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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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Korelasi antara skor Child-Pugh dengan gastropati hipertensi portal pada penderita sirosis hati Faisal Parlindungan; Mabel Sihombing
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Hypertensive portal gastropathy (PHG) is a pathologic appearance on the gastric mucosa which can cause acute or chronic bleeding in liver cirrhotic patients. The pathogenesis of PHG is controversial and there is no agreement on the effect of liver dysfunction to PHG. This study aims to evaluate correlation between liver dysfunction severity that is assessed by Child-Pugh score and PHG in liver cirrhotic patients.Methods : This is an analytic cross sectional study. The demographics and clinical data were recorded, laboratory tests were performed (albumin, INR and bilirubin) to calculate Child-Pugh score, and patients underwent esophagogastroduodenoscopy (EGD) to assess PHG. Correlation between Child-Pugh score and PHG were tested with Spearman correlation analysis. Cut-off value of Child-Pugh score was determined with receiver operating characteristics (ROC) analysis which is followed by diagnostic performance analysis.Results : From 41 subjects, there were 8, 18, 15 patients with Child-Pugh class A,B, and C respectively. On endoscopic examination, there were 10,19, and 12 patients without PHG, with mild PHG, and with severe PHG respectively. There is a positive correlation between Child-Pugh score and the severity of PHG (r = 0.556; P = 0.0001). Among Child-Pugh score components, ascites and bilirubin showed positive correlation with PHG. Using cut off point of • 7, Child Pugh score showed 87.1% sensitivity, 40% specificity, 81.8% PPV, 50% NPV, 1.45 LR(+), 0.32 LR(-), accuracy diagnostic was 75.6% and the AUROC was 0.65 (95% CI:0.437-0.860; P = 0.163)Conclusion: Child-Pugh score has a positive correlation with severity of PHG, in which higher Child-Pugh score is correlated with more severe PHG.Keywords : Child-Pugh Score; portal hypertensive gastropathy; liver cirrhotic; endoscopy
Hubungan antara reseptor progesteron dengan Ki-67 labeling index pada meningioma Steven Tandean; Rr Suzy Indharty; Iskandar Japardi; Sufida dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Meningiomas are benign tumor and the most prevalent intracranial tumors which recur locally. Their morphologic grading do not always correlate with patient outcome and some of them associated with a less favorable clinical outcome. The incidence in women is approximately twice than in men. Progesterone receptors may play role in the proliferation and grading of meningiomas. Aims of this study isto evaluate the correlation of progesterone receptor status with proliferation marker ki67 in various grades of meningioma.Methods : A retrospective research of 30 paraffin-embedded sections of meningiomas was collected that was done histological typing and grading with hematoxylin and eosin. Immunodetection of Progesterone receptors was conducted with peroxidaseantiperoxidase complex and Ki-67 was achieved by streptavidin-biotin peroxidase complex. Progesterone receptors status considered positive if >50% of nuclei were stained with medium intensity or >10 of tumor cell’s nuclei were strongly stained. The Ki-67 is defined into three groups as no proliferation, low proliferation (<14%), and high proliferation (> 14%). Results : Progesterone receptors were positive in 13/27 (48.1%) of grade I tumors, 1/2 (50%) of grade II tumors, and 0/1 (0%) of grade III tumor. In grade I tumor, negative progesterone receptors with negative Ki-67 was 6/14 (42.9%) and low Ki-67 was 8/16 (57.1%). While, positive progesterone receptors with negative Ki-67 was 7/13 (53.8%), low Ki-67 was 4/13 (30.8%), and high Ki-67 was 2/13 (15.4%). In grade II tumor, negative progesterone receptors with negative Ki-67 and positive progesterone receptors with low Ki-67 expression. In grade III tumor, negative progesterone receptors with negative Ki-67 expression. Conclusion : There was a not significant relationship between Ki-67 and progesterone receptors status, but high Ki-67 expression was only found in positive progesterone receptors. Progesterone receptors may play role in proliferation of meningioma. Keywords : meningioma; progesterone; receptor; Ki-67 antige
Pengaruh pemberian klonidine 75 μg oral pre operatif terhadap tramadol hydrochloride 2.5mg/kgbb/iv untuk penatalaksanaan nyeri paska bedah Andri Faizal L; Hasanul Arifin; Syamsul Bahri
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Post surgical pain is an important problem in the process of operation, so that a strong analgesia is needed in the post-surgery. Already popular opioid used as an analgesic tramadol hydrochloride one, but use a single dose require large doses resulting in severe side effects. Preemptive method is one method to produce a satisfactory analgesia. In this study aimed to compare the combination of tramadol hydrochloride 2.5mg / kg / IV and oral clonidine 75•g for pain management after orthopedic surgery extremities.Methods : After the approval of the ethics committee of FK-USU, 45 samples were collected, men and women, from the age of 18- 40 years with ASA physical status 1-2, 1-4 preoperative VAS, who underwent elective orthopedic extremity surgery with general anesthesia Adam Malik Hospital. Samples were then randomly divided into 2 groups with 23 subjects each. This study used a randomized controlled clinical trial double-blind. Group A received tramadol hydrochloride 2.5mg / kg / IV IV and 75 mg oral clonidine. Group B received tramadol hydrochloride 2.5mg / kg / IV and placebo. Systolic and diastolic blood pressure, pulse frequency VAS values were recorded and measured. All data were analyzed using chi-square test and the crosstab. Results : VAS value in hours and hours to 6 to 8 significant difference clinically and statistically significant in both groups, with P = 0:02 on the clock to 6 and P = 0.00 at 8 hours.Conclusion : The result showed that a combination of tramadol hydrochloride with oral clonidine produces better analgesic than tramadol hydrochloride.Keywords : tramadol hydrochloride; klonidine; visual analogue score (VAS)
Gambaran pewarnaan imunohistokimia p53 pada meningioma di Rumah Sakit Umum Pusat H. Adam Malik Medan Donny dr; Adril Arsad Hakim; Iskandar Japardi; Sufida dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Intoduction : P53 is a protein produced by the TP53 gene, this protein is a major tumor suppression pathway of cells. P53 is a 'tumor suppressor gene' which is regarded as the protector of the gene. Although 'p53 pathway' are well known in the pathogenesis of these malignancies, its role in tumorigenesis of meningiomas is still very little understood.This study is intended to get an idea of how p53 expression by immunohistochemistry in patients with meningiomaMethod : The study was conducted with descriptive design. The data was patient’s demographic characteristics and data of tumors. The data was taken from the patient's General Hospital Haji Adam Malik began February 2010-February 2013, the immunohistochemical examination conducted in RS Murni Teguh Memorial.Result : Average patient age 41.2 (SD 11.78) years and mostly female by ratio of 2.3:1. Based on the location of the meningioma, the most common sequence is convexity meningiomas and parasagittal meningiomas (8 patients, 26.7%). Based on the results of histopathology, the highest frequency found was meningothelial type of meningioma by 17 cases (56.7%). Expression of p53 is found in 13.3% of patients who all have male sex. Expression of p53 is found in 25% of recurrent meningioma. Based on the index tumor edema, PTEI, found p53 expression by 50% in meningiomas with PTEI weight, 25% on PTEI moderate, and 5% on PTEI light.Conclusion : p53 expression is only found in the male gender (100%). Picture of p53 expression in recurrent tumors and tumors with a high index of edema seems to be the basis of further research to assess the relationship between these variables. Keywords : meningioma; p53
Kejadian infeksi Klamidia trakomatis di serviks dan tuba pada pasien kehamilan ektopik terganggu di RSUP H. Adam Malik Medan dan RS Jejaring FK USU Hendry Adi S; Henri Salim Siregar; Fidel Gannis Siregar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Chlamydia trachomatis is one of the most common causative agents of sexual transmitting diseases (STD) world wide. Subclinical Chlamydia trachomatis infections on the upper genital tract often emerge due inadequate detetection and early medication, resulting in both acute and chronic infection that would eventually cause ectopic pregancies and inferility. To determine the insidence of cervical and tubal Chlamydia trachomatis infections by means of polymerase chain reaction (PCR) assay methods, the charecteristics of disturbed ectopic pregnancies, the association with both cervical and tubal Chlamydia trachomatis infections in patients diagnosed with disturbed ectopic pregancies at Haji Adam Malik general hospital in Medan and networking hospital of University of North Sumatera medical school.Methods : This research is an observational study with a cross sectional approach conducted on Chlamydia trachomatis patients diagnosed with disturbed ectopic pregnancies.Result : Prevalence rates of cervical and tubal Chlamydia trachomatis infected patients diagnosed with ectopic pregnancies reached 36% (9/25) and 12% (3/25), respectively. Even though these following results are considered statistically irrelevant, history taking and physical examinations concluded a tendency towards an increased risk of Chlamydia trachomatis infections up to 64% in subjects married between 20-35 years old (16 patients out of 25 patients), reaching 72% in patients with confirmed history of leucorrhea (18 out of 25 patients), and 56% in subjects with a confirmed history of genital tract/pelvic infections (14 out of 25 patients).Keywords : ectopic pregnancy; Chlamydia trachomatis; polymerase chain reaction
Serum blood urea nitrogen (BUN) sebagai penanda independen kematian di rumah sakit pada penderita infark miokard akut ST elevasi tanpa reperfusi dini Hilfan Ade Putra Lubis; Tawanita Brahmana
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Renal dysfunction has been associated to adverse cardiovascular outcomes, including in the setting of ACS, and has been routinely assessed with estimated creatinine clearance, serum creatinine or an estimated glomerular filtration rate (eGFR). However, these assays do not adequately assess acute changes in renal dysfunction. BUN level and BUN/creatinine ratio, may provide supplemental information regarding to renal function.Determine whether abnormal admission serum BUN and BUN/creatinine ratio in subjects presenting acute STEMI associated to other risk factors and whether they could be a predictor of inhospital deathMethods : It was a prospective cohort study of patients presenting acute STEMI without early reperfusion therapy (n = 43) included. Elevated BUN (> or • 25 mg/dl) and elevated BUN/creatinine ratio (> or • 5) were assessed on admission. Results : The incidence rate of elevated BUN and BUN/creatinin ratio were 18.6% and 9.3%. There was no significant relationship between elevated BUN and related risk factors (sex P = 0.57, hypertension P = 0.49, diabetes P = 0.61 and hypercholesterolemia P = 0.05). This study also showed no significant relationship between elevated ratio BUN/creatinine and related risk factors (sex P = 0.66, hypertension P = 0.6, diabetes P = 0.11, hypercholesterolemia P = 0.25). No significant increases of inhospital death found in patients with either elevated BUN (P = 0.10) or elevated BUN/creatinine ratio (P = 0.47).Conclusion : Elevated BUN and BUN/creatinine ratio on admission are not an independent predictors of inhospital death in this study.Key word : BUN; creatinine; STEM!; hospital death
Profil dermatomikosis superfisial pada pekerja pabrik tahu di Desa Mabar, Kecamatan Medan Deli Jamaliyah dr; Meidina K. Wardani; Irma D Roesyanto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Superficial dermatomycosis is a fungal infection of the skin, nails and hair, caused by dermatophytes and non-dermatophytes. Factors that predisposing, one of which is exposed to water due to work. Tofu industry knows as a small industry engaged in the informal sector. In the industry, at this stage of the manufacturing process,the factory workers are often exposed to water of doing his work.To know the superficial dermatomycosis profil of tofu industries workers in Mabar Village Medan Deli.Methods : This study is adescriptivesurvey study with cross-sectional design. The study population is all of the employees in nine factories in Mabar Village Medan Deli.Result : Among 72 participants, 18 suffered from superficial dermatomycosis, the proportion was 25%. We obtained 11 workers suffered from cutaneousintertriginous candidiasis, 5workers suffered from tineapedis and 2 workers suffered from tinea pedis and onychomycosis. We obtained Candida sp, Aspergillusfumigatus and M. gypseumas causative agents.Conclusion : In this study, the proportion of superficial dermatomycosis was 25%,the most common superficial dermatomycosis(61.11%) was cutaneous intertriginous candidiasis and Candida spas causative agents.Keywords : superficial dermatomycosis;tofu industries workers
Korelasi kadar endocrine gland-derived vascular endothelial growth factor serum dengan tebal endometrium pada fertilitasi in vitro TJ Avicenna; Ichwanul Adenin; Binarwan Halim
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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introduction :To obtain numerous data concerning charecteristics, EGVEGF serum levels, endometrium thickness, and the correlation between EGVEGF serum levels and endometrium thickness on the day of oocytes aspiration in patients undergoing in vitro fertilization. Method : Analytic retrospective surveyResults : Twenty nine samples were obtained during the research which started from March 29th. Serum samples were obtained on the day of oocytes aspiration (ovum pick-up) conducted. The age group ranged from 31 years until 35 years old with the youngest subject aging 29 years and the oldest reaching 44 years old. The average age of patients undergoing in vitro fertilization was 34, 34 years with the standard deviation of 5.07. Patients undergoing in vitro fertilization were observed with primary infertility in 15 subjects (51.7%) whereas 14 patients undergoing the similar procedure were observed with secondary infertility. Sixteen patients undergoing invitro fertilization were found with a normoweight body mass index, 9 pateints were observed with an overweight value (31.0%), and 2 patients were observed with an underweight and obesity value (6.9%), respectively. Mean value of EGVEGF serum levels obtained from each subjects, reached 14.19 (SD 9.67) pg/mL with a minimal endometrium thickness of 6.5 mm and a maximal value of 14.3 mm. Correlation level tests of EGVEGF serum with a certain endometrium thickness level revealed no correlation value of -0.097 (rho = -0.097), with a P value of 0.617.Conclusion : No existance of correlation between EGVEGF serum levels with endometrium thickness on the day of oocytes aspiration in patients undergoing in vitro fertilization.Keywords : in vitro fertilization; endocrine gland-derived vascular endothelial growth factor (EGVEGF) serum levels; endometrial thickness
Gambaran gangguan pendengaran pada bayi dengan hiperbilirubinemia di Rumah Sakit Umum Pusat. H. Adam Malik Medan R. Yusa Herwanto; Abdul Hanum Rachman; T. Sofia Hanum
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Hearing function screening is usually performed on high risk infant of hyperbilirubinemia. According to Joint Committee of Infant Hearing, bilirubin level >17 mg/dl causing neurologic effect, especially on hearing function. To present the description of hearing disorder on infant with hyperbilirubinemia.Method : Descriptive study with case series design.Result : From 62 samples of hyperbilirubinemia infant on this research, 2 male samples (28.6 %) has bilirubin level >1.8 mg/dl and 5 female samples (71.4%) has bilirubin level >1.8 mg/dl. Based on group of age, samples on group of age '3d15 days with direct bilirubin level >1.8 gr/dl is two samples (28.6%), meanwhile on group of age >15 days with direct bilirubin level >1.8 mg/dl is five samples (71.4%). On group of age '3d15 days with total bilirubin level >17 gr/dl is nine samples (39.1%), and on group of age >15 days with total bilirubin level >17 gr/dl is 14 samples (60.9%). On right OAE with samples who has bilirubin level >1.8 mg/dl who declared pass is not found and who declared refer is 7 samples (100%). On left OAE with samples who has bilirubin level >1.8 mg/dl who declaredpass is not found and who declared refer is seven samples (100%). On Right OAE with samples who has total bilirubin level >17 mg/dl who declared pass is four samples (17.4%) and who declared refer is 19 samples (82.6%). On left OAE with samples who has total bilirubin level >17 mr/dl who declared pass is seven samples (30.4%), and who declared refer is 16 samples (69.6%).Conclusion : This research found 2 catageoris at bilirubin direct and total with left OAE refer have beenvalues (Bilirubin total P = 0.01 and Bilirubin direct P = 0.04) , it is means hearing disorder atinfant hyperbilirubinemia.Keywords : hearing disorder; hyperbilirubinemia of infant; OAE screenin
Peran zink terhadap sistem imun anak Nova Yulia Rita; Rita Evalina; Lily Irsa
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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The human body consists of elements of macro and micro elements. One of the many trace elements are zinc beside iron. It has biologic immunostimulatory, which is a mineral that can stimulate immune function, where these nutrients play an important role in keeping the immune system with the enzyme works as a catalyst, facilitating the formation of proteins and gene expression regulation. Zinc plays a role in the catalytic activity karbonase anhydrase, and is a component of over 100 enzymes of six classes of enzymes. Bioinformatics estimates that about 10% of the body protein binds to zinc. Keywords : zinc; imun system; essensial mineral

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