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Sindrom Hepatorenal pada Anak Yusri Dianne Jurnalis; Yorva Sayoeti; Julinar Julinar
Jurnal Kesehatan Andalas Vol 1, No 3 (2012)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v1i3.88

Abstract

Abstrak Latar belakang:Sindrom hepatorenal (SHR) merupakan suatu keadaan dimana terjadinya gangguan fungsi ginjal pada pasien sirosis hepatis tahap lanjut. Sindrom ini mempunyai karakteristik terjadinya penurunan GFR tanpa adanya kelainan yang lain pada ginjal. Hal yang mendasar penyebab SHR ini adalah terjadinya vasokonstriksii ginjal dan vasodilatasi perifer, tidak disertai protein uria dan kelainan histologi ginjal. Diagnosis SHR ditegakkan pada pasien sirosis hepatis dengan gangguan fungsi ginjal dengan menyingkirkan penyebab lain kelainan ginjal. Tatalaksana dengan menggunakan vasokonstriktor perifer yang dikombinasi dan albumin intravena dapat memperbaiki fungsi ginjal, akan tetapi transplantasi hati tetap merupakan terapi definitif untuk memperpanjang harapan hidup. Prognosis pasien dengan SHR ini buruk, harapan hidup pada bulan pertama hanya 50% dan 6 bulan kemudian hanya 20%. Kata kunci: Sindrom hepatorenal, sirosis hepatis, gangguan fungsi ginjal. Abstract Background: Hepatorenal syndrome (HRS) is functional renal impairment that occurs in patient with advanced liver cirrhosis. It is characteristized by marked reduction in GFR (glomerulous filtration rate) in the absence of other cause of renal failure. The hallmark of HRS is intense renal vasoconstriction with predominant peripheral arterial vasodilation, absence of proteinuria or histological change in kidney. HRS is diagnosis by exclusion and all other cause of acute renal injury in patient advanced liver disease. Management requires combined use of splanchnic and peripheral vasoconstrictor in combination with intravenous albumin may improve renal function in HRS. How ever liver transplantation is the only definitive way of improving long term outcome. The prognosis for patient with cirrhosis and renal failure is poor. The overall survival is approximately 50% at 1 month and 20% at 6 month. Keywords:Hepatorenal syndrome, liver cirrhosis, renal impairment.
ATRESIA BILIER Julinar Julinar; Yusri Dianne Jurnalis; Yorva Sayoeti
Majalah Kedokteran Andalas Vol 33, No 2: Agustus 2009
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.577 KB) | DOI: 10.22338/mka.v33.i2.p%p.2009

Abstract

AbstrakAtresia bilier merupakan penyakit yang jarang terjadi dan penyababnya belum diketahui secara pasti. Karakteristik dari penyakit ini adalah terjadinya inflamasi progresif pada duktus bilier sehingga terjadi obstruksi ekstrahepatal yang akhirnya dapat menyebabkan fibrosis dan sirosis hepar. Atresia bilier ada 2 tipe yaitu: 1.) Syndromic atau fetal, disertai beberapa kelainan kongenital (10-20%). 2.) non syndromic, tanpa disertai kelainan kongenital yang lain (80-90%). Atresia bilier akan berakibat fatal tanpa penanganan yang cepat. Kelainan ini dapat ditangani dengan metode operasi Kasai prosedure yang dapat mengalirkan kembali aliran empedu hampir 80% jika dilakukan secepatnya, gold periode >60 hari. Diagnosis dini sangat penting untuk keberhasilan operasi Kasai. Pada penulisan ini akan dilaporkan sebuah kasus atresia bilier tipe fetal, seorang anak laki-laki berusia 58 hari, dengan keluhan tampak kuning sejak usia 3 minggu disertai dengan buang air besar berwarna pucat, buang air kecil berwarna seperti teh pekat. Diagnosis ditegakkan berdasarkan gejala klinis, laboratorium, USG dan biopsi hepar yang sangat mendukung diagnosis atresia bilier. Operasi Kasai tidak efektif karena disertai dengan komplikasi kholangitis yang akhirnya menyebabkan sirosis hepatis pada 5 bulan kehidupan.Kata kunci : Atresia bilier, Kasai procedure, kholangitis, sirosis hapatisAbstractBiliary atresia is a disease of unknown etiology, characterized by progressive fibro inflammatory of the bile duct and liver that result obstruction of extrahepatic bile duct, leading to the fIbrosis and liver cirrhosis. It has two form of biliary atresia : 1.) syndromic of fetal biliary atresia (10-20%) with various congenital anomalies, 2.) non syndromic biliary atresia (80-90%) with isolated anomaly. In this case we report on an infant with the second form of biliary atresia, with diagnosis and operation was not based on liver biopsy, but on clinical features, laboratorium finding and USG, that were a highly suggestive of fetal form of biliary atresia. A boy 58 days infant with fetal biliary atresia. He developed jaundice in 3 weeks of life, pale stool, dark urine, and liver was palpable. Kasai operation was not effective because he had cholangitis complicated and developed liver cirrhosis at five month of age. Fetal EHBA (Extra Hepatic Biliary Atresia) with worse outcome after Kasai procedure becauseLAPORAN KASUS189of cholangitis complicated. Early diagnosis EHBA is very important for succesfull of Kasai procedure.Key words: biliary atresia, kasai, Cholangitis, liver cirrhosis
Faktor-Faktor Yang Berhubungan dengan Kelengkapan Imunisasi Dasar pada Bayi di Puskesmas Ulee Kareng Julinar Julinar; Isfanda Isfanda; Rayhatul Jinani
Jurnal Mahasiswa Ilmu Kesehatan Vol. 1 No. 3 (2023): Juli : Jurnal Mahasiswa Ilmu Kesehatan
Publisher : STIKes Ibnu Sina Ajibarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59841/jumkes.v1i3.83

Abstract

Factors Associated with Completeness of Basic Immunization for Infants at Ulee Kareng Health Center. Basic immunization is a program carried out to protect a person's body from diseases that can be prevented by immunization (PD3I) caused by viruses or bacteria, including tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, flu, measles and rubella. Based on data from the Directorate General of Disease Prevention and Management, the Indonesian Ministry of Health in 2018, ranks of Aceh Province are the lowest in basic immunization coverage, which is 70%. This study aims to determine the factors associated with completeness of immunization in infants with quantitative analytical methods with a cross sectional design approach (Cut Latitude). The study was conducted in March-July 2021 and obtained as many as 62 samples with the sampling method by accidental sampling. The results of this study indicate that there is a relationship between mother's knowledge and completeness of infant basic immunization with a p-value of 0.000, there is a relationship between mother's education and completeness of infant basic immunization with p-value of 0.000001, there is a relationship between mother's employment status and completeness of infant basic immunization p-value 0.003, and there is a relationship between family support and completeness of basic infant immunization with a p-value of 0.000. The distance to the place of immunization service does not have a relationship with the completeness of infant immunization with a p-value of 0.054. The efforts of the puskesmas in achieving immunization completeness were scored well by conducting an assessment of planning, implementation and assessment activities using a questionnaire containing 5 questions on planning, 5 questions on implementation and 5 questions on assessment. Based on the results of this study, it can be concluded that the level of knowledge, education, employment status, and family support has a relationship with the status of completeness of infant immunization. The distance to the place of immunization service does not have a relationship with the infant's immunization status. The researcher's suggestion is to do research with a larger sample and add various other variables that have a relationship with the infant's immunization status.