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ISM (Intisari Sains Medis) : Jurnal Kedokteran
Published by Universitas Udayana
ISSN : 25033638     EISSN : -     DOI : -
Core Subject : Health, Science,
Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.
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Articles 68 Documents
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Effectiveness comparison of atorvastatin vs. rosuvastatin in reducing CRP level in acute coronary syndrome: A systematic review and meta-analysis I Gusti Ayu Inten Heny Pratiwi; Anak Agung Gde Waisampayana Putra
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1267

Abstract

Background: Acute coronary syndrome (ACS) is a group of various clinical symptoms, including acute myocardial ischemia. When administered for coronary artery instability, one of the targets for statins is to reduce inflammation factor-like c-reactive protein (CRP). Increased levels of CRP are related to ischemic heart disease. Therefore, a meta-analysis was assessed to compare atorvastatin vs. rosuvastatin as the most effective for reducing CRP of a patient with acute coronary syndromeMethods: We searched PubMed and Cochrane databases until October 23th 2020. Search terms included acute coronary syndrome, C-reactive protein or CRP, rosuvastatin, atorvastatin, randomized, random, and randomization. We excluded study populations with acute kidney injury/dyslipidemia/metabolic syndrome. All analyses in our study were carried out using Review Manager version 5.3 (RevMan Cochrane, London, UK).Result: We have found four eligible studies (487 patients) were included. Funnel plots and p-Egger were inspected to assess publication bias. The pooled analysis demonstrated the benefit of atorvastatin or rosuvastatin over therapy for all studies. The result shown (WMD: 2.41; P=0.06; 95% CI: -0.07 – 4.90) on the forest plot.Conclusion: Our meta-analysis clarifies that atorvastatin, compared to rosuvastatin, or vice versa, is not statistically significant in reducing CRP in acute coronary syndrome patients.
Tingginya rasio neutrofil terhadap limfosit serum darah ibu sebagai faktor risiko persalinan preterm spontan Tjokorda Gde Agung Suwardewa; I Nyoman Bayu Mahendra; Anak Agung Gede Putra Wiradnyana; Made Bagus Dwi Aryana; I Gde Sastra Winata; I Wayan Megadhana; Daniel Hadinata Susanto
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (307.161 KB) | DOI: 10.15562/ism.v13i1.1268

Abstract

Introduction: Preterm delivery is still a major problem in pregnancy and causes 70% of all perinatal deaths. The immaturity of the organ systems of preterm infants increases neonatal morbidity and mortality compared to term infants. The incidence of preterm delivery at Sanglah Hospital in 2015 was 285 cases out of 1198 births or 23.7%. Inflammation is thought to be the cause of 40% cases of preterm labor and as much as 70-80% of spontaneous preterm births has a significant relationship with the incidence of infection in the vagina and cervix. The physiological immune response to inflammation is characterized by an increase in the number of circulating neutrophils and a decrease in the number of lymphocytes. There is a controversy regarding the relationship between an increase of neutrophils to lymphocytes ratio in maternal serum and the threatened preterm delivery. This study aims to determine that a high neutrophils to lymphocytes ratio in maternal blood serum is a risk factor for spontaneous preterm delivery. Method: This research was an analytic case control study with 56 samples, and divided into two groups, 28 preterm delivery samples as a case group and 28 preterm pregnancy samples as a control group. This research was conducted at the Obstetric and Gynecology Outpatient clinic as well as the delivery room at Sanglah Hospital Denpasar in the period of November 2020 to April 2021. Result: Analysis results of this study found a statistically significant difference (p = 0.003) between the case and control groups. The group of patients with high maternal neutrophil to lymphocyte serum ratio had a chance of preterm labor 5.6 times higher compared to the group of patients with low maternal neutrophil to lymphocyte serum ratio (OR = 5.6; CI 95% = 1.74-18.42; p=0.003). Conclusion: The conclusion of this study is that the high maternal neutrophils to lymphocytes serum ratio is a risk factor for 5.6 times the occurrence of spontaneous preterm labor.   Pendahuluan: Persalinan preterm masih menjadi masalah utama pada ibu hamil dan menyebabkan 70% dari seluruh kasus kematian perinatal. Imaturitas sistem organ tubuh bayi prematur meningkatkan morbiditas dan mortalitas neonatal dibandingkan dengan bayi lahir cukup bulan. Angka kejadian persalinan preterm di RSUP Sanglah pada tahun 2015 sebesar 285 kasus dari 1198 kelahi­ran atau sebesar 23,7%. Inflamasi diduga sebagai penyebab dari 40% kasus persalinan preterm dan sebanyak 70-80% persalinan preterm spontan mempunyai hubungan bermakna dengan kejadian infeksi pada vagina dan serviks. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah neutrofil yang beredar dan penurunan jumlah limfosit. Terdapat kontroversi hubungan antara peningkatan rasio neutrofil terhadap limfosit serum darah ibu dan ancaman persalinan preterm, sehingga penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko persalinan preterm spontan. Metode: Penelitian ini merupakan penelitian analitik dengan rancangan kasus kontrol dengan jumlah sampel sebanyak 56 sampel, dan dibagi menjadi dua kelompok, yaitu 28 sampel persalinan preterm sebagai kelompok kasus dan 28 sampel kehamilan preterm sebagai kelompok kontrol. Penelitian ini dilakukan di Poliklinik Obstetri dan Ginekologi serta kamar bersalin IGD RSUP Sanglah Denpasar periode November 2020 hingga April 2021. Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang signifikan secara statistik (p = 0,003) antara kelompok kasus dan kontrol. Kelompok pasien dengan nilai rasio neutrofil terhadap limfosit serum darah ibu yang tinggi memiliki kemungkinan sebesar 5,6 kali mengalami persalinan preterm dibandingkan dengan kelompok pasien dengan rasio neutrofil terhadap limfosit serum darah ibu yang rendah (OR = 5,6, IK 95% = 1,74-18,42, p = 0,003). Simpulan: Simpulan dari penelitian ini adalah tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko 5,6 kali terjadinya persalinan preterm spontan.
Melanoma maligna orbita: sebuah laporan kasus Ni Luh Putu Nurindah Sukmawati; Putu Yuliawati; Ni Made Laksmi Utari
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (657.208 KB) | DOI: 10.15562/ism.v13i1.1269

Abstract

Introduction: Orbital melanoma (OM) is the most common type of primary intraocular neoplasm in adults. Although the incidence of OM is only 5% of melanoma tumors, OM causes death in 13% of melanoma tumors. The management of orbital melanoma originating from the uveal tissue is still controversial between surgical and nonsurgical therapy. Case Report: A male patient, 63 years old, complained that the patient's right eye was said to have appeared a lump since five months ago with a size of 6 x 6 x 7 cm, blackish red in color with clinical signs of malignancy. The patient underwent orbital exenteration and the patient's condition had no recurrence or other complaints until four months after the procedure. Conclusion: Orbital melanoma of uveal origin is a complex malignancy that requires a multidisciplinary approach to therapy and management. Early detection and adequate therapy are very important in increasing survival rates.   Pendahuluan: Melanoma orbita (MO) merupakan tipe yang paling sering dari neoplasma primer intraokular pada dewasa. Meskipun insiden MO hanya 5% dari tumor melanoma, namun MO menimbulkan kematian pada 13% akibat tumor melanoma. Tatalaksana melanoma orbita yang berasal dari jaringan uvea sampai saat ini masih kontroversial antara terapi bedah dan nonbedah. Laporan Kasus: Seorang pasien laki-laki, 63 tahun, mengeluh mata kanan pasien dikatakan muncul benjolan sejak lima bulan yang lalu dengan ukuran 6 x 6 x 7 cm, berwarna merah kehitaman dengan klinis mengarah keganasan. Pasien dilakukan eksenterasi orbita dan kondisi pasien tidak terdapat kekambuhan ataupun keluhan lain hingga empat bulan setelah tindakan. Simpulan: Melanoma orbita yang berasal dari uvea merupakan keganasan yang kompleks yang membutuhkan pendekatan multidisiplin dalam terapi dan tatalaksana. Deteksi dini dan terapi yang adekuat sangat penting dalam upaya meningkatkan angka ketahanan hidup.
Analisis kinerja pegawai bagian administrasi RSUP Ratatotok buyat di era sebelum pandemi COVID-19, saat pandemic, dan new normal Riliani Manitik; Starry Homenta Rampengan; Freddy W. Wagey; Aaltje Ellen Manampiring
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (277.432 KB) | DOI: 10.15562/ism.v13i1.1270

Abstract

Introduction: The success of hospitals (RS) in carrying out their functions as health service institutions is characterized by good quality hospital services. Administrative employees as non-health workers must have good performance in order to realize quality health services. This study aimed to analyze the description of employee performance in the administration section of the Ratatotok Buyat Hospital in terms of aspects of work culture and work environment in the era before the Covid-19 pandemic, during the pandemic and the new normal era.Methods: This type of research uses a qualitative descriptive method. Data collection techniques were carried out by in-depth interviews and then documented and analyzed. To obtain the validity of the data, inspection techniques were carried out through several activities, namely triangulation. Qualitative data was obtained based on the results of in-depth interviews using the Mile and Huberman data analysis modelResults: The performance of employees in the administration section shows that systems and activities related to employee work experience changes during the pandemic when there is a decrease in employee performance when compared to performance before the pandemic, in the new normal era, employee performance has increased.Conclusion: The performance of employees in the administration of Ratatotok Buyat Hospital before the Covid-19 pandemic was very good, there was a decline in performance during the pandemic, but increased again in the new normal era. Pendahuluan: Keberhasilan rumah sakit (RS) dalam menjalankan fungsinya sebagai lembaga pelayanan kesehatan ditandai dengan kualitas pelayanan rumah sakit yang baik. Pegawai administrasi sebagai tenaga non kesehatan harus memiliki kinerja yang baik agar dapat mewujudkan pelayanan kesehatan yang berkualitas. Penelitian ini bertujuan untuk menganalisis gambaran kinerja pegawai pada bagian administrasi Rumah Sakit Umum Pusat (RSUP) Ratatotok Buyat ditinjau dari aspek budaya kerja dan lingkungan kerja pada era sebelum pandemi Covid-19, saat pandemi dan era new normal.Metode: Jenis penelitian ini menggunakan metode deskriptif kualitatif. Teknik pengumpulan data dilakukan dengan wawancara mendalam kemudian didokumentasikan dan dianalisis. Untuk mendapatkan keabsahan data, dilakukan teknik pemeriksaan yaitu dengan triangulasi. Data kualitatif diperoleh berdasarkan hasil wawancara mendalam dengan menggunakan model analisis data Mile dan Huberman.Hasil: Kinerja pegawai dibagian administrasi menunjukkan bahwa saat pandemi terjadi penurunan jika dibandingkan dengan dengan kinerja sebelum pandemi, diera new normal kinerja pegawai kembali mengalami peningkatan.Kesimpulan: Kinerja pegawai di bagian administrasi RSUP Ratatotok Buyat sebelum pandemi Covid-19 sangat baik, dan terjadi penurunan kinerja saat pandemi, namun kembali mengalami peningkatan di era new normal.
The microvascular reconstruction in children with maxillofacial defects: A Systematic Review Violetti Valentin; Ratna Rayeni Natasha Roosseno
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (495.021 KB) | DOI: 10.15562/ism.v13i1.1271

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Background: Facial bones trauma in the pediatric population is linked to severe damage and impairment, particularly in maxillofacial, particularly in area. In addition, reconstruction of maxillofacial in pediatric patients has some unique considerations. Therefore, this study described the effectiveness of microvascular reconstruction in children with maxillofacial defects.Methods: The relevant literature from PubMed and Science Direct databases. The strategic search is using the keywords such as "Pediatric" OR "Children" OR "Under-eighteen years" AND "microvascular reconstruction" OR "microvascular surgery" AND "maxillofacial defect". We used a PRISMA method to the selection of those articles. The inclusion criteria were related to microvascular reconstruction in children with maxillofacial defects from 2000-2021.Result: Total of six studies entries with inclusion criteria. These studies show that most free flaps or microvascular reconstruction procedures carried on pediatric patients to resolve maxillofacial defects gave successful functional, and clinical outcomes. In addition, a few complications, mainly infections, occurred following the surgery, however successfully managed with antibiotics.Conclusion: A microvascular reconstruction is a good option for maxillofacial defects reconstruction in pediatric patients due to a shorter surgical time and faster recovery. 
Relationship between Monocarboxylate Transporter 4 (MCT-4) Expression and Breast Cancer Clinicopathology and Subtype in Sanglah General Hospital, Denpasar, Indonesia Gede Andry Nicolas Andry Nicolas; I Wayan Sudarsa; Putu Anda Tusta Adiputra; Desak Made Wihandani; I Gede Putu Supadmanaba
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.108 KB) | DOI: 10.15562/ism.v13i1.1274

Abstract

Background: Breast cancer is the second leading cause of death in women in developing countries. The activity of Warburg and Reverse-Warburg effects on breast cancer is reflected by the expression patterns of two molecules, namely caveolin-1 and Monocarboxylate Transporter-4 (MCT-4). MCT-4 is a transmembrane transport protein that transports lactate from the cytoplasm to the intercellular fluid.Method: This is a cross-sectional analytical study to determine the relationship between MCT-4 expression and breast cancer clinicopathology and subtypes. The study was conducted between April and May of 2020 with 62  breast cancer patients as samples in Sanglah General Hospital, Denpasar. Analysis was done with SPSS 25.Results: A logistic regression analysis was performed to analyze the relationship between the dependent variable (MCT-4) and the covariates (stage, grade, and subtype). Of the three variables significantly associated with MCT-4 expression, only clinical-stage and subtype (luminal and non-luminal) remained independently associated with MCT-4 expression. Analysis on the clinical stage and subtype variables showed an adjusted OR of 4.727 (p = 0.047; 95% CI: 1.109 - 21.922) and 17.850 (p = 0.009; 95% CI: 2.069 - 154.003) , respectively. This suggests that MCT-4 has a significant association with subtype and clinical-stage, increasing the risk of cancer stage progression and developing a more malignant (non-luminal) subtype.Conclusion: High MCT-4 expression was significantly associated with malignant subtypes, high histological-grade cancer and advanced breast cancer.
Non-eosinofilia pada Infeksi Trichuris trichiura: sebuah laporan kasus I Made Cahyadi Dwi Putra; I Nyoman Gde Sumardika; I Made Dharma Pramana; Ni Luh Putu Siska Kahari Sari
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (512.099 KB) | DOI: 10.15562/ism.v13i1.1277

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Background: Trichuris trichiura or whipworm is a Platyhelminthes parasite infecting the human gastrointestinal tract. Trichuris trichiura is a soil-transmitted helminth (STH). A tropical climate like Indonesia is an ideal place for STH. Prevalence of STH is still high in Indonesia, ranging from 2,5 – to 62 %. This parasite lives in the human colon, consuming blood, and nutrition from its host as well as usually manifests with eosinophilia incomplete blood count. However, this case study aims to evaluate the non-eosinophilia in Trichuris trichiura infection.Case Presentation: In this case, the patient is an 11 years old male with symptoms of diarrhea and dehydration; there are also signs of mild dehydration from a physical examination. Several tests are taken to assess the cause of diarrhea, such as a complete blood count (CBC) test which the result is only leukocytosis and slight monocyte increase, no elevation of eosinophil. Trichuris trichiura egg was found on the microscopic stool observation.Conclusion: Some studies show a significant association between the elevation of eosinophil and trichuriasis infection. However, the case report shows leukocytosis only, without elevation of eosinophil. Eosinophilia could be used as a marker of Trichuriasis infection, especially in the acute phase, but not all trichuriasis infections are followed by eosinophilia. This might be because of the natural course of the disease itself and the defense mechanism of the parasite.  Latar Belakang: Trichuristrichiura atau cacing cambuk adalah parasit dari jenis cacing pipih yang menyerang saluran pencernaan manusia.Trichuris trichiura merupakan jenis cacing soil-transmitted helminth (STH) yang dapat berkembang biak dengan baik di iklim tropis seperti Indonesia. Prevalensi kecacingan di Indonesia masing cukup tinggi dan angkanya bervariasi di tiap wilayah, berkisar antara 2,5 – 62 %. Parasit ini hidup di usus besar manusia, memakan darah, dan nutrisi dari inangnya serta biasanya bermanifestasi dengan eosinofilia dalam hitung darah lengkap. Namun, studi kasus ini bertujuan untuk mengevaluasi non-eosinofilia pada infeksi Trichuris trichiura.Presentasi Kasus: Kasus yang kami dapatkan adalah anak laki-laki 11 tahun dengan keluhan buang air besar cair dan dehidrasi. Pada pemeriksaan fisik didapatkan tanda dehidrasi ringan. Untuk mencari penyebab keluhannya dilakukan beberapa pemeriksaan penunjang yaitu pemeriksaan darah lengkap dimana didapatkan peningkatan pada sel darah putih dan sedikit peningkatan monosit, namun tidak disertai dengan peningkatan eosinofil. Pada pemeriksaan feses didapatkan gambaran telur cacing Trichuris trichiura.Kesimpulan: Beberapa penelitian menyatakan bahwa ada hubungan yang signifikan antara peningkatan eosinofil dengan trichuriasis. Namun, pada pasien ini hanya didapatkan leukositosis tanpa diikuti dengan peningkatan eosinofil. Eosinofil dapat dijadikan penanda infeksi terutama pada fase awal trichuriasis, namun tidak semua kasus ditemukan eosinofilia. Hal ini dapat terjadi karena mekanisme perjalanan penyakit itu sendiri dan juga mekanisme pertahanan dari parasit (Trichuristrichiuria) itu sendiri.
Gambaran karakteristik pasien in hospital cardiac arrest dan luaran pasca resusitasi jantung paru oleh tim code blue di RSUP Sanglah Made Satria Yudha Dewangga; Hendy Wirawan; Anak Agung Ayu Dwi Adelia Yasmin
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.484 KB) | DOI: 10.15562/ism.v13i1.1280

Abstract

Background: Cardiac arrest is a medical emergency due to the sudden cessation of the heart’s mechanical function. Cardiac arrest can be reversible with appropriate intervention, but otherwise, it can be fatal and result in death. The incidence of cardiac arrest in hospital or in-hospital cardiac arrest (IHCA) needs to be considered because it is associated with high mortality and describes an early detection system and hospital response speed. In this study, the authors examined the characteristics of the incidence of IHCA and cardiopulmonary resuscitation carried out by the code blue team at the Sanglah Central General Hospital (RSUP), including outcome trends and survival of IHCA patients after cardiopulmonary resuscitation.Methods: The authors analyzed the incidence of IHCA at Sanglah Hospital in 2021 in a retrospective cohort by tracing the patient’s medical records from January to December 2021. The sample was collected using a non-randomized consecutive sampling technique, then univariate analysis was performed to get an overview of the proportion and percentage distribution, as well as analysis. Bivariate method to determine the relationship between age group, comorbidities, response time of the code blue team, and the etiology of cardiac arrest on resuscitation outcomes.Results: In IHCA patients who were resuscitated at Sanglah Hospital, 26.2% had a successful return of spontaneous circulation (ROSC), with >50% of patients dying within <24 hours and only 1% returning home recovering. The majority of IHCA patients were men aged 40 years or older, with a Charlson Comorbidity Index (CCI) 3, with noncardiac causes. Most resuscitation was performed within 5 minutes of the sound of the code blue signal. There was no significant relationship between age group, CCI score, etiology of cardiac arrest, and response time of the code blue team with resuscitation outcomes.Conclusion: IHCA patients at Sanglah Hospital have a relatively low survival rate, but the code blue efforts have been going well. There were no significant differences in the outcome of ROSC and death based on age group variables, comorbidities, response time of the code blue team, and the etiology of cardiac arrest. Latar Belakang: Henti jantung adalah keadaan darurat medis akibat berhentinya fungsi mekanis jantung secara tiba-tiba. Henti jantung dapat bersifat reversible dengan intervensi yang tepat, namun sebaliknya dapat bersifat fatal dan mengakibatkan kematian. Kejadian henti jantung di dalam rumah sakit atau in hospital cardiac arrest (IHCA) perlu diperhatikan karena berkaitan dengan mortalitas yang tinggi serta menggambarkan sistem deteksi dini dan kecepatan respon rumah sakit. Pada penelitian ini, penulis meneliti gambaran karakteristik kejadian IHCA dan resusitasi jantung paru yang dilakukan oleh tim code blue di Rumah Sakit Umum Pusat (RSUP) Sanglah, termasuk tren luaran dan kesintasan pasien IHCA pasca resusitasi jantung paru.Metode: Penulis menganalisis kejadian IHCA di RSUP Sanglah pada tahun 2021 secara kohort retrospektif melalui penelusuran rekam medis pasien dari bulan Januari hingga Desember 2021. Sampel dikumpulkan dengan teknik non randomized consecutive sampling, kemudian dilakukan analisis univariat untuk mendapat gambaran proporsi dan distribusi persentase, serta analisis bivariat untuk mengetahui hubungan antara kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung terhadap luaran resusitasi.Hasil: Pada pasien yang IHCA yang diresusitasi di RSUP Sanglah, 26,2% yang berhasil mengalami return of spontaneous circulation (ROSC), dengan >50% pasien meninggal dalam waktu <24 jam dan hanya 1% yang pulang dalam kondisi sembuh. Mayoritas pasien IHCA adalah laki-laki usia 40 tahun atau lebih, dengan Charlson Comorbidity Index (CCI) ?3, dengan penyebab nonkardiak. Sebagian besar resusitasi sudah dilakukan dalam waktu 5 menit setelah dibunyikannya tanda code blue. Tidak terdapat hubungan yang signifikan antara kelompok usia, skor CCI, etiologi henti jantung, serta waktu respon tim code blue dengan luaran resusitasi.Simpulan: Pasien IHCA di RSUP Sanglah memiliki angka kesintasan yang relatif rendah, namun upaya code blue sudah berjalan dengan baik. Tidak ada perbedaan kejadian luaran ROSC maupun meninggal yang signifikan berdasarkan variabel kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung.
Prognostic value of red cell distribution width-to-platelet ratio in mortality of major burn in Sanglah Hospital Bali Nyoman Siska Ananda; I Gusti Putu Hendra Sanjaya; Sianny Herawati; Agus Roy Rusly Hariantana Hamid; I Made Suka Adnyana; I Wayan Niryana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (259.304 KB) | DOI: 10.15562/ism.v13i1.1284

Abstract

Introduction: The mortality rate in Sanglah Hospital due to major burns is quite high. The ratio of red cell distribution width (RDW) and platelet (PLT) (RPR) as a prognostic marker of mortality in major burns has never been studied in Indonesia. Calculations of RPR are easy, widely available and cost-efficient.Method: This study was retrospective observational case-control, with 60 patients with major burns consisting of 30 cases and 30 controls. Samples were taken from the Sanglah Hospital Medical Record Unit from April 2019 to April 2021. Cases were samples with mortality after day seven, while controls were samples that survived. RDW and PLT value on day seven are associated with the incidence of mortality.Results: The mean of RPR in the case group was higher than in the control group. RPR mean of the control group was 0.0559, and the case group was 0.0947 (p<0.001). The increase of RPR in the case group was 40.97%. Statistical analysis showed that high RPR was a significant mortality risk factor in patients with major burns (OR = 21.36; p < 0.001).Conclusion: High RPR is a prognostic marker of mortality in major burns at Sanglah Hospital.
Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019 (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021 Anak Agung Parama Swari Khrisna; Ni Luh Jaya Kirana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.625 KB) | DOI: 10.15562/ism.v13i1.1287

Abstract

Introduction: COVID-19 is an infectious disease caused by a new virus causes that attacks the upper respiratory tract and the lungs. The numbers of cases and deaths have increased on a daily basis on the scale of a global pandemic. Chest X-ray images have proven useful for monitoring various lung diseases and have recently been used to monitor the COVID-19 disease. Imaging modalities such as chest x-rays have the benefit of providing initial imaging before confirming with RT-PCR examination. The purpose of this study was to determine the value of the diagnostic examination of the chest x-ray compared to the RT-PCR examination which is the gold standard in diagnosing COVID-19.Methods: This study used a diagnostic study design with a retrospective approach at Wangaya Hospital, Denpasar during the period June-November 2021. Analysis of the diagnostic test used cross tabulation and then calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy were performed.Results: Thorax imaging diagnostic test value compared with the gold standard RT-PCR examination in form of sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy was 78%, 23%, 84%, 16.6%, 1.01, 0.95, and 69% respectively.Conclusion: Thorax imaging provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of COVID-19. Pendahuluan: COVID-19 merupakan suatu penyakit menular yang disebabkan oleh virus baru dan menyerang saluran pernapasan bagian atas dan paru-paru. Jumlah kasus dan kematian telah meningkat setiap hari dalam skala pandemik global. Modalitas pencitraan seperti thoraks foto memiliki manfaat untuk memberikan pencitraan awal sebelum mengkonfirmasi dengan pemeriksaan RT-PCR. Tujuan penelitian ini adalah untuk mengetahui nilai pemeriksaan diagnostik yang dimiliki thoraks foto dibandingkan dengan pemeriksaan RT-PCR yang merupakan baku emas dalam mendiagnosis COVID-19.Metode: Penelitian ini menggunakan desain studi diagnostik dengan pendekatan retrospektif di Rumah Sakit Umun Daerah Wangaya Denpasar selama periode Juni-November 2021. Analisis uji diagnostik menggunakan tabulasi silang kemudian perhitungan sensitivitas, spesitifitas, positive predictive value (PPV), negative predictive value (NPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-) dan akurasi dilakukan.Hasil: Nilai uji diagnostik thoraks foto dibandingkan dengan pemeriksaan baku emas RT-PCR berupa sensitivas, spesitifitas, PPV, NPV, LR+, LR-, dan akurasi adalah masing-masing 78%, 23%, 84%, 16.6%, 1.01, 0.95, dan 69%.Simpulan: Thoraks foto memberikan sensitivitas dan akurasi diagnostik yang tinggi secara langsung pada presentasi klinis COVID-19.