Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Staphylococcal scalded skin syndrome pada bayi: laporan kasus
Alberto Afrian, Florencia Christina Sindhu, Peter Prayogo Hsieh, Felicia Emiliana Hosea, Anak Agung Made Sucipta, Tjokorda Dalem PemayunOnline First: Apr 30, 2022
- Abstract
Staphylococcal scalded skin syndrome pada bayi: laporan kasus
Background: Under-five populations are at higher risk of Staphylococcal Scalded Skin Syndrome (SSSS). The incidence of SSSS in developing countries is still a concern because the staphylococcal infection rate is high. This report aims to describe the clinical profiles of SSSS in infants below 1-year-old.
Case: 7 month-old baby boy came with a chief complaint of skin blister for 7 days. It had been preceded by erythema on the right axilla, which turned into blisters on both axilla, perioral, trunk region, and both extremities the following day. The complaint was accompanied by fever. Five days before, he had experienced the common cold. On examinations, he was alert, weighed 9.1 kg, with a heart rate of 134 beats/minute, respiratory rate 40 times/minute, SpO2 98%, and axillary temperature 37.8oC. There were crusts and blisters on the face and trunk with positive Nikolsky’s sign. Genital and lower extremities looked erythematous. Laboratory results showed leukocytes 19,240/uL, neutrophil 50.7%, lymphocytes 35.2%, hemoglobin 9.9 g/dL, hematocrit 30.2%, and platelet 679,000 /uL. He was diagnosed with SSSS and was suggested for hospitalization. He received maintenance fluid therapy with D5%:¼NS 100 ml/kg/day, Cefotaxime injection 3 x 35 mg/kg, Paracetamol syrup 3 x 10 mg/kg, Fusidic Acid 2% cream twice a day, Gentamicin eye ointment 0.3% twice a day, and non-adherent dressing twice a day. He was discharged in good condition after 5 days of hospitalization.
Conclusion: The knowledge about the clinical profiles of SSSS is important in order to give rapid management and reduce mortality.
Latar Belakang: Populasi di bawah usia 5 tahun rentan mengalami Staphylococcal scalded skin syndrome (SSSS). Di negara-negara berkembang, insidens SSSS masih tinggi karena infeksi staphylococcus masih banyak terjadi. Laporan kasus ini ditulis untuk memberi gambaran mengenai SSSS pada bayi berusia di bawah 1 tahun.
Kasus: Bayi laki-laki berusia 7 bulan dibawa dengan keluhan utama kulit melepuh sejak 7 hari sebelumnya. Keluhan didahului kemerahan di ketiak kanan dan keesokan harinya, kulit di ketiak kanan, kiri, dan daerah sekitar bibir, dada, perut, kemaluan, serta kedua tungkai melepuh. Dua hari kemudian, kulit di seluruh tubuh mengelupas. Keluhan disertai dengan demam. Lima hari sebelumnya, pasien mengalami pilek. Pada pemeriksaan, pasien sadar dengan berat badan 9,1 kg, denyut nadi 134 kali/menit, laju pernafasan 40 kali/menit, SpO2 98%, dan suhu aksila 37,8oC. Kulit tampak melepuh disertai krusta pada wajah, dada, abdomen,dan punggung. Tanda Nikolsky positif. Daerah ekstremitas bawah dan genital tampak kemerahan. Pemeriksaan darah menunjukkan leukosit 19.240/uL, neutrofil 50,7%, limfosit 35,2%, hemoglobin 9,9 g/dL, hematokrit 30,2%, dan trombosit 679.000 /uL. Dokter mendiagnosis pasien mengalami SSSS dan menyarankan rawat inap. Pasien menerima terapi cairan rumatan dengan D5%:¼NS 100 ml/kg/hari, Cefotaxime injeksi 3 x 35 mg/kg, Parasetamol sirup 3 x 10 mg/kg, krim Asam Fusidat 2% 2 kali/hari, salep mata Gentamisin 0,3% 2 kali/hari, dan perawatan luka 2 kali/hari. Setelah dirawat selama 5 hari, pasien sembuh dan diizinkan pulang.
Simpulan: Pengetahuan mengenai gambaran klinis SSSS penting untuk memberi tatalaksana yang cepat dan tepat sehingga mortalitas dapat ditekan.
Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review
Kevin Kusuman, Kadek Adit Wiryadana, Su Djie To RanteOnline First: Apr 30, 2022
- Abstract
Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review
Introduction. Inferior shoulder dislocation is considered a rare event. Although there is a seemingly low chance of occurrence, this condition should not be prematurely ruled out in the presence of acute shoulder pain.
Case. A 45 years old woman complained of pain in her left shoulder and was unable to bring her arm lower than 90° after a car accident. The patient unintentionally put her left arm outstretched above her head to avoid head impact during the crash, causing hyperabduction of the shoulder. She experienced pain, numbness and could not move the ipsilateral hand. Her left arm was locked in hyperabduction (100°), and her elbow was extended. Close inspection showed a loss of left shoulder contour. On palpation, the humeral head was palpable in the axilla. Anteroposterior X-ray view confirmed inferior dislocation of the left shoulder with associated greater tuberosity fracture. A closed reduction under general anesthesia with the traction-counter traction technique was conducted as commonly used in rural settings. After perfect anatomical reduction was obtained and confirmed with X-ray, the patient was immobilized using an arm sling. The shoulder was immobilized for three weeks in adducted position to support soft tissue healing. Physiotherapy was started after three weeks.
Conclusion. Inferior shoulder dislocation is a rare orthopedic pathology that should not be easily dismissed in post-traumatic shoulder pain. The mechanism of injury is characterized by downward force or lever mechanism on the hyperabducted arm. Orthopedic surgeons in rural areas could utilize the Traction-countertraction method.
Melanoma maligna orbita: sebuah laporan kasus
Ni Luh Putu Nurindah Sukmawati, Putu Yuliawati, Ni Made Laksmi UtariOnline First: Apr 30, 2022
- Abstract
Melanoma maligna orbita: sebuah laporan kasus
Introduction: Orbital melanoma (OM) is the most common type of primary intraocular neoplasm in adults. Although the incidence of OM is only 5% of melanoma tumors, OM causes death in 13% of melanoma tumors. The management of orbital melanoma originating from the uveal tissue is still controversial between surgical and nonsurgical therapy.
Case Report: A male patient, 63 years old, complained that the patient's right eye was said to have appeared a lump since five months ago with a size of 6 x 6 x 7 cm, blackish red in color with clinical signs of malignancy. The patient underwent orbital exenteration and the patient's condition had no recurrence or other complaints until four months after the procedure.
Conclusion: Orbital melanoma of uveal origin is a complex malignancy that requires a multidisciplinary approach to therapy and management. Early detection and adequate therapy are very important in increasing survival rates.
Pendahuluan: Melanoma orbita (MO) merupakan tipe yang paling sering dari neoplasma primer intraokular pada dewasa. Meskipun insiden MO hanya 5% dari tumor melanoma, namun MO menimbulkan kematian pada 13% akibat tumor melanoma. Tatalaksana melanoma orbita yang berasal dari jaringan uvea sampai saat ini masih kontroversial antara terapi bedah dan nonbedah. Laporan Kasus: Seorang pasien laki-laki, 63 tahun, mengeluh mata kanan pasien dikatakan muncul benjolan sejak lima bulan yang lalu dengan ukuran 6 x 6 x 7 cm, berwarna merah kehitaman dengan klinis mengarah keganasan. Pasien dilakukan eksenterasi orbita dan kondisi pasien tidak terdapat kekambuhan ataupun keluhan lain hingga empat bulan setelah tindakan.
Simpulan: Melanoma orbita yang berasal dari uvea merupakan keganasan yang kompleks yang membutuhkan pendekatan multidisiplin dalam terapi dan tatalaksana. Deteksi dini dan terapi yang adekuat sangat penting dalam upaya meningkatkan angka ketahanan hidup.
Congenital syphilis in neonates: a case report
I Gede Yogi Priyatna Biantara, Romy WindiyantoOnline First: Apr 30, 2022
- Abstract
Congenital syphilis in neonates: a case report
Background: Congenital syphilis (CS) in neonates is diagnosed when Treponema pallidum was identified in a laboratory test of neonates infected by mothers with syphilis. Recently, CS is still a significant and growing health problem worldwide despite being preventable. This case report will provide an overview of CS management conducted at our center, Sanjiwani Hospital, Gianyar, Bali-Indonesia.
Case presentation: We report a case of CS in a newborn female neonate with the positive result of TPHA and VDRL titer 1/128 from a mother diagnosed with the latent phase of syphilis infection. On physical examination found subcostal retraction of the chest, grunting on auscultation, and jaundice. The treatments given include oxygen via cannula nasal with 2 liters per minute, intravenous access with dextrose 10%, the antibiotic combination of cefotaxime 125 mg every 12 hours and gentamicin 12.5 mg every 24 hours. For the management of CS, the patient was given Benzathine Penicillin G at a dose of 125,000 IU single dose intramuscularly. Phototherapy was assisted the patient for 48 hours to manage the hyperbilirubinemia. The patient was discharged on the eight days of treatment with oral antibiotic cefixime 12.5 mg every twelve hours for three days.
Conclusion: The entity of CS is a disease suffered by infants with clinical manifestations or examination supporting the diagnosis of syphilis. The mother should do a screening during her pregnancy to prevent untreated syphilis and its complications for her babies.
Bibir sumbing dengan penyakit jantung bawaan: laporan kasus
Florencia Christina Sindhu, Peter Prayogo Hsieh, Anak Agung Made SuciptaOnline First: Apr 30, 2022
- Abstract
Bibir sumbing dengan penyakit jantung bawaan: laporan kasus
Background: Congenital malformations contribute to neonates’ mortality. Cleft lip is one of the most common congenital malformations. It’s usually accompanied by other organs’ malformations, such as cardiovascular system. This case report aims to increase the awareness about other congenital malformations which can accompany cleft lip.
Case: Baby girl born by sectio caesarea from 39 weeks of pregnancy with premature rupture of membrane. Antenatal USG examination showed that baby was in breech position and suspect congenital malformation. She cried immediately after delivery and had good muscle tone. On examinations, she weighed 2.200 grams, her length was 46 cm, and her head circumference was 30 cm. Her vital signs showed heart rate 152 beats/minute, respiratory rate 50 times/minute, temperature 36.8oC, and SpO2 98%. A cleft on right nose, lip, and palate was found. No abnormalities in thorax, abdomen, vertebra, and extremities examinations. Echocardiography examination showed suspect PFO, mild tricuspid regurgitation, and trivial mitral regurgitation. Her SpO2 dropped to 90% while in perinatology room so she received 0.5-1 liter/minute oxygen supplementation using nasal cannula. On the 7th day, we found secrets on both eyes. Gram examination was done and it tested negative. She received levofloxacin eye drop every 2 hours on both eyes. She was breastfed using specially-designed pacifier. On the 10th day, she was discharged in a good condition.
Conclusion: Cleft lip is usually accompanied by other organs’ malformations, such as cardiovascular system. Comprehensive examinations must be done for every baby born with cleft lip.
Latar Belakang: Malformasi kongenital berkontribusi terhadap angka mortalitas bayi. Bibir sumbing merupakan kelainan kongenital yang sering terjadi dan biasanya disertai malformasi organ lain, seperti sistem kardiovaskular. Penulisan laporan kasus ini bertujuan meningkatkan kewaspadaan terhadap kelainan bawaan yang mungkin menyertai bibir sumbing.
Kasus: Bayi perempuan dilahirkan secara sectio caesarea dari kehamilan berusia 39 minggu 6 hari yang disertai ketuban pecah dini. Pemeriksaan USG saat kehamilan menunjukkan bayi letak sungsang dan curiga kelainan kongenital. Ketika lahir, bayi segera menangis dan tonus kuat sehingga dilakukan perawatan rutin. Pada pemeriksaan, bayi memiliki berat lahir 2.200 gram, panjang badan 46 cm, dan lingkar kepala 30 cm. Tanda vital menunjukkan denyut jantung 152 kali/menit, laju pernafasan 50 kali/menit, suhu 36.8oC, dan SpO2 98%. Pada pemeriksaan kepala ditemukan celah pada hidung, bibir, dan langit-langit mulut kanan serta tidak ditemukan kelainan pada thoraks, abdomen, vertebra, dan ekstremitas. Pemeriksaan echocardiography menunjukkan suspek PFO, mild tricuspid regurgitation, dan trivial mitral regurgitation. Saat perawatan di ruang perinatologi, terjadi penurunan SpO2 menjadi 90% sehingga bayi menerima suplementasi oksigen dengan kanula nasal 0.5-1 liter/menit. Pada hari ke 7, ditemukan sekret putih kekuningan di kedua mata sehingga dilakukan pemeriksaan gram dan hasilnya negatif. Bayi kemudian diberikan levofloksasin tetes mata setiap 2 jam di kedua mata. ASI tetap diberikan menggunakan dot khusus dan pada hari ke 10 bayi diizinkan pulang dalam keadaan baik.
Simpulan: Bibir sumbing biasanya disertai kelainan organ lain seperti sistem kardiovaskular. Oleh karena itu, pemeriksaan yang komprehensif harus dilakukan pada setiap kasus bibir sumbing.
Breathing exercise and chest physiotherapy in post-acute COVID-19 patient: a case report
Nyoman Chandra Adidharma, Bagus Diva Indra Dharma, Kade Ngurah Dwi Putra Negara, I Gede Adi SudewaOnline First: Apr 30, 2022
- Abstract
Breathing exercise and chest physiotherapy in post-acute COVID-19 patient: a case report
Background: Severe acute respiratory syndrome (SARS CoV2) and coronavirus disease 2019 causes vary from mild to severe clinical manifestation. Complications from COVID-19 can show several manifestations such as pulmonary, cardiovascular, neuromuscular, and renal systems, which could lead to multi-organ failure. Lung fibrosis and recurrent pneumonia are some of some sequelae of survivors, and some need readmission to hospital, although the PCR swab test remains negative. Post-acute COVID-19 is a syndrome characterized by persistent clinical symptoms beyond four weeks from the onset of acute symptoms.
Case: In this writing, a 57-year-old male presented with chief complaints of shortness of breath and cough 2 days after being discharged from the hospital because of a COVID-19 infection. His PCR swab test result remains negative when readmission. The patient was on non-invasive ventilation, medical therapy and physical therapies such as breathing exercises and chest physiotherapy. The physical therapy was done twice daily. On the seventh day of exercise, the shortness of breath was improved, and NIV was tapered down. The patient was discharged after 27 days of hospitalization.
Conclusion: This case shows the benefit of breathing exercises and chest physiotherapy for the Post-acute COVID-19 patient. This helps improve respiratory muscle strength and chest expansion in order to improve oxygen perfusion.
Perpanjangan hasil Polymerase Chain Reaction (PCR) pada pasien Acquired Immunodeficiency Syndrome (AIDS): laporan kasus
Yoelius Wijaya Saputra, I Komang Parwata, Ni Komang KrisnawatiOnline First: Apr 30, 2022
- Abstract
Perpanjangan hasil Polymerase Chain Reaction (PCR) pada pasien Acquired Immunodeficiency Syndrome (AIDS): laporan kasus
Background: Since its emergence in Wuhan in 2019, SARS-Cov-2 has become the virus that causes the ongoing pandemic situation. The number of infected humans continues to grow over time. Moreover, there is also the HIV virus which continues to be a global health problem. To date, the available data on the coinfection of SARS-Cov-2 with AIDS are limited.
Case Presentation: This patient was found to have prolonged positive results on the Polymerase Chain Reaction (PCR) examination for 113 days. Female patient, aged 48 years, with complaints of shortness of breath since 3 days before admission to the hospital. Physical examination of the patient was compos mentis with a pulse rate of 113 beats per minute and a body temperature of 37.40C. On auscultation, crackles were found in both lung fields. The patient had anemia, leucocytosis, neutrophilia, lymphopenia, and elevated D-dimer.
Conclusion: The destruction of CD4 and CD8 in AIDS patients can provide a protective effect against the inflammatory process and cytokine storm, but this milder symptom causes inadequate production of neutralizing antibodies. This low number of Neutralizing Antibodies causes prolonged PCR results in SARS-Cov-2 patients.
Latar Belakang: Sejak kemunculannya di Wuhan tahun 2019, SARS-Cov-2 telah menjadi virus yang menyebabkan situasi pandemik yang sedang berlangsung. Data manusia yang terinfeksi terus bertambah dengan sejalannya waktu. Disamping itu terdapat juga virus HIV yang terus menjadi masalah kesehatan global. Sampai saat ini, data yang tersedia tentang ko-infeksi penyakit SARS-Cov-2 dengan AIDS masih terbatas.
Presentasi Kasus: Pada pasien ini ditemukan perpanjangan hasil positif pada pemeriksaan Polymerase Chain Reaction (PCR) selama 113 hari. Pasien perempuan, usia 48 tahun dengan keluhan sesak nafas sejak 3 hari sebelum masuk rumah sakit. Pemeriksaan fisik pasien compos mentis dengan laju nadi 113 kali permenit dan suhu tubuh 37,40 C. Pada auskultasi ditemukan ronchi di kedua lapang paru. Pasien mengalami anemia, leukositosis, neutrofilia, limfopenia, dan peningkatan D-dimer.
Simpulan: Destruksi CD4 dan CD8 pada pasien AIDS dapat memberikan efek protektif terhadap proses inflamasi dan badai sitokin, akan tetapi gejala yang lebih ringan ini menyebabkan produksi Neutralizing Antibody yang terbentuk tidak adekuat. Jumlah Neutralizing Antibody yang kurang ini menyebabkan pemanjangan hasil PCR pada pasien SARS-Cov-2.
Kasus kromoblastomikosis yang awalnya diduga furunkel pada seorang perempuan
Roslina Horo, Ni Luh Putu Ratih Vibriyanti Karna, Ni Putu Ayu Riska Yunita SariOnline First: Apr 30, 2022
- Abstract
Kasus kromoblastomikosis yang awalnya diduga furunkel pada seorang perempuan
Background: Chromoblastomycosis is a chronic profound fungal infection caused by dematiaceous from the surrounding environment. Trauma was the site of fungal implantation. The prevalence is mainly in agriculture workers. The clinical picture varies. Diagnosis is made when muriform cells are found. Early diagnosis is very important because it affects the prognosis.
Case Description: A woman, 24 years old, Balinese, went to The Skin and Genital Polyclinic of Sanglah General Hospital with the main complaint of boils in the area below the left knee six months ago. It starts from red papules and then becomes a painless lump. The lump breaks and contains yellowish pus. Patients have a history of gardening. Physical examination within normal limits. Dermatological status on left cruris, there are solitary erythema nodules, firm borders, round shape, a diameter of 2.5 cm, smooth and shiny surface, and fluctuations containing yellowish pus. From sabouraud dextrose agar culture (SDA) obtained the growth of Cladophialophora carrionii. The diagnosis was chromoblastomycosis. Patients were given a pulse dose of itraconazole 400 mg every 24 hours intraorally. There was a clinical improvement.
Conclusion: There have been reported cases of chromoblastomycosis that were initially suspected to be furuncle in a 24-year-old woman. Diagnosis is made based on anamnesis, physical examination, and laboratory examination. Patients were given a pulse dose of itraconazole. There was a clinical improvement. The prognosis is dubius ad bonam. Extended observations still need to monitor the clinical and mycological healing, medication side effects and complications of the disease.
Latar belakang: Kromoblastomikosis adalah infeksi jamur profunda kronik yang disebabkan oleh dematiaceous yang berasal dari lingkungan sekitar. Penyakit ini biasanya diawali oleh trauma sebagai situs implantasi jamur. Prevalensi penyakit ini terutama pada individu yang bekerja di bidang agrikultural. Gambaran klinis kromoblastomikosis bervariasi. Penegakan diagnosis bila ditemukan sel muriform pada jaringan. Diagnosis dini pada lesi awal sangat penting karena mempengaruhi prognosis penyakit.
Deskripsi kasus: Seorang perempuan, 24 tahun, suku Bali, berobat ke Poliklinik Kulit dan Kelamin RSUP Sanglah Denpasar dengan keluhan utama bisul pada area bawah lutut kiri sejak 6 bulan yang lalu. Awalnya berupa bintil kemerahan lalu menjadi benjolan yang tidak nyeri. Benjolan pecah dan mengeluarkan nanah. Pasien memiliki hobi berkebun. Pemeriksaan fisik dalam batas normal. Status dermatologi pada regio kruris sinistra terdapat nodul eritema soliter, batas tegas, bentuk bulat, diameter 2,5 cm, permukaan halus dan mengkilap, tampak fluktuasi berupa pus kekuningan. Pemeriksaan kultur sabouraud dextrose agar (SDA) didapatkan pertumbuhan Cladophialophora carrionii. Diagnosis kerja adalah kromoblastomikosis. Pasien diterapi dengan itrakonazol 400 mg setiap 24 jam intraoral dosis denyut dan terdapat perbaikan klinis pada lesi.
Simpulan: Telah dilaporkan kasus kromoblastomikosis yang awalnya diduga furunkel pada seorang perempuan usia 24 tahun. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang. Pasien diberikan terapi itrakonazol dosis denyut dan tampak perbaikan klinis yang signifikan pada lesi. Prognosis pada pasien dubius ad bonam. Pengamatan lanjutan masih perlu dilakukan untuk mengamati kesembuhan secara klinis maupun mikologi, efek samping terapi, dan komplikasi penyakit.
Bronkiolitis akut pada bayi: laporan kasus
Peter Prayogo Hsieh, Florencia Christina Sindhu, Fricillia MapantowOnline First: Apr 30, 2022
- Abstract
Bronkiolitis akut pada bayi: laporan kasus
Introduction: Acute respiratory tract infection (ARI) is the major cause of mortality and morbidity in low – and middle–income countries. Bronchiolitis is the most common respiratory tract infection in <2 years old individuals but is often confused with bronchial asthma. This report aims to describe the difference between those two diseases.
Case: Eight–month–old baby girl presented with shortness of breath, abnormal breathing sound, productive cough, fever, nasal discharge, and vomiting for 3 days. She’s got a history of abnormal breathing sound at 4 months old. Parents had no history of allergy or asthma. On examination, she was alert, weighed 6,8 kg, had an axillary temperature of 37°C, heart rate of 128/min, respiratory rate of 56/min with subcostal retraction, rhonchi, and wheezing on both chests. Laboratory findings showed hemoglobin of 11,2 g/dL, hematocrit of 32,3%, leukocyte count of 10.810/mm³, thrombocyte count of 361.000/mm³. Serum electrolytes and blood sugar levels were within normal limits. Chest radiograph showed patchy perihilar infiltrates on both lungs and hyperinflation. She was diagnosed with bronchiolitis and was treated with KAEN3B 700 cc/24 hours, nasal oxygen 2 L/min, 3 x 200 mg ampicillin, 2 x 15 mg gentamicin, 3 x 1 mg dexamethasone, ipratropium bromide and albuterol nebulization 3 times daily, 3 x 70 mg oral paracetamol. Her condition improved, and she was discharged after 7 days of hospitalization.
Conclusion: There are fundamental differences in clinical profiles between bronchiolitis and bronchial asthma, which have to be carefully examined to prevent misdiagnosis.
Latar Belakang: Infeksi saluran pernafasan akut (ISPA) merupakan masalah utama penyebab mortalitas dan morbiditas di negara berpenghasilan menengah ke bawah. Bronkiolitis merupakan salah satu infeksi saluran nafas tersering pada anak berusia di bawah 2 tahun yang sering dikira sebagai asma bronkial. Laporan ini bertujuan untuk memberi gambaran perbedaan antara kedua penyakit tersebut.
Kasus: Bayi perempuan berusia 8 bulan datang dengan keluhan sesak, suara nafas abnormal, batuk berdahak, demam, pilek, dan muntah selama 3 hari. Pasien memiliki riwayat suara nafas abnormal pada usia 4 bulan. Baik pasien maupun orangtua tidak memiliki riwayat alergi maupun asma bronkial. Pada pemeriksaan fisik, pasien sadar, berat badan 6,8 kg, suhu aksila 37° C, nadi 128 kali/menit, laju pernafasan 56 kali/menit, dan didapatkan retraksi subkostal, ronkhi, serta wheezing pada kedua lapang paru. Hasil laboratorium menunjukkan kadar hemoglobin 11,2 g/dL, leukosit 10.810/mm3, trombosit 361.000/mm3, hematokrit 32,3% dengan kadar elektrolit normal. Pemeriksaan foto toraks menunjukkan gambaran hiperinflasi serta patchy infiltrates pada perihilar kanan dan kiri. Pasien didiagnosis menderita bronkiolitis dan mendapatkan terapi cairan dengan KAEN3B 700 cc/ 24 jam, injeksi ampisilin 3 x 200 mg, injeksi gentamicin 2 x 15 mg, injeksi dexamethasone 3 x 1 mg, nebulisasi ipratropium bromide dan albuterol 3 kali/ hari, serta parasetamol oral 3 x 70 mg. Pada hari ke 7, pasien dipulangkan dalam kondisi sehat.
Simpulan: Terdapat perbedaan mendasar pada gejala klinis bronkiolitis dan asma bronkial yang jika tidak dicermati dengan hati – hati akan menyebabkan kesalahan diagnosis.
Penetrating ocular injury due to fish hook accident: A case report
Nyoman Tarita Dewi, Putu Rima Adilitha Widyasari, Fazella Kirara Sakti, Ida Ayu Putri KartiningsihOnline First: Feb 24, 2022
- Abstract
Penetrating ocular injury due to fish hook accident: A case report
Introduction: Open globe trauma is caused by sharp objects (lacerations) or blunt objects (ruptures). Lacerations can be divided into three parts: penetrating wound, intraocular foreign body (IOFB), and perforating wounds. One of the ocular laceration trauma that needs to be aware of is the penetration of fishing hooks. There are two important aspects of injuries due to fishing hooks: intraocular foreign bodies and infections.
Case description: The patient of a 4-year-old girl with a chief complaint left eye was exposed to a fishing hook approximately 3 hours before coming to the hospital. Ophthalmological examination was obtained visual acuity on the right eye fixes and follow the object. Examination of the anterior segment of the right eye was found corneal edema, penetrating injury due to fish hook direction at nine o'clock. The fish hook was stick on the entire thickness of the cornea. Then we also found iris trauma and opacity in the lens. The patient was diagnosed with traumatic cataracts with ocular iridolysis dextra. Initial therapy is tobroson eye drop 1 drop every 3 hours, cefadroxil syrup three times a day, and methylprednisolone 3x1/2 tablets. The patient was advised to undergo surgery.
Conclusion: Initial management should be quick and careful to aggravate the trauma. Adequate eye protection and supervision are necessary to prevent fishing hook trauma, especially children.
Serial kasus pneumonia neonatal dengan kemungkinan transmisi vertikal SARS-CoV-2 pada masa kehamilan
Ida Ayu Sri Kusuma Dewi, Ade Tsarina IndiraOnline First: Feb 26, 2022
- Abstract
Serial kasus pneumonia neonatal dengan kemungkinan transmisi vertikal SARS-CoV-2 pada masa kehamilan
Background: The vertical transmission of SARS-CoV-2 from pregnant women to fetuses during pregnancy is still under debate. However, the incidence of COVID-19 in neonates born to mothers with SARS-Cov-2 infection is increasing. Several case reports suspect that the possibility of transmission of SARS-CoV-2 can occur vertically through the placenta. Most neonates with COVID-19 infection experience mild illness, but some develop severe symptoms.
Case Report: We report two cases of neonates with Neonatal Pneumonia born to mothers with COVID-19 infection. The first case is a baby born to a mother infected with COVID-19 with placenta previa totalis. The baby was born with severe asphyxia. The second case was a baby born to a mother infected with COVID-19 with premature membrane rupture. The baby experiences respiratory distress after four days of age. An RT-PCR swab examination was performed in both cases, and the results were positive. After intensive care, both babies were discharged in stable condition.
Conclusion: The vertical transmission of SARS-CoV-2 is still under debate. Examinations other than nasopharyngeal RT-PCR swabs such as peripheral blood examinations for mother and baby, placenta, umbilical cord, umbilical cord blood, amniotic fluid are needed to support vertical transmission. In this case report, we could only perform the Nasopharyngeal RT-PCR swab test due to various limitations.
Latar Belakang: Transmisi vertical SARS-CoV-2 dari ibu hamil ke janin selama masa kehamilan masih dalam perdebatan. Namun Angka kejadian COVID-19 pada neonatus yang lahir dari ibu dengan infeksi SARS-Cov-2 tersebut kian meningkat. Beberapa laporan kasus mencurigai bahwa kemungkinan transmisi dari SARS-CoV-2 dapat terjadi secara vertikal melalui plasenta. Sebagian besar neonatus dengan infeksi COVID-19 ini mengalami gejala ringan, namun beberapa berkembang menjadi berat.
Laporan Kasus: Pada laporan ini, kami melaporkan dua kasus neonatus dengan pneumonia neonatal yang lahir dari ibu dengan infeksi COVID-19. Kasus pertama merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan plasenta previa totalis, bayi lahir dengan asfiksia berat. Kasus kedua merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan ketuban pecah dini (KPD), bayi mengalami distress napas setelah usia 4 hari. Pada kedua kasus ini dilakukan pemeriksaan swab RT-PCR dan mendapatkan hasil positif. Setelah dilakukan perawatan intensif, kedua bayi dipulangkan dengan kondisi stabil.
Kesimpulan: Transmisi vertikal SARS-CoV-2 masih dalam perdebatan. Pemeriksaan selain swab RT-PCR nasofaring seperti pemeriksaan darah perifer pada ibu dan bayi, plasenta, tali pusat, darah tali pusat, cairanan amnion dibutuhkan untuk menunjang adanya suatu transmisi vertikal. Pada laporan kasus ini kami hanya dapat melakukan tes swab RT-PCR nasofaring dikarenakan keterbatasan pemeriksaan.
Persistent secondary spontaneous pneumothorax as a complication of tuberculosis infection: a case report
Ni Made Lintya Andani, Putu Diah SavitriOnline First: Feb 28, 2022
- Abstract
Persistent secondary spontaneous pneumothorax as a complication of tuberculosis infection: a case report
Introduction: A pneumothorax is a collection of air outside the lung contained within the pleural cavity. Primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax (SSP) are two types of spontaneous pneumothorax that differ due to the underlying illness. If the patient has a history of pulmonary disease, including tuberculosis infection, SSP may be present. Chest X-rays, chest ultrasonography, and CT scans are imaging tests that can be used to diagnose pneumothorax. We report a case of a 20-year-old man with persistent secondary spontaneous pneumothorax as a complication of tuberculosis infection.
Case description: A 20-year-old man complained of shortness of breath two weeks before being admitted to the hospital. He had a story of a TB infection. A chest X-ray and a CT scan were used to assess the patient. The pneumothorax is seen with the sign of reactive old tuberculosis. The surgeon inserted a chest tube drainage to empty the pneumothorax. However, following the assessment, the pneumothorax grew even larger than before.
Conclusion: Clinical evaluation should probably be the key determinant of the care strategy and assist with the initial diagnosis. Imaging modalities can help confirm a pneumothorax diagnosis and provide information about the extent of the pneumothorax.
Non-eosinofilia pada Infeksi Trichuris trichiura: sebuah laporan kasus
I Made Cahyadi Dwi Putra, I Nyoman Gde Sumardika, I Made Dharma Pramana, Ni Luh Putu Siska Kahari SariOnline First: Apr 6, 2022
- Abstract
Non-eosinofilia pada Infeksi Trichuris trichiura: sebuah laporan kasus
Background: Trichuris trichiura or whipworm is a Platyhelminthes parasite infecting the human gastrointestinal tract. Trichuris trichiura is a soil-transmitted helminth (STH). A tropical climate like Indonesia is an ideal place for STH. Prevalence of STH is still high in Indonesia, ranging from 2,5 – to 62 %. This parasite lives in the human colon, consuming blood, and nutrition from its host as well as usually manifests with eosinophilia incomplete blood count. However, this case study aims to evaluate the non-eosinophilia in Trichuris trichiura infection.
Case Presentation: In this case, the patient is an 11 years old male with symptoms of diarrhea and dehydration; there are also signs of mild dehydration from a physical examination. Several tests are taken to assess the cause of diarrhea, such as a complete blood count (CBC) test which the result is only leukocytosis and slight monocyte increase, no elevation of eosinophil. Trichuris trichiura egg was found on the microscopic stool observation.
Conclusion: Some studies show a significant association between the elevation of eosinophil and trichuriasis infection. However, the case report shows leukocytosis only, without elevation of eosinophil. Eosinophilia could be used as a marker of Trichuriasis infection, especially in the acute phase, but not all trichuriasis infections are followed by eosinophilia. This might be because of the natural course of the disease itself and the defense mechanism of the parasite.
Latar Belakang: Trichuristrichiura atau cacing cambuk adalah parasit dari jenis cacing pipih yang menyerang saluran pencernaan manusia.Trichuris trichiura merupakan jenis cacing soil-transmitted helminth (STH) yang dapat berkembang biak dengan baik di iklim tropis seperti Indonesia. Prevalensi kecacingan di Indonesia masing cukup tinggi dan angkanya bervariasi di tiap wilayah, berkisar antara 2,5 – 62 %. Parasit ini hidup di usus besar manusia, memakan darah, dan nutrisi dari inangnya serta biasanya bermanifestasi dengan eosinofilia dalam hitung darah lengkap. Namun, studi kasus ini bertujuan untuk mengevaluasi non-eosinofilia pada infeksi Trichuris trichiura.
Presentasi Kasus: Kasus yang kami dapatkan adalah anak laki-laki 11 tahun dengan keluhan buang air besar cair dan dehidrasi. Pada pemeriksaan fisik didapatkan tanda dehidrasi ringan. Untuk mencari penyebab keluhannya dilakukan beberapa pemeriksaan penunjang yaitu pemeriksaan darah lengkap dimana didapatkan peningkatan pada sel darah putih dan sedikit peningkatan monosit, namun tidak disertai dengan peningkatan eosinofil. Pada pemeriksaan feses didapatkan gambaran telur cacing Trichuris trichiura.
Kesimpulan: Beberapa penelitian menyatakan bahwa ada hubungan yang signifikan antara peningkatan eosinofil dengan trichuriasis. Namun, pada pasien ini hanya didapatkan leukositosis tanpa diikuti dengan peningkatan eosinofil. Eosinofil dapat dijadikan penanda infeksi terutama pada fase awal trichuriasis, namun tidak semua kasus ditemukan eosinofilia. Hal ini dapat terjadi karena mekanisme perjalanan penyakit itu sendiri dan juga mekanisme pertahanan dari parasit (Trichuristrichiuria) itu sendiri.
Case report: a rare case of ocular leptospirosis
I Made Surya Dinajaya, Ida Ayu Ary Pramita, I Gusti Ayu Made Juliari, Ni Ketut Niti Susila, I Made Agus KusumadjajaOnline First: Apr 11, 2022
- Abstract
Case report: a rare case of ocular leptospirosis
Background: Ocular leptospirosis is a rare condition. Transmission of leptospirosis is caused by the bacterium leptospira interrogans transmitted directly or indirectly from animals to humans (zoonosis). Ocular manifestations often caused by leptospirosis are conjunctivitis, keratitis, uveitis (anterior, intermediate, posterior, and panuveitis), complicated cataracts, choroiditis, papillitis, and macular edema. Uveitis is a latent manifestation of leptospirosis. Proper management can lead to a good prognosis of visual.
Case Presentation: Male patient, 55 years old, with complaints of both red and blurry eyes since 5 days. Blurring comes slowly with pain, glare, and seeing shadows like spider webs. The patient's previous medical history was hospitalized because of Weil's disease. Examination of the anterior segment of both eyes revealed eyelid spasm, conjunctival injection, corneal infiltrate, keratic precipitate, and posterior synechiae on both eyes. While in the posterior segment found cells 4+ in the vitreous. The patient was treated with antibiotics and topical steroids, and visual acuity was improved.
Conclusion: Leptospirosis uveitis can have various presentations during the acute and chronic phases of the disease. Even when ocular involvement is extensive and severe, most patients have a good visual prognosis with appropriate therapy. Timely diagnosis is essential to maximize the potential for visual acuity improvement and appropriate systemic monitoring and treatment of extraocular involvement in this potentially fatal condition. Good sanitation in the community plays an important role in preventing exposure to leptospirosis.
Teledermatology for managing COVID-19 patients with cutaneous manifestation: case series study in a rural primary hospital
Dedianto Hidajat, Hamsu Kadriyan, Slamet TjahjonoOnline First: Apr 28, 2022
- Abstract
Teledermatology for managing COVID-19 patients with cutaneous manifestation: case series study in a rural primary hospital
Background: To provide information and experience about using WhatsApp as a tool in teledermatology to facilitate the identification, treatment, and follow-up of skin problems in COVID-19 patients hospitalized at one of a rural primary hospital located in Indonesia.
Methods: All COVID-19 patients with the dermatology manifestation were included in this study. All symptoms and signs of cutaneous manifestation and teledermatology consultation aspect were recorded.
Results: There were 7 cases confirmed with skin manifestation (0.9%) from 783 hospitalized patients from March 2020 to June 2021. There were 5 males and 2 females. The age range was 50 - 66 years old. Pruritus is the main complaint, followed by pain and swelling. The cutaneous lesions were mainly maculopapular, followed by papulovesicular and edematous eruptions. The onset of the lesions appeared between the 2nd and 12th day during hospitalization. Both patients and physicians feel comfortable using this platform in consultation.
Conclusion: There are advantages and disadvantages to utilizing this concept in the medicolegal aspects, including non-uniform audio-visual quality and also ethical and privacy issues, especially in a rural area.Incontinentia pigmenti in neonate: a case report
Putu Gde Hari Wangsa, Luh Made Mas Rusyati, I Gusti Ayu Agung Dwi Karmila, Ni Luh Putu Ratih Vibriyanti Karna, Ketut Wida Komalasari, Made Hermina LaksmiOnline First: Apr 30, 2022
- Abstract
Incontinentia pigmenti in neonate: a case report
Background: Incontinentia pigmenti (IP) is a rare X-linked dominant inherited genodermatosis that occurs almost in females and is usually accompanied by other ectodermal tissue diseases such as the central nervous system, eyes, hair, nails, teeth and skeletal system. This case report aims to enhance understanding of incontinentia pigmenti and provide appropriate treatment to patients and proper education to families.
Case report: A 3-days-od baby girl was consulted by the Pediatric department with complaints of blisters and erythematous rashes on almost her entire body with the Blaschko line distribution. The nails on the right and left big toes appeared inward. No history of fever and seizure. No family had similar complaints. There were no eye and nerve abnormalities involved. She treated with hydrocortisone 1% cream every 12 hours on erythematous papules and vesicles, open compresses with 0.9% NaCl every 8 hours for 10-15 minutes on lesions with yellowish crusts. Thus, the patient diagnosed with incontinentia pigmenti.
Conclusion: The diagnosis of incontinentia pigmenti is based on history and physical examination. This case is very rare, so the family needs to understand the course of this disease. Appropriate management and education can prevent secondary infection.
Psychospiritual in palliative care services: a literature review
I Putu Candra Sasmita Sutarta, Ni Ketut Putri ArianiOnline First: Apr 30, 2022
- Abstract
Psychospiritual in palliative care services: a literature review
Background: Palliative care provide holistic services at the physical, mental, and spiritual levels. Spiritual care is an intrinsic and essential component of palliative care that WHO has recognized. However, spiritual care is still not widely known by the community and health workers in the practice of palliative care.
Methods: This literature review was written based on various books, journals, and scientific articles that related to spiritual care in palliative care. The quantitative and qualitative data were obtained, then collected and sorted into a report based on the appropriate topic.
Result: Spirituality is one of the fundamental dimensions in the quality of life and maintaining culture. Thus, spirituality is an important component of palliative care. Many palliative patients understand their spiritual needs and want health professionals to help them address these needs. Various existing studies show that spiritual care provides benefits, especially in emotional needs and the search for meaning in life at the end of life. Palliative care professionals can provide spiritual care, but spiritual care is complex and requires specialized knowledge, expertise, and experience in assessing and meeting patient needs, requiring further training and education.
Conclusion: Various studies have shown that palliative patients need psychospiritual care to support comfort and meaning in their lives towards the end of life. So, psychospiritual care in palliative care needs to be implemented and improved, especially in training for palliative care teams.
Tatalaksana fiksasi terbuka dengan Plat vs Arm Sling pada fraktur midshaft klavikula: tinjauan pustaka sistematis
Anak Agung Gde Radityaningrat, Ketut Gede Mulyadi RidiaOnline First: Apr 30, 2022
- Abstract
Tatalaksana fiksasi terbuka dengan Plat vs Arm Sling pada fraktur midshaft klavikula: tinjauan pustaka sistematis
Background: Clavicle fracture is one of the most common fractures according to the Allman and Robinson classification. In Indonesia, clavicle fractures account for 2.6-4% of all fractures in adults. There are two types of modalities in the treatment of clavicle fractures: operative and non-operative. This systematic literature review aims to compare the two modalities to see which treatment is better in terms of bone union time, pain score, assessing return of shoulder function after therapy, and complication rates for each treatment group.
Methods: The strategy used is comparing several journals of non-operative and operative management for the midshaft clavicle fractures in adults. The selected reporting items is by using Systematic Review and Meta-Analysis Guidelines (PRISMA) to conduct comprehensive data collection.
Results: The results are presented with a comparison of the ORIF Plate with the Arm Sling for treatment outcomes. This research identified 11 relevant articles on the comparison of ORIF Plate with Arm Sling for treating clavicle midshaft fractures in adults. The number of patients was 1,333 patients. These articles compared bone union time, pain scores, assessing post-therapy return of shoulder function, and complication rates.
Conclusion: Operative management of midshaft clavicle displacement fracture with ORIF Plate gives better results than conservative management with Arm Sling.
Latar Belakang: Fraktur klavikula merupakan salah satu fraktur yang sering di terjadi menurut klasifikasi Allman dan Robinson. Di Indonesia fraktur klavikula berkontribusi sebesar 2,6-4% dari seluruh fraktur pada orang dewasa. Terdapat dua jenis modalitas dalam tatalaksana fraktur klavikula yaitu dengan operatif dan non operatif. Tinjauan pustaka sistematis ini bertujuan untuk membandingkan kedua modalitas tersebut untuk melihat tatalaksana mana yang lebih baik dalam hal waktu tulang untuk menyatu (union), skor nyeri, menilai kembalinya fungsi bahu pasca terapi, dan tingkat komplikasi yang terjadi dari masing- masing kelompok terapi. Strategi yang digunakan adalah dengan membandingkan beberapa jurnal tatalaksana non operatif dan operatif untuk penanganan fraktur midshaft klavikula pada orang dewasa. Butir pelaporan yang dipilih menggunakan Tinjauan Sistematis dan Pedoman Meta-Analisis (PRISMA) untuk melakukan pengumpulan data yang komprehensif. Hasilnya disajikan dengan perbandingan antara ORIF plate dengan Arm Sling untuk hasil pengobatan. Penelitian ini mengidentifikasikan 11 artikel yang relevan tentang perbandingan antara ORIF Plate dengan Arm Sling untuk mengobati fraktur midshaft klafikula pada orang dewasa. Jumlah pasien sebanyak 1.333 pasien. Artikel – artikel tersebut membandingkan waktu tulang untuk menyatu (union), skor nyeri, menilai kembalinya fungsi bahu pasca terapi, dan tingkat komplikasi. Tatalaksana operatif pada fraktur displace midshaft clavicula dengan ORIF Plate memberikan hasil lebih baik dibandingkan dengan tatalaksana konservatif dengan Arm Sling.
The potential role of vitamin D supplementation in the treatment of Dry Eye Disease (DED): a systematic review
Tiara Alexander, Eunike CahyaningsihOnline First: Apr 30, 2022
- Abstract
The potential role of vitamin D supplementation in the treatment of Dry Eye Disease (DED): a systematic review
Background: Dry Eye Disease (DED) is a prevalent condition that involves instability, increased osmolarity, and inflammation of the tear film and ocular surface. Vitamin D is known for its anti-inflammatory properties. Association between vitamin D deficiency and increased incidence of DED has been suggested. However, no study currently exists that systematically reviews the potential role of vitamin D as a treatment for DED.
Methods: The literature search was performed on December 2021 through PubMed, Scopus, ProQuest, EBSCOhost, ScienceDirect, dan Cochrane Library using the relevant keywords. The risk of bias was assessed using the Cochrane Risk of Bias tool, ROBINS-I tools, and the Newcastle-Ottawa Scale.
Results: A total of 700 articles were found, 6 of which were considered relevant based on PRISMA protocol. The included articles consist of 2 case controls, a randomized interventional study, and 3 observational studies. Vitamin D supplementation improved tear stability, symptoms of dry eye disease, and serum vitamin D level affected the efficacy of topical therapy for DED.
Conclusion: Despite this beneficial finding, serum vitamin D level does not significantly correlate with DED symptoms which the multifactorial nature of the disease might cause.
Chronic osteomyelitis treatment with PerOssal®: a literature review
I Kadek Riyandi Pranadiva Mardana, Anak Agung Ngurah Ronny Kesuma, I Komang Agus Krisna Saputra, I Komang Mahendra LaksanaOnline First: Apr 30, 2022
- Abstract
Chronic osteomyelitis treatment with PerOssal®: a literature review
Chronic osteomyelitis is an inflammatory process in the bone followed by bone destruction caused by microorganism infection. The annual incidence of osteomyelitis is approximately 21.8 cases per 100,000 person-years in the general population. Implanting antibiotic-loaded carriers directly at the site of infection becomes a promising treatment approach. PerOssal® is an osteoconductive synthetic bone substitute for restoring and filling bone defects. PerOssal® pellets contain 51.1% nanocrystalline hydroxyapatite and 48.5% calcium sulfate. It has a role as bone material to fill bone defects caused by dead bone in chronic osteomyelitis. The porosity of PerOssal® allows a high initial antibiotic release, then decreases to ensure a local concentration of the antibiotic. PerOssal® did not show any in vitro cytotoxicity and fatal adverse event as bone material. PerOssal® is a promising antibiotic-loaded carrier for the management of chronic osteomyelitis. It demonstrates good biocompatibility with initial high antibiotic release without in vitro cytotoxicity and fatal adverse event.
Platelet-rich plasma (PRP) on orthopedic clinical daily practice: a literature review
Anthony Gunawan, Anak Agung Ngurah Ronny Kesuma, I Komang Agus Krisna Saputra¬¬, I Komang Mahendra LaksanaOnline First: Apr 30, 2022
- Abstract
Platelet-rich plasma (PRP) on orthopedic clinical daily practice: a literature review
The use of PRP (platelet-rich plasma) is beneficial and even more important in the future. The most common indications were tendon damage (77%), osteoarthritis (68%), muscle damage (57%) and cartilage damage (51%). It is a purified autologous blood product with a higher platelet concentration than whole blood. It is rich in various cytokines and growth factors and has been shown to initiate and enhance healing by stimulating cell migration, cell proliferation, angiogenesis, and matrix synthesis. In rotator cuff injury, PRP injection led to significant long-term pain relief but not in functional improvements. In Osteoarthritis, PRP injection is associated with long-term pain relief and function improvements. PRP injection has a better outcome in VAS (visual analog scale) and DASH (The Disabilities of the Arm, Shoulder and Hand) scores in elbow ulnar collateral ligament pathologies, including lateral elbow epicondylitis. In medial epicondylitis, a paucity of studies causing therapeutic modality for PRP has not yet been established. In acute muscle injury, PRP used has no differences in imaging, pain, ROM (range of motion), muscle strength, and muscle function. In Achilles Tendinopathy, PRP injection has been associated with improvement in VAS, but no difference in VISA-A (The Victorian Institute of Sports Assesment – Achilles Questionnaire) score. However, the majority of published literature is secondary and tertiary evidence. Future studies could provide important information about the optimal concentrations of growth factors, platelets and leukocytes required for the desired effect in many specific tissues, as well as the appropriate method of administration and timing of drug application.
Akurasi otoskopi video digital dalam mendiagnosis otitis media akut pada pasien pediatri: sebuah tinjauan sistematik
Anak Agung Wira Ryantama, Ni Luh Parameswari Praptika, Ni Nyoman Astrid Tri BhuwanaOnline First: Feb 11, 2022
- Abstract
Akurasi otoskopi video digital dalam mendiagnosis otitis media akut pada pasien pediatri: sebuah tinjauan sistematik
Introduction: Acute otitis media one of the most prevalent ear and throat infection, mostly affecting children. Diagnosis of this condition was complicated by the perceived invasive procedure and the shortage of qualified otologist. Digital video otoscopy is a new and evolving concept in otology which could be further enhanced with telemedicine. It increases access to specialist otologist care by having the examination performed by less qualified healthcare professional. In this review we would like to assess the newest evidence on digital video otoscopy as diagnostic modality for acute otitis media.
Methods: We identified literature published from 2000 to 2020 from MEDLINE and Google Scholar. We included studies which reported diagnosis of acute otitis media using digital video otoscopy devices. We include both descriptive and analytical studies. We exclude literatures that reported secondary results or those that does not have acute otitis media as the diagnosis of interest. Articles that fulfill the criteria was then analyzed qualitatively to identify the themes that emerges.
Results: Literature search resulted in 10 included studies which includes descriptive studies, diagnostic studies, and RCTs. Digital video devices used varied from add-ons to smartphones to dedicated digital video otoscopy results. The reported examiners also varied from otologist, general practitioners, to telemedicine facilitators. Most studies concur that digital video otoscopy provided adequate inter-examiner and intra-examiner reliability. At the same time, digital video otoscopy provides adequately accurate diagnosis of acute otitis media. Where comparison was available, the accuracy of digital video otoscopy was not significantly different compared to other modes of otoscopy.
Conclusions: Digital video otoscopy provide adequately reliable and accurate diagnostic examination for acute otitis media. Some digital video otoscopy system was simple enough to be operated by nurses or telemedicine facilitators, supporting the utilization of this system for telemedicine.
The efficacy of olmesartan/amlodipine combination in hypertension treatment – a systematic review
Ni Luh Parameswari Praptika, Anak Agung Wira Ryantama, Ni Nyoman Astrid Tri BhuwanaOnline First: Feb 11, 2022
- Abstract
The efficacy of olmesartan/amlodipine combination in hypertension treatment – a systematic review
Introduction: Hypertension is the most common non-communicable disease, which persists as a major risk factor of cardiovascular diseases such as stroke, myocardial infection, and heart failure. Another major problem in clinical practice was the patients' adherence to treatment, directly related to the number of hypertension pills to be taken. Thus, determining the appropriate time duration and action of a hypertensive drug to maintain the blood pressure is needed. Olmesartan is one of the drug compounds frequently used for long-acting anti-hypertensive treatment. It is often combined with amlodipine; however, their combination remains unclear to provide equal efficacy and safety. Thus, in this article, we systematically summarize the combination of Olmesartan with amlodipine.
Methods: This systematic literature review was extracted from Science Direct and Pubmed to identify randomized clinical trials (RCT) of the outcome of the Olmesartan/amlodipine effect compared with other hypertension regimens by using PRISMA guideline 2009. The methodological quality of the included studies was assessed independently by two reviewers using The Cochrane Collaboration's RoB 2 tool.
Results: We evaluated twelve studies in the last ten years, and there were four studies with an intention-to-treat protocol (25% of articles had some concern, and 75% had a low risk of bias.) and eight studies with per-protocol analysis (37,5% of articles were concerned, and the rest had a low risk of overall bias). We also presented the efficacy and safety outcomes of the study reviewed.
Conclusion: Hypertension is a common non-communicable disease, and treatment approaches for hypertension vary widely. Administration of combination drugs is a good approach in reducing the dose of drug administration and reducing the incidence of side effects in monotherapy. Inhibiting the RAA system by olmesartan and reducing vascular smooth muscle tone by amlodipine gives better results and can be a safe and effective option for lowering blood pressure in hypertensive patients. The side effects observed were not severe and only observed in a few cases, making it an option to treat hypertension.
The microvascular reconstruction in children with maxillofacial defects: A Systematic Review
Violetti Valentin, Ratna Rayeni Natasha RoossenoOnline First: Feb 26, 2022
- Abstract
The microvascular reconstruction in children with maxillofacial defects: A Systematic Review
Background: Facial bones trauma in the pediatric population is linked to severe damage and impairment, particularly in maxillofacial, particularly in area. In addition, reconstruction of maxillofacial in pediatric patients has some unique considerations. Therefore, this study described the effectiveness of microvascular reconstruction in children with maxillofacial defects.
Methods: The relevant literature from PubMed and Science Direct databases. The strategic search is using the keywords such as "Pediatric" OR "Children" OR "Under-eighteen years" AND "microvascular reconstruction" OR "microvascular surgery" AND "maxillofacial defect". We used a PRISMA method to the selection of those articles. The inclusion criteria were related to microvascular reconstruction in children with maxillofacial defects from 2000-2021.
Result: Total of six studies entries with inclusion criteria. These studies show that most free flaps or microvascular reconstruction procedures carried on pediatric patients to resolve maxillofacial defects gave successful functional, and clinical outcomes. In addition, a few complications, mainly infections, occurred following the surgery, however successfully managed with antibiotics.
Conclusion: A microvascular reconstruction is a good option for maxillofacial defects reconstruction in pediatric patients due to a shorter surgical time and faster recovery.
Effectiveness comparison of atorvastatin vs. rosuvastatin in reducing CRP level in acute coronary syndrome: A systematic review and meta-analysis
I Gusti Ayu Inten Heny Pratiwi, Anak Agung Gde Waisampayana PutraOnline First: Feb 28, 2022
- Abstract
Effectiveness comparison of atorvastatin vs. rosuvastatin in reducing CRP level in acute coronary syndrome: A systematic review and meta-analysis
Background: Acute coronary syndrome (ACS) is a group of various clinical symptoms, including acute myocardial ischemia. When administered for coronary artery instability, one of the targets for statins is to reduce inflammation factor-like c-reactive protein (CRP). Increased levels of CRP are related to ischemic heart disease. Therefore, a meta-analysis was assessed to compare atorvastatin vs. rosuvastatin as the most effective for reducing CRP of a patient with acute coronary syndrome
Methods: We searched PubMed and Cochrane databases until October 23th 2020. Search terms included acute coronary syndrome, C-reactive protein or CRP, rosuvastatin, atorvastatin, randomized, random, and randomization. We excluded study populations with acute kidney injury/dyslipidemia/metabolic syndrome. All analyses in our study were carried out using Review Manager version 5.3 (RevMan Cochrane, London, UK).
Result: We have found four eligible studies (487 patients) were included. Funnel plots and p-Egger were inspected to assess publication bias. The pooled analysis demonstrated the benefit of atorvastatin or rosuvastatin over therapy for all studies. The result shown (WMD: 2.41; P=0.06; 95% CI: -0.07 – 4.90) on the forest plot.
Conclusion: Our meta-analysis clarifies that atorvastatin, compared to rosuvastatin, or vice versa, is not statistically significant in reducing CRP in acute coronary syndrome patients.
Penanganan inversio uteri: sebuah tinjauan pustaka
Endang Sri Widiyanti, I Gede Mega PutraOnline First: Mar 1, 2022
- Abstract
Penanganan inversio uteri: sebuah tinjauan pustaka
Acute uterine inversion is a rare but life-threatening emergency in the field of obstetrics. The main signs and symptoms of acute uterine inversion are bleeding and shock. The accuracy and speed of diagnosis and case management will reduce morbidity and mortality due to uterine inversion. This literature review is expected to increase our knowledge as practitioners in dealing with uterine inversion cases. In principle, there are two goals for the treatment of acute uterine inversion, namely repositioning the uterus and treating the shock that occurs. The success of uterine inversion repositioning is highly dependent on the speed of early detection. The longer the uterus is inverted, the more difficult it will be to reposition it. There are several non-surgical techniques for repositioning the uterus, including: Johnson maneuver, Henderson and Alles maneuver, use of tocolytics, and repositioning with hydrostatic pressure. Surgical procedures can be performed abdominally, namely the Huntington's Procedure, with abdominal repositioning laparotomy and the Haultain's Procedure, with abdominal cervical repositioning-repositioning laparotomy.
Kejadian inversio uteri akut merupakan kegawatdaruratan di bidang Obstetri yang jarang terjadi namun mengancam nyawa. Tanda dan gejala utama inversio uteri akut adalah perdarahan dan syok. Ketepatan dan kecepatan diagnosa dan penanganan kasus akan mengurangi morbiditas dan mortalitas akibat inversio uteri. Tinjauan pustaka ini diharapkan dapat menambah pengetahuan kita sebagai praktisi dalam menangani kasus inversio uteri. Pada prinsipnya ada dua tujuan penanganan inversio uteri akut, yaitu reposisi uterus dan penanganan syok yang terjadi. Keberhasilan reposisi inversio uteri sangat tergantung pada kecepatan deteksi dini. Semakin lama uterus terinversi akan semakin sulit melakukan reposisi. Terdapat beberapa teknik non-bedah untuk reposisi inversio uteri, antara lain: manuver Johnson, manuver Henderson dan Alles, penggunaan tokolitik, dan reposisi dengan tekanan hidrostatik. Prosedur pembedahan dapat dilakukan melalui abdominal, yaitu Prosedur Huntington, dengan laparotomi-reposisi melalui abdominal dan Prosedur Haultain, dengan laparotomi- insisi cincin servikalis-reposisi melalui abdominal.
Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka
Ni Made Dian Hartaningsih, I Putu Yuda Prabawa, Benediktus Bosman Ariesta Gusti Putu, Dwijo Anargha Sindhughosa, Ida Bagus Amertha Putra Manuaba, I Gusti Ngurah PramesemaraOnline First: Apr 18, 2022
- Abstract
Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka
Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy.
Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien.
Tingginya rasio neutrofil terhadap limfosit serum darah ibu sebagai faktor risiko persalinan preterm spontan
Tjokorda Gde Agung Suwardewa, I Nyoman Bayu Mahendra, Anak Agung Gede Putra Wiradnyana, Made Bagus Dwi Aryana, I Gde Sastra Winata, I Wayan Megadhana, Daniel Hadinata SusantoOnline First: Apr 30, 2022
- Abstract
Tingginya rasio neutrofil terhadap limfosit serum darah ibu sebagai faktor risiko persalinan preterm spontan
Introduction: Preterm delivery is still a major problem in pregnancy and causes 70% of all perinatal deaths. The immaturity of the organ systems of preterm infants increases neonatal morbidity and mortality compared to term infants. The incidence of preterm delivery at Sanglah Hospital in 2015 was 285 cases out of 1198 births or 23.7%. Inflammation is thought to be the cause of 40% cases of preterm labor and as much as 70-80% of spontaneous preterm births has a significant relationship with the incidence of infection in the vagina and cervix. The physiological immune response to inflammation is characterized by an increase in the number of circulating neutrophils and a decrease in the number of lymphocytes. There is a controversy regarding the relationship between an increase of neutrophils to lymphocytes ratio in maternal serum and the threatened preterm delivery. This study aims to determine that a high neutrophils to lymphocytes ratio in maternal blood serum is a risk factor for spontaneous preterm delivery.
Method: This research was an analytic case control study with 56 samples, and divided into two groups, 28 preterm delivery samples as a case group and 28 preterm pregnancy samples as a control group. This research was conducted at the Obstetric and Gynecology Outpatient clinic as well as the delivery room at Sanglah Hospital Denpasar in the period of November 2020 to April 2021.
Result: Analysis results of this study found a statistically significant difference (p = 0.003) between the case and control groups. The group of patients with high maternal neutrophil to lymphocyte serum ratio had a chance of preterm labor 5.6 times higher compared to the group of patients with low maternal neutrophil to lymphocyte serum ratio (OR = 5.6; CI 95% = 1.74-18.42; p=0.003).
Conclusion: The conclusion of this study is that the high maternal neutrophils to lymphocytes serum ratio is a risk factor for 5.6 times the occurrence of spontaneous preterm labor.
Pendahuluan: Persalinan preterm masih menjadi masalah utama pada ibu hamil dan menyebabkan 70% dari seluruh kasus kematian perinatal. Imaturitas sistem organ tubuh bayi prematur meningkatkan morbiditas dan mortalitas neonatal dibandingkan dengan bayi lahir cukup bulan. Angka kejadian persalinan preterm di RSUP Sanglah pada tahun 2015 sebesar 285 kasus dari 1198 kelahiran atau sebesar 23,7%. Inflamasi diduga sebagai penyebab dari 40% kasus persalinan preterm dan sebanyak 70-80% persalinan preterm spontan mempunyai hubungan bermakna dengan kejadian infeksi pada vagina dan serviks. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah neutrofil yang beredar dan penurunan jumlah limfosit. Terdapat kontroversi hubungan antara peningkatan rasio neutrofil terhadap limfosit serum darah ibu dan ancaman persalinan preterm, sehingga penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko persalinan preterm spontan.
Metode: Penelitian ini merupakan penelitian analitik dengan rancangan kasus kontrol dengan jumlah sampel sebanyak 56 sampel, dan dibagi menjadi dua kelompok, yaitu 28 sampel persalinan preterm sebagai kelompok kasus dan 28 sampel kehamilan preterm sebagai kelompok kontrol. Penelitian ini dilakukan di Poliklinik Obstetri dan Ginekologi serta kamar bersalin IGD RSUP Sanglah Denpasar periode November 2020 hingga April 2021.
Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang signifikan secara statistik (p = 0,003) antara kelompok kasus dan kontrol. Kelompok pasien dengan nilai rasio neutrofil terhadap limfosit serum darah ibu yang tinggi memiliki kemungkinan sebesar 5,6 kali mengalami persalinan preterm dibandingkan dengan kelompok pasien dengan rasio neutrofil terhadap limfosit serum darah ibu yang rendah (OR = 5,6, IK 95% = 1,74-18,42, p = 0,003).
Simpulan: Simpulan dari penelitian ini adalah tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko 5,6 kali terjadinya persalinan preterm spontan.
Description of hydrocephalus knowledge in pregnant woman at Puskesmas 1 Denpasar Utara
Made Indra Erlangga Prathiwindya, I Wayan Niryana, Tjokorda Gde Bagus Mahadewa, Sri MaliawanOnline First: Apr 30, 2022
- Abstract
Description of hydrocephalus knowledge in pregnant woman at Puskesmas 1 Denpasar Utara
Background: Hydrocephalus is a pathological brain disorder resulting from increased cerebrospinal fluid without or with elevated intracranial pressure resulting in widening of the space where cerebrospinal fluid flows. Maternal environment such as experiencing infection during pregnancy, consuming alcohol and drugs, lifestyle such as obesity, diabetes, or hypertension, and lack of examinations in preparing for prenatal care and low socioeconomic status affect the risk factors for congenital hydrocephalus. The purpose of this study is to to determine awareness and knowledge level among pregnant women towards hydrocephalus.
Methods: This descriptive research was conducted with a cross-sectional method using consecutive sampling as a sampling technique. 106 Pregnant Women at Puskesmas I Denpasar Utara was involved in completing the survey regarding Hydrocephalus during this research. For the collecting data using a questionnaire filled directly by each respondent containing 9 questions and then analyzed using the software Statistical Package for the Social Sciences (SPSS).
Results: This study was participated by 106 respondents and figured that approximately 84,9% among the total number of respondents have a good knowledge of hydrocephalus while the rest, 15,1% are still at a low level with common characteristics of the respondents, including the age of 24 years old (age group 19-25), multipara (59.4%), with a college education background (45.3%), and working as a housewife (59.4%).
Conclusion: This study conveys good knowledge about hydrocephalus in pregnant women, especially those who have a good level of education.
Profil penggunaan kontrasepsi di klinik Nurjaya, Kabupaten Badung, Bali
Ida Bagus Arjuna, I Made DarmayasaOnline First: Apr 30, 2022
- Abstract
Profil penggunaan kontrasepsi di klinik Nurjaya, Kabupaten Badung, Bali
Background: Contraceptive services are a series of activities, including the provision of education, counseling, medical eligibility screening, provision of contraception, installation or revocation, and handling side effects or complications in an effort to prevent pregnancy. According to BKKBN, active birth control participants among Couples of Childbearing Age (CCA) in 2020 amounted to 67.6%. Bali is ranked 7th, with a participation rate of 66.9%. The pattern of choosing the type of contraceptive in 2020 showed that most acceptors chose to use injectable methods, followed by pills. There aren't many similar studies targeting private clinics. It is very interesting to conduct a study on the pattern of contraceptive use in Nurjaya Clinic, one of the private clinics in Bali that also organizes contraceptive programs.
Methods: This study is a descriptive epidemiology survey. The sample in this study is secondary data in the form of a register of contraceptive acceptors in Nurjaya Clinic from November 2020 to October 2021. The instruments used in this study are patients' register data and data analysis techniques using univariate analysis that is calculated in percentages and presented in a table and narrated.
Results: The use of injectable contraceptives is still the main choice of CCA in Nurjaya Clinic, with users at 78.5% of all contraceptive acceptors, followed by other methods, namely IUD at 13.9%, birth control pills at 6%, and implants at 1.6%. Injectable contraceptives were also the top choice in every age group, 92.6% in the 21year old age group, 74.2% in the 21 to 35-year-old age group, and 82.8% in the 35-year-old age group.
Conclusion: The most widely used contraception use in Nurjaya Clinic is injectable contraceptives for all of the age groups of <21 years, 21-35 years, or >35 years.
Latar Belakang: Pelayanan kontrasepsi adalah serangkaian kegiatan meliputi pemberian KIE, konseling, penapisan kelayakan medis, pemberian kontrasepsi, pemasangan atau pencabutan, dan penanganan efek samping atau komplikasi dalam upaya mencegah kehamilan. Menurut BKKBN, peserta KB aktif di antara Pasangan Usia Subur (PUS) tahun 2020 sebesar 67,6%. Bali menempati peringkat 7 dengan tingkat keikutsertaan KB sebesar 66,9%. Pola pemilihan jenis alat kontrasepsi pada tahun 2020 menunjukkan bahwa sebagian besar akseptor memilih menggunakan metode suntik, diikuti oleh pil. Masih sedikitnya penelitian serupa yang menargetkan klinik swasta, sangat menarik untuk dilakukan suatu penelitian mengenai gambaran penggunaan kontrasepsi di Klinik Nurjaya sebagai salah satu klinik swasta di Bali yang turut menyelenggarakan program KB.
Metode: Penelitian merupakan survei epidemiologi deskriptif. Sampel dalam penelitian ini merupakan data sekunder berupa register akseptor KB di Klinik Nurjaya bulan November 2020 hingga Oktober 2021. Instrumen yang digunakan dalam penelitian ini adalah data register pasien serta teknik analisis data menggunakan analisis univariat yang dihitung persentasenya serta disajikan dalam bentuk tabel dan dinarasikan
Hasil: Penggunaan kontrasepsi suntik masih menjadi pilihan utama PUS di Klinik Nurjaya, dengan pengguna sebesar 78,5% dari seluruh akseptor kontrasepsi, diikuti metode lainnya yaitu IUD 13,9%, pil KB 6%, dan implan 1,6%. Kontrasepsi suntik juga menjadi pilihan utama pada seluruh kelompok usia yaitu 92,6% pada kelompok usia 21 tahun, 74,2% pada kelompok usia 21-35 tahun, dan 82,8% pada kelompok usia 35 tahun.
Kesimpulan: Penggunaan kontrasepsi paling banyak digunakan di FKTP swasta Klinik Nurjaya adalah KB suntik, baik pada kelompok usia <21 tahun, 21-35 tahun, maupun >35 tahun.
Hubungan profil lipid dengan kejadian tuli mendadak di RSUP Sanglah, Bali, Indonesia
Made Prani Windasari, I Made WiranadhaOnline First: Apr 30, 2022
- Abstract
Hubungan profil lipid dengan kejadian tuli mendadak di RSUP Sanglah, Bali, Indonesia
Background: Sudden deafness is a neurotological emergency requiring rapid and comprehensive management. Sudden deafness can be caused by viral infections, neoplasms, rupture of the cochlear membrane, autoimmune, vascular occlusion, neurologic, psychogenic and idiopathic. The pathogenesis of sudden deafness is still being debated. However, the increased blood viscosity, micro thrombosis, and/or changes in blood vessel size can also cause hearing loss. This study evaluates the relationship between lipid profile and sudden deafness in Sanglah General Hospital, Bali, Indonesia.
Methods: This study is analytical research using a retrospective case-control method by taking secondary data from the patient's medical records. The study was conducted at the ENT polyclinic of Sanglah Hospital, Denpasar, from December 2020 to February 2021, with a total sample of 39 people in each group. Data analysis in this study consisted of descriptive statistical analysis, normality test, and correlation test, which were analyzed using the SPSS version 25.0 for Windows.
Results: There was no significant difference of mean total cholesterol in the case group (204.030±38.756 mg/dL) and control group (189.710±27.200 mg/dL) (p> 0.05). There was a significant difference in mean LDL in the case group (140.680±32.177 mg/dL) compared with the control group (118.870±22.498 mg/dL) (p<0.05). In addition, significant differences were also found in the mean HDL (51.050±15.883 vs. 44.710±12.901 mg/dL) and mean triglycerides (93.840±44.665 vs. 154.050±83.975 mg/dL) (p<0.05) between the case and control group.
Conclusion: There is a significant relationship between HDL, LDL and triglycerides with the incidence of sudden deafness.
Latar Belakang: Tuli mendadak merupakan keadaan darurat neurotologi yang memerlukan penatalaksanaan secara cepat dan komprehensif. Tuli mendadak dapat disebabkan oleh infeksi virus, neoplasma, ruptur membran koklea, autoimun, oklusi vaskuler, neurologik, psikogenik dan idiopatik. Patogenesis terjadinya tuli mendadak sampai saat ini masih menjadi perdebatan. Akan tetapi, peningkatan viskositas darah, mikrotrombosis, dan atau perubahan ukuran pembuluh darah juga dapat menyebabkan gangguan pendengaran. Penelitian ini bertujuan untuk menganalisis hubungan antara profil lipid dan kejadian tuli mendadak yang ada di RSUP Sanglah, Bali, Indonesia.
Metode: Penelitian ini menggunakan rancangan penelitian analitik dengan menggunakan metode kasus kontrol retrospektif dari data sekunder catatan medis pasien. Penelitian dilakukan di poliklinik THT-KL RSUP Sanglah, Denpasar dari bulan Desember 2020 – Februari 2021 dengan jumlah sampel sebanyak 39 orang pada masing-masing kelompok. Analisis data pada penelitian ini terdiri dari analisis statistik deskriptif, uji normalitas, dan uji korelasi yang dianalisis menggunakan program SPSS versi 25.0 untuk Windows.
Hasil: Tidak terdapat perbedaan bermakna rerata kolesterol total pada kelompok kasus (204.030±38.756 mg/dL) dan kelompok kontrol (189.710±27.200 mg/dL) (p>0,05). Terdapat perbedaan rerata LDL yang bermakna pada kelompok kasus (140,680±32,177 mg/dL) dibandingkan dengan kelompok kontrol (118,870±22.498 mg/dL) (p<0,05). Selain itu, perbedaan bermakna juga ditemukan pada rerata HDL (51.050±15.883 vs. 44.710±12.901 mg/dL) dan rerata trigliserida (93.840±44.665 vs. 154.050±83,975 mg/dL) (p<0,05) antara kelompok kasus dan kontrol.
Kesimpulan: Terdapat hubungan yang bermakna antara HDL, LDL dan trigliserida dengan kejadian tuli mendadak.
Perbedaan jumlah leukosit darah antara pasien apendisitis akut dan apendisitis perforasi sebagai prediktor diagnosis di RSUD Pulang Pisau, Kalimantan Tengah, Indonesia
Febria Valentine Aritonang, Sanjaya Soebagio, Yan AdityaOnline First: Apr 30, 2022
- Abstract
Perbedaan jumlah leukosit darah antara pasien apendisitis akut dan apendisitis perforasi sebagai prediktor diagnosis di RSUD Pulang Pisau, Kalimantan Tengah, Indonesia
Background. Not all health facilities in Indonesia have an advanced supporting examination to determine patients with acute appendicitis and perforated appendicitis. Several recent studies have shown there are differences in leukocyte count between patients with acute appendicitis and perforated appendicitis, which can be used as a predictor in diagnosing appendicitis and perforated appendicitis.
Methods. This study used an observational analytic research method with a cross sectional approach to 40 patients. Data were taken from the appendicitis patients' medical records at Pulang Pisau Hospital from January to September 2021. The variable is the number of leukocytes between acute appendicitis and perforated appendicitis. ROC analysis was performed to determine the cut-off point of the leukocytes count. The data were calculated with analytical analysis using the Mann-Whitney U test with a significance limit is p <0.05.
Result. In this study, 18 patients had acute appendicitis, and 22 patients had perforated appendicitis. ROC analysis (AUC 0.859) is on the cut-off point of 16,600/uL with a sensitivity of 90.9% and a specificity of 50%. The result of the Mann-Whitney U test is p < 0.05.
Conclusion. There is a significant difference in leukocyte count between patients with acute appendicitis and perforated appendicitis in Pulang Pisau Hospital. The blood leukocyte count can be used as a predictor to differentiate acute appendicitis from perforated appendicitis.
Latar Belakang. Belum semua fasilitas kesehatan di Indonesia memiliki pemeriksaan penunjang yang sudah maju untuk menentukan antara pasien akut apendisitis dengan apendisitis perforasi. Beberapa studi belakangan ini memperlihatkan terdapat perbedaan jumlah leukosit antara pasien dengan apendisitis akut dan apendisitis perforasi yang dapat digunakan sebagai prediktor dalam mendiagnosis apendisitis akut dan apendisitis perforasi.
Metode. Studi ini menggunakan metode penelitian analitik observasional dengan pendekatan cross-sectional terhadap 40 pasien. Data diambil dari rekam medis pasien apendisitis di RSUD Pulang Pisau dari Januari hingga September 2021. Variabel dari penelitian ini adalah jumlah leukosit antara apendisitis akut dan apendisitis perforasi. Dilakukan analisis ROC untuk menentukan nilai potong dari jumlah leukosit. Data dianalisis menggunakan Mann-Whitney U test dengan nilai signifikansi p < 0,05.
Hasil. Dalam penelitian ini, 18 pasien terdiagnosis apendisitis akut dan 22 pasien terdiagnosis apendisitis perforasi. Analisis ROC (AUC 85.9%) menghasilkan nilai potong jumlah leukosit di 16.600/uL dengan nilai sensitivitas 90.0% dan nilai spesifisitas 50%. Hasil uji Mann-Whitney didapatkan p < 0,05.
Kesimpulan. Terdapat perbedaan yang signifikan dari nilai jumlah leukosit antara pasien dengan apendisitis akut dan apendisitis perforasi di RSUD Pulang Pisau. Nilai jumlah leukosit dapat digunakan sebagai prediktor untuk membedakan apendisitis akut dan apendisitis perforasi.
Karakteristik pendengaran pada pelajar pengguna peranti dengar di Denpasar, Bali, Indonesia
Putri Citra Laksmi Darsana, I Made WiranadhaOnline First: Apr 30, 2022
- Abstract
Karakteristik pendengaran pada pelajar pengguna peranti dengar di Denpasar, Bali, Indonesia
Background: Personal Listening Devices (PLDs) can increase noise-induced hearing loss in users. Currently, PLDs have been part of adolescents’ daily lifestyles. Increase of today’s audiovisual and telecommunications technologies, PLDs allow users to listen to music for extended periods and at high sound levels. It can cause chronic noise that can interfere with hearing function. This study aims to determine the characteristic of the hearing level of PLDs user students in Denpasar.
Methods: A total of 48 samples were included in this study. This research is a descriptive study using a cross sectional design. This research used the cluster sampling technique by taking primary data from history taking, physical examination, and pure tone audiometry of students using PLDs at SMAN 8 Denpasar. Data analysis in this study is a descriptive statistical analysis that was analyzed using the SPSS version 24.0 for Windows.
Results: The highest proportion of PLDs users is women (60,4%) and age group of 15–16 years, of which 24 students (50.0%) are 15 years old and 24 students (50.0%) are 16 years old. The most widely used type of PLDs was the earbud (81.3%). Most of the duration of using PLDs in 24 hours is < 1 hour (41.7%). As many as 34 students (70.8%) used PLDs for more than 2 years. The hearing level of students who used PLDs was obtained at most with normal hearing (0–25 dB) as many as 30 students (62.5%) in the right ear and 37 students (77.1%) in the left ear with a mean score of the hearing threshold of the right ear is 24.570±6.487dB and the left ear is 22.960±5.799 dB.
Conclusion: The hearing level of students who used PLDs was obtained at most with normal hearing (0–25 dB) in the right and left ear.
Latar Belakang: Penggunaan peranti dengar memiliki potensi meningkatkan resiko gangguan pendengaran akibat bising pada penggunanya. Saat ini penggunaan peranti dengar dikalangan remaja sudah menjadi bagian dari gaya hidup sehari – hari. Dengan meningkatnya teknologi audio visual dan telekomunikasi saat ini, peranti dengar memungkinkan penggunanya untuk mendengarkan musik dalam jangka waktu lama dan pada tingkat level suara yang tinggi. Hal tersebut dapat menimbulkan bising kronik yang dapat mengganggu fungsi pendengaran. Penelitian ini bertujuan untuk mengetahui karakteristik pendengaran pada pelajar pengguna peranti dengar di Denpasar.
Metode: Penelitian ini melibatkan 48 sampel. Penelitian ini merupakan penelitian deskriptif dengan menggunakan rancangan potong lintang. Peneliti menggunakan teknik cluster sampling dengan mengambil data primer dari anamnesis, pemeriksaan fisik dan pemeriksaan audiometri nada murni pada pelajar pengguna peranti dengar di SMAN 8 Denpasar. Analisis pada penelitian ini adalah analisis univariat (statistik deskriptif) menggunakan program komputer SPSS versi 24.0 untuk Windows.
Hasil: Didapatkan jumlah perempuan lebih banyak dibandingkan laki – laki yaitu 29 pelajar (60,4%). Rentang usia pelajar adalah 15 – 16 tahun, dimana 24 pelajar (50,0%) usia 15 tahun dan 24 pelajar (50,0%) usia 16 tahun. Jenis peranti dengar yang paling banyak digunakan adalah earbud yakni sejumlah 39 pelajar (81,3%). Sebagian besar durasi penggunaan peranti dengar dalam 24 jam adalah < 1 jam yakni sebanyak 20 pelajar (41,7%). Sejumlah 34 pelajar (70,8%) menggunakan peranti dengar selama lebih dari 2 tahun. Derajat pendengaran pelajar pengguna peranti dengar didapatkan paling banyak dengan pendengaran normal (0–25 dB) yakni sebanyak 30 pelajar (62,5%) pada telinga kanan dan 37 pelajar (77,1%) pada telinga kiri dengan nilai rerata ambang dengar pada telinga kanan adalah 24,570±6,487 dB dan telinga kiri 22,960±5,799 dB.
Kesimpulan: Derajat pendengaran pelajar pengguna peranti dengar didapatkan paling banyak dengan pendengaran normal (0–25 dB) yakni pada telinga kanan dan telinga kiri.
Contamination of Escherichia coli, Salmonella sp. and Vibrio sp. on ice cubes at food stalls in Karangasem Regency, Bali Province in 2021
I Gede Wikania Wira Wiguna, Agus Eka Darwinata, Komang Januartha Putra Pinatih, Ni Nengah Dwi FatmawatiOnline First: Apr 30, 2022
- Abstract
Contamination of Escherichia coli, Salmonella sp. and Vibrio sp. on ice cubes at food stalls in Karangasem Regency, Bali Province in 2021
Background: Waterborne diseases spread through drinking water and food products made from drinking water, including cooking utensils that are washed using contaminated water. Ice cube is widely used by the people in Indonesia. There was no study regarding bacteria contamination on an ice cube in Karangasem Regency. This study aimed to determine the contamination of Escherichia coli, Salmonella sp., and Vibrio sp. on ice cubes at food stalls in Karangasem Regency in 2021.
Methods: This study used a cross-sectional research design and simple purposive sampling as the sampling technique. Ice cubes were taken from 42 food stalls from eight sub-districts. Samples were cultured on Lactose Broth (LB) media for the Most Probable Number (MPN) test procedures and Eosin Methylene Blue Agar (EMBA) to identify the presence of E. coli, Salmonella Shigella Agar (SSA) for Salmonella sp., and Thiosulfate Citrate Bile Sucrose (TCBS) for Vibrio sp. and followed by gram staining. Data processing was carried out descriptively to determine the percentage of samples with positive contamination. Data were analyzed using Microsoft Excel version 2010 for Windows.
Results: Based on the study results, it was found that all samples contained coliform bacteria through the MPN test (100.0%). In addition, 5 samples (11.9%) were found positive for E. coli. While the identification of Salmonella sp. and Vibrio sp was found no positive results.
Conclusions: There was coliform bacteria contamination in the tested ice cube samples. In addition, E. coli was found in the sample; however, there were no Salmonella sp. and Vibrio sp. on ice cube samples.
Hubungan nilai mean platelet volume dengan derajat klinis demam berdarah dengue di RSUD Wangaya Kota Denpasar
Callista Beatrice, I Wayan Bikin Suryawan, Anak Agung Made SuciptaOnline First: Apr 30, 2022
- Abstract
Hubungan nilai mean platelet volume dengan derajat klinis demam berdarah dengue di RSUD Wangaya Kota Denpasar
Background: DHF is a health problem in Indonesia because the morbidity and mortality rates are high, so a practical examination is needed to assess the progression of DHF to reduce its morbidity and mortality. MPV is a simple laboratory test that has not been widely studied in DHF. This study aims to determine the relationship between the MPV and the clinical degree of DHF.
Method: The study was conducted with a cross-sectional design on pediatric patients aged 0 – < 18 years with DHF and treated in June 2020 – August 2021 at Wangaya General Hospital, Denpasar, Bali. DHF diagnosis was based on WHO 2011 criteria, divided into groups of DHF and DSS. The normal reference MPV is 7,5-11,5fl, and values >11,5 fl are considered high. Data were analyzed by SPSS 25.
Result: Eighty patients participated in the study, 56 DHF patients and 24 DSS patients. High MPV values >11.5 fl were found more in the DSS patient group (54,16%) than the DHF group (30,35%) (OR: 3,5; 95% CI: 1,29-9,68; p = 0,023). There was a moderate negative correlation between MPV and platelet count values (r: -0,438; p < 0,05).
Conclusion: MPV value has a relationship with the clinical degree of DHF. High MPV values (> 11,5 fl) have a 3,5 times risk higher for the occurrence of DSS compared to patients with normal MPV values (7,5-11,5 fl). The degree of thrombocytopenia in dengue is inversely proportional to the MPV value.
Latar belakang: Demam berdarah dengue (DBD) merupakan masalah kesehatan di Indonesia karena angka kesakitan dan kematiannya yang cukup tinggi, sehingga diperlukan pemeriksaan praktis yang dapat digunakan dalam menilai progresivitas DBD agar dapat mengurangi morbiditas dan mortalitas dari penyakit ini. Mean platelet volume (MPV) adalah pemeriksaan laboratorium sederhana yang yang belum banyak diteliti perannya pada DBD. Penelitian ini bertujuan untuk mengetahui hubungan antara nilai MPV dengan derajat klinis DBD.
Metode: Penelitian dilakukan dengan desain potong lintang tehadap pasien anak usia 0 – <18 tahun dengan DBD dan dirawat pada bulan Juni 2020 – Agustus 2021 di RSUD Wangaya Kota Denpasar. Diagnosis DBD berdasarkan kriteria WHO 2011, dibagi menjadi kelompok DBD tanpa syok dan sindrom syok dengue (SSD). Acuan nilai normal MPV 7,5-11,5 fl dan nilai >11,5 fl dianggap tinggi. Analisa menggunakan SPSS versi 25.
Hasil: Didapatkan 80 pasien mengikuti penelitian, 56 pasien DBD tanpa syok dan 24 pasien SSD. Nilai MPV tinggi >11,5 fl didapatkan lebih banyak pada kelompok pasien SSD (54,16%) dibandingkan kelompok DBD tanpa syok (30,35%) (OR: 3,5; 95% IK: 1,29-9,68; p= 0,023). Didapatkan hubungan korelasi negatif berkekuatan sedang antara nilai MPV dan trombosit (r: -0,438; p< 0,05).
Kesimpulan: Nilai MPV memiliki hubungan dengan derajat klinis DBD. Nilai MPV tinggi (>11,5 fl) memiliki risiko 3,5 kali untuk terjadinya SSD dibandingkan pasien dengan nilai MPV normal (7,5-11,5 fl). Derajat trombositopenia pada dengue berbanding terbalik dengan nilai MPV, semakin berat derajat trombositopenia semakin tinggi nilai MPV.
Potensi antibakteri tetes telinga ekstrak daun Anredera Cordifolia terhadap Pseudomonas aeruginosa penyebab Otitis Media Supuratif Kronis (OMSK)
Ni Putu Oktaviani Rinika Pranitasari, Eka Putra Setiawan, I Wayan Lolik LesmanaOnline First: Apr 30, 2022
- Abstract
Potensi antibakteri tetes telinga ekstrak daun Anredera Cordifolia terhadap Pseudomonas aeruginosa penyebab Otitis Media Supuratif Kronis (OMSK)
Background: Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of the middle ear and mastoid mucosa characterized by perforation of the tympanic membrane and persistent discharge from the middle ear. The high resistance rate to CSOM pathogen brings hope for the development of natural-based drugs. The Binahong plant (Anredera cordifolia) has been known for a long time and is widely used as a traditional herb by Indonesian people. Flavonoid, saponins and alkaloids compounds from Binahong leaf extracts in several studies reveal its antibacterial activity. This study aims to determine the antibacterial activity of Binahong leaf extract ear drops against Pseudomonas aeruginosa, CSOM pathogen in-vitro.
Methods: This is an experimental study with a post-test only control group design by testing antibacterial activity of binahong leaf extract at 1%, 3% and 5% concentrations into Pseudomonas aeruginosa American Type Culture Collection (ATCC) 9027. Chloramphenicol 1% was used as a positive control and ethanol 96% as a negative control. Data were analyzed using SPSS version 20 for Windows.
Results: The minimum Inhibitory Zone Diameter (IZD) in the treatment groups A1, A2, A3 and A4 was the same, namely 0.00 mm and the maximum IZD in the treatment groups A1, A2, A3, A4 was also the same, which was 0.00 mm, so that the average IZD of the treatment groups A1, A2, A3, A4 was 0.00 mm. Meanwhile, in the A4 treatment group, the minimum IZD was 11.00 mm and the maximum IZD was 12.00 mm, so the average IZD was 11.20 mm.
Conclusion: Antibacterial activity of the Binahong (Anredera cordifolia) leaf extract ear drops at 1%, 3% and 5% concentrations showed weak inhibitory response to Pseudomonas aeruginosa bacteria.
Latar Belakang: Otitis media supuratif kronis (OMSK) adalah inflamasi kronis mukosa telinga tengah dan mastoid ditandai perforasi membran timpani dan keluarnya cairan dari telinga tengah yang menetap. Tingginya angka resistensi terhadap bakteri penyebab OMSK membawa harapan bagi pengembangan obat yang berbahan dasar alam. Tanaman Binahong (Anredera cordifolia) telah dikenal sejak dahulu dan banyak digunakan sebagai tanaman obat oleh masyarakat di Indonesia. Senyawa flavonoid, saponin dan alkaloid yang terkandung pada daun Binohong diketahui memiliki aktifitas antibakteri. Penelitian ini bertujuan untuk mengetahui aktivitas antibakteri tetes telinga ekstrak daun Binahong terhadap Pseudomonas aeruginosa penyebab OMSK secara in-vitro.
Metode: Penelitian ini merupakan penelitian eksperimental dengan rancangan post-test only control group design yaitu menguji aktivitas antibakteri berupa diameter daerah hambat (DDH) sediaan tetes telinga ekstrak daun Binahong konsentrasi 1%, 3% dan 5% terhadap Pseudomonas aeruginosa ATCC-9027. Sebagai kontrol positif digunakan Chloramphenicol 1% dan sebagai kontrol negatif digunakan ethanol 96% Data dianalisis menggunakan SPSS versi 20 untuk Windows.
Hasil: Diameter daerah hambat (DDH) minimal pada kelompok perlakuan A1, A2, A3 dan A4 adalah sama, yaitu 0,00 mm dan DDH maksimal pada kelompok perlakuan A1, A2, A3, A4 juga sama, yaitu sebesar 0,00 mm, sehingga rerata diameter daerah hambat kelompok perlakuan A1, A2, A3, A4 adalah 0,00 mm. Sedangkan pada kelompok perlakuan A4, DDH minimal adalah 11,00 mm dan DDH maksimal sebesar 12,00 mm, sehingga rerata DDH adalah 11,20 mm.
Kesimpulan: Aktivitas antibakteri sediaan tetes telinga ekstrak daun Binahong (Anredera cordifolia) pada konsentrasi 1%, 3% dan 5% menunjukkan respon hambat lemah terhadap pertumbuhan bakteri Pseudomonas aeruginosa.
Prevalence of SCCmec Types I, II, III, and pvl gene among Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Sanglah General Hospital
I Gede Sathya Agastya, Agus Eka Darwinata, Komang Januartha Putra Pinatih, Ni Nengah Dwi FatmawatiOnline First: Apr 30, 2022
- Abstract
Prevalence of SCCmec Types I, II, III, and pvl gene among Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Sanglah General Hospital
Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a big challenge for health services worldwide which causes infections both in healthcare and community. Healthcare-associated MRSA (HA-MRSA) strains are shown to be resistant to beta-lactam antibiotics and several non-beta lactam antibiotics. At the same time, the community-associated MRSA (CA-MRSA) tends to be resistant to beta-lactam antibiotics. MRSA carried staphylococcal cassette chromosome (SCCmec) types I, II, III, IV, and V. SCCmec types I, II, and III were predominantly found in HA-MRSA strain while SCCmec types IV and V predominantly found in CA-MRSA strains. Furthermore, the panton valentine leukocidine (pvl) gene is commonly found in CA-MRSA strains. Therefore, this study aimed to determine the prevalence of SCCmec types I, II, III, and pvl gene in MRSA isolated from clinical specimens in Sanglah General Hospital.
Methods: This study was a cross-sectional descriptive study. MRSA was isolated from clinical specimens (sputum, wounds, tissue, blood, etc.) from January 2020 to July 2021 and identified by the Vitek 2 Compact (Biomerieux, France) at the Clinical Microbiology Laboratory of Sanglah Hospital. Prevalence of SCCmec and pvl gene using PCR. Data were analyzed using Microsoft Excel version 2010 for Windows.
Results: Most of the specimens (69.56%) were wound. Seventeen (73.91%) out of 23 MRSA isolates were positive for the SCCmec III and pvl gene, while none was positive for the SCCmec I and SCCmec II. About 19 (82.60%) isolates were resistant to two or more non-beta-lactam antibiotics.
Conclusions: The isolates of MRSA in this study were predominantly isolated from wound specimens, with the most prevalent genetic element being SCCmec III. In this study, although most MRSA isolates carried SCCmec III that suggested as HA-MRSA, however, most of the strains harbored the pvl gene. This interesting phenomenon needs to be further elucidated.
Rasio neutrofil limfosit (RNL), mean platelet volume (MPV), serta red cell distribution width (RDW) sebagai prediktor tunggal sepsis neonatorum awitan dini (SNAD) di RSUD Wangaya Kota Denpasar, Bali
I Gusti Ayu Mahadewi, I Wayan Bikin Suryawan, I Gde Doddy Kurnia IndrawanOnline First: Apr 30, 2022
- Abstract
Rasio neutrofil limfosit (RNL), mean platelet volume (MPV), serta red cell distribution width (RDW) sebagai prediktor tunggal sepsis neonatorum awitan dini (SNAD) di RSUD Wangaya Kota Denpasar, Bali
Background: Sepsis is still a serious world health threat, especially in developing countries, including Indonesia. Blood culture examination as the gold standard for diagnosis has several drawbacks, thus encouraging clinicians to find new markers with shorter examination times and affordable costs. This study examines the relationship between RNL, MPV and RDW with early-onset neonatal sepsis (EONS) at Wangaya Hospital, Denpasar City.
Methods: This cross-sectional analytic observational study using the consecutive sampling method was carried out by collecting medical record data for neonates at risk for neonatal sepsis who were treated at the Wangaya Hospital, Denpasar City from January 2020 to September 2021. The cut off values for RNL, MPV and RDW were determined using a receiver-operating characteristic curve. (ROC). Chi-square analysis and multivariate logistic regression were performed to determine the significant relationship.
Results: Of the 110 sample subjects, 57 subjects (47.5%) had a diagnosis of SNAD. The results of bivariate analysis, RNL with a cut off value of 2.23 (p<0.001), MPV with a cut off value of 9.95 fL (p<0.001), and RDW with a cut off value of 16.15% (p<0.001) were associated with EONS. The results of multivariate analysis showed that RNL (OR=3.32, p=0.012), MPV (OR=3.83, p=0.004), and RDW (OR=3.47, p=0.006) were the single predictors of EONS.
Conclusion: neutrophil lymphocyte ratio (RNL), red cell distribution width (RDW), mean platelet volume (MPV) as independent predictor of early-onset neonatal sepsis (SNAD).
Latar Belakang: Sepsis saat ini masih merupakan ancaman kesehatan dunia yang serius, terutama di negara berkembang, termasuk Indonesia. Pemeriksaan kultur darah sebagai baku emas diagnosis memiliki beberapa kelemahan, sehingga mendorong klinisi untuk menemukan penanda baru dengan waktu pemeriksaan lebih singkat dan biaya terjangkau. Studi ini meneliti hubungan RNL, MPV serta RDW dengan sepsis neonatorum awitan dini (SNAD) di RSUD Wangaya, Kota Denpasar.
Metode: Penelitian observasional analitik potong lintang ini menggunakan metode consecutive sampling dilakukan dengan mengumpulkan data rekam medis neonatus dengan resiko sepsis neonatorum yang dirawat di RSUD Wangaya Kota Denpasar dari Januari 2020 hingga September 2021. Nilai cut off RNL, MPV dan RDW ditentutkan menggunakan kurva receiver-operating characteristic (ROC). Analisis chi-square dan regresi logistik multivariat dilakukan untuk mengetahui hubungan yang bermakna.
Hasil: Dari 110 subjek sampel, sebesar 57 subjek (47,5%) dengan diagnosis SNAD. Hasil analisis bivariat, RNL dengan nilai cut off 2.23 (p<0,001), MPV dengan nilai cut off 9,95 fL (p<0,001), serta RDW dengan nilai cut off 16,15% (p<0,001) berhubungan dengan SNAD. Hasil analisis multivariat, menunjukkan RNL (OR=3,32, p=0,012), MPV (OR=3,83, p=0,004), serta RDW (OR=3,47, p=0,006) merupakan prediktor tunggal kejadian SNAD.
Simpulan: rasio neutrofil limfosit (RNL), red cell distribution width (RDW), mean platelet volume (MPV) sebagai prediktor tunggal sepsis neonatorum awitan dini (SNAD).
Kadar IL-10 plasma berkorelasi positif dengan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler
Ida Ayu Uttari Priyadarshini, Nyoman Suryawati, Luh Made Mas RusyatiOnline First: Apr 30, 2022
- Abstract
Kadar IL-10 plasma berkorelasi positif dengan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler
Introduction: A healthy person who contacts people diagnosed with leprosy can be at a high risk of being infected with leprosy with a predominance of the subclinical stage. The MB type infection has a 4-10 times greater risk of developing into a clinical form. Early detection of subclinical leprosy is important so that it can play a role in the process of eliminating leprosy. If it is not screened, most of the subclinical stage leprosy can develop into the clinical stage and can cause physical deformities. Phenolic glycolipid-1 (PGL-1) is a specific antigen for M.leprae and Interleukin-10 (IL-10) is an anti-inflammatory cytokine that shows the body's immune response. Research on the relationship between levels of IL-10 and IgM anti-PGL-1, especially in Bali, has not been carried out, so this study aims to find a relationship between levels of IL-10 and levels of IgM anti-PGL-1 in household contacts of multibacillary leprosy patients.
Methods: This research is an analytical observational study with a cross-sectional and was carried out in February-May 2021 at the Dermatology and Venereology Polyclinic and Clinical Pathology Laboratory, Sanglah Hospital Denpasar, and the Leprosy reference laboratory, Tropical Diseases Center, Universitas Airlangga. Samples aged 18-65 years were selected through Consecutive Sampling according to inclusion and exclusion criteria. The sample was taken from venous blood and then checked for levels of PGL-1 and IL-10. Data analysis using SPSS version 23. The results were considered significant if p<0.05.
Results: The mean level of IgM anti-PGL-1 in the contact group vs. the non-contact group was 863.07 ± 789.04 u/ml vs 247.75 ± 161.60 u/ml. The mean levels of IL-10 in the contact and non-contact groups were 121.09 ± 144.11 pg/ml and 46.04 ± 11.27 pg/ml. There was a significant difference in levels of IL-10 and IgM anti-PGL-1 in the contact group and non-contact groups (p<0.05) and a weak positive relationship (r=0.296, p=0.02) between levels of IL-10 and anti-PGL-IgM. 1.
Conclusion: The levels of IgM anti-PGL-1 and IL-10 in the contacts were higher than in the non-contacts with a significant difference.
Pendahuluan: Narakontak merupakan salah satu kelompok dengan risiko tinggi terinfeksi kusta dengan dominansi stadium subklinis. Pada infeksi tipe MB memiliki resiko 4-10 kali lebih besar berkembang menjadi bentuk klinis. Deteksi dini pada penyakit kusta subklinis ini menjadi penting sehingga dapat berperan dalam proses eliminasi kusta. Jika dibiarkan sebagian besar kusta stadium subklinis dapat berkembang menjadi kusta klinis dan dapat menimbulkan deformitas pada fisik. Phenolic glycolipid-1 (PGL-1) merupakan antigen spesifik untuk M. leprae dan Interleukin-10 (IL-10) merupakan sitokin anti-inflamasi yang menunjukkan respon imun tubuh. Penelitian mengenai hubungan antara kadar IL-10 dan IgM anti PGL-1 khusunya di Bali belum dilakukan, sehingga penelitian ini bertujuan mencari hubungan antara kadar IL-10 dengan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler.
Metode: Penelitian merupakan studi observasional analitik dengan pendekatan potong lintang dan dilaksanakan bulan Februari-Mei 2021 di Poliklinik Kulit dan Kelamin dan Laboratorium Patologi Klinik, RSUP Sanglah Denpasar dan laboratorium rujukan Leprosy, Tropical Diseases Centre, Universitas Airlangga. Sampel berusia 18-65 tahun dipilih melalui Consecutive Sampling sesuai kriteria inklusi dan eksklusi. Sampel dilakukan pengambilan darah vena kemudian diperiksa kadar PGL-1 dan IL-10. Analisis data menggunakan SPSS versi 23. Hasil dianggap signifikan jika p<0,05.
Hasil: Rerata kadar IgM anti PGL-1 kelompok narakontak vs bukan narakontak sebesar 863,07 ± 789,04 u/ml vs 247,75 ± 161,60 u/ml. Rerata kadar IL-10 kelompok narakontak dan bukan narakontak sebesar 121,09 ± 144,11 pg/ml dan 46,04 ± 11,27 pg/ml. Terdapat perbedaan signifikan pada kadar IL-10 dan IgM anti PGL-1 pada kelompok narakontak dan bukan narakontak (p<0.05) serta hubungan positif lemah (r=0,296, p=0,02) antara kadar IL-10 dengan IgM anti PGL-1.
Simpulan: Kadar IgM anti PGL-1 dan IL-10 pada narakontak lebih tinggi dari non narakontak dengan perbedaan yang signifikan.
Karakteristik anak dengan infeksi dengue di RSUP Sanglah, Denpasar, Bali
Niluh Putu Wida Pangestika, I Wayan Gustawan, I Made Gede Dwi Lingga UtamaOnline First: Apr 30, 2022
- Abstract
Karakteristik anak dengan infeksi dengue di RSUP Sanglah, Denpasar, Bali
Background: Dengue infection is a global health problem. The incidence of this disease in children has tended to increase in the last three decades. The World Health Organization (WHO) noted that Indonesia has the highest dengue infection cases in Southeast Asia.
Objective: To find the characteristics of children with dengue infection in Sanglah General Hospital, Denpasar, Bali
Methods: This research is a retrospective cross-sectional study of pediatric patients aged 1-18 years with dengue infection treated at Sanglah Hospital, Denpasar City, from August 2017 until July 2021 using frame sampling. The collected data was analyzed statistically using SPSS for Windows version 23.0.
Results: In this study, 137 children with dengue infection were treated at Sanglah Hospital. The median age of the subjects was 9 years (range 1-18 years), with the highest number in the 5-to-9-year age group (33.5%). 61.3% male and 38.7% female. The average length of stay of the subjects was 4 days. 79.6% of the subjects live in urban areas. The degree of infection in the study subjects was dengue fever 35.8%, dengue hemorrhagic fever grade I 19%, dengue hemorrhagic fever grade II 14,6%, dengue hemorrhagic fever grade III 19%, and dengue hemorrhagic fever grade IV 11.7%. Based on the outcome of the research subjects, 98.5% of the subjects had good outcomes.
Conclusion: Children with dengue infection are mostly found in school-age children with male sex, living in urban areas, with an average length of stay of 4 days and a good outcome.
Latar belakang: Infeksi dengue masih merupakan masalah kesehatan dunia. Angka kejadian penyakit ini pada anak cenderung meningkat dalam tiga dekade terakhir. World Health Organization (WHO) mencatat negara Indonesia sebagai negara dengan kasus infeksi dengue tertinggi di Asia Tenggara. Penelitian ini bertujuan mengetahui karakteristik anak dengan infeksi dengue di RSUP Sanglah, Denpasar, Bali
Metode: Penelitian ini dilakukan menggunakan rancangan penelitian retrospektif dengan desain potong lintang yang dilakukan di RSUP Sanglah, Denpasar, Bali pada bulan Juli 2021. Penelitian ini menggunakan data register pasien anak usía 1-18 tahun dengan infeksi dengue yang dirawat di RSUP Sanglah, di Kota Denpasar pada Agustus 2017 sampai Juli 2021. Pengambilan sampel dilakukan dengan cara frame sampling. Data yang terkumpul kemudian dianalisis secara statistik menggunakan SPSS for Windows versi 23.0.
Hasil: Pada penelitian ini, terdapat 137 anak dengan infeksi dengue yang berobat di RSUP Sanglah yang dijadikan sampel penelitian. Median usia subjek didapatkan 9 tahun (rentang 1-18 tahun), dengan jumlah terbanyak pada kelompok usia 5-9 tahun (33,5%). Jenis kelamin laki-laki 61,3% dan perempuan 38,7%. Rerata lama rawat subjek adalah 4 hari. 79,6% subjek tinggal di daerah urban. Derajat infeksi pada subjek penelitian adalah demam dengue 35,8%, demam berdarah dengue derajat I 19%, demam berdarah dengue derajat II 14,6%, demam berdarah dengue derajat III 19%, dan demam berdarah dengue derajat IV 11,7%. Berdasarkan luaran subjek penelitian didapatkan 98,5% subjek dengan luaran baik.
Simpulan: Anak dengan infeksi dengue banyak didapatkan pada anak usia sekolah, dengan jenis kelamin laki-laki, tinggal didaerah urban, dengan rerata lama rawat inap 4 hari dan luaran yang baik.
Prevalensi nyeri bahu pada peserta klub kebugaran
F.X Juanda SetiajayaOnline First: Apr 30, 2022
- Abstract
Prevalensi nyeri bahu pada peserta klub kebugaran
Background: Shoulder pain is pain that arises in the shoulder area caused by structural disorders of the shoulder such as muscles, bones, ligaments or tendons. Shoulder pain is often made worse by exercise. Nowadays many people join fitness clubs to exercise, one of the exercises is lifting weights. Certain movements, such as the bench press, pectoral fly, and overhead press, are weight-bearing exercises that put a lot of weight on the shoulders and can cause shoulder pain. Factors of age, gender and level of physical activity also play a role in the occurrence of shoulder pain in a person. This study was conducted to determine the prevalence of shoulder pain in fitness club participants and to describe the influencing factors.
Methods: This study is a cross-sectional survey from July to September 2016. The respondents in this study were the fitness club participants at the Golf Graha Family and Country Club, Surabaya as many as 73 people using purposive sampling technique. The variables in this study consisted of gender, age, level of physical activity, exercise patterns, and shoulder pain. The data obtained will be presented descriptively.
Results: There were 73 samples involved in this study. The mean age was 28.48±10.362, of which 53.4% were in the 17-25 year old group. Female gender, age group 17-25 years, weight training pattern, and moderate activity were found to have the highest percentage of shoulder pain.
Conclusion: In this study, respondents who performed weightlifting exercises that supported the shoulders were also more prone to experiencing shoulder pain.
Latar belakang: Nyeri bahu adalah rasa sakit yang timbul pada daerah bahu disebabkan oleh gangguan struktur bahu seperti otot, tulang, ligamen atau tendon. Nyeri bahu sering diperburuk oleh olahraga. Saat ini banyak orang yang mengikuti klub kebugaran untuk berolahraga, salah satu latihannya adalah angkat beban. Gerakan tertentu seperti bench press, pectoral fly, dan overhead press merupakan latihan angkat beban yang memberi tumpuan yang berat pada bahu dan berisiko menimbulkan nyeri bahu. Faktor usia, jenis kelamin dan tingkat aktifitas fisik juga berperan dalam terjadinya nyeri bahu pada seseorang. Penelitian ini dilakukan untuk mengetahui prevalensi nyeri bahu pada peserta klub kebugaran serta menggambarkan faktor yang berpengaruh.
Metode: Penelitian ini merupakan penelitian survei potong lintang pada bulan Juli hingga September 2016. Responden pada penelitian ini adalah peserta klub kebugaran di Golf Graha Family and Country Club, Surabaya sebanyak 73 orang dengan teknik purposive sampling. Variabel dalam penelitian ini terdiri dari jenis kelamin, usia, tingkat aktivitas fisik, pola latihan, dan nyeri bahu. Data yang didapat akan disajikan secara deskriptif.
Hasil: Terdapat 73 sampel yang terlibat dalam penelitian ini. Rata-rata usia 28,48±10,362 dimana 53,4% dalam rentang kelompok 17 – 25 tahun. Jenis kelamin perempuan, kelompok usia 17 – 25 tahun, pola latihan angkat beban, dan aktivitas sedang ditemukan memiliki persentase nyeri bahu tertinggi.
Kesimpulan: Pada penelitian ini responden yang melakukan latihan angkat beban yang memberi tumpuhan pada bahu juga lebih rentan untuk mengalami nyeri bahu.
Profil deskriptif pasien reaksi anafilaksis Di Rumah Sakit Umum Pusat Sanglah periode 2018-2021
I Gede Aswin Arinata, I Ketut SuardamanaOnline First: Apr 30, 2022
- Abstract
Profil deskriptif pasien reaksi anafilaksis Di Rumah Sakit Umum Pusat Sanglah periode 2018-2021
Introduction: The clinical degree of allergic reactions is divided into acute hypersensitivity reactions, anaphylactic reactions, and anaphylactic shock. Systemic anaphylactic reaction is a rare condition with a prevalence of around 1.6-5.1%. Clinical manifestations involved in anaphylactic reactions include skin and mucosal symptoms, respiratory system, cardiovascular system, digestive system. The purpose of this study was to determine the descriptive profile of patients with anaphylactic reactions at the Sanglah Central General Hospital for the period 2018 to 2021.
Methods: This study used a cross-sectional descriptive study design. Data were obtained secondary through medical records recorded at the Allergy and Immunology Division of Internal Medicine at Sanglah Hospital. Data analysis was done descriptively.
Results: In this study, 115 samples were obtained. The mean age in this study was 39.0±15.6. The sample consisted of 41 men (35.7%) and 74 women (64.3%). The most common allergens that cause anaphylactic reactions are drugs (53%) and food (22.6%). Based on clinical manifestations, the most experienced by patients were skin and mucosal symptoms (97.4%), respiratory system symptoms (86.1%), cardiovascular system symptoms (50.4%), and digestive system symptoms (23.5%). Patients who experienced anaphylactic shock 51 patients (44.3%).
Conclusion: Anaphylactic reactions experienced mostly by women. The most common allergens are drugs. Meanwhile, in terms of the severity of patients experiencing anaphylactic shock, almost half of the cases of anaphylactic reactions.
Pendahuluan: Derajat klinis dari reaksi alergi dibedakan menjadi reaksi hipersensitivitas akut, reaksi anafilaksis, dan syok anafilaksis. Reaksi anafilaksis sistemik merupakan kondisi yang jarang dijumpai dengan prevalensi sekitar 1,6-5,1%. Manifestasi klinis yang terlibat dalam reaksi anafilaksis meliputi gejala kulit dan mukosa, sistem pernafasan, sistem kardiovaskular, sistem pencernaan. Tujuan penelitian ini adalah untuk mengetahui profil deskriptif pasien reaksi anafilaksis di Rumah Sakit Umum Pusat Sanglah periode 2018 hingga 2021.
Metode Penelitian: Penelitian ini menggunakan rancangan studi deskriptif potong lintang. Data diperoleh secara sekunder melalui rekam medis yang tercatat di Bagian Alergi dan Imunologi Penyakit Dalam RSUP Sanglah. Analisis data dilakukan secara deskriptif.
Hasil: Pada penelitian ini didapatkan 115 sampel. Rerata usia pada penelitian ini yaitu 39,0±15,6. Sampel terdiri dari laki-laki 41 (35,7%) dan perempuan 74 (64,3%). Alergen penyebab reaksi anafilaksis terbanyak didapatkan dari obat (53%) dan makanan (22,6%). Berdasarkan manifestasi klinis yang terbanyak dialami pasien adalah gejala kulit dan mukosa sebanyak 97,4%, gejala sistem pernapasan sebanyak 86,1%, gejala sistem kardiovaskular sebanyak 50,4%, dan gejala sistem pencernaan sebanyak 23,5%. Pasien yang mengalami syok anafilaksis 51 pasien (44,3%).
Simpulan: Reaksi Anafilaksis dialami sebagian besar oleh perempuan. Alergen terbanyak adalah obat-obatan. Sedangkan dari sisi derajat keparahan pasien yang mengalami syok anafilaksis hampir setengah dari kasus reaksi anafilaksis.
Perbedaan karakteristik pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus – Oktober tahun 2021
Desak Ayu Dhyana Nitha Dewi, Putu Ayu Swandewi Astuti, I Gusti Agung Alit NayaOnline First: Apr 30, 2022
- Abstract
Perbedaan karakteristik pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus – Oktober tahun 2021
Background: The bite of an animal that transmits rabies is still a problem in Indonesia, one of which is in the province of Bali. The high dog population and the habit of straying dogs cause the risk of rabies transmission due to dog bites to be higher. North Kuta District is one of the areas where the case of bites of animals that transmit rabies is found. The purpose of this study was to determine the differences in the characteristics of patients with rabies-transmitting animal bites at the North Kuta Health Center from August to October 2021.
Methods: The study used a quantitative analytical design with a cross-sectional approach. The sample is patient medical record data at the North Kuta Health Center for the period August to October 2019. Data analysis was carried out using descriptive tests to describe patient characteristics. Bivariate test using Chi-square or Fisher’s Exact test was carried out to determine the differences in the characteristics of patients bitten by rabies-transmitting animals who received the Anti Rabies Vaccine (VAR) with a p value of <0.05 showing a significant value.
Results: There were 96 patients with rabies-transmitting animal bites at the North Kuta Health Center for the period August – October 2019. The characteristics of the patients showed that most of them were 20 years old (37.50%), bitten by a stray dog (70.83%), the condition of the animal when it was found. still alive (68.75%), bitten on the right leg (37.50%), and received VAR (52.08%). The highest cases of animal bites that transmit rabies occurred during the month of October (41.67%). The results of the Chi-square test showed that the amount of VAR administration was significantly different based on the characteristics of the biting animal species (p<0.0001) and the animal's condition (p<0.0001).
Conclusion: There are still cases of animal bites that transmit rabies in North Kuta District. There was a significant difference in the amount of VAR administration based on the characteristics of the biting animal species and the animal's condition.
Latar Belakang: Gigitan hewan penular rabies masih menjadi permasalahan di Indonesia, salah satunya di Provinsi Bali. Populasi anjing yang tinggi serta kebiasaan meliarkan anjing menyebabkan risiko penularan rabies akibat gigitan anjing menjadi semakin tinggi. Kecamatan Kuta Utara merupakan salah satu daerah ditemukannya kasus gigitan hewan penular rabies. Tujuan penelitian ini mengetahui perbedaan karakteristik pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus hingga Oktober 2021.
Metode: Penelitian menggunakan rancangan kuantitatif analitik dengan pendekatan potong lintang. Sampel merupakan data rekam medis pasien di Puskesmas Kuta Utara periode Agustus hingga Oktober 2019. Analisis data dilakukan dengan menggunakan uji deskriptif untuk menggambarkan karakteristik pasien. Uji bivariate menggunakan Chi-square atau Fisher’s Exact test dilakukan untuk mengetahui perbedaan karakteristik pasien gigitan hewan penular rabies yang memperoleh Vaksin Anti Rabies (VAR) dengan nilai p<0,05 menunjukan nilai signifikan
Hasil: Terdapat 96 pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus – Oktober 2019. Gambaran karakteristik pasien memperlihatkan sebagian besar berusia ≤20 tahun (37,50%), digigit oleh anjing liar (70,83%), kondisi hewan saat ditemukan masih hidup (68,75%), digigit di kaki kanan (37,50%), dan memperoleh VAR (52,08%). Kasus gigitan hewan penular rabies tertinggi terjadi selama bulan Oktober (41,67%). Hasil uji Chi-square menunjukkan bahwa jumlah pemberian VAR berbeda signifikan berdasarkan karakteristik jenis hewan penggigit (p<0,0001) dan kondisi hewan (p<0,0001).
Kesimpulan: Masih terdapat kasus gigitan hewan penular rabies di Kecamatan Kuta Utara. Terdapat perbedaan bermakna jumlah pemberian VAR berdasarkan karakteristik jenis hewan penggigit dan kondisi hewan.
Uji toksisitas akut dan subkronik ekstrak daun binahong (Anredera cordifolia) pada mencit Balb/C betina
I Wayan Lolik Lesmana, Eka Putra Setiawan, Ni Putu Oktaviani Rinika PranitasariOnline First: Apr 30, 2022
- Abstract
Uji toksisitas akut dan subkronik ekstrak daun binahong (Anredera cordifolia) pada mencit Balb/C betina
Background: The antibacterial potential of Binahong leaf extract has been known but has not been studied further, especially against disease-causing bacteria in the Ear, Nose and Throat (ENT) field. The antibacterial activity is made possible by the presence of flavonoid compounds, saponins and alkaloids. This study aims to test the acute toxicity in determining the LD50 value and the subchronic toxicity test in the phytopathological examination of liver and kidney function in female Balb/C mice.
Methods: Experimental research was conducted on acute and subchronic toxicity of binahong leaf extract in mice. An acute toxicity test was carried out by giving a single dose of Binahong leaf extract, starting at a dose of 5 mg/kgBW and increasing until 2 mice died or 1 mouse showed symptoms of toxicity. After 28 days of offering Binahong leaf extract, blood serum was taken to check kidney and liver function, while the kidneys and then histopathological examinations were carried out. Data were analyzed with SPSS version 20 for Windows.
Results: There was a significant difference in SGPT levels in the group that received binahong extract treatment at a dose of 250 mg/kgBW (24.08±3.08/L), 500 mg/kgBW (26.84±1.47/L), and 1000 mg/kgBW (30.38±0.68/L) compared to the control group (18.18±0.46/L) (p<0.05). Significant differences were also found in BUN and SC levels measurement compared to the control group (p<0.05). However, significant differences in SGOT levels were only found in the binahong extract group at a dose of 500 mg/kgBW (44.88±2.88/L) and 1000 mg/kgBW (58.18±2.56/L) compared to the control (37 ,48±0.44 /L) (p<0.05).
Conclusion: There were significant differences in the levels of SGPT, SGOT, BUN, and SC after the administration of various doses of binahong leaf extract in female Balb/C mice.
Latar Belakang: Potensi antibakteri ekstrak daun Binahong telah diketahui namun belum diteliti lebih jauh terutama terhadap bakteri penyebab penyakit di bidang Telinga Hidung dan Tenggorok (THT). Aktivitas antibakteri tersebut dimungkinkan oleh adanya kandungan senyawa flavonoid, saponin dan alkaloid. Penelitian ini bertujuan untuk menguji toksisitas akut dalam menentukan nilai LD50 dan uji toksisitas subkronik berupa pemeriksaan fungsi hepar dan ginjal secara biokimia dan histopatologi pada mencit Balb/C betina.
Metode: Penelitian eksperimental dilakukan terhadap toksisitas akut dan subkronik ekstrak daun Binahong pada mencit. Uji toksisitas akut dilakukan dengan memberikan ekstrak daun Binahong dosis tunggal mulai dari dosis 5 mg/kgBB dan ditingkatkan sampai didapatkan ≥ 2 ekor mencit yang mati atau ≥ 1 ekor mencit menunjukkan gejala toksisitas. Setelah 28 hari pemberian ekstrak daun Binahong, dilakukan pengambilan serum darah untuk diperiksa fungsi ginjal dan hepar, sedangkan organ ginjal dan hepar selanjutnya akan dilakukan pemeriksaan histopatologi. Data dianalisis dengan SPSS versi 20 untuk Windows.
Hasil: Terdapat perbedaan yang bermakna kadar SGPT pada kelompok yang mendapatkan perlakuan ekstrak binahong dengan dosis 250 mg/kgBB (24,08±3,08 µ/L), 500 mg/kgBB (26,84±1,47 µ/L), dan 1000 mg/kgBB (30,38±0,68 µ/L) dibandingkan dengan kelompok kontrol (18,18±0,46 µ/L) (p<0,05). Perbedaan yang bermakna juga ditemukan pada pengukuran kadar BUN dan SC dibandingkan dengan kelompok kontrol (p<0,05). Akan tetapi perbedaan bermakna kadar SGOT hanya ditemukan pada kelompok ekstrak binahong dengan dosis 500 mg/kgBB (44,88±2,88 µ/L) dan 1000 mg/kgBB (58,18 ± 2,56 µ/L) dibandingkan dengan kontrol (37,48±0,44 µ/L) (p<0,05).
Simpulan: Terdapat perbedaan yang bermakna pada kadar SGPT, SGOT, BUN, dan SC pasca pemberian berbagai dosis ekstrak daun binahong pada mencit Balb/C betina.
Uji aktivitas antibakteri ekstrak kulit batang tanaman kenanga (cananga odorata) terhadap bakteri penyebab infeksi kulit Staphylococcus aureus in vitro
Putu Gitanjani Mahadewi Semadhi, Ketut Indah Karina Mahardika, Rena Sari Megayanthi, Ni Wayan Prabasiwi Kirana, I Dewa Gde Bagus Panji Palaguna, Made Agus HendrayanaOnline First: Jan 30, 2022
- Abstract
Uji aktivitas antibakteri ekstrak kulit batang tanaman kenanga (cananga odorata) terhadap bakteri penyebab infeksi kulit Staphylococcus aureus in vitro
Background: Staphylococcus aureus resistance to antibiotics or Methicillin Resistance Staphylococcus Aureus (MRSA) is a severe problem worldwide with high morbidity and mortality rates, so it is necessary to identify alternative new antibacterial compounds to overcome this problem, especially those that derived from natural ingredients. One of these natural ingredients is the ylang plant (Cananga odorata) because the phytochemical test results show that this plant contains various bacteriostatic compounds. This study aims to determine whether the bark extract of the ylang plant (Cananga odorata) can inhibit the growth of S. aureus.
Methods: In vitro experimental research using ylang bark extract (Cananga odorata) with concentrations of 20%, 60%, and 100% with 96% ethanol diluent. Inhibition test was carried out using the disc diffusion test method with five repetitions.
Results: The average zone of inhibition of the growth of Staphylococcus aureus bacteria was as follows: 20% extract (P1) 11.8 mm; extract 60% (P2) 12.2 mm; extract 100% (P3) 18.2 mm; positive control (K2) 32.4 mm; and negative control (K1) 0 mm. The statistical analysis results showed that the bark extract of the Cananga plant affected the inhibition of S. aureus bacteria at concentrations of 20%, 60%, and 100%.
Conclusion: Ylang plant (Cananga odorata) bark extract with concentrations of 20%, 60%, and 100% was effective in inhibiting the growth of S. aureus bacteria.
Latar Belakang: Resistensi bakteri Staphylococcus aureus terhadap antibiotik atau Methicillin Resistance Staphyloccus Aureus (MRSA) merupakan salah satu masalah serius di dunia kesehatan, sehingga perlu diidentifikasi alternatif senyawa antibakteri baru untuk mengatasi masalah tersebut, khususnya yang berasal dari bahan alami. Adapun salah satu bahan alami tersebut yakni tanaman kenanga (Cananga odorata) karena hasil uji fitokimia menunjukkan bahwa tanaman ini mengandung berbagai senyawa bakteriostatik. Penelitian ini bertujuan untuk mengetahui apakah ekstrak kulit batang tanaman kenanga (Cananga odorata) dapat menghambat pertumbuhan bakteri S. aureus.
Metode: Penelitian eksperimental in vitro menggunakan ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi sebesar 20%, 60%, dan 100% dengan pengencer etanol 96%. Pengujian daya hambat dilakukan dengan menggunakan metode uji difusi cakram sebanyak lima kali pengulangan.
Hasil: Rerata zona hambat pertumbuhan bakteri Staphylococcus aureus adalah sebagai berikut: ekstrak 20% (P1) 11,8 mm; ekstrak 60% (P2) 12,2 mm; ekstrak 100% (P3) 18,2 mm; kontrol positif (K2) 32,4 mm; dan kontrol negatif (K1) 0 mm. Hasil analisis statistik menyatakan bahwa ekstrak kulit batang tanaman kenanga berpengaruh terhadap daya hambat bakteri S. aureus pada konsentrasi 20%, 60%, dan 100%.
Kesimpulan: Ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi 20%, 60%, dan 100% efektif untuk menghambat pertumbuhan bakteri S. aureus
Faktor-faktor yang mempengaruhi keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado
Madianung Valentine Virginia Bonochdita, Starry Homenta Rampengan, Jeini Ester Nelwan, Aaltje Ellen Manampiring, Dina Victoria RombotOnline First: Feb 5, 2022
- Abstract
Faktor-faktor yang mempengaruhi keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado
Background: One of the health fields that is currently developing in various countries in adopting information and communication technology (ICT) is e-health. Hermina Hospital has a hermina mobile application that is useful for facilitating outpatient services. Initial data collection conducted by researchers in March showed that 23% of outpatient visits from executive polyclinics were registered via this application. Therefore, the aim of this research is to analyze the usage behavior of online registration at Hermina Hospital.
Methods: This research was a quantitative correlational descriptive study with a cross sectional approach. The data used in this study obtained from the questionnaire using the method of convenient sampling with involved the participation of 110 respondents. Independent variables of this study were performance expectancy, effort expectancy, social influence, fcailitating condition dan behavioral intention. Dependent variable of this study is use behavior. The instrument used in this study was a quesioner.
Results: The results of the chi square test found that performance expectancy, usage behavior, and behavioral intention were significantly related to use behavior (p < 0.05). Based on the results of the logistic regression test, it was found that the dominant factor influencing the use behavior is behavioral intention with a value of Exp (B) or Odds Ratio (OR) 2.746 and level of significant <0.05.
Conclusion: The conclusion of this study is that there is a significant relationship between behavioral intention, effort expectancy, and performance expectancy on the decision to adopt the Hermina mobile application.
Latar Belakang: Salah satu bidang kesehatan yang saat ini sudah berkembang di berbagai negara dalam mengadopsi teknologi informasi dan komunikasi (TIK) yaitu e-Kesehatan (e-health). Rumah Sakit Hermina memiliki aplikasi hermina mobile yang berguna untuk mempermudah pelayanan pasien rawat jalan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi keputusan adopsi aplikasi pendaftaran online hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.
Metode: Penelitian ini merupakan penelitian kuantitatif korelasional dengan pendekatan cross sectional. Penelitian ini dilaksanakan di Rumah Sakit Hermina Manado pada November - Desember 2021. Subyek dalam penelitian ini yaitu 110 pasien poli eksekutif. Variabel bebas dari penelitian ini yaitu performance expectancy, effort expectancy, social influence, facilitating condition dan behavioral intention. Variabel terikat dari penelitian ini adalah keputusan adopsi (use behavior). Instrumen yang digunakan yaitu kuesioner. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat. Penyajian data dibuat dalam bentuk tabel dan narasi.
Hasil: Hasil uji chi square ditemukan bahwa performance expectancy, effort expectancy, dan behavioral intention memiliki hubungan bermakna dengan keputusan adopsi (use behavior) (p<0,05). Berdasrkan hasil uji regresi logistik ditemukan faktor dominan berpengaruh terhadap keputusan adopsi pasien poli eksekutif adalah behavioral intention dengan nila Exp (B) atau Odds Ratio (OR) 2,746 dan nilai p<0,05.
Kesimpulan: Terdapat hubungan yang signifikan antara faktor behavioral intention, effort expectancy, dan performance expectancy terhadap keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.
Faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi covid-19
Andrew Christian Pangemanan, Starry Homenta Rampengan, Oksfriani Julfri Sumampouw, Aaltje Ellen ManampiringOnline First: Feb 7, 2022
- Abstract
Faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi covid-19
Latar belakang: Kepuasan pasien dicapai apabila penerima pelayanan memperoleh pelayanan sesuai dengan yang dibutuhkan dan diharapkan. Pandemi Coovid-19 menyebabkan penurunan angka kunjungan pasien, hal ini terjadi karena terdapat alur proses pelayanan kesehatan yang berubah, pembatasan jumlah pasien, serta diterapkannya langkah pencegahan standar, identifikasi awal dan pengendalian sumber virus. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19.
Metode: Penelitian ini merupakan penelitian kuantitatif dengan pendekatan studi potong lintang. Penelitian ini dilaksanakan di Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada November-Desember 2021. Sampel penelitian berjumlah 334 pasien. Variabel bebas dari peneitian ini yaitu kesehatan fisik dan psikis pasien, kompetensi staf medis dan fasilitas rumah sakit. Variabel terikat dari penelitian ini adalah kepuasan pasien. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat.
Hasil: Hasil penelitian menunjukkan bahwa responden paling banyak berjenis kelamin laki-laki (52,69%), mayoritas berumur 36-45 tahun (37,72%), pekerjaan terbanyak swasta (35,33%) dan tingkat pendidikan terbanyak SMA/sederajat (46,41%). Hasil uji korelasi pearson ditemukan bahwa faktor kesehatan fisik dan psikis, kompetensi staf medis dan fasilitas rumah sakit nilai p<0,05. Berdasarkan uji regresi linier berganda ditemukan faktor yang paling mempengaruhi kepuasan pasien adalah fasilitas rumah sakit dengan nilai standardized coefficients beta sebesar 0,314.
Kesimpulan: Faktor kesehatan fisik dan psikis, kompetensi staf medis, dan fasilitas rumah sakit berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19. Fasilitas rumah sakit merupakan faktor yang dominan berpengaruh terhadap kepuasan pasien
Analisis kinerja pegawai bagian administrasi RSUP Ratatotok buyat di era sebelum pandemi COVID-19, saat pandemic, dan new normal
Riliani Manitik, Starry Homenta Rampengan, Freddy W. Wagey, Aaltje Ellen ManampiringOnline First: Feb 7, 2022
- Abstract
Analisis kinerja pegawai bagian administrasi RSUP Ratatotok buyat di era sebelum pandemi COVID-19, saat pandemic, dan new normal
Introduction: The success of hospitals (RS) in carrying out their functions as health service institutions is characterized by good quality hospital services. Administrative employees as non-health workers must have good performance in order to realize quality health services. This study aimed to analyze the description of employee performance in the administration section of the Ratatotok Buyat Hospital in terms of aspects of work culture and work environment in the era before the Covid-19 pandemic, during the pandemic and the new normal era.
Methods: This type of research uses a qualitative descriptive method. Data collection techniques were carried out by in-depth interviews and then documented and analyzed. To obtain the validity of the data, inspection techniques were carried out through several activities, namely triangulation. Qualitative data was obtained based on the results of in-depth interviews using the Mile and Huberman data analysis model
Results: The performance of employees in the administration section shows that systems and activities related to employee work experience changes during the pandemic when there is a decrease in employee performance when compared to performance before the pandemic, in the new normal era, employee performance has increased.
Conclusion: The performance of employees in the administration of Ratatotok Buyat Hospital before the Covid-19 pandemic was very good, there was a decline in performance during the pandemic, but increased again in the new normal era.
Pendahuluan: Keberhasilan rumah sakit (RS) dalam menjalankan fungsinya sebagai lembaga pelayanan kesehatan ditandai dengan kualitas pelayanan rumah sakit yang baik. Pegawai administrasi sebagai tenaga non kesehatan harus memiliki kinerja yang baik agar dapat mewujudkan pelayanan kesehatan yang berkualitas. Penelitian ini bertujuan untuk menganalisis gambaran kinerja pegawai pada bagian administrasi Rumah Sakit Umum Pusat (RSUP) Ratatotok Buyat ditinjau dari aspek budaya kerja dan lingkungan kerja pada era sebelum pandemi Covid-19, saat pandemi dan era new normal.
Metode: Jenis penelitian ini menggunakan metode deskriptif kualitatif. Teknik pengumpulan data dilakukan dengan wawancara mendalam kemudian didokumentasikan dan dianalisis. Untuk mendapatkan keabsahan data, dilakukan teknik pemeriksaan yaitu dengan triangulasi. Data kualitatif diperoleh berdasarkan hasil wawancara mendalam dengan menggunakan model analisis data Mile dan Huberman.
Hasil: Kinerja pegawai dibagian administrasi menunjukkan bahwa saat pandemi terjadi penurunan jika dibandingkan dengan dengan kinerja sebelum pandemi, diera new normal kinerja pegawai kembali mengalami peningkatan.
Kesimpulan: Kinerja pegawai di bagian administrasi RSUP Ratatotok Buyat sebelum pandemi Covid-19 sangat baik, dan terjadi penurunan kinerja saat pandemi, namun kembali mengalami peningkatan di era new normal.
Relationship between Monocarboxylate Transporter 4 (MCT-4) Expression and Breast Cancer Clinicopathology and Subtype in Sanglah General Hospital, Denpasar, Indonesia
Gede Andry Nicolas Andry Nicolas, I Wayan Sudarsa, Putu Anda Tusta Adiputra, Desak Made Wihandani, I Gede Putu SupadmanabaOnline First: Feb 7, 2022
- Abstract
Relationship between Monocarboxylate Transporter 4 (MCT-4) Expression and Breast Cancer Clinicopathology and Subtype in Sanglah General Hospital, Denpasar, Indonesia
Background: Breast cancer is the second leading cause of death in women in developing countries. The activity of Warburg and Reverse-Warburg effects on breast cancer is reflected by the expression patterns of two molecules, namely caveolin-1 and Monocarboxylate Transporter-4 (MCT-4). MCT-4 is a transmembrane transport protein that transports lactate from the cytoplasm to the intercellular fluid.
Method: This is a cross-sectional analytical study to determine the relationship between MCT-4 expression and breast cancer clinicopathology and subtypes. The study was conducted between April and May of 2020 with 62 breast cancer patients as samples in Sanglah General Hospital, Denpasar. Analysis was done with SPSS 25.
Results: A logistic regression analysis was performed to analyze the relationship between the dependent variable (MCT-4) and the covariates (stage, grade, and subtype). Of the three variables significantly associated with MCT-4 expression, only clinical-stage and subtype (luminal and non-luminal) remained independently associated with MCT-4 expression. Analysis on the clinical stage and subtype variables showed an adjusted OR of 4.727 (p = 0.047; 95% CI: 1.109 - 21.922) and 17.850 (p = 0.009; 95% CI: 2.069 - 154.003) , respectively. This suggests that MCT-4 has a significant association with subtype and clinical-stage, increasing the risk of cancer stage progression and developing a more malignant (non-luminal) subtype.
Conclusion: High MCT-4 expression was significantly associated with malignant subtypes, high histological-grade cancer and advanced breast cancer.
Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat
Leony Lim, Ketut Suwiyoga, I Wayan Artana Putra, Anak Agung Ngurah Jaya Kusuma, I Gede Mega Putra, Anom Suardika, I Wayan MegadhanaOnline First: Feb 9, 2022
- Abstract
Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat
Background: Preeclampsia is a health problem because it contributes to high rates of maternal and baby morbidity and mortality. The pathogenesis of preeclampsia is still unknown, but vitamin D deficiency and low HDL-LDL serum ratio are thought to play an important role. Therefore, a study was conducted on low 25(OH)D serum level and low HDL-LDL serum ratio as risk factors for preeclampsia with severe features.
Methods: This study has a case-control design, conducted at Obstetric and Gynecology emergency room at Sanglah Hospital from January 2020 to June 2020. Subjects were 44 pregnant women, consisting 22 normal pregnant women as controls and 22 pregnant women with preeclampsia with severe features as cases, selected by purposive consecutive sampling and analyzed using SPSS 21.
Results: Preeclampsia with severe features was found 5 times higher in pregnant women with low 25(OH)D serum level than in normal pregnant women (OR = 4,91, CI 95% = 1,33-18,21, p = 0,014). Preeclampsia with severe features was found 8 times higher in pregnant women with low HDL-LDL serum ratio than in normal pregnant women (OR = 7,88, CI 95% = 1,96-31,57, p = 0,002).
Conclusion: Low 25(OH)D serum level and low HDL-LDL serum ratio are risk factors for Preeclampsia with severe features.
Pendahuluan: Preeklamsia merupakan masalah kesehatan karena berkontribusi terhadap tingginya angka morbiditas dan mortalitas ibu dan bayi. Patogenesis preeklamsia sampai saat ini masih belum diketahui secara pasti, namun kadar vitamin D dan rasio HDL–LDL serum yang rendah diduga berperan penting dalam mekanisme terjadinya preeklamsia. Penelitian kemudian dilakukan terhadap kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.
Metode : Desain penelitian ini adalah kasus kontrol (case control) yang dilakukan di Instalasi Gawat Darurat Obstetri dan Ginekologi RSUP Sanglah, Denpasar mulai Januari 2020 sampai Juni 2020. Subyek penelitian berjumlah 44 orang ibu hamil, yang terdiri dari 22 ibu hamil normal sebagai kontrol dan 22 ibu hamil dengan preeklamsia dengan gambaran berat sebagai kasus, yang dipilih secara purposive consecutive sampling, dan dianalisis menggunakan SPSS 21.
Hasil: Risiko terjadinya preeklamsia dengan gambaran berat adalah 5 kali lebih tinggi pada ibu hamil dengan kadar 25(OH)D serum yang rendah dibandingkan ibu hamil normal (OR = 4,91, IK 95% = 1,33-18,21, p = 0,014). Risiko terjadinya preeklamsia dengan gambaran berat adalah 8 kali lebih tinggi pada ibu hamil dengan rasio HDL-LDL serum yang rendah dibandingkan ibu hamil normal (OR = 7,88, IK 95% = 1,96-31,57, p = 0,002).
Simpulan : Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah merupakan faktor risiko preeklamsia dengan gambaran berat.
Analisis faktor risiko kejadian infeksi saluran pernapasan akut di Abiansemal Kabupaten Badung tahun 2018
Ni Made Marwati, I Wayan Sali, I Made Bulda Mahayana, I Gusti Ayu Made AryasihOnline First: Feb 15, 2022
- Abstract
Analisis faktor risiko kejadian infeksi saluran pernapasan akut di Abiansemal Kabupaten Badung tahun 2018
Background: Acute Respiratory Tract Infections (ARTI) is one of the main causes of patient visits to the public health center (40%-60%) and hospital (15%-30%). The purpose of this study was to determine various risk factors that influence the incidence of ARTI in Abiansemal in 2018.
Methods: This research was an observational study using a case-control research design by looking for various relationships of risk factors on the incidence of ARTI. The case group consists of patients diagnosed with ARTI and the control group were those who were not diagnosed with ARTI. The independent variables in this study were room occupancy density, kitchen room ventilation, smoking habits of parents, bedroom and living room ventilation, bedroom and living room light intensity, bedroom and living room air temperature, bedroom and living room, floor and wall humidity.
Result: The bivariate analysis showed that the risk factors for the incidence of ARTI were room occupancy density with a value of ?=0.05 (p=0.000, OR=28.444), smoking habits of the parents (p=0.000, OR=20.000), bedroom ventilation (p=0.003, OR=10.500), bedroom light intensity (p=0,000, OR=67,500), living room light intensity (p=0.001, OR=14.063), bedroom air temperature (p=0.002, OR=14.571), bedroom air humidity (p=0,000, OR=20,000).
Conclusion: There were seven factors that were significantly associated with the incidence of ARTI in Abiansemal includeing room occupancy density, smoking habits of the parents, bedroom ventilation, bedroom light intensity, living room light intensity, bedroom air temperature, and bedroom air humidity.
Latar Belakang: Infeksi Saluran Pernafasan Akut (ISPA) merupakan salah satu penyebab utama kunjungan pasien ke Puskesmas (40%-60%) dan rumah sakit (15%-30%). Tujuan dari penelitian ini adalah untuk mengetahui berbagai faktor risiko yang mempengaruhi kejadian ISPA di Abiansemal tahun 2018.
Metode: Penelitian ini merupakan penelitian observasional dengan desain penelitian kasus kontrol dengan mencari berbagai hubungan faktor risiko terhadap kejadian ISPA. Kelompok kasus terdiri dari pasien yang terdiagnosis ISPA dan kelompok kontrol adalah mereka yang tidak terdiagnosis ISPA. Variabel bebas dalam penelitian ini adalah kepadatan hunian kamar, ventilasi ruang dapur, kebiasaan merokok orang tua, ventilasi kamar tidur dan ruang tamu, intensitas cahaya kamar tidur dan ruang tamu, suhu udara kamar tidur dan ruang tamu, kamar tidur dan ruang tamu, kelembaban lantai dan dinding.
Hasil: Analisis bivariat menunjukkan bahwa faktor risiko kejadian ISPA adalah kepadatan hunian kamar dengan nilai 0,05 (p=0,000, OR=28,444), kebiasaan merokok orang tua (p=0,000, OR=20,000), ventilasi kamar tidur (p=0,003, OR=10,500), intensitas cahaya kamar tidur (p=0,000, OR=67,500), intensitas cahaya ruang tamu (p=0,001, OR=14,063), suhu udara kamar tidur (p=0,002, OR= 14,571), kelembaban udara kamar tidur (p=0,000, OR=20,000).
Kesimpulan: Terdapat tujuh faktor yang berhubungan signifikan dengan kejadian ISPA di Abiansemal meliputi kepadatan hunian kamar, kebiasaan merokok orang tua, ventilasi kamar tidur, intensitas cahaya kamar tidur, intensitas cahaya ruang tamu, suhu udara kamar tidur, dan kelembaban udara kamar tidur.
Studi kualitatif dan kuantitatif fitokimia ekstrak air dan ekstrak etanol daun kirinyuh (Chromolaena odorata l.) yang tumbuh di Provinsi Bali
Regina Tedjasulaksana, Maria Martina Nahak, Maria Martina Nahak, Ni Ketut Ratmini, Ni Ketut RatminiOnline First: Feb 16, 2022
- Abstract
Studi kualitatif dan kuantitatif fitokimia ekstrak air dan ekstrak etanol daun kirinyuh (Chromolaena odorata l.) yang tumbuh di Provinsi Bali
Background: Kirinyuh (Chromolaena odorata L.) leaf as a traditional medicine is used for wound healing. Kirinyuh is easy to get because it can still grow well in less fertile areas. This study aims to determine the results of qualitative and quantitative tests of the active substance in kirinyuh leaf extract (Chromolaena odorata L) growing in the province of Bali.
Methods: This research was pre-experimental with completely randomized design with post-test only control group design. The research sample is kirinyuh leaves from three regions in the province of Bali based on geomorphology. Qualitative test results of ethanol and water extract of kirinyuh leaves (Chromolaena Odorata L.) methanol and ethyl acetate fractions contain alkaloids, saponins, tannins, phenols, flavonoids and antioxidants.
Results: The results of the quantitative test of the highest alkaloid content from the ethanol extract of the methanol fraction from Jimbaran, namely 11,690.49 mg/100 gr. The highest tannin content of the ethanol extract of the ethyl acetate fraction from Tabanan was 172777 mg/100 gr. The highest Saponin content from the aqua extract of the ethyl acetate fraction was 2977.27 mg/100gr. The highest phenol content from the ethanol extract of the methanol fraction from Bangli was 19716.1 mg/100 gr. The highest flavonoid content from the ethanol extract of the ethyl acetate fraction from Tabanan was 13704.7 mg/100 gr. The highest antioxidant content of the aqua extract of the methanol fraction from Tabanan was 62.3067 ppm.
Conclusion: Total alkaloids of kirinyuh leaves in Jimbaran, Bangli and Tabanan were significantly different with p value = 0.000 (p < 0.05), tannins with p value = 0.000, phenols with p value = 0.006, flavonoids with p value = 0.000 and antioxidants with p value. p=0.000. Saponins in extracts from Jimbaran, Bangli and Tabanan there was no significant difference because the value of p=0,252 (p>0,05).
Latar Belakang: Daun kirinyuh ( Chromolaena odorata L. ) sebagai obat tradisional digunakan untuk penyembuhan luka. Kirinyuh mudah didapat karena dapat tetap tumbuh baik di daerah yang kurang subur. Penelitian ini bertujuan untuk mengetahui hasil uji kualitatif dan kuntitatif zat aktif dalam ekstrak daun kirinyuh (Chromolaena odorata L) yang tumbuh di propinsi Bali.
Metode: penelitian ini adalah pra eksperimen dengan rancangan completely randomized with post test only control group design. Sampel penelitian yaitu daun kirinyuh dari tiga wilayah di provinsi Bali berdasarkan geomorfologi. Hasil uji kualitatif ekstrak etanol dan air daun kirinyuh (Chromolaena Odorata L.) fraksi methanol dan etil asetat mengandung senyawa alkaloid, saponin, tannin, fenol, flavonoid dan antioksidan.
Hasil: Hasil uji kuantitatif kadar alkaloid terbanyak dari ekstrak etanol fraksi methanol dari Jimbaran, yaitu 11.690,49 mg/100 gr. Kadar tannin terbanyak dari ekstrak etanol fraksi etil asetat dari Tabanan, yaitu 172777 mg/100 gr. Kadar Saponin terbanyak dari ekstrak aqua fraksi etil asetat yaitu 2977,27 mg/100gr. Kadar fenol terbanyak dari ekstrak etanol fraksi methanol dari Bangli, yaitu 19716,1 mg/100 gr. Kadar flavonoid terbanyak dari ekstrak etanol fraksi etil asetat dari Tabanan, yaitu 13704,7 mg/100 gr. Kadar antioksidan terbanyak dari ekstrak aqua fraksi metanol dari Tabanan, yaitu 62,3067 ppm.
Simpulan: Total alkaloid daun kirinyuh Jimbaran, Bangli dan Tabanan berbeda bermakna dengan nilai p=0,000 (p<0,05), tannin dengan nilai p=0,000, fenol dengan nilai p=0,006, flavonoid dengan nilai p=0,000 dan antioksidan dengan nilai p=0,000. Saponin dalam ekstrak dari Jimbaran, Bangli dan Tabanan tidak ada perbedaan bermakna karena nilai p=0,252 (p>0,05).
The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM)
Danny Aguswahyudi, Ketut Suwiyoga, I Ketut Surya Negara, I Wayan Megadhana, I Nyoman Bayu Mahendra, I Gusti Putu Mayun Mayura, Made Bagus Dwi AryanaOnline First: Feb 16, 2022
- Abstract
The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM)
Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.
Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age ?24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.
Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).
Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.
Nilai diagnostik pemeriksaan Antinuclear Antibody (ANA) secara kuantitatif dengan metode Chemiluminescent Immunoassay (CLIA) pada pasien dengan penyakit autoimun
Indah Adhita Wulandari, Hani Susianti, Dian Sukma Hanggara, Kusworini Handono, Raymond Poeng, I Komang Adi Widana, Deasy Ayuningtyas TandioOnline First: Feb 18, 2022
- Abstract
Nilai diagnostik pemeriksaan Antinuclear Antibody (ANA) secara kuantitatif dengan metode Chemiluminescent Immunoassay (CLIA) pada pasien dengan penyakit autoimun
Background: Many serological examination methods have been developed to assist in diagnosing autoimmune diseases, one of which is the Chemiluminescent Immunoassay (CLIA) method. The CLIA method is an alternative method that is faster and estimated to have the same accuracy with IFA as the gold standard examination. It can help diagnose autoimmune diseases more quickly and easily. This study aims to determine the diagnostic value and conformity of the Anti-Nuclear Antibody (ANA) examination using the IFA method with the CLIA method in patients with autoimmune diseases.
Methods: The research design is a cross sectional study with consecutive sampling methods in autoimmune disease patients at Dr. Saiful Anwar Hospital Malang. ANA examination using the IFA method and the CLIA method. The data obtained by examining the IFA method is categorical, and the CLIA method is numerical. The diagnostic test uses the ROC curve and generates the AUC to determine the cut-off point. Furthermore, the suitability test was carried out using the Cohen's Kappa analysis technique. Data were analyzed using SPSS version 25 for Windows.
Results: The research sample collected was 110. Patients with positive ANA IFA results showed the same results with the CLIA method (58,18%). The diagnostic test using the cut-off value of serum ANA levels of 41.79 AU/mL showed a sensitivity value of 98.4%, specificity 95.5%, a positive predictive value of 95.63% and a negative predictive value of 98.35% with an AUC of 0.990. The suitability value of the ANA examination with the IFA and CLIA methods with the Cohen's Kappa test showed very good results, which was 0.908 (p=0.000).
Conclusion: There is a very good suitability value in examining the ANA parameters of the IFA method and the CLIA method. ANA CLIA examination has good diagnostic value.
Latar Belakang: Banyak metode pemeriksaan serologi yang berkembang untuk membantu penegakan diagnosis penyakit autoimun, salah satunya metode Chemiluminescent Immunoassay (CLIA). Metode CLIA merupakan alternatif metode yang lebih cepat dan diperkirakan memiliki keakuratan yang sama dengan pemeriksaan baku emas Immunofluorescence Assay (IFA), sehingga dapat membantu menegakkan diagnosa penyakit autoimun dengan lebih cepat dan mudah. Penelitian ini bertujuan untuk mengetahui nilai diagnostik dan kesesuaian hasil pemeriksaan Anti-Nuclear Antibody (ANA) metode IFA dengan metode CLIA pada pasien dengan penyakit autoimun.
Metode: Desain penelitian adalah studi potong lintang dengan metode consecutive sampling pada pasien penyakit autoimun di RSUD Dr. Saiful Anwar Malang. Pemeriksaan ANA menggunakan metode IFA dan metode CLIA. Data yang diperoleh dengan pemeriksaan metode IFA bersifat kategorikal, dan metode CLIA bersifat numerik. Uji diagnostik menggunakan kurva ROC dan menghasilkan AUC untuk menentukan cut-off-point. Selanjutnya dilakukan uji kesesuaian dengan teknik analisis Cohen’s Kappa. Data dianalisis dengan SPSS versi 25 untuk Windows.
Hasil: Sampel penelitian terkumpul 110. Pasien dengan hasil ANA IFA positif yang menunjukkan hasil yang sama dengan metode CLIA adalah (58,18%). Uji diagnostik menggunakan nilai cut-off kadar ANA serum 41,79 AU/mL menunjukkan nilai sensitivitas 98,4%, spesifisitas 95,5%, nilai ramal positif 95,63% dan nilai ramal negatif 98,35% dengan AUC 0,990. Nilai kesesuaian pemeriksaan ANA dengan metode IFA dan CLIA dengan uji Cohen’s Kappa menunjukkan hasil yang sangat baik secara bermakna yaitu sebesar 0,908 (p=0.000)
Kesimpulan: Terdapat nilai kesesuaian yang sangat baik pada pemeriksaan parameter ANA metode IFA dan metode CLIA. Pemeriksaan ANA CLIA memiliki nilai diagnostik yang bagus
Gambaran karakteristik pasien in hospital cardiac arrest dan luaran pasca resusitasi jantung paru oleh tim code blue di RSUP Sanglah
Made Satria Yudha Dewangga, Hendy Wirawan, Anak Agung Ayu Dwi Adelia YasminOnline First: Feb 14, 2022
- Abstract
Gambaran karakteristik pasien in hospital cardiac arrest dan luaran pasca resusitasi jantung paru oleh tim code blue di RSUP Sanglah
Background: Cardiac arrest is a medical emergency due to the sudden cessation of the heart’s mechanical function. Cardiac arrest can be reversible with appropriate intervention, but otherwise, it can be fatal and result in death. The incidence of cardiac arrest in hospital or in-hospital cardiac arrest (IHCA) needs to be considered because it is associated with high mortality and describes an early detection system and hospital response speed. In this study, the authors examined the characteristics of the incidence of IHCA and cardiopulmonary resuscitation carried out by the code blue team at the Sanglah Central General Hospital (RSUP), including outcome trends and survival of IHCA patients after cardiopulmonary resuscitation.
Methods: The authors analyzed the incidence of IHCA at Sanglah Hospital in 2021 in a retrospective cohort by tracing the patient’s medical records from January to December 2021. The sample was collected using a non-randomized consecutive sampling technique, then univariate analysis was performed to get an overview of the proportion and percentage distribution, as well as analysis. Bivariate method to determine the relationship between age group, comorbidities, response time of the code blue team, and the etiology of cardiac arrest on resuscitation outcomes.
Results: In IHCA patients who were resuscitated at Sanglah Hospital, 26.2% had a successful return of spontaneous circulation (ROSC), with >50% of patients dying within <24 hours and only 1% returning home recovering. The majority of IHCA patients were men aged 40 years or older, with a Charlson Comorbidity Index (CCI) 3, with noncardiac causes. Most resuscitation was performed within 5 minutes of the sound of the code blue signal. There was no significant relationship between age group, CCI score, etiology of cardiac arrest, and response time of the code blue team with resuscitation outcomes.
Conclusion: IHCA patients at Sanglah Hospital have a relatively low survival rate, but the code blue efforts have been going well. There were no significant differences in the outcome of ROSC and death based on age group variables, comorbidities, response time of the code blue team, and the etiology of cardiac arrest.
Latar Belakang: Henti jantung adalah keadaan darurat medis akibat berhentinya fungsi mekanis jantung secara tiba-tiba. Henti jantung dapat bersifat reversible dengan intervensi yang tepat, namun sebaliknya dapat bersifat fatal dan mengakibatkan kematian. Kejadian henti jantung di dalam rumah sakit atau in hospital cardiac arrest (IHCA) perlu diperhatikan karena berkaitan dengan mortalitas yang tinggi serta menggambarkan sistem deteksi dini dan kecepatan respon rumah sakit. Pada penelitian ini, penulis meneliti gambaran karakteristik kejadian IHCA dan resusitasi jantung paru yang dilakukan oleh tim code blue di Rumah Sakit Umum Pusat (RSUP) Sanglah, termasuk tren luaran dan kesintasan pasien IHCA pasca resusitasi jantung paru.
Metode: Penulis menganalisis kejadian IHCA di RSUP Sanglah pada tahun 2021 secara kohort retrospektif melalui penelusuran rekam medis pasien dari bulan Januari hingga Desember 2021. Sampel dikumpulkan dengan teknik non randomized consecutive sampling, kemudian dilakukan analisis univariat untuk mendapat gambaran proporsi dan distribusi persentase, serta analisis bivariat untuk mengetahui hubungan antara kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung terhadap luaran resusitasi.
Hasil: Pada pasien yang IHCA yang diresusitasi di RSUP Sanglah, 26,2% yang berhasil mengalami return of spontaneous circulation (ROSC), dengan >50% pasien meninggal dalam waktu <24 jam dan hanya 1% yang pulang dalam kondisi sembuh. Mayoritas pasien IHCA adalah laki-laki usia 40 tahun atau lebih, dengan Charlson Comorbidity Index (CCI) ?3, dengan penyebab nonkardiak. Sebagian besar resusitasi sudah dilakukan dalam waktu 5 menit setelah dibunyikannya tanda code blue. Tidak terdapat hubungan yang signifikan antara kelompok usia, skor CCI, etiologi henti jantung, serta waktu respon tim code blue dengan luaran resusitasi.
Simpulan: Pasien IHCA di RSUP Sanglah memiliki angka kesintasan yang relatif rendah, namun upaya code blue sudah berjalan dengan baik. Tidak ada perbedaan kejadian luaran ROSC maupun meninggal yang signifikan berdasarkan variabel kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung.
Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019 (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021
Anak Agung Parama Swari Khrisna, Ni Luh Jaya KiranaOnline First: Feb 22, 2022
- Abstract
Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019 (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021
Introduction: COVID-19 is an infectious disease caused by a new virus causes that attacks the upper respiratory tract and the lungs. The numbers of cases and deaths have increased on a daily basis on the scale of a global pandemic. Chest X-ray images have proven useful for monitoring various lung diseases and have recently been used to monitor the COVID-19 disease. Imaging modalities such as chest x-rays have the benefit of providing initial imaging before confirming with RT-PCR examination. The purpose of this study was to determine the value of the diagnostic examination of the chest x-ray compared to the RT-PCR examination which is the gold standard in diagnosing COVID-19.
Methods: This study used a diagnostic study design with a retrospective approach at Wangaya Hospital, Denpasar during the period June-November 2021. Analysis of the diagnostic test used cross tabulation and then calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy were performed.
Results: Thorax imaging diagnostic test value compared with the gold standard RT-PCR examination in form of sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy was 78%, 23%, 84%, 16.6%, 1.01, 0.95, and 69% respectively.
Conclusion: Thorax imaging provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of COVID-19.
Pendahuluan: COVID-19 merupakan suatu penyakit menular yang disebabkan oleh virus baru dan menyerang saluran pernapasan bagian atas dan paru-paru. Jumlah kasus dan kematian telah meningkat setiap hari dalam skala pandemik global. Modalitas pencitraan seperti thoraks foto memiliki manfaat untuk memberikan pencitraan awal sebelum mengkonfirmasi dengan pemeriksaan RT-PCR. Tujuan penelitian ini adalah untuk mengetahui nilai pemeriksaan diagnostik yang dimiliki thoraks foto dibandingkan dengan pemeriksaan RT-PCR yang merupakan baku emas dalam mendiagnosis COVID-19.
Metode: Penelitian ini menggunakan desain studi diagnostik dengan pendekatan retrospektif di Rumah Sakit Umun Daerah Wangaya Denpasar selama periode Juni-November 2021. Analisis uji diagnostik menggunakan tabulasi silang kemudian perhitungan sensitivitas, spesitifitas, positive predictive value (PPV), negative predictive value (NPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-) dan akurasi dilakukan.
Hasil: Nilai uji diagnostik thoraks foto dibandingkan dengan pemeriksaan baku emas RT-PCR berupa sensitivas, spesitifitas, PPV, NPV, LR+, LR-, dan akurasi adalah masing-masing 78%, 23%, 84%, 16.6%, 1.01, 0.95, dan 69%.
Simpulan: Thoraks foto memberikan sensitivitas dan akurasi diagnostik yang tinggi secara langsung pada presentasi klinis COVID-19.
Comparison of albumin 4%, gelatine, and ringer lactate as volume expander post-resuscitative phase on cardiac output and lactate serum after Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized prospective study
Prieta Adriane, Ni Luh Kusuma Dewi, Ardiyan ArdiyanOnline First: Feb 26, 2022
- Abstract
Comparison of albumin 4%, gelatine, and ringer lactate as volume expander post-resuscitative phase on cardiac output and lactate serum after Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized prospective study
Background. The use of protein colloid in fluid management post-cardiac surgery is debatable whether it is more beneficial than non-protein colloid or crystalloid. Patients who still need more volume after the resuscitative phase might benefit from optimal fluid management by choosing the most beneficial fluid. This study compared albumin 4% administration to gelatine and ringer lactate as a volume expanders post-resuscitative phase after coronary artery bypass grafting (CABG) on-pump.
Methods. We conducted a single-centered, single-blind, randomized controlled study that assigned 120 patients undergoing elective CABG on-pump. Subjects who met inclusion criteria received 125 ml/hour of either albumin 4%, gelatine colloid, or Ringer's lactate (RL) as the only infusion fluid for 4 hours after the first assessment post-resuscitative phase, after intensive care unit (ICU) admission. After fluid administration, patients were reassessed. The assessment included cardiac output and lactate serum as the primary outcome, while the duration of mechanical ventilation, ICU, and hospital stay were recorded as secondary outcomes.
Results. The mean of cumulative cardiac output improvement differed between the group albumin 4% 1.18 L/min, gelatine 0.88, and RL 0.74 (p=0.002). Lactate serum decreased in the albumin 4% group as much as 3.31 gr/dl compared to gelatine 2.13 and RL group 2.37 (p=0.005). Duration of mechanical ventilation, length of stay in ICU, and hospital post-operative were shorter in the albumin group than in other groups.
Conclusions. Albumin 4% used as a volume expander in the post-resuscitative phase still improved cardiac output and tissue micro-perfusion than gelatine and ringer lactate.
Prognostic value of red cell distribution width-to-platelet ratio in mortality of major burn in Sanglah Hospital Bali
Nyoman Siska Ananda, I Gusti Putu Hendra Sanjaya, Sianny Herawati, Agus Roy Rusly Hariantana Hamid, I Made Suka Adnyana, I Wayan NiryanaOnline First: Feb 28, 2022
- Abstract
Prognostic value of red cell distribution width-to-platelet ratio in mortality of major burn in Sanglah Hospital Bali
Introduction: The mortality rate in Sanglah Hospital due to major burns is quite high. The ratio of red cell distribution width (RDW) and platelet (PLT) (RPR) as a prognostic marker of mortality in major burns has never been studied in Indonesia. Calculations of RPR are easy, widely available and cost-efficient.
Method: This study was retrospective observational case-control, with 60 patients with major burns consisting of 30 cases and 30 controls. Samples were taken from the Sanglah Hospital Medical Record Unit from April 2019 to April 2021. Cases were samples with mortality after day seven, while controls were samples that survived. RDW and PLT value on day seven are associated with the incidence of mortality.
Results: The mean of RPR in the case group was higher than in the control group. RPR mean of the control group was 0.0559, and the case group was 0.0947 (p<0.001). The increase of RPR in the case group was 40.97%. Statistical analysis showed that high RPR was a significant mortality risk factor in patients with major burns (OR = 21.36; p < 0.001).
Conclusion: High RPR is a prognostic marker of mortality in major burns at Sanglah Hospital.
Hubungan neutrophil-lymphocyte ratio, absolute lymphocyte count, dan platelet lymphocyte ratio terhadap derajat keparahan COVID-19
Lusia NasraniOnline First: Feb 28, 2022
- Abstract
Hubungan neutrophil-lymphocyte ratio, absolute lymphocyte count, dan platelet lymphocyte ratio terhadap derajat keparahan COVID-19
Introduction: The COVID-19 virus was discovered at the end of 2019 as respiratory infectious disease and has become a pandemic until now, so it is very important to predict the severity of COVID-19. Neutrophil Lymphocyte Ratio (NLR), Absolute Lymphocyte Count (ALC), and Platelet Lymphocyte Ratio (PLR) are easy, inexpensive, and fast methods as screening tools for the severity of COVID-19. The purpose of this study was to determine the relationship between NLR, ALC, and PLR to the severity of COVID-19.
Methods: This study is an analytic observational study with a cross-sectional research design—retrieving research data using the total sampling method. The research data are medical records and laboratory examination data from 64 COVID-19 patients at Harapan Keluarga Hospital Cikarang in July–December 2020. The data analysis used was bivariate analysis with chi-square.
Results: There were 64 samples in this study, with the majority of samples being male, the average age was 42 years, the most common symptoms were fever (81.3%) and cough (71.9%), the majority of patients had no comorbidities. There was a significant relationship between NLR, ALC and PLR with the severity of COVID-19 (p = 0.007; p = 0.002; p = 0.013).
Latar belakang: Virus COVID-19 ditemukan pada akhir tahun 2019 sebagai penyakit infeksi pada pernapasan dan telah menjadi pandemi hingga saat ini, sehingga sangat penting untuk memprediksi derajat keparahan COVID-19. Neutrophyl Lymphocyte Ratio (NLR), Absolute Lymphocyte Count (ALC), dan Platelet Lymphocyte Ratio (PLR) merupakan metode yang mudah, murah, dan cepat sebagai alat skrining pada keparahan COVID-19. Tujuan penelitian ini adalah untuk mengetahui hubungan NLR, ALC, dan PLR terhadap derajat keparahan COVID-19.
Metode: Penelitian ini adalah suatu penelitian observasional analitik dengan desain penelitian crosssectional. Pengambilan data penelitian menggunakan metode total sampling. Data penelitian adalah data rekam medis dan pemeriksaan laboratorium dari 64 pasien COVID-19 di RS Harapan Keluarga Cikarang pada periode Juli–Desember 2020. Analisis data yang digunakan adalah analisis bivariat dengan chi-square.
Hasil: Terdapat 64 sampel pada penelitian ini dengan mayoritas sampel merupakan laki-laki, rata-rata usia 42 tahun, gejala yang paling sering ditemukan adalah demam (81,3%) dan batuk (71,9%), mayoritas pasien tidak memiliki komorbid. Terdapat hubungan yang signifikan antara NLR, ALC dan PLR dengan tingkat keparahan COVID-19 (p =0,007; p=0,002; p =0,013).
Simpulan: NLR, ALC, dan PLR memiliki hubungan terhadap derajat keparahan COVID-19.
Hubungan intensitas nyeri dengan kualitas hidup pasien kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo
Duta Angela, Djohan Ardiansyah, Desak Gede Agung SuprabawatiOnline First: Feb 28, 2022
- Abstract
Hubungan intensitas nyeri dengan kualitas hidup pasien kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo
Introduction: Breast cancer occurs because breast cells grow out of control. The incidence of breast cancer is still very high both in developed countries and in Indonesia. One treatment that can be done is chemotherapy. Pain is one of the effects that can occur in undergoing chemotherapy, besides the increasing stage of cancer can increase pain. This increased pain often affects a person's quality of life. This study aims to determine the relationship between pain intensity and quality of life of breast cancer patients undergoing chemotherapy at PPLK RSUD Dr. Soetomo.
Methods: This research is a descriptive analytical study with a cross-sectional method. Sampling was done by total sampling that met the inclusion and exclusion criteria, then filled out the Sf-36 questionnaire and the Wong Baker pain scale. Forty respondents with breast cancer underwent chemotherapy at PPLK RSUD Dr. Soetomo. Analysis using SPSS. The Shapiro Wilk test was used to determine the normality test. Correlation using Spearman's test.
Results: From 40 respondents, the youngest age in this study was 29 years old and the oldest was 61 years old. The highest level of pain in stage 4 breast cancer patients is in the mildly disturbing category, which is measured using the Wong Baker scale. The results of the Spearman test concluded that there were significant results between pain intensity and quality of life. There are 8 components in assessing the quality of life with the SF-36: physical function, physical role, emotional role, energy, mental health, social function, pain, and general health (p<0.05).
Conclusion: This study shows a relationship between pain intensity and quality of life of breast cancer patients undergoing chemotherapy.
Pendahuluan: Kanker payudara terjadi karena sel-sel payudara tumbuh di luar kendali. Angka kejadian kanker payudara masih sangat tinggi baik di negara maju maupun Indonesia. Salah satu pengobatan yang dapat dilakukan adalah kemoterapi. Nyeri merupakan salah satu efek yang dapat terjadi dalam menjalani kemoterapi, selain itu stadium kanker yang meningkat dapat meningkatkan rasa nyeri. Nyeri yang meningkat ini seringkali memengaruhi kualitas hidup seseorang. Penelitian ini bertujuan untuk mengetahui hubungan intensitas nyeri terhadap kualitas hidup pasien kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo.
Metode: Penelitian ini merupakan penelitian deskripsi analitik dengan metode cross-sectional. Pengambilan sampel dilakukan dengan cara total sampling yang memenuhi kriteria inklusi dan eksklusi, kemudian dilakukan pengisian kuisioner Sf-36 dan skala nyeri Wong Baker. Terdapat 40 responden penderita kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo. Analisis menggunakan SPSS. Uji Shapiro Wilk digunakan untuk menentukan uji normalitas. Korelasi hubungan menggunakan uji Spearman.
Hasil: Dari 40 responden diperoleh hasil dengan usia termuda dalam penelitian ini berumur 29 tahun dan tertua berumur 61 tahun. Tingkatan nyeri tertinggi pada pasien kanker payudara stadium 4 masuk dalam kategori agak mengganggu, yang diukur menggunakan skala Wong Baker. Hasil uji Spearman menyimpulkan adanya hasil yang signifikan antara intensitas nyeri dengan kualitas hidup. Terdapat 8 komponen dalam menilai kualitas hidup dengan SF-36, yaitu fungsi fisik, peranan fisik, peranan emosi, energi, kesehatan jiwa, fungsi sosial, rasa nyeri, dan kesehatan umum (p<0,05).
Kesimpulan: Penelitian ini menunjukkan adanya hubungan antara intensitas nyeri dan kualitas hidup pasien kanker payudara yang sedang menjalani kemoterapi.
Perbandingan skor Middle Ear Risk Index (MERI) pada pasien Otitis Media Supuratif Kronis (OMSK) dengan komplikasi intrakranial dan ekstrakranial di RSUD dr. Saiful Anwar, Malang, Indonesia
Ahmad Dian Wahyudiono, David SantosoOnline First: Mar 10, 2022
- Abstract
Perbandingan skor Middle Ear Risk Index (MERI) pada pasien Otitis Media Supuratif Kronis (OMSK) dengan komplikasi intrakranial dan ekstrakranial di RSUD dr. Saiful Anwar, Malang, Indonesia
Background: Chronic Suppurative Otitis Media (CSOM) is a chronic infection in the middle ear mucosa with tympanic membrane perforation and causes complications in the form of intracranial and extracranial. In previous studies, CSOM mortality rates were different between intracranial and extracranial complications. That prompted the researchers to determine the middle ear postoperative prognosis in CSOM with intracranial complications compared to the extracranial. Postoperative prognosis is measured by Middle Ear Risk Index (MERI). This study aims to evaluate the comparison of MERI scores in CSOM patients with intracranial and extracranial complications.
Methods: The research was conducted with an observational analytic design involving 40 research subjects from medical records of CSOM patients at RSUD dr. Saiful Anwar Malang in January 2017 – July 2021. The samples were divided into CSOM with intracranial and extracranial complications, including 12 and 28 subjects, respectively. Those samples are taken using consecutive sampling techniques and tested using an Independent T-test. Data were analyzed using SPSS version 25 for Windows.
Results: The mean of MERI scores in CSOM patients with intracranial complications was 9.170±2.517, and that in extracranial complications was 7.570±1.854. The p-value of 0.031 (P<0.05) was obtained using an Independent T-test, indicating a significant difference of MERI scores mean between CSOM patients with intracranial and extracranial.
Conclusion: There is a significant difference in MERI scores between CSOM with intracranial and extracranial complications.
Latar Belakang: Otitis Media Supuratif Kronis (OMSK) adalah infeksi kronis yang terjadi pada mukosa telinga tengah yang ditandai dengan perforasi membran timpani dan dapat menyebabkan komplikasi intrakranial maupun ekstrakranial. Penatalaksanaan OMSK dengan komplikasi bertujuan untuk menyelesaikan komplikasi, infeksi di telinga tengah dan perbaikan fungsi. Perbaikan fungsi pendengaran bukan tujuan utama tapi tetap menjadi harapan dari pasien. Prognosis fungsi pendengaran pada operasi mastoid dapat dinilai dengan memperhatikan Middle Ear Risk Index (MERI). Penelitian ini bertujuan untuk mengevaluasi perbandingan skor MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial.
Metode: Penelitian dilakukan dengan desain penelitian observasional analitik yang melibatkan 40 subjek penelitian berupa rekam medis pasien OMSK di RSUD dr. Saiful Anwar Malang bulan Januari 2017 – Juli 2021. Sampel terbagi menjadi dua kategori yaitu OMSK dengan komplikasi intrakranial dan ekstrakranial dengan jumlah secara berurutan yaitu 12 dan 28 sampel. Sampel diambil menggunakan teknik konsekutif dan diuji menggunakan Independent T-Test. Data dianalisis dengan SPSS versi 25 untuk Windows.
Hasil: Didapatkan rerata pasien OMSK dengan komplikasi intrakranial sebesar 9,170±2,517 dan ekstrakranial sebesar 7,570±1,854. Pada uji Independent T-Test didapatkan nilai p sebesar 0,031 (p<0,05) yang menunjukkan terdapat perbedaan rerata MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial secara bermakna.
Kesimpulan: Terdapat perbedaan skor MERI yang bermakna antara OMSK dengan komplikasi intrakranial dan ekstrakranial.
Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit perifer
Arina Papita Simanungkalit, Alice Inda SupitOnline First: Mar 22, 2022
- Abstract
Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit perifer
Introduction: Acute myocardial infarction is coronary heart disease that causes an increase in length of stay in hospital and a high mortality rate. Reperfusion strategy is the main modality in treating ST-elevation myocardial infarction (STEMI), but a limitation in facilities and human resources in peripheral hospitals has made it impossible to do. This study aims to observe the characteristics and course of disease in patients diagnosed by STEMI without reperfusion strategy in peripheral hospitals.
Method: This study is a descriptive observational study with a cross sectional research design--retrieving research data using the total sampling method, using secondary data from medical records at Ade M Djoen Sintang Public Hospital in March - December 2021.
Results: 56 samples fulfilled inclusion and exclusion criteria, with the majority of the sample being male, the average age was 53 years. Most of the patients had the same complaint during their stay in the hospital, most of the patients were able to discharge from the hospital, and 57,14% of the patients were admitted back to the hospital with the same chief complaints after less than six months of follow-up.
Conclusion: Management of patients with STEMI without a reperfusion strategy leads to remain of chief complaints and increase of readmission within 6 months follow-up after discharge.
Latar Belakang: Infark miokard akut adalah suatu penyakit jantung koroner yang mengakibatkan peningkatan angka perawatan di rumah sakit dan angka kematian yang tinggi. Strategi reperfusi merupakan modalitas utama dalam penanganan infark miokard akut dengan elevasi segmen ST (IMA-EST), namun pada rumah sakit di perifer, keterbatasan sarana dan prasarana serta sumber daya manusia menyebabkan hal tersebut tidak memungkinkan. Tujuan penelitian ini adalah untuk mengetahui karakteristik dan perjalanan penyakit pasien yang terdiagnosis IMA-EST tanpa tatalaksana reperfusi di rumah sakit di perifer.
Metode: Penelitian ini merupakan penelitian observasional dengan desain penelitian potong lintang. Data penelitian diambil menggunakan metode total sampling, melalui data sekunder dari rekam medis selama periode Maret - Desember 2021 di Rumah Sakit Umum Daerah (RSUD) Ade M Djoen Sintang.
Hasil: Terdapat 56 sampel yang memenuhi kriteria inklusi dan eksklusi, mayoritas sampel adalah laki-laki, rata-rata usia 53 tahun. Sebagian besar pasien mengakami keluhan yang menetap selama perawatan, sebagian besar boleh pulang dari rumah sakit. Dalam periode kurang dari 6 bulan, sebanyak 57,14% pasien masuk kembali ke rumah sakit dengan keluhan yang sama.
Simpulan: Tatalaksana pasien dengan IMA-EST tanpa strategi reperfusi menyebabkan keluhan yang menetap selama perawatan dan peningkatan pasien masuk kembali ke rumah sakit dengan keluhan yang sama setelah 6 bulan dipulangkan dari rumah sakit.
Kadar heat shock protein 70 cairan amnion yang tinggi sebagai faktor risiko terjadinya ketuban pecah dini pada kehamilan aterm
Ines Kurniaty Hartono, Ketut Suwiyoga, I Ketut Surya Negara, I Gede Mega Putra, Made Bagus Dwi Aryana, I Gde Sastra Winata, I Wayan MegadhanaOnline First: Mar 25, 2022
- Abstract
Kadar heat shock protein 70 cairan amnion yang tinggi sebagai faktor risiko terjadinya ketuban pecah dini pada kehamilan aterm
Background: Premature rupture of membranes (PROM) is a condition that complicates labor with an unclear pathogenesis. HSP70 is thought to be involved in this pathogenesis process and the presence of HSP in the extracellular compartment reflects tissue damage and induces an immunologic response. Therefore, this study aimed to study the relationship between HSP70 levels in amniotic fluid and the incidence of PROM.
Methods: This study used a case-control design in the ER delivery room and the laboratory of Sanglah Hospital, Denpasar. Samples were taken from mothers who gave full term delivery in the emergency room at Sanglah Hospital Denpasar with mothers who gave birth at term with KPD as cases and mothers who gave full term delivery without KPD as controls. Data was taken from medical records and measured levels of HSP70 at the Sanglah Hospital Denpasar Laboratory. Data analysis was performed using the Mann-Whitney test and ROC test.
Results: A total of 28 cases and 28 controls were recruited. There were no significant differences in baseline characteristics between cases and controls. The MannWhitney test found significant differences in the mean levels of HSP70, 11.58 (±8.16) ng/mL in controls and 17.15 (±6.51) ng/mL in cases, respectively. ROC analysis found an AUC of 0.737 with an optimal cutoff value of 12.5 ng/mL. An amniotic fluid HSP70 level of more than 12.5 ng/mL was associated with PROM with an OR of 17.33 (95% CI 3.43 - 87.70).
Conclusion: High amniotic fluid HSP 70 level is a risk factor for PROM in term pregnancy.
Latar belakang: Ketuban pecah dini (KPD) merupakan suatu kondisi yang mempersulit persalinan dengan patogenesis yang belum jelas. HSP70 dianggap terlibat dalam proses patogenesis ini dan keberadaan HSP di kompartemen ekstraseluler mencerminkan kerusakan jaringan dan menginduksi respon imunologi. Oleh karena itu, penelitian ini bertujuan untuk mempelajari hubungan kadar HSP70 dalam cairan ketuban dengan kejadian KPD.
Metode: Penelitian ini menggunakan desain kasus kontrol di ruang bersalin IGD dan Laboratorium RSUP Sanglah Denpasar. Sampel diambil dari ibu yang bersalin cukup bulan di ruang bersalin IGD RSUP Sanglah Denpasar dengan ibu yang melahirkan cukup bulan dengan KPD sebagai kasus dan ibu yang bersalin cukup bulan tanpa KPD sebagai kontrol. Data diambil dari rekam medis dan dilakukan pengukuran kadar HSP70 di Laboratorium RSUP Sanglah Denpasar. Analisis data dilakukan dengan menggunakan uji Mann-Whitney dan uji ROC.
Hasil: Sebanyak 28 kasus dan 28 kontrol direkrut. Tidak ada perbedaan yang signifikan dalam karakteristik dasar antara kasus dan kontrol. Uji MannWhitney menemukan perbedaan yang signifikan dalam tingkat rata-rata HSP70, masing-masing 11,58 (± 8,16) ng/mL pada kontrol dan 17,15 (± 6,51) ng/mL dalam kasus. Analisis ROC menemukan AUC 0,737 dengan nilai cutoff optimal 12,5 ng/mL. Tingkat HSP70 cairan ketuban lebih dari 12,5 ng/mL dikaitkan dengan PROM dengan OR 17,33 (95% CI 3,43 - 87,70).
Simpulan: kadar HSP 70 cairan amnion yang tinggi merupakan faktor risiko terjadinya KPD pada kehamilan aterm.
Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah
I Made Gunarsa, Wayan Aryadana, I Made Junior Rina ArthaOnline First: Apr 6, 2022
- Abstract
Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah
Introduction: Non-HDL cholesterol is a lipid parameter that describes the overall component of atherogenic lipids and is strongly correlated with apoB and sdLDL (small-dense LDL). There has been no study linking non HDL cholesterol (high density lipoprotein) with the degree of coronary stenosis based on the assessment of the previous syntax score. This study aims to prove the relationship between high non-HDL cholesterol and the degree of severe coronary artery lesions in patients with chronic coronary syndrome who underwent coronary angiography at Sanglah Hospital Denpasar.
Methods: This analytical observational study was conducted at Sanglah General Hospital from June to November 2020. Sampling was carried out by consecutive sampling. Non HDL cholesterol was calculated by subtracting total cholesterol with HDL and divided into 2 categories based on ROC analysis. The syntax score was calculated based on the results of coronary angiography and was divided into 2 categories (cut off 22). The relationship between non-HDL cholesterol and the degree of coronary stenosis was assessed by chi-square test analysis.
Results: Seventy-two subjects were included in this study with a mean age of 59.43±8.9 years. At the cut-off point of 104.5 mg/dL based on the ROC curve, non-HDL cholesterol had an AUC of 0.846, a sensitivity level of 80% and a specificity of 78.1% (p < 0.001). The results of bivariate analysis showed that high non-HDL cholesterol was associated with the degree of severe coronary stenosis with a prevalence ratio of 3.385 (p<0.001). Multivariate logistic regression analysis showed that high non-HDL cholesterol proved to be an independent predictor of severe coronary artery stenosis in patients with chronic coronary syndrome at Sanglah Hospital.
Conclusion: High non-HDL cholesterol was shown to be independently associated with severe coronary artery stenosis in SKK subjects at Sanglah Hospital.
Pendahuluan: Kolesterol non HDL merupakan parameter lipid yang menggambarkan keseluruhan komponen lipid atherogenik dan berkorelasi kuat dengan apoB dan sdLDL (small-dense LDL). Belum ada penelitian yang menghubungkan kolesterol non HDL (high density lipoprotein) dengan derajat stenosis koroner berdasarkan penilaian skor syntax sebelumnya. Penelitian ini bertujuan untuk membuktikan hubungan kolesterol non HDL yang tinggi dengan derajat lesi arteri koroner yang berat pada penderita sindroma koroner kronis yang dilakukan tindakan angiografi koroner di RSUP Sanglah Denpasar.
Metode: : Penelitian observasional analitik ini dilakukan di Rumah Sakit Umum Sanglah dari Juni hingga November 2020. Pengambilan sampel dilakukan secara concecutive sampling. Kolesterol non HDL dihitung dengan cara mengurangi total kolesterol dengan HDL dan dibagi menjadi 2 kategori berdasarkan analisis ROC. Skor syntax dihitung berdasarkan hasil angiografi koroner dan dibagi menjadi 2 kategori (cut off 22). Hubungan antara kolesterol non HDL dan derajat stenosis koroner dinilai dengan analisis chi-square test.
Hasil: Tujuh puluh dua subyek dilibatkan dalam penelitian ini dengan dengan rerata usia 59,43±8,9 tahun. Pada nilai titik potong 104.5 mg/dL berdasarkan kurva ROC, kolesterol non HDL memiliki AUC 0.846, tingkat sensitifitas 80% dan spesifisitas 78,1% (p <0.001). Hasil analisis bivariat menunjukkan kolesterol non HDL yang tinggi berhubungan derajat stenosis koroner berat dengan rasio prevalens 3,385 (p<0.001). Analisis multivariat regresi logistik menunjukkan kolesterol non HDL yang tinggi terbukti sebagai prediktor independen stenosis arteri koroner berat pada penderita sindroma koroner kronis di RSUP Sanglah.
Simpulan: Kolesterol non HDL yang tinggi terbukti berhubungan secara independen dengan stenosis arteri koroner berat pada subyek SKK di RSUP Sanglah.
Kadar heat shock protein 70 (HSP 70) yang tinggi pada serum ibu sebagai faktor risiko persalinan preterm
Tjokorda G. A. Suwardewa, Ketut Surya Negara, Anak Agung Ngurah Anantasika, I Wayan Artana Putra, I Gde Sastra Winata, Piere Emanuel YoltuwuOnline First: Apr 13, 2022
- Abstract
Kadar heat shock protein 70 (HSP 70) yang tinggi pada serum ibu sebagai faktor risiko persalinan preterm
Introduction: Preterm birth defined as parturition that occurs less than 37 completed weeks of gestation is still being a big problem in obstetrics, especially in perinatology. Preterm delivery is one of the most common causes of neonatal morbidity and mortality. This study examined serum HSP 70 levels as a risk factor for preterm delivery.
Method: The research design was analytic with a case-control method at Sanglah Hospital from February to June 2021. The samples were divided into two groups which are in the case group was 30 samples and the control group was 30 samples. In both groups, HSP 70 levels were collected by taking 5cc of blood sample from cubital vein. Furthermore, the examination was carried out using the enzyme-link immunosorbent assay (ELISA) method at Biomedik Terpadu Laboratory service.
Result: Based on the data on the characteristics of the subjects, respectively maternal age, gestational age, BMI, and parity there was no significant differences between two group. Serum HSP levels were significantly different between the two groups with OR 4.030 (95%CI: 1,372-11,84; p-value 0.01). The cut-off value for serum HSP 70 levels was 12.85 ng/ml, with a sensitivity of 70%, specificity of 63.3%, and an area under the curve (AUC) value of 0.807 (95% CI 0.697 – 0.916, p-value <0.001).
Conclusion: This study revealed that high levels of HSP 70 in serum is a risk factor of preterm labor. High blood serum levels of HSP 70 could be a reference in determining high risk of preterm labor in pregnant women.
Pendahuluan: Persalinan preterm didefinisikan kelahiran sebelum usia gestasi kurang dari 37 minggu masih menjadi masalah besar dalam bidang obstetri khususnya dibidang perinatologi. Persalinan preterm merupakan salah satu penyebab utama tingginya angka morbiditas dan mortalitas neonatus. Penelitian ini meneliti mengenai kadar HSP 70 pada serum ibu sebagai faktor risiko persalinan preterm.
Metode: Rancangan penelitian yang digunakan adalah analitik dengan metode kasus-kontrol, dilakukan di RSUP Sanglah pada periode Februari 2021 sampai Juni 2021. Sampel dibagi menjadi 2 kelompok yakni kelompok kasus sebanyak 30 sampel dan kontrol 30 sampel. Pada kedua kelompok, pemeriksaan kadar HSP 70 dilakukan melalui pengambilan sampel darah 5 ml pada vena cubiti. Selanjutnya dilakukan pemeriksaan dengan metode enzyme-link immunosorbent assay (ELISA) di Unit Laboratorium Biomedik Terpadu.
Hasil: Data karakteristik subyek yaitu usia ibu, usia kehamilan, IMT dan jumlah paritas, tidak ditemukan adanya perbedaan bermakna. Kadar serum HSP yang tinggi berbeda bermakna antara kedua kelompok dengan nilai OR 4.030 (IK 95%: 1,372-11,84; nilai p 0.01). Nilai cut off kadar serum HSP 70 sebesar 12.85 ng/ml, dengan sensitifitas sebesar 70%, spesifisitas 63,3%, dan nilai area under the curve (AUC) sebesar 0,807 (IK 95% 0,697 – 0,916, nilai p <0,001).
Simpulan: Penelitian ini menunjukkan bahwa kadar HSP 70 yang tinggi pada serum ibu sebagai faktor risiko kejadian terjadinya persalinan preterm. Nilai kadar HSP 70 yang tinggi dapat menjadi suatu acuan dalam menentukan risiko tinggi kejadian persalinan preterm pada ibu hamil.
Ekspresi reseptor vitamin D plasenta yang rendah sebagai faktor risiko terjadinya preeklampsia dengan gambaran berat
I Gede Mahendra Adiguna Dira, Ketut Suwiyoga, I Wayan Artana Putra, I Gede Mega Putra, Ida Bagus Gede Fajar Manuaba, I Gde Sastra Winata, I Wayan MegadhanaOnline First: Apr 15, 2022
- Abstract
Ekspresi reseptor vitamin D plasenta yang rendah sebagai faktor risiko terjadinya preeklampsia dengan gambaran berat
Introduction: Preeclampsia is the cause of 10-15% of maternal deaths in Indonesia and occurs in about 2-10% of all pregnancies worldwide. The pathogenesis that underlies the occurrence of preeclampsia is not yet clearly known so that preeclampsia is referred to as a disease of theory. Nutritional factors such as vitamin D also play a role in the development of preeclampsia. This study aims to determine the relationship between vitamin D receptor expression as a risk factor for preeclampsia with severe features.
Method: This study used a case-control design conducted in the maternity ward of Sanglah General Hospital, Denpasar from February to August 2020. A sample of 44 subjects was obtained and divided into case groups and control groups. Examination of vitamin D receptors using a central area placenta measuring 2x2 cm which was then examined semi-quantitatively at the Histology Laboratory, Faculty of Medicine, Udayana University.
Result: The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between low VDR expression in the placenta and the incidence of preeclampsia with severe features (p-value 0.002; 95% CI 1.96-31.57; OR 7.88).
Conclusion: Low VDR placenta expression in pregnant women increases the risk of preeclampsia with a severe picture of 7.88 times greater than high VDR expression.
Pendahuluan: Preeklampsia menjadi penyebab 10-15% kematian maternal di Indonesia, dan terjadi pada sekitar 2-10% dari seluruh kehamilan di seluruh dunia. Patogenesis yang mendasari terjadinya preeklampsia sampai saat ini belum jelas diketahui sehingga preeklampsia disebut sebagai disease of theory. Faktor nutrisi seperti vitamin D juga memainkan peran dalam terjadinya preeklampsia. Penelitian ini bertujuan mencari hubungan ekspresi reseptor vitamin D sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.
Metode: Penelitian ini menggunakan desain kasus-kontrol yang dilakukan di Ruang Bersalin RSUP Sanglah Denpasar pada Februari sampai Agustus 2020. Didapatkan sampel sebanyak 44 subyek dan dibagi kedalam kelompok kasus dan kelompok kontrol. Pemeriksaan reseptor vitamin D menggunakan plasenta area sentral ukuran 2x2 cm yang kemudian diperiksa secara semikuantitatif di Laboratorium Histologi Fakultas Kedokteran Universitas Udayana. Hasil dianalisa menggunakan uji chi square.
Hasil: Tidak terdapat perbedaan karakteristik yang bermakna pada kedua kelompok. Terdapat hubungan yang bermakna antara ekspresi VDR pada plasenta yang rendah terhadap kejadian preeklamsia dengan gambaran berat (p-value 0.002; IK 95% 1.96-31.57; OR 7.88).
SimpulanEkspresi VDR plasenta yang rendah pada ibu hamil meningkatkan risiko terjadinya preeklamsia dengan gambaran berat sebesar 7,88 kali lebih besar dibandingkan ekspresi VDR tinggi.
Polimorfisme gen COL1A1 sebagai faktor risiko terjadinya prolaps organ panggul pada perempuan Bali, Indonesia
Putra Agung Eka Aricandana, I Gede Mega Putra, I Wayan Megadhana, Anak Agung Ngurah Anantasika, Ida Bagus Gde Fajar Manuaba, I Gede Ngurah Harry Wijaya SuryaOnline First: Apr 15, 2022
- Abstract
Polimorfisme gen COL1A1 sebagai faktor risiko terjadinya prolaps organ panggul pada perempuan Bali, Indonesia
Introduction: Pelvic organ prolapse (POP) is still a common health problem in women, especially in the elderly female population. Pelvic organ prolapse is associated with a reduced quality of life for millions of women worldwide. The purpose of this study was to determine the role of the COL1A1 rs 1800012 gene polymorphism as a risk factor for pelvic organ prolapse in Balinese women, Indonesia.
Methods: This case-control observational study involved 60 Balinese women aged 30-70 years divided into 30 subjects with pelvic organ prolapse as a case group and 30 subjects with non-pelvic organ prolapse as a control group. Subject selection and clinical examination were carried out at the Reconstructive Urogynecology Polyclinic and Obstetrics and Gynecology Polyclinic, Sanglah Central General Hospital Denpasar and Prima Medika General Hospital Denpasar. Three ml of blood sample was drawn and then put into a bottle containing EDTA for Polymerase Chain Reaction COL1A1 rs 180012 gene polymorphisms at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The data obtained were then analyzed using the Statistical Product and Service Solutions software version 21.0.
Results: COL1A1 gene polymorphism was found in eight subjects in the case group and one subject in the control group. The results of bivariate analysis showed a significant relationship between the COL1A1 gene polymorphism and the incidence of pelvic organ prolapse (p = 0.011). The results of multivariate analysis revealed a significant relationship between COL1A1 gene polymorphisms and pelvic organ prolapse after controlling for controlled variables (parity status, occupation, BMI, age, menopause, and history of hysterectomy). Multivariate analysis showed adjusted odd ratio of 16.157 for the COL1A1 gene polymorphism (p = 0.021).
Conclusion: COL1A1 gene polymorphism significantly increases the risk of pelvic organ prolapse in Balinese women.
Pendahuluan: Prolaps organ panggul (POP) masih menjadi masalah kesehatan umum pada perempuan, terutama pada populasi wanita lanjut usia. Prolaps organ panggul berkaitan dengan penurunan kualitas hidup dari jutaan wanita di seluruh dunia. Tujuan dari penelitian ini adalah untuk mengetahui peran polimorfisme gen COL1A1 rs 1800012 sebagai faktor risiko kejadian prolaps organ panggul pada perempuan Bali, Indonesia.
Metode: Studi observasional kasus kontrol ini melibatkan 60 orang perempuan Bali berusia 30-70 tahun yang terdiri dari 30 orang dengan diagnosis prolaps organ panggul sebagai kelompok kasus dan 30 orang dengan diagnosis non prolaps organ panggul sebagai kelompok kontrol. Pemilihan subjek dan pemeriksaan klinis dilakukan di Poliklinik Uroginekologi Rekonstruksi dan Poliklinik Obstetri dan Ginekologi Rumah Sakit Umum Pusat Sanglah Denpasar dan Rumah Sakit Umum Prima Medika Denpasar. Sampel darah diambil sebanyak 3 ml kemudian dimasukkan ke dalam botol yang berisi EDTA dan dilakukan pemeriksaan Polymerase Chain Reaction untuk polimorfisme gen COL1A1 rs 180012 di Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Data yang diperoleh kemudian dianalisis menggunakan perangkat lunak Statistical Product and Service Solutions versi 21.0.
Hasil: Polimorfisme gen COL1A1 ditemukan pada 8 subjek pada kelompok kasus dan 1 subjek pada kelompok kontrol. Hasil analisis bivariat menunjukkan adanya hubungan signifikan antara polimorfisme gen COL1A1 dan kejadian prolaps organ panggul (p = 0,011). Hasil analisis multivariat memperjelas hubungan signifikan antara polimorfisme gen COL1A1 dan prolaps organ panggul setelah dikontrol dengan variabel terkendali (status paritas, pekerjaan, imt, umur, menopause, dan riwayat histerektomi). Hasil analisis multivariat menunjukkan adjusted odd ratio sebesar 16,157 untuk polimorfisme gen COL1A1 (p = 0,021).
Simpulan: Polimorfisme gen COL1A1 secara signifikan meningkatkan risiko terjadinya prolaps organ panggul pada perempuan Bali.
Skor assessment of different neoplasias in the adnexa (ADNEX) untuk memprediksi keganasan ovarium di RSUP Sanglah Denpasar
I Nyoman Gede Budiana, Ketut Suwiyoga, Tjokorda Gde Agung Suwardewa, Anom Suardika, Made Bagus Dwi Aryana, Heni SunyotoOnline First: Apr 13, 2022
- Abstract
Skor assessment of different neoplasias in the adnexa (ADNEX) untuk memprediksi keganasan ovarium di RSUP Sanglah Denpasar
Introduction: Ovarian cancer is cancer of the female reproductive organs with the highest mortality and is in the third position of female cancer after mammary and cervical cancer. The mortality rate and survival rate of ovarian cancer is mainly determined by the stage at which ovarian cancer is diagnosed. Until now there is no method for early detection of ovarian cancer with good sensitivity and specificity. Assessment of different neoplasias in the adnexa (ADNEX) is a model proposed by international ovarian tumor analysis (IOTA) to help distinguish benign or malignant adnexa tumors.
Methods: This study is a observational clinical test to find out the accuracy of ADNEX model to predict ovarian malignancy conducted at the Obstetric and Gynecology Outpatient Ward in Sanglah hospital, Denpasar from November 2019 to April 2020. Consecutive sampling was done and 88 sample was recruited with a diagnosis of ovarian tumors. Then the research sample was sent to the Pathology Anatomy laboratory of Sanglah Hospital for histopathological examination. This result would then be compared to the prediction results of the ADNEX model.
Results: 35 samples of benign ovarian tumors and 53 samples of ovarian cancer were found with the ADNEX method. There were 46 samples with malignant tumor both by the ADNEX model and histopathology results, 7 samples of malignant tumor at histopathology result but benign by the ADNEX model, 6 samples of benign tumor according to histopathology but malignant using the ADNEX model, and 29 samples of benign tumor according to histopathology and the ADNEX model. Using cut off of 49,6%, the study reported a sensitivity level of 86.8%, specificity 82.6%, positive predictive value 88.5%, negative predictive value 80.6%, and 85.2% accuracy.
Conclusion: The ADNEX model has a high level of specificity, sensitivity and diagnostic accuracy in diagnosing ovarian cancer and can be used in combination with other clinical markers for early detection of malignancy in ovarian tumors.
Pendahuluan: Kanker ovarium merupakan salah satu jenis kanker organ reproduksi wanita dengan mortalitas tertinggi dan berada pada posisi ke-tiga kanker perempuan setelah kanker mammae dan serviks. Angka mortalitas dan survival rate kanker ovarium sangat ditentukan oleh stadium saat kanker ovarium terdiagnosis. Hingga saat ini belum tersedia metode pemeriksaan untuk deteksi dini kanker ovarium dengan sensitivitas dan spesifisitas yang memadai. Assessment of different neoplasias in the adnexa (ADNEX) adalah model yang diajukan oleh International Ovarian Tumor Analysis (IOTA) untuk membantu membedakan tumor adnexa sebagai tumor jinak atau ganas.
Metode: Penelitian ini merupakan penelitian observasional uji klinik untuk mengetahui akurasi model ADNEX untuk memprediksi keganasan ovarium yang dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah, Denpasar pada bulan November 2019 hingga April 2020. Sampling dilakukan secara consecutive dan didapatkan 88 orang dengan diagnosis tumor ovarium. Sampel penelitian dikirimkan ke laboratorium Patologi Anatomi RSUP Sanglah dan dilakukan pemeriksaan histopatologi untuk kemudian dibandingkan dengan hasil prediksi dari model ADNEX.
Hasil: Dalam penelitian ini didapatkan 35 sampel dengan tumor jinak ovarium dan 53 sampel dengan kanker ovarium dengan menggunakan metode ADNEX. Terdapat 46 sampel dengan hasil pemeriksaan model ADNEX ganas dan hasil pemeriksaan histopatologi ganas, 7 sampel histologi ganas namun model ADNEX jinak, 6 sampel histopatologi jinak namun model ADNEX ganas, dan 29 sampel histopatologi jinak dan model ADNEX jinak. Hasil penelitian memperlihatkan tingkat sensitifitas 86,8%, spesifisitas 82,6%, nilai prediksi positif 88,5%, nilai prediksi negatif 80,6%, dan akurasi 85,2%.
Simpulan: Model ADNEX memiliki tingkat spesifisitas, sensitivitas dan akurasi diagnostik yang tinggi dalam mendiagnosis kanker ovarium dan dapat digunakan bersama dengan penanda klinis lain untuk deteksi dini keganasan pada tumor ovarium.
