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Akurasi Skor Alvarado pada Kasus Apendisitis Gabriella H. Z. P. Siregar; Angelica M. J. Wagiu; Harsali F. Lampus
Medical Scope Journal Vol. 4 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v4i2.44867

Abstract

Abstract: The Alvarado score is the first scoring system developed and the most popular used to diagnose appendicitis, with claims to have advantages, namely high diagnostic accuracy, simple and effective. However, in several studies Alvarado's scores were found to be inaccurate and biased toward certain races, genders, and ages. Therefore, many new scoring systems have emerged to determine a more accurate diagnosis of appendicitis. This study aimed to determine the accuracy of the Alvarado score in cases of appendicitis. This was a literature review study using database of the Clinicalkey, Pubmed and Google Scholar and the PICOS framework selection criteria with the keywords 'accuracy' AND ‘alvarado score’ AND 'appendicitis' AND ‘Asia’ OR ‘Indonesia. The results showed that there was no significant difference in score accuracy found between age groups, but Alvarado's score was more accurate in males than in females. In this study, the average accuracy of the Alvarado score was: sensitivity 72.92%, specificity 67.17%, PPV 92%, NPV 35.8%, and DA 64.6%. in conclusion, the mean accuracy of the Alvarado score for diagnosing appendicitis cases in the Asian region shows that this score can still be used in daily practice. Accuracy of the diagnosis will increase if this scoring system is combined with USG or other biomarkers. Keywords: Alvarado score; accuracy; appendicitis   Abstrak: Skor Alvarado merupakan sistem skor pertama yang dibentuk dan paling popular untuk mendiagnosis apendisitis, dengan klaim memiliki kelebihan yaitu akurasi diagnosis tinggi, sederhana dan efektif. Namun, dalam beberapa penelitian skor Alvarado dinilai kurang akurat dan bias terhadap ras, jenis kelamin, dan usia tertentu. Oleh karena itu, banyak bermunculan sistem skor baru dengan tujuan untuk menentukan diagnosis apendisitis yang lebih akurat. Penelitian ini bertujuan untuk mengetahui akurasi skor Alvarado pada kasus apendisitis. Jenis penelitian ialah suatu literature review menggunakan literatur pada Clinicalkey, Pubmed dan Google Cendekia dengan kriteria seleksi PICOS framework dan kata kunci 'accuracy' AND ‘alvarado score’ AND 'appendicitis' AND ‘Asia’ OR ‘Indonesia’ Hasil penelitian memperlihatkan tidak terdapat perbedaan akurasi skor yang bermakna dalam kelompok usia, akan tetapi skor Alvarado lebih akurat pada laki-laki dibandingkan perempuan. Pada studi ini didapatkan rerata akurasi dari skor Alvarado ialah: sensitivitas 72,92%; spesifisitas 67,17%; PPV 92%; NPV 35,8%; dan DA 64,6%. Simpulan penelitian ini ialah nilai rerata akurasi skor Alvarado untuk mendiagnosis kasus apendisitis di kawasan Asia menunjukkan bahwa skor ini masih dapat digunakan dalam praktik sehari-hari. Bila sistem skor ini dikombinasikan dengan pemeriksaan USG ataupun biomarker lainnya maka akurasi diagnosis akan meningkat. Kata kunci: skor Alvarado; akurasi; apendisitis
Patofisiologi dan Faktor-faktor yang Berhubungan dengan Hernia Inguinalis pada Anak Reskita A. Igirisa; Harsali F. Lampus; Andriessanto C. Lengkong
Medical Scope Journal Vol. 5 No. 1 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i1.45120

Abstract

Inguinal hernia in children is a common surgical problem. Albeit, pathophysiology related to the incidence of inguinal hernias and its predisposing factors are not fully accepted.  This study aimed to determine the pathophysiology and the predisposing factors the lead to inguinal hernia in children. This was a literature study using various medical literatures in line with the topic from the ClinicalKey, Pubmed, and Google Scholar databases. The results obtained 11 literatures that fulfilled the criteria. The pathophysiology of inguinal hernia was closely related to the failure of processus vaginalis obliteration and genetic factors related to the formation of connective tissue. Predisposing factors for inguinal hernias included increased intra-abdominal pressure, patent processus vaginalis, low birth weight, gender, prematurity, and syndromes associated with connective tissue disorders. In conclusion, the pathophysiology of hernia inguinalis in children is strongly related to the failure of  procesus vaginalis to obliterate and genetic factors in the formation of connective tissues with a variety of predisposing factors. Keywords: inguinal hernia in children; pathophysiology; risk factors; processus vaginalis; Marfan syndrome   Abstrak: Hernia inguinalis pada anak merupakan suatu kejadian yang umum terjadi pada ranah bedah. Berbagai pendapat mengenai patofisiologi terkait kejadian hernia inguinalis dan faktor predisposisi yang dapat menyebabkan hernia inguinalis pada anak belum disepakati sepenuhnya. Penelitian ini bertujuan untuk mengetahui patofisiologi terkait kejadian hernia inguinalis pada anak dan faktor predisposisi kejadian ini. Jenis penelitian ialah suatu literature review menggunakan berbagai literatur kedokteran yang sejalan dengan topik dan berasal dari database ClinicalKey, Pubmed, dan Google Scholar. Hasil penelitian mendapatkan 11 literatur yang memenuhi kriteria penelitian. Patofisiologi terjadinya hernia inguinalis erat kaitannya dengan kegagalan penutupan prosesus vaginalis dan juga faktor genetik yang berhubungan dengan pembentukan jaringan ikat. Faktor predisposisi dari hernia inguinalis antara lain peningkatan tekanan intra-abdomen, prosesus vaginalis yang paten, berat badan bayi lahir rendah, jenis kelamin, prematuritas, dan sindrom terkait gangguan jaringan ikat. Simpulan penelitian ini ialah patofisiologi terjadinya hernia inguinalis pada anak erat kaitannya dengan kegagalan penutupan prosesus vaginalis dan faktor genetik dalam pembentukan jaringan ikat dengan faktor predisposisi yang bervariasi. Kata kunci: hernia inguinalis; anak; patofisiologi; faktor risiko; prosesus vaginalis; sindrom Marfan
Patofisiologi dan Faktor Predisposisi yang Berhubungan dengan Omphalocele Angel D. Rarung; Harsali F. Lampus; Eko Prasetyo
Medical Scope Journal Vol. 5 No. 1 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i1.45295

Abstract

Abstract: Omphalocele is one of the most common congenital abnormalities of the abdominal wall. In various countries, the incidence of omphalocele ranges from 1-3.8 per 10,000 pregnancies. This study aimed to determine the pathophysiology and predisposing factors associated with omphalocele. This was a literature review study. Literatures were obtained through several databases: Pubmed, ClinicalKey, and Google Scholar. The results showed 22 articles that fulfilled the inclusion criteria. The pathophysiology of omphalocele was when the abdominal organs herniate for an extended period of time, in results failing the intra-abdominal organs from returning to their normal position. Predisposing factors associated with omphalocele were divided into two aspects namely maternal and neonatal. In conclusion, the pathophysiology of omphalocele is still the same from year to year with the existing theory that there has not been a shift or discoveries. In contrast, for predisposing factors, several studies have reported new aspects of maternal and neonates about factors related to omphalocele. Keywords: omphalocele; pathophysiology; predisposing factors   Abstrak: Omphalocele adalah salah satu kelainan kongenital dinding abdomen yang paling umum terjadi, Insiden omphalocele berkisar pada 1-3,8 per 10.000 kehamilan di berbagai negara. Penelitian ini bertujuan untuk mengetahui patofisiologi dan faktor predisposisi yang berhubungan dengan omphalocele. Jenis penelitian ialah suatu literature review. Literatur diperoleh melalui beberapa basis data yaitu Pubmed, ClinicalKey, dan Google Scholar. Hasil penelitian mendapatkan 22 artikel yang sesuai dengan kriteria inklusi. Patofisiologi omphalocele yaitu ketika terjadi herniasi fisiologis berkepanjangan dari organ abdomen sehingga terjadi kegagalan organ intraabdomen untuk kembali ke posisi normalnya. Faktor predisposisi yang berhubungan dengan omphalocele terbagi atas dua aspek yaitu maternal dan neonatus. Simpulan penelitian ini ialah patofisiologi dari omphalocele masih sama dari tahun ke tahun dengan teori yang ada dimana belum terjadi pergeseran atau penemuan baru sedangkan untuk faktor predisposisinya terdapat beberapa penelitian yang melaporkan hal baru terkait aspek maternal dan neonatus yang berhubungan dengan omphalocele. Kata kunci: omphalocele; patofisiologi; faktor predisposisi
Role of Colonoscopy in Foreign Body (Needle) Ingestion in Children: A Case Report and Literature Review Harsali F. Lampus; Candy Candy; Leo Rendy; Ronald Sorongku; Sabrandi P. Saputra
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51636

Abstract

Abstract: Foreign body (FB) ingestion is one of the most complex and serious emergency conditions for diagnosis that often occurs in children. Most ingested FBs, intentionally or unintentionally, pass through the gastrointestinal tract without complications, and only a small proportion require surgical intervention inter alia colonoscopy. However, if the patient complains of abdominal pain, complications may occur, especially perforation with peritonitis, and in this case a laparotomy is needed. We reported a case of a 13-year-old girl with the chief complaint of needle ingestion two weeks ago. Patient complained of abdominal pain and was unable to defecate. Plain abdominal radiographs showed needle-shaped metal density in the lower intestinal; therefore, the patient was referred to Prof. Dr. R. D. Kandou Hospital for further treatment. An endoscopy was initially performed but no foreign body was found because they might had been in the intestine. Colonoscopy revealed a foreign body in the proximal ascending colon, transverse position. Extraction of the foreign body, along with pulling the scope and evaluating the transverse, descending, sigmoid and rectum colon which were within normal limits was carried out. Monitoring after removal of the foreign body for two days found no complaints of abdominal pain and bowel movements were normal, therefore, the patient was discharged from the hospital. In conclusion, since a sharp foreign body (a needle) was still in the proximal ascending colon, a colonoscopy was performed with successful removal of the needle. Keywords: foreign body; needle; endoscopy; colonoscopy
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