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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 1,063 Documents

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Comparison of knee society scores in osteoarthritis patient before and after total knee arthroplasty: a case report I Dewa Gede Indra Pratama Putra; Dewa Gede Kurnia Pratama; Putu Budi Sucitra
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Introduction: Osteoarthritis is a degenerative disease characterized by joint pain in the cartilage. It requires further management, especially in severe conditions that have not responded to pharmacological therapy, such as Total Knee Arthroplasty (TKA). Therefore, the authors aim to compare the knee quality of patients with Knee Society Scores (KSS) before and after TKA surgery. Case description: Female patient, 55 years old, came with the chief complaint of stiffness and pain in both knees for the last two years. The patient had previously undergone regular treatment and is now getting worse. The radiological found the impression of right and left knee osteoarthritis was grade IV, and the KSS assessment results were 40. The patient was then treated with TKA surgery. After the total knee arthroplasty procedure was observed for one month, the patient had no complaints of joint stiffness and did not feel severe pain in both knees. The KSS assessment results were 71 with good interpretation results. Conclusion: There was an improvement in the knee quality of patients with KSS before and after TKA surgery.

Keloid yang diterapi dengan kombinasi bedah listrik dan bedah beku pada seorang perempuan: sebuah laporan kasus dan tinjauan pustaka NI Putu Ayu Riska Yunita Sari; Ketut Kwartantaya Winaya; Roslina Horo; Luh Nyoman Arya Wisma Ariani
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Keloids are nodular tumors with a soft and spongy consistency and have a shiny and soft surface. Lesions are absent in hair follicles and adnexal glands. The main mediators include transforming growth factor-beta (TGF-β), interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor (TNF), and vascular growth factor (VEGF). This case discusses the combination therapy of electrosurgery and frozen surgery in treating keloids. Case description: A woman, 34 years old, Indonesian, has complained of a lump on her left shoulder since ten years ago, which has been getting harder and harder, sometimes accompanied by pain and itching. There was a solitary hyperpigmented nodule in the left deltoid region with firm boundaries, geographic shape, measuring 5.7 cm x 4 cm x 0.8 cm, regular edges, and a smooth and shiny surface. On palpation, the consistency is firm and firm. Dermoscopy showed multiple erythema nodules with vascular structures in the form of arborizing vessels and linear irregular vessels. Electrocauter surgery was performed with cut mode and continued with cryo surgery and the antibiotic ointment gentamicin 0.1% topically every 12 hours on lesions that have undergone electrosurgery, frozen surgery, and paracetamol tablets 500 mg every 8 hours intraorally if pain. On the 36th day of observation, clinical improvement of the lesions was found. Conclusion: Cryo surgery is minimally invasive and can be combined with electrocautery surgery to reduce bleeding. The lesion improvement was seen after the combination treatment was given, although there were still hypertrophic scar lesions. Latar belakang: Keloid merupakan tumor nodular dengan konsistensi lunak dan kenyal, memiliki permukaan berkilauan dan lunak. Lesi tidak terdapat pada folikel rambut dan kelenjar adneksal. Mediator utama meliputi transforming growth factor beta (TGF-β), interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor (TNF), dan vascular growth factor (VEGF). Kasus ini membahas terapi kombinasi bedah listrik dan bedah beku pada penanganan keloid. Kasus: Wanita, 34 tahun, warga negara Indonesia, mengeluh adanya benjolan pada bahu kiri sejak 10 tahun yang lalu yang semakin lama semakin keras, terkadang disertai rasa nyeri dan gatal. Pada regio deltoid sinistra didapatkan adanya nodul hiperpigmentasi soliter batas tegas, bentuk geografika, berukuran 5,7 cm x 4 cm x 0,8 cm, tepi reguler, permukaan halus dan mengkilat. Pada palpasi didapatkan konsistensi padat kenyal dan terfiksir. Dermoskopi didapatkan gambaran nodul eritema multipel dengan struktur vaskular berupa arborizing vessels dan linear irregular vessels. Dilakukan tindakan bedah listrik dengan mode cut dan dilanjutkan dengan bedah beku serta salep antibiotik gentamisin 0,1% tiap 12 jam secara topikal pada lesi yang telah dilakukan bedah listrik dan bedah beku dan parasetamol tablet 500 mg tiap 8 jam intraoral bila nyeri. Pengamatan hari ke 36 didapatkan perbaikan klinis lesi. Simpulan: Bedah beku merupakan tindakan invasif minimal dan dapat dikombinasikan dengan bedah listrik untuk mengurangi perdarahan selama tidakan dilakukan. Perbaikan lesi telihat setelah diberikan tindakan kombinasi walaupun masih terdapat lesi skar hiperterofik.

Inferior STEMI as the challenge of predicting the right coronary artery vs. the left circumflex artery as culprit lesion using the ECG criteria: a case report Fernanda Savitri Mega Pratistha; Ni Luh Eka Sriayu Wulandari
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: The morbidity and mortality in Inferior ST-elevation myocardial infarction (STEMI) is also determined by the location of the occlusion. Early Identification of the occlusion site is necessary to assist in the appropriate management of Inferior STEMI. This case study aims to evaluate the Electrocardiogram (ECG) examination, which has a basic role in the diagnosis of STEMI, both in determining the location of myocardial infarction and predicting the location of the culprit lesion. Case Presentation: A 48-year-old male patient complained of dull chest pain, such as being pressured by a heavy object and radiating to the back, followed by nausea, vomiting and cold sweats, and shortness of breath for 2 hours before coming to the hospital. On arrival, the patient was fully conscious with a blood pressure of 110/70 mmHg, pulse rate of 129x/minute with a SpO2 of 95% with electrocardiography (ECG) results showing atrial fibrillation with inferoposterolateral STEMI. Shortly after the ECG examination, the patient became unconscious, with blood pressure dropping to 60/palpation and bradycardia at 48 beats/minute. The patient underwent a fibrinolytic revascularization strategy with Streptokinase 1,500,000 U for 30 minutes, but soon the patient became unconscious with the ECG monitor showing ventricular fibrillation (VF). Hence, cardiopulmonary resuscitation was immediately performed with 360 J defibrillation twice, and the ECG returned to sinus rhythm. After stabilizing, the patient was referred for Rescue Percutaneous Coronary Intervention (PCI). The results of Coronary Angiography showed that the culprit lesion, in this case, was the Left Circumflex Artery with the Right Coronary Artery normal small, and non-dominant. Conclusion: ECG is still an important supporting examination in diagnosing and managing Acute Coronary Syndrome (ACS). An ECG can also help determine the culprit lesion in STEMI before angiography. Inferoposterolateral STEMI can be caused by blockage of the Right Coronary Artery (RCA) or Left Circumflex Artery (LCx).

Determinant of service utilization for triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia Ngakan Putu Anom Harjana; Sally Nita; Meirinda Sebayang; Oldri Sherli Mukuan; Asti Setiawati Widihastuti
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: HIV-AIDS and sexually transmitted infections are still a public health burden in Indonesia. Women living with HIV have a higher risk of transmitting HIV, Syphilis, and Hepatitis B to their babies. While the effort to increase the services coverage for the prevention of mother-to-child transmission (PMTCT) was detained due to the COVID-19 pandemic and the lack of published studies that explore this, this study aimed to assess the determinant of service utilization for triple elimination of mother-to-child transmission of HIV, Syphilis, and Hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia. Methods: This cross-sectional study targeted women living with HIV in Indonesia who are planning to get pregnant. A simplified-snowball sampling technique was used in this study. A dependent variable in this study was the service utilization of PMTCT for HIV, Syphilis, and Hepatitis B. In contrast, the independent variables in this study consisted of demographic characteristics, perception according to Health Belief Model constructs, and stigma and discrimination experiences. Multiple logistic regression was used to find the determinants of service utilization. Results: Among 336 women living with HIV that were interviewed, only 28.27% (95% CI = 23.69 – 33.34) accessed the PMTCT services during the COVID-19 pandemic. Moreover, the likelihood of PMTCT service utilization was decreased among the women living with HIV who perceived higher barriers (aOR = 0.56; 95% CI = 0.31 – 0.99) and experienced stigma and discrimination from partner (aOR = 0.50; 95% CI = 0.25 – 0.99). On the other hand, the PMTCT service utilization was increased among those who perceived less severity (aOR = 2.07; 95% CI = 1.21 – 3.54). No other factors were associated with the PMTCT service utilization among women living with HIV during the COVID-19 pandemic. Conclusion: The PMTCT service utilization was relatively low, increased by the higher perceived severity, and reduced among those who perceived higher barriers and experienced stigma and discrimination from the partner. Therefore, improving the knowledge about HIV, Syphilis, and Hepatitis B related to PMTCT services is essential, as well as providing social support to reduce the stigmas and discrimination among women living with HIV.

Perbedaan Kadar serum Liver-Type Fatty Acid Binding Protein (L-FABP) dan Beta Trace Protein (BTP) Dalam Serum Sebelum dan Saat Cedera Ginjal Akut Mona Yuliari; Hani Susianti; Deasy Ayuningtyas Tandio
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: The prevalence of Acute Kidney Injury (AKI) varies, ranging from 3% to 20% of hospitalized patients and 25% to 67% of ICU patients, with 5% to 6% of the ICU population requiring renal replacement therapy following AKI. Establishing the diagnosis of AKI with KDIGO criteria using serum creatinine marker. Serum creatinine has a sensitivity of 52.9% and a specificity of 85.7% for AKI. The Sensitivity and specisifity of serum creatinine is not good because it can increase without any real injury or do not change even though acute tubular injury has occurred due to compensation for increased function by the remaining nephrons. L-FABP (Liver type Fatty Acid Binding Protein) and BTP (Beta Trace Protein) serum are newly discovered biomarkers potential for the early diagnosis of acute kidney damage. This study was conducted to determine the change in L-FABP and BTP concentration levels as markers of AKI. Method: This study is a longitudinal observational study with patients suffering from AKI with serum samples taken before and after an increase in serum creatinine level of ≥0.3 mg/dL in 48 hours. Serum levels of L-FABP and BTP were examined by ELISA method, and serum creatinine by enzymatic colorimetric. Differences between levels before and during AKI were analyzed by the Wilcoxon test. Results: The number of research subjects was 40 people. There was significant difference between serum creatinine before and during AKI (1.97 (1.36-2.77) mg/dL vs. 3.52 (2.53-4.91). mg/dL, p<0.001). Indeed there were also significant differences in serum L-FABP before and during AKI (3775.48 (1614.11-5086.68) ng/mL vs. 5427.28 (4562.79-5765.14) ng/mL, p<0.001), and serum BTP levels before and during AKI (456.36 (290.35-591.67) mg/L vs. 518.38 (436.37-691.90) mg/L, p<0.001). Conclusion: Serum levels of L-FABP and BTP increased significantly in the condition of the AKI so that it has the potential to be a marker for the diagnosis of AKI. Latar belakang: Prevalensi cedera ginjal akut (Acute Kidney Injury/AKI) bervariasi, sekitar 3% hingga 20% dari pasien rawat inap dan 25% hingga 67% dari pasien ICU, dengan 5% hingga 6% dari populasi ICU membutuhkan terapi penggantian ginjal setelah terjadi AKI. Penegakan diagnosis AKI dengan kriteria KDIGO menggunakan marker serum kreatinin. Serum kreatinin mempunyai sensitivitas 52,9% dan spesifisitas 85,7% untuk AKI. Sensitivitas dan spesifisitas serum kreatinin tersebut kurang baik karena kadar serum kreatinin dapat meningkat tanpa ada cedera nyata maupun tidak berubah meskipun telah terjadi cedera tubulus akut karena adanya kompensasi peningkatan fungsi oleh nefron yang tersisa. Serum L-FABP (Liver type Fatty Acid Binding Protein) dan BTP (Beta Trace Protein) adalah biomarker yang ditemukan untuk diagnosis dini AKI. Penelitian ini dilakukan untuk mengetahui perubahan kadar serum L-FABP dan BTP sebagai penanda terjadinya AKI. Metode: Penelitian ini adalah penelitian observasional longitudinal dengan subyek pasien yang menderita AKI dengan sampel serum yang diambil sebelum dan sesudah terjadi peningkatan kadar serum kreatinin ≥0,3 mg/dL dalam 48 jam. Kadar serum L-FABP dan BTP diperiksa dengan metode ELISA, dan serum kreatinin dengan metode enzimatik kolorimetrik. Perbedaan antara kadar sebelum dan saat AKI dianalisis dengan uji Wilcoxon. Hasil: Jumlah subyek penelitian adalah 40 orang. Terdapat perbedaan bermakna antara kreatinin serum sebelum dan selama AKI (1,97 (1,36-2,77) mg/dL vs 3,52 (2,53-4,91), mg/dL, p<0,001. Teradapat juga perbedaan yang signifikan dalam serum L-FABP sebelum dan selama AKI (3775,48 (1614,11-5086,68) ng/mL vs 5427,28 (4562,79-5765,14) ng/mL, p<0,001), dan kadar BTP serum sebelum dan selama AKI (456,36 (290,35-591,67) mg/L vs. 518,38 (436,37-691,90) mg/L, p<0,001). Simpulan: Kadar serum L-FABP dan BTP meningkat signifikan pada kondisi AKI sehingga berpotensi menjadi marker untuk diagnosis AKI.

Faktor risiko yang berhubungan dengan kejadian asfiksia pada neonatus di RSIA Dedari Kupang, Nusa Tenggara Timur, Indonesia Dewa Gede Sahabhiseka Dewanta; Gangga Devi Padma; I Gusti Agung Ayu Novi Wiraningrat
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Asphyxia is one of the three main causes of newborn death. In Indonesia, the neonatal mortality rate (AKN) in 2018 was 15-20% due to asphyxia with several risk factors including maternal age, anemia, number of previous deliveries, history of hypertension, premature rupture of membranes, prematurity, and method of delivery. This study aims to evaluate the risk factors associated with asphyxia in neonates at RSIA Dedari Kupang, East Nusa Tenggara, Indonesia. Methods: The research design is an observational analytic study with a case-control design. This study consisted of 40 case samples and 40 control samples. Sampling was from January 2020 - December 2021 in the maternity ward and perinatology room at RSIA Dedari Kupang with a total sampling technique in the case group and a random sampling technique in the control group. The sample used has met the inclusion and exclusion criteria. Data were analyzed univariate and bivariate using SPSS version 23.0 for Windows. Results: There was a significant relationship between premature rupture of membranes and prematurity on the incidence of neonatal asphyxia in bivariate analysis (p<0.05). In addition, there was also a significant relationship between a history of hypertension and asphyxia with logistic regression analysis (p<0.05). Conclusion: There is a significant relationship between premature rupture of membranes, prematurity and hypertension in pregnancy with the incidence of asphyxia in neonates. Latar Belakang: Asfiksia menjadi salah satu dari tiga penyebab utama kematian bayi baru lahir. Di Indonesia angka kematian neonatal (AKN) pada tahun 2018 sebesar 15-20% disebabkan oleh asfiksia dengan beberapa faktor risiko antara lain usia ibu, kondisi anemia, jumlah persalinan sebelumnya, riwayat hipertensi, ketuban pecah dini, prematuritas, serta metode persalinan. Penelitian ini bertujuan untuk mengevaluasi faktor risiko yang berhubungan dengan kejadian asfiksia pada neonatus di RSIA Dedari Kupang, Nusa Tenggara Timur, Indonesia. Metode: Rancangan penelitian adalah studi analitik observasional dengan desain case-control. Sampel penelitian ini terdiri dari 40 sampel kasus dan 40 sampel kontrol, Pengambilan sampel sejak Januari 2020 - Desember 2021 di Ruang Bersalin dan Ruang perinatologi RSIA Dedari Kupang dengan teknik total sampling pada kelompok kasus serta teknik random sampling pada kelompok kontrol. Sampel yang digunakan telah memenuhi kriteria inklusi dan eksklusi. Data dianalisis secara univariat dan bivariat menggunakan SPSS versi 23.0 untuk Windows. Hasil: Terdapat hubungan yang bermakna antara ketuban pecah dini dan prematuritas terhadap kejadian asfiksia neonatus pada analisis bivariat (p<0,05). Di samping itu terdapat juga hubungan yang bermakna antara riwayat hipertensi dengan asfiksia dengan analisis regresi logistik (p<0,05). Simpulan: Terdapat hubungan yang signifikan antara ketuban pecah dini, prematuritas dan hipertensi dalam kehamilan dengan kejadian asfiksia pada neonatus.

Manajemen anestesi pada operasi koreksi deformitas skoliosis Moses Wijaya; I Wayan Widana
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Adolescent Idiopathic Scoliosis (AIS) is a lateral curvature of the spine with a bulge angle of at least 10°, with no underlying neuromuscular or congenital abnormality. Surgery is the best treatment for patients with AIS. The main goal of AIS surgery is to prevent progression due to fusion, but there are various potential risks, such as the postoperative period. Case: The patient was a 26-year-old female patient with complaints of an misaligned spine. The patient was diagnosed with adolescent idiopathic scoliosis and planned for scoliosis deformity correction. The X-ray shows a thoracic curve with convexity to the right (7th thoracic vertebrae – 1st lumbar vertebra), Cobb angle 54 degrees, right Cobb bending angle 34 degrees, flexibility 20 degrees, left Cobb bending angle 70 degrees, flexibility 26 degrees. The operation was performed using the general anesthesia-orotracheal tube (GA-OTT) technique. After induction, the patient was placed in the prone position. Maintenance of anesthesia with O2, N2O, dexmetomidine, intermittent fentanyl, and rocuronium. The operation lasted for 6 hours, the bleeding during the operation was 1000 ml and was hemodynamically stable. Post-operatively the patient is well conscious and adequate spontaneous breathing. Patient care is carried out in the ICU with the administration of analgesics. Conclusion: Adolescent idiopathic scoliosis is an exception diagnosis from other forms of scoliosis. An approach to find out the causes, risk factors, methods of diagnosis and treatment of patients with adolescent idiopathic scoliosis are needed in order to increase the success of therapy and the quality of life of the patients. Latar Belakang: Adolescent Idiopathic Scoliosis (AIS) adalah kelengkungan lateral tulang belakang dengan sudut tonjolan minimal 10°, tanpa kelainan neuromuskular atau bawaan yang mendasarinya. Pembedahan adalah pengobatan terbaik untuk pasien dengan AIS. Tujuan utama operasi AIS adalah untuk mencegah perkembangan akibat fusi, tetapi ada berbagai potensi risiko, seperti periode pasca operasi. Laporan Kasus: Pasien wanita berusia 26 tahun dengan keluhan bentuk tulang belakang yang tidak lurus. Pasien didiagnosis dengan adolescent idiopathic scoliosis dan direncanakan untuk scoliosis deformity correction. Pada rongent tampak curve thoracalis dengan konveksitas ke kanan (vertebra thorakalis 7 – vertebra lumbal 1), sudut Cobb 54 derajat, sudut Cobb Bending kanan 34 derajat, flexibilitas 20 derajat, sudut Cobb Bending kiri 70 derajat, flexibilitas 26 derajat. Operasi dilakukan dengan teknik anestesi general anesthesia-orotracheal tube (GA-OTT). Setelah dilakukan induksi, pasien diatur ke posisi prone. Pemeliharaan anestesi dengan O2, N2O, dexmetomidine, fentanyl intermitten, dan rocuronium. operasi berlangsung selama 6 jam, perdarahan selama operasi 1000 ml dan hemodinamik stabil. Post-operative pasien sadar baik dan bernafas spontan adekuat. Perawatan pasien dilakukan di ICU dengan pemberian analgetik. Simpulan: Adolescent idiopathic scoliosis adalah diagnosis pengecualian dari bentuk skoliosis lainnya. Penelusuran untuk mengetahui penyebab, faktor risiko, metode diagnosis dan tatalaksana dari pasien dengan adolescent idiopathic scoliosis diperlukan agar dapat meningkatkan keberhasilan terapi dan kualitas hidup dari pasien.

Hubungan D-dimer dengan tingkat keparahan infeksi COVID-19 Kadek Anggiswari Pradnya Angela; I Made Duwi Sumohadi
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Introduction: Inflammation response and endothelial damage caused by COVID-19 resulting coagulopathy by increased D-dimer level. High D-dimer can predict COVID-19 severity. This research conducted to know the correlation, risk, and prediction of severe COVID-19 infection in patients with high D-dimer levels. Method: Cross-sectional with bivariate and multivariates logistic regression analysis was conducted. Samples are ≥18 years old with COVID-19 hospitalized in Tabanan regional hospital during October 2021- March 2022. Data collected from medical records. Patients with chronic liver disease, congestive heart disease, malignancy, post-surgery, pregnancy, and deep vein thrombosis are excluded. COVID-19 severity criterias are based on COVID-19 management protocol. Result: Of 84 patients, 63.1% males and 58.3% ≥ 60 years old. Mean D-dimer level in severe COVID-19 patients are 3,256.06 ng/ml, and 1,543.02 ng/ml in non-severe (p = 0.014, CI 95%: 435.568–2,990.51). Cut-off point of D-dimer level is 788.5 ng/ml, with 71.9% sensitivity and 69.2% specificity on the receiver operating characteristics curve. A significant correlation is found between D-dimer level above cut-off and COVID-19 infection severity (OR 5.75, CI 95%: 2.18-15.16, p= 0.001). Correlation is still significant after variables age ≥60 years old and DM comorbidity adjusted (OR 5.32, CI 95%: 1,922-14,729, p=0.001). Probability of severe COVID-19 infection in patients ≥60 years old with D-dimer level > 788.5 ng/ml and has DM comorbidity is 83.24%. Conclusion: COVID-19 infection severity correlates with increased D-dimer levels with risk more than 5 times after variables age ≥60 years old and DM comorbidity adjusted, with moderate categorized prediction accuracy. Pendahuluan: Respon inflamasi dan kerusakan endotel akibat COVID-19 menyebabkan terjadinya koagulopati, ditandai dengan peningkatan kadar D-dimer. D-dimer tinggi diperkirakan dapat memprediksi keparahan COVID-19. Penelitian ini dilakukan untuk mengetahui hubungan, besar risiko, dan prediksi terjadinya infeksi COVID-19 berat pada penderita D-dimer tinggi. Metode Penelitian: Penelitian ini merupakan penelitian cross-sectional dengan analisis bivariat chi-square dan regresi logistik multivariat. Sampel adalah penderita ≥18 tahun dengan COVID-19 yang dirawat di RSUD Tabanan periode Oktober 2021-Maret 2022. Data diambil dari rekam medik. Penderita penyakit hati kronik, penyakit jantung kongestif, keganasan, paska pembedahan, hamil, dan deep vein thrombosis dieksklusi. Kriteria keparahan COVID-19 menggunakan buku pedoman protokol tatalaksana COVID-19. Hasil Penelitian: Dari 84 penderita memenuhi kriteria, 63,1% laki-laki, 58,3% umur ≥ 60 tahun. Rata-rata kadar D-dimer pada infeksi COVID-19 berat 3.256,06 ng/ml dan 1.543,02 ng/ml pada infeksi COVID-19 tidak berat (p = 0,014, IK 95 %: 435,568 – 2.990,51). Nilai cut off kadar D-dimer didapatkan 788,5 ng/ml dengan sensitivitas 71,9%, spesifisitas 69,2% pada receiver operating characteristics curve. Didapatkan hubungan bermakna D-dimer diatas cut off dengan tingkat keparahan infeksi COVID-19 (OR 5,75, IK 95%: 2,18-15,16, p= 0,001) Hubungan ini tetap bermakna setelah diperhitungkan faktor usia ≥60 tahun dan komorbid DM (OR 5,32, IK 95%: 1.922-14.729, p = 0,001). Probabilitas terjadinya infeksi COVID-19 berat pada penderita usia ≥60 tahun dengan D-dimer > 788,5 ng/ml dan komorbid DM adalah 83,24%. Simpulan: Keparahan infeksi COVID-19 berhubungan dengan peningkatan kadar D-dimer dengan risiko lebih dari lima kali setelah diperhitungkan faktor usia dan komorbid DM dengan akurasi prediksi kategori sedang.

Pengaruh kompetensi dan kinerja sumber daya manusia dalam penerapan prinsip-prinsip Good Corporate Governance pada pegawai di Rumah Sakit Umum Daerah Provinsi Sulawesi Utara Lydia Elvina Rindengan; Billy Johnson Kepel; Starry Homenta Rampengan; Aaltje Ellen Manampiring
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: In supporting exist service, hospitals need competent employees and good performance of human resources in order to optimize organizational performance that implements the principles of good corporate governance. The purpose of this study was to analyze the effect of competence and performance of human resources in the application of the principles of good corporate governance at the Regional General Hospital of North Sulawesi Province.Method: This type of research is analytic observational with a cross sectional study approach. This research was carried out at the Regional General Hospital of North Sulawesi Province in February 2022. The research sample was taken from existing employees with a simple random sampling technique with a total of 182 samples of respondents. The inclusion criteria in this study were ASN and THL who worked at the Regional General Hospital of North Sulawesi Province. The data in this study were taken through the distribution of questionnaires and filled out by employees as respondents. Data analysis used univariate, bivariate and multivariate tests using SPSS version 25 for Windows. Result: Respondents of ASN employees were 104 people (57,1%) and THL were 78 people (42,9%). chi square test shows that there is an influence between competence and performance of human resources in the application of good corporate governance principles (p value<0,000). The logistic regression test shows that competence has a positive effect on the application of the principles of good corporate governance with an odd ratio of 29,234 and the performance of human resources has a positive effect on the application of the principles of good corporate governance with an odd ratio of 10,792. Competence and performance of human resources simultaneously affect the application of the principles of good corporate governance seen from the calculated chi square value is greater than the chi square table (88,895>5,991). Conclusion: Competence and performance of human resources partially have a positive effect on the application of good corporate governance principles to employees at the Regional General Hospital of North Sulawesi Province. Latar Belakang: Dalam menunjang pelayanan yang ada, rumah sakit membutuhkan pegawai yang kompeten dan juga kinerja sumber daya manusia yang baik dalam rangka optimalisasi kinerja organisasi yang menjalankan prinsip good corporate governance. Tujuan penelitian ini untuk menganalisis pengaruh kompetensi dan kinerja sumber daya manusia dalam penerapan prinsip-prinsip good corporate governance di Rumah Sakit Umum Daerah Provinsi Sulawesi Utara Metode: Jenis penelitian bersifat obsevasional analitik dengan pendekatan cross sectional study. Penelitian ini dilaksanakan di Rumah Sakit Umum Daerah Provinsi Sulawesi Utara pada bulan Februari 2022. Sampel penelitian diambil dari pegawai yang ada dengan teknik pengambilan sampel simple random sampling dengan jumlah responden sebanyak 182 sampel. Kriteria inklusi dalam penelitian ini adalah ASN dan THL yang bekerja di Rumah Sakit Umum Daerah Provinsi Sulawesi Utara. Data dalam penelitian ini diambil melalui pembagian kuesioner dan diisi oleh oleh pegawai sebagai responden. Analisis data menggunakan uji univariat, bivariat dan multivariat menggunakan SPSS versi 25 untuk WIndows. Hasil: Responden pegawai ASN 104 orang (57,1%) dan THL sebanyak 78 orang (42,9%). Uji chi square menunjukkan adanya pengaruh antara kopetensi dan kinerja sumber daya manusia dalam penerapan prinsip-prinsip good corporate governance (nilai p<0,000). Uji regresi logsitik menunjukkan kompetensi berpengaruh positif terhadap penerapan prinsip-prinsip good corporate governance dengan odd ratio 29,234 dan kinerja sumber daya manusia berpengaruh positif dalam penerapan prinsip-prinsip good corporate governance dengan odd ratio 10,792. Kompetensi dan kinerja sumber daya manusia berpengaruh secara simultan dalam penerapan prinsip good corporate governance dilihat dari nilai chi square hitung lebih besar dari chi square tabel (88,895>5,991). Kesimpulan: Kompetensi dan kinerja sumber daya manusia secara parsial berpengaruh positif dalam penerapan prinsip-prnsip good corporate governance pada pegawai di Rumah Sakit Umum Daerah Provinsi Sulawesi Utara.

The role of Platelet-Rich Plasma (PRP) in burn wound healing: a literature-review Ni Kadek Parswa Diah Pradnyandari; Ratna Rayeni Natasha
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Burn-related morbidity and mortality are usually caused by secondary infection and long healing time. In these circumstances, the use of products that can accelerate and enhance the wound healing process is urgently needed. One breakthrough in wound healing therapy is platelet-rich plasma (PRP). Platelet-rich plasma is autologous plasma with a platelet concentration above the normal value. This study is a literature review aiming to describe the role of PRP in burn wound healing. PRP has various mechanisms in burn wound healing, such as increasing hemostasis, releasing growth factors, reepithelialization, inducing fibroblast proliferation in the extracellular matrix, and promoting angiogenesis which increases the rate of wound healing. In addition, it also has an antimicrobials effect. Previous studies have been done in animal models and humans to prove the efficacy of PRP in burn wound healing. Most studies have revealed that PRP can accelerate wound healing time and increase the quality of wound healing. So, using PRP in burns can be very useful for patients to reduce burn morbidity and mortality.

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