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Smart Medical Journal
Published by Universitas Sebelas Maret
ISSN : 26211408     EISSN : 26210916     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Smart Medical Journal (SmedJour) is published by Faculty of Medicine Universitas Sebelas Maret. SMedJour publishes original research articles or article review in the basic medical sciences, clinic medical sciences, medical education and public health.
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Hubungan Profil Lipid dan Kadar High-Sensitivity C-Reactive Protein dengan Outcome Pasien Stroke Iskemik Akut Stefanus Erdana Putra; Fauzi Novia Isnaening Tyas; Muhammad Hafizhan; Raden Ajeng Hanindia Riani Prabaningtyas; Diah Kurnia Mirawati
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.43779

Abstract

Pendahuluan: Stroke adalah penyebab utama kecacatan jangka panjang dengan dampak klinis dan sosial ekonomi yang signifikan di seluruh dunia. Hiperlipidemia dan inflamasi memainkan peranan penting dalam patofisiologi stroke iskemik. Meskipun high-sensitivity C-Reactive Protein (hs-CRP) dan kadar lipid merupakan penentu risiko penyakit pembuluh darah, kekuatan penggunaan biomarker ini dalam penentuan prognosis stroke iskemik belum dapat dipastikan. Penelitian ini bertujuan untuk mengetahui hubungan kadar hs-CRP dan profil lipid pada pasien stroke iskemik akut di Rumah Sakit Universitas Sebelas Maret dan memahami hubungan antara biomarker tersebut dengan outcome jangka pendek.Metode penelitian: Penelitian cross-sectional dilakukan pada 34 pasien dengan serangan stroke iskemik pertama kali. Profil lipid dan hs-CRP diukur pada hari pertama masuk rumah sakit. Defisit neurologis diukur menggunakan National Institutes of Health Stroke Scale (NIHSS) dan outcome diukur menggunakan Barthel Index pada hari ke-7 perawatan di unit stroke. Selanjutnya, kadar serum hs-CRP dan profil lipid dianalisis korelasinya dengan defisit neurologis dan outcome jangka pendek.Hasil penelitian: Pasien stroke iskemik memiliki kadar hs-CRP, kolesterol total (TC), trigliserida (TG), low-density lipoprotein (LDL) yang lebih tinggi; serta kadar high-density lipoprotein (HDL) yang lebih rendah dari kriteria normal. Berdasarkan uji korelasi Pearson, LDL memiliki korelasi signifikan dengan NIHSS (r = 0,447; p = 0,008) sedangkan hs-CRP memiliki korelasi signifikan yang lebih kuat dengan Barthel Index daripada NIHSS (r = -0,412; p = 0,015). TC dan HDL juga memiliki korelasi signifikan dengan NIHSS.Kesimpulan: Penelitian ini menunjukkan bahwa profil lipid dan hs-CRP dapat digunakan sebagai prediktor prognosis outcome stroke iskemik akut. Introduction: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. While high-sensitivity C-Reactive Protein (hs-CRP) and lipid levels are established risk determinants for vascular disease, the relative strength of these biomarkers for ischemic stroke is uncertain. The purpose of this study is to investigate the association of hs-CRP levels and lipid profile in acute ischemic stroke patients and understand correlation between those markers and short-term outcome.Methods: This was a cross-sectional study of 34 first-timer ischemic stroke patients. Lipid profiles and hs-CRP were measured on admission day. The neurological deficit was quantified using National Institutes of Health Stroke Scale (NIHSS) and outcome was quantified using Barthel Index at the 7th day in stroke unit. Serum level of hs-CRP and lipid profile were estimated and correlated with neurological deficit and short-term outcome.Results: Ischemic stroke patients had higher levels of hs-CRP, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL); and lower level of high-density lipoprotein (HDL) than normal criteria. Based on Pearson correlation test, LDL had significant correlation with NIHSS (r=0.447; p=0.008) while hs-CRP had stronger significant correlation with Barthel Index than NIHSS (r=-0.412; p=0.015). TC and HDL also had significant correlation with NIHSS.Conclusions: This research suggests that lipid profile and hs-CRP can be used as predictors of prognosis for acute ischemic stroke outcome. Keywords: Barthel index, C-reactive protein, National Institutes of Health Stroke Scale, lipid profile, ischemic stroke.
Hubungan Reseptor Estrogen, Reseptor Progesteron dan Ekspresi Her-2/Neu Dengan Grading Histopatologi pada Pasien Kanker Payudara di RSUD dr. Moewardi Surakarta Warjianto Warjianto; Widyanti Soewoto; Untung Alifianto; Hari Wujoso
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.35228

Abstract

Pendahuluan: Kanker payudara merupakan keganasan pada wanita yang memiliki prosentasi dan angka mortalitas cukup tinggi baik di dunia maupun Indonesia. Pada kanker payudara memiliki reseptor untuk hormon estrogen, progesteron, dan protein Her–2 yang berperan dalam proses terjadinya sel kanker. Dimana keberadaan ER, PR dan Her-2/Neu serta Grading Histopatologi sangat mempengaruhi manajemen dan prognosis pada pasien dengan karsinoma payudara.Tujuan: Mengetahui hubungan antara Reseptor Estrogen, Reseptor Progesteron dan ekspresi Her-2/neu dengan grading histopatologi pada penderita wanita dengan kanker payudara.Bahan & Metode: Pasien kanker payudara sejumlah 73 orang yang berobat di Poliklinik dan dirawat di bangsal serta pengambilan sample di sub Bagian Bedah Onkologi RSUD dr. Moewardi Surakarta antara April sd Desember 2018. Pemeriksaan Immunohistokimia dan Histopatologi di bagian Patologi Anatomi RSUD dr. Moewardi Surakarta. Penelitian prospektif analitik korelasi dengan cross sectional.Kesimpulan: Tidak terdapat hubungan antara reseptor estrogen dengan grading histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah (p=0,901).Tidak terdapat hubungan antara reseptor progesteron dengan grading histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah ( p=0,512).Tidak terdapat hubungan antara ekspresi Her-2/neu dengan grading Histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah ( p=0,629). Introduction: Breast cancer is a malignancy in women who have a high percentage and mortality rate both in the world and Indonesia. Breast cancer has receptors for the hormones estrogen, progesterone, and Her-2 protein which play a role in the process of cancer cells. Where the existence of ER, PR and Her-2 / Neu and Histopathology Grading greatly affect the management and prognosis in patients with breast carcinoma.Objective: To determine the relationship between Estrogen Receptor, Progesterone Receptor and Her-2 / neu expression with histopathological grading in women with breast cancer.Material & Methods: There were 73 breast cancer patients who were treated at the Polyclinic and treated in the ward and taking samples in the sub-section of Surgical Oncology Hospital Dr. Moewardi Surakarta between April to December 2018. Immunohistochemistry and Histopathology Examination in the Anatomy Pathology section of RSUD dr. Moewardi Surakarta. Prospective analytic correlation research with cross sectional study.Conclusion: There is no relationship between estrogen receptors with histopathological grade in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0,901). There was no relationship between progesterone receptors and histopathological grade in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0.512). There was no relationship between Her-2 / neu expression and histopathological grading in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0.629)
Hubungan Status Gizi dengan Angka Kejadian Infeksi Saluran Pernapasan Akut (ISPA) pada Balita Usia 1-5 Tahun di Surakarta Wenny Widyawati; Dwi Hidayah; Ismiranti Andarini
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.35649

Abstract

ABSTRAK Pendahuluan: Infeksi Saluran Pernapasan Akut (ISPA) merupakan salah satu penyebab kematian pada balita. Status gizi dapat mempengaruhi kejadian ISPA. Tujuan penelitian ini adalah untuk mengetahui hubungan antara status gizi dengan angka kejadian ISPA pada balita usia 1-5 Tahun di Surakarta. Pada penelitian ini, peneliti akan meneliti hubungan antara status gizi buruk, kurang, baik, lebih, dan obesitas terhadap angka kejadian ISPA.Metode: Penelitian observasional analitik dengan desain studi case control dilakukan pada 9 September 2019 sampai 15 Oktober 2019 di RSUD Dr. Moewardi dan puskesmas di Surakarta. Subjek penelitian adalah anak berusia 1–5 tahun dengan diagnosis ISPA dan non ISPA, masing-masing sebanyak 120 sampel. Pemilihan puskesmas dilakukan dengan metode stratified random sampling. Data anak diambil dengan metode consecutive sampling. Penelitian dilakukan dengan mengolah data rekam medis dan melakukan klasifikasi status gizi dengan tabel Z-score WHO. Data kemudian dianalisis menggunakan uji Chi Square dan Odds Ratio (OR).Hasil: Terdapat hubungan antara status gizi buruk (OR = 8,63; CI 95% = 1,875–39,714), status gizi kurang (OR = 3,776; CI 95% = 1,586–8,988), dan obesitas (OR = 0,154; CI 95% = 0,032–0,736) dengan angka kejadian ISPA. Sementara, tidak terdapat hubungan antara status gizi lebih (p=0,402) dengan angka kejadian ISPA.Kesimpulan: Terdapat hubungan antara status gizi buruk, kurang, dan obesitas dengan angka kejadian ISPA pada balita di Surakarta. Namun, tidak terdapat hubungan antara status gizi lebih dengan angka kejadian ISPA pada balita di Surakarta. ABSTRACTIntroduction: Acute Respiratory Infection (ARI) is one of the causes of death in toddler. Nutritional status can affect the incidence of ARI. The purpose of this study was to determine the relationship between nutritional status and the incidence of ARI in toddler aged 1-5 years old in Surakarta. In this study, researcher will examine the relationship between poor nutritional status, malnutrition, good nutritional status, overweight, and obesity on the incidence of ARI.Methods: An observational analytic approach with a case-control study design was conducted on 9 September 2019 to 15 October 2019 in RSUD Dr. Moewardi and community health centre in Surakarta. Subjects were children aged 1-5 years old who were diagnosed with ARI and non-ARI, each as many as 120 samples. The community health center was selected by using the stratified random sampling method. Children's data was taken by consecutive sampling method. The study was conducted by processing medical record data and classifying nutritional status with the WHO Z-score table. Data were then analyzed using the Chi Square test and Odds Ratio (OR).Results: There is a relationship between poor nutritional status (p = 0.001; OR = 8.63; 95% CI = 1.875–39.714), malnutrition (p = 0.002; OR = 3.776; 95% CI = 1.586– 8,988), and obesity (p = 0.019; OR = 0.154; 95% CI = 0.032-0.736) with the incidence of ARI. Meanwhile, there was no relationship between overweight (p = 0.402; OR = 0.417; 95% CI = 0.097–1.8) and the incidence of ARI.Conclusion: There is a relationship between poor nutritional status, malnutrition, and obesity with the incidence of ARI in toddler in Surakarta, and there is no relationship between overweight with the incidence of ARI in toddler in Surakarta.
Perbedaan Kualitas Hidup Pasien Hipertensi Ringan yang Melakukan Exercise dan Tidak Melakukan Exercise di Posyandu Lansia Saiful Hidayat; Yuliana Heri Suselo; Dhoni Akbar Ghozali
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.27158

Abstract

ABSTRAKPendahuluan: Hipertensi diderita oleh sekitar 1,13 milyar orang di seluruh dunia, di mana prevalensinya lebih banyak pada lansia dan mengakibatkan penurunan kualitas hidup mereka. Exercise dapat meningkatkan kualitas hidup melalui efeknya pada peningkatan kesehatan fisik dan mental. Penelitian ini bertujuan untuk membuktikan bahwa kualitas hidup pasien hipertensi ringan yang melakukan exercise lebih baik dibandingkan pasien hipertensi ringan yang tidak melakukan exercise di posyandu lansia.Metode: Penelitian ini merupakan penelitian eksperimental quasi dengan posttest only control group design. Subjek adalah wanita berusia 45-70 tahun dengan hipertensi ringan, mampu membaca dan menulis, tidak merokok, tidak rutin meminum obat anti hipertensi, tidak memiliki penyakit terminal, dan telah rutin mengikuti kegiatan senam lansia selama satu tahun untuk kelompok pertama. Subjek berjumlah 35 orang yang dibagi dalam dua kelompok, kelompok pertama sejumlah 18 orang mendapatkan perlakuan berupa exercise berdurasi 10 menit selama 3 kali seminggu, sedangkan kelompok kedua yang berjumlah 17 orang sebagai kontrol. Kualitas hidup diukur menggunakan kuesioner SF-36 versi Bahasa Indonesia yang terdiri dari delapan domain yaitu fungsi fisik, peran fisik, peran emosional, energi, kesehatan emosional, fungsi sosial, nyeri, dan kesehatan umum. Data dianalisis menggunakan uji t independent dan Mann Whitney dengan tingkat kemaknaan α=0,05.Hasil: Kualitas hidup kelompok pertama lebih tinggi dibandingkan kelompok kedua pada semua domain. Akan tetapi, hanya tiga domain yang menunjukkan perbedaan signifikan yaitu fungsi fisik (p=0,003), peran fisik (p=0,013), dan energi (p=0,016).Kesimpulan: Pasien hipertensi ringan yang melakukan exercise memiliki kualitas hidup yang lebih baik dibandingkan pasien hipertensi ringan yang tidak melakukan exercise di posyandu lansia. Introduction: Hypertension affects around 1.13 billion people worldwide. The prevalence mostly are elderly and reduce their quality of life. Exercise improves quality of life through improving physical and mental health. This study aims to prove the quality of life of patients with mild hypertension who exercise were better than those who do not exercise at Posyandu Lansia.Methods: This study was a quasi-experimental study with posttest only control group design. Subjects were women aged 45-70 years with mild hypertension, literate, do not smoke, do not regularly take anti-hypertensive drugs, and without terminal illness. In the first group there was an additional criteria, that was had been exercising regularly for one year. Thirty-five subjects were divided into two groups, the first group of 18 people received treatment in the form of 10 minutes of exercise three times a week for four weeks, the second group of 17 people as controls. The research was conducted at Posyandu Lansia in the working area of Puskesmas Pucang Sawit, Surakarta, Indonesia. Quality of life was measured using the Indonesian version of the SF-36 questionnaire which was consisted of eight domains, namely physical function, physical role, emotional role, energy, emotional health, social function, pain, and general health. Data were analyzed using independent T test and Mann Whitney (α = 0.05).Results: Quality of life in the first group was higher than the second group in all domains, but only three domains showed significant differences: physical function (87.59 ± 11.63 vs 62.31 ± 31.13; p = 0.003), physical role (75.46 ± 33.64 vs 47.06 ± 35.22; p = 0.013), and energy (74.72 ± 14.50 vs 63.42 ± 13.76; p = 0.016).Conclusion: Patients with mild hypertension who exercise have a better quality of life than those who do not exercise at Posyandu Lansia.
Hubungan Anemia pada Ibu Hamil dengan Kejadian Persalinan Prematur di RSUD Dr. Moewardi Surakarta Saskia Nandatari; Yudhistya N Insan; Widardo Widardo
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.37849

Abstract

Pendahuluan: Persalinan prematur adalah persalinan yang terjadi pada usia kehamilan sebelum 37 minggu. Persalinan prematur disebabkan oleh berbagai faktor, salah satunya yaitu anemia. Anemia dalam kehamilan merupakan masalah yang cukup sering terjadi terutama di negara berkembang. Anemia dalam kehamilan merupakan keadaan dimana nilai Hemoglobin ibu hamil dibawah 11 g/dl. Keadaan ini mengakibatkan penurunan jumlah oksigen yang dibawa ke janin sehingga mengakibatkan terjadinya hipoksia pada janin. Tujuan penelitian ini adalah untuk mengetahui hubungan antara anemia pada ibu hamil dengan kejadian persalinan prematur di RSUD Dr. Moewardi Surakarta.Metode Penelitian: Penelitian observasional analitik dengan pendekatan case control, dilakukan pada bulan Agustus-September 2019 di RSUD Dr. Moewardi. Subjek penelitian adalah pasien yang mengalami persalinan prematur dan persalinan tidak prematur dalam kurun waktu Juni 2017 sampai dengan Juni 2019 di RSUD Dr. Moewardi. Penelitian dilakukan dengan mengolah data rekam medis. Pada penelitian dipilih sebanyak 70 sampel penelitian, yang terdiri masing-masing 35 sampel untuk kelompok kasus dan kontrol. Sampel diambil menggunakan purposive sampling. Data kemudian dianalisis menggunakan uji Korelasi Koefisien Kontingensi Uji Kappa dan uji T-test Tidak Berpasangan.Hasil: Didapatkan korelasi antara anemia dengan kejadian persalinan prematur bermakna secara statistik. Nilai korelasi sebesar 0,031 menunjukkan korelasi positif dengan kekuatan korelasi yang signifikan dan bermakna secara klinis. Selain itu, didapatkan perbedaan yang bermakna dan signifikan antara rata-rata nilai Hemoglobin ibu hamil dengan persalinan prematur dan tidak prematur, dengan nilai p sebesar 0,003.Simpulan: Terdapat hubungan yang signifikan dan bermakna secara klinis antara anemia pada ibu hamil dengan kejadian persalinan prematur di RSUD Dr. Moewardi Surakarta pada Juni 2017 – Juni 2019. Background: Premature labor is labor that occurs at gestational age before 37 weeks. Premature labor is caused by various factors, one of which is anemia. Anemia in pregnancy, hemoglobin condition of pregnant women under 11 g / dl which is quite common, especially in developing countries. This situation results in a decrease in the amount of oxygen carried to the fetus, resulting in hypoxia in the fetus and stimulates stress hormones associated with labor induction. The purpose of this study was to determine the relationship between anemia in pregnant women with the incidence of preterm labor in Dr. Moewardi Surakarta.Methods: This study was analytic observational research with case-control approach, conducted in August-September 2019 at Dr. Moewardi. Research subjects were patients who experienced preterm labor and non-preterm labor in the period June 2017 to June 2019 at the RSUD Dr. Moewardi. The study was conducted by processing medical record data. In this study 70 research samples were chosen, consisting of 35 samples for the case and control groups. Samples were taken using purposive sampling. Data were then analyzed using the Kappa Test Contingency Coefficient Correlation test and the unpaired T-test.Result: The correlation between anemia and preterm labor was statistically significant. Correlation value (p=0.031) shows a positive correlation with the strength of the correlation that is significant and clinically meaningful. In addition, a significant and significant difference was found between the average hemoglobin value of pregnant women with preterm and non-preterm labor, with a value (p = 0.003).Conclusion: There is a significant and significant relationship between anemia in pregnant women and the incidence of preterm labor in Dr. Moewardi Surakarta in June 2017 - June 2019, where anemia in pregnant women increases the risk of preterm labor.
Analisis Karakteristik Individu dengan Pola Hidup Bersih dan Sehat pada Santri di Pati Sigit Setyawan; Sri Haryati; Yulia Sari; Yusuf Ari Mashuri; Sutartinah Sri Handayani; Sonya Dellania Raharja
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.37874

Abstract

ABSTRAKPendahuluan: Soil-Transmitted Helminths (STH) merupakan kumpulan jenis cacing yang menginfeksi manusia dan menular melalui media tanah. Sekitar 24% penduduk dunia terinfeksi oleh soil-transmitted helminths. Faktor risiko terjadinya infeksi soil-transmitted helminths berhubungan kondisi sanitasi serta higiene yang kurang, kondisi sosial ekonomi, dan perilaku banyak ditemukan di pesantren.Metode: Penelitian ini merupakan studi analitik observasional dengan pendekatan cross-sectional. Variabel bebas dari penelitian ini adalah Perilaku Hidup Bersih dan Sehat (PHBS) anak sekolah. Sedangkan variabel terikat dari penelitian ini adalah kejadian kecacingan. Sampel yang digunakan adalah feses dari 100 santri Pondok Pesantren Al-Kholiqiyyah dan Pondok Pesantren An-Nur, Kecamatan Gabus Kabupaten Pati dengan pengambilan sampel secara simple random sampling. Data akan dianalisis dengan metode Chi- square dan Mann-Whitney pada aplikasi SPSS.Hasil: Usia santri menunjukkan perbedaan signifikan (p<0.05) terhadap skor total pelaksanaan PHBS terutama pada kebiasaan membuang sampah pada tempatnya baik di rumah maupun di sekolah. Sedangkan usia, pendidikan dan penghasilan orang tua tidak berpengaruh pada skor total pelaksanaan PHBS sekolah oleh para santri.Kesimpulan: Usia santri menunjukkan perbedaan signifikan terhadap skor total pelaksanaan PHBS. Introduction: Soil-Transmitted Helminths (STH) are a group of worms that infect humans and are transmitted through soil. About 24% of the world's population is infected by SoilTransmitted Helminths. Risk factors for Soil-Transmitted Helminths infection are related to poor sanitation and hygiene conditions, socioeconomic conditions, and behavior found in many pesantren.This study aims to investigate individual characteristics as STH risk factors and healthy lifestyle of Santri in Pati district.Method: This was an observational analytic study with a cross-sectional approach. The samples used were faeces from 100 Al-Kholiqiyyah Islamic Boarding School students and An-Nur Islamic Boarding School, Kecamatan Gabus Kabupaten Pati with simple random sampling The Clean and Healthy Life Behavior (PHBS) of school children data were collected using questionnaire, while STH infection was investigate using feces examination with direct smear method . Data were analyzed using Chi-square, Fisher’s exact, and Mann-Whitney methods in Statistical Package for the Social Sciences (SPSS).Result: There was no STH infection among Santri in Pati. However, the risk factors of STH infection were identified The gender of the santri showed a significant difference (p<0.05) on the total score of the implementation of PHBS, especially in the habit of disposing garbage in its place both at home and at school. While the age, education and income of parents did not associate with the total score of the implementation of school PHBS by the santri.Conclusion: The gender of the santri showed a significant difference in the total score for implementing PHBS
Tinjauan Terkini Hemofilia A yang Didapat : Aspek Diagnosis dan Manajemen Ibnu Purwanto
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.45870

Abstract

Hemofilia A yang didapat adalah penyakit yang jarang terdiagnosis dan seringkali salah terdiagnosis namun berpotensi menyebabkan perdarahan yang mengancam nyawa. Penyakit autoimun akibat pembentukan autoantibodi (inhibitor) terhadap FVIII ini hampir setengahnya memiliki gangguan lain yang mendasari. Pemanjangan activated partial thromboplastin time, mixing test yang tidak terkoreksi, rendahnya aktivitas FVIII, dan bukti inhibitor FVIII mendukung penegakan diagnosis Hemofilia A yang didapat. Rintangan dalam manajemen pasien dimulai dari penegakan diagnosis hingga penentuan terapi, baik terapi hemostatik, imunosupresi, serta pengobatan penyakit penyerta. Pemilihan terapi serta pengendalian terhadap efek samping dari pengobatan memerlukan perhatian khusus agar tercapai hemostasis dan remisi yang bertahan lama.Acquired Hemophilia A can potentially cause life-threatening conditions due to profuse bleeding, but this autoimmune disease is mostly underdiagnosed. Hemophilia A occurs due to the development of an antibody against FVIII, moreover up to half of these cases have underlying conditions. Prolonged activated partial thromboplastin time, uncorrected mixing test, low FVIII activity, and detection of FVIII inhibitors support the diagnosis of acquired Hemophilia A. However, several challenges lay within patients’ management strategy, such as diagnosis workup and therapeutical choices. Treatment for acquired hemophilia A encompasses hemostatic therapy, immunosuppression, and treatment of underlying disease. Moreover, therapeutical choice and side effects control require special consideration to achieve hemostasis and durable remission.
Hubungan Pengetahuan Kode Etik Kedokteran Indonesia dengan Kejadian Kekerasan di Wahana Pendidikan Klinis pada Dokter Muda di Surakarta Yudhistira Andarusukma; Adji Suwandono; Wahyu Dwi Atmoko
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.40753

Abstract

Pendahuluan: Kekerasan di tempat kerja terhadap tenaga kesehatan saat ini berada dalam taraf yang mengkhawatirkan seiring dengan naiknya angka kejadian tersebut. Hal ini juga dialami oleh dokter muda dalam menjalani masa studinya pada program profesi dokter di wahana pendidikan klinis. Salah satu faktor yang menyebabkan hal tersebut berkaitan dengan penerapan etika profesi saat bekerja. Etika profesi dokter diatur dalam Kode Etik Kedokteran Indonesia yang ditujukan untuk mempertahankan hubungan kepercayaan dokter-pasien. Pengetahuan yang memadai mengenai kode etik menimbulkan sikap yang sesuai dengan ketentuan yang harusnya dilakukan, sehingga diharapkan mampu mengurangi risiko terjadinya gesekan yang berujung pada terjadinya kekerasan. Penelitian ini ditujukan untuk mengetahui apakah terdapat hubungan pengetahuan Kode Etik Kedokteran Indonesia dengan kejadian kekerasan di wahana pendidikan klinis.Metode: Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional yang dilaksanakan pada bulan Januari hingga Feburari 2020 pada dokter muda RSUD dr. Moewardi Surakarta. Pengambilan subjek dilakukan dengan teknik purposive sampling. Data yang didapat dianalisis menggunakan uji korelasi Pearson dan uji regresi linier sederhana.Hasil: Hasil analisis data pada 54 subjek penelitian menunjukkan hubungan negatif antara pengetahuan tentang kode etik kedokteran dengan kejadian kekerasan di wahana pendidikan klinis (r=-0.313, p= 0,021). Pada analisis regresi linier sederhana didapatkan pengaruh antara kedua variabel (r2=0.098, koefisien regresi=-0.364, p<0,05).Kesimpulan: Terdapat hubungan dan pengaruh yang bermakna secara statistik antara pengetahuan kode etik kedokteran dengan kejadian kekerasan di wahana pendidikan klinis dengan dengan kekuatan lemah dan arah korelasi negatif. Introduction: Workplace violence against health workers currently are rising at a worrying rate. This condition are also affecting medical students during their stage of clinical clerkship in teaching hospital. One of its contributing factors is related to the implementation of medical ethics during working. Here, medical ethic is regulated in Indonesian Medical Ethics Code, aimed to maintain the trust between doctor and patient. A better understanding of ethical code can result in better behavior that can potentially decrease the tension between doctor and patient. This research aims to find the correlation between the Indonesian Medical Ethics Code’s knowledge and the occurrence of workplace violence among medical students during clinical clerkship.Methods: This is an analytic observational research with cross-sectional approach conducted between January to February 2020. The subjects are medical students in clinical clerkship stage in Dr.Moewardi General Hospital Surakarta. The sample was taken using purposive sampling method and the data was analyzed using Pearson correlation test and simple linear regression test.Results: The analyzed data from 54 subjects resulted in a negative correlation between the Indonesian Medical Ethics Code’s knowledge and the occurrence of workplace violence among clinical clerkship students (r=-0.313, p= 0.021) and both factors are influencing each othe (r2=0.098, regression slope=-0.364, p<0,05).Conclusion: There is a statistically significant correlation and influence between Indonesian Medical Ethics Code’s knowledge and the occurrence of workplace violence among medical student during clinical clerkship, resulted in a weak negative correlation.
Evaluasi Pemakaian Antibiotik Profilaksis Ceftriaxone Injeksi dan Cefadroxil Oral Terhadap Penyembuhan Luka Post Sectio Caesarea Ivanna Beru Brahmana; Ika Setyawati
Smart Medical Journal Vol 3, No 2 (2020): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v3i2.42014

Abstract

Pendahuluan: Penyembuhan luka operasi sectio caesarea (SC) yang baik sangat diharapkan oleh setiap pasien dan dokter. Pemilihan antibiotik yang tepat dibutuhkan dalam penyembuhan luka operasi. Ceftriaxone injeksi merupakan antibiotik spektrum luas yang banyak dipakai sebagai antibiotik profilaksis SC. Cefadroxil oral dipilih sebagai antibiotik yang diberikan pada pasien post operasi SC. Penelitian ini bertujuan menilai efektifitas pemakaian ceftriaxone injeksi dan cefadroxil oral pada penyembuhan luka operasi post SC. Metode: Data diambil dari rekam medis pasien selama tiga tahun (tahun 2016-2018) pada saat kontrol di dokter praktek swasta di Klaten, Jawa Tengah. Kriteria inklusi adalah pasien yang menjalani operasi SC, hamil aterm, dan tidak menderita DM. Waktu kontrol antara dua sampai dengan tujuh hari setelah operasi SC. Data diolah secara deskriptif. Hasil: Didapatkan 73 subjek penelitian yang memenuhi kriteria inklusi. Waktu kontrol dua hari post SC didapatkan sebanyak 23,3% (17/73), tiga hari post SC sebanyak 21,9% (16/73), empat hari post SC sebanyak 23,3% (17/73), lima hari post SC sebanyak 21,9% (16/73), enam hari post SC sebanyak 2,7% (2/73), dan tujuh hari post SC sebanyak 6,8% (5/73). Kejadian luka infeksi ditandai dengan keluarnya cairan bernanah dari luka bekas operasi SC. Kejadian luka infeksi terjadi sebanyak 5,5% (4/73). Kejadian luka infeksi terjadi pada pasien yang kontrol pada hari kedua sebanyak tiga kasus dan kontrol pada hari keempat sebanyak satu kasus. Kesimpulan: Ceftriaxone injeksi dan cefadroxil oral efektif memberikan kesembuhan pada luka operasi post SC.Introduction: Good healing of caesarean section (CS) wound is highly expected by every patient and doctor. Selection of the right antibiotic is needed in healing wound surgery. Ceftriaxone injection and oral cefadroxil are widely used in CS prophylactic antibiotics. This study was to assess the effectiveness of the use of injection ceftriaxone and oral cefadroxil in wound healing in post CS.Methods: Data were collected from a patient's medical record for three years (2016-2018) at the time of control at a private practice doctor in Klaten, Central Java. Inclusion criteria were patients who underwent CS, term pregnant, and didn’t have DM. The control time is between two to seven days after CS. Data processed descriptively.Results: There were 73 study subjects who met the inclusion criteria. The control time of two days post CS was 23.3% (17/73), three days post CS were 21.9% (16/73), four days post CS were 23.3% (17/73), five days post CS were 21.9% (17/73) 16/73), six days post CS were 2.7% (2/73), and seven days post CS were 6.8% (5/73). The incidence of infection wounds is characterized by discharge of festering fluid from CS scars. The incidence of infection wounds occurs as much as 5.5% (4/73), who occurred in patients who were control on day two in three cases and controls on day four in one case.Conclusion: Ceftriaxone injection and oral cefadroxil are effective in healing postoperative wound healing.

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