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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 1,074 Documents
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Hubungan Tipe Fistula, Waktu Operasi, dan Toilet Training pada Malformasi Anorektal dengan Pola Defekasi Pascaoperasi Berdasarkan Skor Rintala Saputra, Sabrandi P.; Lampus, Harsali F.; Candy, Candy
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.61271

Abstract

Abstract: Anorectal malformation is a congenital abnormality in which the anus does not open normally into the perineum. In several studies, earlier surgery time has a better impact on patients. Toilet training performed postoperatively is assumed to help improve patient defecation patterns. This study is an observational analytical study with a retrospective cohort design. The population in this study were pediatric patients after surgery for Anorectal Malformation based on the Wingspread classification at Prof. R.D. Kandou General Hospital, Manado. The independent variables were fistula type, surgery time, and toilet training. In this study, the dependent variable was postoperative defecation pattern based on the Rintala Score. Bivariate analysis was used to analyze the relationship between independent variables and dependent variables. The Somers' D test was used to measure the relationship between categorical variables. The results showed that the variables namely fistula type, surgery time, and toilet training in anorectal malformation did not have statistically significant relationships with postoperative defecation pattern based on the Rintala score (p-value >0.05). The Rintala score does not always describe the anatomical or functional conditions of the anus in detail. In conclusion, there is no significant relationship between fistula type, surgery time, and toilet training in anorectal malformation with postoperative defecation pattern based on the Rintala score.   Keywords: anorectal malformation; fistula type; surgery time; toilet training; Rintala score   Abstrak: Malformasi anorektal merupakan sebagai salah satu kelainan bawaan dengan kondisi anus tidak membuka secara normal ke perineum. Toilet training yang dilakukan pascaoperasi diasumsikan membantu memperbaiki pola defekasi pasien. Penelitian ini bertujuan untuk mengevaluasi hubungan antara tipe fistula, waktu operasi, dan toilet training pada malformasi anorektal dengan pola defekasi pascaoperasi berdasarkan skor Rintala. Jenis penelitian ialah analitik observasional dengan desain kohort retrospektif. Populasi penelitian ialah pasien anak pascaoperasi malformasi anorektal berdasarkan klasifikasi Wingspread di RSUP Prof. Dr. R. D. Kandou Manado. Variabel bebas ialah tipe fistula, waktu operasi, dan toilet training sedangkan variabel terikat ialah pola defekasi paska operasi berdasarkan Skor Rintala. Analisis bivariat digunakan untuk menganalisis hubungan kedua variabel, dan uji Somers’D untuk mengukur hubungan variabel kategori. Hasil penelitian ini yaitu variabel tipe fistula, waktu operasi, dan toilet training pada malformasi anorektal tidak berhubungan bermakna secara statistik dengan pola defekasi pascaoperasi berdasarkan skor Rintala (p>0,05). Skor Rintala tidak selalu menggambarkan kondisi anatomis atau fungsional anus secara rinci. Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara tipe fistula, waktu operasi, dan toilet training pada malformasi anorektal dengan pola defekasi pascaoperasi berdasarkan skor Rintala. Kata kunci: malformasi anorektal; tipe fistula; waktu operasi; toilet training; skor Rintala
Prediksi Apendisitis dengan Komplikasi Menggunakan Systemic Inflammation Response Index dan Systemic Immune-Inflamation Index Tilaar, Enika N. C.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.64424

Abstract

Abstract: This study aimed to predict complications in appendicitis using the Systemic Inflammation Response Index (SIRI) and Systemic Immune-Inflammation Index (SII) values. This was a hospital-based retrospective study. Patients in this study were those who entered the Emergency Room of Daha Sejahtera Hospital, Hulu Sungai Selatan Regency, South Kalimantan, with a diagnosis of appendicitis, and underwent appendectomy by a general surgeon between September 2024 - April 2025. Data were presented in groups of appendicitis with and without complications based on intraoperative characteristics. The results showed that 14 patients met the inclusion criteria. Mean SIRI level in appendicitis with complications was significantly higher than without complications [6.15 (4.96, 7.17) vs 1.44 (0.78, 1.88), p=0.000]. Similiarly, SII level in complicated appendicitis was also significantly higher than in uncomplicated appendicitis [3269.04 (1894.05, 5550.38) vs 649.30 (408.63, 1004.67), p=0.011]. The ability of SIRI in predicting complications was higher than SII, leukocytes, and neutrophils (area under the curve 0.855). In conclusion, SIRI and SII can be used in predicting the presence of complicated appendicitis. Keywords: appendicitis; diagnosis; SII; SIRI   Abstrak: Penelitian ini bertujuan untuk memrediksi adanya komplikasi pada apendisitis dengan menggunakan nilai Systemic Inflammation Response Index (SIRI) dan Systemic Immune-Inflammation Index (SII). Penelitian ini menggunakan metode retrospektif berbasis rumah sakit. Pasien dalam penelitian ini yakni yang masuk ke IGD RSUD Daha Sejahtera, Kabupaten Hulu Sungai Selatan, Kalimantan Selatan, dengan diagnosis apendisitis, dan menjalani operasi apendektomi oleh dokter bedah umum antara September 2024 – April 2025. Data disajikan dalam kelompok appendisitis dengan dan tanpa komplikasi berdasarkan temuan intra operasi. Hasil penelitian mendapatkan 14 pasien yang memenuhi kriteria inklusi. Nilai rerata SIRI pada apendisitis dengan komplikasi lebih tinggi secara bermakna dibanding dengan tanpa komplikasi [6,15 (4,96, 7,17) vs 1,44 (0,78, 1,88), p=0,000]. Pada SII nilai rerata pada apendisitis dengan komplikasi juga lebih tinggi secara bermakna dibanding pada apendisitis tanpa komplikasi [3269,04 (1894,05, 5550,38) vs  649,30 (408,63, 1004,67), p=0,011]. Kemampuan SIRI dalam mengindikasikan komplikasi lebih tinggi dibandingkan SII, leukosit, dan neutrofil (area under the curve 0,855). Simpulan penelitian ini ialah SIRI dan SII dapat digunakan dalam memrediksi adanya apendisitis dengan komplikasi. Kata kunci: apendisitis; diagnosis; SII; SIRI
Implementasi Critical Care Outreach Team (CCOT) di Rumah Sakit Sentra Medika Minahasa Utara Watuna, Monica C.; Lantang, Eka Y.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.64939

Abstract

Abstract: Clinical deterioration among hospitalized patients often occurs suddenly and can be prevented through early identification and timely intervention. The Critical Care Outreach Team (CCOT), as part of the Rapid Response System (RRS), is designed to detect and manage clinical deterioration before patients require admission to the Intensive Care Unit (ICU). This study aimed to describe the implementation of CCOT at Sentra Medika Hospital, North Minahasa, during the period from August 2024 to August 2025. A descriptive observational design was employed, with the researcher acting as a non-participant observer. Data collected included patient demographics, Early Warning Score (EWS) at admission and discharge, and the effectiveness of CCOT interventions based on patient stability, ICU readmission, code blue events, and mortality. Among 136 monitored patients, the highest proportion (30.8%) were aged 56–65 years and presented with moderate to high EWS upon admission. Following CCOT intervention, the average EWS decreased from 5.9 to 4.5. A total of 94.1% of patients remained stable in the ward, 3.7% were readmitted to the ICU, 1.5% experienced code blue events, and 0.7% died. In conclusion, the implementation of CCOT at this hospital has proven effective in the early detection of clinical deterioration and timely intervention, contributing to improved patient safety and service efficiency. Keywords: Early Warning Score (EWS); Rapid Response System (RRS); Critical Care Outreach Team (CCOT); clinical deterioration; early intervention   Abstrak: Kemunduran kondisi pasien rawat inap sering kali terjadi secara tiba-tiba dan dapat dicegah melalui identifikasi dini serta intervensi cepat. Critical Care Outreach Team (CCOT) merupakan bagian dari sistem Rapid Response System (RRS) yang bertujuan mendeteksi dan menangani kemunduran kondisi sebelum pasien membutuhkan perawatan di Intensive Care Unit (ICU). Penelitian ini bertujuan untuk memberikan gambaran implementasi CCOT di Rumah Sakit Sentra Medika Minahasa Utara selama periode Agustus 2024 hingga Agustus 2025. Metode penelitian menggunakan desain deskriptif observasional. Peneliti berperan sebagai pengamat yang mencatat data demografis pasien, skor Early Warning Score (EWS) saat masuk dan keluar, serta efektivitas intervensi CCOT berdasarkan stabilitas pasien, kebutuhan masuk ICU ulang, kejadian code blue, dan kematian. Hasil penelitian mendapatkan dari 136 pasien yang dipantau, persentase tertinggi 30,8% di usia 56-65 tahun dan memiliki skor EWS sedang hingga tinggi saat masuk. Setelah intervensi CCOT, terjadi penurunan skor EWS rerata dari 5,9 menjadi 4,5. Sebanyak 94,1% pasien tetap stabil di bangsal, 3,7% kembali ke ICU, 1,5% mengalami code blue, dan 0,7% meninggal. Simpulan penelitian ini ialah implementasi CCOT di rumah sakit ini telah berjalan dengan baik dalam mendeteksi dini kemunduran kondisi pasien dan memberikan intervensi yang tepat waktu, sehingga meningkatkan keselamatan dan efisiensi pelayanan. Kata kunci: Early Warning Score; Rapid Response System; Critical Care Outreach Team (CCOT); kemunduran kondisi; intervensi dini
Faktor-faktor yang Memengaruhi Fungsi Anus setelah Prosedur PSARP pada Pasien Malformasi Anorektal Suryoprabowo, Vincent; Lampus, Harsali F.; Rendy, Leo
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65307

Abstract

Abstract: In anorectal malformations (ARM), posterior sagittal anorectoplasty (PSARP) procedure is the standard management, however, the anorectal functional outcomes vary. This study aimed to assess the factors affecting anorectal function after the PSARP procedure using the Rintala score. This was a retrospective cohort study of 29 ARM patients who underwent PSARP at Prof. Dr. R. D. Kandou Hospital Manado during the 2019–2022 period. Medical records and patient follow-up data were analyzed using the chi-square test and linear regression. The results showed that of the 29 patients (13 males, 16 females), 86.2% underwent staged repair, while the rest had one-stage repair. The mean Rintala score was 14.59±4.17; 24.1% had normal function, 62.1% good, 6.9% fair, and 6.9% poor. Adequate bowel management was performed in all patients. Surgical wound infection was found in one patient (3.4%). Re-do PSARP was performed in four patients (13.8%). There were no cases of malnutrition or musculoskeletal abnormalities. Syndromic diseases were found in three patients (10.3%). Multivariate analysis showed that no variables were significantly associated with the Rintala score (p>0.05). In conclusion, the majority of patients have good–normal anal function after PSARP. There is no significant relationship between bowel management, surgical wound infection, redo PSARP, malnutrition, musculoskeletal abnormalities, or syndromic diseases and anal function. Continuous bowel management education remains important for long-term outcomes. Keywords: anorectal malformation; PSARP; anal function; Rintala score    Abstrak: Pada malformasi anorektal (MAR), prosedur posterior sagittal anorectoplasty (PSARP) merupakan standar tatalaksana, namun luaran fungsi anus bervariasi. Penelitian ini bertujuan untuk menilai faktor-faktor yang memengaruhi fungsi anus setelah prosedur PSARP menggunakan skor Rintala. Jenis penelitian ialah kohort retrospektif terhadap 29 pasien MAR yang menjalani PSARP di RSUP Prof. Dr. R. D. Kandou Manado periode 2019–2022. Data rekam medis dan follow-up pasien dianalisis menggunakan uji chi-square dan regresi linear. Hasil penelitian mendapatkan dari 29 pasien (13 laki-laki, 16 perempuan), 86,2% menjalani staged repair, sisanya one stage repair. Skor Rintala rerata 14,59±4,17; 24,1% fungsi normal, 62,1% baik, 6,9% cukup, dan 6,9% buruk. Businasi adekuat dilakukan pada seluruh pasien. Infeksi luka operasi ditemukan pada satu pasien (3,4%). Re-do PSARP dilakukan pada empat pasien (13,8%). Tidak terdapat kasus malnutrisi maupun kelainan muskuloskeletal. Penyakit sindromik penyerta ditemukan pada tiga pasien (10,3%). Analisis multivariat menunjukkan tidak terdapat variabel yang berhubungan bermakna dengan skor Rintala (p>0,05). Simpulan penelitian ini ialah mayoritas pasien memiliki fungsi anus baik–normal pasca-PSARP. Tidak terdapat hubungan bermakna faktor businasi, infeksi luka operasi, re-do PSARP, malnutrisi, kelainan muskuloskeletal, maupun penyakit sindromik terhadap fungsi anus. Edukasi businasi berkelanjutan tetap penting untuk luaran jangka panjang. Kata kunci: malformasi anorektal; PSARP; fungsi anus; skor Rintala
Profil Kasus Kematian Mendadak di RSUP Prof. Dr. R. D. Kandou Manado pada Tahun 2022-2024 Tindaon, Yohana D. E.; Kristanto, Erwin G.; Siwu, James F.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65530

Abstract

Abstract: Although sudden natural unexpected death is still common in Indonesia, data on sudden natural unexpected death are very limited. This study aimed to determine the profile of sudden natural unexpected death cases at Prof. Dr. R. D. Kandou Manado General Hospital in 2022-2024. This was a retrospective and descriptive study with a cross-sectional design, using secondary data from the medical records of Prof. Dr. R. D. Kandou Manado General Hospital. The results showed that between 2022 and 2024, there were 878 cases of sudden natural unexpected death at Prof. Dr. R. D. Kandou General Hospital in Manado that met the inclusion criteria. Year 2023 had the highest number of cases (331 cases). The highest number of cases was male, with 516 cases. Adults were the largest age group, with 420 cases, and most sudden natural unexpected deaths were caused by respiratory disorders or abnormalities, with 411 cases. In conclusion, the majority of sudden natural unexpected death cases at Prof. Dr. R. D. Kandou Manado General Hospital during 2022-2024 were males, within the adult age group, and had respiratory system disorders as the most common cause. Keywords: death; sudden natural unexpected death; cause of death     Abstrak: Kematian mendadak masih banyak terjadi di Indonesia akan tetapi data mengenai kematian mendadak masih sangat terbatas. Penelitian ini bertujuan untuk mengetahui profil kasus kematian mendadak di RSUP Prof. Dr. R.D. Kandou Manado pada tahun 2022-2024. Metode penelitian yang digunakan ialah deskriptif retrospektif dengan desain potong lintang dan menggunakan data sekunder yang berasal dari rekam medis RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 878 kasus kematian mendadak di RSUP Prof. Dr. R. D. Kandou Manado pada tahun 2022 sampai tahun 2024 yang memenuhi kriteria inklusi. Tahun 2023 merupakan tahun terbanyak dengan jumlah 331 kasus. Jenis kelamin terbanyak merupakan jenis kelamin laki-laki dengan jumlah 516 kasus. Kelompok usia dewasa merupakan kelompok usia terbanyak dengan jumlah 420 kasus, dan kematian mendadak paling banyak disebabkan oleh gangguan atau kelainan dari sistem respirasi dengan 411 kasus. Simpulan penelitian ini ialah jumlah kasus kematian mendadak di RSUP Prof. Dr. R. D. Kandou Manado selama tahun 2022-2024 terbanyak terjadi pada jenis kelamin laki-laki, kelompok usia dewasa, dan dengan penyebab oleh gangguan atau kelainan sistem respirasi. Kata kunci: kematian; kematian mendadak; penyebab kematian
In Vitro Antibacterial Effectiveness of Stingless Bee Propolis against Infected Breast Cancer Ulcer Manginstar, Christian; Merung, Marselus; Albert, Albert
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65682

Abstract

Abstract: Breast cancer is the most common cancer in women and often presents with malignant ulcers prone to infection. These wounds are difficult to manage, especially during chemotherapy, due to polymicrobial colonization and rising antibiotic resistance. Stingless bee propolis, rich in bioactive flavonoids, has shown promising antibacterial properties. This study aimed to evaluate in vitro antibacterial effectiveness of stingless bee propolis against bacteria from breast cancer ulcers. This was an in vitro study conducted at the Poltekkes Kemenkes Manado Medical Laboratory (July 2024–January 2025). Methanol-extracted stingless bee propolis was tested against MRSA and P. aeruginosa using disc diffusion, MIC, and MBC methods. Antibacterial activity was evaluated through inhibition zones and bacterial growth in serial dilutions. The outcomes were analyzed based on inhibition zone diameters and bacterial growth in serial dilutions. The results showed that propolis extract demonstrated antibacterial activity against MRSA and P. aeruginosa, with inhibition zones observed in both disc diffusion and dilution methods. Strong inhibition was noted at concentrations ≥80%, while minimal or no effect occurred below 30%. MIC and MBC were estimated at around 20%. Statistical analysis confirmed a significant dose-response relationship (ANOVA, p 0.0003), with stronger correlation in MRSA (R=0.84; p<0.001) than P. aeruginosa (R=–0.09; p 0.046). The minimum effective concentration was estimated at 32% for MRSA and 37% for P. aeruginosa. In conclusion, stingless bee propolis demonstrated concentration-dependent antibacterial activity against both Gram-positive (MRSA) and Gram-negative (P. aeruginosa) bacteria in vitro, with increased activity observed at higher concentrations. Minimum effective concentrations were 32% for MRSA and 37% for P. aeruginosa, supporting its potential use in treating infected breast cancer ulcers. These findings highlight propolis as a potential natural alternative for infection control and wound healing. Keywords: breast cancer; ulcer; stingless bee; propolis; antibacterial effect
Partial Intestinal Obstruction Caused by Left Diaphragmatic Hernia: A Case Report Pirade, Audi; Paat, Rigel K.; Tangkilisan, Adrian
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65769

Abstract

Abstract: Diaphragmatic hernia in adults is a rare but potentially serious condition that often presents with non-specific gastrointestinal and respiratory symptoms. This case highlights a left-sided diaphragmatic hernia complicated by partial intestinal obstruction. We reported a 54-year-old male presented with a one-week history of progressive abdominal bloating and intermittent abdominal pain, accompanied by nausea but no vomiting or fever. Bowel movements and flatus were present. In examination, he was hemodynamically stable with abdominal distension and positive bowel sounds. Nasogastric tube drainage produced greenish fluid. Digital rectal examination showed normal stool without blood or mucus. Chest X-ray suggested a left diaphragmatic hernia, and abdominal X-ray revealed partial bowel obstruction without signs of pneumoperitoneum. Laboratory findings were within normal limits, except for mild hypokalemia (K⁺ 3.3 mmol/L). A diagnosis of partial mechanical intestinal obstruction due to a left diaphragmatic hernia was made. The patient underwent an urgent non-contrast abdominal CT followed by combined laparotomy and thoracotomy. Intraoperatively, a diaphragmatic defect (3×3 cm and 10×10 cm) with adhesions between the left lung and diaphragm was identified. Adhesiolysis was performed, and the defect was repaired using non-absorbable sutures, followed by diaphragmatic plication and chest tube insertion. In conclusion, this case underscores the importance of including diaphragmatic hernia in the differential diagnosis of adult patients with persistent abdominal symptoms. Timely imaging and a multidisciplinary surgical approach enabled resolution of obstruction and definitive repair, preventing serious complications. In conclusion, early recognition and appropriate surgical management are key to optimizing outcomes in adult diaphragmatic hernia with bowel involvement. Keywords: diaphragmatic hernia; intestinal obstruction
Dampak Perundungan terhadap Kesehatan Mental Mahasiswa Fakultas Kedokteran Tatambihe, Brainly M. H.; Dundu, Anita E.; Kairupan, Bernabas H. R.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65770

Abstract

Abstract: Bullying behavior often occurs in learning environments, including medical education with seniors as executor in most cases. Not everyone has the psychological defense to deal with bullying. Therefore, bullying can cause impacts that not only affect the victims’ psychology but also their performance in the future. This study aimed to obtain bullying behavior among medical students and its impacts on the medical students. This was a systematic review study using databases of Google Scholar, Pubmed, and Clincal Key. The literatures used to be in Indonesian or English, published in last five years. The results obtained nine articles from several countries. Bullying still occurred in medical environments. Moreover, bullying could cause depression, anxiety, and other mental disorders to their victims. The lack of reported cases supported the large number of cases of bullying in the medical environment. In conclusion, bullying is still common in medical environment, and causes decreased academic prestation and many mental disorders. Keywords: bullying; mental impacts; medical students   Abstrak: Perilaku perundungan sering terjadi di lingkungan pembelajaran, termasuk pembelajaran kedokteran dengan para senior sebagai pelaku di kebanyakan kasus. Tidak semua individu memiliki pertahanan psikologis untuk menghadapi perundungan. Perundungan menyebabkan dampak yang tidak hanya berdampak bagi psikologis korban tetapi juga bagi kinerja korban di masa depan. Penelitian ini bertujuan untuk mengevaluasi perundungan di kalangan mahasiswa kedokteran serta dampaknya bagi korban perundungan. Jenis penelitian ialah systematic literature review dengan menggunakan database Google Scholar, Pubmed, dan Clinical Key. Literatur yang digunakan menggunakan bahasa Indonesia dan bahasa Inggris, yang diterbitkan dalam lima tahun terakhir. Hasil penelitian mendapatkan sembilan artikel dari berbagai negara. Perundungan masih sering terjadi di lingkungan kedokteran. Perundungan menyebabkan depresi, kecemasan, dan gangguan mental bagi para korban. Kurangnya tingkat pelaporan mendukung tingginya angka perundungan di lingkungan kedokteran. Simpulan penelitian ini ialah perundungan di lingkungan kedokteran masih banyak ditemukan dan menyebabkan penurunan prestasi akademik dan berbagai gangguan mental. Kata kunci: perundungan; dampak mental; mahasiswa kedokteran
Perbandingan Luaran Open Surgical Repair dan Endovascular Aneurysm Repair pada Pasien Aneurisma Aorta Abdominalis di Asia Aritonang, Ochta C.; Tangel, Stephanus J. C.; Lengkong, Andriessanto C.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65774

Abstract

Abstract: Abdominal aortic aneurysm (AAA) is a pathological dilation of the aorta that carries a risk of rupture and high mortality. Two methods of AAA management are Open Surgical Repair (OSR) and Endovascular Aneurysm Repair (EVAR). However, comparative data on the outcomes of these two methods in Asia is still limited. This study aimed to analyze the comparison of OSR and EVAR outcomes in AAA patients in Asia, including length of hospital stay, mortality, complications, and reintervention. This was a systematic review study using articles searched in the Epistemonikos, PubMed, Sage Journals, and ScienceDirect databases. The results obtained a total of 18 articles that met the inclusion and exclusion criteria based on the PICOS framework were obtained. The analysis was performed descriptively on postoperative outcome data. EVAR showed a significantly shorter length of hospital stay compared to OSR, but was accompanied by higher rates of reintervention and long-term complications, such as endoleak. Conversely, OSR was superior in terms of long-term durability and stability. The 30-day mortality rates showed inconsistent and statistically insignificant results. In conclusion, EVAR provides better short-term outcomes, while OSR is more reliable for the long term. The choice of method should consider the patient's condition. Keywords: abdominal aortic aneurysm; Open Surgical Repair; Endovascular Aneurysm Repair   Abstrak: Aneurisma aorta abdominalis (AAA) merupakan dilatasi patologis aorta yang berisiko ruptur dan menimbulkan mortalitas tinggi. Terdapat dua metode dalam penatalaksanaan AAA yaitu Open Surgical Repair (OSR) dan Endovascular Aneurysm Repair (EVAR), namun, data perbandingan luaran keduanya di Asia masih terbatas. Penelitian ini bertujuan untuk menganalisis perbandingan luaran OSR dan EVAR pada pasien AAA di Asia yang meliputi lama rawat inap, mortalitas, komplikasi, dan reintervensi. Jenis penelitian ialah systematic review dari artikel-artikel yang ditelusuri pada basis data Epistemonikos, PubMed,  Sage Journals, dan ScienceDirect. Didapatkan sebanyak 18 artikel yang memenuhi kriteria inklusi dan eksklusi berbasis PICOS framework. Analisis dilakukan secara deskriptif terhadap data luaran pascaoperatif. EVAR menunjukkan lama rawat inap yang lebih singkat secara bermakna dibandingkan OSR, namun disertai angka reintervensi dan komplikasi jangka panjang, seperti endoleak, yang lebih tinggi. Sebaliknya, OSR unggul dalam durabilitas dan stabilitas jangka panjang. Tingkat 30-day mortality menunjukkan hasil yang tidak konsisten dan tidak bermakna secara statistik. Simpulan penelitian ini ialah EVAR memberikan hasil jangka pendek lebih baik, sedangkan OSR lebih andal untuk jangka panjang. Pemilihan metode perlu mempertimbangkan kondisi pasien. Kata kunci: aneurisma aorta abdominalis; Open Surgical Repair; Endovascular Aneurysm Repair
Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang UGD dan Kamar Operasi RSIA Kirana Manado Hompas, Sania G. H.; Homenta, Heriyannis; Waworuntu, Olivia A.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65796

Abstract

Abstract: Healthcare-Associated Infections (HAIs) are infections acquired during healthcare delivery, primarily caused by aerobic bacteria. Emergency rooms and operating rooms pose high HAI risks due to vulnerable patients and invasive procedures. This study aimed to determine aerobic bacterial patterns and antibiotic sensitivity in the emergency room and operating room of RSIA Kirana Manado. This was an observational and cross-sectional. There were 24 samples collected from walls, floors, air, medical equipment and non-medical equipment (14 from emergency room, 10 from operating room). Bacterial identification utilized nutrient agar and MacConkey agar culture, Gram staining, catalase test, coagulase test, and biochemical tests. Antibiotic sensitivity testing employed disc diffusion method on Mueller-Hinton agar against 11 antibiotics. The results showed that emergency room samples yielded 14 colonies on nutrient agar with no MacConkey growth. All were Gram-positive: Bacillus sp. (78.6%), Staphylococcus sp. (14.3%), and Streptococcus sp. (7.1%). Operating room samples produced nine colonies: Bacillus sp. (55.6%) and Staphylococcus sp. (44.4%). High sensitivity was observed for sulphamethoxazole/trimethoprim (90.9-100%), ciprofloxacin (90.9-100%), and meropenem (80-90.9%), while high resistance occurred with aztreonam (100%) and cefepime (54.5-60%). In conclusion, three bacterial genera were identified: Bacillus sp., Staphylococcus sp., and Streptococcus sp., showing high sensitivity to sulphamethoxazole/trimethoprim, ciprofloxacin, and meropenem, but resistance to aztreonam and cefepime. Keywords: aerobic bacterial pattern identification; antibiotic sensitivity test; emergency room; operating room   Abstrak: Healthcare-Associated Infections (HAIs) merupakan infeksi yang didapat pasien selama perawatan di rumah sakit, terutama disebabkan bakteri aerob. Ruang UGD dan kamar operasi memiliki risiko tinggi HAIs karena pasien rentan dan prosedur invasif. Penelitian inin bertujuan untuk mengetahui pola bakteri aerob dan uji sensitivitas antibiotik di ruang UGD dan kamar operasi RSIA Kirana Manado. Jenis penelitian ialah observasional deskriptif dengan desain potong lintang. Sebanyak 24 sampel dikumpulkan dari dinding, lantai, udara, peralatan medis dan peralatan non-medis (14 dari UGD, 10 dari kamar operasi). Identifikasi bakteri menggunakan kultur Nutrient Agar dan MacConkey Agar, pewarnaan Gram, uji katalase, koagulase, dan biokimia. Uji sensitivitas antibiotik menggunakan metode difusi cakram pada Mueller-Hinton Agar terhadap 11 jenis antibiotik. Hasil penelitian memperlihatkan sampel UGD menghasilkan 14 koloni pada Nutrient Agar tanpa pertumbuhan pada MacConkey. Semua bakteri Gram positif: Bacillus sp. (78,6%), Staphylococcus sp. (14,3%), dan Streptococcus sp. (7,1%). Sampel kamar operasi menghasilkan sembilan koloni: Bacillus sp. (55,6%) dan Staphylococcus sp. (44,4%). Sensitivitas tinggi terhadap sulphamethoxazole/trimethoprim (90,9-100%), ciprofloxacin (90,9-100%), dan meropenem (80-90,9%), namun resistan terhadap aztreonam (100%) dan cefepime (54,5-60%). Simpulan penelitian ini ialah ditemukan tiga genus bakteri (Bacillus sp., Staphylococcus sp., dan Streptococcus sp.) dengan sensitivitas tinggi terhadap sulphamethoxazole/trimethoprim, ciprofloxacin, dan meropenem, namun resistan terhadap aztreonam dan cefepime. Kata kunci: identifikasi pola bakteri aerob; uji sensitivitas antibiotik; ruang UGD; kamar operasi

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