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All Journal e-CliniC Medical Scope Journal (MSJ) Jurnal Sosial dan Sains Jurnal Lentera: Penelitian dan Pengabdian Masyarakat Jurnal Widya Medika
Fredrik G. Langi
Universitas Sam Ratulangi
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 1 
Relationship between Serum Fibronectin and Level of Consciousness according to FOUR Score in Traumatic Brain Injury Patients Rinaldy T. Setiawan; Eko Prasetyo; Maximillian Ch. Oley; Fredrik G. Langi
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.39165

Abstract

Abstract: Traumatic brain injuries (TBI) are determined by the severity of the primary and secondary brain damage. Fibronectin and FOUR score are suggested to be diagnostic and prognostic predictors in patients with traumatic brain injuries (TBI). This study aimed to evaluate the relationship between serum fibronectin level and FOUR score in TBI patients. This was an observational study with a prospective cohort method design, conducted on TBI patients admitted to the emergency room at Prof. Dr. R. D. Kandou Hospital. Serum fibronectin examination and assessment of the level of consciousness determined by the FOUR score were performed when the patient entered the emergency room <24 hours. A proportional regression model was used to assess the relationship between serum fibronectin levels and the FOUR score. The results obtained 65 patients, median FOUR score of 13, and 8 patients (12%) with high-risk TBI, median serum fibronectin level of 4 ng/ml, and seven patients (11%) died. The ability of fibronectin as a prognostic factor, especially mortality, did not differ from FOUR score. Logistic regression estimated that serum fibronectin levels >7 ng/ml would increase mortality 33 times and the incidence of mortality increased 23 times. A FOUR score of 8 or less had mortality 34 times and a relative risk of 28 times. In conclusion, there is a significant relationship between serum fibronectin level and FOUR score in terms of stratification of TBI patients. Elevated serum fibronectin level can be used as a diagnostic biomarker and prognostic evaluation of mortality in TBI patients.Keywords: fibronectin; FOUR score; traumatic brain injury Abstrak: Fibronektin dan Skor FOUR disarankan sebagai prediktor diagnostik dan prognositk pada pasien COT. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar fibronektin serum dan skor FOUR pada pasien COT. Jenis penelitian ialah observasional dengan desain metode kohort prospektif, dilakukan pada pasien COT yang masuk ke IGD RSUP Prof. Dr. R. D. Kandou Manado. Pemeriksaan fibronektin serum dan penilaian tingkat kesadaran ditentukan dengan skor FOUR dilakukan saat pasien masuk ke IGD <24 jam. Model regresi proporsional digunakan untuk menilai hubungan antara kadar fibronektin serum dan skor FOUR. Hasil penelitian mendapatkan 65 pasien COT. Median skor FOUR 13, 8 pasien (12%) COT risiko tinggi (FOUR 0-7), median kadar serum fibronektin 4 ng/ml, 7 pasien (11%) meninggal. Fibronektin sebagai faktor prognostik, khususnya mortalitas, tidak berbeda dengan skor FOUR, regresi logistik mengestimasi bahwa kadar serum fibronektin >7 ng/ml mening-katkan OR mortalitas 33 kali dan insidens mortalitas 23 kali. skor FOUR 8 memiliki odds mortalitas 34 kali dan resiko relatif 28 kali. Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar serum fibronektin dan Skor FOUR dalam hal stratifikasi pasien COT. Peningkatan kadar serum fibronektin dapat dijadikan sebagai biomarker diagnostik dan evaluasi prognostik mortalitas pasien COT.Kata kunci: fibronektin; skor FOUR; cedera otak traumatik
Relationship between Level of Serum Fibronectin and Level of Consciousness according to Glasgow Coma Scale in Traumatic Brain Injury Patients Andreas K. Suwito; Eko Prasetyo; Maximillian Ch. Oley; Fredrik G. Langi
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.39168

Abstract

Abstract: Traumatic brain injury (TBI) occurs worldwide causing death and serious disability. Adequate initial assessment of the level of consciousness with GCS and early intervention are critical components of managing a patient with TBI. Levels of fibronectin, especially c-Fn in patients with severe TBI, increase significantly over time for several days after the trauma and are associated with poorer disease prognosis. This study aimed to analyze the relationship between serum fibronectin level and the Glasgow coma scale in patients with TBI and serum fibronectin level as a predictive parameter of trauma severity in TBI. Plasma fibronectin levels were measured blindly using ELISA according to the ELISA kit instructions for fibronectin. There were 65 COT patients as samples. The majority of patients had mild to moderate COT, and only 10 (15%) patients were in the severe COT category (GCS 3-8). The distribution of serum fibronectin level was moderately skewed to the right with a median of 4 ng/ml (IQR 2.7-6.4 ng/ml). In conclusion, there is a negative relationship between serum fibronectin and GCS which could be used for COT stratification. Serum fibronectin levels tend to be high in patients with low GCS or severe COT. Fibronectin is also high in patients that did not survive.Keywords: fibronectin; Glasgow coma scale; traumatic brain injury  Abstrak: Cedera otak traumatik (COT) banyak terjadi di seluruh dunia dan menyebabkan kematian dan disabilitas berat. Penilaian awal dengan Glasgow coma scale (GCS) dan intervensi yang dini merupakan komponen yang penting dalam menangani pasien. Kadar fibronektin khususnya c-Fn pada pasien dengan trauma kepala berat meningkat secara bermakna seiring waktu selama beberapa hari setelah trauma kepala dan berhubungan dengan prognosis penyakit yang lebih buruk. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar serum fibronektin dengan GCS pada pasien COT dan kadar serum fibronektin sebagai parameter prediktif tingkat keparahan trauma. Kadar fibronektin plasma diukur secara blind menggunakan ELISA sesuai instruksi kit ELISA untuk fibronektin. Sampel penelitian berjumlah 65 orang pasien COT. Umumnya pasien mengalami COT ringan atau sedang, dan hanya 10 orang (15%) pasien berada pada kategori COT berat (GCS 3-8). Distribusi kadar serum fibronektin cukup miring ke kanan dengan median 4 ng/ml (IQR 2,7-6,4 ng/ml). Simpulan penelitian ini ialah terdapat hubungan negatif antara fibronektin serum dan GCS yang dapat digunakan untuk stratifikasi COT. Kadar serum fibronektin cenderung tinggi pada pasien dengan GCS rendah atau COT relatif berat. Fibronektin juga ditemukan tinggi pada pasien yang meninggal.Kata kunci: fibronektin; Glasgow coma scale; cedera otak akibat trauma
Complete Blood Test as a New Prognostic Factor in Fournier’s Gangrene Ivan D. P. Sunardi; Ari Astram; Christof Toreh; Eko Arianto; Fredrik G. Langi
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.39811

Abstract

Abstract: Fournier’s gangrene is a form of necrotizing fasciitis that begins in the genital and perineal areas and can extend through the fascia to the groin, thigh, and even the abdominal wall. This disease is still associated with a high mortality rate even though with comprehensive therapy. Simple examination, such as a complete blood count, is widely used as a marker of inflammation and could be used as a prognostic factor for Fournier’s gangrene. This study aimed to compare Fournier Gangrene Severity Index (FGSI) and complete blood count as a prognostic factor in Fournier’s gangrene cases by using machine learning. This was an observational study with a longitudinal data collection design according to cohort method. The results obtained 30 patients with Fournier’s gangrene at Prof. Dr. R. D. Kandou Hospital, Manado. Mortality prediction analysis using algorithms of regularized generalized linear model (GLM) and support vector machine (SVM) showed that the AUCs were 98% and 97.5% for GLM and SVM respectively for the regularized GLM and SVM in the ROC curve analysis, with the superiority to the FGSI (p<0.001). In conclusion, the complete blood count could be used as a novel prognostic value of Fournier’s gangrene cases.Keywords: complete blood count; Fournier Gangrene Severity Index (FGSI); prognostic scoring system; Fournier’s gangrene Abstrak: Gangren Fournier adalah bentuk fasiitis nekrotikans yang dimulai di daerah genital dan perineum dan dapat meluas melalui fasia ke selangkangan, paha, dan bahkan dinding perut. Penyakit ini masih dikaitkan dengan angka kematian yang tinggi meskipun dengan terapi komprehensif. Pemeriksaan sederhana seperti hitung darah lengkap, banyak digunakan sebagai penanda peradangan dan dapat digunakan sebagai faktor prognostik untuk gangren Fournier. Penelitian ini bertujuan untuk membandingkan Fournier Gangrene Severity Index (FGSI) dengan pemeriksaan parameter hitung darah lengkap sebagai faktor prognostik pada kasus dengan gangren Fournier menggunakan machine learning. Jenis penelitian ialah observasional dengan desain pengumpulan data longitudinal menurut metode kohort. Hasil penelitian mendapatkan 30 pasien dengan gangren Fournier di RSUP Prof. Dr. R. D. Kandou Manado. Analisis prediksi mortalitas menggunakan algoritma Regularized Generalized Linear Model (GLM) dan Support Vector Machine (SVM) menunjukkan bahwa AUC masing-masing sebesar 98% dan 97,5% untuk GLM dan SVM tereguler pada analisis kurva ROC, dengan keunggulan dibandingkan FGSI (p<0,001). Simpulan penelitian ini ialah pemeriksaan darah lengkap dapat dijadikan sebagai faktor prognostik baru untuk kasus gangren Fournier.Kata kunci: hitung darah lengkap; Fournier Gangrene Severity Index (FGSI); sistem skoring prognostik; gangren Fournier
Effects of Drainage Volume on Changes of Blood Acidity, and Partial Arterial Pressure of Oxygen and Carbon Dioxide in Massive Pleural Efusion Denny U. Suprapto; Adrian Tangkilisan; Wega Sukanto; Christha Tamburian; Fredrik G. Langi
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.41492

Abstract

Abstract: Massive pleural effusion is a condition in which there is a buildup of fluid beyond normal in the pleural cavum with a volume of two-thirds of one side of the pulmonary field proven with the help of chest X-ray. Drainage of pleural effusion fluid is a management treatment for pleural effusion, but nevertheless it has complications such as pain, bleeding, pneumothorax, and pulmonary edema. Blood gas analysis is simple and essential examination in emergency medicine, which is able to provide valuable information about the acid-base status, ventilation, and oxygenation of a patient. This study aimed to analyze changes in blood acidity (pH), oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2) in patients with massive pleural effusion at Prof. Dr. R. D. Kandou Hospital, Manado. This was a prospective cohort study with a longitudinal data collection design according to the cohort method. The results of the overall linear regression analysis supported the effect of drainage on PaCO2, PaO2, and pH, and indicated that the relationship between drainage volume and PaO2 was positive. Meanwhile, descriptively and statistically, there was no meaningful relationship between pH and PaCO2 and drainage volume. In conclusion, there is a positive relationship between drainage volume and PaO2, however, there is no significant relationship between pH and PaCO2 with drainage volume.Keywords: massive pleural effusion; pH; PaCO2; PaO2 Abstrak: Efusi pleura masif adalah suatu keadaan dimana terjadi penumpukan cairan melebihi volum normal di dalam kavum pleura dengan volume duapertiga dari satu sisi lapang paru yang dapat dibuktikan dengan bantuan X foto toraks. Drainase cairan efusi pleura merupakan manajemen tatalaksana untuk efusi pleura, namun memiliki komplikasi seperti nyeri, perdarahan, pneumotorak, dan edema paru. Analisis gas darah merupakan pemeriksaan yang sederhana namun esensial dalam ilmu kedokteran gawat darurat, yang mampu memberikan informasi berharga mengenai status asam basa, ventilasi maupun oksigenasi dari pasien. Penelitian ini bertujuan untuk untuk menganalisis perubahan tingkat keasaman darah (pH), tekanan parsial oksigen (PaO2) dan karbon dioksida (PaCO2) pada pasien dengan efusi pleura massif. Jenis penelitian ialah prospektif dengan desain pengumpulan data longitudinal menurut metode kohort di RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi linear secara keseluruhan menunjang efek volume drainase terhadap PaCO2, PaO2, dan pH dengan hasil hubungan volume drainase dengan PaO2 bersifat positif namun tidak didapatkan hubungan bermakna antara pH dan PaCO2 dengan volume drainage. Simpulan penelitian ini ialah terdapat hubungan positif antara volume drainase dengan PaO2, namun tidak didapatkan hubungan bermakna antara pH dan PaCO2 dan volume drainase.Kata kunci: efusi pleura massif; pH; PaCO2; PaO2
Prospective Study on Determination of Optimal Drainage Volume in Massive Pleural Effusion Based on Pleural Effusion Index Jeff Lapian; Adrian Tangkilisan; Wega Sukanto; Christha Tamburian; Fredrik G. Langi
e-CliniC Vol. 10 No. 2 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i2.41495

Abstract

Abstract: Clinical manifestations of pleural effusion are influenced by the fluid volume and the underlying disease. Pleural effusion index (PEI) is the ratio between the maximum width of pleural effusion and maximum width of hemithorax in patient with lateral decubitus position. However, PEI as the indicator of pleural effusion volume is rarely used. This study aimed to determine the optimal drainage volume of massive pleural effusion based on initial PEI value. This was an observational study with a hospital-based prospective cohort design conducted at Prof. Dr. R. D. Kandou Hospital in Manado, Indonesia. Samples were patients presented with massive pleural effusion. This study analyzed the details of thoracentesis, demographic profile, past medical history, clinical charac-teristics, laboratory findings, postoperative observations, admission and discharge time. The results obtained 32 patients with massive pleural effusion, consisting of 17 males (53%) and 15 females (47 %). The average respirations of pre-drainage and delta-drainage patients were 27 times per minute and 24 times per minute respectively while the standard deviations were slightly different. The median respiratory rate of post-drainage was 24 times per minute. In conclusion, measurement of PEI in pre-drainage patients had significant correlation in determining the optimal drainage volume.Keywords: pleural effusion; pleural effusion index Abstrak: Manifestasi klinis efusi pleura dipengaruhi oleh volume cairan dan penyakit yang mendasarinya. Pleural effusion index (PEI) adalah perbandingan antara lebar maksimum efusi pleura dan lebar maksimum hemitoraks pada pasien dengan posisi lateral dekubitus, namun PEI sebagai indikator volume efusi pleura jarang digunakan. Penelitian ini bertujuan untuk menentukan volume drainase optimal efusi pleura masif berdasarkan nilai PEI awal. Jenis penelitian ialah studi observasional dengan desain kohort prospektif berbasis rumah sakit di Prof. Dr. R. D. Rumah Sakit Kandou Manado, Indonesia. Sampel penelitian ialah pasien dengan efusi pleura masif. Pada penelitian ini dianalisis rincian torakosentesis, profil demografis, riwayat penyakit terdahulu, karakteristik klinis, hasil laboratorium, pengamatan pasca operasi, waktu masuk dan keluar. Penelitian ini melibatkan 32 pasien terdiri dari 17 laki-laki (53%) dan 15 perempuan (47%). Respirasi rerata pasien pra-drainase dan delta-drainase masing-masing 27 kali per menit dan 24 kali per menit sedangkan standar deviasinya hanya sedikit berbeda. Tingkat pernapasan rerata pasca drainase ialah 24 kali per menit. Simpulan penelitian ini ialah pengukuran PEI pada pasien pra drainase memiliki korelasi bermakna dalam menentukan volume drainase yang optimal.Kata kunci: efusi pleura; pleural effusion index
Analysis of Chest Tube Scars on the Use of Conventional versus Knotless Methods Claudia Loho; Mendy Hatibie; Adrian Tangkilisan; Wega Sukanto; Fredrik G. Langi
e-CliniC Vol. 10 No. 1 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i1.36927

Abstract

Abstract: Removal of chest tube is a one of the most distressing and frustrating experience for patients. Moreover, it has a tendency of scar formation. A relatively new method has been developed using a type of suture without knots (knotless). Assessment of scar is an objective and subjective method performed by using patient and observer scar assessment scale (POSAS). This study was aimed to assess the scars formed due to chest tube removal using conventional and knotless sutures. This was a controlled trial design. The Mann-Whitney test was used to compare the PSOAS scores of scars formed due to conventional and knotless sutures performed by patients and observers after three months, and obtained a p-value of less than 0.05. In conclusion, scar formation due to knotless suture is more acceptable for patients compared to conventional suture among chest tube removal wounds; therefore, the knotless suture can be a cosmetically alternative for wound closure management. Keywords: chest tube; scar tissue; knotless suture; conventional suture Abstrak: Pelepasan chest tube merupakan hal yang menyakitkan dan pengalaman yang membuat frustasi bagi pasien. Selain itu, tindakan ini berpeluang menyebabkan pembentukan jaringan parut. Telah dikembangkan metode baru dengan material jahitan baru yang tidak perlu disimpul. Penilaian jaringan parut dapat berupa penilaian obyektif dan subyektif dengan menggunakan Patient and Observer Scar Assessment Scale (POSAS). Penelitian ini bertujuan untuk menilai jaringan parut akibat pelepasan chest tube antara penjahitan metode konvensional dan knotless. Desain penelitian ialah controlled trial. Penilaian PSOAS baik dari pasien, observer, atau keduanya dilakukan tiga bulan kemudian terhadap jaringan parut yang terbentuk akibat penggunaan kedua metode. Perbandingan hasil skor PSOAS dianalisis dengan uji Mann-Whitney yang mendapatkan nilai p<0,05. Simpulan penelitian ini ialah pembentukan jaringan parut pada metode knotless lebih akseptabel bagi pasien dibandingkan metode konvensional. Hal ini dapat menjadi salah satu metode alternatif penutupan luka chest tube dengan hasil yang lebih dapat diterima.Kata kunci: chest tube; jaringan parut; metode knotless; metode konvensional
Factors Correlated to Hospital Performance Aviliana R. Wenas; Suryadi Tatura; Fredrik F. L. G. Langi
e-CliniC Vol. 10 No. 1 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i1.39348

Abstract

Abstract: In Indonesia, studies on hospital performance are still based on financial performance, meanwhile, performance based on cost, quality, and relative value of service cost is not carried out.  Moreover, data based on cost and service quality is very difficult to accessed. On the contrary, data of hospital performance, facility type, cost of service, and quality of service are available for the United States region. This study aimed to analyze the relationship between the type of facility, cost of services, and quality of services related to the performance of hospitals in the United States, using secondary data analysis of hospital performance data collected routinely by The Centers for Medicare and Medicaid Services (CMS). Dataset Project was on their page corgis-edu.github.io/corgis/csv/ hospitals. The hospital performance was the dependent variable, meanwhile, the service costs, service quality, and relative value of service costs to the national average were the independent variables. The results showed that most of the variables used as predictors of hospital performance were related to the outcomes even after controlling the other variables. On the contrary, the quality, cost, and relative value of cardiac arrest services did not affect hospital-level service outcomes. Increased costs are not surprisingly associated with a reduced likelihood of achieving higher performance; the size of the decline is not large, namely 1-0.90 or 10%. In conclusions, the type of facilities, service costs, and service quality are related to the hospital performance.Keywords: hospital performance; type of facilities; service costs; service quality Abstrak: Penelitian kinerja rumah sakit di Indonesia masih mengkaji kinerja berdasarkan kinerja keuangan sedangkan kinerja rumah sakit berdasarkan biaya, kualitas dan nilai relatif biaya layanan masih belum dilakukan. Selain itu, data yang berkaitan dengan biaya dan kualitas layanan masih sangat sulit diakses. Berbeda halnya dengan wilayah Amerika Serikat dimana data kinerja rumah sakit, jenis fasilitas, biaya layanan, dan kualitas layanan telah tersedia. Penelitian ini bertujuan untuk menganalisis hubungan antara jenis fasilitas, biaya layanan, dan kualitas layanan berhubungan dengan kinerja rumah sakit di Amerika Serikat menggunakan data kinerja rumah-rumah sakit yang secara rutin dikumpulkan The Centers for Medicare and Medicaid Services (CMS). Dataset Project terdapat di laman corgis-edu.github.io/corgis/csv/hospitals. Kinerja rumah sakit merupakan variabel dependen dalam analisis sedangkan biaya layanan, kualitas layanan, dan nilai relatif biaya layanan terhadap rerata nasional merupakan variabel independen. Hasil penelitian mendapatkan bahwa sebagian besar variabel penelitian yang digunakan sebagai prediktor kinerja rumah sakit berhubungan bermakna dengan luaran tersebut bahkan setelah pengontrolan variabel lain. Berbeda dengan kualitas layanan, biaya dan nilai relatif biaya layanan serangan jantung yang tidak memengaruhi hasil penilaian kinerja rumah sakit. Peningkatan biaya berhubungan dengan penurunan kemungkinan pencapaian kinerja lebih tinggi; besar penurunannya memang tidak besar, yaitu 1-0,90 atau 10%. Simpulan penelitian ini ialah jenis fasilitas, biaya layanan, dan kualitas layanan berhubungan dengan kinerja rumah sakit.Kata kunci: kinerja rumah sakit; jenis fasilitas; biaya layanan; kualitas layanan
Karakteristik Pasien Operasi Rekonstruksi Hipospadia yang Menjalani Terapi Oksigen Hiperbarik di RSUP Prof. Dr. R. D. Kandou dan RS Siloam Manado Irawan Sukarno; Ari Astram; Mendy J. Hatibie; Fredrik G. Langi
e-CliniC Vol. 12 No. 1 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i1.46457

Abstract

Abstract: Hypospadias is a congenital abnormality of urethral meatus in male. Hypospadias can be corrected by urethroplasty. Hyperbaric oxygen therapy (HBOT) can accelerate wound healing after surgery by increasing oxygenation, angiogenesis, and collagen synthesis. This study aimed to describe the characteristics of hypospadias reconstructive surgery patients who underwent hyperbaric oxygen therapy. This was a quantitative and descriptive study. Data were analyzed with SPSS ver 22.0. The results showed that from 20 patients who underwent reconstructive hypospadias surgery, 10 patients received HBOT as adjuvant therapy and 10 patients received conservative therapy post-surgery. The mean age of patients who underwent HBOT was 17.4±7.1 years old. The most frequent type of hypospadias found was subcoronal (35%), followed by the other types: glandular (20%), distal penile (10%), midshaft penile (10%), proximal penile (10%), penoscrotal (10%), and the least was scrotal (5%). All of the patients underwent urethroplasty with Sidik-Chaula and Manset Flap method. In conclusion, the mean age of patients who underwent HBOT was 17.4±7.1 years old, and the most frequent type of hypospadias found was subcoronal. Keywords: hypospadias; hyperbaric oxygen therapy; characteristics of hypospadias patients   Abstrak: Hipospadia merupakan kelainan kongenital meatus uretra pada laki-laki. Hipospadia dapat dikoreksi dengan uretroplasti. Terapi oksigen hiperbarik (TOHB) dapat mempercepat penyembuhan luka pascaoperasi melalui peningkatan oksigenasi, angiogenesis, dan sintesis kolagen. Penelitian ini bertujuan untuk mengetahui karakteristik pasien rekonstruksi hipospadia yang menjalani TOHB. Jenis penelitian ialah deskriptif kuantitatif dengan alat analisis SPSS ver. 22.0. Hasil penelitian mendapatkan 20 pasien yang dilakukan operasi rekonstruksi hipospadia; 10 pasien menjalani TOHB dan 10 pasien menjalani terapi konservatif pasca pembedahan. Rerata usia pasien yang menjalani TOHB yaitu 17,4±7,1 tahun. Tipe hipospadia yang paling sering ialah subcoronal (35%), diikuti tipe glandular (20%), dan sisanya ialah tipe distal penile (10%), midshaft penile (10%), proximal penile (10%), penoscrotal (10%), dan yang paling sedikit ialah tipe scrotal (5%). Semua pasien menjalani operasi dengan metode Sidik-Chaula dan Manset Flap. Simpulan penelitian ini ialah rerata usia pasien yang menjalani TOHB ialah 17,4±7,1 tahun dengan tipe hipospadia yang paling sering ialah subcoronal. Kata kunci: hipospadia; terapi oksigen hiperbarik; karakteristik pasien hipospadia
Faktor-faktor yang Memengaruhi Luaran Penanganan Gastroschisis Michael Raktion; Harsali F. Lampus; Candy Candy; Fredrik G. Langi
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.46617

Abstract

Abstract: Gastroschisis is a congenital disorder in which the internal abdominal viscera protrudes through a defect in the anterior abdominal wall. Survival rates exceed 96% in high-income countries, but in low-income countries, mortality rates can reach >90%. This study aimed to determine the factors that influenced the outcome of gastroschisis treatment. This was an analytical study using SPSS ver. 22.0. The results obtained 18 infants with gastroschisis who met the criteria. All of the babies later developed sepsis and died. Characteristics of the sample were as follows: most gastroschisis diagnosis was confirmed after birth (83%), most cases recieved antenatal care from the midwife only (83%), delivery at the primary health facility (78%), baby was referred to the hospital without nasogastric tube and plastic wrap (50%)  and most babies had low risk (GPS≤1) (61%). Influencing significant factors found were the medical procedures performed before reffering to the length of hospital stay (p=0.007), length of parenteral nutrition (p=0.009), and duration to enteral feeding (p=0.005). In conlusion, medical procedures performed before reffering influence the outcome of gastroschisis treatment. Keywords: gastroschisis; factors inflluencing the outcome of gastroschisis; Gastroschisis Prognostic Score   Abstrak: Gastroschisis adalah kelainan kongenital berupa protrusi visera internal abdominal melalui defek dinding abdomen anterior. Angka survival melebihi 96% di negara dengan pendapatan tinggi, namun di negara berpendapatan rendah, angka mortalitas dapat mencapai >90%. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi luaran penanganan gastroschisis. Penelitian ini menggunakan metode analitik dengan alat analisis SPSS ver. 22.0. Hasil penelitian mendapatkan 18 bayi dengan gastroschisis yang memenuhi kriteria. Setelah dilakukan operasi, seluruh bayi dirawat kemudian mengalami sepsis dan meninggal. Karakteristik sampel ialah diagnosis gastroschisis baru ditegakkan saat lahir (83%), ibu bayi memeriksakan kehamilannya pada bidan (83%), ibu melahirkan di faskes primer (78%), bayi dirujuk ke rumah sakit tanpa pemasangan NGT dan penutupan usus (50%), dan sebagian besar beresiko rendah (skor GPS ≤1) (61%). Faktor yang bermakna memengaruhi luaran penanganan gastroschisis ialah tindakan medis yang belum dilakukan sebelum merujuk terhadap lama rawatan rumah sakit (p=0,007), lama nutrisi parenteral (p=0,009), dan durasi hingga enteral feeding (p=0,005). Sinpulan penelitian ini ialah tindakan medis yang belum dilakukan sebelum merujuk merupakan faktor yang berpengaruh pada luaran penanganan bayi dengan gastroschisis. Kata kunci: gastroschisis; faktor yang berperan terhadap luaran penanganan; Gastroschisis Prognostic Score
Co-Authors Adrian Tangkilisan Adrian Tangkilisan Andreas K. Suwito Andrew Eka Pramudita Sunardi Ari Astram Ari Astram Aviliana R. Wenas Billy Salem Candy Candy Christha Tamburian Christian Manginstar Christof Toreh Christof Toreh Claudia Loho Denny U. Suprapto Dewi Utari Djafar Edmond Leonard Jim Eko Arianto Eko Prasetyo Eko Prasetyo Eko Prasetyo Eko S. Sinaga Ferdinand Tjandra Filandy Pai Hardianto Musu Harsali F. Lampus Irawan Sukarno Ivan D. P. Sunardi Jeff Lapian Karina E. Clearesta Marcella Merung Marselus Merung Maximilian C. Oley Maximillian C. Oley Maximillian Ch. Oley Maximillian Ch. Oley Mendy Hatibie Michael Iskandar Michael Raktion Michael Tendean Nico Lumintang Pinkan Johana Lintong Rendy J. Bangonang Rinaldy T. Setiawan Sherly Tandililing Suryadi Tatura Toar Mambu Wega Sukanto Wega Sukanto Woodford B. S. Joseph