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NILAI RUJUKAN HEMATOLOGI ORANG DEWASA NORMAL DI RSUD ULIN BANJARMASIN Rosida, Azma; Hendriyono, FX
Jurnal Berkala Kedokteran Vol 11, No 1 (2015): Februari 2015
Publisher : Pendidikan Dokter Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v11i1.190

Abstract

Results of laboratory tests are interpreted through value. Hematological examination is an examination that is often requested and performed to determine the state of the blood and its components so that the patients medical condition can be known. Reference value can be obtained from brochure instruments or laboratory has its own research using populations in the laboratory because of possible variation between the laboratory values with other laboratories due to differences in methods of examination and patient characteristics. The objective of the study is to get hematology reference values in Ulin Hospital, Banjarmasin. This study is cross-sectional observasional analytic  study, conducted in hospitals Ulin Banjarmasin, June-July 2014. The subject of the study consisted of 120 women and 120 men who came for medical examinations in clinical pathology laboratories Hospital Ulin, Banjarmasin. Results obtained Hb 12.5-16.7 from the men and women are from 12.0 to 15.6 g / dL. The numbers of male erythrocytes are from 4.1 to 6.0 million / uL and women are 4.0 to 5.3 million / uL. Leukocyte numbers are 4650-10300 / uL. Platelet numbers are 150-356 thousand from men and women are 177-401 thousand / uL. Parameters 75-96 fL MCV, MCH 28-32 pg, MCHC 33-37 g / dL, and RDW-CV 12.1 to 14%. The results of this study did not differ significantly with the reference value that has been used but the obtained values of MCV are lower. Keywords: Reference value, haematology, normal adult,  RSUD Ulin
Pemeriksaan Laboratorium Penyakit Hati Rosida, Azma
Berkala Kedokteran Vol 12, No 1 (2016): Februari 2016
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v12i1.364

Abstract

Abstract: Liver as the largest glandular organ which has an important role in glucose and lipid metabolism which helps digestion, absorption of fats and fat-soluble vitamins, as well as the detoxification of the body against toxic substances. Laboratory tests often required liver disease clinician for screening and detecting of abnormalities or liver disease, to help maintaining diagnosis, to estimate the severity of the disease, to help find the etiology of a disease, assess the results of treatment, and also to help direct further diagnostic efforts and assessing the prognosis of liver disease and organ dysfunction. Interpretation of the results of liver function tests was not able to use only one parameter but also used a combination of the results examination, because the integrity of the liver cells was also influenced by factors extra hepatic. In this article discussed some liver function test is divided into three big that liver function tests, measurement of enzyme activity, and a test to look for the etiology of liver disease.Keywords: laboratory, liver disease, liver function tests Abstrak: Hati sebagai organ kelenjar terbesar memiliki peran penting dalam metabolisme glukosa dan lipid, membantu proses pencernaan, absorbsi lemak dan vitamin yang larut dalam lemak, serta detoksifikasi tubuh terhadap zat toksik.  Pemeriksaan laboratorium penyakit hati sering diminta klinisi untuk penapisan dan deteksi adanya kelainan atau penyakit hati, membantu menengakkan diagnosis, memperkirakan beratnya penyakit, membantu mencari etiologi suatu penyakit, menilai hasil pengobatan, membantu mengarahkan upaya diagnostik selanjutnya serta menilai prognosis penyakit dan disfungsi organ hati.  Interpretasi hasil pemeriksaan uji fungsi hati tidak dapat menggunakan hanya satu parameter tetapi menggunakan gabungan beberapa hasil pemeriksaan, karena keutuhan sel hati juga dipengaruhi faktor ekstrahepatik. Pada artikel ini dibahas  beberapa uji fungsi hati yang dibagi menjadi 3 besar yaitu uji fungsi hati, pengukuran aktivitas enzim, dan uji untuk mencari etiologi penyakit hati. Kata-kata kunci :laboratorium, penyakit hati, uji fungsi hati
PERBEDAAN POLA MAKAN REMAJA PUTERI SLTP/SEDERAJAT YANG MENDERITA ANEMIA DAN TIDAK ANEMIA DI KABUPATEN BANJAR Adenan, Adenan; Rahayu, Atikah; Yulidasari, Fahrini; Rosida, Azma; Noor, Meitria Syahadatina; Ismaya, Renny
Jurnal Publikasi Kesehatan Masyarakat Indonesia Vol 2, No 1 (2015): April 2015
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jpkmi.v2i1.2702

Abstract

AbstrakAngka anemia di Indonesia sebanyak 72,3%. Prevalensi anemia pada remaja puteri di Indonesia adalah 26,5%. Berdasarkan hasil survei Dinas Kesehatan Provinsi Kalimantan Selatan pada tahun 2012 menunjukkan bahwa kejadian anemia sebesar ≥ 65,21% pada remaja putri SMP/Mts di Kabupaten Banjar. Penyebabnya antara lainfaktor orangtua dan remaja.  Karena remaja sangat tergantung dengan orangtuanya, maka faktor orangtua sangat berperan terutama pola makan yang disediakan oleh orangtua.Tujuan penelitian ini adalah menganalisis perbedaan pola makan remaja puteri SLTP/sederajat yang menderita anemia dan tidak anemia di Kabupaten Banjar Tahun 2014.Penelitian ini menggunakan rancangan observasional analitikmelalui pendekatancross-sectional.Populasipenelitianiniadalahorang tua remaja putri SMP wilayah Kabupaten Banjar.Pengambilan sampel menggunakan purposive sampling.Besar sampel yang didapatkan adalah 92 orang.Hasilpenelitianmenunjukkanremaja yang mengalami anemia sebanyak 19 responden (20,7%) dan yang tidak anemia sebanyak 73 responden (79,3%), dengan pola makan pada siswi SMP di Kabupaten Banjar tergolong baik sebanyak 37 responden (40,2%) dan tidak baik sebanyak 55 responden (59,8%).Hasil chi square menunjukkan p value 0,000, berarti dapat disimpulkan terdapat perbedaan pola makan remaja puteri SLTP/sederajat yang menderita anemia dan tidak di Kabupaten Banjar tahun 2014. Kata-kata kunci: pola makan, remaja putri, anemia AbstractAnaemia in Indonesia is about 72,3%. Prevalence of anaemia in teenagers especially girls is about 26,5%. The survey of Health Department of South Kalimantan in 2012 showed that anaemia in SMP/Mts was about ≥ 65,21%.  The causes were parent factor and teen factor.  Because of teenagers still depent to their parents, so parents factors influence more, especially eating pattern by their parents.  The goal of this research was analyzing the difference of eating pattern in girls with and without anaemia in Banjar District 2014.  This research used observational analytic with cross-sectional.  The population was all of the the girls’ parents in Banjar District 2014.  Sampling was using purposive sampling. Tha sample size that was gotten were 92 people. The result was the girls who got anaemia were 19 (20,7%) and normal were 73 (79,3%), eating pattern of girls in Banjar District was good for 37 people (40,2%) and not good for 55 people (59,8%).  Chi square test showed that p value was 0,000, so we could conclude that there was difference of eating pattern in girls with and without anaemia in Banjar Distric 2014.   Key words: eating pattern, girls, anaemia
PERBEDAAN JUMLAH TROMBOSIT DAN PLR PADA PREEKLAMPSIA DAN PREEKLAMPSIA BERAT Dharagita, Putu Galuh; Yuseran, Hariadi; Hendriyono, Fransiskus Xaverius; Abimanyu, Bambang; Rosida, Azma
Homeostasis Vol 7, No 1 (2024)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/ht.v7i1.12403

Abstract

Abstract: Preeclampsia is hypertension in pregnancy >20 weeks with ≥140/90 mmHg and proteinuria. Preeclampsia when trophoblast invasion fails, causing ischemia, damage to placental endothelium that triggers platelet aggregation. Excessive platelet activity reduces systemic platelet counts. The PLR describes platelet to lymphocyte ratio. Placental ischemia causing chronic inflammation. The general objective determined the difference platelet count and PLR in preeclampsia and severe preeclampsia at RSUD Ulin Banjarmasin. This research is observational analytical, cross sectional, non-probability sampling techniques. The results is 70 subjects with preeclampsia and severe preeclampsia according the inclusion criteria. It was found the mean platelet in preeclampsia 294.82 ± 97.65 thousand/µL and severe preeclampsia 231.80 ± 75.99 thousand/µL. The mean PLR in preeclampsia 176.76 ± 79. The median PLR for severe pre-eclampsia is 74.92, the minimum value 23.16, the maximum value 195.56. Conclusion: There were significant differences in platelet count and PLR in preeclampsia and severe preeclampsia (p=0.004; p=0.000). Keywords: Preeclampsia, severe Preeclampsia, Trombosit, PLR, Pregnant woman.  Abstrak: Preeklampsia adalah hipertensi dalam kehamilan (>20 minggu) dengan tekanan darah ≥140/90 mmHg dan disertai proteinuria. Preeklampsia ketika invasi trofoblas ke plasenta gagal, menyebabkan iskemia dan kerusakan endotel plasenta yang memicu agregasi trombosit. Aktivitas trombosit berlebihan menurunkan jumlah trombosit di sistemik. Jumlah PLR menjelaskan rasio trombosit dan limfosit absolut. Iskemia plasenta menghasilakan ketidakseimbangan fungsi kekebalan menyebabkan peradangan kronis. Tujuan umum mengetahui perbedaan jumlah trombosit dan PLR pada preeklampsia dan preeklampsia berat di RSUD Ulin Banjarmasin. Penelitian ini observasional analitik dengan cross sectional menggunakan teknik non-probability sampling. Hasil penelitian didapatkan 70 subjek dengan preeklampsia dan preeklampsia berat sesuai kriteria inklusi dan ekslusi. Didapatkan rerata jumlah trombosit pada preeklampsia 294,82±97,65 ribu/µL dan preeklampsia berat 231,80±75,99 ribu/µL. Rerata jumlah PLR pada preeklampsia 176,76±79. PLR preeklampsia berat median 74,92, nilai minimum 23,16 dan nilai maksimum 195,56. Kesimpulan: Didapatkan perbedaan bermakna jumlah trombosit dan PLR pada preeklampsia dan preeklampsia berat (p=0,004;p=0,000). Kata-kata kunci: Preeklampsia, Preeklampsia berat, Trombosit, PLR, Ibu hamil.
PROFIL URINALISIS PASIEN HIPERTENSI DALAM KEHAMILAN Di Bagian Obstetri dan Ginekologi RSUD Ulin Banjarmasin Periode Juni 2021-Mei 2022 Iman, Muhammad Nur; Nizomy, Ihya Ridlo; Rosida, Azma; Armanza, Ferry; Hendriyono, Franciscus Xaverius
Homeostasis Vol 6, No 3 (2023)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/ht.v6i3.11460

Abstract

Hypertension disorders in pregnancy (HDP) is one of the most common complications in pregnancy forming a triad along with bleeding and infection which are the main causes of maternal and prenatal morbidity and mortality. Urinalysis examination is one of the important laboratory tests in the diagnosis of HDP, especially to identify the presence of preeclampsia which can lead to eclampsia. Through urinalysis it can be seen the presence of protein in the urine which is one of the diagnostic criteria for preeclampsia-eclampsia and assessing kidney function during pregnancy. The purpose of this study was to determine the urinalysis profile of hypertensive patients in pregnancy. This study used an observational research design with a cross-sectional approach, using secondary data from medical records. This study used the entire population according to the inclusion and exclusion criteria. The subjects of this study were 69 patients. The results showed that preeclampsia was the most common type of HDP, namely 122 people (59.2%). Based on the results of urinalysis in Preeclampsia, the results of urinalysis that showed the most positive results were proteinuria, namely Trace 4 people (9.8%), 1+ 10 people (24.4%), 2+ 10 people (24.4%), and 3+ 4 people (9.8%). Whereas in Preeclampsia Superimposed Hypertension showed the same results where proteinuria was the most positive, namely Trace 1 people (5.9%), 1+ 3 people (17.6%), and 2+ 8 people (47.1%).
HUBUNGAN ASUPAN VITAMIN C DENGAN KEJADIAN ANEMIA PADA REMAJA PUTRI DI SMP NEGERI 12 BANJARMASIN Kireyna, Ervia; Noor, Meitria Syahadatina; Rosida, Azma; Heriyani, Farida; Muthmainah, Noor
Homeostasis Vol 7, No 2 (2024)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/ht.v7i2.13218

Abstract

Abstract: Adolescents are impacted by the worldwide health issue of anemia. Inadequate consumption of vitamin C through diet is one of the causes of anemia. The purpose of this study was to find out if vitamin C consumption and the incidence of anemia in teenage girls attending Banjarmasin Junior High School were related. Analytical observational research methodology using a cross-sectional approach is used. According to the research findings, 37,8% of cases were non-anemic, while 62.2% of cases had anemia. Of the individuals, 71.1% reported consuming enough amounts of vitamin C daily, while 28.9% reported inadequate intake. The chi-square test statistical analysis results in a p-value of 0.03 and a probability ratio of 3.5. Therefore, it is clear that vitamin C intake and the incidence of anemia in adolescents girls attending Banjarmasin Junior High School 12 are significantly correlated. Keywords: vitamin C intake, anemia, adolescents girls Abstrak: Kondisi anemia merupakan masalah kesehatan di seluruh dunia terutama pada remaja. Menurut data dari Dinkes Kota Banjarmasin (2022), 43,05% remaja putri di Banjarmasin mengalami anemia. Rendahnya asupan vitamin C merupakan salah satu penyebab anemia. Penelitian ini bertujuan untuk mengetahui hubungan antara asupan vitamin C dengan angka kejadian anemia pada remaja putri yang bersekolah di SMP Negeri 12 Banjarmasin. Metode penelitian yang digunakan adalah observasional analitik menggunakan pendekatan cross-sectional. Purposive sampling digunakan untuk memilih 90 remaja putri dari SMP Negeri 12 Banjarmasin yang menjadi sampel penelitian. Hasil penelitian didapatkan kejadian anemia sebesar 62,2% dan tidak anemia sebesar 37,8%, asupan vitamin C memenuhi kecukupan harian sebesar 71,1% dan yang kurang sebesar 28,9%. Setelah diuji statistik dengan uji chi square didapatkan nilai p = 0,03. Dengan demikian, dapat disimpulkan terdapat hubungan signifikan asupan vitamin C dengan kejadian anemia pada remaja putri SMP Negeri 12 Banjarmasin.   Kata-kata kunci: asupan vitamin C, anemia, remaja putri
PERBEDAAN HEMATOKRIT MCV DAN MCHC PADA PREEKLAMPSIA DAN PREEKLAMPSIA BERAT Asie, Gracia Chika Medylona Eka; Yuseran, Hariadi; Hendriyono, Fransiskus Xaverius; Abimanyu, Bambang; Rosida, Azma
Homeostasis Vol 7, No 1 (2024)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/ht.v7i1.12378

Abstract

Abstract: Preeclampsia is a condition of hypertension and proteinuria at gestational age >20 weeks. Preeclampsia causes endothelial dysfunction resulting in plasma extravasation and hemoconcentration, characterized by an increase in hematocrit. Erythrocytes swell, causing an increase in MCV and a decrease in MCHC. The aim of the research was to determine the differences between hematocrit, MCV and MCHC in preeclampsia versus severe preeclampsia at Ulin Hospital, Banjarmasin. Analytical observational research method, retrospective cross-sectional research design. Purposive sampling for the 2020-2022 period, using 60 subjects according to inclusion and exclusion criteria. Analysis used unpaired T test and Mann Whitney. The results showed that the mean hematocrit for preeclampsia was 36.05 ± 3.64% and severe preeclampsia was 38.89 ± 2.83%. The median MCV for preeclampsia was 84.25 fL, the minimum value was 67.40 fL and the maximum value was 92.20 fL and the median for severe preeclampsia was 88.10 fL, the minimum value was 77.70 fL and the maximum value was 94.20 fL. The mean MCHC for preeclampsia was 33.53±1.38 g/dl and severe preeclampsia 34.16±0.88 g/dl. It can be concluded that there is a significant difference between hematocrit, MCV and MCHC in pregnant women with preeclampsia and severe preeclampsia (p<0.05). Keywords: preeclampsia, severe preeclampsia, hematocrit, MCV, MCHC Abstrak: Preeklampsia merupakan kondisi adanya hipertensi dan proteinuria pada usia kehamilan >20 minggu. Preeklampsia menyebabkan disfungsi endotel sehingga terjadi ekstravasasi plasma dan terjadi hemokonsentrasi, ditandai peningkatan hematokrit. Eritrosit membengkak, menyebabkan peningkatan MCV dan penurunan MCHC. Tujuan penelitian mengetahui perbedaan hematokrit, MCV dan MCHC pada preeklampsia terhadap preeklampsia berat di RSUD Ulin Banjarmasin. Metode penelitian observasional analitik, desain penelitian cross sectional retrospektif. Pengambilan sampel purposive sampling periode 2020-2022, menggunakan 60 subjek sesuai kriteria inklusi dan eksklusi. Analisis menggunakan uji t-tidak berpasangan dan Mann Whitney. Hasil penelitian menunjukan rerata hematokrit preeklampsia 36,05±3,64% dan preeklampsia berat 38,89±2,83%. Median MCV preeklampsia 84,25 fL, nilai minimum 67,40 fL dan nilai maksimum 92,20 fL serta median preeklampsia berat 88,10 fL, nilai minimum 77,70 fL dan nilai maksimum 94,20 fL. Rerata MCHC preeklampsia 33,53±1,38 g/dl dan preeklampsia berat 34,16±0,88 g/dl. Dapat disimpulkan adanya perbedaan bermakna antara hematokrit, MCV dan MCHC pada ibu hamil dengan preeklampsia dan preeklampsia berat (p < 0,05). Kata-kata kunci: preeklampsia, preeklampsia berat, hematokrit, MCV, MCHC
Correlation Of Albumin Levels With Glucose Levels in Hypoglycemic Patients After The Use Of Insulin Therapy Fajari, Nanang Miftah; Kholifah, Rika; Rosida, Azma
Clinical and Research Journal in Internal Medicine Vol. 5 No. 1 (2024): Volume 5 No 1, May 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2024.005.01.04

Abstract

Background: Most of the incidence of hypoglycemia in hospital (11.29%) is caused by administering insulin therapy as a therapeutic modality in diabetes mellitus patients during hospitalization. The bond between albumin and insulin using the help of fatty acids makes insulin control the body's glycemic levels. Aim: The purpose of this study was to determine and analyze the correlation between albumin levels and glucose levels in hypoglycemia patients after the administration of insulin therapy at the Ratu Zalecha General Hospital. Methods: This study was an analytic observational study with a cross-sectional approach. A total of 32 samples were obtained by purposive sampling Results: The patient's mean glucose level was 48.95 ± 11.5 mg/dL and the patient's mean albumin level was 2.4 ± 0.6 g/dL. Bivariate analysis using Pearson's correlation test showed a correlation between albumin levels and glucose levels (p = 0.045 <0.05; r = 0.356). Conclusion: The conclusion is that there is a significant correlation between albumin levels and blood glucose levels, the direction of the positive correlation with the strength of the weak correlation in the endocrine internal medicine ward of the Ratu Zalecha Martapura Hospital.
Effect of Heavy Metal Polluted River Water on Body Weight and Hemoglobin Level in White Rats (Rattus novergicus) Hendriyono, Franciscus Xaverius; Devi, Wivina Riza; Rosida, Azma; Hidayat, Taufiq
Berkala Kedokteran Vol 20, No 1 (2024)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v20i1.18783

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Contamination of heavy metal on the South Kalimantan River has become a well thrived issue. In the Barito River watershed, it is reported that there are heavy metals in the form of Pb, Hg and Cd. Heavy metals can affect physiological anatomical changes and the hematopoietic system. This study aims to determine the impact of heavy metal contamination on changes in body weight and hemoglobin levels. The research method is a true laboratory experiment using a pre-post-test group design. The subjects used were healthy male white rats (Rattus norvegicus), aged 2-6 months and weighing 250-300 gr. The research group was divided into two groups, the control group (K) was a group of experimental animals that were given distilled water while the treatment group (P) was a group of experimental animals that were given water contaminated with heavy metals (Pb, Cd, and Hg) ad libitum for 30 days. The results showed that there was no effect of giving Pb metal; 0.01 mg/l = 0.006 mg/kgBW, Cd; 0.003 mg/l = 0.018 mg/kgBW, Hg; 0.001 mg/l = 0.0006 mg/kgBW and Pb+Cd+Hg; 0.006 mg/kgBB + 0.018 mg/kgBB + 0.0006 mg/kgBB on body weight of white rats. There was a significant decrease in Hb levels in white rat hemoglobin after administration of Pb metal; 0.01 mg/l = 0.006 mg/kgBB. Pb metal in water can influence changes in decreasing Hb levels during sub-acute administration. It can be concluded that there was a significant difference in hemoglobin levels before and after giving water containing Pb/lead metal, whereas in the other groups there was no significant difference, as did the Hb levels.
HUBUNGAN DURASI KOLESISTEKTOMI LAPAROSKOPI DENGAN PERUBAHAN KADAR BILIRUBIN TOTAL PASIEN KOLELITIASIS Manik, Sarmono Lotma Saipon; Wibowo, Agung Ary; Yuliana, Ida; Winata, Winardi Budi; Rosida, Azma
Homeostasis Vol 7, No 3 (2024)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/ht.v7i3.14597

Abstract

Abstract: Laparoscopic cholecystectomy is the gold standard treatment for treating symptomatic cholelithiasis. Recent studies have shown an increase in total bilirubin levels in patients undergoing laparoscopic cholecystectomy due to liver ischemia caused by CO2 pneumoperitoneum during the procedure. The duration of cholecystectomy is thought to be related to changes in total bilirubin levels that occur, where the longer the duration, the longer the ischemia that occurs so that total bilirubin levels will increase. This study aims to analyze the correlation between the duration of laparoscopic cholecystectomy and changes in total bilirubin levels in cholelithiasis patients at RSUD Ulin Banjarmasin. This study uses an analytical observational method with a cohort study approach. There is a positive significant correlation between the duration of laparoscopic cholecystectomy and changes in total bilirubin levels in cholelithiasis patients at RSUD Ulin Banjarmasin with moderate strength (p = 0.000; r = 0.511). Keywords: cholelithiasis, laparoscopic cholecystectomy, total bilirubin. Abstrak: Kolesistektomi laparoskopi adalah tatalaksana baku emas untuk mengobati kolelitiasis bergejala. Studi terkini menunjukkan terjadinya peningkatan kadar bilirubin total pada pasien yang menjalani kolesistektomi laparoskopi karena iskemia hati yang disebabkan pneumoperitoneum CO2 selama prosedur. Durasi kolesistektomi diduga berhubungan dengan perubahan kadar bilirubin total yang terjadi dimana semakin lama durasinya maka semakin lama iskemia yang terjadi sehingga kadar bilirubin total akan semakin meningkat. Penelitian ini bertujuan untuk menganalisis hubungan durasi kolesistektomi laparoskopi dengan perubahan kadar bilirubin total pasien kolelitiasis di RSUD Ulin Banjarmasin. Penelitian ini menggunakan metode observasional analitik dengan pendekatan studi kohort. Terdapat hubungan bermakna positif antara durasi kolesistektomi laparoskopi dengan perubahan kadar bilirubin total pasien kolelitiasis di RSUD Ulin Banjarmasin dengan kekuatan sedang (p = 0,000; r = 0,511). Kata-kata kunci: kolelitiasis, kolesistektomi laparoskopi, bilirubin total.