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INDONESIA
Majalah Kedokteran Nusantara The Journal Of Medical School
Published by Universitas Sumatera Utara
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Arjuna Subject : -
Articles 181 Documents
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Perbedaan fungsi seksual pada wanita pasca persalinan spontan dengan seksio sesaria dengan menggunakan Female Sexual Function Index (FSFI) di Rumah Sakit Umum Pusat H. Adam Malik dan rumah sakit jejaring Fakultas Kedokteran Universitas Sumatera Utara Meda Arvitamuriany Triyanthi Lubis; M. Rhiza Z Tala; Edy Ardiansyah; Henry Salim Siregar; Iman Helmi Effendi; David Luther
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Abstract Pendahuluan : Disfungsi seksual perempuan didefinisikan sebagai gangguan fungsi seksual yang melibatkan satu atau beberapa fase dalam siklus respon seksual, cara persalinan banyak dikaitkan dengan timbulnya disfungsi seksual di kemudian hari. Persalinan spontan akan menimbulkan resiko trauma jalan lahir lebih tinggi dibandingkan seksio sesaria demikian juga dengan risiko terjadinya disfungsi seksual.Mengetahui perbedaan fungsi seksual perempuan setelah melahirkan spontan dan paska seksio sesaria menggunakan skor FSFI. Metode : Penelitian ini adalah penelitian analitik dengan desain penelitian cross sectional study pada 90 wanita yang melahirkan spontan dan 90 wanita yang menjalani seksio sesariadi Departemen Obstetri dan Ginekologi RSUP H. Adam Malik Medan bulan Desember 2014 - April 2015. Disfungsi seksual dinilai dengan kuesioner FSFI yang diisi oleh responden. Ambang batas skor diambil 26,55. Data kemudian dianalisis secara statistik Hasil : Mayoritas subyek pasca persalinan spontan berasal dari kelompok 20-35 tahun yaitu sebanyak 72 sampel (80%). Hal ini juga sebanding pada sampel usia 20-35 tahun dengan riwayat seksio sesaria yaitu 79 sampel (87,8%).51 sampel (82,3%) pasca persalinan spontan memiliki total skor FSFI £26,55 .Sedangkan untuk pasien dengan riwayat seksio sesaria, terdapat 11 sampel (17,7%) dengan rerata total skor FSFI £26,55. Perbedaan antara pasien dengan riwayat pasca persalinan spontan dan seksio sesaria terhadap perbedaan rerata total skor FSFI memiliki nilai p=0,007. Kesimpulan :Terdapat perbedaan yang bermakna secara statistik rerata skor FSFI antara kelompok persalinan spontan dan kelompok seksio sesaria Kata kunci : Fungsi seksual; Persalinan spontan, Seksio sesaria  Abstrak Introduction:f emale sexual dysfunction is defined as sexual dysfunction involving one or several phases of the sexual response cycle, method of delivery is associated with the onset of sexual dysfunction later in life. Vaginal delivery will create higher risk of birth route trauma than cesarean section as well as higher incidence of sexual dysfunction. Objective:To determine the differences in female sexual function of post vaginal delivery women and post cesarean section women usingFemale Sexual Function Index (FSFI) Methods:This is an analytic study with cross sectional design on 90 women who had vaginal delivery and 90 women who had Caesarean section at the Department of Obstetrics and Gynecology Adam Malik General Hospital, Medan from Desember 2014 to April 2015. Sexual dysfunction was assessed using FSFI questionnaires. Threshold scores used is 26.55. The obtained data was then analyzed statistically. Results:Majority of subjects from post vaginal delivery group were from the age group of 20-35 years old with 72 subjects (80%). Similarly, the majority of subjects from cesarean section group were from the age group of 20-35 years old with 79 subjects (87,8%). Based on total score of FSFI, majority of subjects from post vaginal delivery group were with total score of £26,55 . While only 11 subjects (17,7%) from post cesarean group were with total score of •'3d 26,55. Statistical analysis showed that there is a significant difference in mean total score of FSFI between post vaginal delivery group and post cesarean group with  p=0,007. Conclusion: There is a statistically significant difference in sexual function assessed with FSFI between post vaginal delivery women and post cesarean section women. Keywords : Sexual function; vaginal delivery; Cesarean section
Gambaran spesies candida penyebab kandidiasis vulvovaginalis rekuren di RSUP Haji Adam Malik Medan Deryne Anggia Paramita; Kristina Nadeak; Richard Hutapea
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 2 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Recurrent vulvovaginal candidiasis (RVVC) is an episode four times or more vulvovaginal candidiasis within 12 months, nearly 85% up to 95% are caused by Candida albicans. The rest 10% to 20% are caused by non-albicans species. RVVC caused by non-albicans species is clinically indistinguishable from that caused by Candida albicans, and non-albicans species usually are more resistant to therapy.Objective : To reveal which is the most Candida species that cause recurrent vulvovaginal candidiasis in Haji Adam Malik General Hospital MedanMethod : Cross sectional study was conducted in August-September 2012, involving 30 people with RVVC. To each subject, vaginal swab examination, culture and fermentation test was done to see Candida species.Result : The study found the following results: Candida albicans (43.3%) Candida parapsilosis (16.6%), Candida tropicalis (10%), Candida glabrata (6.7%), Candida lusitinae (6.7%), Candida guiliermondi (6.7%), Candida kefyr (6.7%), Candida catenulata (3.3%)Conclusion : Candida albicans is the most widely Candida species that cause RVVC in Haji Adam Malik General Hospital Keywords: recurrent candidiasis vulvovaginalis, Candida species
Pengaruh modifikasi pola hidup medis dengan atau tanpa metformin terhadap kadar asymmetrical dimethyl arginine (ADMA) pada penderita obesitas Sari Harahap; Dharma Lindarto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Obesity, accumulation of excessive adipose tissue, is a risk factor of cardiovascular diseases. Human adipocytesproduce asymmetrical dimethyl arginine (ADMA), an inhibitor nitric oxide synthase which has important role in endotheldysfunction, and express the full enzymatic machinery responsible for ADMA metabolism. Lifestyle modification and metforminhave lowering body weight and ADMA level effects. This study intends to find out whether lifestyle modification with metforminin obese subjects can make the improvement of ADMA level better.Method : A randomized double blind clinical trial held in 12 weeks on 40 obese subjects having lifestyle modification with andwithout metformin. Antropometric parametres and ADMA level were measured before and after intervention.Results : After intervention, there were decreasement in ADMA level, body weight, waist circumfrence and body mass indexin both group. Mean of ADMA, weight, waist circumfrence, and body mass index reduction in metformin versus placebo groupwere .0235 (SD 0.12) ug/l vs 0.03 (SD 0.1) ug/l (P=0.726), 3.88 (SD 1.23) kg vs 2.36 (SD 1.12) kg (P = 0.0001), 6.39 (SD 0.99)cm vs 5.75 (SD 1.71) cm (P = 0.0001), and 1.76 (SD 0.85) kg/m2 vs 1.08 (SD 0.61) kg/m2 (P = 0.0001).Conclusion : In obese subjects, lifestyle modification in 12 weeks could improve some antropometric parametres but extrametformin did not improve the ADMA level significantly.Keywords : obesity; lifestyle modification; metformin; ADMA
Penggunaan kontrasepsi implan 2 batang selama 1 tahun Muhammad Dezarino; Teuku Muhammad Ichsan; Muhammad Oky Prabudi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background : Indonesia is a country with the largest subdermal dermal implant hormonal contraception acceptors. It is a necessity to obtain the continuation rate, side effects and effectivity data of the method.Objective : To assess the continuation rate, side effects and effectivity of 2 rods subdermal implant hormonal contraception for 1 year.Methods : A prospective designed descriptive study, from July of 2011 until July of 2012 of 150 women who accept the method. The continuation rate, side effects and effectivity of the method is recorded as data.Results : The continuation rate is as high as 94 % with menstrual disorders as the most common side effect which also the largest reason for discontinuation (55 %). Using the 3 months reference periode, the menstrual patterns are : irregular menstrual cycles (40.26-59.45%) , amenorrhea (27.02-39.01%), and normal cycles (13.51-28.85%), respectively. The method's effectivity is high, as no pregnancy were found among subjects.Conclusion: High continuation rate and effectivity, along with good tolerability related to the side effects which no serious adverse events found, suggesting the method is a feasible contraception choice.Keywords : contraception; 2 rod implants; continuation rate; effectivity; side effects; menstrual pattern
The relationship between children’s blood pressure and blood pressure of their parents Desy Aswira Nasution; Rusdidjas dr; Supriatmo dr; Rafita Ramayati; Oke Rina Ramayani; Rosmayanti Siregar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background : Family history of hypertension is a risk factor for hypertension in children. Some studies have reported significant relationship of elevated blood pressure in children with hypertensive parents.Objective : To determine the relationship between blood pressure in children and blood pressure of their parents Methods : A cross sectional study was conducted in 90 children aged 6 until 18 years in Baringin village, Panyabungan on May until June 2010. Sample was collected with consecutive sampling. Classification of hypertension determined by measurement of blood pressure, height, weight based on Fourth Task Force. We used student t-test to analyzed numerical data. Simple linier regression was used to investigate the relationship between blood pressure of children and blood pressure of their parents. Results : Of 90 participants that had been examined, 24 boys and 17 girls have hypertensive parents. The mean systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MABP) was significantly higher in children with hypertensive parents than normotensive parents (116.7 and 7.07 respectively ; P = 0.0001 for SBP, 77.8 and 8.33 respectively; P = 0.0001 for DBP, 90.7 and 7.41 respectively; P = 0.0001 for MABP). There was a significant relationship between elevated SBP in boys and SBP of his father was indicated by the correlation coefficient (r = 0.806; P = 0.0001).Conclusions: The blood pressure of children was significantly higher in children with hypertensive parents than normotensive parents. There was a strong correlation between SBP in boys with SBP of his father.Keywords : hypertension; blood pressure; parents; children
Peran inhibitor HMG-CoA reduktase dalam penurunan Interleukin6 terhadap hasil akhir klinis penderita kontusio serebri Sabri Ibrahim; Rr. Suzy Indhary; Iskandar Japardi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background : The cascade of dead cells in response of secondary brain damage is still a major problem in brain injury managementObject : Evaluate HMG-CoA reductase inhibitor as a neuroprotective agent with IL-6 biomarker, to patients with clinical outcome of cerebral contussionMethods : The authors used prospective experimental research on 50 moderate brain injury patients with cerebral contussion appearance in Head CT - Scan, research was done from May 2011 until July 2012. Respondents were divided into two groups; the first group were treated with standard moderate brain injury therapy and the other group were added with HMG-Co A reductase inhibitor (Simvastatin). As parameter, IL-6 biomarker was tested in the first day and the fifth day weekly. Clinical final results (GOS and Barthel’s) were scored monthly and were also noted when the patients left the hospital. Results : Based on this research, the authors found that GOS score in 1 month period with standard therapy is 4.81 (SD 0.39 and the score in patients with HMG added is 4.90 (SD 0.30). Barthel’s score in 1 month period for standard therapy is 95.00 (SD 7.56) and the score for other group is 96.67 (SD 5.55), slightly higher in patients with HMG added (P = 0.616). Decreasing number on IL-6 was commonly found after therapy was added P = 0.295 for the 1st day and P = 0.834 for the 5th day. The researchers were also found that there was weak positive correlation on IL-6 serum during the 1st day with GOS (r = 0.124, P = 0.444) and Barthel’s (r = 0.029, P = 0.852) for 1 month. From the analysis we found P = 0.187 for GOS in 1 month and Barthel’s in 1 month 0.219 with P >0.05. Therefore, there was no correlation IL-6 serum in the 5th day with GOS and Barthel’s in 1 monthConclusions : There was no significant corelation between HMG-CoA reductase inhibitor and the clinical outcome (GOS and Barthel Index).Keywords : cerebral contussion; IL-6; GOS; Barthel’s Inde
Hubungan kadar adiponektin dengan migren dan tension type headache Eva Meutia; Alfansuri Kadri; Khairul P. Surbakti; Hasan Sjahrir
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background: Migraine and tension type headache (TTH) are the primary headaches that most complained and can lead to disability significantly. Obesity is already known to be one of the headache chronification risk factors, and adiponectin is a cytokine that is secreted by adipocytes tissue primarily. Adiponectin has been known to play a role in modulated some inflammatory pathways of the primary headache pathophysiology or in central sensitization process in conjunction with chronic headache. Objective: To evaluate association level of adiponectin with migraine and TTH.Methods: This cross-sectional study was conducted in migraine and TTH patients who came to sefalgia outpatient department of Adam Malik Hospital, which sex-and age matched for this study sample. Each subject completed a questionnaire adapted from the research Ho KH and BK Ong-C, and do anthropometric examination also adiponectin examination at Prodia laboratory. Result: There is significantly difference of mean adiponectin level between migraine 7.58 (SD 4.69) and TTH 4.99 (SD 2.63) (P = 0.008). Association of adiponectin level with episodic migraine is found not significant (P = 0.35), but the significant association is found with TTH (P = 0.013), which adiponectin level is found higher in chronic TTH 8.5 (SD 1.39) than episodic TTH 4.64 (SD 2.47). From the Spearman correlation test, there is negative association between WHR with adiponectin level significantly (r = -0.28. P = 0.02).Conclusion: There is association between adiponectin level with TTH, but it’s not significant with episodic migraine, and there is negative association between WHR and adiponectin level.Keywords : migraine; tension type headache; adiponectin level; obesity; waist hip ratio
Karakteristik dari penderita cedera medula spinalis traumatik di RSUP Haji Adam Malik Medan Benny dr; Otman Siregar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background : Traumatic spinal cord injury was associated with high mortality rate, disabilities, prolonged rehabilitation and treatment, and high economic burden.Aim : Preventive measures can only be carried out through identification of the variables associated with this condition through an extensive and comprehensive epidemiology study.Methods : Collection of secondary data that was recorded in the patient’s medical record that diagnosed with traumatic spinal cord injury that was treated in Haji Adam Malik General Hospital Medan from January 2009 to December 2010. Results : At the period of two years (January 2009 to December 2010) as many as 44 medical records with diagnosis of traumatic spinal cord injury in Haji Adam Malik General Hospital were collected. Most of them were male (86.36%) in the productive age 21-40 years old (45.4%) with the most common causes was road traffic accident (45.5%) followed by fall from height (31.8%) and diving (2.3%). In general, patients arrived in the emergency room of Haji Adam Malik General Hospital after 8 hours (93%). The severity of spinal cord injury according to the Frankel Grading was dominated by Frankel A (40.9%) with the most level of neurological injury was twelfth thoracic (18%). Generally, patients sustaining traumatic spinal cord injury did not undergo surgery (86%). More than half of the patients (59%) were hospitalized less than 10 days with forced discharge as many as 19 patients (43.1%).Conclusion : Most of the patients with traumatic spinal cord injury in Haji Adam Malik General Hospital were male in their productive age with the most common cause was road traffic accident. Almost all of the patients arrived in Haji Adam Malik Medan after golden period hours. Preventive measures with the focus on reducing road traffic accident rate was the first priority followed by comprehensive counseling and education regarding the prevention, management and consequence of the traumatic spinal cord injury to the community.Keyword : injury; medula spinalis; traumatic; characteristic
Gantung diri (Hanging) Abdul Karim Lubis; Guntur Bumi Nasution; Mistar Ritonga
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Dead by hanging is very common in the community. This form of suicide is often encountered since it can be done anywhere or anytime and it requires only a piece of rope, a neck tie, or anything that can strangle the neck. Dead is hanging is often caused by asphyxia The most common by encountered sign of asphyxia in the victims are cyanosis, congestion, oedema, petechial haemoorrhage.Keywords: hanging; asphyxia
Pemberian kemoterapi pada tumor tulang primer Benny dr; Nazar Moesbar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Primary bone tumors are uncommon. The most common malignant tumor of bone is osteosarcoma, which accounts forapproximately 20 to 45% of all bone tumors followed by chondrosarcoma and the ewing's/PNET family of tumors.Amputation had been the standard method of treatment for most bone sarcomas, but the 1980’s witnessed the developmentof limb-sparing surgery for most malignant bone tumors. Today, limb-sparing surgery is considered safe and routine forapproximately 90% of patients with extremity osteosarcomas. Advances in orthopedics, bioengineering, radiographic imaging,radiotherapy, and chemotherapy have contributed to safer, more reliable surgical procedures. Paralleling these advances hasbeen the demonstrated effectiveness of adjuvant chemotherapy in dramatically increasing overall survival the bleak 15% to20% survival rate associated with surgery alone before the 1970’s rose to 55% to 80% with various adjuvant treatment regimensby the 1980’s.While therapy for patients with relapsed osteosarcoma often depends upon whether the disease is resectable, what priorchemotherapy a patient has received and the time to relapse, attention has begun to shift to a variety of novel therapeuticagents. Categories of these novel therapies include agents targeting receptor tyrosine kinases (RTKs), agents targeting signaltransductionpathways, agents that interfere with the tumor microenvironment, immunomodulatory agents and agents designedto overcome mechanisms of resistance.Keywords: osteosarcoma; chondrosarcoma; ewing’s sarcoma; chemotherapy

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