Background: Breast cancer has the second-highest prevalence of cancer in Indonesia. The aetiology of breast cancer involves endogenous sex hormone activity, estrogen. Besides, thyroid hormones have estrogen-like effects on breast tissue which are thought to play a role in the development of breast cancer. This case report aims to evaluate the physiological aspect of thyroid-induced breast cancer.

Case Report: A 49-year-old Balinese woman came to the Primary Health Care with a history of uncontrolled hyperthyroidism for 5 years (2014-2019), complaining of a lump in her left breast. Open biopsy and immunohistochemistry were done (Grade III Invasive Carcinoma ER + 50%, Her + 2-3). Patients were diagnosed with stage 3B breast cancer and conservative treatment has been taken. The examination of TSH thyroid hormone was 0.204 µIU/mL (normal = 0.5 - 6 µIU/mL) and FT4 3.1 ng/dL (normal = 0.7-1.9 ng/dL).The primary management of patients was chemotherapy following by Modified Radical Mastectomy (MRM), hormone suppressant injection, as well as Herceptin. Those medications were effective in reducing the development of breast cancer through thyroid hormone pathway.

Introduction: Peyronie’s disease (PD) is a progressive fibrotic tissue disorder of the penile tunica albuginea. PD can cause the formation of fibrous plaques, penile deformity, pain during erection, penile curvature, and erectile dysfunction (ED). Surgical treatment is the gold standard in PD because it is a fast and reliable therapy. There are many surgical options for PD such as plication procedures, incision and grafting procedures, and implantation of penile prosthesis. There are three types of graft material have been reported: autologous graft, xenograft and synthetic graft. Considering the higher rate of infections, inflammatory reactions and allergies, synthetic grafts are rarely used. Autologous graft is currently widely used because of the incidence of inflammatory reactions and low allergic reactions. Tunica vaginalis grafts are rarely used widely. Testicular tunica vaginalis was first reported as an autologous graft in 1980.

Case Report: A 53-year-old man comes to the urology clinic at Sidowaras Hospital complaining of pain during erection and erection cannot be straight. This complaint has been felt since a few months ago but the patient ignored it. An assessment of ED with International Index of Erectile Function (IIEF)-5 score obtained a score of 12 (mild-moderate dysfunction). Physical examination found a curvature of the penis around 70⁰ and in palpation there was a hard lump on the dorsal penis. After the diagnosis was made, testicular tunica vaginalis grafting procedure was performed on this patient. At a 6-month re-evaluation after surgery, patient-reported reduced penile pain on erection with improved erectile function score (IIEF)-5 score 21 (mild dysfunction).

Conclusion: Testicular tunica vaginalis grafting was chosen because it is feasible and safe for patient with PD. Testicular tunica vaginalis Grafting used due to their easy incorporation into host tissue and few incidences of local inflammatory reaction.

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequent than duodenal or colonic atresias while single atresias are most commonly encountered. Jejunal atresia is classified into 4 types: Type I (a mucosal/septal), Type II (a fibrous cord/band), Type III (blind ends are entirely separated without a fibrous cord between them and a large mesenteric defect), and Type IV (combination of atresia type I to III). This study aims to elaborate jejunal atresia in the newborn after resection and end-to-end anastomoses.

Case Description: We report three cases of jejunal atresia consists of different types: type IV (first case), type IIIa (second case) and type I (third case). Cases were neonates born with signs of upper gut obstruction. Bile-stained vomiting was reported a few hours after birth and failed to pass meconium in the first 24 hours. Postnatal abdominal X-ray showed dilatation of the gaster and no gas present in the pelvic floor. In the third case, it showed a triple bubble sign on abdominal x-ray and a laparotomy revealed the type of jejuno-ileal atresia. Also, the resection on the atresias and end to end anastomosis were performed. Cases were admitted to neonatal intensive care unit with total parenteral nutrition. The first two cases died due to sepsis, while the third case survived.

Conclusion: Jejunal atresia is a rare disease among newborn. All of the patients have provided resection and end-to-end anastomoses, although 2 of them did not survive. 

Introduction: Chronic limb-threatening ischemia (CLTI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels who suffered from diabetes mellitus type 2, and also associated with physical, as well as psychosocial, consequences such as amputation and depression. Successful revascularization decreases the major amputation rate in patients with CLTI. The efficacy of peripheral bypass grafts and percutaneous transluminal angioplasty in accomplishing limb salvage has been recognized.

Case Description: A 42-year-old man came to the RSUZA emergency room with chief complaints claudication above the right thigh and continuous pain (rest pain) at the right lower extremity since 9 months ago. History of finger amputation 2^nd, 3^rd and 4^th right foot since 10 months ago at local hospital, and now there are necrotic wounds on his toes. Patients suffered from type 2 diabetes mellitus and have bad habits such as smoking 3 packs a day all the time. Physical examination has a wound in the lower leg area of more than 10 cm x 8 cm. Right ankle-brachial index (ABI) 0.6 and left ABI 1.3. CT-angiography (CTA) shows infra inguinal type D TASC II classification. A revascularization procedure is performed to salvage the limb with the right femoro-popliteal bypass technique with graft R-SVG and debridement in the right lower leg area so that chronic right lower limb ischemia can be overcome. Systemic heparinization was given post operatively and complaints of pain in the right lower limb begin to disappear. Patient was discharged on the 5^th day of treatment with good results.

Conclusion: Open surgical bypass continues to be a primary treatment of choice, durable approach in a significant proportion of patients. Lower extremity bypass grafting is most successful with a good quality, long, single-segment autogenous vein of at least 3.5mm diameter.

 

Background: Osteosarcoma is the most common non hematopoietic primary malignant tumor in the bone. Several factors have been related through the development and prognosis of osteosarcoma. One of them is the mutation of p53 gene that encodes p53 protein. This literature review aims to evaluate the role p53 in the progressiveness and prognosis of osteosarcoma.

Methods: A review of relevant literature was performed to elaborate p53 involvement in osetosarcoma. A total of 22 qualified published literature from 2006 until 2017 were collected from several electronic database as well as manual search and included in this review.

Results: P53 has an important role in maintaining genome integrity through its ability to induce genes involved in senescence process, DNA repair and apoptosis. Loss of P53 induces progenitor cells to proliferate and experience differentiation disturbances thereby increasing the potential malignant transformation to osteosarcoma. Loss of p53 also increases osteosarcoma progression by increasing proliferation and providing a good microenvironment for tumor cells. P53 causes inhibition to other tumor suppressor proteins such as BMP-2 and CD137L. Loss of P53 has a role in providing a good microenvironment for osteosarcoma cells to invade surrounding tissue, metastasis and suppressed immune response through increased activity of SDF-1, HIF-1α, VEGF, and NO. High mutant p53 expression has a positive association with short-term survival but does not have a strong association to predict long-term survival.

Conclusion: A p53 gene has a pivotal role in the progressiveness and prognosis of osteosarcoma through increasing proliferation and providing a good microenvironment for tumor cells

 

Latar Belakang: Osteosarkoma merupakan tumor ganas primer non hematopoietik tersering pada tulang. Berbagai faktor telah dikaitkan dengan perkembangan dan prognosis pasien osteosarkoma, Salah satunya adalah mutasi gen p53 yang menyandi protein p53. Tinjauan pustaka ini bertujuan untuk mengevaluasi peran p53 dalam progresif dan prognosis osteosarkoma.

Metode: Tinjauan pustaka yang relevan dilakukan untuk menguraikan keterlibatan p53 dalam osetosarcoma. Sebanyak 22 literatur yang diterbitkan berkualitas dari 2006 hingga 2017 dikumpulkan dari beberapa basis data elektronik serta pencarian manual dan dimasukkan dalam ulasan ini.

Hasil: P53 mempunyai peranan yang sangat penting dalam menjaga integritas genom melalui kemampuannya untuk menginduksi gen-gen yang terlibat dalam proses penuaan sel, perbaikan DNA maupun apoptosis. Hilangnya p53 menginduksi sel-sel progenitor osteosarkoma untuk berproliferasi dan mengalami gangguan diferensiasi sehingga meningkatkan potensi transformasi keganasan menjadi osteosarkoma. Kehilangan p53 juga meningkatkan progresivitas osteosarkoma melalui peningkatan proliferasi dan penyediaan lingkungan mikro yang baik bagi sel tumor. P53 menyebabkan hambatan fungsi protein penekan tumor lainnya yaitu BMP-2 dan CD137L. Kehilangan p53 berperan dalam menyediakan lingkungan mikro yang baik untuk sel-sel osteosarkoma untuk menginvasi jaringan sekitar, bermetastasis dan menghambat aktivitas sistem imun melalui peningkatan aktivitas SDF-1, HIF-1α, VEGF, dan NO. Ekspresi p53 mutan yang tinggi memiliki hubungan positif dengan angka harapan hidup jangka pendek namun tidak memiliki hubungan yang kuat untuk memprediksi harapan hidup jangka panjang.

Kesimpulan: Gen p53 memiliki peran penting dalam progresivitas dan prognosis osteosarkoma melalui peningkatan proliferasi dan menyediakan lingkungan mikro yang baik untuk sel tumor.

Introduction: An increase in the incidence of refractive disorders provides an increasing need for visual aids such as glasses and contact lenses. The use of long-term contact lenses provides a new problem which is adana keratitis which can arise with prolonged use of contact lenses.

Objective: The literature review this time aims to provide a review of how long the role of contact lens use is at risk for keratitis.

Conclusion: Extended use of contact lenses can increase the risk for corneal keratitis. The choice of contact lens type characteristics and duration of use is a matter that should be observed to avoid the risk of keratitis.

 

Pendahuluan: Peningkatan kejadian kelainan refraksi memberikan semakin tingginya kebutuhan akan alat penunjang pengelihatan seperti kaca mata dan lensa kontak. Adanya penggunaan lensa kontak jangka panjang memberikan suatu masalah baru yang yaitu adana keratitis yang dapat muncul dengan lama penggunaan lensa kontak.

Tujuan: Tinjauan pustaka kali ini bertujuan untuk memberikan suatu ulasan mengenai bagaimana peranan penggunaan lensa kontak yang panjang terhadap risiko dari keratitis.

Simpulan: Penggunaan lensa kontak secara extended dapat meningkatkan risiko untuk terjadi keratitis kornea. Pemilihan karakteristik jenis lensa kontak dan durasi penggunaan menjadi hal yang patut dicermati untuk menghindari risko keratitis.

Background: Diabetes mellitus (DM) is a growing health problem and its prevalence is dramatically increasing, particularly in Indonesia. It can affect every organ in the body, and one of the oral manifestations is periodontitis characterized by the loss of tissue attachment. This review aims to identify further the periodontitis as early detection of diabetes mellitus

Methods: A review of relevant literature was performed to elaborate on periodontitis involvement in diabetes mellitus. A total of 25 qualified published literature of all years were collected from several electronic database and manual search and included in this review.

Results: On average, patients with periodontitis showed higher glycated haemoglobin (HbA1c) plasma levels compared with individuals without periodontitis. Diabetes and periodontitis are complex chronic diseases with an established bidirectional relationship. There is long-established evidence that hyperglycemia in diabetes is associated with adverse periodontal outcomes. Here, we show that periodontitis is an early sign of diabetes mellitus and may, therefore, serve as a valuable risk indicator. A dentist who got patient with periodontitis is a suitable location for screening for diabetes by a simple finger stick and validated HbA1c dry spot analysis.

Conclusion: Literature from a different type of study concluded that periodontitis is one of the oral manifestations that could be used as early detection in diabetes mellitus

Background: In the globalization era, the high number of obesities is happened to the teenagers because of the unhealthy life-style. Obesity in the teenagers or pediatric obesity is important to be handled because it can trigger another complication that happened in the early age. This study aims to collect and analyze any source related to anthocyanin (ASN) from purple sweet potato (Ipomoea batatas L) as modality of obesity that is packaged as dry jelly.

Methods: A literature search strategy was conducted to obtained eligible source of study such as books and journals from Google Scholar, Research Gate, and PubMed. The criteria of eligible literature used in this study were articles published on 1981-2019 from different type of study. About 73 literature were used as references regarding the potency of ASN from purple sweet potato (Ipomoea batatas L) as the modality for obese people.

Results: ASN in the purple sweet potato has anti-obesity effect by decreasing the a-glucosidase enzyme and a-amylase, increasing glucagon-like-peptide-1 and peptide YY, changing the size of adipose cell, decreasing the lipogenic activity and inflammation, increasing the lipolysis and β-oxyanion adipose cell, as well as increasing the concentrate of brain-derived neutrophil factor in a brain. To increase the bioavailability of ASN, it has to be done the encapsulation with liposome base.  Modality is packaged in the dry jelly form with pectin base as a formulation in powder form taken orally. The modality consumption is 24 mg/kg of weight, however, after eating, the obese people tend to give the weight decreasing effect and cross section attractive to target modalities.

Conclusion: According to the studies, the ASN from purple sweet potato and package in Pectin-Based Dry Jelly could be used as a novel strategy in managing the pediatric obesity.

Background: Mucociliary clearance is a significant element of the defence system of the entire respiratory tract. Impairment of the mucociliary clearance serves as a medium for sinonasal infections. Saline nasal irrigation is believed to alleviated rhinosinusitis symptoms by clearing excess mucus, reducing congestion and remove infectious materials from the inspired air. This study aimed to determine the efficacy of mucociliary transport time of isotonic saline nasal solutions in patients with acute rhinosinusitis.

Methods: An experimental study using pre- and post-test with control group design was conducted in this study. Mucociliary transport time was measured by the saccharine test on 20 acute rhinosinusitis patients before and after 7 days’ treatment with intranasal isotonic saline solutions and standard therapy (ciprofloxacin, pseudoephedrine/ triprolidine, ambroxol) for the case group and standard treatment for the control group. Data were analysed using SPSS version 20 for Windows.

Result: The average mucociliary transport time before therapy was 35.5±10.7 minutes and 29.2±7.7 minutes for the case group and control group, respectively. The average mucociliary transport time after therapy was 22.9±8.7 minutes and 18.0 ± 5.6 minutes for case group and control group, respectively. The mean difference mucociliary transport time before and after therapy was 11.0±7.5 minutes and 9.4±5.3 minutes for the case and control group, respectively (p=0.499).

Conclusions: The addition of intranasal isotonic saline solutions in acute rhinosinusitis patients has the same effect of mucociliary transport time with oral medication with the antibiotic, decongestant, and mucolytic without intranasal isotonic saline solutions.

 

Latar Belakang: Transpor mukosilia merupakan salah satu mekanisme pertahanan saluran pernapasan. Adanya gangguan pada sistem tersebut menjadi predisposisi terjadinya infeksi sinonasal. Larutan pencuci hidung dengan salin isotonis dipercaya dapat mengurangi gejala akibat rinosinusitis dengan cara membersihkan sekret, mengurangi odema dan mengeluarkan bahan-bahan berbahaya yang masuk bersama udara pernapasan. Tujuan penelitian ini adalah untuk menilai efektivitas waktu transpor mukosilia larutan pencuci hidung salin isotonis pada pasien rinosinusitis akut.

Metode: Uji eksperimental dengan desai pre-post test dengan kontrol dilakukan pada penelitian ini. Waktu transpor mukosilia diukur menggunakan uji sakarin terhadap 20 pasien rinosinusitis akut sebelum dan 7 hari sesudah pemberian larutan pencuci hidung salin isotonis dan terapi standar (ciprofloxacine, pseudoephedrine/triprolidine, ambroxol) pada Kelompok Perlakuan dan terapi standar pada Kelompok Kontrol. Data dianalisis menggunakan SPSS versi 20 untuk Windows.

Hasil: Rerata waktu transpor mukosilia sebelum perlakuan pada Kelompok Perlakuan adalah 35,5 ± 10,7 menit dan 29,2 ± 7,7 menit pada Kelompok Kontrol. Rerata waktu transpor mukosilia sesudah terapi adalah 22,9 ± 8,7 menit dan 18,0±5,6 menit berturut-turut pada Kelompok Perlakuan dan Kelompok Kontrol. Median selisih waktu transpor mukosilia sebelum dan sesudah terapi adalah 11,0±7,5 menit pada Kelompok Perlakuan dan 9,4 ± 5,3 menit pada Kelompok Kontrol (p=0,499).

Kesimpulan: Penambahan larutan cuci hidung salin isotonis pada rinosinusitis akut memiliki efek waktu transpor mukosilia yang sama dengan pemberian antibiotika, dekongestan dan mukolitik tanpa larutan cuci hidung salin isotonis.

Background: Tuberculosis (TB) is one of the infectious diseases that still need attention, especially in developing countries where the prevalence is still high. Health promotion is a step that can be done to prepare citizens in terms of their abilities and knowledge regarding TB disease. This study aims to see changes in people's knowledge after health promotion about TB in the village of Trojan, Klungkung, Bali.

Methods: A cross-sectional descriptive study has been conducted to assesses the knowledge responses before and after delivery of material on TB. Health promotion was carried out on April 2^nd 2018 in Banjar Desa Trojan Klungkung. Before giving the material 3 questions were given to 3 participants randomly, then after giving the material for 30 minutes, 3 questions were given to 9 random communities. Data were analyzed using SPSS version 17 for Windows

Results: A total pre-test score was 44.4% while the post-test score was 88.9% where there was an increase of 44.5% after the material was given. In addition, all of the respondents showed a perfect post-test score (100,0%) both in the questions related to the symptoms of TB as well as the route of transmission for TB, respectively,

Conclusion: This study shows that there is an increase in knowledge after the provision of health promotion through post-test evaluation.

 

Latar Belakang: Tuberkulosis (TB) merupakan salah satu penyakit menular yang masih perlu diperhatikan terutama di negara berkembang dimana prevalensinya masih tinggi. Penyuluhan merupakan suatu langkah yang dapat dilakukan untuk mempersiapkan warga dalam hal kemampuan dan pengetahuan mengenai penyakit TB. Studi ini bertujuan untuk melihat perubahan pengetahuan warga setelah dilakukan penyuluhan mengenai TB di Desa Trojan, Klungkung, Bali.

Metode: Sebuah studi potong lintang deskriptif telah dilakukan untuk menilai respon pengetahuan sebelum dan sesudah penyampaian materi penyuluhan mengenai TB. Penyuluhan dilakukan pada tanggal 2 April 2018 di banjar Desa Trojan Kelungkung. Sebelum pemberian materi diberikan 3 buah pertanyaan kepada 3 peserta secara acak, kemudian setelah pemberian materi selama 30 menit, diberikan 3 buah pertanyaan kepada 9 masayarakat acak. Data dianalisis menggunakan SPSS versi 17 untuk Windows.

Hasil: Total nilai pre-test adalah 44,4% sedangkan nilai post-test adalah 88,9% dimana terjadi peningkatan sebesar 44,5% setelah pemberian materi. Di samping itu, seluruh responden menunjukkan hasil nilai post-test sempurna (100,0%) baik pada pertanyaan yang berhubungan dengan gejala TB maupun jalur transmisi TB, secara berturut-turut.

Kesimpulan: Studi ini menunjukkan bahwa terdapat peningkatan pengetahuan setelah pemberian penyuluhan melalui evaluasi post-test.

Background: Pyoderma is a skin infection caused by bacteria Staphylococcus, Streptococcus, or both of it. Pyoderma often experienced by children which caused he skin resistance against the invasion of pathogenic germs, which not perfect as ts. Pyoderma morbidity in pediatric patients still occurs, especially in developing countries with tropical climates. This study aims to determine the pyoderma profile among children 0-14 years old at Sanglah General Hospital, Denpasar, in June 2015-2016 period.

Methods: A cross-sectional descriptive design using a retrospective approach was conducted in this study. Samples were determined using total sampling technique and this sample using pediatric patients aged 0-14 years in Sanglah General Hospital periods June 201 5to June 2016 who had pyoderma. The data obtained in this study were analyzed descriptively using SPSS version 17 for Windows.

Results: The results founded that there were 347 admissions, 53 patients suffering from pyoderma in Sanglah General Hospital. The majority of patients aged ≤ 4 years were 31 patients (58.5%), followed by the sex of the male as many as 34 patients (64.2%), diagnosis of bullous impetigo 27 patients (50.9%) and the location of lesions on the head of 32 patients (60.4%). Positive results of gram-positive coccus examination were 28 patients (52.8%) followed by the majority of patients getting a combination of topical and systemic antibiotics were 42 patients (79.2%).

Conclusion: According to the data analysis and discussion, it can be concluded that the incidence of pyoderma in children is still quite a lot happening in Sanglah General Hospital during June 2015-2016 period.

 

Latar Belakang: Pioderma merupakan infeksi kulit yang disebabkan oleh kuman staphylococcus, streptococcus, atau oleh keduanya. Pioderma sering dialami anak-anak, karena daya tahan kulit terhadap invasi kuman pathogen belum sesempurna orang dewasa. Angka morbiditas pioderma pada pasien anak masih cukup terjadi terutama di negara berkembang dengan iklim tropis. Tujuan dari penelitian ini adalah ntuk mengetahui profil pioderma pada anak usia 0-14 tahun di Rrumah Sakit Umum Pusat Sanglah Denpasar periode Juni 2015- Juni 2016.

Metode: Penelitian ini menggunakan studi potong lintang deskriptif dengan desain penelitian retrospektif. Sampel ditentukan dengan menggunakan teknik total sampling, dalam sampel ini yang digunakan adalah pasien anak yang berusia 0-14 tahun di Rumah Sakit Umum Pusat Sanglah Denpasar periode Juni 2015- Juni 2016 yang mengalami pioderma. Data yang diperoleh dalam penelitian ini dianalisis secara deskriptif menggunakan SPSS versi 17 untuk Windows.

Hasil: Hasil penelitian secara deskriptif menunjukan bahwa dari 347 kunjungan, 53 pasien yang menderita pioderma di Rumah Sakit Umum Pusat Sanglah Denpasar. Sebagian besar pasien berusia ≤ 4 tahun sebanyak 31 pasien (58.5%), diikuti dengan jenis kelaminl laki-laki sebanyak 34 pasien (64.2%), diagnosis impetigo bulosa 27 pasien (50.9%) dan lokasi lesi pada kepala yaitu 32 pasien (60.4%). Hasil positif pemeriksaan kokus gram positif sebanyak 28 pasien (52.8%) diikuti dengan sebagian besar pasien mendapatkan kombinasi topikal dan antibiotik sistemik adalah 42 pasien (79.2%).

Kesimpulan: Berdasarakan hasil analisis data dan pembahasan, maka dapat disimpulkan bahwa insidens pioderma pada anak masih cukup banyak terjadi di Rumah Sakit Umum Pusat Sanglah periode Juni 2015-2016.

Background: Dyspepsia is recurrent and persistent pain or discomfort in the upper abdomen. Dyspepsia can be divided into two, which are organic dyspepsia and functional dyspepsia, respectively. Endoscopy is one of the recommended diagnostic tools for dyspepsia. This study aims to describe the endoscopic results in dyspeptic patients at Sanglah General Hospital.

Method: The quantitative cross-sectional descriptive study design was used. This study used secondary data from medical records. The sample population of this study was patients with dyspepsia who undergone endoscopy procedure at the Sanglah Central General Hospital in 2015 with a total sampling method that resulted in 260 samples. Data were analyzed using SPSS version 21 for Windows.

Results: The sex of the respondents involved in this study were male (50.8%) and female (49.2%), which have almost the same percentage. Nearly half of the study respondents were 41-60 years old (47.7%). About 92.3%, patients were organic dyspepsia and 7.7%, functional dyspepsia. While the most diagnosed endoscopic examination results were gastritis (40.0%) and found in the young age group (≤ 64 years).

Conclusion: Patients with symptoms of dyspepsia are mostly male, young adults, have organic dyspepsia, and the picture of endoscopic examination is dominated by gastritis at a young age.

 

Latar Belakang: Dispepsia adalah nyeri yang berulang dan menetap atau rasa tidak nyaman di daerah perut bagian atas. Dispepsia dapat dibagi menjadi dua yaitu dispepsia organik dan dispepsia fungsional. Endoskopi merupakan salah satu alat diagnostik yang di rekomendasikan untuk diagnosis dispepsia. Penelitian ini bertujuan untuk mengambarkan hasil endoskopi pada pasien dispepsia di RSUP Sanglah.

Metode: Desain studi penelitian deskriptif kuantitatif cross sectional dengan menggunakan data sekunder dari rekam medis. Populasi sampel penelitian ini adalah pasien dispepsia yang melakukan endoskopi di Rumah Sakit Umum Pusat Sanglah Tahun 2015 dengan metode Total sampling yang menghasilkan 260 sampel. Data dianalisis menggunakan SPSS 21

Hasil: Jenis kelamin responden yang terlibat pada penelitian ini adalah laki-laki (50,8%) dan perempuan (49,2%) dimana memiliki persentase yang hampir sama. Hampir setengah responden penelitian berusia 41-60 tahun (47,7%). Sekitar 92,3%, pasien merupakan dispepsia organik dan 7,7%, merupakan dispepsia fungsional. Sedangkan diagnosis terbanyak pada hasil pemeriksaan endoskopi adalah gastritis (40,0%) dan ditemukan pada kelompok usia muda (≤ 64 tahun).

Kesimpulan: Pasien dengan gejala dispepsia sebagian besar berjenis kelamin laki-laki, berusia dewasa muda, memiliki dispepsia organik, dan gambaran pemeriksaan endoskopi didominasi oleh gastritis pada usia muda.

Introduction: Hepatitis B virus is a double stranded DNA virus that belongs to hepadnaviridae family. This virus can be transmitted through unsterile medical instruments, unsafe sex, and blood transfusions from hepatitis B infected individuals. This study aims to evaluate the knowledge and attitude of hepatitis B among dentist in North Denpasar.

Method: This study was a descriptive cross sectional study. Data collection was done by using questionnaire. The study population were dentists in North Denpasar. Subject consisted of 28 respondents that were chosen by random sampling. Study was done from November 2016 until January 2017.

Result: Majority of the respondent had a high knowledge level (75%) regarding transmission of hepatitis B. Similar proportion was found for high and low knowledge level regarding prevention of hepatitis B. Most respondent (57.8%) had a low level of knowledge regarding hepatitis B in general. More respondent had a positive attitude regarding hepatitis B (71.4%). Majority of respondent aged <30 years old had a good knowledge (64.2%), meanwhile bad knowledge was found in more respondent for other age group. Based on the characteristic of attitude regarding hepatitis B according to age and gender, it was found that more respondent had a positive attitude in each group.

Conclusion: Results of this study found that most of the respondent had a good knowledge and attitude regarding hepatitis B, but the knowledge in respondent aged over 30 were found to be bad.

 

Pendahuluan: Virus hepatitis B merupakan virus DNA beruntai ganda yang termasuk dalam famili hepadnaviridae. Penularan hepatitis B terjadi melalui alat medis tidak steril, hubungan seksual berisiko, dan transfusi darah dari individu yang terinfeksi virus hepatitis B. Penelitian ini dilakukan untuk mengetahui tingkat pengetahuan dan sikap mengenai hepatitis B pada dokter gigi di Denpasar Utara.

Metode: Penelitian ini merupakan studi deskriptif cross-sectional dengan metode pengumpulan data melalui kuisioner. Subjek penelitian adalah dokter gigi di Denpasar Utara. Sejumlah 28 sampel dipilih dengan teknik random sampling yang dilaksanakan dari November 2016 hingga Januari 2017.

Hasil: Mayoritas subjek memiliki tingkat pengetahuan yang tinggi (75%) mengenai penyebaran hepatitis B.  Proporsi yang sama didapatkan untuk tingkat pengetahuan tinggi dan rendah mengenai pencegahan hepatitis B. Mayoritas subjek (57,8%) memiliki tingkat pengetahuan yang rendah tentang hepatitis B secara umum. Lebih banyak responden didapatkan memiliki sikap positif terhadap hepatitis B (71,4%). Sebagian besar responden berusia <30 tahun memiliki tingkat pengetahuan yang baik (64,2%), sedangkan tingkat pengetahuan buruk lebih banyak didapatkan pada kedua kelompok usia lainnya. Berdasarkan karakteristik sikap dokter gigi terhadap hepatitis sesuai umur maupun sesuai jenis kelamin, pada tiap kelompoknya didapatkan lebih banyak responden yang memiliki sikap positif.

Simpulan: Hasil penelitian menunjukkan bahwa tingkat pengetahuan dan sikap tentang hepatitis B pada dokter gigi di Denpasar Utara sebagian besar adalah baik, namun pada kelompok usia diatas 30 tahun, tingkat pengetahuan terkait hepatitis B adalah kurang baik.

Background: Anemia is one of the four micronutrient problems in Indonesia. Based on Global Prevalence on Anemia, the Southeast Asian region is one of the areas with the highest prevalence of anemic populations, more than 53.8% of children aged 6-59 months were classified as mild anemia, and 3.6% of them are severe anemia. In the first 1000 day birth gold period, anemia was associated with delays and developmental disorders, both motor and intellectual, which may be irreversible. This study aims to analyze the risk factors for the incidence of anemia to optimize child development.

Objective: To analyze the relations of the risk of age under two years old, low birth weight, underweight, short stunting, and not exclusive breastfeeding, to the incidence of anemia in children aged 6-59 months in Kaswari Room, Wangaya General Hospital, Denpasar in 2019.

Methods: Observational analytic epidemiology design with case-control study. The research subjects were determined by consecutive sampling method and fulfilled the inclusion criteria with a comparison of case and control groups, namely 1: 1. Data were analyzed bivariate by chi-square statistical test and Odds Ratio (OR) at the significance limit of α=5%, and multivariate analysis was performed with logistic regression test. Data was processed using the Statistical Package for Social Science (SPSS) version 23 for Windows program.

Results: The research subjects were 62 samples, consisting of 31 anemia samples, and 31 samples had no anemia. The results showed that there was no significant relationship between the risk of low birth weight and the incidence of anemia (95% CI = 0.80 - 22.29; p: 0.073), the risk of malnutrition with the incidence of anemia (95% CI = 0.81 - 63.85; p: 0.052), and the risk of not exclusive breastfeeding with the incidence of anemia (95% CI = 0.21 - 1.63; p: 0.440). However, there was a significant relationship between the risk of age <2 years with the incidence of anemia (OR 3.870; 95% CI = 1.34 - 11.17; p: 0.022) and the risk of short stature with the incidence of anemia (OR 7.686; 95% CI = 1, 92 - 30.70; p: 0.002). Logistic regression test results obtained significant results in short stature variables (sig 0.020; OR 5.379).

Conclusion: age <2 years and short stature (stunting) have a significant relationship with the incidence of anemia in children aged 6-59 months in Kaswari Room, Wangaya Hospital, Denpasar in 2019.

 

Latar belakang : Anemia merupakan salah satu dari empat masalah gizi mikro masyarakat Indonesia. Berdasarkan Global Prevalence on Anaemia, regio Asia Tenggara menjadi salah satu kawasan dengan prevalensi tertinggi populasi anemia, lebih dari 53,8% anak usia 6-59 bulan diklasifikasikan anemia ringan, serta 3,6% di antaranya adalah anemia berat¹. Pada periode emas 1000 HPK, anemia berhubungan dengan keterlambatan dan gangguan perkembangan baik motorik maupun intelektual yang mungkin irreversible². Penelitian ini bertujuan untuk menganalisis faktor-faktor risiko kejadian anemia sebagai langkah mengoptimalkan tumbuh kembang anak.

Tujuan : Menganalisis hubungan risiko usia  < 2 tahun, berat badan lahir rendah, gizi kurang (underweight), perawakan pendek (stunting), dan tidak ASI eksklusif, terhadap kejadian anemia pada anak usia 6-59 bulan di Ruang Kaswari, RSUD Wangaya, Denpasar tahun 2019.

Metode : Rancangan epidemiologi analitik observasional dengan desain studi case control. Subyek penelitian ditentukan dengan metode consecutive sampling, serta memenuhi kriteria inklusi dengan perbandingan kelompok kasus dan kontrol yaitu 1:1. Data dianalisis bivariat dengan  uji statistic chi-square dan Odds Ratio (OR) pada batas kemaknaan α 5%, serta dilakukan analisis multivariat dengan uji regresi logistic. Data diproses menggunakan program Statistical Package for Social Science (SPSS) versi 23 for Windows.

Hasil : Subjek penelitian sejumlah 62 sampel, terdiri dari 31 sampel anemia dan 31 sampel tidak anemia. Hasil penelitian menunjukkan bahwa tidak didapatkan hubungan bermakna antara risiko berat badan lahir rendah dengan kejadian anemia (95% CI = 0,80 – 22,29; p:0,073), risiko gizi kurang dengan kejadian anemia (95% CI = 0,81 – 63,85; p:0,052),  serta risiko tidak ASI eksklusif dengan kejadian anemia (95% CI = 0,21 – 1,63; p:0,440). Namun didapatkan hubungan bermakna antara risiko usia < 2 tahun dengan kejadian anemia (OR 3,870; 95% CI = 1,34 – 11,17; p:0,022) dan risiko perawakan pendek dengan kejadian anemia (OR 7,686; 95% CI = 1,92 – 30,70; p:0,002). Hasil uji regresi logistic, didapatkan hasil bermakna pada variabel perawakan pendek (sig 0,020; OR 5,379).

Kesimpulan:  usia < 2 tahun dan perawakan pendek (stunting) memiliki hubungan bermakna dengan kejadian anemia pada anak usia 6-59 bulan di Ruang Kaswari, RSUD Wangaya, Denpasar tahun 2019.

Garlic (Allium sativum) is a plant that known to have various properties that can be used in treatment as a hepatoprotective agent. This study aim was to determine the effect of garlic ethanol extract (Allium sativum) in Wistar strain white male rats (Rattus norvegicus) which was induced by paracetamol in hepatotoxic dose. This research is an experimental study with randomized the post-test only control group design with sample consisted of twenty-four Wistar strain white male rats (Rattus norvegicus). The sample were divided into four groups: control groups, group P1 (given garlic ethanol extract 10 mg/kg), group P2 (ethanol extract of garlic was given 20 mg/kg) and group P3 (given the ethanol extract garlic 30 mg/kg). This study for seventeen days. The entire samples were terminated in order to draw blood to examine SGPT and SGOT. The data of SGPT and SGOT examined by One Way ANOVA. Result showed that there was significant difference in SGPT and SGOT values between groups after given ethanol extract of garlic (Allium sativum) (α <0.05). From the analysis we can concluded that garlic ethanol extract (Allium sativum) can be used as a hepatoprotective agent in Wistar strain white male rats (Rattus norvegicus)  induced by paracetamol in hepatotoxic dose.

Background: Acute appendicitis is one of the most common acute abdomen disease. Morbidity and mortality increased when the complications occur. The most severe complication is perforation which can cause peritonitis and sepsis. So it needs to be known as early as possible to prevent deterioration. This study aims to determine the predictor factors of perforation in appendicitis.

Method: This study was retrospective cross sectional design using secondary data from medical records of appendicitis patients treated at Aricanti Hospital, Gianyar in 2018. Total samples are 96 and they were selected by consecutive technique sampling. Data about age, sex, Total Leukocyte Count (TLC), and symptoms duration of appendicitis patients were collected and analyzed using the Chi-square test.

Result: From 96 samples, 33 (34.4%) were perforated appendicitis and 63 (65.6%) were acute appendicitis. Chi-square test results showed that the predictor factors associated with perforated appendicitis were age under 10 and above 49 years (PR = 2.0; X² = 5.474; p <0.05), male more affected than females (X² = 8.800; p < 0.05), TLC more than 18000/mm³ (PR = 3.3; X² = 20.862; p <0.05) and symptoms duration above 24 hours (PR = 4.1; X² = 24.834; p<0.05 ).

Conclusion: Age, sex, TLC, and symptoms duration can be used as predictors for perforated appendicitis. These predictor factors should be evaluated in appendicitis patients to prevent the occurrence of perforation or to provide immediate treatment in cases of perforation.

 

Latar Belakang: Apendisitis akut merupakan salah satu akut abdomen yang paling sering dijumpai. Peningkatan morbiditas dan mortalitas terjadi bila terjadi komplikasi. Komplikasi yang terberat adalah perforasi apendiks yang dapat menyebabkan peritonitis dan sepsis. Sehingga perlu diketahui sedini mungkin untuk mencegah perburukan. Penelitian ini bertujuan untuk mengetahui faktor prediktor perforasi pada kasus apendisitis.

Metode: Penelitian ini berdesain retrospektif cross sectional dengan menggunakan data sekunder berupa rekam medis pasien apendisitis yang dirawat di RSU Aricanti Gianyar tahun 2018. Sampel pada penelitian ini berjumlah 96 yang dipilih secara consecutive sampling. Data mengenai usia, jenis kelamin, Total Leukosit Count (TLC), dan symptoms duration pasien apendisitis dikumpulkan dan dianalisa menggunakan uji Chi-square.

Hasil: Dari 96 sampel, sebanyak 33 (34,4%) merupakan apendisitis perforasi dan 63 (65,6%) merupakan apendisitis akut. Hasil uji Chi-square menunjukan faktor prediktor yang berhubungan dengan apendisitis perforasi adalah usia dibawah 10 dan diatas 49 tahun (PR=2,0; X²= 5,474; p<0,05), jenis kelamin laki laki (X²=8,800; p<0,05), TLC lebih dari 18000/mm³ (PR=3,3; X²=20,862; p<0,05) dan symptoms duration diatas 24 jam (PR=4,1; X²=24,834; p<0,05).

Simpulan: Berdasarkan hasil uji statistik tersebut dapat disimpulkan bahwa usia, jenis kelamin, TLC, dan symptoms duration dapat dijadikan faktor prediktor terjadinya apendisitis perforasi. Faktor prediktor ini sebaiknya diperhatikan untuk mencegah kejadian perforasi pada pasien apendisitis ataupun memberikan penanganan yang lebih cepat pada kasus perforasi.

Background: Circumcision is the gold standard in the management of phimosis cases. Nowadays, there is some basic science research that showed topical steroid might be used to decrease the morbidity of phimosis cases. This research aims to determine which management is more effective in treating phimosis by using a systematic evidence-based medicine approach.

Methods: Literature searching was done to find journals that are deemed appropriate for these cases. We included 3 RCT studies in this review. Critical appraisal was conducted to determine the efficacy of topical steroid. We compared those two methods in managing cases of phimosis among children.

Results: Topical steroids effectively cause the preputium skin be soft and comfortable to retract. In several cases, some patients had difficulty to get retracted. For these cases, circumcision is needed.

Conclusion: Topical steroid is effective in reducing the phimosis signs and symptoms, especially in patients who are younger and less than 3 years old. Further study and meta-analysis should be conducted in Indonesia to determine the effectiveness of this therapy in Indonesia.

Backgrounds: Neonatal sepsis is a significant cause of mortality and long-term morbidity. The preterm infant has high-risk sepsis and its sequelae. Low birth weight infants were more susceptible to sepsis. Initial infections in neonates may not be identified due to non-specific symptoms and sign with the limited laboratory criteria. This study aims to describe the characteristics of neonatal sepsis in low birth weight infants in the neonatology intensive care unit of Sanglah Hospital.

Methods: A retrospective cross-sectional study was conducted among 168 infants aged zero to 28 days with birth weights <2,500 grams from May 2017 – April 2018 at Sanglah General Hospital, Bali, Indonesia using a purposive sampling technique. The inclusion criteria were sepsis infants who were hospitalized in neonatology care rooms during the study period at Sanglah General Hospital. Variables assessed in this study were sex, location and mode of delivery, birth weight, gestational age, number of parity, length of stay, the onset of sepsis, as well as the outcome. Data were analysed using SPSS version 17 for Windows.

Results: The mortality rate of sepsis in low birth weight infants was 29.8%. Most of the subjects were male (53%), location of delivery at Sanglah Hospital (60.7%), born spontaneously (51.2%), birth weight were 1500-2499 grams (58,3%) and the most gestational ages were 32-36 weeks (44,6%). Early-onset neonatal sepsis (EONS) dominates patients with neonatal sepsis, with a mean length of stay was 23.27±20.32 days. The major infection risk factor was premature rupture membrane (PRM) >24 hours (14.9%), and minor infection risk factor was gestational age <37 weeks (78%), very low birth weight (44.6%) and asphyxia (41.1%). The total blood culture positivity was 38 (22.6%) cases, and Enterococcus faecalis was the most common organism in this study.

Conclusion: The incidence and mortality of neonatal sepsis in LBW infants were still high. The importance of knowledge and awareness of pregnant women about danger signs and the risk of infection can reduce the incidence of early-onset neonatal sepsis. Prevention of healthcare-associated infections can reduce the incidence of late-onset neonatal sepsis.

Background: Breast cancer is a malignancy originating from breast tissue. In Indonesia, the prevalence rate of breast cancer is 0.5% or around 61,628, and the incidence of breast cancer in Bali reached 0.6% in 2013. The aetiology of breast cancers are multifactorial, and the main factor is still unknown. This study aims to determine the prevalence and characteristics of breast cancer patients in the Sanglah General Hospital oncology surgery clinic. 

Methods: This study was a descriptive cross-sectional study. The sample used was a patient suffering from breast cancer who visited Sanglah General Hospital's oncology surgical clinic, both outpatient and hospitalization in 2016 and was willing to submit informed consent. Variables assessed in this study were age, education level, jobs, symptoms, history of breast cancer, the staging of breast cancer, and type of medication. Data were analyzed using SPSS version 17 for Windows. 

Results: The results showed the dominant sociodemographic characteristics of respondents in the age range 41-50 years as many as 27 people (42.18%), had an education level equivalent to senior high school 27 people (42.18%), worked as private employees, and there were 23 entrepreneurs (35.93%) from 62 samples. Other characteristics obtained 55 people (85.94%) respondents experienced initial symptoms of lumps in the breast, 13 people (20.31%) respondents had a family history of breast cancer. A total of 13 patients (20.31%) claimed to use herbal medicine, and 7 (10.94%) admitted to undergoing alternative treatment other than treatment in Sanglah General Hospital, Bali, Indonesia. Only 43.75% decided to seek treatment for their own sake. The majority of patients, as many as 41 people (64.06%) were diagnosed in stage III.

Conclusion: People living with Breast cancer at Sanglah Hospital have a younger age compared to the majority of breast cancer sufferers in the world. Lack of knowledge of women about breast cancer itself is one of the causes.

 

Latar Belakang: Kanker payudara adalah keganasan yang berasal dari jaringan payudara. Di Indonesia kanker payudara merupakan kenker dengan angka prevalensi kejadian 0.5% atau sekitar 61.628 dan kejadian kanker payudara di Bali mencapai 0.6% pada tahun 2013. Penyebab kanker payudara termasuk multifaktorial yang belum diketahui penyebab utamanya. Penelitian ini bertujuan untuk mengetahui distribusi prevalensi gambaran karakteristik penderita kanker payudara di poliklinik bedah onkologi RSUP Sanglah.

Metode: Penelitian ini merupakan penelitian observasional deskriptif cross-sectional. Sampel yang digunakan merupakan pasien yang menderita kanker payudara yang mengunjungi poliklinik bedah onkologi RSUP Sanglah baik rawat jalan maupun rawat inap pada tahun 2016 dan bersedia mengisi informed consent. Variabel yang dinilai dalam penelitian ini adalah usia, tingkat pendidikan, pekerjaan, gejala, riwayat kanker payudara, stadium kanker payudara, dan jenis pengobatan. Data dianalisis menggunakan SPSS versi 17 untuk Windows.

Hasil: Hasil penelitian menunjukkan karakteristik sosiodemografi responden dominan berada pada rentang usia 41-50 tahun sebanyak 27 orang (42,18%), memiliki tingkat pendidikan setara Sekolah Menengah Atas (SMA) sebanyak 27 orang (42,18%), bekerja sebagai karyawan swasta dan wiraswasta sebanyak 23 orang (35,93%) dari 62 orang sampel. Karakteristik lain yang diperoleh, sebanyak 55 orang (85,94%) responden mengalami gejala awal berupa benjolan pada payudara, responden memiliki riwayat keluarga dengan kanker payudara sebanyak 13 orang (20,31%). Sebanyak 13 penderita (20,31%) mengaku menggunakan pengobatan herbal, dan 7 (10,94%) mengaku menjalani pengobatan alternatif selain pengobatan di RSUP. Hanya sebesar 43,75 % yang memutuskan berobat karena keinginan sendiri. Mayoritas penderita terdiagnosis padaa stadium III yaitu sebanyak 41 orang (64,06%).

Kesimpulan: Penderita kanker payudara di RSUP Sanglah memiliki usia yang lebih muda jika dibandingkan dengan mayoritas penderita kanker payudara di dunia. Kurangnya pengetahuan wanita terhadap kanker payudara itu sendiri merupakan salah satu penyebabnya.

Background: Fracture is the cause of a high number of disabilities worldwide. One of the fractures is humerus fracture, often occur because of injury. The classic symptoms of a fracture are a history of trauma, pain and swelling in the fractured bone, deformity, and musculoskeletal malfunction. This study aims to determine the prevalence of humerus fracture in Sanglah General Hospital Centre of April 2015 - December 2016.

Methods: A retrospective descriptive cross-sectional study by secondary data was conducted among 27 medical records of the patient. The sample population of this study were all inpatients with humerus fracture at orthopaedic installation Sanglah General Hospital during April 2015–December 2016. Data were analyzed using SPSS version 21 for Windows.

Results: Most cases were females (51.9%). The age groups of <20 years old and 20-40 years old have the highest frequency (29.6%, respectively). The students had the most common of humerus fracture (33.0%). Closed fracture prevalence was found by 77,8%, and the open fracture was 22,2% from all cases. Management of the most committed to a closed fracture is ORIF while the open fracture is having debridement ORIF as the most committed management.

Conclusion: The most prevalence of humerus fracture at Sanglah General Hospital during the 2015-2016 period was females, age group <20 and 20-40 years old, occurred in students, and closed fracture type.

 

Latar belakang: Fraktur merupakan penyebab tingginya angka kecatatan di seluruh dunia. Salah satunya fraktur humerus, sering terjadi karena cedera. Gejala klasik fraktur adalah adanya riwayat trauma, rasa nyeri dan bengkak di bagian tulang yang patah, deformitas, gangguan fungsi muskuloskletal, putusnya kontinuitas tulang dan gangguan neurovascular. Penelitian ini bertujuan untuk menentukan prevalensi fraktur humerus di RSUP Sanglah dari April 2015 – Desember 2016

Metode: Penelitian potong lintang deskriptif retrospektif dengan data sekunder dilakukan terhadap 27 catatan medis pasien. Populasi sampel penelitian ini adalah semua pasien rawat inap dengan fraktur humerus di instalasi ortopedi RSUP Sanglah selama April 2015 - Desember 2016. Data dianalisis menggunakan SPSS versi 21 untuk Windows.

Hasil: Sebagian besar kasus adalah perempuan (51,9%). Kelompok usia <20 tahun dan 20-40 tahun memiliki frekuensi tertinggi (masing-masing 29,6%). Para siswa memiliki proporsi fraktur humerus yang paling sering (33,0%). Prevalensi fraktur tertutup ditemukan oleh 77,8%, dan fraktur terbuka adalah 22,2% dari semua kasus. Manajemen yang paling banyak terhadap fraktur tertutup adalah ORIF sedangkan fraktur terbuka mengalami debridemen ORIF sebagai manajemen yang paling banyak.

Kesimpulan: Prevalensi fraktur humerus yang paling banyak di RSUP Sanglah selama periode 2015-2016 adalah wanita, kelompok usia <20 dan 20-40 tahun, terjadi pada siswa, dan tipe fraktur tertutup.

Background: Hypertension is a disease that is a significant problem in the world. The prevalence of hypertension worldwide based on JNC-7 covers more than two-thirds of individuals after the age of 65 years. Hypertension can have an impact on the quality of life of patients which is influenced by various complications. PTB with the occurrence of hypertension in UPT Puskesmas Abang I, Karangasem, Bali, Indonesia.

Methods: A cross-sectional study with a total sampling technique was conducted to the 5 villages in the Abang I Public Health Services during September-October 2018. A total of 48 respondents who meet the inclusion and exclusion criteria were included in this study. The variables assessed included gender, age group, level of education, occupational status, degree of hypertension, and overall quality of life among respondents based on the SF-36 questionnaire. Data were analyzed using SPSS software version 17 for Windows. 

Results: The gender proportion of females and males did not differ (50.00%). Most respondents were ≥ 65 years-old (54.17%), followed by low education level (85.42%), jobless (52.08%), hypertension (HT) grade II (56.25%), Rerata systolic blood pressure 159.5±18 mmHg, and diastolic blood pressure of 93±8 mmHg. Most respondents have a good quality of life in the domain of physical roles (100.00%), health (58.33%), vitality (60.41%), emotions (64.58%), and mental health (58.33%).

Conclusion: The quality of life among respondents with hypertension at UPT Abang I Public Health Services, Karangasem, Bali, Indonesia showed good results in the domains of a physical role, health, vitality, emotions, and mental health.

 

Latar Belakang: Hipertensi adalah salah satu penyakit yang menjadi masalah utama di dunia. Prevalensi hipertensi di seluruh dunia berdasarkan JNC-7 mencakup lebih dari dua pertiga individu setelah usia 65 tahun. Hipertensi dapat berdampak pada kualitas hidup pasien dimana dipengaruhi oleh berbagai komplikasi penyertanya. Penelitian ini bertujuan untuk mengetahui gambaran kualitas hidup peserta POSBINDU PTM dengan kejadian hipertensi di UPT Puskesmas Abang I, Karangasem, Bali, Indonesia.

Metode: Penelitian ini menggunakan desain potong lintang dengan teknik Total Sampling pada 5 Desa di Kawasan UPT Kesmas Abang I selama September-Oktober 2018. Sebanyak 48 orang yang telah memasuki kriteria inklusi dan eksklusi dimasukkan dalam penelitian ini. Variabel yang dinilai meliputi jenis kelamin, kelompok usia, tingkat pendidikan, status pekerjaan, derajat hipertensi, dan kualitas hidup responden secara keseluruhan berdasarkan kuisioner SF-36. Data dianalisis menggunakan piranti lunak SPSS versi 17 untuk Windows.

Hasil: Proporsi jenis kelamin perempuan dan laki-laki tidak berbeda (50%). Sebagian besar pasien berusia ≥ 65 tahun (54,17%), diikuti dengan pendidikan rendah (85,42%,), tidak bekerja (52,08%,), hipertensi (HT) derajat II (56,25%), rata-rata tekanan darah sistolik 159.5±18 mmHg, dan tekanan darah diastolik 93±8 mmHg. Sebagian besar responden memiliki kualitas hidup yang baik pada domain peran fisik (100,00%), kesehatan (58,33%), vitalitas (60,41%), emosi (64,58%), dan kesehatan mental (58,33%).

Kesimpulan: Kualitas hidup responden dengan hipertensi di UPT Puskesmas Abang I, Karangasem, Bali, Indonesia menunjukkan hasil yang baik pada domain peran fisik, kesehatan, vitalitas, emosi, dan kesehatan mental.

Background: Overweight or obesity is a global health problem that is significantly rising, and it can reduce a person’s quality of life, and also his family. Several factors could influence the Body Mass Index (BMI) as a simple indicator to assess obesity. This study aims to know the factors-related to the BMI among Senior High School students in Buleleng District, Bali, Indonesia, in 2016.

Methods: An analytic cross-sectional study using primary data was conducted through direct anthropometric measurements and questionnaires among 164 students at Buleleng District, Bali, Indonesia, in 2016. A stratified random sampling technique was used to enrol the students in Buleleng District that meet the inclusion and exclusion criteria. Variables assessed in this study were gender, age, BMI, parent’s BMI, level of physical activity, and eating habit. Data were analysed using SPSS version 23 for Windows software with a significance level of 0.05.

Results: Females were predominant in this study (54.00%) compared with males (46.00%), followed by age 16 years old (41.00%), average BMI of respondents 31.25 kg/m2, and the average parent’s BMI were 27.25 kg/m2. Bivariate analysis showed there was no significant relationship between physical activity level with student’s BMI (p = 0.330), diet level the student’s BMI (p = 0.550), father’s BMI to the student’s BMI (p = 0.205). However, a significant relationship was found between a mother’s BMI to the student’s BMI (p=0.038) 

Conclusion: A significant relationship was found between mother’s BMI to the BMI of Senior High Scholl students in Buleleng District, Bali, Indonesia, in 2016. According to the result, special attention and counselling on nutritional status against the senior high school students and parents in Buleleng District are necessarily important.

 

Latar Belakang: Kelebihan berat badan atau obesitas merupakan masalah kesehatan dunia yang memiliki kenaikan secara signifikan, dan dapat mengurangi kualitas hidup seseorang, dan juga keluarganya. Beberapa faktor dapat memengaruhi Indeks Massa Tubuh (IMT) sebagai indikator sederhana untuk menilai obesitas. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan BMI di antara siswa SMA di Kabupaten Buleleng, Bali, Indonesia, pada tahun 2016.

Metode: Penelitian potong lintang analitik menggunakan data primer dilakukan dengan pengukuran antropometrik dan kuesioner secara langsung terhadap 164 siswa di Kabupaten Buleleng, Bali, Indonesia, pada tahun 2016. Teknik pengambilan sampel acak stratifikasi digunakan untuk melibatkan siswa di Kabupaten Buleleng yang memenuhi kriteria inklusi dan eksklusi. Variabel yang dinilai dalam penelitian ini adalah jenis kelamin, usia, BMI, BMI orang tua, tingkat aktivitas fisik, dan kebiasaan makan. Data dianalisis menggunakan SPSS versi 23 untuk perangkat lunak Windows dengan tingkat kebermaknaan 0,05.

Hasil: Jenis kelamin perempuan dominan dalam penelitian ini (54,00%) dibandingkan dengan laki-laki (46,00%), diikuti dengan usia 16 tahun (41,00%), BMI rata-rata responden 31,25 kg/m², dan BMI orang tua rata-rata sebesar 27,25 kg/m2. Analisis bivariat menunjukkan tidak terdapat hubungan yang bermakna antara tingkat aktivitas fisik dengan BMI siswa (p = 0,330), tingkat diet BMI siswa (p = 0,550), maupun BMI ayah dengan BMI siswa (p = 0,205). Namun, terdapat hubungan yang bermakna ditemukan antara BMI ibu dengan BMI siswa (p = 0,038).

Kesimpulan: Hubungan yang bermakna ditemukan antara BMI ibu dengan BMI siswa SMA di Kabupaten Buleleng, Bali, Indonesia, pada tahun 2016. Berdasarkan hasil ini, perhatian khusus dan konseling tentang status gizi terhadap siswa SMA dan orang tua di Kabupaten Buleleng merupakan hal yang penting.

Background: Infertility is one of the most common health problems in the world. Malefactors contribute to 50% of cases and about 15-30% of infertile men are categorized as unexplained infertility. There have been numerous studies investigating the role of spermatozoa DNA fragmentation in male infertility. Spermatozoa nuclear DNA integrity has been suggested as a better predictor of male infertility and oxidative stress has been known related to it. This study was conducted to determine the oral supplementation of Vitamin C and Ubiquinone in reducing the spermatozoa DNA fragmentation index (DFI) among infertile men. 

Methods: This was an experimental clinical trial with a pre-test and post-test group design. Thirty infertile men were randomized double-blindingly into 3 groups: Vitamin C and Ubiquinone; Vitamin C and Placebo; Ubiquinone and Placebo groups, each treatment was given for 35 days. The DFI was evaluated by Sperm Chromatin Dispersion (SCD) test, before and after treatment. Data were analyzed using SPSS version 21 for Windows.

Results: The average age of respondents was 32.6 years old, followed by 4.6 years of infertility duration in 5.8 years of marriage. Most of the respondents had a normal Body Mass Index (BMI) (46.7%), no smoking history (75.0%), no history of heat (90.0%) or chemical (73.3%) exposure, and diagnosed with primary male infertility (90.0%). Vitamin C group showed a significant reduction in the spermatozoa DFI (95% CI, p<0.05), while the other two groups showed no differences in the spermatozoa DFIs (95% CI, p>0.05). Comparison analysis showed no differences in the reduction of the spermatozoa DFIs (95% CI, p>0.05) among these three groups. 

Conclusion: The recent findings suggest that oral supplementation of vitamin C can reduce the spermatozoa DFI, while ubiquinone and the combination of vitamin C and ubiquinone could not reduce the spermatozoa DFI.

Background: Acute pharyngitis is an infection of the pharynx caused by viruses or bacteria, which is characterized by the presence of a sore throat, exudate, hyperemia, fever, lymph nodes enlargement of the neck, and malaise. The most common etiology are the germs of Streptococci β-haemolyticus, Streptococcal viridans, and Streptococci pyogenes. It can also be caused by viral infections such as influenza and adenovirus. Acute pharyngitis can be transmitted through contact by nasal or droplet infection of people suffering pharyngitis.

Aim: The study aimed to report acute pharyngitis in the Wangaya General Hospital in the period January - December 2015.

Method: This study was an observational study using a descriptive cross sectional design for patients with acute pharyngitis in the Wangaya General Hospital in the period January - December 2015.

Result and Conclusion: Proportion of acute pharyngitis patients based on age at Wangaya General Hospital were the highest in the age group 0-14 years as many as 47 people (55.9%). The lowest proportion is in the age group > 50 years, 16 people (19%). By its sex proportion, the highest was among women, 48 people (57.2%) as against 36 people (42.8%) for men. Based on clinical symptoms proportion in Wangaya General Hospital, throat pain as many as 57 people (67.9%), followed by difficulty of swallowing as many as 47 (55.9%), fever 19 (22.6%), vomiting 18 (21.4%), malaise 17 (20.2%), lymph nodes enlargement 13 (15.5%), and those with a headache 4 (4.8%)

 

Faringitis akut adalah infeksi pada faring yang disebabkan oleh virus atau bakteri, yang ditandai oleh adanya nyeri tenggorokan, faring eksudat dan hiperemis, demam, pembesaran limfanodi leher dan malaise. Penyebab terbanyak radang ini adalah kuman golongan Streptokokus β-haemolyticus, Streptoccocus viridans dan Streptoccocus pyogenes. Penyakit ini juga dapat disebabkan oleh infeksi virus seperti virus influenza dan adenovirus. Faringitis akut dapat menular melalui kontak dari sekret hidung dan ludah (droplet infection) dari orang yang menderita faringitis.

Tujuan: untuk mengetahui gambaran tentang penyakit faringitis akut di Rumah Sakit Umum Daerah (RSUD) Wangaya Denpasar periode Januari – Desember 2015.

Metode: Penelitian ini merupakan penelitian observasional yang menggunakan rancangan desktiptif cross sectional terhadap penderita penyakit faringitis akut di RSUD Wangaya Denpasar periode Januari - Desember 2015.

Hasil dan Simpulan: Proporsi penderita Faringitis Akut berdasarkan umur di RSUD Wangaya Denpasar yang tertinggi dijumpai pada pada kelompok umur 0-14 tahun, yaitu 47 orang (55,9%). Proporsi terendah terdapat pada kelompok umur >50 tahun, yaitu 16 orang (19,0%). Proporsi penderita Faringitis Akut berdasarkan jenis kelamin di RSUD Wangaya Denpasar yang tertinggi adalah pada perempuan yaitu 48 orang (57,2%). Sedangkan pada laki-laki yaitu 36 orang (42,8%). Proporsi penderita Faringitis Akut berdasarkan gejala klinis yang dialami di RSUD Wangaya yang tertinggi adalah nyeri tenggorok sebanyak 57 orang (67,9% ), diikuti sulit menelan sebanyak 47 orang (55,9% ), demam 19 orang (22,6% ), muntah 18 orang (21,4% ), malaise 17 orang ( 20,2%), kelenjar limfa bengkak 13 orang (15,5% ), dan yang disertai nyeri kepala 4 orang (4,8%)

Background: Carcinoma of the cervix is the second most common cancer in women worldwide, Cervical cancer is the most common cancer in women in developing countries. Cervical cancer is the fourth most common cancer in women overall, with an estimated 528,000 new cases in 2012. According to the data clinicopathology of cervical cancer in Bali its still in a small amount.

Aims: To obtain information about clinicopathology of cervical carcinoma from the year 2012 – 2016.

Methods: A descriptive design study is conducted to determine the clinical pathology profile of cervical carcinoma among patients in Sanglah Hospital, Denpasar, Bali in the year 2012 – 2016. Medical records of the patients were used as the secondary data for this research. This research used the histopathologic document that available in Pathological Anatomy at RSUP Sanglah which mainly reports about patient condition starting from the early anamnesis period until the exact diagnosis of the patient which is due to the laboratory examination or other.

Result and Conclusion: As of 2012 to 2016, there were 142 cases of cervical cancer patients in RSUP Sanglah.The age group of 41-50 years has the highest number of patients in the year 2012 – 2016 which is about 52 patients. Abnormal vaginal bleeding is the most common clinical finding of cervical cancer patients from the year 2012- 2016 and carries 53% in 142 cases. It is found out that the most common histopathologic type of cervical cancer from the year 2012 – 2016 is squamous cell followed by adenocarcinoma in the list.

Background: Alzheimer’s disease (AD) is a chronic, irreversible, progressive, neurodegenerative that slowly impair memory and thinking skills especially in elderly people. This study aims to determine the level of awareness of AD among elderly people in Denpasar, Bali.

Methods: A descriptive cross-sectional study was conducted by using self–administered validated questionnaire to determine the level of awareness of Alzheimer’s disease among the elderly people in Denpasar, Bali. The level of awareness could be classified into high awareness (>80%), moderate awareness (50-79%) and low awareness (<50%)

Results: There were 50 subjects with 50 years old or above enrolled in this study. Most of the respondents had low awareness (82%) to the AD. About 38% of elderly people knew about AD and 58% of respondents said losing memory is a common thing in old age. Low education was said responsible increasing the risk of AD (30%). Only about 24% answered depression was prone to AD. In addition, about 34% said there was no cure for Alzheimer’s disease.

Background: Fungal infections are one of the most common dermatologic conditions affecting elderly population. Elderly population is susceptible to all of the superficial mycoses such as tinea pedis, candidiasis, and onychomycosis in geriatric populations compared to other age groups.

Objective:  To determine the profile of onychomycosis among elderly patients over a period of 1 years (January 2018–August 2019) at Dermatology and Venereology outpatient clinic, Sanglah General Hospital

Methods:  Retrospective study was performed at Department of Dermatology and Venereology, Sanglah General Hospital, Denpasar, Bali. The data collected from patient’s register data of outpatient clinic.

Result:  A total of 11 patients were diagnosed with onychomycosis, consist of 5 women and 6 men. From these, 4 (36,3%) was reported with chronic systemic diseases and 7 (63,6%) reported with no concomitant diseases. The most common clinical sign were onychodystrophy, hyperkeratotic subungual and dyschromia (6 patients, 54,54%). Potassium hydroxide examination reveal positive results in all patient. From 5 patients, on culture examination, Candida (2 patients, 40%), Trichophyton rubrum (2 patients, 40%), and Trychophyton mentagrophytes (1 patient, 20%) were found. For therapy, there were 7 patients got combination therapy (fluconazole 150 mg and ciclopirox lacquer 8%) and 4 patients with single therapy (ciclopirox lacquer 8%).

Conclusion: Onychomycosis is more common in the elderly or geriatric patients, this occurs because old age can change the body's immune function, including decreased immune response to fight infections against viruses, bacteria, and fungi.

 

Pendahuluan: Infeksi jamur adalah salah satu kondisi dermatologis paling umum yang mempengaruhi populasi lansia. Populasi lansia rentan terhadap semua mikosis superfisial seperti tinea pedis, kandidiasis, dan onikomikosis pada populasi geriatri dibandingkan dengan kelompok usia lainnya.

Tujuan:  Untuk menentukan profil onikomikosis pada pasien usia lanjut selama 1 tahun (Januari 2018 - Agustus 2019) di poliklinik rawat jalan Dermatologi dan Venereologi, Rumah Sakit Umum Pusat Sanglah.

Metode:  Studi retrospektif dilakukan di Departemen Dermatologi dan Venereologi, Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali. Data dikumpulkan dari data pendaftaran pasien di klinik rawat jalan.

Hasil:  Sebanyak 11 pasien didiagnosis menderita onikomikosis, terdiri dari 5 wanita dan 6 pria. Dari hasil ini, sebanyak 4 orang (36,3%) dilaporkan dengan penyakit sistemik kronis dan 7 orang (63,6%) dilaporkan tanpa penyakit bersamaan. Tanda klinis yang paling umum adalah onikodistrofi, hiperkeratotik subungual dan dischromia (6 pasien, 54,54%). Pemeriksaan kalium hidroksida mengungkapkan hasil positif pada semua pasien. Dari 5 pasien pada hasil pemeriksaan kultur ditemukan adanya infeksi Candida (2 pasien, 40%), Trichophyton rubrum (2 pasien, 40%), dan Trychophyton mentagrophytes (1 pasien, 20%). Untuk penatalaksanaan, terdapat sejumlah 7 orang pasien mendapatkan terapi kombinasi (fluconazol 150 mg dan ciclopirox lacquer 8%) dan 4 orang pasien dengan terapi tunggal (ciclopirox lacquer 8%).

Simpulan: Onikomikosis lebih sering terjadi pada pasien usia lanjut atau usia lanjut dimana hal ini terjadi karena usia tua dapat mengubah fungsi kekebalan tubuh, termasuk penurunan respons imun untuk melawan infeksi terhadap virus, bakteri, dan jamur.

Background: Elderly are those who already 60 years old or more. Elderly gave many impacts, some were positive, some are negative. Positive only if they are still productive and healthy, but there were also some negative impacts which cannot be ruled out, especially those who got illness and dysfunctions. Depression is one of the main contributors to elderly illness. This study aims to represent the depression status of elderly at UPT Kesmas Dawan I Klungkung, Bali, Indonesia. 

Methods: This cross-sectional study was involving 55 elder patients in UPT Kesmas Dawan I, Klungkung at the first week on June 2018. Sex, age, metabolic disease history, vision impairment, hearing impairment, and depression status by using the Geriatric Depression Scale (GDS) were included. Data were collected by interviewing the respondent. Those data were analyzed using SPSS version for Windows for the univariate and bivariate results.

Results: From a total of 55 samples, 61.8% in males. Prevalence of depression is 45.5%. Prevalence of depressed elderly that have metabolic disease history is 84%, and those who have vision impairment is 88%. Lastly, those who have hearing impairment is 56%. Of the 25 people who were depressed, most of them were women (68.0%), had metabolic diseases (84.0%), vision problems (88.0%), and hearing loss (56.0%).

Conclusion: In this study, almost half of the samples are on depression. Further investigation using other designs and study methods are needed to get better results. 

 

Latar Belakang: Orang lanjut usia (lansia) adalah seseorang yang telah mencapai usia 60 tahun ke atas. Banyak dampak yang diberikan lansia terhadap kondisi suatu negara, baik negatif maupun positif. Positif apabila lansia tersebut masih dapat produktif dan sehat, namun dampak negatif juga tidak dapat dikesampingkan, terutama banyaknya lansia yang mengalami penurunan kesehatan. Depresi merupakan salah satu penyumbang angka kesakitan pada lansia. Penelitian ini bertujuan untuk menggambarkan status depresi pada lansia di UPT Kesmas Dawan I Klungkung, Bali, Indonesia.

Metode: Penelitian potong-lintang ini melibatkan 55 pasien lansia di UPT Kesmas Dawan I, Klungkung pada minggu pertama bulan Juni 2018. Pengumpulan data mencakup jenis kelamin, usia, riwayat penyakit metabolik, gangguan penglihatan, gangguan pendengaran, dan status depresi menggunakan Geriatric Depression Scale (GDS). Data diperoleh melalui wawancara terhadap responden. Data dianalisis menggunakan SPSS versi 20 untuk Windows untuk hasil univariat dan bivariat.

Hasil: Dari total 55 sampel, diperoleh 61,8% adalah laki-laki. Prevalensi pasien yang menderita depresi sebesar 45,5%. Prevalensi lansia dengan riwayat penyakit metabolik yang mengalami depresi sebesar 84,0%, sedangkan lansia dengan riwayat gangguan penglihatan sebesar 88,0%, dilanjutkan dengan gangguan pendengaran sebanyak 56,0%. Dari sebanyak 25 orang yang mengalami depresi, sebagian besar adalah perempuan (68,0%), memiliki penyakit metabolik (84,0%), gangguan penglihatan (88,0%), maupun gangguan pendengaran (56,0%).

Kesimpulan: Pada penelitian ini tampak hampir setengah total sampel menderita depresi. Penelitian lebih lanjut menggunakan desain dan metode penelitian lain dibutuhkan untuk mendapatkan hasil yang lebih baik lagi.

Background: Gastrointestinal Bleeding (GIB) is an emergency case that often found in the condition. In Indonesia, the prevalence of GIB in the population is still unknown. Endoscopy is an examination procedure that used to see abnormalities in gastrointestinal mucosa or lumen of GIT, which is a relatively safe procedure to determine the causal of GIB. This study aims to evaluate the endoscopy profile of patients with GIB at Klungkung Regional General Hospital, Bali, Indonesia during the 2014-2018 period

Methods: A descriptive cross-sectional study was conducted among the medical records of 410 patient’s register who underwent endoscopy due to GIB during 2014-2018 period using total sampling technique at Klungkung Regional General Hospital, Bali, Indonesia. Variables assessed in this study included the sociodemographic of patients, type of endoscopy, and the outcome of endoscopy procedure. Data were analyzed using SPSS version 21 for Windows.

Results: The highest proportion based on age were in the age of 51-60 years-old (23.4%) group. Males were predominant in this study (57.1%) compared with females (42.9%). Based on the type of endoscopy, Esophagogastroduodenoscopy (EGD) examination was predominant (80.7%) compared with colonoscopy (19.3%). Superficial Gastritis was the most common findings (41.5%) from EGD, while colorectal tumours with suspected colorectal cancer and haemorrhoid (6.1%) were predominant in colonoscopy evaluation.

Conclusion: The endoscopy profile found among patients with GIB at Klungkung Regional General Hospital, Bali, Indonesia was dominated by age 51-60 years-old group, males gender, EGD assessment, superficial Gastritis in EGD, and colorectal tumour in colonoscopy evaluation.

Background: Parents' body height is one factor associated with stunting incidence in the child. In under-five years old children, the body height is influenced by genetic factors and the environment during development periods. Short mothers are one of the factor that related to the incidence of stunting. This study aims to determine the associations of parents' body height with stunting in children age 1-5 years old in Nagi Primary Health Care working area, Larantuka City.  

Methods: A cross-sectional study was conducted among 123 children age 1-5 years old who met the inclusion criteria were included in this study at Nagi Primary Health Care, Larantuka City. Data was taken from primary data and questionnaire distributed that consist of 3 main parts contains research sample characteristics, father's body height, and mother's body height. Chi-square is used to analyze the relationship between the father's body height and mother's body height with stunting. All of the data were analyzed using SPSS version 17 for Windows.

Results: Most of the respondents were female (53.7%), followed by having a normal body height (67.5%), normal body weight (97.6%), >155 cm of mother's body height (65.0%), and >165 cm of father's body height (62.6%). In bivariate analysis, there is no relationship between father's body height with stunting (p>0.01), but statistically significant between mother's body height with stunting (p<0.01). In addition, a moderate positive correlation was found between Mid-Parental Height (MPH) with the children body weight (r=0.41; p=0.01).

Conclusion: Mother's body height had a significant association with stunting incidence. In addition, the MPH also had a moderate positive correlation to the children body height.

Background: Patients with Diabetes Mellitus Type-2 (DM-2) have a high probability of suffering from urinary tract infections (UTIs) and asymptomatic bacteriuria (AB). AB is the presence of significant bacteriuria > 10⁵ cfu/ml in urine cultures without clinical symptoms (asymptomatic). This study aims to find out the different types of the pathogen in DM-2 patients with urinary tract infections and bacteriuria asymptomatic at H. Adam Malik Hospital, Medan, Indonesia. 

Methods: A total of 18 DM-2 patients with UTIs and 18 patients with AB who met the criteria were included in this study from H. Adam Malik Hospital, Medan, Indonesia. Fasting blood glucose and blood glucose levels in 2 hours postprandial were examined. The middle portion of urine sample using a sterile container was conducted for urinalysis test using dipstick (Combur10 Test M, Roche Mannheim, Germany) and a Cobas U 411 ROCHE urine analyzer. Urine leukocytes were evaluated using leukocyte esterase. The urine culture for identification of bacterial and antibiotic sensitivity tests was conducted if leukocytes count > 5 / LPB. Data were analyzed using SPSS version 17 for Windows. 

Results: Most of the DM-2 respondents were females in both Urinary Tract Infection (UTI) group (77.8%) and Asymptomatic Bacteriuria (AB) group (88.9%). The age group of 39-50 years was predominant in the UTIs group (50.0%) compared with AB group in age 51-62 years old group (44.4%). Data were normally distributed between types of bacterial infection on both groups (p=0.945). However, based on the sensitivity and resistance of antibiotics, no significant difference was found between both groups (P>0.05) except for cefixime (p=0.018) from the Chi-square test.  

Conclusion: There were no differences in the types of pathogen in UTIs and AB among DM-2 patients. Besides, no significant difference for bacterial sensitivity and resistance found between groups except in cefixime. 

 

Latar Belakang: Pasien Diabetes Mellitus Tipe-2 (DM-2) memiliki kemungkinan tinggi menderita Infeksi Saluran Kemih (ISK) dan Bakteriuria Asimptomatik (BAS). BAS adalah adanya bakteriuria yang signifikan >10⁵ cfu/ml dalam kultur urin tanpa gejala klinis (asimptomatik). Penelitian ini bertujuan untuk mengetahui berbagai jenis patogen pada pasien DM-2 dengan infeksi saluran kemih dan bakteriuria asimptomatik di Rumah Sakit H. Adam Malik, Medan, Indonesia.

Metode: Sebanyak 18 pasien DM-2 dengan ISK dan 18 pasien dengan BA yang memenuhi kriteria dimasukkan dalam penelitian ini dari Rumah Sakit H. Adam Malik, Medan, Indonesia. Glukosa darah puasa dan kadar glukosa darah dalam 2 jam post-prandial diperiksa. Bagian tengah sampel urin menggunakan wadah steril diambil untuk menjalani tes urinalisis menggunakan dipstick (Combur10 Test M, Roche Mannheim, Jerman) dan alat analisis urin Cobas U 411 ROCHE. Leukosit urin dievaluasi menggunakan leukosit esterase. Kultur urin untuk identifikasi tes sensitivitas bakteri dan antibiotik dilakukan jika jumlah leukosit > 5/LPB. Data dianalisis menggunakan SPSS versi 17 untuk Windows.

Hasil: Sebagian besar responden DM-2 adalah perempuan dalam kelompok Infeksi Saluran Kemih (ISK) (77,8%) dan kelompok Bakteriuria Asimtomatik (BAS) (88,9%). Kelompok usia 39-50 tahun dominan pada kelompok ISK (50,0%) dibandingkan dengan BA pada kelompok usia 51-62 tahun (44,4%). Data terdistribusi secara normal terhadap jenis infeksi bakteri pada kedua kelompok (p = 0,945). Namun, berdasarkan sensitivitas dan resistensi antibiotik, tidak ada perbedaan bermakna yang ditemukan antara kedua kelompok (P> 0,05) kecuali untuk sefiksim (p = 0,018) dari uji Chi-square.

Kesimpulan: Tidak ada perbedaan dalam jenis patogen pada ISK dan AB pada pasien DM-2. Selain itu, tidak ada perbedaan bermakna untuk sensitivitas dan resistensi bakteri yang ditemukan antara kelompok kecuali pada sefiksim.

Background: Malaria is an infectious disease that often arises in post-disaster situations such as earthquakes. The earthquake that occurred in Lombok caused damage to people's homes and forced them to live in emergency tents. This condition increases the risk of malaria transmission so that malaria outbreak occurs. This study aims to determine the risk factors for malaria infection after the earthquake disaster in West Lombok Regency.

Methods: A case-control study was conducted among 168 respondents located in four Public Health Services working areas in West Lombok. Cases were positive malaria sufferers based on microscopic examination results and were recorded in the health centre register in the September-November 2018 period. In addition, the controls were people who did not suffer from malaria based on microscopic examination results and lived in the study area. Case samples were selected by systematic random sampling from the register of health centres and control samples were selected by convenient sampling from communities living in one hamlet with cases. The bivariate analysis uses Chi-Square and Fisher-Exact test, while multivariate analysis uses logistic regression in SPSS version 20 for Windows.

Results: The results showed that the proportion of male and female did not differ between groups of cases and controls (50.0%; p = 1.00). Most of the case groups were > 34 years old (51.8%) while controls were ≤ 34 years old (55.4%). There were no differences in proportions at the level of education, occupation, type of residence, length of refuge, and location of refuge in the two groups (p> 0.05). The results of multivariate analysis showed that the risk factors for malaria infection after the earthquake disaster in the district of West Lombok were primarily due to the presence of gardens in refugee camps (AOR = 11,899; 95% CI: 2,369-59,774).

Conclusion: The existence of gardens in refugee camps is the most influential risk factor for malaria infection after the earthquake disaster in West Lombok Regency.

 

Latar Belakang: Malaria adalah penyakit menular yang sering muncul pada situasi sesudah bencana seperti gempa bumi. Gempa bumi yang terjadi di Lombok ini mengakibatkan kerusakan pada rumah-rumah warga dan mengharuskan mereka tinggal di tenda-tenda darurat. Kondisi ini meningkatkan risiko penularan malaria sehingga terjadi Kejadian Luar Biasa (KLB) malaria. Penelitian ini bertujuan untuk mengetahui faktor risiko infeksi malaria sesudah bencana gempa bumi di Kabupaten Lombok Barat.

Metode: Penelitian kasus-kontrol (case-control) dan berlokasi di empat wilayah kerja puskesmas di Kabupaten Lombok Barat sebanyak 168 responden dilakukan pada penelitian ini. Kasus adalah penderita malaria positif berdasarkan hasil pemeriksaan mikroskopis dan tercatat dalam buku register puskesmas pada periode September-November 2018. Sedangkan kontrol adalah orang yang tidak menderita malaria berdasarkan hasil pemeriksaan mikroskopis dan tinggal di wilayah tempat penelitian. Sampel kasus dipilih secara systematic random sampling dari buku register puskesmas dan sampel kontrol dipilih secara convenient sampling dari masyarakat yang tinggal satu dusun dengan kasus. Analisis bivariat menggunakan chi square dan fisher sedangkan analisis multivariat menggunakan regresi logistik pada SPSS versi 20 untuk Windows.

Hasil: Hasil penelitian menunjukkan bahwa proporsi jenis kelamin laki-laki dan perempuan tidak berbeda antar kelompok kasus dan kontrol (50,0%; p=1,00). Sebagian besar kelompok kasus berusia > 34 tahun (51,8%) sedangkan kontrol berusia ≤ 34 tahun (55,4%). Tidak terdapat perbedaan proporsi pada tingkat pendidikan, pekerjaan, jenis tempat tinggal, lama mengungsi, dan lokasi mengungsi pada kedua kelompok (p>0,05). Hasil analisis multivariat menunjukkan bahwa faktor risiko infeksi malaria sesudah bencana gempa bumi di kabupaten Lombok Barat adalah sebagian besar oleh keberadaan kebun di lokasi pengungsian (AOR=11,899; 95%IK: 2,369-59,774).

Simpulan: Keberadaan kebun di lokasi pengungsian merupakan faktor risiko yang paling berpengaruh terhadap infeksi malaria sesudah bencana gempa bumi di Kabupaten Lombok barat.

Background: Cemented Hip Arthroplasty is the first choice of surgical treatment in fractures of neck femur and advanced hip osteoarthritis. Nevertheless, the complication, Bone Cement Implantation Syndrome can produce intra/postoperative mortality. The systemic effects of bone cement uses is hemodynamic disturbance and pulmonary embolism. These complications are thought due to the entry of semen particles into the systemic circulation caused by increased intramedullary pressure and local vasodilation. Intramedullary flushing with epinephrine after cement implantation is one of the interventions that is expected to reduce this impact. This study aims to determine the difference in hemodynamic effects and lipid profile in patients undergone flushing with epinephrine versus NaCl 0.9%.

Methods: A cross-sectional study involving 30 patients who underwent Cemented Hip Arthroplasty, randomly divided into 2 groups. Surgical procedures differ only in the components used for intramedullary flushing, namely NaCl 0.9% (control) and epinephrine 1: 50000 (intervention). Vital signs are observed and recorded at minute 2,4,6,8, and 10 after cementation. Serial data were analyzed with repeated measures ANOVA. Lipid profile examination was performed before and 12 hours postoperatively and the results were analyzed with Wilcoxon-test.

Results: The study observed a decreased of mean arterial pressure (MAP) in the control group after two minutes of cementation, and reached its lowest point in the sixth minute (p <0.05). In the intervention group, the decrease occurred in second to sixth minutes, but the decrease was more stable and there was no significant difference between time-point (p> 0.05). There were no significant differences of triglyceride and cholesterol level before and 12 hours after the procedure (p> 0.05).

Conclusion: Intramedullary flushing with epinephrine after semen implantation in the Cemented Hip Arthroplasty procedure results in a minimal reduction of MAP compared to flushing without epinephrine. However, there were no difference in preoperative and postoperative cholesterol and triglyceride levels.

Latar Belakang: Cemented Hip Arthroplasty menjadi pilihan utama terapi pembedahan pada fraktur collum femoris (Neck of Femur) serta osteoarthritis sendi panggul stadium lanjut. Meskipun demikian, komplikasi Bone cement implantation syndrome dapat menghasilkan morbiditas dan mortalitas intra/pasca operasi. Efek sistemik dari penggunaan semen tulang adalah gangguan hemodinamik dan emboli paru yang diduga akibat masuknya dari partikel semen ke sirkulasi sistemik akibat peningkatan tekanan intrameduler dan vasodilatasi lokal. Flushing intramedula dengan epinefrin paska implantasi semen merupakan salah satu intervensi yang diharapkan mengurangi dampak tersebut. Penelitian ini dilakukan untuk mengetahui perbedaan dampak hemodinamik dan profil lipid pada pasien dengan flushing epinefrine dan NaCl 0,9%.

Metode: Penelitian potong lintang dengan melibatkan 30 pasien yang menjalani cemented arthroplasty, dibagi rata menjadi 2 kelompok secara acak. Prosedur pembedahan hanya berbeda pada komponen yang digunakan untuk flushing intramedula, yakni NaCl 0,9% (kontrol) dan epinefirn 1:50.000 (intervensi). Tanda vital diamati dan dicatat pada menit ke-2,4,6,8, dan 10 setelah sementasi. Data serial dianalisis dengan repeated measure Anova. Pemeriksaan profil lipid dilakukan sebelum dan 12 jam pasca operasi dan hasil dianalisis dengan Wilcoxon-test. 

Hasil: Penurunan mean arterial pressure (MAP) pada kelompok kontrol sejak menit ke 2 setelah sementasi, dan mencapai titik terendah pada menit ke 6 (p<0,05). Pada kelompok intervensi didapatkan penurunan terjadi pada menit ke 2 hingga ke 6, tetapi penurunan lebih stabil dan tidak terdapat perbedaan bermakna (p>0.05). Pada profil lipid (trigliserida dan kolesterol), tidak ditemukan perbedaan yang bermakna antara kadar sebelum operasi dan 12 jam setelah tindakan operatif (p>0,05).

Kesimpulan: Flushing epinefrin paska implantasi semen pada prosedur Cemented Hip Arthroplasty menghasilkan penurunan MAP yang minimal dibandingkan flushing tanpa epinefrin. Akan tetapi, flushing epinefrin tidak memberikan perbedaan pada kadar kolesterol dan trigliserida paska operasi.

Background: Birth asphyxia is a serious clinical problem worldwide. There are many reasons a baby may not be able to take in enough oxygen before, during, or just after birth. Birth asphyxia is the inabiity of neonates to start breathing spontaniously right after birth.

Objective: This study was designed to assess the risk factors of birth asphyxia in neonates in Wangaya General Hospital.

Methods: It is a case control study. The data of the newborn and mother was retrospectively collected from medical record in Wangaya Regional General Hospital between November 2018 to March 2019. It uses consecutive sampling. Bivariate analysis using chi square and multivariate analysis using logistic regresssion.

Results: Bivariate analysis of risk factors of birth asphyxia that are studied are: low birth weight p value 0.000 (OR: 30.118); Number of birth p value 0,013 (OR 4,025); Prematurity p value 0.001 (OR 18.286); PROM p value 0.751 (OR 1.508); preeclampsia p value 1.000 (OR 0.804); and Cesarean Section p value 0.218 (OR 0.479). From multivariate analysis, the result was low birth weight p value 0.020; number of birth p value 0.003; prematurity p value 0.766; caesarean section p value 0,028.

Conclusion: Risk factor of birth asphyxia in Wangaya General Hospital are low birth weight; number of birth (Primipara); and caesarean section.

 

Latar Belakang: Asfiksia neonatorum adalah suatu kondisi yang serius di seluruh dunia. Ada beberapa penyebab dimana bayi tidak bisa mendapatkan oksigen yang cukup sebelum, selama, atau setelah lahir. Asfiksia neonatorum adalah keadaan dimana neonatus tidak dapat memulai bernafas dengan spontan segera setelah lahr.Penelitian ini dilakukan untuk melihat faktor resiko terjadinya asfiksia neonatorum pada neonatus di RSUD Wangaya.

Metode: Penelitian ini adalah penelitian case control. Data neonatus dan data ibu diambil dari data rekam medis di RSUD Wangaya sejak November 2018 hingga Maret 2019. Studi ini menggunakan consecutive sampling. Analisa bivariat menggunakan chi square dan analisa multivariat menggunakan regressi logistik.

Hasil: Hasil dari analisa bivariat adalah: BBLR p value 0,000 (OR: 30.118); Paritas p value 0,013 (OR 4,025); Prematuritas p value 0.001 (OR 18.286); KPD p value 0.751 (OR 1.508); Preeklampsia p value 1.000 (OR 0.804); and Bedah Caesar p value 0.218 (OR 0.479). Dari analisa multivariat, hasilnya adalah BBLR p value 0.020; Paritas p value 0.003; prematuritas p value 0.766; bedah sesar p value 0,028.

Simpulan: Fakor resiko terjadinya asfiksia neonatorum di RSUD Wangaya adalah BBLR; Paritas (Primipara); and bedah sesar.

Background: cancer is the second leading cause of death in Indonesia, whereas 70% of patients have themselves examined at an advanced stage. One of the methodes to do breast cancer screening is by ultrasound examination to see each characteristic in several aspects (form, size, ecogenicity, components) found in the clinical suspicion of malignant cases.

Methods: This study was conducted to see the importance of the role of ultrasonography in knowing the characteristics of malignant breast tumors in Sanglah General Hospital. This study was a cross-sectional descriptive (retrospective) at Sanglah General Hospital. Ultrasound examination data collection had been done from medical record of breast tumor patients (total sampling from January to December 2015). Data analysis study used digital data processing programs and presented in crosstabulating tables.

Results: Total of 52 subjects showed 51 patients with normal characteristics of cutaneous tissue (98.1%), normal ecoparenkim in 47 patients (90.4%), 34 with no abnormalities characteristics of nodules/masses/cysts (65.4 %), 46 with normal ecogeneity characteristics (88.5%), regular lesion characteristics of shape/edge in 47 patients (90.4%), 37 with no abnormalities characteristics of the lesion (71.2%), 49 patients (94.2%) did not show any abnormalities characteristics of papillary calcification and retraction, 49 patients without abnormalities characteristics of papilla retraction, 47 patients (90.4%) without abnormalities characteristics of axilla glands.

Conclusions: Ultrasonography characteristics result as the screening tool for malignant breast tumor in this study is able to asess some general features founded in malignant breast tumor cases. 

 

Latar Belakang: Kanker payudara merupakan keganasan penyebab mortalitas kedua tersering di Indonesia, dimana 70% dari penderita memeriksakan dirinya pada stadium lanjut. Salah satu cara skrining kanker payudara yaitu dengan pemeriksaan ultrasonografi. Setiap karakteristik hasil ultrasonografi memiliki tujuan penting untuk mengetahui bentuk, ukuran, ekogenitas, dan komponen lain yang dijumpai pada kecurigaan klinis tumor payudara ganas.

Metode: Penelitian ini bertujuan melihat pentingnya peranan ultrasonografi dalam mengetahui karakteristik tumor payudara ganas di RSUP Sanglah. Penelitian ini merupakan penelitian deskriptif cross-sectional retrospektif di RSUP Sanglah. Prosedur penelitian berupa pengumpulan data pemeriksaan ultrasonograsi dari data rekam medis pasien tumor payudara (total sampling dari bulan Januari-Desember 2015). Analisis data menggunakan program pengolah data digital dan menyajikannya dalam tabel crosstabulating.

Hasil: Total dari 52 orang subjek, 51 orang (98,1%) menunjukkan hasil normal pada karakteristik jaringan kutis, 47 orang (90,4%) dengan hasil normal pada karakteristik ekoparenkim, dari karakteristik nodul/massa/kista 34 orang pasien (65,4%) tidak tampak adanya kelainan, dari karakteristik ekogenitas 46 orang pasien (88,5%) menunjukan hasil normal, dari karakteristik bentuk/tepi lesi 47 orang pasien (90,4%) dengan bentuk/tepi lesi yang reguler, dari karakteristik batas lesi tidak ditemukan adanya kelainan pada 37 orang pasien (71,2%), dari karakteristik kalsifikasi dan retraksi papilla masing-masing 49 orang pasien (94,2%) tidak tampak adanya kelainan, dari karakteristik retraksi papilla 49 orang pasien tidak ditemukan adanya kelainan, dari karakteristik kelenjar aksila 47 orang pasien (90,4%) tidak ditemukan adanya kelainan.

Simpulan: Karakteristik gambaran ultrasonografi sebagai skrining kasus tumor payudara ganas dalam penelitian ini mampu menilai beberapa temuan yang umum terjadi pada pasien tumor payudara ganas.

Background:  Pneumonia is the leading cause of under five children’s mortality worldwide. In Indonesia, pneumonia still the second largest cause of mortality in infants (12.3%) and under five children (13.2%) after diarrhea. However, the incidence of pneumonia didn’t receive some attention so it’s often referred as “the forgotten killer of children”. Therefore, the aim of our study is to control pneumonia in children under five by investigating the risk factors of pneumonia.

Methods:  A case control study was conducted from January 2019 to May 2019 by using the consecutive sampling methods. The subjects were children aged 12-59 months old with pneumonia at Wangaya Hospital for the case and children aged 12-59 months old without pneumonia at Wangaya Hospital for the control. Subject’s characteristics such as gender, age, weight birth, immunization status, exclusive breastfeeding status, history of asthma, smoke exposure, and nutritional status. Matching was performed on exclusive breastfeeding variable. Will be done the bivariate analysis with McNemar and multivariate analysis with logistic regression.

Result:  Among 96 subjects divided into 48 subjects in each group. Bivariate analysis showed that immunization status (p-value 0.009, OR 5.209) and smoke exposure (p-value 0.008, OR 2.238) were the significant risk factors of pneumonia. While gender, nutritional status, and history of asthma weren’t significant risk factors of pneumonia in children under five at Wangaya Hospital.

Conclusion:  Incomplete immunization status and exposed to cigarette smoke are the risk factors of pneumonia in children aged 12-59 months old at Wangaya Hospital.

 

Latar Belakang:  Pneumonia merupakan pembunuh nomor satu balita di dunia. Di Indonesia, Pneumonia menduduki peringkat kedua penyebab kematian bayi (12,3%) dan balita (13,2%) setelah diare. Sayangnya, kejadian pneumonia tidak begitu banyak mendapat perhatian khusus. Tujuan penulisan laporan kasus ini adalah mempelajari faktor-faktor resiko yang menyebabkan pneumonia.

Metode:  Dengan menggunakan studi kasus-kontrol yang dilakukan pada bulan Januari 2019-Mei 2019 menggunakan metode sampel konsekutif. Subjek penelitian adalah anak berusia 12-59 bulan dengan pneumonia di RSUD Wangaya untuk kasus, dan anak berusia 12-59 bulan tidak dengan pneumonia di RSUD Wangaya untuk kontrol. Karakteristik subjek berupa jenis kelamin, usia, berat badan lahir, status ASI eksklusif, status imunisasi, riwayat asma, paparan asap, dan status gizi. Dilakukan matching pada variabel ASI eksklusif. Dan akan dilakukan analisis bivariat dengan uji McNemar dan multivariat dengan regresi logistik.

Hasil: Sebanyak total 96 subjek, dengan 48 subjek untuk masing-masing kelompok penelitian. Didapatkan hasil yang signifikan pada faktor resiko status imunisasi (nilai p 0.009 dan OR 5.209) dan faktor resiko paparan asap (nilai p 0.008 dan OR 2.238). Sedangkan jenis kelamin, status gizi, dan riwayat asma tidak didapatkan hasil yang signifikan sebagai fakto resiko pneumonia di RSUD Wangaya.

Simpulan: Status imunisasi yang tidak lengkap dan terpapar asap rokok merupakan faktor resiko terjadinya pneumonia pada anak usia 12-59 bulan di RSUD Wangaya.

Background: Vertebrae are the bones supporting the head and torso. Vertebra protects the spinal cord, and as a liaison ribs and muscles. At the location of the vertebra the spinal cord that are the source of innervation of peripheral and connecting parts neurological signals between the brain with other body parts. Thus, the injuries that occur in the vertebra is fatal and can result in neurological defects such as paralysis. In Indonesia is still very little research on spine injury and spinal cord injury. Therefore, the authors wanted to know about the profile of patients with spine injuries due to trauma in Sanglah Hospital 2015

Methods: This study uses descriptive observational research with cross sectional design is to collect data one by using medical records. In terms of retrospective time, respondents in this study were selected through the total sampling. Variables examined in this study include gender, age, location of the injury, and the most common cause of the injury.

Results: According on the research profile vertebra due to trauma patients injured in Sanglah Hospital in 2015 is largely male sex (75%), are in the age group 51-60 years (26.7%), with the most common cause is a fall from a height (62.9%), the location of most injured are the cervical part with 45.8%, and most cases of spine injury patients are without SCI with a percentage of 52.4%.

Conclusions: Based on the results, it can be concluded profiles of patients with spine injuries due to trauma in 2015 under the Sanglah Hospital is the same when compared to other literatures and experiments with just little differences

 

Latar Belakang: Tulang belakang merupakan tulang penyangga kepala dan batang tubuh. Tulang belakang berfungsi melindungi spinal cord. Pada lokasi tulang belakang terdapat spinal cord yang menjadi sumber persarafan bagian perifer dan menghubungkan sinyal neurologis antara otak dengan bagian tubuh lainnya. Maka dari itu cedera yang terjadi pada bagian tulang belakang sangatlah fatal dan mengakibatkan defek – defek neurologis seperti kelumpuhan. Di Indonesia masih sedikit penelitian mengenai cedera tulang belakang dan spinal cord injury. Oleh karena itu penulis ingin mengetahui mengenai profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015

Metode: Penelitian ini menggunakan metode deskriptif observasional dengan desain cross sectional study yaitu dengan melakukan pengumpulan data satu kali dan menggunakan data rekam medis. Dari segi waktu secara retrospektif, Responden dalam penelitian ini dipilih melalui total sampling. Variabel yang diteliti pada penelitian ini antara lain jenis kelamin, umur, lokasi cedera, penyebab terbanyak cedera pada tulang belakang.

Hasil: Hasil penelitian di RSUP Sanglah menunjukkan bahwa profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015 adalah sebagian besar berjenis kelamin laki-laki (75%), berada dalam kelompok umur 51-60 tahun (26.7%), dengan penyebab terbanyak adalah jatuh dari ketinggian (62.9%), lokasi terbanyak yang mengalami cedera adalah pada bagian cervical dengan 45.8% dan paling banyak kasus penderita cedera tulang belakang adalah tanpa disertai SCI dengan presentase 52.4%.

Simpulan: Berdasarkan hasil penelitian, dapat disimpulkan profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015 sesuai dengan hasil penelitian lain dan literatur yang ada.