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VIPERIDAE SNAKE BITE: KASUS SERIAL Alfi Rizky Medikanto; Lothar Matthaeus Manson Vanende Silalahi; Sri Sutarni
Berkala Ilmiah Kedokteran Duta Wacana Vol 2, No 2 (2017): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (520.361 KB) | DOI: 10.21460/bikdw.v2i2.61

Abstract

Latar Belakang: Gigitan ular merupakan salah satu kegawatdaruratan medis dan penyakit akibat okupasi yang sering diabaikan oleh tenaga medis, paramedis maupun pemangku kebijakan kesehatan sehingga sangat terbatas untuk dipelajari karena sistem pelaporan yang lemah. Ular golongan Viperidae sering ditemukan di wilayah Asia Tenggara memiliki bisa dengan kandungan hematotoksin dengan mekanisme aktivasi faktor koagulasi, trombositopenia, hiperfibrinolisis, dan koagulasi intravaskular luas. Laporan Kasus: Dilaporkan dua kasus gigitan ular golongan Viperidae. Kasus pertama seorang pria, 73 tahun datang dengan gigitan ular pada pergelangan kaki kiri. Pasien mengalami penurunan kesadaran, anemia, koagulopati, insufisiensi renal, dan perdarahan saluran kemih. Pemeriksaan funduskopi dan CT scan kepala tidak didapatkan perdarahan. Kasus kedua adalah seorang pria, 58 tahun datang dengan gigitan ular pada pergelangan kaki kanan. Pasien mengalami penurunan kesadaran, anemia, gangguan fungsi hati, koagulopati, perdarahan saluran kemih, dan hiponatremia. Kesimpulan: Manifestasi klinis gigitan ular Viperidae dapat berefek pada sistem koagulasi dan jika tidak ditangani dengan tepat dapat menyebabkan gangguan sistem saraf pusat, kardiovaskular dan urogenital
SINKOP PADA PASIEN STROKE VERTEBROBASILER Erupsi Ana; Sri Sutarni
Berkala Ilmiah Kedokteran Duta Wacana Vol 3, No 1 (2018): BERKALA ILMIAH KEDOKTERAN DUTA WACANA
Publisher : Faculty of Medicine Universitas Kristen Duta Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (738.06 KB) | DOI: 10.21460/bikdw.v3i1.82

Abstract

Sinkop merupakan penyakit yang umum terjadi di masyarakat. Sinkop adalah kehilangan kesadaran sementara dengan awitan akut yang diikuti dengan jatuh, dan pemulihan spontan sempurna tanpa intervensi. Sinkop merupakan gejala dari suatu penyakit sehingga harus dicari etiologinya. Salah satu penyebab sinkop adalah kelainan sentral atau neurologis berupa insufisiensi vertebrobasiler, TIA, dan kelainan jantung.Case report. Laki- laki usia 67 tahun, seorang pegawai swasta, datang dengan post sinkop. Terdapat kelemahan anggota gerak kanan, paresis N. VII (S) UMN dan paresis N XII (S) UMN. Wanita usia 57 tahun, seorang ibu rumah tangga, datang dengan dizziness akut, dengan riwayat penyakit jantung, diabetes mellitus dan vertigo. Terdapat nistagmus horizontal fase cepat ke kiri dan hiperkolesterolemi.Mengetahui bahwa sinkop adalah sebuah gejala penyakit yang harus dicari penyebabnya, karena bisa berakibat kematian.Sinkop adalah salah satu tanda stroke infark yang berkaitan dengan jantung.
HUBUNGAN INTERNET GAMING DISORDER DENGAN GANGGUAN ATENSI DAN MEMORI PADA SISWA SMP DI DAERAH PERDESAAN DI YOGYAKARTA Cempaka Thursina; Sri Sutarni; RA Yayi Suryo Prabandari; Retno Sutomo; Carla Raymondalexas Machira; Alfi Rizky Medikanto
Callosum Neurology Vol 4 No 1 (2021): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v4i1.94

Abstract

Latar belakang: Internet gaming merupakan kejadian yang merambak dan menjadi hal yang lazim di seluruh dunia. Seiring itu pula, timbul keresahan terkait internet gaming, yaitu peningkatan jumlah gamers yang teradiksi. Maka dari itu, penelitian ini dlakukan untuk mengenal internet gaming disorderi(IGD) terutama di daerah perdesaan di Yogyakarta. Modified Children Mini Mental Status Examination(MMMSEC) merupakan alat ukur yang dipakai dalam pengukuran fungsi kognitif maupun atensi pada anak-anak. Tujuan Penelitian: Untuk mengetahui hubungan antara nilai MMMSEC bagian atensi, dan memori dengan IGD pada siswa SMP di daerah perdesaan, Yogyakarta Metode Penelitian: Metode menggunakan studi potong lintang di sejumlah SMP di daerah perdesaan Bantul, Yogyakarta pada Mei-Juni 2019. Subyek penelitian kemudian dilakukan assessment terhadap kejadian IGD, dan setelah itu dilanjutkan dengan assessment. Didapatkan total 74 subyek penelitian dengan 37 subyek dengan IGD, dan 37 merupakan subyek kontrol. Hasil: Prevalensi dari siswa SMP yang terkena IGD yaitu 8.2% di daerah perdesaan di Yogyakartan,. Terdapat 74 subyek penelitian, sebanyak 64.9% laki-laki dan 35.1% perempuan. Analisis non parametrik dengan Mann-Whitney hasil MMMSEC antara IGD dan kontrol mendapatkan hasil yang bermakna di penilaian atensi (p value =0.00), dan nilai total (p value=0.029), sedangkan pada penilaian orientasi, registrasi, recall dan bahasa tidak didapatkan hasil yang bermakna. Hasil analisist terhadap perbedaan nilai MMSMEC pada jenis kelamin tidak mendapatkan hasil yang bermakna. Simpulan: Terdapat hubungan antara nilai MMSMEC pada bagian atensi, dan total dengan IGD pada siswa SMP di perdesaan Yogyakarta. Kata Kunci: Internet Gaming Disorder, IGD, MMMSEC, Atensi, Memori
LAPORAN KASUS: VERTIGO PADA PASIEN STROKE ISKEMIK VERTEBROBASILER DAN SYOK HIPOVOLEMI Hanifah Hayati; Sri Sutarni
Callosum Neurology Vol 3 No 2 (2020): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2713.593 KB) | DOI: 10.29342/cnj.v3i2.110

Abstract

Latar Belakang: Vertigo merupakan gejala yang paling sering timbul pada stroke iskemik vertebrobasiler. Mekanisme penyebab yang paling sering adalah emboli. Syok hipovolemi pada stroke iskemik vertebrobasiler merupakan kasus yang jarang terjadi. Laporan Kasus: Seorang wanita usia 56 tahun datang ke IGD dengan keluhan lemas dan pusing berputar onset akut. Pusing berputar dirasakan terus menerus, intensitas sedang, disertai mual, muntah dan keringat dingin. Sejak 5 hari sebelum masuk rumah sakit, dikatakan oleh keluarga pasien mengalami penurunan nafsu makan dan minum. Pada pemeriksaan fisik didapatkan hipotensi, paresis nervus VII dan XII dextra UMN, hemiparese dextra, dan refleks babinski bilateral. Positif hasil radiologi CT scan kepala menunjukan iskemik lakunar di medulla oblongata, laboratorium ditemukan adanya hemokonsentrasi, imbalans eletrolit, hiperglikemi, dan penurunan fungsi ginjal. Pasien diberikan rehidrasi intravena, balans cairan, antiplatelet dan terapi simptomatis sesuai keluhan. Diskusi: Stroke iskemik vertebrobasiler disebabkan oleh mekanisme embolik, trombotik, atau hemodinamik. Penyebab mekanisme hemodinamik adalah penurunan aliran darah sistem vertebrobasiler yang sering terjadi pada usia tua. Pada pasien ini terdapat gangguan hemodinamik yaitu hipotensi akibat syok hipovolemik sehingga aliran darah menuju otak berkurang. Kondisi hipovolemi yang parah akan menyebabkan iskemik otak yang diperberat oleh aritmia dan hiperglikemi. Kesimpulan: Vertigo sebagai gejala utama stroke iskemik vertebrobasiler merupakan kasus yang memiliki tingkat mortalitas dan morbiditas tinggi. Iskemik pada kasus ini kemungkinan disebabkan oleh syok hipovolemi dan diperberat adanya aritmia jantung. Penting bagi klinisi untuk dapat mendiagnosis dan memberikan terapi dengan tepat pada pasien stroke vertebrobasiler . Kata Kunci: Vertigo, Stroke Vertebrobasiler, Syok Hipovolemik
Hubungan timbal dan krom pada pemakaian pewarna batik dengan kadar hemoglobin dan packed cell volume pada pengrajin batik di Kecamatan Lendah Kulon Progo Pramudji Hastuti; Sunarti Sunarti; Prasetyastuti Prasetyastuti; Ngadikun Ngadikun; Tasmini Tasmini; Dianandha Septiana Rubi; Sri Sutarni; Indrasari Kusuma Harahap; Kusumo Dananjoyo; Suhartini Suhartini; Ida Bagus Gd. Surya Putra Pidada; Hendro Widagdo; Martiana Suciningtyas
Journal of Community Empowerment for Health Vol 1, No 1 (2018)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (822.051 KB) | DOI: 10.22146/jcoemph.39156

Abstract

ABSTRAK Cara membatik di Indonesia mulai banyak beralih dari pemakaian bahan alami menjadi bahan cat sintesis. Cat sintetis yang digunakan sering kali mengandung logam berat di antaranya timbal (Pb) dan kromium (Cr). Pemakaian logam berat dalam waktu lama akan mengganggu kesehatan. Penelitian ini dilakukan untuk melihat hubungan kadar logam Pb dan Cr dalam darah dan limbah dengan kadar hemoglobin (Hb) dan packed cell volume (PCV) serta mengetahui prevalensi gejala toksisitas yang dirasakan pada pekerja di tiga sentra batik di Kecamatan Lendah Kulon Progo. Sebanyak 76 pegawai di tiga sentra batik terdiri atas 37 orang dari sentra SB, 20 orang dari FA dan 19 orang dari SA ditentukan kadar Hb, PCV, kadar Pb dan Cr-nya dengan metode inductively coupled plasma (ICP). Air limbah lingkungan dari ketiga lokasi sentra batik diambil dan diperiksa kadar Pb dan Cr-nya. Hasil antara ketiga lokasi diujinormalitasnya dan dianalisis dengan analisis varian atau Kruskal-Wallis. Hubungan antara kadar Pb dan Cr baik darah maupun limbah dengan kadar logam berat dalam darah dianalisis dengan uji korelasi Pearson atau Spearman. Hasil dinyatakan berbeda bermakna jika p < 0,05. Gejala penyakit yang dialami pekerja yang diperkirakan berhubungan dengan toksisitas logam berat dihitung frekuensinya. Hasil pemeriksaan antropometri, tekanan darah, kadar Hb, PCV dan logam berat dari ketiga lokasi yang diperiksa tidak berbeda bermakna (p > 0,05). Kadar Pb darah dan krom di sentra SB dan FA berbeda bermakna dengan di sentra SA (p < 0,05). Tidak terdapat korelasi yang signifikan secara statistik antara kadar Pb darah, Cr darah, dan Pb limbah dengan kadar Hb dan PCV. Gejala iritasi kulit, pusing, dan nyeri sendi dirasakan oleh 36,8-48,7% responden. Kadar timbal dan krom darah pembatik di sentra SB dan FA lebih tinggi dari pada di sentra SA. Tidak terdapat hubungan bermakna antara toksisitas Pb dan Cr dengan kadar Hb dan PCV. Gejala toksisitas di antara pekerja batik diperkirakan dapat terjadi karena toksisitas logam berat kronis akibat pemakaian cat batik. KATA KUNCI batik; hemoglobin; kromium; sel darah; timbal ABSTRACT The dye used to color batik has changed from natural to synthetic materials in several places in Indonesia. Synthetic paints often contain heavy metals including lead (Pb) and chromium (Cr). Chronic use of heavy metals can affect health. This study was conducted to examine the relationship between blood and waste water levels of Pb and Cr with hemoglobin (Hb) and packed cell volume (PCV), and to determine how many workers felt the toxicity symptoms in three batik centers in Lendah, Kulon Progo. A total of 76 batik center employees, consisted of 37, 20, and 19 people from the SB, FA, and SA centers were recruited. Determination of Hb, PCV, Pb and Cr levels were conducted with the inductively coupled plasma (ICP) method. Waste water from the three batik centers is taken and examined. The data were analyzed by Oneway ANOVA or Kruskal-Wallis. Correlation analyses were performed with Pearson or Spearman correlation test. Results were considered significant if p < 0.05. Disease symptoms experienced by workers that were estimated to be associated with heavy metal toxicity were calculated in frequency. Anthropometrics, blood pressure, Hb levels, PCV and heavy metals levels were not significantly different between centers (p>0.05). Blood Pb and Cr from the SB and FA were significantly different from those at the SA center (p<0.05). There were no statistically significant correlations between blood Pb levels, blood Cr, and Pb waste with hemoglobin and PCV levels. Symptoms of skin irritation, dizziness, and joint pain were felt by 37-49% of respondents. Blood levels of Pb and Cr in the SB and FA centers are higher than in the SA centers. There was no significant correlation between Pb and Cr toxicity with hemoglobin and PCV levels. Symptoms of toxicity among batik workers are thought to occur due to chronic heavy metal toxicity due to the use of synthetic paint.KEYWORDS batik; haemoglobin; chromium; blood cell; plumbum
Karakteristik limbah dan dampaknya bagi kesehatan pembatik di Lendah, Kulon Progo Suhartini - suhartini; Sri Awalia Febriani; IBG. Surya Putra Pidada; Hendro Widagdo; Martiana Suciningtyas; Yudha Nurhantari; Dewanto Yusuf Priyambodo; Agus Surono; Roto Roto; Geraldine Nadita Putri Kinasih; Pramudji Hastuti; Sri Sutarni
Journal of Community Empowerment for Health Vol 2, No 2 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.42250

Abstract

Synthetic batik coloring often uses heavy metals element such as lead (Pb), chromium (Cr),silica (Si), and hydrochloric acid (HCl). The exposure of heavy metals in long period results in health impair on the artisans and eventually harming the environment. The purpose of this research is to analyze the waste characteristics and health impact towards the artisans in the Lendah, Kulon Progo. Seventy-six batik artisan, consisting of 37 from SB, 20 from FA, and 19 from SA underwent 5 ml blood sampling. The samples were used to determine their hemoglobin (Hb) level, packed cell volume (PCV), blood sugar, and total cholesterol. Blood plasma and wastewater were examined for Pb and Cr using the inductively coupled plasma (ICP) method; Si using atomic absorption spectrophotometry (AAS); and Cl- using spectrophotometry. Respondents underwent health checks and were interviewed about the impact of waste and disease complaints experienced using a questionnaire. Cognitive disorders were examined using mini-mental state examination (MMSE) and peripheral neuropathy was assessed using diabetic neuropathy symptom (DNS) score. The results obtained were analyzed by analysis of variance and t-test. Correlation test was used to examine the relationship of Pb and Cr with cognitive disorders. Total cholesterol levels and blood sugar were analyzed descriptively. There is no difference in knowledge about waste in batik makers in SB, FA, and SA. The level of Pb, Cr, and Cl- within the three production centers showed no significant difference (p > 0,05), whilst Si level showed significant difference between centers (p < 0,05). There is no correlation between Pb and Cr blood levels with cognitive impairing according to MMSE and occurence of peripheral neuropathy according to DNS score (p > 0.05). Normal cholesterol levels (< 200mg/dL) andnormal blood glucose levels (< 200 mg/dL) were observed in 70.0-80.5% and 85.0-95.1% batik artisans, respectively. Si levels in all three production centers’ waste shows significant difference. The most frequent complaint was back pain and dizziness. There is no correlation caused by Pb and Cr levels toward cognitive impairing. Cholesterol level in batik artisans tended to be high.
Perbandingan kadar merkuri, kreatinin, dan urea pada pekerja industri di Kotagede dan Banguntapan, Yogyakarta sebagai indikator pencemaran Pramudji Hastuti; Sri Sutarni
Journal of Community Empowerment for Health Vol 2, No 2 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.42654

Abstract

Study from the Environmental Office of Yogyakarta, indicates in Kotagede found the pollution of mercury from the environment because of improper disposal of wastewater. This study aims to assess the levels of mercury, creatinine and urea in the serum and urine of people working in several industries in Kotagede and Banguntapan. Subjects of this study were 52 employees in several industries in Kotagede Yogyakarta with a range of ages between 20 - 71 years and length of work between 3 - 38 years. A total of 42 people with the age range was 21 - 63 years and the length of work between 1 - 20 years were taken from industrial employees in Bantul who have almost the same geographical conditions as Kotagede. Determination of mercury levels using the Atomic Absorption Spectrophotometry (AAS) method while the determination of urea and creatinine levels by a Dyasis kit. In Kotagede, there were 3 people (5.8%) with the average mercury serum of 0.217 ppb and no mercury in the urine was found in all subjects. In Banguntapan, one person (2.4%) had 0.200 ppb mercury serum and 6 people (14.3%) had an average mercury urine level of 0.395 ppb. Urine creatinine and urea levels in subjects from Kotagede were higher than those from Banguntapan (p<0.05), despite being on the normal range. The presence of mercury in several industrial employees in Kotagede and Banguntapan is still on the low range even though it was correlated to creatinine levels.
Nyeri Sebelum Kemoterapi sebagai Prediktor Rendahnya Kualitas Hidup Penderita Leukemia Limfoblastik Akut (LLA) Anak-Anak RIVAN DANUAJI; SRI MULATSIH; SRI SUTARNI
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v4i2.90

Abstract

Chemotherapy and stem cell transplantation are the main therapy in childhood leukemia. Pain is one of symptom that may occur in acute lymphoblastic leukemia (ALL) and may influence quality of life (QOL). The aim of this study is to determine correlation between pain before chemotherapy and the QOL of children with ALL. A cohort retrospective study was conducted. Quality of life was measured by PedsQLTM 3,0 version. Univariate analysis showed 7 factors as predictor of QOL. There were age, fathers and mothers education, family income, risks group, pain after and before chemotherapy. Multivariate analysis showed family income (RR: 1,61; 95% CI: 1.50 17.29) and pain after chemotherapy (RR: 3.24, 95% CI: 1.36 7.68) were significantly influenced ALL childhoods QOL. Pain before chemotherapy could be used as a predictor of ALL childhoods QOL. Family income and pain after chemotherapy was independent predictor.
Toksisitas merkuri sebagai faktor risiko epilepsi anak Sri Sutarni
Berita Kedokteran Masyarakat (BKM) Vol 21, No 4 (2005)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.3669

Abstract

Background: Mercury (Hg) is one of the heavy metal which uses to make silver handicraft. Kotagede in special regency of Yogyakarta is one of the place to product that. The side effect of mercury consists of a few aspects of neurological deficits as epilepsy. The aim of this paper: want to know the risk factors of mercury to epilepsy in children with Hg exposure. Methods: by case control design to be taken the children from integrity health care Semoyan, Kotagede. As control group the children of integrity health care Pondok Suruh, Cangkringan. Result: 45 children consist of 21 (46,67%) with epilepsy from WHO diagnose. Thirtheen male (28,89%) and 8 female (17,78%) samples compare with control group. The most common age was 1-5 years ofd: 14 children (31,11%) pregnant fess from 9 months: 9 children (20%), birth of body weight = 2,5 kg: 11 children (24,44%). Twelve children (26,67%) was born by doctors. Incomplete immunization of 12 children (26,67%), water for drink were wheel of 11 children (24,22%) and parents as silvers handicraft of 16 children (35,56%).By univariate analysis the Odds Ratio of each variable which significant correlation to epilepsy: irregular control of pregnancy (OR = 11,667; 95% C.i 2,373 — 57,365 p = 0,01) pregnancy < 9 months (OR 27,353; 95% C.i 3,320 —225, 365; p = 0,00). incomplete immunization (OR = 7,00; 95% C.i 1,993 — 24.581; p = 0,01), the parents as silver handicraft (OR = 11,88; 95% C.i 2,442 — 38,267, p 0,00).By multivariate analysis: immunization and the parents workers were significant to be epilepsy. Conclusions: Hg exposure could influence to child neurological aspects as epilepsy. Vaccination and the parent's workers as silver handicrafts must be careful for prevention of child epilepsy. Suggestions: Complete vaccination to the children less than 5 years old especially for silver handicraft workers and environment of Hg exposure. To protect environment and people who lived with Hg exposure. Keywords: mercury, epilepsy, children, exposure
A report of two cases of type 2 diabetes mellitus (T2DM): happy and longevity Hemi Sinorita; Sri Sutarni; Abdul Gofir
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 4 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005404202211

Abstract

Chronic hyperglycemia in patients with type 2 diabetes mellitus (T2DM) is associated with the development of complications and the increase of risk of mortality. Patients with T2DM have a shorter life expectancy than non-diabetic population. It is attributed to cardiovascular disease, stroke, renal disease, and infection. Depression secondary to T2DM worsens the quality of life. On the contrary, positive emotions correlated strongly with long life expectancy. A number of mechanisms might explain this correlation. We reported two geriatric patients over 80 y.o. with T2DM comorbidity for more than 20 years. Discussion point of these cases is the subject’s longer life span compared to the average diabetic patient’s life expectancy and great quality of life despite the disease burden of chronic hyperglycemia in T2DM and cardiovascular risk.