Publisher: Universitas Udayana (Total: 68 journals)   [Sort alphabetically]

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E-J. of Tourism     Open Access   (Followers: 11)
E-Jurnal Manajemen Universitas Udayana     Open Access   (Followers: 10)
Matrik : Jurnal Manajemen, Strategi Bisnis dan Kewirausahaan     Open Access   (Followers: 7)
Sport and Fitness J.     Open Access   (Followers: 5)
Advances in Tropical Biodiversity and Environmental Sciences     Open Access   (Followers: 5)
e-J. of Linguistics     Open Access   (Followers: 4)
Buletin Studi Ekonomi     Open Access   (Followers: 4)
Buletin Veteriner Udayana     Open Access   (Followers: 3)
J. of Marine and Aquatic Sciences     Open Access   (Followers: 2)
Agrotrop : J. on Agriculture Science     Open Access   (Followers: 2)
J. of Food Security and Agriculture     Open Access   (Followers: 2)
Majalah Ilmiah Peternakan     Open Access   (Followers: 2)
Simbiosis : J. of Biological Sciences     Open Access   (Followers: 2)
E-Jurnal Medika Udayana     Open Access   (Followers: 2)
Jurnal Master Pariwisata (J. Master in Tourism Studies)     Open Access   (Followers: 2)
Jurnal Ergonomi Indonesia (The Indonesian J. of Ergonomic)     Open Access   (Followers: 2)
E-J. of Cultural Studies     Open Access   (Followers: 2)
Majalah Ilmiah Teknologi Elektro : J. of Electrical Technology     Open Access   (Followers: 2)
J. of Veterinary and Animal Sciences     Open Access   (Followers: 1)
Linguistika : Buletin Ilmiah Program Magister Linguistik Universitas Udayana     Open Access   (Followers: 1)
E-Jurnal Ekonomi dan Bisnis Universitas Udayana     Open Access   (Followers: 1)
COPING (Community of Publishing in Nursing)     Open Access   (Followers: 1)
itepa : Jurnal Ilmu dan Teknologi Pangan     Open Access   (Followers: 1)
Humanis : J. of Arts and Humanities     Open Access   (Followers: 1)
E-Jurnal Agroekoteknologi Tropika (J. of Tropical Agroecotechnology)     Open Access   (Followers: 1)
J. of Health Sciences and Medicine     Open Access   (Followers: 1)
E-Jurnal Ekonomi Pembangunan Universitas Udayana     Open Access   (Followers: 1)
Jurnal Ilmiah Akuntansi dan Bisnis     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Jurnal Matematika     Open Access   (Followers: 1)
Jurnal Ekonomi Kuantitatif Terapan     Open Access   (Followers: 1)
Indonesia Medicus Veterinus     Open Access   (Followers: 1)
Jurnal Veteriner     Open Access   (Followers: 1)
Jurnal Magister Hukum Udayana (Udayana Master Law J.)     Open Access   (Followers: 1)
Jurnal Spektran     Open Access   (Followers: 1)
Jurnal Ilmu dan Kesehatan Hewan (Veterinary Science and Medicine J.)     Open Access   (Followers: 1)
Public Health and Preventive Medicine Archive     Open Access   (Followers: 1)
Bumi Lestari J. of Environment     Open Access  
E-Jurnal Akuntansi     Open Access  
Jurnal Biologi Udayana     Open Access  
Jurnal Farmasi Udayana     Open Access  
Jurnal BETA (Biosistem dan Teknik Pertanian)     Open Access  
Jurnal Rekayasa dan Manajemen Agroindustri     Open Access  
Piramida     Open Access  
Jurnal Kimia (J. of Chemistry)     Open Access  
Indonesian J. of Legal and Forensic Sciences     Open Access  
Kertha Patrika     Open Access  
Jurnal Destinasi Pariwisata     Open Access  
Lingual : J. of Language and Culture     Open Access  
Jurnal Arsitektur Lansekap     Open Access  
Buletin Fisika     Open Access  
Intl. J. of Engineering and Emerging Technology     Open Access  
Jurnal Analisis Pariwisata     Open Access  
Udayana J. of Law and Culture     Open Access  
J. of Electrical, Electronics and Informatics     Open Access  
Jurnal IPTA     Open Access  
Jurnal Kepariwisataan dan Hospitalitas     Open Access  
Jurnal Ilmu Komputer     Open Access  
Lontar Komputer : Jurnal Ilmiah Teknologi Informasi     Open Access  
JBN (Jurnal Bedah Nasional)     Open Access  
Jurnal Ilmiah Merpati (Menara Penelitian Akademika Teknologi Informasi)     Open Access  
Intisari Sains Medis     Open Access  
Jurnal Energi Dan Manufaktur     Open Access  
Jurnal Ilmiah Mahasiswa SPEKTRUM     Open Access  
Jurnal Udayana Mengabdi     Open Access  
Ecotrophic : J. of Environmental Science     Open Access  
Ruang-Space: Jurnal Lingkungan Binaan (J. of The Built Environment)     Open Access  
Cakra Kimia (Indonesian E-J. of Applied Chemistry)     Open Access  
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Intisari Sains Medis
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ISSN (Print) 2089-9084 - ISSN (Online) 2503-3638
Published by Universitas Udayana Homepage  [68 journals]
  • Telerehabilitation as a physical therapy solution for post-stroke patient
           in COVID-19 pandemic situations: a review

    • Authors: I Made Yoga Prabawa, Dedi Silakarma, M. Widnyana
      Pages: 1 - 5
      Abstract: Background: Stroke is one of the leading causes of disability among the adult population. One-third of post-stroke patients require ongoing physical rehabilitation to improve their motoric function. But in this COVID-19 pandemic situation, all outpatient visits or non-emergency cases, including in-clinic physical rehabilitation therapy, have been postponed and limited to maintain physical distancing to prevent the spreading of infection. Telerehabilitation can be the answer to overcome this circumstance.Methods: We conducted a comprehensive search for online literature or studies in 2020. We explored evidence using the following database Cochrane Library, PubMed, and Google Scholar. The keywords used to obtain the relevant research include “telerehabilitation” OR “telemedicine” AND “physical rehabilitation” AND “stroke patient” AND “COVID-19 pandemic”. The literature was analyzed based on the results of previous studies.Results: Telerehabilitation delivers rehabilitation services via communication technologies involving the patient and the physical therapist communicate using telehealth platform and video-teleconference. Several telerehabilitation techniques can be used for stroke patients' physical exercise, such as portable transcutaneous electrical stimulation (TENS), mirror therapy, home exercise program, and virtual reality exercise. Several studies have shown that telerehabilitation is not inferior than in-clinic physical exercise, and both showed significant improvement in post-stroke patients' motor function.Conclusions: Telerehabilitation can be the solution for post-stroke patient’s physical rehabilitation in the COVID-19 pandemic. This novel health innovation allowed the post-stroke patient to exercise at home and prevent them from the risk of COVID-19 infection.
      PubDate: 2021-01-07
      Issue No: Vol. 12, No. 1 (2021)
  • Clinical profile of steroid-induced glaucoma in Bali Mandara Eye Hospital
           year 2019

    • Authors: Ni Kompyang Rahayu, Ardelia Emily
      Pages: 6 - 8
      Abstract: Introduction: Glaucoma is an optic neuropathy characterized by optic disc cupping and visual field loss usually associated with raised intraocular pressure. Glaucoma incidence is rapidly increasing, with global incidence is estimated to reach 76 million in 2020. There are many causes of glaucoma; one of them is corticosteroid use. Unmonitored steroid use can be resulting in undesirable side effects such as steroid-induced glaucoma. This study aims to evaluate the clinical profile of steroid-induced glaucoma in Bali Mandara Hospital year 2019.Method: A descriptive-cross sectional study was conducted using secondary data involving 35 medical records of patients diagnosed with glaucoma in Bali Mandara Eye Hospital, Denpasar, from January to December 2019. Age, gender, steroid type, routes and duration of steroid administration were recorded from medical records. Obtained data were analyzed descriptively using SPSS version 23 for Windows.   Results: Patient’s characteristics mostly were male 57.14% and 42.86% female, 31.43% were elderly >55 years old. They mostly used eye drops steroid (85.71%), and 14.29% took oral steroids. The most used eye drops were Dexamethasone eye drops (77.14%). For oral steroids, they took Methylprednisolone (8.57%) and Dexamethasone (5.71%). Most of them have symptoms after one year of steroid use (34.39%). Conclusion: Steroid-induced glaucoma can occur in both males or females in all age groups, which the elderly and children have a higher risk. Most cases occur from topical steroids. Steroid-induced glaucoma is avoidable irreversible blindness. Therefore, the use of steroids must be judicious; self-medication must be avoided. The doctor must provide education to patients who are given steroid therapy.
      PubDate: 2021-02-04
      Issue No: Vol. 12, No. 1 (2021)
  • Karakteristik pasien stenosis vena sentral dengan penyakit ginjal kronik
           yang menjalani hemodialisa di RSUP Sanglah Denpasar, Bali, Indonesia

    • Authors: Nyoman Saka Ranuartha, Ketut Putu Yasa
      Pages: 9 - 13
      Abstract: Introduction: Chronic Kidney Disease is a pathophysiological process with multiple etiologies causing chronic progressive impairment of kidney function and/or structure. Renal replacement therapy or hemodialysis is the optimal therapeutic option and is widely used in various developing countries. In the last 3 years, chronic kidney disease (CKD) patients at Sanglah General Hospital with the use of hemodialysis vascular access are often followed by central venous stenosis.Method: A retrospective descriptive study with a cross-sectional design was carried out involving patients with a stage 5 chronic kidney disease diagnosed with symptomatic central venous stenosis clinicaly and radiological finding that met the inclusion and exclusion criteria. The independent variables of this study were age, gender, and risk factors. The dependent variables of this study were the type of location, symptom onset, duration, and history of hemodialysis access.Result: It was recorded that 40 subjects, 77.5% aged <60 years, 52.5% were male, 75% had a history of hypertension as the etiology of chronic kidney disease. The location of the most stenosis locations was in the subclavian vein (62.5%), from the duration of using hemodialysis access was 80% over 6 weeks also using of catheter more than 2 is (55%).Conclusion: The most history of using access to hemodialysis was tunneled type of double lumen catheter (70%) and the most often locations for insertion catheter is left subclavian vein (50%). Based on the results of this study, CKD patients with central venous stenosis showed a history of using double lumen catheters more frequently and from the location of the stenosis found in the subclavian veins, the locations that were found mostly in central venous stenosis. Latar belakang: Penyakit Ginjal Kronis merupakan suatu proses patofisiologis dengan etiologi yang beragam sehingga menyebabkan gangguan fungsi dan atau struktur ginjal yang bersifat kronik progresif. Terapi pengganti ginjal atau hemodialisa menjadi pilihan terapi yang optimal dan banyak digunakan di berbagai Negara berkembang. Dalam 3 tahun terakhir, pada pasien penyakit ginjal kronis (PGK) di RSUP Sanglah dengan penggunaan akses vaskular hemodialisa kerap diikuti dengan stenosis vena sentral.Metode: Dilakukan studi deskriptif retrospektif dengan desain potong lintang melibatkan pasien penyakit ginjal kronik stadium 5 yang terdiagnosis simptomatik stenosis vena sentral secara klinis dan penunjang radiologis yang memenuhi dari kriteria inklusi dan ekslusi. Variabel independen dari penelitian ini adalah usia, jenis kelamin, faktor komorbid. Variabel dependen dari penelitian ini adalah jenis, lokasi, onset gejala, durasi serta riwayat penggunaan akses hemodialisa.Hasil: Tercatat 40 subjek, 77,5% berusia <60 tahun, 52,5% berjenis kelamin laki-laki, 75% memiliki riwayat hipertensi sebagai faktor komorbid penyakit ginjal kronik. Letak lokasi stenosis terbanyak terdapat di vena subklavia 62,5%, dari durasi penggunaan akses hemodialisa yaitu 80% lebih dari 6 minggu dengan frekuensi penggunaan lebih dari 2 kali sebesar 55%. Riwayat penggunaan akses hemodialisa terbanyak yaitu kateter double lumen tipe tunneled sebesar 70% dengan lokasi pemasangan kateter pada vena subklavia kiri sebanyak 50%.Simpulan: Berdasarkan hasil dari penelitian ini, pada pasien PGK dengan stenosis vena sentral menunjukkan riwayat penggunaan kateter double lumen lebih sering dijumpai serta dari lokasi stenosis didapatkan pada vena sublkavia lokasi yang banyak ditemukan pada stenosis vena sentral.
      PubDate: 2021-02-04
      Issue No: Vol. 12, No. 1 (2021)
  • Transarterial chemoembolization (TACE) in hepatocellular carcinoma BCLC B
           patients: case series

    • Authors: Ni Nyoman Widyasari, Firman Parulian Sitanggang, Putu Patriawan, Dewa Gede Mahiswara
      Pages: 14 - 18
      Abstract: Introduction: Hepatocellular carcinoma (HCC) is the fifth leading cause of death for men and the seventh for women worldwide, HCC is one out of 10 most cancers in Indonesia. HCC grows in the background of chronic liver disease and often associated with hepatitis virus infection such as hepatitis B virus (HBV) and hepatitis C virus (HCV).  Transarterial chemoembolization (TACE) is a minimally invasive procedure performed by interventional radiologist as the treatment of choice for intermediate stage HCC.Case report: Here in we report a 62 and 59 years old female with hepatocellular carcinoma Barcelona clinic liver cancer (BCLC) B who were treated with TACE using 50 mg doxorubicin mixed with Iopamiro and lipiodol. Both were patients with history of HBV infection. After 5 weeks of TACE, triphase abdominal CT-Scan was done to evaluate tumour progression, however one patient was loss to follow up.  Evaluation of one patient was done and revealed more than 30% decrease  solid viable tumour with increase of necrotic area.  Expansion of necrotic area is one of the HCC treatment response criteria, while decrease tumour enhancement explains the viability of the tumour itself.Conclusion: TACE is the therapy of choice for patient with HCC BCLC B, which can give enlargement of necrotic area and decrease tumour viability.  
      PubDate: 2021-03-02
      Issue No: Vol. 12, No. 1 (2021)
  • The association between overweight and shock in children with dengue
           hemorrhagic fever at Wangaya General Hospital, Bali, Indonesia

    • Authors: Jade Irene Linardi, I Wayan Bikin Suryawan, Anak Agung Made Widiasa
      Pages: 19 - 22
      Abstract: Background: Dengue Hemorrhagic Fever (DHF) which severity varies, has devastating complications and outcomes, especially when shock events appeared and are prolonged. There is no predictor of whether DHF patients would develop into shock (called Dengue Shock Syndrome or DSS). Previous studies claimed overweight as a predictor of DSS, although it remains controversial.Objective: To find the association between overweight and shock events in children with DHF.Methods: This was an observational analytic study with a case-control design. Data were taken from medical records with children hospitalized at Wangaya General Hospital from May 2019 through April 2020. Inclusion criteria were children < 18 years who have been diagnosed with DHF grade I through IV. Data were analyzed using the chi-square test in SPSS 24.0 for windows.Results: Of 126 subjects who fulfilled the inclusion criteria, there were 42 DSS patients as the case group and 84 non-DSS patients as the control group. From the data analysis, there was a significant association between overweight and shock events in children with DHF (p=0.001; OR 3.76; 95% CI 1.72 to 8.20). Furthermore, pleural effusion (p=0.001), highest hematocrit of ' 46% (p=0.001), and lowest platelet count of ' 50,000/µL (p=0.006) also had significant association with shock events.Conclusion: Overweight is associated with shock events in children with DHF. Pleural effusion, hematocrit level of ' 46%, and platelet count of ' 50,000/µL were also counted as risk factors to develop shock.
      PubDate: 2021-03-10
      Issue No: Vol. 12, No. 1 (2021)
  • Nilai diagnostik dari mean platelet volume (MPV) pada sepsis neonatorum di
           RSUD Wangaya, Denpasar, Bali, Indonesia

    • Authors: Jeven Reggie Santoso, I Wayan Bikin Suryawan, Made Ratna Dewi
      Pages: 23 - 27
      Abstract: Background: Neonatal sepsis is a clinical syndrome of systemic disease with high morbidity and mortality. Early diagnosis of neonatal sepsis is still difficult to be done. A cheap, fast, and accurate septic marker is needed. Several studies of mean platelet volume have been done and are considered as one of the markers that can help diagnose neonatal sepsis early and accurately. The objective of this study is to assess the diagnostic value of MPV in neonatal sepsis.Methods: This analytic observational study with the diagnostic test was done by collecting secondary data from medical records of neonates with suspicion of neonatal sepsis in Wangaya Hospital, Denpasar, from January 2019 to June 2020.  MPV cut-off point was determined with receiver-operating characteristic (ROC) curve. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MPV in neonatal sepsis were determined using a 2x2 table.Results: Of 104 sample subjects, 16 subjects (15.4%) were diagnosed with neonatal sepsis. MPV with a cut-off point of 9.95 fl had 62.5% sensitivity, 61.4% specificity, 22% PPV, 90% NPV, and 61% accuracy.Conclusion: MPV with a cut-off point of 9.95 fl can be used to diagnose neonatal sepsis with a 62.5% sensitivity and a 61.4% specificity.  Latar Belakang: Sepsis neonatorum merupakan sindrom klinik penyakit sistemik yang memiliki angka morbiditas dan mortalitas yang tinggi pada neonatus. Diagnosis sepsis neonatorum masih sulit dilakukan dengan cepat. Diperlukannya alat penanda sepsis yang murah, cepat, dan akurat. Beberapa penelitian mengenai mean platelet volume (MPV) telah dilakukan dan salah satu pilihan pemeriksaan yang diharapkan dapat membantu penegakan diagnosis sepsis neonatorum dengan cepat dan akurat. Tujuan penelitian ini adalah untuk mengetahui nilai diagnostik dari MPV pada sepsis neonatorum.Metode: Studi observasional analitik dengan uji diagnostik ini dilakukan dengan mengumpulkan data sekunder dari rekam medis neonatus yang dirawat di RSUD Wangaya, Denpasar dengan kecurigaan sepsis neonatorum dari Januari 2019 hingga Juni 2020. Titik potong nilai MPV akan ditentukan menggunakan kurva receiver-operating characteristic (ROC). Nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), dan akurasi dari nilai MPV pada sepsis neonatorum akan ditentukan menggunakan tabel 2x2.Hasil: Dari 104 subjek sampel, didapatkan subjek dengan diagnosis sepsis neonatorum sebesar 16 subjek (15.4%). Dengan titik potong MPV sebesar 9,95 fl, didapatkan nilai sensitifitas 62,5%, spesifisitas 61,4%, NDP 22%, NDN 90%, dan akurasi 61%.Kesimpulan: MPV dengan titik potong 9,95 fl dapat mendiagnosis sepsis neonatorum dengan sensitifitas 62,5% dan spesifisitas 61,4%.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Left scapulothoracic dissociation with floating shoulder and grade IIIC
           open left clavicle fracture with Ideberg type III scapula fracture: a rare
           case report

    • Authors: Yohannes Sugiarto, Andri Ruliananto Winoto, Muhammad Ali Shodiq
      Pages: 28 - 31
      Abstract: Background: A high-energy trauma can cause fractures involving clavicle, scapula, and scapulothoracic dissociation with floating shoulder and vascular injuries. Early and correct diagnosis of fracture with vascular injury should be performed to prevent the patient from mortality. This case report aims to evaluate the left scapulothoracic dissociation with floating shoulder and grade IIIC open left clavicle fracture with Ideberg type III scapula fractureCase Presentation: A 19 years old male was on a motorcycle-truck accident which was diagnosed with a rare left scapulothoracic dissociation with floating shoulder and grade IIIC open left clavicle fracture with Ideberg type III scapula fracture. The patient underwent arteriography, repair of the vascular injury, and open reduction internal fixation for the fracture.Conclusion: A rare and complex case of scapulothoracic dissociation with floating shoulder and traumatic subclavian artery injury and clavicle with scapula fractures require early recognition and a multi-disciplinary approach to manage the injuries.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Prosedur Falsanella-Servat pada pada ptosis traumatika: laporan kasus

    • Authors: Rima Febry Lesmana, Anak Agung Ayu Sukartini Djelantik, Putu Yuliawati, Ni Made Laksmi Utari, I Made Agus Kusumadjaja
      Pages: 32 - 35
      Abstract: Background : Ptosis is a drooping or infero displacement of the upper eyelid. Traumatic Ptosis is the second most common type after acquired aponeurotic ptosis. In this case the patient with mild traumatic ptosis had no improvement for 1 year. Surgery was performed for correction of traumatc ptosis with falsanella servat procedure. The aims of case report are to know managament patient with mild traumatic ptosis who underwent surgery with falsanella-servat procedure.Case presentation: A 18-year-old boy with dropping of left upper eyelid since 1 year ago. He had a history of hordeolum and had a curettage incision for three times. Complete opthalmology examination was perfomed on both eyes and found on right eyelid vertical palpebra fissure 12mm, horizontal palpebra fissure 35mm, levator action 18, margin limbal distance 9, margin reflect distance 4, lid crease 8, no lidlag, positive bell's phenomenon. Left eyelid examination results 8mm vertical palpebra fissure, 35mm horizontal palpebra fissure, levator action 16, margin limbal distance 7, margin reflect distance 2, lid crease 10, no lid lag, positive bell's phenomenon. Correction of traumatic ptosis with falsanella servat was performed and ptosis measurement had done after correction. Conclusion: Surgical procedure using falsanella-servat on traumatic mild ptosis gives good contour, functional and cosmetic results.  Latar belakang: Ptosis adalah penurunan kelopak mata atas dari posisi normal. Ptosis traumatika merupakan kejadian tersering kedua setelah acquired aponeurotic ptosis. Pada kasus ini pasien dengan mild ptosis traumatika yang tidak mengalami perbaikan selama 1 tahun, dilakukan pembedahan dengan teknik operasi falsanell-servat. Tujuan dari penelitian ini adalah untuk melaporkan hasil penatalaksanaan pada pasien dengan mild ptotis traumatika yang dilakukan prosedur terapi dengan tekhnik falsanella-servat.Laporan kasus: Pasien laki-laki 18 tahun dengan penurunan kelopak atas mata kiri sejak 1 tahun yang lalu. Pasien riwayat hordeolum pada kelopak atas mata kiri dan sempat di insisi-kuretase sebanyak 3x. Pemeriksaan mata lengkap dilakukan pada kedua mata dan didapatkan kelopak mata kanan fisura palpebra vertikal 12mm, fisura palpebra horisontal 35mm, levator action 18, margin limbal distance 9,  margin  reflect  distance  4,  lid  crease  8,  lid  lag  tidak ada,  bell’s phenomenon positif. Hasil pemeriksaan kelopak mata kiri didapatkan fisura palpebra vertikal 8mm, fisura palpebra horisontal 35mm, levator action 16, margin limbal distance 7,  margin  reflect  distance  2,  lid  crease  10,  lid  lag  tidak ada,  bell’s phenomenon positif. Pasien dilakukan perbaikan ptosis traumatika dengan tekhnik pembedahan falsanella-servat dan pengukuran ptosis setelah perbaikan.Simpulan: Prosedur pembedahan dengan Falsanella-servat pada mild ptosis traumatika memberikan hasil yang baik dalam segi kontur, fungsi dan kosmetik. 
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Pengaruh teh kombinasi Euphobia milii dan Propolis terhadap fungsi ginjal
           tikus Wistar jantan

    • Authors: I Dewa Made Agus Paramarta Putra, I Gusti Kamasan Nyoman Arijana, Ni Made Linawati
      Pages: 36 - 40
      Abstract: Introduction. Indonesia has abundant natural resources that can be used as traditional medicine. For example, Euphorbia milii and Propolis. Euphorbia milii and Propolis have various benefits such as antioxidants, antibacterials, and immunomodulators. The toxic effects of the combination of Euphorbia milii and Propolis on renal function has not been studied. The purpose of this study was to determine the effects of the combination of Euphorbia milii and Propolis on the kidney function of male Wistar rats.Methods: This study was an experimental analytical study with a randomized post-test only control group design. Twenty-four male rats aged 2-3 months, body weight ± 200 grams were divided into 4 groups, namely; control group (standard feed + aquabidest), P1 (combination of Euphorbia milii and Propolis 40mg/100gram body weight (grbw) for 2 weeks), P2 (combination of Euphorbia milii and Propolis flower 40mg / 100grbw for 4 weeks), and P3 (combination of Euphorbia milii and Propolis flowers 40mg / 100grbw for 6 weeks).Results: Based on data analysis, the mean levels of blood urea nitrogen were not found to be significant between the control group, P2 and P3 from treatment groups, but there was a significant differences between  P1 and the other three groups. The serum creatinine does not show significant difference among all the groups.Conclusion. The combination of Euphorbia milii and Propolis does not increase the the blood urea nitrogen and serum creatinine of the Wistar rat.  Latar belakang. Indonesia memiliki kekayaan alam yang berlimpah yang dapat dimanfaatkan sebagai pengobatan tradisional. Misalnya tanaman Euphorbia milii dan Propolis. Euphorbia milii dan Propolis mempunyai beragam manfaat seperti antioksidan, antibakteri, dan imunomodulator. Efek toksik dari teh kombinasi Euphorbia milii dan Propolis terhadap fungsi ginjal belum pernah diteliti sebelumnya. Tujuan dari penelitian ini untuk mengetahui efek pemberian teh kombinasi dari bunga Euphorbia milii dan Propolis terhadap fungsi ginjal tikus Wistar jantan.Metode. Penelitian ini adalah penelitian analitik eksperimental dengan rancangan randomized post-test only, control group design. Dua puluh empat tikus wistar jantan berusia 2-3 bulan, berat badan ± 200 gram yang dibagi menjadi 4 kelompok, yaitu; kelompok kontrol (pakan standar + aquabidest), P1 (teh kombinasi bunga Euphorbia milii dan Propolis 40 mg/100 gram berat badan (grbb) selama 2 minggu), P2 (teh kombinasi bunga Euphorbia milii dan Propolis 40mg/100grbb selama 4 minggu), dan P3 (teh kombinasi bunga Euphorbia milii dan Propolis 40mg/100grbb selama 6 minggu).Hasil. Berdasarkan analisis data dari rerata kadar blood urea nitrogen (BUN) tidak ditemukan perbedaan yang signifikan antara kelompok kontrol dengan kelompok perlakuan P2 dan P3. Namun P1 menunjukan rerata yang lebih tinggi daripada kelompok lainnya. Pada kreatinin serum tidak terjadi peningkatan yang signifikan pada keempat kelompok.Simpulan. Pemberian teh kombinasi Euphorbia milii dan Propolis tidak menimbulkan peningkatan yang bermakna terhadap BUN dan kreatinin serum tikus Wistar.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Asam urat serum tinggi dan risiko mortalitas kardiovaskular: sebuah
           tinjauan sistematik penelitian kohort

    • Authors: Anak Agung Gede Bilwa Bhavendra, Yuliana Yuliana, Muliani Muliani, I Nyoman Gede Wardana
      Pages: 41 - 46
      Abstract: Introduction: Serum uric acid has been reported as a predictor of cardiovascular mortality, but there are many debates regarding this finding. This systematic review will analyze and discuss about serum uric acid as an indicator of cardiovascular mortality risk.Methods: A literature search was carried out on the PubMed and ProQuest databases for publication that focused on the association of serum uric acid and cardiovascular mortality risk within 2015-2020. The preparation of this systematic review is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).Results: In this review, four studies were relevant and met the selection criteria. All studies were prospective cohort studies. There were a total of 668,768 participants involved, with a slight female majority (55%). Participants involved in this study were aged 35 years or older. Three of the studies examined showed an association between high serum uric acid levels and cardiovascular disease mortality. Only one study did not show a statistically significant relationship. Each study used a different cut-off point for serum uric acid categories, making the uric acid indicator difficult to apply in clinical practice. The three studies conducted in Asia provide a more practical result that is relevant to the Indonesian population. In all three studies, results were consistent, showing elevated serum uric acid increases cardiovascular mortality risk.Conclusion: Serum uric acid level can predict the risk of death from cardiovascular disease. The study conducted in Asia is quite relevant to the Indonesian population, where the results of the study significantly and consistently found that high serum uric acid levels can increase the risk of cardiovascular mortality.  

      Pendahuluan: Asam urat serum dilaporkan dapat memperkirakan risiko dari mortalitas kardiovaskular, akan tetapi masih terdapat banyak perdebatan terkait temuan tersebut. Dalam tinjauan ini akan dibahas lebih jauh mengenai hubungan asam urat serum terhadap risiko mortalitas kardiovaskular yang disajikan dalam systematic review.Metode: Pencarian literatur dilakukan pada database PubMed dan ProQuest dengan mengidentifikasi jurnal yang diterbitkan dari tahun 2015-2020 yang berfokus pada topik asam urat serum dan hubungannya terhadap risiko mortalitas kardiovaskular. Penyusunan systematic review ini disusun berdasarkan pedoman Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA).Hasil: Dalam tinjauan ini terdapat 4 studi yang relevan dan memenuhi kriteria seleksi. Seluruh studi merupakan studi kohort prospektif. Terdapat total 668.768 partisipan yang terlibat dengan persentase perempuan sebesar 55%. Partisipan yang terlibat dalam studi ini berusia 35 tahun atau lebih. Tiga dari empat penelitian yang ditinjau menunjukan adanya hubungan antara kadar asam urat serum yang tinggi dengan kematian akibat penyakit kardiovaskular. Hanya satu penelitian yang tidak menunjukan hubungan yang bermakna secara statistik. Masing-masing penelitian menggunakan titik potong kategori asam urat serum yang berbeda-beda yang menyebabkan efektivitas indikator asam urat serum sulit untuk diaplikasikan. Tiga studi yang dilakukan di Asia memberikan gambaran yang lebih sesuai untuk aplikasi di Indonesia karena populasi partisipannya lebih mendekati keadaan populasi Indonesia.  Pada ketiga studi tersebut diperoleh hasil yang konsisten menunjukan peningkatan asam urat serum meningkatkan risiko mortalitas kardiovaskular.Kesimpulan: Kadar asam urat serum dapat dapat memperkirakan risiko mortalitas akibat penyakit kardiovaskular. Studi yang dilakukan di Asia, cukup relevan dengan populasi Indonesia, dimana hasil studi ini secara signifikan dan konsisten mendapatkan kadar asam urat serum yang tinggi dapat meningkatkan risiko mortalitas akibat penyakit kardiovaskular.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan durasi ketuban pecah dini dengan asfiksia neonatorum di RSUD
           Negara tahun 2020

    • Authors: I Gde Ketut Fendy Indrapermana, Vidya Saraswati Putri Duarsa, Iswara Somadina Duarsa
      Pages: 47 - 51
      Abstract: Introduction: Premature rupture of membranes (PROM) was still a significant cause of maternal or neonatal morbidity. Prolonged PROM caused asphyxia due to oligohydramnios that exert pressure to the placenta and causing vasoconstriction of blood vessels. This study aimed to understand the association between duration of PROM and the presence of asphyxia among neonates delivered in RSUD Negara in 2020.Methods: This was a cross-sectional study involving woman who was diagnosed with PROM and delivered in RSUD Negara during January - December 2020, included by total sampling. The duration of PROM, neonatal asphyxia, parity, maternal age and mode of delivery data were collected from medical records. The data were analyzed by the Chi-square test. The p-value <0.05 was considered significant.Results: This study included 220 mothers with PROM. The incidence of asphyxia neonatorum in this study was 17.7%. The majority of the patients were 20-35 years old (75.5%), had parity <2 or> 3 (79.1%), had assisted-delivery (63.6%) and duration of PROM was 6-12 hours (59.5%). The duration of PROM was significantly associated with the incidence of neonatal asphyxia (p<0.05).Conclusion: The longer duration of PROM was associated with a higher incidence of neonatal asphyxia. Effective management of PROM is important to minimize the risk of neonatal asphyxia.  Latar belakang: Ketuban pecah dini (KPD) masih menjadi penyebab morbiditas maternal maupun neonatus. KPD berkepanjangan berpotensi menyebabkan asfiksia karena terjadinya oligohidramnion yang menekan plasenta sehingga menimbulkan vasokonstriksi pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan antara durasi KPD dengan asfiksia neonatorum di RSUD Negara pada tahun 2020.Metode: Rancangan penelitian ini adalah analitik observasional potong lintang. Sampel penelitian adalah wanita yang terdiagnosis dengan KPD dan menjalani persalinan di RSUD Negara pada periode Januari – Desember 2020 yang dikumpulkan secara total sampling. Data durasi KPD, kejadian asfiksia neonatorum, paritas, usia maternal dan cara persalinan dikumpulkan dari rekam medis. Data kemudian dianalisis secara bivariat dengan uji Chi-square. Hubungan dikatakan signifikan bila diperoleh nilai p<0,05.Hasil: Penelitian ini menginklusi sebanyak 220 ibu dengan KPD. Kejadian asfiksia neonatorum pada penelitian ini sebanyak 17,7%. Mayoritas pasien berusia 20-35 tahun (75,5%), memiliki paritas <2 atau >3 (79,1%), melakukan persalinan dengan tindakan (63,6%) dan memiliki durasi KPD 6-12 jam (59,5%). Durasi KPD berhubungan signifikan dengan kejadian asfiksia neonatorum (p<0,05).Simpulan: Durasi KPD yang lebih lama berhubungan dengan kejadian asfiksia neonatorum yang lebih tinggi. Pemilihan penatalaksanaan KPD yang efektif penting untuk meminimalisasi risiko asfiksia neonatorum.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Anomalies of the sigmoid colon during laparotomy exploration: a case
           report of a redundant colon in the sigmoid and transverse colon

    • Authors: Made Bagus Sastrapramaya Bharata, Made Dwi Yoga Bharata, I Gusti Ayu Agung Bella Jayaningrum
      Pages: 52 - 54
      Abstract: Introduction: The redundant colon is rare, often resulting in a late diagnosis because it is often asymptomatic and eventually leads to complications. The average person has a large intestine/colon 120-150 cm long in his abdominal cavity. The large intestine organ does not extend to the side but is tortuous to occupy the abdominal cavity. An abnormal condition can be found in the intestine length is beyond normal, known as “redundant colon”. The redundant colon may have additional loops or turns, which cause it to become longer. In people who experience the redundant colon, the process of removing feces in the body tends to be longer, so it often experiences constipation.Case description: In this case, A 40-year-old patient of female gender reportedly came to the BIMC Hospital and complaints of her abdominal pain, unable to defecate for 3 weeks ago, and did not improve with enemas. The patient had a history of total hysterectomy 13 years ago. The abdomen's physical examination is distended while inspected, there is no tenderness during palpation, and has normal auscultation. CT-Scan investigation found redundant transverse colon, low ileocecal junction location, and many intraluminal (colonic) stools, as well as plain abdominal images with obstruction of the large intestine. In patients, an exploratory laparotomy has been performed.Conclusion: Ileus obstruction was found due to momentum adhesion which tangled the sigmoid colon and was redundant in the transverse colon during the surgery. With proper management of this case, we hope this surgery can attain this case back to normal.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan antara terapi statin dengan kadar gula darah puasa dan profil
           lipid pada pasien coronary artery disease di RSUD Sanjiwani

    • Authors: I Gusti Ayu Inten Heny Pratiwi, Ketut Erna Bagiari, I Gede Bagus Gita Pranata Putra
      Pages: 55 - 59
      Abstract: Background: Statin therapy has an important role to coronary artery disease (CAD) which can lowered cholesterol levels and give pleiotropic effects to inhibit inflammatory reactions. Statin have some side effects and new onset diabetes is one of them, where diabetes is also a risk factor for CAD. This study aims to know the correlation of statin therapy and fasting blood glucose levels of CAD patient in Sanjiwani Hospital.Methods: The design of this study was analytic cross-sectional study that started from November 17th 2020 until January 31st 2021 in Sanjiwani Hospital. A total of 68 patients were included in this study. The data source of this study was secondary data from patient’s medical record. The inclusion criteria was all CAD patients with statin therapy who had history of fasting blood glucose test that visited cardiology department of Sanjiwani Hospital at year 2020. Normality test, bivariate, and multivariate analysis was done in this study.Results: Bivariate analysis using Spearman showed a weak positive correlation between duration of statin therapy with fasting blood glucose levels (r=0,353; p= 0,003), and Kruskal Wallis analysis showed no correlation between statin type with fasting blood glucose levels.Conclusion: Duration of statin therapy has a weak correlation with fasting blood glucose levels so that statin still can be given with concerns to its benefit of reduced mortality. Prevention of new onset diabetes should be done by lifestyle modification and periodic blood glucose monitoring.  Latar Belakang: Terapi statin memiliki peranan penting terhadap coronary artery disease (CAD) yang mampu menurunkan kadar kolesterol serta memberikan efek pleiotropik untuk menghambat reaksi inflamasi. Statin memiliki beberapa efek samping, salah satunya adalah risiko diabetes onset baru dimana diabetes merupakan salah satu faktor risiko CAD. Penelitian ini dilakukan untuk mengetahui hubungan antara terapi statin dengan kadar gula darah puasa pasien CAD di RSUD Sanjiwani.Metode: Desain penelitian yang digunakan adalah analitik cross-sectional yang dilakukan dari 17 November 2020 sampai 31 Januari 2021 di RSUD Sanjiwani. Sebanyak 68 pasien diikutkan dalam penelitian ini. Sumber data pada penelitian ini berupa data sekunder yang didapatkan dari rekam medis pasien dengan kriteria inklusi yaitu semua pasien CAD dengan terapi statin dan memiliki riwayat pemeriksaan kadar gula darah puasa yang melakukan kontrol di poli jantung RSUD Sanjiwani tahun 2020. Uji normalitas, analisis bivariat, dan multivariat dilakukan pada penelitian ini.Hasil: Analisis bivariat dengan Spearman menunjukan adanya korelasi positif lemah antara durasi terapi statin dengan kadar gula darah puasa (r=0,353; p= 0,003), sedangkan hasil analisis Kruskall Wallis menunjukan tidak ada korelasi antara jenis statin dengan kadar gula darah puasa.Simpulan: Durasi terapi statin memiliki hubungan lemah dengan kadar gula darah puasa sehingga terapi statin masih dapat diberikan dengan memperhatikan keuntungan terapi yang lebih besar. Pencegahan terhadap risiko diabetes onset baru tetap dilakukan dengan modifikasi gaya hidup serta pemantauan gula darah berkala.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • High dose and long-term use of spironolactone induce gynecomastia in an
           elderly man with chronic heart failure: a case report

    • Authors: Putu Giani Anabella Bestari Putri, Nurfitriani Nurfitriani, I Gusti Ayu Suryawati
      Pages: 60 - 63
      Abstract: Introduction: Gynecomastia is caused by an imbalance of estrogen and androgen in the male breast tissue. It can be divided into three causes, physiological, drug-induced, and idiopathic. Spironolactone is a potassium-sparing diuretic that has known to pose an antiandrogen effect and can cause gynecomastia.Case Description: A 75 years old man came for a regular cardiac examination at the hospital. He complained of tenderness and pain at his right breast for the last six months and only getting worse since the previous two weeks. He had a regular appointment with a cardiologist after diagnosed with Chronic Heart Failure Functional Class III, Suspected as Coronary Artery Disease, Hypertensive Heart Disease since January 2017. The patient regularly takes Furosemide 40 mg once a day, Clopidogrel 75 mg once a day, Valsartan 10 mg once a day, Bisoprolol 1.25 mg once a day, and Spironolactone 100 mg once a day. On physical examination, tenderness was felt on the right breast. Fine-needle aspiration cytology examination of the right breast was conducted, the finding was compatible with gynecomastia.Conclusion: Gynecomastia is a breast enlargement in men that occurred due to hormonal imbalance and most often caused by the side effect of a high-dose and long-term use of Spironolactone. Discontinuation of the spironolactone treatment or switching to other therapy is recommended. However, gynecomastia should not be used as a reason for not prescribing Spironolactone to patients with severe heart failure.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Constipation that needs attention: late Hirschsprung disease

    • Authors: Kristin Agustina, Ni Nyoman Margiani, Pande Putu Yuli Anandasari, Ni Made Mahastuti
      Pages: 64 - 67
      Abstract: Background: Hirschprung disease (HD) or congenital aganglionic megacolon is an intestinal motor disorder that occurs in approximately 1 in 5000 live births. It makes colon fail to relax, mainly producing the symptoms of constipation. Approximately 90% of cases are diagnosed in the first year of life. Most of the remaining 10% are made in early childhood, with less than 1% being made in teenagers or adulthood.Case report: A 13 years old girl reported to the pediatric surgical outpatient department complaining constipation since birth. There was no history of delayed passage of meconium. A contrast enema study with water-soluble contrast showed high probability of ultrashort segment HD. Histopathological examination revealed neither nerve fibers with ganglion cells nor hypertrophy of nerve fibers were seen confirming the aganglionosis. Surgical treatment was performed with good clinical progression. Conclusion: Despite of its rarity, the possibility of HD should be considered in teenagers with chronic refractory constipation, especially when there was a history of delayed or non-passage of meconium after birth. An accurate diagnosis is mainly based on collective assessment of medical history, clinical examination, contrast enema study, and rectal biopsy as a gold standard. 
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Chorioangioma in pregnancy: a case report

    • Authors: Rio Yoga Erlambang, I Wayan Artana Putra
      Pages: 68 - 70
      Abstract: Background: Placental chorioangioma is a rare benign non-trophoblastic tumor of the placenta, derived from primitive chorionic mesenchyme. It can cause adverse outcomes on the mother and fetus, depending on its size. Most of the cases are accidentally detected during ultrasonography because small size tumors are usually asymptomatic. However, larger size of tumor can cause complications such as fetal anemia, fetal hydrops, polyhydramnios, premature birth, intrauterine growth restriction, and fetal death.Case report: A 27-year-old primigravida presented at Sanglah Hospital gynecology polyclinic at 27th-28th week of gestation. She was referred by an obstetric and gynecologist due to polyhydramnion since 26th-27th week of gestation. A 7.86 x 8.19 cm hypoechoic cysts with hyperechoic border were found during fetal scanning. Chorioangioma was suspected with SDP 9.11 cm. Amniocentesis was planned, however the patient had a premature uterine contraction. By this time, the fundal height was accordant with 31st-32nd week of gestation, and speculum examination showed rupture of membrane with 4 cm cervix dilation. Spontaneous vaginal delivery was performed and a boy neonate with 4/6 Apgar score and birth weight of 1150 g was delivered. Placenta was extracted out completely. There was no complication after delivery process. Macroscopic and microscopic placental examination confirmed the initial diagnosis, chorioangioma.Conclusion: Early management in determining the cause of polyhydroamnion is challenging and needs comprehensive investigation. Ultrasonography is a choice of method in initial detection of polyhydroamnion. Serial ultrasonography is needed to evaluate the amount of amniotic fluid and detect the probable cause of complications for mother, fetus, and delivery process. One of the complications is premature uterine contraction that causes premature birth. As a result, the fetus may not be viable and this remains one of the biggest challenges for clinicians. There are several possible causes that cannot be ruled out from polyhydroamnion differential diagnoses, such as a rare placental tumor chorioangioma.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Kesesuaian hasil pengukuran Low Density Lipoprotein Cholesterol
           menggunakan persamaan Friedewald, Hopkins, dan Homogeneous Enzymatic
           Colorimetric Assay di RSUP Sanglah, Bali, Indonesia

    • Authors: I Made Dharma Pramana, Ida Ayu Putri Wirawati, Ni Nyoman Mahartini
      Pages: 71 - 75
      Abstract: Background: LDL-C concentration can be obtained by calculation from equations and measurement methods. There are many LDL-C equations, but the most commonly used is the Friedewald equation, and the most recent is the Hopkins equation. This study aims to determine LDL-C measurements' agreement using the Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay.Methods: This was a cross-sectional study, from January-February 2020, with 570 samples LDL-C examination results by Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay divided into 3 groups based on TG levels. Data were analyzed by SPSS version 17 for Windows.Results: Spearman correlation test found a near-perfect correlation between LDL-C using Friedewald and Hopkins equations to direct examinations with values r =0.921 and r =0.907. Limit of agreement from the Bland-Altman test shows an average of >90% for both equations with direct measurements. Mann-Whitney test showed a significant difference between LDL-C direct measurement and Friedewald equation in Total Group, TG 200-400 mg/dL and TG> 400 mg/dL while for Hopkins equation only in TG group> 400 mg/dL (p<0.05). Based on Total Allowable Error (TAE) analysis, LDL-C from Hopkins equation in TG group 200-400 mg/dL appears to be superior to the Friedewald equation.Conclusion: Friedewald equation and Hopkins equation give good concordance at TG levels <200 mg/dL while at triglyceride levels 200-400 mg/dL Hopkins equation gives better concordance than the Friedewald equation. At triglyceride levels,> 400 mg/dL Friedewald and Hopkins equations show low accuracy, so it is recommended to use the direct method. Latar Belakang: Konsentrasi low density lipoprotein cholesterol (LDL-C) dapat diperoleh dengan 2 cara yaitu menggunakan perhitungan dengan persamaan dan metode pengukuran langsung (direct). Banyak persamaan perhitungan LDL-C tetapi yang paling umum digunakan adalah persamaan Friedewald dan yang terbaru adalah persamaan Hopkins. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil pengukuran LDL-C menggunakan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assayMetode: Penelitian menggunakan rancangan analitik potong lintang dari bulan Januari-Pebruari 2020 dengan 570 sampel hasil pemeriksaan LDL-C dengan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assay yang dibagi 3 kelompok berdasarkan kadar trigliserida (TG). Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Uji statistik Spearman didapatkan korelasi mendekati sempurna antara  LDL-C menggunakan persamaan Friedewald dan Hopkins terhadap pemeriksaan direct dengan nilai r=0,921 dan r=0,907. Limit of agreement dari uji Bland-Altman menunjukkan rata-rata > 90% untuk kedua persamaan dengan pengukuran direct. Uji Mann-Whitney menunjukkan perbedaan bermakna antara LDL-C pengukuran direct dengan persamaan Friedewald pada Kelompok Total, TG 200-400 mg/dL dan TG >400 mg/dL sedangkan untuk persamaan Hopkins perbedaan hasil yang bermakna hanya pada kelompok TG >400 mg/dL (p<0,05). Berdasarkan analisis Total Allowable Error (TAE), LDL-C persamaan Hopkins pada kelompok TG 200-400 mg/dL lebih unggul dari persamaan Friedewald.Kesimpulan: Persamaan Friedewald dan persamaan Hopkins memberikan kesesuaian yang baik pada kadar TG <200 mg/dL sedangkan pada kadar trigliserida 200-400 mg/dL, persamaan Hopkins memberikan kesesuaian yang lebih baik daripada persamaan Friedewald. Pada kadar TG >400mg/dL persamaan Friedewald dan Hopkins menunjukkan akurasi yang rendah sehingga disarankan untuk menggunakan metode direct.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Kondiloma akuminata perianal pada seorang laki-laki biseksual disertai
           infeksi HIV stadium III yang diterapi dengan kombinasi asam trikloroasetat
           80% dan seng oral

    • Authors: Rahel Lisana Debora Hutagalung, Anak Agung Gde Putra Wiraguna
      Pages: 76 - 82
      Abstract: Background: Condyloma acuminata in the homosexual population caused by anogenital sexual behavior causes more microabrasion to occur which increases the risk of infection with human papilloma virus (HPV) and HIV. This case report aims to provide an overview of the clinical outcome of condyloma acuminata in homosexual patients with HIV grade III.Case: Male, 26 years old with an itchy and painless lump around the genitals and anal canal since two months ago. The new patient was diagnosed with HIV since two weeks before the visit to the Sanglah Hospital polyclinic. It was found that the patient was a homosexual with a history of multiple partners and had been going on for five years. Physical examination of the perianal region revealed multiple skin-colored tumors, geographic shape, 3x5cm - 3x5.5cm in size, with a verrucous surface, and solid consistency with a positive acetowhite test that concluded as perianal condyloma acuminata. It was decided to give tricolor acetate (TCA) 80% spotted therapy and oral zinc sulfate 100mg/day. Up to 2 TCA session therapy and oral zinc administration in approximately three weeks, the lesion was getting better with efflorescence in the form of multiple papules, color of the mucosa that confluent to form a tumor, geographic shape, size 3x2cm - 3x3cm, smooth surface, solid consistency.Conclusion: The response to treatment with TCA 80% for 2 times and oral zinc for 3 weeks was quite good, the number of lesions was reduced and the size of the lesions was reduced. The prognosis of the patient is dubious because even if the condyloma acuminata lesion has been repaired, the presence of HIV infection can lead to the risk of recurrence and the risk of progression to malignancy. Latar belakang: Kondiloma akuminata pada populasi homoseksual diakibatkan oleh perilaku seksual secara anogenital menyebabkan lebih banyak mikroabrasi yang terjadi yang menyebabkan peningkatan risiko infeksi human papilloma virus (HPV) dan HIV. Laporan kasus ini bertujuan untuk memberikan suatu gambaran luaran klinis dari kondiloma akuminata pada pasien homoseksual dengan HIV derajat III.Kasus: Laki-laki, 26 tahun dengan benjolan risakan gatal dan tidak nyeri pada sekitar kelamin dan lubang anus sejak dua bulan yang lalu. Pasien baru terdiagnosa HIV sejak dua minggu sebelum kunjungan poliklinik RSUP Sanglah. Diketahui pasien merupakan seorang homoseksual dengan riwayat berganti-ganti pasangan dan sudah berlangsung selama lima tahun. Pemeriksaan fisik region perianal menunjukkan tumor sewarna kulit multipel, bentuk geografika, ukuran 3x5cm – 3x5,5cm, dengan permukaan verukosa, dan konsistensi padat dengan hasil tes acetowhite positif yang disimpulkan sebagai suatu kondiloma akuminata perianal. Diputuskan untuk memberikan terapi tutul tricolor acetat 80% dan seng sulfat oral 100mg/hari. Hingga terapi 2 kali tutul dan pemeberian seng oral dalam jangka waktu kurang lebih tiga minggu terjadi perbaikan lesi dengan efloresensi berupa papul multipel sewarna mukosa yang berkonfluen membentuk tumor, bentuk geografika, ukuran 3x2cm – 3x3cm, permukaan licin, konsistensi padat.Simpulan: Respon pengobatan dengan TCA 80% selama 2 kali dan seng oral selama 3 minggu cukup baik, jumlah lesi berkurang dan ukuran lesi mengecil. Prognosis dari pasien adalah dubius karena walaupun telah terjadi perbaikan lesi kondiloma akuminata, adanya infeksi HIV dapat menyebabkan risiko terjadinya rekurensi dan risiko perkembangan ke arah keganasan.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Korelasi Total Nasal Symptom Score (TNSS) dengan kualitas tidur penderita
           rhinitis alergi mahasiswa fakultas kedokteran Universitas Mataram

    • Authors: Ni Made Metrya Savita Gera, Didit Yudanto, Muhammad Ghalvan Sahidu, Ilsa Hunaifi
      Pages: 83 - 87
      Abstract: Introduction. Allergic rhinitis is a disease that is a worldwide concern because of its increasing prevalence and morbidity. Among the various symptoms of RA, nasal congestion is one of the most disturbing symptoms and is often associated with sleep problems. Sleep problems that occur will reduce the quality of sleep and then can cause other health problems. This study aims to determine the relationship between RA symptoms and the sleep quality of RA patients in students of the Faculty of Medicine, University of Mataram.Methods. This cross-sectional study involved students of the Faculty of Medicine, University of Mataram who met the inclusion criteria and did not meet the exclusion criteria. Data were collected by filling out the Total Nasal Symptom Score (TNSS) questionnaire to assess RA symptoms and the Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality using the google form application.Results. There were 50 respondents who filled out the questionnaire. Based on the results of the PSQI questionnaire, 98% had poor sleep quality and only 2% had good sleep quality. 46% of respondents with poor sleep quality had moderate RA, and 24% had severe RA. The Spearman rank correlation test showed a significant correlation (p value <0.05) between TNSS RA on sleep quality with a correlation coefficient (r) of 0.558.Conclusion. This shows that there is a moderate positive correlation between the TNSS and the sleep quality of students at the Faculty of Medicine, University of Mataram. Pendahuluan. Rhinitis alergi merupakan penyakit yang kini menjadi perhatian di dunia karena prevalensi dan morbiditasnya yang semakin meningkat. Dari berbagai gejala RA, kongesti hidung merupakan salah satu gejala yang sangat mengganggu dan sering dihubungkan dengan masalah tidur. Masalah tidur yang terjadi akan menurunkan kualitas tidur dan kemudian dapat menyebabkan masalah kesehatan lainnya. Penelitian ini bertujuan untuk mengetahui hubungan gejala RA dengan kualitas tidur penderita RA di mahasiswa Fakultas Kedokteran Universitas Mataram.Metode. Penelitian cross-sectional ini melibatkan mahasiswa Fakultas Kedokteran Universitas Mataram yang memenuhi kriteria inklusi dan tidak memenuhi kriteria eksklusi. Pengambilan data dilakukan melalui pengisian kuesioner Total Nasal Symptom Score (TNSS) untuk menilai gejala RA dan  kuesioner Pittsburgh Sleep Quality Index (PSQI) untuk menilai kualitas tidur menggunakan aplikasi google form.Hasil. Terdapat 50 responden yang melakukan pengisian kuesioner. Berdasarkan hasil kuesioner PSQI, sebanyak 98% memiliki kualitas tidur buruk dan hanya 2% yang memiliki kualitas tidur baik. Sebesar 46% responden dengan kualitas tidur yang buruk memiliki RA derajat sedang, dan 24% memiliki RA derajat berat. Uji korelasi rank Spearman menunjukkan adanya korelasi yang signifikan (nilai p <0,05) antara TNSS RA terhadap kualitas tidur dengan koefisien korelasi (r) sebesar 0,558.Kesimpulan. Hal ini menunjukkan adanya korelasi positif yang cukup antara TNSS dengan kualitas tidur mahasiswa Fakultas Kedokteran Universitas Mataram.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan diabetes mellitus dengan obstructive sleep apnea (OSA) di Gedung
           Mario Tabanan, Bali-Indonesia

    • Authors: Tince Sarlin Nalle, I Dewa Gede Arta Eka Putra
      Pages: 88 - 91
      Abstract: Background: Diabetes mellitus (DM) is a chronic case caused by the pancreas not being able to produce insulin and when there is insulin resistance. This disease is characterized by a lot of drinking, eating, weight loss and frequent urination. This drastic weight loss results in a decrease in body mass, one of which is the nasopharynx and oropharynx so that it can cause collapse and cause Obstructive sleep apnea (OSA). This study aims to determine whether there is a relationship between diabetes mellitus and OSA in the social service held at the Mario Tabanan building on June 16, 2008.Methods: An observational analytic study with cross sectional design with a sample of 110 people. This study was conducted at Mario Building, Tabanan, Bali, Indonesia.Results: A total of 110 samples were successfully collected in this study, with an age range of 50-70 years, 55 patients with diabetes mellitus (DM) and 55 patients without diabetes. From the research above, it was found that there were more men than women, namely 67 people (58.3%) and women amounting to 43 people (42.7%). The average age who received OSA was 57.35 ± 10.89. The results of the study of the prevalence of patient respondents who suffered from DM with OSA were 65 people (53.5%) and patients who did not suffer from DM were 45 (46.5) and patients who did not have DM with OSA were 46 people (47.8%), and those who did not have diabetes and no OSA were 64 people (52.2%). There was a significant relationship between OSA and DM with a p value <0.05 and the prevalence ratio value was the Prevalent Ratio (RP) 1.432 with a confidence interval (1.024 to 5.980).Conclusion: Diabetes is a risk factor for OSA, and there is a significant relationship between diabetes and the incidence of OSA. Latar Belakang: Diabetes mellitus (DM) merupakan kasus kronis yang diakibatkan pankreas tidak mampu memproduksi insulin dan ketika ada resistensi insulin. Penyakit ini ditandai dengan banyak minum, makan, berat badan turun drastis dan sering buang air kecil. Penurunan berat badan drastis ini mengakibatkan penurunan massa otot tubuh salah satunya adalah nasofaring dan orofaring sehingga dapat menyebabkan kolaps dan menimbulkan terjadinya Obstructive sleep apnea (OSA). Penelitian ini bertujuan mengetahui apakah ada hubungan antara diabetes mellitus dan OSA pada baksos yang diadakan di gedung Mario Tabanan pada tanggal 16 Juni 2008.Metode: Penelitian analitik observasional dengan rancangan cross sectional dengan sampel sebanyak 110 orang yang dilakukan di Gedung Mario Tabanan, Bali, Indonesia.Hasil: Total 110 sampel berhasil dikumpulkan dalam penelitian ini, dengan rentangan usia 50-70 tahun, 55 pasien dengan diabetes mellitus (DM) dan 55 pasien tidak DM. Dari penelitian diatas didapatkan laki-laki lebih banyak daripada perempuan yaitu 67 orang (58,3%) dan perempuan berjumlah 43 orang (42,7%). Rata rata umur yang mendapatkan  OSA 57,35± 10,89. Hasil penelitian prevalensi responden pasien yang menderita DM dengan OSA adalah 65 orang (53,5%) dan, pasien yang tidak menderita DM adalah sejumlah 45 (46,5) dan pasien yang tidak DM dengan OSA adalah sejumlah 46 orang (47,8%) dan yang tidak DM dan tidak OSA adalah 64 orang (52,2%) Didapatkan adanya hubungan signifikan antara OSA dengan DM dengan nilai p<0,05 dan nilai rasio prevalens adalah Rasio Prevalen (RP) 1,432 dengan interval kepercayaan (1,024 sampai 5,980).Simpulan: Diabetes merupakan faktor risiko dari terjadinya OSA, dan didapatkan hubungan yang bermakna antara diabetes terhadap kejadian OSA.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Karakteristik presbikusis di Kecamatan Sukawati Kabupaten Gianyar tahun

    • Authors: I Gusti Ayu Mahaprani Danastri, Made Wiranadha
      Pages: 92 - 97
      Abstract: Introduction: Presbycusis is sensorineural hearing loss that related to age and the most common cause of hearing loss in elderly.  Total population in Gianyar regency in 2010 is 445.031 and the population of people aged over 60 year old is 46.468 or 10.44% from total population.Method: This study was conducted in Sukawati district, Gianyar Regency on Saturday, September 30, 2017. The hearing threshold is measured one time by audiometric examination. This study used a descriptive cross sectional design and data analysis was carried out with the SPSS program.Result:  The results of this study were presbycusis most prevalent in women (60%). Presbycusis most prevalent at ages 65-69 years old (48%). Most type of presbycusis was strial type (57.69%). The average hearing treshold on right ear was 51.86 dB and average hearing threshold on left ear was 53.95 dB. The highest level of education in this study was elementary school and is obtained in the age group of 65-69 years old.Conclusion: This study shows various degree of deafness, hearing acuity, age, sex and level of education so the possibility of presbycusis burden can increase later in the population.  Latar belakang: Presbikusis merupakan gangguan pendengaran sensorineural yang dikaitkan dengan faktor usia dan merupakan penyebab terbanyak gangguan pendengaran pada orang tua. Jumlah penduduk Kabupaten Gianyar tahun 2010 sebesar 445.031 jiwa dan usia 60 tahun ke atas sebesar 46.468 jiwa atau 10,44%.Metode: Penelitian dilakukan di Kecamatan Sukawati, Kabupaten Gianyar pada hari Sabtu, 30 September 2017. Ambang dengar diukur sebanyak satu kali dengan pemeriksaan audiometri. Penelitian ini menggunakan rancangan penelitian deskriptif Cross sectional dan analisis data dilakukan dengan program SPSS 16.0.Hasil: Dari seluruh sample, didapatkan penderita perempuan 30 orang (60%) dan laki-laki 20 orang (40%). Rerata ambang dengar pada perempuan 49,67 dB, dan pada laki-laki 51,23 dB. Berdasarkaan kelompok umur, penderita terbanyak masuk ke kelompok umur 65-69 yaitu 24 penderita (48%). Tingkat pendidikan terbanyak pada penelitian ini yaitu sekolah dasar dan didapatkan pada kelompok umur 65-69 tahun. Rerata ambang dengar telinga kanan 51,86 dB dan telinga kiri 53,95 dB. Tipe presbikusis yang paling banyak ditemukan adalah tipe strial 57,69%.Simpulan: Presbikusis memperlihatkan variasi yang beragam pada derajat ketulian, ketajaman pendengaran, onset umur, jenis kelamin dan tingkat pendidikan sehingga kemungkinan beban presbikusis di populasi dapat meningkat di kemudian hari.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Brittle bone brothers: osteogenesis imperfecta conventional serial case

    • Authors: Marsha Ruthy Darmawan, Elysanti Dwi Martadiani
      Pages: 98 - 100
      Abstract: Background: Osteogenesis Imperfecta (OI) is a heredity connective tissue disorder due to COL1A1/2 gene mutation, causing a defect in encoding proteins to metabolize collagen. One of OI’s manifestations to musculoskeletal is bone incompetence, hence the name Brittle bone disease. We report three cases of OI type IV in adults with pathognomonic radiology findings.Case Presentation: In Case 1, a 40-year-old Indonesian male came to the hospital with small stature and unsuited with his age. Conventional radiology examination found OI on all four extremities, anterior dislocation of left shoulder, and old fracture with an acute angle in the left radial shaft. In Case 2, a 41-year-old Indonesian male came to the hospital with short stature, causing limitation to his activities, and he confessed always to be shorter than people his age. Radiology evaluation suggests an OI in bilateral superior and inferior extremities, old fractures in the right humeral shaft also the left clavicle, acute angles right radius-ulna shaft, and osteoporosis in all visualized bones. In addition, in Case 3, a 42-year-old Indonesian male came to the hospital with short stature and pain within his bones, causing limitation to his activity. Conventional radiology imaging shows bilateral superior and inferior extremities, old fracture in the medial third of the left humerus and bilateral femur, acute-angled bilateral antebrachial-femur-cruris, and osteoporosisConclusion: Based on OI categorization, only type I and IV can live to adulthood, and the same type of OI can be found in siblings. Conventional radiology imaging provides a great help in diagnosing OI.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan antara densitas mikrovaskular dan limfoplasmasitik dengan
           metastasis kelenjar getah bening inguinal pada pasien karsinoma penis di
           RSUP Sanglah, Bali, Indonesia

    • Authors: Silvester Kristian Taopan, Anak Agung Gde Oka, I Gde Raka Widiana, I Wayan Juli Sumadi
      Pages: 101 - 106
      Abstract: Background: Carcinoma is the most common malignancy that occurs in penile tissue. Most of the metastasis of penile carcinoma is lymphogenic to the nearest lymph node. Metastasis is a significant prognosis factor in reflecting the outcome of penile carcinoma patients. To begin a process of metastasis requires the formation of new blood vessels (angiogenesis) and infiltration of mononuclear cells. Both of these can be assessed through micro vessel density and lymphoplasmacytic. This study aims to determine the relationship between microvascular and lymphoplasmic density with inguinal lymph node metastases in penile carcinoma patients at Sanglah General Hospital, Bali, Indonesia.Methods: This research is an analytic cross-sectional study. Data collection was carried out from the patient's Medical Record during January 2014 - December 2018. From 40 samples of penectomy surgery the micro vessel Density and lymphoplasmacytic readings were first stained with staining of hematoxylin eosin by anatomic pathologist. Cut-off point microvessel density and lymphoplasmacytic is taken by calculating the mean and standard deviation. Bivariate analysis with Chi Square Test and multivariate analysis using logistic regression tests were used for statistical analysis. Data were analyzed using SPSS version 20 for Windows.Results: From the Bivariate Analysis it was found that there was a significant relationship between Micro-vessel Density and Metastasis to the inguinal lymph node (P=0.019) and there was a significant relationship between lymphoplasmacytic and metastasis to the inguinal lymph node (P=0.005). The Multivariate Analysis confirms that microvessel density, lymphoplasmacytic and history of phimosis are significantly related to the occurrence of metastasis to inguinal lymph node in penile carcinoma patients (p=0.040).Conclusion: There were significant relationships between Micro vessel Density and Lymphoplasmacytic density with metastasis to inguinal lymph nodes in patients with penile SCC. A history of phimosis was proved to be a dominant risk factor.  Latar Belakang: Karsinoma merupakan keganasan tersering yang terjadi pada jaringan penis. Sebagian besar metastasis karsinoma penis bersifat limfogen menuju Kelenjar Getah Bening (KGB) terdekat. Untuk memulai suatu proses metastasis diperlukan pembentukan pembuluh darah baru (angiogenesis) dan infiltrasi sel mononuklear. Kedua hal tersebut bisa dinilai melalui densitas mikrovaskuler dan limfoplasmositik. Penelitian ini bertujuan untuk mengetahui hubungan antara densitas mikrovaskular dan limfoplasmositik dengan metastasis kelenjar getah bening inguinal pada pasien karsinoma penis   di RSUP Sanglah, Bali, Indonesia  Metode: Penelitian ini merupakan penelitian potong lintang analitik. Pengambilan data dilaksanakan dari Rekam Medis pasien selama Januari 2014 – Desember 2018. Dari 40 sampel Operasi Penektomi dilakukan pembacaan densitas mikrovaskuler dan limfoplasmositik yang telah lebih dulu diberikan pewarnaan Hematoxylin Eosin oleh ahli patologi anatomi. Titik potong densitas mikrovaskuler dan limfoplasmositik diambil dengan cara menghitung rerata dan standar deviasi. Analisis bivariat dengan Uji Chi-Square dan analisis multivariat dengan menggunakan uji regresi logistik digunakan untuk analisis statistik. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Analisis bivariat didapatkan hubungan yang bermakna antara Densitas Mikrovaskuler dengan metastasis ke KGB Inguinal (p=0,019) dan terdapat hubungan yang bermakna antara limfoplasmositik dengan metastasis ke KGB inguinal (p=0,005). Analisis multivariat menegaskan bahwa densitas mikrovaskuler, limfoplasmositik dan riwayat fimosis berhubungan secara bermakna dengan terjadinya metastasis ke KGB Inguinal pada pasien karsinoma penis (p=0,040).Simpulan: Adanya hubungan antara Densitas Mikrovaskular dan Limfoplasmositik dengan metastasis ke KGB inguinal pada pasien dengan KSS penis. Riwayat fimosis merupakan faktor resiko dominan.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Prevalensi kejadian perdarahan uterus abnormal di Rumah Sakit Umum Daerah
           Wangaya Denpasar periode Januari – Desember 2020

    • Authors: Ida Bagus Aditya Mayanda, I Gede Deni Surasandi
      Pages: 107 - 112
      Abstract: Introduction: Abnormal uterine bleeding (AUB) is the most common gynecological disorder experienced by women of reproductive age. The Federation of Gynecology and Obstetrics (FIGO) classifies AUB according to its etiology into PALM-COEIN. This study aims to determine the prevalence of AUB incidence according to the FIGO classification and AUB patients' characteristics based on age group, parity, BMI, and educational level at Wangaya Hospital Denpasar.Method: The study design is descriptive retrospective. Samples were collected by total sampling. Data was taken from medical records of patients diagnosed with AUB in Obstetrics-Gynaecology Polyclinic and Obstetrics-Neonatal Comprehensive Emergency Services at Wangaya Hospital Denpasar period January-December 2020.Result: The results showed 68 cases of AUB (15.8%) from 437 gynecologic cases. AUB due to structural abnormalities is 45 people (66.2%) with the most cases being AUB-L are 26 people (38.2%). In comparison, AUB was not due to structural abnormalities are 23 people (33.8%) with the most cases AUB-O, namely 18 people (26.4%). The AUB incidence most occurred in the age group '41 years which is 25 people (36.8%). Parity '2 times had the most AUB incidence, namely 26 people (57.8%). The most AUB incidence in normal BMI (18.5-24.9), namely 53 people (77.8%), and 37 people (54.4%) at the nongraduated.Conclusion: Prevalence of AUB incidents at Wangaya Hospital Denpasar period January-December 2020 almost one-fifth of all gynecological cases. The AUB incidence most prevalent in the age group '41 years, parity ' 2 times, normal BMI, and non-graduated.  Latar Belakang: Perdarahan uterus abnormal (PUA) merupakan kelainan di bidang ginekologi yang paling sering dialami oleh perempuan usia produktif. Federation of Gynecology and Obstetrics (FIGO) mengklasifikasikan PUA menurut etiologinya menjadi PALM-COEIN. Penelitian ini bertujuan untuk mengetahui prevalensi kejadian PUA sesuai klasifikasi FIGO dan mengetahui karakteristik pasien PUA berdasarkan kelompok usia, paritas, IMT, dan tingkat pendidikan di RSUD Wangaya Denpasar.Metode: Rancangan penelitian yang digunakan adalah deskriptif retrospektif. Teknik penentuan sampel yang digunakan adalah total sampling. Data penelitian didapatkan dari rekam medis pasien di Poliklinik Kebidanan-Kandungan dan Pelayanan Obstetri Neonatal Emergensi Komprehensif (PONEK) Rumah Sakit Umum Daerah (RSUD) Wangaya Denpasar periode Januari – Desember 2020.Hasil: Dari hasil penelitian didapatkan 68 kasus PUA (15,8%) dari 437 kasus di ginekologi. PUA karena kelainan struktural sebanyak 45 orang (66,2%) dengan kasus terbanyak adalah PUA-L 26 orang (38,2%), sedangkan PUA bukan karena kelainan struktural sebanyak 23 orang (33.8%) dengan kasus terbanyak PUA-O yaitu 18 orang (26,4%). Kejadian PUA paling banyak terjadi pada kelompok usia '41 tahun sebanyak 25 orang (36,8%). Paritas '2 kali paling banyak mengalami kejadian PUA yaitu 26 orang (57,8%). Kejadian PUA paling banyak pada IMT Normal (18,5-24,9) yaitu 53 orang (77,8%), dan tingkat pendidikan bukan Sarjana/D3 sebanyak 37 orang (54,4%).Simpulan: Prevalensi Kejadian PUA di RSUD Wangaya Denpasar periode Januari – Desember 2020 hampir seperlima dari seluruh kasus ginekologi. Kejadian PUA paling banyak terjadi pada kelompok usia '41 tahun, paritas '2 kali, IMT normal, dan tingkat pendidikan bukan Sarjana/D3.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Anemia defisiensi besi pada pasien dengan ulkus peptikum: Laporan kasus

    • Authors: I Dewa Agung Gede Agastya Janardhana, I Dewa Gede Agung Suta Ariwangsa
      Pages: 113 - 116
      Abstract: Background: Anemia is a decrease in hemoglobin levels from the standard limit that can be caused by iron deficiency and chronic bleeding. One-third (32.9%) of the world population is estimated to suffer from anemia, and iron deficiency is a common cause of anemia in all countries. The diagnosis is made through history taking, physical examination and investigations.Case report: 59-year-old male patient with complaints of black stool, abdominal pain and weakness. On physical examination, found pale conjunctiva, angular stomatitis and atrophy of the tongue. On complete blood, the examination found a decrease in erythrocyte levels, hemoglobin, MCV, MCH, and MCHC and increased RDW-CV. Analysis of peripheral blood smears presents with hypochromic microcytic poikilocytosis anemia, serum iron is decreased, and increased TIBC. Chronic bleeding anemia accompanied by iron deficiency will cause ferritin levels to decrease or be normal to 60 µg / dl. The patient was diagnosed with peptic ulcers as seen from esophagoduodenoscopy and severe anemia caused by iron deficit and chronic bleeding. Patients were treated supportively with PRC transfusion, ferrous sulfate and vitamin C.Conclusion: The patient’s iron deficiency anemia resulted from peptic ulcers, which caused chronic bleeding.  Latar belakang: Anemia merupakan kondisi dengan kadar hemoglobin yang lebih rendah dari nilai normal. Anemia dapat disebabkan akibat defisiensi besi atau perdarahan kronis. Sebesar sepertiga (32,9%) populasi didunia diperkirakan menderita anemia. Defisiensi besi merupakan penyebab umum anemia di seluruh negara. Penegakan diagnosis anemia dilakukan melalui anamnesis, pemerikaan fisik, dan pemeriksaan penunjang.Laporan kasus: Pasien laki-laki 59 tahun dengan keluhan BAB hitam, nyeri perut dan lemas. Pada pemeriksaan fisik ditemukan konjungtiva anemis, stomatitis angularis dan atrofi papil lidah. Pada pemeriksaan darah lengkap ditemukan penurunan kadar eritrosit, Hemoglobin, MCV, MCH, dan MCHC, peningkatan RDW-CV. Pemeriksaan apusan darah tepi gambaran anemia bikromik mikrositer poikilositosis, serum besi menurun, dan peningkatan TIBC. Anemia perdarahan kronis disertai defisiensi besi akan menimbulkan kadar ferritin menurun atau normal hingga 60µg/dl. Pasien didiagnosis dengan ulkus peptikum dilihat dari hasil Esofagoduodenoskopi dan anemia berat yang disebabkan oleh defisensi besi dan perdarahan kronis.  Pasien diterapi suportif dengan Tranfusi PRC, pemberian ferrous sulphate dan vitamin C.Kesimpulan: Anemia defisiensi besi pada pasien ditimbulkan oleh ulkus peptikum yang menyebabkan terjadinya perdarahan kronis. 
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Rheumatic mitral stenosis based on Wilkins score and echo score revisited
           for patients undergoing balloon mitral valvuloplasty

    • Authors: Prayoga Setiawan, Ni Made Ayu Wulan Sari, Luh Olivia Saraswati Suastika, Ida Bagus Rangga Wibhuti
      Pages: 117 - 121
      Abstract: Background: An important factor for obtaining good results with good clinical outcomes from BMV procedure in rheumatic mitral stenosis is selecting the right candidate. This study aimed to determine rheumatic mitral stenosis characteristics based on conventional scoring system and echo score revisited for patients undergoing balloon mitral valvuloplasty.Method: This was a retrospective descriptive study with a cross-sectional approach. The study was conducted at the Department of Cardiology and Vascular Medicine, Sanglah Hospital Denpasar. Data were collected between January 1, 2019 and December 31, 2019 from registry and medical records.Result: Both groups had the same median age, which is 43 years old. The majority of research subjects were female, namely 16 people or 94.4%. There were no subjects from the failed group who had low echo score revisited. A total of 3 subjects (100.0%) with Wilkins score of 7 and high echo score revisited categorized as failed because of occurrence of significant mitral regurgitation post-procedure. In the successful group with Wilkins score of 8, there were no subjects who had a low echo score revisited value. In subjects with a Wilkins score of 8 and high echo score revisited value, 3 subjects categorized as failed and 1 subject obtained significant mitral regurgitation post-procedure.Conclusion: Patients with a low Wilkins score, but a high echo score revisited had a higher procedure failure rate.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Tatalaksana bedah pada eksotropia traumatika et causa ruptur total otot
           rectus medial: laporan kasus

    • Authors: Christine Natalia Gunawan, Ni Made Ayu Surasmiati, I Made Agus Kusumadjaja, Ni Made Laksmi Utari
      Pages: 122 - 127
      Abstract: Introduction: Traumatic strabismus may result because of closed or open head and/or orbital trauma. Trauma to the extraocular muscles will often result directly in specific ocular motility disorders. Vertical transposition is one of the surgical management in traumatic exotropia with medial rectus muscle total rupture. The aims of case report are to know about examination and management in patient with traumatic exotropia.Case Illustration: Male, 30 years old, came with chief complaints pain on the right eye after being exposed a wire bounce when take off a banner wire, with squint eye, blurry vision, diplopia, redness, bleeding. On ophthalmology examination, 45° exotropia, visual acuity on the right eye 6/18 ph NI, proptosis, edema, hematom, spasm palpebral. Medial rectus muscle rupture, full thickness conjunctival rupture, cresent shaped, 15x7mm, 3 mm from limbal. Eyeball movement limited to medial, superomedial, inferomedial, FGT medial parese right eye (RE). visual acuity on the left eye 6/6, anterior and posterior segment within normal limit. Patient was diagnosed with traumatica exotropia et causa medial rectus muscle total rupture right eye (RE) with complication axial proptosis ec retrobulbar hemorrhage, palpebral hematom, full thickness conjunctival ruptured, sub conjunctival bleeding, erosion cornea, iridoplegy, traumatic iritis. Vertical transposition with augmented Hummelsheim technique, cantotomy cantolysis, repair conjunctival ruptured was done to the patient. Conclusion: Vertical transposition is one of the surgical management in traumatic exotropia caused by medial rectus muscle total rupture  Pendahuluan: Eksotropia traumatik dapat disebabkan oleh adanya trauma terbuka/tertutup pada kepala/mata. Trauma pada otot ekstraokuler akan menyebabkan gangguan gerakan bola mata yang spesifik. Salah satu penanganan bedah pada eksotropia traumatik karena ruptur total otot rektus medial adalah dengan transposisi vertikal. Tujuan dari pembuatan laporan kasus in adalah untuk mengetahui pemeriksaan dan penanganan pasien dengan eksotropia traumatika.Laporan kasus: Pria dengan usia 30 tahun, datang dengan keluhan nyeri pada mata kanan setelah terkena pentalan kawat, disertai mata juling keluar, pandangan ganda, kabur, berdarah, mata merah. Pada pemeriksaan oftalmologi didapatkan eksotropia 45°, tajam penglihatan mata kanan 6/18 ph NI, dengan proptosis, edema, hematom, spasme pada palpebra. Pada konjungtiva didapatkan tampak ruptur rektus medialis, ruptur konjungtiva full thickness bentuk bulan sabit ukuran 15x7mm, 3 mm dari limbus. Gerakan bola mata terhambat ke medial, superomedial, inferomedial, Forced Generation Test (FGT) mata kanan paresis ke medial. Tajam  penglihatan mata kiri 6/6, segmen anterior dan posterior dalam batas normal. Pasien didiagnosis dengan eksotropia traumatika et causa ruptur total otot rektus medial oculi dextra (OD) dengan komplikasi proptosis axial ec suspek pendarahan retrobulbar, hematom palpebral, ruptur konjungtiva full thickness, pendarahan sub konjungtiva, erosi kornea, iridoplegia, traumatic iritis. Pada pasien ini dilakukan transposisi vertikal dengan teknik augmented Hummelsheim, kantotomi kantolisis, dan repair ruptur konjungtiva full thickness. Simpulan: Transposisi otot rektus vertikal merupakan salah satu tindakan untuk tatalaksana pembedahan pada eksotropia traumatika et causa ruptur total otot rektus medial  
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Evaluation of modified unilateral nasoplasty in patient with post
           operation of unilateral labioplasty at Malahayati Hospital Banda Aceh: a
           cohort study from 2017-2019

    • Authors: Devyana Enggar Taslim, Muhammad Taufik, Muhammad Jailani, Syamsul Rizal, Mirnasari Amirsyah
      Pages: 128 - 130
      Abstract: Background: Nasal deformity associated with a cleft lip has been viewed as one of the most challenging reconstructive rhinoplasty problems.The common clinical features associated with cleft lip nasal deformity are its lack of symmetry, alar collapse on the affected side, short nasal length, loss of tip definition, obtuse nasal labial angle, and altered columella show among others. This study aims to evaluate the modified unilateral nasoplasty in a patient with post-operation of unilateral labioplasty at Malahayati Hospital Banda Aceh as a cohort study.Methods: We conducted a retrospective cohort study involving 139 patients who completed the unilateral rhinoplasty operation at Malahayati Hospital from January 2017 to November 2019. Demographic information was recorded, such as the ratio between pre–operation and post–operation, gender, and age. Data were analyzed using SPSS version 20 for Windows.Results: Our results have shown the comparison between cleft nose before rhinoplasty and cleft nose after rhinoplasty is 0.26 vs. 0.58 cm. The patients who came to the hospital to do the unilateral rhinoplasty surgery are 81.00%. Females (61.20%) experienced rhinoplasty more dominant compare to man (38.80%), and the highest age average is between 1 year old until 7 years old (71.00%)Conclusion: Improvement in procedure’s duration and better positioning of both nasal tip and nostril. Expected improvements in terms of aesthetics and functions were observed, but further documentation is still needed.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam
           pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka

    • Authors: Andre Hendrajaya
      Pages: 131 - 136
      Abstract: Management of type II diabetes mellitus is a science that continues to develop. Treatment of type II diabetes mellitus can affect various organ functions, one of which is the kidneys, which function to excrete glucose, namely SGLT II inhibitors. The class of sodium-glucose transport protein 2 (SGLT2) inhibitors has a new mechanism of action and is complementary to the older drugs used to treat type II diabetes. The sodium-glucose cotransporter-2 (SGLT2) protein is expressed in the proximal tubule of the renal convolution. These transporters are ideal targets for the treatment of diabetes because they account for approximately 90% of filtered glucose reabsorption SGLT2 inhibitors can be a useful option in obese and hypertensive patients because of their weight loss and antihypertensive benefits and thus benefit cardiovascular function. Patients at high risk for hypoglycemia may benefit from a combination of metformin and SGLT2 inhibitors because the risk of hypoglycemia with SGLT2 inhibitors is small when compared with insulin and sulfonylurea. Tatalaksana DM mellitus tipe II merupakan ilmu yang terus berkembang. Pengobatan DM tipe II dapat mempengaruhi berbagai fungsi organ, salah satunya adalah ginjal yang berfungsi untuk mengeksreksikan glukosa  yakni penghambat SGLT II. Kelas obat penghambat sodium-glukosa transport protein 2 (SGLT2) memiliki karakteristik ini, dan mekanisme aksi yang baru melengkapi obat yang lebih lama yang digunakan untuk mengobati DM tipe II. Protein sodium-glukosa cotransporter-2 (SGLT2) diekspresikan dalam tubulus proksimal konvolusi ginjal. Transporter ini adalah target yang ideal untuk pengobatan diabetes karena mereka bertanggung jawab atas sekitar 90% dari reabsorpsi glukosa yang difiltrasi Inhibitor SGLT2 dapat menjadi pilihan yang berguna pada pasien obesitas dan hipertensi karena penurunan berat badan dan manfaat antihipertensi sehingga memberikan manfaat terhadap fungsi kardiovaskular. Pasien yang berisiko tinggi untuk hipoglikemia dapat mengambil manfaat dari kombinasi metformin dan inhibitor SGLT2 karena risiko hipoglikemia dengan inhibitor SGLT2 kecil jika dibandingkan dengan insulin dan sulfonylurea.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Prevalensi obesitas pada pasien kanker kolorektal di RSUP Sanglah periode
           2019 - 2020

    • Authors: Bagus Agung Arya Dharma Pramana Dwi Sutanegara, Ni Nyoman Ayu Dewi, I Wayan Gede Sutadarma
      Pages: 137 - 140
      Abstract: Background: Colorectal cancer is cancer that develops slowly and begins as a tumor or growth of tissue from the inner surface of the rectum or colon. Colorectal cancer can be influenced by exogenous factors that can be modified, one of which is obesity. This study aims to determine the prevalence of obesity in colorectal cancer patients.Methods: This research was a descriptive study with a retrospective approach using medical record data and the sampling technique was total sampling. The data obtained according to the inclusion and exclusion criteria were 100 data which were then analyzed using SPSS version 20 for Windows. Data was taken from the 100 medical records for age, sex, Body Mass Index (BMI), and histopathology of colorectal cancer. The data was obtained from the Installation Medical Record at Sanglah Hospital.Results: The results found a difference in colorectal cancer patients with BMI '25 and <25 kg/m2. Patients with a BMI <25 kg/m2 were 90 patients (90.00%) more suffering from colorectal cancer than 10 patients (10.00%) who had a BMI '25 kg/m2. Based on age, the most colorectal cancer was found at ' 56 years old, namely 52.0%. In contrast, based on the type of cancer, there were more adenocarcinoma types, namely 88 patients (88.0%) compared to histopathological types of cancer that were difficult to find (12.00%).Conclusion: From the results of this study, it can be concluded that colorectal cancer patients attack more than or equal to 56 and BMI <25 kg/m2. Latar Belakang: Kanker kolorektal merupakan kanker yang berkembang dengan lambat dan berawal sebagai tumor atau perkembangan jaringan dari permukaan dalam rektum atau kolon. Kanker kolorektal dapat dipengaruhi oleh faktor eksogen yang dapat dimodifikasi salah satunya adalah obesitas. Penelitian ini bertujuan untuk mengetahui prevalensi obesitas pada pasien kanker kolorektal.Metode: Penelitian ini merupakan penelitian deskriptif dengan pendekatan retrospektif menggunakan data rekam medis dan teknik pengambilan sampel adalah total sampling. Data yang diperoleh sesuai dengan kriteria inklusi dan eksklusi sebanyak 100 data yang kemudian dianalisis menggunakan SPSS versi 20 untuk Windows. Dari 100 rekam medis diambil data umur, jenis kelamin, IMT dan histopatologi kanker kolorektal. Data diperoleh dari Instalasi Rekam Medis RSUP Sanglah.Hasil: Pada hasil ditemukan adanya perbedaan pada pasien kanker kolorektal dengan IMT'25 dengan <25 kg/m2. Pasien dengan IMT<25 kg/m2 yaitu sebanyak 90 pasien (90,0%) lebih banyak menderita kanker kolorektal dibandingkan dengan 10 pasien (10,0%) yang memiliki IMT '25 kg/m2. Dilihat dari usia pasien, didapatkan kanker kolorektal paling banyak pada usia ' 56 tahun yaitu 52,0%, sedangkan pada jenis kanker didapatkan tipe adenokarsinoma lebih banyak yaitu 88 pasien (88,0%) dibandingkan tipe histopatologi kanker yang sulit dijelaskan (12,0%).Kesimpulan: Dari hasil penelitian ini dapat disimpulkan bahwa pasien kanker kolorektal lebih banyak menyerang pada usia lebih dari atau sama dengan 56 dan IMT <25 kg/m2.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Differences in union time, dash score and range of motion between giving
           bisphosphonate and without giving bisphosphonate of osteoporosis patients
           with distal radius fracture: a systematic review and meta-analysis

    • Authors: Dwiwahyonokusuma Dwiwahyonokusuma, Putu Astawa, I Wayan Suryanto Dusak, I Ketut Suyasa, Made Bramantya Karna
      Pages: 141 - 146
      Abstract: Background: Osteoporosis is a common health problem. Meanwhile, the incidence of distal radius fracture increases with osteoporosis. The standard modality for osteoporosis is a combination of pharmacological therapy, one example of which is the administration of bisphosphonates. There is some disagreement about bisphosphonates' effect on the treatment of distal radius fractures in osteoporosis patients. This study aims to conclude the effect of bisphosphonates for this condition on both functional and radiological outcomesMethods: A systematic search was carried out on the PUBMED database and Google Scholar on studies comparing the timing of bone fusion, Disability of Arm, Shoulder, And Hand (DASH) scores, and wrist Range of Motion (ROM) among distal radius fracture patients with or without additional bisphosphonate therapy. A prospective or retrospective cohort study and a randomized controlled trial were included in this study during 2000-2020. Inclusion and exclusion criteria were used for sample selection. Weight Mean Difference (WMD) was used to assess the statistical results in RevMan version 5.3 for Windows.Results: A search through the PUBMED and Google Scholar databases yielded 376 studies. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 6 articles. In total, there were 973 patients with distal radius fractures who received different treatment on bisphosphonate therapy. There was a significant difference in time to union with bisphosphonates (WMD=0.56; 95% CI=-0.94-2.06). Meanwhile, there was no significant difference in the assessment of DASH and ROM scores (WMD=0.27; 95% CI= -1.01-1.55).Conclusion Bisphosphonates provide a slower time to union in osteoporotic patients with distal radius fracture.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Nodular anterior scleritis in systemic sclerosis: a case report

    • Authors: Komang Putra Tridiyoga, Ida Ayu Ary Pramita, I Gusti Ayu Made Juliari, A. A Mas Putrawati Triningrat, I Made Agus Kusumadjaja, N.K Niti Susila
      Pages: 147 - 151
      Abstract: Introduction: Scleritis is an inflammation of the sclera’s lining, characterized by cellular infiltration, collagen damage, and vascular changes. The incidence rate of scleritis accompanied by systemic disease generally is around 39% to 50%. Scleritis can be divided into two, namely anterior and posterior scleritis. Anterior scleritis can be divided into four, diffuse anterior scleritis, nodular anterior scleritis, necrotizing anterior scleritis with inflammation and without inflammation. One of the causes of nodular anterior scleritis is systemic sclerosis which is an autoimmune disease. Nodular anterior scleritis in systemic sclerosis is very rare, with an estimated prevalence rate of 4.4%.Case Description: A man, 46 years old, complaining of red, watery, painful, and visible white membrane on his right eye since two weeks ago and was referred from an ophthalmologist with scleritis on his right eye. The patient had a history of asthma and cataract surgery. Physical examination showed right eye VA was 6/45 pinhole (PH) 6/18, conjunctival and scleral injection, nodule on superior conjunctiva with yellowish-white in color. Laboratory examination showed a clinical representation of autoimmune disease, consulted to the rheumatology division, and was diagnosed with systemic sclerosis. The patient has been prescribed corticosteroids and immunosuppressant’s for the therapy, the patient's eye condition improves after.Conclusion: Systemic sclerosis with a presenting ophthalmologic complaint is a rare disease. This case illustrates that nodular anterior scleritis needs comprehensive intervention to seek the etiology and provide the treatment. This case has shown that nodular anterior scleritis with systemic sclerosis improved with corticosteroids and immunosuppressants, a typical treatment for autoimmune disease. 
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Perbandingan kapasitas vital paru dan FEV1 antara atlet olahraga aerobik
           dan nonatlet: sebuah tinjauan sistematik

    • Authors: Anak Agung Ratih Kusumadewi Wiraputri, I Nyoman Gede Wardana, Yuliana Yuliana, Muliani Muliani
      Pages: 152 - 157
      Abstract: Introduction: Physical exercise, such as aerobic exercise, depends on the aerobic energy generation process or requires oxygen. One way to determine the benefits of physical activity in individuals is to look at the differences in lung function in the group who regularly exercise (athletes) with the sedentary group. This review will discuss further the comparison of vital lung capacity and Forced Expiratory Volume in 1 sec (FEV1), which is presented in the form of a systematic review.Methods: A search for journals published from 2015-2020 was conducted on the CENTRAL, ProQuest, Pubmed, and ScienceDirect databases that compared cardiorespiratory endurance values in athletes and non-athletes. The preparation of this systematic review is based on guidelines for writing systematic reviews by Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA).Results: The literature search results in 30 studies. These studies were analyzed based on the intervention or exposure to see the description and differences of lung function characteristics, especially vital capacity and FEV1 in aerobic and non-athletic athletes.Conclusion: Aerobic sports athletes tend to have better lung function than non-athletes, where lung function is assessed based on the higher FVC and FEV1 values in aerobic athletes. Several studies that showed insignificant differences on the lung function of aerobic athletes and non-athletes were caused by differences in the anthropometric characteristics of each group, which was a confounding factor in the study.  Pendahuluan: Latihan fisik seperti olahraga aerobik merupakan aktivitas fisik yang bergantung pada proses pembentukan energi secara aerob dan dapat memberikan efek positif terhadap sistem kardiovaskular dan respirasi. Salah satu cara untuk mengetahui manfaat aktivitas fisik pada individu adalah dengan melihat perbedaan fungsi paru pada kelompok yang rutin berolahraga (atlet) dengan kelompok sedenter. Dalam tinjauan ini akan dibahas lebih jauh mengenai perbandingan kapasitas vital paru dan Forced Expiratory Volume in 1 sec (FEV1) yang disajikan dalam bentuk tinjauan sistematik.Metode: Pencarian jurnal yang membandingkan nilai daya tahan kardiorespirasi pada atlet dan nonatlet yang diterbitkan dari tahun 2015-2020 melalui database CENTRAL, ProQuest, Pubmed, dan ScienceDirect. Penyusunan systematic review ini didasarkan pada pedoman penulisan tinjauan sistematik oleh Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Hasil: Hasil pencarian literatur berupa 30 studi yang relevan dan kemudian dianalisis berdasarkan pada intervensi atau paparan yang dilakukan untuk melihat gambaran serta perbedaan karakteristik fungsi paru khususnya kapasitas vital dan FEV1 pada atlet aerobik dan nonatlet.Simpulan: Atlet olahraga aerobik cenderung mempunyai fungsi paru yang baik jika dibandingkan dengan non-atlet, dimana fungsi paru ini dinilai berdasarkan lebih tingginya nilai FVC dan FEV1 pada atlet aerobik. Beberapa studi yang menunjukkan hasil tidak signifikan terhadap fungsi paru atlet aerobik dan nonatlet disebabkan oleh adanya perbedaan karakteristik antropometri dari masing-masing kelompok dimana hal ini merupakan faktor perancu dalam penelitian.
      PubDate: 2021-04-01
      Issue No: Vol. 12, No. 1 (2021)
  • Profil klinis pasien dengan gejala gangguan motilitas predominan
           konstipasi di unit endoskopi gastrointestinal rumah sakit tersier

    • Authors: Godfried Erycesar Yeremia Saragih, I Dewa Nyoman Wibawa, I Ketut Mariadi, Gde Somayana
      Pages: 158 - 163
      Abstract: Background: Investigating constipation requires careful evaluation of general examinations cascaded into specifics to identify treatable or significant causes for early detection. This study aims to determine patients' clinical profile with symptoms of motility disorders, predominantly constipation, in the gastrointestinal endoscopy unit of the tertiary hospital.Methods: This descriptive cross-sectional study involved 82 participants collected through consecutive sampling. Patients with predominant constipation symptoms who underwent colonoscopy in Sanglah Hospital Endoscopy Unit from 2017 to 2018 were recruited. Primary data comprising clinical assessments, laboratory test results, and colonoscopy and histopathology interpretation were analyzed accordingly. Constipation and fecal incontinence severity was indicated by Patient Assessment of Constipation – Symptoms (PAC-SYM) and Jorge-Wexner score. Data was analyzed using SPSS version 25 for Windows.Results: Most of the respondents were male (62.2%). The PAC-SYM and Jorge-Wexner Score were relatively low, with mean values of 2.44±0.73 and 2.18±0.99, respectively. The prevalence of patients initially assessed with chronic constipation (57.32%) remained high (26.83%) despite adjustment being done after colonoscopic exclusion.Conclusion: Diagnostic challenges of constipation exceeded the exhaustive efforts utilizing extensive diagnostic modalities. Suboptimal treatment would be inevitable in the absence of a good-quality management algorithm. Latar Belakang: Investigasi konstipasi memerlukan kecermatan dalam mengevaluasi pemeriksaan umum yang berjenjang menjadi spesifik untuk mengidentifikasi kausa yang dapat ditangani atau bermakna terhadap deteksi dini. Penelitian ini bertujuan untuk mengetahui profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal Rumah Sakit Tersier.Metode: Penelitian deskriptif potong lintang ini melibatkan 82 responden yang dikumpulkan melalui pengambilan sampel secara konsekutif. Pasien dengan gejala dominan konstipasi yang menjalani kolonoskopi di Unit Endoskopi RSUP Sanglah selama tahun 2017 hingga 2018 direkrut. Data primer yang terdiri dari penilaian klinis, hasil tes laboratorium, dan interpretasi kolonoskopi maupun histopatologi dianalisis. Tingkat keparahan konstipasi dan inkontinensia feses ditunjukkan pada skor Patient Assessment of Constipation – Symptoms (PAC-SYM) dan Jorge-Wexner. Data dianalisis menggunakan SPSS versi 25 untuk Windows.Hasil: Sebagian besar atau responden berjenis kelamin laki-laki (62,2%). Skor PAC-SYM dan Jorge-Wexner relatif rendah dengan nilai rata-rata masing-masing 2,44±0,73 dan 2,18±0,99. Prevalensi pasien yang awalnya dinilai dengan konstipasi kronis (57,32%) tetap tinggi (26,83%) meskipun penyesuaian dilakukan setelah eksklusi kolonoskopi.Simpulan: Tantangan diagnostik konstipasi melebihi upaya maksimal dengan memanfaatkan modalitas diagnostik yang luas. Terapi yang kurang optimal tidak dapat dihindari jika tidak ada algoritma manajemen yang berkualitas baik.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Gonadotropin Releasing Hormone Agonis (GNRH-A) vs Human Chorionic
           Gonadotropin (hCG) vs Gonadotropin Releasing Hormone Agonis (GNRH-A) +
           Human Chorionic Gonadotropin (HCG) sebagai stimulan pematangan oosit,
           tingkat pembuahan, kualitas embrio, tingkat keha

    • Authors: Putu Nody Asta Kusuma, Jaqueline Sudirman, Made Suyasa Jaya, I Gede Ngurah Harry Wijaya Surya, Anak Agung Ngurah Anantasika, Ida Bagus Putra Adnyana
      Pages: 164 - 170
      Abstract: Background: The stimulation of Human Chorionic Gonadotropin (hCG) vs. Gonadotropin-Releasing Hormone (GnRH) agonists vs. hCG + GnRH agonists plays an important role in influencing oocyte maturation, fertilization, embryo quality, pregnancy, live birth rates, and Ovarian Hyperstimulation Syndrome (OHSS) during IVF. This study aims to determine the effectiveness of hCG vs. GnRH agonist stimulation vs. hCG + GnRH agonists regarding oocyte maturation levels, embryo quality, fertilization, pregnancy, live birth rates, and OHSS while undergoing IVF program.Methods: This cross-sectional analytic study was conducted on 86 samples, including 33 hCG group, 12 GnRH agonist group, and 41 hCG + GnRH agonist group. The secondary data was obtained from the IVF clinical laboratory results at Puri Bunda Hospital and BROS hospital. Data were analyzed using SPSS version 20 for Windows.Results: There were no significant differences in age, duration of infertility, levels of Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), estradiol, duration of stimulation, level of oocyte maturation, fertilization, embryo quality, pregnancy, live birth rate and OHSS ( p> 0.05) in each group. However, there was a significant difference in the Body Mass Index (BMI) (p = 0.032) and the number of oocytes (p = 0.020) in each group.Conclusion: There were no significant differences in oocyte maturation, fertilization rates, embryo quality, pregnancy, live birth rates, and OHSS.  Latar Belakang: Stimulasi Human Chorionic Gonadotropin (hCG) vs Gonadotropin Releasing Hormone (GnRH) agonis vs hCG+GnRH agonis berperan penting dalam mempengaruhi pematangan oosit, pembuahan, kualitas embrio, kehamilan, tingkat kelahiran hidup, dan Ovarian Hiperstimulation Syndrome (OHSS) pada saat menjalani program bayi tabung. Penelitian ini bertujuan untuk mengetahui efektifitas dari stimulasi hCG vs GnRH agonis vs hCG+GnRH agonis mengenai tingkat pematangan oosit, kualitas embrio, pembuahan, kehamilan, kelahiran dan OHSS saat menjalani program bayi tabung.Metode: Penelitian potong lintang analitik ini dilakukan terhadap 86 sampel meliputi 33 kelompok hCG, 12 kelompok GnRH agonis, dan 41 kelompok hCG+GnRH agonis. Data sekunder diperoleh dari hasil laboratorium klinik IVF Rumah Sakit Puri Bunda dan rumah sakit BROS. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Tidak terdapat perbedaan bermakna pada usia, durasi infertilitas, kadar Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), estradiol, durasi stimulasi, tingkat pematangan oosit, pembuahan, kualitas embrio, kehamilan, tingkat kelahiran hidup dan OHSS (p>0,05) pada masing-masing kelompok. Namun, terdapat perbedaan bermakna pada Indeks Massa Tubuh (IMT) (p=0,032) dan jumlah oosit (p=0,020) pada masing-masing kelompok.Kesimpulan: Tidak ditemukannya perbedaan yang bermakna pada tingkat pematangan oosit, pembuahan, kualitas embrio, kehamilan, tingkat kelahiran hidup dan OHSS.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Gambaran proporsi dan faktor resiko anemia pada pasien diabetes melitus di
           RSUP Sanglah, Bali, Indonesia

    • Authors: Komang Satvika Yogiswara, Sianny Herawati, I Nyoman Wande
      Pages: 171 - 176
      Abstract: Background: Patients with Type 2 Diabetes Mellitus (T2DM) are known to suffer from anemia as a direct or indirect result of their diabetes. In Indonesia, there are no studies that have looked at anemia in DM patients and the risk factors that influence it. Therefore, this study aims to determine the proportion and risk factors for anemia in T2DM patients at Sanglah General Hospital, Bali, Indonesia.Methods: This study is a descriptive study with a cross-sectional approach that uses secondary data from medical records determined by the Purposive Sampling technique. The data obtained according to the inclusion and exclusion criteria were 100 data which were then processed with SPSS version 23 for Windows.Results: In this study, it was found that 15.00% of T2DM patients in Sanglah General Hospital suffered from anemia. It was found that the risk factor that influenced the occurrence of anemia in T2DM patients was Chronic Kidney Disease (CKD) (r=0.581; p=0.000). Variable gender, HbA1c levels, BMI, type of drug, and the number of drugs were not associated with anemia in T2DM patients (p> 0.05).Conclusion: The CKD condition was known significantly as a factor affecting the occurrence of anemia in T2DM patients at Sanglah General Hospital. Latar belakang:  Pasien dengan Diabetes Melitus Tipe 2 (DMT2) diketahui dapat menderita anemia sebagai akibat langsung maupun tidak langsung dari diabetes yang mereka derita. Di Indonesia, belum ditemukan adanya penelitian yang melihat anemia pada pasien DM serta faktor resiko yang mempengaruhinya. Oleh karena itu penelitian ini bertujuan untuk mengetahui proporsi dan faktor risiko anemia pada pasien DMT2 di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan penelitian deskriptif dengan pendekatan potong lintang dimana menggunakan data sekunder rekam medis yang ditentukan dengan teknik Purposive Sampling. Data yang didapat sesuai kriteria inklusi dan eksklusi adalah 100 data yang kemudian diolah dengan SPSS versi 23 untuk Windows.Hasil: Pada studi ini ditemukan bahwa 15,00% pasien DMT2 di RSUP Sanglah menderita anemia, ditemukan bahwa faktor resiko yang mempengaruhi terjadinya anemia pada pasien DMT2 adalah kondisi Penyakit Ginjal Kronis (PGK) (r=0,581; p=0,000). Variabel jenis kelamin, kadar HbA1c, IMT, jenis obat, dan jumlah obat tidak berhubungan dengan kondisi anemia pada pasien DMT2 (p>0,05).Kesimpulan: Keadaan PGK diketahui secara bermakna sebagai faktor yang mempengaruhi terjadinya anemia pada pasien DMT2 di RSUP Sanglah.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan antara ekspresi Vascular Endothelial Growth Factor (VEGF) dengan

    • Authors: Johanes Prasetyo Harjanto, I Wayan Juli Sumadi, I Made Gotra, Ni Putu Ekawati
      Pages: 177 - 182
      Abstract: Background: Osteosarcoma is the most common malignant primary bone tumor. Although osteosarcoma cases are relatively rare compare to carcinoma, the mortality rate is quite high. Osteosarcoma prognosis can be seen from conventional pathology and biological markers, such as Vascular Endothelial Growth Factor (VEGF). In various studies, the presence of VEGF expression has been associated with the worsening prognosis of osteosarcoma. This study aims to determine the relationship between VEGF expression and osteosarcoma's clinicopathological characteristics at Sanglah General Hospital, Denpasar, 2015-2019.Method: This research is a cross-sectional analytic study. The sampling technique used all affordable populations that were included in the inclusion criteria, with a total sample of 30 samples. The research data used secondary data obtained from the archive of histopathological examination reports at the Anatomical Pathology Laboratory at Sanglah General Hospital and paraffin blocks from all available samples for immunohistochemical examination. Data were analyzed using SPSS version 22 for Windows.Results: The clinicopathological characteristics of the osteosarcoma studied were age, tumor location, histological type, and grading. Patients with osteosarcoma in this study were predominantly found in the age group <20 years (66.67%), femur locations (60.00%), mixed type osteosarcoma (53.33%), and high grade (100.00%). A total of 26 samples (86.67%) had high VEGF expression and 4 samples had low VEGF expression (13.30%). There was no significant relationship between age (p=0.241), location of the tumor (p=0.739), and histological type (p=1.000) to the VEGF expression.Conclusion: The relation between each osteosarcoma clinicopathological characteristic associated with VEGF expression showed insignificant results in age, location, and histological type. Further research is needed with a more significant number of samples to get better results. Latar Belakang: Osteosarkoma adalah tumor tulang primer ganas yang paling umum. Meskipun kasus osteosarkoma relatif jarang dibandingkan dengan karsinoma, angka kematiannya cukup tinggi. Prognosis osteosarkoma dapat dilihat dari patologi konvensional dan penanda biologis, salah satunya adalah Vascular Endothelial Growth Factor (VEGF). Dalam berbagai penelitian, kehadiran ekspresi VEGF telah dikaitkan dengan prognosis yang memburuk dari osteosarcoma. Penelitian ini bertujuan untuk mengetahui hubungan ekspresi VEGF dengan karakteristik klinikopatologi osteosarkoma di RSUP Sanglah Denpasar tahun 2015-2019.Metode: Penelitian ini merupakan penelitian analitik potong lintang. Teknik pengambilan sampel menggunakan semua populasi terjangkau yang termasuk dalam kriteria inklusi, dengan jumlah sampel sebanyak 30 sampel. Data penelitian menggunakan data sekunder yang diperoleh dari arsip laporan pemeriksaan histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah dan blok parafin dari semua sampel yang tersedia untuk pemeriksaan imunohistokimia. Data dianalisis dengan SPSS versi 22 untuk Windows.Hasil: Karakteristik klinikopatologi dari osteosarkoma yang diteliti adalah usia, lokasi tumor, tipe histologis, dan grading. Penderita osteosarkoma pada penelitian ini paling banyak ditemukan pada kelompok usia <20 tahun (66,67%), lokasi femur (60%), tipe campuran osteosarkoma (53,33%) dan High-Grade (100.00%). Sebanyak 26 sampel (86,67%) memiliki ekspresi VEGF tinggi dan 4 sampel memiliki ekspresi VEGF rendah (13,30%). Tidak terdapat hubungan yang bermakna antara usia (p=0,241), lokasi (p=0,739), dan tipe histologis (p=1,000).Kesimpulan: Hubungan antara masing-masing karakteristik klinikopatologi osteosarkoma yang terkait dengan ekspresi VEGF menunjukkan hasil yang tidak bermakna pada usia, lokasi, dan tipe histologis. Diperlukan penelitian lebih lanjut dengan jumlah sampel yang lebih banyak untuk mendapatkan hasil yang lebih baik.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Bacterial growth from the surgical wound base smear at the end of the
           operation and superficial surgical site infection in the administration of
           cefazolin single dose, ceftriaxone single dose, and ceftriaxone 3 days as
           prophylactic antibiotics in cases of

    • Authors: Mario Daniel Simatupang, I Wayan Suryanto Dusak, I Ketut Suyasa, I Gede Eka Wiratnaya
      Pages: 183 - 186
      Abstract: Background: The use of prophylactic antibiotics in hospitals still often found to be not in accordance with the guidelines of prophylactic antibiotics used and therapy published by the hospital itself. This study aims to compare the effectiveness of prophylactic antibiotics between cefazolin and ceftriaxone in single-dose administration in patients with closed long bone fractures after implant surgery in Sanglah General Hospital on the incidence of Surgical Site Infection (SSI) and germ growth on the base of the surgical wound.Methods: This study used a randomized clinical trial design from a population of closed long bone fracture patients who underwent implant surgery at Sanglah General Hospital. The sample selection was carried out by consecutive sampling during the period July-August 2020. The statistical test was the Chi-Square Test or Fisher Exact Test using the SPSS version 20 for Windows.Results It was found that there was no growth of germs, or in other words, negative culture results were obtained in all study subjects (growth of N (%) 0 (0%), p = -) bacteria in all three groups on a single dose and 3-days dose. SSI did not occur in all study subjects in the three groups so that it could automatically be concluded that there was no difference in the proportion of SSI incidents in the three groups (SSI incidence N (%) 0 (0%), p = -) on single-dose and 3 days dose antibiotics administration, so that the proportional comparison test, either the Chi-Square test or the Fisher Exact test, cannot be performed.Conclusion The prophylactic antibiotics (which are the cephalosporins, namely single dose generic cefazolin and single-dose generic ceftriaxone and 3 days dose) have the same effectiveness in preventing the growth of germs on the surgical wound base smear and prevent the occurrence of superficial SSI on the 30th postoperative day.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Correlation of glutamine and serial absolute neutrophil count as a
           parameter of infection in major burn trauma patients at Sanglah General
           Hospital, Bali, Indonesia

    • Authors: Shita Diwyani Sudarsa, Agus Roy Rusly Hariantana Hamid, Agustinus I Wayan Harimawan, Ni Nyoman Sri Budayanti
      Pages: 187 - 191
      Abstract: Background: Burns are thermal trauma that often results in high morbidity. In major burns, gastrointestinal dysfunction plays a vital role in the progression of infection to organ failure. Glutamine is a pharmaconutrient that has important implications for burn patients, including in the prevention of infection. This study evaluates the relationship between glutamine administration and the serial absolute neutrophil count as a parameter for infection incidence in patients with major burns.Methods: This study was an analytical study with a cross-sectional design to see the relationship between glutamine administration and the serial absolute neutrophil count levels of major burn patients at Sanglah General Hospital. The sample consisted of 56 patients from the medical records of burn patients. The data were extracted from the medical records and then inserted into the data collection sheet. Then performed data analysis using SPSS version 21 for Windows.Results: Bivariate analysis showed that there was a significant difference between glutamine administration and the absolute neutrophil count levels on days 3, 5, and 14 (p = 0.004, 95% CI: 1.70-8.46), (p = 0.000, 95% CI: 2.71-7.83), and (p = 0.035, 95% CI: 0.61-7.27), respectively. This showed that patients given glutamine had lower neutrophil levels on days 3, 5, and 14 than patients who were not given glutamine. Multivariate analysis confirmed that glutamine administration did independently affect and decrease the absolute neutrophil count levels on days 3, 5, 14, and the mean without being influenced by other variables with p value = 0.004 (95% CI: [-8.445] - [-1,732]), p = 0.000 (95% CI: [-7,808]-[-2,743]), p = 0.020 (95% CI: [-7.251]-[-0.639]), and p = 0.017 (95% CI: [-5,815]-[-0.588]), respectively.Conclusion: This study has shown that glutamine administration was significantly associated with and decreased the serial absolute neutrophil count in major burn patients.
      PubDate: 2021-04-22
      Issue No: Vol. 12, No. 1 (2021)
  • Prevalence and recurrence of hamstring injuries among professional soccer
           players in Petaling Jaya City Football Club (FC)

    • Authors: Dharshinee Suresh Kumar, Ketut Tirtayasa, I Putu Adiartha Griadhi
      Pages: 192 - 195
      Abstract: Background: There is considerable evidence that hamstring injuries are moderate among professional soccer players and that the rates continue to remain elevated when these professional soccer players play soccer avidly. This study aims to determine the prevalence and recurrence of hamstring injuries among professional soccer players in Petaling Jaya City FC.Methods: A simple random consecutive sampling research data is the past medical record of professional soccer players from Petaling Jaya City FC Physiology Centre. They suffer from hamstring injuries directly taken from Petaling Jaya City FC. Data were analyzed using SPSS version 23 for Windows.Results: There are 30 players in Petaling Jaya City FC and 5 of them had a developing Hamstring Injury case. Out of 5 players suffering from Hamstring Injury, 2 of them had a recurrence of Hamstring Injury and all of them were males (100.00%).  Most of the soccer players have played for 10-12 years (60.00%).Conclusion: The risk of getting hamstring injury increases as the age increases because of the hip flexor and the years of playing soccer excessively. In conclusion, it is safe to say that as each player's age increases, the more the possibility of the player to have a hamstring injury.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Faktor-faktor klinikopatologi kekambuhan kanker serviks stadium I-IIA2
           pasca histerektomi radikal di RSUP Sanglah periode 2019–2020

    • Authors: Putu Raka Widhiarta, I Nyoman Bayu Mahendra, Made Bagus Dwi Aryana, I Gede Megaputra
      Pages: 196 - 200
      Abstract: Background: Cervical cancer is the second-largest malignant disease in Indonesia. Recurrence in early-stage cervical cancer is high. However, data of clinicopathological factors for recurrence of early stage cervical cancer in Indonesia, especially in Denpasar, are still challenging to find. Thus, this study aims to determine the clinicopathological factors for recurrence cervical stage I-IIA2 post radical hysterectomy at Sanglah General Hospital.Methods: This research is an analytical cross sectional study using medical record data and the sampling technique is total sampling. According to the inclusion and exclusion criteria, the data obtained were 46 data, which were then analyzed using SPSS version 25 for Windows.Results: The bivariate analysis of this study showed that the variables age, histopathology, incision margin, and parametrial involvement were not significantly associated with the recurrence rate (p> 0.05). The factors significantly associated with the recurrence rate were a clinical stage, tumor size, and positive lymph nodes (p <0.05).Conclusion: Clinical stage, tumor size, and lymph node metastases are three independent factors for cervical cancer recurrence after radical hysterectomy surgery.Keywords: Cervical Cancer, Recurrence, Radical Hysterectomy, Sanglah General Hospital Denpasar.  Latar belakang:  Kanker serviks adalah penyakit keganasan kedua terbanyak di Indonesia. Kekambuhan pada kanker serviks stadium awal tergolong tinggi. Namun, data mengenai faktor-faktor kekambuhan kanker serviks stadium awal di Indonesia khususnya di Denpasar masih sulit ditemukan. Sehingga, penelitian ini bertujuan untuk mengetahui faktor-faktor kekambuhan kanker serviks stadium I-IIA2 pasca histerektomi radikal di RSUP Sanglah Denpasar.Metode: penelitian ini merupakan penelitian analitik potong lintang dengan menggunakan data rekam medis dan teknik penentuan sampel adalah Total Sampling.  Data yang didapat sesuai kriteria inklusi dan eksklusi adalah 46 data yang kemudian doiolah dengan SPSS versi 25 untuk Windows.Hasil: Analisis bivariat penelitian ini menunjukan bahwa variabel usia, histopatologi, batas sayatan, dan keterlibatan parametrium tidak berhubungan secara bermakna dengan tingkat kekambuhan (p>0,05). Faktor-faktor yang berhubungan secara bermakna dengan tingkat kekambuhan adalah stadium klinis, ukuran tumor, dan kelenjar limfe positif (p<0,05).Kesimpulan: Stadium klinis, ukuran tumor, dan metastasis pada kelenjar limfe adalah tiga faktor independen untuk kekambuhan kanker serviks setelah operasi radikal histerektomi.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Fistulectomy in a 9-years old boy with pre-auricular fistula

    • Authors: Komang Soniananda Pradnyana Putri, Luh Witari Indrayani
      Pages: 201 - 204
      Abstract: Introduction: Preauricular fistule is a congenital malformation of the six auditory hillocks during the development of auricle. It mostly appears like a small pit close to the first ascending portion of the helix's anterior margin. The sebaceous glands secreted fluid through the opening of the fistule. Surgery is needed if the discharge is prolonged or if there was a repeated infection. It must be completely removed to prevent a recurrence. Accuracy is required in performing fistulectomy and aesthetics because the operation is in the area around the face.Case description: Male patient, 9 years old, complained of itching in the right ear. Since birth, the patient has an abnormal hole (fistule) in front of his right ear, anterior of the medial supra auricle helix, round and the size of a tip of the pencil. The mother has the same history. There is an abscess near that hole that secretes yellow pus. That occurred twice this year and it has greatly disturbed the patient's activities at school. The patient was diagnosed with a preauricular fistula with an abscess in the right ear. An abscess drainage incision was performed and an antibiotic was given. Fistulectomy is performed after the acute infection subsides under general anesthesia. The patient underwent a simple fistulectomy surgery. The whole track and sinus were removed, the defect was undermined and sutured.Conclusion: A simple fistulectomy is a good option as a standard procedure for preauricular fistula excision. It is especially useful as an alternative in cases where the other approaches are difficult to be performed.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • The awareness of low sexual desire in female among married women in
           Indonesia: a preliminary study

    • Authors: Jivitha Munusamy, I Made Oka Negara
      Pages: 205 - 207
      Abstract: Background: Sexual dysfunction is difficulty experienced by any individual or a couple during any stage of normal sexual activity. Sexual dysfunction occurs among men and also women. This study aims to identify the level of awareness, knowledge, and attitude of married women towards hypoactive sexual desire disorder in their life.Methods: A cross-sectional descriptive study was conducted among 75 married women using a self-administered questionnaire through social media platforms to ensure easy accessibility to a wider participant. This study's inclusion criteria are married women from the age of 20-40 years old who volunteer themselves and take place in the survey. Factors that influence low sexual desire in married women, such as age, social life, hypoactive sexual desire, and the level of communications or understanding among their partners, are assessed in this study. Data were analyzed using SPSS version 20 for Windows.Results: From the total of 75 participants, a total of 56.00% haven't heard or came across the term low sexual desire in their life. Meanwhile, a total of have 32.00% came across this term. The survey shows that participants who have participated in this survey have a higher morbidity rate on pregnancy history with complications that represent 59.00% of them. Meanwhile, participants with a history of pregnancy without complications consist of 41.00%.Conclusion: There is still a more significant number of women still unaware of hypoactive sexual desire disorder. Most of them think that hypoactive sexual desire disorder is common.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • The use of compression stockings produces lower Interleukin-6 (IL-6)
           levels, Higher American Orthopaedic Foot and Ankle Society Score (AOFAS),
           and does not produce higher alkaline phosphatase level in postoperative
           patients with fracture around the ankle

    • Authors: Gede Agung Krisna Yudha, I Ketut Siki Kawiyana, Ketut Gede Mulyadi Ridia, I Ketut Suyasa, I Gede Eka Wiratnaya
      Pages: 208 - 211
      Abstract: Background: Fractures around the ankles are common injuries. The use of compression stockings is one of the postoperative modalities that has been widely used in developing countries but is rarely used in Indonesia. This study aimed to determine the effect of using compression stockings on changes in inflammatory biomarkers level and functional outcomes in postoperative patients with fractures around the ankle.Methods: This study was a randomized clinical trial (post-operative-only design) in 26 patients with fractures around the ankle. The study subjects were divided into groups using postoperative compression stockings and groups without compression stockings. Its efficacy was assessed by measuring levels of Interleukin-6 (IL-6), Alkaline Phosphatase (ALP), and American Orthopedic Foot and Ankle Society (AOFAS) scores. Data were analyzed using SPSS version 20 for Windows.Results: Postoperative 24-hour IL-6 levels were not significantly different (p=0.200; -59.93–266.42), but they were significantly different postoperatively in 3 days (p = 0.001; 8.76-30.21), 14 days (p=0.015; 2.40-20.49), and 30 days (p=0.000; -15.49–[-5.03]). ALP was not different significantly, both at 24 hours (p=0.160; -16.0-2.80), 3 days (p=0.072; -0.65-14.19), 14 days (p=0.098; -1,310–12,54), and 30 days (p=0.419; -5.00–11.61) after surgery. The AOFAS scores was different significantly 30 days postoperatively (p=0.000; -3.915– [-1.469]).Conclusion: The use of compression stockings can be considered as postoperative therapy to lower the IL-6 levels but do not affect ALP levels in postoperative patients with fractures around the ankle. The use of compression stocking resulted in a higher AOFAS score than without wearing compression stockings in postoperative patients with fractures around the ankle.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Efek antibakteri ekstrak etanol daun sirsak (Annona muricata L.) muda dan
           tua terhadap Pseudomonas aeruginosa ATCC 9027

    • Authors: Gede Agung Dhimasena Widyananda, Agung Nova Mahendra, I Made Jawi
      Pages: 212 - 218
      Abstract: Background: Pseudomonas aeruginosa is an organism that is difficult to handle because it has the ability to resist various antibiotics. Two mechanisms have been studied regarding how Pseudomonas aeruginosa is resistant to both intrinsic and adaptive action of antibiotics. This study aims to determine the antibacterial effect of young and old soursop (Annona muricata L.) leaves ethanol extract against Pseudomonas aeruginosa ATCC 9027.Methods: This study uses the True Experimental Control Group Design method. Samples were divided into 3 groups, namely the control group (K), the intervention group young soursop leaves (EDM) and old soursop leaves (EDT). The control group was divided into negative and positive controls and the intervention group was divided into three groups based on the dosage of using the ethanol extract of Annona muricata L leaves in each isolate with a concentration of 25 mg/mL, 50 mg/mL, and 100 mg/mL, respectively, in group of young and old soursop leaves. Data were analyzed using SPSS version 20 for Windows.Results: The results of the Kruskal-Wallis test showed that there was a significant difference in the inhibition zone in the treatment group, namely the concentration of young and old soursop leaves ethanol extract (25%, 50%, 100%) against the inhibition zone of Pseudomonas aeruginosa bacteria (P <0.05. ).Conclusion: The ethanol extract of young soursop (Annona muricata L.) leaves did not have the effect of inhibiting the growth of Pseudomonas aeruginosa bacteria in vitro. Besides that, the ethanol extract of old soursop (Annona muricata L.) leaves did not have the effect of inhibiting the growth of Pseudomonas aeruginosa bacteria in vitro. Latar Belakang: Pseudomonas aeruginosa  merupakan organisme yang sulit untuk ditangani karena memiliki kemampuan resistensi terhadap berbagai antibiotik.  Terdapat dua mekanisme yang telah dipelajari mengenai bagaimana Pseudomonas aeruginosa resisten terhadap kerja antibiotik baik intrinsik maupun adaptif. Penelitian ini bertujuan untuk mengetahui efek antibakteri ekstrak etanol daun sirsak (Annona muricata L.) muda dan tua terhadap Pseudomonas aeruginosa ATCC 9027.Metode: Penelitian ini menggunakan metode True Experimental Control Group Design. Sampel dibagi dalam 3 kelompok yakni kelompok kontrol (K), kelompok intervensi daun sirsak muda (EDM) dan daun sirsak tua (EDT). Kelompok kontrol dibagi atas kontrol negatif dan positif serta kelompok intervensi dibagi atas tiga kelompok berdasarkan dosis penggunaan ekstrak etanol daun Annona muricata L. pada masing-masing isolat, dengan konsentrasi 25 mg/mL, 50 mg/mL, dan 100 mg/mL pada masing-masing kelompok daun sirsak muda dan tua. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil uji Kruskal-Wallis yang dapat dilihat menunjukan terdapat perbedaan bermakna zona hambat pada kelompok perlakuan yaitu konsentrasi ekstrak etanol daun sirsak muda dan tua (25%, 50%, 100%) terhadap zona hambat bakteri Pseudomonas aeruginosa (P < 0,05).Kesimpulan: Ekstrak etanol daun sirsak (Annona muricata L.) muda tidak memiliki efek menghambat pertumbuhan bakteri Pseudomonas aeruginosa secara in vitro. Disamping itu, ekstrak etanol daun sirsak (Annona muricata L.) tua tidak memiliki efek menghambat pertumbuhan bakteri Pseudomonas aeruginosa secara in vitro.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Epidemiologi pasien luka bakar di RSUP Sanglah Denpasar tahun 2018-2019

    • Authors: Ni Kadek Ayunda Sarini Dewi, I Made Suka Adnyana, I Gusti Putu Hendra Sanjaya, Agus Roy Rusly Hariantana Hamid
      Pages: 219 - 223
      Abstract: Background: Burns are loss of tissue or a form of tissue damage that occurs as a result of contact with heat sources such as fire, chemicals, hot water, electricity, and radiation which are a type of trauma with high morbidity and mortality so that they require special treatment from the initial phase to advanced phase. This study aims to find out, comprehend, and describe the epidemiology of burn patients' causes and mortality at the Sanglah General Hospital in 2018-2019.Methods: The research was conducted with a descriptive method using cross-sectional studies. Samples were selected from the population-based on inclusion and exclusion criteria. Data were analyzed using SPSS version 24 software to obtain the epidemiology of the causes, length of stay, and burns mortality.Results: The results showed that the highest cause of burns was caused by fire, namely 65 people (53.3%). In the adult group, most burns were caused by fire, namely 55 people (45.1%), while in the group of children, most burns were caused by objects / hot water, namely 14 people (11.5%). The mortality of burnt sufferers was 11 people (9%) out of 122 people (100%), where all deaths occurred in the adult group. An IIAB degree burns were the highest burns with the highest mortality with 10 people (90.9%). Most of the burn injuries caused by fire burns were 7 people (63.6%) and the highest case was second-degree burns caused by fire, namely 60 people (56.1%).Conclusion: The results showed that the most common burns were caused by a fire in the adult group and objects/hot water in the children group. IIAB degree burns are the highest degree of burns with mortality.

      Latar Belakang: Luka bakar adalah kehilangan jaringan atau suatu bentuk kerusakan jaringan yang terjadi akibat dari kontak dengan sumber panas seperti api, bahan kimia, air panas, listrik dan radiasi yang merupakan jenis trauma dengan morbiditas dan mortalitas yang tinggi sehingga memerlukan perawatan yang khusus mulai fase awal hingga fase lanjut. Penelitian ini bertujuan untuk mengetahui, memahami dan mendeskripsikan epidemiologi penyebab dan mortalitas pasien luka bakar di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2018-2019.Metode: Penelitian dilakukan dengan metode deskriptif menggunakan studi potong lintang. Sampel dipilih dari populasi berdasarkan kriteria inklusi dan eksklusi. Data dianalisis menggunakan software SPSS versi 24 untuk mendapatkan epidemiologi penyebab dan mortalitas luka bakar.Hasil: Hasil penelitian menunjukkan bahwa epidemiologi penyebab luka bakar tertinggi disebabkan oleh api yaitu 65 orang (53,3%).  Pada kelompok dewasa, pasien luka bakar terbanyak disebabkan oleh api yaitu 55 orang (45,1%), sedangkan pada kelompok anak-anak luka bakar terbanyak disebabkan oleh benda/air panas yaitu 14 orang (11,5%). Mortalitas pasien luka bakar yaitu 11 orang (9%) dari 122 orang (100%), dimana semua kematian terjadi pada kelompok dewasa. Luka bakar derajat IIAB merupakan derajat luka bakar dengan kematian tertinggi yaitu 10 orang (90,9%). Kematian luka bakar terbanyak disebabkan oleh luka bakar akibat api sebanya 7 orang (63,6%) dan kasus tertinggi adalah luka bakar derajat IIAB yang disebabkan oleh api yaitu 60 orang (56,1 %).Kesimpulan: Hasil penelitian ini menunjukkan bahwa luka bakar tersering disebabkan oleh api pada kelompok dewasa dan benda/air panas pada kelompok anak-anak. Luka bakar derajat IIAB merupakan derajat luka bakar dengan kematian tertinggi. 
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Laminoplasty provides better functional outcomes than laminectomy in the
           management of cervical stenosis myelopathy: a systematic review

    • Authors: Putu Kermawan, I Ketut Siki Kawiyana, I Gusti Ngurah Wien Aryana, I Gusti Lanang Ngurah Agung Artha Wiguna, I Gede Eka Wiratnaya, I Ketut Suyasa
      Pages: 224 - 228
      Abstract: Background: Increasing the life expectancy of an individual will be accompanied by the emergence of various degenerative diseases such as cervical stenosis myelopathy (CSM). CSM is characterized by the presence of signs and symptoms of spinal cord compression associated with narrowing the spinal canal dimensions. Decompression can be achieved by conventional methods such as laminectomy or a lamina reshaping procedure known as a laminoplasty. This study reports recent evidence regarding laminectomy and laminoplasty procedures in managing CSM in terms of functional outcomes.Methods: A systematic search was conducted on the PUBMED database to identify and find studies comparing laminoplasty and laminectomy procedures. Inclusion criteria included patients older than 65 years diagnosed with cervical myelopathy, including CSM and/or ossified posterior longitudinal ligament (OPLL). Randomized controlled studies and prospective and retrospective cohorts were included in this study, while case series and case reports were excluded. The comparison of effectiveness is based on the results of measuring functional outcomes using the Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and the visual analogue scale (VAS) for pain assessment.Results: A thorough search through the PUBMED database yielded 156 citations. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 14 articles. All articles have a retrospective cohort design. In total, there were 187 patients in the laminoplasty group and 161 patients in the laminectomy group. There was no significant difference between laminoplasty and laminectomy when viewed from the JOA score in weighted mean difference (WMD) (WMD 0.28; 95% Confidence Interval [CI]:-0.34-0.91) and VAS score (WMD 0.06; 95% CI: -1.13-1.02). However, laminoplasty was shown to have a better NDI score (WMD 3.32; 95% CI: -6.50-0.14).Conclusion: Laminoplasty is superior to laminectomy for managing cervical myelopathic stenosis in terms of NDI score.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Seorang penderita leukemia myeloid akut dengan leukemia kutis: laporan

    • Authors: Reza Surahmanto, Ketut Suega
      Pages: 229 - 233
      Abstract: Background: Acute leukemia can show multiple manifestations of extramedullary tissue and extramedullary involvement is relatively rare. Patients with leukemia cutis usually coexist with systemic leukemia, but sometimes precede involvement of the bone marrow or peripheral blood. In rare instances, cutaneous leukemia can be an early manifestation of systemic disorders.Case: A 61 year old male, Balinese ethnicity, presented with the main complaint of ulcers on the right groin area near the genitals since one month ago, accompanied by fever and weight loss of about 5 kg in one month. Right and left inguinal lymph nodes were enlarged. In the right inguinal area, a solitary ulcer was seen. Laboratory results showed an increase in white blood cells, anemia, and thrombocytopenia. Bone marrow aspiration showed hematopoietic distribution predominantly of the myeloid series and appears to suppress erythroid series and megakaryocytes. The myeloid series consists of 20% positive maturation blast cells without auer rod. The excisional biopsy of the right inguinal ulcer depicts the dermis showed mature and immature granulocyte infiltration. The patient was diagnosed with matured AML (M2) and leukemia cutis. The patient was planned to be given a chemotherapy regimen but the patient developed complications from pneumonia and passed away.Conclusion: A case of 61 years old man has been reported, with complaints of injuries to the right groin near the genitals and fever. The patient was diagnosed with matured acute myeloid leukemia (M2) and leukemia cutis. Leukemia cutis is an extramedullary involvement of leukemia and is of clinical importance. Latar Belakang: Leukemia akut dapat menunjukkan beragam manifestasi pada jaringan ekstramedula dan keterlibatan ekstramedula relatif jarang terjadi. Pasien dengan leukemia kutis biasanya terjadi bersamaan dengan leukemia sistemik, namun terkadang mendahului keterlibatan dari sumsum tulang atau darah tepi. Pada kasus yang jarang, leukemia kutis dapat menjadi manifestasi awal dari kelainan sistemik.Laporan Kasus: Laki-laki 61 tahun, suku Bali, datang dengan keluhan utama borok pada daerah selangkangan kanan dekat dengan kemaluan sejak satu bulan yang lalu. Keluhan juga disertai demam dan penurunan berat badan sekitar 5 kg dalam satu bulan. Pada inguinal kanan dan kiri didapatkan pembesaran kelenjar getah bening. Pada daerah inguinal kanan tampak ulkus soliter. Hasil lab didapatkan peningkatan sel darah putih, anemia, serta trombositopenia. Aspirasi sumsum tulang menunjukkan sebaran hematopoietik yang didominasi seri myeloid dan tampak menekan seri eritroid serta megakaryosit. Seri myeloid terdiri dari sel blast 20% dengan maturasi positif tanpa auer rod. Hasil biopsi eksisi pada ulkus daerah inguinal kanan menggambarkan jaringan yang terdiri dari epidermis dan dermis. Pada dermis tampak infiltrasi granulosit matur dan imatur. Pasien didiagnosis dengan LMA dengan maturasi (M2) dan leukemia kutis. Pasien direncanakan pemberian regimen kemoterapi namun pasien mengalami komplikasi infeksi pneumonia dan meninggal.Simpulan: Telah dilaporkan kasus laki-laki 61 tahun, dengan keluhan luka pada selangkangan kanan dekat kemaluan serta demam. Pasien didiagnosis leukemia myeloid akut dengan maturasi (M2) dan leukemia kutis. Leukemia kutis merupakan keterlibatan ekstramedula dari leukemia dan memiliki arti penting secara klinis.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Hubungan andropause dengan skor IPSS pada pegawai di institusi pusat
           pemerintahan Kabupaten Badung-Bali

    • Authors: Assuncao Caviota Da Silva Pinto, Yukhi Kurniawan, I Gusti Ngurah Pramesemara
      Pages: 234 - 239
      Abstract: Background: Andropause is a term which indicate reduced male testosterone levels. The mechanism of andropause is due to decreased male reproductive function which results in decreased levels of testosterone in the blood below normal levels. On the other hand, almost 50% of men aged 45-60 years experience complaints of urination due to Benign Prostate Hyperplasia (BPH). Until now, BPH is believed to be related to the aging process and decreased levels of the hormone testosterone or andropause. However, no clear evidence indicate a relathionship between andropause and severe micturition probelm. This study aims to determine the relathionship of andropause and the IPSS score.Methods: This study is an analytic observational study with a cross sectional method. Sampling in this study using purposive sampling with respondent taken from the Central Government Institution of Badung Regency, Bali. The total number of research respondents was 40 man. Symptoms and signs of andropause were evaluated using the Androgen Deficiency in the Aging Male (ADAM) questionnaire, while the degree of symptoms of micturition was determined by the International Prostate Symptom Score (IPSS). The data was analyze descriptively and analytically with Chi-square to determine the relationship between andropause status and the degree of micturition problem.Results: Complaints of moderate micturition problem were the most common complaint in andropause respondents (45.5%) while mild complaints were the most common among respondents who did not experience andropause (72.2%). The results showed a significant relationship between respondents who experienced andropause and the tendency to complain of symptoms of obstruction due to prostate enlargement as assessed by the IPSS score (p = 0.038).Conclusion: There is a significant relationship between respondents experiencing andropause and the tendency to complain of symptoms of obstruction due to prostate enlargement. Pendahuluan: Andropause merupakan suatu istilah yang berarti menurunnya kadar hormon testosteron pada laki-laki. Mekanisme terjadinya andropause adalah karena menurunnya fungsi reproduksi laki-laki yang berakibat menurunnya kadar testosteron dalam darah dibawah angka normal. Disisi lain, laki-laki usia 45-60 tahun hampir 50% mengalami keluhan miksi akibat Benign Prostate Hyperplasia (BPH). BPH hingga saat ini diyakini berhubungan dengan proses penuaan dan penuruan kadar hormon testosteron atau andropause. Akan tetapi belum banyak bukti menunjukan hubungan andropause dengan beratnya gangguan miksi akibat BPH. Penelitian ini bertujuan untuk mengetahui hubungan status andropause dengan skor IPSS.Metode: Penelitian ini merupakan penelitian observasional analitik dengan metode potong lintang. Pengambilan sampel pada penelitian ini menggunakan purposive sampling dengan responden diambil dari Institusi Pusat Pemerintah Kabupaten Badung, Bali. Keseluruhan responden penelitian berjumlah 40 orang. Gejala dan tanda andropause dievaluasi dengan kuisioner Androgen Deficiency in the Aging Male (ADAM) sedangkan derajat gejala gangguan miksi ditetukan dengan skor International Prostate Symptom Score (IPSS). Analisis data berupa deskriptif serta analitik dengan Chi-square untuk menentukan hubungan status andropause dengan derajat gangguan miksi.Hasil: Keluhan gangguan miksi derajat sedang merupakan tingkat keluhan paling umum pada responden andropause (45,5%) sedangkan keluhan ringan merupakan keluhan paling umum pada responden tidak mengalami andropause (72,2%). Hasil penelitian menunjukkan hubungan yang signifikan antara responden yang mengalami andropause dan kecenderungan mengeluhkan gejala obstruksi akibat pembesaran prostat yang dinilai melalui Skor IPSS (p=0,038).Simpulan: Terdapat hubungan yang signifikan antara responden yang mengalami andropause dan kecenderungan mengeluhkan gejala obstruksi akibat pembesaran prostat. 
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Gambaran hingga tatalaksana COVID-19 pada anak

    • Authors: Marissa Leviani Hadiyanto
      Pages: 250 - 255
      Abstract: Background: Coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus started in Wuhan, China, spreading rapidly to various countries. This literature review aims to provide an overview, diagnosis and management of COVID-19 in children.Methods: In this paper, the literature review method is used. Sources of reading come from relevant and appropriate journals and books from PubMed, Ebsco and Proquest.Results: Based on data from the Indonesian Ministry of Health dated January 15, 2021, it shows that 2.7% of confirmed cases of COVID-19 are children aged 0-5 years, and 8.9% children aged 6- 18 years. The mortality rate for COVID-19 in children aged 0-5 years is 0.8% and aged 6-18 years is around 1.5%. The most common pattern of transmission of COVID-19 to children is from family clusters. Symptoms and signs of COVID-19 in children include fever, cough, rhinorrhea, painful swallowing, weakness, lacrimation, headache, diarrhea, vomiting, cyanosis and in severe cases Multisystem Inflammatory Syndrome COVID-19 (MIS-C). Diagnosis of COVID-19 in children is confirmed from clinical symptoms and supportive laboratory results such as low to normal leukocytes, increased CRP and radiological abnormalities such as hazy opacities on X rays and ground glass appearance on thoracic computed tomography (CT), despite Real Time Polymerase Chain Reaction ( RT-PCR) is the standard method for diagnosing this disease. General management of children with COVID-19 in the form of complete rest, supportive therapy, symptomatic therapy, administration of vitamins and monitoring of vital signs and oxygen supplementation. Antiviral therapy, antibiotics and steroids are given as indicated. The COVID-19 vaccine for children is currently in the process of being researched.Conclusion: The COVID-19 pandemic is spreading rapidly, and confirmed cases in children are increasing significantly. The prevalence of COVID-19 in children tends to be lower and most of them have milder symptoms than adults, but proper diagnosis and management is needed.  Latar Belakang: Coronavirus disease (COVID-19) disebabkan oleh virus SARS-CoV-2 diawali di Wuhan, Cina menyebar dengan cepat ke berbagai negara. Tinjauan pustaka ini bertujuan memberikan gambaran, diagnosis dan tatalaksana COVID-19 anak.Metode: Dalam penulisan ini digunakan metode tinjauan pustaka. Sumber bacaan berasal jurnal-jurnal dan buku relevan dan sesuai dari PubMed, Ebsco dan Proquest.Hasil: Berdasarkan data Kementrian Kesehatan Indonesia tanggal 15 Januari 2021 menujukkan 2,7 % kasus terkonfirmasi COVID-19 adalah anak usia 0-5 tahun, dan 8,9% anak usia 6- 18 tahun. Angka Kematian COVID-19 pada anak usia 0-5 tahun adalah 0,8% dan usia 6-18 tahun sekitar 1,5%. Pola tersering penularan COVID-19 pada anak adalah berasal dari kluster keluarga. Gejala dan tanda COVID-19 pada anak meliputi demam, batuk, rhinorrhea, nyeri menelan, lemas, lakrimasi, nyeri kepala, diare, muntah, sianosis dan pada kasus berat terjadi Multisystem Inflammatory Syndrome COVID-19 (MIS-C). Diagnosa COVID-19 anak ditegakkan dari gejala klinis dan hasil laboratorium mendukung seperti leukosit yang rendah ke normal, peningkatan CRP dan abnormalitas radiologis seperti hazy opacities pada X ray dan ground glass appearance pada Computed Tomography (CT) toraks, meskipun Real Time Polymerase Chain Reaction (RT-PCR) merupakan metode baku untuk menegakkan diagnosis penyakit ini. Tatalaksana umum pasien COVID-19 anak berupa istirahat total, terapi suportif, terapi simtomatik, pemberian vitamin serta pemantauan tanda vital dan suplementasi oksigen. Terapi antivirus, antibiotik, dan steroid diberikan sesuai indikasi. Vaksin COVID-19 anak saat ini masih dalam proses penelitian.Kesimpulan: Pandemi COVID-19 meyebar dengan cepat, dan kasus terkonfirmasi pada anak meningkat secara signifikan. Prevalensi COVID-19 anak cenderung lebih rendah dan sebagian besar memiliki gejala yang lebih ringan dibanding dewasa namun diagnosis dan tatalaksana yang tepat sangat diperlukan.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Gambaran tingkat pengetahuan tenaga kesehatan terhadap penerapan rekam
           medis berbasis family folder di Puskesmas Denpasar Barat I dan Puskesmas
           Denpasar Barat II periode tahun 2020

    • Authors: I Kadek Meidi Antika, Anak Agung Sagung Sawitri, Luh Seri Ani
      Pages: 256 - 261
      Abstract: Introduction: Family folder is a method of recording medical data using a special code and which also integrated within the family scope. Family folder carries the concept of  family approach as the main focus in dealing with public health problems, especially in the field of preventive medicine at the primary health service level such as Puskesmas. This study aims to measure the knowledge level of health workers related to the implementation of family-folder-based medical records at Puskesmas Denpasar Barat I and Puskesmas Denpasar Barat II in the period of 2020.Methods: This study is a descriptive study with a cross-sectional approach that uses primary data collected through questionnaire related to knowledge of family folders. During the study, data were collected using a combination of printed questionnaires and online forms which must be filled in completely. Data was collected once for each health worker. The results of the data will be analyzed descriptively to present the results of the study using frequency distribution tables.Results: This study includes 50 health workers who  pass the inclusion criteria. The results showed that 19 health workers (38%) had a good level of knowledge, while 31 other health workers (62%) had knowledge level below the cut-off point (p value <0.001). In terms of sociodemographic characteristics, the majority of health workers with a good knowledge score were female, 40-49 years old, nursing profession, bachelor degree, from the Puskesmas Denpasar Barat I, and health workers with at least 5 years of work experience.Conclusion: The overall level of knowledge among health workers regarding the concept of family folder as a whole was below expectation.  Latar Belakang: Family folder adalah suatu metode perekaman data medis menggunakan kode khusus dan juga terintegrasi dalam lingkup keluarga. Family folder mengusung konsep pendekatan keluarga sebagai fokus utama dalam menangani permasalahan kesehatan masyarakat terutama dalam bidang pencegahan penyakit di tingkat layanan primer. Penelitian ini bertujuan untuk mengukur tingkat pengetahuan tenaga kesehatan terkait penerapan rekam medis berbasis family folder di Puskesmas Denpasar Barat I dan Puskesmas Denpasar Barat II periode tahun 2020.Metode: Penelitian ini merupakan studi deskriptif dengan pendekatan cross-sectional yang menggunakan data primer berupa kuisioner terkait pengetahuan mengenai family folder. Pengambilan data menggunakan kombinasi kuisoner cetak dan formulir daring yang harus diisi dengan lengkap. Pengambilan data dilakukan satu kali pada setiap tenaga kesehatan. hasil data tersebut dianalisis secara deskriptif untuk memberikan gambaran hasil penelitian dalam bentuk tabel distribusi frekuensi.Hasil: Selama penelitian, terkumpul sebanyak 50 orang tenaga kesehatan. Hasil penelitian ini mendapatkan sebanyak 19 tenaga kesehatan (38%) memiliki tingkat pengetahuan baik, sedangkan 31 tenaga kesehatan (62%) lainnya memiliki pengetahuan yang kurang baik (p = < 0,0001). Ditinjau dari karakteristik sosiodemografi, proporsi tenaga kesehatan berpengetahuan baik mayoritas berasal dari jenis kelamin perempuan, kelompok rentang usia 40-49 tahun, profesi perawat, pendidikan terakhir S1, asal instansi Puskesmas Denpasar Barat I, dan tenaga kesehatan dengan lama bekerja 5 Tahun.Simpulan: Gambaran tingkat pengetahuan tenaga kesehatan terhadap konsep rekam medis family folder secara keseluruhan adalah kurang baik.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Diagnosis dan manajemen pada blefaritis anterior dan posterior

    • Authors: Gusti Ayu Dian Listyani Utami
      Pages: 262 - 268
      Abstract: Introduction: Blepharitis is a chronic inflammatory condition of the eyelid margin. Blepharitis can be distinguished based on its location, namely anterior and posterior blepharitis. Anterior blepharitis is bilateral inflammation that occurs in the area around the base of the eyelashes and on the edge of the eyelid. Anterior blepharitis generally has two main types, namely, staphylococcal blepharitis and seborrheic blepharitis. Posterior blepharitis is inflammation of the eyelid on the posterior side due to dysfunction of the meibomian gland, chronic and bilateral.Aim: The aim of the study is to describe the comprehensive review regarding diagnosis and management of blepharitisConclusion: The general management used to relieve symptoms of blepharitis are warm compresses, cleaning the eyelids, including massage of the meibomian glands in cases of posterior blepharitis, antibiotic therapy (topically or systemically), topical anti-inflammatory, combination of antibiotics and topical corticosteroids, calcineuric inhibitor and Intensed Light Pulse (IPL) therapy. The treatment of blepharitis is done in combination to increase its effectiveness and get better treatment results. However, further research is still needed to select the regimen that has the highest efficacy and safety because blepharitis is a chronic disease with a high recurrence rate.  Pendahuluan: Blefaritis merupakan peradangan yang bersifat kronis atau menahun dan pada umumnya berlokasi pada tepi kelopak mata. Blefaritis dapat dibedakan berdasarkan lokasinya yaitu blefaritis anterior dan posterior. Blefaritis anterior adalah peradangan bilateral yang terjadi di daerah sekitar dasar bulu mata dan pada tepi kelopak mata. Blefaritis anterior pada umumnya memiliki dua jenis utama yaitu, blefaritis stafilokokus dan blefaritis seboroik. Blefaritis posterior adalah peradangan kelopak mata pada bagian posterior akibat disfungsi dari kelenjar meibom, bersifat kronis dan bilateral.Tujuan: Tujuan dari tinjauan pustaka ini adalah untuk memberikan gambaran komperhensif akan diagnosis dan tatalaksanan dari bleparitis posterior.Simpulan: Manajemen umum yang gunakan untuk meringankan gejala blefaritis adalah kompres hangat, pembersihkan kelopak mata, termasuk didalamnya adalah pemijatan pada kelenjar meibom dalam kasus blefaritis posterior, terapi antibiotika (secara topical maupun sistemik), anti inflamasi topikal, kombinasi antibiotika dan kortikosteroid topikal dan calcineuric inhibitor serta intense light pulse therapy (IPL). Penanganan blefaritis dilakukan secara kombinasi untuk meningkatkan efektifitas dan mendapatkan hasil pengobatan yang lebih baik. Namun masih diperlukan penelitian lebih lanjut guna memilih regimen yang memiliki efikasi dan keamanan yang paling tinggi karena blefaritis merupakan penyakit kronis dengan tingkat kekambuhan yang tinggi.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Pengaruh pemberian edukasi kepada pengasuh terhadap tingkat kepatuhan
           pemberian obat anti epilepsi pada anak dengan epilepsi

    • Authors: I Gusti Ngurah Made Suwarba, Ni Made Dani Febriansiswanti, Anita Purnamayanti
      Pages: 269 - 274
      Abstract: Background: Adherence was the main problem in anti-epilepsy drug therapy because it has to be consumed up to 2 years free of seizures to require education intervention. This research aimed to analyze the effect of oral and written (leaflet) education on patient carer's adherence level in administering epilepsy medicines to the pediatric patient ('18 years old).Methods: The design of This study was one group pre - post-test research. Subjects were collected using consecutive sampling.Results: This study's subject was 24 patient carers with low and moderate levels of medication adherence. Oral and written education material was provided every week for eight weeks, and the adherence level was analyzed through the pills count and self-report checklist every week during the study. The Wilcoxon signed-rank test results were significantly different between pre and post-pill counts, and the result of repeated measure test showed that there was an increasing level of medication adherence significantly in third obtained by pill count method week ( p=0,000 ) and remained high until the end of this study.Conclusion: Oral and written education could improve the caregivers administering medication adherence level to their epilepsy children.  Latar belakang: Kepatuhan merupakan masalah utama dalam terapi obat anti epilepsi karena obat anti epilepsi harus dikonsumsi sampai 2 tahun bebas kejang, sehingga diperlukan edukasi. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian edukasi berupa lisan dan tertulis (leaflet) terhadap tingkat kepatuhan pemberian obat oleh pengasuh kepada pasien epilepsi anak usia '18 tahun.Metode: Rancangan penelitian ini adalah one group pre – post test design. Pengumpulan subjek dengan consecutive sampling.Hasil: Subjek penelitian sebanyak 24 orang dengan kriteria tingkat kepatuhan rendah dan sedang. Edukasi lisan dan tertulis diberikan setiap minggu selama 8 minggu, penilaian tingkat kepatuhan melalui pill count dan self report checklist setiap minggu selama 8 minggu. Hasil uji wilcoxon signed rank terdapat perbedaan pre pill count dan post pill count, dan hasil uji repeated measure terdapat pengaruh pemberian edukasi, yang dapat dilihat dari peningkatan nilai pill count secara signifikan pada minggu ke-3 (p=0,000) dan tetap tinggi sampai akhir penelitian.Simpulan: Pemberian edukasi berupa lisan dan tertulis memberikan pengaruh peningkatan kepatuhan pemberian obat oleh pengasuh kepada pasien epilepsi anak.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Mengenal New Psychoactive Substances (NPS): sebuah tinjauan pustaka

    • Authors: Ni Made Leni, Luh Nyoman Alit Aryani, I Wayan Westa
      Pages: 275 - 284
      Abstract: Drug abuse is a global phenomenon that is difficult to control. Until now, various types of narcotics have been distributed in many countries, one of which is New Psychoactive Substances (NPS). Despite its fast growing and massive spread, NPS is still a new substance, considering the little number of data recorded up to recent days. This also results in difficulty of NPS identification in toxicological samples . The use of NPS is associated with many health problems, which causes physical and psychological disturbance potentially more severe than ordinary narcotics. This review aims to summarize the existing literature on NPS that focuses on identifying the types of NPS substances and symptoms as well as the management which could be provided to the patients. Penyalahgunaan narkotika merupakan fenomena global yang sulit dikendalikan, hingga saat ini variasi narkotika telah beredar di begitu banyak negara salah satunya termasuk Zat Psikoaktif Baru atau New Psychoactive Substances (NPS).  Terlepas dari penyebarannya yang cepat dan masif, masih banyak orang yang belum memiliki pengetahuan akan NPS mengingat pendataan zat-zat ini masih sedikit dilakukan. Hal tersebut juga menyebabkan identifikasi NPS dalam sampel toksikologi masih sulit dilakukan. Padahal penggunaan NPS sering dikaitkan dengan masalah kesehatan, dimana efek yang ditimbulkan dapat menyebabkan gejala gangguan fisik dan psikologis yang lebih berat dibandingkan zat narkotika pada umumnya. Tinjauan ini dibuat untuk merangkum literatur yang ada mengenai NPS yang berfokus pada pengenalan jenis-jenis zat NPS serta gejala juga tatalaksana yang dapat diberikan pada pasien pengguna NPS.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Infeksi COVID-19 pada pasien myasthenia gravis: sebuah tinjauan pustaka

    • Authors: Made Ratna Dewi Setiawan, I Ketut Sumada
      Pages: 285 - 289
      Abstract: Coronavirus disease (COVID-19) has rapidly become a global pandemic and during this condition, there might be at greater risk of exacerbation in patients with myasthenia gravis. This is related to the viral infection that has been known to increase the risk of a myasthenic crisis. In addition, some experimental drugs used in COVID-19 has been reported to increase the risk of exacerbation in patient with myasthenia gravis. In the other hand, several studies show higher morbidity and mortality rates due to COVID-19 in patient with myasthenia gravis. Myasthenia gravis might be a risk factor for severe COVID-19 infection due to several mechanisms, such as the effect of the immunosuppressive therapy and the inherent respiratory muscle weakness and vulnerabilities. The comprehensive study based on several case report is needed to respond the needs of adaptation in treating patient with myasthenia gravis during this pandemic era.  Coronavirus disease (COVID-19) telah menjadi pandemi global dalam waktu singkat. Selama pandemi ini, terdapat peningkatan resiko eksaserbasi pada pasien dengan myasthenia gravis. Hal ini terjadi karena sejak lama telah diketahui bahwa infeksi virus dapat meningkatkan resiko krisis myasthenia pada pasien myasthenia gravis. Beberapa obat eksperimental yang diberikan pada pasien dengan infeksi COVID-19 juga dilaporkan memiliki resiko yang tinggi dalam menimbulkan eksaserbasi gejala myasthenia gravis. Di sisi lain, beberapa studi terkait COVID-19 menunjukkan angka morbiditas dan mortalitas yang lebih tinggi pada pasien dengan myasthenia gravis. Myasthenia gravis juga merupakan faktor resiko untuk infeksi COVID-19 berat yang berhubungan degan beberapa mekanisme seperti efek dari terapi imunosupresan dan kondisi kelemahan otot pernafasan pada penyakit myasthenia gravis. Telaah yang komprehensif berdasarkan beberapa laporan kasus terkait infeksi COVID-19 pada pasien myasthenia gravis sangat diperlukan untuk melakukan adaptasi manajemen terapi pada era pandemi ini.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Refractive lens exchange on keratoconus patient: a case report

    • Authors: Ivane Jessica Adit Buddyman, Cokorda Istri Dewiyani Pemayun, Ariesanti Tri Handayani
      Pages: 290 - 293
      Abstract: Introduction. Keratoconus is a vision disorder that occurs when the cornea becomes thin and irregularly (cone) shaped. Instead of being focused correctly on the retina, this abnormal shape causes the light entering the eye to improperly refracted and manifested as a distortion of vision. Refractive Lens Exchange is one type of Invasive therapy in Keratoconus. Here we describe a case of Keratoconus managed by the Refractive Lens Exchange procedure in our Center.Case Description. A male, 25 years old, visited the clinic due to blurry vision since ten years ago. Every six months or a year, he needs to adjust his lens power. Ophthalmology examination found visual acuity in the right eye was 2/60 PH 6/60, and if using S-9.00, visual acuity improved to 6/30. Meanwhile, visual acuity in the left eye was 1/60 PH 6/60 and if using S–11.75, visual acuity improved to 6/48. Corneal topography supports the finding of Keratoconus. Management for this patient was Refractive Lens Exchange + Intraocular Lens + Capsular Tension Ring. Initially, This  advised was differ from the patient expectation, as he wanted a LASIK procedure. An important reminder was given, that Keratoconus is contraindicated for LASIK and any corneal surface ablation procedure. After series of procedure, the VA of the right eye was 6/15 PH 6/6, with C - 4.00 x 1800 VA became 6/6. VA left eye was 6/18 PH 6/9, with C - 4,00 x 1800 VA became 6/9. Binocular vision was 6/6. For near vision, S +3.00 was added for both eyes.Conclusions. Refractive Lens Exchange + Intraocular lens implantation is effective and safe procedures to treat high myopia in keratoconus cornea.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Status resistensi larva nyamuk Aedes aegypti terhadap temefos di Desa
           Peguyangan Kaja, Kota Denpasar tahun 2020

    • Authors: Ida Bagus Putra Adyatma, Putu Ayu Asri Damayanti, I Kadek Swastika
      Pages: 294 - 297
      Abstract: Introduction: Temephos 1% larvicide (Abate 1SG) has been used en mass and for a long time in an effort to control the Ae. aegypti mosquito population. Due to that usage, it might have induced a certain degree of resistance. The purpose of this study was to determine the resistance status, the temephos lethal concentration for the 50% (LC50) and 99% (LC99) of the A. aegypti larvae population from Peguyangan Kaja Village, Denpasar.Methods: This research is an experimental study to assess resistance status and determine the 24-hour LC50 and LC99 values with control and 4 treatment groups, namely the temephos concentration group 0.012 mg/l; 0.025 mg/l; 0.125 mg/l; and 0.625 mg/l. Resistance testing is carried out by biological testing according to WHO standard.Results: The results showed that the percentage of mortality of A. aegypti larvae on exposure to temephos with WHO diagnostic concentration (0.012 mg/l) was 54%. The results of the probit analysis showed that the LC50 24 hours ranged from 0.003-0.017 mg/l with an average of 0.011 mg/l, while the 24-hour LC99 ranged from 0.049-13.64 mg/l with an average of 0.112 mg/l.Conclusion: This research shows that A. aegypti larvae in Peguyangan Kaja Village, Denpasar have shown resistance against temephos larvicide.  Pendahuluan: Larvasida temefos 1% (Abate 1SG) telah digunakan secara massal dan dalam jangka waktu yang lama dalam upaya pengendalian populasi nyamuk A. aegypti.  Hal ini dapat memicu terjadinya resistensi. Tujuan penelitian ini adalah untuk mengetahui status resistensi, nilai konsentrasi temefos yang efektif membunuh 50% (LC50) dan 99% (LC99) larva dari larvasida temefos terhadap populasi larva A. aegypti dari Desa Peguyangan Kaja, Kota Denpasar.Metode: Penelitian ini merupakan studi eksperimental untuk menilai status resistensi dan mengetahui nilai LC50 dan LC99 24 jam dengan kontrol dan 4 kelompok perlakuan yaitu kelompok konsentrasi temefos 0.012 mg/l; 0.025 mg/l; 0.125 mg/l; dan 0.625 mg/l. Uji resistensi dilakukan dengan uji hayati sesuai standar WHO.Hasil: Hasil penelitian menunjukkan persentase kematian larva A. aegypti terhadap paparan temefos dengan konsentrasi diagnostik WHO (0,012 mg/l) sebesar 54%. Hasil analisis probit menunjukkan bahwa nilai LC50 24 jam berkisar antara 0,003-0,017 mg/l dengan rata-rata 0,011 mg/l, sedangkan LC99 24 jam berkisar antara 0,049-13,64 mg/l dengan rata-rata 0,112 mg/l.Simpulan: Penelitian ini menunjukkan bahwa larva A. aegypti di Desa Peguyangan Kaja, Kota Denpasar telah memiliki sifat resisten terhadap larvasida temefos.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Clinical characteristics and demographics figures of patients with
           age-related macular degeneration at a tertiary-level hospital in Denpasar,

    • Authors: Bobby Kristianto, Ari Andayani, Anak Agung Mas Putrawati Triningrat, Ni Made Ari Suryathi, I Wayan Gede Jayanegara, I Gusti Ayu Ratna Suryaningrum
      Pages: 298 - 301
      Abstract: Introduction: Age-Related Macular Degeneration (AMD) is a macular disease that characteristically affects the loss of central vision of the elderly. Unlike the western world, Indonesia has a relatively undocumented AMD epidemiology due to a lack of scientific attention, as indicated by few AMD publications. As a result, it is difficult to determine AMD's features and characteristics in the Indonesian population. This study aimed to evaluate AMD patients' characteristics and demographics at a tertiary hospital in Bali.Methods: This is a Cross-Sectional study. Data were collected from medical records on Sanglah General Hospital from January 2017 until December 2019. The characteristics and features were collected and analyzed. The characteristics and demo-figure were analyzed with descriptive statistics and a Chi-square test.Results: This study data consist of 172 patients, 90 (52.33 %) male and 82 (47.67 %) female. Most of the patients in the age group 66-83 years. The distribution of dry AMD showed the highest number on males, but the inverse occurs in wet AMD. Subjects had a smoking lifestyle in 50% of the patients. The smoking history more likely in dry AMD, but the inverse occurs in wet AMD. Hypertension occurs in more than half (51.16 %), with larger distribution in wet AMD. The proportion of gender, smoking history, hypertension but not age are significantly different between wet and dry AMD.Conclusion: Age-related macular degeneration is a common cause of blindness in the elderly population. This study found that the prevalence of AMD increases with age. The significant factors associated with AMD were sex, hypertension and smoking habit.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Glaukoma sekunder pada pasien anak dengan Sindrom Sturge Weber: laporan

    • Authors: Putu Dian Megasafitri, I Gusti Ayu Ratna Suryaningrum, I Made Agus Kusumadjaja
      Pages: 302 - 308
      Abstract: Background: Sturge Weber's Syndrome (SSW) is a rare congenital disorder characterized by hemangiomas found in several parts of the body, such as the ocular, intracranial, and facial skin structures. Patients with SSW often experience glaucoma as one of the frequent ocular manifestations which can occur from birth or throughout life and can cause blindness. This case report aims to report the management of a pediatric patient with SSW who underwent trabeculectomy after failing to maintain intraocular pressure with topical drugs.Case Presentation: A 5-year-old girl had increased intraocular pressure and optic nerve glaucoma signs in her right eye. This patient also had a birthmark in the form of a port-wine stain on her face's right side. After undergoing several tests, the patient was diagnosed with secondary glaucoma due to SSW with poor intraocular pressure control after 1.5 years of topical selective beta-blocker treatment. Trabeculectomy + 5-fluorouracil (5-FU) is performed to reduce intraocular pressure and prevent worsening of glaucoma. On the first day after surgery, the intraocular pressure was 20 mmHg in the right eye and decreased significantly during follow-up.Conclusion: Trabeculectomy is one of the treatment options to treat glaucoma in SSW patients, which results in reasonable control of intraocular pressure.  Latar Belakang: Sindrom Sturge Weber (SSW) adalah kelainan bawaan yang jarang terjadi dimana ditandai dengan adanya hemangioma yang terdapat pada beberapa bagian tubuh, seperti struktur kulit okuler, intrakranial, dan wajah. Pasien dengan SSW sering mengalami glaukoma sebagai salah satu manifestasi okuler yang sering terjadi dimana dapat muncul sejak lahir maupun sepanjang masa kehidupannya serta dapat menyebabkan kebutaan. Laporan kasus ini bertujuan untuk melaporkan penatalaksanaan pada pasien anak dengan SSW yang menjalani prosedur trabekulektomi setelah gagal mempertahankan tekanan intraokuler dengan obat topikal.Presentasi Kasus: Seorang anak perempuan berusia 5 tahun mengalami peningkatan tekanan intraokuler dan tanda-tanda saraf optik glaukoma di mata kanannya. Pasien ini juga memiliki tanda lahir berupa port wine stain di bagian kanan wajahnya. Setelah menjalani beberapa pemeriksaan, pasien terdiagnosa menderita glaukoma sekunder oleh karena SSW dengan kontrol tekanan intraokuler yang buruk setelah 1,5 tahun menjalani pengobatan topikal golongan beta bloker selektif. Operasi trabekulektomi + 5-fluorouracil (5-FU)dilakukan untuk menurunkan tekanan intraokuler dan mencegah perburukan glaukoma. Pada hari pertama setelah operasi, tekanan intraokuler menjadi 20 mmHg pada mata kanan dan berkurang secara bermakna selama masa tindak lanjut.Kesimpulan: Trabekulektomi merupakan salah satu pengobatan pilihan untuk mengobati glaukoma pada pasien SSW yang menghasilkan kontrol tekanan intraokuler yang baik.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Management of pregnant women with Refractory Immune Thrombocytopenia
           Purpura (ITP) receiving eltrombopag therapy at Sanjiwani Hospital,
           Gianyar, Indonesia

    • Authors: Anak Agung Raka Budayasa, Cokorda Gede Angga Ary Nugraha
      Pages: 309 - 312
      Abstract: Background: Immune Thrombocytopenia Purpura (ITP) is an autoimmune disease characterized by a low level of platelets in the blood caused by accelerated platelet destruction or disruption of the thrombopoiesis due to antibodies to platelets. Drugs with similar functions to thrombopoietins (TPO) such as eltrombopag and romiplostim have been widely used and have been shown to be quite successful in treating ITP in nonpregnant patients. This case study aims to evaluate eltrombopag therapy's role in managing the refractory ITP in pregnant women.Case Presentation: A 25-year-old patient, a housewife, presented to the obstetrics clinic at Sanjiwani Hospital for the first time at a gestational age of 13 weeks for her third pregnancy, with a history of two abortions. ITP was diagnosed in 2017 during the second abortion treatment. The platelet examination results were between 32,000-66,000/'l, with platelet count during delivery planning at 34 weeks of 41,000/'l. The patient was diagnosed with chronic refractory ITP and was considered for second-line drug administration. Intravenous Immunoglobulin Therapy (IVIG) and anti-D administration as second-line drugs were not possible due to cost. The patient was given 50 mg eltrombopag per day for a week. The platelet counts increased to 202,000/'l a week after therapy. The patient then underwent vaginal delivery with a baby weight of 2,850 gram, Apgar Score of 8-10. The baby was exclusively breastfed and subjected to clinical monitoring and laboratory tests. The patient's clinical condition was favorable and the platelets fell to 20,000/'l nineteen days after delivery.Conclusion: In this case, the patient with chronic ITP refractory to steroid therapy showed an immediate response to eltrombopag. However, the platelet level decreased two weeks after the treatment cessation. More studies are needed on the use of eltrombopag in pregnant women.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Manifestasi dan transmisi okular pada coronavirus disease 2019 (COVID-19):
           klinis dan pencegahan

    • Authors: Nyoman Brahmani Pitanatri, Ni Made Indah Kencanawati
      Pages: 313 - 316
      Abstract: Background: Coronavirus disease 2019 (COVID-19) pandemic is an infectious disease caused by a novel Coronavirus called Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Respiratory tract is the main route for this virus transmission through droplets, with common symptoms as fever, cough and dyspnea. Beside the manifestation on the respiratory track, patient with COVID-19 can also have ocular complaints.Methods: In writing this article, the literature review method was used and sources consist of relevant journals obtained through online search engines.Results: Conjunctivitis and keratoconjunctivitis was the most ocular manifestation reported on patients. The eye can be one of the entry routes for the virus because of the connection between the upper respiratory tract and the ocular surface mucosa through the nasolacrimal duct.Conclusion: The ocular manifestation in COVID-19 patients must not be ignored. The eye can be port of entry of the virus. Therefore, it is important to know the ocular manifestation and prevent the transmission of COVID-19.  Latar belakang: Pandemi coronavirus disease 2019 (COVID-19) merupakan suatu penyakit infeksius yang disebabkan oleh novel coronavirus yang disebut sebagai Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Saluran pernapasan merupakan jalur utama penyebaran virus ini, yaitu melalui droplet, dengan gejala umum berupa demam, batuk disertai dispnea. Selain bermanifestasi pada saluran pernapasan, COVID-19 juga dapat bermanifestasi pada okular.Metode: Dalam penulisan artikel ini digunakan metode tinjauan pustaka dengan bersumber pada artikel relevan yang didapatkan melalui pencarian secara daring. Hasil: Konjungtivitis dan keratokonjungtivitis merupakan beberapa manifestasi okular yang paling sering dilaporkan pada pasien dengan COVID-19. Mata dapat menjadi salah satu jalur masuk virus oleh karena adanya hubungan saluran pernapasan atas dan mukosa permukaan okuli melalui duktus nasolakrimalis.Simpulan: Manifestasi okular pada COVID-19 tidak dapat diabaikan. Mata dapat menjadi salah satu port de entry virus. Oleh sebab itu, mengenali gejala pada okular serta pencegahan trasnsmisi okular virus COVID-19 menjadi sangatlah penting.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Factors related to the long-term effect and condition to child abuse: a
           preliminary study

    • Authors: Suvitra Ravi, Luh Nyoman Alit Aryani, Lely Setyawati Kurniawan
      Pages: 317 - 322
      Abstract: Background: Child abuse is any behavior that harms a child under 18 years old. It can take many forms, including physical, sexual and emotional abuse, as well as neglect. This study aims to determine factors related to child abuse's long-term effect and condition as a preliminary study.Methods: A cross-sectional study was conducted among 73 students out of 232 students from Semester 7. They have been approached and have been explained this research. The age of students must be more than 18 years old, from both genders who are pursuing their studies in Medical Faculty of Universitas Udayana. Data were analyzed using SPSS version 20 for Windows.Results: Most of the respondents were age 21 years old (58.9%), female (67.1%), strongly disagree with physical abuse (41.1%), sexual abuse (63.0% and 60.3%), emotional abuse (39.7% and 37.0%), and child neglect (68.5%).  Most of several conditions that students disagree with the long term effect of child abuse are sleep at night (38.4%), nightmare problems (43.8%), breathing problems (47.9%), loneliness (27.4%), fears of people judgment (28.8%), as well as fear and anxiety issue (39.7%).Conclusion: The medical students strongly disagree with many kinds of child abuse and disagree with several factors related to child abuse's long-term effect.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
  • Karakteristik pasien kebidanan dengan infeksi COVID-19 di Ruang Praja RSUD
           Wangaya Bali periode Mei - Desember 2020

    • Authors: Johan Qalaba, Gede Alit Wardana
      Pages: 323 - 328
      Abstract: Background: Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the SARS-COV2 virus. Pregnant women are important because pregnant women are more susceptible to viral infections and severe pneumonia due to physiological changes in the immune and cardiopulmonary systems during pregnancy, with manifestations ranging from asymptomatic to very severe. At this time, no research has been conducted on the local population, so that the authors will examine the characteristics of obstetric patients with COVID-19 infection in the Praja room of RSUD WANGAYA Bali. To determine the characteristics of midwifery patients with COVID-19 infection in the Praja room at Wangaya Bali Hospital for the period May 2020 - December 2020.Methods: This study was a retrospective descriptive study using medical records from mothers related to COVID-19. The inclusion criteria were obstetric patients with COVID-19 infection in the Praja room with the results of a reactive Rapid Test or RT-PCR at Wangaya Hospital. The data collected were age, parity, screening rapid test, comorbid, probable case, clinical symptoms, laboratory results, chest x-ray, baby weight and APGAR score, type of delivery, amount of postpartum hemorrhage, confirm case with RT-PCR, length of treatment, the need for ICU rooms and the number of deaths.Results: In this study, there were 67 respondents. Most of them were in the age range of 21-30 years and had given birth more than once. More than half of the respondents had a cesarean section, and most of the respondents tested positive for COVID-19 through the RT-PCR test. APGAR scores and baby weight were mostly normal. There were 62 respondents confirmed as RT-PCR, while with the Rapid reactive results, 66 people. Patients with mild anemia were found and found an increase in the number of CRP and neutrophils. Asymptomatic and non-comorbid patients were the most common, and on the x-ray image, most had pneumonia. There was no postpartum hemorrhage in either method of delivery. Only one person needs an ICU room. Patients infected with COVID-19 require a longer treatment time.Conclusion: Most were found in no comorbid and asymptomatic. Laboratory results were mostly found with mild anemia, leukocytosis with neutrophilia and high NLR, and high CRP. Most pregnant women do not need ICU care. Latar belakang: Penyakit corona virus 2019 (COVID-19) merupakan penyakit yang sangat menular yang disebabkan oleh virus SARS-COV2. Wanita hamil penting untuk diperhatikan karena wanita hamil lebih rentan terhadap infeksi virus dan pneumonia parah akibat adanya perubahan fisiologis pada sistem imun dan cardiopulmonal selama kehamilan, dengan manisfestasi dari tanpa gejala hingga sangat berat. Pada saat ini belum ada penelitian yang di lakukan pada populasi lokal, sehingga penulis akan meneliti karakteristik pasien kebidanan dengan infeksi COVID-19 di ruang Praja RSUD WANGAYA Bali. Untuk mengetahui karakteristik pasien kebidanan dengan infeksi COVID-19 di ruang Praja RSUD Wangaya Bali periode Mei 2020 - Desember 2020.Metode: Penelitian deskriptif retrospektif dengan data catatan medik dari ibu terkait COVID-19. Kriteria inklusi merupakan pasien kebidanan dengan infeksi COVID-19 di ruang Praja dengan hasil Rapid Test atau RT-PCR reaktif di RSUD Wangaya. Data yang dikumpulkan adalah usia, paritas, skrining rapid test, komorbid, probable case, gejala klinis, hasil laboratorium, ronsen thorax, berat badan dan skor APGAR bayi, jenis persalinan, jumlah perdarahan post partum, confirm case dengan RT-PCR, lama perawatan, kebutuhan ruang rawat ICU dan jumlah yang meninggal.Hasil: Pada penelitian ini terdapat 67 responden, sebagian besar berada dalam rentang usia 21-30 tahun dan sudah pernah melahirkan lebih dari satu kali. Lebih dari separuh responden jenis persalinannya merupakan seksio sesaria, dan sebagian besar responden positif COVID-19 melalui tes RT-PCR. Skor APGAR dan berat badan bayi sebagian besar normal. Terdapat 62 responden terkonfirmasi RT-PCR, sedangkan dengan hasil Rapid reaktif, sebanyak 66 orang. Ditemukan pasien dengan keadaan anemia ringan, serta di dapatkan adanya peningkatan jumlah CRP dan Neutrofil. Pasien tanpa gejala dan tanpa komorbid paling banyak dijumpai dan pada gambaran ronsen terbanyak mengalami pneumonia. Tidak terdapatnya perdarahan post partum pada kedua metode persalinan. Hanya 1 orang yang memerlukan ruangan ICU. Pasien terinfeksi COVID-19 memerlukan waktu perawatan yang lebih lama.Kesimpulan: Sebagian besar ditemukan dalam tanpa kmorbid dan tanpa gejala. Hasil laboratorium sebagian besar ditemukan dengan anemia ringan, leukositosis dengan neutrofilia dan NLR tinggi, serta CRP tinggi. Sebagian besar ibu hamil tidak mebutuhkan perawatan ICU.
      PubDate: 2021-04-30
      Issue No: Vol. 12, No. 1 (2021)
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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