56, nilai p=0,3. Median GGT kelompok ekstrahepatal 654 [67 – 3568], nilai p=0,002. Median total bilirubin kelompok intrahepatal 9,2 [0,19 – 29,35], nilai p=0,281. Median bilirubin terkonjugasi kelompok ekstrahepatal 7,78 [2,07 – 22,9], nilai p=0,331.
Simpulan : Hasil laboratorium untuk uji fungsi hati pasien dengan kolestasis intrahepatik dan ekstrahepatik tidak berbeda secara signifikan kecuali untuk GGT yang lebih tinggi pada pasien kolestasis ekstrahepatik. GGT memiliki kemampuan diagnostik terbaik dibandingkan dengan hasil tes fungsi hati lainnya.
Faktor-faktor yang berhubungan dengan status gizi anak HIV/AIDS di Rumah Sakit Umum Daerah Wangaya
Luh Putu Arya Putri Ratnasari, I Wayan Bikin Suryawan, Made Ratna DewiOnline First: Sep 11, 2023
- Abstract
Faktor-faktor yang berhubungan dengan status gizi anak HIV/AIDS di Rumah Sakit Umum Daerah Wangaya
Background: Nutritional status is essential in children with HIV/AIDS infection and is related to morbidity and mortality rates. Predictors that affect the nutritional status of children with HIV/AIDS in Indonesia are still limited and have not been widely studied.
Methods: A cross-sectional analytic study analyzing 45 children with HIV/AIDS who went to the children's polyclinic and Kaswari ward at Wangaya General Hospital. Data were collected from February to March 2022 through secondary data from patient medical records.
Results: 53.3% of the children have a good nutritional status, followed by 40% of children with malnutrition and 6.7% of children with overweight. The predictor factors analyzed were the hemoglobin value (r = 0.42; p<0.05), T-CD4 (r = 0.105; p>0.05), and duration of ART consumption (r = 0.147; p>0.05). ANOVA analysis on the variable viral load, consumption of ART, adherence to ART, and presence of opportunistic infections jointly influenced the nutritional status of children with HIV/AIDS (p<0.05).
Conclusion: The hemoglobin value, viral load, consumption of ART, adherence to ART, and opportunistic infections affect the nutritional status of children with HIV/AIDS.
Latar Belakang: Status gizi merupakan hal penting yang diperhatikan pada anak dengan infeksi HIV/AIDS dan berkaitan dengan angka morbiditas dan mortalitas. Prediktor yang memengaruhi status gizi anak dengan HIV/AIDS di Indonesia masih terbatas dan belum banyak diteliti.
Metode: Studi analitik potong lintang dengan menganalisis 45 anak dengan HIV/AIDS yang berobat ke poliklinik anak dan ruang rawat inap kaswari di RSUD Wangaya. Data dihimpun sejak bulan Februari-Maret 2022 melalui data sekunder yang berasal dari rekam medis pasien.
Hasil: Sebanyak 53,3% anak memiliki gizi baik, diikuti dengan 40% anak gizi kurang dan 6,7% anak gizi lebih. Faktor prediktor yang di analisis seperti kadar hemoglobin ( r = 0.42; p<0,05), nilai T-CD4 (r = 0,105; p>0,05), dan lama konsumsi ART (r = 0,147; p>0,05). Analisis ANOVA pada variabel viral load, konsumsi ART, kepatuhan ART, dan adanya infeksi oportunistik secara bersama-sama memengaruhi status gizi anak dengan HIV/AIDS (p<0,05).
Simpulan: Kadar hemoglobin, viral load, konsumsi ART, kepatuhan ART, dan adanya infeksi oportunistik memengaruhi status gizi anak dengan HIV/AIDS.
Karakteristik anemia pada penderita Diabetes Melitus Tipe 2 (DMT2) di RSUP Prof. Dr. I.G.N.G. Ngoerah, Bali, Indonesia tahun 2019-2021
Putu Anasita Vira Saraswati, Ni Made Renny Anggreni Rena, I Made Pande Dwipayana, Tjokorda Raka PutraOnline First: Jul 13, 2023
- Abstract
Karakteristik anemia pada penderita Diabetes Melitus Tipe 2 (DMT2) di RSUP Prof. Dr. I.G.N.G. Ngoerah, Bali, Indonesia tahun 2019-2021
Background: In Indonesia, diabetes is the third most common cause of death after stroke and ischemic heart disease in 2019. The prevalence of diabetes has increased by approximately 49.9% since 2009. Anemia is a common complication of diabetes and has been identified as a risk factor for cardiovascular disease and end-stage renal disease in diabetic patients. Even so, approximately 25% of anemia in patients with type 2 diabetes mellitus (T2DM) is still not recognized.
Methods: This research is an observational analytic study with a cross-sectional research method. The data were taken from the patient's medical records using the consecutive sampling technique. The subjects of this study were T2DM patients registered at Prof. Dr. I.G.N.G. Ngoerah General Hospital from January 2019 to December 2021. Data that comply with the inclusion and exclusion criteria are then processed with SPSS version 20.0 for Windows.
Results: This study found that 28.9% of T2DM patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital suffered from anemia. Most T2DM patients with anemia came from 50-59 years and 60-69 years (34.6%) and were male (69.2%). The most frequent type of anemia was the normochromic normocytic type (76.9%). When viewed from the severity, the most common anemia found was mild anemia (88.5%).
Conclusion: Compared to the general population, T2DM patients have a higher risk of anemia. Anemia in T2DM can also trigger and worsen complications. Therefore, early detection and management of anemia are needed in T2DM patients.
Latar Belakang: Di Indonesia, diabetes merupakan penyebab kematian terbanyak ketiga setelah stroke dan penyakit jantung iskemik pada tahun 2019. Prevalensi diabetes meningkat sebanyak kira-kira 49,9% dari tahun 2009. Anemia merupakan komplikasi diabetes yang umum ditemukan, dan telah diidentifikasi sebagai faktor risiko dari penyakit kardiovaskular serta penyakit ginjal stadium akhir pada pasien diabetes. Meski begitu, kurang lebih 25% anemia pada penderita diabetes melitus tipe 2 (DMT2) masih tidak dikenali.
Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode penelitian cross-sectional. Data diambil dari rekam medis pasien dengan teknik pengambilan sampel secara konsekutif. Subjek penelitian ini adalah pasien DMT2 yang terdaftar di RSUP Prof. Dr. I.G.N.G. Ngoerah pada Januari 2019 hingga Desember 2021. Data yang sesuai kriteria inklusi dan eksklusi kemudian diolah dengan SPSS versi 20.0 untuk Windows.
Hasil: Pada studi ini ditemukan bahwa 28,9% pasien DMT2 di RSUP Prof. Dr. I.G.N.G. Ngoerah menderita anemia. Pasien DMT2 dengan anemia kebanyakan berasal dari kelompok usia 50-59 tahun dan 60-69 tahun (keduanya 34,6%), dan berjenis kelamin laki-laki (69,2%). Tipe anemia yang paling banyak muncul yaitu tipe normokromik normositer (76,9%). Apabila dilihat dari derajatnya, anemia yang paling banyak diderita adalah anemia ringan (88,5%).
Kesimpulan: Jika dibandingkan dengan populasi umum, pasien DMT2 memiliki risiko lebih tinggi untuk menderita anemia. Anemia pada DMT2 juga dapat memacu serta memperburuk komplikasi. Oleh karena itu, deteksi dini dan manajemen anemia sangat diperlukan pada pasien DMT2.