Vol. 13 No. 3 (2022): (Available online: 1 December 2022)
Wide eksisi dan flap rhomboid pada karsinoma basal sel regio facial
Kadek Nopy Arianti, Made Oka Sastrawan, Fatur Reyhan Muradi, Muhammad Aflah, Casvin JusOnline First: Nov 16, 2022
- Abstract
Wide eksisi dan flap rhomboid pada karsinoma basal sel regio facial
Background: Basal cell carcinoma is one of the most common classifications of non-melanoma skin cancer (75% - 80%) of all cancers. Basal cell carcinoma causes widespread local destruction including soft tissue, cartilage, and bone, thus impairing function and aesthetics, especially for the facial area. One of the most common reconstructive techniques for Basal Cell Carcinoma is the Rhomboid flap. This case report aims to report the use of the rhomboid flap reconstruction technique in post-wide excision of basal cell carcinoma.
Case Description: A man, 54 years old, ethnic Balinese, came to the General Surgery Clinic of RSUD Klungkung with a complaint that a mole on the patient's left eye appeared enlarged with itching and bleeds easily. These complaints began to be felt since about 2 weeks before entering the hospital. Initially the patient's mole had been there for 5 years, previously the patient had no complaints about the mole, the initial lesion was in the form of a small brownish lump which was then felt to be getting bigger with itching and bleeding easily. The patient did not complain of pain. Examination of the localized status on the lateral periorbital sinistra showed blackish nodules with hyperpigmented macules, solitary, 2cm x 1cm in size, visible erosions, well-defined borders, irregular shape.
Conclusion: The provisional diagnosis of Suspected Malignant Skin Tumor was established based on history, physical examination, with management therapy wide excision and reconstruction with Rhomboid Flap followed with biopsy.
Latar Belakang : Karsinoma Sel Basal (KSB) adalah salah satu kanker kulit yang paling sering ditemukan dari seluruh kanker kulit non melanoma. Karsinoma Sel Basal dapat mengakibatkan kerusakan local dengan infiltrasi yang luas sehingga mengganggu fungsi dan estetika, terutama untuk daerah wajah. Salah satu pilihan teknik rekonstruksi yang bisa dilakukan pada Karsinoma Sel Basal di regio wajah adalah Rhomboid flap. Laporan kasus ini bertujuan untuk melaporkan penggunaan tehnik rekonstruksi dengan flap rhomboid pada pasca eksisi luas pada karsinoma sel basal.
Deskripsi Kasus: Seorang laki-laki, 54 tahun, suku Bali, datang ke Poliklinik bedah Umum RSUD Klungkung dengan keluhan tahi lalat pada sebelah mata kiri pasien tampak membesar disertai gatal dan mudah berdarah. Keluhan tersebut mulai dirasakan sejak sekitar 2 minggu sebelum masuk RS. Awalnya tahi lalat pasien sudah ada sejak 5 tahun yang lalu, sebelumnya pasien tidak ada keluhan pada tahi lalat tesebut, lesi awal berupa benjolan kecil berwarna kecoklatan yang kemudian makin lama dirasakan makin membesar disertai rasa gatal dan mudah berdarah. Keluhan nyeri tidak dikeluhkan oleh pasien. Pemeriksaan status lokalis pada periorbital lateral S tampak nodul kehitaman disertai makula hiperpigmentasi, soliter, ukuran 2cm x 1cm, tampak erosi, batas tegas, bentuk tidak beraturan.
Kesimpulan: Diagnosis sementara Tumor Kulit Suspek Malignant ditegakkan berdasarkan anamnesis, pemeriksaan fisik dengan terapi eksisi luas + biopsi + rekonstruksi dengan Rhomboid Flap.
a case report Right femur malunion treated with open osteotomy and open reduction with internal fixation percutaneous surgery (ORIF PS): A case report
Pande Putu Agung Willa Kesawa Putra, Anak Agung Ngurah Ronny KesumaOnline First: Nov 2, 2022
- Abstract
a case report Right femur malunion treated with open osteotomy and open reduction with internal fixation percutaneous surgery (ORIF PS): A case report
Introduction: Fracture femur distal third is a common orthopedic problem in patients of all ages. Malunion is common due to neglected conditions; an osteotomy plus ORIF PS procedure is required in the management. Surgery is currently the treatment of choice for distal femoral malunion fractures. Malunion requires deep fixation of compression using lag screws, cortical screws or cancellous screws depending on the type of fracture. Patients with distal femoral malunion are also treated with grafting using bone graft, allograft, autograft, synthetic graft and blade plate with screws in combination with a safe quadriceps approach.
Case description: A 16-year-old female patient complained of unbalanced walking and cramps in the right leg for the last 3 months. The patient had a history of traffic accidents and then suffered femur fracture 9 months ago, debridement and a plaster cast. The physical examination found that the right leg was shorter than the left, and the AVN and active ROM distal right leg were still good. Then X-Ray examination obtained the results of his Malunion fracture of the middle 1/3 right femur and then decided to do an osteotomy + ORIF PS. The patient returned home in good condition and then controlled through the outpatient polyclinic.
Conclusion: In most malunion patients, osteotomy and PS ORIF are surgical methods. Corrective osteotomy with ORIF PS should be regarded as a salvage procedure for treating distal third malunion.
Kondiloma Akuminata Perianal Disertai Sifilis Sekunder Dan Infeksi HIV Stadium II Pada Remaja Laki-Laki Yang Berhubungan Seksual Dengan Laki-Laki: Laporan Kasus
Putu Yunita Primasari, I.G.A.A. Elis Indira, Anak Agung Indah JayanthiOnline First: Dec 30, 2022
- Abstract
Kondiloma Akuminata Perianal Disertai Sifilis Sekunder Dan Infeksi HIV Stadium II Pada Remaja Laki-Laki Yang Berhubungan Seksual Dengan Laki-Laki: Laporan Kasus
Introduction: Men who have sex with men (MSM) have a high proportion of HIV infection. This is due to anal intercourse, multi-partner relationships, and low use of protection such as condoms. The difficulty of reaching the MSM community is one of the factors behind the high prevalence of HIV in this group. One study found that the majority of HIV prevalence was among MSM aged 25-49 years. Even though from this proportion, the number of MSM with HIV positive is not among teenagers, it does not rule out the possibility that there will be changes in the trend of rapid technological development and high levels of promiscuity. HIV infection that is not handled properly can cause patients to experience other types of STIs. For this reason, the group of MSM infected with HIV and other STI infections needs further review. This case report will discuss cases of condyloma acuminata in the perianal region accompanied by secondary syphilis and Stage II HIV infection in young boys who have sex with other men.
Case Description: Male patient aged 17 years, had a lump in his anus which grew 9 months ago. The patient also experienced weight loss. The patient had first sexual intercourse at the age of 15 years, then frequently changed partners with six different men. The patient never had sex with a woman. Sexual intercourse is carried out anogenitally. Acetowhite examination on verrucous papules-tumor lesions was positive. Darkfield microscopy (DFM) examination on papules lesions revealed treponemes and reactive results were obtained on VDRL (titer 1:256) and TPHA (titer >1:5120). PITC examination was reactive with a CD4 count of 27.65%/779 cells/mm3 and a CD8 count of 51.01%/1436 cells/mm3. Treatment given were trichloroacetic acid (TCA) 80% weekly topically on condyloma acuminata lesions, injection of benzathine penicillin G 2.4 million international units single dose intramuscularly for secondary syphilis treatment, and antiretroviral (ARV) tenofovir/lamivudine/dolutegrafir 300/300/50 mg 24 hours intraorally for HIV treatment.
Conclusion: Clinical manifestations of condyloma acuminata and secondary syphilis improved after therapy. Currently, the patient's prognosis is still dubious.
Pendahuluan: Laki – laki yang berhubungan seksual dengan sasama laki-laki memiliki proporsi yang tinggi mengalami HIV. Hal tersebut dikarenakan hubungan seksual melalui anus, hubungan multi partner, dan rendahnya penggunaan pelindung seperti kondom. Sulitnya menjangkau komunitas LSL menjadi salah satu faktor tingginya prevalensi HIV pada kelompok tersebut. Sebuah penelitian menemukan mayoritas prevalensi HIV di kalangan LSL berusia 25-49 tahun. Meskipun dari proporsi tersebut, angka LSL dengan positif HIV tidak dari kalangan remaja, namun tidak menutup kemungkinan akan terjadi perubahan trend dikarenakan perkembangan teknologi yang pesat dan tingginya tingkat pergaulan bebas. Infeksi HIV yang tidak tertangani dengan baik dapat menyebabkan pasien mengalami jenis IMS lainnya. Untuk itu, kelompok LSL yang terhjangkit HIV dengan infeksi IMS lainnya perlu dikaji lebih lanjut. Pada laporan kasus ini akan dibahas kasus kondiloma akuminata regio perianal disertai sifilis sekunder dan infeksi HIV Stadium II pada remaja laki-lagi yang berhubungan seksual dengan sesama laki-laki.
Deskripsi Kasus: Pasien laki-laki berusia 17 tahun, mengalami benjolan pada anus yang membesar sejak 9 bulan lalu. Pasien juga mengalami penurunan berat badan. Pasien melakukan hubungan seksual pertama kali pada usia 15 tahun, kemudian berganti-ganti pasangan dengan sekitar enam laki-laki yang berbeda. Pasien tidak pernah berhubungan seksual dengan perempuan. Hubungan seksual dilakukan secara anogenital. Pemeriksaan penunjang acetowhite pada lesi papul-tumor verukosa didapatkan hasil positif. Pemeriksaan dark field microscopy (DFM) pada lesi papul didapatkan treponema serta didapatkan hasil yang reaktif pada pemeriksaan VDRL (titer 1:256) dan TPHA (titer >1:5120). Pemeriksaan KTIP pada pasien reaktif dengan jumlah CD4 27,65%/779 sel/mm3 dan jumlah CD8 51,01%/1436 sel/mm3. Tatalaksana yang diberikan yaitu tutul Trichloroacetic Acid (TCA) 80% setiap minggu pada lesi kondiloma akuminata, injeksi benzatin penisilin G 2,4 juta internasional unit intramuskular dosis tunggal untuk tatalaksana sifilis sekunder dan antiretroviral (ARV) yaitu tenofovir/lamivudine/dolutegrafir 300/300/50 mg per 24 jam intra oral untuk tatalaksana HIV.
Simpulan: Manifestasi klinis pada kondiloma akuminata dan sifilis sekunder mengalami perbaikan setelah terapi. Prognosis pasien adalah dubius.
Treatment of a pediatric pathological fracture of the proximal phalanx due to enchondroma using plate and screw: a case report
Made Bramantya KarnaOnline First: Dec 30, 2022
- Abstract
Treatment of a pediatric pathological fracture of the proximal phalanx due to enchondroma using plate and screw: a case report
Introduction: The most typical primary bone tumour of the hand is an enchondroma. A pathologic fracture is a common presentation of this benign cartilaginous tumour. It is common for asymptomatic solitary enchondromas to be discovered during regular x-rays. However, in nearly half of the cases, acute pain, swelling, and deformity indicate a pathologic fracture. For symptomatic lesions, surgical therapy with curettage and bone graft is the norm.
Case Presentation: A 15-year-old girl with chief complain of pain on her right little finger and history of trauma after playing basketball 5 days before admission. At inspection, the fifth finger was painful during movement, with a discrete residual hematoma around the proximal phalanx. The x-rays showed a minimally displaced fracture at the shaft of the proximal phalanx of the 5th finger of the right hand, and lytic lesion occupying the whole middle third of the phalanx. We assessed the patient with pathological fracture suggestive of an enchondroma. A 1-stage surgical treatment was decided: a curettage followed by open reduction internal fixation using miniplate titanium matrix, and bone graft to fill the defect. Postoperative x-rays showed complete healing of the fracture at 4 weeks.
Conclusion: Enchondromas pose the risk of pathological fracture, recurrence and, to a lesser extent, malign transformation. We describe an option of surgical management which is simple and results in good and excellent short-term results. Successful treatment of these lesions is dependent on the complete removal of the tumour bed followed by stabilization.
Bilateral femoral agenesis in 3-month-old baby: A case report
Emiliana Susanti Foris, Mario Realino Nara, Defranky TheodorusOnline First: Nov 7, 2022
- Abstract
Bilateral femoral agenesis in 3-month-old baby: A case report
Background: Bilateral congenital femoral agenesis is a rare congenital anomaly. To our knowledge, there have only been three examples of simple congenital abnormalities linked to the femoral facial syndrome. We present a straightforward case of bilateral femoral agenesis in a 3-month-old female infant who did not have femoral facial syndrome and whose mother did not have diabetes.
Discussion: Bilateral femoral agenesis is a rare and unusual anomaly; only six cases have been reported. Other structural are often involved; these include the acetabulum, musculature, vessels, and ligaments of the knee, tibia, fibula, and foot. In our case, there are no other anomalies found. The majority of cases, however, are sporadic; therefore, the parents may be reassured that the risk of further offspring being affected is negligible. The classification by Aitken is widely used. This classification is based on the severity of the hip and femur radiographic findings
Case Presentation: A 3-month-old female baby presents with a complaint of short stature. The baby was born full term spontaneous labor, 2570 grams vigorous and started to cry immediately after birth. The mother has no history of diabetes, cigarette smoking, and exposure to teratogens. The parents were not related by blood. X-ray examination showed bilateral agenesis of the femur, normal tibia and fibula, and proximal cruris in lateral acetabula.
Conclusion: Bilateral congenital femoral agenesis is a rare congenital anomaly. Although frequently related to maternal diabetes mellitus, there is no recognized cause for most cases.
Myeloma Multipel pada Pasien dengan Fraktur Patologis: Laporan Kasus
I Putu Agni Rangga Githa, Anak Agung Davyn Anantha RhejaOnline First: Nov 16, 2022
- Abstract
Myeloma Multipel pada Pasien dengan Fraktur Patologis: Laporan Kasus
Background: Multiple myeloma (MM) is a haematological malignancy characterized by destructive bone lesions, renal injury, anemia and hypercalcemia. Multiple myeloma is a neoplasm that often occurs in adults to the elderly. Complications of pathological fractures occur as a result of lytic lesions of the bone. Complications of MM can appear as a clinical manifestation of the patient so that further examination is needed in patients with pathological fractures to establish MM.
Case: A 67-year-old female patient came to the hospital emergency room accompanied by her family in August 2022 with complaints of pain in her right thigh after falling on the homestairs. The patient has a history of heart disease and hypertension. The patient then underwent an examination and found anemia, an increase in serum creatinine and a complete fracture of the distal 1/3 of the right femur with multiple lytic lesions with decreased bone trabeculation in the skull and pelvis, clavicle, humerus, and femur bilaterally, left costae 7-8th with suspected multiple myeloma, differential diagnosis of malignant metastases and vertebral body compression 12th. Bone survey examination and sampling for histopathological examination were then carried out during the operative management of fractures with the impression of plasmacytosis so that the patient was diagnosed with Post ORIF PS, bone graft and post biopsy e.c. pathological fracture right supracondylar femur with multiple lytic lesions e.c. multiple myeloma. The patient was then referred to the orthopedic oncology department.
Conclusion: Patients with pathological fracture manifestations need to be investigated further regarding the underlying cause of the condition. Multiple myeloma is one of the hematological malignancies that can cause bone lesions due to an imbalance of bone destructive factors so that it can increase the risk of pathological fracture complications. Knowing the complications, clinical manifestations and supporting characteristics of multiple myeloma can help in making the diagnosis of myeloma in patients with pathological fractures.
Latar belakang: Mieloma multipel (MM) adalah keganasan hematologi yang ditandai dengan lesi tulang yang destruktif, cedera ginjal, anemia dan hiperkalsemia. Mieloma multipel merupakan neoplasma yang sering terjadi pada orang dewasa hingga lanjut usia. Komplikasi fraktur patologis terjadi akibat lesi litik pada tulang. Komplikasi MM dapat muncul sebagai manifestasi klinis pasien sehingga perlu dilakukan pemeriksaan lanjutan pada pasien fraktur patologis untuk menegakkan MM.
Laporan Kasus: Pasien perempuan berusia 67 tahun datang ke IGD Rumah Sakit diantar oleh keluarganya pada Agustus 2022 dengan keluhan nyeri pada paha kanan setelah terjatuh di tangga rumah. Pasien memiliki Riwayat penyakit jantung dan hipertensi. Pasien kemudian melakukan pemeriksaan dan ditemukan kondisi anemia, peningkatan serum kreatinin dan fraktur komplit 1/3 distal os femur kanan dengan lesi litik multipel dengan penurunan trabekulasi tulang pada skull dan pelvis, os klavikula, humerus, dan femur bilateral, costae 7-8 kiri dengan suspek mieloma multipel diagnosis banding metastasis keganasan dan kompresi korpus vertebra 12. Pemeriksaan survei tulang dan pengambilan sampel untuk pemeriksaan histopatologi kemudian dilakukan saat tatalaksana operatif penanganan fraktur dengan kesan plasmasitosis sehingga pasien didiagnosis dengan Post ORIF PS dan pemasangan bone graft dan pasca biopsi e.c. pathological fracture right supracondylar femur with multiple lytic lesion e.c. multiple myeloma. Pasien kemudian dirujuk ke bagian orthopaedi onkologi.
Simpulan: Pasien dengan manifestasi fraktur patologis perlu dilakukan pemeriksaan lebih lanjut mengenai penyebab yang mendasari keadaan tersebut. Mieloma multipel menjadi salah satu keganasan hematologi yang dapat menimbulkan lesi tulang akibat ketidakseimbangan faktor destruktif tulang sehingga dapat meningkatkan risiko komplikasi fraktur patologis. Mengetahui komplikasi, manifestasi klinis dan penunjang yang menjadi karakteristik dari mieloma multipel dapat membantu dalam menegakkan diagnosis mieloma pada pasien dengan fraktur patologis.
Kecurigaan rapid progressive glomerulonephritis akibat nefropati IgA : Sebuah laporan kasus
Kadek Anggiswari Pradnya Angela, I Nyoman SutarkaOnline First: Sep 21, 2022
- Abstract
Kecurigaan rapid progressive glomerulonephritis akibat nefropati IgA : Sebuah laporan kasus
Introduction: Clinical features of IgA nephropathy (IgAN) vary widely from asymptomatic hematuria, gross hematuria, and nephrotic range proteinuria to Rapid Progressive Glomerulonephritis (RPGN). RPGN is a challenge in itself in its diagnostic and treatment, especially in conditions of inadequate resources and facilities
Case Description: Male, 52 years old, with complaints of uremia, oliguria, and leg edema. Obtained hypertension with blood pressure 159/91 mmHg. Urinalysis found +4 protein, full erythrocyte sediment, and positive erythrocyte cast. Albumin to Creatinine Ratio (ACR) levels 2163.10 g/mg creatinine. Blood Urea Nitrogen levels were 78.3 mg/dL, serum creatinine 5.11 mg/dL, serum IgA 546 mg/L, albumin, lipid profile and urological ultrasound were normal. The patient was diagnosed with acute glomerulonephritis due to IgA nephropathy with RPGN. The therapy was given Methylprednisolone 2x16mg for one month, followed by alternating days, Lisinopril 1x5mg, and Atorvastatin 1x20mg. One month of treatment follow-up showed general condition improvement, normal blood pressure, serum creatinine 1.69 mg/dL, urinalysis of erythrocyte sediments 5-10/LPB with ACR levels of 486.44 µg/mg creatinine.
Discussion: RPGN is acute glomerulonephritis with a sudden, rapid, and progressive decline in renal function, accompanied by oliguria, edema, hypertension, and active urine sediment. The suspicion of RPGN, in this case, was based on the findings of nephritic symptoms and signs in the form of microscopic hematuria, erythrocyte casts, subnephrotic proteinuria, hypertension, edema, oliguria, uremia and serum creatinine increased more than two times normal. With the administration of corticosteroids, kidney function improved rapidly. A kidney biopsy was not performed due to limited human resources and facilities.
Conclusion: We report a case of a 52-year-old man with acute glomerulonephritis whose clinical picture is suspected of being RPGN due to IgAN. The response to therapy is quite good with the administration of corticosteroids, ACE-I and statins.
Pendahuluan : Gambaran klinis nefropati IgA (IgAN) sangat bervariasi dari hematuria asimptomatik, gross hematuria, nephrotic range proteinuria hingga Rapid Progressive Glomerulonephritis (RPGN). RPGN merupakan tantangan tersendiri dalam diagnostik dan penanganannya, khususnya pada kondisi sumber daya serta fasilitas yang tidak memadai
Deskripsi Kasus: Laki-laki, 52 tahun dengan keluhan uremia, oligouria, dan edema tungkai. Didapatkan hipertensi dengan tekanan darah 159/91 mmHg. Urinalis didapatkan protein +4, sedimen eritrosit penuh, eritrosit cast positif. Kadar Albumin to Creatinine Ratio (ACR) 2163,10 µg/mg kreatinin. Kadar Blood Urea Nitrogen (BUN) 78,3 mg/dL, serum kreatinin 5,11 mg/dL, IgA serum 546 mg/L, serta albumin, lipid profil dan USG urologi normal. Penderita didiagnosis dengan glomerulonefritis akut oleh karena nefropati IgA dengan RPGN. Pasien diberikan metilprednisolon 2x16mg selama 1 bulan dilanjutkan alternating day, lisinopril 1x5mg, dan atorvastatin 1x20mg. Hasil follow-up 1 bulan pengobatan menunjukkan kondisi umum membaik, tekanan darah normal, serum kreatinin 1,69 mg/dL, urinalisis sedimen eritrosit 5-10 /LPB dengan kadar ACR 486,44 µg/mg kreatinin.
Diskusi: RPGN adalah salah satu jenis glomerulonefritis akut dengan manifestasi penurunan fungsi ginjal mendadak, cepat, dan progresif, disertai oliguria, edema, hipertensi, serta urin sedimen aktif. Kecurigaan RPGN pada kasus ini didasarkan atas ditemukannya gejala dan tanda nefritik berupa hematuria mikroskopik, eritrosit cast, proteinuria subnefrotik, hipertensi, edema, oligouria, uremia dan serum kreatinin meningkat lebih 2 kali normal, serta dengan pemberian kortikosteroid fungsi ginjal cepat membaik. Biopsi ginjal tidak dilakukan karena keterbatasan tenaga dan sarana.
Simpulan: Dilaporkan kasus laki-laki 52 tahun dengan glomerulonefritis akut yang gambaran klinisnya dicurigai sebagai RPGN karena IgAN. Respon terapi cukup baik dengan pemberian kortikosteroid, ACE-I dan statin.
Alopesia universalis pada anak yang berespon baik dengan terapi kombinasi: sebuah laporan kasus
I Gusti Ayu Agung Praharsini, I Gusti Ayu Agung Dwi Karmila, Ratih Purnamasari Nukana, Henny WijayaOnline First: Sep 19, 2022
- Abstract
Alopesia universalis pada anak yang berespon baik dengan terapi kombinasi: sebuah laporan kasus
Background: Alopecia universalis is an autoimmune disease of the hair follicles, which results in complete loss of head and body hair. Until now there is no proven effective therapy in dealing with this disease. We report a case of alopecia universalis that responded well to combination therapy.
Case: Female, 22 months old, complained by her parents due to hair loss on her head, eyebrows and eyelashes that had not grown back since the age of 8 months. On the fingernails and toenails found pitting nails, trachonycia. On scalp dermoscopy examination, multiple yellow dots were found. Severity of Alopecia Tool Score (SALT) was 100%. The patient was treated with minoxidil 5%, mometasone 0.1%, triamcinolone 12 mg and excimer laser. Administration of minoxidil increases prostaglandin production and maintains the anagen phase. Corticosteroids are immunosuppressive which suppress the immune attack of T cells on hair follicles. UV light on the excimer laser can reduce the proliferation of T lymphocytes, thereby reducing perifollicular inflammation and hair follicle damage. In this case, after 4 months of observation, the growth of terminal hair and vellus hair on the scalp, eyebrows and eyelashes was seen. On the patient's nails, the trachonycia was improved, with pitting nails remaining. SALT decreased to 58%.
Conclusion: The combination therapy of minoxidil, corticosteroid and excimer laser gave good results in this case. During treatment, there were no side effects or recurrences.
Latar belakang : Alopesia universalis adalah penyakit autoimun pada folikel rambut, yang mengakibatkan kerontokan seluruh rambut kepala dan tubuh. Hingga saat ini belum ada terapi yang terbukti efektif dalam menangani penyakit ini. Berikut dilaporkan kasus alopesia universalis yang memberikan respon baik dengan terapi kombinasi.
Kasus: Pasien perempuan, 22 bulan, dikeluhkan orang tuanya mengalami rambut kepala, alis dan bulu mata yang rontok dan tidak tumbuh kembali sejak usia 8 bulan. Pada kuku tangan dan kaki didapatkan adanya pitting nails, trachonycia. Pada pemeriksaan dermoskopi kulit kepala didapatkan adanya multiple yellow dots. Severity of Alopecia Tool Score (SALT) 100%. Pasien diberikan terapi minoksidil 5%, mometason 0.1%, triamsinolone 12 mg dan laser excimer. Pemberian minoksidil meningkatkan produksi prostaglandin dan mempertahankan fase anagen. Kortikosteroid bersifat imunosupresif yang menekan serangan imunitas sel T pada folikel rambut. Sinar UV pada laser excimer dapat menurunkan proliferasi sel T limfosit sehingga mengurangi peradangan perifolikular dan kerusakan folikel rambut. Pada kasus, setelah pengamatan selama 4 bulan nampak adanya pertumbuhan rambut terminal dan rambut vellus pada kulit kepala, alis dan bulu mata. Pada kuku pasien nampak trachonycia membaik, tersisa pitting nails. SALT menurun menjadi 58%.
Simpulan: Terapi kombinasi minoksidil, kortikosteroid dan laser excimer memberikan hasil yang baik pada kasus ini. Selama pengobatan tidak didapatkan adanya efek samping dan rekurensi.
Keloid yang diterapi dengan kombinasi bedah eksisi dan injeksi kortikosteroid intralesi: sebuah laporan kasus
Ketut Wida Komalasari, Ketut Kwartantaya Winaya, Putu Gde Hari Wangsa, I Dewa Made Rendy SanjayaOnline First: Oct 3, 2022
- Abstract
Keloid yang diterapi dengan kombinasi bedah eksisi dan injeksi kortikosteroid intralesi: sebuah laporan kasus
Background: Keloids are soft solid tumors with a smooth surface that extend beyond the wound margins and invade adjacent normal tissue. Appears at the age of 10-30 years, occurs as a result of an imbalance between increased collagen synthesis and extracellular matrix. There are several types of therapeutic modalities such as intralesional or topical corticosteroids, surgical excision, electrosurgery, frozen surgery, radiotherapy and laser therapy. Combination therapy of surgical excision and intralesional corticosteroids used for this case.
Case Description: A woman, 43 years old, complained since 3 years ago, in the lower left abdomen there is a lump, which has been getting bigger over the past 1 year, sometimes feels pain and itching. In the left inferior abdominal region, multiple tumors were found to be erythematous to hyperpigmented, with firm boundaries, oval in shape, 0.2 cm to 0.5 cm in diameter, with a length and width of 0.3 cm and 0.5 cm, respectively. 1 cm and 1.5 cm, the surface feels smooth and shiny. On palpation, the tumor was fixed and firm in consistency. Surgical excision was performed and continued with intralesional injection of triamcinolone acetonide once a week on keloid and post-excision lesions. There was clinical improvement of keloids, on the 21st day of observation.
Conclusion: Surgical excision is minimally invasive and can be combined with weekly intrakeloid triamcinolone acetonide injection therapy for keloid lesions and post-excision area to reduce the risk of new keloids appearing. On follow-up observation of keloids in the left inferior abdominal region, the lesion was getting smaller and softened and there was no new keloid growth in the post-excision area.
Latar belakang: Keloid adalah tumor yang padat lunak, dengan permukaan licin berkembang melebihi batas luka dan menginvasi jaringan normal yang berdekatan. Muncul pada usia 10-30 tahun, terjadi akibat dari ketidakseimbangan antara peningkatan sintesis kolagen dan matriks ekstraseluler. Terdapat beberapa macam modalitas terapi seperti kortikosteroid intralesi atau topikal, bedah eksisi, bedah listrik, bedah beku, radioterapi dan terapi laser. Kasus ini membahas terapi kombinasi bedah eksisi dan kortikosteroid intralesi.
Kasus: Seorang wanita, berusia 43 tahun, mengeluh sejak 3 tahun yang lalu, pada perut kiri bawah terdapat benjolan, yang semakin lama semakin membesar selama 1 tahun terakhir, rasa nyeri dan gatal terkadang dirasakan. Pada regio abdominalis inferior sinistra ditemukan tumor multipel berwarna eritema sampai hiperpigmentasi, dengan batas yang tegas, berbentul bulat oval, berdiameter 0,2 cm sampai 0,5 cm, dengan panjang dan lebar masing-masing 0,3 cm dan 0,5 cm serta 1 cm dan 1,5 cm, permukaan teraba licin dan mengkilat. Pemeriksaan palpasi ditemukan tumor terfiksir dan konsistensinya keras. Dilakukan tindakan bedah eksisi dan dilanjutkan dengan injeksi triamsinolon asetonid intralesi seminggu sekali pada lesi keloid dan lesi paska eksisi. Terdapat perbaikan klinis keloid, pada pengamatan hari ke-21.
Simpulan: Tindakan invasif minimal seperti bedah eksisi dapat dikombinasi dengan injeksi triamsinolon asetonid intrakeloid seminggu sekali pada lesi keloid dan daerah paska eksisi untuk mengurangi risiko munculnya keloid baru. Pada pengamatan lanjutan keloid pada regio abdominalis inferior sinistra, didapatkan lesi semakin mengecil dan melunak dan tidak terdapat pertumbuhan keloid baru pada daerah paska tindakan eksisi.
Luaran kualitas hidup pasien lansia pasca tatalaksana operatif fraktur osteoporotik: Sebuah laporan kasus
Anak Agung Davyn Anantha Rheja, I Putu Agni Rangga Githa, Anak Agung Ngurah Ronny KesumaOnline First: Nov 16, 2022
- Abstract
Luaran kualitas hidup pasien lansia pasca tatalaksana operatif fraktur osteoporotik: Sebuah laporan kasus
Background: Fractures in the elderly population arise primarily from fall injuries and low bone density. Osteoporosis fracture is a condition with comorbid osteoporosis that can occur due to minor trauma. Osteoporosis fractures are associated with significant morbidity. Osteoporosis fracture recovery takes a long time and increases the risk of complications. Many patients lose independence and require full daily activity care from caregivers.
Case: A 66-year-old female patient came to the hospital emergency room in July 2022 complaining of pain and swelling in her right leg after a fall in her home. Local examination of the patient's right leg showed edema, deformity, shortening without visible open wound, and palpable stiffness with normal arterial pulsation. The patient has limited movement due to pain. The patient was diagnosed with Closed Fracture Right Subtrochanter Femur Russel Taylor Type 1B with Severe Osteoporosis. The patient underwent open elective reduction and internal fixation percutaneous surgery (ORIF PS). After treatment, the patient's family assists the patient's daily activities. A month later, the patient fell back in her yard. The patient came to the emergency room complaining of pain in the left hip. Local examination found swelling in the proximal left thigh and decreased ROM in the hip joint. The patient received operative management of bipolar hemiarthroplasty. The patient's daily activities still depend on the patient's family due to the patient's limited mobility.
Conclusion: Patients with comorbid osteoporosis are highly susceptible to fracture and have worse long-term morbidity and increased dependence on others for long-term rehabilitation.
Latar belakang: Fraktur pada populasi lanjut usia muncul terutama dari kombinasi cedera akibat jatuh dan kepadatan tulang yang rendah. Fraktur osteoporotik merupakan kondisi fraktur pada populasi dengan komorbid osteoporosis yang dapat terjadi akibat trauma ringan. Fraktur osteoporotik dikaitkan dengan morbiditas yang signifikan. Pemulihan fraktur osteoporotik memerlukan waktu yang lama dan meningkatkan risiko komplikasi. banyak pasien kehilangan kemandirian dan membutuhkan perawatan penuh dari orang lain.
Laporan Kasus: Pasien perempuan dengan usia 66 tahun datang ke IGD Rumah Sakit pada Juli 2022 dengan keluhan nyeri dan bengkak pada kaki kanan setelah terjatuh di halaman rumah. Pemeriksaan lokalis pada kaki kanan pasien menunjukkan pada regio femur kanan ditemukan edema, deformitas, pemendekkan tanpa adanya luka terbuka yang terlihat, teraba kaku dengan pulsasi arteri yang masih baik. Pasien mengalami keterbatasan pergerakan karena nyeri. Berdasarkan pemeriksaan fisik dan penunjang, pasien didiagnosis dengan Closed Fracture Right Subtrochanter Femur Russel Taylor Type 1B dengan Severe Osteoporosis. Pasien menjalani tatalaksan operatif open reduction and internal fixation percutaneous surgery (ORIF PS) elektif. Pasca tatalaksana, aktivitas harian pasien dibantu oleh keluarga pasien. Sebulan kemudian pasien kembali terjatuh dihalaman rumahnya. Pasien datang ke IGD RS dengan keluhan nyeri pada pinggul kiri. Pada pemeriksaan lokalis ditemukan pembengkakan pada paha kiri proksimal dan penurunan ROM pada sendi panggul. Pasien mendapatkan tatalaksana operatif bipolar hemiarthoplasty. Aktivitas harian pasien masih tergantung pada keluarga pasien akibat keterbatasan mobilitas pasien.
Simpulan: Pasien dengan komorbid osteoporosis memiliki kerentanan yang tinggi untuk terjadinya fraktur dan meningkatkan luaran morbiditas yang lebih buruk panjang dan meningkatkan ketergantungan terhadap orang lain untuk proses rehabilitasi dalam waktu yang panjang.
A neglected case of blunt eye injury leading to pediatric cataract: a lifetime consequence case report
Jelly Vianti Fransisca Oeiyano, Raymond Oliver Mantu, Samuel SamataraOnline First: Nov 2, 2022
- Abstract
A neglected case of blunt eye injury leading to pediatric cataract: a lifetime consequence case report
Background: A pediatric traumatic cataract is one of the children's main causes of unilateral visual impairment. It is defined as a permanent opacification of the lens caused by penetrating or blunt trauma to the eye, which might damage the vision. A traumatic pediatric cataract is preventable and treatable. This case study aims to evaluate a neglected case of blunt eye injury leading to pediatric cataracts.
Case Description: A 15-year-old boy came with chief complaints of decreased visual acuity in his left eye for the last 2 years. He has a history of blunt eye injury around 3 years prior in the left eye but left untreated. The patient's visual acuity was 1 per light perception in the left eye. An ophthalmologic examination of the left eye showed an opacity in the lens. The posterior segment cannot be examined. The patient was assessed with a traumatic cataract and was planned to be operated on, but the parents refused.
Conclusion: Prompt first aid and timely surgical intervention are necessary for optimal results. Parents play a critical role in the patient's prognosis by observing closely after eye trauma and bringing their children to the right medical facility.
Interrupted Aortic Arch (IAA): sebuah laporan kasus
Yori Primanda, Pande Putu Yuli Anandasari, I Made Dwija Putra AyustaOnline First: Dec 30, 2022
- Abstract
Interrupted Aortic Arch (IAA): sebuah laporan kasus
Background: Interrupted aortic arch (IAA) is a congenital abnormality in which there is a discontinuity between the lumen of the ascending and descending aorta. This disorder is classified as a rare congenital disorder with an incidence of 0.003 out of 1000 live births. It is important to detect this disorder early because of the high mortality rate of untreated patients with the interrupted aortic arch in the first year of life, reaching 90%. This case report aims to report the sign and symptoms of interrupted aortic arch abnormalities, other accompanying congenital abnormalities, and the radiological feature of this disorder.
Case Presentation: In this case, a baby boy was born at 37 weeks 6 days of gestation with a birth weight of 2100 grams. At birth, the patient did not cry immediately, with an Apgar score of 6-8. It was found that there were differences in oxygen saturation rates of the upper and lower extremities. Initially, the patient underwent echocardiography and cardiac catheterization and the results were severe coarctation of the aorta and bidirectional large tubular patent ductus arteriosus. Then when the patient was 9 months old, a CT angiography examination was performed. A separation between the ascending and descending aortic lumen and several other congenital heart defects was obtained.
Conclusion: Although an interrupted aortic arch is a rare congenital abnormality, it is important to detect early signs and symptoms, other accompanying congenital abnormalities, and the radiological feature of this disorder. CT angiography is an imaging modality that plays an important role in establishing the diagnosis and determining the management of this case to prevent patient morbidity and mortality.
Latar Belakang: Interrupted aortic arch adalah kelainan kongenital dimana terdapat diskontinuitas antara lumen aorta ascenden dan descenden. Kelainan ini tergolong kelainan kongenital yang jarang terjadi dengan insiden 0.003 dari 1000 bayi yang lahir hidup. Penting untuk mendeteksi kelainan ini secara dini karena tingginya angka mortalitas pasien interrupted aortic arch yang tidak di treatment dalam satu tahun pertama kehidupan mencapai 90%. Laporan kasus ini bertujuan untuk melaporkan gejala dan tanda kelainan interrupted aortic arch, kelainan kongenital lain yang menyertai, serta bagaimana gambaran radiologis dari kelainan ini.
Presentasi Kasus : Dalam kasus ini dilaporkan bayi laki-laki yang lahir pada umur kehamilan 37 minggu 6 hari dengan berat badan lahir 2100 gram. Pada saat lahir pasien tidak segera menangis dengan apgar score 6-8. Saat dilakukan pengecekan saturasi oksigen, didapatkan perbedaan angka saturasi oksigen ekstremitas atas dan bawah. Awalnya pasien menjalani pemeriksaan echocardiografi dan kateterisasi jantung didapatkan hasil severe coarctatio aorta dan large tubular patent ductus arteriosus bidirectional. Kemudian saat pasien berusia 9 bulan dilakukan pemeriksaan CT angiography dan didapatkan hasil pemisahan antara lumen aorta ascenden dan descenden serta beberapa kelainan jantung bawaan yang lain.
Simpulan: Walaupun interrupted aortic arch merupakan kelainan kongenital yang jarang terjadi, namun penting untuk dapat mendeteksi gejala dan tanda awal, kelainan kongenital lain yang menyertai, serta bagaimana gambaran radiologis dari kelainan ini. Modalitas pencitraan CT angiography memegang peranan penting dalam penegakkan diagnosis dan penentuan tatalaksana kasus ini untuk mencegah morbiditas dan mortalitas pasien.
Variations of dengue shock syndrome cases and their management: report of three cases
Gede Bagus Mahendra Wirajaya, Ayu Agung Pradnya Paramitha Dwi Sutanegara, Desak Nyoman Desy LestariOnline First: Nov 2, 2022
- Abstract
Variations of dengue shock syndrome cases and their management: report of three cases
Background: Dengue hemorrhagic fever (DHF) occurs due to plasma leakage due to increased vascular permeability, which is also supported by an active complement system, which makes DHF fall into complications such as shock or dengue shock syndrome (DSS). The comprehensive management of DSS could prevent morbidity and mortality in patients. We aimed to report three variations of dengue shock syndrome cases and their management.
Case presentation: Three cases of DSS from our hospital. Two case reports with clinical dengue fever patients with shock and one case report with clinical dengue patients with shock and complications of acute liver failure. The first case was a 24 years olds male patient with classic signs of dengue fever plus spontaneous bleeding in the form of nosebleeds accompanied by hemodynamic disturbances. Laboratory examination revealed severe thrombocytopenia. In the second case, a male patient with dengue shock syndrome accompanied acute liver failure. The patient complains of heartburn and nausea accompanied by tea-like urine. Dengue patients with abdominal pain typical of liver disorders, nausea, vomiting and anorexia, and hepatomegaly with or without jaundice are typical of liver disorders. The third case, a male patient with dengue shock syndrome, accompanied the suspicion of ascites. The main treatment is the administration of isotonic crystalloid fluids according to body weight. While in cases of acute liver failure, NAC can be given.
Conclusion: We found three cases of DSS with some complications. It is important to know the right treatment immediately so that complications do not occur.
Geriatric Patient Outcomes of Major Burn due to High-Voltage Electrical Injury: A Case Report
Vincent Anggriant, Ratna Rayeni Natasha Roosseno, Daniel Puguh Pramudyo, Yoseph ChandraOnline First: Sep 22, 2022
- Abstract
Geriatric Patient Outcomes of Major Burn due to High-Voltage Electrical Injury: A Case Report
Introduction: Electrical burns are uncommon but result in high morbidity and mortality due to severe tissue damage. Geriatrics are vulnerable to aggressive burns because of skin atrophy, comorbidities, diminished host defence mechanisms and reduced mobility. A high-voltage electrical injury has complex complications, especially long-term complications. This study aimed to present the case of geriatric patient outcomes of major burn due to high-voltage electrical injury.
Case Presentation: This is a case report of electrical burn injuries; a 70 years old man came to the emergency room approximately 1 hour after the incident, and a chief complaint was burning due to electrical shock. The patient had a history of electrical shock when fishing on the side of the river bank, where there is a high-voltage electrical central behind him. When he threw his fishing line, the fishing line caught on the exposed high-voltage transformer cable causing an electric shock. The examination showed that the patient was conscious of burns on the right chest to the abdomen and palm to the right hand, as well as on both soles of the feet. Another complaint was a pain in the wound due to electrical shock without a history of fainting, shortness of breath, chest pain, headache, and vomiting. The patient’s previous medical history showed uncontrolled hypertension.
Conclusion: Our study demonstrates a rare geriatric patient discharged without complications due to a high-voltage injury. Strict multi-specialty management and rehabilitation are required to treat electrical injuries properly.
Tatalaksana laser CO2 pada hiperplasia kelenjar sebasea: laporan kasus
Maylita Sari, Arisia Fadila, Muhammad Yulianto Listiawan, Bagus Haryo Kusumaputra, Irmadita CitrashantyOnline First: Dec 7, 2022
- Abstract
Tatalaksana laser CO2 pada hiperplasia kelenjar sebasea: laporan kasus
Background: Sebaceous gland hyperplasia is a benign skin disorder in the form of macules or papules which are generally < 1 mm in size, skin color or yellowish at the mouth of the pilosebaceous gland follicle.1 This disorder can cause cosmetic morbidity and psychosocial impacts for patients. There are various treatment modalities for sebaceous gland hyperplasia associated with the risk of pain, depigmentation, bleeding during the procedure, scarring, and recurrence. CO2 laser is one of the therapeutic approaches that are considered effective and safe.
Case: A female patient came with the chief complaint of lumpy skin-colored lumps on the back of the ear to the left neck that had increased in number and had not been painful since about 4 years ago. Histopathological examination was performed on the lump showing hyperplasia of the sebaceous glands. The patient was treated with 2 CO2 Laser sessions with an even skin surface result. Observations made within 9 months after the procedure did not reveal any recurrence of the lesion.
Conclusion: CO2 laser can be an effective and safe alternative therapy for sebaceous gland hyperplasia.
Latar Belakang: Hiperplasia kelenjar sebasea adalah kelainan jinak kulit berupa makula atau papula yang umumnya berukuran < 1 mm sewarna kulit atau kekuningan di muara folikel kelenjar pilosebasea.1 Kelainan ini dapat menimbulkan morbiditas kosmetik dan dampak psikososial bagi pasien. Terdapat berbagai modalitas tatalaksana hiperplasia kelenjar sebasea yang berhubungan dengan risiko nyeri, depigmentasi, perdarahan selama prosedur, skar, hingga kekambuhan. Laser CO2 merupakan salah satu pendekatan terapi yang dianggap efektif dan aman.
Kasus: Pasien wanita datang dengan keluhan utama benjolan bergerombol sewarna kulit pada telinga bagian belakang hingga leher kiri yang bertambah banyak dan tidak nyeri sejak kurang lebih 4 tahun yang lalu. Pemeriksaan histopatologi dilakukan pada benjolan menunjukkan hasil hiperplasia kelenjar sebasea. Pasien diterapi dengan 2 sesi Laser CO2 dengan hasil permukaan kulit rata. Observasi yang dilakukan dalam 9 bulan paska tindakan tidak didapatkan rekurensi pada lesi.
Simpulan: Laser CO2 dapat menjadi alternatif terapi pada hiperplasia kelenjar sebasea yang efektif dan aman.
Kasus dermatosis langka: confluent and reticulated papillomatosis pada seorang anak
I Gusti Ayu Agung Dwi Karmila, Herman Saputra, Joice Gunawan Putri, Made Sanitca IndahOnline First: Dec 30, 2022
- Abstract
Kasus dermatosis langka: confluent and reticulated papillomatosis pada seorang anak
Background: Confluent and reticulated papillomatosis (CARP) or Gougerot-Carteaud syndrome is a rare and chronic skin disorder characterized by hyperpigmented and cofluent papules/macules/plaques forming a reticular pattern. The characteristics especially occur in adolescents and young adults. Treatment of CARP is difficult and has not yielded good results. This case describes CARP in a young male patient.
Case: A 6-year-old male complained of brownish spots on his face, hands and feet since 5 years ago. It were initially appeared small without itching or pain. Dermatological exmaniation showed hyperpigmented macules, hyperpigmented plaques, confluent to form a reticular pattern. Dermoscopy examination showed a brownish appearance, homogeneous separated by white striae. Histopathological examination revealed acanthosis down growth, reticulated, mild distribution of lymphocytes and perivascular mast cells in the superficial and mild dermis. The patient was diagnosed with CARP and given intraoral azithromycin 250 mg every 24 hours for 2 weeks and ketoconazole 2% shampoo 3 times a week. Follow-up at week 4 there was no significant improvement.
Conslucion: Incident cases of CARP are rare, so there is no alternative therapy for the management of this disease. In this case, new lesions were found after administration of therapy and the prognosis for the patient was poor.
Latar belakang: Confluent and reticulated papillomatosis (CARP) atau sindrom Gougerot-Carteaud merupakan suatu kelainan kulit langka dan kronis dengan karakteristik papul/makula/plak hiperpigmentasi konfluen membentuk pola retikuler. Kelainan ini terutama pada remaja dan dewasa muda. Terapi CARP sulit dan belum memberikan hasil yang baik. Kasus ini mendeskripsikan CARP pada seorang anak laki-laki.
Kasus: Seorang anak laki-laki 6 tahun dengan keluhan bercak kecoklatan pada wajah, tangan dan kaki sejak 5 tahun lalu, awalnya muncul kecil, tanpa disertai gatal maupun nyeri. Status dermatologi didapatkan makula hiperpigmentasi, plak hiperpigmentasi, berkonfluens membentuk pola retikuler. Pemeriksaan dermoskopi didapatkan gambaran kecoklatan, homogen dipisahkan oleh striae putih. Pemeriksaan histopatologi didapatkan gambaran acanthosis down growth, reticulated, sebaran ringan limfosit dan sel mast perivascular pada superfisial dan mild dermis. Pasien didiagnosis CARP dan diberi terapi Azitromisin 250 mg tiap 24 jam intraoral selama 2 minggu dan ketokonazol 2% sampo 3 kali seminggu. Follow-up minggu ke-4 tidak terdapat perbaikan signifikan.
Simpulan: Insiden kasus CARP jarang ditemukan sehingga belum terdapat terapi pilihan untuk tatalaksana penyakit ini. Pada kasus ini masih ditemukan muncul lesi baru setelah pemberian terapi dan prognosis pada pasien adalah dubia ad malam.
A case report: a 38-year-old man with vivax relapse malaria
Ayu Agung Pradnya Paramitha, I Putu Gede Putra Darmawan, Rachmawanti Agustina FitrianiOnline First: Nov 2, 2022
- Abstract
A case report: a 38-year-old man with vivax relapse malaria
Introduction: Malaria is a parasitic disease caused by blood protozoa of the Plasmodium genus transmitted through the bite of a female Anopheles mosquito. Indonesia is still an endemic area, especially in the eastern regions. About 40% of malaria cases in the world are caused by Plasmodium vivax. Tertiana or vivax malaria can cause relapse because it has a hypnozoite stage that is dormant in the liver. This case report will discuss a case of relapse vivax malaria with thrombocytopenia.
Case Illustration: A 38-year-old man came to the emergency room consciously with a fever complaint since 4 days before entering the hospital. Fever occurred throughout the body, disappeared, accompanied by chills and sweating. On the second day the fever began to decrease somewhat but the next day the fever began to increase. The patient has a history of serving in Papua and contracted malaria 3 months before entering the hospital. While in Papua, the patient worked as a supporter for the 2021 PON event and malaria treatment was not complete. A complete blood examination found thrombocytopenia and microscopic examination of thin drops of the presence of ring-shaped Plasmodium vivax. The patient is diagnosed with vivax relapse malaria. The patient was treated with antimalarial therapy with DHP 4 tablets in a day for 3 days and primaquine 2 tablets in a day for 14 days. Monitoring therapy was done on the eighth day, with microscopic examination, and the result was negative malaria plasmodium.
Conclusion: This case report discusses vivax relapse malaria and proper management to irradiate the hypnozoite stage which has an important role in the recurrence phase.
Negative Presure Wound Therapy in Treating Diabetic Foot Ulcers: A Systematic Review about Efficacy and Complication
Saraswati Putri Yogita, Tommy SutantoOnline First: Dec 25, 2022
- Abstract
Negative Presure Wound Therapy in Treating Diabetic Foot Ulcers: A Systematic Review about Efficacy and Complication
Objective: To assess the effectiveness of negative pressure wound therapy (NPWT) in treating diabetic foot ulcers as well as its drawbacks
Method: We selected articles systematically based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICO criteria for studies in the last 10 years. Keywords were searched by Boolean operator. All selected articles were assesed for their quality by STROBE checklist.
Results: Seven articles of randomized-controlled trials were selected, which involved 564 patients whom received NPWT for their diabetic foot ulcers, while 404 others received non-NPWT such as those of standard or moist wound care. Although some studies still showed varying results due to different data collection tools, overall data showed better outcome of NPWT with faster rate of ulcer size reduction and wound closure compared to its counterparts. With different methods of NPWT, this procedure did not show any difference of respected outcomes. On the other hand, complications of NPWT seemed to be lower than comparison groups in most of the reviewed studies. Nonetheless, it does not rule out the possibilty of complication after the treatment, thus meticulous surgery procedure, timely wound management and prophylaxis of infection are absolutely essential.
Conclusion: It has been demonstrated that NPWT is more successful than non-NPWT wound care at treating patients with diabetic foot ulcers and results in fewer complications.
Personal hygiene genitalia wanita
Made Hermina Laksmi, Ni Made Dwi Puspawati, Aurelia Stephanie, Putu Gde HariwangsaOnline First: Sep 19, 2022
- Abstract
Personal hygiene genitalia wanita
Since the beginning, genital hygiene has become a concern for women susceptible to infections of the urinary tract and reproductive system where the vagina is an unsterile organ related to external exposure and close to the anus. Several problems related to the personal hygiene of female genitalia arise due to a lack of understanding and literature discussing this matter. This literature review will discuss the normal flora of the female genitalia and procedures for daily vaginal care, which aims to increase understanding of female genital personal hygiene.
Sejak dahulu hygiene genetalia sudah menjadi perhatian kaum wanita, karena wanita sangat rentan terkena infeksi traktus urinarius dan sistem reproduksi dimana vagina merupakan organ yang tidak steril yang berhubungan dengan dunia luar serta berdekatan dengan anus. Beberapa masalah terkait personal hygiene genitalia wanita timbul akibat kurang pemahaman dan sedikitnya literatur yang membahas tentang hal ini. Tinjauan pustaka ini akan membahas mengenai flora normal genitalia wanita dan tata cara perawatan vagina sehari-hari yang bertujuan untuk meningkatkan pemahaman terhadap personal hygiene genitalia wanita.
The Fundamental Concepts of High SMAS Facelift: Literature Review
Gede Wara Samsarga, I Made Suka Adnyana, Astrinita Lestari Suyata, Shita Diwyani Sudarsa, Dewa Ayu Agung Anggita NingratOnline First: Dec 7, 2022
- Abstract
The Fundamental Concepts of High SMAS Facelift: Literature Review
A number of facelift procedures have been introduced by many surgeons but there is no consensus has yet been established to carry. Since the first description of superficial musculoaponeurotic system (SMAS), it is used as the basis for many facelift methods that produce superior result in rejuvenation compared to traditional skin only facelift. Extended SMAS facelift becoming SMAS modification techniques that is still being developed. It produces two different vector of subcutaneous and SMAS flap, that is essential to restore drooping deep facial tissue with natural appearance. Despite the beneficial use of extended SMAS flap, most of plastic surgeons still traditionally incise the SMAS under the zygomatic arch. However, the low SMAS incision results only on rejuvenation of the lower face and is not sufficient to correct mid-facial aging. Fundamental concepts of high SMAS facelift by reviewing some literatures explain that high SMAS flap transection allowing the surgeon to achieve greater vertical elevation of the deep structures of the face by undermining the middle face, combined with fixation to a fixed structure produces lasting results and oblique vector of skin envelope creating no tension look. Incision above zygomatic arch turns out to be safely performed without facial nerve injury thorough knowledge of the anatomy. The final result is a balanced and harmonious elevation of sagging tissues of the midface, cheek, and jawline, to such an extent that high SMAS facelift becomes optimal, durable, technically simple, reproducible and with a comparatively high safety margin in facelift procedures.
Efektivitas vaksin influenza terhadap kejadian rawat inap pada anak dengan influenza: sebuah tinjauan sistematik dan meta analisis
Dewa Ayu Ketut Oka Sadnyani, I Gusti Agung Ayu Novi Wiraningrat, Romy WindiyantoOnline First: Oct 31, 2022
- Abstract
Efektivitas vaksin influenza terhadap kejadian rawat inap pada anak dengan influenza: sebuah tinjauan sistematik dan meta analisis
Background: Influenza is a respiratory infection that is often experienced by children. Influenza particularly happens in developing countries with a high number of cases. Global influence on influenza vaccine research has now been carried out to reduce the incidence of inpatient and severe influenza complications.
Objective: To examine the effectiveness of the influenza vaccine (EVI) on inpatient events related to influenza disease in children.
Methods: Search for published scientific articles using the prism method (preferred reporting, items for systematic reviews and meta-analysis). The search was carried out on a PubMed database, Cochrane Library and Medline published in the last 10 years until 1st May 2022, about influenza vaccines on inpatient events related to influenza in children. All types of studies are included if the result is inpatient, respondents under the age of 18 and influenza infections are confirmed for the laboratory results. All analyses in our research were conducted using STATA V13.1 (Stata Corporation, College Station, TX)
Results: A randomized meta-analysis of 34 studies that use seasonal cohort and cross-sectional designs assesses the effectiveness of influenza vaccine (EVI) on inpatient events in children by 52.6% (95% CI: 50.9 -54,2) for all influenza. It was found that EVI was higher in influenza A/H1N1PDM09 at 70.0% (95%CI: 66.3-73.6) compared to Influenza A/H3n2 (38.9%; 95%CI: 31.8-46.1) and influenza B (46.7%; 95%CI: 41.9-51.4). According to the type of vaccine, EVI is obtained in the higher QIV type, which is 60.4% (95% CI: 55.3-65.5) compared to other types of vaccines.
Conclusion: Based on the results of this meta-analysis reinforces evidence that shows that influenza vaccination is generally an effective action to prevent inpatient events related to influenza in children.
Latar belakang: Penyakit influenza merupakan salah satu penyakit infeksi pernapasan yang sering dialami anak-anak. Influenza khususnya terjadi negara berkembang dengan kondisi jumlah kasus yang masih tinggi. Untuk menurunkan kejadian rawat inap dan komplikasi penyakit infuenza yang berat, saat ini telah dilakukan penelitian vaksin influenza secara global.
Tujuan: Untuk menelaah efektivitas vaksin influenza (EVI) terhadap kejadian rawat inap terkait penyakit influenza pada anak-anak.
Metode: Penelusuran artikel-artikel ilmiah terpublikasi menggunakan metode PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta Analysis). Pencarian dilakukan dengan basis data PubMed, Cochrane library dan Medline yang diterbitkan pada 10 tahun terakhir hingga bulan Mei 2022, tentang vaksin influenza terhadap kejadian rawat inap terkait penyakit influenza pada anak-anak. Semua jenis studi dimasukkan jika hasilnya adalah rawat inap, responden yang berumur di bawah 18 tahun dan infeksi influenza dikonfirmasi atas hasil laboratorium. Semua analisis dalam penelitian kami dilakukan dengan menggunakan Stata v13.1 (Stata Corporation, College Station, TX)
Hasil: Sebuah meta-analisis efek acak dari 34 studi yang menggunakan desain cohort dan cross-sectional musiman yang dikumpulkan menilai efektivitas vaksin influenza (EVI) terhadap kejadian rawat inap pada anak-anak sebesar 52,6% (95%CI: 50,9-54,2) untuk semua influenza. Diperoleh bahwa EVI lebih tinggi terhadap influenza A/H1N1pdm09 sebesar 70,0% (95%CI: 66,3-73,6) dibandingkan influenza A/H3N2 (38,9%; 95%CI: 31,8-46,1) dan influenza B (46,7%; 95%CI: 41,9-51,4). Berdasarkan jenis vaksin, diperoleh EVI pada jenis QIV lebih tinggi yaitu sebesar 60,4% (95%CI: 55,3-65,5) dibandingkan dengan jenis vaksin lainnya.
Simpulan: Berdasarkan hasil meta-analisis ini menguatkan bukti yang menunjukkan bahwa vaksinasi influenza umumnya adalah tindakan efektif untuk mencegah kejadian rawat inap terkait penyakit influenza pada anak-anak.
A review of multisystem inflammatory syndrome in children (MIS-C) related to COVID-19
Carlson KurniawanOnline First: Dec 1, 2022
- Abstract
A review of multisystem inflammatory syndrome in children (MIS-C) related to COVID-19
Global pandemic of Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2, a novel virus which first reported in Wuhan in December 2019. It can cause severe respiratory conditions including respiratory failure. Different from adults, children usually have milder symptoms of the disease. A post-infection complication that involves multisystem organ failure in children is reported in numerous countries. It is mentioned as multisystem inflammatory syndrome in children (MIS-C) or Kawa-COVID-19, because it resembles Kawasaki Disease. The pathogenesis remains unclear, but it is presumed that hosts’ innate immune response triggered the condition. Modulating the immune response is the main target of the therapy. High doses of intravenous immunoglobulins, low doses of corticosteroids (methylprednisolone), anti-IL-1 (anakinra), antiplatelet such as aspirin can be used to treat MIS-C. Antiviral therapy is not proven to be effective and other immunomodulatory agents still needed further studies.
Necrotizing fasciitis: sebuah tinjauan pustaka
Pande Agung Mahariski, Ni Luh Putu Ratih Vibriyanti Karna, Luh Made Mas Rusyati, Aditya Permana, Ratih Purnamasari Nukana, Pande Tiara MaharaniOnline First: Feb 2, 2023
- Abstract
Necrotizing fasciitis: sebuah tinjauan pustaka
Necrotizing fasciitis (NF) is an infection of the skin to subcutaneous tissue characterized by necrosis of the muscle fascia and subcutaneous tissue. The typical clinical signs and symptoms of NF begin with pain, followed by an inflammatory response. Necrotizing fasciitis is generally caused by infection with immune disorders, old age, peripheral vascular disease, and obesity have been reported to be associated with the incidence of NF. Cases of NF have symptoms similar to those of cellulitis or abscesses. Surgery is currently the gold standard of therapy if NF is suspected or diagnosed. Surgical exploration and debridement of the affected tissue should be performed immediately. Improving knowledge of NF and immediate treatment are needed due to serious, life-threatening infections with a mortality rate exceeding 30%.
Necrotizing fasciitis (NF) infeksi pada kulit hingga jaringan dibawah kulit dengan karakteristik adanya nekrosis pada fasia otot dan jaringan subkutan. Gejala dan tanda klinis khas dari NF diawali dengan nyeri kemudian diikuti respons inflamasi. Necrotizing fasciitis umumnya disebabkan oleh adanya infeksi dengan gangguan kekebalan, usia tua, penyakit pembuluh darah perifer, dan obesitas telah dilaporkan berkaitan dengan kejadian NF. Kasus-kasus NF memiliki gejala yang mirip dengan selulitis atau abses. Saat ini pembedahan merupakan terapi gold standard ketika dicurigai atau didiagnosis dengan NF. Pada Eksplorasi bedah dan debridemen jaringan yang terkena harus segera dilakukan. Diperlukan peningkatan pemahaman NF dan penanganan segera karena NF merupakan infeksi serius yang mengancam jiwa dengan angka kematian melebihi 30%.
Pemberian Air Susu Ibu (ASI) eksklusif sebagai faktor protektif terjadinya stunting pada balita: sebuah tinjauan sistematik
I Kadek Ariarta MahartamaOnline First: Dec 30, 2022
- Abstract
Pemberian Air Susu Ibu (ASI) eksklusif sebagai faktor protektif terjadinya stunting pada balita: sebuah tinjauan sistematik
Background. Stunting is short according to age as measured by the index of height/body length according to age (TB/U or PB/U). Stunting is a major nutritional problem in developing countries, with a global incidence of 149 million in 2020. Prevention of stunting can be done with nutritional interventions in the first thousand days of life, one of which is exclusive breastfeeding. This systematic review aims to determine exclusive breastfeeding as a protective factor for stunting in toddlers.
Method. This systematic review was conducted by searching for studies on electronic databases such as Google Scholar, Cochrane Library, and PubMed. The study selection was done according to the PRISMA diagram and the eligibility criteria. The study assessment was performed using a checklist from the Joanna Briggs Institute for cross-sectional and case-control studies.
Results. A total of 24 studies consisting of 14 cross-sectional studies and 10 case-control studies were included in the analysis. The majority of studies are from Indonesia. The majority of the study samples were male and received exclusive breastfeeding. The incidence of stunting is more common in toddlers who do not receive exclusive breastfeeding. A total of 22 out of 24 studies found a significant relationship between exclusive breastfeeding and the incidence of stunting in toddlers. Exclusive breastfeeding as a protective factor for stunting was found to have varying odds ratio (OR) values, ranging from 0.15 (0.07-0.31) to 61 (21-174).
Conclusion. The incidence of stunting is more common in toddlers who do not receive exclusive breastfeeding. Exclusive breastfeeding is a protective factor against stunting in toddlers.
Latar belakang. Stunting merupakan pendek menurut umur yang diukur melalui indeks tinggi/panjang badan menurut umur (TB/U atau PB/U). Stunting merupakan permasalahan gizi utamanya di negara berkembang dengan angka kejadian global sebanyak 149 juta pada tahun 2020. Pencegahan stunting dapat dilakukan dengan intervensi gizi dalam seribu hari pertama kehidupan, salah satunya dengan pemberian ASI eksklusif. Systematic review ini bertujuan untuk mengetahui pemberian ASI eksklusif sebagai faktor protektif terjadinya stunting pada balita.
Metode. Tinjauan sistematik ini dilakukan pencarian studi pada basis data elektronik berupa Google Scholar, Cochrane Library, dan PubMed. Pemilihan studi dilakukan sesuai dengan diagram PRISMA dan menggunakan kriteria eligibilitas. Penilaian studi dilakukan dengan menggunakan ceklist dari the Joanna Briggs Institute untuk studi cross-sectional dan kasus-kontrol.
Hasil. Sebanyak 24 studi yang terdiri atas 14 studi cross-sectional dan 10 studi kasus-kontrol diikutkan dalam analisis. Studi mayoritas berasal dari Indonesia. Mayoritas sampel penelitian berjenis kelamin laki-laki dan mendapatkan ASI eksklusif. Kejadian stunting lebih banyak ditemukan pada balita yang tidak mendapatkan ASI eksklusif. Sebanyak 22 dari 24 studi menemukan hubungan signifikan antara pemberian ASI eksklusif dengan kejadian stunting pada balita. Pemberian ASI eksklusif sebagai faktor protektif stunting ditemukan memiliki nilai odds ratio (OR) yang bervariasi, yakni antara 0,15 (0,07-0,31) hingga 61 (21-174).
Simpulan. Kejadian stunting lebih banyak ditemukan pada balita yang tidak mendapatkan ASI eksklusif. Pemberian ASI eksklusif merupakan faktor protektif terhadap kejadian stunting pada balita.
Sedot lemak pada area wajah dan leher
Putu Ayuni Yayas Ramaswari, I Gusti Nyoman Darmaputra, Putu Shinta Widari Tirka, Gusti Ayu AnggawatiOnline First: Dec 19, 2022
- Abstract
Sedot lemak pada area wajah dan leher
Liposuction or liposuction is the most commonly performed aesthetic surgical procedure worldwide. Liposuction is considered a safe, simple, and effective surgical method to improve body contours. The purpose of facial and neck liposuction is to reshape the neck and improve contours, not to remove all fat. Once the fat is removed from liposuction, it is expected that the skin will shrink to take on a new contour. It is important to warn patients that if excessive skin laxity develops after the procedure, they may require additional surgical procedures. Liposuction can be performed on various areas of the body that have excess fat deposits. Liposuction is indicated for the removal and reduction of locally isolated adipose tissue deposits.
Sedot lemak atau liposuction merupakan prosedur bedah estetik yang paling sering dilakukan di seluruh dunia. Sedot lemak dinilai sebagai suatu metode tindakan bedah yang aman, sederhana, dan efektif untuk memperbaiki kontur tubuh. Tujuan dari sedot lemak wajah dan leher adalah untuk membentuk kembali leher dan memperbaiki kontur, bukan untuk menghilangkan semua lemak. Setelah lemak dihilangkan dari sedot lemak, diharapkan kulit menyusut untuk mengambil kontur yang baru. Penting untuk memperingatkan pasien bahwa jika kelemahan kulit berlebih berkembang setelah prosedur, mereka mungkin memerlukan prosedur pembedahan tambahan Sedot lemak dapat dilakukan pada berbagai area tubuh yang memiliki deposit lemak berlebih. Sedot lemak diindikasikan untuk menghilangkan dan mengurangi deposit jaringan adiposa yang terisolasi secara lokal.
Pelayanan kesehatan terkait infeksi menular seksual pada lesbian, gay, biseksual, dan transgender
I Gusti Ayu Agung Elis Indira, Anak Agung Indah Jayanthi, Putu Yunita PrimasariOnline First: Dec 30, 2022
- Abstract
Pelayanan kesehatan terkait infeksi menular seksual pada lesbian, gay, biseksual, dan transgender
Penyakit infeksi menular seksual (IMS) dan Human Immunodeficiency Virus (HIV) banyak diderita oleh kelompok LGBT, namun orang-orang LGBT yang mengalami masalah kesehatan masih mengalami kesenjangan dalam perawatan kesehatan. Masyarakat Indonesia, memandang kelompok lesbian, gay, biseksual, dan transgender (LGBT) sebagai suatu bentuk penyimpangan terhadap budaya, norma sosial, dan agama. Meski demikian populasinya kian meningkat disetiap tahunnya. Secara keseluruhan pernah terjadi peningkatan jumlah waria secara bermakna antara tahun 2002 dan 2009, namun dari tahun 2009 dan 2012 peningkatan tidak sebanyak periode sebelumnya. Sayangnya, jumlah populasi LGBT di Indonesia tidak diketahui secara pasti, namun mengacu data populasi rawan terdampak HIV pada waria diperkirakan mencapai 597.000 orang. Hingga kini kelompok LGBT masih dipandang negatif oleh masyarakat sehingga hal tersebut berdampak pada populasi tersebut. Gay yang menggunakan layanan kesehatan akan cenderung menyembunyikan seksualitas mereka karena takut mendapatkan stigma sehingga menyembunyikan orientasi seksual merupakan solusi terbaik mengobati penyakit yang dideritanya. Pada akhirnya, hal tersebut akan menurunkan kualitas hidup mereka. Selain HIV, tidak menutup kemungkinan seorang gay mengalami infeksi menular seksual lainnya seperti infeksi klamidia, gonore, treponema pallidum, herpes simpleks, dan kondiloma. Untuk itu konseling pada kelompok LGBT saat dilakukan skrining untuk IMS harus selalu dilakukan bersamaan dengan konseling pencegahan IMS. Secara umum, yang terbaik adalah memberikan konseling kesehatan seksual dalam konteks kesehatan preventif yang positif daripada berfokus pada pesan-pesan yang berbasis pada rasa takut, yang mungkin menstigmatisasi. Kelompok LGBT harus diberi konseling tentang cara menggunakan kondom lateks saat berhubungan seks oral, anal, dan vagina, yang bertujuan untuk mengurangi risiko penularan HIV dan IMS.
Anemia on Chronic Kidney Disease: The Role of Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors
Ni Wayan Anantika Riani, I Gde Raka WidianaOnline First: Dec 7, 2022
- Abstract
Anemia on Chronic Kidney Disease: The Role of Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors
Anemia is one of the homeostatic abnormalities caused by chronic kidney disease and also frequently problem encountered in end-stage renal disease patients, regardless of the hemodialysis treatment. Anemia in chronic kidney disease significantly impairs kidney function, increases morbidity and mortality risk, and deteriorates the quality of life. Chronic kidney disease’s patients with anemia conditions are affected by numerous factors, including decreased production of endogenous erythropoietin, functional and absolute iron deficiency, and elevated hepcidin levels due to inflammation, particularly in hemodialysis patients. Treatment options for anemia in chronic kidney disease include exogenous erythropoietin and iron supplementation. A new mechanism known as the "hypoxia-sensing system" termed a mediator of erythropoietin synthesis, has been proposed to boost endogenous erythropoietin synthesis. The hypoxia-inducible factor activates specific gene expression and contributes to a physiological response to lower tissue oxygen levels. Chronic kidney disease’s patients who are contraindicated or are hyporesponsive to therapy with erythropoiesis-stimulating drugs may utilize this mechanism as an alternative.
Analisis faktor resiko yang berhubungan dengan nilai Neutrophil Lymphocyte Ratio (NLR) tinggi pada pasien diabetes mellitus tipe 2 yang terinfeksi COVID-19 di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia
Marisye Christantia, Made Ratna Saraswati, Anak Agung Gde Budhiarta, Ketut Suastika, Wira Gotera, I Made Pande Dwipayana, I Made Siswadi Semadi, Ida Bagus Aditya NugrahaOnline First: Oct 31, 2022
- Abstract
Analisis faktor resiko yang berhubungan dengan nilai Neutrophil Lymphocyte Ratio (NLR) tinggi pada pasien diabetes mellitus tipe 2 yang terinfeksi COVID-19 di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia
Background: Coronavirus disease (COVID-19) infection has become a worldwide pandemic. Diabetes Mellitus is a comorbid disease that can increase in severity. The most common clinical finding in severe COVID-19 infection is a high Neutrophil Lymphocyte Ratio (NLR). In patients with Diabetes Mellitus (DM) type 2, it is also known that high NLR values have a poor prognosis. This study analyzes the risk factors associated with high NLR values in type 2 DM patients infected with COVID-19 at Sanglah General Hospital.
Methods: A cross-sectional analytical study was conducted on the medical records of 70 patients with COVID-19 infection with type 2 DM who were treated at Sanglah General Hospital, Denpasar, for the period April 2020-October 2020. The samples were divided into two groups, namely high and normal NLR. The analysis was conducted to see which risk factors were significantly associated with high NLR values in COVID-19 patients with type 2 diabetes. The analysis was carried out using an independent T-test for numerical variables and chi-square for nominal variables.
Results: Most of the study samples had high levels of NLR (65.71%). Risk factors that had a significant relationship with high NLR values were random blood sugar levels (p=0.00), fasting blood sugar levels (p=0.00), HbA1c (p=0.002), CRP levels (p=0.00), leukocyte level (p=0.00), BUN level (p=0.004), history of type 2 DM before COVID-19 infection (p=0.009) and control HbA1c (0.001).
Conclusion: The risk factors associated with high NLR values in COVID-19 patients with type 2 DM at Sanglah Hospital Denpasar are random blood sugar levels, fasting blood sugar levels, HbA1c, CRP levels, leukocyte levels, BUN levels, history of type 2 diabetes before COVID-19 infection and HbA1c control.
Latar Belakang: Infeksi Coronavirus disease (COVID-19) telah menjadi pandemik di seluruh dunia. Diabetes Mellitus merupakan penyakit komorbid yang dapat meningkatkan keparahan. Temuan klinis yang banyak ditemukan pada infeksi COVID-19 berat adalah nilai neutrophil lymphocyte ratio (NLR) yang tinggi. Pada pasien Diebetes Mellitus (DM) tipe 2 juga diketahui nilai NLR yang tinggi memiliki prognosis buruk. Penelitian ini bertujuan untuk menganalisis faktor risiko yang berhubungan dengan nilai NLR tinggi pada pasien DM tipe 2 yang terinfeksi COVID-19 di RSUP Sanglah.
Metode: Studi analitik potong lintang dilakukan pada rekam medik 70 pasien dengan infeksi COVID-19 dengan DM tipe 2 yang dirawat di RSUP Sanglah Denpasar periode April 2020-Oktober 2020. Sampel dibagi menjadi dua kelompok yakni NLR tinggi dan normal. Analisis dilakukan untuk melihat faktor risiko yang signifikan berhubungan dengan nilai NLR tinggi pada pasien COVID-19 dengan DM tipe 2. Analisis dilakukan menggunakan uji independent T-test untuk variabel numerik dan chi-square untuk variabel nominal.
Hasil: Mayoritas sampel penelitian memiliki kadar NLR tinggi (65,71%). Faktor risiko yang memiliki hubungan signifikan dengan nilai NLR tinggi adalah kadar gula darah acak (p=0,00), kadar gula darah puasa (p=0,00), HbA1c (p=0,002), kadar CRP (p=0,00), kadar leukosit (p=0,00), kadar BUN (p=0,004), riwayat DM tipe 2 sebelum infeksi COVID-19 (p=0,009) dan kontrol HbA1c (0,001).
Kesimpulan: Faktor risiko yang berhubungan dengan nilai NLR tinggi pada pasien COVID-19 dengan DM tipe 2 di RSUP Sanglah Denpasar adalah kadar gula darah acak, kadar gula darah puasa, HbA1c, kadar CRP, kadar leukosit, kadar BUN, riwayat DM tipe 2 sebelum infeksi COVID-19 dan kontrol HbA1c.
Hubungan antara pemberian vaksin COVID-19 dengan berat derajat COVID-19 pada pasien di ruang isolasi RSUD Tabanan tahun 2022
I Kadek Agus Artawan, I Gede Agus SastrawanOnline First: Dec 17, 2022
- Abstract
Hubungan antara pemberian vaksin COVID-19 dengan berat derajat COVID-19 pada pasien di ruang isolasi RSUD Tabanan tahun 2022
Background: COVID-19 vaccination is the administration of COVID-19 vaccine to increase a person's immunity to COVID-19. Currently in Indonesia, the third vaccine (booster) has been implemented where this vaccination is given as an additional dose to provide extra protection because the effects of the vaccine may decrease over time. The booster vaccine is considered the best model to increase immunity. The Ministry of Health, Republic of Indonesia noted that 1,090 patients died during the time when the Omicron variant dominated COVID-19 cases in Indonesia. From the data of 1,090 patients who died, 68% of them had not been fully vaccinated. This study aims to determine the correlation between the administration of the COVID-19 vaccine and the severity of the COVID-19 degree in patients in the isolation ward of Tabanan Hospital in 2022.
Methods: the type of research used was analytic research with a cross sectional design. The sampling technique used was total sampling, obtained a sample of 174 respondents from February 1, 2022 to April 30, 2022. Data collection was done by collecting data from patient medical records. The statistical test used was the Wilcoxon signed rank test with p<0.05.
Results: The average value of the severity of COVID-19 in patients who have not received the COVID-19 vaccination is 6.40 with a standard deviation of 1.673 and the average value of the severity of COVID-19 in patients who have received the COVID-19 vaccination has an increased of 11.13 with a standard deviation of 2.240. The results of the Wilcoxon signed rank test statistic resulted in a significance (p) of 0.000, which means Ha is accepted.
Conclusion: There was correlation between COVID-19 vaccinations with the severity of COVID-19 in patients in the isolation ward of the Tabanan District Hospital
Latar Belakang: Vaksinasi COVID-19 adalah pemberian vaksin COVID-19 untuk menimbulkan kekebalan seseorang terhadap COVID-19. Saat ini di Indonesia sudah mulai dilaksanakan vaksin ketiga (booster) dimana vaksinasi ini diberikan sebagai dosis tambahan untuk memberikan perlindungan ekstra karena efek dari vaksin dapat menurun seiring berjalannya waktu. Dengan adanya vaksin booster dianggap sebagai model yang paling baik untuk meningkatkan imun. Kemenkes RI mencatat sudah ada 1.090 pasien meninggal di masa varian Omicron mendominasi kasus COVID-19 di Indonesia. Dari data 1.090 pasien yang meninggal, 68% diantaranya belum divaksinasi lengkap. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara pemberian vaksin COVID-19 dengan derajat COVID-19 pada pasien di ruang isolasi RSUD Tabanan tahun 2022.
Metode: Jenis penelitian yang digunakan adalah penelitian analitik dengan desain cross sectional. Teknik sampling yang digunakan adalah total sampling, diperoleh sampel sebanyak 174 responden dari 1 Februari 2022 sampai dengan 30 April 2022. Pengumpulan data dilakukan dengan melakukan pengumpulan data dari rekam medis pasien. Uji statistik yang digunakan adalah uji Wilcoxon signed-rank test dengan p<0,05.
Hasil: Nilai rata-rata derajat berat COVID-19 pada pasien yang belum mendapatkan vaksinasi COVID-19 adalah 6,40 dengan standar deviasinya 1,673 dan nilai rata-rata derajat berat COVID-19 pada pasien yang sudah mendapatkan vaksinasi COVID-19 mengalami kenaikan yaitu 11,13 dengan standar deviasinya adalah 2,240. Hasil uji statistik Wilcoxon signed-rank test menghasilkan signifikansi (p) sebesar 0,000 yang artinya Ha diterima.
Kesimpulan: Terdapat hubungan pemberian vaksinasi COVID-19 dengan derajat COVID-19 pada pasien di ruang isolasi RSUD Kabupaten Tabanan
Anosmia dan ageusia sebagai faktor prognosis baik pada pasien COVID-19 rawat inap di RSUP Sanglah Denpasar
Senja Decy Ningrum, Ida Bagus Ngurah Rai, I Gede Ketut Sajinadiyasa, Anak Agung Raka Sudewi, Ida Ayu Jasminarti Dwi Kusumawardani, Ni Wayan Candrawati, Ni Luh Putu Eka ArisantiOnline First: Oct 4, 2022
- Abstract
Anosmia dan ageusia sebagai faktor prognosis baik pada pasien COVID-19 rawat inap di RSUP Sanglah Denpasar
Background: Anosmia and ageusia are early symptoms that are widely reported in COVID 19 patients and are associated with low rates of intensive care and mortality, so the hypothesis arises that anosmia and ageusia can be good prognostic factors in COVID-19 patients. This study aims to examine anosmia and ageusia as prognostic factors in COVID-19 patients.
Methods: This study is an observational analytic study with a retrospective cohort design conducted at Sanglah General Hospital Denpasar from January to June 2022.
Results: obtained a total of 1048 subjects with 344 subjects experiencing anosmia, 210 subjects experiencing ageusia, and 474 subjects experiencing a combination of anosmia and ageusia. Variable symptoms of anosmia and ageusia were statistically significant predictors for the recovery of COVID-19 patients (p<0.05). The cure rate in the group of patients with symptoms of anosmia was 1.8 times (RR = 1.783, 95% CI = 1.667-1.908) and the group of patients with symptoms of ageusia experienced 1.6 times higher recovery (RR = 1.564, 95% CI = 1.478 -1,655). After adjusting for other variables as confounders, the combination of symptoms of anosmia and ageusia in patients was a significant predictor of recovery for COVID-19 patients by 1.5 times compared to patients who did not experience the combination of symptoms of anosmia and ageusia (ARR = 1.523, 95% CI = 1.245- 1.864, p<0.05).
Conclusion: Anosmia, ageusia and the combination of both, indicate protective factors against possible mortality and indicate a good prognosis in COVID-19 patients.
Latar belakang: Anosmia dan ageusia merupakan gejala awal yang banyak dilaporkan pada pasien COVID-19 serta dikaitkan dengan tingkat rawat intensif dan mortalitas yang rendah sehingga muncul hipotesis bahwa anosmia dan ageusia dapat menjadi faktor prognosis yang baik pada pasien COVID-19. Penelitian ini bertujuan untuk meneliti anosmia dan ageusia sebagai faktor prognosis pada pasien COVID- 19.
Metode: Penelitian ini merupakan studi analitik observasional dengan rancangan kohort retrospektif yang dilakukan di RSUP Sanglah Denpasar pada bulan Januari hingga Juni 2022.
Hasil: Didapatkan total 1048 subjek dengan 344 subjek mengalami anosmia, 210 subjek mengalami ageusia, serta 474 subjek mengalami kombinasi anosmia dan ageusia. Variabel gejala anosmia maupun ageusia secara statistik merupakan prediktor signifikan untuk kesembuhan pasien COVID-19 (p<0,05). Tingkat kesembuhan pada kelompok pasien bergejala anosmia mencapai 1,8 kali (RR = 1,783, IK 95% = 1,667-1,908) lebih tinggi dan kelompok pasien bergejala ageusia mengalami kesembuhan 1,6 kali lebih tinggi (RR = 1,564, IK 95% = 1,478-1,655). Setelah disesuaikan dengan variabel lain sebagai perancu, kombinasi gejala anosmia dan ageusia pada pasien menjadi prediktor kesembuhan pasien COVID-19 secara signifikan sebesar 1,5 kali lipat dibandingkan pasien yang tidak mengalami kombinasi gejala anosmia dan ageusia (ARR = 1,523, IK95% = 1,245-1,864, p<0,05).
Simpulan: Anosmia, ageusia, dan kombinasi keduanya menunjukkan adanya faktor protektif terhadap kemungkinan mortalitas serta menandakan adanya prognosis yang baik pada pasien COVID-19
Studi deskriptif kasus malaria sebelum dan sesudah gempa di Kecamatan Gunung Sari, Lombok Barat, Indonesia
Ni Luh Made Mirah Rahayu, Indah Sapta Wardani, Dewi Suryani, Ni Luh Putu Harta WedariOnline First: Nov 21, 2022
- Abstract
Studi deskriptif kasus malaria sebelum dan sesudah gempa di Kecamatan Gunung Sari, Lombok Barat, Indonesia
Background: Indonesia is the country where malaria transmission still occurs. Malaria disease transmission has increased, for example when an earthquake occurred in Lombok. This research aims to explore the comparison of malaria cases in Gunung Sari District before and after the Lombok earthquake.
Methods: Primary data were obtained by filling in the online google form by the interviewees and then continued by interviewing on telephone. Secondary data were obtained from online medical records from the information section of Gunung Sari and Penimbung Health Center, West Lombok.
Results: Malaria incidence 6 months before the earthquake was 16 cases with the dominant type of malaria, namely P. falciparum malaria, and 6 months after the earthquake was 830 cases with the dominant type of malaria, namely mixed Plasmodium malaria (P. falciparum and P. vivax). Malaria incidence 1 year after the earthquake was 8 cases with the dominant type of malaria, namely P. falciparum. Efforts to reduce malaria cases include eradicating mosquitoes, increasing public awareness, early diagnosis of malaria, monitoring treatment, and using bed nets.
Conclusion: Malaria incidence has increased in the 6 months after the earthquake because of loss of homes and post-disaster ecological changes. Malaria incidence 1 year after the earthquake has decreased. Efforts to reduce cases include eradication of mosquitoes, public knowledge, and environment restoration.
Latar Belakang: Indonesia merupakan salah satu negara dimana masih terjadi transmisi malaria. Penularan penyakit malaria meningkat pada populasi yang terkena bencana contohnya gempa yang terjadi di Lombok. Penelitian ini bertujuan mengetahui perbandingan kasus malaria di Kecamatan Gunung Sari sebelum dan sesudah gempa Lombok.
Metode: Data primer diperoleh dengan pengisian google form secara daring oleh narasumber lalu dilanjutkan wawancara melalui sambungan telepon. Data sekunder diperoleh dari data rekam medis secara daring dari bagian informasi Puskesmas Gunung Sari dan Penimbung, Lombok.
Hasil: Angka kasus malaria 6 bulan sebelum gempa adalah 16 kasus dengan jenis malaria dominan yakni malaria P. falciparum. Sedangkan angka kasus malaria 6 bulan sesudah gempa adalah 830 kasus dengan jenis malaria dominan yakni malaria Plasmodium campuran (P. falciparum dan P. vivax). Angka kasus malaria 1 tahun pasca gempa tersebut adalah 8 kasus dengan jenis malaria dominan yakni P. falciparum. Upaya penurunan kasus malaria meliputi pemberantasan nyamuk, peningkatan wawasan masyarakat, diagnosis dini malaria, pemantauan pengobatan, dan penggunaan kelambu.
Simpulan: Angka kasus malaria mengalami peningkatan pada 6 bulan sesudah gempa Lombok. Faktor yang meningkatkan penularan penyakit malaria ini adalah kehilangan rumah dan perubahan ekologi pasca bencana. Sedangkan angka kasus malaria 1 tahun pasca gempa Lombok mengalami penurunan. Upaya penurunan kasus yakni pemberantasan nyamuk, pengetahuan masyarakat, dan pemulihan lingkungan tempat tinggal korban bencana.
Preeklampsia dengan gambaran berat sebagai faktor risiko kejadian asfiksia neonatorum
I Putu Gede Danika Adikarya, Gede Alit WardanaOnline First: Nov 2, 2022
- Abstract
Preeklampsia dengan gambaran berat sebagai faktor risiko kejadian asfiksia neonatorum
Background: Asphyxia neonatorum is one of the most frequent perinatal issues caused by preeclampsia, which is one of the most common prenatal disorders. Neonatal asphyxia is one of the health problems that is very important to pay attention to because this condition is associated with perinatal morbidity and mortality. Several maternal conditions are thought to be associated with neonatal asphyxia, including maternal age, gestational age, obstetric history, degree of preeclampsia, and method of delivery. This study aims to confirm this hypothesis.
Methods: This study used an observational analytic design with a cross sectional design conducted between June 2021 and June 2022 at the Department of Obstetrics and Gynecology at Wangaya Hospital Denpasar, 97 pregnant women with preeclampsia were included. The research data were obtained through direct recording from medical records. The data collected were maternal age, gestational age, gravida, parity, history of abortion, degree of preeclampsia and method of delivery.
Results: Pregnant women with preeclampsia who had gestational age <37 weeks [p = 0.021; OR = 3.27 (1,2-8.8)], has a gravida of 1 and > 3 [p = 0.019; OR = 2.97 (1,2-7,1)], has a parity of 1 and > 3 [p = 0.033; OR = 2.62 (1.1-6.1)], had preeclampsia with severe features [p = 0.002; OR = 5.62 (1.7-17.8)], and delivered by SC [p = 0.005; OR = 6.9 (1.5-31.9)] had a higher probability of having a child with asphyxia neonatorum. Meanwhile, the mother's age at delivery [p = 0,516; OR = 0.72 (0.3-1.7)] and history of abortion [p = 0.074; OR = 2.53 (0.9-6.7)] is not a factor that causes asphyxia neonatorum.
Conclusions: Factors related to the incidence of asphyxia neonatorum in pregnant women with preeclampsia are gestational age, gravida, parity, degree of preeclampsia, and method of delivery.
Latar Belakang: Preeklampsia merupakan salah satu penyulit kehamilan yang sangat umum ditemukan dan menyebabkan berbagai masalah perinatal, salah satunya asfiksia neonatorum. Asfiksia neonatorum merupakan salah satu masalah kesehatan yang sangat penting untuk diperhatikan karena kondisi ini terkait dengan morbiditas dan mortalitas perinatal. Beberapa kondisi maternal diduga terkait dengan asfiksia neonatorum, antara lain usia ibu, usia kehamilan, riwayat obstetri, derajat preeklampsia, dan metode persalinan. Penelitian ini bertujuan untuk mengkonfirmasi hipotesis tersebut.
Metode: Penelitian ini menggunakan rancangan analitik observasional dengan desain cross sectional yang melibatkan 97 orang ibu hamil dengan preeklampsia di Departemen Obstetri dan Ginekologi RSUD Wangaya Denpasar periode bulan Juni 2021 sampai Juni 2022. Data penelitian diperoleh melalui pencatatan langsung dari rekam medis. Data yang dikumpulkan adalah usia ibu, usia kehamilan, gravida, paritas, riwayat abortus, derajat preeclampsia dan metode persalinan
Hasil: Ibu hamil dengan preeklampsia yang memiliki usia kehamilan < 37 minggu [p = 0,021; OR = 3,27 (1,2-8,8)], memiliki gravida 1 dan > 3 [p = 0,019; OR = 2,97 (1,2-7,1)], memiliki paritas 1 dan > 3 [p = 0,033; OR = 2,62 (1,1-6,1)], mengalami preeklampsia dengan gambaran berat [p = 0,002; OR = 5,62 (1,7-17,8)], dan bersalin secara SC [p = 0,005; OR = 6,9 (1,5-31,9)] memiliki kemungkinan lebih besar untuk memiliki anak yang mengalami asfiksia neonatorum. Sedangkan usia ibu saat bersalin [p = 0,516; OR = 0,72 (0,3-1,7)] dan riwayat abortus [p = 0,074; OR = 2,53 (0,9-6,7)] bukanlah faktor yang menyebabkan terjadinya asfiksia neonatorum.
Kesimpulan: Faktor yang berhubungan dengan kejadian asfiksia neonatorum pada ibu hamil dengan preeklampsia adalah usia kehamilan, gravida, paritas, derajat preeklampsia, dan metode persalinan
Pengaruh tingkat pengetahuan, sikap dan perilaku dengan kejadian COVID-19 pada mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warwadewa
Agus Santosa, Luh Gde Evayanti, Angga PriyanaOnline First: Dec 6, 2022
- Abstract
Pengaruh tingkat pengetahuan, sikap dan perilaku dengan kejadian COVID-19 pada mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warwadewa
Introduction: Efforts in preventing COVID-19 are carried out by increasing knowledge and improving attitudes and behavior. These three components affect the occurrence of COVID-19, especially among medical students. This study aimed to determine the relationship between knowledge, attitudes, and behavior and the incidence of COVID-19 in students of the Faculty of Medicine and Health Sciences (FKIK Unwar).
Methods: Analytical design and a cross sectional study were used. The study was conducted from October – November 2021. Several 88 samples were selected by purposive sampling from 2018-2020 class students in the Unwar FKIK environment. Data were analyzed using Fisher Exact test (p<0.05).
Results: Medical students have knowledge of 94.3% in the good category, 79.5% positive attitude and 55.7% positive behavior towards COVID-19, although there is no significant relationship (p>0.05).
Conclusion: Education and implementation of strict health protocols at FKIK Unwar increase the knowledge, behavior, and attitudes of FKIK Unwar students. Those were related to the low incidence of COVID-19 at FKIK Unwar for the last 3 months.
Latar Belakang: Peningkatan pengetahuan, perbaikan sikap serta perilaku dilaksanakan dalam upaya pencegahan COVID-19. Ketiga komponen tersebut mempengaruhi kejadian COVID-19 terutama dikalangan mahasiswa kedokteran. Penelitian ini bertujuan mengetahui pengaruh tingkat pengetahuan, sikap dan perilaku dengan kejadian COVID-19 pada mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan (FKIK Unwar).
Metode: Rancangan analitik ini menggunakan studi cross sectional dan dilaksanakan pada bulan Oktober – November 2021. Sebanyak 88 sampel dipilih dengan purposive sampling dari mahasiswa angkatan 2018-2020 di lingkungan FKIK Unwar. Data dianalisis sengan uji Fisher Exact (p<0,05).
Hasil: Mahasiswa kedokteran memiliki pengetahuan persentase 94,3% dalam kategori baik, sikap positif 79,5% dan perilaku positif 55,7% terhadap COVID-19 meskipun tidak terdapat pengaruh bermakna (p>0,05).
Simpulan: Edukasi dan penerapan protokol kesehatan yang ketat di FKIK Unwar meningkatkan pengetahuan, perilaku, dan sikap mahasiswa FKIK Unwar. Hal ini terkait rendahnya kejadian COVID-19 di FKIK Unwar selama 3 bulan terakhir.
Faktor Yang Mempengaruhi Rekurensi Pada Pasien Kanker Payudara Pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah
Made Revina Chandradewi, Ida Bagus Tjakra Wibawa Manuaba, Putu Anda Tusta AdiputraOnline First: Dec 7, 2022
- Abstract
Faktor Yang Mempengaruhi Rekurensi Pada Pasien Kanker Payudara Pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah
Background: In Indonesia, the incidence of breast cancer is 42,1 per 100,000 people, whereas the average mortality rate is 17 per 100,000 people. 8-10% of women with breast cancer will experience locoregional recurrence, and 15-30% may develop distant metastases. This study aimed to examine if cancer subtypes, histological grading, and LVI were linked with breast cancer recurrence in patients after Modified Radical Mastectomy at Prof. RSUP. Dr. I G.N.G. Ngoerah.
Methods: Medical record data are used as the study data source to discover the factors that impact breast cancer recurrence in patients who have had a modified radical mastectomy. This research was done using a sequential sampling method. This study's sample utilized inclusion and exclusion criteria to generate 363 patients. The data obtained were analyzed using SPSS ver 22.
Results: The results revealed that 327 patients, or 90.1%, did not have a recurrence, whereas 36 patients, or 9.9%, did. There were 50 Luminal A subtype patients, 127 Luminal B subtype patients, 61 Luminal-Her2 subtype patients, 65 Her2 subtype patients, and 60 TNBC subtype patients. 231 individuals were found to have a negative LVI, whereas 132 patients had a positive LVI. Forty-seven individuals were diagnosed with grade I, 174 with grade II, and 142 with grade III. Breast cancer recurrence was significantly impacted by LVI (p<0.05).
Conclusion: LVI is strongly related to breast cancer recurrence in patients undergoing Modified Radical Mastectomy, but subtype and histological grading are not.
Latar Belakang: Angka kejadian kanker untuk kanker payudara di Indonesia sebesar 42,1 per 100.000 penduduk dengan rata-rata kematian sebesar 17 per 100.000 penduduk. Antara 8-10% wanita yang didiagnosis dengan kanker payudara akan mengalami kekambuhan locoregional dan 15-30% akan mengalami metastasis jauh. Tujuan penelitian ini dilakukan yaitu untuk mengetahui apakah subtipe kanker, grading histopatologi dan LVI menjadi faktor yang berhubungan dengan terjadinya rekurensi kanker payudara pada pasien pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah.
Metode: Desain penelitian cross sectional digunakan dalam penelitian ini, dimana data rekam medis menjadi sumber data penelitian. Penelitian menggunakan pengambilan sampel secara konsekutif. Sampel dalam penelitian menggunakan kriteria inklusi dan eksklusi dan diperoleh jumlah sampel 363 pasien. Data yang didapatkan dianalisis dengan menggunakan SPSS ver 22.
Hasil: Hasil penelitian menunjukkan sebanyak 327 pasien atau sebesar 90,1% tidak rekuren, sedangkan 36 pasien atau sebesar 9,9% mengalami rekurensi. Terdapat 50 pasien dengan subtipe Luminal A, 127 pasien dengan subtipe Luminal B, 61 pasien dengan subtipe Luminal-Her2, 65 pasien dengan subtipe Her2, dan 60 pasien dengan subtipe TNBC. Dari 231 pasien didapatkan dalam kategori LVI negatif, sedangkan 132 pasien memiliki LVI positif. Sebanyak 47 pasien didapatkan dengan grade I, 174 pasien dengan dengan grade II, dan 142 pasien memiliki grade III. LVI memiliki pengaruh signifikan (p<0,05) terhadap rekurensi kanker payudara.
Simpulan: LVI berhubungan signifikan terhadap rekurensi kanker payudara pada pasien pasca Modified Radical Mastectomy, sedangkan subtipe dan grading histopatologis tidak.
Gambaran tingkat kecemasan dalam menghadapi UTBK SBMPTN pada calon mahasiswa baru angkatan 2020/2021 di Denpasar
Dhanira Mahaliana Bramantya Suanda Putri, Luh Made Indah Sri Handari Adiputra, Ketut Tirtayasa, Indira Vidiari JuhannaOnline First: Oct 4, 2022
- Abstract
Gambaran tingkat kecemasan dalam menghadapi UTBK SBMPTN pada calon mahasiswa baru angkatan 2020/2021 di Denpasar
Introduction: Such tight competition is suspected to cause anxiety in prospective new students in facing the computer-based written examination of the joint selection to enter state universities (UTBK SBMPTN). Anxiety is a combination of various responses that include intense networking, feeling worried and disturbing. Preparation for exams can create a high level of anxiety. However, anxiety can also be a positive energy when it is still at a low level. So, it is important when knowing the level of anxiety in prospective students facing the UTBK SBMPTN
Methods: This study is a descriptive study with a retrospective approach. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS) questionnaire which was distributed to prospective students graduating from SMAN 4 Denpasar and SMA PGRI 2 Denpasar in 2021 who registered for the UTBK SBMPTN with a sample of 88 people.
Results: The level of anxiety of respondents in this study had a relatively mild level of anxiety, namely 35 people (28%), 25 people (28%) experienced moderate anxiety and only 2 people (2%) experienced severe anxiety. Symptoms experienced by many respondents were difficulty concentrating (55 people), easily distracted (72 people), lethargic (60 people), restless (65 people).
Conclusion: The level of anxiety of most of the respondents in this study had a relatively mild level of anxiety, namely as many as 35 people (40%).
Pendahuluan: Persaingan yang begitu ketat diduga menimbulkan rasa cemas pada calon mahasiswa baru dalam menghadapi ujian tulis berbasis komputer seleksi bersama masuk perguruan tinggi negeri (UTBK SBMPTN). Kecemasan merupakan kombinasi dari berbagai respon mencakup ketakutan yang intens, merasa khawatir dan bersifat mengganggu. Persiapan untuk ujian dapat menciptakan tingkat kecemasan yang tinggi. Namun, kecemasan juga bisa menjadi energi positif ketika masih pada tingkatan rendah. Maka, penting mengetahui tingkatan kecemasan pada calon mahasiswa ketika menghadapi UTBK SBMPTN
Hasil: Tingkat kecemasan responden dalam penelitian ini memiliki tingkat kecemasan yang tergolong ringan yaitu sebanyak 35 orang (40%), 25 orang (28%) mengalami cemas sedang dan hanya 2 orang (2%) yang mengalami cemas berat. Gejala yang banyak dialami oleh responden adalah sulit konsentrasi (55 orang), mudah terganggu (72 orang), lesu (60 orang), gelisah (65 orang).
Simpulan: Tingkat kecemasan sebagian besar responden dalam penelitain ini memiliki tingkat kecemasan yang tergolong ringan yaitu sebanyak 35 orang (40%).
Kadar interleukin-10 serum yang tinggi berkorelasi dengan indeks bakteri yang tinggi pada penderita kusta tipe multibasiler
Putu Ayu Dewita Ganeswari, I Gusti Nyoman Darmaputra, Luh Made Mas RusyatiOnline First: Dec 30, 2022
- Abstract
Kadar interleukin-10 serum yang tinggi berkorelasi dengan indeks bakteri yang tinggi pada penderita kusta tipe multibasiler
Introduction: Leprosy is a contagious disease that has the potential to cause health problems, giving a psychological impact due to discrimination and stigma caused by the disabilities it causes. Leprosy, also known as Morbus Hansen (MH), is a chronic inflammatory disease caused by Mycobacterium leprae (M. leprae), which has obligate intracellular. Apart from bacterial factors, the incidence of leprosy is strongly influenced by the host, immunity status, and also genetic variation. Lepromatous type (LL) leprosy is characterized by the appearance of skin lesions, high bacterial index, nerve damage, and also the production of T helper-2 cytokines, such as interleukin-4, I interleukin-5 and interleukin-10. One of the cytokines that play a role in multibacillary type leprosy is interleukin -10 (IL-10). The aim of this study is to determine the correlation between IL-10 serum with bacterial index in multibacillary type of leprosy.
Method: This study was a cross-sectional observational analytic study involving 50 subjects of multibacillary type leprosy, consist of 25 subjects who were receiving MDT therapy and 25 subjects who had completed therapy or release from treatment (RFT). Sample were taken using consecutive sampling and have fulfilled inclusion and exclusion criteria, with age range of 18-65 years. Interleukin-10 serum levels were derived from venous blood sampling that was measured by the ELISA method.
Result: The results of this study were significant differences between IL-10 serum levels between MB type of leprosy that receiving therapy and MB type leprosy that had completed therapy with median 22,67 (12,87) dan 2,22 (5,87), p<0,001. In this study, a very strong positive correlation (Spearman Correlation r = 0.974; p <0.001) was found between serum IL-10 levels and the bacterial index.
Conclusion: The conclusion of this study is that there is a significant between IL-10 serum levels in multibacillary type leprosy patients who are receiving MDT therapy and who have completed therapy or release from treatment (RFT), and high IL-10 serum levels are correlated with a high bacterial index in patient with multibacillary type of leprosy.
Pendahuluan: Kusta merupakan salah satu penyakit menular yang berpotensi menimbulkan masalah kesehatan, memberikan dampak psikologis akibat diskriminasi dan stigma yang disebabkan oleh karena kecacatan yang ditimbulkan. Kusta dikenal juga dengan sebutan Morbus Hansen (MH) merupakan penyakit inflamasi kronik yang disebabkan oleh Mycobacterium leprae (M. leprae), yang memiliki sifat obligat intraseluler. Selain faktor bakteri, kejadian kusta sangat dipengaruhi oleh host yaitu status imunitas, dan juga variasi genetik. Kusta tipe lepromatosa (LL) ditandai dengan munculnya lesi di kulit, indeks bakteri yang tinggi, dan adanya kerusakan saraf, serta adanya produksi berbagai sitokin oleh T helper-2 yaitu interleukin-4, interleukin-5 dan interleukin-10. Salah satu sitokin yang berperan pada kusta tipe multibasiler adalah interleukin-10 (IL-10). Penelitian ini bertujuan untuk mengetahui korelasi IL-10 serum dengan indeks bakteri penderita kusta tipe multibasiler.
Metode: Penelitian ini adalah penelitian analitik observasional cross sectional yang melibatkan 50 subjek kusta tipe multibasiler, yang terdiri dari 25 subjek yang sedang mendapat terapi MDT dan 25 subjek yang telah menyelesaikan terapi atau release from treatment (RFT). Pengambilan sampel menggunakan cara consecutive sampling dan telah memenuhi kriteria inklusi dan eksklusi, dengan rentang usia 18-65 tahun. Kadar IL-10 serum berasal dari pengambilan darah vena yang diperiksa dengan metode ELISA.
Hasil: Hasil penelitian ini terdapat perbedaan kadar IL-10 serum antara kusta tipe MB yang sedang mendapat terapi dan kusta tipe MB yang telah menyelesaikan terapi secara bermakna dengan nilai median 22,67 (12,87) dan 2,22 (5,87), p<0,001. Pada penelitian ini juga didapatkan korelasi positif sangat kuat (Spearman Correlation r = 0,974; p<0,001) antara kadar IL-10 serum dengan indeks bakteri.
Simpulan: Terdapat perbedaan antara kadar IL-10 serum pada penderita kusta tipe multibasiler yang sedang mendapat terapi MDT dan yang telah menyelesaikan terapi atau release from treatment (RFT) secara bermakna, dan kadar IL-10 serum yang tinggi berkorelasi dengan indeks bakteri yang tinggi pada penderita kusta tipe multibasiler.
Faktor risiko kejadian ileus paralitik patologis pasca laparotomi dengan reseksi dan anastomosis pada traktus gastrointestinal
Mira Dewi Prawira, Made Agus Dwianthara Sueta, Nyoman GoldenOnline First: Nov 14, 2022
- Abstract
Faktor risiko kejadian ileus paralitik patologis pasca laparotomi dengan reseksi dan anastomosis pada traktus gastrointestinal
Background: Postoperative paralytic ileus is a physiological response of the intestine to surgical stress. However, if this condition lasts more than 3 days, it is pathological. Some factors related to postoperative ileus have been identified, but the results are still confusing. This study aimed to identify risk factors of postoperative ileus following laparotomy for anastomosis and resection of the gastrointestinal tract at Prof. Dr. I.G.N.G. Ngoerah Hospital.
Method: This was a retrospective cohort study between January 2019 until July 2020. The subjects were recruited consecutively, which included adult patients who had undergone laparotomic surgery with anastomosis and resection. Data was taken in Prof. Dr. I.G.N.G. Ngoerah Hospital until the needed samples were fulfilled. Data were analyzed using SPSS version 24 for Windows.
Result: There were 50 subjects aged from 32 to 74 years old in this study. About 62% of subjects were female. Analysis showed a correlation between postoperative ileus occurrence and Age; it also correlates with the operation duration. Multivariate analysis found that patients aged 65 years and older have a 5.96 greater risk of developing postoperative ileus than younger patients (95% CI 1.55-22.99; p=0.010). This study also found that an operation lasting 180 minutes or more had a 6.14 greater risk of postoperative ileus than a shorter surgery duration (95% CI 1.57-24.05; p=0.009).
Conclusion: Age over 65 years old and duration of operation more than 3 hours were associated with postoperative paralytic ileus in adult patients who had undergone laparotomy for anastomosis and resection of the gastrointestinal tract.
Latar Belakang: Ileus paralitik pasca operasi merupakan sebuah respon fisiologis usus terhadap stress pembedahan. Namun ketika ileus yang terjadi berlangsung lebih dari 3 hari maka kondisi ini masuk dalam kondisi patologis. Beberapa faktor sudah diidentifikasi untuk memprediksi kejadian ileus post operasi namun hasilnya masih ambigu. Penelitian ini bertujuan mengetahui faktor risiko ileus paralitik patologis pasca operasi pada populasi pasien laparatomi reseksi dengan anastomosis di RSUP Prof. Dr. I.G.N.G. Ngoerah.
Metode: Penelitian ini menggunakan pendekatan kohort retrospektif yang berlangsung sejak Januari 2019 hingga Juli 2020. Pengambilan data dilakukan dengan metode konsekutif sampling pada pasien dewasa. Pengambilan data dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah sampai jumlah sampel terpenuhi. Data dianalisis dengan SPSS versi 24 untuk Windows.
Hasil: Sebanyak 50 subjek diikutsertakan dalam penelitian ini dengan rentang usia 32 hingga 74 tahun. Sebanyak 62% adalah perempuan. Pada analisis ditemukan adanya hubungan usia dan durasi operasi dengan kejadian ileus post operasi. Pada analisis multivariat ditemukan bahwa usia di atas 65 tahun memiliki risiko mengalami ileus post operasi 5,96 kali lebih besar dibanding usia yang lebih muda (95% IK=1,55-22,99; p=0,010). Selain itu juga ditemukan operasi yang berlangsung selama 180 menit atau lebih memiliki risiko 6.14 kali lebih besar mengalami ileus post operasi dibanding durasi operasi yang lebih singkat (95% IK=1,57–24,05; p=0,009).
Simpulan: Usia pasien di atas 65 tahun dan durasi operasi lebih dari 3 jam berhubungan dengan kejadian ileus paralitik patologis paska operasi pada pasien yang menjalani operasi laparotomi dengan reseksi dan anastomosis.
Profil pasien COVID-19 rawat inap di Rumah Sakit Ari Canti, Gianyar, Bali, Indonesia
Ni Putu Nita Wiryandari, Ketut SuardamanaOnline First: Dec 7, 2022
- Abstract
Profil pasien COVID-19 rawat inap di Rumah Sakit Ari Canti, Gianyar, Bali, Indonesia
Background: Since March 2020, Coronavirus Disease 2019 (COVID-19) has been declared a pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) underwent genetic evolution and changes in the nature of the virus, clinical manifestations, and response to treatment. This study aims to determine the profile of hospitalized COVID-19 patients at Ari Canti Hospital (RSAC), one of the COVID-19 referral hospitals in Gianyar, Bali.
Methods: The design was a descriptive cross-sectional retrospective study, using the medical records of confirmed COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) patients selected by a simple random sampling technique.
Results: From 290 samples, the majority of COVID-19 patients treated at RSAC were 60.7% male, in the age range of 50-59 years 26.5%, with severe symptoms 45.8% and recovered 83.4%. The dominant symptoms were fever 85.2%, cough 80%, and shortness of breath 60%. The most common comorbidities were >1 comorbidity, hypertension, and diabetes mellitus. Hematological examination at the first time of hospitalization showed leukopenia (4.8%), lymphopenia (14.5%), thrombocytopenia (12.8%), and anemia (21.7%). The results also showed an increase in Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP) (66.6%). Most showed bilateral infiltrates on chest x-ray. The most common treatment for COVID-19 at RSAC uses antiviral remdesivir (77.9%), quinolone antibiotics (73.4%), and Low Molecular Weight Heparin (LMWH) (53.4%). A total of 56.6% of patients received corticosteroid therapy.
Conclusion: Patients hospitalized at RSAC mostly showed severe symptoms and recovered. The treament folowing the standard of inpatient treatment for COVID-19 patients.
Latar belakang: Sejak Maret 2020, Coronavirus Disease 2019 (COVID 19) dinyatakan sebagai pandemi. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mengalami evolusi genetik dan perubahan sifat virus, manifestasi klinis serta respon pengobatan. Penelitian ini bertujuan untuk mengetahui profil pasien COVID-19 yang dirawat di Rumah Sakit Ari Canti (RSAC), salah satu rumah sakit rujukan COVID-19 di Gianyar, Bali
Metode: Rancangan penelitian ini adalah cross-sectional deskriptif retrospektif, menggunakan rekam medis pasien terkonfirmasi COVID-19 dengan Real Time Polymerase Chain Reaction (RT-PCR) sejak Juli 2020 - Maret 2022 yang dipilih dengan teknik simple random sampling.
Hasil: Dari 290 sampel, mayoritas pasien COVID-19 yang dirawat di RSAC adalah laki-laki 60.7%, berada pada rentang usia 50-59 tahun 26.5%, dengan gejala berat 45.8% dan sembuh 83.4%. Gejala didominasi demam 85.2%, batuk 80%, dan sesak 60%. Komorbid tersering yaitu >1 komorbid, hipertensi, dan diabetes melitus. Gambaran hematologi menunjukkan leukopenia (4.8%), limfopenia (14.5%), trombositopenia (12.8%), dan anemia (21.7%). Hasil juga menunjukkan peningkatan Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP) (66.6%). Sebagian besar menunjukkan infiltrat bilateral pada x-ray thorax. Tatalaksana COVID-19 di RSAC tersering menggunakan antivirus remdesivir (77.9%), antibiotik golongan kuinolon (73.4%), dan antikoagulan Low Molecule Weight Heparin (LMWH) (53.4%). Sebanyak 56.6 % pasien mendapat terapi kortikosteroid.
Kesimpulan: Pasien COVID-19 yang dirawat di RSAC sebagian besar menunjukkan gejala berat dan sembuh. Terapi yang diberikan mengikuti standar terapi rawat inap pasien COVID-19.
Faktor risiko yang berhubungan dengan kejadian bayi berat lahir rendah di Rumah Sakit Umum Daerah Negara
I Ketut Krisna Indrawan, I Gusti Ketut Winata AdnyanaOnline First: Dec 1, 2022
- Abstract
Faktor risiko yang berhubungan dengan kejadian bayi berat lahir rendah di Rumah Sakit Umum Daerah Negara
Background. Sustainable Development Goals (SDGs) targets the decrease of neonatal mortality rate until 12 per 1.000 live birth. One of the neonatal death’s causes is premature baby which is related to the low birth weight (LBW) infant. The incidences of LBW were 15%-20% and almost 95% of those were born in developing countries. The aim of this study is to know several risk factors that related to the incidences of LBW infant in Regional Public Hospital Negara.
Material. This case control study was conducted in September 2021. The subjects were inpatient babies in Perinatology ward and was born in Regional Public Hospital Negara, from 01 January 2020 to 30 December 2020. Consecutive sampling and gender matching were performed for the subjects selection. There are 42 sampels that match to the inclusion and exclusion criteria for each group. The data of risk factors and LBW were collected from the medical record. Statistical analyses included McNemar and logistic regression using SPSS v22 software with p<0,05
.
Results. Bivariate statistical analyses results from LBW’s risk factors were p value=0.001 for gestational age, p value=0.031 for parity, p value= 0.049 for anemia during pregnancy, p value=0.267 for maternal age, p value=1.000 history of LBW before, p value=0.344 for miscarriage history, and p value=0.804 for preeclampsia. Meanwhile, multivariate statistical analyses showed that gestational age risk factor, p value=0,001 (OR=44,97; 95%IC: 8,44-239,75) and parity risk factor, p value=0,011 (OR=5,04: 95%IC: 1,44-17,66) were the risk factors that related to the incidences of LBW infant in Regional Public Hospital Negara
Conclusion. Gestational age and parity were the risk factors that related to the incidences of LBW infant in Regional Public Hospital Negara
Latar Belakang : Sustainable Development Goals (SDGs) memfokuskan penurunan angka kematian neonatus hingga 12 per 1.000 kelahiran hidup. Salah satu penyebab utama kematian pada neonatus di dunia adalah bayi prematur yang merupakan komponen dalam bayi berat lahir rendah (BBLR). Angka kejadian BBLR sekitar 15%-20% dari seluruh kelahiran dan hampir 95% BBLR terjadi di Negara berkembang. Penelitian ini bertujuan untuk mengetahui beberapa faktor risiko yang berhubungan dengan kejadian BBLR di Rumah Sakit Umum Daerah (RSUD) Negara.
Metode : Penelitian ini adalah penelitian kasus kontrol yang dilakukan pada bulan September 2021. Penelitian ini melibatkan bayi lahir hidup di RSUD Negara yang dirawat di ruang Perinatologi RSUD Negara mulai 01 januari 2020 - 30 Desember 2020. Pengambilan sampel menggunakan metode consecutive sampling dan dilakukan matching jenis kelamin. Sampel yang memenuhi kriteria inklusi dan eksklusi adalah 42 sampel kasus dan 42 sampel kontrol. Data faktor risiko dan BBLR di ambil dari catatan rekam medis. Uji statistik menggunakan uji McNemar dan regresi logistik dengan perangkat lunak SPSS versi 22 dengan batas nilai p <0,05.
Hasil : Uji statistik bivariat terhadap BBLR menemukan bahwa faktor risiko usia gestasi p=0,001, paritas p=0,031, anemia ibu p=0,049, faktor risiko usia ibu p=0,267, faktor risiko riwayat melahirkan anak BBLR p=1,000, faktor risiko riwayat abortus p=0,344, dan faktor risiko preeklampsia p=0,804. Sementara itu, uji Satistik multivariat menemukan bahwa faktor usia gestasi, nilai p=0,001 (OR=44,97; 95%IK: 8,44-239,75) dan faktor risiko paritas, nilai p=0,011 (OR=5,04: 95%IK: 1,44-17,66) merupakan faktor risiko kejadian BBLR di RSUD Negara.
Hubungan hipertensi dengan kejadian presbikusis di Poliklinik THT-KL RSUP Sanglah Denpasar
Agus Santosa, Pande Ayu Naya Kasih Permatananda, I Putu Wirasatya Eka PutraOnline First: Dec 20, 2022
- Abstract
Hubungan hipertensi dengan kejadian presbikusis di Poliklinik THT-KL RSUP Sanglah Denpasar
Introduction: Presbycusis or age-related hearing loss has several risk factors, with hypertension as one of them. Hypertension might cause presbycusis since it can interfere with nutrient and oxygen intake to the auditory nerve cells of the ear. This study aimed to determine the relationship between hypertension with the incidence of presbycusis at the Poliklinik THT-KL RSUP Sanglah Denpasar.
Methods: This study used an analytic retrospective design and cross-sectional method. The study was conducted at the Poliklinik THT-KL RSUP Sanglah Denpasar with a sample of 60 people. Data were obtained using medical records and analyzed univariately and bivariate using SPSS for Windows with a p-value of 0.05.
Results: Most subjects are 65-75 years old rather than >75, with male subjects of the same amount as female subjects. Chi-square test (x2) distribution table analysis demonstrated an association between hypertension and presbycusis incident in Poliklinik THT-KL RSUP Sanglah Denpasar with a p-value of 0,002.
Conclusion: Most samples are in the 65-75 age range with the same proportionate amount of gender. There is an association between hypertension and presbycusis in Poliklinik THT-KL RSUP Sanglah Denpasar.
Latar Belakang: Presbikusis atau age related hearing loss memiliki beberapa faktor resiko dengan hipertensi sebagai salah satunya. Hipertensi dapat menyebabkan presbikusis karena dapat mengganggu asupan nutrisi dan oksigen sel-sel saraf auditori di telinga. Penelitian ini bertujuan mengidentifikasi hubungan hipertensi dan kejadian presbikusis di poliklinik Telinga, Hidung, Tenggorokan, Bedah Kepala dan Leher (THT-KL) RSUP Sanglah Denpasar.
Metode: Desain yang digunakan yakni retrospektif analitik dan metode cross-sectional. Lokasi penenlitian yakni poliklinik THT-KL RSUP Sanglah Denpasar dan jumlah sampel 60 orang. Data diperoleh dengan menggunakan rekam medis dan dianalisis secara univariat dan bivariat melalui aplikasi SPSS dengan nilai p ≤ 0,05.
Hasil: Didapatkan sampel lebih banyak berumur 65-75 tahun dibanding sampel berumur >75 tahun. Untuk jenis kelamin, ditemukan sampel dalam proporsi yang sama dan dari hasil uji chi square, didapat adanya korelasi antara hipertensi dengan kejadian presbikusis di Poliklinik THT-KL RSUP Sanglah Denpasar dengan nilai p = 0,002.
Simpulan: Mayoritas sampel berumur 65-75 tahun dengan proporsi jenis kelamin yang sama. Diperoleh hubungan hipertensi dan kejadian presbikusis di poliklinik THT-KL RSUP Sanglah Denpasar.
Comparison between serum pleural effusion albumin gradient, total protein, lactate dehydrogenase, and erythrocyte count in malignant and non-malignant pleural effusion
Victor Nugroho Wijaya, I Gede Ketut Sajinadiyasa, Ni Wayan Candrawati, Ida Ayu Jasminarti Dwi Kusumawardani, Ni Luh Putu Eka Arisanti, I Gusti Ngurah Bagus Artana, Ida Bagus Ngurah RaiOnline First: Dec 8, 2022
- Abstract
Comparison between serum pleural effusion albumin gradient, total protein, lactate dehydrogenase, and erythrocyte count in malignant and non-malignant pleural effusion
Background: Malignant pleural effusion carries a bad prognosis. Pathologic examination as the gold-standard diagnosis of malignant pleural effusion has sensitivity limitations and may cause delayed diagnosis. Several affordable examinations, such as serum pleural effusion albumin gradient, total protein, lactate dehydrogenase (LDH), and erythrocyte count, might be useful as malignant pleural effusion diagnostic tools.
Methods: This is an observational analytic study with a cross-sectional design conducted at Sanglah Central General Hospital in Denpasar from December 2021 to July 2022. Pleural effusion fluid and blood were taken from subjects with malignant and non-malignant pleural effusion. Data were analyzed with SPSS version 25 software for Windows.
Results: Total subjects were 47 persons consisting of 26 subjects with malignant pleural effusion and 21 subjects with non-malignant pleural effusion. Results from statistical analysis of malignant and non-malignant pleural effusion were serum pleural effusion albumin gradient median (IQR) 0.91 (0.65) g/dL vs. 1.22 (1.2) g/dL (p=0.129), total protein mean 3.92±0.95 g/dL vs. 3.52±1.67 g/dL (p=0.334), LDH median 535 (840) IU/L vs. 187 (1,016) IU/L (p=0.057), and erythrocyte count median 23,500 (109,250) cells/mm3 vs. 3,000 (11,000) cells/mm3 (p=0.004). The AUC of erythrocyte count from the ROC method was 0.745 (95%CI=0.599-0.890; p=0.004). Using a cut-off point ≥ 4,500 cells/mm3, it had a sensitivity of 80.8%, specificity of 61.9%, and Odds Ratio (OR) of 6.8 (95%CI=1.8-25.4).
Conclusion: Erythrocyte count as routine examination showed good validity for diagnosing malignant pleural effusion and expected to reduce diagnosis delay. Meanwhile, albumin gradient, total protein, and LDH delivered no difference.
Hubungan kejadian eating disorder dengan status gizi remaja putri di Denpasar, Bali
Made Violin Weda Yani, Made Sindy Astri Pratiwi, Made Priska Arya Agustini, Putu Cintya Denny Yuliyatni, I Gede Putu SupadmanabaOnline First: Nov 1, 2022
- Abstract
Hubungan kejadian eating disorder dengan status gizi remaja putri di Denpasar, Bali
Background: Nutrition problems in adolescents both malnutrition and overnutrition in Indonesia are quite high. Nutrition problems are multifactorial, but several previous studies have shown that eating behavior will interfere with eating disorders related to nutritional quality. This study aims to analyze the relationship between eating attitude and eating disorders on nutritional status in adolescent girls.
Methods: This research design was cross sectional observation conducted at SMAN 1 Denpasar, Bali. The samples were 119 adolescent girls that were selected by simple random sampling. Assessment of eating behavior used the adolescent food habit checklist, and eating disorders were assessed by EAT-26 questionnaire.
Results: The subjects were 119 adolescent girls. Most of them were 15 and 16 years old. There were 53.8% of subjects having unhealthy food behavior and 86.6% did not experience eating disorders. There were 75.6% of students having normal nutritional status, followed by thin, overweight, and obese respectively 3.4%, 15.1%, and 5.9%. There was a significant relationship between eating attitude with nutritional status of adolescent girls (p value = 0.04; PR (95% CI) = 2.15 (1.09-4.21)). There is also a significant relationship between eating disorder with nutritional status of adolescent girls (p value=0.01; PR (95% CI) = 2.45 (1.32-4.56))
Conclusion: This study found that eating behavior was not related to nutritional status. The condition of eating disorders has a significant relationship with adolescent nutritional disorders. Individuals with eating disorders have a greater risk of experiencing nutritional disorders than individuals without eating disorders.
Latar Belakang: Masalah gizi pada remaja baik undernutrition ataupun overnutrition di Indonesia cukuplah tinggi. Masalah gizi pada remaja bersifat multifaktorial, namun beberapa penelitian sebelumnya menunjukkan bahwa faktor perilaku makan yang tidak baik akan memicu eating disorder yang berhubungan dengan kualitas gizi remaja putri. Sejauh ini belum terdapat studi terkait hubungan eating disorder dengan status gizi remaja putri di Bali. penelitian ini bertujuan untuk menganalisis hubungan antara perilaku makan dan eating disorder terhadap status gizi pada remaja putri.
Metode: Desain penelitian yaitu observasi cross sectional yang dilakukan di SMAN 1 Denpasar, Bali. Sampel berjumlah 119 orang remaja putri berusia 14-18 tahun yang dipilih dengan simple random sampling. Penilaian perilaku makan menggunakan the adolescent food habbit checklist, dan gangguan makan dinilai menggunakan kuesioner EAT-26.
Hasil: Dari 119 subjek penelitian, dominasis siswi putri berusia 16 tahun. Sebanyak 53.8% remaja putri memiliki perilaku makanan yang tidak sehat dan 86.6% tidak mengalami eating disorder. Mayoritas siswi memiliki status gizi yang normal yaitu 75.6%, diikuti dengan status gizi kurus, gemuk, dan obesitas berturut-turut yaitu sebesar 3.4%, 15.1% dan 5.9%. Terdapat hubungan yang signifikan antara perilaku makan buruk dengan gangguan gizi (p value=0.049; PR(95%CI) = 0.52 (0.27-1.01)) dan terdapat pula hubungan yang signifikan antara eating disorder dengan gangguan gizi remaja putri (p value=0.01; PR (95% CI) = 2.45 (1.32-4.56))
Simpulan: Penelitian ini mendapatkan bahwa perilaku makan dan kondisi eating disorder memiliki hubungan signifikan dengan gangguan gizi remaja putri. Individu dengan eating disorder memiliki risiko lebih besar mengalami gangguan gizi dibandingkan individu tanpa eating disorder.
Perbandingan kerusakan saraf perifer melalui pemeriksaan elektroneuromiografi pada kusta tipe multibasiler
I Dewa Made Rendy Sanjaya, Luh Made Mas Rusyati, Ketut Kwartantaya Winaya, I Komang Arimbawa, I Gusti Ayu Agung Praharsini, Ni Made Dwi PuspawatiOnline First: Nov 2, 2022
- Abstract
Perbandingan kerusakan saraf perifer melalui pemeriksaan elektroneuromiografi pada kusta tipe multibasiler
Background: Leprosy is a bacterial infection that is still a neglected disease. This disease leads to peripheral neuropathy despite routine treatment. Moreover, early detection of peripheral neuropathy in leprosy patients is very important. ENMG is known to have fairly good sensitivity and specificity in detecting it. Therefore, this study aims to determine the relationship between type 2 leprosy reactions and the risk of peripheral neuropathy through ENMG examination.
Methods: The study design was a prospective, cross-sectional observational study. The research was conducted in July-September 2022 at Prof. dr. I G.N.G. Ngoerah General Hospital, Denpasar. The sample will be selected based on inclusion and exclusion criteria and then divided into two groups as a group with type 2 leprosy reaction and a group without type 2 leprosy reaction. The data were analyzed using SPSS version 25. The analysis was carried out in the form of descriptive and analytical analyses. The analytical analysis used is fisher's exact.
Results: This study obtained 20 samples with an average age of 36.2±13.3 years. There were 40% of patients with type 2 leprosy reactions. All patients had polyneuropathy with 30% axonal type polyneuropathy and 70% mixed type. Bivariate analysis showed that there was no significant relationship between type 2 leprosy reaction to the type of peripheral neuropathy and the number of nerves involved based on ENMG examination (p=0.64).
Conclusion: From this study, it can be concluded that there was no statistically significant relationship between the type 2 leprosy reaction to the type of peripheral neuropathy and the number of nerves involved based on the ENMG examination.
Latar belakang: Kusta merupakan infeksi bakteri yang masih menjadi penyakit terbengkalai. Penyakit ini dapat menimbulkan terjadinya neuropati perifer meskipun telah melakukan pengobatan yang rutin. Untuk itu deteksi dini neuropati perifer pada pasien kusta sangat penting. ENMG diketehui memiliki sensitivitas dan spesifisitas yang cukup baik dalam mendeteksi hal tersebut. Maka dari itu, penelitian ini bertujuan untuk mengetahui hubungan antara reaksi kusta tipe 2 dengan resiko neuropati perifer melalui pemeriksaan ENMG.
Metode: Disain penelitian ini merupakan observasional prospektif, potong lintang. Penelitian dilakukan pada bulan Juli-September 2022 di RSUP Prof. dr. I G.N.G. Ngoerah, Denpasar. Sampel akan diseleksi berdasarkan kriteria inklusi dan eksklusi kemudian di bagi menjadi dua kelompok yaitu, kelompok dengan reaksi kusta tipe 2 dan kelompok tanpa rekasi kusta tipe 2. Data dianalisis menggunakan SPSS versi 25. Analisis yang dilakukan berupa analisis deskriptif, dan analitik. Analisis analitik yang digunakan berupa fisher’s exact.
Hasil: Pada penelitian ini mendapatkan 20 sampel dengan rata-rata berusia 36,2±13,3 tahun. Terdapat 40% pasien dengan reaksi kusta tipe 2. Seluruh pasien mengalami polineuropati dengan 30% merupakan polineuropati tipe aksonal dan 70% tipe campuran. Analissi bivariat menunjukkan tidak ditemukannya hubungan yang signifikan antara rekasi kusta tipe 2 terhadap jenis nauropati perifer dan jumlah saraf yang terlibat berdasarkan pemeriksaan ENMG (p=0,64).
Simpulan: Dari penelitian ini dapat disimpulkan bahwa tidak ditemukannya hubungan yang signifikan secara statistik antara rekasi kusta tipe 2 terhadap jenis nauropati perifer dan jumlah saraf yang terlibat berdasarkan pemeriksaan ENMG.
Kadar Urine Urea Nitrogen (UUN) sebagai prediktor mortalitas pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah Denpasar
Grace Inriani Rongre, I Gusti Putu Hendra Sanjaya, Agustinus I Wayan Harimawan, Sianny HerawatiOnline First: Sep 21, 2022
- Abstract
Kadar Urine Urea Nitrogen (UUN) sebagai prediktor mortalitas pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah Denpasar
Background: Urine urea nitrogen (UUN) is an examination of nitrogen balance with the concept of calculating the amount of urea excreted through urine. The amount of urea that comes out of the urine is in line with the amount of protein breakdown in the body and the amount of protein that enters the body. This study aimed to evaluate UUN levels on days 1, 3 and 7 as a predictor of mortality in burn patients >20%.
Methods: This study was an observational analytic retrospective study. Data were collected from January 2020 to December 2021. This study used secondary data from medical records of patients with IIAB-III degree burns with burn area > 20% TBSA treated at Prof. Dr. I. G. N. G. Ngoerah General Hospital for 2020-2021. Data were analyzed using SPSS version 21 for Windows.
Results: The majority of burn patients were male, about 73.9%. The average age of burn patients is 48.26±15.95 years. On the first examination day, the UUN value was still low (29.4 mg/24 hours). Then on the 3rd day, there was an increase in the average UUN level, namely the maximum value of 61,987 mg/24 hours. Examination on the 7th day showed an increase in line with the previous day, namely the maximum value of 57,489 mg/24 hours. On day 1, the mean UUN value was higher in patients who died, while on days 3 and 7 the mean UUN level in patients with living outcomes was higher than in patients who died, but not significantly (p>0.05).
Conclusion: Urine urea nitrogen levels on days 1, 3 and 7 in burn patients >20% at Prof. Dr. I. G. N. G. Ngoerah General Hospital showed an increasing trend. Urine urea nitrogen levels cannot be used to predict mortality in burn patients because the results were insignificant.
Latar Belakang: Urin urea nitrogen (UUN) merupakan pemeriksaan keseimbangan nitrogen yang berkonsep pada perhitungan jumlah urea yang dieksresikan lewat urin. Jumlah urea yang keluar bersama urine sejalan dengan jumlah pemecahan protein dalam tubuh serta jumlah protein yang masuk dalam tubuh. Penelitian ini bertujuan untuk mengevaluasi kadar UUN hari ke-1,3, dan 7 sebagai prediktor mortalitas pasien luka bakar >20%.
Metode: Studi ini merupakan studi retrospektif analitik observasional. Data dikumpulkan dari Januari 2020 hingga Desember 2021. Studi ini menggunakan data sekunder dari catatan rekam medis pasien luka bakar derajat IIAB-III dengan luas luka bakar > 20% TBSA yang dirawat di RSUP Prof. Dr. I. G. N. G. Ngoerah periode 2020-2021. Data dianalisis dengan SPSS versi 21 untuk Windows.
Hasil: Mayoritas pasien luka bakar berjenis kelamin laki-laki yaitu sebesar 73,9%. Usia rata-rata pasien luka bakar yaitu 48,26±15,95 tahun. Pada pemeriksaan hari pertama didapatkan nilai UUN masih rendah (29,4 mg/24 jam). Kemudian pada hari ke-3 didapatkan peningkatan rata-rata kadar UUN yakni nilai maksimum 61.987 mg/24 jam. Pemeriksaan pada hari ke-7 menunjukkan peningkatan yang sejalan dengan hari sebelumnya yakni nilai maksimum 57.489 mg/24 jam. Pada hari ke-1, nilai rerata UUN lebih tinggi pada pasien meninggal, sedangkan pada hari ke 3 dan 7 kadar rerata UUN pasien dengan luaran hidup lebih tinggi dibandingkan pasien yang meninggal, namun tidak bermakna secara signifikan (p>0,05).
Simpulan: Kadar UUN pada hari ke-1, 3 dan 7 pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah menunjukkan adanya trend peningkatan. Kadar UUN tidak dapat dipakai sebagai prediktor mortalitas pada pasien luka bakar karena hasil tidak signifikan.