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e-CliniC
Published by Universitas Sam Ratulangi
ISSN : 23375949     EISSN : -     DOI : -
Core Subject : Health,
Health Professions
Jurnal e-CliniC (eCl) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia bekerja sama dengan Fakultas Kedokteran Universitas Sam Ratulangi Manado. Jurnal ini diterbitkan 3 (tiga) kali setahun (Maret, Juli, dan November). Sejak tahun 2016 Jurnal e-CliniC diterbitkan 2 (dua) kali setahun (Juni dan Desember). Jurnal e-CliniC memuat artikel penelitian, telaah ilmiah, dan laporan kasus di bidang ilmu kedokteran klinik.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 20 Documents
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Search results for , issue "Vol. 12 No. 2 (2024): e-CliniC" : 20 Documents clear
Perbandingan antara Skor ALBI, Child-Pugh, dan MELD dalam Memrediksi Kejadian Post Hepatectomy Liver Failure pada Pasien Karsinoma Hepato-seluler di RSUP Prof. Dr. R. D. Kandou Manado Martino, Celine; Tendean, Michael; Mambu, Toar D. B.; Langi, Fredrik G.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.51814

Abstract

Abstract: Hepatocellular carcinoma (HCC) accounts for nearly 90% of hepatic malignancies. ALBI (Albumin-Bilirubin), Child-Pugh, and MELD (Model for End-stage Liver Disease) scores can predict the incidence of Post Hepatectomy Liver Failure (PHLF) in patients undergoing liver resection. This study aimed to obtain the comparison of ALBI, Child-Pugh, and MELD scores in predicting the incidence of PHLF in patients undergoing liver resection. This was a descriptive and retrospective study using medical records of Prof. Dr. R. D. Kandou Hospital, Manado, from 2019 to early 2022. The results obtained 54 patients who had undergone liver resection. The Child Pugh, ALBI, and MELD scores had similar ability in predicting the prognosis of PHLF. The MELD score had the sensitivity dan specifity of 64% and 81%, and the accuracy of 78% meanwhile the ALBI dan Child-Pugh scores had sensitivity less than 50%. In conclusion, compared with the ALBI and Child Pugh scores, the MELD score has higher sensitivity. Keywords: hepatocellular carcinoma; ALBI score; Child-Pugh score; MELD score; post hepatectomy liver failure   Abstrak: Karsinoma hepatoseluler (HCC) menyumbang hampir 90% kasus keganasan pada hepar. Skor ALBI, Child-Pugh dan MELD (Model for End-stage Liver Disease) dapat memrediksi kejadian post hepatectomy liver failure (PHLF) pada pasien yang menjalani reseksi hepar. Penelitian ini bertujuan untuk membandingkan skor ALBI, Child-Pugh dan MELD dalam memrediksi kejadian PHLF pada pasien yang menjalani reseksi hepar. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medis di RSUP Prof. Dr. R. D. Kandou Manado dari tahun 2019 sampai awal tahun 2022. Hasil penelitian mendapatkan 54 pasien yang telah menjalani reseksi hati. Skoring Child-Pugh, ALBI dan MELD memiliki kemampuan serupa dalam menentukan prognosis PHLF. Skor  MELD menunjukkan sensitivitas dan spesifisitas berturut-turut sebesar 64% dan 81%, dengan akurasi 78% sedangkan skor ALBI dan Child-Pugh memiliki sensitivitas di bawah 50%. Simpulan penelitian ini ialah dibandingkan dengan skor ALBI dan Child-Pugh, skor MELD memiliki sensitivitas lebih tinggi dalam memrediksi kejadian PHLF. Kata kunci: karsinoma hepatoseluler; skor ALBI; skor Child-Pugh; skor MELD; post hepatectomy liver failure
Effect of Propolis Trigona Sp on Expression of TNF-α in Superficial Dermal Burns through In Vivo Test Siwabessy, Melfrits R.; Manginstar, Christian; Merung, Marselus A.; Langi, Fredrik G. L.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.51816

Abstract

Abstract: Burn is caused by exposure to high-temperature substances such as hot, solid liquids or gases such as smoke, steam, engines, stoves, radiators and objects that emit heat energy. In severe burns, there is an excessive neutrophil inflammatory response that triggers SIRS, where there is an excessive increase in pro-inflammatory mediators such as TNFα and IL-6. Propolis contains a number of compounds, such as flavonoids, CAPE, phenol compounds, arginine, ferulic acid and albumin which play a good role in healing burns. This study aimed to find out the effect of propolis on TNF-α expression through in-vivo testing in cases of superficial dermal burns. This was an experimental and laboratory study to assess the bioactive compounds contained in Trigona Sp propolis. Descriptive analysis was performed on the bioactive composition of Trigona Sp propolis and experimental effectiveness of propolis on TNF-α expression in superficial dermal burns. The study was conducted at the laboratory of experimental animals "Alike Quality System", Manado. The results showed that the group treated with propolis had smaller burn areas compared to the groups treated with 1% silver sulfadiazine or with 0.9% NaCl. Granulation had been formed throughout all wounds, however, macroscopically, burns with propolis treatment showed reddish wound appearance while treated wounds with 1% silver sulfadiazine and 0.9% NaCl were darker in color and had thicker crust formation. The one-way ANOVA test showed no significant difference between propolis and 1% silver sulfadiazine on TNF-α expression in dermal superficial burns (p=0.666) meanwhile the effect of propolis compared with NaCl 0.9% on TNF-α expression in dermal superficial burns, showed significant differences (p=0.006 and p=0.040). In conclusion, administration of propolis can reduce the expression of TNF-α in superficial dermal burn. Keywords: propolis; Trigona sp; burns; in vivo study
Pengaruh Radioterapi Short-course Neoadjuvant terhadap Kadar Carcino-embryonic Antigen pada Adenokarsinoma Rekti Jeffri, Jeffri; Tjandra, Ferdinand; Mambu, Toar D. B.; Napitupulu, Enrico
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.51820

Abstract

Abstract: Neoadjuvant therapy is starting to be used as an alternative treatment in type A medical centers, however, there is still no specific consensus in determining the role and type of neoadjuvant therapy in adenocarcinoma recti patients. As a result, the use of neoadjuvant therapy is still not widely used. This study aimed to compare the outcome in the form of carcinoembryonic antigen (CEA) in patients who continued surgery with short-course neoadjuvant radiotherapy with those who did not. This was a descriptive and retrospective study. Samples were recti cancer patients stage II – IV at Prof. Dr. R. D. Kandou Hospital Manado in the medical record of 2017-2022. Patients were divided into two groups, those who received short-course neoadjuvant radiotherapy and the control group with similar characteristics. The results showed that there was a difference in the decrease of CEA in the two groups. The mean decrease of CEA in the short-course neoadjuvant group was 16.54 5 µg/L which was higher compared to the control group 5.64 5 µg/L. In conclusion, neoadjuvant short-course radiotherapy can decrease the CEA level in adenocarcinoma recti patients. Keywords: adenocarcinoma recti; short-course neoadjuvant radiotherapy; carcinoembryonic antigen    Abstrak: Terapi neoadjuvan mulai digunakan sebagai alternatif penanganan pada pusat kesehatan tipe A, namun belum ada konsensus spesifik dalam penentuan peran dan tipe terapi neoadjuvan pada pasien adenokarsinoma rekti sehingga terapi ini belum dapat digunakan secara bebas. Penelitian ini bertujuan untuk membandingkan luaran berupa kadar carcinoembryonic antigen (CEA) pada pasien yang melanjutkan tindakan operasi dan radioterapi short-course neoadjuvant maupun yang tidak. Jenis penelitian ialah deskriptif retrospektif menggunakan pasien kanker rekti stadium II hingga IV di RSUP Prof. Dr. R. D. Kandou Manado yang terdata di rekam medis periode tahun 2017-2022. Pasien dibagi atas dua kelompok yaitu yang menerima radioterapi short-course neoadjuvant dan kelompok kontrol dengan karakteristik serupa. Hasil penelitian memperlihatkan bahwa terdapat perbedaan penurunan kadar CEA yang bermakna pada pasien adenokarsinoma rekti yang dilakukan radioterapi neoadjuvant short-course dibandingkan dengan kontrol. Rerata penurunan nilai CEA pada kelompok yang menjalani radioterapi short-course neoadjuvant sebanyak 16,54 5 µg/L, lebih tinggi dibandingkan pada kelompok kontrol sebanyak 5,64 5 µg/L. Simpulan penelitian ini ialah pemberian radioterapi neoadjuvant short-course dapat menurunkan kadar CEA pada pasien adenokarsinoma rekti. Kata kunci: adenokarsinoma rekti, terapi short-course neoadjuvant; carcinoembryonic antigen
Percutaneous Coronary Intervention in a Saphenous Vein Graft Failure: A Case Report Jim, Edmond L.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.52514

Abstract

Abstract: Recent published data from the Society of Thoracic Surgery (STS) national database displayed that among patients aged >65 years old who survived following an initial coronary artery bypass graft (CABG) operation, rates of repeat revascularization at 1, 5, 10, and 18 years were 2%, 8%, 16%, and 25%, respectively. The most preferred mode of revascularization was percutaneous coronary intervention (PCI). While remain the most frequently used conduits beside left internal mammary artery (LIMA), saphenous vein grafts (SVGs) have high failure rates. Percutaneous coronary intervention in SVGs is associated with an increased risk of distal coronary embolization, commonly resulting in periprocedural MI. We reported a 79-year-old male patient admitted due to progressive symptoms of chronic coronary syndrome. The patient had a history of hypertension and a CABG surgery in 2012. Electrocardiogram showed ischemia and old myocardial infarction (OMI) in inferior leads as well as poor R wave progression in the precordial leads. Transthoracic echocardiogram displayed a normal ejection fraction but impaired left ventricular (LV) diastolic relaxation. Diagnostic coronary angiography revealed a 70% tubular stenosis in proximal part of SVG supplying posterior descending artery, patent LIMA graft to left anterior descending artery, and complex lesion on native vessel (chronic total occlusion in mid right coronary artery). Implantation of drug eluting stent in SVG-posterior descending artery was performed. Direct-stenting PCI technique using undersized-stent was done to prevent any complications. In conclusion, despite the high risk of complications, vein graft intervention was successfully performed without any complications. Since the high rates of in-stent restenosis following PCI in SVGs, long-term dual antiplatelet therapy should be commenced in this patient. Keywords: saphenous vein graft; vein graft intervention; percutaneous coronary intervention
Penerapan Sistem Informasi Manajemen Rumah Sakit di RSUD Dr. Sam Ratulangi Tondano Tangel, Pricillia T.; Manampiring, Aaltje E.; Kapantow, Nova H.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.52755

Abstract

Abstract: Hospital management information system (HMIS) is an integrated information system prepared to handle the entire process of hospital management and services. This study aimed to analyze the implementation of hospital management information systems at RSUD Dr. Sam Ratulangi Tondano. This was a qualitative case study with in-depth interviews and observation methods. Samples were four informants. Data analysis is a content analysis through the data reduction stage, data presentation in a matrix, and the validity of the research results using source and method triangulation to draw conclusions. The results showed that based on infrastructure indicators, there was a lack of available computers in each section, the internet network quality was inadequate, due to a lack of budget allocation for HMIS. Based on human resource indicators, there was a lack of qualified and competent IT personnel as well as indiscipline on duty, absence of a strict reward and punishment system, that actually disrupted the flow of services in the hospital.  Based on indicators of the operational procedure system, it is in accordance with the existing standards of the hospital to carry out the duties and functions according to their respective duties. In conclusion, the application of HMIS at RSUD Dr. Sam Ratulangi Tondano related to the quality of infrastructure and human resource indicators is still lacking, on the other hand the standard operating procedure indicators are good which are regulated directly by the hospital leadership. Keywords: hospital management information system; infrastructure; human resources; standard operating procedures    Abstrak: Sistem informasi manajemen rumah sakit (SIMRS) merupakan sistem informasi terintegrasi yang disiapkan untuk menangani keseluruhan proses manajemen dan pelayanan rumah sakit. Penelitian ini bertujuan untuk menganalisis penerapan sistem informasi manajemen rumah sakit di RSUD Dr. Sam Ratulangi Tondano. Metode penelitian ialah studi kualitatif kasus melalui wawancara mendalam dan observasi dengan empat informan. Analisis data melalui tahap reduksi data, penyajian data dalam matriks, validitas hasil penelitian menggunakan triangulasi sumber dan metode hingga penarikan simpulan. Hasil penelitian mendapatkan pada indikator infrastruktur ialah kurangnya keter-sediaan komputer di setiap bagian dan kualitas jaringan internet yang belum memadai, disebabkan karena kurangnya anggaran alokasi untuk SIMRS. Pada indikator sumber daya manusia (SDM) didapatkan kurangnya tenaga IT yang sesuai kualifikasi dan kompetensi serta adanya ketidakdisiplinan waktu saat bertugas, dan tidak adanya sistem reward dan punishment yang tegas; hal ini justru mengganggu alur pelayanan di rumah sakit. Indikator sistem operasional prosedur sudah sesuai standar rumah sakit untuk menjalankan tugas tupoksi sesuai tugas masing-masing. Simpulan penelitian ini ialah penerapan SIMRS di RSUD Dr. Sam Ratulangi Tondano dari indikator infrastruktur dan SDM kualitasnya masih kurang, di sisi lain indikator standar operasional prosedur sudah baik yang diatur langsung oleh pimpinan rumah sakit. Kata kunci: sistem informasi manajemen rumah sakit; infrastruktur; sumber daya manusia; standar operasional prosedur
Hubungan Kadar Fibronektin Serum dengan Tingkat Kesadaran Menurut Klasifikasi CT-Marshall pada Cedera Otak Sedang dan Berat Akibat Trauma Mogi, Diornald J.; Prasetyo, Eko; Oley, Maximillian C.; Tjungkagi, Ferdinan; Manuhutu, Yovanka N.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.52956

Abstract

Abstract: Traumatic brain injury (TBI) is the main cause of brain damage in the adolescent and productive age generations, and its incidence is increasing every year. To date, there is still no accurate biological marker for detection of traumatic brain damage or prognosis related to the brain damage. One of the promising biological markers for detection of brain damage is fibronectin. This study aimed to evaluate the relationship between level of serum fibronectin and level of consciousness based on CT-Marshall in TBI patients. This was an observational and analytical study with a cross-sectional design. Samples that met the study criteria were taken sequentially from the study hospital without differentiating exposure status (serum fibronectin levels) or outcome (CT-Marshall category). The regression test on level of serum fibronectin and level of consciousness based on the CT-Marshall category obtained significant result indicating that the higher the serum fibronectin level, the higher the patient's CT-Marshall category which meant the patient had a higher degree of severity and poor consciousness. In conclusion, there is a significant relationship between level of serum fibronectin and level of consciousness based on the CT-Marshall category in moderate and sever traumatic brain injury patients. Keywords: traumatic brain injury; biological marker; serum fibronectin; CT-Marshall category   Abstrak: Cedera otak akibat trauma (COT) merupakan penyebab utama kerusakan otak pada generasi muda dan usia produktif dengan angka kejadian meningkat setiap tahunnya.  Saat ini, belum terdapat penanda biologis yang akurat untuk mendeteksi kerusakan otak traumatik ataupun menilai prognosis terkait kerusakan otak traumatik. Salah satu penanda biologis yang cukup menarik perhatian ialah fibronektin. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar fibronektin serum dengan tingkat kesadaran menurut klasifikasi CT-Marshall pada COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel yang memenuhi kriteria penelitian diambil berurutan dari rumah sakit tempat penelitian tanpa membedakan status paparan (kadar fibronektin serum) atau luaran (kategori CT-Marshall). Hasil uji regresi pada variabel utama kadar fibronektin serum dengan kesadaran menggunakan kategori CT-Marshall mendapatkan hasil bermakna yaitu semakin tinggi kadar fibronektin serum, semakin tinggi pula kategori CT-Marshall pasien yang berarti pasien memiliki derajat keparahan dan kondisi kesadaran yang buruk. Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar fibronektin serum dan tingkat kesadaran menggunakan kategori CT-Marshall pada pasien cedera otak traumatic sedang dan berat. Kata kunci: cedera otak akibat trauma; penanda biologis; fibronektin serum; kategori CT-Marshall
Pola Bakteri dan Resistensi Antimikroba pada Infeksi Terkait Fraktur Terbuka di RSUP Prof. Dr. R. D. Kandou Manado Senduk, Ryan A.; Lengkong, Andriessanto; Sunaryo, Haryanto
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.54339

Abstract

Abstract: Fracture-related infection is a serious complication in orthopedic trauma, both in terms of infection and surgery. The use of antibiotics is a crucial component in the management of fracture-related infection, however, it can also lead to antibiotic resistance. This study aimed to evaluate the patterns of bacteria and antimicrobial resistance in open fracture-related infections at Prof. Dr. R. D. Kandou Hospital in Manado. This was a descriptive study with a cross-sectional design. Samples consisted of patients with open fracture-related infections and had microbiological culture and drug sensitivity data. Secondary data were collected and analyzed using categorical and numerical data. The results obtained 20 subjects with the average age of 42.8±19.0 years, dominated by males (80%), and the most common location of fracture was tibia/fibula (65%). The highest multidrug resistance rates by bacterial type were found in Klebsiella and Enterobacter (medians of 9 and 7, respectively). Based on bacterial type and antimicrobial resistance, the most common bacteria were Staphylococcus aureus and Enterobacter (30%), followed by MRSA and Klebsiella (15%), Acinetobacter baumanni and Pseudomonas (1%). The highest percentage of antibiotic resistance was found in ampicillin-sulbactam, ciprofloxacin, and gentamicin. Meanwhile, the highest distribution of antibiotic sensitivity was found in trimethoprim sulfamethoxazole, amikacin, clindamycin, and meropenem. In conclusion, open fracture cases are most commonly associated with Staphylococcus aureus and Enterobacter. Antibiotic resistance is predominantly observed in ampicillin sulbactam, ciprofloxacin, and gentamicin. Keywords: infection; open fracture; antibiotics; bacterial resistance   Abstrak: Infeksi terkait fraktur merupakan komplikasi serius dalam trauma ortopedi, baik dari segi infeksi maupun pembedahan. Penggunaan antibiotik menjadi salah satu bagian dalam penatalaksanaan infeksi, namun hal ini dapat mengakibatkan resistensi antibiotik. Penelitian ini bertujuan untuk mengevaluasi pola bakteri dan resistensi antimikroba pada infeksi terkait fraktur terbuka di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah pasien dengan infeksi terkait fraktur terbuka yang memiliki data hasil pemeriksaan kultur mikroba dan sensitivitas obat. Pengumpulan data melalui data sekunder dan dianalisis melalui data kategorik dan numerik. Hasil penelitian mendapatkan 20 subjek, dengan rerata usia 42,8±19,0 tahun. Majoritas subjek ialah laki-laki (80%), dan jenis fraktur terbanyak di tibia/fibula (65%). Hasil multidrug resistance tertinggi menurut jenis bakteri ialah pada Klebsiella dan Enterobacter dengan median masing-masing 9 dan 7. Berdasarkan jenis bakteri dan resistensi antimikroba, yang terbanyak yaitu Staphylo-coccus aureus dan Enterobacter (30%), diikuti MRSA dan Klebsiella (15%), Acinetobacter baumanni dan Pseudomonas (1%). Distribusi resistensi antibiotik tertinggi pada ampicilin-sulbactam, ciprofloxacin, dan gentamisin, sedangkan distribusi sensitivitas antibiotik tertinggi pada trimethoprim sulfomethoxa-zole, amikasin, clindamycin, dan meropenem. Simpulan penelitian ini ialah pada kasus patah tulang terbuka jenis bakteri terbanyak ialah Staphylococcus aureus dan Enterobacter. Resistensi antibiotik didominasi oleh ampicillin sulbactam, ciproflocacin, dan gentamicin. Kata kunci: infeksi; fraktur terbuka; antibiotik; resistensi bakteri
Gambaran Kasus Penganiayaan di Wilayah Kerja Polsek Langowan Periode 2021-2022 Tumiwa, Josua S.; Siwu, James F.; Tomuka, Djemi
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.54472

Abstract

Abstract: Illness and death can occur not only as a result of abnormalities or disease, but also through accidents or criminal acts. One form of crimes that is often encountered is persecution. Langowan is one of the areas in North Sulawesi where acts of abuse are often found. This study aimed to describe cases of persecution in the working area of Polsek Langowan in years 2021-2022. This was a descriptive and retrospective study with a cross-sectional design using reports of cases of persecution in the working area of Polsek Langowan in years 2021-2022. The results obtained a total of 55 cases of persecution occurred in 2021-2022, and the highest percentages of cases were in July 2021 and January 2022, each of six cases (10.91%). Gender was dominated by men, namely 52 cases (94.55%). The largest age range is 17-25 years which was late adolescence with a total of 24 cases (43.64%). The most common form of maltreatment was moderate maltreatment in 50 cases (90.91%). The most common type of violence was blunt violence with a total of 34 cases (58,62%). Most of the injuries occurred on the head with a total of 38 cases (50%). In conclusion, the most persecution occurred in July 2021 and January 2022, dominated by male victims, aged 17-25 years, moderate form of persecution, blunt violence, and the location of injury on the head. Keywords: persecution; blunt trauma; victim   Abstrak: Kesakitan dan kematian bisa terjadi bukan hanya akibat adanya kelainan atau penyakit, tetapi juga melalui kecelakaan maupun tindakan kejahatan. Salah satu bentuk kejahatan yang sering ditemui yaitu penganiayaan. Langowan merupakan salah satu daerah di Sulawesi Utara yang sering didapatkan adanya tindak penganiayaan. Penelitian ini bertujuan untuk mengetahui gambaran kasus penganiayaan di Wilayah Kerja Polsek Langowan Periode 2021-2022. Jenis penelitian ialah potong lintang dengan mengumpulkan data sekunder yaitu laporan kasus penganiayaan di wilayah kerja Polsek Langowan Periode 2021-2022. Hasil penelitian mendapatkan sebanyak 55 kasus penganiayaan di wilayah kerja Polsek Langowan periode 2021-2022, dengan kasus penganiayaan terbanyak terjadi pada bulan Juli 2021 dan Januari 2022 dengan total masing-masing enam kasus (10,91%). Jenis kelamin didominasi oleh laki-laki yaitu sebanyak 52 kasus (94,55%). Rentang usia terbanyak yaitu 17-25 tahun yang merupakan masa remaja akhir dengan total 24 kasus (43,64%). Bentuk penganiayaan terbanyak yaitu penganiayaan sedang sebanyak 50 kasus (90,91%). Jenis kekerasan terbanyak yaitu kekerasan tumpul dengan total 34 kasus (58,62%). Lokasi perlukaan terbanyak terjadi di bagian kepala dengan total 38 kasus (50%). Simpulan penelitian ini ialah penganiayaan paling banyak terjadi di bulan Juli 2021 dan Januari 2022, didominasi oleh korban laki-laki, usia 17-25 tahun, bentuk penganiayaan sedang, jenis kekerasan tumpul, dan lokasi perlukaan di bagian kepala. Kata kunci: penganiayaan; trauma tumpul; korban
Rehabilitation for Marfan Syndrome Hartanto, Christi E.; Rondonuwu, Gloria E .; Gessal, Joudy
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.54474

Abstract

Abstract: Marfan syndrome is a spectrum of disorders caused by a heritable genetic defect of connective tissue that has an autosomal dominant mode of transmission. The defect itself has been isolated to the FBN1 gene on chromosome 15, which codes for the connective tissue protein fibrillin. Abnormalities in this protein cause a myriad of distinct clinical problems, of which the musculoskeletal, cardiac, and ocular system problems predominate. The skeleton of patients with Marfan syndrome typically displays multiple deformities. Mitral valve prolapses that requires valve replacement can occur as well. Given the variable expressivity of Marfan Syndrome, no single sign is pathognomonic; the diagnosis is made on clinical grounds on the basis of typical abnormalities. We reported a boy, 12 years old, referred from surgeon with diagnosis pectus carinatum pro brace. Chest protusion appeared since age 6, getting bigger without any complaint but cosmetic. Other complaints on feet which looked flat, sometimes ankle sore after long distance running or futsal. He was the first child and no family history had a condition like him. His hobby was playing futsal, and daily activities were independent without assistive devices. General appearance and vital signs were normal, cardiorespiratory assessment was normal, BMI on percentile 10-25, arm span to height ratio 1.09, lens subluxation of left eye, lens dislocation of right eye, poor standing balance, inadequate toe off, thoracic hyperkyphotic, positive wrist sign, true leg length discrepancy of 1 cm (left>right), bilateral ankle ROM limitation, rigid flat feet suspected bilateral vertical talus, left hallux valgus, Marfan syndrome score 9, and normal echocardiography. In this patient, we gave semi rigid thoraco-lumbo-sacral orthosis (TLSO) with 3 points pressure system and rigid bar on protution area (custom molded).  resistance exercise (F: 3x/week, I: moderate fatigue, Borg scale 13-15/20, T: 8-15 reps/ set, 2-3 set/ session, T: major muscle group upper and lower extremities aerobic exercise (F: 3x/week, I: moderate to vigorous, borg scale 13-15/20, T: ≥60 min/session, @5-10 min warming up and cooling down (stretching), T: sport (swimming, running, cycling). The patient was referred to a surgeon for a brace. In conclusion, this case report highlights the multidisciplinary management of patients with Marfan syndrome. Keywords: Marfan syndrome; typical abnormalities; multiple deformities
Profil Pasien Trauma di RSUP Prof Dr. R. D. Kandou Manado Periode Januari - Desember 2021 Kalampung, Jendry; Lampus, Harsali F.; Wagiu, Angelica M. J.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.55047

Abstract

Abstract:  Trauma is a holistic condition that can cause loss of productivity even to death. This study aimed to obtain an overview of trauma patients at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2021. This was a retrospective and descriptive study using patient medical record data. The results showed that out of 223 patients, the highest percentages were found in the adult group (43.1%), male sex (81.6%), and private employees (25.5%). The causes of trauma were sharp trauma (59.2%) and blunt trauma (40,8%). The most common location for injuries due to blunt trauma was the head (60.6%) meanwhile for injuries due to sharp trauma was the chest (51.6%). Based on the GCS of trauma patients, the most common type of head injury was mild head injury (45 of 223 patients). In conclusion, most trauma patients were adult, male, worked as private employee, had sharp trauma, wound site on the chest, and mild head injury Keywords: sharp trauma; blunt trauma; cause of trauma   Abstrak: Trauma adalah kejadian yang bersifat holistik dan menyebabkan hilangnya produktivitas seseorang bahkan sampai kematian. Penelitian ini bertujuan untuk mendapatkan gambaran pasien trauma di RSUP Prof. Dr. R. D. Kandou Manado pada periode Januari sampai Desember tahun 2021. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medik pasien. Hasil penelitian mendapatkan bahwa dari 223 pasien trauma, yang terbanyak ialah usia dewasa (43,1%), jenis kelamin laki–laki (81,6%), dan pekerjaan sebagai pegawai swasta (25,5%). Penyebab trauma yaitu trauma tajam (59,2%) dan trauma tumpul (40,8%). Lokasi luka akibat trauma tumpul terbanyak yaitu kepala (60,6%) sedangkan akibat trauma tajam yaitu dada (51,6%). Berdasarkan perolehan GCS yang terbanyak pada pasien trauma ialah cedera kepala ringan (45 dari 223 pasien). Simpulan penelitian ini ialah pasien trauma yang terbanyak ialah golongan dewasa, laki–laki,  pegawai swasta, trauma tajam, lokasi luka pada dada, dan cedera kepala ringan. Kata kunci: trauma tajam; trauma tumpul; penyebab trauma

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