Vol. 14 No. 1 (2023): (In Press: 1 April 2023)
Dengue Shock Syndrome Unusual Appearance With Multisystem Inflammatory Syndrome in Children: A Case Report
Anak Agung Puteri Indira Rajani, Romy Windiyanto, Anak Agung Ratna PurnamaOnline First: Mar 31, 2023
- Abstract
Dengue Shock Syndrome Unusual Appearance With Multisystem Inflammatory Syndrome in Children: A Case Report
Background: Dengue and coronavirus disease 2019 (COVID-19) have recently become endemic in various tropical countries. Multisystem inflammatory syndrome in children (MIS-C) is a clinical manifestation of COVID-19 with a life-threatening syndrome of hyperinflammation, multiorgan failure, and shock, and it closely resembles the manifestations of severe dengue. Many attempts have been made in research to differentiate the two. Here we aims to describe a case of a patient with dengue coinfection with MIS-C.
Case Presentation: A 17-year-old woman came in a state of shock, with cold extremities, fever, jaundice, shortness of breath, acute abdominal pain, and hematuria, decreased urine output. Further investigations reveal increased parameters of hepato-renal organ damage, c-reactive protein, and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG). Patient was positive for anti-dengue IgM and IgG, but negative for COVID-19 based on SARS-CoV-2 antigen and polymerase chain reaction.
Conclusion: This case demonstrates the possibility of dengue coinfection and MIS-C co-occurring, causing the patient to develop a hyperinflammatory syndrome and clinical deterioration.
Latissimus dorsi flap after mastectomy surgery: case series
Cecillia Young, Sweety Pribadi, Bernard Agung BaskoroOnline First: Jan 25, 2023
- Abstract
Latissimus dorsi flap after mastectomy surgery: case series
Background: Breast cancer is the most common type of cancer in women. Breast cancer can be treated with mastectomy surgery, chemotherapy, hormonal, radiation, and biological agent therapy. Surgery is the primary therapy for breast cancer. The most common surgical procedure is a mastectomy which can be continued with breast reconstruction after mastectomy surgery to improve the shape and close the breast defects. Breast reconstructions can be performed with breast implant surgery and autologous or “flap” reconstruction. Latissimus Dorsi (LD) flap is a pedicled flap often used for breast reconstruction. Mastectomy surgery and breast reconstruction complications are seromas, late hypertrophic scars, hematomas, pain, muscle weakness, and infections. This study aimed to describe the case series of latissimus dorsi flaps in breast cancer patients after mastectomy surgery.
Case presentation: The author presents 6 cases of breast cancer patients after mastectomy surgery performed breast reconstruction using an LD flap. Five patients had a history of surgery on the abdomen, and one did not have a history of abdominal surgery but had planned pregnancy in the future. There were no complications after LD flap reconstruction surgery. LD flap surgery may be accompanied by implants so that the shape and size can be close to another breast, but related to the cost, and the patients refuse to use a breast implant. All patients were given chemotherapy before surgery.
Conclusion: Breast reconstructive surgery is used to close defects after mastectomy surgery and can improve the quality of life of breast cancer patients. Pedicled LD flaps are one of the techniques often used for breast reconstruction cases because of rare complications of necrosis in the donor area or flaps.
Management of Fuchs endothelial corneal dystrophy (FECD): a case series
Ni Made Ayu Wulandari, Siska, Made Agus Kusumadjaja, Wayan Gede Jayanegara, I Gusti Ayu Made Juliari, I Made Agus Kusumadjaja, Ida Ayu Ary Pramita, Putu Dian Mega SafitriOnline First: May 8, 2023
- Abstract
Management of Fuchs endothelial corneal dystrophy (FECD): a case series
Background: Fuchs endothelial corneal dystrophy (FECD) is the most common corneal dystrophy and often results in visual loss. This study aims to discuss the etiology, pathophysiology, diagnosis, and management of FECD.
Case presentations: We reported three cases of FECD. The first patient was 60 years old female diagnosed with corneal scar post-penetrating keratoplasty (PK) and pseudophakia in the right eye (RE) and FECD grade II in the left eye (LE). The right and left eye (RLE) visual acuity was 6/18 and 6/12, respectively. The patient was managed thrice a day with lubricant eye drops in the RE and Phacoemulsification and Descemet membrane endothelial keratoplasty (DMEK) in the LE. The second patient was 80 years old female with RLE FECD grade II, LE Pseudophakia, and RE Immature Cataract. Visual acuity was light perception in the right eye and 1/60 in the LE. She was managed with Siloxane eye drop 2x1, Oculenta gel 1x1 in RLE, and DMEK in LE. The third patient was 73 years old male with pseudophakia, FECD grade III, and corneal neovascularization in the RE. Visual acuity in RE was hand movement, and LE was 6/6. He was planned for PK on RE, Diquafosol sodium (Diquas®) eye drop twice a day, and eye fresh plus eye drops 4x1 in RLE.
Conclusion: FECD is the most common endothelial dystrophy and the main indication for corneal transplantation in the presence of visual disturbances. Medical therapy in the form of topical hyperosmotic agents can be given in the early phase and is useful for reducing corneal edema. The preferred management of FECD is currently Endothelial Keratoplasty (EK), such as DMEK, which has demonstrated excellent corneal clearance. Although the graft rejection rate in DMEK is low, there is a risk of rejection with the discontinuation of topical corticosteroids.
Seorang laki-laki dewasa muda dengan multiple myeloma monoklonal gamopati lambda: sebuah laporan kasus
Cahyo Edi Baskoro, Ni Made Renny Anggreni RenaOnline First: Feb 23, 2023
- Abstract
Seorang laki-laki dewasa muda dengan multiple myeloma monoklonal gamopati lambda: sebuah laporan kasus
Introduction: Multiple myeloma is the second most common hematological malignancy after non-Hodgkin's lymphoma with a case prevalence in Prof. Dr. I.G.N.G. Ngoerah Hospital for the 2013-2017 period was 4.64% with the most cases occurring in 2017 (33.3%), where 45.8% of multiple myeloma patients were in the age group of 51-60 years old. This study aims to describe a case of multiple myeloma monoclonal gammopathy lambda in a young adult male which is a very rare case.
Case Presentation: 35-year-old male patient whose laboratory and radiological findings supported a diagnosis of multiple myeloma, the right clavicle pain was the primary complaint, and radiological imaging revealed brittle bones. Furthermore, the examination of bone marrow aspiration smear, serum protein electrophoresis, routine hematology, erythrocyte sedimentation rate, clinical chemistry (such as calcium, uric acid, liver function tests, urea and creatinine), and radiological examination, such as the plain X-ray of bone) shows prominent and specific laboratory findings to confirm multiple myeloma.
Conclusion: The diagnosis of multiple myeloma was established with manifestations of bone lesions, serum protein electrophoresis and bone marrow biopsy were carried out for diagnosis based on the International Myeloma Working Group (IMWG) diagnostic criteria. Monitoring after administering six series of primary management of multiple myeloma in patient showed significant improvement from the results of laboratory evaluation, radiology, and bone marrow imaging.
Latar Belakang: Multiple myeloma adalah keganasan hematologis kedua yang paling umum setelah limfoma non-Hodgkin dengan prevalensi kasus di RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2013-2017 adalah 4,64% dengan kasus terbanyak terjadi pada tahun 2017 (33,3%), dimana 45,8% pasien multiple myeloma berada pada kelompok umur 51-60 tahun. Studi ini bertujuan ini untuk mendeskripsikan kasus multiple myeloma monoklonal gamopati lambda pada seorang laki-laki dewasa muda yang merupakan kasus sangat jarang.
Presentasi Kasus: Pasien laki-laki berusia 35 tahun dengan hasil laboratorium dan radiologis mendukung diagnosis multiple myeloma, nyeri klavikula kanan adalah keluhan utama, dan pemeriksaan radiologi menunjukkan tulang rapuh. Selanjutnya pemeriksaan apusan aspirasi sumsum tulang, elektroforesis protein serum, hematologi rutin, laju endap darah, kimia klinik (seperti kalsium, asam urat, tes fungsi hati, ureum, dan kreatinin), dan pemeriksaan radiologis, seperti foto polos X- ray tulang) menunjukkan temuan laboratorium yang menonjol dan spesifik untuk mengkonfirmasi multiple myeloma.
Simpulan: Diagnosis multiple myeloma ditegakkan dengan manifestasi lesi tulang, telah dilakukan pemeriksaan elektroforesis protein serum dan biopsi sumsum tulang untuk penegakan diagnosis berdasarkan kriteria diagnostik International Myeloma Working Group (IMWG). Monitoring setelah pemberian enam seri tatalaksana primer multiple myeloma pada pasien didapatkan perbaikan yang signifikan dari hasil evaluasi laboratorium, radiologis, dan gambaran sumsum tulang.
Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus
Kadek Enny Pradnyaswari, Anak Agung Ratna Purnama Santhi, Romy WindiyantoOnline First: Mar 3, 2023
- Abstract
Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can attack various organ systems with varying severity, ranging from mild to life-threatening. Multisystem inflammatory syndrome (MIS-C) is a hyper-inflammatory state characterized by multiorgan dysfunction caused by secondary inflammation to previous SARS-CoV-2 infection. SLE and MIS-C have similar symptoms because both diseases attack various organ systems. This paper aims to provide an overview of pediatric patients who are enforced with two diagnoses, namely SLE and MIS-C.
Case presentation: A 10-year-old female patient came to the emergency room at Sanjiwani Regional General Hospital, Gianyar, with the chief complaint of fever for four days before entering the hospital. Complaints accompanied by swollen eyelids, cough, nausea, abdominal pain, diarrhea, and lymphadenopathy. Clinical manifestations were found in various organ systems based on anamnesis, physical examinations, and laboratory examinations. The patient was diagnosed with SLE based on the EULAR/ACR 2019 criteria (obtained a score of 13) and MIS-C based on the MIS-C case definition criteria according to WHO.
Conclusion: The diagnosis of SLE is established based on EULAR/ACR 2019 criteria (obtained a score of 13), and the diagnosis of MIS-C is selected based on the MIS-C case definition criteria according to WHO.
Latar belakang: Lupus eritematosus sistemik (LES) adalah penyakit autoimun kronis yang mampu menyerang berbagai sistem organ dengan tingkat keparahan penyakit yang beragam, mulai dari ringan hingga mengancam nyawa. Multisystem inflammatory syndrome (MIS-C) adalah suatu keadaan hiperinflamasi yang ditandai dengan disfungsi multiorgan yang disebabkan oleh peradangan sekunder akibat infeksi SARS-CoV-2 sebelumnya. LES dan MIS-C memiliki kemiripan gejala karena sama-sama menyerang berbagai sistem organ. Tujuan penulisan ini adalah untuk memberikan gambaran kasus pasien anak yang ditegakkan dengan dua diagnosis yaitu LES dan MIS-C.
Presentasi kasus: Seorang pasien perempuan, berusia 10 tahun datang ke IGD RSUD Sanjiwani, Gianyar dengan keluhan utama demam sejak 4 hari sebelum masuk rumah sakit. Keluhan disertai kedua kelopak mata bengkak, batuk, mual, nyeri perut, diare, dan limfadenopati. Berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang didapatkan adanya manifestasi klinis pada berbagai sistem organ. Pasien didiagnosis dengan LES berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan MIS-C berdasarkan kriteria definisi kasus MIS-C menurut WHO.
Simpulan: Diagnosis LES ditegakkan berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan diagnosis MIS-C ditegakkan berdasarkan kriteria definisi kasus MIS-C menurut WHO.
Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka
Luh Made Indrasuari, Sari Linda SilvanaOnline First: Apr 9, 2023
- Abstract
Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka
Introduction: Supraventricular tachycardia (SVT) is one of the children's most common heart rhythm abnormalities. Episodes of SVT attacks in children are often recurring and, if not properly recognized, can be life-threatening. This case reports the incidence of SVT in children and its management, supported by a literature review
Case Description: A 1-year-old boy came to the hospital complaining of palpitations accompanied by an increase in carotid pulse and cold sweat 30 minutes before entering the hospital. The patient has a history of dilated cardiomyopathy and had the same complaint at the age of 6 months. On physical examination, blood pressure was 197/68 mmHg, pulse 235x/m, respiratory rate 32x/m accompanied by cold acral. The EKG showed SVT. Initial non-pharmacological management is carried out with vagal maneuvers, namely circular massage in the carotid sinus area for 10 seconds, followed by ice packs for 10 seconds. Then pharmacological cardioversion with amiodarone was carried out and continued with amiodarone maintenance therapy and treatment in the PICU room, as well as chest X-ray investigations and echocardiography.
Conclusion: Diagnosis of SVT is based on a detailed history and physical examination. EKG and echocardiography should be performed in children suspected of having SVT. Successful elimination of SVT results in improved quality of life in pediatrics regarding physical, emotional, social, school and psychosocial functioning.
Pendahuluan : Supraventricular tachycardia (SVT) merupakan salah satu kelainan irama jantung yang paling sering muncul pada anak. Episode serangan SVT pada anak sering berulang dan jika tidak dikenali dengan baik dapat mengancam nyawa. Kasus ini melaporkan kejadian SVT pada anak serta manajemen yang dilakukan dengan ditunjang telaah pustaka
Laporan Kasus : Laki-laki usia 1 tahun datang ke ke rumah sakit dengan keluhan berdebar disertai peningkatan pulsasi nadi karotis dan keringat dingin sejak 30 menit sebelum masuk rumah sakit. Pasien memiliki riwayat kardiomiopati dilatasi dan sempat mengalami keluhan yang sama pada usia 6 bulan. Pada pemeriksaan fisik didapatkan tensi 97/68 mmHg, nadi 235x/m, laju napas 32x/m disertai dengan akral dingin. Pada EKG ditemukan gambaran SVT. Tatalaksana awal non-farmakologi dilakukan dengan vagal manuver yaitu pemijatan sirkular di area sinus karotis selama 10 detik dan dilanjutkan dengan kompres es selama 10 detik. Dilakukan kardioversi farmakologis dengan amiodaron dan dilanjutkan terapi rumatan amiodaron. Dilakukan pemeriksaan penunjang rontgen thorax dan echocardiografi pada pasien.
Kesimpulan : Untuk menegakkan diagnosis SVT, anamnesis terperinci dan pemeriksaan fisik sangat penting untuk dilakukan. EKG dan ekokardiografi harus dilakukan pada anak yang diduga menderita SVT. Keberhasilan eliminasi SVT menghasilkan peningkatan kualitas hidup pediatrik mengenai fungsi fisik, emosional, sosial, sekolah dan psikososial.
A full-term infant with large patent ductus arteriosus successfully closed with oral ibuprofen: a case report
Hans Christian, Eka Gunawijaya, Veronica Lily Limantara, Ancelia Limantara, Joseph GerdymanOnline First: Apr 30, 2023
- Abstract
A full-term infant with large patent ductus arteriosus successfully closed with oral ibuprofen: a case report
Background: Ductus arteriosus is a vascular shunt between the aorta and pulmonary artery. Within the first 24-48 hours of life, the ductus usually closes. Failure of closure is called patent ductus arteriosus (PDA). Timing for treatment is crucial. Early treatment can decrease the need for drugs or surgery, but it can cause more adverse events, such as brain hemorrhage, bowel perforation and renal dysfunction. On the other hand, late treatment can cause complications such as pulmonary hemorrhage, necrotizing enterocolitis and can render drugs to be less effective.
Case Presentation: The patient was a 2 hours old male, 39 weeks, Apgar 7/8, 3100 grams, referred to the cardiology team because of tachypnea and peripheral cyanosis. Initial echocardiographic showed large patent ductus arteriosus, coarctation aorta, patent foramen ovale and moderate tricuspid regurgitation. The patient was given 60mg of oral ibuprofen for the first day and 30mg of oral ibuprofen for the second and third days. In addition, the patient was given 2mg of furosemide, 2.5mg of spironolactone and 12.5mcg of digoxin twice daily to prevent heart failure. Echocardiographic evaluation after three days showed closure of large patent ductus arteriosus, no mild preductal coarctation aorta remains, trivial tricuspid and patent foramen ovale. No side effects were observed.
Conclusion: This case showed successful early treatment of large PDA in full-term infants with a double dose of oral ibuprofen. Adverse events were not found. As a result, Ibuprofen should be considered as an early treatment for PDA in full-term infants.
Pre-operatif sildenafil dan perannya pada hipertensi pulmonal terkait dengan penyakit katup jantung kiri: Laporan Kasus dan telaah pustaka
I Gusti Bagus Aginda Dwipawana, IGN Putra Gunadhi, Hendy Wirawan, Rani Maliawan, Ketut Putu YasaOnline First: Mar 7, 2023
- Abstract
Pre-operatif sildenafil dan perannya pada hipertensi pulmonal terkait dengan penyakit katup jantung kiri: Laporan Kasus dan telaah pustaka
Introduction: Pulmonary hypertension (PH) is a pathological disorder of the pulmonary vessels that results in various clinical manifestations and causes cardiovascular and respiratory complications. This case report will discuss patients with heart failure due to rheumatic heart disease with severe mitral stenosis, moderate aortic stenosis, moderate-severe aortic regurgitation, severe tricuspid stenosis and the role of sildenafil in the preoperative period in patients with left heart valve disease with PH.
Case Description: A 40-year-old man came to the polyclinic complaining of fatigue and shortness of breath 6 months ago. From a regular S1 S2 heart examination, there was a murmur, and no signs of congestion were found in the patient. Electrocardiography showed 94 beats per minute sinus rhythm with poor R wave progression. On echocardiography found, patients with severe mitral stenosis, moderate aortic stenosis and regurgitation, and severe tricuspid regurgitation, with decreased LV systolic function and RV systolic function. The patient was planned for DVR + TV repair by a Cardiothoracic Surgeon. During the 24 hours preoperatively, the patient was given sildenafil 20 mg every 8 hours, which was continued for 72 hours postoperatively. The patient started mobilization on the third postoperative day, and there were no significant complications during the hospitalization. The patient was discharged on the 10th postoperative day with a total stay of 12 days.
Discussion: In patients with PH associated with left heart disease, the main strategy for repairing HP is to treat the underlying left heart condition. This also applies to significant left valve disease. One of the PH therapy options related to heart valve disease is sildenafil. Sildenafil relaxes pulmonary vascular smooth muscle and reduces pulmonary arterial pressure in various types of PH. Studies have shown that preoperative use of sildenafil significantly affects patients with PH associated with valvular heart disease. The administration of sildenafil is also effective for use postoperatively to reduce the need for postoperative inotropic support and reduce postoperative ventilation time.
Conclusion: One of the PH therapy options related to heart valve disease is sildenafil because of its effectiveness and relatively safe use before and after surgery.
Pendahuluan: Hipertensi Pulmonal (HP) merupakan kelainan patologis pada pembuluh darah paru yang mengakibatkan berbagai manifestasi klinis dan menimbulkan komplikasi kardiovaskular maupun respirasi. Pada laporan kasus akan dibahas pasien yang mengalami gagal jantung karena penyakit jantung rematik dengan stenosis mitral berat, stenosis aorta sedang, regurgitasi aorta sedang-berat, stenosis trikuspid berat serta peranan sildenafil pada masa pre-operatif pasien penyakit katup jantung kiri dengan HP.
Deskripsi Kasus: Laki-laki usia 40 tahun, datang ke poliklinik jantung dengan keluhan cepat lelah dan mudah sesak sejak 6 bulan yang lalu. Dari pemeriksaan jantung S1 S2 reguler didapatkan adanya murmur dan tidak ditemukan tanda kongesti pada pasien Elektrokardiografi menunjukkan irama sinus 94 kali per menit dengan poor R wave progression. Pada ekokardiografi didapatkan pasien dengan stenosis mitral berat, stenosis dan regurgitasi aorta sedang, regurgitasi trikuspid berat, dengan fungsi sistolik LV dan fungsi sistolik RV yang menurun. Pasien direncanakan untuk tindakan double valve replacement dan tricuspid valve repair oleh sejawat Bedah Thoraks Kardiovaskular. Saat 24 jam pre operasi, pasien diberikan sildenafil 20 mg tiap 8 jam yang diteruskan hingga 72 jam pasca operasi. Pasien memulai mobilisasi pada hari ketiga pasca operasi dan tidak ada komplikasi signifikan yang dialami pasien selama rawat inap. Pasien dipulangkan pada hari ke 10 pasca operasi dengan total lama rawat 12 hari.
Diskusi: Salah satu opsi terapi HP terkait dengan penyakit katup jantung adalah sildenafil. Sildenafil merelaksasi otot polos pembuluh darah pulmonal dan menurunkan tekanan arteri paru pada berbagai jenis HP. Penelitian-penelitian menunjukkan penggunaan sildenafil sebelum operasi memiliki efek yang signifikan pada pada pasien dengan HP yang terkait dengan penyakit katup jantung. Pemberian sildenafil juga efektif digunakan pasca operasi sehingga dapat mengurangi kebutuhan akan dukungan inotropik pasca operasi dan mengurangi waktu ventilasi pasca operasi.
Simpulan: Sildenafil merupakan salah satu opsi terapi HP terkait dengan penyakit katup jantung dikarenakan efektivitasnya dan penggunaanya relatif aman untuk digunakan baik sebelum tindakan operasi maupun setelah tindakan operasi.
Management of thyroid crisis in a patient with febrile neutropenia
Wira Gotera, Stephanie Sugiharto, Ida Bagus Aditya NugrahaOnline First: Feb 7, 2023
- Abstract
Management of thyroid crisis in a patient with febrile neutropenia
Introduction: Thyroid storm is a life-threatening complication of acute hyperthyroidism. The diagnosis of thyroid storm can only be based on its clinical manifestations, which include decreased consciousness, high fever, heart failure, diarrhea and jaundice. Antithyroid drug therapy (ATD) is one option for treating hyperthyroidism, along with surgery and radioactive iodine. ATD is thought to cause neutropenia through the agranulocytosis pathway. The most common symptoms are fever and sore throat accompanied by symptoms of a thyroid crisis. There is no specific method for predicting the appearance of febrile neutropenia caused by ATD. Routine complete blood counts in patients taking ATD should be performed. The diagnosis of febrile neutropenia due to ATD needs to be done immediately so that timely intervention can be carried out and reduce mortality.
Case Presentation: a 25 years old female with thyroid crisis and febrile neutropenia. Clinical findings in the patient include fever, decreased consciousness, palpitation, excessive sweat, diarrhea, nausea and vomiting, weight loss, and the laboratory findings of leukopenia and neutropenia of (leucocyte 1.03x103/uL, neutrophil 1.90x103/ul). Ultrasonography examination of the thyroid reveals a thyroiditis image with multiple solid nodules. Blood smear examination reveals leukopenia with differential count examination of blood showed neutropenia, moderate lymphocytosis, erythrocyte hypochromic micrositer, poikilocytosis ovalocyte, teardrop cell, fragmentosist and target cell. Polychromasia and normoblast cells are not found.
Conclusion: Thyroid crisis refers to the clinical findings and thyroid hormone test results. There is no specific method to predict the appearance of febrile neutropenia caused by the antithyroid drug. Frequent blood tests must be done in patients who consume antithyroid drugs.
Acute kidney injury in a covid-19 patient with Non-ST elevation myocardial infarction: case report
Indry Agatha Rihi Pake, Putu Eka Dianti Putri, Agung Pradnyana Suwirya, Desak Nyoman Desy LestariOnline First: Mar 31, 2023
- Abstract
Acute kidney injury in a covid-19 patient with Non-ST elevation myocardial infarction: case report
Introduction: Coronavirus disease 2019 (COVID-19) has a variety of manifestations, from asymptomatic to acute illness that can affect several organs, although being primarily associated with the respiratory system. The virus binds to angiotensin-converting enzyme-2 (ACE-2) receptors in humans and the expression of ACE-2 in heart and kidneys explains the association of COVID-19 with the renal and cardiovascular systems.
Case description: Male, 62-year-old, was admitted to the emergency room (ER) for presented shortness of breath, angina pain, and gastric pain. He was a smoker and denied having comorbidities. At arrival, an examination of vital signs and physical showed tachypnea, tachycardia, hypertension, and bilateral crackles. The electrocardiography (ECG) showed left ventricular hypertrophy and Non-ST-Elevation in anterolateral. The chest x-ray showed pneumonia and cardiomegaly. Laboratory findings showed that decreased renal function and Polymerase Chain Reaction (PCR) test was positive, and increased in serum Troponin level supported the diagnosis of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) pneumonia with Non-ST elevation myocardial infarct (NSTEMI) and Acute Kidney Injury (AKI). Loading of Aspilet, Clopidogrel, Atorvastatin, and Thrombolysis with Fondaparinux was done. The following day, transthoracic echocardiography was performed anterolateral regional wall motion abnormality with 43% of Left Ventricle Ejection Fraction (LVEF). Two weeks after hospital discharge, the echocardiography evaluation showed no improvement and was diagnosed with Chronic Heart Failure with New York Heart Association (NYHA) Functional Classification II et causa Coronary Artery Disease.
Conclusion: Treatment of covid-19 patients with cardiovascular and renal complications is quite challenging since there is no specific guideline for COVID-19 patients with renal and cardiovascular complications.
A uterine leiomyoma with the prolapse large pedunculated submucosal myoma: a case report
Endy Cahyono, Teuku Mirza Iskandar, Ediwibowo Ambari, Very Great Eka Putra, Lubena, Apdhika Kristian TrisantoOnline First: Apr 30, 2023
- Abstract
A uterine leiomyoma with the prolapse large pedunculated submucosal myoma: a case report
Introduction: Leiomyoma is a benign tumor that originates from the smooth muscle cells of the uterus and is one of the most common tumors in women. Sometimes, this tumor can become very large and even stick out of the vagina, which is called prolapse pedunculated myoma. Having a large fibroid with prolapse myoma that protrudes out of the vagina can cause problems like a low blood count or anemia, infection risk, blockage of other organs, and tissue necrosis. Therefore, this condition needs a different treatment approach than other cases.
Case Report: A 50-year-old woman, P1A1, complained of bleeding from the vagina accompanied by a mass that protrudes out of the vagina, and also having an enlarged abdomen. On physical examination, the patient appears pale. Abdominal examination presence of a mass as high as the umbilicus. On a gynecological examination, Fluxus was found. In the vagina, there is a blue-black mass the size of a fist coming out of it. Hemoglobin examination obtained a result of 10.2 gr/dl. Gynecologic ultrasound examination showed the uterus with a size of more than 9.42 x 15.68 x 13.27 cm, a positive endometrial thickening, and there also appeared a hyperechoic mass with a size of 7.38 x 8.11 cm. Abdominal MSCT examination using contrast showed enlargement of the uterus with solid inhomogeneous mass and intramural calcification. There is also a mass and cervical prolapse to the perineum, mild hydronephrosis, and right proximal hydroureter. It is also found multiple lymphadenopathies in paraaortic and common iliac lymph nodes. The patient then decided to perform a total abdominal hysterectomy.
Conclusion: Total abdominal hysterectomy is one of the procedures that can be done on patients who are experiencing symptoms, such as bleeding caused by a large leiomyoma size and the presence of prolapse pedunculated submucosal myoma.
Kondiloma lata perianal yang awalnya diduga bowenoid papulosis disertai balanitis candida pada remaja laki-laki
Joice Gunawan Putri, Ni Made Dwi Puspawati, Herman SaputraOnline First: Jan 19, 2023
- Abstract
Kondiloma lata perianal yang awalnya diduga bowenoid papulosis disertai balanitis candida pada remaja laki-laki
Background: Condyloma lata is a form of secondary syphilis that manifest in moist, flat, firm boundaries papules or plaques with macerated surface that resembles the appearance of bowenoid papulosis. Differentiating this disease requires supporting examinations so that appropriate treatment can be determined. This case report discusses a case of condyloma lata, which was originally suspected to be bowenoid papulosis and accompanied by balanitis candida.
Case: A 14 years teenage boy, complained of warts near the anus and white spots on the gland penis since 1 month ago. Dermatovenereology examination on the perianal region showed a hyperpigmented solitary plaque, well-defined margin, geographic shape, flat surface and a solitary ulcer at the edges. On the glans penis, multiple white plaques, well defined, geographic shape, moist surface. Acetowhite examination was negative and a dark field microscope (DFM) examination of perianal lesions found Treponema pallidum. The potassium hydroxide examination on the glans penis found pseudohyphae and blastospores. Gram examination was found normal. The VDRL serology examination was reactive (1:64), and the TPHA was found to be reactive. The patient was diagnosed with condyloma lata coinfection with balanitis candida. Treatment involves a single intramuscular injection of benzathine penicillin 2.4 million IU and fluconazole 150 mg capsules intraorally single dose. Observations within 1 month showed clinical improvement in condyloma lata and balanitis.
Conclusion: This case provides an understanding of condyloma lata's clinical course, which mimics other diseases in an immunocompetent patient. Treatment based on etiology provides a good clinical improvement in patients.
Latar belakang: Kondiloma lata merupakan suatu bentuk sifilis sekunder yang dapat bermanifestasi berupa papul maupun plak yang lembab, datar, berbatas tegas dengan permukaan maserasi. Bowenoid papulosis adalah penyakit yang menyerupai gambaran kondiloma lata. Membedakan penyakit ini diperlukan pemeriksaan penunjang sehingga dapat menentukan pengobatan yang sesuai. Laporan kasus ini membahas kasus kondiloma lata yang semula diduga bowenoid papulosis dan disertai balanitis candida pada remaja laki-laki.
Kasus: Seorang remaja laki-laki, usia 14 tahun, mengeluhkan adanya kutil di dekat dubur dan bercak putih pada kelamin sejak 1 bulan yang lalu. Status dermatovenereologi pada regio perianal didapatkan plak soliter hiperpigmentasi, batas tegas, bentuk geografika, permukaan rata dan di tepinya terdapat ulkus soliter. Pada glans penis didapatkan plak putih multipel, berbatas tegas, bentuk geografika, permukaan lembab. Pemeriksaan acetowhite didapatkan negatif, pemeriksaan dark field microscope (DFM) pada lesi perianal didapatkan Treponema pallidum. Pemeriksaan kalium hidroksida (KOH) pada glans penis didapatkan adanya pseudohifa dan blastospora. Pemeriksaan gram pada glans penis tidak ditemukan adanya leukosit, kokus gram positif maupun batang gram negatif. Pemeriksaaan serologi Venereal Disease Research Laboratory (VDRL) reaktif 1:64 dan Treponema Pallidum Haemagglutination Assay (TPHA) didapatkan reaktif. Pasien didiagnosis kondiloma lata disertai balanitis candida. Penatalaksanaan dengan injeksi benzatin penisilin 2,4 juta IU intramuskular dosis tunggal dan flukonazol kapsul 150 mg intraoral dosis tunggal. Pengamatan dalam 1 bulan didapatkan perbaikan klinis pada kondiloma lata dan balanitis.
Simpulan: Kasus ini memberikan pemahaman mengenai klinis kondiloma lata yang menyerupai dengan penyakit lain dan disertai koinfeksi candida pada pasien imunokompeten. Penanganan berdasarkan etiologi memberikan perbaikan klinis yang baik pada pasien.
24-year-old obese woman with dilated cardiomyopathy: a case report of obese cardiomyopathy
Gede Dehandra Dipastraya Wikananda, Putu Gupta Arya Gumilang, Agung Pradnyana SuwiryaOnline First: Apr 1, 2023
- Abstract
24-year-old obese woman with dilated cardiomyopathy: a case report of obese cardiomyopathy
Background: Dilated cardiomyopathy is a disease characterized by enlargement of the heart ventricles with impaired left ventricular or biventricular systolic function. Obesity is a risk factor for changes in the structure and function of the heart, known as obese cardiomyopathy. The purpose of writing this case report is to holistically discuss obesity as a risk factor for dilated cardiomyopathy based on a literature review.
Case presentation: A 24-year-old woman complained of shortness of breath 2 months ago, appeared during activities and while she slept at night, and improved when sitting and resting. Other complaints are palpitations, swollen feet, nausea, and vomiting. Childhood history of obesity. Blood pressure 160/95 mmHg, respiratory rate 22 times/minute, and body mass index 33.8 kg/m2 (obesity II). The jugular venous pressure is increased. Auscultation revealed a systolic murmur at ICS 4 grade 3/6 and pulmonary crackles, with pitting edema in the legs. Electrocardiography revealed sinus tachycardia. Laboratory tests showed high triglycerides and total cholesterol, and other laboratories were within normal limits. Echocardiographic examination showed decreased left ventricular systolic function, severe left ventricular dilatation, and an ejection fraction of 27.9%. No significant lesions were found during the angiographic examination. A magnetic resonance imaging examination revealed non-ischemic cardiomyopathy, moderate left ventricular dysfunction, and severe right ventricular dysfunction. Patients were given heart failure therapy according to guidelines. On routine control, the patient's condition was stable.
Conclusion: Obesity is believed to be a risk factor for dilated cardiomyopathy through an increased hemodynamic load, neurohormonal dysregulation, inflammation, and lipotoxicity. Modalities such as the electrocardiogram, echocardiography, and magnetic resonance imaging can support the results of examinations for diagnosing dilated cardiomyopathy due to obesity. The management of obese cardiomyopathy involves changing lifestyles and administering drugs according to the clinical manifestations of heart failure.
Laporan kasus: kanker caput pankreas pada pasien dengan infeksi hepatitis B kronis
Ni Kadek Seri Mahayanti, I Putu Alit SudarsanaOnline First: Feb 16, 2023
- Abstract
Laporan kasus: kanker caput pankreas pada pasien dengan infeksi hepatitis B kronis
Background: Pancreatic cancer is the seventh leading cause of cancer death globally according to the 2020 Global Cancer Statistics. Pancreatic cancer does not show clear clinical signs in its early stages and it is usually diagnosed in the advanced phase with poor response to treatment. The risk is increased in smokers, black race, high-fat diet, alcohol, the elderly, the presence of infection, diabetes mellitus, and chronic pancreatitis.
Case report: We report a 72-year-old female patient with complaints of abdominal enlargement and jaundice. Patients also with complain of light colored stools and dark urine. Physical examination revealed tenderness on palpation of the right upper quadrant of the abdomen accompanied by an enlarged liver. Laboratory examination revealed anemia accompanied by an increase in total bilirubin with predominance in direct bilirubin. HbsAg examination showed positive results. Ultrasound examination showed a mass in the head of the pancreas with dilatation of the common bile duct to the intrahepatic bile duct and there was a hydrops gallbladder. Abdominal CT scan showed a well-defined contrast-enhanced mass measuring 36 cm x 4.4 cm x 6 cm in the head area.
Conclusion: Pancreatic head cancer is a rare type of cancer, but has a high malignancy. Establishing the correct diagnosis is generally difficult. This is because symptoms generally appear after the cancer has reached an advanced stage.
Latar Belakang: Kanker pankreas menjadi penyebab kematian ketujuh terbanyak akibat kanker secara global menurut Global Cancer Statistics tahun 2020. Kanker pankreas tidak menunjukkan tanda-tanda klinis yang jelas pada fase awal dan biasanya didiagnosis pada fase lanjut dengan respon yang buruk terhadap pengobatan. Risiko meningkat pada perokok, ras kulit hitam, diet tinggi lemak, alkohol, lansia, adanya infeksi, diabetes mellitus, dan pankreatitis kronis.
Laporan kasus: Kami melaporkan seorang pasien wanita berusia 72 tahun dengan keluhan keluhan pembesaran abdomen dan jaundice. Pasien juga dengan keluhan feses berwarna terang dan urin gelap. Ditemukan nyeri tekan pada palpasi kuadran kanan atas abdomen disertai pembesaran hati. Pemeriksaan laboratorium didapatkan anemia disertai peningkatan pada bilirubin toal dengan dominan pada bilirubin direk. Pemeriksaan HbsAg menunjukkan hasil positif. Pemeriksaan ultrasonograafi menunjukkan adanya massa pada caput pancreas dengan dilatasi common bile duct hinga intrahepatic bile duct dan terdapat hydrops gall bladder. Pemeriksaan CT scan abdomen menunjukkan massa menyangat kontras berbatas tegas ukuran 36 cm x 4,4 cm x 6 cm di daerah caput.
Kesimpulan: Kanker caput pancreas merupakan jenis kanker yang tergolong jarang, namun memiliki keganasan yang tinggi. Penegakan diagnosis yang tepat pada umumnya mengalami kesulitan. Hal ini disebabkan karena gejala pada umumnya muncul setelah kanker telah mencapai stadium lanjut.
Hypernatremic hemorrhagic encephalopathy as an unexpected critical complication in children: a case report from a tertiary hospital
Ricky Saunders, Ida Bagus Gde Suparyatha, Dyah Kanya Wati, I Nyoman Budi Hartawan, Agung Bagus Sista SatyarsaOnline First: Apr 1, 2023
- Abstract
Hypernatremic hemorrhagic encephalopathy as an unexpected critical complication in children: a case report from a tertiary hospital
Introduction: Hypernatremic hemorrhagic encephalopathy (HHE) is one of the complications of hypernatremic dehydration which is relatively uncommon in patients with hypernatremia. Severe hypernatremia might lead to brain shrinkage resulting in intracranial bleeding which can increase morbidity and mortality, especially in children. Hypernatremic hemorrhagic encephalopathy is harmful, but only limited cases are reported. This case highlights the role of cautious management of hypernatremic dehydration and the need for intense monitoring due to the unexpected complication of HHE.
Case presentation: A 4 months old female infant presented with a decreased consciousness. She showed signs of shock along with acute diarrhoea and severe dehydration. Laboratory findings revealed severe hypernatremia and high septic marker. Rehydration and correction of hypernatremia were done, but during the process, several episodes of general tonic-clonic seizure occurred. A Head CT scan was done and showed subdural hemorrhage in the posterior interhemispheric fissure and intraventricular hemorrhage in the posterior horn of the right lateral ventricle. Conservative management was undertaken and the patient was clinically improved progressively. On the 11th day of hospitalization, the patient's condition had been significantly improved without neurological sequelae and was later discharged on the 11th day of hospitalization.
Conclusion: Close monitoring of clinical, neurological, and laboratory examination is essential in the management of hypernatremic dehydration due to the possibility of HHE, even when on the right procedure. Once neurological complication is suspected, an immediate imaging study should be performed and modifying therapy is required.
Sklerosis multipel pada pria Bali: sebuah laporan kasus
I Putu Eka Kusmadana, Wandy Margo, Gede SuputraOnline First: Apr 1, 2023
- Abstract
Sklerosis multipel pada pria Bali: sebuah laporan kasus
Introduction: Multiple Sclerosis (MS) is a chronic autoimmune disorder of the central nervous system characterized by lesions that predominantly attack the brain, optic nerves and spinal cord. The incidence of MS in Asia and Oceania is rare, but with the evolution of diagnostic modalities, the incidence of MS is increasing.
Case Presentation: This is a case report of multiple sclerosis; A 42-year-old Balinese male patient presenting with being unable to walk since 3 months ago as the chief complaint accompanied by tingling, a blurred eye and dripping urine. During the last ten years these complaints lasted for several months but improved on their own without treatment. The physical examination showed visual loss, paraparesis, sensory disturbances, cerebellar ataxia, and urinary incontinence. The patient underwent an MRI and showed lesions suggestive of MS. The patient was diagnosed as MS and treated with methyl-prednisolone 3x16 mg for 3 month and was referred to a medical rehabilitation unit. After one month of treatment, the patient's condition getting better.
Conclusion: This case report provides a deeper understanding of MS as an autoimmune disease of the central nervous system that is rarely found and often misdiagnosed in primary health care, so that knowledge regarding early diagnosis and early management of MS patients should be widely known to prevent worsening of the condition and suppress recurrence rates.
Pendahuluan: Sklerosis multipel (multiple sclerosis/MS) merupakan kelainan autoimun kronis pada sistem saraf pusat yang ditandai dengan lesi-lesi yang predominan menyerang otak, nervus optikus dan medula spinalis. Kejadian MS di benua Asia dan Oseania diketahui jarang ditemukan, namun seiring terjadinya evolusi modalitas diagnostik insiden MS makin tahun ditemukan semakin meningkat.
Laporan Kasus: Laporan kasus ini mengenai sklerosis multipel; Pasien laki-laki 42 tahun, suku bali, datang dengan tidak bisa berjalan sejak 3 bulan yang lalu sebagai keluhan utama, disertai dengan kesemutan pada tangan dan kaki kiri, mata kanan kabur dan urin menetes. Selama sepuluh tahun terakhir keluhan-keluhan tersebut hilang timbul, berlangsung dan menetap selama beberapa bulan namun membaik dengan sendirinya tanpa pengobatan. Hasil pemeriksaan fisik menunjukkan visual loss mata kanan, paraparese, gangguan sensorik, ataksia serebelar, serta inkotinensia urin. Pasien dilakukan MRI dan hasil menunjukkan lesi sugestif MS. Pasien ditegakkan sebagai MS dan diterapi menggunakan metil-prednisolon 3x16 mg selama 3 bulan dan dikonsulkan ke unit rehabilitasi medis. Pasca satu bulan pengobatan, keluhan-keluhan pasien dikatakan membaik.
Conclusion: Laporan kasus ini memberikan pemahanan lebih mendalam mengenai MS sebagai suatu penyakit autoimun pada sistem saraf pusat yang jarang ditemukan dan kerap terjadi misdiagnosis di layanan kersehatan primer, sehingga pengetahuan mengenai diagnosis awal dan tatalaksana awal pada pasien MS sebaiknya diketahui secara luas untuk mecegah perburukan kondisi dan menekan angka kekambuhan.
Appendisitis akut dengan kecurigaan ruptur pada kista korpus luteum: laporan kasus
Ayuningtyas Anatika SantosaOnline First: Apr 30, 2023
- Abstract
Appendisitis akut dengan kecurigaan ruptur pada kista korpus luteum: laporan kasus
Background: Appendicitis is an acute or chronic inflammatory process that occurs in the vermiform appendix due to an obstruction that occurs in the lumen of the appendix. Acute appendicitis is one of the most common acute abdomen cases in patients in the emergency room. This case study aims to evaluate the acute appendicitis with suspected rupture of a corpus luteum cyst
Case Presentation: A 17-year-old woman with complaints of abdominal pain accompanied by nausea, vomiting, and fever, which is supported by investigations towards acute appendicitis was admitted to the Siloam Hospital, Denpasar, Bali. On physical examination, the patient was aware of compost mentis with a general condition that looked mildly ill, Blood Pressure 120/70 mmHg, Pulse: 76 times/minutes, Respiration 16 times/minutes, Ttemperature 36.3oC, SpO2 98% room air, and Visual Analogue Scales (VAS) was 7. However, the CT scan of the abdomen not only found a swollen appendix but also found suspicion of intra-peritoneal bleeding due to corpus luteal cyst rupture. The patient was then given an injection of omeprazole 40 mg IV, primperan 10 mg IV, and ketorolac 30 mg IV. After being given the drug injection, complaints were felt to decrease and the patient was allowed to be outpatient.
Conclusion: Appendicitis can cause serious complications, namely perforation of the appendix which can cause peritonitis and sepsis thereby increasing morbidity and mortality, so it needs to be known as early as possible to prevent worsening.
Latar Belakang: Apendisitis adalah proses inflamasi akut atau kronis yang terjadi pada apendiks vermiformis akibat adanya sumbatan yang terjadi pada lumen apendiks. Apendisitis akut merupakan salah satu kasus akut abdomen yang paling sering terjadi pada pasien di ruang gawat darurat. Studi kasus ini bertujuan untuk mengevaluasi apendisitis akut dengan dugaan pecahnya kista korpus luteum
Presentasi Kasus: Seorang wanita berusia 17 tahun dengan keluhan nyeri perut disertai mual, muntah, dan demam, yang didukung pemeriksaan penunjang ke arah apendisitis akut, dirawat di Rumah Sakit Siloam, Denpasar, Bali. Pada pemeriksaan fisik diketahui pasien kompos mentis dengan keadaan umum tampak sakit ringan, tekanan darah 120/70 mmHg, nadi 76 kali/menit, Respirasi 16 kali/menit, suhu 36.3oC, SpO2 98% udara ruangan, dan Visual Analogue Scales (VAS) adalah 7. Namun, CT scan perut tidak hanya menemukan apendiks yang membengkak tetapi juga menemukan kecurigaan adanya perdarahan intra-peritoneal akibat pecahnya kista korpus luteal. Pasien kemudian diberikan suntikan omeprazole 40 mg IV, primer 10 mg IV, dan ketorolac 30 mg IV. Setelah diberikan obat suntik keluhan dirasakan berkurang dan pasien diperbolehkan untuk berobat jalan.
Kesimpulan: Apendisitis dapat menimbulkan komplikasi yang serius yaitu perforasi apendiks yang dapat menyebabkan peritonitis dan sepsis sehingga meningkatkan morbiditas dan mortalitas, sehingga perlu diketahui sedini mungkin untuk mencegah perburukan.
The effect of hypertonic dextrose prolotherapy on knee osteoarthritis outpatients in Dr. Ramelan Navy Hospital Surabaya: case series
Avissia Zivanna, Eka PoerwantoOnline First: Apr 10, 2023
- Abstract
The effect of hypertonic dextrose prolotherapy on knee osteoarthritis outpatients in Dr. Ramelan Navy Hospital Surabaya: case series
Background: The high use and pressure on the knee cause osteoarthritis to occur frequently. Prolotherapy is a non-surgical injection therapy used to treat chronic pain in musculoskeletal conditions, including knee OA. This solution can create local irritation, inflammation, and tissue regeneration, thereby increasing the strength of damaged ligaments, tendons, and intra-articular structures. Therefore, the aim of this research is to assess the changes in VAS and WOMAC scores, as well as plain radiographs of knee OA patients after hypertonic dextrose prolotherapy.
Methods: This experimental case series was done at the Physical Medicine and Rehabilitation Polyclinic of dr. Ramelan Navy Hospital Surabaya from December 2021 to April 2022, by giving hypertonic dextrose prolotherapy injection intraarticularly to 3 knee OA subjects using a 22G or 23G needle. This procedure was performed 3 times on each subject, with an interval of 4 weeks each. The assessments were carried out with VAS and WOMAC scores, as well as plain radiographs of the knees before the procedure and 1 month after the third injection for evaluation.
Results: In all 3 subjects, the knee joint spaces were slightly widened on plain radiographs, as well as decreased VAS and WOMAC scores after injection.
Conclusion: Hypertonic dextrose prolotherapy here had minimal side effects, affordable prices, and a fast process. It also causes a reduction in pain and joint stiffness and causes functional improvement. Prolotherapy may be considered a therapy for knee OA patients.
Aspek laboratorium pemeriksan keton pada kasus preeklamsia berat: laporan kasus
I Gede Sukma Okta Perdana, I Nyoman Gde Sumardika, Made Dharma Pramana, Ni Luh Putu Siska Kahari SariOnline First: Apr 30, 2023
- Abstract
Aspek laboratorium pemeriksan keton pada kasus preeklamsia berat: laporan kasus
Background: Ketones are the product of fat metabolism, consisting of 20% aceto-acetic acid, 78% β-hydroxy butyrate and 2% acetone. Aceto-acetic acid and acetone that experience an increase is called ketosis while ketosis that occurs in the urine is called ketonuria. This case report aims to evaluate the laboratory aspects of ketone testing in cases of severe preeclampsia.
Case Presentation: Increased levels of ketonuria in the body can cause ketoacidosis and a decrease in blood pH if not treated immediately, in pregnant women it can cause fetal death and ketoacidic coma. A 30 year old female patient with a diagnosis of G4P3003 UK 26 mg T/IUFD accompanied by ketonuria and severe preeclampsia. At the diagnostic examination, blood pressure was found: 170/100 mmHg, urine examination: protein 1+ and ketones 2+. The patient was treated with MgSO4, nifedipine, drip transamin 1 ampoule 28 tpm, cefotaxime and observation for bleeding.
Conclusion: During early pregnancy, there were persistent complaints of nausea and vomiting where laboratory tests, especially urine for remote areas and blood ketone examination for urban areas, were needed in early pregnancy to prevent preeclampsia.
Latar Belakang: Keton merupakan produk hasil dari metabolisme lemak, terdiri dari 20% asam aseto-asetat, 78% β-hidroksi butirat dan 2% aseton. Asam aseto-asetat dan aseton yang mengalami peningkatan disebut ketosis sedangkan ketosis yang terjadi di dalam urin disebut Ketonuria. Laporan kasus ini bertujuan untuk mengevaluasi aspek laboratorium pemeriksan keton pada kasus preeklamsia berat.
Presentasi Kasus: Peningkatan kadar ketonuria didalam tubuh dapat menyebabkan ketoasidosis dan penurunan pH darah jika tidak segera mendapatkan penanganan, pada ibu hamil dapat menyebabkan kematian janin serta ketoacidic koma. Pasien perempuan umur 30 tahun dengan diagnosis G4P3003 UK 26 mg T/IUFD disertai ketouria dan Preeklamsia Berat. Pada pemeriksaan penegakan diagnosis didapatkan tekanan darah: 170/100 mmHg, Pemeriksaan urin : protein 1+ dan keton 2+. Pasien diterapi dengan MgSO4, nifedipine, drip transamin 1 ampul 28 tpm, cefotaxime dan observasi perdarahan.
Kesimpulan: Pada masa kehamilan awal didapatkan keluhan mual muntah terus menerus dimana pemeriksaan laboratorium khususnya urin untuk daerah terpencil dan pemeriksaan keton darah untuk daerah perkotaan pada awal kehamilan diperlukan untuk mencegah preeklamsia.
Tantangan dalam mengobati kanker payudara stadium lanjut tipe Luminal B HER2 negatif dengan krisis viseral
Elvidawati, Khairiyah Darojat, Lia Sasmithae, Trinugroho Heri FadjariOnline First: Apr 30, 2023
- Abstract
Tantangan dalam mengobati kanker payudara stadium lanjut tipe Luminal B HER2 negatif dengan krisis viseral
Introduction: Breast cancer is the most prevalent form of malignancy in women, with over two million new cases yearly. The complex instance of advanced breast cancer with visceral crisis occurs when cancer has spread to vital organs such as the liver, lungs, and brain. This case report aims to teach us how to prevent visceral crisis, which will increase mortality, particularly in advanced breast cancer.
Case presentation: A 50-year-old woman who presented with complaints of shortness of breath was diagnosed with advanced breast cancer and visceral crisis. On examination, there were indications of hypervolemia, including a rightward displaced trachea and diminished vocal fremitus. The anatomical pathology results revealed a grade II invasive breast carcinoma. (Luminal B HER2 negative). X-rays of the chest reveal bilateral pleural effusion. The lumbosacral X-ray and abdominal ultrasonography both revealed liver metastases. Before intra-thoracic metastases and visceral crisis, the patient received hormonal therapy (tamoxifen). When intra-thoracic metastases and visceral problems occurred, the treatment was substituted with capecitabine for 3 months. However, capecitabine was discontinued because the cancer spread to the bones and liver. Patients were administered chemotherapy using docetaxel following NCCN and ESMO guidelines. The patient perished during chemotherapy with docetaxel due to complications from the disease and adverse effects.
Conclusion: Patients with advanced breast cancer who are not appropriately treated run a high risk of developing visceral crisis complications. Therefore, it is crucial that clinicians provide education about routine examinations and adhere to established evaluation procedures in order to prevent these complications.
Latar Belakang: Kanker payudara adalah jenis keganasan yang paling umum terjadi pada wanita dengan lebih dari dua juta kasus per tahun. Kanker payudara stadium lanjut dengan krisis viseral merupakan kasus yang kompleks, dimana kanker menyebar ke organ vital seperti hati, paru-paru dan otak. Tujuan diangkatnya laporan kasus ini adalah menjadi pembelajaran bagi kita bagaimana upaya untuk mencegah kondisi krisis viseral terutama pada kanker payudara stadium lanjut yang akan meningkatkan mortalitas.
Presentasi kasus: Seorang perempuan berusia 50 tahun datang dengan keluhan sesak nafas, pasien terdiagnosa kanker payudara stadium lanjut dengan krisis viseral. Pada pemeriksaan didapatkan adanya tanda-tanda hipervolemia, trakea terdorong ke kanan, penurunan fremitus vokal. Hasil patologi anatomi didapatkan gambaran invasive carcinoma mammae grade II. (Luminal B HER2 negative). Gambaran rontgen thorax menunjukkan adanya efusi pleura bilateral. Hasil rontgen lumbosakral didapatkan metastasis ke tulang dan pada ultrasonografi abdomen didapatkan metastasis hati. Sebelumnya pasien mendapatkan terapi hormonal (tamoxifen), dan pada saat terjadi metastasis intra thoracal serta krisis viseral terapi diganti dengan capecitabine selama 3 bulan namun terjadi progresifitas berupa penyebaran ke tulang dan hati, selanjutnya capecitabine dihentikan. Pasien diberikan kemoterapi berupa docetaxel sesuai guidelines pada NCCN dan ESMO. Selama masa kemoterapi menggunakan docetaxel akhirnya pasien meninggal dunia akibat komplikasi penyakit dan efek samping.
Kesimpulan: Pasien yang menderita kanker payudara stadium lanjut dapat mengalami komplikasi krisis viseral yang berisiko tinggi jika tidak ditangani dengan tepat. Oleh karena itu, laporan kasus ini sangat penting bagi klinisi untuk memberikan edukasi tentang pemeriksaan rutin dan mematuhi prosedur evaluasi yang ditetapkan guna mencegah terjadinya komplikasi tersebut.
Cerebral salt wasting syndrome: A case report
Resha Wisadianta, Ni Wayan Anantika RianiOnline First: Apr 10, 2023
- Abstract
Cerebral salt wasting syndrome: A case report
Introduction: The development of extracellular volume reduction due to decreased renal sodium transport in individuals with the intracranial illness and normal adrenal and thyroid function is known as a cerebral salt wasting syndrome (CSWS). Complications of cerebral salt-wasting syndrome include symptomatic hyponatremia and dehydration. We reported and discussed the diagnostic approach and the management of a 66-year-old woman who experienced severe hyponatremia with a history of head trauma and was treated at Udayana University Hospital.
Case Description: A 66-year-old female patient complained of decreased consciousness. According to family information, the patient complained of having decreased consciousness one hour before admission and was accompanied by vomiting one time. Two weeks before admission, the patient had fallen, and the back of the patient's head had hit the table. The patient also had time to experience stiffness in the right and left hands and stomping. Urine collected 24 hours as much as 3880 ml on the first day of treatment.
Conclusion: In cerebral salt wasting syndrome (CSWS) the management mainly focuses on the correction of intravascular volume depletion using 0.9% sodium chloride and hyponatremia, as well as on the replacement of ongoing urinary sodium loss, usually with iv hypertonic saline solutions, Fludrocortisone/mineralocorticoid that directly acts on the renal tubules to increase sodium reabsorption showed a favorable response in CSWS.
Thoracopagus parasitic twin with omphalocele rupture: a case report
Made Indah Pradnya Paramita, I Made Kardana, Made Sukmawati, Putu Junara Putra, I Wayan Dharma ArtanaOnline First: May 8, 2023
- Abstract
Thoracopagus parasitic twin with omphalocele rupture: a case report
Background: Heteropagus or parasitic twin is a rare congenital anomaly that affects two connected children with imprecisely understood anatomy and physiology. This case report aims to describe a thoracopagus patient with severe complications.
Case presentation: One-day-old female baby was born with thoracopagus and omphalocele rupture. She was the third child, born aterm from a 36-year-old mother, with a birth weight of 3000 grams. Laboratory and radiography examinations showed leukocytosis, metabolic acidosis, prolonged coagulation profile, acute kidney injury, hypoglycemia, transaminitis, and congenital heart defects. She was treated in the intensive care unit and managed conservatively. Unfortunately, she died on the sixth day of treatment due to severe complications.
Conclusion: Conjoined twins have a poor prognosis. If it is coupled with other congenital anomalies, it will worsen the outcome.
Tatalaksana kasus trombosis vena dalam iliofemoral akut dengan sistem trombektomi aspirasi mekanik Indigo CAT8
Anak Agung Gde Agung Anom Arie Wiradana, I Gusti Agung Bagus Krisna Wibawa, Ida Bagus BudiartaOnline First: Apr 15, 2023
- Abstract
Tatalaksana kasus trombosis vena dalam iliofemoral akut dengan sistem trombektomi aspirasi mekanik Indigo CAT8
Introduction: Acute deep vein thrombosis is a common cause of morbidity and mortality. Venous thrombosis commonly involves the lower extremities, including the iliac veins, femoral veins and vena cava. Optimal therapy of deep vein thrombosis, both ileofemoral and central can prevent complications.
Case Presentation: A 51 years old man complained of swelling of his right leg accompanied by acute pain. On duplex ultrasonography examination, there was a venous thrombosis in the iliofemoral area descending from the common iliac vein to the deep femoral vein. Endovascular venous mechanical thrombectomy was immediately performed because the symptoms were acute, and signs of swelling and pain intensity did not improve. An 8-F catheter was inserted into the patient's right distal superficial femoral vein under ultrasound guidance after administration of intravenous heparin. The CAT8 was inserted through the 8-F sheath and found the thrombus, then vacuum thrombectomy was performed. Swelling and pain disappeared a few hours after the procedure, and the patient was discharged 2 days later.
Conclusion: The Indigo CAT 8 mechanical aspiration thrombectomy system can be an effective treatment modality for patients with acute iliofemoral or central deep vein thrombosis.
Latar Belakang: Trombosis vena dalam akut adalah penyebab umum morbiditas dan mortalitas. Trombosis vena umumnya melibatkan ekstremitas bawah, termasuk vena iliaka, vena femoralis, dan vena cava. Terapi optimal trombosis vena dalam, baik ileofemoral maupun sentral dapat mencegah komplikasi.
Presentasi Kasus: Seorang laki-laki 51 tahun mengeluh kaki kanan bengkak disertai nyeri akut. Pada pemeriksaan ultrasonografi dupleks, terdapat trombosis vena di daerah iliofemoral turun dari vena iliaka komunis ke vena femoralis dalam. Trombektomi mekanik vena endovaskular segera dilakukan karena gejalanya akut, dan tanda pembengkakan serta intensitas nyeri tidak membaik. Kateter 8-F dimasukkan ke dalam vena femoralis superfisial distal kanan pasien di bawah panduan ultrasonografi setelah pemberian heparin intravena. Kateter CAT8 dimasukkan melalui selubung 8-F dan ditemukan trombus, kemudian dilakukan trombektomi vakum. Bengkak dan nyeri menghilang beberapa jam setelah prosedur, dan pasien dipulangkan 2 hari kemudian.
Simpulan: Sistem trombektomi aspirasi mekanik Indigo CAT 8 dapat menjadi modalitas pengobatan yang efektif untuk pasien dengan trombosis vena dalam sentral atau iliofemoral akut.
Pasien stroke akibat sengatan lebah di Rumah Sakit TK. II Dustira Cimahi, Jawa Barat, tahun 2022: sebuah laporan kasus
Ngakan Made Adyaksa, Aprilia Grace SweetasariOnline First: Apr 30, 2023
- Abstract
Pasien stroke akibat sengatan lebah di Rumah Sakit TK. II Dustira Cimahi, Jawa Barat, tahun 2022: sebuah laporan kasus
Background: Bee sting venom is quite common in Indonesia. Allergic reactions at the sting site such as edema, erythema, itching and burning sensations are common manifestations of bee venom poisoning. In this case report, we report a 68-year-old man with a bee bite and experiencing complications in the form of a neurological deficit.
Case Presentation: A 68-year-old man was brought by his family to the Dustira Hospital Emergency Room because of complaints of decreased consciousness. The sudden loss of consciousness was felt by the family and the right-side experienced weakness. The patient cannot communicate, understand the contents of the other person's speech or speak to express his intentions. On physical examination, the patient was found to be somnolent with a blood pressure of 150/90mmHg and a temperature of 37.9 degrees Celsius. On neurological examination, a decrease in motor strength was found. On CT scan without contrast, an infarction was found in the cortical subcortical area in the left temporoparietooccipital region (embolism).
Conclusion: Unusual and more severe complications have also been seen such as anaphylactic shock, myocardial infarction, acute renal failure, pulmonary hemorrhage and atrial fibrillation. Neurologic complications are rare in bee venom poisoning.
Latar Belakang: Racun sengatan lebah cukup umum di Indonesia. Reaksi alergi di tempat sengatan seperti edema, eritema, sensasi gatal dan rasa terbakar adalah manifestasi yang umum terjadi dari keracunan racun lebah. Dalam laporan kasus ini kami laporkan seorang laki-laki usia 68 tahun dengan gigitan lebah dan mengalami komplikasi berupa defisit neurologis.
Presentasi Kasus: Seorang laki-laki berusia 68 tahun dibawa oleh keluarga ke Instalasi Gawat Darurat RS Dustira karena keluhan penurunan kesadaran. Penurunan kesadaran dirasakan keluarga mendadak dan sisi sebelah kanan mengalami kelemahan. Pasien tidak dapat berkomunikasi, memahami isi pembicaraan lawan bicara maupun berbicara mengutarakan maksudnya. Pada pemeriksaan fisik pasien ditemukan kesadaran pasien somnolen dengan tekanan darah 150/90mmHg dan suhu 37,9 derajat Celcius. Pada pemeriksaan neurologi ditemukan penurunan kekuatan motorik. Pada pemeriksaan CT-Scan tanpa kontras didapatkan infark di daerah kortikal subkortikal regio temporoparietooksipital sinistra (emboli).
Kesimpulan: Komplikasi yang tidak biasa dan lebih parah juga terlihat seperti syok anafilaksis, infark miokard, gagal ginjal akut, perdarahan paru dan fibrilasi atrium. Komplikasi neurologi jarang terjadi pada keracunan racun lebah.
Patency of tertiary vascular access in hemodialysis patients: case series
Raymen Satria, I Wayan Sudarma, I Nyoman SemadiOnline First: Mar 30, 2023
- Abstract
Patency of tertiary vascular access in hemodialysis patients: case series
Background: Transposed brachio-basilic arteriovenous fistula (TBB-AVF) or arteriovenous graft (AVG) can be considered when primary and secondary vascular access options have been exhausted. Evidence that compared both procedures remains scarce. We aimed to report and describe the effectiveness of TBB-AVF and AVG as tertiary vascular access, reviewing literature about the advantages of each procedure.
Case Presentation: We presented a series of end-stage renal disease (ESRD) patients needing tertiary vascular access to compare each procedure's effectiveness. Our study included 17 patients with ESRD and multiple vascular access failures who needed tertiary vascular access for hemodialysis between January 2019 and August 2022. Patency in 6 months and 1 year were compared between TBB-AVF and AVG using the Kaplan-Meier curve. The early failure rate was 14.4% for TBB-AVF and 87.5% for AVG. TBB-AVF had a better patency rate than AVG (p=0.005; log-rank). Cumulative patency rates in six months and one year were 91.7% and 85.7% for TBB-AVF compared to 87.5% and 16.7% for AVG, respectively.
Conclusion: The creation of TBB-AVF should only be suggested if primary and secondary vascular access options have been exhausted. The TBB-AVF was more effective in functional patency than AVG as tertiary vascular access.
Autologous Serum Eye Drops (ASEDs) as dry eye disease treatment option
Anak Agung Ayu Putri Oktiadewi, I Putu Rustama PutraOnline First: Mar 28, 2023
- Abstract
Autologous Serum Eye Drops (ASEDs) as dry eye disease treatment option
Background: Nowadays, there are a lot of treatment options available for dry eye syndrome (DES) or disease (DED). Autologous Serum Eye Drops (ASEDs) is one of the options that offer a potential advantage over conventional therapy. Biochemical elements in ASEDs resemble real tears and act as a lacrimal substitute to provide lubrication. As a severe dry eye treatment, using ASEDs has grown in favor.
Aim: This review aims to deliver knowledge from the current literature on applying ASEDs for dry eye disease in the medical worker.
Method: The method used was a literature review. A comprehensive search was performed on Pubmed and Google Scholar databases in December 2022 using each of the following keywords “ASEDs”, “serum”, “eyedrop”, “DED” and “DES”.
Conclusion: Dry eye disease is incurable and symptom management is the focus of therapy. Studies have shown that ASEDs reduced dry eye symptoms in over 60% of patients by inhibiting the release of inflammatory cytokines and increasing the number of goblet cells and mucin expression in the conjunctiva. The serum eye drop is typically well tolerated and can be one of the best treatment options for severe DED due to its close resemblance to tears, preservatives free and minimum side effects.
Low serum irisin levels in newly diagnosed patients with type 2 diabetes mellitus: a meta-analysis
I Gusti Ngurah Metta Nurcahya, Ayu Agung Pradnya Paramitha, Ida Bagus Indra Wibawa Putrawan, Dewi Catur WulandariOnline First: Mar 1, 2023
- Abstract
Low serum irisin levels in newly diagnosed patients with type 2 diabetes mellitus: a meta-analysis
Background: Low irisin levels, a marker widely reported to be associated with developing insulin resistance and type 2 diabetes mellitus. This study aims to provide evidence regarding irisin levels in patients newly diagnosed with type 2 diabetes mellitus.
Methods: A systematic review and meta-analysis of observational studies in adults over 18 newly diagnosed with type 2 diabetes mellitus. The databases used for this study were PubMed, ProQuest and ScienceDirect. Only English studies were considered in the database searched from the beginning to October 2022. The data obtained were analyzed using the RevMan 5.4 application.
Results: Twelve studies met the inclusion criteria. These were identified using a total of 1,621 patients with; 880 cases and 741 controls. This main point shows that the serum irisin level in patients newly diagnosed with type 2 diabetes mellitus has a mean difference of -7.72 with 95% CI -9.49 to -5.95. Since the evidence collected in our meta-analysis showed heterogeneity (I2 = 99%), a random effects model was performed. The z-test results for the overall effect were statistically significant (P≤0.001).
Conclusion: Irisin levels were significantly lower in patients newly diagnosed with type 2 diabetes mellitus than in the healthy group.
Evaluasi Kemampuan Komunikasi dan Kerjasama Tim dalam Pelaksanaan Interprofessional Education (IPE): Sebuah Tinjauan Literatur
Ida Bagus Amertha Putra Manuaba, Made Violin Weda YaniOnline First: Apr 1, 2023
- Abstract
Evaluasi Kemampuan Komunikasi dan Kerjasama Tim dalam Pelaksanaan Interprofessional Education (IPE): Sebuah Tinjauan Literatur
Collaboration is needed to provide comprehensive services in dealing with complex health problems. However, collaboration in the world of health in Indonesia is still not optimal. So early learning is needed to increase the effectiveness of collaboration, one of which is by organizing interprofessional education (IPE). IPE is a collaborative learning process that involves educators and students from two or more health professions and basic disciplines. IPE can provide various benefits, including training cooperation, communication, leadership, and respect for other professions. With the implementation of the IPE program since college, it is hoped that it will be a provision for students when carrying out professional activities. This study aims to assess communication and teamwork's ability to implement IPE. The method in this study was a literature review, with 19 articles that met the inclusion criteria. Based on a review of several literatures, it was found that implementing IPE can improve communication skills and teamwork.
Dalam menghadapi permasalahan kesehatan yang kompleks, diperlukan kolaborasi guna memberikan pelayanan yang komprehensif. Namun, kolaborasi di dunia kesehatan Indonesia masih belum maksimal. Sehingga diperlukan pembelajaran sejak dini untuk meningkatkan efektivitas kolaborasi, salah satunya dengan penyelenggaraan interprofessional education (IPE). IPE merupakan proses pembelajaran kolaboratif yang melibatkan pendidik dan peserta didik dari dua atau lebih profesi kesehatan dan disiplin dasar. IPE dapat memberikan berbagai manfaat mulai dari melatih kerjasama, komunikasi, kepemimpinan, dan menghormati profesi lain. Dengan penerapan program IPE sejak kuliah, diharapkan dapat menjadi bekal mahasiswa saat menjalani kegiatan profesi. Penelitian ini bertujuan untuk menilai kemampuan komunikasi dan kerjasama tim dalam pelaksanaan IPE. Metode pada studi ini adalah tinjauan literatur, dengan 19 artikel yang memenuhi kriteria inklusi. Berdasarkan kajian terhadap beberapa literatur, didapatkan bahwa pelaksanaan IPE dapat meningkatkan kemampuan komunikasi dan kerjasama tim.
Polyphenol in olive oil: A promising adjuvant therapeutic agent in wound healing management and wound complication prevention
Auddrey Sindhutomo, Gede Wara Samsarga, Astrinita Lestari Suyata, Shita Diwyani SudarsaOnline First: Apr 30, 2023
- Abstract
Polyphenol in olive oil: A promising adjuvant therapeutic agent in wound healing management and wound complication prevention
Wound is one of the most common findings in medical problems. Tissue repairment would return tissue integrity normally in morphology and function, but in certain cases, tissue repairment could be disrupted or uncontrolled. Disrupted tissue repair by infection agents, inadequate treatment, or other risk factors would lead to complications such as ulcers, gangrene, tissue death, or hypertrophic scar. These complications could lead to physical, mental, social, aesthetic, and financial burdens. Olive oil is a substance extracted from whole olive fruits widely used in the culinary world. Olive oil in skin treatment has been used since ancient times, and current research has developed in olive oil as an adjuvant treatment. Several researches have resulted in a positive result for olive oil as a promising agent for wound treatment to emulate tissue regeneration and prevent wound complications. According to several studies, flavonoids, oleuropein, phenolic acids, phenolic alcohols, lignans, and other compounds contribute as antioxidant and anti-inflammatory compounds. Certain substances in olive oil contribute as a cell protector, antimicrobial, and anticarcinogenic, which are important aspects of wound management, tissue recovery and complication prevention. These substances are found in eliminating oxidative species, lowering inflammatory responses, and inducing protein synthesis in tissue regeneration.
Candida auris as a pathogen that can cause emerging infectious disease: a literature review
Ni Nyoman Nami Arthisari, Ni Nyoman Sri Budayanti, Ni Made Adi TariniOnline First: Apr 21, 2023
- Abstract
Candida auris as a pathogen that can cause emerging infectious disease: a literature review
Candida auris is a fungal pathogen that can cause emerging infectious disease and infections related to health services (healthcare-associated infections) and threaten global health. It is one of the causes of candidemia, which has been connected to outbreaks and high mortality rates in medical facilities all over the world. Hospitalized patients who are critically ill, primarily in intensive care unit settings, account for the majority of reported infections. C. auris can be multi-resistant to various antifungal classes commonly used to treat other Candida infections. Invasive infection due to C. auris causes high mortality and morbidity rates. C. auris easily survives long enough in the surrounding environment to cause the rapid spread of outbreaks in health facilities. The critical need for novel, candidate antifungal medicines for C. auris therapies is driven by the pathogenicity, drug resistance, and widespread distribution of C. auris. In limiting the spread of C. auris, prompt investigations and aggressive interventions are required. These include alerting public health agencies, implementing contact precautions, thoroughly cleaning and disinfecting the environment, performing infection control assessments, tracing and screening contacts for colonization, reviewing the history of microbiology tests, and conducting prospective surveillance for cases at labs. C. auris poses a unique challenge in clinical settings due to its identification challenges, multidrug resistance traits, evolution of virulence factors, associated high patient fatality rates, and long-term survival on surfaces in the environment. This study aims to understand the epidemiology, clinical manifestations, characteristics, virulence factors, methods of identification, therapy and prevention control of infection by C. auris.
Peranan klinis Measurable Residual Disease (MRD) sebagai faktor prognostik dan optimalisasi terapi pada Leukemia Myeloid Akut (LMA): sebuah tinjauan pustaka
Sandra LisaOnline First: Apr 30, 2023
- Abstract
Peranan klinis Measurable Residual Disease (MRD) sebagai faktor prognostik dan optimalisasi terapi pada Leukemia Myeloid Akut (LMA): sebuah tinjauan pustaka
Background: Acute Myeloid Leukemia (AML) is the most common type of blood cancer and accounts for 80% of cases in the adult population. The condition of relapse in AML occurs due to residual cells in the spinal cord after chemotherapy, defined as Measurable Residual Disease (MRD). This literature review aims to determine the clinical role of MRD as a prognostic factor and optimization of therapy in AML.
Methods: This literature review was carried out by searching studies on online databases in the form of PubMed, Cochrane library, and Google Scholar using the keywords "acute myeloid leukemia", "measurable residual disease", "prognostic", "clinical outcome", and "clinical implication". Appropriate studies then carried out a narrative synthesis analysis.
Results: There are some MRD examination methods, including karyotyping, fluorescence in situ hybridization (FISH), multiparameter flow cytometry (MFC), reverse transcription-quantitative Polymerase Chain Reaction (RT-qPCR), and Next-Generation Sequencing (NGS). Positive MRD status is associated with higher recurrence rates and lower overall survival and disease-free survival than LMA patients with negative MRD status.
Conclusion: Measurable Residual Disease (MRD) is an examination that has a significant relationship with the clinical outcome of ALM patients and has therapeutic implications for the determination of consolidation therapy in the form of hematopoietic stem cell transplantation.
Latar Belakang: Leukemia Myeloid Akut (LMA) merupakan jenis kanker darah yang paling umum ditemui dan menyumbang sebanyak 80% kasus pada populasi dewasa. Kondisi relapse pada LMA terjadi akibat adanya sisa sel pada sumsum tulang belakang pasca kemoterapi yang didefinisikan sebagai Measurable Residual Disease (MRD). Tinjauan pustaka ini bertujuan untuk mengetahui peranan klinis MRD sebagai faktor prognostik dan optimalisasi terapi pada LMA.
Metode: Tinjauan pustaka ini dilakukan dengan pencarian studi pada basis data online berupa PubMed, Cochrane library, dan Google Scholar dengan menggunakan kata kunci “acute myeloid leukemia”, “measurable residual disease”, “prognostic”, “clinical outcome”, dan “clinical implication”. Studi yang sesuai kemudian dilakukan analisis sintesis secara naratif.
Hasil: Terdapat sejumlah metode pemeriksaan MRD diantaranya kariotiping, fluorescence in situ hybridization (FISH), multiparameter flow cytometry (MFC), reverse transcription-quantitative polymerase chain reaction (RT-qPCR), dan next generation sequencing (NGS). Status MRD positif diketahui berhubungan dengan angka kekambuhan yang tinggi dan kesintasan keseluruhan serta kelangsungan hidup bebas penyakit yang lebih rendah dibandingkan pasien LMA dengan status MRD negatif.
Simpulan: Measurable Residual Disease (MRD) merupakan pemeriksaan yang memiliki hubungan signifikan dengan luaran klinis pasien LMA dan memiliki implikasi terapeutik untuk penentuan dilakukannya terapi konsolidasi berupa transplantasi sel punca hematopoietik.
Hubungan antara durasi tidur dengan kejadian obesitas pada anak: sebuah tinjauan sistematis
Peter Prayogo Hsieh, Florencia Christina Sindhu, Made Ratna Dewi, I Gusti Lanang SidhiartaOnline First: Mar 13, 2023
- Abstract
Hubungan antara durasi tidur dengan kejadian obesitas pada anak: sebuah tinjauan sistematis
Background: Obesity in children is a serious health problem with a rapidly increasing global prevalence. Children with obesity are at high risk of developing several metabolic diseases as adults. Studies show that short sleep duration is a risk factor for obesity. Short sleep duration will affect the diurnal rhythm and disrupt homeostasis and energy metabolism. This systematic review aims to determine the relationship between sleep duration and obesity in children.
Methods: A systematic literature review was carried out by literature searching on PubMed and Google Scholar using the PRISMA diagram and based on the eligibility criteria in selecting literature. The study was limited to the last five years (2017-2021). Studies that met the criteria were included in the analysis.
Results: There were 17 studies included in the analysis with cross sectional studies, prospective cohorts and clinical trials study designs regarding the relationship between sleep duration and obesity in children. All studies show a strong association between sleep duration and obesity in children and adolescents. The underlying mechanism is short sleep duration affects the balance of hormones controlling hunger and appetite so that appetite increases and causes excess energy intake, resulting in obesity. Children with short sleep duration are 2-4 times more prone to obesity compared to children with normal sleep duration.
Conclusion: There is a significant relationship between sleep duration and obesity in children and adolescents. Adequate sleep duration is recommended to prevent obesity and the risk of metabolic and cardiovascular diseases.
Comparison of mortality and severity in Coronavirus disease 2019 (COVID-19) patient with and without diabetes mellitus: a systematic review
Christian PoerniawanOnline First: Jan 7, 2023
- Abstract
Comparison of mortality and severity in Coronavirus disease 2019 (COVID-19) patient with and without diabetes mellitus: a systematic review
Background. Coronavirus disease-19 (COVID-19) has been a global pandemic since it was first discovered in Wuhan, China, on December 2019. Several studies found that comorbidity in COVID-19 patients, such as diabetes mellitus is a risk factor for mortality and more severe infection in COVID-19 patients. This systematic review aims to review the comparison of mortality and severity in COVID-19 patients with and without DM.
Method. This systematic review was performed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) diagram Google Scholar, PubMed, and Europe PMC as electronic database sources. We used a checklist from Joanna Briggs Institute for cross sectional, cohort, and case-control studies for quality assessment.
Result. We included 24 studies in this systematic review, consisting of 19 cohort studies, three cross sectional studies, and two case-control studies. All studies included were classified as good studies by study quality assessment. Most study samples are male patients with an average age of more than 50. All studies found a higher mortality rate and severe infection in COVID-19 patients in the DM group compared with the non-DM group. COVID-19 patients in the DM group have a 7.67 higher mortality risk compared with the non-DM group. While for the severity, COVID-19 patients in the DM group have a 6.07 greater risk for severe infection than the non-DM group.
Conclusion. There is a higher mortality rate and more severe infection in COVID-19 patients in the DM group compared with the non-DM group.
Pengaruh Asupan Air pada Diabetes Melitus Tipe 2: Tinjauan Pustaka
Handayani Eka Puspita Sari, Diana Sunardi, Krisadelfa SutantoOnline First: Apr 30, 2023
- Abstract
Pengaruh Asupan Air pada Diabetes Melitus Tipe 2: Tinjauan Pustaka
Introduction: Diabetes mellitus (DM) is a health problem that is increasing globally. In 2021, about 19,4 million people in Indonesia were living with DM. This number is predicted to rise to 28.5 million by 2045. The main modifiable risk factors for DM are diet and physical activity. One dietary factor that has not been comprehensively studied is water intake.
Objective: This review aims to demonstrate the effect of water intake to type 2 DM.
Methods: The design used in this study is a literature review. The literature review was done using the PubMed Central® search engine.
Results: Hormone arginine vasopressin (AVP) only known as hormone which play a role in maintaining fluid balance and not linked in glucose metabolism, previously. Through copeptin as a surrogate marker, AVP levels in plasma can be known. When water intake is insufficient to maintain plasma osmolality, AVP will be released. Several researches show unusual role of AVP in glucose metabolism. Increased AVP will stimulate AVP receptors, thereby increasing glycogenolysis and gluconeogenesis and decreasing insulin sensitivity. Increased copeptin is linked to an increased risk of insulin resistance, DM, and metabolic syndrome. By giving more water to individuals with low water drinking habits, as seen from high plasma copeptin values, has proven effective in reducing copeptin and plasma glucose.
Conclusion: Low water intake may increase risk factor for the development of type 2 DM. Individual needs to comply water intake recommendation to reduce the risk of type 2 DM.
Pendahuluan: Diabetes melitus (DM) merupakan permasalahan kesehatan yang semakin meningkat di dunia. Penderita DM di Indonesia pada tahun 2021 mencapai 19,4 juta jiwa dan diperkirakan akan terus meningkat mencapai 28,5 juta jiwa pada tahun 2045. Faktor risiko utama yang dapat dimodifikasi pada penyakit DM adalah diet dan aktivitas fisik. Satu faktor diet yang belum dipelajari secara komprehensif adalah asupan air putih.
Tujuan: Tinjauan ini bertujuan untuk memberikan ulasan pengaruh asupan air putih terhadap DM tipe 2.
Metode: Metode penelitian yang digunakan adalah tinjauan pustaka. Tinjauan literatur dilakukan dengan menggunakan mesin pencari PubMed Central®.
Hasil: Sebelumnya, hormon arginin vasopresin (AVP) diketahui hanya berperan dalam menjaga keseimbangan cairan dalam tubuh dan tidak terkait dengan metabolisme glukosa. Kadar AVP dapat diketahui melalui kopeptin dalam plasma sebagai penanda pengganti AVP. Ketika asupan air putih tidak cukup untuk mempertahankan osmolalitas plasma, AVP akan dilepaskan. Beberapa penelitian menunjukkan ternyata terdapat peran yang tidak biasa dari AVP dalam metabolisme glukosa. Peningkatan AVP akan menstimulasi reseptor-reseptor AVP sehingga meningkatkan glikogenolisis dan glukoneogenesis serta penurunan sensitivitas insulin. Peningkatan kopeptin berkaitan dengan peningkatan risiko resistensi insulin, diabetes, dan sindrom metabolik. Dengan intervensi pemberian air putih pada individu yang memiliki kebiasaan minum air putih rendah, yang terlihat dari kopeptin plasma yang tinggi, terbukti efektif dalam menurunkan kopeptin dan glukosa plasma.
Kesimpulan: Asupan air yang rendah dapat meningkatkan risiko terjadinya DM tipe 2. Individu perlu mematuhi rekomendasi asupan air putih agar mengurangi risiko DM tipe 2.
Comparison of rotational and orbital atherectomy: A systematic review of efficacy and safety in patients who underwent percutaneous coronary intervention
Saraswati Putri Yogita, I Gede Sumantra, Pintoko TedjokusumoOnline First: Apr 28, 2023
- Abstract
Comparison of rotational and orbital atherectomy: A systematic review of efficacy and safety in patients who underwent percutaneous coronary intervention
Background: To assess the clinical results of CAD patients who underwent orbital atherectomy (OA) and rotational atherectomy (RA).
Methods: PICO criteria for publication in the last 5 years and preferred reporting elements for systematic reviews and meta-analyses (PRISMA) were used to systematically choose publications. Boolean operators were used to search for keywords. The effectiveness of each chosen article was evaluated using the STROBE checklist.
Results: Five articles of non-randomized observational analysis were selected, which involved 72.982 patients whom underwent RA, while 6.431 others underwent OA which is a new atherectomy method that was approved for use in coronary arteries in 2003. Although some studies still showed varying results due to different data collection tools, overall data showed there was no difference between the two techniques in terms of contrast volume, outcomes of coronary artery dissection, periprocedural myocardial infarction (MI), arterial perforation caused by device, cardiac tamponade, in-hospital mortality, slow flow/no reflow, 30-day of mortality, target vessel revascularization (TVR), MI and major adverse cardiovascular events (MACE). The burr size and rotational speed for RA may lead to complication rates.
Conclusion: Except for a shorter fluoroscopy time with OA, there are no discernible differences between OA and RA in patients with calcified CAD undergoing PCI.
Diagnosis dan tatalaksana massa di mediastinum anterior
Ni Made Ayu Damayanti, Merlynda Ayu Rara DiniOnline First: Apr 4, 2023
- Abstract
Diagnosis dan tatalaksana massa di mediastinum anterior
The mediastinum is an anatomical space between the lungs that houses the thymus, heart, great vessels, lymph nodes, nerves, and parts of the esophagus and trachea. One of the biggest problems of the mediastinal cavity is mediastinal tumors. Mediastinal tumors have a wide variety of clinical conditions. Difficulties in diagnosing masses in the anterior mediastinal caused by non-specific symptoms and various etiologies can make it difficult to determine the best management for patients. Some masses in the anterior mediastinum that need to be known are thymoma, lipoma, lymphangioma, carcinoma and adenoma. This article aims to describe the various etiologies of masses in the anterior mediastinum along with the management that can be done so that clinicians can provide better treatment.
Mediastinum merupakan sebuah ruang anatomi antara paru-paru yang menampung timus, jantung, pembuluh darah besar, kelenjar getah bening, saraf, dan bagian kerongkongan dan trakea. Salah satu masalah terbesar dari rongga mediastinum yaitu tumor mediastinum. Tumor mediastinum memiliki keragaman yang luas dari kondisi klinis penyakit. Kesulitan dalam mendiagnosis massa pada mediastinal anterior disebabkan oleh gejala yang tidak spesifik dan etiologi yang beragam dapat menjadi penyulit dalam menentukan tatalaksana terbaik bagi pasien. Beberapa massa di mediastinum anterior yang perlu diketahui ialah timoma, lipoma, limfangioma karsinoma dan adenoma. Artikel ini bertujuan untuk memaparkan berbagai etiologi dari massa di mediastinum anterior disertai tatalaksana yang dapat dilakukan sehingga klinisi dapat memberikan penanganan yang lebih baik.
The role of Botulinum toxin type A for prevention and treatment of cleft lip palate (CLP) post-operative scar: a systematic review
Priska Yunita BachtiarOnline First: Apr 28, 2023
- Abstract
The role of Botulinum toxin type A for prevention and treatment of cleft lip palate (CLP) post-operative scar: a systematic review
Background. Cleft lip palate (CLP) defects are the common orofacial defects found in newborns. The main treatment is lip and palate surgery, often resulting in a hypertrophic scar that significantly affects the patient's aesthetic appearance. Several studies showed the role of Botulinum toxin type A injections for prevention and treatment of CLP post-operative scarThis systematic review aims to review the role of Botulinum toxin type A for prevention and treatment of cleft lip palate surgery scar.
Method. Online databases were searched for relevant studies from Google Scholar, PubMed and ProQuest. Data sources were searched using MeSH terms "botulinum toxin," "cleft lip palate," and "surgery scar" for all publications up to October 2022. All English papers regarding the role of Botulinum toxin type A in preventing and treating CLP post-operative scar were included. Papers not available in full text or English and not an experimental study were excluded.
Result. Six studies are included in this systematic review consisting of three randomized controlled trials and three clinical studies. The experimental group received Botulinum toxin type A injections, while the control group received an injection of normal saline or other topical treatment. All of the included studies showed positive results regarding the role of Botulinum toxin type A marked with reduced scar width, good Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), patient satisfaction and no complications or side effects were found.
Conclusion. The Botulinum toxin type A showed promising results for the prevention and treatment of CLP post-operative scar.
Karakteristik pasien diabetic retinopathy dengan dislipidemia di RSUP Sanglah Denpasar
Putu Andrea Wisnu Sebastian, Made Agus Kusumadjaja, I Gusti Ayu Made Juliari, I Gusti Ayu Ratna SuryaningrumOnline First: Jan 10, 2023
- Abstract
Karakteristik pasien diabetic retinopathy dengan dislipidemia di RSUP Sanglah Denpasar
Introduction: Diabetic retinopathy is diabetes mellitus complication which progressively causes microvascular changes in the retina, causing physical and psychosocial impact. According to WHO, diabetic retinopathy ranks fourth in causing blindness with fairly high incidence in Indonesia, namely 42%. There are several risk factors in increasing diabetic retinopathy incidence, one of which is dyslipidemia. Dyslipidemia is disorder body's metabolism of lipid fractions that can be at risk of causing cardiovascular disease. This study aims to determine characteristics dyslipidemia in patients with Diabetic Retinopathy at Sanglah Hospital.
Methods: This research is cross-sectional descriptive study using total sampling technique in taking research samples according inclusion and exclusion criteria. There were five research variables, namely age, sex, body mass index, diabetes duration, and lipid fraction levels.
Results: Diabetic Retinopathy patients with dyslipidemia had prevalence of 76.5% with PDR (64.7%) and mixed dyslipidemia (61.5%) found to be the most dominant. The highest frequency of age, sex, body mass index, and diabetes duration were 45 to 64 years (80.6%), female (92.3%), normoweight (38.5%), more than five years, respectively. years (53.8%).
Conclusion: The prevalence of diabetic retinopathy patients with dyslipidemia in period 2021-2022 is quite high with dominant variable characteristics found in form age 45 to 64 years, female sex, normoweight body mass index, and diabetes duration more than five years.
Pendahuluan: Diabetic retinopathy merupakan suatu komplikasi dari penyakit diabetes melitus yang secara progresif menyebabkan perubahan mikrovaskular di retina sehingga berdampak secara fisik dan psikososial. Menurut WHO, penyakit diabetic retinopathy menempati posisi empat dalam menyebabkan kebutaan dengan kejadian yang cukup tinggi di Indonesia yaitu 42%. Salah satu faktor risiko dalam meningkatkan kejadian penyakit diabetic retinopathy adalah dislipidemia. Dislipidemia merupakan suatu gangguan metabolisme tubuh terhadap fraksi lipid yang bisa berisiko menyebabkan penyakit kardiovaskular. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik dislipidemia pada penderita diabetic retinopathy di RSUP Sanglah.
Metode: Peneltian ini merupakan penelitian deskriptif potong lintang dengan menggunakan teknik total sampling dalam melakukan pengambilan sampel penelitian menyesuaikan kriteria inklusi dan eksklusi. Variabel penelitian berjumlah lima, yaitu umur, jenis kelamin, indeks massa tubuh, durasi diabetes, dan kadar fraksi lipid.
Hasil: Pasien diabetic retinopathy dengan dislipidemia memiliki prevalensi sebesar 76,5% dengan PDR (64,7%) serta dislipidemia campuran (61,5%) ditemukan paling dominan. Frekuensi terbesar pada umur, jenis kelamin, indeks massa tubuh, dan durasi diabetes secara berturut-turut adalah 45 sampai 64 tahun (80,6%), perempuan (92,3%), normoweight (38,5%), lebih dari lima tahun (53,8%).
Simpulan: Prevalensi pasien diabetic retinopathy dengan dislipidemia periode tahun 2021-2022 cukup tinggi dengan karakteristik variabel dominan yang ditemukan berupa umur 45 sampai 64 tahun, jenis kelamin perempuan, indeks massa tubuh normoweight, dan durasi diabetes lebih dari lima tahun.
Pengaruh perubahan zona waktu terhadap kualitas tidur pada mahasiswa internasional
Ayuni Putri Adhini, I Putu Gede Adiatmika, I Dewa Ayu Inten Dwi Primayanti, Luh Putu Ratna SundariOnline First: Apr 17, 2023
- Abstract
Pengaruh perubahan zona waktu terhadap kualitas tidur pada mahasiswa internasional
Background: Sleep is one of the basic needs needed by humans so that the body can function normally. Sleep quality and quantity can be affected by changes in time zones. When someone travels transmeridianly through longitudes and enters a new time zone, there will be flight dysrhythmias or jet lag. This can occur when there is an imbalance between the body's circadian structure and the day to night cycle in the destination area. This study aims to determine the effect of changing time zones on sleep quality in international students.
Methods: Non-experimental quantitative research using the cross-sectional correlational descriptive research method was conducted online for one month, from January to February 2023. The sample collection technique used was purposive sampling. Data was collected using the PSQI and LJLQ questionnaires. Research data were analyzed using SPSS version 25.0.
Results: Most of the subjects in this study were female (52.72%). As many as 91.8% of international students were found to have poor sleep quality. Meanwhile, 86.4% of international students experience jet lag, which is divided into moderate levels of jet lag (47.3%) and very high levels of jet lag (39.1%). Bivariate analysis showed that there was a significant correlation between jet lag and the sleep quality of international students (p=0.001).
Conclusion: Most international students are found to experience jet lag and have poor sleep quality. Changes in time zones assessed through the level of jet lag were found to have a significant effect on the quality of sleep for international students.
Latar belakang: Tidur merupakan salah satu kebutuhan pokok yang dibutuhkan oleh manusia agar tubuh dapat berfungsi dengan normal. Kualitas dan kuantitas tidur dapat dipengaruhi oleh perubahan zona waktu. Ketika seseorang melakukan perjalanan transmeridian melalui garis bujur dan masuk dalam zona waktu yang baru, maka akan terjadi disritmia penerbangan atau jet lag. Hal ini dapat terjadi ketika terjadi ketidakselarasan antara struktur sirkadian tubuh dengan siklus siang ke malam pada daerah tujuan. Penelitian ini bertujuan untuk mengetahui pengaruh perubahan zona waktu terhadap kualitas tidur pada mahasiswa internasional.
Metode: Penelitian kuantitatif non-eksperimental dengan metode penelitian deskriptif korelatif cross-sectional dilakukan secara dalam jaringan selama satu bulan pada bulan Januari–Februari 2023. Teknik pengumpulan sampel yang digunakan adalah purposive sampling. Data dikumpulkan menggunakan kuesioner PSQI dan LJLQ. Data hasil penelitian dianalisis menggunakan program SPSS ver. 25.0.
Hasil: Sebagian besar subjek dalam penelitian ini berjenis kelamin perempuan (52,72%). Sebanyak 91,8% mahasiswa internasional ditemukan memiliki kualitas tidur yang buruk. Sementara itu, sebanyak 86,4% mahasiswa internasional mengalami jet lag yang terbagi ke dalam tingkatan cukup jet lag (47,3%) dan sangat jet lag (39,1%). Analisis bivariat menunjukkan bahwa terdapat korelasi yang signifikan antara jet lag dengan kualitas tidur mahasiswa internasional (p=0,001).
Kesimpulan: Sebagian besar mahasiswa internasional ditemukan mengalami jet lag dan memiliki kualitas tidur yang buruk. Perubahan zona waktu yang dinilai melalui tingkat jet lag ditemukan berpengaruh secara signifikan terhadap kualitas tidur pada mahasiswa internasional.
Hubungan bayi berat lahir rendah dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya, Denpasar, Bali, Indonesia
Virly Isella, I Wayan Bikin Suryawan, Made Ratna DewiOnline First: Jan 7, 2023
- Abstract
Hubungan bayi berat lahir rendah dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya, Denpasar, Bali, Indonesia
Background: Infant mortality death is still high, 24 per 1,000 live births, and this is still far from the target of the Sustainable Development Goals (SDG) to decrease the infant mortality rate to 12 per 1,000 live births in 2030. One of the causes of the high burden of infant mortality rate is neonatal sepsis. There are some risk factors that contribute to neonatal sepsis, such as low birth weight and prematurity. The aim of this study was to determine if there were a correlation between low birth weight and prematurity with neonatal sepsis in Wangaya regional general hospital.
Methods: This was an observational analytic study with a cross-sectional design. All data were obtained from secondary data from medical records of patients that were hospitalized in neonatal intensive unit care and perinatology room in Wangaya regional general hospital from January until December 2019. The collected data will be analyzed by univariate and bivariate analysis with statistical Chi-Square at a 95% confidence interval.
Results: Total samples in this study were 50 neonates. The prevalence of neonatal sepsis in this study was 12 neonates (24%), with 6 neonates having early-onset neonatal sepsis (EOS) and 6 neonates having late-onset neonatal sepsis (LOS). Seventeen neonates (34%) were in the low birth weight category, and 15 neonates (30%) were premature. In bivariate analysis, we found that low birth weight had a p-value of 0.009, a prevalence ratio of 3.9, with a 95% CI of 1.36 – 11.07. Meanwhile, prematurity had a p-value of 0.003 with a prevalence ratio of 4.7, with a 95% CI of 1.66 – 13.16.
Conclusion: There was a correlation between low birth weight and prematurity with neonatal sepsis in Wangaya regional general hospital.
Latar Belakang: Angka kematian neonatus hingga saat ini masih cukup tinggi yaitu 24 per 1.000 kelahiran hidup dan belum mencapai target Sustainable Development Goals (SDG) yaitu menurunkan angka kematian neonatus menjadi 12 per 1.000 kelahiran hidup pada tahun 2030. Salah satu penyebab tingginya angka kematian neonatus adalah sepsis neonatorum. Terdapat beberapa faktor risiko yang menyebabkan sepsis neonatorum, antara lain bayi berat lahir rendah (BBLR) dan prematuritas. Tujuan penelitian ini adalah untuk mengetahui hubungan antara BBLR dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross-sectional. Data penelitian diambil dari data sekunder, berupa rekam medis pasien yang dirawat di ruangan Perina dan Neonatal Intensive Care Unit (NICU) RSUD Wangaya pada periode Januari – Desember 2019. Data yang berhasil dikumpulkan akan dilakukan analisis bivariat menggunakan uji statistik Chi-Square pada interval kepercayaan (IK) 95%.
Hasil: Total sampel pada penelitian ini sebanyak 50 neonatus. Prevalensi sepsis neonatorum pada penelitian ini sebanyak 12 bayi (24%), dengan rincian 6 bayi (50%) menderita sepsis neonatal awitan dini (SNAD) dan sisanya 6 bayi (50%) menderita sepsis neonatal awitan lambat (SNAL). Jumlah bayi BBLR sebanyak 17 bayi (34%) dan prematur sebanyak 15 bayi (30%). Hasil analisis bivariat didapatkan faktor BBLR memiliki p-value 0,009; rasio prevalens (RP) 3,9 dengan 95% IK 1,36 – 11,07, sedangkan faktor prematuritas memiliki p-value 0,003; RP 4,7 dengan 95% IK 1,66 – 13,16.
Simpulan: Terdapat hubungan antara BBLR dan prematuritas dengan sepsis neonatorum di RSUD Wangaya.
Hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung tahun 2022
Anak Agung Ayu Ratih Andira Putri, Yukhi Kurniawan, I Gusti Ngurah Pramesemara, I Nyoman Mangku KarmayaOnline First: Jan 11, 2023
- Abstract
Hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung tahun 2022
Introduction: Andropause is a collection of clinical symptoms due to a decrease in testosterone levels below normal limits. Androgenic alopecia is baldness caused by the susceptibility of the follicles to androgen hormones. The aims of study is determining the relationship between androgenic alopecia and andropause in civil servants at the Badung Regency Government Center.
Methods: The study design is cross-sectional with descriptive analytic. ADAM questionnaire is used to assessed andropause. Meanwhile, Norwood-Hamilton baldness scale is used to assessed androgenic alopecia.
Results: Respondents in this study amounted to 40 people. A total of 27 (67.5%) positive andropause respondents and 13 respondents (33.5%) negative andropause. Meanwhile, 21 respondents (52.1%) were positive for androgenic alopecia and 19 respondents (47.5%) were negative for androgenic alopecia. There was a significant relationship (p<0.001) between andropause and androgenic alopecia. The odd ratio value (OR 95%CI) between andropause and androgenic alopecia is 34.3 (3.726-313.837).
Conclusion: Andropause has a significant relationship to androgenic alopecia of civil servants at the Badung Regency Government Center.
Pendahuluan: Andropause adalah kumpulan gejala klinis akibat kadar testosteron yang menurun di bawah batas normal. Alopesia androgenik adalah kebotakan yang disebabkan kerentanan folikel terhadap hormon androgen. Tujuan penelitian adalah menganalisis hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.
Metode: Rancangan penelitian adalah cross-sectional dengan deskriptif analitik. Kuesioner ADAM digunakan untuk menilai andropause dinilai. Sedangkan, alopesia androgenik dinilai dengan menggunakan skala kebotakan Norwood-Hamilton.
Hasil: Responden dalam penelitian ini berjumlah 40 orang. Sebanyak 27 (67,5%) responden positif andropause dan 13 responden (33,5%) negatif andropause. Sementara itu, 21 responden (52,1%) positif alopesia androgenik dan 19 responden (47,5%) negatif alopesia androgenik. Terdapat hubungan yang signifikan (p<0,001) antara andropause dan alopesia androgenik. Adapun nilai odd ratio (OR 95%CI) antara andropause dan alopesia androgenik adalah 34,3 (3,726-313,837).
Simpulan: Andropause memiliki hubungan signifikan terhadap alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.
Efektifitas penggunaan bubuk biji buah papaya (Carica papaya L) sebagai larvasida jentik nyamuk Aedes aegypti
I Gusti Ngurah Rama Tirta Tamba, I Made Sudarmaja, I Kadek Swastika, Ni Luh Putu Eka DiarthiniOnline First: Apr 30, 2023
- Abstract
Efektifitas penggunaan bubuk biji buah papaya (Carica papaya L) sebagai larvasida jentik nyamuk Aedes aegypti
Background: Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the dengue virus that is spread through the bite of the Aedes aegypti. One way in suppressing the hench population is still using larvicides, such as temephos (abate). Compounds such as the alkaloids carpaine, saponin, tannin, and papain found in papaya seeds have toxic properties against the larvae of the Aedes aegypti. This study aimed to find out the effectiveness of the powder of papaya seeds (Carica papaya) as a natural larvicide of the Aedes aegypti.
Methods: The in vitro study used a randomized post-test-only control group design method that used a mosquito larva of Aedes aegypti given four doses of papaya seed powder: 200 mg/200 ml, 300 mg/200 mL, 500 mg/200 mg, and the control group. All data was analyzed statistically using SPSS. 20.
Results: The percentage of larva mortality in the control group was 0%, the 200mg treatment group was 17%; the 300mg treatment group was 27%; and the 500mg treatments group was 60%. Based on bivariate analysis, there were significant differences between the trial groups (p<0,05), except between the 200 mg and 300 mg groups. The results showed that the larger the dose given, the greater the percentage of death in mosquito larvae.
Conclusion: Papaya seed powder as a natural larvicide effectively kills the Aedes aegypti in vitro. The 500mg group has the highest percentage of larva mortality.
Latar Belakang: Demam Berdarah Dengue (DBD) merupakan penyakit infeksi yang disebabkan oleh virus dengue yang disebarkan melalui gigitan nyamuk Aedes aegypti. Salah satu cara dalam menekan populasi jentik masih menggunakan larvasida, seperti temephos (abate). Senyawa seperti alkaloid karpaina, saponin, tannin, dan papain yang terdapat pada biji pepaya memiliki sifat toksik terhadap larva nyamuk Aedes aegypti. Penelitian ini bertujuan untuk mengetahui efektivitas dari bubuk biji buah pepaya (Carica papaya L) sebagai larvasida alami jentik nyamuk Aedes aegypti.
Metode: Penelitian in vitro ini menggunakan metode randomized post-test only control group design yang menggunakan larva nyamuk Aedes aegypti yang diberikan empat dosis bubuk biji pepaya yaitu 200 mg/200 mL, 300 mg/200 mL, 500 mg/200 mL, dan kelompok kontrol. Seluruh data dianalisis secara statistik menggunakan SPSS ver. 20.
Hasil: Didapatkan persentase kematian larva pada kelompok kontrol sebesar 0%, kelompok perlakuan 200mg sebesar 17%; kelompok perlakuan 300mg sebesar 27%; dan kelompok perlakuan 500mg sebesar 60%. Berdasarkan analisis bivariat, terdapat perbedaan yang signifikan antar kelompok uji (p<0,05), kecuali antara kelompok 200 mg dan 300 mg. Hasil tersebut menunjukkan bahwa semakin besar dosis yang diberikan, maka semakin besar persentase kematian pada larva nyamuk.
Kesimpulan: Bubuk biji buah pepaya sebagai larvasida alami efektif mematikan jentik nyamuk Aedes aegypti secara in vitro. Kelompok 500mg memiliki persentase kematian larva tertinggi.
Asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan di RSUD Wangaya Kota Denpasar
Han's Christian, Ancelia Limantara, Wayan Bikin Suryawan, I Kadek SuarcaOnline First: Mar 3, 2023
- Abstract
Asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan di RSUD Wangaya Kota Denpasar
Background: Febrile seizures are one of the most common neurological disorders during childhood. Febrile seizures' prevalence is about 2% to 5%. Electrolyte disturbance, especially hyponatremia, has been thought to be one of the factors for enhanced susceptibility to febrile seizures. This study aims to know the association between hyponatremia with febrile seizures in children ages 6 months to 60 months.
Methods: An analytical observational case-control study using medical records at Wangaya Hospital during the period between January 2020-January 2022. Inclusion criteria include patients aged 6 months to 60 months diagnosed with febrile seizure and natrium serum level measured during hospitalization. Exclusion criteria include patients who got fever after vaccination, brain defect, vascular malformation, tumors and acid and base disorder during hospitalization.
Results: Among 100 subjects, 63% were males, and 37% were females. The mean natrium level in the group of febrile seizures was 136.760 ± 5.326 mEq/L, and 136.500 ± 4.362 mEq/L in the group of fever without seizures, with an Independent t-test, showed a P-value of 0.788. No significant differences were found between hyponatremia and seizures, with the Mann-Whitney test, which showed a P-value of 0.678.
Conclusion: No significant differences were found between natrium serum level and febrile seizures. The mean natrium serum level between the febrile seizures group and the fever without seizures group showed no significant differences.
Latar Belakang: Kejang demam merupakan salah satu kelainan neurologis yang paling sering dijumpai pada anak. Prevalensi kejang demam berkisar antara 2% hingga 5%. Ketidakseimbangan elektrolit, terutama hiponatremia, bisa menjadi salah satu faktor penyebab kejang demam. Tujuan penelitian adalah mengetahui asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan.
Metode: Penelitian ini merupakan penelitian analitik observasional dengan rancangan penelitian kasus kontrol, menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi: anak berusia 6 bulan hingga 60 bulan dengan kejang demam, dan dilakukan pemeriksaan kadar natrium selama perawatan. Kriteria eksklusi: anak yang mengalami kejang setelah dilakukan vaksinasi, memiliki defek otak, malformasi vaskular, memiliki tumor, dan memiliki kelainan pH darah saat dilakukan pemeriksaan.
Hasil: Dari 100 subjek penelitian, 63% berjenis kelamin laki-laki, 37% perempuan. Rerata kadar natrium serum pada kelompok kejang demam sebesar 136,760 ± 5,326 mEq/L dan sebesar 136,500 ± 4,362 mEq/L pada kelompok demam tanpa kejang, dengan uji nilai P 0,788 menggunakan independent t-test. Tidak terdapat hubungan antara kadar natrium dengan kejadian kejang, dengan uji nilai P sebesar 0,678 menggunakan uji Mann-Whitney dan odd ratio 1,190
Kesimpulan: Tidak ada hubungan yang signifikan antara kadar natrium dengan kejang demam. Rerata kadar natrium baik pada kelompok kejang demam dan demam tanpa kejang menunjukkan perbedaan yang tidak bermakna.
Hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal di kota Banda Aceh, Indonesia
Safrizal Rahman, Alya Kurnila Ramazani, Darma Satria, Azharuddin, Liza SalawatiOnline First: Jan 16, 2023
- Abstract
Hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal di kota Banda Aceh, Indonesia
Introduction: The prevalence of musculoskeletal trauma in Indonesia is increasing. Complications that occur due to mishandling are often found in health facilities. The development of medical health facilities has not made people switch from traditional medicine as an alternative treatment for musculoskeletal trauma that has been passed down for generations. Education and attitude can be factors in considering risks in choosing the right treatment. The purpose of this study was to determine the relationship between education level and attitude towards musculoskeletal trauma treatment options.
Method: This research method is an observational analytic with a cross-sectional design. The research subjects were residents of Banda Aceh City was as many as 200 respondents who were carried out in eleven public health centers representing nine sub-districts in Banda Aceh City.
Result: The results of this study indicate that 108 (54.0%) respondents chose traditional medicine while 92 (46.0%) other respondents chose medical treatment as a solution for treating musculoskeletal trauma. Respondents with secondary education chose traditional medicine by 62.7%, while respondents with higher education chose traditional medicine by 42.9%. Respondents with a sufficient attitude chose traditional medicine by 95.6%, while respondents with a good attitude chose traditional medicine by 31.4%. Based on the results of the Spearman rho test, it showed that there was a relationship between educational level (p=0.039) and attitude (p=0.000) towards the choice of musculoskeletal trauma treatment.
Conclusion: Various promotive efforts and health education, especially musculoskeletal trauma, need to be continuously carried out by both health workers and policy makers to improve people's attitudes in choosing the right treatment and reducing the number of complications due to mishandling of musculoskeletal trauma in Banda Aceh City.
Pendahuluan: Prevalensi trauma muskuloskeletal di Indonesia semakin meningkat. Komplikasi yang terjadi akibat kesalahan penanganan banyak ditemukan di fasilitas kesehatan. Berkembangnya fasilitas kesehatan medis tidak membuat masyarakat beralih dari pengobatan tradisional sebagai alternatif pengobatan trauma muskuloskeletal yang sudah turun temurun. Pendidikan dan sikap dapat menjadi faktor dalam mempertimbangkan risiko dalam memilih pengobatan yang tepat. Tujuan dari penelitian ini adalah untuk mengetahui hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal.
Metode: Metode penelitian ini berupa analitik observasional dengan desain cross-sectional. Subjek penelitian adalah penduduk Kota Banda Aceh sebanyak 200 responden yang dilaksanakan pada sebelas puskesmas yang mewakili sembilan kecamatan di Kota Banda Aceh.
Hasil: Hasil penelitian ini menunjukkan bahwa 108 (54,0%) responden memilih pengobatan tradisional sedangkan 92 (46,0%) responden lainnya memilih pengobatan medis sebagai solusi untuk penanganan trauma muskuloskeletal. Responden dengan pendidikan menengah memilih pengobatan tradisional sebesar 62,7%, sedangkan responden dengan pendidikan tinggi memilih pengobatan tradisional sebesar 42,9%. Responden dengan sikap yang cukup memilih pengobatan tradisional sebesar 95,6%, sedangkan responden dengan sikap yang baik memilih pengobatan tradisional sebesar 31,4%. Berdasarkan hasil uji Spearmann rho menunjukkan bahwa terdapat hubungan antara tingkat pendidikan (p=0,039) dan sikap (p=0,000) terhadap pilihan pengobatan trauma muskuloskeletal.
Simpulan: Berbagai upaya promotif dan penyuluhan kesehatan khususnya trauma muskuloskeletal perlu terus dilakukan baik dari tenaga kesehatan maupun pemegang kebijakan untuk meningkatkan sikap masyarakat dalam memilih pengobatan yang tepat serta menekan angka komplikasi akibat kesalahan penanganan trauma muskuloskeletal di Kota Banda Aceh.
D-dimer correlation as a marker of coagulopathy with neuroimaging abnormalities on head CT scans of COVID-19 patients
Anak Agung Dewi Adnyani, Farhan AnwaryOnline First: Apr 30, 2023
- Abstract
D-dimer correlation as a marker of coagulopathy with neuroimaging abnormalities on head CT scans of COVID-19 patients
Background: COVID-19 is a coronavirus disease with the main symptoms in the respiratory tract which can cause hypoxia. The duration and severity of the hypoxia can lead to oxidative stress that can affect the brain. The phenomenon of thromboembolism was also found in the form of an increase in coagulopathy markers which can cause abnormalities in small blood vessels in various organs, including the brain.
Methods: We conducted a prospective crossectional study of 23 samples that met the inclusion criteria. Duration of hypoxia, degree of hypoxia based on oxygen saturation, and D-Dimer level as independent variables underwent Spearman correlation test with neuroimaging abnormalities on head CT scan.
Results: The sample population consisted of 14 men (60.90%) and 9 women (39.10%), with the highest age group being 61 – 80 years old (56.50%) who underwent a head CT scan without contrast administration. Eighteen samples were found to have brain infarction, while 5 samples were without abnormalities. The Spearman correlation test found a correlation (p=0.003) with moderate correlation (r=0.558) between the D-Dimer level as a coagulopathy marker and abnormal findings on the head CT scan of samples. Where 15 samples with high D-Dimer levels (D-Dimer values above the normal level) and 3 samples with normal D-Dimer levels were found to have brain infarction. Meanwhile, the duration and degree of hypoxia based on the oxygen saturation value did not show a significant correlation with neuroimaging abnormalities (p>0.05).
Conclusion: There was a moderate correlation between the D-Dimer value. No significant correlation was found between the duration of hypoxia and the degree of oxygen saturation toward neuroimaging abnormalities in COVID-19 patients.
Hubungan nilai APGAR dan sepsis neonatorum di RSUD Wangaya, Bali
Vidya Dewi Sutanto, Wayan Bikin Suryawan, I Gde Doddy Kurnia IndrawanOnline First: Apr 30, 2023
- Abstract
Hubungan nilai APGAR dan sepsis neonatorum di RSUD Wangaya, Bali
Backgrounds: Sepsis is one of the causes of neonatal death which is affected by many factors. One of them is asphyxia, a condition lack of oxygen supply that can occure before, during and after birth. The APGAR score is a fastest way to assess wether a newborn has asphyxia. For this reason, this study aims to determine the relationship between APGAR score and the incidence of neonatal sepsis.
Methods: A cross-sectional observational analytic study was conducted by collecting data from the medical records of patients who met the inclution and exclution criterias with consecutive sampling techniques. The research samples were neonates aged 0-28 days who were treated in the Perinatology and NICU rooms at Wangaya General Hospital Bali in January 2018 until March 2022. After the datas were collected, the datas were processed using SPSS software and bivariate analysis by using the chi-square test. Confounder varibles will be controlled by design and by analysis.
Result: From 114 neonates that treated in January 2018 until March 2022, there are 52 (45,6%) of them experienced neonatal sepsis. Factors that have a corellation with the incidendences of neonatal sepsis are the 1st minute APGAR value (P = 0,000) and the 5th minute APGAR value (P= 0,000).
Conclusion: Neonates with APGAR scores < 7 are twice at risk of suffering from neonatal sepsis compared to babies with APGAR values 7 at 1 and 5 minutes.
Latar belakang: Sepsis merupakan salah satu penyebab kematian neonatus yang dipengaruhi banyak faktor. Salah satunya adalah asfiksia, kondisi kekurangan asupan oksigen yang dapat terjadi sebelum, sesaat dan setelah bayi lahir. Nilai APGAR merupakan salah satu cara cepat untuk menilai apakah bayi baru lahir mengalami asfiksia. Untuk itu penelitian ini bertujuan mengetahui hubungan nilai APGAR dengan kejadian sepsis neonatorum.
Metode: Penelitian analitik observasional potong lintang dilakukan dengan mengambil data rekam medis pasien yang memenuhi kriteria inklusi dan eksklusi dengan teknik consecutive sampling sampel. Sampel penelitian adalah neonatus berusia 0-28 hari yang dirawat diruang Perinatologi dan NICU RSUD Wangaya, Denpasar pada bulan Januari 2018 – Maret 2022. Setelah terkumpul, data diolah menggunakan software SPSS dan dianalisa secara bivariat menggunakan uji Chi-square. Variabel perancu akan dikendalikan by design dan by analysis.
Hasil: Dari 114 neonatus yang dirawat pada bulan Januari 2018 – Marat 2022, 52 (45,6%) bayi diantaranya mengalami sepsis neonatorum. Faktor yang memiliki hubungan dengan kejadian sepsis neonatorum adalah nilai APGAR menit ke 1 (P = 0,000) dan nilai APGAR menit ke 5 (P = 0,000).
Kesimpulan: Bayi dengan nilai APGAR < 7 beresiko > 2 kali menderita sepsis neonatorum dibanding bayi dengan nilai APGAR ≥ 7 pada menit ke 1 dan ke 5.
Karakteristik penderita deviasi septum di RSUP Sanglah Denpasar periode Januari 2019 – Desember 2020
Michael Alexander Dhira Damanik, Luh Made RatnawatiOnline First: Apr 30, 2023
- Abstract
Karakteristik penderita deviasi septum di RSUP Sanglah Denpasar periode Januari 2019 – Desember 2020
Background: Septal deviation is an anatomical abnormality that occurs in the nasal septum and can affect the physiological function of the nose. Septal deviation can be caused by genetic disorders, trauma, infections, and tumors. Nasal septum abnormalities that occur frequently and complaints that often arise in sufferers, make researchers feel the need to conduct research on the characteristics of patients with septal deviation found in Sanglah General Hospital, Denpasar.
Methods: This study used a retrospective descriptive method by taking secondary data from the patient's medical records. The characteristics assessed in this study were gender, age, occupation, main complaint, and type of septal deviation based on Mladina's classification. The study was conducted at the ENT-HNS clinic at Sanglah Hospital, Denpasar from January 2019 - December 2020 with total sample are 200 patients. The data obtained is then displayed in tabular form. Data were analyzed using the SPSS version 25.0 for Windows.
Results: Based on gender, the highest total number of patients with septal deviation was in the male sex with 127 people (63.5%) with the highest average age of 25-44 years with 87 people (43.5%) and employees was the highest number diagnosed with septal deviation with 66 people (33.0%). Based on the most frequent main complaints, nasal congestion is the highest with 100 people (50.0%). The most common type of septal deviation in this study was type 2 in 98 people (49.0%).
Conclusion: There are many septal deviations in patients with male sex with an average age of 25-44 years with the most common type of work being employees. The main complaint found in the patients with septal deviation studied was nasal congestion with the most common type of septal deviation according to the Mladina classification, namely type 2.
Latar Belakang: Deviasi septum merupakan kelainan anatomi yang terjadi septum nasi dan cukup banyak terjadi yang dapat mempengaruhi fungsi fisiologis dari hidung. Deviasi septum dapat disebabkan oleh kelainan genetik, trauma, infeksi, dan tumor. Kelainan sekat hidung yang banyak terjadi dan keluhan yang sering muncul pada penderitanya, membuat peneliti merasa perlu untuk membuat penelitian mengenai karakteristik penderita-penderita deviasi septum yang terdapat di RSUP Sanglah Denpasar.
Metode: Penelitian ini menggunakan metode deskriptif retrospektif dengan mengambil data sekunder dari catatan medis pasien. Karakteristik yang dinilai pada penelitian ini yakni jenis kelamin, usia, pekerjaan, keluhan utama, dan tipe deviasi septum berdasarkan klasifikasi Mladina. Penelitian dilakukan di poliklinik THT-KL RSUP Sanglah, Denpasar dari bulan Januari 2019 – Desember 2020 dengan jumlah sampel sebanyak 200 pasien. Data yang didapatkan kemudian ditampilkan dalam bentuk tabel. Data dianalisis dengan SPSS versi 25.0 untuk Windows.
Hasil: Berdasarkan jenis kelamin, total penderita deviasi septum terbanyak yakni pada jenis kelamin laki-laki sejumlah 127 orang (63,5%) dengan usia rata-rata terbanyak yakni 25-44 tahun sejumlah 87 orang (43,5%) dan pekerjaan pegawai merupakan jumlah terbanyak terdiagnosa deviasi septum sejumlah 66 orang (33,0%). Berdasarkan keluhan utama yang paling banyak muncul, keluhan hidung tersumbat merupakan yang tertinggi sejumlah 100 orang (50,0%). Tipe deviasi septum terbanyak pada penelitian ini yakni tipe 2 sejumlah 98 orang (49,0%).
Kesimpulan: Deviasi septum terdapat banyak pada penderita dengan jenis kelamin laki-laki dengan rentan usia rata-rata 25-44 tahun dengan jenis pekerjaan yang paling banyak didapati adalah pegawai. Keluhan utama yang banyak didapatkan pada penderita deviasi septum yang diteliti yakni hidung tersumbat dengan tipe deviasi septum menurut klasifikasi Mladina terbanyak yakni tipe 2.
Hubungan antara riwayat hipersensitivitas dan kadar imunoglobulin e (IgE) total serum dengan sindrom koroner akut di unit pelayanan jantung terpadu RSUP sanglah denpasar
Kadek Wisnu Mataram, Ketut Suryana, Wayan AryadanaOnline First: Apr 30, 2023
- Abstract
Hubungan antara riwayat hipersensitivitas dan kadar imunoglobulin e (IgE) total serum dengan sindrom koroner akut di unit pelayanan jantung terpadu RSUP sanglah denpasar
Background: Currently, mast cells are implicated in the pathogenesis of coronary heart disease. Mast cells are the only cell tissue that expresses on the surface of the high affinity receptor for IgE (FCεR) and synthesizes vasoactive, spasmogenic, fibrogenic factors and can damage the connective tissue covering the atheroma plaque so that the plaque is prone to rupture. The aim of this study was to determine the relationship between a history of hypersensitivity and total serum IgE levels with acute coronary syndrome.
Methods: This study was an analytic cross-sectional study to determine the relationship between history of hypersensitivity and total serum IgE levels with acute coronary syndrome. The study was conducted at the Integrated Cardiac Service Unit Sanglah Hospital Denpasar with consecutive sampling according to the inclusion and exclusion criteria of 68 samples.
Results: The results of the history of hypersensitivity analysis with ACS obtained a p value of 0.685; OR 0.778. Analysis of the relationship between total serum IgE levels and ACS resulted in a p value of 0.000; OR 10.385, a history of hypersensitivity with IMA obtained a p value of 0.187; OR 0.281 and total IgE levels with IMA obtained a p value of 0.584; OR 0.273.
Conclusion: There is a relationship between total serum Immunoglobulin E (IgE) levels with acute coronary syndrome and MI. There is no relationship between history of hypersensitivity with acute coronary syndrome or MI.
Latar Belakang: Saat ini, sel mast diimplikasikan dalam patogenesis dari penyakit jantung koroner. Sel mast merupakan satu-satunya jaringan sel yang ekpresinya pada permukaan high affinity receptor untuk IgE (FCεR) dan mensintesis faktor vasoaktif, spasmogenik , fibrogenik dan dapat merusak jaringan ikat yang menutupi plak atheroma sehingga plak rentan pecah. Tujuan Penelitian ini untuk mengetahui hubungan antara riwayat hipersensitivitas dan kadar IgE total serum dengan sindrom koroner akut.
Metode: Penelitian ini merupakan penelitian dengan rancangan potong lintang analitik untuk mengetahui hubungan antara riwayat hipersensitivitas dan kadar IgE total serum dengan sindrom koroner akut. Penelitian dilakukan di Unit Pelayanan Jantung Terpadu RSUP Sanglah Denpasar dengan consecutive sampling sesuai kriteria inklusi dan eksklusi sebesar 68 sampel.
Hasil: Hasil analisis riwayat hipersensitivitas dengan SKA didapatkan nilai p 0,685; OR 0,778. Analisis hubungan antara kadar IgE total serum drngan SKA didapatkan hasil nilai p 0,000; OR 10,385, riwayat hipersensitivitas dengan IMA didapatkan nilai p 0,187;OR 0,281 serta kadar IgE total dengan IMA didapatkan hasil nilai p 0,584; OR 0,273.
Simpulan: Terdapat hubungan antara kadar Immunoglobulin E (IgE) total serum dengan sindrom koroner akut dengan IMA. Tidak terdapat hubungan antara riwayat hipersensitivitas dengan sindom koroner akut maupun IMA.
Karakteristik klinis hidrosefalus pada anak di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G Ngoerah Denpasar tahun 2021-2022
Ni Wayan Aristia Budi Utami, Dewi Sutriani Mahalini, I Nyoman Budi Hartawan, Dyah Kanya WatiOnline First: Jan 31, 2023
- Abstract
Karakteristik klinis hidrosefalus pada anak di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G Ngoerah Denpasar tahun 2021-2022
Introduction: Hydrocephalus is pathological condition that results in disturbances of formation, flow, and absorption of cerebrospinal fluid (CSF) resulting an increase in the volume of CSF in the brain. The etiology of hydrocephalus is distinguished by congenital and acquired. Hydrocephalus in children have not been widely discussed, especially characteristics of hydrocephalus in children. This study aims to determine the characteristics of hydrocephalus in children at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022.
Methods: This research is a descriptive study using medical record data. This research was conducted at Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar from September to October 2022. The sampling technique used is total sampling.
Result: As many as 73 children with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 with characteristics in the form of congenital hydrocephalus in 41 people (56.2%), the highest age group in infants (0-2 years) as many as 34 people (46.6%), in the boy group as many as 43 people (58.9%) with clinical symptoms of macrocephaly in 43 people (58.9%) and headache in 18 people (24.7%), with management of VP shunt surgery 55 people (75.3%), and patient outcome the most living are 61 people (83.6%).
Conclusion: Children suffering with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 mostly due to a congenital etiology with clinical symptoms of macrocephaly treated with VP shunt surgery and life outcomes in the age range of 0-2 years.
Pendahuluan: Hidrosefalus adalah suatu keadaan patologis yang mengakibatkan adanya gangguan pada pembentukan, aliran, maupun penyerapan cairan serebrospinal (CSS) sehingga terjadi peningkatan volume CSS pada otak. Etiologi hidrosefalus dibedakan berdasarkan kongenital dan acquired (didapat). Kasus hidrosefalus pada anak tersebut belum banyak dibahas khususnya dalam hal karakteristik penderita hidrosefalus pada anak. Tujuan penelitian ini adalah untuk mengetahui karakteristik hidrosefalus pada anak di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dari aspek etiologi, klinis, tatalaksana, dan luaran.
Metode: Penelitian ini merupakan penelitian deskriptif menggunakan data rekam medis. Penelitian ini dilaksanakan di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar pada bulan September sampai Oktober tahun 2022. Adapun teknik sampling yang digunakan adalah total sampling.
Hasil: Ditemukan 73 kasus anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dengan karakteristik etiologi berupa hidrosefalus kongenital yaitu 41 orang (56,2%), kelompok usia tertinggi pada bayi (0-2 tahun) berjumlah 34 orang (46,6%), pada kelompok jenis kelamin laki-laki yaitu 43 orang (58,9%) dengan gejala klinis terbanyak makrosefali 43 orang (58,9%) dan nyeri kepala 18 orang (24,7%), dengan tatalaksana berupa bedah VP shunt 55 orang (75,3%), dan luaran terbanyak pasien hidup yaitu 61 orang (83,6%).
Simpulan: Anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 tinggi pada laki-laki, akibat etiologi kongenital dengan gejala klinis makrosefali yang ditatalaksana dengan bedah berupa VP shunt serta luaran hidup pada rentang usia 0-2 tahun.
Overview of fractures caused by The 2018 Lombok earthquake in Radiology Department of General Hospital of North Lombok Regency West Nusa Tenggara, Indonesia
Fauzy Ma’ruf, Wiwik Sari AprianturiOnline First: Jan 6, 2023
- Abstract
Overview of fractures caused by The 2018 Lombok earthquake in Radiology Department of General Hospital of North Lombok Regency West Nusa Tenggara, Indonesia
Introduction: The Lombok earthquake that occurred in July-August 2018 has caused many casualties, both deaths and injuries. North Lombok regency is the district that suffered the most fatalities. Therefore, the data on the number of patients examined in the radiology department of the General Hospital of North Lombok Regency can provide an overview of the condition of injured victims in the district. This retrospective research aims to provide an overview of fracture patients of Lombok earthquake victims conducted in the radiology department.
Method: The data were collected from the medical records of Lombok earthquake victims who were examined in the Radiology department during August 2018.
Result: A total of 378 patients were examined. From the x-ray examination, 111 victims suffered fractures. Most of the victims were female and aged >15 to 65 years old. Most of them suffered single region fractures (75 victims) and multiple region fractures (36 victims). Meanwhile, the most fractures suffered by the victims were the lower limb fractures identified in 60 victims (54%) and the shoulder-upper limb fractures found in 32 victims (28.9%). The remaining 19 victims suffered fractures of ankle –foot, wrist-hand, head, ribs, spine and pelvis.
Conclusion: The 2018 Lombok earthquake has had a health impact and increased morbidity and mortality, a total of 111 victims experienced fractures in the earthquake.
Karakteristik audiometri pada pasien dengan otitis media supuratif kronis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari 2018–Desember 2019
Gede Kurnia Mayura, I Made WiranadhaOnline First: Feb 15, 2023
- Abstract
Karakteristik audiometri pada pasien dengan otitis media supuratif kronis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari 2018–Desember 2019
Background: Chronic suppurative otitis media (CSOM) is one of the causes of ear disorders in various countries, especially developing countries. The prevalence of CSOM in Indonesia is 3.8% or an estimated 6.6 million Indonesian population. The purpose of this study was to determine the audiometric characteristics of CSOM patients at the ENT Polyclinic, Prof. Dr. I.G.N.G. Ngoerah Hospital in the period of 2018-2019.
Methods: This research used a retrospective descriptive study design. Sampling was carried out by total sampling, namely every patient who met the research inclusion criteria was included in the research sample. The number of samples used are all descriptive data collected on a predetermined period scale in the research design where the study obtained 70 research samples.
Results: There were 33 (47.14%) female and 37 (52.86%) male with CSOM. There were 4 people (5.71%) of CSOM aged ≤ 10 years, 10 (14.29%) aged 11-20 years, 8 (11.43%) aged 21-30 years, 9 (12.86%) aged 31-40 years, 19 (27.14%) aged 41-50 years, 11 (15.71%) aged 51-60 years, 5 (7.14%) aged 61-70 years, 4 (5.71%) aged more than 70 years. Furthermore, 42 people (60%) with CSOM had conductive hearing loss (CHL). 12.86% of patients had sensorineural hearing loss (SNHL), 13 people with CSOM had mild deafness (22.86%), 13 people had moderate deafness (34.29%), 24 people had moderate-severe deafness (28.57%), 20 people had severe deafness (28.6%), 8 people had very severe deafness (11.46%).
Conclusion: The proportion of CSOM patients in the ENT polyclinic at RSUP Prof. Dr. I.G.N.G. Ngoerah from 2018 to 2019, there were more males than females and the highest distribution of CSOM was in the age range of 41-50 years. Conductive deafness is the highest type of hearing loss and judging from the degree of deafness, most people with CSOM have moderate to severe deafness.
Latar Belakang: Otitis media supuratif kronis (OMSK) merupakan salah satu penyebab gangguan telinga di berbagai negara, terutama negara berkembang. Prevalensi OMSK di Indonesia adalah 3,8% atau diperkirakan sekitar 6,6 juta penduduk Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik audiometri pada penderita OMSK di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2018-2019.
Metode: Penelitian ini menggunakan rancangan penelitian deskriptif retrospektif. Pengambilan sampel dilakukan secara total sampling yaitu setiap penderita yang memenuhi kriteria inklusi penelitian dimasukkan dalam sampel penelitian. Jumlah sampel yang dipergunakan adalah semua data deskriptif yang terkumpul pada skala periode yang telah ditentukan pada rancangan penelitian dimana pada penelitian didapatkan 70 sampel penelitian.
Hasil: Penderita OMSK perempuan sebanyak 33 orang (47,14%) dan penderita OMSK laki-laki sebanyak 37 orang (52,86%). Terdapat 4 orang (5,71%) OMSK berusia ≤ 10 tahun, 10 (14,29%) berusia 11-20 tahun, 8 (11,43%) berusia 21-30 tahun, 9 (12,86%) berusia 31-40 tahun, 19 (27,14%) berusia 41-50 tahun, 11 (15,71%) berusia 51-60 tahun, 5 (7,14%) berusia 61-70 tahun, 4 (5,71%) berusia lebih dari 70 tahun. Lebih lanjut, 42 pasien (60%) dengan OMSK mengalami gangguan pendengaran konduktif. 12,86% pasien mengalami gangguan pendengaran sensorineural, OMSK dengan tuli ringan sebanyak 13 orang (22,86%), tuli sedang 13 orang (34,29%), tuli sedang-berat 24 orang (28,57%), tuli berat 20 orang, tuli berat (28,6%), tuli sangat berat 8 orang (11,46%).
Simpulan: Proporsi penderita OMSK di poliklinik THT KL RSUP Prof. Dr. I.G.N.G. Ngoerah dari tahun 2018 sampai dengan tahun 2019, laki-laki lebih besar dari pada penderita perempuan dan distribusi OMSK tertinggi pada rentang usia 41-50 tahun. Tuli konduktif merupakan tipe gangguan pendengaran yang paling tinggi dan dilihat dari derajat ketuliannya, penderita OMSK sebagian besar memiliki derajat ketulian sedang-berat.
Prevalence and factors associated with anxiety during echocardiography procedure
Kadek Maharini, Eka Gunawijaya, Ni Putu Veny Kartika Yantie, I Gusti Ayu Trisna Windiani, I Gusti Agung Ngurah Sugitha Adnyana, Ni Luh Sukma Pratiwi MurtiOnline First: Apr 30, 2023
- Abstract
Prevalence and factors associated with anxiety during echocardiography procedure
Purpose: Echocardiography is the main modality for definitive diagnosis and evaluation of children with congenital heart disease. Anxiety is the most common feeling experienced by children when they visit healthcare facilities. The first aim of this study was to give an overview of the prevalence of anxiety symptoms, and the second aim was to investigate the factors associated with anxiety during the echocardiography procedure.
Patients and methods: The cross-sectional study was conducted in the pediatric cardiology outpatient clinic at Prof. Dr. I G.N.G. Ngoerah General Hospital, Denpasar-Bali period February 2022 to August 2022. Children aged 18 months-6 years who underwent echocardiography evaluation were included. The visual analog scale of anxiety (VAS-A) was used to measure the severity of anxiety. The analysis is using chi-square test and logistic regression. The significance of risk factors is reported as a prevalence ratio with 95% confidence intervals and p<0.05.
Results: In a total of 156 subjects, the prevalence of anxiety during the procedure was 64,1% with a similar gender proportion. Multivariate analysis found that age ≤3 years old and did not attend school were associated with anxiety (PR 60.53; 95% CI 13.07-280; p<0.001 and PR 5.59; 95% CI 1.31-23.77; p < 0.001).
Conclusion: Anxiety during the echocardiography procedure is common. Age ≤3 years old and did not attend school were associated with anxiety during echocardiography.
Prevalensi dan faktor risiko penyakit jantung koroner pada pasien diabetes melitus tipe 2 Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar
Richard Timothy Elkurnia, Cokorde Istri Yuliandari Krisnawardani K, Luh Oliva Saraswati Suastika, Cyndiana Widia Dewi SinardjaOnline First: Jan 10, 2023
- Abstract
Prevalensi dan faktor risiko penyakit jantung koroner pada pasien diabetes melitus tipe 2 Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar
Background: Coronary heart disease (CHD) is a complication of type 2 diabetes mellitus (DMT2). However, in the process of developing CHD in T2DM patients, other risk factors that contribute multifactorial are needed. This study aims to determine the prevalence of CHD events in T2DM patients as well as to determine the relationship between risk factors and CHD events in T2DM patients.
Methods: This study is an analytic cross-sectional study conducted at Prof. Dr. I.G.N.G. Ngoerah Hospital. The population target was all T2DM patients in the period January 2021-December 2021, in which 80 patient samples were obtained according to the inclusion and exclusion criteria and were taken through secondary data on patient medical records. Data processing was carried out using the SPSS ver. 28.0.1.1.
Results: The prevalence of CHD in T2DM patients was 25 people (31.3%). The risk factors for CHD in T2DM patients are hyperglycemia (HbA1c ≥6.5%) (p=0.036, 95% CI=1.166-85.788, aOR=10.567), blood pressure ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), and obesity (p=0.014, 95%CI=1.364-16.420, aOR=4.732) while male sex (p=0.428), age ≥50 years (p=0.543), smoking (p=0.937), family history of cardiovascular disease (p=0.663), LDL ≥160 mg/dL (p=0.946), triglyceride ≥200 mg/dL (p=0.192, 95%CI=0.680-6.847, aOR=2.158), HDL <40 mg/dL (p=0.487), and total cholesterol level ≥240 mg/dL (p=0.866) are not significantly associated with CHD events in patients DMT2.
Conclusion: The prevalence of CHD in T2DM patients is 31.1% at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2021. Risk factors such as hyperglycemia, blood pressure ≥140/90 mmHg, and obesity are significantly associated with the incidence of CHD in T2DM patients.
Latar belakang: Penyakit jantung koroner (PJK) merupakan salah satu komplikasi diabetes melitus tipe 2 (DMT2). Namun, dalam proses perkembangan PJK pada pasien DMT2, diperlukan faktor risiko lainnya yang berkontribusi secara multifactorial. Secara teoritis, jenis kelamin laki-laki, usia, riwayat merokok, riwayat penyakit kardiovaskuler keluarga, hiperglisemia, dislipidemia, tekanan darah ≥140/90mmHg, dan obesitas merupakan faktor risiko PJK pada DMT2. Penelitian ini bertujuan untuk mengetahui prevalensi kejadian PJK pada pasien DMT2 sekaligus untuk mengetahui hubungan faktor risiko dengan kejadian PJK pada pasien DMT2.
Metode: Penelitian ini merupakan penelitian cross-sectional analitik yang dilakukan pada RSUP Prof. Dr. I.G.N.G. Ngoerah dengan target penelitian adalah seluruh pasien DMT2 pada periode Januari 2021-Desember 2021. Pada penelitian ini, 80 sampel pasien yang sesuai dengan kriteria inklusi dan eksklusi diambil melalui data sekunder rekam medis pasien. Pengolahan data dilakukan menggunakan aplikasi SPSS ver. 28.0.1.1.
Hasil: Prevalensi PJK pada pasien DMT2 adalah sebanyak 25 orang (31.3%). Adapun faktor risiko PJK pada pasien DMT2 adalah Hiperglisemia (HbA1c ≥6.5%) (p=0.036, 95%CI=1.166-85,788, aOR=10.567), tekanan darah ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), dan obesitas (p=0.014, 95%CI=1.364-16.420, aOR=4.732) sedangkan jenis kelamin laki-laki (p=0.428), usia ≥50 tahun (p=0.543), riwayat merokok (p=0.937), riwayat penyakit kardiovaskuler keluarga (p=0.663), kadar LDL ≥160 mg/dL (p=0.946), kadar trigliserida ≥200 mg/dL(p=0.192, CI=0.680-6.847, aOR=2.158), kadar HDL <40 mg/dL (p=0.487), kadar total kolesterol ≥240 mg/dL (p=0.866) tidak berhubungan secara signifikan dengan kejadian PJK pada pasien DMT2.
Simpulan: Prevalensi PJK pada pasien DMT2 sebesar 31.1%. Faktor risiko berupa hiperglisemia, tekanan darah ≥140/90 mmHg, dan obesitas berhubungan signifikan dengan kejadian PJK pada pasien DMT2.
The association of comorbidities with mortality and severity among children with COVID-19
Ni Made Dwi Angga Riani, Ni Putu Siadi Purniti, Ida Bagus SubanadaOnline First: Feb 19, 2023
- Abstract
The association of comorbidities with mortality and severity among children with COVID-19
Background: Several case series have described the clinical characteristics of COVID-19 in pediatric patients and suggest milder illness severity in children compared with adults. However, some cases presented more severe diseases with small numbers of deaths have been documented. Some studies in developed countries demonstrated that the presence of comorbidities among COVID-19 patients could increase the severity of the disease. Therefore, this study aimed to identify the association of comorbidities with mortality and severity among children with COVID-19.
Methods: This was an analytic retrospective cross-sectional study conducted in Prof. Dr. IGNG Ngoerah Hospital, Denpasar, from May 2020 until March 2022. A total of 94 children aged 28 days-18 years old with confirmed COVID-19 were included in this study and divided into two groups, with comorbidities and without comorbidities. The chi-square test was used to determine the association between comorbidities and their relation to mortality and severity. The statistical significance was set at p less than 0.05.
Results: The normality test showed that the age data distribution is not normal with the median age of 72 months (IQR 45-189) and 108 months (IQR 64-240) in the comorbidities and without comorbidities group, respectively. Bivariate analysis showed there was a significant association between comorbidities with the mortality and severity among children with COVID-19 (PR 3.21; 95% CI 1.04-9.90; p= 0.036) and (PR 10.71; 95%CI 4.12-27.83; p< 0.001), respectively. The multivariate analysis revealed the comorbidities increased risk of mortality and severity with adjusted OR (aOR) 3.74 (95%CI 1.14-12.25) and adjusted OR (aOR) 11.8 (95%CI 4.35-32.41), respectively; after adjusting for age and nutritional status.
Conclusion: Comorbidities significantly affect mortality and severity among children with COVID-19.
Hubungan kualitas udara, aktivitas kerja, dan kesehatan paru pada driver ojek online di kota denpasar
Azza Roffana, I Putu Gede Adiatmika, I Dewa Ayu Inten Dwi Primayanti, Luh Putu Ratna SundariOnline First: Apr 17, 2023
- Abstract
Hubungan kualitas udara, aktivitas kerja, dan kesehatan paru pada driver ojek online di kota denpasar
Background: Air quality in Denpasar City is generally affected by exhaust gasses which contribute to polluting the environment. Online motorcycle taxi drivers have been reported to be at risk of exposure to pollutants that have an effect on lung health. Therefore, this study aims to determine the relationship between air quality, work activity, and lung health in online motorcycle taxi drivers in Denpasar City.
Method: This cross-sectional study is an observational analytic study. The sample were online motorcycle taxi drivers who fit the inclusion and exclusion criteria. Air quality data, consisting of air quality index (AQI); PM2.5; and PM10.0 were obtained from the IQAir application on a smartphone, primary data related to work activity and lung health were obtained from questionnaires and direct measurements using spirometry. Statistical analysis was performed with SPSS v. 25.
Results: A total of 30 online motorcycle taxi drivers in the city of Denpasar with an average age of 35.3 years were obtained as subjects. Average AQI score; PM2.5; and PM10 in Denpasar City was 62.00±20.584; 20.16±19.693 µg/m³ and 14.57±5.110 µg/m³ respectively. In the work activities, most of the drivers have worked for >4 years (66.7%) and with a daily work duration of >8 hours (63.3%). Most of the drivers used PPE (95.7%). Bivariate analysis showed that there was no significant relationship between work activity and lung health in total work duration (p=0.584), work duration in one day (p=0.612), and use of PPE (p=1.000).
Conclusion: There is no significant relationship between work activity and lung health.
Latar belakang: Kualitas udara di Kota Denpasar secara umum dipengaruhi oleh gas buangan yang berkontribusi dalam mencemari lingkungan. Sebagian besar gas dihasilkan oleh kendaran bermotor yang keberadaannya semakin meningkat, khususnya kendaraan pribadi yang digunakan dalam menjalani pekerjaan sebagai ojek online. Adapun driver ojek online telah dilaporkan berisiko terkena paparan zat polutan yang berefek pada kesehatan paru. Penelitian ini dilakukan untuk mengetahui hubungan kualitas udara, aktivitas kerja, dan kesehatan paru pada driver ojek online di Kota Denpasar.
Metode: Penelitian ini adalah studi analitik observasional dengan pendekatan potong lintang (cross-sectional). Sampel pada penelitian ini adalah driver ojek online yang sesuai dengan kriteria inklusi dan eksklusi. Data kualitas udara, terdiri atas air quality index (AQI); PM2,5; dan PM10,0 diperoleh dari aplikasi IQAir pada smartphone, data primer terkait aktivitas kerja dan kesehatan paru diperoleh dari kuesioner dan pengukuran menggunakan alat spirometri. Analisis statistik dilakukan dengan SPSS v. 25.
Hasil: Sebanyak 30 driver ojek online di kota Denpasar dengan rata-rata berusia 35,3 tahun diperoleh sebagai subjek penelitian. Rata-rata skor AQI; PM2,5; dan PM10 di Kota Denpasar masing-masing sebesar 62,00±20,584; 20,16±19,693 µg/m³’ dan 14,57±5,110 µg/m³. Pada gambaran aktivitas kerja, sebagian besar driver telah bekerja selama >4 tahun (66,7%) dan dengan durasi bekerja harian >8 jam (63,3%). Sebagian besar driver menggunakan APD selama bekerja (95,7%). Analisis bivariat menunjukkan tidak terdapat hubungan yang signifikan antara aktivitas kerja dan kesehatan paru pada komponen durasi total bekerja (p=0,584), durasi bekerja dalam satu hari (p=0,612), dan penggunaan APD (p=1,000).
Kesimpulan: Tidak terdapat hubungan yang signifikan antara aktivitas kerja dan kesehatan paru.
Hubungan laju detak jantung dengan rehospitalisasi pada penderita gagal jantung di RSUP Prof. dr. I.G.N.G. Ngoerah, Bali, Indonesia
Ni Komang Yovita Mirah Pradnyani, I Made Putra Swi Antara, I Wayan Wita, Luh Oliva Saraswati SuastikaOnline First: Apr 30, 2023
- Abstract
Hubungan laju detak jantung dengan rehospitalisasi pada penderita gagal jantung di RSUP Prof. dr. I.G.N.G. Ngoerah, Bali, Indonesia
Background: Heart failure is one of the main causes of death in Indonesia. Many factors can cause it, and one factor which is still being debated is heart rate. This research aims to find the correlation between heart rate and rehospitalization in patients with heart failure at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali.
Methods: Cross-sectional analytical research design is used in this research. The data are taken through consecutive sampling methods from medical records and hospital management information systems, starting from January 2021 - January 2022. The research subjects are the patients who have undergone heart failure hospitalization at the Integrated Cardiac Service (PJT) in Prof.Dr. I.G.N.G. Ngoerah Hospital. The heart rate is taken at the time the patients are discharged after being hospitalized. The bivariate data are analyzed with Spearman correlation and simple regression tests.
Results: Most of the study respondents were male (54.10%), did not have a history of CHD (77.60%), did not have hypertension (54.10%), did not smoke (70.60%), their heart rate was not optimal (≥70 times/minute) (74.10%), and more than 1 hospitalization (51.80%). Based on the results of the bivariate analysis of 85 samples; there are ≥70 with non-optimal heart rate, and there are 60,3 who underwent rehospitalization (>1 hospitalization) (p = 0.007; r=0.290).
Conclusion: This research concludes that heart rate has both significant and weak correlation in increasing the risk of rehospitalization in patients with heart failure. It is not just a single factor, since it is also influenced by hypertension.
Latar Belakang: Penyakit gagal jantung adalah salah satu penyebab utama kematian di Indonesia. Banyak faktor yang dapat menjadi penyebab gagal jantung. Salah satu faktor yang masih menjadi perdebatan adalah laju detak jantung. Tujuan dari penelitian ini adalah mengetahui hubungan laju detak jantung dengan rehospitalisasi pada penderita gagal jantung di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar Bali.
Metode: Desain penelitian potong-lintang analitik dilakukan Data diambil dengan metode consecutive sampling dari rekam medis dan sistem informasi manajemen rumah sakit dari periode januari 2021 sampai januari 2022. Subjek penelitian adalah pasien yang mengalami hospitalisasi gagal jantung di pelayanan jantung terpadu (PJT) RSUP Prof.Dr. I.G.N.G. Ngoerah. Laju detak jantung diambil pada saat pasien dipulangkan setelah mengalami hospitalisasi. Analisis data secara bivariat dengan uji korelasi spearman dan regresi sederhana.
Hasil: Sebagian besar responden penelitian berjenis kelamin laki-laki (54,10%), tidak memiliki riwayat PJK (77,60%), tidak hipertensi (54,10%), tidak merokok (70,60%), laju detak jantung tidak optimal (≥70 kali/menit) (74,10%), dan lebih dari 1 kali rawat inap (51,80%). Berdasarkan hasil analisis secara bivariat dari 85 sampel. Pada laju detak jantung tidak optimal ≥70 yang mengalami rehospitalisasi >1 kali rawat inap 60,3 (p = 0,007; r=0,290).
Kesimpulan: Kesimpulan dari penelitian ini adalah laju detak jantung berhubungan signifikan dan lemah dalam meningkatkan risiko rehospitalisasi pada penderita gagal jantung. Laju detak jantung bukan merupakan faktor tunggal melainkan dipengaruhi juga oleh faktor hipertensi.
Kadar interleukin-17 plasma berkorelasi positif dengan kadar imunoglobulin M (IgM) anti phenolic glycolipid-1 (PGL-1) pada narakontak serumah pasien kusta tipe multibasiler
Anak Agung Indah Jayanthi, Luh Made Mas Rusyati, Ni Made Dwi Puspawati, I Gusti Ayu Agung Elis Indira, I Gusti Nyoman Darmaputra, I Gusti Ayu Agung Dwi KarmilaOnline First: May 17, 2023
- Abstract
Kadar interleukin-17 plasma berkorelasi positif dengan kadar imunoglobulin M (IgM) anti phenolic glycolipid-1 (PGL-1) pada narakontak serumah pasien kusta tipe multibasiler
Introduction: Household contacts are the group most at risk of contracting subclinical leprosy, which acts as a transmission source. Immunoglobulin M (IgM) anti-Phenolic Glycolipid-1 (PGL-1) serological indicates the abundance of M. leprae in person and Interleukin-17 (IL-17) levels play an important role in preventing clinical leprosy. Thus, this study aims to determine the correlation of IL-17 to IgM-anti PGL-1 in household contacts of multibacillary type leprosy patients.
Methods: This study was an analytic observational study with a cross-sectional approach. The research was conducted from October to November 2022 at the Skin and Venereology Polyclinic and the Clinical Pathology Laboratory, Prof. Hospital. Dr. I.G.N.G. Ngoerah Denpasar. Samples were selected using a consecutive sampling technique. The total sample was divided into groups of contacts and non-contacts. Data were analyzed using SPSS 23. The bivariate analysis used was chi-square, man-withney. Then a correlation analysis was performed using the Spearman rho test. The significant p-value was <0.05.
Results: The total number of samples obtained was 72. The mean levels of IL-17 and anti-PGL-1 IgM levels in the contact group were 45.47 ± 20.57 pg/ml and 605.59 ± 2,94.30 u/ml, while in the non-contact group were 31.46 ± 19.25 pg/ml and 140.46 ± 93.42 u/ml. There was a significant difference in IL-17 and anti-PGL-1 IgM levels in the contact and non-contact groups (p<0.001). Correlation analysis showed a weak positive relationship (r=0.290, p=0.014) between IL-17 levels and anti-PGL-1 IgM levels.
Conclusion: The levels of anti-PGL-1 and IL-17 IgM in contacts were higher than in non-contacts, with a significant difference. There was a significant weak positive correlation between levels of IL-17 and anti-PGL-1 IgM.
Pendahuluan: Narakontak serumah merupakan kelompok paling berisiko terjangkitnya kusta subklinis yang berperan sebagai sumber penularan. Pemeriksaan serologis Imunoglobulin M (IgM) anti Phenolic Glycolipid-1 (PGL-1) dapat menjadi indikasi banyaknya M. leprae dalam tubuh narakontak dan kadar Interleukin-17 (IL-17) berperan penting mencegah terjadinya kusta klinis. Untuk itu penelitian ini bertujuan untukmengetahui korelasi IL-17 terhadap IgM-anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler.
Metode: Studi ini merupakan observasional analitik dengan pendekatan potong lintang. Penelitian dilaksanakan mulai bulan Oktober - November 2022 di Poliklinik Kulit dan Kelamin dan Laboratorium Patologi Klinik, RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar. Sampel dipilih menggunakan teknik consecutive sampling. Total sampel di bagi menjadi kelompok narakontak dan bukan narakontak. Data di analisis menggunakan SPSS 23. Analisis bivariat yang digunakan adalah chi-square, man-withney. Selanjutnya dilakukan analisis korelasi menggunakan uji Spearman rho. Nilai p dikatakan signifikan jika <0.05.
Hasil: Total sampel yang diperoleh adalah 72. Rerata kadar IL-17 dan kadar IgM anti PGL-1 pada kelompok narakontak yaitu 45,47 ± 20,57 pg/ml dan 605,59 ± 294,30 u/ml sementara pada kelompok bukan narakontak yaitu 31,46 ± 19,25 pg/ml dan 140,46 ± 93,42 u/ml. Terdapat perbedaan yang signifikan pada kadar IL-17 dan IgM anti PGL-1 pada kelompok narakontak dan bukan narakontak (p<0.001). Analisis korelasi menunjukkan hubungan positif lemah nilai (r=0,290, p=0,014) antara kadar IL-17 dengan kadar IgM anti PGL-1.
Kesimpulan: Kadar IgM anti PGL-1 dan IL-17 pada narakontak lebih tinggi dari bukan narakontak dengan perbedaan yang signifikan. Terdapat korelasi positif lemah yang signifikan antar kadar IL-17 dan IgM anti PGL-1.
Manifestasi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017
Lisa Alverina, I Gusti Ayu Febi Risantari, I Wayan Hendrawan, Dedianto Hidajat, I Gusti Agung Ayu Ratna Medikawati, Dinie Ramdhani KusumaOnline First: Jan 7, 2023
- Abstract
Manifestasi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017
Introduction: Indonesian Ministry of Health gave a third dose (booster) which was prioritized by the medical staff within 3 months since the second dose was given. The vaccine used for a booster is mRNA-1273 (Moderna) which had been approved by FDA (Food and Drug Administration) with modality mRNA and considerable efficacy. The adverse reaction to the skin which may present post-Moderna vaccination is a local reaction on the injection site on the first dose and increased on the second dose, delayed large local reaction on the first dose and decreased on the second dose. This study aims to determine the characteristics of dermatological lesions in the co-occurrence of post-COVID-19 booster Moderna vaccination in profession stage students of the Faculty of Medicine, Universitas Mataram, class of 2015-2017.
Method: The research design used was descriptive by taking data from respondents who received the Moderna booster who were students of the Faculty of Medicine, Universitas Mataram, class 2015-2017 and were willing to fill out a questionnaire.
Result: It was found that there were adverse reactions after vaccination as many as 90 respondents of 100 respondents with skin manifestations after Moderna booster vaccination, such as pain in the injection area (84%), edema (40%), erythema of the injection area (27%), itching (8%), urticaria (3%) and angioedema (1%). The onset of most symptoms occurred at 12-24 hours post-injection (33.3%) and 6-12 hours post-injection (23.3%).
Conclusion: There were skin manifestations in most of the respondents who received the Moderna vaccine booster (90%), with the most symptoms onset at 12-24 hours post-injection 33.3%.
Latar Belakang: Kementerian Kesehatan Republik Indonesia memberikan vaksinasi dosis ketiga (booster) yang diutamakan untuk tenaga kesehatan dengan jarak minimal 3 bulan setelah dosis kedua. Pemberian vaksin booster berupa vaksin mRNA-1273 (Moderna) yang diakui oleh FDA (Food and Drug Administration) dengan modalitas mRNA dan memiliki efikasi yang cukup besar. Efek samping pada kulit yang dapat muncul pasca vaksinasi Moderna adalah reaksi lokal pada tempat injeksi pada dosis pertama dan meningkat pada dosis kedua, delayed large local reaction pada dosis pertama dan menurun pada dosis kedua.
Tujuan: Penelitian ini bertujuan untuk mengetahui karakteristik lesi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017.
Metode: Desain penelitian yang digunakan adalah deskriptif dengan cara mengambil data dari responden penerima booster Moderna yang merupakan mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017 dan bersedia mengisi kuesioner.
Hasil: Dari penelitian yang dilakukan didapatkan adanya kejadian ikutan pasca vaksinasi sebanyak 90 responden dari 100 responden dengan manifestasi kulit pasca vaksinasi booster Moderna berupa nyeri pada daerah injeksi (84%), edema (40%), eritema daerah injeksi (27%), gatal (8%), urtikaria (3%) dan angioedema (1%). Awitan timbulnya gejala terbanyak pada 12-24 jam pasca injeksi (33,3 %) dan 6-12 jam pasca injeksi (23,3%).
Simpulan: Terdapat manifestasi kulit pada sebagian besar responden yang menerima booster vaksin Moderna (90%) dengan awitan timbulnya gejala terbanyak pada 12 jam-24 jam pasca injeksi sebesar 33,3%.
Kadar luteinizing hormone yang tinggi menjadi faktor risiko melasma pada pria
Henny Wijaya, Ketut Kwartantaya Winaya, Ni Made Dwi Puspawati, IGAA Praharsini, IGN Darmaputra, Ratih Vibriyanti KarnaOnline First: Feb 19, 2023
- Abstract
Kadar luteinizing hormone yang tinggi menjadi faktor risiko melasma pada pria
Introduction: Melasma is a hyperpigmented disorder that generally occurs on the face, mostly in women. Meanwhile, the incidence of melasma in men is still little documented, especially in studies that specifically discuss hormonal risk factors for the occurrence of melasma in men. Therefore, this study aimed to evaluate the relationship between high levels of the luteinizing hormone as a risk factor for melasma in men.
Methods: The design used is an analytic retrospective and case-control method. The research location is the Dermatology and Venereology Polyclinic, the cosmetic-medical subdivision of the Central General Hospital Prof. Dr. IGNG Ngoerah, Denpasar, Bali, from June 2022 to August 2022. The melasma samples were paired with non-melasma samples based on age, Fitzpatrick type, and duration of sun exposure. Data were obtained using medical records and analyzed univariate to multivariate through SPSS application with a p-value of 0.05.
Results: A total of 60 respondents were included in this study, 30 people with melasma cases and 30 as controls. Based on the characteristics of the respondents, the mean age was 48.83±6.30 years. Based on the analysis, several factors significantly affect the occurrence of melasma in men: family history, duration of sun exposure > 6 hours, and high serum LH. levels (p<0.05). The results of logistic regression analysis showed serum LH levels > 15.09 mIU/ml (OR: 6.986; 95%CI: 1.905-25,622; p=0.003). This result shows that the risk factor for LH serum levels of 15.09 IU/ml has a 6.9 times risk of melasma in male patients compared to those with LH levels < 15.09. The results of the Pearson correlation test showed a strong relationship between high serum LH Levels and an increase in the patient's MASI score (r=0.982; p<0.001).
Conclusion: It can be concluded that high serum LH levels are the main risk factor for melasma in men.
Latar Belakang: Melasma merupakan kelainan hiperpigmentasi yang umumnya terjadi pada daerah wajah dan mayoritas terjadi wanita. Sedangkan, kejadian melasma pada pria masih sedikit didokumentasikan, khususnya studi yang membahas secara spesifik faktor risiko hormonal terhadap terjadinya melasma pada pria. Oleh karenanya, penelitian ini bertujuan mengevaluasi hubungan antara kadar luteinizing hormone yang tinggi sebagai faktor risiko melasma pada pria.
Metode: Desain yang digunakan yakni retrospektif analitik dan metode case control. Lokasi penenlitian yakni Poliklinik Kulit dan Kelamin subdivisi kosmedik Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah, Denpasar, Bali, mulai bulan Juni 2022 hingga Agustus 2022. Sampel melasma dipasangkan dengan sampel non melasma berdasarkan usia, tipe kulit Fitzpatrick, dan lama paparan matahari. Data diperoleh dengan menggunakan rekam medis dan dianalisis secara univariat sampai multivariat melalui aplikasi SPSS dengan nilai p ≤ 0,05.
Hasil: Total terdapat 60 responden yang masuk dalam studi ini, 30 orang dengan kasus melasma dan 30 orang sebagai kontrol. Berdasarkan karakteristik responden diperoleh memiliki rerata usia 48,83±6,30 tahun. Berdasarkan analisis diperoleh beberapa faktor yang berpengaruh signifikan terhadap terjadinya melasma pada pria adalah, riwayat keluarga, lama paparan sinar matahari > 6 jam, dan tingginya kadar serum LH (p<0,05). Hasil analisis regresi logistik menunjukan kadar serum LH > 15,09 mIU/ml (AOR: 6,986; 95%CI:1,905-25,622; p=0,003). Pada hasil ini menunjukan nilai faktor risiko kadar serum LH ≥ 15,09 IU/ml memiliki risiko sebesar 6,9 kali terjadi melasma pada pasien laki-laki dibandingkan yang memiliki kadar LH < 15,09. Hasil uji korelasi Pearson menunjukan adanya hubungan kuat antara kadar serum LH tinggi dengan peningkatan skor MASI pasien (r=0,982; p<0,001)
Simpulan: Dapat disimpulkan bahwa kadar serum LH yang tinggi menjadi faktor risiko utama kejadian melasma pada pria
Karakteristik pasien fraktur pelvis di unit gawat darurat RSUP Prof. dr. I.G.N.G Ngoerah periode januari 2019 – september 2022
I Gusti Ayu Devina Putri Aryana, Putu Feryawan Mergawa, Made Agus MaharjanaOnline First: Jan 9, 2023
- Abstract
Karakteristik pasien fraktur pelvis di unit gawat darurat RSUP Prof. dr. I.G.N.G Ngoerah periode januari 2019 – september 2022
Introduction: The high mortality rate due to pelvic fractures in Indonesia requires the latest data regarding case descriptions related to the causes of pelvic fracture incidents, treatment and complications that can be caused.
Methods: The study design is a retrospective descriptive study with a cross-sectional approach. The sample population was determined by total sampling, namely all patients with pelvic fractures who received treatment at the ER of Prof. Dr. I.G.N.G Nogerah Denpasar. All data were taken from medical records and then analyzed descriptively. The independent variables in this study were age, gender, mechanism of injury, classification of Young-Burges and Tile fractures, emergency management of pelvic fractures and acute complications experienced. While the dependent variable was the incidence of pelvic fractures.
Results: A total of 75 samples of pelvic fracture cases were obtained for the period January 2019 to September 2022. Men dominated the majority of pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah from January 2019 – September 2022 with a proportion of 64%. Most of the cases were adults aged 25-59 years (66.67%) with the mechanism of injury most often caused by traffic accidents (77.3%). Most cases of pelvic fractures that occur fall into the category of stable pelvic fractures with the Young Burges APC II classification (18.7%) and the Tile A1 classification (14.7%). More than half of the cases (58.7%) of pelvic fractures were treated operatively with the most common procedure being ORIF PS (90.9%). There were 14 cases that experienced acute complications, where most cases of pelvic fractures were accompanied by internal organ injuries (64.3%) and hypovolemic shock (71.4%).
Conclusion: Most pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah Denpasar Hospital was treated operatively and 19% of them experienced acute complications. Future studies should focus on tracing the causes of acute complications that occur to achieve more effective and efficient management of pelvic fracture cases.
Pendahuluan: Tingginya angka mortalitas akibat fraktur pelvis di Indonesia membutuhkan data terbaru terkait gambaran kasus yang berhubungan dengan penyebab kejadian insiden fraktur pelvis, penanganan serta komplikasi yang dapat disebabkan.
Metode: Desain studi yaitu penelitian deskriptif retrospektif dengan pendekatan potong lintang. Populasi sampel ditentukan secara total sampling yaitu seluruh pasien dengan fraktur pelvis yang mendapatkan penanganan di UGD RSUP Prof. Dr. I.G.N.G Nogerah Denpasar. Seluruh data diambil dari rekam medis dan kemudian dianalisis secara deskriptif. Variabel bebas dalam penelitian ini adalah usia, jenis kelamin, mekanisme cidera, klasifikasi fraktur Young-Burges dan Tile, penanganan darurat fraktur pelvis dan komplikasi akut yang dialami. Sementara variabel tergantung adalah kejadian fraktur pelvis.
Hasil: Sebanyak 75 sampel kasus fraktur pelvis didapatkan untuk periode Januari 2019 hingga September 2022. Laki-laki mendominasi sebagian besar kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah dari Januari 2019 – September 2022 dengan proporsi 64%. Sebagian besar kasus merupakan orang dewasa berusia 25-59 tahun (66,67%) dengan mekanisme cidera yang paling sering disebabkan oleh kecelakaan lalu lintas (77,3%). Sebagian besar kasus fraktur pelvis yang terjadi masuk dalam kategori fraktur pelvis stabil dengan klasifikasi Young Burges APC II (18,7%) dan klasifikasi Tile A1 (14,7%). Lebih dari setengah jumlah kasus (58,7%) fraktur pelvis ditangani secara operatif dengan tindakan yang paling sering adalah ORIF PS (90,9%). Terdapat sebanyak 14 kasus yang mengalami komplikasi akut, dimana sebagian besar kasus fraktur pelvis disertai dengan cidera organ dalam (64,3%) dan syok hipovolemik (71,4%).
Simpulan: Kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar sebagian besar ditangani secara operatif dan 19% diantaranya mengalami komplikasi akut, studi selanjutnya agar dapat fokus pada penelusuran penyebab komplikasi akut yang terjadi untuk mencapai tatalaksana kasus fraktur pelvis yang lebih efektif dan efisien.
Gambaran klinis dan laboratoris penderita penyakit ginjal kronis yang menjalani hemodialisis di RSUD Muara Teweh, Barito Utara, Kalimantan Tengah
I Gede Suprayoga Sukmana Putra, Ahadini IslamiahOnline First: Apr 30, 2023
- Abstract
Gambaran klinis dan laboratoris penderita penyakit ginjal kronis yang menjalani hemodialisis di RSUD Muara Teweh, Barito Utara, Kalimantan Tengah
Introduction: Chronic kidney disease (CKD) is defined by changes in kidney structure, function, or both. CKD shows a variety of clinical and laboratory abnormalities.
Purpose: This study aims to determine the clinical and laboratory features of CKD patients undergoing HD at Muara Teweh Hospital.
Methods: This research is an observational descriptive study conducted at the Hemodialysis Unit of Muara Teweh Hospital in January 2023. The sampling method used was total sampling.
Results: Most of the samples were female (56.1%), aged 40-60 years (68.3%), and had HD for more than 3 months (51.2%). The most common complaints were nausea (46.3%), muscle/bone pain (36.6%), and shortness of breath (34.1%). From the physical examination, it was found that most of them had grade II hypertension (48.8%), normal nutritional status (68.3%), oliguria (68.3%), and peripheral edema (63.4%). The average hemoglobin level was 9.05 g/dL, urea 128.80 mg/dL, and creatinine 9.17 mg/dL. The average glomerular filtration rate was 7.31 mL/min/1.73 m2.
Conclusion: The main clinical features of CKD in this study were nausea, muscle/bone pain, shortness of breath, grade II hypertension, normal nutritional status, and fluid retention while the laboratory features were anemia, uremia, and hypercreatininemia.
Pendahuluan: Penyakit ginjal kronis (PGK) merupakan kondisi kelainan medis yang ditandai dengan adanya perubahan pada struktur ginjal, fungsi, atau keduanya. PGK menunjukkan beragam kelainan klinis dan laboratoris.
Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran klinis dan laboratoris penderita PGK yang menjalani HD di RSUD Muara Teweh.
Metode: Penelitian ini merupakan penelitian deskriptif observasional yang dilakukan di Unit Hemodialisis RSUD Muara Teweh pada bulan Januari 2023. Metode pengambilan sampel yang digunakan adalah total sampling.
Hasil: Sebagian besar sampel berjenis kelamin perempuan (56,1%), berusia 40-60 tahun (68,3%), dan menjalani HD lebih dari 3 bulan (51,2%). Keluhan yang paling banyak ditemukan adalah mual (46,3%), nyeri otot/tulang (36,6%), dan sesak nafas (34,1%). Dari pemeriksaan fisik didapatkan sebagian besar mengalami hipertensi derajat II (48,8%), status gizi normal (68,3%), oliguria (68,3%), dan edema perifer (63,4%). Kadar rata-rata hemoglobin adalah 9,05 g/dL, ureum 128,80 mg/dL, dan kreatinin 9,17 mg/dL. Laju filtrasi glomerulus rata-rata adalah 7,31 mL/mnt/1,73 m2.
Simpulan: Gambaran klinis utama PGK pada penelitian ini adalah mual, nyeri otot/tulang, sesak nafas, hipertensi derajat II, status gizi normal, dan retensi cairan sedangkan gambaran laboratorisnya adalah anemia, uremia, dan hiperkreatininemia.
The quality of life in children with nephrotic syndrome at Prof I.G.N.G Ngoerah Hospital, Denpasar, Bali
Luh Putu Eka Sari Kresnandari, Gusti Ayu Putu Nilawati, I Gusti Ayu Trisna Windiani, I Gusti Agung Ngurah Sugitha Adnyana, Soetjiningsih, Bagus Ngoerah Mahakrishna, Ni Luh Sukma Pratiwi MurtiOnline First: Apr 23, 2023
- Abstract
The quality of life in children with nephrotic syndrome at Prof I.G.N.G Ngoerah Hospital, Denpasar, Bali
Introduction: Nephrotic syndrome (NS) is a common chronic renal disease in children. For chronic illness, the patients requested regular hospital visits and required long term use of steroids or immunosuppressive agents. Besides agents needing therapy, the patients also face the probability of recurrent disease, multiple complications, hospitalization, side effect of treatment and fall into chronic renal disease. The impact could be physical or psychological (emotional, social, school performance). Thus, in this article, we provide the quality of life (QoL) evaluation among children with NS in Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali.
Methods: This cross-sectional study was conducted at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali. The cases included 60 children with NS aged 2–18 years diagnosed as NS based on the medical record and attended a pediatric nephrology clinic from January 2022 until July 2022. The patient’s quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) generated from 4.0. All the data were analyzed descriptively by using SPSS version 25. The data will be provided in the table.
Result: There were sixty children as study subjects, consisting of 36 (60%) male and 24 (40%) female. The Male gender was more dominant in this study (60% of study subjects). Female patients, lower-income families, duration of illness less than 1 year, group B NS (SRNS, steroid dependence NS), and children not in remission phase and on cyclophosphamide therapy demonstrate a higher proportion of QoL disturbance.
Conclusion: According to this study, we can conclude that most of the NS patients have not disturbed QoL based on the child and the parents’ reports.
Uji daya hambat minyak atsiri kulit buah jeruk bali (Citrus maxima) terhadap bakteri Pseudomonas aeruginosa
I Gede Krisna Arim Sadeva, Ni Nyoman Sri Budayanti, Made Agus Hendrayana, I Dewa Made SukramaOnline First: Jan 31, 2023
- Abstract
Uji daya hambat minyak atsiri kulit buah jeruk bali (Citrus maxima) terhadap bakteri Pseudomonas aeruginosa
Background: Pseudomonas aeruginosa is a gram-negative bacterium that is commonly associated with Healthcare-Associated infections (HAI), particularly Multidrug-resistance (MDR) P. aeruginosa. The polyphenolic compounds found in the peel of pomelo (C. maxima) are reported to have shown an effective antimicrobial effect. Therefore, this study aimed to investigate the inhibitory effect of C. maxima peel essential oil on the growth of P. aeruginosa bacteria.
Methods: This in vitro study evaluates the inhibitory effect of C. maxima peel essential oil against clinical isolate strains (SP47) and MDR P. aeruginosa by measuring the diameter of the inhibition zone (mm). Five series of essential oil concentrations (20%, 40%, 60%, 80%, and 100%) and the control group were used in the paper disk diffusion test with three repetitions (triplet). All data were statistically analyzed using SPSS ver. 20.
Results: A total of 4.85 mL of essential oil from 7.2 kg of C. maxima fruit peel was obtained. Inhibition zones were observed in clinical isolates of P. aeruginosa by concentrations of 60%, 80%, 100%, and K+ with means of 6.27±0.08 mm; 6.71±0.19 mm; 9.08±0.29 mm; and 40.8±0.48 mm, respectively. In MDR P. aeruginosa, the inhibition zone by concentrations of 80%, 100%, and K+ with means of 6.45±0.13 mm; 7.15±0.13 mm; and 9.08±0.34 mm, respectively. There was a significant difference in the mean diameter within groups (p<0.05).
Conclusion: C. maxima fruit peel essential oil was able to inhibit the growth of P. aeruginosa bacteria, both clinical and MDR isolates. There were differences in inhibition between the concentration series.
Metode: Penelitian ini merupakan studi in vitro yang mengevaluasi daya hambat minyak atsiri kulit buah C. maxima terhadap strain isolat klinis (SP47) dan MDR P. aeruginosa melalui pengukuran diameter zona hambat (mm). Sebanyak lima seri konsentrasi minyak atsiri (20%, 40%, 60%, 80%, dan 100%) dan kelompok kontrol digunakan dalam uji paper disk diffusion dengan pengulangan sebanyak tiga kali (triplet) Seluruh data dianalisis secara statistik menggunakan SPSS ver. 20.
Hasil: Sebanyak 4,85 mL minyak atsiri dari 7,2 kg kulit buah C. maxima diperoleh dengan metode destilasi uap. Zona hambat teramati pada isolat klinis P. aeruginosa oleh konsetrasi 60%, 80%, 100%, dan K+ dengan rerata sebesar 6,27±0,08 mm; 6,71±0,19 mm; 9,08±0,29 mm; dan 40,8±0,48 mm berturut-turut. Zona hambat juga teramati pada isolat MDR P. aeruginosa oleh konsetrasi 80%, 100%, dan K+ dengan rerata sebesar 6,45±0,13 mm; 7,15±0,13 mm; dan 9,08±0,34 mm berturut-turut. Terdapat perbedaan rerata diameter yang signifikan antar kelompok uji (p<0,05).
Simpulan: Minyak atsiri kulit buah C. maxima mampu menghambat pertumbuhan bakteri P. aeruginosa baik isolat klinis maupun MDR. Adapun terdapat perbedaan daya hambat antar seri konsentrasi.
Kata kunci: antimikroba, citrus maxima, minyak atsiri, multidrug resistant
Insiden mild cognitive impairment tipe amnestik dan non-amnestik pada kelompok usia lanjut di Puskesmas Uabau
Ni Putu Inna Ariani, Anak Agung Ayu Agung PramaswariOnline First: Apr 9, 2023
- Abstract
Insiden mild cognitive impairment tipe amnestik dan non-amnestik pada kelompok usia lanjut di Puskesmas Uabau
Background: Mild Cognitive Impairment (MCI) is a mild cognitive function disorder in the form of decreased memory function but does not interfere with daily activities. Decreased memory and impaired orientation of place and time due to MCI will increase the risk of injury in the elderly in their daily lives. Knowing the incidence of MCI earlier is very important, as finding MCI sufferers earlier can inhibit the progression and improve the quality of life of sufferers. Thus, this study aims to determine the incidence of amnestic and non-amnestic MCI in the elderly, especially in the Puskesmas Uabau working area.
Methods: The research design used a cross-sectional method where data was collected by interviewing using the MMSE-Ina questionnaire. A total of 135 subjects consisting of the elderly (45-60 years) and elderly (>60 years) age group in the Puskesmas Uabau working area were included in the study using consecutive random sampling—selection of the sample according to the eligibility criteria. Data analysis was carried out to determine the incidence of amnestic and non-amnestic MCI types.
Results: There was an incidence of MCI of 47.4% (64 people), which was dominated by women in the elderly group >71 years with comorbidities (diabetes mellitus, hyperuricemia, stroke), and did not have comorbid hypertension and dyslipidemia. Single realm amnestic type MCI was obtained as much as 3.1%, plural amnestic type MCI was 57.8%, plural non-amnestic type MCI was 39.1%, and no elderly group was found with single domain non-amnestic type MCI.
Conclusion: The incidence of MCI in the elderly group at the Uabau Health Center is high, so special attention is needed from an early age so as not to fall into a state of more severe cognitive impairment.
Latar Belakang: Mild Cognitive Impairment (MCI) merupakan gangguan fungsi kognitif ringan berupa menurunnya fungsi memori namun tidak mengganggu aktivitas sehari-hari. Menurunnya daya ingat serta gangguan orientasi tempat dan waktu akibat MCI akan meningkatkan risiko kejadian cedera pada kelompok usia lanjut dalam kesehariannya. Mengetahui insiden MCI sejak dini sangatlah penting, dimana ditemukannya penderita MCI sejak dini dapat menghambat progresifitas serta meningkatkan kualitas hidup penderitanya. Dengan demikian, penelitian ini bertujuan untuk mengetahui insidensi dari MCI tipe amnestik dan non-amnestik pada kelompok usia lanjut, khususnya di lingkungan Puskesmas Uabau.
Metode: Desain penelitian menggunakan metode potong lintang dimana pengambilan data dilakukan dengan wawancara menggunakan kuisioner MMSE-Ina. Sebanyak 135 subjek yang terdiri dari kelompok usia prelansia (45-60 tahun) dan lansia (>60 tahun) di wilayah kerja Puskesmas Uabau dimasukkan dalam penelitian menggunakan consecutive random sampling. Pemilihan sampel sesuai dengan kriteria eligibilitas. Analisis data dilakukan untuk mengetahui insiden MCI tipe amnestik dan non amnestik.
Hasil: Didapatkan insiden MCI sebesar 47.4% (64 orang), dimana didominasi oleh perempuan di kelompok lansia >71 tahun dengan komorbid (diabetes melitus, hiperurisemia, stroke), serta tidak memiliki komorbid hipertensi dan dislipidemia. MCI tipe amnestik ranah tunggal didapatkan sebanyak 3.1%, MCI tipe amnestik ranah jamak sebanyak 57.8%, MCI tipe non-amnestik ranah jamak sebanyak 39.1%, dan tidak ditemukan kelompok usia lanjut dengan MCI tipe non-amnestik ranah tunggal.
Kesimpulan: Insiden MCI pada kelompok usia lanjut di Puskesmas Uabau tinggi sehingga dibutuhkan perhatian khusus sejak dini agar tidak jatuh ke keadaan gangguan kognitif yang lebih berat.
Hubungan perilaku merokok dan obesitas dengan kejadian hipertensi pada guru sman di kota mataram
Emalisa Gea Rezqi, Prima Belia Fathana, Bayu Tirta DirjaOnline First: Mar 13, 2023
- Abstract
Hubungan perilaku merokok dan obesitas dengan kejadian hipertensi pada guru sman di kota mataram
Background: Hypertension is a condition of increased blood pressure which is currently the majority in society and is one of the causes of death worldwide. The highest prevalence of hypertension according to the highest occupational group is the government employees group, one of the government employees is a teacher. However, there are still few reports on the incidence of hypertension in teachers. Thus, the authors aimed to conduct a study to evaluate the relationship between smoking behavior and obesity with the incidence of hypertension among high school teachers in Mataram City.
Methods: This study used a cross-sectional design in August 2021. The population in this study were High School teachers in Mataram who are obese and smokers (not use electric cigarettes), determining the sample by purposive sampling. The independent variables included in this study were gender, obesity, and smoking behavior (smoking history, smoking duration, number of cigarettes, and type of cigarettes), and the dependent variable in this study was the incidence of hypertension. The data obtained is primary data collected using a questionnaire, then analyzed using the statistical application SPSS.
Results: A total of 52 subjects were included in this study, with an average age of 42.88 ± 9.17 years. We found that the majority were male (100%), obese type I (82.7%), with smoking behavior (active smokers (61.5%), moderate-heavy smokers (50%), smoking duration > 20 years (44.2%)) and the incidence of hypertension (50%). Based on the Chi-square test, smoking status had a significant relationship with the incidence of hypertension with a p-value = 0.046. Still, obesity did not have a significant relationship with the incidence of hypertension (p> 0.05).
Conclusion: It can be concluded that there is a significant relationship between smoking behavior and the incidence of hypertension, but not significant for obesity among high school teachers in Mataram City.
Latar belakang: Hipertensi adalah keadaan terjadinya peningkatan tekanan darah yang saat ini mayoritas terjadi di masyarakat dan menjadi salah satu penyebab kematian di seluruh dunia. Prevalens Hipertensi tertinggi menurut kelompok pekerjaan tertinggi adalah kelompok PNS (Pegawai Negeri Sipil), salah satu PNS adalah guru. Namun, masih sedikit yang melaporkan kejadian hipertensi pada guru sekolah. Dengan demikian, penulis bertujuan melakukan penelitian untuk mengevaluasi hubungan antara perilaku merokok dan obesitas dengan kejadian hipertensi pada Guru SMAN di Kota Mataram.
Metode: Penelitian ini menggunakan desain studi potong lintang pada Agustus 2021. Populasi pada penelitian ini adalah guru SMAN Kota Mataram yang mengalami obesitas serta merupakan perokok (tidak menggunakan rokok elektrik) dengan penentuan sampel dengan purposive sampling. Variabel bebas yang termasuk dalam penelitian ini adalah jenis kelamin, obesitas, dan perilaku merokok (riwayat merokok, lama merokok, jumlah rokok, dan jenis rokok) dan variabel terikat dalam penelitian ini adalah kejadian hipertensi. Data yang diperoleh adalah data primer dikumpulkan menggunakan kuesioner. Data yang telah terkumpul selanjutnya dilakukan analisis data menggunakan bantuan aplikasi statistik SPSS.
Hasil: Terdapat total 52 subjek yang termasuk dalam penelitian ini dengan rerata usia 42,88 ± 9,17 tahun. Kami menemukan mayoritas berjenis kelamin laki-laki (100%), obesitas tipe I (82,7%), dengan perilaku merokok (perokok aktif (61,5%), perokok sedang-berat (50%), lama merokok > 20 tahun (44,2%)) dan kejadian hipertensi (50%). Berdasarkan uji Chi-square melaporkan hasil bahwa status merokok memiliki hubungan yang signifikan terhadap kejadian hipertensi dengan nilai p = 0,046, namun obesitas tidak memiliki hubungan yang signifikan dengan kejadian hipertensi (p>0,05).
Simpulan: Dapat disimpulkan bahwa adanya hubungan yang signifikan antara perilaku merokok dengan kejadian hipertensi namun tidak signifikan untuk kondisi obesitas pada Guru SMAN di Kota Mataram.
Klasifikasi Etiologi Presbikusis Berdasarkan Hasil Audiogram di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Januari-Desember 2020
Pande Nyoman Bayu Tirtayasa, I Made WiranadhaOnline First: Jan 9, 2023
- Abstract
Klasifikasi Etiologi Presbikusis Berdasarkan Hasil Audiogram di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Januari-Desember 2020
Background: Presbycusis or age-related hearing loss, is the most common cause of hearing loss and also the most common neurodegenerative disorder. This age-related hearing loss occurs in the population over 60 years of age. This study aims to determine the type of presbycusis in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.
Methods: This study is a retrospective descriptive study with a total sample of 42 people taken consecutively in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.
Results: The results showed that the audiogram results based on the right and left ears, 42.8% and 45.2% had strial type presbycusis, 30.9% and 28.6% had cochlear type presbycusis, 21.4% and 23.8% had sensory type presbycusis, 4.8% and 2.4% had neural type presbycusis.
Conclusion: From the results of this study, it can be concluded that the average degree of deafness of the right and left ears is moderate-heavy, with the dominant type of presbycusis being the strial or metabolic type. Presbycusis shows a wide variation in the degree of deafness, hearing acuity, age of onset, and progression, so it is likely that the burden of presbycusis in the population may increase in the future.
Latar Belakang: Presbikusis atau penurunan pendengaran terkait usia, merupakan penyebab gangguan pendengaran dan sekaligus juga merupakan gangguan neurodegeneratif yang paling sering terjadi. Penurunan pendengaran terkait usia ini terjadi pada populasi usia lebih dari 60 tahun. Penelitian ini bertujuan untuk mengetahui jenis presbikusis pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.
Metode: Penelitian ini adalah penelitian deskriptif retrospektif dengan total sampel sebanyak 42 orang yang diambil secara konsekutif pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.
Hasil: Hasil penelitian menunjukkan bahwa hasil audiogram berdasarkan telinga kanan dan kiri, sebanyak 42,8% dan 45,2% mengalami presbikusis tipe strial, 30,9% dan 28,6% mengalami presbikusis tipe koklea, 21,4% dan 23,8% mengalami presbikusis tipe sensori, sebanyak 4,8% dan 2,4% mengalami presbikusis tipe neural.
Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa derajat ketulian telinga kanan dan kiri rata-rata adalah derajat sedang-berat, dengan tipe presbikusis yang dominan adalah tipe strial atau metabolik. Presbikusis memperlihatkan variasi yang beragam pada derajat ketulian, ketajaman pendengaran, onset umur, dan progresinya sehingga kemungkinan beban presbikusis di populasi dapat meningkat di kemudian hari.
Hubungan kualitas tidur terhadap intoleransi glukosa pada mahasiswa pendidikan dokter fakultas kedokteran universitas udayana
Dewa Gde Agung Aditya Mahadarmika, I Made Krisna Dinata, Nila WahyuniOnline First: Mar 31, 2023
- Abstract
Hubungan kualitas tidur terhadap intoleransi glukosa pada mahasiswa pendidikan dokter fakultas kedokteran universitas udayana
Background: Sleep play significant role in maintaining human homeostasis. However, lately many people forgot about their sleep, especially medical student that vulnerable to bad sleep quality. Bad sleep quality can disrupt glucose metabolism. That impairment can lead to manifesting glucose intolerance in that individual. The purpose of this study is to find out the correlation between poor sleep quality and glucose intolerance on medical education student at the Faculty of Medicine, Udayana University.
Methods: This research is analytics cross sectional using a retrospective questionnaire and Oral Glucose Tolerance Test (OGTT), using variable measurement: sleep quality, glucose tolerance, age, gender, and body mass index (BMI), with a total of 57 samples. Data is processed, analyzed, and presented using IBM SPSS Statistic 26.
Results: Majority of samples was male as many as 32 peoples (56.1%) and female, namely 25 peoples (43.1%). The highest number of samples aged 21 years (80.7%), and BMI <25, was 41 peoples (71.9%) and obesities or with BMI ≥ 25 as many as 16 peoples (28.1%). Samples with poor sleep quality was 28 peoples (49.1%) and with enough sleep quality 29 samples, and identified with glucose intolerance, was 13 samples (22.8%). Majority of student with enough and poor sleep quality had normal glucose tolerance. Correlation test using spearman rank indicate p=0,704.
Conclusion: There is no correlation between poor sleep quality and glucose intolerance on medical education student at the Faculty of Medicine, Udayana University, probably caused by other variables that not included in this research.
Latar belakang: Tidur berperan penting dalam mempertahankan homeostasis tubuh. Namun, belakangan ini banyak orang yang melupakan tidurnya, khususnya mahasiswa kedokteran yang merupakan kelompok yang rentan mengalami kualitas tidur yang buruk. Buruknya kualitas tidur dapat menyebabkan gangguan pada metabolisme glukosa. Hal tersebut akan mengarah pada terjadinya intoleransi glukosa pada individu tersebut. Tujuan penelitian ini mengetahui hubungan antara kualitas tidur dengan intoleransi glukosa pada mahasiswa Pendidikan Dokter Fakultas Kedokteran Universitas Udayana.
Metode: Penelitian ini bersifat analitik secara cross sectional menggunakan kusioner retrospektif dan pemeriksaan Oral Glucose Tolerance Test (OGTT), menggunakan pengukuran variabel: kualitas tidur, toleransi glukosa, usia, jenis kelamin, dan indeks massa tubuh (IMT), dengan jumlah sampel sebanyak 57 orang. Pengolahan, analisis, dan penyajian data menggunakan IBM SPSS Statistic 26.
Hasil: Sebagian besar sampel berjenis kelamin laki-laki sebanyak 32 orang (56,1%), diikuti perempuan sebanyak 25 orang (43,1%). Mayoritas sampel berusia 21 tahun (80,7%), dan memiliki IMT <25 sebanyak 41 orang (71,9%) dan obesitas atau IMT ≥ 25 sebanyak 16 orang (28,1%). Sampel dengan kualitas tidur kurang sebanyak 28 orang (49,1%) dan kualitas tidur cukup 29 orang (50,1%), serta teridentifikasi dengan intoleransi glukosa 13 (22,8%). Mahasiswa dengan kualitas tidur cukup maupun kurang, sebagian besar memiliki toleransi glukosa yang baik. Uji korelasi menggunakan spearman rank menunjukkan p=0,704.
Kesimpulan: tidak terdapat hubungan antara antara kualitas tidur dengan intoleransi glukosa pada mahasiswa Pendidikan Dokter Universitas Udayana yang kemungkinan disebabkan variabel lain yang tidak diteliti pada penelitian ini.
Hubungan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh pada pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha selama periode 2019-2021
I Gusti Ayu Tania Dwi Cahyanti, Sony Wijaya, Welly Hartono RuslimOnline First: Mar 1, 2023
- Abstract
Hubungan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh pada pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha selama periode 2019-2021
Background: Breast cancer is a malignancy that occurs in the breast tissue of the ductal epithelium and lobules of the breast. Indonesia, in this case, ranked first out of the four countries with the highest number of breast cancer cases, namely 58.265 new cases found and 22.692 death cases. Goldhirsch et al. found a classification of breast cancer based on the results of immunohistochemistry (IHC) staining of estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) receptors using fluorescent in situ hybridization. The classification was determined genetically and molecularly, namely: luminal A, luminal B, HER2- overexpressed cancer and triple negative (basal like) cancer. Obesity which is rated using the body mass index (BMI) is one of the risk factors for some cancers, including postmenopausal breast cancer and especially estrogen receptor (ER)-positive/progesterone receptor (PR)-positive breast cancer. Rose et al stated that obesity is inversely related to pre-menopausal breast cancer, where obesity is a protective factor.
Methods: The research plan for this research is research with a cross-sectional research design which will be using purposive sampling type of non-probability sampling as the sample selection technique.
Result: There are 94 medical records of breast cancer patients who visit Rumah Sakit Umum Ganesha (Ganesha Public Hospital). The value found from the analysis that has been done between the intrinsic subtype and BMI (body mass index) risk factors is p>0.05 which means there is no correlation between the two.
Conclusion: There is no relationship between the patient’s body mass index (BMI) with intrinsic subtypes in breast cancer patients.
Latar Belakang: Kanker payudara merupakan keganasan pada jaringan payudara yang berasal dari epitel duktus maupun lobulusnya. Indonesia merupakan peringkat pertama dari empat negara yang memiliki jumlah kasus kanker payudara tertinggi yaitu sebesar 58.265 kasus baru yang ditemukan dan sebanyak 22.692 kasus mengalami kematian. Goldhirsch et al. menemukan klasifikasi kanker payudara berdasarkan hasil pewarnaan imunohistokimia (IHK) dari reseptor estrogen, progesteron, dan human epidermal growth factor receptor 2 (HER2) menggunakan hibridisasi in situ fluoresen. Klasifikasi tersebut ditentukan secara genetik dan molekuler, yaitu: kanker luminal A, luminal B, HER2- yang diekspresikan secara berlebihan dan kanker triple negative (basal like). Obesitas yang dinilai melalui indeks massa tubuh (IMT) merupakan salah satu faktor risiko timbulnya beberapa kanker, termasuk pascamenopause kanker payudara dan khususnya reseptor estrogen (ER)-positif/ reseptor progesterone (PR)-positif kanker payudara. Rose et al menyebutkan bahwa obesitas berbanding terbalik dengan perimenopause kanker payudara, dimana obesitas merupakan faktor protektif.
Metode: Rancangan penelitian ini menggunakan desain penelitian cross-sectional dengan pemilihan sampel menggunakan teknik non-probability sampling jenis purposive sampling.
Hasil: Didapatkan 94 rekam medis pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha. Dari hasil analisis yang dilakukan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh (IMT) memiliki nilai p>0.05 yang memiliki arti tidak terdapat hubungan antara keduanya.
Simpulan: Tidak terdapat hubungan antara indeks massa tubuh (IMT) pasien dengan subtipe intrinsik pada pasien kanker payudara.
The predictive model of acute heart failure rehospitalization: A retrospective study in Prof. I.G.N.G Ngoerah Hospital
Nyoman Ririn Chandrika Sari, Hendy Wirawan, Rani Paramitha Iswari Maliawan, IGN Putra GunadhiOnline First: Feb 15, 2023
- Abstract
The predictive model of acute heart failure rehospitalization: A retrospective study in Prof. I.G.N.G Ngoerah Hospital
Introduction. Heart failure is one of the main causes of cardiovascular morbidity and mortality. Research stated that heart failure patients who have undergone 3 rehospitalizations have a survival rate of <50% within 1 year. Therefore, the purpose of this study is to characterize the risk factors that contribute to the occurrence of heart failure rehospitalization.
Method. This is a retrospective analysis of 113 patients with a first hospitalization for heart failure at Prof. I.G.N.G. Ngoerah Hospital between July 2018–February 2020. We collected and compared demographic data, clinical findings, electrocardiogram, laboratory, and echocardiography parameters during the first hospitalization between rehospitalized and non-rehospitalized patients. Rehospitalization was defined as recurrent hospital admission due to worsening heart failure symptoms. Patients were followed for rehospitalization events until death or November 2021.
Results. The rehospitalization rate in this study was 62.8% during a median follow-up of 234 days (12–1098 days). The average of heart failure rehospitalizations during follow-up was 1.73 times (±1.97), with an average length of stay of 6.40 days (±3.27 days). We discovered that the presence of mid/apical rales at admission (odds ratio [OR] 3.509; p=0.027), hyponatremia (<135 mmol/L) at pre-discharge (odds ratio [OR] 3.840; p=0.015), and tricuspid annular plane systolic excursion (TAPSE) values <1.80 cm (odds ratio [OR] 2.905; p=0.020) were independent risk factors for rehospitalization due to worsening heart failure symptoms. Patients with these three independent risk factors have a probability of 96.24% being readmitted.
Conclusion. Mid/apical rales at admission, hyponatremia at pre-discharge, and TAPSE values <1.80 cm in patients admitted for heart failure are associated with further rehospitalization.
Karakteristik analisa gas darah dan elektrolit pasien COVID-19 di RSUD Wangaya Denpasar
Xaverius Sastra Jaya, Gede Ngurah Budiasa, I Gusti Ayu Wiradari Tedja, Yoshevine Lorisika Ginting, Basri Nelson ManurungOnline First: Apr 30, 2023
- Abstract
Karakteristik analisa gas darah dan elektrolit pasien COVID-19 di RSUD Wangaya Denpasar
Background: Various laboratory results have been identified as predictors that can assist in diagnosis, disease staging, monitoring and treatment, prognosis, and surveillance in COVID-19 patients. Very little data is available on the analysis of blood gases (AGD) analysis electrolytes in COVID-19 patients.
Method: This study uses a descriptive study research method. The number of subjects was obtained by a total sampling approach with a total of 49 patients. The data was taken from the results of the examination of COVID-19 patients at the Clinical Pathology Laboratory of Wangaya Hospital from January to February 2022. This study used 2 variables, namely blood gas and electrolyte analysis of COVID-19 patients.
Result: A total of 49 patients were obtained. From 49 patients, the average age of patients with COVID-19 was 61.49 years with an age range of 20 to 97 years. Most of the COVID-19 patients had metabolic acidosis (21 patients; 42.9%). Compensatory conditions were found in 19 patients (38.8%). Electrolyte results on sodium levels were mostly normal values. Potassium results in most patients are at normal potassium levels. Chloride levels are mostly at normal chloride levels.
Conclusion: This study is expected to provide an overview of the analysis of blood gases and electrolytes of COVID-19 patients in determining the management of COVID-19 patients and can be used as a reference for further research.
Latar Belakang. Hasil laboratorium telah diidentifikasi sebagai prediktor yang dapat membantu dalam diagnosis, penentuan stadium penyakit, pemantauan dan pengobatan, prognosis hingga surveilenas pada pasien COVID-19. Sangat sedikit data yang tersedia pada hasil analisis gas darah (AGD) dan elektrolit pada pasien COVID-19.
Metode. Penelitian ini menggunakan metode penelitian studi deskriptif. Jumlah subjek didapatkan dengan pendekatan total sampling dengan total 49 pasien. Data diambil dari hasil pemeriksaan pasien COVID-19 di Laboratorium Patologi Klinik RSUD Wangaya dari Januari hingga Februari 2022. Penelitian ini menggunakan 2 variabel yaitu Analisa gas darah dan elektrolit pasien COVID-19.
Hasil. Didapatkan total 49 pasien. Dari 49 pasien didapatkan rata-rata usia pasien yang COVID-19 adalah 61,49 tahun dengan rentang usia 20 sampai 97 tahun. Pasien COVID-19 sebagian besar mengalami asidosis metabolik (21 pasien;42,9%). Kondisi kompensasi ditemukan pada 19 pasien (38,8%). Hasil elektrolit pada kadar natrium sebagian besar berada pada nilai normal. Hasil kalium sebagian besar pasien berada pada kadar kalium yang normal. Kadar klorida sebagian besar berada pada kadar klorida yang normal.
Kesimpulan. Penelitian ini diharapkan dapat memberikan gambaran analisa gas darah dan elektrolit pasien COVID-19 dalam menentukan manajemen pasien COVID-19 dan dapat digunakan sebagai dasar acuan penelitian selanjutnya.
Tingkat Pengetahuan, Sikap, dan Perilaku Mahasiswa PSSK FK Unud Angkatan 2021 Terhadap Pola Makan Sebagai Faktor Risiko Diabetes Melitus Tipe 2
Andre Lintang Kinivaldy, Ida Ayu Dewi Wiryanthini, I Wayan Gede Sutadarma, I Wayan SurudarmaOnline First: Mar 30, 2023
- Abstract
Tingkat Pengetahuan, Sikap, dan Perilaku Mahasiswa PSSK FK Unud Angkatan 2021 Terhadap Pola Makan Sebagai Faktor Risiko Diabetes Melitus Tipe 2
Background: Diabetes mellitus (DM) is still one of the most feared diseases and is the number three disease with the highest mortality risk globally. One of the risk factors for the occurrence of type 2 DM is bad eating habits that lead to obesity, which is the factor that tends to cause type 2 DM. Therefore, this study aims to know diet as a risk factor for type 2 diabetes mellitus in college students.
Methods: This research was conducted at the Faculty of Medicine, Udayana University, from September to November 2022, using a cross-sectional descriptive method. The primary data source was collected using a questionnaire. Data were analyzed univariately using the original SPSS version 25.
Results: Total of 247 respondent was include in this research. It was found that the majority of respondents were women aged 19 years with a good level of knowledge (91.5%) and good attitudes (81.4%) regarding diet as a risk factor for type 2 DM, and had the habit of regularly eating three times a day (66,8%).
Conclusion: Undergraduate medical students in the faculty of medicine at Udayana University class of 2021 have a good level of knowledge and attitudes towards diet as a risk factor for type 2 DM, and the behavior of regularly eating three times a day.
Latar belakang: Penyakit diabetes melitus (DM) sampai sekarang masih menjadi salah satu penyakit yang paling ditakuti dan merupakan penyakit nomor tiga yang paling berisiko tinggi tingkat mortalitasnya di dunia. Salah satu faktor risiko terjadinya DM tipe 2 adalah kebiasaan pola makan yang salah sehingga menimbulkan obesitas yaitu salah satu faktor kecenderungan terjadinya DM tipe 2. Studi ini bertujuan mengetahui pola makan sebagai faktor risiko diabetes melitus tipe 2 pada mahasiswa.
Metode: Penelitian ini dilakukan di Fakultas Kedokteran Universitas Udayana pada bulan September hingga November 2022 menggunakan metode deskriptif potong lintang dan sumber data yaitu data primer yang dikumpulkan menggunakan kuesioner. Data dianalisis secara univariat menggunakan aplikasi SPSS versi 25 original.
Hasil: Terdapat total 247 responden yang termasuk dalam penelitian ini. Didapatkan bahwa mayoritas responden merupakan perempuan dan berusia 19 tahun dengan tingkat pengetahuan baik (91,5%) dan sikap baik (81,4%) terhadap pola makan sebagai faktor risiko DM tipe 2, serta memiliki perilaku teratur makan tiga kali sehari (66,8%).
Kesimpulan: Mahasiswa PSSK FK UNUD angkatan 2021 memiliki tingkat pengetahuan serta sikap yang baik terhadap pola makan sebagai faktor risiko DM tipe 2, dan perilaku teratur makan tiga kali sehari.
Determinan stunting pada anak balita di kabupaten Pidie, Aceh, Indonesia
Putri Ilham Sari, Herlina Dimiati, Sofia , Muhammad SubiantoOnline First: May 17, 2023
- Abstract
Determinan stunting pada anak balita di kabupaten Pidie, Aceh, Indonesia
Background: Stunting is a chronic nutritional problem due to lack of nutrition in the long term, resulting in impaired growth in children. Stunting in children under five is a consequence of several factors that are often associated with poverty including nutrition, health, sanitation and the environment. There are many factors that influence stunting, one of the main factors causing stunting is an infectious disease that affects mothers and toddlers. The purpose of this study was to determine the relationship between maternal age, maternal infectious diseases, toddler age, sex and toddler infectious diseases with the incidence of stunting in toddlers in Simpang Tiga District and Kembang Tanjong District, Pidie Regency, Aceh, Indonesia in 2022.
Method: this study used an analytic observational design through a cross-sectional approach. The instrument in this study used a questionnaire with a total sampling technique of 25 toddlers and mothers in Simpang Tiga District and 35 mothers and toddlers in Kembang Tanjong District, Pidie Regency.
Results: Simpang Tiga District showed that maternal age (p=0.404), maternal infectious disease (p=0.897), toddler age (p=0.346), toddler infectious disease (p=0.173), and gender (p=0.561) these five variables have nothing to do with the incidence of stunting. Meanwhile in Kembang Tanjung District, the variable mother's age (p=0.002) and toddler's gender (p=0.010) showed a relationship with the incidence of stunting, while the other three variables, namely maternal infectious disease (p=0.445), toddler's age (p=0.096) ), and toddler infectious diseases (p=0.298) showed no association with stunting.
Conclusion: This study can be concluded that the age of the mother and the sex of the toddler greatly influence the incidence of stunting in Kembang Tanjung District, Pidie Regency.
Latar belakang: Stunting merupakan masalah gizi kronis karena kurangnya asupan gizi dalam jangka waktu panjang, sehingga mengakibatkan terganggunya pertumbuhan pada anak. Stunting pada anak balita merupakan konsekuensi dari beberapa faktor yang sering dikaitkan dengan kemiskinan termasuk gizi, kesehatan, sanitasi dan lingkungan. Banyak sekali faktor yang mempengaruhi stunting, salah satu faktor utama penyebab stunting yaitu penyakit infeksi yang diderita oleh ibu dan balita. Tujuan penelitian ini yaitu untuk mengetahui hubungan usia ibu, penyakit infeksi ibu, usia balita, jenis kelamin dan penyakit infeksi balita dengan kejadian stunting pada balita di Kecamatan Simpang Tiga dan Kecamatan Kembang Tanjong Kabupaten Pidie, Aceh, Indonesia tahun 2022.
Metodelogi: penelitian ini menggunakan desain observasional analitik melalui pendekatan cross secitonal. Instrumen dalam penelitian ini menggunakan kuesioner dengan teknik total sampling semuanya sebanyak 25 balita dan ibu di Kecamatan Simpang Tiga dan sebanyak 35 ibu dan balita di Kecamatan Kembang Tanjong Kabupaten Pidie.
Hasil penelitian: Kecamatan Simpang Tiga menunjukkan bahwa usia ibu (p=0,404), Penyakit infeksi ibu (p=0,897), usia balita (p=0,346), penyakit infeksi balita (p=0,173), dan jenis kelamin (p=0,561) kelima variabel tersebut tidak ada hubungan dengan kejadian stunting. Sementara di Kecamatan Kembang Tanjung bahwa variabel usia ibu (p=0,002) dan jenis kelamin balita (p=0,010) menujukkan ada hubungan dengan kejadian stunting, sedangkan ketiga variabel lain yaitu penyakit infeksi ibu (p=0,445), usia balita (p=0,096), dan penyakit infeksi balita (p=0,298) menunjukkan tidak ada hubungan dengan kejadian stunting.
Simpulan. Penelitian ini dapat disimpulkan bahwa usia ibu dan jenis kelamin balita sangat mempengaruhi terhadap kejadian stunting di Kecamatan Kembang Tanjung Kabupaten Pidie.
Gambaran Tingkat Pengetahuan Wanita Usia Subur Tentang Kanker Serviks dan Inspeksi Visual Asam Asetat (IVA) Terhadap Perilaku Pemeriksaan IVA di Puskesmas Mengwi II
Anom Krisna Mahatmika, Ni Nyoman Ayu Dewi, I Made Winarsa RumaOnline First: Mar 30, 2023
- Abstract
Gambaran Tingkat Pengetahuan Wanita Usia Subur Tentang Kanker Serviks dan Inspeksi Visual Asam Asetat (IVA) Terhadap Perilaku Pemeriksaan IVA di Puskesmas Mengwi II
Background: Early detection is one step to reducing cervical cancer morbidity and mortality. The low level of early detection of cervical cancer is influenced by the lack of knowledge in women of childbearing age regarding cervical cancer and visual inspection of acetic acid (IVA). This study aimed to evaluate the association between the level of knowledge about cervical cancer and IVA with IVA examination behavior.
Methods: This analytic observational study with a cross-sectional design involved women of childbearing age aged 15-49 years who visited the Mengwi II Badung Public Health Center (Puskesmas). Subjects were selected by accidental sampling and asked to fill out a questionnaire. Association between variables were assessed using chi-square test.
Results: A total of 109 respondents participated in this study. The majority of respondents were in the age range of 31-40 years (44%), the last education level was high school (59.6%), and were housewives (55%). More than half of the respondents had a low level of knowledge related to cervical cancer (59.6%), but the majority had sufficient and good knowledge about IVA examination (76.2%), although many had never had an IVA examination (79.8%). Knowledge level regarding IVA examination was related to IVA examination behavior (p=0.012), whereas knowledge level regarding cervical cancer was not related to IVA examination behavior (p=0.633).
Conclusion: The level of knowledge regarding IVA examination is associated with IVA examination behavior. Strategies to encourage early detection through IVA examination in women of childbearing age can be done with IVA education.
Latar belakang: Deteksi dini merupakan langkah untuk menurunkan morbiditas dan mortalitas kanker serviks. Upaya deteksi dini kanker serviks yang rendah dipengaruhi oleh kurangnya pengetahuan wanita usia subur mengenai kanker serviks dan inspeksi visual asam asetat (IVA). Penelitian ini bertujuan mengevaluasi hubungan tingkat pengetahuan mengenai kanker serviks dan IVA dengan perilaku pemeriksaan IVA.
Metode: Penelitian observasional analitik dengan desain cross-sectional ini melibatkan wanita usia subur dengan rentang usia 15-49 tahun yang berkunjung ke Puskesmas Mengwi II Badung. Subyek dipilih secara accidental sampling dan diminta untuk mengisi kuesioner. Uji chi-square digunakan untuk menilai hubungan antara variabel.
Hasil: Total 109 responden berpartisipasi dalam penelitian ini. Mayoritas responden dalam rentang usia 31-40 tahun (44%), pendidikan terakhir SMA (59,6%), dan seorang ibu rumah tangga (55%). Lebih dari separuh responden memiliki tingkat pengetahuan yang kurang terkait kanker serviks (59,6%), namun mayoritas memiliki pengetahuan yang cukup dan baik mengenai pemeriksaan IVA (76,2%), meskipun banyak yang belum pernah melakukan pemeriksaan IVA (79,8%). Tingkat pengetahuan mengenai pemeriksaan IVA berhubungan dengan perilaku pemeriksaan IVA (p=0,012), sebaliknya tingkat pengetahuan mengenai kanker serviks tidak berhubungan dengan perilaku pemeriksaan IVA (p=0,633).
Kesimpulan: Tingkat pengetahuan mengenai pemeriksaan IVA berhubungan dengan perilaku pemeriksaan IVA. Strategi dalam mendorong deteksi dini melalui pemeriksaan IVA pada wanita usia subur dapat dilakukan dengan edukasi IVA.
Psychosomatic disorder screening in health officers during the COVID-19 pandemic
Yanuar Ardani, Hamzah Shatri, Rudi Putranto, Dika Iyona Sinulingga, Edward Faisal, Rendi Faris AnggonoOnline First: Feb 13, 2023
- Abstract
Psychosomatic disorder screening in health officers during the COVID-19 pandemic
Background: Health workers are at high risk of developing depression, anxiety, and sleep disturbances due to increased stress during the COVID-19 pandemic; that matter is closely related to fatigue. The impact of psychosomatic disorders will have an immediate or indirect impact on the quality of health care services. This study aims to evaluate the psychosomatic disorder screening in health officers during the COVID-19 pandemic
Methods: A cross-sectional study was conducted in Esensia Clinic Semarang in February 2022. This study surveyed clinic health workers with completed questionnaires and had their Heart-Rate Variability (HRV) measurement. Data were analyzed using SPSS version 20 for Windows.
Results: About 138 subjects were recruited from Esensia Clinic, 100 subjects underwent this study until analysis. The unanxious subjects have the highest percentage accounting for 61.0%, followed by 25.0% mild anxiety, 12.0% moderate, and 2.0% severe. Furthermore, 86.0% were undepressed, followed by 13% mild and 1% moderate, but there was no severe case. Also, 65.0% did not experience fatigue and the percentage of good sleep quality (8.0%) is significantly lower than the poor (92.0%). The results also showed that 76.0% of the subjects had a balanced autonomic nervous system compared to the 24.0% of subjects with an autonomic imbalance.
Conclusion: The outcomes of psychosomatic disorders such as anxiety, depression, fatigue, and autonomic imbalance are generally poor. However, this study's prevalence of poor sleep quality was very high.
Characteristics of vascular risk factor and the presence of ventriculomegaly among patients with white matter changes in Bangli General Hospital, Bali, Indonesia
Made Dwi Andhika Yogiswara, Anak Agung Dewi AdnyaniOnline First: Apr 28, 2023
- Abstract
Characteristics of vascular risk factor and the presence of ventriculomegaly among patients with white matter changes in Bangli General Hospital, Bali, Indonesia
Background: White matter changes (WMC) is a common yet often incidental and neglected finding among older people in head CT or MRI examinations. This finding rarely becomes the main examination focus, although much research has proven its correlation with elderly disabilities, such as cognitive, executive, and motor function impairment. This lesion form is not fully understood, but chronic ischemic conditions may contribute due to a vascular risk factor (VRF) and ependymal cell impairment at the ventricular wall due to dilatation.
Methods: This research aimed to explore the characteristics of VRF (history of hypertension, diabetes mellitus, and dyslipidemia) and the presence of ventriculomegaly among patients with WMC finding on head CT examination. This research was conducted with a descriptive retrospective method using a data registry at Bangli General Hospital, Bali, Indonesia, in 2022.
Result: From 97 patients with WMC findings, most were aged >60 (77.30%). Ventriculomegaly was found in 33.00% of them. Almost all had a history of hypertension (92.80%), and a history of dyslipidemia was found in 61.9%. Of all VRF components, diabetes mellitus was the least frequently found in patients (19.60%). The majority of WMC lesions involved the periventricular structure.
Conclusion: WMC finding was more frequent among patients aged >60, with a history of hypertension being the most frequent compared to other components of VRF. Ventriculomegaly was found in one-third of them.
Karakteristik computer vision syndrome pada siswa SMA dengan internet gaming disorder
Putu Anggara Ahara Kartika, I Gusti Ayu Made Juliari, I Gusti Ayu Ratna Suryaningrum, I Wayan Eka SutyawanOnline First: Apr 17, 2023
- Abstract
Karakteristik computer vision syndrome pada siswa SMA dengan internet gaming disorder
Background: The rapid development of technology accompanied by a shift in sports interest towards eSports or online games in adolescents causes them to spend longer in front of the screen. Poor application of ergofthalmology can trigger Computer Vision Syndrome (CVS), while bad gaming habits can cause Internet Gaming Disorder (IGD).
Purpose: The purpose of this study is to know the characteristics of CVS with IGD in high school students.
Method: A descriptive study using a cross-sectional method with total sampling. Samples were taken from one of the high schools in Tabanan Regency. There were 362 samples that met the inclusion criteria. CVS diagnosis based on the CVS-Q questionnaire and the IGD with the IGDS-9-SF questionnaire in Indonesian. The features are based on gender, screentime and daily leisure time routine.
Results: The mean age of the respondents was 16.64 years ± 0.692. The overall CVS prevalence was 59.9% (n=217). The distribution of CVS symptoms included itchy eyes (53.3%; n=193), headaches (50.5%; n=183) and the sensation of burning and watery eyes (50.3%; n=182). The prevalence of ED was 0.8% (n=3); CVS without IGD 59.4% (n=215); while CVS with IGD was 0.6% (n=2). There are characteristics in screentime of more than 4 hours and daily routine of watching dramas/movies, while differences are found based on gender. Based on gender, CVS without IGD was more common in women (37.6%;n=136), while CVS accompanied by IGD had the same prevalence in both men and women of 0.3% (n=1)
Conclusion: There are similarities between CVS without IGD and CVS accompanied by IGD based on screen time and daily routines. Different characteristics found by sex.
Latar Belakang: Perkembangan teknologi yang semakin pesat diiringi pergeseran minat olahraga menuju eSports atau game online pada remaja menyebabkan mereka lebih lama melakukan aktivitas di depan layar. Penerapan ergoftalmologi yang buruk dapat memicu Computer Vision Syndrome (CVS), sedangkan kebiasaan bermain game yang buruk dapat menimbulkan Internet Gaming Disorder (IGD). Penelitian ini bertujuan untuk mengetahui karakteristik CVS pada siswa SMA dengan IGD
Metode: Studi deskriptif menggunakan metode potong lintang dengan total sampling. Sampel yang diambil dari salah satu SMA di Kabupaten Tabanan. Terdapat 362 sampel yang memenuhi kriteria inklusi. Diagnosis CVS berdasarkan kuisioner CVS-Q serta IGD dengan kuesioner IGDS-9-SF dalam bahasa Indonesia. Karakteristik dibandingkan berdasarkan jenis kelamin, screentime dan rutinitas harian saat senggang.
Hasil: Rerata usia responden 16,64 tahun ±0,692. Prevalensi CVS secara keseluruhan 59.9% (n=217). Distribusi gejala CVS diantaranya mata gatal (53,3%; n=193), sakit kepala (50,5%; n=183) dan sensasi mata perih serta berair (50,3%; n=182). Prevalensi IGD sebesar 0,8% (n=3); CVS tanpa disertai IGD 59,4% (n=215); sedangkan CVS disertai IGD 0,6% (n=2). Terdapat kesamaan karakteristik pada screentime lebih dari 4 jam dan rutinitas harian menonton drama/film, sedangkan perbedaan ditemukan berdasarkan jenis kelamin. Berdasarkan jenis kelamin, CVS tanpa disertai IGD lebih banyak terjadi pada perempuan (37,6%;n=136), sedangkan CVS disertai IGD memiliki prevalensi yang sama baik pada laki-laki dan perempuan sebesar 0,3% (n=1)
Kesimpulan: Karakteristik antara CVS tanpa disertai IGD dengan CVS disertai IGD terdapat kesamaan berdasarkan screentime dan rutinitas harian. Perbedaan karakteristik ditemukan berdasarkan jenis kelamin.
Hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia
Rogerio Andrez Kosasih, Luh Oliva Saraswati Suastika, Cyndiana Widia Dewi Sinardja, I Gusti Ngurah Bagus ArtanaOnline First: Jan 10, 2023
- Abstract
Hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia
Introduction: The prevalence of Rheumatic heart disease (RHD) was reported to reach 30 million cases worldwide with mortality up to 305,000 people each year. RHD can be accompanied by rheumatic aortic stenosis which is a narrowing of the aortic valve of the heart. Recent studies have shown that increasing age is associated with worsening of the stenosis condition caused by several mechanisms including the calcification process and cytokine dysregulation, but related research is still limited in Indonesia. This study aims to determine the correlation between the severity of aortic stenosis related to rheumatic heart disease and age at Prof. RSUP. Dr. I.G.N.G Ngoerah, Denpasar, Bali.
Method: This cross-sectional study was conducted on the population of patients with rheumatic aortic stenosis at Prof. RSUP. Dr. I.G.N.G Ngoerah. Data collection was carried out using medical records of 2018-2022 period. All data processing was carried out using the SPSS ver. 26.
Result: A total of 34 patients with rheumatic aortic stenosis were collected to be mostly <60 years old, 29 patients (85,3%) with the mean age of all patients was 48 ± 14.5 years. As many as 19 patients (55.9%) had severe, 10 patients (29.4%) had moderate, and 5 patients (14.7%) had mild stenosis severity. Bivariate analysis showed there was a significant correlation between age and severity of stenosis (r=0.501; p=0.003).
Conclusion: Therefore, this study concluded that there was a significant correlation between the severity of stenosis and age in patients with rheumatic aortic stenosis at Prof. RSUP. Dr. I.G.N.G Ngoerah.
Pendahuluan: Prevalensi Rheumatic heart disease (RHD) dilaporkan mencapai 30 juta kasus di seluruh dunia serta menjadi penyebab kematian sebanyak 305 ribu jiwa tiap tahunnya. RHD dapat disertai dengan rheumatic aortic stenosis yang merupakan penyempitan katup aorta jantung. Studi terbaru menunjukkan bahwa peningkatan usia berkaitan dengan perburukan kondisi stenosis yang disebabkan oleh beberapa mekanisme termasuk proses kalsifikasi dan disregulasi sitokin, namun penelitian terkait masih terbatas di Indonesia. Penelitian ini bertujuan untuk mengetahui hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia di RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, Bali.
Metode: Penelitian ini merupakan studi observasional dengan desain potong lintang dengan teknik pengumpulan data menggunakan total sampling pada populasi pasien rheumatic aortic stenosis di di RSUP Prof. Dr. I.G.N.G Ngoerah. Pengumpulan data dilakukan dengan rekam medis periode 2018-2022. Pengolahan data dilakukan menggunakan aplikasi SPSS ver.26 dengan analisis univariat dan bivariat (Uji Spearm`an’s Rho).
Hasil: Sebanyak 34 pasien rheumatic aortic stenosis diperoleh dengan sebagian besar berusia <60 tahun, yakni sebanyak 29 pasien (85,3%) dengan rerata usia seluruh pasien adalah 46,4 ± 14,7 tahun. Adapun sebanyak 19 orang (55,9%) memiliki tingkat keparahan berat (severe), 10 orang (29,4%) dengan keparahan sedang (moderate), dan 5 orang (14,7%) dengan keparahan ringan (mild). Analisis bivariat menunjukkan terdapat hubungan yang signifikan antara usia dengan tingkat keparahan stenosis pada pasien rheumatic aortic stenosis (r=0,501; p=0,003).
Conclusion: Terdapat hubungan yang signifikan antara tingkat keparahan stenosis dengan usia pada pasien rheumatic aortic stenosis di RSUP Prof. Dr. I.G.N.G Ngoerah.
Rasio perbandingan nilai transepidermal water loss (TEWL) dan power of hydrogen (PH) lesi psoriatic dan non-lesi psoriatic
Putu Gde Hari Wangsa, Ketut Kwartantaya Winaya, I Gusti Ayu Agung Elis Indira, I Gusti Ayu Agung Praharsini, I Gusti Nyoman Darmaputra, Ni Made Dwi Puspawati, Made WardhanaOnline First: Jan 27, 2023
- Abstract
Rasio perbandingan nilai transepidermal water loss (TEWL) dan power of hydrogen (PH) lesi psoriatic dan non-lesi psoriatic
Introduction: Psoriasis is a chronic inflammation of the skin. The remission rate of psoriasis is 10-60%, with the risk of depression, skin cancer and suicide. Inflammation leads decrease of skin hydration, and pH, thus it makes destruction of skin barrier. Therefore, this study aimed to determine the function and integrity of the skin barrier as seen from TEWL and pH in psoriatic and non-psoriatic lesions in psoriasis vulgaris patients.
Method: This was a crossectional study, that was conducted in RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar around May – July 2022. This study used a consecutive sampling technique, after that the sample was adjusted with the inclusion and exclusion criteria. The data was analyzed by using SPSS version 25. Bivariate analysis used Independent T-Test, for the multivariate analysis used linear regression.
Results: This study obtained 28 samples with the majority was male (60.7%). The average age of the sample was 45.68±15.04. The mean TEWL value in the psoriatic lesion group (24.78 ± 4.77) was higher and the mean pH was lower (5.25 ± 0.18) than the non-psoriatic lesion (TEWL:11.75 ± 2.79; pH 5.63 ± 0.21). TEWL and pH ratio between psoriatic lession and non psoriatic lesion is (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). The difference was statistically significant (p<0,01).
Conclusion: There was a significant relationship between an increase in TEWL value and a decrease in pH value in the psoriatic group of lesions compared to the non-psoriatic group.
Latar Belakang : Psoriasis merupakan penyakit inflamasi kronis pada kulit. Psoriasis dilaporkan memiliki tingkat remisi yang tinggi sebesar 10-60%, dengan risiko depresi, kanker kulit, dan bunuh diri. Inflamasi dapat menyebabkan penurunan hidrasi dan PH kulit, sehingga menyebakan kerusakan barrier kulit. Tujuan dari penelitian ini adalah untuk mengetahui fungsi dan integritas barrier kulit dilihat dari TEWL dan pH pada lesi psoriatic dan non-lesi psoriatic pada pasien psoriasis vulgaris.
Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar, dilakukan pada bulan Mei – Juli 2022. Teknik pengambilan sampel yang digunakan yaitu consecutive sampling dan diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah di tentukan. Data di analisis menggunakan SPSS versi 25. Analisis bivariat menggunakan Independent T-Test, dan analisis multivariat yang digunakan menggunakan regresi linear.
Hasil : Penelitian ini mendapatkan 28 sampel dengan mayoritas berjenis kelamin laki-laki (60,7%). Rata-rata sampel berusia 45,68±15,04. Rerata nilai TEWL pada pada kelompok lesi psoriatic (24,78 ± 4,77) lebih tinggi dan rerata pH lebih rendah (5,25 ± 0,18) dibandingkan non-lesi psoriatic (TEWL:11,75 ± 2,79; pH 5,63 ± 0,21). Rasio TEWL dan pH lesi psoriatic dibandingkan non-lesi psoriatic adalah (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). Perbedaan tersebut signifikan secara statistik (p<0,01).
Simpulan: Adapun kesimpulan dari penelitian ini yakni lesi psoriatic secara signifikan memiliki nilai TEWL yang lebih tinggi namun pH yang lebih rendah dengan rasio TEWL sebesar 2,19 ± 0,11 dan rasio pH sebesar 0,93 ± 0,01.
Hubungan kebugaran jasmani terhadap kemampuan memori jangka pendek pada mahasiswa program studi sarjana kedokteran fakultas kedokteran Universitas Udayana
Daffa Satria Nugraha, Ketut Tirtayasa, Indira Vidiari Juhanna, Nila WahyuniOnline First: Apr 17, 2023
- Abstract
Hubungan kebugaran jasmani terhadap kemampuan memori jangka pendek pada mahasiswa program studi sarjana kedokteran fakultas kedokteran Universitas Udayana
Background: Physical fitness is one aspect that needs to be fulfilled by humans in order to be able to carry out activities without feeling significant fatigue. Short-term memory is a memory storage system with limited capabilities. The educational process requires good memory skills so that a person can receive information that can then be processed according to the individual's needs. Increased physical fitness caused by aerobic exercise has been reported to be able to increase brain perfusion and plasticity in the hippocampal area which then improves memory abilities. This study aims to determine the relationship between physical fitness and short-term memory abilities.
Method: This analytic observational study used a cross-sectional design to evaluate the relationship between the test variables. The research sample was students of the Bachelor of Medicine Study Program, Faculty of Medicine, Udayana University for the academic year 2022/2023 who met the research criteria, and the method of taking was using simple random sampling. Physical fitness is measured by the physical fitness index. Short-term memory ability was assessed by the Modified Harvard Step Test and Digit span test. Data analysis was performed with SPSS v. 20.
Results: A total of 100 students were obtained as research subjects. Most of the subjects had a very good physical fitness index, 33 students (33%) and good short-term memory skills, 37 students (37%). The results of the bivariate analysis showed a significant relationship between the two variables in students of the Medical Faculty Study Program, Faculty of Medicine, Udayana University with a chi-square value (p = 0.02) and a Spearman rank value (p = 0.018).
Conclusion: There was a significant relationship between physical fitness and the short-term memory of the student.
Latar Belakang: Kebugaran jasmani merupakan aspek yang berkaitan dengan kesehatan fisik manusia. Memori jangka pendek merupakan sistem penyimpanan memori dengan kapasitas yang terbatas. Adapun proses pendidikan membutuhkan kemampuan memori yang baik. Meningkatnya kebugaran jasmani yang disebabkan oleh olahraga aerob telah dilaporkan mampu meningkatkan perfusi dan plastisitas otak pada daerah hipokampus yang dapat meningkatkan kemampuan memori. Penelitian ini bertujuan mengetahui hubungan kebugaran jasmani terhadap kemampuan memori jangka pendek pada mahasiswa.
Metode: Penelitian ini merupakan studi observasional analitik dengan desain cross sectional untuk melihat hubungan antara variabel uji. Sampel penelitian adalah mahasiswa Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun ajaran 2022/2023 yang memenuhi kriteria penelitian, dengan cara pengambilan menggunakan simple random sampling. Kebugaran jasmani diukur dengan indeks kebugaran jasmani berdasarkan Modified Harvard Step Test. Kemampuan memori jangka pendek dinilai dengan dan Digit span test. Analisis data dilakukan dengan SPSS v.20.
Hasil: Sebanyak 100 mahasiswa diperoleh sebagai subjek penelitian. Sebagian besar subjek memiliki indeks kebugaran jasmani yang sangat baik, yakni sebanyak 33 orang (33%) dan kemampuan memori jangka pendek yang baik, sebanyak 37 orang (37%). Analisis bivariat menunjukkan hubungan yang signifikan antara kedua variabel pada mahasiswa Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana berdasarkan uji chi-square (p = 0,02) dan rank spearman (p=0,018).
Simpulan: Terdapat hubungan signifikan antara kebugaran jasmani dengan kemampuan memori jangka pendek pada mahasiswa.
Mutasi Gen KRAS Ekson 2 Kodon 12 dan 13 Pada Pasien Kanker Kolorektal di RSUP Prof. Dr. I.G.N.G. Ngoerah Tahun 2018-2019
Angelynn Rachelle Ormand, Made Winarsa Ruma, Ni Putu Ekawati, I Made Mulyawan, Ni Nyoman Ayu DewiOnline First: Mar 30, 2023
- Abstract
Mutasi Gen KRAS Ekson 2 Kodon 12 dan 13 Pada Pasien Kanker Kolorektal di RSUP Prof. Dr. I.G.N.G. Ngoerah Tahun 2018-2019
Background: Colorectal cancer is commonly found to be regulated by the KRAS gene mutation. Studies reporting the occurrence of mutations in the KRAS gene in Indonesia are still limited. The purpose of this study was to determine the prevalence and characteristics of mutations in the KRAS gene exon 2 codon 12 and codon 13 in colorectal cancer patients at Prof. dr. I.G.N.G. Ngoerah, Denpasar-Bali.
Methods: This study used a quantitative descriptive method with a cross-sectional design. The sample used in this study was the Formalin-Fixed Paraffin-Embedded (FFPE) sample of colorectal cancer patients in year 2018-2019. KRAS gene mutations were identified using PCR and sequencing method. Univariate analysis was used to display data in proportions or graphics with the Microsoft Excel application.
Results: A total of 50 colorectal cancer samples were examined. The majority of patients were aged ≥50 years (76.0%) and male (62.0%). Based on histopathology, the majority cases were adenocarcinoma (80%) and mostly were left tumor location (64.0%). The results of sequencing showed mutations in the KRAS gene that 6 cases of exon 2 codon 12 mutations (13.63%) and 3 cases of exon 2 codon 13 mutations (6.8%); with features of 5 cases (11.36%) of G12D mutations and 1 case (2.27%) of G12V mutation and all the 3 mutations in the KRAS gene exon 2 codon 13 were G13D (6.81%).
Conclusion: This study concluded that exon 2 KRAS gene mutations in colorectal cancer patients at Prof. dr. I.G.N.G Ngoerah in 2018-2019 can be identified by the characteristics of the type of mutation, namely G12D followed by G12V and G13D. The types of mutations sequentially from the most frequent are G12D, G12V, and G13D. Further studies are needed to identify the correlation of this mutation with clinicopathology of colorectal cancer.
Latar belakang: Kanker kolorektal umumnya ditemukan diregulasi oleh mutasi gen KRAS. Studi yang melaporkan kejadian mutasi pada gen KRAS di Indonesia masih terbatas. Tujuan penelitian ini adalah untuk mengetahui prevalensi dan karakteristik mutasi gen KRAS ekson 2 kodon 12 dan 13 pada pasien kanker kolorektal di RSUP Prof. dr. I.G.N.G. Ngoerah tahun 2018-2019.
Metode: Penelitian ini menggunakan metode deskriptif kuantitatif dengan desain potong lintang. Sampel yang digunakan dalam penelitian ini adalah sampel Formalin-Fixed Parrafin-Embedded (FFPE) pasien kanker kolorektal tahun 2018-2019. Penilaian mutasi gen KRAS dengan metode PCR dan sequencing. Analisis univariat digunakan untuk menampilkan data dalam bentuk persentase ataupun grafik dengan aplikasi Microsoft Excel.
Hasil: Total 50 sampel kanker kolorektal diperiksa. Mayoritas pasien berusia ≥50 tahun (76,0%) dan laki-laki (62,0%). Berdasarkan histopatologi mayoritas ditemukan tipe Adenocarcinoma (80%) dan lokasi tumor bagian kiri (64,0%). Hasil pemeriksaan sequencing menunjukkan mutasi gen KRAS diperoleh 6 kasus mutasi ekson 2 kodon 12 (13,63%) dan 3 kasus mutasi ekson 2 kodon 13 (6,8%) dengan karakteristik mutasi yaitu 5 kasus (11,36%) mutasi tipe G12D dan 1 kasus (2,27%) mutasi tipe G12V dan 3 mutasi pada gen KRAS ekson 2 kodon 13 yaitu tipe G13D (6,81%).
Simpulan: Penelitian ini menyimpulkan bahwa mutasi gen KRAS ekson 2 pada pasien kanker kolorektal di RSUP Prof. dr. I.G.N.G Ngoerah tahun 2018-2019 dapat diindentifikasi dengan karakteristik jenis mutasi yaitu G12D diikuti G12V dan G13D. Jenis mutasinya secara berurutan dari yang paling sering adalah G12D, G12V, dan G13D. Studi lebih lanjut diperlukan untuk mengidentifikasi korelasi mutasi ini dengan klinikopatologi kanker kolorektal.
Prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021
Bella Trisha Agung Saraswati, I Dewa Ayu Inten Dwi Primayanti, Luh Putu Ratna Sundari, I Putu Adiartha GriadhiOnline First: Jan 11, 2023
- Abstract
Prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021
Introduction: One of the mandatory health protocols during the COVID-19 pandemic is wearing a mask. Masks that are used for a long time can increase the risk of developing acne vulgaris in the area around the mouth and nose (mask acne). The impact caused by acne masks is very detrimental both in terms of aesthetics, comfort, and psychology. This study aims to analyze the prevalence and risk factors for mask acne in undergraduate medical students and the medical profession at Udayana University class of 2019-2021.
Methods: This study has a cross-sectional design with observational analytic methods. The sample of this research was 260 respondents who were taken by consecutive sampling. Data analysis was performed by chi-square test and logistic regression.
Results: The prevalence of mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 is 50.8%. Risk factors for mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 include skin type (p = 0.025), oily skin condition after using a mask (p <0.001), and having a history of acne vulgaris due to sunlight (p = 0.002).
Conclusion: About half of the 2019-2021 class of Udayana University Faculty of Medicine students experience mask acne with various risk factors.
Pendahuluan: Salah satu protokol kesehatan saat pandemi COVID-19 yang wajib dilakukan adalah menggunakn masker. Masker yang digunakan dalam waktu lama dapat meningkatkan risiko timbulnya acne vulgaris di area sekitar mulut dan hidung (mask acne). Dampak yang ditimbulkan mask acne sangat merugikan baik dari segi estetika, kenyamanan, dan psikologis. Penelitian ini memiliki tujuan untuk menganalisis prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021.
Metode: Penelitian ini memiliki desain cross-sectional dengan metode analitik observasional. Sampel dari penelitian ini sebanyak 260 responden yang diambil dengan cara consecutive sampling. Analissi data dilakukan dengan uji chi-square dan regresi logistik.
Hasil: Prevalensi mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 adalah 50,8%. Faktor risiko mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 antara lain jenis kulit (p = 0,025), kondisi kulit berminyak setelah menggunakan masker (p<0,001), dan memiliki riwayat acne vulgaris akibat sinar matahari (p = 0,002).
Simpulan: Sekitar setengah dari jumlah mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 mengalami mask acne dengan berbagai faktor risiko.
Hubungan lama mengalami Diabetes Melitus Tipe-2 (DMT2) dengan terjadinya Sindrom Defisiensi Testosteron (SDT) di Puskesmas Denpasar Selatan I, Bali, Indonesia
Arlinto Martogi Simanjuntak, I Gusti Ngurah Pramesemara, I Gusti Ayu Dewi RatnayantiOnline First: Apr 28, 2023
- Abstract
Hubungan lama mengalami Diabetes Melitus Tipe-2 (DMT2) dengan terjadinya Sindrom Defisiensi Testosteron (SDT) di Puskesmas Denpasar Selatan I, Bali, Indonesia
Background: Type 2 Diabetes Mellitus (T2DM) is a metabolic condition defined by uncontrolled blood sugar due to disruptions in insulin secretion, insulin performance, or both, which can lead to Testosterone Deficiency Syndrome (SDT) in males. This study aims to assess the link between the length of T2DM and the occurrence of SDT at the South Denpasar I Health Center in Bali, Indonesia.
Methods: An analytic cross-sectional study was undertaken at the South Denpasar I Health Center in Bali, Indonesia, utilizing purposive sampling based on inclusion and exclusion criteria in 2022. The duration of T2DM was the independent variable in this study, while the dependent variable was Testosterone Deficiency Syndrome (TDS) (ADAM score). TDS was calculated using the ADAM score questionnaire, which consisted of ten validated "yes or no" items translated into Indonesian. SPSS version 20 for Windows was used to analyze the data.
Results: Most of the respondents were aged 36-45 years (46.7%), domiciled in Denpasar (70.0%), had normal BMI (18-25 kg/m2) (66.7%), had smoking habits (63.3%), did not have a habit of consuming alcohol (86.7%), duration of type II DM > 12 months (83.3%), and positive ADAM score (80.0%). The bivariate analysis results showed a significant relationship between the duration of T2DM and the ADAM score (p=0.003).
Conclusion: There is a statistically significant relationship between the length of time experiencing T2DM and the occurrence of testosterone deficiency syndrome obtained through medical record data and filling out the ADAM score questionnaire
Latar Belakang: Diabetes Melitus tipe 2 (DMT2) adalah suatu penyakit metabolik yang dikarakteristikkan dengan tidak terkontrolnya gula darah karena adanya gangguan pada sekresi insulin, kinerja insulin, ataupun keduanya dimana dapat memicu komplikasi pada laki-laki berupa Sindrom Defisiensi Testosteron (SDT). Penelitian ini bertujuan untuk mengevaluasi hubungan lama mengalami DMT2 dengan terjadinya SDT di Puskesmas Denpasar Selatan I, Bali, Indonesia.
Metode: Penelitian observasional analitik dengan pendekatan potong lintang dilakukan di Puskesmas Denpasar Selatan I, Bali, Indonesia pada tahun 2022 dengan purposive sampling berdasarkan kriteria inklusi dan eksklusi. Variabel bebas pada penelitian ini adalah lama mengalami DMT2 sedangkan variabel tergantung pada penelitian ini adalah Sindrom Defisiensi Testosteron (SDT) (skor ADAM). SDT ditetapkan berdasarkan kuesioner skor ADAM yang terdiri dari 10 pertanyaan “ya atau tidak” yang sudah divalidasi dan dialih bahasa ke Bahasa Indonesia. Data dianalisis dengan SPSS versi 20 untuk Windows.
Hasil: Sebagian besar responden berusia 36-45 tahun (46,7%), berdomisili di Denpasar (70,0%), memiliki IMT normal (18-25 kg/m2) (66,7%), memiliki kebiasaan merokok (63,3%), tidak memiliki kebiasaan konsumsi alkohol (86,7%), durasi DM tipe II > 12 bulan (83,3%), dan hasil positif skor ADAM (80,0%). Hasil analisis bivariat menunjukkan bahwa terdapat hubungan yang bermakna antara durasi DMT2 dengan skor ADAM (p=0,003)
Kesimpulan: Terdapat hubungan bermakna secara statistik antara lama waktu mengalami DMT2 dengan terjadinya sindrom defisiensi testosteron yang didapat melalui data rekam medis dan pengisian kuesioner skor ADAM
Hubungan kecanduan penggunaan smartphone dan kualitas tidur terhadap tekanan darah mahasiswa Fakultas Kedokteran Unizar Angkatan 2019, 2020, dan 2021
Kadek Dyah Kirana Pusparani, I Gusti Putu Winangun, Nisia Putri Rinayu, Danang Nur AdiwibawaOnline First: Apr 1, 2023
- Abstract
Hubungan kecanduan penggunaan smartphone dan kualitas tidur terhadap tekanan darah mahasiswa Fakultas Kedokteran Unizar Angkatan 2019, 2020, dan 2021
Background: Hypertension is a disease with a high prevalence which is the second highest disease in NTB for 2 consecutive years. The conditions of the 4.0 era which resulted in a high level of smartphone use among college students and poor sleep quality in theory could lead to an increase in blood pressure. However, in the development of these two variables there are pros and cons. There are still very few studies in Mataram and the pros and cons regarding these two variables make researchers interested in researching this matter. The aim of this study is to analyze the relationship between addiction to smartphone use and sleep quality to blood pressure of Unizar Faculty of Medicine students Batch 2019-2021.
Methods: This study used a cross-sectional research design and stratified random sampling technique using students from the Faculty of Medicine, Islamic University of Al-Azhar Mataram from the 2019-2021 class, totaling 81 respondents who met the exclusion criteria, namely not experiencing or undergoing treatment for hypertension, sleep disorders, and anxiety disorders, or anxiety disorders.
Results: In total, the majority of 81 respondents had a high level of addiction to smartphone use (91.4%), then as many as 65.4% had poor sleep quality. The sleep quality variable has no significant relationship to systolic blood pressure with a p-value of 0.265 and to diastolic blood pressure with a p-value of 0.469. There is no significant relationship between the level of addiction to smartphone use with systolic blood pressure with a p-value of 0.863 and diastolic blood pressure with a p-value of 0.396.
Conclusion: Based on the results of this study it can be concluded that there is no significant relationship between the level of addiction to smartphone use and sleep quality on blood pressure.
Latar Belakang: Hipertensi merupakan penyakit dengan prevalensi tinggi yang menjadi penyakit dengan urutan kedua tertinggi di NTB selama 2 tahun berturut-turut. Kondisi era 4.0 yang menjadikan tingkat penggunaan smartphone yang tinggi pada mahasiswa serta kualitas tidur yang buruk secara teori dapat menimbulkan peningkatan tekanan darah. Namun, dalam perkembangannya kedua variabel tersebut terdapat pro dan kontra. Masih sedikitnya penelitian ini di Mataram serta adanya pro kontra mengenai kedua variabel tersebut membuat peneliti tertarik untuk meneliti hal ini. Tujuan dari penelitian ini adalah menganalisis hubungan kecanduan penggunaan smartphone dan kualitas tidur terhadap tekanan darah mahasiswa FK Unizar angkatan 2019-2021.
Metode: Penelitian ini menggunakan desain penelitian cross sectional dan teknik stratified random sampling menggunakan mahasiswa Fakultas Kedokteran Universitas Islam Al-Azhar Mataram dari angkatan 2019 - 2021 yang berjumlah 81 responden yang memenuhi kriteria eksklusi yaitu tidak mengalami dan atau menjalani pengobatan hipertensi, gangguan tidur, serta gangguan kecemasan atau anxiety disorder.
Hasil Penelitian : Total 81 responden mayoritas memiliki tingkat kecanduan penggunaan smartphone yang tinggi (91,4 %), lalu sebanyak 65,4 % memiliki kualitas tidur yang buruk. Variabel kualitas tidur tidak memiliki hubungan yang signifikan terhadap tekanan darah sistol dengan p-value 0.265 dan terhadap tekanan darah diastol dengan p-value 0.469. Variabel tingkat kecanduan penggunaan smartphone tidak terdapat hubungan yang signifikan terhadap tekanan darah sistol dengan p-value 0.863 dan tekanan darah diastolik dengan p-value 0.396.
Simpulan: Berdasarkan hasil penelitian ini dapat disimpulkan bahwa, tidak terdapat hubungan yang signifikan antara tingkat kecanduan penggunaan smartphone dan kualitas tidur terhadap tekanan darah.
Hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada karsinoma sel skuamosa serviks uteri di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar
Mellinda Wijaya, Ni Wayan Winarti, I Gusti Ayu Sri Mahendra Dewi, Herman Saputra, Putu Erika Paskarani, I Made MuliartaOnline First: Feb 15, 2023
- Abstract
Hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada karsinoma sel skuamosa serviks uteri di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar
Background: Cervical cancer still shows a high incidence rate in developing countries. Various factors play roles in cancer progression, including Galectin 3, which contributes to apoptosis, metastasis, immune response, molecular systems, mRNA splicing, gene expression and inflammation. This study aims to prove the association between Galectin 3 expression and FIGO stage of cervical squamous cell carcinoma (SCC) patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, to strengthen the evidence of Galectin 3 roles in cervical SCC prognosis.
Methods: This study is an analytic observational study with a cross-sectional design. Sample size was 42. Evaluation of H-E slides was performed to assess diagnosis and FIGO. Galectin 3 expression was assessed by immunohistochemical method. Data were analyzed by Chi-Square test and prevalence risk ratio analysis using SPSS version 20.0 for Windows.
Results: The mean of patients age was 52.34±9.86 years, with the highest incidence in the sixth decade age and in the early FIGO stage (IB - IIA). About 81% of patients show positive Galectin 3 expression. The relationship between Galectin 3 expression and FIGO stage was statistically significant (p=0.016). The prevalence risk analysis showed that patients with positive Galectin 3 expression had a 1.9 times greater prevalence risk of developing an advanced stage than patients with negative expression (95% CI: 1.376 - 2.593).
Conclusion: There is an association between Galectin 3 expression and FIGO stage in cervical cancer patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, in which patients with positive Galectin 3 have a greater risk of developing an advanced stage.
Latar Belakang : Kanker serviks uteri masih menunjukkan angka insiden tinggi di negara berkembang. Berbagai faktor berperan dalam progresi kanker, salah satunya Galectin 3, yang berkontribusi dalam proses apoptosis, metastasis, respon imun, sistem molecular, mRNA splicing, ekspresi gen dan inflamasi. Penelitian ini bertujuan untuk membuktikan hubungan ekspresi Galectin 3 dengan stadium FIGO pasien karsinoma sel skuamosa (KSS) serviks di RSUP Prof. Dr. I.G.N.G. Ngoerah, untuk memperkuat bukti peran Galectin 3 pada prognosis KSS serviks.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan potong lintang. Besar sampel 42. Evaluasi preparat hematoxyllin-eosin dilakukan untuk menilai diagnosis dan stadium FIGO. Ekspresi Galectin 3 dinilai dengan metode imunohistokimia. Data dianalisis dengan uji Chi-Square, yang dilanjutkan dengan uji rasio risiko prevalensi menggunakan SPSS versi 20.0 untuk Windows.
Hasil: Rerata usia pasien 52,34±9,86 tahun, dengan kejadian tertinggi pada kelompok umur dekade keenam dan dengan stadium FIGO dini (IB - IIA). Sekitar 81% pasien menunjukkan ekspresi Galectin 3 positif. Hubungan antara ekspresi Galectin 3 dengan stadium FIGO ditemukan signifikan secara statistik (p=0,016). Pada analisis risiko prevalensi didapatkan pasien dengan ekspresi Galectin 3 positif memiliki risiko prevalensi 1,9 kali lebih besar menjadi stadium lanjut daripada pasien dengan ekspresi negatif (95% IK: 1,376 - 2,593).
Kesimpulan: Terdapat hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada pasien KSS serviks di RSUP Prof. Dr. I.G.N.G. Ngoerah, di mana pasien dengan Galectin 3 positif memiliki risiko lebih besar menjadi stadium lanjut.
Karakteristik pasien ptosis di Rumah Sakit Umum Pusat Prof. dr. I G.N.G. Ngoerah
Putri Ayu Wulandari, Ni Made Laksmi Utari, Ni Made Ayu Surasmiati, I Gusti Ayu Ratna SuryaningrumOnline First: Jan 10, 2023
- Abstract
Karakteristik pasien ptosis di Rumah Sakit Umum Pusat Prof. dr. I G.N.G. Ngoerah
Background: Ptosis or blepharoptosis is a condition where the eyelid droops below its normal position. Ptosis can affect the visual field by reducing the patient's visual acuity. Ptosis is also considered a problem in appearance because the patient will always look tired and sleepy. If not treated immediately, ptosis can cause further complications, such as refractive errors, strabismus, and amblyopia. The purpose of this study is to identify the demographic and clinical characteristics of ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital.
Methods: This descriptive study with a cross-sectional design and total sampling was carried out at Prof. dr. I G.N.G. Ngoerah Hospital with ptosis patient data in 2019-2021.
Results: There were 45 ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021. In this study, the majority of ptosis patients were male. (53.3%). Patients in this study had a mean age of 37.91±23.55 years old with a median of 33(1-85). Unilateral ptosis (88.9%) and acquired ptosis (73.3%) were the most common ptosis cases found in this study. There are three etiologies that dominate ptosis cases, namely neurogenic (28.9%), traumatic (28.9%), and myogenic (26.7%) ptosis. Most of the ptosis patients have a severe degree of ptosis (60.0%). As many as 80% of ptosis patients receive surgical management.
Conclusion: Ptosis cases in Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021 were dominated by male patients, unilateral ptosis, acquired ptosis, neurogenic, and severe degree. Further research is required to evaluate the association between variables. with a larger population.
Latar Belakang: Ptosis atau blepharoptosis merupakan kondisi turunnya kelopak mata di bawah posisi normal. Ptosis dapat memengaruhi lapang pandang dengan mengurangi ketajaman visual pasien. Ptosis juga dianggap sebagai permasalahan dalam penampilan dikarenakan pasien akan selalu terlihat kelelahan dan mengantuk. Apabila tidak segera ditangani, ptosis dapat menyebabkan terjadinya komplikasi lebih lanjut, seperti kelainan refraksi, strabismus, dan ambliopia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik demografis dan klinis pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah.
Metode: Penelitian deskriptif dengan desain cross-sectional dan penentuan sampel secara total sampling ini dilaksanakan di RSUP Prof. dr. I G.N.G. Ngoerah dengan data pasien ptosis pada tahun 2019-2021.
Hasil: Pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 berjumlah 45 orang. Sebagian besar pasien ptosis dalam penelitian ini berjenis kelamin laki-laki (53,3%). Pasien dalam penelitian ini memiliki rerata usia 37,91±23,55 tahun dengan median 33 (1-85). Ptosis unilateral (88,9%) dan acquired ptosis (73,3%) merupakan kasus ptosis yang mendominasi dalam penelitian ini. Terdapat tiga etiologi yang mendominasi kasus ptosis pada pasien, yaitu ptosis neurogenik (28,9%), traumatik (28,9%), dan miogenik (26,7%). Sebagian besar pasien ptosis memiliki derajat keparahan dalam kategori berat (60,0%). Sebanyak 80% dari pasien ptosis menerima tatalaksana operasi.
Simpulan: Kasus ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 didominasi oleh pasien laki-laki, ptosis unilateral, acquired ptosis, neurogenik, dan derajat berat. Penelitian lebih lanjut diperlukan untuk menilai hubungan antar variabel dengan populasi yang lebih besar.
Kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris
Aditya Permana, Made Swastika Adiguna, Luh Made Mas RusyatiOnline First: Jan 31, 2023
- Abstract
Kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris
Introduction: Psoriasis is a chronic autoimmune cutaneous disorder, which the exact etiology remains unknown. There is study showed psoriasis is associated with low levels of vitamin D. In recent years, vitamin D acted by vitamin D receptor (VDR) has been reported, which keratinocyte is one of the tissues presenting vitamin D receptor. This study aims to prove that low levels vitamin D receptor plasma is a risk factor for psoriasis vulgaris.
Method: This case-control study design in 25 patients with psoriasis vulgaris as cases and 25 controls who fulfilled the inclusion and exclusion criteria as well as in matching based on age and gender in Dermatovenereology Polyclinic of I.G.N.G Ngoerah Hosptital, then performed venous blood sampling as material examination vitamin D receptor plasma levels with enzyme-linked immunosorbent assay (ELISA) technique. The collected data was analyzed using SPSS version 20.0 with Pearson Chi square test to obtain Odds Ratio. This study showed that vitamin D receptor plasma levels in the case group were significantly lower than the control group (p<0.05).
Result: Odds ratio for vitamin D receptor plasma was 46.00 (95% CI= 8.03-263.63; p<0.001).
Conclusion: Based on these study results we can conclude low levels vitamin D receptor plasma as a risk factor the occurrence of psoriasis vulgaris.
Pendahuluan: Psoriasis merupakan penyakit kulit autoimun kronis yang belum diketahui penyebabnya dengan jelas. Terdapat penelitian yang menunjukkan psoriasis berhubungan dengan kadar vitamin D yang rendah. Beberapa tahun terakhir, terdapat penelitian yang menyatakan bahwa vitamin D bekerja melalui vitamin D receptor (VDR), dimana keratinosit merupakan salah satu jaringan yang mempresentasikan VDR. Penelitian ini bertujuan untuk membuktikan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Metode: Penelitian ini menggunakan rancangan case control study yang melibatkan 25 pasien psoriasis vulgaris sebagai kasus dan 25 kontrol yang memenuhi kriteria inklusi dan eksklusi serta dilakukan matching berdasarkan umur dan jenis kelamin di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP I.G.N.G Ngoerah Denpasar, kemudian dilakukan pengambilan darah vena sebagai pemeriksaan kadar vitamin D receptor plasma menggunakan teknik enzyme-linked immunosorbent assay (ELISA). Data yang terkumpul kemudian dianalisis menggunakan SPSS versi 20.0 dengan uji Pearson Chi Square untuk mendapatkan Odds rasio.
Hasil: Pada penelitian ini menunjukkan bahwa kadar vitamin D receptor plasma pada kelompok kasus lebih rendah secara bermakna dibandingkan kelompok kontrol (p<0,05) dengan Odds rasio untuk kadar vitamin D receptor plasma adalah 46,00 (IK 95%= 8,03-263,63, p<0,001).
Simpulan: Berdasarkan penelitian ini dapat disimpulkan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Karakteristik Pasien COVID-19 Rawat Inap di RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Juni-Agustus 2021
I Gusti Ngurah Metta Nurcahya, Sonia Elvira Salim, Luh Wulandari, I Made Siswadi SemadiOnline First: Mar 30, 2023
- Abstract
Karakteristik Pasien COVID-19 Rawat Inap di RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Juni-Agustus 2021
Background: The clinical manifestations of coronavirus disease 2019 (COVID-19) in Indonesia vary, ranging from asymptomatic to severe symptoms, and various factors influence the clinical course. This study aims to determine the characteristics of hospitalized COVID-19 patients.
Methods: A study with descriptive cross-sectional design was conducted at the Prof. Dr. I.G.N.G. Ngoerah General Hospital, involving COVID-19 patients hospitalized during June-August 2021. The characteristics studied included age, gender, body mass index (BMI), domicile, last education level, occupation, smoking history, history of co-morbidities, and increased c-reactive protein and D-Dimer level. Descriptive analysis was conducted for the data obtained through medical records.
Results: 80 COVID-19 patients were recorded during the study period. The majority of patients were >55 years old (51.25%), female (51.25%), with normal BMI (45%), domiciled in Denpasar (48.75%), last education level was Senior High School (46.25 %), did not work (22.5%), did not have a history of smoking (53.75%), had comorbidities (91.25%), and experienced increased CRP (80%) and D-Dimer (88.75%).
Conclusion: The majority of COVID-19 patients hospitalzed in Prof. Dr. I.G.N.G. Ngoerah General Hospital during June-August 2021 were >55 years old, female, had normal BMI, with comorbidities, and had elevated levels of CRP and D-Dimer.
Latar belakang: Manifestasi klinis coronavirus disease 2019 (COVID-19) di Indonesia bervariasi, mulai dari asimtomatik hingga gejala berat, dan perjalanan klinisnya dipengaruhi berbagai faktor. Penelitian ini ingin melaporkan karakteristik pasien COVID-19 rawat inap.
Metode: Penelitian cross-sectional deskriptif di Rumah Sakit Umum Pusat (RSUP) Prof. Dr. I.G.N.G. Ngoerah, melibatkan pasien COVID-19 yang dirawat inap, dilakukan pada periode Juni-Agustus 2021. Karakteristik pasien meliputi usia, jenis kelamin, indeks massa tubuh (IMT), domisili, tingkat pendidikan terakhir, pekerjaan, riwayat merokok, riwayat penyakit penyerta, serta peningkatan c-reactive protein dan D-Dimer. Data diperoleh melalui rekam medis dan dianalisis secara univariat.
Hasil: Sebanyak 80 pasien COVID-19 tercatat selama periode penelitian. Mayoritas pasien berusia >55 tahun (51,25%), berjenis kelamin perempuan (51,25%), dengan IMT normal (45%), berdomisili Denpasar (48,75%), tingkat pendidikan terakhir Sekolah Menengah Atas (46,25%), tidak bekerja (22,5%), tidak memiliki riwayat merokok (53,75%), memiliki komorbid (91,25%), serta mengalami peningkatan CRP (80%) dan D-Dimer (88,75%).
Kesimpulan: Pasien COVID-19 dirawat inap di RSUP Prof. Dr. I.G.N.G. Ngoerah pada periode Juni-Agustus 2021 mayoritas berusia >55 tahun, perempuan, memiliki IMT normal, dengan komorbid, dan mengalami peningkatan kadar CRP dan D-Dimer.
The prognostic role of NLR, PLR, and LMR in predicting mortality of COVID-19 patients in a rural area
Ade Ajeng Cempakadewi, Brigitta Marcia Budihardja, Carissa Cornelia Chundiawan, Apolonia Berenika Badu, Anselmus Ake, Gusti Ayu Sri BidaniOnline First: Mar 7, 2023
- Abstract
The prognostic role of NLR, PLR, and LMR in predicting mortality of COVID-19 patients in a rural area
Introduction: COVID-19 has been a challenge worldwide. This infection can manifest in various characteristics, from asymptomatic to severe, leading to mortality. Predictive tools to predict mortality are highly important in better therapeutic strategies. Hematology ratios, including neutrophil, platelet, lymphocyte, and monocyte, have been suggested as a prognostic tool that is widely available. The study aimed to assess the prognostic significance of NLR, PLR, and LMR in predicting COVID-19 patients' mortality in a rural setting.
Methods: Hospitalized patients with COVID-19 at Bajawa Regional General Hospital were included in this retrospective cohort study. The patient's medical records from January 2021 to August 2021 were examined. The patients were separated into two groups; in-hospital death and discharged group. The routine blood examination during admission gave NLR, PLR, and LMR results. Data analysis was processed with SPSS 26. The Receiver Operating Characteristic (ROC) curve is used to determine whether NLR, PLR, and LMR may be used as prognostic indicators for hospitalized patients’ outcomes. The area under the curve (AUC) results were used to rate the accuracy.
Results: There were 91 patients in total. NLR, PLR, and LMR, AUCs were 0.689, 0.635, and 0.653, with cut-off values of 4.28, 184.12, and 2.69, respectively. Each indicator’s sensitivity and specificity remained poor. The cut-off value of PLR was the only indicator that had significant differences when compared between the two groups.
Conclusion: NLR, PLR, and LMR performed poor values as predictors of mortality in hospitalized patients with COVID-19.
Kadar 4-hidroksinonenal pada melasma lebih tinggi dibandingkan dengan kontrol dan berkorelasi positif dengan tingkat keparahan melasma
I Gusti Ngurah Ariwangsa Asbita, I Gusti Ayu Agung Elis Indira, Ketut Kwartantaya Winaya, Luh Made Mas Rusyati, Nyoman Suryawati, Ni Made Dwi PuspawatiOnline First: Apr 15, 2023
- Abstract
Kadar 4-hidroksinonenal pada melasma lebih tinggi dibandingkan dengan kontrol dan berkorelasi positif dengan tingkat keparahan melasma
Background: Melasma or chloasma is a condition of hyperpigmentation of the skin, especially the facial area which is commonly found in women due to exposure to ultraviolet (UV) and hormonal influences. The development of melasma disease is generally evaluated using oxidative parameters that reflect conditions of oxidative stress and accumulation of ROS in the skin. 4 Hydroxinonenal (4-HNE) is a photo-oxidation product that is more stable than other ROS groups and can represent the condition of cyanocytes and melanocytes in the skin.
Method: Analytical observational study with a cross-sectional approach. The research was carried out from October – December 2022 at the Dermatology and Venereology Polyclinic and Clinical Pathology Laboratory, Sanglah Hospital Denpasar. The sample consisted of 40 melasma samples and 20 non-melasma samples aged 18-65 years who were selected through consecutive sampling according to inclusion and exclusion criteria. The sample is taken by taking 3 milliliters of venous blood which will then be examined for 4-HNE with an ELISA kit. Data analysis was carried out using SPSS version 23 and the value of p <0.05 was significant.
Results: The results of the analysis showed that the group with melasma had significantly higher levels of 4-HNE (765.22±243.65 ng/mL) compared to the non-melasma group (347,68±110,99 ng/mL). The results of the correlation analysis showed that there was a significant correlation between 4-HNE levels and the MASI score with a correlation coefficient (r) of 0.955 and a p-value of 0.000.
Conclusion: The mean 4-HNE level in melasma group was significantly higher when compared to non-melasma group. 4-HNE levels were significantly correlated and directly proportional to the severity of melasma as measured by the MASI score.
Latar Belakang: Melasma atau chloasma merupakan suatu kondisi hiperpigmentasi pada kulit, khususnya daerah wajah yang umumnya ditemukan pada wanita akibat adanya paparan sinar ultraviolet (UV) dan pengaruh hormonal. Perkembangan penyakit melasma umumnya dievaluasi menggunakan parameter oksidatif yang mencerminkan kondisi stres oksidatif dan akumulasi ROS pada kulit. 4 Hidroksinonenal (4-HNE) merupakan photo-oxidation product yang bersifat lebih stabil dibandingkan golongan ROS lainnya dan dapat merepresentasikan kondisi keranosit dan melanosit pada kulit.
Metode: Studi observasional analitik dengan pendekatan potong lintang. Penelitian dilaksanakan mulai bulan Oktober - Desember 2022 di Poliklinik Kulit dan Kelamin dan Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Sampel terdiri dari 40 sampel melasma dan 20 sampel bukan melasma yang berusia 18-65 tahun yang dipilih melalui consecutive sampling sesuai kriteria inklusi dan eksklusi. Sampel dilakukan pengambilan 3 mililter darah vena yang kemudian akan diperiksa 4-HNE dengan kit ELISA. Analisis data dengan SPSS versi 23 dan nilai p<0.05 bermakna signifikan.
Hasil: Hasil analisis menunjukkan bahwa kelompok dengan melasma secara signifikan memiliki kadar 4-HNE yang lebih tinggi (765,22±243,65 ng/mL) dibandingkan dengan kelompok non-melasma (347,68±110,99 ng/mL). Hasil analisis korelasi menunjukkan bahwa korelasi yang signifikan antara kadar 4-HNE dengan skor melasma area and severity index (MASI) dengan nilai koefisien korelasi (r) sebesar 0,955 dan nilai p sebesar 0,000.
Kesimpulan: Rerata kadar 4-HNE pada kelompok melasma secara signifikan lebih tinggi jika dibandingkan dengan kelompok non-melasma. Kadar 4-HNE berkorelasi secara signifikan dan berbanding lurus dengan tingkat keparahan melasma yang diukur dengan skor MASI.
Luaran klinis pada pasien dengan penyakit hirschprung paska tindakan transanal Swenson-like dan transanal Soave satu tahap
Nyoman Rudy Kurniawan Giri, Made Darmajaya, I Gde Raka WidianaOnline First: Apr 4, 2023
- Abstract
Luaran klinis pada pasien dengan penyakit hirschprung paska tindakan transanal Swenson-like dan transanal Soave satu tahap
Introduction: Hirsprung's case surgery method is usually done through 3 stages. Since the three-step method greatly influences the incidence of postoperative enterocolitis and malnutrition, a single-stage surgery technique was developed. This technique is safe, cost-effective, and avoid stoma-related morbidity in infants. This study aimed to determine the difference in the clinical outcome between Swenson-like transanal and Soave 1 stage transanal procedures in patients with hirschsprung's disease.
Methods: This was a retrospective cohort study by taking secondary data from patient medical records from years 2017 to 2021. The total sample of 100 Hirschprung patients was divided into two groups; patients with transanal Swenson-like surgical techniques and Soave. Data were tabulated and statistically analyzed with descriptive and association analysis.
Results: There were differences in operating time based on the surgical technique used, with a median of 120.00 minutes in the 1st stage Swenson-like transanal technique group and 150.17 minutes in the transanal Soave group. The length of stay of patients with the Swenson-like surgical technique was shorter than the Soave technique (p <0.001). Postoperative complications of enterocolitis were less common with the Swenson-like technique than with the Soave technique.
Conclusion: There are differences in clinical outcomes in postoperative Hirschsprung patients with the Swenson-like and Soave 1 stage transanal technique..
Pendahuluan: Metode pembedahan kasus hirschsprung pada umumnya dilakukan melalui 3 tahap. Namun metode tiga tahap sangat berpengaruh terhadap kejadian enterokolitis dan malnutrisi paska pembedahan, sehingga dikembangkan pembedahan dengan teknik 1 tahap yang diketahui aman, cost-effective, dan menghindari morbiditas akibat stoma pada bayi. Penelitian ini bertujuan untuk mengetahui perbedaan luara klinis antara tindakan transanal Swenson-like dan transanal Soave 1 tahap pada pasien dengan penyakit Hirschsprung.
Metode: Penelitian ini merupakan penelitian retrospective cohort dengan mengambil data sekunder dari rekam medis pasien dari tahun 2017 sampai 2021. Total sampel sebanyak 100 pasien Hirschprung dibagi menajadi dua kelompok, yaitu teknik operasi transanal Swenson-like dan teknik operasi Soave. Data ditabulasi dan dianalisis statistik dengan menggunakan uji deskriptif dan asosiasi.
Hasil: Terdapat perbedaan lama waktu operasi berdasarkan teknik operasi yang digunakan, dengan median 120,00 menit pada kelompok teknik transanal Swenson-like 1 tahap dan 150,17 menit pada kelompok transanal Soave. Durasi lama rawat inap pasien teknik operasi Swenson-like lebih singkat dibandingkan teknik Soave (p < 0,001). Komplikasi enterokolitis paska bedah lebih jarang terjadi pada teknik operasi Swenson-like dibandingkan dengan Soave.
Simpulan: Terdapat perbedaan luara klinis pada pasien hirschsprung paska tindakan bedah dengan teknik transanal Swenson-like dan Soave 1 tahap.
Komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah di RSUD Wangaya Kota Denpasar
Ancelia Limantara, Wayan Bikin Suryawan, Anak Agung Made Sucipta, Han's ChristianOnline First: Jan 10, 2023
- Abstract
Komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah di RSUD Wangaya Kota Denpasar
Background: A bilirubin level in the blood higher than normal is called hyperbilirubinemia. Hyperbilirubinemia's prevalence is 60% in term newborns and 80% in preterm newborns. Low birth weight is a risk factor for hyperbilirubinemia. Phototherapy for low birth weight with hyperbilirubinemia is given for a longer time and has a higher rebound effect. This study aims to compare phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth weight.
Methods: Analytical study using medical records at Wangaya Hospital during January 2020-January 2022. Inclusion criteria include hyperbilirubinemia required phototherapy, bilirubin level before and after phototherapy checked, and single light phototherapy. Exclusion criteria include conjugated hyperbilirubinemia, exchange transfusion, sepsis, severe congenital malformation, patients in NICU and incomplete medical record.
Results: From 99 study subjects, 19% had low birth weight, and 81% had normal birth weight. The mean bilirubin serum before phototherapy was 15.52mg/dL for LBW and 15.27mg/dL for NBW. The mean bilirubin serum after phototherapy was 5.77mg/dL for LBW and 7.46mg/dL for NBW. The mean bilirubin difference was 9.75mg/dL for LBW and 7.81mg/dL for NBW. The mean phototherapy duration was 52 hours for LBW and 47.6 hours for NBW. Decreasing rate of bilirubin was 0.19mg/dL/hour for LBW and 0.18mg/dL/hour for NBW. Independent t-test showed a p-value of 0.571, meaning no significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth.
Conclusion: No significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between NBW and LBW. But, phototherapy in LBW was started earlier, required more time and has a lower bilirubin level target than NBW.
Latar Belakang: Bilirubin darah melebihi normal disebut hiperbilirubinemia. Prevalensi hiperbilirubinemia berkisar antara 60% pada bayi cukup bulan dan 80% pada bayi prematur. Bayi berat lahir rendah merupakan risiko hiperbilirubinemia. Fototerapi bayi berat lahir rendah diberikan lebih lama daripada bayi berat lahir normal dan memiliki efek rebound lebih tinggi. Tujuan penelitian adalah mengetahui komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Metode: Penelitian analitik menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi pada penelitian ini adalah pasien hyperbilirubinemia yang memerlukan fototerapi, kadar bilirubin sebelum dan sesudah fototerapi, dan fototerapi single-light. Kriteria eksklusi meliputi hiperbilirubinemia terkonjugasi, transfusi tukar, sepsis, kelainan kongenital berat, pasien perawatan di NICU, serta rekam medis tidak lengkap.
Hasil: Dari 99 subyek penelitian, 19% BBLR dan 81% BBLN. Rerata bilirubin pre-fototerapi 15,52 mg/dL pada BBLR dan 15,27 mg/dL pada BBLN. Rerata bilirubin post fototerapi 5,77mg/dL pada BBLR dan 7.46 mg/dL pada BBLN. Rerata selisih bilirubin fototerapi 9,75 mg/dL pada BBLR dan 7,81 mg/dL pada BBLN. Rerata waktu fototerapi 52 jam pada BBLR dan 47,6 jam pada BBLN. Laju turun bilirubin 0,19 mg/dL/jam pada BBLR dan 0,18 mg/dL/jam pada BBLN. Uji t-test tidak berpasangan menunjukkan p-value > 0,05 yaitu 0,571 menandakan tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Kesimpulan: Tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah. Namun, didapatkan bahwa fototerapi dimulai pada usia yang lebih awal, dengan waktu fototerapi yang lebih lama dan target bilirubin pasca fototerapi yang lebih rendah pada kelompok BBLR dibandingkan BBLN.
Hubungan kemampuan berpikir kritis terhadap keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana
Icha Milenia Yanwar, I Gusti Ayu Sri Darmayani, I Gde Haryo Ganesha , I Putu Bayu MayuraOnline First: Jan 10, 2023
- Abstract
Hubungan kemampuan berpikir kritis terhadap keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana
Introduction: Problem-based learning is a method of approach in assisting students in finding problems from a real event. This can affect learning methods to increase skills of critical thinking and active learning, where critical thinking will encourage the formation of knowledge and will be interpreted personally and will be applied to conditions or problems so as to increase active learning. This study aims to determine association between critical thinking skills towards active learning in medical students at Universitas Udayana.
Methods: The respondents of this study were medical students class 2020 in Universitas Udayana. The type of this research is analytic research with a cross-sectional approach. The sampling technique used was the total sampling method and used a questionnaire of critical thinking and active learning.
Results: A total of 165 respondents met the inclusion criteria in this research. The analysis results showed that critical thinking skills increased active learning significantly (p < 0.001) with moderate and direct correlation (r = 0.574).
Conclusion: The ability to think critically can affect the level of active learning in medical education students.
Pendahuluan: Salah satu metode pendekatan untuk membantu mahasiswa dalam menemukan masalah dari suatu peristiwa yang nyata adalah pembelajaran berbasis masalah. Hal ini dapat mempengaruhi metode belajar yang menyebabkan peningkatan kemampuan berpikir dan keaktifan belajar. Berpikir kritis akan mendorong terbentuknya pengetahuan dan akan diinterpretasi personal dan akan diaplikasikan pada kondisi atau masalah sehingga meningkatkan keaktifan belajar. Penelitian ini memiliki tujuan untuk menganalisis hubungan antara kemampuan berpikir kritis dan keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Metode: Responden penelitian ini adalah mahasiswa program studi sarjana kedokteran Universitas Udayana angkatan 2020. Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang. Teknik pengambilan sampel dilakukan dengan total sampling dan menggunakan kuesioner berpikir kritis dan keaktifan belajar.
Hasil: Sebanyak 165 responden memenuhi kriteria inklusi dalam penelitian ini. Hasil analisis menunjukkan bahwa kemampuan berpikir kritis meningkatkan keaktifan belajar secara signifikan (p < 0,001) dengan korelasi sedang dan searah (r = 0,574).
Simpulan: Kemampuan berpikir kritis dapat mempengaruhi tingkat keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Asupan protein hewani berhubungan dengan stunting pada anak usia 1-5 tahun di lingkungan kerja Puskesmas Nagi Kota Larantuka, Kabupaten Flores Timur
Wega Upendra Sindhughosa, I Gusti Lanang SidiarthaOnline First: Apr 20, 2023
- Abstract
Asupan protein hewani berhubungan dengan stunting pada anak usia 1-5 tahun di lingkungan kerja Puskesmas Nagi Kota Larantuka, Kabupaten Flores Timur
Background: Protein is an essential macronutrient that contains essential components. Protein plays a crucial role in the growth and development of children. Imbalance between protein requirements and protein intake can lead to stunting in children.
Objective: To determine the relationship between animal protein intake in children aged 1-5 years who experience stunting in the working environment of Nagi Public Health Center in Larantuka City.
Methods: This study was a cross-sectional study. Data were obtained from primary data, and questionnaires were distributed consisting of three main parts, including the characteristics of the research sample, nutritional intake of the research sample, and eating habits of the research sample. Protein intake in this study was calculated using nutritional survey. Chi-square was used as the statistical test. Comparative categorical Chi-square analysis was also performed with the independent variable of animal protein intake pattern and the dependent variable of stunting.
Results: A total of 124 children who met the inclusion criteria were included in this study. The results of this study showed that among all respondents who experienced stunting, 78.3% had an animal protein intake pattern of <2 times/week. This was statistically significant with a p-value <0.01 and confidence interval of 5.16-28.89. Furthermore, among all respondents who experienced stunting, 34.8% had a plant protein intake pattern of <2 times/week. This was not statistically significant with a p-value >0.01 and confidence interval of 0.651-1.809. The results of multivariate analysis with logistic regression showed that only animal protein consumption variable showed a significant association with stunting with an odds ratio (OR) of 76.6 and 95% confidence interval (CI) of 20.4-291.7.
Conclusion: Animal protein intake has a greater influence on the occurrence of stunting compared to plant protein intake.
Latar Belakang: Protein merupakan makronutrien penting yang mengandung komponen esensial. Protein berperan penting dalam pertumbuhan dan perkembangan anak. Tidak seimbangnya antara kebutuhan protein dengan asupan protein menyebabkan terjadinya stunting pada anak.
Tujuan: Menentukan hubungan asupan protein hewani pada anak usia 1-5 tahun yang mengalami stunting di lingkungan kerja Puskesmas Nagi Kota Larantuka.
Metode: Penelitian ini merupakan penelitian cross-sectional. Data berasal dari data primer kemudian dilakukan penyebaran kuesioner yang terdiri atas 3 bagian utama yang mencakup karakteristik sampel penelitian, asupan nutrisi sampel penelitian serta kebiasaan makan dari sampel penelitian. Cara menghitung asupan protein pada penelitian ini dengan menggunakan nutritional survey. Uji statistik yang digunakan adalah Chi-square. Kemudian dilakukan juga analisis komparatif kategorik Chi-square dengan variabel independen pola asupan protein hewani dan variabel dependent berupa stunting.
Hasil: Sebanyak 124 anak yang memenuhi kriteria inklusi diikutsertakan dalam penelitian ini. hasil studi ini menunjukkan bahwa dari semua responden yang mengalami stunting, sebanyak 78,3% memiliki pola asupan protein hewani <2x/minggu. Hal ini signifikan secara statistik dengan nilai p<0,01 dan interval kepercayaan 5,16-28,89, kemudian dari semua responden yang mengalami stunting, sebanyak 34,8% memiliki pola asupan protein nabati <2x/minggu. Dimana hal ini tidak signifikan secara statistik dengan nilai p>0,01 dan interval kepercayaan 0,651-1,809. Hasil uji analisis multivariat dengan regresi logistik, hanya variabel konsumsi protein hewani yang menunjukkan hubungan yang bermakna terhadap stunting dengan (OR 76,6 95% CI 20,4-291,7).
Simpulan: Asupan protein hewani lebih berpengaruh terhadap terjadinya stunting dibandingkan asupan protein nabati.
Profil klinikopatologi karsinoma prostat di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar periode tahun 2017-2020
Jennifer Louisa, I Wayan Juli Sumadi, Herman Saputra, Ni Putu EkawatiOnline First: Jan 31, 2023
- Abstract
Profil klinikopatologi karsinoma prostat di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar periode tahun 2017-2020
Background: Prostate cancer or prostate carcinoma is a malignancy that occurs in the cells of the prostate gland and is associated with chronic problems with sexual function, urination, and the patient's psychological well-being. This study was conducted to investigate the clinicopathological profile of prostate cancer patients at Prof dr. I G.N.G. Ngoerah in the period 2017 – 2020.
Methods: This descriptive study used a cross-sectional design conducted at Prof. dr. I G.N.G. Ngoerah Central Hospital. The inclusion criteria were prostate cancer patients in 2017-2020 and the exclusion criteria were patients with incomplete medical record data. The determination of the sample using total sampling with the number of samples that meet the criteria of 82 patients. All statistical analyzes used SPSS ver.25.
Results: Patients in this study had a mean age of 70.89±9.26 years, with the majority aged 50 years and above (97.6%). Most of the patients had the main symptom of urination difficulty (57.5%). PSA levels in patients had a mean of 543.3 ng/mL. Most of the patients had reached stage IV at the time of diagnosis (92.1%). Transurethral resection is the most common specimen retrieval method (47.6%). Almost all samples were diagnosed as acinar adenocarcinoma (95.2%) with the majority categorized into Gleason grade group 5 (64.9%).
Conclusion: Prostate carcinoma cases at Prof. dr. I G.N.G. Ngoerah mostly occurs at the age of >50 years with the main complaint of urination difficulty. The majority of the patients had stage IV with acinar adenocarcinoma histopathological type and Gleason grade group 5.
Latar belakang: Kanker prostat atau karsinoma prostat merupakan keganasan yang terjadi pada sel-sel kelenjar prostat yang berkaitan dengan permasalahan kronis terhadap fungsi seksual, berkemih, serta kesejahteraan psikologis pasien. Penelitian ini dilaksanakan dengan tujuan untuk menyelidiki profil klinikopatologi pasien karsinoma prostat di RSUP Prof dr. I G.N.G. Ngoerah pada periode tahun 2017 – 2020.
Metode: Penelitian ini bersifat deskriptif dengan desain penelitian cross-sectional yang dilakukan di RSUP Prof. dr. I G.N.G. Ngoerah. Kriteria inklusi berupa pasien karsinoma prostat pada tahun 2017-2020 dan kriteria eksklusi berupa pasien dengan data rekam medis yang tidak lengkap. Adapun penentuan sampel menggunakan total sampling dengan jumlah sampel yang memenuhi kriteria sebanyak 82 orang. Seluruh analisis statistik menggunakan SPSS ver.25.
Hasil: Subjek dalam studi ini memiliki mean usia 70,89 ± 9,26 tahun, dengan mayoritas berusia ≥ 50 tahun (97,6%). Sebagian besar pasien mengalami keluhan utama berupa sulit berkemih (57,5%). Kadar PSA pada pasien memiliki mean 543,3 ng/mL. Mayoritas pasien sudah mencapai stadium IV saat terdiagnosis (92,1%). Reseksi transuretral merupakan cara pengambilan sampel dengan frekuensi terbanyak (47,6%). Hampir semua sampel didiagnosis sebagai adenokarsinoma asinar prostat (95,2%) dengan mayoritas Gleason grade group 5 (64,9%).
Simpulan: Kasus karsinoma prostat di RSUP Prof. dr. I G.N.G. Ngoerah sebagian besar terjadi pada usia >50 tahun dengan keluhan utama sulit berkemih. Mayoritas dari pasien menderita stadium IV dengan tipe histopatologi adenokarsinoma asinar dan Gleason grade group 5.
Sintesa nanopartikel senyawa bioaktif ekstrak etanol kulit kayu manis dengan teknik emulsi spontan di dalam ruang tabung gelas berdiameter 500 μm
Maria Vani Manullang, Horasdia SaragihOnline First: Apr 9, 2023
- Abstract
Sintesa nanopartikel senyawa bioaktif ekstrak etanol kulit kayu manis dengan teknik emulsi spontan di dalam ruang tabung gelas berdiameter 500 μm
Background: The bioactive compounds material sourced from cinnamon has many benefits, especially as a medicinal ingredient. Therefore, this material has enormous potential to be developed in the future as a raw material for medicine. However, due to its hydrophobic nature, low chemical stability, easily degraded, and has relatively large particle size, its use is constrained. To overcome these problems, emulsifying of these bioactive compounds with a surfactant and making it nanometer in size, has been carried out.
Method: The cinnamon bark bioactive compounds nanoparticles were synthesized by spontaneous emulsion technique using tween 80 surfactant in a cylindrical chamber with a diameter of 500 μm and a length of 50 cm.
Results: The bioactive compounds contained in cinnamon bark are: (1) cinnamaldehyde (68%), (2) bornylester of acrylic acid (10,31%), (3) alpha-copaene (3,32%), (4) cumarine (12,30%), and (5) methyl isoheptadecanoate (5.25%). Synthesized using four different concentrate masses of these compounds, namely: 4 mg, 6 mg, 8 mg and 10 mg dissolved in 100 ml of ethanol, resulting in an average nanoparticle diameter of: 11.0 nm; 12.1nm; 12.5nm; and 13.9 nm. The polydispersity indices of the synthesized nanoparticles in each synthesis process are 0,292; 0,300; 0,215; dan 0,313.
Conclusion: From the data obtained, it shows that the greater the mass of the concentrate used, the greater the average diameter of the resulting nanoparticles. The relationship is linear. The same thing happened to the polydispersity index. The value of the polydispersity index increases when the concentrate mass used increases.
Latar Belakang: Material senyawa bioaktif yang bersumber dari kulit kayu manis (cinnamon) memiliki banyak manfaat terutama sebagai bahan obat-obatan. Oleh karena itu material senyawa bioaktif ini memiliki potensi yang sangat besar untuk dikembangkan ke depan sebagai bahan baku obat. Namun, karena sifatnya yang hidrofobik, stabilitas kimianya yang rendah, mudah terdegradasi, dan ukuran partikelnya yang relatif besar, penggunaannya mengalami kendala. Untuk mengatasi masalah ini suatu pendekatan mengemulsi senyawa bioaktif tersebut dengan suatu surfaktan dan membuat ukurannya berorde nanometer, telah dilakukan.
Metode: Untuk menghasilkan partikel senyawa bioaktif kulit kayu manis berukuran nanometer, sintesa dengan teknik emulsi spontan dengan menggunakan surfaktan tween 80, telah dilakukan di dalam suatu ruang berbentuk tabung berdiameter 500 μm dan panjang 50 cm.
Hasil: Dari hasil identifikasi, senyawa bioaktif yang terkandung di dalam kulit kayu manis adalah: (1) cinnamaldehyde (68%), (2) bornylester of acrylic acid (10,31%), (3) alpha-copaene (3,32%), (4) cumarine (12,30%), dan (5) methyl isoheptadecanoate (5,25%). Sintesa dengan menggunakan empat ragam massa konsentrat dari senyawa-senyawa tersebut, yaitu: 4 mg, 6 mg, 8 mg dan 10 mg yang dilarutkan ke dalam 100 ml etanol, menghasilkan diameter rata-rata nanopartikel masing-masing sebesar 11,0 nm; 12,1 nm; 12,5 nm; dan 13,9 nm. Indeks polidispersitasnya masing-masing sebesar 0,292; 0,300; 0,215; dan 0,313.
Simpulan: Dari data yang diperoleh menunjukkan bahwa semakin besar massa konsentrat yang digunakan, semakin besar pula diameter rata-rata nanopartikel yang dihasilkan. Hubungannya bersifat linier. Hal yang sama terjadi pada indeks polidispersitasnya. Nilai indeks polidispersitas semakin besar ketika massa konsentrat yang digunakan semakin besar.
Hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun 2022
Bagus Indra Nagastya, I Dewa Ayu Inten Dwi Primayanti , Luh Putu Ratna Sundari, I Putu Adiartha GriadhiOnline First: Jan 31, 2023
- Abstract
Hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun 2022
Introduction: Dysmenorrhea is pain that is quite severe during menstruation which interferes with daily activities and habits. Women who suffer from dysmenorrhea are about 50% of the world's population. Prostaglandin levels that are out of balance in primary dysmenorrhea lead to pain through increased uterine contractility, decreased uterine blood flow, and increased sensitivity of peripheral nerves. Coffee drinking is one of the risk factors for primary dysmenorrhea. This study aims to determine the association between coffee consumption and primary dysmenorrhea of female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana.
Methods: This is an analytic study with a cross-sectional approach. The research sample was selected randomly by purposive random sampling technique. The data obtained were then processed and analyzed using Microsoft Excel and SPSS.
Results: The study was conducted on 95 female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana. Based on analysis tests, it was found that there was a significant association between coffee consumption and the incidence of primary dysmenorrhea (p = 0,003). The results of the odds ratio (OR) test were 4.03, thus female students who consumed coffee may have a risk of primary dysmenorrhea of 4.03 times.
Conclusion: There is a significant association between coffee consumption and the incidence of primary dysmenorrhea in female students bachelor of medicine programs batch 2021, Faculty Of Medicine, Udayana University.
Pendahuluan: Dismenore adalah rasa nyeri cukup parah pada masa menstruasi yang mengganggu aktivitas dan kebiasaan sehari-hari. Wanita yang menderita dismenore yaitu sekitar 50% dari populasi dunia. Dismenore primer disebabkan oleh ketidakseimbangan level prostaglandin yang menciptakan rasa sakit karena meningkatnya kontraktilitas uterus, penurunan aliran darah uterus, dan peningkatan sensitivitas saraf perifer. Konsumsi kopi merupakan salah satu faktor risiko dari dismenore primer. Penelitian ini memiliki tujuan untuk mengevaluasi hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana (PSSK FK UNUD) angkatan 2021.
Metode: Penelitian menggunakan studi analitik dengan desain cross-sectional. Teknik pengambilan sampel adalah purposive random sampling. Data yang diperoleh selanjutnya diolah dan dianalisis menggunakan perangkat lunak Microsoft Excel dan SPSS.
Hasil: Penelitian dilakukan pada 95 mahasiswi PSSK FK UNUD angkatan 2021. Berdasarkan uji analisis, didapatkan hubungan signifikan antara konsumsi kopi (p = 0,003). Hasil dari pengujian odds ratio (OR) didapat sebesar 4,03 sehingga mahasiswi yang mengonsumsi kopi memiliki risiko terjadinya dismenore primer sebesar 4,03 kali.
Simpulan: Terdapat terdapat hubungan yang bermakna antara konsumsi kopi dengan kejadian dismenore primer pada mahasiswi PSSK FK UNUD angkatan 2021.
Efek base genep terhadap total plate count dan most probable number Escherichia coli pada lawar plek
Gusti Ayu Pradipta Devi Suastina, I Putu Dedy Arjita, I Gede Angga Adnyana, RozikinOnline First: Apr 30, 2023
- Abstract
Efek base genep terhadap total plate count dan most probable number Escherichia coli pada lawar plek
Background: Foodborne disease is a disease caused by microbes. Lawar plek is a Balinese traditional dish using raw meat and fresh pork blood as its main ingredients. Lawar plek contain Balinese special seasoning named base genep. Several components in base genep contain antibacterial activity, thus it probably could affect the Total Plate Count (TPC) and Most Probable Number Escherichia coli (MPN E.coli) in lawar plek. We aimed to analyze the effect of adding base genep to the amount of Escherichia coli bacteria contamination in the lawar plek.
Methods: This study used a true experimental method with post test only control design. This study consisted of 36 samples divided into 6 groups. TPC data were analyzed using One Way Analysis of Variance test (One Way ANOVA) and Tamhane's post hoc test, while MPN E. coli data were analyzed using Kruskal-Wallis test and Mann-Whitney post hoc test. The significance value limit is (p≤0.05).
Results: This study showed a significant decrease in the TPC and MPN values of E. coli in each group. Group K had an average TPC value of 23.03 x 105 ± 258,198.89 CFU/gram and a median MPN E. coli value of 240 MPN/gram. Group E had an average TPC value of 0.92 x 105; ± 4,335.90 CFU/gram and the median MPN E. coli value of 3 MPN/gram. The results of the bivariate analysis showed that the p-value of TPC < 0,001 and the p-value of MPN E. coli <0,001
Conclusion: Addition of base genep could affect the value of TPC and MPN E.coli. Group E with raw pork meat to blood and base genep ratio of 70:30 shows the strongest antibacterial effect on the value of TPC and MPN E.coli.
Latar belakang: Lawar plek merupakan kuliner tradisional khas Bali yang menggunakan daging mentah dan darah babi segar sebagai bahan utamanya. Daging mentah dan darah babi segar yang digunakan pada kuliner tersebut berpotensi terkontaminasi oleh bakteri sehingga berpotensi menyebabkan foodborne disease. Pada lawar plek terdapat bumbu khas Bali bernama base genep. Beberapa komponen base genep memiliki aktivitas antibakteri sehingga base genep secara keseluruhan diperkirakan dapat berefek pada nilai Total Plate Count (TPC) dan Most Probable Number Escherichia coli (MPN E.coli) pada lawar plek. Tujuan penelitian ini adalah menganalisis pengaruh penambahan base genep terhadap jumlah cemaran bakteri Escherichia coli pada lawar plek.
Metode: Metode penelitian yang digunakan adalah true experimental dengan rancangan penelitian post test only control design. Sampel penelitian berjumlah 36 sampel yang terbagi dalam 6 kelompok. Data TPC dianalisis dengan uji One Way Analysis of Variance dan uji post hoc Tamhane’s, sedangkan data MPN E. coli dianalisis dengan uji Kruskal-Wallis dan uji post hoc Mann-Whitney. Batas nilai signifikansi adalah (p≤0,05).
Hasil: Penelitian menunjukkan adanya tren penurunan yang signifikan nilai TPC dan MPN E. coli pada masing-masing kelompok. Kelompok kontrol positif (Kelompok K) memiliki rerata nilai TPC sebesar 23,03 x 105 ± 258.198,89 CFU/gram dan nilai median MPN E. coli sebesar 240 MPN/gram. Kelompok E memiliki rerata nilai TPC sebesar 0,92 x 105; ± 4.335,90 CFU/gram dan nilai median MPN E. coli sebesar 3 MPN/gram. Hasil analisis bivariat menunjukkan bahwa nilai p-value TPC < 0,001 dan nilai p-value MPN E.coli < 0,001.
Kesimpulan: Terdapat pengaruh base genep terhadap nilai TPC dan MPN E.coli. Kelompok perbandingan campuran daging dan darah babi dengan base genep 70:30 (Kelompok E) memberikan efek antibakteri paling signifikan terhadap nilai TPC dan MPN E. coli.
Hubungan tingkat aktivitas fisik dengan andropause pada guru sekolah menengah atas di Kota Denpasar tahun 2022
Anak Agung Bagus Putra Indrakusuma, Yukhi Kurniawan, I Gusti Ngurah Pramesemara, I Nyoman Mangku KarmayaOnline First: Jan 10, 2023
- Abstract
Hubungan tingkat aktivitas fisik dengan andropause pada guru sekolah menengah atas di Kota Denpasar tahun 2022
Introduction: Andropause is clinical syndrome due to testosterone levels reduction below normal in the body experienced by elderly men. The level of physical activity is one of the risk factors for andropause. This study aims to determine the relationship between the level of physical activity and andropause in high school teachers in Denpasar City.
Methods: This study is an observational analysis with a cross-sectional approach. Andropause was assessed using the ADAM questionnaire consisting of 10 questions. Meanwhile, the level of physical activity assessed using the GPAQ questionnaire consisting of 16 questions. The sampling technique used is purposive sampling.
Results: Total 50 respondents include in this study. As many as 66% of respondents have low levels of physical activity, 26% moderate physical activity, and 4% high physical activity. A total of 32 (64.0%) respondents experienced andropause and 18 (36.0%) did not experience andropause. There was a significant association between low levels of physical activity and andropause (p=0,05). The odds ratio (OR 95%CI) between andropause with low levels of physical activity is 11,14 (1,0 – 124,33).
Conclusion: The lower level of physical activity teachers at Denpasar City Senior High School, the higher risk of experiencing andropause. This research is expected to motivate and educate men to be more aware of andropause and keep physically active.
Pendahuluan: Andropause adalah sindrom klinis akibat penurunan kadar testosteron di bawah normal dalam tubuh yang dialami oleh pria lanjut usia. Tingkat aktivitas fisik menjadi salah satu faktor risiko terhadap andropause. Penelitian ini bertujuan untuk mengetahui hubungan tingkat aktivitas fisik dengan andropause pada guru SMA di Kota Denpasar.
Metode: Penelitian ini merupakan analisis observasional dengan pendekatan cross-sectional. Andropause dinilai menggunakan kuesioner ADAM yang terdiri dari 10 buah pertanyaan. Sementara itu, tingkat aktivitas fisik dinilai menggunakan kuesioner GPAQ yang terdiri dari 16 buah pertanyaan. Teknik pengambilan sampel yang digunakan adalah purposive sampling.
Hasil: Responden dalam penelitian ini berjumlah 50 orang. Sebanyak 66% responden memiliki tingkat aktivtas fisik yang rendah, 26% aktivitas fisik sedang, dan 4% aktivitas fisik tinggi. Sebanyak 32 (64,0%) responden mengalami andropause dan 18 (36,0%) tidak mengalami andropause. Terdapat hubungan yang signifikan antara tingkat aktivitas fisik rendah dengan andropause (p = 0,05). Adapun nilai odd ratio (OR 95%CI) antara andropause dengan tingkat aktivitas fisik rendah adalah 11,14 (1,0 – 124,33).
Simpulan: Semakin rendah tingkat aktivitas fisik guru di SMA Kota Denpasar, maka semakin tinggi risiko mengalami andropause. Penelitian ini diharapkan dapat memotivasi dan mengedukasi pria untuk lebih waspada terhadap andropause serta menjaga fisiknya tetap aktif.
Knowledge regarding cervical cancer and HPV vaccination in adolescent girls
Mikael Stevan Jodjana, I Gusti Ayu Trisna Windiani, I Gusti Agung Ngurah Sugitha Adnyana, Ni Luh Sukma Pratiwi, SoetjiningsihOnline First: Apr 30, 2023
- Abstract
Knowledge regarding cervical cancer and HPV vaccination in adolescent girls
Introduction: Cervical cancer is the second most common cancer in women worldwide. The highest cancer incidence in women in Indonesia is cervical cancer, with a total of 17 cases per 100,000 female population. Human papillomavirus (HPV) is the main cause of cervical cancer. Acceptance of this vaccine is related to the level of knowledge about the virus and the vaccine itself. Previous systematic studies revealed that most women do not have a sufficient level of knowledge about the relationship between HPV virus infection and cervical cancer. This study aims to know the level of knowledge about cervical cancer and HPV vaccination in an adolescent girl
Methods: This research was conducted with a cross-sectional design. This study uses primary data in the form of answers to questionnaires distributed to respondents, where the questionnaire has been tested for validity and reliability in previous studies. The subjects were girl students aged 14 to 18 years at the senior high school level in the city of Denpasar.
Results: Most of the research subjects (95,3%) had fairly good-sufficient knowledge about cervical cancer, with a median value of 8 (4-10) of the assessment result. However, the majority of the research subjects (50,4%) had a low level of knowledge about HPV vaccination, with a median value of 11 (0-22) of the assessment result.
Conclusion: This study shows that the majority of students in senior high school have good knowledge about cervical cancer but a lack of knowledge about HPV vaccination.
Karakteristik pasien hamil dengan penyakit jantung yang dirawat di RSUP Dr. Kariadi tahun 2020-2021
Made Helthayana Trisnawan, Aruman Yudanto Aribowo Binarso Mochtar, Julian DewantiningrumOnline First: Apr 17, 2023
- Abstract
Karakteristik pasien hamil dengan penyakit jantung yang dirawat di RSUP Dr. Kariadi tahun 2020-2021
Background: During pregnancy there’s an increase of fluid which may cause problems in the cardiovascular system that were previously undiagnosed. Approximately 1–4% of pregnancies globally cause complications of cardiovascular disease. This study aims to determine the characteristics of pregnant patients with heart disease who were inpatients at Dr. Kariadi Hospital in the year 2020-2021.
Methods: This study used a descriptive research design conducted at Dr. Kariadi Hospital with secondary data through medical records for the year period of 1 January 2020 – 31 December 2021. A sample of 157 was all cases of pregnancy with heart disease treated in the obstetrics room or intensive care unit (ICU).
Result: Heart disease most suffered by pregnant patients was hypertensive heart disease as many as 90 cases (57.65%), peripartum cardiomyopathy 18 cases (11.54%). From echocardiography, 17 cases (16.34%) had decreased left ventricular ejection fraction and 14 cases (11.02%) had decreased right ventricular systolic function. 25 cases (19.54%) had impaired cardiac muscle kinesity and 57 cases (50.43%) had diastolic dysfunction. Most valve disorders occurred in the mitral, those were 22 cases (17.33%). Only 5 cases (3.2%) of these patients had COVID-19. Based on vital signs and laboratory examinations, data were obtained for 35 cases (22.29%) patients had a pulse of more than 100x/minute upon arrival at Dr. Kariadi Hospital only 2 cases (1.27%) had a pulse below 60x/minute. On saturation examination, 13 cases (8.26%) patients experienced desaturation.
Conclusion: Hypertensive heart disease has the highest prevalence. Premature birth and the incidence of low birth weight is the highest incidence in pregnant patients with heart disease.
Latar belakang: Selama kehamilan terjadi peningkatan cairan yang dapat menyebabkan masalah pada sistem kardiovaskular yang sebelumnya tidak terdiagnosis. Sekitar 1-4% kehamilan secara global menyebabkan komplikasi penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui karakteristik pasien hamil dengan penyakit jantung yang dirawat inap di RSUP Dr. Kariadi periode tahun 2020-2021.
Metode: Studi ini menggunakan desain penelitian deskriptif yang dilakukan di RSUP Dr. Kariadi dengan data sekunder melalui rekam medis periode 1 Januari 2020 - 31 Desember 2021. Sampel sebanyak 157 adalah semua kasus kehamilan dengan penyakit jantung yang dirawat di ruang obstetri maupun intensive care unit (ICU).
Hasil: Penyakit jantung yang paling banyak diderita oleh pasien hamil adalah penyakit jantung hipertensi sebanyak 90 kasus (57,65%), kardiomiopati peripartum 18 kasus (11,54%). Dari ekokardiografi, 17 kasus (16,34%) mengalami penurunan fraksi ejeksi ventrikel kiri dan 14 kasus (11,02%) mengalami penurunan fungsi sistolik ventrikel kanan. 25 kasus (19,54%) mengalami gangguan kinesitas otot jantung dan 57 kasus (50,43%) mengalami disfungsi diastolik. Kelainan katup paling banyak terjadi pada mitral yaitu 22 kasus (17,33%). Hanya 5 kasus (3,2%) dari pasien ini yang memiliki COVID-19. Berdasarkan tanda vital dan pemeriksaan laboratorium didapatkan data sebesar 35 kasus (22,29%) pasien memiliki denyut nadi lebih dari 100x/menit saat tiba di RSUP Dr. Kariadi, hanya 2 kasus (1,27%) yang memiliki denyut nadi dibawah 60x/menit. Pada pemeriksaan saturasi sebesar 13 kasus (8,26%) pasien mengalami desaturasi.
Simpulan: Penyakit jantung hipertensi memiliki prevalensi tertinggi. Kelahiran prematur dan kejadian berat badan lahir rendah merupakan kejadian tertinggi pada pasien hamil dengan penyakit jantung.
Hubungan glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe-2 di RSUD Kabupaten Lombok Utara
Desak Made Paramestri Dyah Parameswari, Kadek Dwi Pramana, HardinataOnline First: Mar 7, 2023
- Abstract
Hubungan glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe-2 di RSUD Kabupaten Lombok Utara
Latar Belakang : DM merupakan penyakit yang umum terjadi yakni sebesar 425 juta orang dengan angka mortalitas sebesar 1,5 juta orang. Komplikasi kronis dari DM tipe 2 dapat berupa komplikasi mikrovaskular dan makrovaskular. DM tipe 2 yang tidak terkontrol akan menyebabkan terjadinya hipertensi. Hal ini dapat dicegah sedini mungkin dengan menilai pemeriksaan rutin kadar glukosa darah dan tekanan darah, namun masih sedikit dokumentasi penelitian mengenai hubungan kadar glukosa pada pasien DM dengan kejadian hipertensi. Oleh karenanya, peneliti tertarik melakukan penelitian untuk mengetahui hubungan glukosa darah puasa dengan hipertensi pada pasien DM tipe 2 yang dirawat jalan di RSUD Kabupaten Lombok Utara
Metode Penelitian : Penelitian ini merupakan penelitian analitik observasional dengan desain penelitian cross sectional menggunakan metode purposive sampling pada data Rekam Medis pasien DM yang memenuhi kriteria inklusi yakni pasien yang terdiagnosis menderita DM tipe 2 oleh dokter apabila GDP ≥ 126 mg/dl dan pasien yang berusia 18 tahun dan ekslusi yakni pasien DM dengan keadaan tertentu (HIV, CKD, Keganasan) serta pasien yang menjalani kemoterapi di RSUD Kabupaten Lombok Utara
Hasil Penelitian : Total terdapat 329 responden yang termasuk dalam penelitian ini dengan rerata usia adalah 50-60 tahun dan mayoritas jenis kelamin perempuan (66%). Ditemukan dari seluruh responden dengan kontrol glikemik yang terkontrol sebesar 13,4% dan kejadian hipertensi terjadi sebanyak 35,9%. Berdasarkan hasil uji Chi-square diperoleh bahwa Hasil analisis bivariat menunjukkan bahwa nilai p-value < 0,05 (p-value = 0,006).
Kesimpulan : Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa terdapat hubungan yang signifikan antara kadar glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe 2 di RSUD Kabupaten Lombok Utara.
Hubungan antara stres dan kebiasaan makan dengan kejadian dispepsia pada mahasiswa pendidikan dokter Universitas Udayana
Rosyda Nur Afifah, I Ketut Mariadi, I Wayan Losen Adnyana, Ketut Tuti Parwati MeratiOnline First: Apr 1, 2023
- Abstract
Hubungan antara stres dan kebiasaan makan dengan kejadian dispepsia pada mahasiswa pendidikan dokter Universitas Udayana
Background: Dyspepsia syndrome was a health problem commonly found in everyday life. There were several factors related to the etiology and pathophysiology of dyspepsia, one of them was stress and eating habits. High stress levels and bad eating habits often occur in college students, especially medical students.
Objective: To evaluate the association between stress and eating habits in medical students at the Faculty of Medicine, Udayana University.
Methods: This was an observational analytic study with a cross-sectional approach. The sampling method is consecutive sampling. Primary data was taken from questionnaires filled out online by respondents.
Results: Bivariate analysis showed stress was associated with the incidence of dyspepsia (p = 0.022). Irregular eating habits (p = 0.011), spicy (p = 0.001), sour (p = 0.001), and fatty foods (p <0.001) were significantly associated with the incidence of dyspepsia. Meanwhile, multivariate analysis showed the significance of several factors for dyspepsia, namely irregular eating habits (OR: 2.350 and 95% CI: 1.201-4.599), habit of consuming spicy food (OR: 2.132; 95% CI: 1.075-4.227, habit of consuming sour foods (OR: 2.455; 95% CI: 1.107-5.444), and habit of consuming fatty foods (OR: 2.185; 95% CI: 1.109-4.307).
Conclusion: In medical students at the Faculty of Medicine at Udayana University, there was no significant correlation between stress and the prevalence of dyspepsia, however there was a correlation between eating habits and the condition.
Latar belakang: Sindroma dispepsia merupakan masalah kesehatan yang umum ditemukan. Terdapat beberapa faktor yang berhubungan dengan etiologi dan patofisiologi dispepsia, salah satunya adalah stres dan kebiasaan makan. Mahasiswa kedokteran sering mengalami tingkat stres yang tinggi dan kebiasaan makan yang tidak baik.
Tujuan: Untuk mengevaluasi hubungan antara stres dan kebiasaan makan terhadap dispepsia pada mahasiswa pendidikan dokter Fakultas Kedokteran Universitas Udayana (FK Unud).
Metode: Studi ini menggunakan desain analitik observasional dengan pendekatan potong lintang (cross sectional). Metode pengambilan sampling adalah consecutive sampling. Data primer diambil dari kuesioner yang diisi secara daring oleh responden.
Hasil: Analisis bivariat menunjukkan stres berhubungan signifikan dengan kejadian dispepsia (p = 0,022). Kebiasaan makan yang tidak teratur (p = 0,011), kebiasaan mengkonsumsi makanan pedas (p = 0,001), asam (p = 0,001), dan berlemak (p < 0,001) berhubungan signifikan terhadap kejadian dispepsia. Sementara itu, analisis multivariat menunjukkan signifikansi dari beberapa faktor terhadap dispepsia, yaitu kebiasaan makan yang tidak teratur (OR: 2,350 dan 95% CI: 1,201-4.599), kebiasaan mengkonsumsi makanan pedas (OR: 2,132; 95% CI: 1,075-4,227, kebiasaan mengkonsumsi makanan asam (OR: 2,455; 95% CI : 1,107-5,444), dan kebiasaan mengkonsumsi makanan berlemak (OR: 2,185; 95% CI: 1,109-4,307).
Simpulan: Stres tidak berhubungan signifikan terhadap kejadian dispepsia. Namun, kebiasaan makan yang buruk berhubungan signifikan terhadap kejadian dispepsia pada mahasiswa pendidikan dokter FK Unud.