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LAPORAN KASUS : OBSTRUKSI INTESTINAL TOTAL YANG DISEBABKAN OLEH ENDOMETRIOSIS INTESTINAL DAN ENDOMETRIOSIS UTERUS PADA WANITA 43 TAHUN DI RUMAH SAKIT ABDUL MOELOEK LAMPUNG Risal Wintoko; Wina Nazula Makrufa
Medula Vol 10 No 3 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i3.115

Abstract

Intestinal endometriosis is a disorder where the endometrium glands and stroma grow outside the uterus. Endometriosis could involve various intraperitoneal and extraperitoneal organs. Endometriosis occurs on the gastrointestinal organs in 3-15% women in reproductive age. The most common organs involved were rectosigmoid colon (71%), appendix (19%), terminal ileum (6.7%), caecum (5.5%) and transversal colon. Endometriosis mostly occurs in age group 40-44 years old (26,4%). Symptoms that usually happen in endometriosis are bleeding outside the menstrual cycle, pain during menstruation, pain during intercourse, pain during defecation, and pain during urination. In addition, usually there is pain on the hips before menstruation. Symptoms of intestinal endometriosis are pain on the abdomen and pelvis, constipation, diarrhea, enlarged abdomen, mucus in the stool, rectal bleeding, nausea, vomiting and intestinal obstruction. In this case report, a 43 years old woman with total intestinal obstruction due to intestinal endometriosis and uterine endometriosis. Patient were given laparotomy and found cystic masses in ileum, mesentrium, caecum, and uterus. Therapies given in this case are hysterectomy, resection of the terminal ileum until tranversal colon, and as well as end-to-end anastomose ileum and transversal colon. After a successful surgical therapy, hormonal suppression therapy is given to prevent recurrence.
Frozen Shoulder Anggun Budi Wardani; Risal Wintoko
Medula Vol 11 No 2 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i2.297

Abstract

Frozen shoulder or also known as adhesive capsulitis is a shoulder pain disorder that It is caused by thickening and tightening of the connective tissue capsule around the shoulder joint. The most common risk factors are age > 40 years, women > men as much as 70%, recent trauma such as surgery or fracture of the arm can cause immobility during recovery. Typical in frozen shoulder, there is progressive shoulder stiffness, severe pain (especially at night) and almost complete loss of passive and active external rotation of the shoulder. In the history, it is necessary to know the onset and duration of symptoms, location, function, and previous trauma. On physical examination, deltoid and supraspinatus atrophy can be found in the old case, the arm can be adducted and turned inward and painful when pressed. Plain radiography, ultrasound, and MRI investigations. Management is carried out both non-operatively to help relieve pain and relieve inflammation in the early phase by administering NSAIDs, corticosteroids (oral/injection), physiotherapy and cryotherapy. Surgical management may be considered if previous conservative efforts have failed.
LITERATURE REVIEW: Pengaruh Penerapan Protokol ERAS (Enhanced Recovery After Surgery) Terhadap Length of Stay pada Pasien Pasca Pembedahan Miladina Zahra Aulia; Risal Wintoko; Sutyarso Sutyarso; Anggraeni Janar Wulan
Medula Vol 13 No 3 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i3.653

Abstract

Surgery is a follow-up action of invasive emergency treatment by making an incision in a certain part of the body so that it can reach the target organ, after which it ends with closing or suturing the wound. The patient will experience the postoperative impact which is limited movement due to the pain felt after the surgical wound. Furthermore, because the patient cannot mobilize properly, it will affect wound healing. This has an impact on the patient's length of stay which is getting longer and will ultimately make the patient's quality of life worse. Patients with prolonged length of stay are at risk of developing other complications because the patient experiences a decrease in functional status during hospitalization. In addition, the impact of an extended length of stay can increase the financing burden for the hospital. Therefore, efforts are needed to accelerate effective post-surgical healing by implementing the ERAS (Enhanced Recovery After Surgery) protocol. ERAS is a multidisciplinary-based perioperative management protocol with the aim that postoperative patients experience immediate recovery by maintaining postoperative organ function, reducing stress response during surgery, and reducing morbidity in surgery. In several studies, the length of stay of postoperative patients applying the ERAS protocol was shorter than that of patients who did not use the ERAS protocol. This is because in the ERAS protocol, preparations are made for patients starting from pre-admission, pre-operative, intra-operative, and post-operative, each of which has components that can have an impact on accelerating post-operative patient recovery so that the patient's length of stay becomes shorter.
Faktor-faktor yang Memengaruhi Pelaporan Insiden Keselamatan Pasien: Literature Review Salsabila Nurislami; Bayu Anggileo Pramesona; Risal Wintoko; Rasmi Zakiah Oktarlina
Jurnal Penelitian Perawat Profesional Vol 5 No 2 (2023): Mei 2023, Jurnal Penelitian Perawat Profesional
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jppp.v5i2.1436

Abstract

Pelaporan insiden dilakukan untuk menurunkan insiden dan mengevaluasi sistem keselamatan pasien. Laporan akan dikaji dan diberi umpan balik berupa rekomendasi untuk mencegah insiden yang sama terulang kembali. Namun, pada tahun 2022, tingkat pelaporan insiden di Indonesia hanya sebesar 0,22%. Studi ini bertujuan untuk mengetahui faktor apa saja yang memengaruhi pelaporan insiden keselamatan pasien. Dengan mengetahui faktor yang memengaruhi pelaporan insiden keselamatan pasien, institusi terkait dapat membuat kebijakan atau melakukan intervensi untuk meningkatkan pelaporan insiden keselamatan pasien. Tinjauan literatur ini mengunakan beberapa data base, yaitu Pubmed dan Science Direct. Artikel yang digunakan dibatasi pada artikel yang relevan dengan tujuan, artikel tentang pelaporan insiden, artikel penelitian, dan dipublikasikan pada 5 tahun terakhir yaitu 2017-2022 sehingga diperoleh enam artikel. Hasil tinjauan literatur menunjukkan faktor tersering yang berpengaruh terhadap pelaporan insiden yaitu rasa takut, pengetahuan dan pelatihan, umpan balik, serta perbaikan. Faktor-faktor yang berpengaruh terhadap pelaporan insiden keselamatan pasien secara umum berasal dari tiga faktor, yaitu faktor individu, faktor psikologi, dan faktor organisasi.
Ewing Sarkoma: Ulasan Singkat Keganasan: Indonesia Rafi Gutra Aslam; Helmi Ismunandar; Risal Wintoko; Exsa Hadibrata; Anisa Nuraisa Jausal
Medula Vol 13 No 5 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i5.336

Abstract

A malignancy that identified first by James Ewing in 1921. Ewing sarcoma is a malignancy of the bones caused by abnormal activity of progenitor cell mesenchymal occurs by a genetic factor where the patient had a combination of translocation chromosome non-random in t(11; 22) (q24;q12) or t(21; 22) (q22; q12). The patient will have pathognomonic findings of periosteal reaction similar to "Onion skin", lesions like “Moth-eaten”, and “Codman’s Triangle” in radiology findings. Second highest malignancy bone prevalent worldwide after osteosarcoma. This malignancy occurs commonly in the male gender, incidence peaked in the approximately first decade in life with a prognosis range of about 5 years more or less. The malignancy occurs in the metaphysis-diaphysis part of the bone that has a variety of prognoses based on stage, metastasis, and therapy. Literature Review method is used in this article writing by article, journal, and book that review shortly about Ewing sarcoma from multi-aspect of etiology, epidemiology, pathogenesis and pathophysiology, clinical manifestations, treatment, staging, prognosis, complication, and education as the last topic. Prognosis of Ewing Sarcoma patient will be better if given multimodal therapy including chemotherapy, radiotherapy, and operation that adjusted with the condition in every patient. Nevertheless, further research is needed about best treatment in goals to extend patient survivability and enhance prognoses approximately in 3 years.