Publisher: Universitas Udayana (Total: 62 journals)   [Sort by number of followers]

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Advances in Tropical Biodiversity and Environmental Sciences     Open Access   (Followers: 4)
Agrotrop : J. on Agriculture Science     Open Access   (Followers: 1)
Buletin Studi Ekonomi     Open Access   (Followers: 2)
Buletin Veteriner Udayana     Open Access   (Followers: 1)
Bumi Lestari J. of Environment     Open Access  
Cakra Kimia (Indonesian E-J. of Applied Chemistry)     Open Access  
COPING (Community of Publishing in Nursing)     Open Access   (Followers: 1)
E-J. of Cultural Studies     Open Access   (Followers: 1)
e-J. of Linguistics     Open Access   (Followers: 3)
E-J. of Tourism     Open Access   (Followers: 8)
E-Jurnal Agroekoteknologi Tropika (J. of Tropical Agroecotechnology)     Open Access  
E-Jurnal Akuntansi     Open Access  
E-Jurnal Ekonomi dan Bisnis Universitas Udayana     Open Access  
E-Jurnal Ekonomi Pembangunan Universitas Udayana     Open Access  
E-Jurnal Manajemen Universitas Udayana     Open Access  
E-Jurnal Medika Udayana     Open Access  
Ecotrophic : J. of Environmental Science     Open Access  
Indonesia Medicus Veterinus     Open Access  
Indonesian J. of Legal and Forensic Sciences     Open Access   (Followers: 1)
Intisari Sains Medis     Open Access  
Intl. J. of Engineering and Emerging Technology     Open Access  
itepa : Jurnal Ilmu dan Teknologi Pangan     Open Access  
J. of Food Security and Agriculture     Open Access   (Followers: 1)
J. of Health Sciences and Medicine     Open Access  
J. of Marine and Aquatic Sciences     Open Access   (Followers: 2)
J. of Veterinary and Animal Sciences     Open Access  
JBN (Jurnal Bedah Nasional)     Open Access  
Jurnal Analisis Pariwisata     Open Access  
Jurnal Arsitektur Lansekap     Open Access  
Jurnal BETA (Biosistem dan Teknik Pertanian)     Open Access  
Jurnal Biologi Udayana     Open Access  
Jurnal Destinasi Pariwisata     Open Access  
Jurnal Ekonomi Kuantitatif Terapan     Open Access  
Jurnal Energi Dan Manufaktur     Open Access  
Jurnal Ilmiah Akuntansi dan Bisnis     Open Access  
Jurnal Ilmiah Mahasiswa SPEKTRUM     Open Access  
Jurnal Ilmiah Merpati (Menara Penelitian Akademika Teknologi Informasi)     Open Access  
Jurnal Ilmu dan Kesehatan Hewan (Veterinary Science and Medicine J.)     Open Access   (Followers: 1)
Jurnal Ilmu Komputer     Open Access  
Jurnal IPTA     Open Access  
Jurnal Kepariwisataan dan Hospitalitas     Open Access  
Jurnal Kimia (J. of Chemistry)     Open Access  
Jurnal Magister Hukum Udayana (Udayana Master Law J.)     Open Access  
Jurnal Master Pariwisata (J. Master in Tourism Studies)     Open Access  
Jurnal Matematika     Open Access  
Jurnal Rekayasa dan Manajemen Agroindustri     Open Access  
Jurnal Spektran     Open Access  
Jurnal Udayana Mengabdi     Open Access  
Jurnal Veteriner     Open Access   (Followers: 1)
Kertha Patrika     Open Access  
Lingual : J. of Language and Culture     Open Access  
Linguistika : Buletin Ilmiah Program Magister Linguistik Universitas Udayana     Open Access   (Followers: 1)
Lontar Komputer : Jurnal Ilmiah Teknologi Informasi     Open Access  
Majalah Ilmiah Peternakan     Open Access   (Followers: 1)
Majalah Ilmiah Teknologi Elektro : J. of Electrical Technology     Open Access   (Followers: 1)
Matrik : Jurnal Manajemen, Strategi Bisnis dan Kewirausahaan     Open Access  
Piramida     Open Access  
Ruang-Space: Jurnal Lingkungan Binaan (J. of The Built Environment)     Open Access  
Simbiosis : J. of Biological Sciences     Open Access  
Sport and Fitness J.     Open Access   (Followers: 4)
Udayana J. of Law and Culture     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  [62 journals]
  • Pembesaran ginjal bilateral pada seorang anak dengan limfoma renal: sebuah
           laporan kasus

    • Authors: Listyani Gunawan, Pande Putu Yuli Anandasari, Ni Nyoman Margiani
      Pages: 1 - 5
      Abstract: Background: Renal lymphoma is a tumor disorder that is rarely found in pediatrics, with only 0.7% cases of extranodal lymphoma from several previous studies. B cell non-Hodgkin lymphoma, including Burkitt lymphoma more common in pediatrics over 5 years old. Burkitt lymphoma is very aggressive in its development. This case report aims to evaluate bilateral renal enlargement in a child with renal lymphoma in radiology.Case Presentation: In this case, it was reported that a 6 years old boy with complaints of a painless dilated stomach and weight loss since the last 2 months. Complaints that arise after a long period cause the mass development to be more diffuse and there has been infiltration, as well as pressure on the surrounding organs. Bilateral nephromegaly without lymph node enlargement or retroperitoneal mass on radiological images resembles bilateral nephroblastoma, but it points to Burkitt's lymphoma on histopathological examination. Radiological features may resemble other primary kidney tumors.Conclusion: It is important to discuss the differential diagnosis of renal lymphoma; CT-Scan and MRI modalities are expected to be more specific in making the diagnosis and knowing the extent of the mass for consideration of the management that will be given. Early diagnosis and treatment improve prognosis to prevent and reduce patient morbidity and mortality. Latar Belakang: Limfoma ginjal merupakan kelainan tumor yang sangat jarang dijumpai pada pediatrik, hanya 0.7% dari jumlah limfoma ekstranodal dari beberapa studi sebelumnya. Tipe Non-Hodgkin Lymphoma sel B termasuk di dalamnya Limfoma Burkitt, lebih sering dijumpai pada pediatrik berusia lebih dari 5 tahun. Limfoma Burkitt merupakan Non-Hodgkin Lymphoma sel B yang sangat agresif dalam perkembangannya. Laporan kasus ini bertujuan untuk mengevaluasi pembesaran ginjal bilateral pada seorang anak dengan limfoma renal secara radiologi.Presentasi Kasus: Dalam kasus ini dilaporkan anak laki-laki berusia 6 tahun dengan keluhan perut yang semakin besar tanpa rasa nyeri dan penurunan berat badan sejak 2 bulan terakhir. Keluhan yang timbul setelah jangka waktu lama menyebabkan perkembangan massa semakin difus dan sudah terjadi infiltrasi, serta pendesakan terhadap organ di sekitarnya. Nefromegali bilateral tanpa disertai pembesaran kelenjar getah bening ataupun massa di retroperitoneal pada gambaran radiologi menyerupai nefroblastoma bilateral, namun pada pemeriksaan histopatologi mengarah kepada limfoma Burkitt. Gambaran radiologi dapat menyerupai tumor ginjal primer lainnya.Simpulan: Penting untuk menyingkirkan diagnosa banding nefroblastomatosis dengan menggunakan modalitas pemeriksaan USG, CT-Scan maupun MRI. Diagnosa dan tatalaksana lebih dini meningkatkan prognosis, untuk mencegah dan mengurangi morbiditas dan mortalitas pasien.
      PubDate: 2022-01-30
      DOI: 10.15562/ism.v13i1.1115
      Issue No: Vol. 13, No. 1 (2022)
       
  • Uji aktivitas antibakteri ekstrak kulit batang tanaman kenanga (cananga
           odorata) terhadap bakteri penyebab infeksi kulit Staphylococcus aureus in
           vitro

    • Authors: Putu Gitanjani Mahadewi Semadhi, Ketut Indah Karina Mahardika, Rena Sari Megayanthi, Ni Wayan Prabasiwi Kirana, I Dewa Gde Bagus Panji Palaguna, Made Agus Hendrayana
      Pages: 6 - 10
      Abstract: Background: Staphylococcus aureus resistance to antibiotics or Methicillin Resistance Staphylococcus Aureus (MRSA) is a severe problem worldwide with high morbidity and mortality rates, so it is necessary to identify alternative new antibacterial compounds to overcome this problem, especially those that derived from natural ingredients. One of these natural ingredients is the ylang plant (Cananga odorata) because the phytochemical test results show that this plant contains various bacteriostatic compounds. This study aims to determine whether the bark extract of the ylang plant (Cananga odorata) can inhibit the growth of S. aureus.Methods: In vitro experimental research using ylang bark extract (Cananga odorata) with concentrations of 20%, 60%, and 100% with 96% ethanol diluent. Inhibition test was carried out using the disc diffusion test method with five repetitions.Results: The average zone of inhibition of the growth of Staphylococcus aureus bacteria was as follows: 20% extract (P1) 11.8 mm; extract 60% (P2) 12.2 mm; extract 100% (P3) 18.2 mm; positive control (K2) 32.4 mm; and negative control (K1) 0 mm. The statistical analysis results showed that the bark extract of the Cananga plant affected the inhibition of S. aureus bacteria at concentrations of 20%, 60%, and 100%.Conclusion: Ylang plant (Cananga odorata) bark extract with concentrations of 20%, 60%, and 100% was effective in inhibiting the growth of S. aureus bacteria. Latar Belakang: Resistensi bakteri Staphylococcus aureus terhadap antibiotik atau Methicillin Resistance Staphyloccus Aureus (MRSA) merupakan salah satu masalah serius di dunia kesehatan, sehingga perlu diidentifikasi alternatif senyawa antibakteri baru untuk mengatasi masalah tersebut, khususnya yang berasal dari bahan alami. Adapun salah satu bahan alami tersebut yakni tanaman kenanga (Cananga odorata) karena hasil uji fitokimia menunjukkan bahwa tanaman ini mengandung berbagai senyawa bakteriostatik. Penelitian ini bertujuan untuk mengetahui apakah ekstrak kulit batang tanaman kenanga (Cananga odorata) dapat menghambat pertumbuhan bakteri S. aureus.Metode: Penelitian eksperimental in vitro menggunakan ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi sebesar 20%, 60%, dan 100% dengan pengencer etanol 96%. Pengujian daya hambat dilakukan dengan menggunakan metode uji difusi cakram sebanyak lima kali pengulangan.Hasil: Rerata zona hambat pertumbuhan bakteri Staphylococcus aureus adalah sebagai berikut: ekstrak 20% (P1) 11,8 mm; ekstrak 60% (P2) 12,2 mm; ekstrak 100% (P3) 18,2 mm; kontrol positif (K2) 32,4 mm; dan kontrol negatif (K1) 0 mm. Hasil analisis statistik menyatakan bahwa ekstrak kulit batang tanaman kenanga berpengaruh terhadap daya hambat bakteri S. aureus pada konsentrasi 20%, 60%, dan 100%.Kesimpulan: Ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi 20%, 60%, dan 100% efektif untuk menghambat pertumbuhan bakteri S. aureus
      PubDate: 2022-01-30
      DOI: 10.15562/ism.v13i1.1201
      Issue No: Vol. 13, No. 1 (2022)
       
  • Faktor-faktor yang mempengaruhi keputusan adopsi aplikasi hermina mobile
           pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado

    • Authors: Madianung Valentine Virginia Bonochdita, Starry Homenta Rampengan, Jeini Ester Nelwan, Aaltje Ellen Manampiring, Dina Victoria Rombot
      Pages: 11 - 18
      Abstract: Background: One of the health fields that is currently developing in various countries in adopting information and communication technology (ICT) is e-health. Hermina Hospital has a hermina mobile application that is useful for facilitating outpatient services. Initial data collection conducted by researchers in March showed that 23% of outpatient visits from executive polyclinics were registered via this application. Therefore, the aim of this research is to analyze the usage behavior of online registration at Hermina Hospital.Methods: This research was a quantitative correlational descriptive study with a cross sectional approach. The data used in this study obtained from the questionnaire using the method of convenient sampling with involved the participation of 110 respondents. Independent variables of this study were performance expectancy, effort expectancy, social influence, fcailitating condition dan behavioral intention. Dependent variable of this study is use behavior. The instrument used in this study was a quesioner.Results: The results of the chi square test found that performance expectancy, usage behavior, and behavioral intention were significantly related to use behavior (p < 0.05). Based on the results of the logistic regression test, it was found that the dominant factor influencing the use behavior is behavioral intention with a value of Exp (B) or Odds Ratio (OR) 2.746 and level of significant <0.05.Conclusion: The conclusion of this study is that there is a significant relationship between behavioral intention, effort expectancy, and performance expectancy on the decision to adopt the Hermina mobile application.   Latar Belakang: Salah satu bidang kesehatan yang saat ini sudah berkembang di berbagai negara dalam mengadopsi teknologi informasi dan komunikasi (TIK) yaitu e-Kesehatan (e-health). Rumah Sakit Hermina memiliki aplikasi hermina mobile yang berguna untuk mempermudah pelayanan pasien rawat jalan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi keputusan adopsi aplikasi pendaftaran online hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.Metode: Penelitian ini merupakan penelitian kuantitatif korelasional dengan pendekatan cross sectional. Penelitian ini dilaksanakan di Rumah Sakit Hermina Manado pada November - Desember 2021. Subyek dalam penelitian ini yaitu 110 pasien poli eksekutif. Variabel bebas dari penelitian ini yaitu performance expectancy, effort expectancy, social influence, facilitating condition dan behavioral intention. Variabel terikat dari penelitian ini adalah keputusan adopsi (use behavior). Instrumen yang digunakan yaitu kuesioner. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat. Penyajian data dibuat dalam bentuk tabel dan narasi.Hasil: Hasil uji chi square ditemukan bahwa performance expectancy, effort expectancy, dan behavioral intention memiliki hubungan bermakna dengan keputusan adopsi (use behavior) (p<0,05). Berdasrkan hasil uji regresi logistik ditemukan faktor dominan berpengaruh terhadap keputusan adopsi pasien poli eksekutif adalah behavioral intention dengan nila Exp (B) atau Odds Ratio (OR) 2,746 dan nilai p<0,05.Kesimpulan: Terdapat hubungan yang signifikan antara faktor behavioral intention, effort expectancy, dan performance expectancy terhadap keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.
      PubDate: 2022-02-05
      DOI: 10.15562/ism.v13i1.1288
      Issue No: Vol. 13, No. 1 (2022)
       
  • Faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat
           jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi
           covid-19

    • Authors: Andrew Christian Pangemanan, Starry Homenta Rampengan, Oksfriani Julfri Sumampouw, Aaltje Ellen Manampiring
      Pages: 19 - 24
      Abstract: Latar belakang: Kepuasan pasien dicapai apabila penerima pelayanan memperoleh pelayanan sesuai dengan yang dibutuhkan dan diharapkan. Pandemi Coovid-19 menyebabkan penurunan angka kunjungan pasien, hal ini terjadi karena terdapat alur proses pelayanan kesehatan yang berubah, pembatasan jumlah pasien, serta diterapkannya langkah pencegahan standar, identifikasi awal dan pengendalian sumber virus. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19. Metode: Penelitian ini merupakan penelitian kuantitatif dengan pendekatan studi potong lintang. Penelitian ini dilaksanakan di Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada November-Desember 2021. Sampel penelitian berjumlah 334 pasien. Variabel bebas dari peneitian ini yaitu kesehatan fisik dan psikis pasien, kompetensi staf medis dan fasilitas rumah sakit. Variabel terikat dari penelitian ini adalah kepuasan pasien. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat. Hasil: Hasil penelitian menunjukkan bahwa responden paling banyak berjenis kelamin laki-laki (52,69%), mayoritas berumur 36-45 tahun (37,72%), pekerjaan terbanyak swasta (35,33%) dan tingkat pendidikan terbanyak SMA/sederajat (46,41%). Hasil uji korelasi pearson ditemukan bahwa faktor kesehatan fisik dan psikis, kompetensi staf medis dan fasilitas rumah sakit nilai p<0,05. Berdasarkan uji regresi linier berganda ditemukan faktor yang paling mempengaruhi kepuasan pasien adalah fasilitas rumah sakit dengan nilai standardized coefficients beta sebesar 0,314. Kesimpulan: Faktor kesehatan fisik dan psikis, kompetensi staf medis, dan fasilitas rumah sakit berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19. Fasilitas rumah sakit merupakan faktor yang dominan berpengaruh terhadap kepuasan pasien 
      PubDate: 2022-02-07
      DOI: 10.15562/ism.v13i1.1289
      Issue No: Vol. 13, No. 1 (2022)
       
  • Analisis kinerja pegawai bagian administrasi RSUP Ratatotok buyat di era
           sebelum pandemi COVID-19, saat pandemic, dan new normal

    • Authors: Riliani Manitik, Starry Homenta Rampengan, Freddy W. Wagey, Aaltje Ellen Manampiring
      Pages: 25 - 29
      Abstract: Introduction: The success of hospitals (RS) in carrying out their functions as health service institutions is characterized by good quality hospital services. Administrative employees as non-health workers must have good performance in order to realize quality health services. This study aimed to analyze the description of employee performance in the administration section of the Ratatotok Buyat Hospital in terms of aspects of work culture and work environment in the era before the Covid-19 pandemic, during the pandemic and the new normal era.Methods: This type of research uses a qualitative descriptive method. Data collection techniques were carried out by in-depth interviews and then documented and analyzed. To obtain the validity of the data, inspection techniques were carried out through several activities, namely triangulation. Qualitative data was obtained based on the results of in-depth interviews using the Mile and Huberman data analysis modelResults: The performance of employees in the administration section shows that systems and activities related to employee work experience changes during the pandemic when there is a decrease in employee performance when compared to performance before the pandemic, in the new normal era, employee performance has increased.Conclusion: The performance of employees in the administration of Ratatotok Buyat Hospital before the Covid-19 pandemic was very good, there was a decline in performance during the pandemic, but increased again in the new normal era. Pendahuluan: Keberhasilan rumah sakit (RS) dalam menjalankan fungsinya sebagai lembaga pelayanan kesehatan ditandai dengan kualitas pelayanan rumah sakit yang baik. Pegawai administrasi sebagai tenaga non kesehatan harus memiliki kinerja yang baik agar dapat mewujudkan pelayanan kesehatan yang berkualitas. Penelitian ini bertujuan untuk menganalisis gambaran kinerja pegawai pada bagian administrasi Rumah Sakit Umum Pusat (RSUP) Ratatotok Buyat ditinjau dari aspek budaya kerja dan lingkungan kerja pada era sebelum pandemi Covid-19, saat pandemi dan era new normal.Metode: Jenis penelitian ini menggunakan metode deskriptif kualitatif. Teknik pengumpulan data dilakukan dengan wawancara mendalam kemudian didokumentasikan dan dianalisis. Untuk mendapatkan keabsahan data, dilakukan teknik pemeriksaan yaitu dengan triangulasi. Data kualitatif diperoleh berdasarkan hasil wawancara mendalam dengan menggunakan model analisis data Mile dan Huberman.Hasil: Kinerja pegawai dibagian administrasi menunjukkan bahwa saat pandemi terjadi penurunan jika dibandingkan dengan dengan kinerja sebelum pandemi, diera new normal kinerja pegawai kembali mengalami peningkatan.Kesimpulan: Kinerja pegawai di bagian administrasi RSUP Ratatotok Buyat sebelum pandemi Covid-19 sangat baik, dan terjadi penurunan kinerja saat pandemi, namun kembali mengalami peningkatan di era new normal.
      PubDate: 2022-02-07
      DOI: 10.15562/ism.v13i1.1270
      Issue No: Vol. 13, No. 1 (2022)
       
  • Relationship between Monocarboxylate Transporter 4 (MCT-4) Expression and
           Breast Cancer Clinicopathology and Subtype in Sanglah General Hospital,
           Denpasar, Indonesia

    • Authors: Gede Andry Nicolas Andry Nicolas, I Wayan Sudarsa, Putu Anda Tusta Adiputra, Desak Made Wihandani, I Gede Putu Supadmanaba
      Pages: 30 - 34
      Abstract: Background: Breast cancer is the second leading cause of death in women in developing countries. The activity of Warburg and Reverse-Warburg effects on breast cancer is reflected by the expression patterns of two molecules, namely caveolin-1 and Monocarboxylate Transporter-4 (MCT-4). MCT-4 is a transmembrane transport protein that transports lactate from the cytoplasm to the intercellular fluid.Method: This is a cross-sectional analytical study to determine the relationship between MCT-4 expression and breast cancer clinicopathology and subtypes. The study was conducted between April and May of 2020 with 62  breast cancer patients as samples in Sanglah General Hospital, Denpasar. Analysis was done with SPSS 25.Results: A logistic regression analysis was performed to analyze the relationship between the dependent variable (MCT-4) and the covariates (stage, grade, and subtype). Of the three variables significantly associated with MCT-4 expression, only clinical-stage and subtype (luminal and non-luminal) remained independently associated with MCT-4 expression. Analysis on the clinical stage and subtype variables showed an adjusted OR of 4.727 (p = 0.047; 95% CI: 1.109 - 21.922) and 17.850 (p = 0.009; 95% CI: 2.069 - 154.003) , respectively. This suggests that MCT-4 has a significant association with subtype and clinical-stage, increasing the risk of cancer stage progression and developing a more malignant (non-luminal) subtype.Conclusion: High MCT-4 expression was significantly associated with malignant subtypes, high histological-grade cancer and advanced breast cancer.
      PubDate: 2022-02-07
      DOI: 10.15562/ism.v13i1.1274
      Issue No: Vol. 13, No. 1 (2022)
       
  • Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko
           terjadinya preeklamsia dengan gambaran berat

    • Authors: Leony Lim, Ketut Suwiyoga, I Wayan Artana Putra, Anak Agung Ngurah Jaya Kusuma, I Gede Mega Putra, Anom Suardika, I Wayan Megadhana
      Pages: 35 - 40
      Abstract: Background: Preeclampsia is a health problem because it contributes to high rates of maternal and baby morbidity and mortality. The pathogenesis of preeclampsia is still unknown, but vitamin D deficiency and low HDL-LDL serum ratio are thought to play an important role. Therefore, a study was conducted on low 25(OH)D serum level and low HDL-LDL serum ratio as risk factors for preeclampsia with severe features.Methods: This study has a case-control design, conducted at Obstetric and Gynecology emergency room at Sanglah Hospital from January 2020 to June 2020. Subjects were 44 pregnant women, consisting 22 normal pregnant women as controls and 22 pregnant women with preeclampsia with severe features as cases, selected by purposive consecutive sampling and analyzed using SPSS 21.Results: Preeclampsia with severe features was found 5 times higher in pregnant women with low 25(OH)D serum level than in normal pregnant women (OR = 4,91, CI 95% = 1,33-18,21, p = 0,014). Preeclampsia with severe features was found 8 times higher in pregnant women with low HDL-LDL serum ratio than in normal pregnant women (OR = 7,88, CI 95% = 1,96-31,57, p = 0,002).Conclusion: Low 25(OH)D serum level and low HDL-LDL serum ratio are risk factors for Preeclampsia with severe features. Pendahuluan: Preeklamsia merupakan masalah kesehatan karena berkontribusi terhadap tingginya angka morbiditas dan mortalitas ibu dan bayi. Patogenesis preeklamsia sampai saat ini masih belum diketahui secara pasti, namun kadar vitamin D dan rasio HDL–LDL serum yang rendah diduga berperan penting dalam mekanisme terjadinya preeklamsia. Penelitian kemudian dilakukan terhadap kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode : Desain penelitian ini adalah kasus kontrol (case control) yang dilakukan di Instalasi Gawat Darurat Obstetri dan Ginekologi RSUP Sanglah, Denpasar mulai Januari 2020 sampai Juni 2020. Subyek penelitian berjumlah 44 orang ibu hamil, yang terdiri dari 22 ibu hamil normal sebagai kontrol dan 22 ibu hamil dengan preeklamsia dengan gambaran berat sebagai kasus, yang dipilih secara purposive consecutive sampling,  dan dianalisis menggunakan SPSS 21.Hasil: Risiko terjadinya preeklamsia dengan gambaran berat  adalah 5 kali lebih tinggi pada ibu hamil dengan kadar 25(OH)D serum yang rendah dibandingkan ibu hamil normal (OR = 4,91, IK 95% = 1,33-18,21, p = 0,014). Risiko terjadinya preeklamsia dengan gambaran berat adalah 8 kali lebih tinggi pada ibu hamil dengan rasio HDL-LDL serum yang rendah dibandingkan ibu hamil normal (OR = 7,88, IK 95% = 1,96-31,57, p = 0,002).Simpulan : Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah merupakan faktor risiko preeklamsia dengan gambaran berat.
      PubDate: 2022-02-09
      DOI: 10.15562/ism.v13i1.1219
      Issue No: Vol. 13, No. 1 (2022)
       
  • Akurasi otoskopi video digital dalam mendiagnosis otitis media akut pada
           pasien pediatri: sebuah tinjauan sistematik

    • Authors: Anak Agung Wira Ryantama, Ni Luh Parameswari Praptika, Ni Nyoman Astrid Tri Bhuwana
      Pages: 41 - 49
      Abstract: Introduction: Acute otitis media one of the most prevalent ear and throat infection, mostly affecting children. Diagnosis of this condition was complicated by the perceived invasive procedure and the shortage of qualified otologist. Digital video otoscopy is a new and evolving concept in otology which could be further enhanced with telemedicine. It increases access to specialist otologist care by having the examination performed by less qualified healthcare professional. In this review we would like to assess the newest evidence on digital video otoscopy as diagnostic modality for acute otitis media.Methods: We identified literature published from 2000 to 2020 from MEDLINE and Google Scholar. We included studies which reported diagnosis of acute otitis media using digital video otoscopy devices. We include both descriptive and analytical studies. We exclude literatures that reported secondary results or those that does not have acute otitis media as the diagnosis of interest. Articles that fulfill the criteria was then analyzed qualitatively to identify the themes that emerges.Results: Literature search resulted in 10 included studies which includes descriptive studies, diagnostic studies, and RCTs. Digital video devices used varied from add-ons to smartphones to dedicated digital video otoscopy results. The reported examiners also varied from otologist, general practitioners, to telemedicine facilitators. Most studies concur that digital video otoscopy provided adequate inter-examiner and intra-examiner reliability. At the same time, digital video otoscopy provides adequately accurate diagnosis of acute otitis media. Where comparison was available, the accuracy of digital video otoscopy was not significantly different compared to other modes of otoscopy.Conclusions: Digital video otoscopy provide adequately reliable and accurate diagnostic examination for acute otitis media. Some digital video otoscopy system was simple enough to be operated by nurses or telemedicine facilitators, supporting the utilization of this system for telemedicine. 
      PubDate: 2022-02-11
      DOI: 10.15562/ism.v13i1.1131
      Issue No: Vol. 13, No. 1 (2022)
       
  • The efficacy of olmesartan/amlodipine combination in hypertension
           treatment – a systematic review

    • Authors: Ni Luh Parameswari Praptika, Anak Agung Wira Ryantama, Ni Nyoman Astrid Tri Bhuwana
      Pages: 50 - 58
      Abstract: Introduction: Hypertension is the most common non-communicable disease, which persists as a major risk factor of cardiovascular diseases such as stroke, myocardial infection, and heart failure. Another major problem in clinical practice was the patients' adherence to treatment, directly related to the number of hypertension pills to be taken. Thus, determining the appropriate time duration and action of a hypertensive drug to maintain the blood pressure is needed. Olmesartan is one of the drug compounds frequently used for long-acting anti-hypertensive treatment. It is often combined with amlodipine; however, their combination remains unclear to provide equal efficacy and safety. Thus, in this article, we systematically summarize the combination of Olmesartan with amlodipine.Methods: This systematic literature review was extracted from Science Direct and Pubmed to identify randomized clinical trials (RCT) of the outcome of the Olmesartan/amlodipine effect compared with other hypertension regimens by using PRISMA guideline 2009. The methodological quality of the included studies was assessed independently by two reviewers using The Cochrane Collaboration's RoB 2 tool.Results: We evaluated twelve studies in the last ten years, and there were four studies with an intention-to-treat protocol (25% of articles had some concern, and 75% had a low risk of bias.) and eight studies with per-protocol analysis (37,5% of articles were concerned, and the rest had a low risk of overall bias). We also presented the efficacy and safety outcomes of the study reviewed.Conclusion: Hypertension is a common non-communicable disease, and treatment approaches for hypertension vary widely. Administration of combination drugs is a good approach in reducing the dose of drug administration and reducing the incidence of side effects in monotherapy. Inhibiting the RAA system by olmesartan and reducing vascular smooth muscle tone by amlodipine gives better results and can be a safe and effective option for lowering blood pressure in hypertensive patients. The side effects observed were not severe and only observed in a few cases, making it an option to treat hypertension.
      PubDate: 2022-02-11
      DOI: 10.15562/ism.v13i1.1132
      Issue No: Vol. 13, No. 1 (2022)
       
  • Gambaran karakteristik pasien in hospital cardiac arrest dan luaran pasca
           resusitasi jantung paru oleh tim code blue di RSUP Sanglah

    • Authors: Made Satria Yudha Dewangga, Hendy Wirawan, Anak Agung Ayu Dwi Adelia Yasmin
      Pages: 59 - 64
      Abstract: Background: Cardiac arrest is a medical emergency due to the sudden cessation of the heart’s mechanical function. Cardiac arrest can be reversible with appropriate intervention, but otherwise, it can be fatal and result in death. The incidence of cardiac arrest in hospital or in-hospital cardiac arrest (IHCA) needs to be considered because it is associated with high mortality and describes an early detection system and hospital response speed. In this study, the authors examined the characteristics of the incidence of IHCA and cardiopulmonary resuscitation carried out by the code blue team at the Sanglah Central General Hospital (RSUP), including outcome trends and survival of IHCA patients after cardiopulmonary resuscitation.Methods: The authors analyzed the incidence of IHCA at Sanglah Hospital in 2021 in a retrospective cohort by tracing the patient’s medical records from January to December 2021. The sample was collected using a non-randomized consecutive sampling technique, then univariate analysis was performed to get an overview of the proportion and percentage distribution, as well as analysis. Bivariate method to determine the relationship between age group, comorbidities, response time of the code blue team, and the etiology of cardiac arrest on resuscitation outcomes.Results: In IHCA patients who were resuscitated at Sanglah Hospital, 26.2% had a successful return of spontaneous circulation (ROSC), with >50% of patients dying within <24 hours and only 1% returning home recovering. The majority of IHCA patients were men aged 40 years or older, with a Charlson Comorbidity Index (CCI) 3, with noncardiac causes. Most resuscitation was performed within 5 minutes of the sound of the code blue signal. There was no significant relationship between age group, CCI score, etiology of cardiac arrest, and response time of the code blue team with resuscitation outcomes.Conclusion: IHCA patients at Sanglah Hospital have a relatively low survival rate, but the code blue efforts have been going well. There were no significant differences in the outcome of ROSC and death based on age group variables, comorbidities, response time of the code blue team, and the etiology of cardiac arrest. Latar Belakang: Henti jantung adalah keadaan darurat medis akibat berhentinya fungsi mekanis jantung secara tiba-tiba. Henti jantung dapat bersifat reversible dengan intervensi yang tepat, namun sebaliknya dapat bersifat fatal dan mengakibatkan kematian. Kejadian henti jantung di dalam rumah sakit atau in hospital cardiac arrest (IHCA) perlu diperhatikan karena berkaitan dengan mortalitas yang tinggi serta menggambarkan sistem deteksi dini dan kecepatan respon rumah sakit. Pada penelitian ini, penulis meneliti gambaran karakteristik kejadian IHCA dan resusitasi jantung paru yang dilakukan oleh tim code blue di Rumah Sakit Umum Pusat (RSUP) Sanglah, termasuk tren luaran dan kesintasan pasien IHCA pasca resusitasi jantung paru.Metode: Penulis menganalisis kejadian IHCA di RSUP Sanglah pada tahun 2021 secara kohort retrospektif melalui penelusuran rekam medis pasien dari bulan Januari hingga Desember 2021. Sampel dikumpulkan dengan teknik non randomized consecutive sampling, kemudian dilakukan analisis univariat untuk mendapat gambaran proporsi dan distribusi persentase, serta analisis bivariat untuk mengetahui hubungan antara kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung terhadap luaran resusitasi.Hasil: Pada pasien yang IHCA yang diresusitasi di RSUP Sanglah, 26,2% yang berhasil mengalami return of spontaneous circulation (ROSC), dengan >50% pasien meninggal dalam waktu <24 jam dan hanya 1% yang pulang dalam kondisi sembuh. Mayoritas pasien IHCA adalah laki-laki usia 40 tahun atau lebih, dengan Charlson Comorbidity Index (CCI) '3, dengan penyebab nonkardiak. Sebagian besar resusitasi sudah dilakukan dalam waktu 5 menit setelah dibunyikannya tanda code blue. Tidak terdapat hubungan yang signifikan antara kelompok usia, skor CCI, etiologi henti jantung, serta waktu respon tim code blue dengan luaran resusitasi.Simpulan: Pasien IHCA di RSUP Sanglah memiliki angka kesintasan yang relatif rendah, namun upaya code blue sudah berjalan dengan baik. Tidak ada perbedaan kejadian luaran ROSC maupun meninggal yang signifikan berdasarkan variabel kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung.
      PubDate: 2022-02-14
      DOI: 10.15562/ism.v13i1.1280
      Issue No: Vol. 13, No. 1 (2022)
       
  • Analisis faktor risiko kejadian infeksi saluran pernapasan akut di
           Abiansemal Kabupaten Badung tahun 2018

    • Authors: Ni Made Marwati, I Wayan Sali, I Made Bulda Mahayana, I Gusti Ayu Made Aryasih
      Pages: 65 - 69
      Abstract: Background: Acute Respiratory Tract Infections (ARTI) is one of the main causes of patient visits to the public health center (40%-60%) and hospital (15%-30%). The purpose of this study was to determine various risk factors that influence the incidence of ARTI in Abiansemal in 2018.Methods: This research was an observational study using a case-control research design by looking for various relationships of risk factors on the incidence of ARTI. The case group consists of patients diagnosed with ARTI and the control group were those who were not diagnosed with ARTI. The independent variables in this study were room occupancy density, kitchen room ventilation, smoking habits of parents, bedroom and living room ventilation, bedroom and living room light intensity, bedroom and living room air temperature, bedroom and living room, floor and wall humidity.Result: The bivariate analysis showed that the risk factors for the incidence of ARTI were room occupancy density with a value of '=0.05 (p=0.000, OR=28.444), smoking habits of the parents (p=0.000, OR=20.000), bedroom ventilation (p=0.003, OR=10.500), bedroom light intensity (p=0,000, OR=67,500), living room light intensity (p=0.001, OR=14.063), bedroom air temperature (p=0.002, OR=14.571), bedroom air humidity (p=0,000, OR=20,000).Conclusion: There were seven factors that were significantly associated with the incidence of ARTI in Abiansemal includeing room occupancy density, smoking habits of the parents, bedroom ventilation, bedroom light intensity, living room light intensity, bedroom air temperature, and bedroom air humidity. Latar Belakang: Infeksi Saluran Pernafasan Akut (ISPA) merupakan salah satu penyebab utama kunjungan pasien ke Puskesmas (40%-60%) dan rumah sakit (15%-30%). Tujuan dari penelitian ini adalah untuk mengetahui berbagai faktor risiko yang mempengaruhi kejadian ISPA di Abiansemal tahun 2018.Metode: Penelitian ini merupakan penelitian observasional dengan desain penelitian kasus kontrol dengan mencari berbagai hubungan faktor risiko terhadap kejadian ISPA. Kelompok kasus terdiri dari pasien yang terdiagnosis ISPA dan kelompok kontrol adalah mereka yang tidak terdiagnosis ISPA. Variabel bebas dalam penelitian ini adalah kepadatan hunian kamar, ventilasi ruang dapur, kebiasaan merokok orang tua, ventilasi kamar tidur dan ruang tamu, intensitas cahaya kamar tidur dan ruang tamu, suhu udara kamar tidur dan ruang tamu, kamar tidur dan ruang tamu, kelembaban lantai dan dinding.Hasil: Analisis bivariat menunjukkan bahwa faktor risiko kejadian ISPA adalah kepadatan hunian kamar dengan nilai 0,05 (p=0,000, OR=28,444), kebiasaan merokok orang tua (p=0,000, OR=20,000), ventilasi kamar tidur (p=0,003, OR=10,500), intensitas cahaya kamar tidur (p=0,000, OR=67,500), intensitas cahaya ruang tamu (p=0,001, OR=14,063), suhu udara kamar tidur (p=0,002, OR= 14,571), kelembaban udara kamar tidur (p=0,000, OR=20,000).Kesimpulan: Terdapat tujuh faktor yang berhubungan signifikan dengan kejadian ISPA di Abiansemal meliputi kepadatan hunian kamar, kebiasaan merokok orang tua, ventilasi kamar tidur, intensitas cahaya kamar tidur, intensitas cahaya ruang tamu, suhu udara kamar tidur, dan kelembaban udara kamar tidur.
      PubDate: 2022-02-15
      DOI: 10.15562/ism.v13i1.1183
      Issue No: Vol. 13, No. 1 (2022)
       
  • Studi kualitatif dan kuantitatif fitokimia ekstrak air dan ekstrak etanol
           daun kirinyuh (Chromolaena odorata l.) yang tumbuh di Provinsi Bali

    • Authors: Regina Tedjasulaksana, Maria Martina Nahak, Maria Martina Nahak, Ni Ketut Ratmini, Ni Ketut Ratmini
      Pages: 70 - 74
      Abstract: Background: Kirinyuh (Chromolaena odorata L.) leaf as a traditional medicine is used for wound healing. Kirinyuh is easy to get because it can still grow well in less fertile areas. This study aims to determine the results of qualitative and quantitative tests of the active substance in kirinyuh leaf extract (Chromolaena odorata L) growing in the province of Bali.Methods: This research was pre-experimental with completely randomized design with post-test only control group design. The research sample is kirinyuh leaves from three regions in the province of Bali based on geomorphology. Qualitative test results of ethanol and water extract of kirinyuh leaves (Chromolaena Odorata L.) methanol and ethyl acetate fractions contain alkaloids, saponins, tannins, phenols, flavonoids and antioxidants.Results: The results of the quantitative test of the highest alkaloid content from the ethanol extract of the methanol fraction from Jimbaran, namely 11,690.49 mg/100 gr. The highest tannin content of the ethanol extract of the ethyl acetate fraction from Tabanan was 172777 mg/100 gr. The highest Saponin content from the aqua extract of the ethyl acetate fraction was 2977.27 mg/100gr. The highest phenol content from the ethanol extract of the methanol fraction from Bangli was 19716.1 mg/100 gr. The highest flavonoid content from the ethanol extract of the ethyl acetate fraction from Tabanan was 13704.7 mg/100 gr. The highest antioxidant content of the aqua extract of the methanol fraction from Tabanan was 62.3067 ppm.Conclusion: Total alkaloids of kirinyuh leaves in Jimbaran, Bangli and Tabanan were significantly different with p value = 0.000 (p < 0.05), tannins with p value = 0.000, phenols with p value = 0.006, flavonoids with p value = 0.000 and antioxidants with p value. p=0.000. Saponins in extracts from Jimbaran, Bangli and Tabanan there was no significant difference because the value of p=0,252 (p>0,05). Latar Belakang: Daun kirinyuh ( Chromolaena odorata L. ) sebagai obat tradisional digunakan untuk penyembuhan luka. Kirinyuh  mudah didapat karena dapat tetap tumbuh baik di daerah yang kurang subur. Penelitian ini bertujuan untuk mengetahui hasil uji kualitatif dan kuntitatif zat aktif dalam ekstrak daun kirinyuh (Chromolaena odorata L) yang tumbuh di propinsi Bali.Metode: penelitian ini adalah pra eksperimen dengan rancangan completely randomized with post test only control group design. Sampel penelitian yaitu daun kirinyuh dari tiga wilayah di provinsi Bali berdasarkan geomorfologi. Hasil uji kualitatif  ekstrak etanol dan air daun kirinyuh (Chromolaena Odorata L.) fraksi methanol dan etil asetat mengandung senyawa alkaloid, saponin, tannin, fenol, flavonoid dan antioksidan.Hasil: Hasil uji kuantitatif kadar alkaloid terbanyak dari ekstrak etanol fraksi methanol dari Jimbaran, yaitu 11.690,49 mg/100 gr. Kadar tannin terbanyak dari ekstrak etanol fraksi etil asetat dari Tabanan, yaitu 172777 mg/100 gr.  Kadar Saponin terbanyak dari ekstrak aqua fraksi etil asetat yaitu 2977,27 mg/100gr. Kadar fenol terbanyak dari ekstrak etanol fraksi methanol dari Bangli, yaitu 19716,1 mg/100 gr. Kadar flavonoid terbanyak dari ekstrak etanol fraksi etil asetat dari Tabanan, yaitu 13704,7 mg/100 gr.  Kadar antioksidan terbanyak dari ekstrak aqua fraksi metanol dari Tabanan, yaitu 62,3067 ppm.Simpulan: Total alkaloid daun kirinyuh Jimbaran, Bangli dan Tabanan berbeda bermakna dengan nilai p=0,000 (p<0,05), tannin dengan nilai p=0,000, fenol dengan nilai p=0,006, flavonoid dengan nilai p=0,000 dan antioksidan dengan nilai p=0,000.  Saponin dalam ekstrak dari Jimbaran, Bangli dan Tabanan tidak ada perbedaan bermakna karena nilai p=0,252 (p>0,05).
      PubDate: 2022-02-16
      DOI: 10.15562/ism.v13i1.1188
      Issue No: Vol. 13, No. 1 (2022)
       
  • The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing
           fluid as a predictor of Premature Rupture of Membrane (PROM)

    • Authors: Danny Aguswahyudi, Ketut Suwiyoga, I Ketut Surya Negara, I Wayan Megadhana, I Nyoman Bayu Mahendra, I Gusti Putu Mayun Mayura, Made Bagus Dwi Aryana
      Pages: 75 - 78
      Abstract: Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age '24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.
      PubDate: 2022-02-16
      DOI: 10.15562/ism.v13i1.1216
      Issue No: Vol. 13, No. 1 (2022)
       
  • Nilai diagnostik pemeriksaan Antinuclear Antibody (ANA) secara kuantitatif
           dengan metode Chemiluminescent Immunoassay (CLIA) pada pasien dengan
           penyakit autoimun

    • Authors: Indah Adhita Wulandari, Hani Susianti, Dian Sukma Hanggara, Kusworini Handono, Raymond Poeng, I Komang Adi Widana, Deasy Ayuningtyas Tandio
      Pages: 79 - 82
      Abstract: Background: Many serological examination methods have been developed to assist in diagnosing autoimmune diseases, one of which is the Chemiluminescent Immunoassay (CLIA) method. The CLIA method is an alternative method that is faster and estimated to have the same accuracy with IFA as the gold standard examination. It can help diagnose autoimmune diseases more quickly and easily. This study aims to determine the diagnostic value and conformity of the Anti-Nuclear Antibody (ANA) examination using the IFA method with the CLIA method in patients with autoimmune diseases.Methods: The research design is a cross sectional study with consecutive sampling methods in autoimmune disease patients at Dr. Saiful Anwar Hospital Malang. ANA examination using the IFA method and the CLIA method. The data obtained by examining the IFA method is categorical, and the CLIA method is numerical. The diagnostic test uses the ROC curve and generates the AUC to determine the cut-off point. Furthermore, the suitability test was carried out using the Cohen's Kappa analysis technique. Data were analyzed using SPSS version 25 for Windows.Results: The research sample collected was 110. Patients with positive ANA IFA results showed the same results with the CLIA method (58,18%). The diagnostic test using the cut-off value of serum ANA levels of 41.79 AU/mL showed a sensitivity value of 98.4%, specificity 95.5%, a positive predictive value of 95.63% and a negative predictive value of 98.35% with an AUC of 0.990. The suitability value of the ANA examination with the IFA and CLIA methods with the Cohen's Kappa test showed very good results, which was 0.908 (p=0.000).Conclusion: There is a very good suitability value in examining the ANA parameters of the IFA method and the CLIA method. ANA CLIA examination has good diagnostic value. Latar Belakang: Banyak metode pemeriksaan serologi yang berkembang untuk membantu penegakan diagnosis penyakit autoimun, salah satunya metode Chemiluminescent Immunoassay (CLIA). Metode CLIA merupakan alternatif metode yang lebih cepat dan diperkirakan memiliki keakuratan yang sama dengan pemeriksaan baku emas Immunofluorescence Assay (IFA), sehingga dapat membantu menegakkan diagnosa penyakit autoimun dengan lebih cepat dan mudah. Penelitian ini bertujuan untuk mengetahui nilai diagnostik dan kesesuaian hasil pemeriksaan Anti-Nuclear Antibody (ANA) metode IFA dengan metode CLIA pada pasien dengan penyakit autoimun.Metode: Desain penelitian adalah studi potong lintang dengan metode consecutive sampling pada pasien penyakit autoimun di RSUD Dr. Saiful Anwar Malang. Pemeriksaan ANA menggunakan metode IFA dan metode CLIA. Data yang diperoleh dengan pemeriksaan metode IFA bersifat kategorikal, dan metode CLIA bersifat numerik. Uji diagnostik menggunakan kurva ROC dan menghasilkan AUC untuk menentukan cut-off-point. Selanjutnya dilakukan uji kesesuaian dengan teknik analisis Cohen’s Kappa. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Sampel penelitian terkumpul 110. Pasien dengan hasil ANA IFA positif yang menunjukkan hasil yang sama dengan metode CLIA adalah (58,18%). Uji diagnostik menggunakan nilai cut-off kadar ANA serum 41,79 AU/mL menunjukkan nilai sensitivitas 98,4%, spesifisitas 95,5%, nilai ramal positif 95,63% dan nilai ramal negatif 98,35% dengan AUC 0,990. Nilai kesesuaian pemeriksaan ANA dengan metode IFA dan CLIA dengan uji Cohen’s Kappa menunjukkan hasil yang sangat baik secara bermakna yaitu sebesar 0,908 (p=0.000)Kesimpulan: Terdapat nilai kesesuaian yang sangat baik pada pemeriksaan parameter ANA metode IFA dan metode CLIA. Pemeriksaan ANA CLIA memiliki nilai diagnostik yang bagus
      PubDate: 2022-02-18
      DOI: 10.15562/ism.v13i1.1223
      Issue No: Vol. 13, No. 1 (2022)
       
  • Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019
           (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di
           Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021

    • Authors: Anak Agung Parama Swari Khrisna, Ni Luh Jaya Kirana
      Pages: 83 - 86
      Abstract: Introduction: COVID-19 is an infectious disease caused by a new virus causes that attacks the upper respiratory tract and the lungs. The numbers of cases and deaths have increased on a daily basis on the scale of a global pandemic. Chest X-ray images have proven useful for monitoring various lung diseases and have recently been used to monitor the COVID-19 disease. Imaging modalities such as chest x-rays have the benefit of providing initial imaging before confirming with RT-PCR examination. The purpose of this study was to determine the value of the diagnostic examination of the chest x-ray compared to the RT-PCR examination which is the gold standard in diagnosing COVID-19.Methods: This study used a diagnostic study design with a retrospective approach at Wangaya Hospital, Denpasar during the period June-November 2021. Analysis of the diagnostic test used cross tabulation and then calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy were performed.Results: Thorax imaging diagnostic test value compared with the gold standard RT-PCR examination in form of sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy was 78%, 23%, 84%, 16.6%, 1.01, 0.95, and 69% respectively.Conclusion: Thorax imaging provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of COVID-19. Pendahuluan: COVID-19 merupakan suatu penyakit menular yang disebabkan oleh virus baru dan menyerang saluran pernapasan bagian atas dan paru-paru. Jumlah kasus dan kematian telah meningkat setiap hari dalam skala pandemik global. Modalitas pencitraan seperti thoraks foto memiliki manfaat untuk memberikan pencitraan awal sebelum mengkonfirmasi dengan pemeriksaan RT-PCR. Tujuan penelitian ini adalah untuk mengetahui nilai pemeriksaan diagnostik yang dimiliki thoraks foto dibandingkan dengan pemeriksaan RT-PCR yang merupakan baku emas dalam mendiagnosis COVID-19.Metode: Penelitian ini menggunakan desain studi diagnostik dengan pendekatan retrospektif di Rumah Sakit Umun Daerah Wangaya Denpasar selama periode Juni-November 2021. Analisis uji diagnostik menggunakan tabulasi silang kemudian perhitungan sensitivitas, spesitifitas, positive predictive value (PPV), negative predictive value (NPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-) dan akurasi dilakukan.Hasil: Nilai uji diagnostik thoraks foto dibandingkan dengan pemeriksaan baku emas RT-PCR berupa sensitivas, spesitifitas, PPV, NPV, LR+, LR-, dan akurasi adalah masing-masing 78%, 23%, 84%, 16.6%, 1.01, 0.95, dan 69%.Simpulan: Thoraks foto memberikan sensitivitas dan akurasi diagnostik yang tinggi secara langsung pada presentasi klinis COVID-19.
      PubDate: 2022-02-22
      DOI: 10.15562/ism.v13i1.1287
      Issue No: Vol. 13, No. 1 (2022)
       
  • Penetrating ocular injury due to fish hook accident: A case report

    • Authors: Nyoman Tarita Dewi, Putu Rima Adilitha Widyasari, Fazella Kirara Sakti, Ida Ayu Putri Kartiningsih
      Pages: 87 - 90
      Abstract: Introduction: Open globe trauma is caused by sharp objects (lacerations) or blunt objects (ruptures). Lacerations can be divided into three parts:  penetrating wound, intraocular foreign body  (IOFB), and perforating wounds. One of the ocular laceration trauma that needs to be aware of is the penetration of fishing hooks. There are two important aspects of injuries due to fishing hooks: intraocular foreign bodies and infections.Case description: The patient of a 4-year-old  girl with a chief complaint left eye was exposed to a fishing hook approximately 3 hours before coming to the hospital. Ophthalmological examination was obtained visual acuity on the right eye fixes and follow the object. Examination of the anterior segment of the right eye was found corneal edema, penetrating injury due to fish hook direction at nine o'clock. The fish hook was stick on the entire thickness of the cornea. Then we also found iris trauma and opacity in the lens. The patient was diagnosed with traumatic cataracts with ocular iridolysis dextra. Initial therapy is tobroson eye drop 1 drop every 3 hours, cefadroxil syrup three times a day, and methylprednisolone 3x1/2 tablets. The patient was advised to undergo surgery.Conclusion: Initial management should be quick and careful to aggravate the trauma. Adequate eye protection and supervision are necessary to prevent fishing hook trauma, especially children.
      PubDate: 2022-02-24
      DOI: 10.15562/ism.v13i1.1257
      Issue No: Vol. 13, No. 1 (2022)
       
  • Serial kasus pneumonia neonatal dengan kemungkinan transmisi vertikal
           SARS-CoV-2 pada masa kehamilan

    • Authors: Ida Ayu Sri Kusuma Dewi, Ade Tsarina Indira
      Pages: 91 - 95
      Abstract: Background: The vertical transmission of SARS-CoV-2 from pregnant women to fetuses during pregnancy is still under debate. However, the incidence of COVID-19 in neonates born to mothers with SARS-Cov-2 infection is increasing. Several case reports suspect that the possibility of transmission of SARS-CoV-2 can occur vertically through the placenta. Most neonates with COVID-19 infection experience mild illness, but some develop severe symptoms.Case Report: We report two cases of neonates with Neonatal Pneumonia born to mothers with COVID-19 infection. The first case is a baby born to a mother infected with COVID-19 with placenta previa totalis. The baby was born with severe asphyxia. The second case was a baby born to a mother infected with COVID-19 with premature membrane rupture. The baby experiences respiratory distress after four days of age. An RT-PCR swab examination was performed in both cases, and the results were positive. After intensive care, both babies were discharged in stable condition.Conclusion: The vertical transmission of SARS-CoV-2 is still under debate. Examinations other than nasopharyngeal RT-PCR swabs such as peripheral blood examinations for mother and baby, placenta, umbilical cord, umbilical cord blood, amniotic fluid are needed to support vertical transmission. In this case report, we could only perform the Nasopharyngeal RT-PCR swab test due to various limitations. Latar Belakang: Transmisi vertical SARS-CoV-2 dari ibu hamil ke janin selama masa kehamilan masih dalam perdebatan. Namun Angka kejadian COVID-19 pada neonatus yang lahir dari ibu dengan infeksi SARS-Cov-2 tersebut kian meningkat. Beberapa laporan kasus mencurigai bahwa kemungkinan transmisi dari SARS-CoV-2 dapat terjadi secara vertikal melalui plasenta. Sebagian besar neonatus dengan infeksi COVID-19 ini mengalami gejala ringan, namun beberapa berkembang menjadi berat. Laporan Kasus: Pada laporan ini, kami melaporkan dua kasus neonatus dengan pneumonia neonatal yang lahir dari ibu dengan infeksi COVID-19. Kasus pertama merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan plasenta previa totalis, bayi lahir dengan asfiksia berat. Kasus kedua merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan ketuban pecah dini (KPD), bayi mengalami distress napas setelah usia 4 hari. Pada kedua kasus ini dilakukan pemeriksaan swab RT-PCR dan mendapatkan hasil positif. Setelah dilakukan perawatan intensif, kedua bayi dipulangkan dengan kondisi stabil. Kesimpulan: Transmisi vertikal SARS-CoV-2 masih dalam perdebatan. Pemeriksaan selain swab RT-PCR nasofaring seperti pemeriksaan darah perifer pada ibu dan bayi, plasenta, tali pusat, darah tali pusat, cairanan amnion dibutuhkan untuk menunjang adanya suatu transmisi vertikal. Pada laporan kasus ini kami hanya dapat melakukan tes swab RT-PCR nasofaring dikarenakan keterbatasan pemeriksaan. 
      PubDate: 2022-02-26
      DOI: 10.15562/ism.v13i1.1212
      Issue No: Vol. 13, No. 1 (2022)
       
  • The microvascular reconstruction in children with maxillofacial defects: A
           Systematic Review

    • Authors: Violetti Valentin, Ratna Rayeni Natasha Roosseno
      Pages: 96 - 101
      Abstract: Background: Facial bones trauma in the pediatric population is linked to severe damage and impairment, particularly in maxillofacial, particularly in area. In addition, reconstruction of maxillofacial in pediatric patients has some unique considerations. Therefore, this study described the effectiveness of microvascular reconstruction in children with maxillofacial defects.Methods: The relevant literature from PubMed and Science Direct databases. The strategic search is using the keywords such as "Pediatric" OR "Children" OR "Under-eighteen years" AND "microvascular reconstruction" OR "microvascular surgery" AND "maxillofacial defect". We used a PRISMA method to the selection of those articles. The inclusion criteria were related to microvascular reconstruction in children with maxillofacial defects from 2000-2021.Result: Total of six studies entries with inclusion criteria. These studies show that most free flaps or microvascular reconstruction procedures carried on pediatric patients to resolve maxillofacial defects gave successful functional, and clinical outcomes. In addition, a few complications, mainly infections, occurred following the surgery, however successfully managed with antibiotics.Conclusion: A microvascular reconstruction is a good option for maxillofacial defects reconstruction in pediatric patients due to a shorter surgical time and faster recovery. 
      PubDate: 2022-02-26
      DOI: 10.15562/ism.v13i1.1271
      Issue No: Vol. 13, No. 1 (2022)
       
  • Comparison of albumin 4%, gelatine, and ringer lactate as volume expander
           post-resuscitative phase on cardiac output and lactate serum after
           Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized
           prospective study

    • Authors: Prieta Adriane, Ni Luh Kusuma Dewi, Ardiyan Ardiyan
      Pages: 102 - 108
      Abstract: Background. The use of protein colloid in fluid management post-cardiac surgery is debatable whether it is more beneficial than non-protein colloid or crystalloid. Patients who still need more volume after the resuscitative phase might benefit from optimal fluid management by choosing the most beneficial fluid. This study compared albumin 4% administration to gelatine and ringer lactate as a volume expanders post-resuscitative phase after coronary artery bypass grafting (CABG) on-pump.Methods. We conducted a single-centered, single-blind, randomized controlled study that assigned 120 patients undergoing elective CABG on-pump. Subjects who met inclusion criteria received 125 ml/hour of either albumin 4%, gelatine colloid, or Ringer's lactate (RL) as the only infusion fluid for 4 hours after the first assessment post-resuscitative phase,  after intensive care unit (ICU) admission. After fluid administration, patients were reassessed. The assessment included cardiac output and lactate serum as the primary outcome, while the duration of mechanical ventilation, ICU, and hospital stay were recorded as secondary outcomes.Results. The mean of cumulative cardiac output improvement differed between the group albumin 4% 1.18 L/min, gelatine 0.88, and RL 0.74 (p=0.002). Lactate serum decreased in the albumin 4% group as much as 3.31 gr/dl compared to gelatine 2.13 and RL group 2.37 (p=0.005). Duration of mechanical ventilation, length of stay in ICU, and hospital post-operative were shorter in the albumin group than in other groups. Conclusions. Albumin 4% used as a volume expander in the post-resuscitative phase still improved cardiac output and tissue micro-perfusion than gelatine and ringer lactate.
      PubDate: 2022-02-26
      DOI: 10.15562/ism.v13i1.1043
      Issue No: Vol. 13, No. 1 (2022)
       
  • Hubungan intensitas nyeri dengan kualitas hidup pasien kanker payudara
           yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo

    • Authors: Duta Angela, Djohan Ardiansyah, Desak Gede Agung Suprabawati
      Pages: 109 - 116
      Abstract: Introduction: Breast cancer occurs because breast cells grow out of control. The incidence of breast cancer is still very high both in developed countries and in Indonesia. One treatment that can be done is chemotherapy. Pain is one of the effects that can occur in undergoing chemotherapy, besides the increasing stage of cancer can increase pain. This increased pain often affects a person's quality of life. This study aims to determine the relationship between pain intensity and quality of life of breast cancer patients undergoing chemotherapy at PPLK RSUD Dr. Soetomo.Methods: This research is a descriptive analytical study with a cross-sectional method. Sampling was done by total sampling that met the inclusion and exclusion criteria, then filled out the Sf-36 questionnaire and the Wong Baker pain scale. Forty respondents with breast cancer underwent chemotherapy at PPLK RSUD Dr. Soetomo. Analysis using SPSS. The Shapiro Wilk test was used to determine the normality test. Correlation using Spearman's test.Results: From 40 respondents, the youngest age in this study was 29 years old and the oldest was 61 years old. The highest level of pain in stage 4 breast cancer patients is in the mildly disturbing category, which is measured using the Wong Baker scale. The results of the Spearman test concluded that there were significant results between pain intensity and quality of life. There are 8 components in assessing the quality of life with the SF-36: physical function, physical role, emotional role, energy, mental health, social function, pain, and general health (p<0.05).Conclusion: This study shows a relationship between pain intensity and quality of life of breast cancer patients undergoing chemotherapy.  Pendahuluan: Kanker payudara terjadi karena sel-sel payudara tumbuh di luar kendali. Angka kejadian kanker payudara masih sangat tinggi baik di negara maju maupun Indonesia. Salah satu pengobatan yang dapat dilakukan adalah kemoterapi. Nyeri merupakan salah satu efek yang dapat terjadi dalam menjalani kemoterapi, selain itu stadium kanker yang meningkat dapat meningkatkan rasa nyeri. Nyeri yang meningkat ini seringkali memengaruhi kualitas hidup seseorang. Penelitian ini bertujuan untuk mengetahui hubungan intensitas nyeri terhadap kualitas hidup pasien kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo.Metode: Penelitian ini merupakan penelitian deskripsi analitik dengan metode cross-sectional. Pengambilan sampel dilakukan dengan cara total sampling yang memenuhi kriteria inklusi dan eksklusi, kemudian dilakukan pengisian kuisioner Sf-36 dan skala nyeri Wong Baker. Terdapat 40 responden penderita kanker payudara yang menjalani kemoterapi di PPLK RSUD Dr. Soetomo. Analisis menggunakan SPSS. Uji Shapiro Wilk digunakan untuk menentukan uji normalitas. Korelasi hubungan menggunakan uji Spearman.Hasil: Dari 40 responden diperoleh hasil dengan usia termuda dalam penelitian ini berumur 29 tahun dan tertua berumur 61 tahun. Tingkatan nyeri tertinggi pada pasien kanker payudara stadium 4 masuk dalam kategori agak mengganggu, yang diukur menggunakan skala Wong Baker. Hasil uji Spearman menyimpulkan adanya hasil yang signifikan antara intensitas nyeri dengan kualitas hidup. Terdapat 8 komponen dalam menilai kualitas hidup dengan SF-36, yaitu fungsi fisik, peranan fisik, peranan emosi, energi, kesehatan jiwa, fungsi sosial, rasa nyeri, dan kesehatan umum (p<0,05).Kesimpulan: Penelitian ini menunjukkan adanya hubungan antara intensitas nyeri dan kualitas hidup pasien kanker payudara yang sedang menjalani kemoterapi.
      PubDate: 2022-02-28
      DOI: 10.15562/ism.v13i1.1236
      Issue No: Vol. 13, No. 1 (2022)
       
  • Prognostic value of red cell distribution width-to-platelet ratio in
           mortality of major burn in Sanglah Hospital Bali

    • Authors: Nyoman Siska Ananda, I Gusti Putu Hendra Sanjaya, Sianny Herawati, Agus Roy Rusly Hariantana Hamid, I Made Suka Adnyana, I Wayan Niryana
      Pages: 117 - 120
      Abstract: Introduction: The mortality rate in Sanglah Hospital due to major burns is quite high. The ratio of red cell distribution width (RDW) and platelet (PLT) (RPR) as a prognostic marker of mortality in major burns has never been studied in Indonesia. Calculations of RPR are easy, widely available and cost-efficient.Method: This study was retrospective observational case-control, with 60 patients with major burns consisting of 30 cases and 30 controls. Samples were taken from the Sanglah Hospital Medical Record Unit from April 2019 to April 2021. Cases were samples with mortality after day seven, while controls were samples that survived. RDW and PLT value on day seven are associated with the incidence of mortality.Results: The mean of RPR in the case group was higher than in the control group. RPR mean of the control group was 0.0559, and the case group was 0.0947 (p<0.001). The increase of RPR in the case group was 40.97%. Statistical analysis showed that high RPR was a significant mortality risk factor in patients with major burns (OR = 21.36; p < 0.001).Conclusion: High RPR is a prognostic marker of mortality in major burns at Sanglah Hospital.
      PubDate: 2022-02-28
      DOI: 10.15562/ism.v13i1.1284
      Issue No: Vol. 13, No. 1 (2022)
       
  • Effectiveness comparison of atorvastatin vs. rosuvastatin in reducing CRP
           level in acute coronary syndrome: A systematic review and meta-analysis

    • Authors: I Gusti Ayu Inten Heny Pratiwi, Anak Agung Gde Waisampayana Putra
      Pages: 121 - 126
      Abstract: Background: Acute coronary syndrome (ACS) is a group of various clinical symptoms, including acute myocardial ischemia. When administered for coronary artery instability, one of the targets for statins is to reduce inflammation factor-like c-reactive protein (CRP). Increased levels of CRP are related to ischemic heart disease. Therefore, a meta-analysis was assessed to compare atorvastatin vs. rosuvastatin as the most effective for reducing CRP of a patient with acute coronary syndromeMethods: We searched PubMed and Cochrane databases until October 23th 2020. Search terms included acute coronary syndrome, C-reactive protein or CRP, rosuvastatin, atorvastatin, randomized, random, and randomization. We excluded study populations with acute kidney injury/dyslipidemia/metabolic syndrome. All analyses in our study were carried out using Review Manager version 5.3 (RevMan Cochrane, London, UK).Result: We have found four eligible studies (487 patients) were included. Funnel plots and p-Egger were inspected to assess publication bias. The pooled analysis demonstrated the benefit of atorvastatin or rosuvastatin over therapy for all studies. The result shown (WMD: 2.41; P=0.06; 95% CI: -0.07 – 4.90) on the forest plot.Conclusion: Our meta-analysis clarifies that atorvastatin, compared to rosuvastatin, or vice versa, is not statistically significant in reducing CRP in acute coronary syndrome patients.
      PubDate: 2022-02-28
      DOI: 10.15562/ism.v13i1.1267
      Issue No: Vol. 13, No. 1 (2022)
       
  • Hubungan neutrophil-lymphocyte ratio, absolute lymphocyte count, dan
           platelet lymphocyte ratio terhadap derajat keparahan COVID-19

    • Authors: Lusia Nasrani
      Pages: 127 - 130
      Abstract: Introduction: The COVID-19 virus was discovered at the end of 2019 as respiratory infectious disease and has become a pandemic until now, so it is very important to predict the severity of COVID-19. Neutrophil Lymphocyte Ratio (NLR), Absolute Lymphocyte Count (ALC), and Platelet Lymphocyte Ratio (PLR) are easy, inexpensive, and fast methods as screening tools for the severity of COVID-19. The purpose of this study was to determine the relationship between NLR, ALC, and PLR to the severity of COVID-19.Methods: This study is an analytic observational study with a cross-sectional research design—retrieving research data using the total sampling method. The research data are medical records and laboratory examination data from 64 COVID-19 patients at Harapan Keluarga Hospital Cikarang in July–December 2020. The data analysis used was bivariate analysis with chi-square.Results: There were 64 samples in this study, with the majority of samples being male, the average age was 42 years, the most common symptoms were fever (81.3%) and cough (71.9%), the majority of patients had no comorbidities. There was a significant relationship between NLR, ALC and PLR with the severity of COVID-19 (p = 0.007; p = 0.002; p = 0.013). Latar belakang: Virus COVID-19 ditemukan pada akhir tahun 2019 sebagai penyakit infeksi pada pernapasan dan telah menjadi pandemi hingga saat ini, sehingga sangat penting untuk memprediksi derajat keparahan COVID-19. Neutrophyl Lymphocyte Ratio (NLR), Absolute Lymphocyte Count (ALC), dan Platelet Lymphocyte Ratio (PLR) merupakan metode yang mudah, murah, dan cepat sebagai alat skrining pada keparahan COVID-19. Tujuan penelitian ini adalah untuk mengetahui hubungan NLR, ALC, dan PLR terhadap derajat keparahan COVID-19.Metode: Penelitian ini adalah suatu penelitian observasional analitik dengan desain penelitian crosssectional. Pengambilan data penelitian menggunakan metode total sampling. Data penelitian adalah data rekam medis dan pemeriksaan laboratorium dari 64 pasien COVID-19 di RS Harapan Keluarga Cikarang pada periode Juli–Desember 2020. Analisis data yang digunakan adalah analisis bivariat dengan chi-square.Hasil: Terdapat 64 sampel pada penelitian ini dengan mayoritas sampel merupakan laki-laki, rata-rata usia 42 tahun, gejala yang paling sering ditemukan adalah demam (81,3%) dan batuk (71,9%), mayoritas pasien tidak memiliki komorbid. Terdapat hubungan yang signifikan antara NLR, ALC dan PLR dengan tingkat keparahan COVID-19 (p =0,007; p=0,002; p =0,013).Simpulan: NLR, ALC, dan PLR memiliki hubungan terhadap derajat keparahan COVID-19. 
      PubDate: 2022-02-28
      DOI: 10.15562/ism.v13i1.1241
      Issue No: Vol. 13, No. 1 (2022)
       
  • Persistent secondary spontaneous pneumothorax as a complication of
           tuberculosis infection: a case report

    • Authors: Ni Made Lintya Andani, Putu Diah Savitri
      Pages: 131 - 135
      Abstract: Introduction: A pneumothorax is a collection of air outside the lung contained within the pleural cavity. Primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax (SSP) are two types of spontaneous pneumothorax that differ due to the underlying illness. If the patient has a history of pulmonary disease, including tuberculosis infection, SSP may be present. Chest X-rays, chest ultrasonography, and CT scans are imaging tests that can be used to diagnose pneumothorax. We report a case of a 20-year-old man with persistent secondary spontaneous pneumothorax as a complication of tuberculosis infection.Case description: A 20-year-old man complained of shortness of breath two weeks before being admitted to the hospital. He had a story of a TB infection. A chest X-ray and a CT scan were used to assess the patient. The pneumothorax is seen with the sign of reactive old tuberculosis. The surgeon inserted a chest tube drainage to empty the pneumothorax. However, following the assessment, the pneumothorax grew even larger than before.Conclusion: Clinical evaluation should probably be the key determinant of the care strategy and assist with the initial diagnosis. Imaging modalities can help confirm a pneumothorax diagnosis and provide information about the extent of the pneumothorax.
      PubDate: 2022-02-28
      DOI: 10.15562/ism.v13i1.1260
      Issue No: Vol. 13, No. 1 (2022)
       
  • Penanganan inversio uteri: sebuah tinjauan pustaka

    • Authors: Endang Sri Widiyanti, I Gede Mega Putra
      Pages: 136 - 142
      Abstract: Acute uterine inversion is a rare but life-threatening emergency in the field of obstetrics. The main signs and symptoms of acute uterine inversion are bleeding and shock. The accuracy and speed of diagnosis and case management will reduce morbidity and mortality due to uterine inversion. This literature review is expected to increase our knowledge as practitioners in dealing with uterine inversion cases. In principle, there are two goals for the treatment of acute uterine inversion, namely repositioning the uterus and treating the shock that occurs. The success of uterine inversion repositioning is highly dependent on the speed of early detection. The longer the uterus is inverted, the more difficult it will be to reposition it. There are several non-surgical techniques for repositioning the uterus, including: Johnson maneuver, Henderson and Alles maneuver, use of tocolytics, and repositioning with hydrostatic pressure. Surgical procedures can be performed abdominally, namely the Huntington's Procedure, with abdominal repositioning laparotomy and the Haultain's Procedure, with abdominal cervical repositioning-repositioning laparotomy. Kejadian inversio uteri akut merupakan kegawatdaruratan di bidang Obstetri yang jarang terjadi namun mengancam nyawa. Tanda dan gejala utama inversio uteri akut adalah perdarahan dan syok. Ketepatan dan kecepatan diagnosa dan penanganan kasus akan mengurangi morbiditas dan mortalitas akibat inversio uteri. Tinjauan pustaka ini diharapkan dapat menambah pengetahuan kita sebagai praktisi dalam menangani kasus inversio uteri. Pada prinsipnya ada dua tujuan penanganan inversio uteri akut, yaitu reposisi uterus dan penanganan syok yang terjadi. Keberhasilan reposisi inversio uteri sangat tergantung pada kecepatan deteksi dini. Semakin lama uterus terinversi akan semakin sulit melakukan reposisi. Terdapat beberapa teknik non-bedah untuk reposisi inversio uteri, antara lain: manuver Johnson, manuver Henderson dan Alles, penggunaan tokolitik, dan reposisi dengan tekanan hidrostatik. Prosedur pembedahan dapat dilakukan melalui abdominal, yaitu Prosedur Huntington, dengan laparotomi-reposisi melalui abdominal dan Prosedur Haultain, dengan laparotomi- insisi cincin servikalis-reposisi melalui abdominal.
      PubDate: 2022-03-01
      DOI: 10.15562/ism.v13i1.1262
      Issue No: Vol. 13, No. 1 (2022)
       
  • Perbandingan skor Middle Ear Risk Index (MERI) pada pasien Otitis Media
           Supuratif Kronis (OMSK) dengan komplikasi intrakranial dan ekstrakranial
           di RSUD dr. Saiful Anwar, Malang, Indonesia

    • Authors: Ahmad Dian Wahyudiono, David Santoso
      Pages: 143 - 147
      Abstract: Background: Chronic Suppurative Otitis Media (CSOM) is a chronic infection in the middle ear mucosa with tympanic membrane perforation and causes complications in the form of intracranial and extracranial. In previous studies, CSOM mortality rates were different between intracranial and extracranial complications. That prompted the researchers to determine the middle ear postoperative prognosis in CSOM with intracranial complications compared to the extracranial. Postoperative prognosis is measured by Middle Ear Risk Index (MERI). This study aims to evaluate the comparison of MERI scores in CSOM patients with intracranial and extracranial complications. Methods: The research was conducted with an observational analytic design involving 40 research subjects from medical records of CSOM patients at RSUD dr. Saiful Anwar Malang in January 2017 – July 2021. The samples were divided into CSOM with intracranial and extracranial complications, including 12 and 28 subjects, respectively. Those samples are taken using consecutive sampling techniques and tested using an Independent T-test. Data were analyzed using SPSS version 25 for Windows.Results: The mean of MERI scores in CSOM patients with intracranial complications was 9.170±2.517, and that in extracranial complications was 7.570±1.854. The p-value of 0.031 (P<0.05) was obtained using an Independent T-test, indicating a significant difference of MERI scores mean between CSOM patients with intracranial and extracranial. Conclusion: There is a significant difference in MERI scores between CSOM with intracranial and extracranial complications. Latar Belakang: Otitis Media Supuratif Kronis (OMSK) adalah infeksi kronis yang terjadi pada mukosa telinga tengah yang ditandai dengan perforasi membran timpani dan dapat menyebabkan komplikasi intrakranial maupun ekstrakranial. Penatalaksanaan OMSK dengan komplikasi bertujuan untuk menyelesaikan komplikasi, infeksi di telinga tengah dan perbaikan fungsi. Perbaikan fungsi pendengaran bukan tujuan utama tapi tetap menjadi harapan dari pasien. Prognosis fungsi pendengaran pada operasi mastoid dapat dinilai dengan memperhatikan Middle Ear Risk Index (MERI). Penelitian ini bertujuan untuk mengevaluasi perbandingan skor MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial.Metode: Penelitian dilakukan dengan desain penelitian observasional analitik yang melibatkan 40 subjek penelitian berupa rekam medis pasien OMSK di RSUD dr. Saiful Anwar Malang bulan Januari 2017 – Juli 2021. Sampel terbagi menjadi dua kategori yaitu OMSK dengan komplikasi intrakranial dan ekstrakranial dengan jumlah secara berurutan yaitu 12 dan 28 sampel. Sampel diambil menggunakan teknik konsekutif dan diuji menggunakan Independent T-Test. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Didapatkan rerata pasien OMSK dengan komplikasi intrakranial sebesar 9,170±2,517 dan ekstrakranial sebesar 7,570±1,854. Pada uji Independent T-Test didapatkan nilai p sebesar 0,031 (p<0,05) yang menunjukkan terdapat perbedaan rerata MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial secara bermakna.Kesimpulan: Terdapat perbedaan skor MERI yang bermakna antara OMSK dengan komplikasi intrakranial dan ekstrakranial.
      PubDate: 2022-03-10
      DOI: 10.15562/ism.v13i1.1203
      Issue No: Vol. 13, No. 1 (2022)
       
  • Karakteristik dan perjalanan penyakit pasien infark miokard akut dengan
           elevasi segmen ST (IMA-EST) tanpa tatalaksana reperfusi pada rumah sakit
           perifer

    • Authors: Arina Papita Simanungkalit, Alice Inda Supit
      Pages: 148 - 152
      Abstract: Introduction: Acute myocardial infarction is coronary heart disease that causes an increase in length of stay in hospital and a high mortality rate. Reperfusion strategy is the main modality in treating ST-elevation myocardial infarction (STEMI), but a limitation in facilities and human resources in peripheral hospitals has made it impossible to do. This study aims to observe the characteristics and course of disease in patients diagnosed by STEMI without reperfusion strategy in peripheral hospitals.Method: This study is a descriptive observational study with a cross sectional research design--retrieving research data using the total sampling method, using secondary data from medical records at Ade M Djoen Sintang Public Hospital in March - December 2021.Results: 56 samples fulfilled inclusion and exclusion criteria, with the majority of the sample being male, the average age was 53 years. Most of the patients had the same complaint during their stay in the hospital, most of the patients were able to discharge from the hospital, and 57,14% of the patients were admitted back to the hospital with the same chief complaints after less than six months of follow-up.Conclusion: Management of patients with STEMI without a reperfusion strategy leads to remain of chief complaints and increase of readmission within 6 months follow-up after discharge. Latar Belakang: Infark miokard akut adalah suatu penyakit jantung koroner yang mengakibatkan peningkatan angka perawatan di rumah sakit dan angka kematian yang tinggi. Strategi reperfusi merupakan modalitas utama dalam penanganan infark miokard akut dengan elevasi segmen ST (IMA-EST), namun pada rumah sakit di perifer, keterbatasan sarana dan prasarana serta sumber daya manusia menyebabkan hal tersebut tidak memungkinkan. Tujuan penelitian ini adalah untuk mengetahui karakteristik dan perjalanan penyakit pasien yang terdiagnosis IMA-EST tanpa tatalaksana reperfusi di rumah sakit di perifer.Metode:  Penelitian ini merupakan penelitian observasional dengan desain penelitian potong lintang. Data penelitian diambil menggunakan metode total sampling, melalui data sekunder dari rekam medis selama periode Maret - Desember 2021 di Rumah Sakit Umum Daerah (RSUD) Ade M Djoen Sintang.Hasil: Terdapat 56 sampel yang memenuhi kriteria inklusi dan eksklusi, mayoritas sampel adalah laki-laki, rata-rata usia 53 tahun. Sebagian besar pasien mengakami keluhan yang menetap selama perawatan, sebagian besar boleh pulang dari rumah sakit. Dalam periode kurang dari 6 bulan, sebanyak 57,14% pasien masuk kembali ke rumah sakit dengan keluhan yang sama.Simpulan: Tatalaksana pasien dengan IMA-EST tanpa strategi reperfusi menyebabkan keluhan yang menetap selama perawatan dan peningkatan pasien masuk kembali ke rumah sakit dengan keluhan yang sama setelah 6 bulan dipulangkan dari rumah sakit.
      PubDate: 2022-03-22
      DOI: 10.15562/ism.v13i1.1322
      Issue No: Vol. 13, No. 1 (2022)
       
  • Kadar heat shock protein 70 cairan amnion yang tinggi sebagai faktor
           risiko terjadinya ketuban pecah dini pada kehamilan aterm

    • Authors: Ines Kurniaty Hartono, Ketut Suwiyoga, I Ketut Surya Negara, I Gede Mega Putra, Made Bagus Dwi Aryana, I Gde Sastra Winata, I Wayan Megadhana
      Pages: 153 - 157
      Abstract: Background: Premature rupture of membranes (PROM) is a condition that complicates labor with an unclear pathogenesis. HSP70 is thought to be involved in this pathogenesis process and the presence of HSP in the extracellular compartment reflects tissue damage and induces an immunologic response. Therefore, this study aimed to study the relationship between HSP70 levels in amniotic fluid and the incidence of PROM.Methods: This study used a case-control design in the ER delivery room and the laboratory of Sanglah Hospital, Denpasar. Samples were taken from mothers who gave full term delivery in the emergency room at Sanglah Hospital Denpasar with mothers who gave birth at term with KPD as cases and mothers who gave full term delivery without KPD as controls. Data was taken from medical records and measured levels of HSP70 at the Sanglah Hospital Denpasar Laboratory. Data analysis was performed using the Mann-Whitney test and ROC test.Results: A total of 28 cases and 28 controls were recruited. There were no significant differences in baseline characteristics between cases and controls. The MannWhitney test found significant differences in the mean levels of HSP70, 11.58 (±8.16) ng/mL in controls and 17.15 (±6.51) ng/mL in cases, respectively. ROC analysis found an AUC of 0.737 with an optimal cutoff value of 12.5 ng/mL. An amniotic fluid HSP70 level of more than 12.5 ng/mL was associated with PROM with an OR of 17.33 (95% CI 3.43 - 87.70).Conclusion: High amniotic fluid HSP 70 level is a risk factor for PROM in term pregnancy.  Latar belakang: Ketuban pecah dini (KPD) merupakan suatu kondisi yang mempersulit persalinan dengan patogenesis yang belum jelas. HSP70 dianggap terlibat dalam proses patogenesis ini dan keberadaan HSP di kompartemen ekstraseluler mencerminkan kerusakan jaringan dan menginduksi respon imunologi. Oleh karena itu, penelitian ini bertujuan untuk mempelajari hubungan kadar HSP70 dalam cairan ketuban dengan kejadian KPD.Metode: Penelitian ini menggunakan desain kasus kontrol di ruang bersalin IGD dan Laboratorium RSUP Sanglah Denpasar. Sampel diambil dari ibu yang bersalin cukup bulan di ruang bersalin IGD RSUP Sanglah Denpasar dengan ibu yang melahirkan cukup bulan dengan KPD sebagai kasus dan ibu yang bersalin cukup bulan tanpa KPD sebagai kontrol. Data diambil dari rekam medis dan dilakukan pengukuran kadar HSP70 di Laboratorium RSUP Sanglah Denpasar. Analisis data dilakukan dengan menggunakan uji Mann-Whitney dan uji ROC.Hasil: Sebanyak 28 kasus dan 28 kontrol direkrut. Tidak ada perbedaan yang signifikan dalam karakteristik dasar antara kasus dan kontrol. Uji MannWhitney menemukan perbedaan yang signifikan dalam tingkat rata-rata HSP70, masing-masing 11,58 (± 8,16) ng/mL pada kontrol dan 17,15 (± 6,51) ng/mL dalam kasus. Analisis ROC menemukan AUC 0,737 dengan nilai cutoff optimal 12,5 ng/mL. Tingkat HSP70 cairan ketuban lebih dari 12,5 ng/mL dikaitkan dengan PROM dengan OR 17,33 (95% CI 3,43 - 87,70).Simpulan: kadar HSP 70 cairan amnion yang tinggi merupakan faktor risiko terjadinya KPD pada kehamilan aterm.
      PubDate: 2022-03-25
      DOI: 10.15562/ism.v13i1.1220
      Issue No: Vol. 13, No. 1 (2022)
       
  • Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri
           koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah

    • Authors: I Made Gunarsa, Wayan Aryadana, I Made Junior Rina Artha
      Pages: 162 - 170
      Abstract: Introduction: Non-HDL cholesterol is a lipid parameter that describes the overall component of atherogenic lipids and is strongly correlated with apoB and sdLDL (small-dense LDL). There has been no study linking non HDL cholesterol (high density lipoprotein) with the degree of coronary stenosis based on the assessment of the previous syntax score. This study aims to prove the relationship between high non-HDL cholesterol and the degree of severe coronary artery lesions in patients with chronic coronary syndrome who underwent coronary angiography at Sanglah Hospital Denpasar.Methods: This analytical observational study was conducted at Sanglah General Hospital from June to November 2020. Sampling was carried out by consecutive sampling. Non HDL cholesterol was calculated by subtracting total cholesterol with HDL and divided into 2 categories based on ROC analysis. The syntax score was calculated based on the results of coronary angiography and was divided into 2 categories (cut off 22). The relationship between non-HDL cholesterol and the degree of coronary stenosis was assessed by chi-square test analysis.Results: Seventy-two subjects were included in this study with a mean age of 59.43±8.9 years. At the cut-off point of 104.5 mg/dL based on the ROC curve, non-HDL cholesterol had an AUC of 0.846, a sensitivity level of 80% and a specificity of 78.1% (p < 0.001). The results of bivariate analysis showed that high non-HDL cholesterol was associated with the degree of severe coronary stenosis with a prevalence ratio of 3.385 (p<0.001). Multivariate logistic regression analysis showed that high non-HDL cholesterol proved to be an independent predictor of severe coronary artery stenosis in patients with chronic coronary syndrome at Sanglah Hospital.Conclusion: High non-HDL cholesterol was shown to be independently associated with severe coronary artery stenosis in SKK subjects at Sanglah Hospital.  Pendahuluan: Kolesterol non HDL merupakan parameter lipid yang menggambarkan keseluruhan komponen lipid atherogenik dan berkorelasi kuat dengan apoB dan sdLDL (small-dense LDL). Belum ada penelitian yang menghubungkan kolesterol non HDL (high density lipoprotein) dengan derajat stenosis koroner berdasarkan penilaian skor syntax sebelumnya. Penelitian ini bertujuan untuk membuktikan hubungan kolesterol non HDL  yang tinggi dengan derajat lesi arteri koroner yang berat pada penderita sindroma koroner kronis yang dilakukan tindakan angiografi koroner di RSUP Sanglah Denpasar.Metode: : Penelitian observasional analitik ini dilakukan di Rumah Sakit Umum Sanglah dari Juni hingga November  2020. Pengambilan sampel dilakukan secara concecutive sampling. Kolesterol non HDL dihitung dengan cara mengurangi total kolesterol dengan HDL dan dibagi menjadi 2 kategori berdasarkan analisis ROC. Skor syntax dihitung berdasarkan hasil angiografi koroner dan dibagi menjadi 2 kategori (cut off 22). Hubungan antara kolesterol non HDL dan derajat stenosis koroner dinilai dengan analisis chi-square test.Hasil: Tujuh puluh dua subyek dilibatkan dalam penelitian ini dengan dengan rerata usia 59,43±8,9 tahun. Pada nilai titik potong 104.5 mg/dL berdasarkan kurva ROC, kolesterol non HDL memiliki AUC 0.846, tingkat sensitifitas 80% dan spesifisitas 78,1% (p <0.001). Hasil analisis bivariat menunjukkan kolesterol non HDL yang tinggi berhubungan derajat stenosis koroner berat dengan rasio prevalens 3,385 (p<0.001). Analisis multivariat regresi logistik menunjukkan kolesterol non HDL yang tinggi terbukti sebagai prediktor independen stenosis arteri koroner berat pada penderita sindroma koroner kronis di RSUP Sanglah.Simpulan: Kolesterol non HDL yang tinggi terbukti berhubungan secara independen dengan stenosis arteri koroner berat pada subyek SKK di RSUP Sanglah.
      PubDate: 2022-04-06
      DOI: 10.15562/ism.v13i1.1004
      Issue No: Vol. 13, No. 1 (2022)
       
  • Non-eosinofilia pada Infeksi Trichuris trichiura: sebuah laporan kasus

    • Authors: I Made Cahyadi Dwi Putra, I Nyoman Gde Sumardika, I Made Dharma Pramana, Ni Luh Putu Siska Kahari Sari
      Pages: 171 - 174
      Abstract: Background: Trichuris trichiura or whipworm is a Platyhelminthes parasite infecting the human gastrointestinal tract. Trichuris trichiura is a soil-transmitted helminth (STH). A tropical climate like Indonesia is an ideal place for STH. Prevalence of STH is still high in Indonesia, ranging from 2,5 – to 62 %. This parasite lives in the human colon, consuming blood, and nutrition from its host as well as usually manifests with eosinophilia incomplete blood count. However, this case study aims to evaluate the non-eosinophilia in Trichuris trichiura infection.Case Presentation: In this case, the patient is an 11 years old male with symptoms of diarrhea and dehydration; there are also signs of mild dehydration from a physical examination. Several tests are taken to assess the cause of diarrhea, such as a complete blood count (CBC) test which the result is only leukocytosis and slight monocyte increase, no elevation of eosinophil. Trichuris trichiura egg was found on the microscopic stool observation.Conclusion: Some studies show a significant association between the elevation of eosinophil and trichuriasis infection. However, the case report shows leukocytosis only, without elevation of eosinophil. Eosinophilia could be used as a marker of Trichuriasis infection, especially in the acute phase, but not all trichuriasis infections are followed by eosinophilia. This might be because of the natural course of the disease itself and the defense mechanism of the parasite.  Latar Belakang: Trichuristrichiura atau cacing cambuk adalah parasit dari jenis cacing pipih yang menyerang saluran pencernaan manusia.Trichuris trichiura merupakan jenis cacing soil-transmitted helminth (STH) yang dapat berkembang biak dengan baik di iklim tropis seperti Indonesia. Prevalensi kecacingan di Indonesia masing cukup tinggi dan angkanya bervariasi di tiap wilayah, berkisar antara 2,5 – 62 %. Parasit ini hidup di usus besar manusia, memakan darah, dan nutrisi dari inangnya serta biasanya bermanifestasi dengan eosinofilia dalam hitung darah lengkap. Namun, studi kasus ini bertujuan untuk mengevaluasi non-eosinofilia pada infeksi Trichuris trichiura.Presentasi Kasus: Kasus yang kami dapatkan adalah anak laki-laki 11 tahun dengan keluhan buang air besar cair dan dehidrasi. Pada pemeriksaan fisik didapatkan tanda dehidrasi ringan. Untuk mencari penyebab keluhannya dilakukan beberapa pemeriksaan penunjang yaitu pemeriksaan darah lengkap dimana didapatkan peningkatan pada sel darah putih dan sedikit peningkatan monosit, namun tidak disertai dengan peningkatan eosinofil. Pada pemeriksaan feses didapatkan gambaran telur cacing Trichuris trichiura.Kesimpulan: Beberapa penelitian menyatakan bahwa ada hubungan yang signifikan antara peningkatan eosinofil dengan trichuriasis. Namun, pada pasien ini hanya didapatkan leukositosis tanpa diikuti dengan peningkatan eosinofil. Eosinofil dapat dijadikan penanda infeksi terutama pada fase awal trichuriasis, namun tidak semua kasus ditemukan eosinofilia. Hal ini dapat terjadi karena mekanisme perjalanan penyakit itu sendiri dan juga mekanisme pertahanan dari parasit (Trichuristrichiuria) itu sendiri.
      PubDate: 2022-04-06
      DOI: 10.15562/ism.v13i1.1277
      Issue No: Vol. 13, No. 1 (2022)
       
  • Case report: a rare case of ocular leptospirosis

    • Authors: I Made Surya Dinajaya, Ida Ayu Ary Pramita, I Gusti Ayu Made Juliari, Ni Ketut Niti Susila, I Made Agus Kusumadjaja
      Pages: 175 - 180
      Abstract: Background: Ocular leptospirosis is a rare condition. Transmission of leptospirosis is caused by the bacterium leptospira interrogans transmitted directly or indirectly from animals to humans (zoonosis). Ocular manifestations often caused by leptospirosis are conjunctivitis, keratitis, uveitis (anterior, intermediate, posterior, and panuveitis), complicated cataracts, choroiditis, papillitis, and macular edema. Uveitis is a latent manifestation of leptospirosis. Proper management can lead to a good prognosis of visual.Case Presentation: Male patient, 55 years old, with complaints of both red and blurry eyes since 5 days. Blurring comes slowly with pain, glare, and seeing shadows like spider webs. The patient's previous medical history was hospitalized because of Weil's disease. Examination of the anterior segment of both eyes revealed eyelid spasm, conjunctival injection, corneal infiltrate, keratic precipitate, and posterior synechiae on both eyes. While in the posterior segment found cells 4+ in the vitreous. The patient was treated with antibiotics and topical steroids, and visual acuity was improved.Conclusion: Leptospirosis uveitis can have various presentations during the acute and chronic phases of the disease. Even when ocular involvement is extensive and severe, most patients have a good visual prognosis with appropriate therapy. Timely diagnosis is essential to maximize the potential for visual acuity improvement and appropriate systemic monitoring and treatment of extraocular involvement in this potentially fatal condition. Good sanitation in the community plays an important role in preventing exposure to leptospirosis.
      PubDate: 2022-04-11
      DOI: 10.15562/ism.v13i1.1320
      Issue No: Vol. 13, No. 1 (2022)
       
  • Kadar heat shock protein 70 (HSP 70) yang tinggi pada serum ibu sebagai
           faktor risiko persalinan preterm

    • Authors: Tjokorda G. A. Suwardewa, Ketut Surya Negara, Anak Agung Ngurah Anantasika, I Wayan Artana Putra, I Gde Sastra Winata, Piere Emanuel Yoltuwu
      Pages: 181 - 184
      Abstract: Introduction: Preterm birth defined as parturition that occurs less than 37 completed weeks of gestation is still being a big problem in obstetrics, especially in perinatology. Preterm delivery is one of the most common causes of neonatal morbidity and mortality. This study examined serum HSP 70 levels as a risk factor for preterm delivery.Method: The research design was analytic with a case-control method at Sanglah Hospital from February to June 2021. The samples were divided into two groups which are in the case group was 30 samples and the control group was 30 samples. In both groups, HSP 70 levels were collected by taking 5cc of blood sample from cubital vein. Furthermore, the examination was carried out using the enzyme-link immunosorbent assay (ELISA) method at Biomedik Terpadu Laboratory service.Result: Based on the data on the characteristics of the subjects, respectively maternal age, gestational age, BMI, and parity there was no significant differences between two group. Serum HSP levels were significantly different between the two groups with OR 4.030 (95%CI: 1,372-11,84; p-value 0.01). The cut-off value for serum HSP 70 levels was 12.85 ng/ml, with a sensitivity of 70%, specificity of 63.3%, and an area under the curve (AUC) value of 0.807 (95% CI 0.697 – 0.916, p-value <0.001).Conclusion: This study revealed that high levels of HSP 70 in serum is a risk factor of preterm labor. High blood serum levels of HSP 70 could be a reference in determining high risk of preterm labor in pregnant women.  Pendahuluan: Persalinan preterm didefinisikan kelahiran sebelum usia gestasi kurang dari 37 minggu masih menjadi masalah besar dalam bidang obstetri khususnya dibidang perinatologi. Persalinan preterm merupakan salah satu penyebab utama tingginya angka morbiditas dan mortalitas neonatus. Penelitian ini meneliti mengenai kadar HSP 70 pada serum ibu sebagai faktor risiko persalinan preterm.Metode: Rancangan penelitian yang digunakan adalah analitik dengan metode kasus-kontrol, dilakukan di RSUP Sanglah pada periode Februari 2021 sampai Juni 2021. Sampel dibagi menjadi 2 kelompok yakni kelompok kasus sebanyak 30 sampel dan kontrol 30 sampel. Pada kedua kelompok, pemeriksaan kadar HSP 70 dilakukan melalui pengambilan sampel darah 5 ml pada vena cubiti. Selanjutnya dilakukan pemeriksaan dengan metode enzyme-link immunosorbent assay (ELISA) di Unit Laboratorium Biomedik Terpadu.Hasil: Data karakteristik subyek yaitu usia ibu, usia kehamilan, IMT dan jumlah paritas, tidak ditemukan adanya perbedaan bermakna. Kadar serum HSP yang tinggi berbeda bermakna antara kedua kelompok dengan nilai OR 4.030 (IK 95%: 1,372-11,84; nilai p 0.01). Nilai cut off kadar serum HSP 70 sebesar 12.85 ng/ml, dengan sensitifitas sebesar 70%, spesifisitas 63,3%, dan nilai area under the curve (AUC) sebesar 0,807 (IK 95% 0,697 – 0,916, nilai p <0,001).Simpulan: Penelitian ini menunjukkan bahwa kadar HSP 70 yang tinggi pada serum ibu sebagai faktor risiko kejadian terjadinya persalinan preterm. Nilai kadar HSP 70 yang tinggi dapat menjadi suatu acuan dalam menentukan risiko tinggi kejadian persalinan preterm pada ibu hamil.
      PubDate: 2022-04-13
      DOI: 10.15562/ism.v13i1.1329
      Issue No: Vol. 13, No. 1 (2022)
       
  • Ekspresi reseptor vitamin D plasenta yang rendah sebagai faktor risiko
           terjadinya preeklampsia dengan gambaran berat

    • Authors: I Gede Mahendra Adiguna Dira, Ketut Suwiyoga, I Wayan Artana Putra, I Gede Mega Putra, Ida Bagus Gede Fajar Manuaba, I Gde Sastra Winata, I Wayan Megadhana
      Pages: 185 - 190
      Abstract: Introduction: Preeclampsia is the cause of 10-15% of maternal deaths in Indonesia and occurs in about 2-10% of all pregnancies worldwide. The pathogenesis that underlies the occurrence of preeclampsia is not yet clearly known so that preeclampsia is referred to as a disease of theory. Nutritional factors such as vitamin D also play a role in the development of preeclampsia. This study aims to determine the relationship between vitamin D receptor expression as a risk factor for preeclampsia with severe features.Method: This study used a case-control design conducted in the maternity ward of Sanglah General Hospital, Denpasar from February to August 2020. A sample of 44 subjects was obtained and divided into case groups and control groups. Examination of vitamin D receptors using a central area placenta measuring 2x2 cm which was then examined semi-quantitatively at the Histology Laboratory, Faculty of Medicine, Udayana University.Result: The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between low VDR expression in the placenta and the incidence of preeclampsia with severe features (p-value 0.002; 95% CI 1.96-31.57; OR 7.88).Conclusion: Low VDR placenta expression in pregnant women increases the risk of preeclampsia with a severe picture of 7.88 times greater than high VDR expression. Pendahuluan: Preeklampsia menjadi penyebab 10-15% kematian maternal di Indonesia, dan terjadi pada sekitar 2-10% dari seluruh kehamilan di seluruh dunia. Patogenesis yang mendasari terjadinya preeklampsia sampai saat ini belum jelas diketahui sehingga preeklampsia disebut sebagai disease of theory. Faktor nutrisi seperti vitamin D juga memainkan peran dalam terjadinya preeklampsia. Penelitian ini bertujuan mencari hubungan ekspresi reseptor vitamin D sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode: Penelitian ini menggunakan desain kasus-kontrol yang dilakukan di Ruang Bersalin RSUP Sanglah Denpasar pada Februari sampai Agustus 2020. Didapatkan sampel sebanyak 44 subyek dan dibagi kedalam kelompok kasus dan kelompok kontrol. Pemeriksaan reseptor vitamin D menggunakan plasenta area sentral ukuran 2x2 cm yang kemudian diperiksa secara semikuantitatif di Laboratorium Histologi Fakultas Kedokteran Universitas Udayana. Hasil dianalisa menggunakan uji chi square.Hasil: Tidak terdapat perbedaan karakteristik yang bermakna pada kedua kelompok. Terdapat hubungan yang bermakna antara ekspresi VDR pada plasenta yang rendah terhadap kejadian preeklamsia dengan gambaran berat (p-value 0.002; IK 95% 1.96-31.57; OR 7.88).SimpulanEkspresi VDR plasenta yang rendah pada ibu hamil meningkatkan risiko terjadinya preeklamsia dengan gambaran berat sebesar 7,88 kali lebih besar dibandingkan ekspresi VDR tinggi.
      PubDate: 2022-04-15
      DOI: 10.15562/ism.v13i1.1208
      Issue No: Vol. 13, No. 1 (2022)
       
  • Polimorfisme gen COL1A1 sebagai faktor risiko terjadinya prolaps organ
           panggul pada perempuan Bali, Indonesia

    • Authors: Putra Agung Eka Aricandana, I Gede Mega Putra, I Wayan Megadhana, Anak Agung Ngurah Anantasika, Ida Bagus Gde Fajar Manuaba, I Gede Ngurah Harry Wijaya Surya
      Pages: 191 - 196
      Abstract: Introduction: Pelvic organ prolapse (POP) is still a common health problem in women, especially in the elderly female population. Pelvic organ prolapse is associated with a reduced quality of life for millions of women worldwide. The purpose of this study was to determine the role of the COL1A1 rs 1800012 gene polymorphism as a risk factor for pelvic organ prolapse in Balinese women, Indonesia.Methods: This case-control observational study involved 60 Balinese women aged 30-70 years divided into 30 subjects with pelvic organ prolapse as a case group and 30 subjects with non-pelvic organ prolapse as a control group. Subject selection and clinical examination were carried out at the Reconstructive Urogynecology Polyclinic and Obstetrics and Gynecology Polyclinic, Sanglah Central General Hospital Denpasar and Prima Medika General Hospital Denpasar. Three ml of blood sample was drawn and then put into a bottle containing EDTA for Polymerase Chain Reaction COL1A1 rs 180012 gene polymorphisms at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The data obtained were then analyzed using the Statistical Product and Service Solutions software version 21.0.Results: COL1A1 gene polymorphism was found in eight subjects in the case group and one subject in the control group. The results of bivariate analysis showed a significant relationship between the COL1A1 gene polymorphism and the incidence of pelvic organ prolapse (p = 0.011). The results of multivariate analysis revealed a significant relationship between COL1A1 gene polymorphisms and pelvic organ prolapse after controlling for controlled variables (parity status, occupation, BMI, age, menopause, and history of hysterectomy). Multivariate analysis showed adjusted odd ratio of 16.157 for the COL1A1 gene polymorphism (p = 0.021).Conclusion: COL1A1 gene polymorphism significantly increases the risk of pelvic organ prolapse in Balinese women.  Pendahuluan: Prolaps organ panggul (POP) masih menjadi masalah kesehatan umum pada perempuan, terutama pada populasi wanita lanjut usia. Prolaps organ panggul berkaitan dengan penurunan kualitas hidup dari jutaan wanita di seluruh dunia. Tujuan dari penelitian ini adalah untuk mengetahui peran polimorfisme gen COL1A1 rs 1800012 sebagai faktor risiko kejadian prolaps organ panggul pada perempuan Bali, Indonesia.Metode: Studi observasional kasus kontrol ini melibatkan 60 orang perempuan Bali berusia 30-70 tahun yang terdiri dari 30 orang dengan diagnosis prolaps organ panggul sebagai kelompok kasus dan 30 orang dengan diagnosis non prolaps organ panggul sebagai kelompok kontrol. Pemilihan subjek dan pemeriksaan klinis dilakukan di Poliklinik Uroginekologi Rekonstruksi dan Poliklinik Obstetri dan Ginekologi Rumah Sakit Umum Pusat Sanglah Denpasar dan Rumah Sakit Umum Prima Medika Denpasar. Sampel darah diambil sebanyak 3 ml kemudian dimasukkan ke dalam botol yang berisi EDTA dan dilakukan pemeriksaan Polymerase Chain Reaction untuk polimorfisme gen COL1A1 rs 180012 di Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Data yang diperoleh kemudian dianalisis menggunakan perangkat lunak Statistical Product and Service Solutions versi 21.0.Hasil: Polimorfisme gen COL1A1 ditemukan pada 8 subjek pada kelompok kasus dan 1 subjek pada kelompok kontrol. Hasil analisis bivariat menunjukkan adanya hubungan signifikan antara polimorfisme gen COL1A1 dan kejadian prolaps organ panggul (p = 0,011). Hasil analisis multivariat memperjelas hubungan signifikan antara polimorfisme gen COL1A1 dan prolaps organ panggul setelah dikontrol dengan variabel terkendali (status paritas, pekerjaan, imt, umur, menopause, dan riwayat histerektomi). Hasil analisis multivariat menunjukkan adjusted odd ratio sebesar 16,157 untuk polimorfisme gen COL1A1 (p = 0,021).Simpulan: Polimorfisme gen COL1A1 secara signifikan meningkatkan risiko terjadinya prolaps organ panggul pada perempuan Bali.
      PubDate: 2022-04-15
      DOI: 10.15562/ism.v13i1.1209
      Issue No: Vol. 13, No. 1 (2022)
       
  • Skor assessment of different neoplasias in the adnexa (ADNEX) untuk
           memprediksi keganasan ovarium di RSUP Sanglah Denpasar

    • Authors: I Nyoman Gede Budiana, Ketut Suwiyoga, Tjokorda Gde Agung Suwardewa, Anom Suardika, Made Bagus Dwi Aryana, Heni Sunyoto
      Pages: 197 - 201
      Abstract: Introduction: Ovarian cancer is cancer of the female reproductive organs with the highest mortality and is in the third position of female cancer after mammary and cervical cancer. The mortality rate and survival rate of ovarian cancer is mainly determined by the stage at which ovarian cancer is diagnosed. Until now there is no method for early detection of ovarian cancer with good sensitivity and specificity. Assessment of different neoplasias in the adnexa (ADNEX) is a model proposed by international ovarian tumor analysis (IOTA) to help distinguish benign or malignant adnexa tumors.Methods: This study is a observational clinical test to find out the accuracy of ADNEX model to predict ovarian malignancy conducted at the Obstetric and Gynecology Outpatient Ward in Sanglah hospital, Denpasar from November 2019 to April 2020. Consecutive sampling was done and 88 sample was recruited with a diagnosis of ovarian tumors. Then the research sample was sent to the Pathology Anatomy laboratory of Sanglah Hospital for histopathological examination. This result would then be compared to the prediction results of the ADNEX model.Results: 35 samples of benign ovarian tumors and 53 samples of ovarian cancer were found with the ADNEX method. There were 46 samples with malignant tumor both by the ADNEX model and histopathology results, 7 samples of malignant tumor at histopathology result but benign by the ADNEX model, 6 samples of benign tumor according to histopathology but malignant using the ADNEX model, and 29 samples of benign tumor according to histopathology and the ADNEX model. Using cut off of 49,6%, the study reported a sensitivity level of 86.8%, specificity 82.6%, positive predictive value 88.5%, negative predictive value 80.6%, and 85.2% accuracy.Conclusion: The ADNEX model has a high level of specificity, sensitivity and diagnostic accuracy in diagnosing ovarian cancer and can be used in combination with other clinical markers for early detection of malignancy in ovarian tumors.  Pendahuluan: Kanker ovarium merupakan salah satu jenis kanker organ reproduksi wanita dengan mortalitas tertinggi dan berada pada posisi ke-tiga kanker perempuan setelah kanker mammae dan serviks. Angka mortalitas dan survival rate kanker ovarium sangat ditentukan oleh stadium saat kanker ovarium terdiagnosis. Hingga saat ini belum tersedia metode pemeriksaan untuk deteksi dini kanker ovarium dengan sensitivitas dan spesifisitas yang memadai. Assessment of different neoplasias in the adnexa (ADNEX) adalah model yang diajukan oleh International Ovarian Tumor Analysis (IOTA) untuk membantu membedakan tumor adnexa sebagai tumor jinak atau ganas. Metode: Penelitian ini merupakan penelitian observasional uji klinik untuk mengetahui akurasi model ADNEX untuk memprediksi keganasan ovarium yang dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah, Denpasar pada bulan November 2019 hingga April 2020. Sampling dilakukan secara consecutive dan didapatkan 88 orang dengan diagnosis tumor ovarium. Sampel penelitian dikirimkan ke laboratorium Patologi Anatomi RSUP Sanglah dan dilakukan pemeriksaan histopatologi untuk kemudian dibandingkan dengan hasil prediksi dari model ADNEX.Hasil: Dalam penelitian ini didapatkan 35 sampel dengan tumor jinak ovarium dan 53 sampel dengan kanker ovarium dengan menggunakan metode ADNEX. Terdapat 46 sampel dengan hasil pemeriksaan model ADNEX ganas dan hasil pemeriksaan histopatologi ganas, 7 sampel histologi ganas namun model ADNEX jinak, 6 sampel histopatologi jinak namun model ADNEX ganas, dan 29 sampel histopatologi jinak dan model ADNEX jinak. Hasil penelitian memperlihatkan tingkat sensitifitas 86,8%, spesifisitas 82,6%, nilai prediksi positif 88,5%, nilai prediksi negatif 80,6%, dan akurasi 85,2%.Simpulan: Model ADNEX memiliki tingkat spesifisitas, sensitivitas dan akurasi diagnostik yang tinggi dalam mendiagnosis kanker ovarium dan dapat digunakan bersama dengan penanda klinis lain untuk deteksi dini keganasan pada tumor ovarium.
      PubDate: 2022-04-13
      DOI: 10.15562/ism.v13i1.1328
      Issue No: Vol. 13, No. 1 (2022)
       
  • Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin
           (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif
           (ANO): tinjauan pustaka

    • Authors: Ni Made Dian Hartaningsih, I Putu Yuda Prabawa, Benediktus Bosman Ariesta Gusti Putu, Dwijo Anargha Sindhughosa, Ida Bagus Amertha Putra Manuaba, I Gusti Ngurah Pramesemara
      Pages: 202 - 209
      Abstract: Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy. Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien. 
      PubDate: 2022-04-18
      DOI: 10.15562/ism.v13i1.1363
      Issue No: Vol. 13, No. 1 (2022)
       
  • Penanganan pasien dengan coloboma iris, coloboma lensa dan coloboma
           chorioretinal: laporan kasus

    • Authors: I Gusti Ayu Dian Ratnasari, I Wayan Eka Sutyawan, Ni Made Ayu Surasmiati, Ari Andayani
      Pages: 210 - 216
      Abstract: Introduction: Ocular coloboma  is a congenital abnormality caused by incomplete and damaged closure of the embryonal cleft. Coloboma can appear unilateral or bilateral and is associated with a variety of complications in the eye, including amblyopia and refractive errors.Case Description: An 8 year old male patient complained of glare since 1 year ago. There are no complaints of both red and painful eyes. This complaint was felt since the patient started entering school. The patient's mother stated that he had frequent glare and watery eyes since he was a baby. Visual aquity on right eye was 1/60 pinhole not improve (PHNI) and on left eye was 6/18 PH 6/15. The anterior chamber depth on both eyes was in accordance with Van Herick (VH) III. The irises of both eyes were irregular, coloboma inferiorly, and had posterior synechiae. Both eye lenses appeared cloudy with iris pigment and also a coloboma in the inferior segment. The fundus of the right eye showed ovally nerve II (NII) papules, but borders were blurred, CDR (cup-to-disc) was hard to evaluate, and having RC. Meanwhile, the fundus of the left eye was well-defined rounded NII papilla, CDR 0.3, aa/vv 2/3, positive macular reflex, and RC inferiorly. Both eyes performed a streak and best refraction. As regard to the last procedurse, the patient felt adaptable with right and left visual aquities were 6/90 and 6/12, respectively.Conclusion: Coloboma is a congenital disorder that generally develops from an early age and can occur bilaterally. The degree of visual impairment caused by a coloboma ranges from asymptomatic to total vision loss, depending on the size and location of the defect. The excavation of the optic nerve extends usually inferiorly. Optic nerve OCT can explain a variety of optic nerve anomalies that look similar on fundoscopy alone. Additional management of this patient includes improvement of refraction in cases of low visual acuity.  Pendahuluan: Coloboma okuler  adalah kelainan kongenital yang disebabkan oleh penutupan yang tidak lengkap dan rusak pada celah embrional. Coloboma bisa muncul unilateral atau bilateral dan berkaitan dengan berbagai komplikasi pada mata, termasuk ambliopia dan gangguan refraksi.Deskripsi Kasus: Pasien laki-laki dengan umur 8 tahun mengeluh silau sejak 1 tahun yang lalu. Tidak ada keluhan mata merah dan nyeri. Keluhan tersebut dirasakan sejak pasien mulai memasuki bangku sekolah. Ibu pasien menyatakan pasien sering silau dan mata berair sejak masih bayi. Tajam penglilhatan mata kanan 1/60 pinhole not improve (PHNI) dan mata kiri 6/18 PH 6/15.  Kedalaman bilik mata depan kedua mata sesuai dengan Van Herick (VH) III. Iris kedua mata tampak iregular, disertai koloboma di inferior, dan terdapat sinekia posterior. Lensa kedua mata tampak keruh disertai pigmen iris dan juga adanya koloboma di segmen inferior. Fundus mata kanan tampak papil nervus II (NII) oval, tetapi batasnya kabur, CDR (cup-to-disc) sulit dievaluasi, dan disertai RC. Sedangkan fundus mata kiri papil NII bulat berbatas tegas, CDR 0,3, aa/vv 2/3, reflekx macula positif dan disertai RC di inferior. Kedua mata dilakukan streak dan refraksi terbaik. Paska tindakan, pasien merasa nyaman pada tajam penglihatan mata kanan 6/90 dan mata kiri 6/12.Simpulan: Coloboma adalah gangguan kongenital yang umumnya berkembang sejak usia dini dan bisa terjadi secara bilateral pada sekitar sepertiga dari pasien. Tingkat gangguan penglihatan yang disebabkan oleh koloboma berkisar dari tanpa gejala hingga kehilangan penglihatan total, tergantung pada ukuran dan lokasi defek. Ekskavasi saraf optik meluas biasanya di bagian inferior. OCT saraf optik dapat membantu menjelaskan berbagai anomali saraf optik yang terlihat serupa pada fundoskopi saja. Penatalaksanaan tambahan pada pasien ini termasuk perbaikan refraksi dalam kasus ketajaman penglihatan rendah.
      PubDate: 2022-04-19
      DOI: 10.15562/ism.v13i1.1264
      Issue No: Vol. 13, No. 1 (2022)
       
  • Teledermatology for managing COVID-19 patients with cutaneous
           manifestation: case series study in a rural primary hospital

    • Authors: Dedianto Hidajat, Hamsu Kadriyan, Slamet Tjahjono
      Pages: 217 - 220
      Abstract: Background: To provide information and experience about using WhatsApp as a tool in teledermatology to facilitate the identification, treatment, and follow-up of skin problems in COVID-19 patients hospitalized at one of a rural primary hospital located in Indonesia.Methods: All COVID-19 patients with the dermatology manifestation were included in this study. All symptoms and signs of cutaneous manifestation and teledermatology consultation aspect were recorded.Results: There were 7 cases confirmed with skin manifestation (0.9%) from 783 hospitalized patients from March 2020 to June 2021. There were 5 males and 2 females. The age range was 50 - 66 years old. Pruritus is the main complaint, followed by pain and swelling. The cutaneous lesions were mainly maculopapular, followed by papulovesicular and edematous eruptions. The onset of the lesions appeared between the 2nd and 12th day during hospitalization. Both patients and physicians feel comfortable using this platform in consultation.Conclusion: There are advantages and disadvantages to utilizing this concept in the medicolegal aspects, including non-uniform audio-visual quality and also ethical and privacy issues, especially in a rural area.
      PubDate: 2022-04-28
      DOI: 10.15562/ism.v13i1.1224
      Issue No: Vol. 13, No. 1 (2022)
       
  • Incontinentia pigmenti in neonate: a case report

    • Authors: Putu Gde Hari Wangsa, Luh Made Mas Rusyati, I Gusti Ayu Agung Dwi Karmila, Ni Luh Putu Ratih Vibriyanti Karna, Ketut Wida Komalasari, Made Hermina Laksmi
      Pages: 221 - 223
      Abstract: Background: Incontinentia pigmenti (IP) is a rare X-linked dominant inherited genodermatosis that occurs almost in females and is usually accompanied by other ectodermal tissue diseases such as the central nervous system, eyes, hair, nails, teeth and skeletal system. This case report aims to enhance understanding of incontinentia pigmenti and provide appropriate treatment to patients and proper education to families. Case report: A 3-days-od baby girl was consulted by the Pediatric department with complaints of blisters and erythematous rashes on almost her entire body with the Blaschko line distribution. The nails on the right and left big toes appeared inward. No history of fever and seizure. No family had similar complaints. There were no eye and nerve abnormalities involved. She treated with hydrocortisone 1% cream every 12 hours on erythematous papules and vesicles, open compresses with 0.9% NaCl every 8 hours for 10-15 minutes on lesions with yellowish crusts. Thus, the patient diagnosed with incontinentia pigmenti. Conclusion: The diagnosis of incontinentia pigmenti is based on history and physical examination. This case is very rare, so the family needs to understand the course of this disease. Appropriate management and education can prevent secondary infection.
      PubDate: 2022-04-30
      Issue No: Vol. 13, No. 1 (2022)
       
 
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