This Author published in this journals
All Journal Jurnal Sinaps
Arthur H.P Mawuntu
Staf, Divisi Neuroinfeksi, Neuroimunologi, dan Neuro-AIDS. Bagian/KSM Neurologi Fakultas Kedokteran Universitas Sam Ratulangi/RSUP Prof. Dr. R.D. Kandou Manado, Sulawesi Utara, Indonesia

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

IRAMA SIRKADIAN PADA STROKE AKUT: CIRCADIAN RHYTHM IN ACUTE STROKE Merry septemi Ekayanti; Muhammad Fandy Bachtiar; Arthur H.P Mawuntu
Jurnal Sinaps Vol. 2 No. 1 (2019): volume 2 Nomor 1, Februari 2019
Publisher : Neurologi Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (337.045 KB)

Abstract

Latar Belakang: Irama sirkadian mempengaruhi perilaku dan hampir setiap fungsi fisiologis manusia. Stroke dapat mengganggu irama sirkadian sampai jangka waktu tertentu. Tujuan: Mengetahui perubahan pola irama sirkadian pada stroke akut di Manado. Metode: Penelitian kohort deskriptif di RSUP Prof. dr. R.D. Kandou, Manado bulan Desember 2015-Februari 2016. Subjek dibagi menjadi kelompok stroke iskemik dan stroke hemoragik. Perubahan irama sirkadian dinilai dengan melihat perubahan tekanan darah sistolik dan diastolik, denyut nadi, dan glukosa darah dalam 72 jam pertama perawatan. Hasil: Didapatkan 35 subjek (23 stroke iskemik dan 12 stroke hemoragik). Kenaikan tekanan sistolik dan diastolik pada stroke iskemik dan hemoragik mencapai puncaknya pada pukul 04.00. Tekanan darah sistolik menurun pada pukul 20.00 dan diastolik menurun lebih awal, pada pukul 08.00. Peningkatan rerata denyut nadi mencapai puncaknya pada pukul 16.00 dan menurun pada pukul 00.00 untuk kedua kelompok. Didapatkan peningkatan rerata kadar glukosa darah pada pukul 20.00 yang menurun pada pukul 08.00 untuk kedua kelompok. Diskusi: Pola diurnal dan nokturnal irama sirkadian untuk tekanan darah dan kadar glukosa darah masih terlihat tetapi nilai lonjakannya lebih tinggi daripada pola normal. Denyut nadi tidak mengalami perubahan berarti dibandingkan dengan pola normal. Umumnya irama sirkadian kembali normal setelah stroke melewati masa akut. Kata kunci : irama sirkadian, stroke akut, tekanan darah, nadi, glukosa darah. ABSTRACT Background: Circadian rhythm affects human behavior and almost all physiological functions. Stroke could disrupt the circadian rhythm until a certain period. Aim To learn the changes of circadian rhythm in acute stroke in Manado. Method: Descriptive cohort study conducted in R.D. Kandou hospital in Manado in December 2015-February 2016. Subjects were divided to ischemic stroke and hemorrhagic stroke groups. Changes in circadian rhythm was assessed by measuring the changes in systolic and diastolic blood pressures, heart rate, and blood glucose level within the first 72 hours of admission. Result: There were 35 subjects (23 ischemic stroke and 12 hemorrhagic stroke). The increase of systolic and diastolic blood pressures in ischemic and hemorrhagic stroke reached their peak at 04.00 am. Systolic blood pressure decreased at 08.00 pm while diastolic blood pressure decreased earlier at 08.00 am. The increase in average heart rate reached its peak at 04.00 pm and decreased at 00.00 am in both groups. There was an increase in the average blood glucose level at 08.00 pm that decreased at 08.00 am in both groups. Discussion: Diurnal-nocturnal pattern of circadian rhythm for blood pressure and blood glucose was still present but the spike was higher than normal. In general, the circadian rhythm returned to normal after stroke surpassed the acute period. Keywords: circadian rhythm, acute stroke, blood pressure, heart rate, blood glucose.
ANALISIS BIAYA SATUAN PASIEN MENINGITIS TUBERKULOSIS YANG DIRAWAT INAP DI RSUP PROF. DR. R. D. KANDOU MANADO: UNIT COST ANALYSIS OF TUBERCULOUS MENINGITIS PATIENTS ADMITTED IN R.D. KANDOU HOSPITAL MANADO Anugrah Febriantama; Sekplin A.S Sekeon; Edward Nangoy; Christoffel M.O Mintardjo; Arthur H.P Mawuntu
Jurnal Sinaps Vol. 2 No. 1 (2019): volume 2 Nomor 1, Februari 2019
Publisher : Neurologi Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.577 KB)

Abstract

Latar Belakang:Meningitis tuberkulosis (TB) banyak ditemukan di Indonesia dan perawatan pasiennya memerlukan biaya yang cukup besar. Untuk uji diagnostik awal, World Health Organization merekomendasikan pemeriksaanXpert MTB/Rif cairan serebrospinal. Namun demikian, analisis biaya satuan belum pernah dilakukan untuk kasus ini di RSUP. Prof. dr. R.D Kandou (RS RDK).Kami hendakmengetahui biaya satuan pasien meningitis TB di RS RDK, tanpa dan dengan menggunakan pemeriksaanXpert MTB/Rif. Metode: Dilakukan analisis biaya satuan dengan metode satu langkah.Biaya langsung dihitung dengan melihat data rekam medis dan billing system pasien meningitis TB nonoperatif yang dirawat inap di RS RDK tahun 2017.Biaya tidak langsung diestimasi dari hasil wawancara metode semi-structured interview pada responden yang sesuai. Biaya satuan dihitung dari penjumlahan rerata biaya dari setiap komponen biaya yang ditemukan. Dicatat juga biayakomponen tertinggi dan terendah masing-masing. Hasil: Didapatkan 25 subjek yang memenuhi kriteria penelitian. Persentase laki-laki 60% dengan rerata usia 46tahun dan rerata lama rawat adalah 12 hari. Biaya satuan langsung adalah Rp.14.779.178 dan biaya satuan tidak langsung Rp. 3.369.767. Biaya pemeriksaan Xpert MTB/Rif di RS RDK ditanggung oleh pemerintah tetapi pemeriksaan dari sampel cairan serebrospinal belum dapat dikerjakan. Kesimpulan: Biaya satuan meningitis TB di RS RDK lebih besar dari paket Indonesian Case-Based Group dengan selisih Rp. 1.564.278. Pemeriksaan Xpert MTB/Rif tidak dikenakan biaya sehingga perbedaannya dapat diabaikan. Kata kunci: Meningitis tuberkulosis, biaya satuan, Xpert MTB/Rif, Manado. ABSTRACT Background: Tuberculous (TB) meningitis is commonly seen across Indonesia and its treatment requires a huge cost. World Health Organization recommends the utilization of Xpert MTB/Rif from the cerebrospinal fluid as the initial diagnostic test. However, the unit cost analysis for this case has never been done in Kandou Hospital. We intend to find out the unit cost of TB meningitis patient in R.D. Kandou Hospital, without and with the utilization of Xpert MTB/Rif. Method: We performed a unit cost analysis using the simple distribution method. Direct cost was calculated from medical record and billing system data of nonsurgical TB meningitis patients admitted in Kandou Hospital in the year 2017. Indirect cost was estimated from the result of interviews using the semi-structured interview method on appropriate respondents. Unit cost was calculated from the sum of average costs from each cost component found. The highest and lowest cost for each cost component were also recorded. Result: We found 25 eligible subjects. The male percentage was 60% with average age 46 years old and average length of stay 12 days. The direct unit cost was Rp. 14.779.178 and the indirect unit cost was Rp. 3.369.767. The cost of the Xpert MTB/Rif examination was paid by the government, but the cerebrospinal fluid sample was still unable to be tested. Conclusion: The unit cost of TB meningitis in Kandou Hospital was higher than the Indonesian Case-Based Group package with Rp. 1.564.278 cost difference. The Xpert MTB/Rif examination was not charged so the difference is negligible. Keywords: Tuberculous meningitis, unit cost, Xpert MTB/Rif, Manado.