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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

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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Search results for , issue "Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)" : 68 Documents clear

Faktor-faktor yang mempengaruhi keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado Madianung Valentine Virginia Bonochdita; Starry Homenta Rampengan; Jeini Ester Nelwan; Aaltje Ellen Manampiring; Dina Victoria Rombot
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: One of the health fields that is currently developing in various countries in adopting information and communication technology (ICT) is e-health. Hermina Hospital has a hermina mobile application that is useful for facilitating outpatient services. Initial data collection conducted by researchers in March showed that 23% of outpatient visits from executive polyclinics were registered via this application. Therefore, the aim of this research is to analyze the usage behavior of online registration at Hermina Hospital.Methods: This research was a quantitative correlational descriptive study with a cross sectional approach. The data used in this study obtained from the questionnaire using the method of convenient sampling with involved the participation of 110 respondents. Independent variables of this study were performance expectancy, effort expectancy, social influence, fcailitating condition dan behavioral intention. Dependent variable of this study is use behavior. The instrument used in this study was a quesioner.Results: The results of the chi square test found that performance expectancy, usage behavior, and behavioral intention were significantly related to use behavior (p < 0.05). Based on the results of the logistic regression test, it was found that the dominant factor influencing the use behavior is behavioral intention with a value of Exp (B) or Odds Ratio (OR) 2.746 and level of significant <0.05.Conclusion: The conclusion of this study is that there is a significant relationship between behavioral intention, effort expectancy, and performance expectancy on the decision to adopt the Hermina mobile application. Latar Belakang: Salah satu bidang kesehatan yang saat ini sudah berkembang di berbagai negara dalam mengadopsi teknologi informasi dan komunikasi (TIK) yaitu e-Kesehatan (e-health). Rumah Sakit Hermina memiliki aplikasi hermina mobile yang berguna untuk mempermudah pelayanan pasien rawat jalan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi keputusan adopsi aplikasi pendaftaran online hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.Metode: Penelitian ini merupakan penelitian kuantitatif korelasional dengan pendekatan cross sectional. Penelitian ini dilaksanakan di Rumah Sakit Hermina Manado pada November - Desember 2021. Subyek dalam penelitian ini yaitu 110 pasien poli eksekutif. Variabel bebas dari penelitian ini yaitu performance expectancy, effort expectancy, social influence, facilitating condition dan behavioral intention. Variabel terikat dari penelitian ini adalah keputusan adopsi (use behavior). Instrumen yang digunakan yaitu kuesioner. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat. Penyajian data dibuat dalam bentuk tabel dan narasi.Hasil: Hasil uji chi square ditemukan bahwa performance expectancy, effort expectancy, dan behavioral intention memiliki hubungan bermakna dengan keputusan adopsi (use behavior) (p<0,05). Berdasrkan hasil uji regresi logistik ditemukan faktor dominan berpengaruh terhadap keputusan adopsi pasien poli eksekutif adalah behavioral intention dengan nila Exp (B) atau Odds Ratio (OR) 2,746 dan nilai p<0,05.Kesimpulan: Terdapat hubungan yang signifikan antara faktor behavioral intention, effort expectancy, dan performance expectancy terhadap keputusan adopsi aplikasi hermina mobile pada pasien rawat jalan poli eksekutif di Rumah Sakit Hermina Manado.

Faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi covid-19 Andrew Christian Pangemanan; Starry Homenta Rampengan; Oksfriani Julfri Sumampouw; Aaltje Ellen Manampiring
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Latar belakang: Kepuasan pasien dicapai apabila penerima pelayanan memperoleh pelayanan sesuai dengan yang dibutuhkan dan diharapkan. Pandemi Coovid-19 menyebabkan penurunan angka kunjungan pasien, hal ini terjadi karena terdapat alur proses pelayanan kesehatan yang berubah, pembatasan jumlah pasien, serta diterapkannya langkah pencegahan standar, identifikasi awal dan pengendalian sumber virus. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19. Metode: Penelitian ini merupakan penelitian kuantitatif dengan pendekatan studi potong lintang. Penelitian ini dilaksanakan di Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada November-Desember 2021. Sampel penelitian berjumlah 334 pasien. Variabel bebas dari peneitian ini yaitu kesehatan fisik dan psikis pasien, kompetensi staf medis dan fasilitas rumah sakit. Variabel terikat dari penelitian ini adalah kepuasan pasien. Data hasil penelitian dianalisis secara univariat, bivariat, dan multivariat. Hasil: Hasil penelitian menunjukkan bahwa responden paling banyak berjenis kelamin laki-laki (52,69%), mayoritas berumur 36-45 tahun (37,72%), pekerjaan terbanyak swasta (35,33%) dan tingkat pendidikan terbanyak SMA/sederajat (46,41%). Hasil uji korelasi pearson ditemukan bahwa faktor kesehatan fisik dan psikis, kompetensi staf medis dan fasilitas rumah sakit nilai p<0,05. Berdasarkan uji regresi linier berganda ditemukan faktor yang paling mempengaruhi kepuasan pasien adalah fasilitas rumah sakit dengan nilai standardized coefficients beta sebesar 0,314. Kesimpulan: Faktor kesehatan fisik dan psikis, kompetensi staf medis, dan fasilitas rumah sakit berhubungan dengan kepuasan pasien di instalasi rawat jalan Rumah Sakit Tingkat IV Lanud Sam Ratulangi Manado pada masa pandemi Covid-19. Fasilitas rumah sakit merupakan faktor yang dominan berpengaruh terhadap kepuasan pasien

Congenital syphilis in neonates: a case report I Gede Yogi Priyatna Biantara; Romy Windiyanto
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Congenital syphilis (CS) in neonates is diagnosed when Treponema pallidum was identified in a laboratory test of neonates infected by mothers with syphilis. Recently, CS is still a significant and growing health problem worldwide despite being preventable. This case report will provide an overview of CS management conducted at our center, Sanjiwani Hospital, Gianyar, Bali-Indonesia. Case presentation: We report a case of CS in a newborn female neonate with the positive result of TPHA and VDRL titer 1/128 from a mother diagnosed with the latent phase of syphilis infection. On physical examination found subcostal retraction of the chest, grunting on auscultation, and jaundice. The treatments given include oxygen via cannula nasal with 2 liters per minute, intravenous access with dextrose 10%, the antibiotic combination of cefotaxime 125 mg every 12 hours and gentamicin 12.5 mg every 24 hours. For the management of CS, the patient was given Benzathine Penicillin G at a dose of 125,000 IU single dose intramuscularly. Phototherapy was assisted the patient for 48 hours to manage the hyperbilirubinemia. The patient was discharged on the eight days of treatment with oral antibiotic cefixime 12.5 mg every twelve hours for three days. Conclusion: The entity of CS is a disease suffered by infants with clinical manifestations or examination supporting the diagnosis of syphilis. The mother should do a screening during her pregnancy to prevent untreated syphilis and its complications for her babies.

Profil deskriptif pasien reaksi anafilaksis Di Rumah Sakit Umum Pusat Sanglah periode 2018-2021 I Gede Aswin Arinata; I Ketut Suardamana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction: The clinical degree of allergic reactions is divided into acute hypersensitivity reactions, anaphylactic reactions, and anaphylactic shock. Systemic anaphylactic reaction is a rare condition with a prevalence of around 1.6-5.1%. Clinical manifestations involved in anaphylactic reactions include skin and mucosal symptoms, respiratory system, cardiovascular system, digestive system. The purpose of this study was to determine the descriptive profile of patients with anaphylactic reactions at the Sanglah Central General Hospital for the period 2018 to 2021. Methods: This study used a cross-sectional descriptive study design. Data were obtained secondary through medical records recorded at the Allergy and Immunology Division of Internal Medicine at Sanglah Hospital. Data analysis was done descriptively. Results: In this study, 115 samples were obtained. The mean age in this study was 39.0±15.6. The sample consisted of 41 men (35.7%) and 74 women (64.3%). The most common allergens that cause anaphylactic reactions are drugs (53%) and food (22.6%). Based on clinical manifestations, the most experienced by patients were skin and mucosal symptoms (97.4%), respiratory system symptoms (86.1%), cardiovascular system symptoms (50.4%), and digestive system symptoms (23.5%). Patients who experienced anaphylactic shock 51 patients (44.3%). Conclusion: Anaphylactic reactions experienced mostly by women. The most common allergens are drugs. Meanwhile, in terms of the severity of patients experiencing anaphylactic shock, almost half of the cases of anaphylactic reactions. Pendahuluan: Derajat klinis dari reaksi alergi dibedakan menjadi reaksi hipersensitivitas akut, reaksi anafilaksis, dan syok anafilaksis. Reaksi anafilaksis sistemik merupakan kondisi yang jarang dijumpai dengan prevalensi sekitar 1,6-5,1%. Manifestasi klinis yang terlibat dalam reaksi anafilaksis meliputi gejala kulit dan mukosa, sistem pernafasan, sistem kardiovaskular, sistem pencernaan. Tujuan penelitian ini adalah untuk mengetahui profil deskriptif pasien reaksi anafilaksis di Rumah Sakit Umum Pusat Sanglah periode 2018 hingga 2021. Metode Penelitian: Penelitian ini menggunakan rancangan studi deskriptif potong lintang. Data diperoleh secara sekunder melalui rekam medis yang tercatat di Bagian Alergi dan Imunologi Penyakit Dalam RSUP Sanglah. Analisis data dilakukan secara deskriptif. Hasil: Pada penelitian ini didapatkan 115 sampel. Rerata usia pada penelitian ini yaitu 39,0±15,6. Sampel terdiri dari laki-laki 41 (35,7%) dan perempuan 74 (64,3%). Alergen penyebab reaksi anafilaksis terbanyak didapatkan dari obat (53%) dan makanan (22,6%). Berdasarkan manifestasi klinis yang terbanyak dialami pasien adalah gejala kulit dan mukosa sebanyak 97,4%, gejala sistem pernapasan sebanyak 86,1%, gejala sistem kardiovaskular sebanyak 50,4%, dan gejala sistem pencernaan sebanyak 23,5%. Pasien yang mengalami syok anafilaksis 51 pasien (44,3%). Simpulan: Reaksi Anafilaksis dialami sebagian besar oleh perempuan. Alergen terbanyak adalah obat-obatan. Sedangkan dari sisi derajat keparahan pasien yang mengalami syok anafilaksis hampir setengah dari kasus reaksi anafilaksis.

Perbedaan jumlah leukosit darah antara pasien apendisitis akut dan apendisitis perforasi sebagai prediktor diagnosis di RSUD Pulang Pisau, Kalimantan Tengah, Indonesia Febria Valentine Aritonang; Sanjaya Soebagio; Yan Aditya
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background. Not all health facilities in Indonesia have an advanced supporting examination to determine patients with acute appendicitis and perforated appendicitis. Several recent studies have shown there are differences in leukocyte count between patients with acute appendicitis and perforated appendicitis, which can be used as a predictor in diagnosing appendicitis and perforated appendicitis. Methods. This study used an observational analytic research method with a cross sectional approach to 40 patients. Data were taken from the appendicitis patients' medical records at Pulang Pisau Hospital from January to September 2021. The variable is the number of leukocytes between acute appendicitis and perforated appendicitis. ROC analysis was performed to determine the cut-off point of the leukocytes count. The data were calculated with analytical analysis using the Mann-Whitney U test with a significance limit is p <0.05. Result. In this study, 18 patients had acute appendicitis, and 22 patients had perforated appendicitis. ROC analysis (AUC 0.859) is on the cut-off point of 16,600/uL with a sensitivity of 90.9% and a specificity of 50%. The result of the Mann-Whitney U test is p < 0.05. Conclusion. There is a significant difference in leukocyte count between patients with acute appendicitis and perforated appendicitis in Pulang Pisau Hospital. The blood leukocyte count can be used as a predictor to differentiate acute appendicitis from perforated appendicitis. Latar Belakang. Belum semua fasilitas kesehatan di Indonesia memiliki pemeriksaan penunjang yang sudah maju untuk menentukan antara pasien akut apendisitis dengan apendisitis perforasi. Beberapa studi belakangan ini memperlihatkan terdapat perbedaan jumlah leukosit antara pasien dengan apendisitis akut dan apendisitis perforasi yang dapat digunakan sebagai prediktor dalam mendiagnosis apendisitis akut dan apendisitis perforasi. Metode. Studi ini menggunakan metode penelitian analitik observasional dengan pendekatan cross-sectional terhadap 40 pasien. Data diambil dari rekam medis pasien apendisitis di RSUD Pulang Pisau dari Januari hingga September 2021. Variabel dari penelitian ini adalah jumlah leukosit antara apendisitis akut dan apendisitis perforasi. Dilakukan analisis ROC untuk menentukan nilai potong dari jumlah leukosit. Data dianalisis menggunakan Mann-Whitney U test dengan nilai signifikansi p < 0,05. Hasil. Dalam penelitian ini, 18 pasien terdiagnosis apendisitis akut dan 22 pasien terdiagnosis apendisitis perforasi. Analisis ROC (AUC 85.9%) menghasilkan nilai potong jumlah leukosit di 16.600/uL dengan nilai sensitivitas 90.0% dan nilai spesifisitas 50%. Hasil uji Mann-Whitney didapatkan p < 0,05. Kesimpulan. Terdapat perbedaan yang signifikan dari nilai jumlah leukosit antara pasien dengan apendisitis akut dan apendisitis perforasi di RSUD Pulang Pisau. Nilai jumlah leukosit dapat digunakan sebagai prediktor untuk membedakan apendisitis akut dan apendisitis perforasi.

Breathing exercise and chest physiotherapy in post-acute COVID-19 patient: a case report Nyoman Chandra Adidharma; Bagus Diva Indra Dharma; Kade Ngurah Dwi Putra Negara; I Gede Adi Sudewa
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Severe acute respiratory syndrome (SARS CoV2) and coronavirus disease 2019 causes vary from mild to severe clinical manifestation. Complications from COVID-19 can show several manifestations such as pulmonary, cardiovascular, neuromuscular, and renal systems, which could lead to multi-organ failure. Lung fibrosis and recurrent pneumonia are some of some sequelae of survivors, and some need readmission to hospital, although the PCR swab test remains negative. Post-acute COVID-19 is a syndrome characterized by persistent clinical symptoms beyond four weeks from the onset of acute symptoms. Case: In this writing, a 57-year-old male presented with chief complaints of shortness of breath and cough 2 days after being discharged from the hospital because of a COVID-19 infection. His PCR swab test result remains negative when readmission. The patient was on non-invasive ventilation, medical therapy and physical therapies such as breathing exercises and chest physiotherapy. The physical therapy was done twice daily. On the seventh day of exercise, the shortness of breath was improved, and NIV was tapered down. The patient was discharged after 27 days of hospitalization. Conclusion: This case shows the benefit of breathing exercises and chest physiotherapy for the Post-acute COVID-19 patient. This helps improve respiratory muscle strength and chest expansion in order to improve oxygen perfusion.

Tatalaksana fiksasi terbuka dengan Plat vs Arm Sling pada fraktur midshaft klavikula: tinjauan pustaka sistematis Anak Agung Gde Radityaningrat; Ketut Gede Mulyadi Ridia
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Clavicle fracture is one of the most common fractures according to the Allman and Robinson classification. In Indonesia, clavicle fractures account for 2.6-4% of all fractures in adults. There are two types of modalities in the treatment of clavicle fractures: operative and non-operative. This systematic literature review aims to compare the two modalities to see which treatment is better in terms of bone union time, pain score, assessing return of shoulder function after therapy, and complication rates for each treatment group. Methods: The strategy used is comparing several journals of non-operative and operative management for the midshaft clavicle fractures in adults. The selected reporting items is by using Systematic Review and Meta-Analysis Guidelines (PRISMA) to conduct comprehensive data collection. Results: The results are presented with a comparison of the ORIF Plate with the Arm Sling for treatment outcomes. This research identified 11 relevant articles on the comparison of ORIF Plate with Arm Sling for treating clavicle midshaft fractures in adults. The number of patients was 1,333 patients. These articles compared bone union time, pain scores, assessing post-therapy return of shoulder function, and complication rates. Conclusion: Operative management of midshaft clavicle displacement fracture with ORIF Plate gives better results than conservative management with Arm Sling. Latar Belakang: Fraktur klavikula merupakan salah satu fraktur yang sering di terjadi menurut klasifikasi Allman dan Robinson. Di Indonesia fraktur klavikula berkontribusi sebesar 2,6-4% dari seluruh fraktur pada orang dewasa. Terdapat dua jenis modalitas dalam tatalaksana fraktur klavikula yaitu dengan operatif dan non operatif. Tinjauan pustaka sistematis ini bertujuan untuk membandingkan kedua modalitas tersebut untuk melihat tatalaksana mana yang lebih baik dalam hal waktu tulang untuk menyatu (union), skor nyeri, menilai kembalinya fungsi bahu pasca terapi, dan tingkat komplikasi yang terjadi dari masing- masing kelompok terapi. Strategi yang digunakan adalah dengan membandingkan beberapa jurnal tatalaksana non operatif dan operatif untuk penanganan fraktur midshaft klavikula pada orang dewasa. Butir pelaporan yang dipilih menggunakan Tinjauan Sistematis dan Pedoman Meta-Analisis (PRISMA) untuk melakukan pengumpulan data yang komprehensif. Hasilnya disajikan dengan perbandingan antara ORIF plate dengan Arm Sling untuk hasil pengobatan. Penelitian ini mengidentifikasikan 11 artikel yang relevan tentang perbandingan antara ORIF Plate dengan Arm Sling untuk mengobati fraktur midshaft klafikula pada orang dewasa. Jumlah pasien sebanyak 1.333 pasien. Artikel – artikel tersebut membandingkan waktu tulang untuk menyatu (union), skor nyeri, menilai kembalinya fungsi bahu pasca terapi, dan tingkat komplikasi. Tatalaksana operatif pada fraktur displace midshaft clavicula dengan ORIF Plate memberikan hasil lebih baik dibandingkan dengan tatalaksana konservatif dengan Arm Sling.

Chronic osteomyelitis treatment with PerOssal®: a literature review I Kadek Riyandi Pranadiva Mardana; Anak Agung Ngurah Ronny Kesuma; I Komang Agus Krisna Saputra; I Komang Mahendra Laksana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Chronic osteomyelitis is an inflammatory process in the bone followed by bone destruction caused by microorganism infection. The annual incidence of osteomyelitis is approximately 21.8 cases per 100,000 person-years in the general population. Implanting antibiotic-loaded carriers directly at the site of infection becomes a promising treatment approach. PerOssal® is an osteoconductive synthetic bone substitute for restoring and filling bone defects. PerOssal® pellets contain 51.1% nanocrystalline hydroxyapatite and 48.5% calcium sulfate. It has a role as bone material to fill bone defects caused by dead bone in chronic osteomyelitis. The porosity of PerOssal® allows a high initial antibiotic release, then decreases to ensure a local concentration of the antibiotic. PerOssal® did not show any in vitro cytotoxicity and fatal adverse event as bone material. PerOssal® is a promising antibiotic-loaded carrier for the management of chronic osteomyelitis. It demonstrates good biocompatibility with initial high antibiotic release without in vitro cytotoxicity and fatal adverse event.

Perbedaan karakteristik pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus – Oktober tahun 2021 Desak Ayu Dhyana Nitha Dewi; Putu Ayu Swandewi Astuti; I Gusti Agung Alit Naya
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: The bite of an animal that transmits rabies is still a problem in Indonesia, one of which is in the province of Bali. The high dog population and the habit of straying dogs cause the risk of rabies transmission due to dog bites to be higher. North Kuta District is one of the areas where the case of bites of animals that transmit rabies is found. The purpose of this study was to determine the differences in the characteristics of patients with rabies-transmitting animal bites at the North Kuta Health Center from August to October 2021. Methods: The study used a quantitative analytical design with a cross-sectional approach. The sample is patient medical record data at the North Kuta Health Center for the period August to October 2019. Data analysis was carried out using descriptive tests to describe patient characteristics. Bivariate test using Chi-square or Fisher’s Exact test was carried out to determine the differences in the characteristics of patients bitten by rabies-transmitting animals who received the Anti Rabies Vaccine (VAR) with a p value of <0.05 showing a significant value. Results: There were 96 patients with rabies-transmitting animal bites at the North Kuta Health Center for the period August – October 2019. The characteristics of the patients showed that most of them were 20 years old (37.50%), bitten by a stray dog (70.83%), the condition of the animal when it was found. still alive (68.75%), bitten on the right leg (37.50%), and received VAR (52.08%). The highest cases of animal bites that transmit rabies occurred during the month of October (41.67%). The results of the Chi-square test showed that the amount of VAR administration was significantly different based on the characteristics of the biting animal species (p<0.0001) and the animal's condition (p<0.0001). Conclusion: There are still cases of animal bites that transmit rabies in North Kuta District. There was a significant difference in the amount of VAR administration based on the characteristics of the biting animal species and the animal's condition. Latar Belakang: Gigitan hewan penular rabies masih menjadi permasalahan di Indonesia, salah satunya di Provinsi Bali. Populasi anjing yang tinggi serta kebiasaan meliarkan anjing menyebabkan risiko penularan rabies akibat gigitan anjing menjadi semakin tinggi. Kecamatan Kuta Utara merupakan salah satu daerah ditemukannya kasus gigitan hewan penular rabies. Tujuan penelitian ini mengetahui perbedaan karakteristik pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus hingga Oktober 2021. Metode: Penelitian menggunakan rancangan kuantitatif analitik dengan pendekatan potong lintang. Sampel merupakan data rekam medis pasien di Puskesmas Kuta Utara periode Agustus hingga Oktober 2019. Analisis data dilakukan dengan menggunakan uji deskriptif untuk menggambarkan karakteristik pasien. Uji bivariate menggunakan Chi-square atau Fisher’s Exact test dilakukan untuk mengetahui perbedaan karakteristik pasien gigitan hewan penular rabies yang memperoleh Vaksin Anti Rabies (VAR) dengan nilai p<0,05 menunjukan nilai signifikan Hasil: Terdapat 96 pasien kasus gigitan hewan penular rabies di Puskesmas Kuta Utara periode Agustus – Oktober 2019. Gambaran karakteristik pasien memperlihatkan sebagian besar berusia ≤20 tahun (37,50%), digigit oleh anjing liar (70,83%), kondisi hewan saat ditemukan masih hidup (68,75%), digigit di kaki kanan (37,50%), dan memperoleh VAR (52,08%). Kasus gigitan hewan penular rabies tertinggi terjadi selama bulan Oktober (41,67%). Hasil uji Chi-square menunjukkan bahwa jumlah pemberian VAR berbeda signifikan berdasarkan karakteristik jenis hewan penggigit (p<0,0001) dan kondisi hewan (p<0,0001). Kesimpulan: Masih terdapat kasus gigitan hewan penular rabies di Kecamatan Kuta Utara. Terdapat perbedaan bermakna jumlah pemberian VAR berdasarkan karakteristik jenis hewan penggigit dan kondisi hewan.

Inferior shoulder dislocation with greater tuberosity avulsion fracture treated with Traction-Countertraction method in a rural hospital: A case report and literature review Kevin Kusuman; Kadek Adit Wiryadana; Su Djie To Rante
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction. Inferior shoulder dislocation is considered a rare event. Although there is a seemingly low chance of occurrence, this condition should not be prematurely ruled out in the presence of acute shoulder pain. Case. A 45 years old woman complained of pain in her left shoulder and was unable to bring her arm lower than 90° after a car accident. The patient unintentionally put her left arm outstretched above her head to avoid head impact during the crash, causing hyperabduction of the shoulder. She experienced pain, numbness and could not move the ipsilateral hand. Her left arm was locked in hyperabduction (100°), and her elbow was extended. Close inspection showed a loss of left shoulder contour. On palpation, the humeral head was palpable in the axilla. Anteroposterior X-ray view confirmed inferior dislocation of the left shoulder with associated greater tuberosity fracture. A closed reduction under general anesthesia with the traction-counter traction technique was conducted as commonly used in rural settings. After perfect anatomical reduction was obtained and confirmed with X-ray, the patient was immobilized using an arm sling. The shoulder was immobilized for three weeks in adducted position to support soft tissue healing. Physiotherapy was started after three weeks. Conclusion. Inferior shoulder dislocation is a rare orthopedic pathology that should not be easily dismissed in post-traumatic shoulder pain. The mechanism of injury is characterized by downward force or lever mechanism on the hyperabducted arm. Orthopedic surgeons in rural areas could utilize the Traction-countertraction method.

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Location Kota denpasar, Bali INDONESIA

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Contact Name
-

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-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA