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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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%.

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.

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.

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.

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

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.

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.

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.