Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
A large-liver abscess with severe anaemia in 6 years-old patient: a case report
I Gusti Istri Agung Widnyani, I Putu Gede Karyana, I Gusti Ngurah Sanjaya Putra, Nyoman Metriani NesaOnline First: Feb 29, 2020
- Abstract
A large-liver abscess with severe anaemia in 6 years-old patient: a case report
Background: Liver abscess are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amoebic. A pyogenic liver abscess (PLA) is a potentially lethal condition. This study aims to describe the signs, symptoms, and prognosis of pyogenic liver abscess in children with severe anaemia.
Case Description: Six years old boy complained about abdominal pain for 4 months before admitted to the hospital. The abdomen began to stiff 23 days before. Since 4 weeks, there was several episodes of fevers, more than 4 times but not more than 3 days, relieved by antipyretic. Every fever followed by a stomachache. His parents said he looked paler than before and his activities decreased, was sleepy and irritable. In physical examination, we found the patient looked anaemic, with a distended abdomen with hepatomegaly. Routine CBC revealed: WBC was 16.99, Hemoglobin was 5.45g/dL platelet was 796.20, iron parameters was: iron serum: 11.27 ug/dL (normal: 50-120 ug/dL) TIBC: 180 ug/dL(normal 225-450 ug/dL). A liver abscess 4.5 cm x 5.1 cm with liquefaction was obtained by ultrasound and confirmed by abdomen MSCT with contrast 4,4 x 4,3 x 6,1 cm. The patient family refused abscess draining surgery, so only conservative therapy by antibiotics was given and further followed up in polyclinic. Nine-month after therapy, follow up by ultrasound was normal.
Conclusion: The sign and symptom of pyogenic LA were non-specific; abdomen MSCT confirmed the diagnosis with contrast. The prognosis was good.
The physiological aspect of thyroid-induced breast cancer: a case report
Putu Austin Widyasari WijayaOnline First: Mar 3, 2020
- Abstract
The physiological aspect of thyroid-induced breast cancer: a case report
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.
Conclusion: Some studies showed hyperthyroidism increase the risk of breast cancer and that high thyroid levels can cause estrogen-like effects, trigger proliferation and angiogenesis by activating the same pathway as estrogen those are mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase ½ (ERK ½).Self-foreign omphalitis in adult: a case report
Daniel Ardian Soesilo, April BabyOnline First: Mar 5, 2020
- Abstract
Self-foreign omphalitis in adult: a case report
Introduction: Severe omphalitis in adults is rare and can be caused by both congenital and acquired etiologies. We are reporting an impacted self-foreign-body in omphalitis case induced by accumulated keratin fragments.
Case: A 28-year-old overweight male presented with a 3-day history of persistent purulent umbilical discharge with a remittent fever a few days before, constant abdominal tenderness with edema and erythema around navel area. There were no other GIT-related symptoms. He was given oral antibiotics, which showed no improvement. Upon surgery, we examined deep umbilical cavity without urachal connection to the navel. From the umbilical cavity scooped out multiple polypoid umbolith debris. Histopathologic examination revealed pyogenic granuloma with numerous keratin fragments without any foreign bodies.
Conclusion: An impacted and infected self-foreign-body may be a cause of omphalitis in adults and could lead to severe and wide-spread infection if left untreated.
Testicular tunica vaginalis grafting for the treatment of Peyronie’s disease: a case report
Rahmat Husein, Antono PratanuOnline First: Mar 5, 2020
- Abstract
Testicular tunica vaginalis grafting for the treatment of Peyronie’s disease: a case report
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.
Penyakit Ginjal Kronik Stadium V Akibat nefrolitiasis
Helen WidianiOnline First: Feb 15, 2020
- Abstract
Penyakit Ginjal Kronik Stadium V Akibat nefrolitiasis
Background: Chronic kidney disease (CKD) is a kidney disorder characterized by abnormality in kidney structure and its function for more than three months, or decrease of glomerular filtration rate less than 60 ml/minute/1.73m2. The cause of CKD including hypertension, diabetes mellitus, obstruction in urinary tract and infection.
Case description: male 34 years old hospitalized with chief complaint of nausea and vomiting since 10 days before admission. The patient also complained of pain in the right flank since one year. The urination tend to decrease since one week before admission. Phsyical examination found the patient in moderate illness, anemic in conjungtiva, pain in costovertebral angle with edema in inferior extremities. Radiology examination revealed nefrolitiasis in right region, grade II hydronephrosis caused by stone in distal ureter and cystitis. Abdominal CT-Scan revealed mild hydronephrosis caused by stone in pyelum, with nephrolithiasis in right part.
Conclusion: Chronic kidney disease is an injury in kidney which occur for more than three months, according to pathological abnormality or kidney injury marker like. Its management renal replacement therapy, diet for CKD patients, and controlling the hypertension (its comorbid condition).
Latar belakang: Penyakit Ginjal Kronik (PGK) merupakan suatu gangguan pada ginjal yang ditandai dengan abnormalitas struktur dan fungsi ginjal yang berlangsung lebih dari tiga bulan, atau penurunan laju filtrasi glomerulus kurang dari 60 ml/menit/1,73 m2.
Deskripsi kasus: Seorang pasien laki-laki usia 34 tahun dirawat dengan keluhan utama mual dan muntah dialami sejak 10 hari sebelum masuk rumah sakit. Pasien juga mengeluhkan nyeri pinggang kanan yang dialami sejak 1 tahun terakhir. Buang air kecil sedikit-sedikit dialami sejak 1 minggu sebelum masuk rumah sakit. Dari pemeriksaan fisik pasien tampak sakit sedang, konjungtiva anemis, nyeri ketok CVA, dan ditemukan edema pada ekstremitas inferior. Pada pemeriksaan radiologi didapatkan nefrolitiasis dextra, hidronefrosis grade II akibat batu distal ureter, sistitis. Pemeriksaan CT-Scan abdomen didapatkan kesan hidronefrosis ringan akibat batu pyelum, nefrolitiasis kanan.
Kesimpulan: Penyakit ginjal kronik (PGK) merupakan kerusakan ginjal yang telah terjadi dalam kurun waktu lebih dari tiga bulan, yang ditandai dari kelainan patologis atau petanda kerusakan ginjal. Tatalaksana yang diberikan pada pasien meliputi terapi berupa terapi pengganti ginjal, diet khusus pada pasien dengan PGK, serta pengaturan tekanan darah pasien (penanganan pada kondisi komorbid).
Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses
Ni Made Sukewanti, I Wayan Dharma Artana, Putu Junara Putra, I Made Kardana, Made Sukmawati, Kadek Deddy AriyantaOnline First: Mar 26, 2020
- Abstract
Jejunal atresia in the newborn: three cases after resection and end-to-end anastomoses
Background:Â 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:Â 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:Â 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.Â
High ureum and creatinine level in 18-year-old male: first diagnosed with chronic kidney disease
I Made Dwi Payana, Ni Nengah Tuti Arianthi, I Made Sila DarmanaOnline First: Mar 27, 2020
- Abstract
High ureum and creatinine level in 18-year-old male: first diagnosed with chronic kidney disease
Introduction: Chronic Kidney Disease (CKD) needs to be rapidly diagnosed and treated correctly. The classic patient characteristics were anaemia, hypertension, oedema, albuminuria and decrease of renal function. Â In a few cases, CKD can occur in an atypical patient, such as in young age.
Case report: We herein report a case of an 18-year-old male with Renal failure. The patient noted to be anaemic, fatigue, oedema, hypertension which is consisted of features typical of Chronic kidney disease. Laboratory examination revealed low haemoglobin level, high ureum and creatinin, and albuminuria. The patient underwent hemodialysis and was given Packed Red Cell (PRC) transfusions.
Conclusion: CKD had to be suspected of all age so that it can be rapidly diagnosed and treated correctly.
Revascularization limb salvage in chronic limb-threatening ischemia: does open surgery still the best option in the era of endovascular therapy?
Ashabul Anhar, Yopie Afriandi HabibieOnline First: Apr 1, 2020
- Abstract
Revascularization limb salvage in chronic limb-threatening ischemia: does open surgery still the best option in the era of endovascular therapy?
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 2nd, 3rd and 4th 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 5th 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.
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Foto polos abdomen megaureter kongenital pada kecurigaan cystoma ovari maligna: Laporan kasus
Rein Matondang, Ni Nyoman MargianiOnline First: Apr 1, 2020
- Abstract
Foto polos abdomen megaureter kongenital pada kecurigaan cystoma ovari maligna: Laporan kasus
Background: Megaureter defined as dilated ureter with or without dilatation of the renal pelvis and calyces. Megaureter is a common diagnosis in children, representing 23% of children with urinary tract obstruction. The diagnosis is more common in boys than girls, and more often is on the left side.
Case description: A 17-year-old female was referred with a suspicion of malignant ovarian cystoma. On examination, the abdomen was distended. Plain radiograph of the abdomen revealed ground glass appearance in abdominal-pelvic cavity suspected of abdominal mass. An ultrasound of the abdomen revealed moderate right hydronephrosis and severe left hydronephrosis. Abdominal CT Scan with contrast demonstrated grade II right hydronephrosis with proximal hydroureter and grade III-IV left hydronephrosis, no solid mass in abdomen. Gynecologyst suspected this patient with left ovarian cystic mass. During the operation, evaluation to obtained ovarian cystic mass was done, yet no mass was obtained. They found a left mega ureter from proximal to distal suspected of a congenital giant mega ureter, followed by left nefrectomy and ureterectomy.
Conclusion: A ground glass appearance in plain x-ray may mimicking as hydronephrosis or gynecological mass, particularly in young female patients with suspicion of abdominal mass.
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Latar belakang: Megaureter didefinisikan sebagai ureter yang melebar dengan atau tanpa dilatasi pelvis renalis dan calix ginjal. Megaureter adalah diagnosis yang umum pada anak-anak, mewakili 23% diagnosis pada anak-anak dengan obstruksi saluran kemih. Diagnosis ini lebih sering terjadi pada anak laki-laki daripada anak perempuan, dan lebih sering di sisi kiri.
Deskripsi kasus: Seorang wanita berusia 17 tahun dirujuk dengan kecurigaan sistoma ovarium maligna. Pada pemeriksaan, perut tampak distensi. Foto polos abdomen menunjukkan ground glass appearence di rongga perut-panggul yang diduga massa abdomen. Ultrasonografi abdomen menunjukkan hidronefrosis kanan sedang dan hidronefrosis kiri berat. CT-Scan abdomen dengan kontras menunjukkan hidronefrosis kanan derajat II dengan hidroureter proksimal dan hidronefrosis kiri derajat III-IV, tidak tampak massa padat di perut. Dicurigai suatu massa kistik ovarium kiri. Selama operasi, dilakukan evaluasi untuk menemukan massa kistik ovarium, namun tidak didapatkan. Ditemukan megaureter kiri dari proksimal ke distal yang diduga sebagai giant megaureter kongenital, dilanjutkan nefrektomi kiri dan ureterektomi.
Kesimpulan: Suatu gambaran ground glass appearance pada foto polos dapat menyerupai hidronefrosis atau masa ginekologi terutama pada wanita muda yang dicurigai massa abdomen.
Peranan p53 dalam perkembangan dan prognosis osteosarkoma: tinjauan pustaka
I Wayan Juli Sumadi, Nyoman AdiputraOnline First: Mar 3, 2020
- Abstract
Peranan p53 dalam perkembangan dan prognosis osteosarkoma: tinjauan pustaka
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
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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.
Oklusi Vena Sentral Retina: Tinjauan Pustaka
Ni Putu Ayu Reza Dhiyantari, Listya Dyah RihardiniOnline First: Mar 3, 2020
- Abstract
Oklusi Vena Sentral Retina: Tinjauan Pustaka
Introduction: Central retinal vein occlusion is vascular eye disease commonly found at ophthalmologist daily practice and also responsible for a large percentage of blindness and eye morbidity. Early diagnosis and prompt treatment may elaborate the disease and slow down disease progression.
Methods: Literature review was carried out, where studies were identified through searching the PubMed, Google Scholar and Proquest database using the keywords: “central retinal vein occlusionâ€, “anti-VEGFâ€, “intraocular corticosteroidâ€, “retinal imagingâ€, “macular oedemaâ€. Inclusion criteria include any reviews on CRVO. Exclusion criteria was reviews which were published more than 10 years ago. From 75 reviewed journals, 55 journals were included. The literatures were then analysed systematically based on the results of previous studies.
Results: CRVO can be diagnosed clinically based on anamnesis, general physical examination to evaluate risk factors related to the disease and also based on routine ophthalmologic examination. Advanced imaging modalities are useful mainly to evaluate severity of the disease, to choose treatment modalities and also to evaluate disease response to therapy. CRVO management has two main goals, namely (1) to identify major risk factor underlying the disease and control it, (2) to diagnose sight threatening complications of CRVO, such as macular oedema and neovascularisation and to manage them.Â
Conclusion: Current CRVO treatment modalities includes anti-VEGF and corticosteroid implants have been extensively studied in big clinical trials and already proven clinically to treat CRVO related macular oedema.
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Pendahuluan: Oklusi vena sentral mata (central retinal vein occlusion/CRVO) merupakan penyakit vaskular mata yang sering dijumpai pada praktek sehari-hari dan bertanggung jawab atas sejumlah kebutaan dan morbiditas pada mata sehingga diagnosis dini dan penatalaksanaan yang tepat dapat meningkatkan keberhasilan terapi dan mencegah komplikasi lebih lanjut
Metode: Metodologi penulisan yang digunakan adalah tinjauan pustaka. Sumber literatur terdiri dari jurnal-jurnal yang relevan dari search engine PubMed, Google Scholar dan Proquest. Kata kunci yang digunakan adalah “central retinal vein occlusionâ€, “anti-VEGFâ€, “kortikosteroid intraocularâ€, “pencitraan retinaâ€, “edema makulaâ€. Kriteria inklusi adalah semua tinjauan mengenai CRVO. Kriteria eksklusi adalah literatur yang diterbitkan lebih dari 10 tahun terakhir. Dari 75 jurnal yang ditinjau, 55 ditemukan cocok sebagai referensi untuk makalah ini. Informasi yang dikumpulkan dicatat dan dianalisis untuk validitas dan reliabilitas, ditafsirkan dan disusun menjadi satu kajian literatur ilmiah.
Hasil: Diagnosis CRVO dapat ditegakkan secara klinis berdasarkan anamnesis, pemeriksaan fisik umum, serta pemeriksaan ophthalmologis rutin. Pemeriksaan pencitraan penunjang dibutuhkan terutama untuk menilai derajat keparahan penyakit, mempertimbangkan tindakan atau pengobatan, serta berguna dalam menilai respon terapi. Penatalaksanaan CRVO memiliki dua tujuan utama yaitu mengidentifikasi dan mengontrol faktor risiko mayor yang mencetuskan CRVO serta mendiagnosis dan menangani komplikasi yang mengancam penglihatan, terutama edema makula dan neovaskularisasi.
Kesimpulan: Penatalaksanaan CRVO saat ini sudah mengalami perkembangan yang pesat dengan banyaknya modalitas baru termasuk anti-VEGF dan implant kortikosteroid yang telah terbukti secara klinis mampu mengobati edema makula terkait CRVO
Durasi penggunaan lensa kontak dengan resiko terjadinya keratitis: tinjauan pustaka
Agnes Angela Mahdalena SimanjuntakOnline First: Mar 3, 2020
- Abstract
Durasi penggunaan lensa kontak dengan resiko terjadinya keratitis: tinjauan pustaka
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.
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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.
Iron-deficiency anemia: a review of diagnosis and management
Putu Amanda WidiadaOnline First: Mar 3, 2020
- Abstract
Iron-deficiency anemia: a review of diagnosis and management
Background: Anemia is the most common medical problem encountered in daily practice. It is a significant health problem, especially in developing countries that have a high prevalence. Iron-deficiency anemia (IDA) is anemia that arises due to decrease in iron supply for erythropoiesis regarded with lack of iron storage that consequently leads to reduced haemoglobin formation.
Aim: This literature review aims to review diagnosis to the management of IDA.
Conclusion: IDA has severe and detrimental health effects. Complete history taking, physical examination, and laboratory test need to be done thoroughly to be able to establish the diagnosis of IDA as well as to determine its cause. Currently used therapies include oral iron therapy which is the first-line therapy, intravenous iron therapy, and blood transfusion.Â
Periodontitis as early detection of diabetes mellitus: a literature review
Ade Indah PratiwiOnline First: Mar 4, 2020
- Abstract
Periodontitis as early detection of diabetes mellitus: a literature review
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
The role of salivary biomarker as a diagnostic tool in oral cancer: a literature review
Ni Made Ista PrestiyantiOnline First: Mar 4, 2020
- Abstract
The role of salivary biomarker as a diagnostic tool in oral cancer: a literature review
Background: Saliva is an informative biological fluid that has gained a lot of interest because of its physiologic diagnostic medium. The recent findings suggest that saliva could be used as a biomarker in diagnosing oral cancer. This study aims to elaborate further on the role of salivary biomarker as a diagnostic tool in oral cancer through literature review.
Methods: A total of 44 relevant kinds of literature were studied regarding saliva and oral cancer. The data collection for eligible articles were conducted from 1997 to 2019. Different database and manual search methods were used to find the topic-related articles.
Results: The study of saliva as a biological matrix has been identified as a new landmark initiative in search of a useful biomarker to diagnose oral cancer through proteomics and transcriptomics. Most oral cancers are oral squamous cell carcinoma. Using saliva for early oral cancer detection in the search for new clinical markers is a promising approach because of its noninvasive sampling and easy collection method. Identification of this salivary biomarker could help to screen patients at risk, predict disease outcome and effectively contribute to planning treatment strategies.
Conclusion: proteomics and transcriptomics molecules on the saliva could be used as a biomarker in diagnosing oral cancer.
Encapsulated liposome toward anthocyanin in Pectin-Based Dry Jelly as a management in pediatric obesity Management: a literature review
Putu Nandika Tungga Yudanti Mahardani, Komang Diah Kurnia Kesumaputri, I Gede Wikania Wira Wiguna, Dyah Kanya WatiOnline First: Jan 29, 2020
- Abstract
Encapsulated liposome toward anthocyanin in Pectin-Based Dry Jelly as a management in pediatric obesity Management: a literature review
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.
Plasmodium falciparum Serine Repeat Antigen 5 (PfSERA5): current vaccine candidate for Plasmodium falciparum malaria
Ayuti Bulaan, W. Riski Widya Mulyani, Agung Nova Mahendra, I Wayan SumardikaOnline First: Apr 1, 2020
- Abstract
Plasmodium falciparum Serine Repeat Antigen 5 (PfSERA5): current vaccine candidate for Plasmodium falciparum malaria
Background: Most of the malaria cases are caused by Plasmodium falciparum infection. The prevalence of cases and high mortality rates due to malaria should be watched out globally. However, currently, efforts to prevent and treat malaria suffer obstacles due to resistance to insecticides and antimalarial drugs. For these reasons, other preventive measures are needed, such as vaccines. This study aims to review the Plasmodium falciparum Serine Repeat Antigen 5 (PfSERA5) as a potential candidate for Plasmodium falciparum malaria vaccine development.Â
Methods:Â Of the 65 journals reviewed, 51 journals were found to be suitable as references for this paper. The keywords included in selected search engines are "malaria" "PfSERA5", "Plasmodium falciparum", and "malaria vaccine". Search results and studies show that the erythrocytic phase of the vaccine can fight malaria parasites that escape the liver stage while reducing or eliminating clinical symptoms. Data were analyzed and written in a narrative form.
Results:Â PfSERA5 is an asexual erythrocytic stage antigen that accumulates in the parasitophorous vacuole. The PfSERA5, SE47 and SE36 (modified SE47) domains can induce the formation of antibodies that protect against falciparum malaria infection in vivo and in vitro. This protective mechanism, caused by PfSERA5 (anti-SE47 and anti-SE36) specific antibodies, occurs through inhibition of parasite growth and merozoite lysis. PfSERA5 also does not show antigenic variations and has limited polymorphism, so the probability of resistance can be reduced.Â
Conclusion:Â Based on this, PfSERA5 has great potential as an effective erythrocytic phase vaccine candidate. However, further studies are needed regarding the toxicological and pharmacological properties of PfSERA5, both in vivo and in clinical settings.
Larutan pencuci hidung salin isotonis tidak terbukti mempercepat waktu transpor mukosilia pada pasien dengan rinosinusitis akut di RSUP Sanglah, Bali, Indonesia
Ni Putu Oktaviani Rinika Pranitasari, Luh Made Ratnawati, I Nyoman AdiputraOnline First: Jan 29, 2020
- Abstract
Larutan pencuci hidung salin isotonis tidak terbukti mempercepat waktu transpor mukosilia pada pasien dengan rinosinusitis akut di RSUP Sanglah, Bali, Indonesia
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.
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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.
Profil penderita Diabetes Mellitus Tipe-2 (DM-2) dengan komplikasi yang menjalani rawat inap di Rumah Sakit Umum Daerah (RSUD) Klungkung, Bali tahun 2018
I Gede Restu Mahendra Sugiarta, I Gusti Ketut DarmitaOnline First: Feb 29, 2020
- Abstract
Profil penderita Diabetes Mellitus Tipe-2 (DM-2) dengan komplikasi yang menjalani rawat inap di Rumah Sakit Umum Daerah (RSUD) Klungkung, Bali tahun 2018
Background: DM is a metabolic disease with the characteristic of hyperglycemia due to insulin abnormality, insulin action, or a combination of insulin abnormality and insulin action. Klungkung accounted for the third-largest prevalence of DM after Jembrana and Buleleng with 1.6%. Preliminary survey in Klungkung’s Hospital 2019, shown that the number of patients with T2DM with a complication that hospitalized in 2018 were 253 people.
Method: This was a cross-sectional descriptive study aimed to determine the proportion of T2DM patient with complication and average Length of Stay (LOS) T2DM patient with complication. This study was carried out at the medical record installation of Klungkung’s Hospital using secondary data obtained from medical record Klungkung’s Hospital. Samples were all T2DM patients with the complication that hospitalized with 253 samples using a total sampling method. Data were processed and analyzed using the SPSS version 21 for Windows.
Result: The highest proportion of T2DM patient with complication based on age was 61 to 70 years old (36.0%), based on sex was men (54.5%), based on complication was diabetic foot (18.2%), based on treatment was insulin (83.4%), based on discharged from hospital was outpatient treatment (90.5%), and based on source of cost was BPJS (94.9%). The average LOS for patients T2DM with complication was 5.81 day.
Conclusion: Effort needed to reduce the prevalence of T2DM with complication and needed maximum services in the management of T2DM with complication to prevent further worsening patient’s condition of T2DM with complication. One of them is giving strong education to patient regarding T2DM with complication.
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Latar Belakang: DM merupakan penyakit metabolik dengan karakteristik berupa hiperglikemia akibat kelainan insulin, kerja insulin, atau kombinasi dari kelainan insulin dan kerja insulin. Klungkung menyumbang prevalensi DM terbesar ketiga setelah Jembrana dan Buleleng sebesar 1,6%. Survei pendahuluan di RSUD Klungkung 2019, mendapatkan jumlah penderita DMT2 beserta komplikasi yang dirawat inap tahun 2018 sebanyak 253 orang.
Metode :. Penelitian ini merupakan penelitian deskriptif cross sectional untuk mengetahui proporsi penderita DMT2 dengan komplikasi dan lama rawatan rata-rata penderita DMT2 dengan komplikasi. Penelitian dilaksanakan di instalasi rekam medis RSUD Klungkung menggunakan data sekunder yang diperoleh dari catatan rekam medis di RSUD Klungkung. Sampel adalah semua penderita DMT2 dengan komplikasi yang dirawat inap dengan jumlah 253 orang menggunakan metode total sampling. Data diolah dan dianalisis menggunakan program SPSS versi 21 untuk Windows.
Hasil : Proporsi penderita DMT2 dengan komplikasi tertinggi pada umur 61 s/d 70 tahun (36,0%), jenis kelamin pada laki-laki (54,5%), komplikasi pada diabetic foot (18,2%), pengobatan pada insulin (83,4%), keadaan sewaktu pulang pada berobat jalan (90,5%), dan sumber biaya pada BPJS (94,9%). Lama rawatan rata-rata penderita DMT2 dengan komplikasi adalah 5,81 hari.
Kesimpulan: Diperlukan suatu upaya untuk menurunkan angka kejadian DMT2 dengan komplikasi serta memaksimalkan pelayanan dalam penatalaksanaan DMT2 dengan komplikasi untuk mencegah perburukan komplikasi penderita yang lebih lanjut. Salah satunya berupa pemberian edukasi yang kuat kepada penderita mengenai DMT2 beserta komplikasi.
Perubahan tingkat pengetahuan pasca penyuluhan penyakit menular tuberculosis (TB) terhadap masyarakat di Desa Tojan, Klungkung, Puskesmas Klungkung I, Bali, Indonesia
Sintia Sugiarta Rahmasari, I Wayan WetaOnline First: Feb 29, 2020
- Abstract
Perubahan tingkat pengetahuan pasca penyuluhan penyakit menular tuberculosis (TB) terhadap masyarakat di Desa Tojan, Klungkung, Puskesmas Klungkung I, Bali, Indonesia
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 2nd 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.
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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.
Drug prescription pattern of hypertension patients at primary healthcare facilities in West Denpasar
Kartiga Silvaraju, I Gusti Ayu ArtiniOnline First: Mar 3, 2020
- Abstract
Drug prescription pattern of hypertension patients at primary healthcare facilities in West Denpasar
Background: In the treatment of hypertension, investigating and monitoring the prescription patterns of antihypertensive medications time by time is essential to assess the adherence to treatment guidelines. Inappropriate prescribing negatively impacts on health and economy of individual and the society.
Aim: The study aims to know the antihypertensive prescribing pattern of hypertension patients at primary healthcare facilities.
Method: This studyis a descriptive study with cross sectional design as well as concern to the drug prescribing pattern of hypertension in both 1st and 2nd West Denpasar primary healthcare (PHC), Bali as many as 54 samples from January-December 2016.
Result: Mean age is between 60-69 years old, and female were more prone to hypertension than male.
Conclusion: The study revealed that the prescription of antihypertensive medication in West Denpasar primary healthcare was related to JNC guidelines, except monotherapy of diuretics.
Profil pioderma pada anak usia 0-14 tahun di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar periode Juni 2015-2016
Dewa Ayu Agung Dwita Arthaningsih, Ni Luh Putu Ratih Vibriyanti KarnaOnline First: Mar 3, 2020
- Abstract
Profil pioderma pada anak usia 0-14 tahun di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar periode Juni 2015-2016
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.
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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.
Karakteristik infeksi virus dengue pada pasien anak di poliklinik anak Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar tahun 2016
I Made Bagus Wilaksmana Putra, I Nyoman Budi Hartawan, I Wayan GustawanOnline First: Mar 3, 2020
- Abstract
Karakteristik infeksi virus dengue pada pasien anak di poliklinik anak Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar tahun 2016
Background: Dengue infection is a mosquito induced viral infection with the highest virility level in the world. This disease is an international emergency problem and creates economic and social burdens around the world. Therefore, this study aims to determine the characteristics of dengue virus infection in pediatric patients in 2016 based on several parameters.
Methods: A cross-sectional study was conducted among 96 pediatric patients with dengue virus infection who were treated at Sanglah General Hospital, Bali in 2016 period. A secondary data obtained from the collection of medical records of patients were used in this study. Data were analyzed using Microsoft Excel 2010 for Windows software.
Results: Most of patients were female (54.17%), aged 5-18 years (67.71%), and with normal BMI status (42.71%). Most subject comes with bleeding signs and have positive tourniquets tests (64.58%), followed by abdominal clinical symptoms with nausea (50.00%), and neurological status with headache (41.67%). The length of stay of patients were mostly 3-5 days (73.96%) and the results of the axial temperature examination at the time of hospital admission were dominant <37ºC (65.63%). Based on laboratory examination, most subject has hemoglobin examination of 11-13 g/dl (57.29%), platelet examination results 50,000-100,000 (65.63%), hematocrit examination results <41% (44.79%), and leukocyte examination results <5,000/µl (59.38%). Most subjects are patient with Grade I DHF (56.25%%).
Conclusion: The most predominant characteristics of pediatric patients with dengue virus infection was female, bleeding signs, nausea, headache, 3-5 days length of stay, atypical hematological parameters such as on hematocrit, platelet, and leucocyte examination.
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Latar Belakang: Penyakit infeksi dengue merupakan penyakit infeksi virus vektor nyamuk dengan tingkat penyebaran tertinggi di dunia. Penyakit ini seringkali menjadi masalah darurat antarnegara serta menimbulkan beban ekonomi dan sosial di dunia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui karakteristik infeksi virus dengue pada pasien anak tahun 2016 berdasarkan beberapa parameter.
Metode: Sebuah studi potong lintang dilakukan pada 96 pasien anak-anak dengan infeksi virus dengue yang dirawat di Rumah Sakit Umum Pusat Sanglah, Bali pada periode tahun 2016. Data sekunder yang diperoleh dari rekam medis pasien digunakan dalam penelitian ini. Data dianalisis menggunakan piranti lunak Microsoft Excel 2010 untuk Windows.
Hasil: Sebagian besar pasien adalah perempuan (54,17%), berusia 5-18 tahun (67,71%), dan dengan status BMI normal (42,71%). Sebagian besar subjek datang dengan tanda-tanda perdarahan dan memiliki tes tourniquets positif (64,58%), diikuti oleh gejala klinis perut mual (50,00%), dan status neurologis dengan sakit kepala (41,67%). Lama tinggal pasien sebagian besar 3-5 hari (73,96%) dan hasil pemeriksaan suhu aksial saat masuk rumah sakit didominasi <37ºC (65,63%). Berdasarkan pemeriksaan laboratorium, sebagian besar subjek memiliki pemeriksaan hemoglobin 11-13 g/dl (57,29%), hasil pemeriksaan trombosit 50.000-100.000 (65,63%), hasil pemeriksaan hematokrit <41% (44,79%), dan hasil pemeriksaan leukosit <5.000 / μl (59,38%). Sebagian besar subyek adalah pasien dengan DBD kelas I (56,25%%).
Kesimpulan: Karakteristik yang paling dominan dari pasien anak dengan infeksi virus dengue adalah wanita, tanda-tanda perdarahan, mual, sakit kepala, 3-5 hari tinggal, parameter hematologis khusus seperti pada hematokrit, trombosit, dan pemeriksaan leukosit.
Gambaran hasil pemeriksaan endoskopi pada pasien dispepsia di Rumah Sakit Umum Pusat (RSUP) Sanglah tahun 2015
Anak Agung Gde Waisampayana Putra, I Dewa Nyoman WibawaOnline First: Mar 3, 2020
- Abstract
Gambaran hasil pemeriksaan endoskopi pada pasien dispepsia di Rumah Sakit Umum Pusat (RSUP) Sanglah tahun 2015
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.
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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.
Gambaran klinis akibat intoksikasi metanol pada pasien yang di rawat di RSUP Sanglah Denpasar tahun 2010-2015
Khairul Abrar, Dudut RustyadiOnline First: Mar 3, 2020
- Abstract
Gambaran klinis akibat intoksikasi metanol pada pasien yang di rawat di RSUP Sanglah Denpasar tahun 2010-2015
Introduction: Methanol is a colorless and odorless with a little chemical formula CH3OH. Methanol is also called methyl alcohol, wood spirit, carbinol, wood alcohol, wood and naphtha. Methanol for consumption was not allowed because methanol is not for consumption and the substances is toxic for the body. Compared to alcohol, methanol has a higher toxic dose. Alcohols toxic dose is 100 mg/dL and a minimum lethal dose of alcohol is 300 mg/dL, whereas methanol toxic dose of 100 mg/kg (10 mg/dL) and letal minimal 300-1000 dose mg/kg body weight (30-100 mg/dL). The main effect of methanol can be intoxicating, metabolic products can cause metabolic acidosis, blindness, and death after a latent period of 6-48 hours.
Method: The research data obtained from the Installation Medical Record Sanglah General Hospital by taking samples of patients suspected methanol poisoning based on medical records of patients in the form of medical records from 2010 to 2015. Sample already obtained 11 patient. Based on the results in this study, clinical organ damage in systemic samples, results of physical examination and lab tests shows that are interrelated. In patients with methanol poisoning can be found some characteristic changes in body organs both in general and microscopic. In almost all patients treated regularly consume alcohol and when it happens poisoning complaints and clinical symptoms are the same. Some disorders such as headache, blurred vision, nausea, vomiting, difficulty breathing often to be found in every case of methanol poisoning.
Conclusion: Symptoms caused by methanol poisoning are systemic, laboratory tests are very important because it provides an overview of the extent of organ damage that occurs.
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Latar Belakang: Metanol adalah cairan tidak berwarna dan sedikit berbau dengan rumus kimia CH3OH. Metanol disebut juga methyl acohol, wood spirit, carbinol, wood alcohol, dan wood naphta. Penggunaan metanol untuk konsumsi tidak lah dibenarkan karena metanol adalah zat tidak layak konsumsi dan beracun bagi tubuh. Dibandingkan alkohol, metanol mempunyai dosis toksik yang lebih tinggi. Dosis toksik alkohol adalah 100 mg/dL dan dosis letal minimal alkohol adalah 300 mg/dL, sedangkan methanol dosis toksiknya 100 mg/kgBB (10 mg/dL) dan dosis letal minimal300-1000 mg/kgBB (30-100 mg/dL). Efek utama metanol dapat memabukkan, produk metaboliknya dapat menyebabkan asidosis metabolik, kebutaan, dan kematian setelah periode laten 6-48 jam.
Metode: Data penelitian didapatkan dari Instalasi Rekam Medis RSUP Sanglah dengan mengambil sampel pasien yang diduga keracunan metanol berdasar catatan medis pasien  dalam bentuk data rekam medis dari tahun 2010 hingga 2015. Didapatkan sampel yang memenuhi kriteria inklusi dan ekslusi sebanyak 11 pasien.
Hasil: Berdasarkan hasil dan pembahasan pada penelitian ini, maka dapat ditarik kesimpulan bahwa Gambaran Klinis kerusakan organ pada sampel bersifat sistemik, Hasil pemeriksaan fisik dan pemeriksaan lab menunjukan hasil yang saling terkait. Pada pasien keracunan metanol bisa ditemui beberapa karakteristik perubahan asam-basa dalam tubuh baik. Pada hampir keseluruhan pasien yang di rawat rutin mengkonsumsi alcohol dan ketika terjadi keracunan memiliki keluhan dan gejala klinis yang sama. Beberapa gangguan seperti Nyeri kepala, penglihatan kabur, mual, muntah, hingga susah bernapas seringkali di temukan pada setiap kasus keracunan metanol.
Simpulan: Gejala yang diakibatkan oleh keracunan methanol bersifat sistemik, pemeriksaan laboratorium sangat penting dilakukan karena memberikan gambaran sejauh mana kerusakan organ tubuh yang terjadi.
Tingkat pengetahuan dan sikap tentang hepatitis B pada dokter gigi di Denpasar Utara
I Gusti Ngurah Bagus Jayanta Ananda, I Ketut Agus SomiaOnline First: Mar 3, 2020
- Abstract
Tingkat pengetahuan dan sikap tentang hepatitis B pada dokter gigi di Denpasar Utara
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.
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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.
Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia
Ni Putu Wirantari, I Wayan Gustawan, Made Gede Dwilingga Utama, Bagus Ngurah Putu Arhana, Ni Nengah Dwi Fatmawati, Ni Made Adi TariniOnline First: Mar 3, 2020
- Abstract
Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia
Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquired infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%–30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.
Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.
Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).
Conclusion: The MPV ≥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).
Faktor – faktor yang berhubungan dengan kejadian anemia pada anak usia 6-59 bulan di RSUD Wangaya, Denpasar, Bali, Indonesia tahun 2019
Elien Yuwono, I Wayan Bikin Suryawan, Anak Agung Made SuciptaOnline First: Mar 3, 2020
- Abstract
Faktor – faktor yang berhubungan dengan kejadian anemia pada anak usia 6-59 bulan di RSUD Wangaya, Denpasar, Bali, Indonesia tahun 2019
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.
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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:Â 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.
Gambaran dampak psikologis, sosial dan ekonomi pada ODHA di Yayasan Spirit Paramacitta Denpasar
Nicholas Prathama Limalvin, Wayan Citra Wulan Sucipta Putri, Komang Ayu Kartika SariOnline First: Mar 3, 2020
- Abstract
Gambaran dampak psikologis, sosial dan ekonomi pada ODHA di Yayasan Spirit Paramacitta Denpasar
HIV or Human Immunodeficiency Virus is a type of virus that infects white blood cells and causes the decline of human immune. Physical problems are more visible in people living with HIV/AIDS (PLWHA). On the other hand, there are still psychological, social and economic problems that are still getting less attention from the community which also affect the lives of PLWHA.
Aim: The purpose of this research is to describe the psychological, social and economic impact on PLWHA in Yayasan Paramacitta Spirit Denpasar as well as the form of hope and support that expected by PLWHA.
Method: This study used qualitative method with 8 informants interviewed at Yayasan Spirit Paramacitta Denpasar and Poli NAPZA Sanglah Hospital Denpasar.
Result: Some informants showed rejection or denial of his HIV status. Denial form that looks like depression until the desire to commit suicide. Some informants said that the spiritual support and group of fellow PLWHA can reduce the denial. After some time PLWHA can change perception and start accepting their condition. Some informants are still withdrawing from the community and do not open their status to others for fear of stigma and discrimination from the public if they open their HIV status. In addition, if HIV status is not known, people living with HIV have not felt stigmatized and discriminated. Health workers complained of still providing stigma and discrimination on PLWHA. Family still plays an important role in providing financial support to PLWHA. An informant who lost their jobs is not because of their HIV status, but their physical condition.
Conclusion: Â The form of support that expected by PLWHA is the recognition of the community and they are treated by the same as others.
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HIV atau Human Immunodeficiency Virus adalah sejenis virus yang menyerang/menginfeksi sel darah putih dan menyebabkan turunnya kekebalan tubuh manusia. Di samping masalah fisik yang lebih terlihat pada ODHA (Orang dengan HIV/AIDS) masih ada masalah psikologis, sosial dan ekonomi yang masih kurang mendapat perhatian dari masyarakat yang tentunya juga mempengaruhi kehidupan dari ODHA.
Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui gambaran dampak psikologis, sosial dan ekonomi pada ODHA di Yayasan Spirit Paramacitta Denpasar serta bentuk harapan dan dukungan yang diharapkan ODHA dari masyarakat.
Metode: Penelitian ini menggunakan metode kualitatif dengan jumlah informan 8 orang yang diwawancarai di Yayasan Spirit Paramacitta Denpasar dan Poli Napza RSUP Sanglah Denpasar.
Hasil: Dalam penelitian ini didapatkan bahwa sebagian informan memunculkan penolakan atau denial akan status HIV-nya. Bentuk denial yang terlihat seperti depresi hingga adanya keinginan untuk bunuh diri. Sebagian informan mengatakan bahwa dukungan spiritual dan kelompok sesama ODHA dapat meringankan masa denial-nya. Setelah beberapa waktu ODHA bisa merubah persepsi dan mulai menerima kondisinya. Sebagian informan masih menarik diri dari masyarakat dan belum terbuka pada orang lain karena khawatir akan stigma dan diskriminasi dari masyarakat apabila mereka membuka status HIV-nya. Di samping itu, apabila status HIV tidak diketahui, ODHA belum merasakan stigma dan diskriminasi. Tenaga kesehatan dikeluhkan masih memberikan stigma dan diskriminasi pada ODHA. Keluarga masih berperan penting dalam memberi dukungan finansial kepada ODHA. Seorang informan kehilangan pekerjaan bukan karena status HIV-nya melainkan karena kondisi fisiknya.
Simpulan: Bentuk dukungan yang diharapkan ODHA adalah pengakuan dari masyarakat dan diperlakukan sama seperti orang lain.
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Efek pemberian ekstrak etanol bawang putih (Allium sativum) sebagai hepatoprotektor pada tikus putih jantan galur wistar (Rattus norvegicus) yang diinduksi parasetamol dosis hepatotoksik
Made Subhawa HarsaOnline First: Mar 4, 2020
- Abstract
Efek pemberian ekstrak etanol bawang putih (Allium sativum) sebagai hepatoprotektor pada tikus putih jantan galur wistar (Rattus norvegicus) yang diinduksi parasetamol dosis hepatotoksik
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.
Assessment of quality of life among chronic kidney disease patients undergoing hemodialysis in Sanglah General Hospital, Denpasar from April-May 2017 using EQ-5D-5L questionnaire
Ni Putu Rani Apsari Dewi, Yenny Kandarini, I Gde Ketut Sajinadiyasa, Triharnoto TriharnotoOnline First: Mar 4, 2020
- Abstract
Assessment of quality of life among chronic kidney disease patients undergoing hemodialysis in Sanglah General Hospital, Denpasar from April-May 2017 using EQ-5D-5L questionnaire
Introduction: Hemodialysis or renal function replacement therapy is routine medical care for chronic kidney disease (CKD) patients. Many problems arise among patients with chronic kidney disease (CKD) undergoing hemodialysis, including physical, psychological, social and family relationships. Those will affect patient’s quality of life (QOL).
Method: A cross-sectional study performed from April-May 2017 in Sanglah General Hospital Denpasar using EuroQol 5 (EQ-5D-5L) Questionnaire to assess the Health-Related Quality of Life (HRQOL). All of CKD patients undergoing hemodialysis in Sanglah General Hospital Denpasar that matched the inclusion and exclusion criteria were recruited to this study.
Results: There were 46 patients participated in this study. Overall, 37 (86.05%) were male and divided into four age groups. The reported HRQOL as measured by means of EQ-5D-5L Index Value and EQ-VAS (Visual Analog Scale) Score was 0.71 ± 0.22 and 75.7 ± 0.635, respectively. The median of EQ-5D-5L Index Value and EQ-VAS Score was 0.71 [0.63-0.84] and 75 [70-80].
Conclusion: This study provided associations between sociodemographic characteristics and their HRQOL. Healthcare providers should be aware of low HRQOL among patients with female gender, elderly patients and unemployed patients to improve their quality of life.
Gambaran prediktor perforasi pada penderita apendisitis di Rumah Sakit Umum Ari Canti Gianyar, Bali, Indonesia tahun 2018
Cokorda Bagus Nurparma Putra, Sang Nyoman SuryanaOnline First: Mar 5, 2020
- Abstract
Gambaran prediktor perforasi pada penderita apendisitis di Rumah Sakit Umum Ari Canti Gianyar, Bali, Indonesia tahun 2018
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.
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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.
Evaluation of fracture on children in orthopaedic and traumatology division in Dr. Wahidin Sudirohusodo Central General Hospital Makassar January 2016-December 2017
Robin Kurnia Wijaya, Muhammad Nasser MustariOnline First: Mar 5, 2020
- Abstract
Evaluation of fracture on children in orthopaedic and traumatology division in Dr. Wahidin Sudirohusodo Central General Hospital Makassar January 2016-December 2017
Background: Fractures in children can be caused by a long term disability and decreasing quality of life in every people that involved. Factors that affect fractures incidences must be identified so that we can create prevention management. This study aims to evaluate the fractures pattern of children in orthopaedic and traumatology in dr. Wahidin Sudirohusodo Central General Hospital Makassar.
Methods: A cross-sectional study was conducted among children under 19 years old by collecting a medical record of patients. The prevalence and patterns of fractures were reviewed for details, such sex, range of age, causes, place of injury, single or multiple fractures, types or location of single fracture, and treatment of fractures. Data were analysed using SPSS version 17 for Windows.
Results: There were 152 children in the study, and 72.3% were boys. Most common occur at the 12-18 years age group (92.8%), most of them were caused by traffic accidents (73.6%). Consequently, the location in which fractures were most prevalent was the street (76.9%). Most of them were presented as a single fracture (72.3%) dominated by closed fracture (63.6%), while distal radius/ulna (12.7%) was the most common fracture sites in this study and most patients have undergone surgery for their treatment (84.8%).
Conclusion: Most of the patients were boys and caused by traffic accidents. A single and close fracture were the most common types of fracture.
Efficacy of topical steroid therapy for phimosis treatment: a systematic review
Andika Rendy, Arry Rodjani, Irfan WahyudiOnline First: Mar 5, 2020
- Abstract
Efficacy of topical steroid therapy for phimosis treatment: a systematic review
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.
Perbedaan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap pemeriksaan kultur darah dalam mendiagnosis sepsis pada pasien peritonitis di RSUP Sanglah, Bali, Indonesia
I Putu Gede Sudiartha, I Ketut Wiargitha, Tjokorda Gde Bagus MahadewaOnline First: Mar 4, 2020
- Abstract
Perbedaan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap pemeriksaan kultur darah dalam mendiagnosis sepsis pada pasien peritonitis di RSUP Sanglah, Bali, Indonesia
Background:Â Sepsis is a leading cause of death worldwide. A delayed or missed diagnosis of sepsis could increase its morbidity and mortality. The abdomen is the most common source of sepsis, which known as peritonitis-induced-sepsis. Peritonitis leads to an inflammatory and anti-inflammatory response. This study aims to elaborate on the role of Neutrophil Lymphocyte Ratio (NLR) as an easy, fast and inexpensive infection marker compared to blood culture, which known as the gold standard of sepsis in peritonitis patients.Â
Methods:Â This is a diagnostic study which combined secondary data taken at Sanglah Hospital Medical Record Department and new cases of generalized peritonitis patients with sepsis who came to Surgical Emergency Unit of Sanglah Hospital as the subjects. A total of 86 subjects, complete blood count analysis was done to calculate NLR. Besides, 2-sided blood culture was tested to see whether the results were positive or negative. Data were analyzed using Stata/SE version 12.1
Results:Â We found that sensitivity of NLR compared to blood culture was 80% (CI:63.1-91.6), with specificity of 88.2% (CI:76.1-95.6), positive predictive value of 82.4% (CI:65.5-93.2), negative predictive value of 86.5% (74.2-94.4), accuracy of 84.9% and likelihood ratio (LR) positive value of 6.8>1. Our results showed that NLR has an enormous value in predicting the occurrence of sepsis in patients with generalized peritonitis.Â
Conclusion:Â NLR can be used as a screening tool for sepsis in generalized peritonitis patients because it has better sensitivity and accuracy, but it has to confirmed by blood culture as the gold standard.
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Latar belakang: Sepsis merupakan penyebab kematian diseluruh dunia. Keterlambatan atau kesalahan dalam mendiagnosis dapat menyebabkan peningkatkan morbiditas dan mortalitas. Abdomen merupakan sumber penyebab paling sering terjadinya sepsis yang disebut dengan sepsis diinduksi peritonitis (peritonitis-induced sepsis). Penelitian ini bertujuan untuk menguji kemampuan Neutrophil Lymphocyte Ratio (NLR) sebagai marker infeksi yang mudah, cepat dan murah dibandingkan kultur darah yang merupakan standar baku dalam mendiagnosis sepsis pada pasien peritonitis.
Metode: Rancangan penelitan yang digunakan dalam penelitian ini adalah uji diagnostik dengan subjek penelitian merupakan gabungan antara data sekunder yang diambil di Instalasi Rekam Medis RSUP Sanglah serta identifikasi kasus baru yaitu pasien sepsis pada peritonitis generalisata yang datang ke IRD Bedah RSUP Sanglah sehingga jumlah total sampel 86 orang. Pasien kemudian diambil darah lengkap untuk nilai NLR dan kultur darah 2 sisi apakah hasilnya positif atau negatif. Data dianalisis menggunakan Stata/SE versi 12.1
Hasil: Â Â Dari penelitian ini didapatkan sensitifitas NLR dibandingkan dengan kultur darah adalah sebesar 80% (CI: 63,1-91,6) dengan spesifitas 88,2% (CI: 76,1-95,6), nilai prediktif positif 82,4% (CI: 65,5-93,2), nilai prediktif negatif 86,5% (CI: 74,2-94,4) dan akurasi 84,9%, serta nilai likelihood ratio (LR) positif didapatkan 6,8>1. NLR mempunyai nilai yang besar dalam meprediksi terjadinya sepsis pada pasien peritonitis generalisata.
Simpulan: NLR dapat digunakan sebagai skrinning pasien sepsis pada peritonitis generalisata karena memiliki sensistifitas dan akurasi yang lebih baik tetapi tetap dikonfirmasi dengan kultur darah sebagai standar baku.
The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia
Novita Purnamasari Assa, I Wayan Dharma Artana, I Made Kardana, Putu Junara Putra, Made SukmawatiOnline First: Mar 19, 2020
- Abstract
The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, 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.
Analisis korelasi kadar serum prokalsitonin dengan jumlah leukosit pada penderita dengan kecurigaan sepsis di RSUP Sanglah, Bali, Indonesia
Bagus Dwiki Arya Dharma, Ni Kadek Mulyantari, I Putu Yuda PrabawaOnline First: Apr 1, 2020
- Abstract
Analisis korelasi kadar serum prokalsitonin dengan jumlah leukosit pada penderita dengan kecurigaan sepsis di RSUP Sanglah, Bali, Indonesia
Background:Â Sepsis is a systemic inflammatory response to infection, where the pathogen or toxin is released into the blood circulation, causing activation of the inflammatory process. Laboratory tests are used to detect inflammatory processes, one of which is procalcitonin. This study aims to determine the correlation between procalcitonin (PCT) serum levels by the leukocytes counts on suspected sepsis patients at Sanglah Hospital in Denpasar.
Methods:Â An analytic observational study with the cross-sectional design was conducted among 21 samples by consecutive sampling technique. The population in this study were sepsis patients who were treated at Sanglah Hospital Denpasar during February-June 2016 period. Data were analyzed using SPSS version 17 for Windows.Â
Results:  Most of respondents were >35 years old (85.7%), Body Mass Index (BMI) > 20 kg/m2 (76.2%), leucocyte counts < 10.000/μL (42.9%), and PCT levels ≤ 0.5 ng/mL (61.9%). There is no significant correlation between white blood cells (WBC) and PCT by Spearman Correlation test (p=0.061; r=0,641).
Conclusion:Â The recent findings suggest that there was no significant correlation between PCT serum levels with the leucocytes counts among patients with sepsis.
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Latar Belakang: Sepsis merupakan suatu respon inflamasi sistemik terhadap infeksi, dimana patogen atau toksin dilepaskan ke dalam sirkulasi darah sehingga terjadi aktivasi proses inflamasi. Tes laboratorium yang digunakan untuk mengetahui adanya proses inflamasi salah satunya adalah prokalsitonin (PCT). Penelitian ini bertujuan untuk mengetahui korelasi antara kadar serum prokalsitonin dengan jumlah leukosit pada penderita dengan kecurigaan sepsis di RSUP Sanglah Denpasar.
Metode: Penelitian observasional analitik dengan desain tong lintang dilakukan terhadap 21 sampel dengan teknik konsekutif. Populasi dalam penelitian ini adalah pasien sepsis yang dirawat di Rumah Sakit Sanglah Denpasar selama periode Februari-Juni 2016. Data dianalisis menggunakan SPSS versi 17 untuk Windows.
Hasil: Sebagian besar responden berusia> 35 tahun (85,7%), Indeks Massa Tubuh (IMT)>20 kg / m2 (76,2%), jumlah leukosit <10.000 / μL (42,9%), dan tingkat PCT ≤ 0,5 ng / mL (61,9%). Tidak terdapat korelasi yang bermakna antara sel darah putih (WBC) dan PCT dengan uji Korelasi Spearman (p = 0,061; r = 0,641).
Kesimpulan: Hasil penelitian saat ini menunjukkan bahwa tidak terdapat korelasi yang bermakna antara kadar serum PCT dengan jumlah leukosit pada pasien dengan sepsis.
Prevalensi dan gambaran karakteristik penderita kanker payudara di poliklinik bedah onkologi RSUP Sanglah, Bali, Indonesia tahun 2016
I Dewa Ayu Putu Mas Narisuari, Ida Bagus Tjakra Wibawa ManuabaOnline First: Mar 24, 2020
- Abstract
Prevalensi dan gambaran karakteristik penderita kanker payudara di poliklinik bedah onkologi RSUP Sanglah, Bali, Indonesia tahun 2016
Background:Â 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.Â
Methods:Â 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.Â
Results:Â 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:Â 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.
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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.
Gambaran tingkat pengetahuan tentang Periksa Payudara Sendiri (SADARI) pada mahasiswa Fakultas Kedokteran Universitas Udayana, Bali, Indonesia angkatan 2013-2015
Annisa Alviariza, Putu Anda Tusta AdiputraOnline First: Mar 24, 2020
- Abstract
Gambaran tingkat pengetahuan tentang Periksa Payudara Sendiri (SADARI) pada mahasiswa Fakultas Kedokteran Universitas Udayana, Bali, Indonesia angkatan 2013-2015
Background:Â BSE (Breast Self-Examination) is a systematic approach to inspection and palpation examination of the chest and armpit independently. BSE can be used as a means of early detection of breast cancer using a simple, inexpensive and safe. This study aims to determine the level of knowledge about BSE among students of Medical Education Faculty of Medicine Udayana University class of 2013, 2014 and 2015.
Methods:Â A descriptive cross-sectional study was conducted among 285 respondents at Faculty of Medicine, Medical Education Program class of 2013, 2014, and 2015. The instrument used in this study was a valid and reliable questionnaire to identify the respondents' knowledge about breast cancer and BSE. Questionnaire data that has been collected is processed in the form of descriptive data analysis by calculating proportion and percentages. Data were analyzed using SPSS version 17 for Windows.
Results:Â The highest average score about SADARI were obtained in Class 2013 (75%), followed by Class 2014 (72%), and Class 2015 (67%) students. A high level of knowledge criteria about SADARI also suggest similar results where Class 2013 was having the highest percentage (63%), followed by Class 2014 (25%), and Class 2015 (8%). However, based on the overall results, the students had a moderate score of 66%. Besides, according to the questions on the questionnaire, the students had an excellent average score about signs and symptoms (83%), cause (79%), and stage of breast cancer (79%).
Conclusion:Â Class 2013 had a good level of knowledge regarding SADARI compared with Class 2014 and 2015. However, overall students still at a moderate average score of SADARI.
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Latar Belakang: SADARI (Periksa Payudara Sendiri) adalah metode sistematik untuk pemeriksaan inspeksi dan palpasi dada dan ketiak secara mandiri. SADARI dapat digunakan sebagai cara deteksi dini kanker payudara dengan menggunakan cara yang sederhana, murah dan aman. Penelitian ini bertujuan untuk mengetahui tingkat pengetahuan mengenai SADARI Mahasiswa Pendidikan Dokter Fakultas Kedokteran Universitas Udayana angkatan 2013, 2014 dan 2015.
Metode: Sebuah studi potong lintang deskriptif dilakukan terhadap 285 responden di Fakultas Kedokteran, Program Pendidikan Kedokteran kelas 2013, 2014, dan 2015. Instrumen yang digunakan dalam penelitian ini adalah kuesioner yang sahih dan reliabel untuk mengidentifikasi pengetahuan responden tentang kanker payudara dan BSE. Data kuesioner yang telah dikumpulkan diolah dalam bentuk analisis data deskriptif dengan menghitung proporsi dan persentase. Data dianalisis menggunakan SPSS versi 17 untuk Windows.
Hasil: Nilai rata-rata tertinggi tentang SADARI diperoleh pada siswa di Kelas 2013 (75%), diikuti oleh Kelas 2014 (72%), dan Kelas 2015 (67%). Kriteria tingkat pengetahuan tinggi tentang SADARI juga memberikan hasil yang serupa di mana Kelas 2013 memiliki persentase tertinggi (63%), diikuti oleh Kelas 2014 (25%), dan Kelas 2015 (8%). Namun, berdasarkan hasil keseluruhan, para siswa memiliki skor sedang 66%. Selain itu, menurut pertanyaan pada kuesioner, para siswa memiliki skor rata-rata yang sangat baik tentang tanda dan gejala (83%), penyebab (79%), dan stadium kanker payudara (79%).
Kesimpulan: Kelas 2013 memiliki tingkat pengetahuan yang baik tentang SADARI dibandingkan dengan Kelas 2014 dan 2015. Namun, keseluruhan siswa masih berada pada skor rata-rata SADARI yang moderat.
Gambaran prevalensi fraktur humerus di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia periode tahun 2015-2016
Ni Kadek Dyah Devita Sari, Anak Agung Gde Yuda AsmaraOnline First: Mar 24, 2020
- Abstract
Gambaran prevalensi fraktur humerus di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia periode tahun 2015-2016
Background:Â 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:Â 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:Â 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.
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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.
Perbedaan olahraga aerobik intensitas sedang dan High-Intensity Interval Training (HIIT) terhadap kebugaran fisik pada mahasiswa Fakultas Kedokteran Universitas Udayana, Bali, Indonesia
Komang Satrya Wirawan, I Putu Adiartha GriadhiOnline First: Mar 26, 2020
- Abstract
Perbedaan olahraga aerobik intensitas sedang dan High-Intensity Interval Training (HIIT) terhadap kebugaran fisik pada mahasiswa Fakultas Kedokteran Universitas Udayana, Bali, Indonesia
Background:Â Exercise is a healthy habit, which is already a lot of becoming obsolete. In addition to able to increase our endurance, it can also indirectly reduce or even cure some disease. This study aims to know the difference in physical fitness between aerobic exercise with moderate intensity and High-Intensity Interval Training (HIIT).
Methods: A randomized observational experimental study using pre- and post-test group design was conducted among 16 respondents at Department of Physiology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia during March-April 2016. The respondents were divided into 2 groups: Group 1 for High-Intensity Interval Training (HIIT) and Group 2 for moderate aerobic intensity exercise. Harvard Step Test was carried out to determine the physical fitness between both groups. Data were analyzed using SPSS version 23 for Windows.Â
Results:Â Most of the respondents were males (68.75%) and age 21 years-old (68.75%). Mann-Whitney test found no significant difference between HIIT and moderate training before and after the exercise (p=0.293; p=0.247). However, a significant difference in physical fitness by Wilcoxon Test before and after exercise was found in HIIT (p=0.001) and moderate exercise (p=0.001) groups.
Conclusion:Â By doing aerobic exercise training, either high or moderate-intensity, can lead to an increase in physical fitness. However, the difference obtained from both types of training is not too visible or insignificant.
Â
Latar Belakang: Olahraga merupakan suatu kebiasaan sehat yang selama ini sudah banyak mulai ditinggalkan. Disamping mampu meningkatkan ketahanan tubuh kita, olahraga juga dapat secara tidak langsung mengurangi atau bahkan meyembuhkan beberapa penyakit. Penelitian ini bertujuan untuk mengetahui perbedaan antara olahraga aerobik dengan intensitas sedang dan High-Intensity Interval Training (HIIT).
Metode: Penelitian eksperimental observasional acak menggunakan rancangan kelompok sebelum dan sesudah pengujian dilakukan terhadap 16 responden di Departemen Fisiologi, Fakultas Kedokteran, Universitas Udayana, Bali, Indonesia selama Maret-April 2016. Para responden dibagi menjadi 2 kelompok: Grup 1 untuk Pelatihan Interval Intensitas Tinggi (HIIT) dan Grup 2 untuk pelatihan olahraga aerobic intensitas sedang. Harvard Step Test dilakukan untuk menentukan kebugaran fisik antara kedua kelompok. Data dianalisis menggunakan SPSS versi 23 untuk Windows.
Hasil: Sebagian besar responden adalah laki-laki (68,75%) dan berusia 21 tahun (68,75%). Uji Mann-Whitney tidak menemukan perbedaan yang bermakna antara HIIT dan pelatihan sedang sebelum dan sesudah latihan (p = 0,293; p = 0,247). Namun, perbedaan yang bermakna dalam kebugaran fisik oleh Tes Wilcoxon sebelum dan sesudah latihan ditemukan pada kelompok HIIT (p = 0,001) dan olahraga sedang (p = 0,001).
Kesimpulan: Dengan melakukan latihan aerobik, baik intensitas tinggi atau sedang, dapat menyebabkan peningkatan kebugaran fisik. Namun, perbedaan yang didapat dari kedua jenis pelatihan ini tidak terlalu terlihat atau tidak signifikan.
Gambaran kualitas hidup peserta Pos Binaan Terpadu Penyakit Tidak Menular (POSBINDU PTM) dengan kejadian hipertensi di wilayah kerja Unit Pelaksana Teknis (UPT) Puskesmas Abang I, Karangasem, Bali, Indonesia
I Putu Sakamekya Wicaksana Sujaya, Ni Made Sri Nopiyani, Ni Wayan MeniOnline First: Mar 26, 2020
- Abstract
Gambaran kualitas hidup peserta Pos Binaan Terpadu Penyakit Tidak Menular (POSBINDU PTM) dengan kejadian hipertensi di wilayah kerja Unit Pelaksana Teknis (UPT) Puskesmas Abang I, Karangasem, Bali, Indonesia
Background:Â 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:Â 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.Â
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:Â 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.
Â
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.
Gambaran perkembangan kognitif dan bahasa pada anak usia di bawah 3 tahun di Taman Pengasuhan Anak (TPA)/(Daycare) Kota Denpasar, Bali
I Gusti Istri Agung Widnyani, I Gusti Ayu Trisna Windiani, I Gusti Agung Ngurah Sugitha Adnyana, Soetjiningsih SoetjiningsihOnline First: Mar 26, 2020
- Abstract
Gambaran perkembangan kognitif dan bahasa pada anak usia di bawah 3 tahun di Taman Pengasuhan Anak (TPA)/(Daycare) Kota Denpasar, Bali
Background:Â Speech and language developmental disorders can affect various functions in learning difficulties. This often happens to children who are less stimulated because today, many parents work so that child care will be reduced. Therefore, the childcare park (TPA) can be a choice of place to leave the child so that it is expected to get proper stimulation according to age level. This study aims to assess the status of cognitive and language development in children under 3 years of age at the Denpasar City, Bali.
Methods:Â A cross-sectional study was conducted to 48 children who were in 4 TPAs in Denpasar during February 2018. Variables assessed in this study included cognitive and language aspects using adaptive cognitive test (CAT) / clinical linguistic & auditory milestone scale questionnaires. (CLAMS) that is valid and reliable. The research data obtained were analyzed using SPSS software version 19 for Windows.
Results: Most respondents were female (56.3%), mean age 19.5 ± 10.0 months, and have high levels of education for both fathers (87.5%) and mothers (91.7%). The Caput Scale results show that the average DQ CAT value is 98.1 ± 11.0, DQ CLAMS 92.1 ± 12.0, and FSDQ 95.1 ± 11.0. As many as 27.1% of children in TPA have abnormal FSDQ score. The FSDQ score of the respondent's characteristics showed that most of the normal values were obtained for male (76.2%), high education on fathers (78.5%) and mothers (77.2), as well as jobs as a civil servant for fathers (73.3) and mothers (78.6)
Conclusion:Â About 27.1% of children experience cognitive and language impairment in TPA through CAT/CLAMS examination. In this regard, further assessment with a better research design is needed to find a causal effect.
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Latar Belakang: Gangguan perkembangan bicara dan bahasa dapat memengaruhi berbagai fungsi dalam kesulitan belajar. Hal ini sering terjadi pada anak yang kurang mendapat stimulasi dikarenakan saat ini banyak orang tua bekerja sehingga pengasuhan terhadap anak akan berkurang. Oleh karena itu Taman pengasuhan anak (TPA) dapat menjadi pilihan tempat untuk menitipkan anak sehingga diharapkan mendapatkan stimulasi yang baik sesuai dengan tingkat usia. Penelitian ini bertujuan untuk menilai status perkembangan kognitif dan bahasa pada anak di bawah usia 3 tahun di TPA Kota Denpasar, Bali.
Metode: Penelitian ini menggunakan pendekatan potong lintang terhadap 48 anak yang berada pada 4 TPA di Denpasar pada bulan Februari 2018. Variabel yang dinilai pada penelitian ini meliputi aspek kognitif dan bahasa dimana menggunakan kuisioner cognitif adaptive test (CAT)/clinical linguistic & auditory milestone scale (CLAMS) yang sahih dan reliabel. Data penelitian yang diperoleh dianalisis menggunakan piranti lunak SPSS versi 19 untuk Windows.
Hasil: Sebagian besar responden berjenis kelamin perempuan (56,3%), usia rata-rata 19,5±10,0 bulan, dan tingkat pendidikan yang tinggi baik pada ayah (87,5%) maupun ibu (91,7%). Hasil Caput Scale menunjukkan bahwa rata-rata nilai DQ CAT adalah 98,1±11,0, DQ CLAMS 92,1±12,0, dan FSDQ 95,1±11,0. Sebanyak 27,1% anak di TPA memiliki nilai FSDQ tidak normal. Nilai FSDQ karakteristik responden menunjukkan sebagian besar nilai normal diperoleh pada laki-laki (76,2%), Pendidikan tinggi ayah (78,5%) dan ibu (77,2), maupun pekerjaan PNS pada ayah (73,3) dan ibu (78,6)
Simpulan: Anak yang mengalami gangguan fungsi kognitif dan bahasa di TPA sebanyak 27,1% melalui pemeriksaan CAT/CLAMS. Berkaitan dengan hal tersebut maka penilaian lebih lanjut dengan desain penelitian yang lebih baik diperlukan untuk mencari hubungan sebab akibat.
Faktor-faktor yang berpengaruh pada Indeks Massa Tubuh (IMT) pada anak Sekolah Menengah Atas (SMA) di Kecamatan Buleleng, Bali, Indonesia tahun 2016
Gede Bagus Rawida Wijaya, I Made Muliarta, Padma PermanaOnline First: Mar 26, 2020
- Abstract
Faktor-faktor yang berpengaruh pada Indeks Massa Tubuh (IMT) pada anak Sekolah Menengah Atas (SMA) di Kecamatan Buleleng, Bali, Indonesia tahun 2016
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)Â
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.
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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.
Sistem tunggal ureter ektopik dengan ginjal multikistik displastik di RSUP Sanglah, Bali, Indonesia: laporan kasus
Donny Oktavius, Gede Wirya Kusuma DuarsaOnline First: Mar 26, 2020
- Abstract
Sistem tunggal ureter ektopik dengan ginjal multikistik displastik di RSUP Sanglah, Bali, Indonesia: laporan kasus
Background:Â Ectopic ureter is a condition when the ureter does not enter the bladder properly. The occurrence of the ectopic ureter is 1:2.000 - 1:4.000 in general population with gender ratio 6:1 in favour of females. More than 80% of cases of ectopic ureters are generally associated with complete duplication of the pelvic-ureteric system. Still, the ectopic ureter can also occur in a single pelvic-ureteric system, which is typically dysplastic or poorly functioning, such as in multicystic dysplastic kidney. This study aims to evaluate the current management of a single ectopic ureteral system with dysplastic multicystic kidneys at Sanglah General Hospital, Bali, Indonesia.
Case Description:Â A 3-year-old girl was referred to the urology clinic of Sanglah General Hospital with chief complaint cloudy urinary since 1,5 years ago. Past medical history, the patient had a recurrent urinary tract infection with fever. Physical examination and laboratory findings were normal. However, an abdominal ultrasound showed a multicystic dysplastic kidney. VCUG showed vesicoureteral reflux grade V and ectopic ureter. Cystoscopy with retrograde pyelography and ureterorenoscopy showed an ectopic ureter opening was located in the proximal urethra above the external sphincter. Nephroureterectomy was performed. After the surgical procedure, the patient was treated and had no complaint. The patient was discharged from the hospital four days after surgery.
 Conclusion: The management of ectopic ureteral cases varies for each case. In this regard, the nephroureterectomy surgery performed in the case has provided good outcomes.
Latar Belakang: Ureter ektopik merupakan suatu kondisi dimana ureter tidak masuk ke buli-buli pada tempat yang seharusnya. Insiden ureter ektopik 1:2.000 - 1:4.000 kelahiran pada populasi secara umum dengan perbandingan jenis kelamin perempuan lebih banyak daripada laki-laki, yaitu 6:1. Lebih dari 80% kasus ureter ektopik umumnya berhubungan dengan duplikasi sistem pelvis-ureter yang lengkap. Tetapi ureter ektopik juga dapat terjadi pada sistem pelvis-ureter tunggal, yang pada umumnya displastik atau fungsinya buruk, seperti pada keadaan ginjal multikistik displastik. Studi ini bertujuan untuk mengevaluasi manajemen terkini pada sistem tunggal ureter ektopik dengan ginjal multikistik displastik di RSUP Sanglah, Bali, Indonesia.
Deskripsi Kasus: Seorang anak perempuan berusia 3 tahun dirujuk ke poliklinik urologi Rumah Sakit Sanglah dengan keluhan buang air kecil keruh sejak 1,5 tahun lalu. Riwayat penyakit dahulu, penderita mengalami infeksi saluran kemih berulang disertai demam. Hasil pemeriksaan fisik dan laboratorium normal. Hasil USG abdomen menunjukkan gambaran ginjal multikistik displastik, VCUG menunjukkan vesikoureteral refluks grade V dan ureter ektopik. Sistoskopi dengan retrograde pyelografi dan ureterorenoskopi menunjukkan muara ureter ektopik terletak di uretra proksimal di atas sfingter uretra eksterna. Lalu dilakukan tindakan nefroureterektomi. Setelah dioperasi, selama perawatan, pasien tidak memiliki keluhan. Pasien dipulangkan setelah empat hari perawatan.
Kesimpulan: Tatalaksana pada kasus ureter ektopik bervariasi untuk setiap kasus. Berkaitan dengan hal tersebut maka tindakan pembedahan nefrouretektomi yang dilakukan pada kasus tersebut telah memberikan luaran yang baik.
Vitamin C and ubiquinone have the same ability in reducing the spermatozoa DNA fragmentation index in infertile men at Doctor Soetomo General Hospital, Surabaya, Indonesia
Ayang Halim, Supardi Supardi, Hamdani LunardhiOnline First: Mar 26, 2020
- Abstract
Vitamin C and ubiquinone have the same ability in reducing the spermatozoa DNA fragmentation index in infertile men at Doctor Soetomo General Hospital, Surabaya, Indonesia
Background:Â 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.Â
Methods:Â 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:Â 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.Â
Conclusion:Â 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.
Procalcitonin (PCT) levels in pulmonary tuberculosis patients with acid fast bacilli positive and negative smear at Haji Adam Malik General Hospital, Medan, Indonesia
Dina Fikry, Ricke Loesnihari, Parluhutan SiagianOnline First: Mar 26, 2020
- Abstract
Procalcitonin (PCT) levels in pulmonary tuberculosis patients with acid fast bacilli positive and negative smear at Haji Adam Malik General Hospital, Medan, Indonesia
Background: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis which enters the droplet nuclei into the mouth or nasal passages to reach the pulmonary alveoli. The sputum smear examination for smear-positive and negative smear pulmonary tuberculosis is challenging due to requiring a longer time to get the results. Therefore, a specific marker is needed that is able to detect bacterial infections immediately, such as procalcitonin (PCT). This study aims to determine the levels of PCT in pulmonary tuberculosis patients with acid-fast bacilli positive and negative smear at Haji Adam Malik General Hospital, Medan, Indonesia.
Method:Â A cross sectional was conducted among 40 pulmonary tuberculosis patients who met the inclusion and exclusion criteria at Haji Adam Malik General Hospital, Medan, Indonesia. The subjects were 20 positive smears and 20 negative smears. PCT examination with mini VIDAS BRAHMS was carried out using the Sandwich principle using the ELFA method (Enzyme-Linked Fluorescent Assay). Sputum examination was carried out by smear of Zhiel Neelsen smear, which was analyzed by the Mann-Whitney (Non-Parametric) test using SPSS version 17 for Windows.Â
Results: Most of the respondents were males in both positive and negative smears group (65.0% and 70.0%, respectively) and not significantly different (P>0.05). The age of subjects was slightly older in positive smear (49.75 ± 17.993 years) compare with negative smear group (42.50 ± 14.816 years) but not statistically significant (P=0.172). The PCT levels in pulmonary tuberculosis patients with positive smear (0.1550; 21.65 ng/mL) differ significantly from the PCT levels in pulmonary tuberculosis patients with negative smear (0.05; 3.14 ng/mL) (p=0.0001). The cut off value using ROC found 0.06 ng/mL (AUC: 0.842) with a sensitivity of 80% and a specificity of 80%.
Conclusion: There was a significant difference in the level of procalcitonin in patients with pulmonary tuberculosis who smear-positive and smear-negative.
Karakteristik kasus faringitis akut di Rumah Sakit Umum Daerah Wangaya Denpasar periode Januari – Desember 2015
Darryl Alby Triadi, I Made SudiptaOnline First: Mar 26, 2020
- Abstract
Karakteristik kasus faringitis akut di Rumah Sakit Umum Daerah Wangaya Denpasar periode Januari – Desember 2015
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%)
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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%)
Prevalence of anemia on chronic kidney disease and its influenced factors in Sanglah General Hospital 2015-2017, Bali
Rubahshini Gunaseelan, I Wayan Surudarma, Desak Made Wihandani, I Wayan Gede SutadarmaOnline First: Mar 26, 2020
- Abstract
Prevalence of anemia on chronic kidney disease and its influenced factors in Sanglah General Hospital 2015-2017, Bali
Background: Anemia is the most common disease among chronic kidney disease (CKD) patients. Its prevalence increased gradually as kidney function decreased. Globally, it affects 1.62 billion people, which corresponds to 24.8% of the population.
Aim: To determine the prevalence of anemia on CKD and its influenced factors at Sanglah Hospital, Bali.
Method: This was a descriptive design study conducted in Sanglah General Hospital, Denpasar, Bali from 2015 until 2017. Medical records of the patients became the secondary data for this research.
Result: From 2015 to 2017, there were 384 cases of CKD and 95 were anemic in the hospital. The prevalence of this case was 24.7 %. The age group of 51 - 60 years had the highest case. The males majorly dominated anemia on CKD. Anemia in stage V of CKD patients was the highest, and it increased more significant as the stages worsen, and diabetes was the leading underlying disease among anemia in CKD patients followed by CVD and glomerulonephritis. The hemoglobin level mean and glomerular filtration rate was lower than the normal one.
Clinicopathological patterns of cervical carcinoma in pathological anatomy laboratory at RSUP Sanglah Denpasar, Bali since 2012-2016
Shameni Subramaniam, I Wayan Juli Sumadi, I.G.A. Sri Mahendra DewiOnline First: Mar 26, 2020
- Abstract
Clinicopathological patterns of cervical carcinoma in pathological anatomy laboratory at RSUP Sanglah Denpasar, Bali since 2012-2016
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.
Sore throat pada siswa-siswi perokok dan non-perokok SMA Kota Denpasar tahun 2017
Tommy Sutanto, Putu Aryani, Anak Agung Sagung SawitriOnline First: Mar 27, 2020
- Abstract
Sore throat pada siswa-siswi perokok dan non-perokok SMA Kota Denpasar tahun 2017
Background: Sore throat is a symptom that occurs due to the inflammation process that often disrupts everyday activities and decreases the quality of life of the patient. Smoking cigarette is one of the causes of a sore throat. Prevalence of smokers in Indonesia, especially in adolescents has reached 45%.
Aim: This study aimed to find the prevalence of sore throat as well as its tendency on smokers and non-smokers in high school students in Denpasar City and the characteristics of sore throat and smoking behavior.
Method: This is a descriptive study with a cross sectional research design. The samples of this study are students of SMA PGRI 1 Denpasar. The data in this study is primary data, gathered from questionnaires.
Result: Of the 63 samples included in the study, it was found that the prevalence of active smokers among high school students in Denpasar city reached 27% (95%CI: 16.6-39.7) with a higher proportion of men. The sore throat tends to occur more on active smokers with a proportion of 76.5% (95%CI: 50.1-93.2) than non-smokers with a proportion of 63% (95%CI: 47.5-76.8). Smoking behavior was found to have started, mostly, for 12 months with everyday consumption as the majority. The number of cigarettes smoked could reach 16 cigarettes a day.
Conclusion: Sore throat tends to occur more on smokers than non-smokers even though the difference is not a lot. The results of this study are expected to be used to educate adolescents about the harmful effect of smoking cigarette on health, considered on making policies around the consumption of cigarette in students and to be a foundation for further research to find the relationship between smoking behavior and sore throat.
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Sore throat merupakan gejala yang terjadi akibat proses inflamasi yang sering kali mengganggu kegiatan sehari-hari dan menurunkan kualitas hidup penderita. Merokok merupakan salah satu penyebab dari munculnya gejala ini. Prevalensi perilaku merokok di Indonesia, khususnya golongan remaja sudah mencapai 45.0%.
Tujuan: Untuk mencari prevalensi sore throat serta kecenderungan nya pada siswa-siswi perokok dan non-perokok SMA kota Denpasar serta mendapatkan karakteristik dari sore throat dan perilaku merokok.
Metode: Penelitian ini bersifat deskriptif dengan rancangan penelitian potong lintang. Sampel pada penelitian ini adalah siswa-siswi SMA PGRI 1 Denpasar. Data penelitian bersifat data primer dengan menggunakan kuesioner angket yang diisi sendiri oleh sampel.
Hasil: Dari 63 sampel yang diikutsertakan dalam peneltiian didapatkan prevalensi perokok aktif SMA kota Denpasar sebesar 27% (95%CI: 16,6-39,7) dengan proporsi pria yang lebih banyak. Sore throat lebih cenderung terjadi pada perokok aktif yaitu 76,5% (95%CI: 50,1-93,2) dibandingkan non-perokok yaitu 63% (95%CI: 47,5-76,8). Perilaku merokok ditemukan paling banyak sudah dilakukan semenjak 12 bulan terakhir dengan frekuensi konsumsi tersering adalah setiap hari dengan jumlah batang rokok yang dikonsumsi dapat mencapai 16 batang perhari.
Simpulan: Sore throat memiliki kecenderungan untuk lebih banyak terjadi pada perokok dibandingkan non-perokok walaupun tidak jauh berbeda. Hasil penelitian ini diharapkan dapat diterapkan untuk mengedukasi pelajar remaja tentang pengaruh rokok terhadap kesehatan, digunakan untuk pertimbangan pembuatan peraturan seputar konsumsi rokok di kalangan pelajar dan menjadi dasar untuk penelitian lebih lanjut untuk menemukan hubungan antara perilaku merokok dengan sore throat.Â
Level of awareness of alzheimer’s disease among elderly people in Denpasar, Bali
Sabrina Annamma Philip, Desak Made Wihandani, Ni Nyoman Ayu DewiOnline First: Mar 27, 2020
- Abstract
Level of awareness of alzheimer’s disease among elderly people in Denpasar, Bali
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.
Conclusion: Level of awareness among elderly people towards Alzheimer’s disease was low and needed improvement. Development and execution of educational programs should be carried out to the public to expand knowledge and understanding about Alzheimer’s disease.Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital
Michelle Anne Anthonysamy, Luh Putu lin Indrayani Maker, I Made Gotra, Herman SaputraOnline First: Mar 27, 2020
- Abstract
Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital
Background: Colorectal carcinoma (CRC) is a disease in which epithelial cells in the colon or rectum become abnormal and divide without control, forming a mass called a tumor. Colorectal carcinoma is the fourth most frequent cancer in men after prostate and lung or bronchus cancers whereas in women is the third most frequent cancer after breast and lung or bronchus cancers. Colorectal cancer is a leading cause of cancer death worldwide, accounting for 693,900 deaths in 2012 and is the fourth most frequent cancer in men whereas in women is the third most frequent cancer. In Indonesia amount of rectal cancer were 1407 (5.67%) and 990 cases (3.99%) of colon cancer. Specifically in Denpasar, there are a total of 75 cases (7.11%) of rectal cancer and 38 cases (3.60%) of colon cancer in the year.
Aim: This study aims to know the prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital in Denpasar from January 2014 to January 2016.
Method: This study used descriptive retrospective research based on the secondary data from patients medical record which was taken at Sanglah General Hospital from January 2014 to January 2016. Population and sample amounted to 275 patients.
Results: This study shows that the highest prevalence of colorectal carcinoma was in a group of age <50 years old with 86 samples (31.3%) and in a male with 163 samples (59.3%). Adenocarcinoma has the highest prevalence of colorectal carcinoma with 270 samples (98.2%). The rectum was the most frequent tumor location with 170 samples (61.8%). In adenocarcinoma, the age group with the highest prevalence of CRC was <50 years with 85 samples (30.9%). The highest prevalence of CRC based on anatomical location and age group was <50 years in the rectum with 57 samples (20.7%).
Conclusion: Most of the CRC was found in age group < 50 years, men had a higher risk to get colorectal carcinoma, adenocarcinoma is the most common microscopic type, and rectum was the most common site of colorectal carcinoma.
Korelasi volume prostat terhadap derajat lower urinary tract symptoms
Jufriady Ismy, Sarah Safira, Iskandar ZakariaOnline First: Mar 27, 2020
- Abstract
Korelasi volume prostat terhadap derajat lower urinary tract symptoms
Introduction: Benign prostatic hyperplasia is a health problem whose incidence ranks second highest in the field of urology. One of the cause is the more severe the complaint that arises is the heavier prostat volume which can cause the iritative and obstructive symptoms or better known as lower urinary tract symptoms(LUTS) which will be assessed based of international prostate symptoms score (IPSS). This study aims to determine prostate volume correlation with lower urinary tract symptoms severity in RSUD dr. Zainoel Abidin Banda Aceh. Knowledge of the volume of the prostate is important in management of patients with benign prostatic hyperplasia.
Method: This study uses the Cross Sectional design by selecting respondents in accidental sampling with a total of 31 patient. The data obtained were then analyzed by the Spearman test.
Result: The univariat data shows that 18 patient (58.1%)Â are in Grade III (31-50 cc) and the most coming patient have LUTS scoring symptoms level on moderate (8-19) are 12 patient (38.7%) and severe symptoms (20-35) are 17 patient (54.8%). The results of prostate volume with lower urinary tract symptoms data analysis show that the p-value = 0.323 (p>0.05).
Conclusion: The results of this study indicate that the prostate volume doesn’t have correlation with lower urinary tract symptoms severity in patient with benign prostatic hyperplasia in RSUD dr. Zainoel Abidin Banda Aceh.
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Latar Belakang: Benign prostatic hyperplasia (BPH) merupakan masalah kesehatan yang insidensinya menempati urutan kedua tertinggi di bidang urologi. Salah satu penyebab semakin beratnya keluhan yang muncul adalah semakin besarnya volume prostat dan dapat menyebabkan gejala klinis berupa gejala iritatif dan obstruktif atau lebih dikenal dengan lower urinary tract symptoms (LUTS) yang akan dinilai berdasarkan international prostate symptoms score (IPSS).
Metode: Penelitian ini bertujuan untuk mengetahui korelasi volume prostat dengan derajat lower urinary tract symptoms di RSUD dr. Zainoel Abidin Banda Aceh. Pengetahuan tentang volume prostat sangat penting dalam menangani pasien-pasien dengan benign prostatic hyperplasia. Studi ini menggunakan desain Cross Sectional dengan memilih responden secara accidental sampling dengan jumlah sebanyak 31 pasien.
Hasil: Data yang didapat kemudian dianalisis dengan uji Spearman. Hasil analisis data univariat menunjukkan bahwa 18 orang pasien (58,1%) memiliki volume prostat Grade III (31-50 cc) dan paling banyak pasien yang memiliki skor derajat LUTS sedang (8-19) yaitu sebanyak 12 pasien (38,7%) dan derajat LUTS berat (20-35) sebanyak 17 pasien (54,8%). Hasil analisis data volume prostat dengan derajat LUTS menunjukkan bahwa nilai p-value = 0,323 (p>0,05).
Simpulan: Hasil penelitian ini menunjukkan bahwa volume prostat tidak memiliki korelasi dengan derajat LUTS pasien BPH di RSUD dr. Zainoel Abidin Banda Aceh.
Hubungan proteinuria dan batu saluran kemih: studi analitik
Zulfikar Ali, Eko AriantoOnline First: Mar 27, 2020
- Abstract
Hubungan proteinuria dan batu saluran kemih: studi analitik
Latar Belakang: Batu saluran kemih (BSK) masih merupakan salah satu masalah tersering yang dihadapi urolog. Proteinuria dapat ditemukan pada kondisi gagal ginjal kronis (GGK), infeksi saluran kemih (ISK), keganasan, ataupun BSK. Protein urin diketahui berperan dalam proses supersaturasi dan agregasi BSK. Studi terkini menemukan hubungan protein marker urin dengan BSK pada level molekular setelah proses elektroforesis. Penelitian ini bertujuan untuk mengetahui hubungan proteinuria pada urinalisa dengan BSK.
Metode: Penelitian ini adalah penelitian studi potong lintang dengan subjek pasien poli urologi di RSUD Kardinah, Tegal. Total sampel 200 pasien yang dikelompokkan menjadi 100 pasien BSK dan 100 pasien kontrol. Seluruh pasien dilakukan pemeriksaan ultrasound (USG) sebagai pemeriksaan diagnosis awal, kemudian dilakukan pemeriksaan urinalisa. Proteinuria dianggap positif untuk nilai protein urin +1 sampai +4 dan negatif pada nilai protein urin trace dan negatif. Variabel lain yang dianalisa adalah ISK, ph urin, usia, dan jenis kelamin.
Hasil: Pasien laki-laki memiliki kecenderungan BSK yang lebih tinggi dibandingkan perempuan dengan rasio 1,8:1. Rentang usia kelompok BSK 23-78 tahun dan pada kelompok kontrol 17-85 tahun. Tidak didapatkan hubungan yang bermakna antara proteinuria dengan BSK (p = 0,203). Terdapat hubungan antara ISK dengan BSK (p = 0,002) dan ph urin dengan BSK (p = 0,024). Terdapat hubungan antara ISK dengan proteinuria pada uji univariat dan multivariat (p = 0,000).
Kesimpulan: Tidak didapatkan hubungan antara proteinuria dengan BSK. Terdapat hubungan antara proteinuria dengan ISK. Proteinuria muncul karena proses inflamasi pada kasus infeksi akibat batu. Penelitian lanjutan diperlukan untuk menentukan jenis protein urin yang menjadi inhibitor pada pasien non stone former dan jenis protein urin yang ditemukan pada stone former.
Profil onikomikosis pada pasien lanjut usia di Rumah Sakit Umum Pusat Sanglah, Bali, Indonesia: studi retrospektif
I Gusti Ayu Agung Dwi Karmila, Made Swastika Adiguna, Luh Made Mas RusyatiOnline First: Apr 1, 2020
- Abstract
Profil onikomikosis pada pasien lanjut usia di Rumah Sakit Umum Pusat Sanglah, Bali, Indonesia: studi retrospektif
Background: Fungal infections are one of the most common dermatologic conditions affecting elderly population. Elderly population is susceptible to all of the superï¬cial 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:Â 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.
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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:Â 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:Â 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:Â 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.
Positive nikolsky sign and “pinpoint lake of pus†in acute generalized exanthematous pustulosis: a case report
Ketut Alit Pinidha Savitri, Ketut Suteja Wibawa, Komang Harry SupradnyanOnline First: Mar 3, 2020
- Abstract
Positive nikolsky sign and “pinpoint lake of pus†in acute generalized exanthematous pustulosis: a case report
Introduction: Acute generalized exanthematous pustulosis (AGEP) is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base and spontaneous resolution usually within two weeks. Current report aims to present management of AGEP in our center at Singaraja Regional Hospital, Bali-Indonesia.
Case: A 78 years old woman with a history of acute coronary syndrome, was reported to have a severe allergic drug reaction. Patients reported taking cefixime medication for the past 2 days because of acute bronchitis. The patient was hospitalized because of the complaint, and diffuse miliary pustules were found above the base of erythematous skin. On examination of lesions, the Nikolsky sign was positive on lesions in the back and abdomen without any tenderness. Histopathological examination was suitable for the diagnosis of acute generalized exanthema pustulosis (AGEP). Systemic intravenous corticosteroid with oral antihistamines was choosen as a primary treatment for this patient.
Conclusion: Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids
Prevalensi dan gambaran karakteristik kejadian depresi pada pasien geriatri di Unit Pelayanan Terpadu (UPT) Kesehatan Masyarakat (Kesmas) Dawan I Klungkung, Bali, Indonesia
Petrus Kanisius Yogi Hariyanto, Muhammad Faisal Putro Utomo, Ni Putu Chandra Paramita, Cok Gde Prema Kurnia Baswara, Putu Cintya Denny YuliyatniOnline First: Apr 1, 2020
- Abstract
Prevalensi dan gambaran karakteristik kejadian depresi pada pasien geriatri di Unit Pelayanan Terpadu (UPT) Kesehatan Masyarakat (Kesmas) Dawan I Klungkung, Bali, Indonesia
Background:Â 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.Â
Methods:Â 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:Â 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:Â 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.Â
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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.
Relaksasi autogenik menurunkan keluhan gastritis pada orang dengan infeksi HIV-AIDS (ODHA) di RSUD Wangaya, Bali, Indonesia
I Wayan Surasta, I Ketut Suardana, I Ketut LabirOnline First: Apr 1, 2020
- Abstract
Relaksasi autogenik menurunkan keluhan gastritis pada orang dengan infeksi HIV-AIDS (ODHA) di RSUD Wangaya, Bali, Indonesia
Background:Â The current society is demanded many obligations and responsibilities in daily life. This situation can affect the mental stress that leads to stress in facing many problems of life. Psychological stress has an impact on system disturbances in the digestive organs such as gastritis. People with HIV/AIDS (ODHA) are often faced with this condition, so one of the efforts that can be done is to do autogenic relaxation. This study aims to determine the differences in gastritis complaints of ODHA people before and after autogenic relaxation.Â
Methods:Â A quasi-experimental study with pre-test and post-test without a control group was conducted among 21 respondents at Countermeasures AIDS at Badung Regency from May-September 2017. Variables assessed in this study were gender, type of works, marital status, the origin of respondents, and the symptoms of respondents before and after autogenic relaxation intervention. Data were analyzed using SPSS version 17 for Windows.
Results:Â Most of ODHA patients were males (61.9%), followed by working as housewives (28.6%), marriage (81.0%), and living in North Kuta (28.6%). There was a significant difference in the average value of gastritis symptoms before (1.77) and after autogenic relaxation treatment (1.53) (p=0.002).Â
Conclusion:Â Autogenic relaxation therapy can reduce the symptoms of gastritis among ODHA patients at Wangaya Hospital, Bali, Indonesia.Â
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Latar belakang: Masyarakat saat ini dituntut dengan banyak kewajiban dan tanggung jawab dalam kehidupan sehari-hari. Keadaan ini akan berdampak pada tekanan mental yang mengarah pada stres dalam menghadapi banyak masalah kehidupan. Tekanan mental akan berdampak pada organ pencernaan seperti gastritis. Penderita HIV/AIDS (ODHA) kerap dihadapkan pada kondisi ini sehingga salah satu upaya yang dapat dilakukan adalah melakukan relaksasi autogenik. Penelitian ini bertujuan untuk mengetahui perbedaan keluhan gastritis pada ODHA sebelum dan sesudah relaksasi autogenik.
Metode: Sebuah penelitian eksperimental-semu dengan pre-test dan post-test tanpa kelompok kontrol dilakukan terhadap 21 responden pada Penanggulangan AIDS di Kabupaten Badung dari Mei-September 2017. Variabel yang dinilai dalam penelitian ini adalah jenis kelamin, jenis pekerjaan, status perkawinan, asal responden, dan gejala responden sebelum dan sesudah intervensi relaksasi autogenik. Data dianalisis menggunakan SPSS versi 17 untuk Windows.
Hasil: Sebagian besar pasien ODHA adalah laki-laki (61,9%), diikuti dengan bekerja sebagai ibu rumah tangga (28,6%), menikah (81,0%), dan tinggal di Kuta Utara (28,6%). Ada perbedaan yang bermakna dalam nilai rata-rata gejala gastritis sebelum (1,77) dan setelah perawatan relaksasi autogenik (1,53) (p = 0,002).
Kesimpulan: Terapi relaksasi autogenik dapat mengurangi gejala grastritis di antara pasien ODHA di Rumah Sakit Wangaya, Bali, Indonesia.
The endoscopy profile of patients with Gastrointestinal Bleeding (GIB) at Klungkung Regional General Hospital, Bali, Indonesia during the 2014-2018 period
I Gede Restu Mahendra Sugiarta, I Ketut SumandiOnline First: Apr 1, 2020
- Abstract
The endoscopy profile of patients with Gastrointestinal Bleeding (GIB) at Klungkung Regional General Hospital, Bali, Indonesia during the 2014-2018 period
Background:Â 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:Â 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:Â 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.
Perbedaan kadar serum feritin dengan dan tanpa infeksi Soil – Transmitted Helminth (STH) pada anak sekolah dasar di Pesantren Hidayatullah Tanjung Morawa, Kabupaten Deli Serdang, Sumatera Utara, tahun 2018
Noffrizal Noffrizal, Ricke Loesnihari, Muzahar MuzaharOnline First: Apr 1, 2019
- Abstract
Perbedaan kadar serum feritin dengan dan tanpa infeksi Soil – Transmitted Helminth (STH) pada anak sekolah dasar di Pesantren Hidayatullah Tanjung Morawa, Kabupaten Deli Serdang, Sumatera Utara, tahun 2018
Background: Worm infections caused by Soil-Transmitted Helminths (STH) currently remains a public health problem in the world, especially Indonesia. STH infection is a risk factor for iron deficiency and eventually reaches the stage of iron deficiency anaemia in chronic infections. Serum ferritin levels were measured as early detection of loss of iron reserves in the body to prevent anaemia. This study aims to compare serum ferritin levels in elementary school/ibtidaiyah children with and without STH infection.
Method:Â A cross-sectional study was conducted among 60 children at Pesantren Hidayatullah Tanjung Morawa in 2018. About 30 children infected with STH and 30 children not-infected with STH, who fulfilled the inclusion and exclusion criteria were included in this study. Every child was examined for faeces with the Kato-Katz Method and serum ferritin levels with Cobas e411 (Electrochemiluminescence immunoassay). The results obtained were analyzed by Mann Whitney's test by SPSS version 17 for Windows.
Result:Â Serum ferritin levels in the group with STH infection were 10-281 ng/ml, whereas, in the group that did not suffer from STH infection, the values were 15 - 283 ng/ml. The median rank between groups was 5.26 (>5), so clinically, there were significant differences between the two groups. But statistically, there was no significant difference between serum ferritin levels between the two groups (p = 0.24), with the significance value of the Mann-Whitney test p <0.05.
Conclusion:Â The study showed no significant difference between serum ferritin levels between groups of children who had STH infection and groups of children who did not have STH infection.
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Pendahuluan: Infeksi cacing yang disebabkan Soil Transmitted Helminths (STH) saat ini tetap menjadi permasalahan kesehatan masyarakat di dunia khususnya Indonesia. Infeksi STH merupakan salah satu faktor resiko terjadinya defisiensi besi dan akhirnya mencapai tahapan anemia defisiensi besi pada infeksi kronis. Kadar serum feritin diukur sebagai deteksi dini hilangnya cadangan zat besi dalam tubuh untuk mencegah terjadinya anemia. Tujuan penelitian ini adalah untuk untuk membandingkan kadar serum ferritin pada anak sekolah dasar/ ibtidaiyah dengan dan tanpa infeksi STH
Metode: Sebuah penelitian potong lintang dilakukan terhadap 60 anak pada Pesantren Hidayatullah Tanjung Morawa pada tahun 2018. Sekitar 30 anak terinfeksi STH dan 30 anak tidak terinfeksi STH dimana telah memenuhi kriteria inklusi dan ekslusi terlibat dalam penelitian ini. Setiap anak dilakukan pemeriksaan tinja dengan Metode Kato-Katz serta kadar serum ferritin dengan alat Cobas e411 (Electrochemiluminescence immunoassay). Hasil yang didapat dianalisa dengan uji Mann-Whitney menggunakan SPSS versi 17 untuk Windows.
Hasil: Kadar serum feritin pada kelompok dengan infeksi STH adalah 10 – 281 ng/ml sedangkan pada kelompok yang tidak menderita infeksi STH di peroleh nilai 15 – 283 ng/ml. Rank median antar kelompok 5,26 (>5), maka secara klinis terdapat perbedaan bermakna antara kedua kelompok. Tetapi secara statistik tidak terdapat perbedaan yang bermakna antara kadar serum feritin antara kedua kelompok (p = 0,24).
Kesimpulan : Penelitian menunjukkan tidak terdapat perbedaan yang bermakna antara kadar serum feritin antara kelompok anak yang mengalami infeksi STH dan kelompok anak yang tidak mengalami infeksi STH.
Association between parents’ body height with stunting in children ages 1-5 years old in Nagi Primary Health Care Working Area Larantuka City, East Flores, Indonesia
Wega Upendra Sindhughosa, I Made ArimbawaOnline First: Apr 1, 2020
- Abstract
Association between parents’ body height with stunting in children ages 1-5 years old in Nagi Primary Health Care Working Area Larantuka City, East Flores, Indonesia
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. Â
Methods:Â 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.
Peningkatan kadar Mean Platelet Volume-Lymphocyte Ratio (MPVLR) terhadap resiko diabetik nefropati pada pasien dengan diabetes melitus tipe II (DM-2) di RSUP Sanglah, Bali, Indonesia
Budi Ratna Aryani, I Made Yoga Prabawa, Made Ratna SaraswatiOnline First: Mar 19, 2020
- Abstract
Peningkatan kadar Mean Platelet Volume-Lymphocyte Ratio (MPVLR) terhadap resiko diabetik nefropati pada pasien dengan diabetes melitus tipe II (DM-2) di RSUP Sanglah, Bali, Indonesia
Background: Diabetic Nephropathy (DN) is Diabetes Mellitus’s microvascular complication with albuminuria and decrease glomerular filtration rate. DN pathogenesis is related with inflammatory process induced by chronic hyperglycaemia. Mean platelet volume (MPV) and platelet-lymphocyte ratio (PLR) are potential for reviewing systemic inflammation. The combination of MPV and PLR index into MPVLR shows significant results in prognostic patients with diabetes mellitus and acute myocardial infarction and predicted DN. This study aims to determine the MPVLR index of DN risk in type II diabetes mellitus patients at Sanglah Hospital, Denpasar.
Method: Cross-sectional study of 50 DM-2 patients at Sanglah Hospital in 2016. The data is secondary data from the medical records of DM-2 patients according the inclusion and exclusion criteria with purposive sampling technique. Diabetic nephropathy is diagnose based on diagnostic criteria. Complete blood count (CBC) using the CELL-DYN Ruby System. MPVLR is an absolute comparison of the calculation of MPV and total lymphocytes. T-test and Mann-Whitney Test to assess differences mean of data. The MPVLR index for diabetic nephropathy was assessed by Receiver Operating Curve (ROC) and Area Under the Curve (AUC). p <0.05 is statistically significant.
Results: 50 data were grouped into nephropathy and without nephropathy groups. Men is dominant in both groups (p>0.05). The MPVLR ratio was statistically significantly higher in the nephropathy group (5.11 ± 2.20; P = 0.004). The MPVLR index cut point value was 3.835 with a sensitivity value of 73.7% and specificity of 71%.
Conclusion: MPVLR can use as independent predictor of diabetic nephropathy in diabetic patients.
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Latar Belakang: Diabetik Nefropati (DN) merupakan komplikasi mikrovaskular Diabetes Melitus dengan albuminuria dan penurunan estimasi laju filtrasi glomerulus. Patogenesis DN berkaitan dengan proses inflamasi terinduksi hiperglikemia kronis. Indeks rerata volume trombosit (MPV) dan rasio trombosit-limfosit (PLR) potensial untuk meninjau inflamasi sistemik. Gabungan indeks MPV dan PLR menjadi MPVLR menunjukan hasil yang signifikan dalam diagnostik prognostik pada pasien diabetes melitus dan infarksi miokardial akut serta menjadi prediktor DN. Penelitian ini bertujuan untuk mengetahui indeks MPVLR terhadap risiko DN pada pasien diabetes melitus tipe II di RSUP Sanglah, Denpasar.
Metode: Studi potong lintang (cross-sectional) terhadap 50 pasien DM-2 di RSUP Sanglah tahun 2016. Data penelitian adalah data sekunder dari rekam medis pasien DM-2 yang memenuhi kriteria Inklusi dan Eksklusi dengan teknik purposive sampling. Diabetik nefropati ditegakkan berdasarkan kriteria diagnosis. Pemeriksaan darah lengkap (DL) menggunakan CELL-DYN Ruby System. Rasio MPV terhadap limfosit (MPVLR) adalah perbandingan absolut dari perhitungan MPV dan limfosit total. Uji-t dan Uji Mann-Whitney untuk menilai perbedaan antara rata-rata data dua kelompok. Indeks MPVLR terhadap diabetic nefropati dinilai dengan Receiver Operating Curve (ROC) dan Area Under the Curve (AUC). Nilai p<0,05 bermakna secara statistik.
Hasil: 50 data dikelompokkan menjadi kelompok dengan nefropati dan tanpa nefropati. Jenis kelami laki-laki dominan di kedua keompok tersebut (p>0,05). Rasio MPVLR secara statistik bermakna lebih tinggi pada kelompok dengan nefropati (5,11±2,20; P=0,004). Nilai titik potong indeks MPVLR sebesar 3,835 dengan nilai sensitifitas sebesar 73,7% dan spesifisitas 71%.
Simpulan: MPVLR dapat sebagai prediktor kuat dan independen diabetik nefropati pada pasien diabetes.
Perbedaan jenis kuman pada pasien Diabetes Mellitus Tipe-2 (DM-2) dengan infeksi saluran kemih dan bakteriuria asimtomatik di RSUP H. Adam Malik, Medan, Indonesia
Deby Novayanti, Ricke Loesnihari, Muzahar MuzaharOnline First: Apr 1, 2020
- Abstract
Perbedaan jenis kuman pada pasien Diabetes Mellitus Tipe-2 (DM-2) dengan infeksi saluran kemih dan bakteriuria asimtomatik di RSUP H. Adam Malik, Medan, Indonesia
Background:Â 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.Â
Methods:Â 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.Â
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. Â
Conclusion:Â 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.Â
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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.
The association between Body Surface Area (BSA) and vitamin D level among obese adolescent patients in Denpasar, Bali, Indonesia
Luh Gede Yuliadewi NS, I Gusti Lanang SidiarthaOnline First: Apr 1, 2020
- Abstract
The association between Body Surface Area (BSA) and vitamin D level among obese adolescent patients in Denpasar, Bali, Indonesia
Background:Â Prevalence of obesity in adolescent in Indonesia is still high. An obese adolescent is likely to stay obese into adulthood and tends to develop into cardiovascular and metabolic diseases. Obese subjects have larger body surface area and should be able to produce more vitamin D from cutaneous synthesis. This study aims to determine the prevalence of obesity in adolescent in Denpasar, determine vitamin D status among obese adolescents and obtained an association between body surface area and vitamin D levels.
Methods:Â A descriptive observational study using a cross-sectional approach has been conducted among 51 obese adolescents in Denpasar during May to December 2018. Several variables assessed in this study were age, sex, weight, height, Body Mass Index (BMI), Body Surface Area (BSA), and vitamin D levels. Factors associated with vitamin D levels in obese adolescence were analyzed with appropriate statistical analysis. Data were analyzed using SPSS version 17 for Windows.Â
Results: From 51 subjects, 32 (62.74%) male and 19 (37.26%) female subjects were enrolled in this study. The mean weight and height of respondents were 89.4±9.8 kg and 158.6±7.3 cm. In addition, the average Body Mass Index (BMI) and Body Surface Area (BSA) were 33.6±3.4 kg/m2 and 2.1±0.2 m2. The mean Vitamin D levels was 18.9±4.9 ng/mL with 40 subjects (78,4%) were known in a vitamin D deficiency state. There was a significant weak positive association between BSA and vitamin D levels (r=0.32; p=0,002).
Conclusion:Â Most obese adolescents were in vitamin D deficiency with a significant weak positive association between BSA and vitamin D levels.Â
Analisis faktor risiko infeksi malaria sesudah bencana gempa bumi di Kabupaten Lombok Barat, Indonesia
Michelle Amazing Grace Rampengan, Ni Made Utami Dwipayanti, Putu Cintya Denny YuliyatniOnline First: Apr 1, 2020
- Abstract
Analisis faktor risiko infeksi malaria sesudah bencana gempa bumi di Kabupaten Lombok Barat, Indonesia
Background:Â 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:Â 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:Â The existence of gardens in refugee camps is the most influential risk factor for malaria infection after the earthquake disaster in West Lombok Regency.
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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.
Hemiartroplasti Bipolar menghasilkan luaran C-Reactive Protein dan Harris Hip Score yang lebih tinggi dibandingkan Cephalomedulary Nailing
Komang Septian Sandiwidayat, Putu Astawa, Ketut Gede Mulyadi Ridia, Ketut Siki Kawiyana, I Wayan Suryanto Dusak, I Ketut Suyasa, I Gede Eka Wiratnaya, Anak Agung Wiradewi LestariOnline First: Apr 1, 2020
- Abstract
Hemiartroplasti Bipolar menghasilkan luaran C-Reactive Protein dan Harris Hip Score yang lebih tinggi dibandingkan Cephalomedulary Nailing
Background: Bipolar Hemiarthroplasty and Cephalomedullary Nailing (PFNA) are operative procedures for the management of proximal femoral fractures. Both of these surgical techniques have their respective advantages and disadvantages. This study aims to determine the differences in biological and functional outcomes. C-Reactive Protein (CRP) used to measure inflammation due to tissue damage and Harris Hip Score (HHS) used to measure functional output. This study hoped to facilitate the selection of appropriate techniques for the treatment of proximal femoral fractures.
Methods: Prospective cohort study conducted among patient with proximal femoral fractures who underwent Bipolar Hemiarthroplasty and PFNA surgery. CRP levels were examined before surgery and 12 hours postoperatively. The HHS assessment was performed at weeks 4, 6, and 8 postoperatively.
Results: In general, the preoperative CRP levels of the groups undergoing Bipolar Hemiarthroplasty and PFNA were not significantly different (32.4±16.7 and 33.7±17.1; p> 0.05), whereas postoperatively, Bipolar Hemiarthroplasty shown significantly higher CRP (76.5±27.3 and 42.6±17.6; p <0.0001). Similar results were also shown from the ∆CRP analysis (45.1±22.1 and 8.9±3.2; p<0.0001). The mean HHS score was higher in the Bipolar Hemiarthroplasty group than in PFNA group at each measurement. At the 4th week, the mean HHS score did not show a significant difference (52.3±4.2 vs 52.2±5.4; p>0.05). The 6th week evaluation showed Bipolar Hemiarthroplasty had a mean HHS of 76.5±4.6 while PFNA 61.4±5.4 (p <0.0001). At week 8, HHS in Bipolar Hemiarthroplasty was consistently higher than PFNA (89.43±4.5 and 74.95±4.9; p <0.0001). The Bipolar Hemiarthroplasty group was hospitalized 56% longer (6.1±1.3 and 3.9±1.3 days; p<0.0001) and the Bipolar Hemiarthroplasty had an average bleeding volume of 4.5 times more (407.4±122.8 and 90±13 ml; p <0.0001).
Conclusion: Bipolar Hemiarthroplasty and PFNA procedures have significantly different functional and biological outcomes. The postoperative HHS score in Bipolar Hemiarthroplasty is better but with a higher delta CRP.
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Latar Belakang: Hemiarthroplasti bipolar dan Cephalomedullary Nailing (PFNA) merupakan prosedur operatif penatalaksanaan fraktur proksimal femur. Kedua prosedur tersebut menggunakan pendekatan yang berbeda utamanya pada upaya preservasi bagian proksimal femur. Kedua teknik bedah ini memiliki keuntungan dan kerugian masing-masing. Penelitian ini bertujuan untuk mengetahui perbedaan luaran biologis dan fungsional kedua teknik tersebut. C-Reactive Protein (CRP) digunakan sebagai parameter terkait inflamasi akibat kerusakan jaringan dan Harris Hip Score (HHS) digunakan mengukur luaran fungsional. Studi ini diharapkan dapat mempermudah pemilihan teknik yang tepat untuk penanganan fraktur proksimal femur.
Metode: Penelitian ini adalah penelitian kohort prospektif pada pasien dengan fraktur proksimal femur yang menjalani operasi Hemiartroplasti Bipolar dan PFNA. Kadar CRP diperiksa sebelum operasi dan 12 jam paska operasi. Penilaian HHS dilakukan pada minggu ke-4, 6, dan 8 paska operasi.
Hasil: Secara umum kadar CRP preoperasi kelompok yang menjalani Hemiarthroplasti Bipolar dan PFNA tidak berbeda signifikan (32,4±16,7 dan 33,7±17,1; p>0,05), sedangkan pada paska operasi kadar CRP Hemiarthroplasti Bipolar secara signifikan lebih tinggi (76,5±27,3 dan 42,6±17,6; p<0,0001). Hasil yang sama juga ditunjukan dari analisis ∆CRP (45,1±22,1 dan 8,9±3,2; p < 0,0001). Rerata skor HHS lebih tinggi pada kelompok Hemiarthroplasti Bipolar daripada PFNA pada setiap kali pengukuran. Pada minggu ke-4 nilai rerata HHS tidak menunjukan perbedaan yang signifikan (52,3±4,2 vs 52,2±5,4, p>0,05). Evaluasi minggu ke-6 menunjukan Hemiarthroplasti Bipolar memiliki rerata HHS 76,5±4,6 sementara PFNA 61,4±5,4 (p<0,0001). Pada minggu ke-8, HHS pada Hemiarthroplasti Bipolar konsisten lebih tinggi daripada PFNA (89,43±4,5 dan 74,95±4,9; p<0,0001). Kelompok Hemiarthroplasti Bipolar menjalani rawat inap 56% lebih lama (6,1±1,3 dan 3,9±1,3 hari; p < 0,0001) serta Hemiarthroplasti Bipolar memiliki rerata volume perdarahan 4,5 kali lebih banyak (407,4±122,8 dan 90±13 ml; p < 0,0001).
Kesimpulan: Prosedur Hemiarthroplasti Bipolar dan PFNA memiliki luaran fungsional dan biologis yang berbeda secara signifikan. Skor HHS pada Hemiarthroplasti Bipolar lebih baik tetapi selisih CRP yang lebih tinggi.
Flushing intramedular dengan epinefrin pada prosedur Cemented Hip Arthroplasty menstabilkan mean arterial pressure tanpa mempengaruhi profil lipid
Aakash Aakash, Ketut Siki Kawiyana, I Wayan Suryanto Dusak, Ketut Gede Mulyadi Ridia, I Ketut Suyasa, I Gusti Ngurah Wien Aryana, I Gede Eka Wiratnaya, Anak Agung Wiradewi LestariOnline First: Apr 1, 2020
- Abstract
Flushing intramedular dengan epinefrin pada prosedur Cemented Hip Arthroplasty menstabilkan mean arterial pressure tanpa mempengaruhi profil lipid
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.Â
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.
Hubungan dan titik potong skor Caprini terhadap D-dimer sebagai parameter resiko trombosis vena dalam pada pasien paska fiksasi internal fraktur tulang panjang ekstremitas bawah
Made Wirabhawa, Ketut Siki Kawiyana, I Ketut Suyasa, Putu Astawa, Ketut Gede Mulyadi Ridia, I Wayan Suryanto Dusak, I Gede Eka Wiratnaya, Anak Agung Wiradewi LestariOnline First: Apr 1, 2020
- Abstract
Hubungan dan titik potong skor Caprini terhadap D-dimer sebagai parameter resiko trombosis vena dalam pada pasien paska fiksasi internal fraktur tulang panjang ekstremitas bawah
Background: Fractures contribute to a substantial proportion of the emergency department cases. Surgical procedures such as internal fixation of lower limb fractures posed a risk to develop deep vein thrombosis (DVT). The current diagnosis of DVT is still a challenge, as the current main parameter, the D-dimer, requires additional laboratory time and cost. Threrefore, an easier and faster alternative should be used in clinical decision making. Caprini score is among a simple method to assess the risk of a DVT, but validation is still needed before it can be implemented.
Methods: This is an cross-sectional analytic study aimed to determine the relationship between Caprini scores and D-dimer level in patients with post-internal fixation of long bone fractures in lower extrimities at Sanglah Hospital Denpasar. Caprini scores were determined before surgery then D-dimer measurements were taken postoperatively. Statistical analysis was performed using the Pearson correlation method and ROC curve were generated to determine the cut-off point of Caprini Score equivalent of high risk DVT with the D-dimer as the predictor.
Result: The average Caprini score was 9.37 (7-13). Mean preoperative D-dimer was 6.59 µg/ml (2.50-13.20 µg/ml), postoperatively 11.50 µg / ml (3.71-19.89 µg/ml) and mean delta D -Dimer 5.23 µg/ml (0.56-12.28 µg/ml). Pearson correlation test obtained a strong positive relationship (r = 0.726 and p≤0,0001). Analysis of the ROC curve to determine the cut-off point for Caprini score which equivalent to the high risk of DVT from D-dimer prediction (> 7.2 µg / ml) resulted in AUC of 0.824 (95% CI 0.669-0.979, p= 0.024) with the optimal cut-off point for Caprini score was 8.
Conclusion: Caprini and D-dimer scores show a strong positive correlation. Caprini scores can be considered to estimate the risk of DVT in post-internal fixation patients of lower extremities long bone fractures.
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Latar Belakang. Kejadian fraktur memiliki proporsi yang substansial dari total pasien yang datang ke unit gawat darurat rumah sakit. Prosedur operasi seperti pemasangan fiksasi internal pada fraktur ekstremitas bawah memiliki resiko untuk terjadinya trombosis vena dalam (DVT). Penegakan diagnosis DVT saat ini masih merupakan suatu tantangan salah satunya karena pemeriksaan laboratorium D-dimer membutuhkan waktu dan biaya tambahan, sehingga dibutuhkan alternatif yang lebih mudah dan cepat digunakan dalam pengambilan keputusan klinis. Skor Caprini merupakan salah satu cara untuk menilai resiko terjadinya suatu DVT, akan tetapi masih diperlukan validasi sebelum dapat diimplementasikan.
Metode: Penelitian cross-sectional analitik dilakukan untuk mengetahui hubungan Skor Caprini dengan kadar D-dimer pada pasien paska operasi fiksasi internal fraktur tulang panjang ekstremitas bawah di RSUP Sanglah Denpasar. Skor Caprini ditentuakan sebelum operasi kemudian pengukuran D-dimer dilakukan paska operasi. Analisis statistik dilakukan dengan metode korelasi Pearson dan penentan titik potong risiko DVT dengan prediktor D-dimer menggunakan metode kurva ROC.
Hasil: Rerata Skor Caprini adalah 9,37 dengan rentang skor 7-13. Rerata D-dimer sebelum operasi sebesar 6,59 µg/ml (2,50-13,20 µg/ml), paska operasi 11,50 µg/ml (3,71-19,89 µg/ml) dan rerata delta D-Dimer 5,23µg/ml (0,56-12,28 µg/ml). Uji korelasi Pearson diperoleh hubungan positif kuat antara Skor Caprini dengan kadar D-dimer (nilai r=0,726 dan nilai p≤0,0001). Analisis kurva ROC untuk menentukan itik potong  Skor Caprini yang setara dengan resiko tinggi terjadinya DVT dari prediksi D-dimer (>7,2 µg/ml) memperoleh Area Under Curve 0,824 (95% CI 0,669-0,979, p = 0,024) dengan titik potong optimal skor Caprini 8.
Kesimpulan: Skor Caprini dan D-dimer menunjukkan korelasi positif yang kuat pada pasien paska fiksasi internal fraktur tulang panjang ekstremitas bawah. Skor Caprini dapat dipertimbangkan sebagai acuan dalam menentukan resiko terjadinya DVT.
Faktor yang mempengaruhi kejadian asfiksia neonatorum di RSUD Wangaya Kota Denpasar
Bella Kurnia, I Wayan Bikin Suryawan, A.A. Made SuciptaOnline First: Apr 1, 2020
- Abstract
Faktor yang mempengaruhi kejadian asfiksia neonatorum di RSUD Wangaya Kota Denpasar
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.
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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.
Pola Mikroba dan Sensitivitasnya Terhadap Antibiotik pada Pasien dengan Infeksi Saluran Kemih di RSUD Prof. Dr. W.Z. Johannes, Kupang Periode Januari-Desember 2017
Vivi Anggelia, Clarissa Oktavia, Heri Sutrisno, Hermi InditaOnline First: Apr 1, 2020
- Abstract
Pola Mikroba dan Sensitivitasnya Terhadap Antibiotik pada Pasien dengan Infeksi Saluran Kemih di RSUD Prof. Dr. W.Z. Johannes, Kupang Periode Januari-Desember 2017
Background: Urinary tract infection (UTI) is a serious public health problem which involves infection of any parts of the urinary tract. In the past few years, treatment of UTI becomes very challenging due to increase emergence of antibiotics resistance in uro-pathogens. This study was performed to determine microbial patterns and its sensitivity to antibiotics.
Methods: This was an observational descriptive study. The data were collected from 130 urine samples in RSUD Prof. Dr. W.Z. Johannes during period of January-December 2017. Patients were diagnosed UTI by using Vitek 2.
Results: We obtained 130 samples of urine culture in RSUD. Prof. Dr. W. Z. Johannes during period of January-December 2017. From 130 samples of urine culture, 83 samples showed growth of bacteria and fungi (63,85%) whereas 47 samples showed no growth (36,15%). From 83 growth samples, we identified 20 types of bacteria which include 4 types of gram positive bacteria, 16 types of gram negative bacteria and 1 type of fungi. The most common causes of UTI were E. coli (22,89%), Candida albicans (10,84%), Klebsiella pneumoniae ss pneumoniae (9,64%) and Acinetobacter baumanii (6,02%). Meropenem, gentamycin and amikacin were still sensitive to uropathogen. The most common antibiotics which were resistance to bacteria were ampicillin and ceftriaxone.
Conclusion: Escherichia coli is the most prevalence contribute to UTI in outpatient and inpatient. There were only three types of non-resistant antibiotic to uropathogens.
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Latar Belakang: Infeksi saluran kemih (ISK) merupakan salah satu masalah kesehatan serius. Beberapa tahun belakangan ini, pengobatan ISK menjadi tantangan tersendiri bagi para klinisi karena tingginya angka resistensi antibiotik. Penelitian ini bertujuan untuk mengetahui pola mikroba dan senstivitasnya terhadap antibiotik.
Metode: Pada penelitian deskriptif observasional ini, didapatkan 130 sampel urin di RSUD Prof. Dr. W.Z. Johannes dari bulan Januari-Desember 2017 dimana pasien didiagnosis ISK melalui pemeriksaan dengan Vitek 2.
Hasil: Sebanyak 130 sampel urin yang dikultur, 83 sampel menunjukan perkembangan bakteri dan jamur (63,85%) dimana 47 sampel menunjukan tidak adanya pertumbuhan (36,15%). Dari 83 sampel yang tumbuh, teridentifikasi sebanyak 20 tipe bakteri dimana 4 tipe merupakan gram-positif dan 16 tipe gram negatif serta 1 tipe jamur. Penyebab terbanyak ISK adalah E. coli (22,89%), Candida albicans (10,84%), Klebsiella pneumoniae ss pneumoniae (9,64%) dan Acinetobacter baumanii (6,02%). Dimana antibiotik jenis meropenem, gentamisin dan amikasin masih sensitif untuk uropatogen. Sedangkan ampisilin dan seftriakson adalah jenis antibiotik yang memiliki angka resistensi tertinggi.
Kesimpulan: Escherichia coli adalah penyebab tersering ISK dan hanya ditemukan tiga jenis antibiotik yang masih sensitif untuk uropatogen.
Temuan ultrasonografi pada kecurigaan klinis tumor payudara ganas di RSUP Sanglah periode januari – desember 2015
I Kadek Riyandi Pranadiva Mardana, Elysanti Dwi Martadiani, Firman Parulian SitanggangOnline First: Apr 1, 2020
- Abstract
Temuan ultrasonografi pada kecurigaan klinis tumor payudara ganas di RSUP Sanglah periode januari – desember 2015
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.Â
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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.
Hubungan jenis persalinan dengan kejadian asfiksia neonatorum di ruang perinatologi dan Neonatal Intensive Care Unit (NICU) RSUD Wangaya Kota Denpasar
Cynthia Jodjana, I Wayan Bikin SuryawanOnline First: Apr 1, 2020
- Abstract
Hubungan jenis persalinan dengan kejadian asfiksia neonatorum di ruang perinatologi dan Neonatal Intensive Care Unit (NICU) RSUD Wangaya Kota Denpasar
Background: Newborn deaths are still a major health problem and several health efforts have been made to improve children's health. Based on the results of the Indonesian Demographic and Health Survey (IDHS) in 2017, the Neonatal Mortality Rate (NMR) is 15 per 1000 live births. One of some cause deaths is asphyxia or  respiratory problems 36%. Neonatal asphyxia is a condition of a newborn who fails to breath spontaneously and regular immediately after birth. Based on the annual report of the Sanglah Central General Hospital (RSUP) in Denpasar, the percentage of asphyxia events has increased 11.31% in 2014. Factors that cause neonatal asphyxia including maternal factor, infant factor, placental factor and labor factor. The purpose of this study is  to determine the relationship between types of labor with asphyxia neonatorum.
Method: The type of research used is observational analytic study with case-control. In this study, sampling was perfomed at Wangaya Hospital June 2018-December 2018 in the NICU and and Perinatology room until the number of research samples fullfillig the inclusion and exclusion criteria with 45 cases and 45 samples.The samples was obtained by consecutive sampling method. The case in this research is neonates who has neonatal asphyxia and controls in this study were neonates who did not have neonatal asphyxia. Data obtained were analyzed analytically, using SPSS 23.0 software using the Mc Nemar test with p value of <0.05 considered significant.
Results: There was no relationship between types of labor with neonatal asphyxia (p = 0.481, OR = 1.429, IK95% = 0.368-5,548).
Conclusion: There is no significant relationship between the type of labor asphyxia neonatorum.
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Latar Belakang: Kematian bayi baru lahir masih merupakan masalah kesehatan yang utama dan beberapa upaya kesehatan telah dilakukan untuk meningkatkan kesehatan anak. Berdasarkan hasil Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2017, Angka Kematian Neonatal (AKN) sebesar 15 per 1000 kelahiran hidup. Penyebab utama kematian salah satunya adalah asfiksia atau gangguan pernapasan sebesar 36%. Asfiksia neonatorum adalah suatu keadaan bayi baru lahir yang ditandai dengan gagal bernafas secara spontan dan teratur segera setelah lahir. Berdasarkan laporan tahunan Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar, persentase kejadian asfiksia meningkat kembali 11,31% pada tahun 2014. Faktor yang menyebabkan asfiksia neonatorum antara lain faktor ibu, faktor bayi, faktor plasenta dan faktor persalinan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan jenis persalinan dengan asfiksia neonatorum.
Metode: Jenis penelitian yang digunakan adalah studi observasional analitik dengan metode case-control. Pada penelitian ini, pengambilan sampel dilakukan di RSUD Wangaya periode Juni 2018-Desember 2018 di ruang NICU dan dan Perinatologi sampai jumlah sampel penelitian yang memenuhi kriteria inklusi dan ekslusi dengan jumlah 45 kasus dan 45 sampel. Sampel diperoleh melalui metode consecutive sampling. Kasus pada penelitian ini adalah neonatus yang mengalami asfiksia neonatorum, sedangkan kontrol pada penelitian ini adalah neonatus yang tidak mengalami asfiksia neonatorum. Data yang diperoleh dianalisis secara analitik, menggunakan perangkat lunak komputer SPSS 23.0 dengan menggunakan tes Mc Nemar dengan nilai p<0,05 dianggap signifikan.
Hasil: Tidak terdapat hubungan antara jenis persalinan dengan asfiksia neonatorum (p =0,481,OR=1,429, IK95% = 0,368-5,548).
Simpulan: Tidak terdapat hubungan yang signifikan antara jenis persalinan dengan kejadian asfiksia neonatorum.
Faktor-faktor resiko kejadian pneumonia pada pasien pneumonia usia 12-59 bulan di RSUD Wangaya
Susan Natalia Budihardjo, I Wayan Bikin SuryawanOnline First: Apr 1, 2020
- Abstract
Faktor-faktor resiko kejadian pneumonia pada pasien pneumonia usia 12-59 bulan di RSUD Wangaya
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 childrenâ€. 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:Â Incomplete immunization status and exposed to cigarette smoke are the risk factors of pneumonia in children aged 12-59 months old at Wangaya Hospital.
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Latar Belakang:Â 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:Â 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.
Prevalence of risk factors associated with hypertension at Sanglah General Hospital, Bali
Mahen Isaac Pannir Chelvam, I Wayan Sugiritama, I Gusti Nyoman Kamasan ArijanaOnline First: Apr 1, 2020
- Abstract
Prevalence of risk factors associated with hypertension at Sanglah General Hospital, Bali
Background: High blood pressure, also called "hypertension," is a serious medical condition. It happens when the force of the blood pumping through the arteries is too strong. The World Health Organization rates hypertension as one of the most important causes of premature death worldwide, and the problem is growing. This study aimed to determine the risk factors affecting Hypertension at Sanglah general hospital.
Methods: This study was a descriptive study with a cross-sectional approach. The data used in this study is a secondary data collected from medical record of the patients with Hypertension at Sanglah general hospital, Denpasar, Bali in the year of 2015 until 2016. The data was categorized based on Body Mass Index (BMI), gender, age, alcohol consumption, and history of cardiovascular diseases.
Results: There are 73(60.83%) males and 47(39.17%) females, the majority of patients were in the age group of 18 – 70 years of age with the age group of 40 - 50 carrying a rather large quantity of 45.8% among the male gender and for the female gender the age group of 51 – 60 showed the highest percentage of 38.2%, the sample consists of 60.83% of males and 39.17 of females from the total 120 samples taken from Sanglah general hospital. As for Body Mass Index (BMI), 25 – 29.9 has the most significant value of 49 (40.83%) when compared to the other nutritional statuses present. The patients with the cardiovascular disease showed a very substantial amount of 69 (57.5%) among males and 41 (34.17%) among females. Patients with a history of alcohol consumption for the male gender had a value of 34 (28.30%), and for the female gender group, it carried an amount of 2 (1.70%).
Conclusions: This study succeeded in identifying 120 samples of patients with hypertension and their contributing risk factors. The majority of the Samples were with body mass index (BMI) 25 – 29.9 (40.83%). The samples with a history of cardiovascular disease showed a value of 69 (57.5%) among males and 41 (34.17%) among females. Patients with a history of alcohol consumption for the male gender had a value of 34 (28.30%), and for the female gender group, it carried an amount of 2 (1.70%)
Profil penderita dengan cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015
Jonathan Pratama Swannjo, I Ketut SuyasaOnline First: Apr 1, 2020
- Abstract
Profil penderita dengan cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015
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
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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.
Topical application of purple cabbage (Brassica oleracea L. var. capitata f. rubra) ethanol cream extract of dermic collagen on male Wistar rats (Rattus norvegicus) exposed to ultraviolet B
Komang Jegek Triangga Apsari, I Gusti Ayu Dewi Ratnayanti, I Gusti Komang Nyoman Arijana, I Wayan SugiritamaOnline First: Mar 26, 2020
- Abstract
Topical application of purple cabbage (Brassica oleracea L. var. capitata f. rubra) ethanol cream extract of dermic collagen on male Wistar rats (Rattus norvegicus) exposed to ultraviolet B
Background: Purple cabbage or also known as red cabbage (Brassica oleracea L. var. capitata f. rubra) contains polyphenols, especially anthocyanin (cyanidin-3-diglucoside-5-glucoside). Anthocyanin has a protective effect against radical oxidative superoxide (ROS). Thus it can prevent skin damage caused by ultraviolet (UV)-B radiation.
Aim: The research aims to prove the effectivity of distribution of purple cabbage ethanol cream extract prevented the decrease of dermal collagens on Wistar rats (Rattus norvegicus) exposed to UV-B rays.
Method: This research was arranged with the randomize post-test only control group design. 30 rats were divided into 6 groups containing 5 rats each, there are control group (P1) without distribution of any cream, Treatment Group (P2) with a distribution of base cream (placebo), (P3) sunblock 33 SPF, (P4) 5%, (P5) 10 %, and (P6) 20 % smeared by purple cabbage ethanol cream extract. All groups exposed to UV-B with a total dose of 840 mJ/cm2 for 4 weeks. Then a sampling rats skin was done for examining the level of collagen skin with Sirius red staining. The level of collagen was calculated by the percentage of the area of the pixel of collagen and was compared with the pixels of entire dermal tissues.
Result: The result demonstrated that the mean of collagens in The First Group/P1 (57.74%) and P2 (60.84%) decreased more significantly than P3 (82.17%), P4 (68.23%), P5 (76.93%), and P6 (84.54%) following UV-B exposure. The Post Hoc result showed that there was no significant difference in the level of collagen in the control group and placebo group and the sunblock group with the purple cabbage’s ethanol cream extract group of 20% (p>0.05).
Conclusion: the distribution of purple cabbage ethanol cream extract prevented the decrease of dermal collagens on male Wistar rats skin exposed to UV-B.