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Subcutaneous Endometriosis after Cesarean Section : A Case Report Tansil, Tan, Ardio Rizky; Savitri, Irma; Rambulangi, John
Nusantara Medical Science Journal Volume 8 Issue 1, January - June 2023
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v8i1.21634

Abstract

Introduction and importance: Endometriosis is a condition in which both the stromal tissue and the functional endometrial glands are observed outside the uterine cavity. Endometriosis can be found in pelvic organs and extra-pelvic. Subcutaneous Endometriosis is a condition which may occur after surgical procedures such as cesarean section. Presentation of case: We report a 37-year-old female patient who had undergone two cesarean sections, presented with cyclic hypogastric pain and vaginal bleeding. Cyclic bleeding also occurred from the cesarean section scar since 1 year ago. Total abdominal hysterectomy, right salpingooophorectomy, left salpingectomy and wide excision of the scar were performed. Histopathology results of stromal tissue and functional endometrial glands on subcutaneous part of the skin were found. Discussion: The incidence of subcutaneous endometriosis can occur months to years after the surgical procedure with an average of about 30 months. Complaints in patients are usually in the form of a painful and enlarged abdominal mass, especially during menstruation. In establishing the diagnosis of subcutaneous endometriosis, the gold standard is pathological examination. The main management of this subcutaneous endometriosis case is a wide excision procedure by performing excision and providing a minimum clearance of 1 cm. Conclusions: Subcutaneous endometriosis is extrapelvic endometriosis, which is mainly caused by surgery, one of which is cesarean section. Establishing a definite diagnosis of subcutaneous endometriosis is difficult without any pathological examination. The main management of subcutaneous endometriosis is wide excision with a margin of 1 cm to prevent recurrence of this disease.
Validitas Komik Fisika Digital Untuk Melatihkan Berpikir Kritis Peserta Didik Pada Materi Gaya Gesek Savitri, Irma; Kholiq, Abd
IPF: Inovasi Pendidikan Fisika Vol. 12 No. 3 (2023): Volume 12 Nomor 3 Tahun 2023
Publisher : Universitas Negeri Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26740/ipf.v12n3.p41-47

Abstract

Abstract 21st century education, implementing learning by utilizing the development of science and technology. 21st century learning is not just knowledge that is relied on, but also involves skills in learning. One of the skills in the 21st century is critical thinking skills. Critical thinking is an ability that students must have to interpret, analyze, explain, conclude, and evaluate, in problem solving activities. The development of 21st century skills must be carried out by educators in order to achieve effective and efficient learning objectives. In developing 21st century skills, educators can use instructional media by utilizing technological developments in the 21st century. Thus, the research aims to produce digital physics comics to train students' critical thinking on frictional material which is declared valid. This development research uses the DDD-E model with the stages of decide, design, develop, and evaluate. The validity of digital physics comics was obtained based on instrument validation by the validator on media, material, and language aspects. The validators consisted of 3 expert lecturers majoring in physics at Surabaya State University. The results showed that the percentage of validity on the media aspect was 90%, on the material aspect was 93%, and on the language aspect was 95%. Based on these results, the validity of the comic was obtained by an average validation score percentage of 93% with a very valid category. Thus digital physics comics are declared feasible to be used as physics learning media to train students' critical thinking on friction material,. Keywords: digital physics comics, critical thinking, frictional force
The Effectiveness of Plasmapheresis Compared to Intravenous Immunoglobulin in Guillain-Barre Syndrome Patients Mustika, Alyssa Putri; Hakim, Manfaluthy; Sari, Waode Satriana; Octaviana, Fitri; Budikayanti, Astri; Safri, Ahmad Yanuar; Wiratman, Winnugroho; Indrawati, Luh Ari; Fadli, Nurul; Harsono, Adrian Ridski; Savitri, Irma
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.24

Abstract

Introduction : Guillain-Barré syndrome (GBS) is the second most common cause of acute and subacute general paralysis. The management is symptom-adjusting, but plasmapheresis (plasma exchange/PE) and intravenous immunoglobulin immunotherapy (IVIG) can be administered to accelerate the return of neurological function. This study aim to determine PE's effectiveness compared to IVIG in GBS patients and the side effects or complications that may arise. Method : The literature study is carried out on four databases. Selection is carried out using inclusion and exclusion criteria. The articles were screened and extracted independently by two investigators. Results : The literature study obtained three systematic review studies. In the first study, shows the outcomes in the form of improved Hughes Score (OR 1.9; 95% CI 1.11-3.28) and mortality (OR 0.8; 95% CI 0.31-2.29) against IVIG. The second study, outcomes shown in the form of improved disability scores (WMD -0.02, p: 0.83), and secondary outcomes such as mortality or relapse (p >0.05, respectively). The third study showed that IVIG had higher efficacy (OR 1.6, p: 0.067, 95% CI 0.972-2.587), shorter duration of hospitalization, 38 days, compared to 49-day PE therapy (SMD -3.389, 95% CI -11.601-4.824; p: 0.419), however, had higher side effect (OR 0.8, p: 0.430, 95% CI 0.389-1.495). Conclusion : PE efficacy is generally lower than IVIG, as indicated by disability scores/motor ability scores in various studies, as well as the duration of hospitalization. The safety of therapy is assessed by the side effects that appear and appear-more-often in IVIG therapy rather than PE.
Validity and reliability of the Indonesian version of the Douleur Neuropathique 4 for neuropathic pain Sofyan, Henry Riyanto; Hartono, Chandra; Savitri, Irma; Alvonsius, Raymond Aris Nimrod; Hakim, Manfaluthy; Aninditha, Tiara
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257725

Abstract

BACKGROUND The Douleur Neuropathique 4 (DN4) is a widely used questionnaire for assessing neuropathic pain, demonstrating good sensitivity and specificity across various languages. Originally developed in France, cultural and linguistic differences necessitate its translation, validation, and reliability testing before use in Indonesia. This study aimed to translate, culturally adapt, and evaluate the validity and reliability of the Indonesian version of the DN4 questionnaire (DN4-Ina) for use in clinical and research settings. METHODS Translation and cross-cultural adaptation were conducted following World Health Organization guidelines in Indonesian. A cross-sectional study was conducted in the Neurology Clinic, Cipto Mangunkusumo Hospital, to assess the validity and reliability of the DN4-Ina. The study subjects were selected through consecutive sampling of adult patients with chronic pain visiting the clinic from June to December 2023. Validity and reliability were assessed using SPSS software version 25. Validity testing utilized adjusted item-total correlation analysis, while reliability testing was evaluated using the test-retest method, intraclass correlation coefficient (ICC), and Cronbach’s alpha for internal consistency. RESULTS Of 40 participants, 65% were female, with a mean age of 51.85 (13–92) years, moderate pain intensity (mean numeric rating scale of 4.25 [2.99]), and pain duration of 7.95 (4.41) months. All DN4-Ina questions showed a correlation coefficient (r) greater than the table’s value (0.312). The reliability test showed an ICC of 0.99 and a Cronbach’s alpha of 0.746. CONCLUSIONS The DN4-Ina score is a valid and reliable questionnaire for assessing neuropathic pain in the Indonesian population.