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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
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.
Arjuna Subject : -
Articles 1,063 Documents
 103   104   105   106   107 
Analisis faktor resiko yang berhubungan dengan nilai Neutrophil Lymphocyte Ratio (NLR) tinggi pada pasien diabetes mellitus tipe 2 yang terinfeksi COVID-19 di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia Marisye Christantia; Made Ratna Saraswati; Anak Agung Gde Budhiarta; Ketut Suastika; I Made Pande Dwipayana; I Made Siswadi Semadi; Ida Bagus Aditya Nugraha
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1340

Abstract

Background: Coronavirus disease (COVID-19) infection has become a worldwide pandemic. Diabetes Mellitus is a comorbid disease that can increase in severity. The most common clinical finding in severe COVID-19 infection is a high Neutrophil Lymphocyte Ratio (NLR). In patients with Diabetes Mellitus (DM) type 2, it is also known that high NLR values ​​have a poor prognosis. This study analyzes the risk factors associated with high NLR values ​​in type 2 DM patients infected with COVID-19 at Sanglah General Hospital. Methods: A cross-sectional analytical study was conducted on the medical records of 70 patients with COVID-19 infection with type 2 DM who were treated at Sanglah General Hospital, Denpasar, for the period April 2020-October 2020. The samples were divided into two groups, namely high and normal NLR. The analysis was conducted to see which risk factors were significantly associated with high NLR values ​​in COVID-19 patients with type 2 diabetes. The analysis was carried out using an independent T-test for numerical variables and chi-square for nominal variables. Results: Most of the study samples had high levels of NLR (65.71%). Risk factors that had a significant relationship with high NLR values ​​were random blood sugar levels (p=0.00), fasting blood sugar levels (p=0.00), HbA1c (p=0.002), CRP levels (p=0.00), leukocyte level (p=0.00), BUN level (p=0.004), history of type 2 DM before COVID-19 infection (p=0.009) and control HbA1c (0.001). Conclusion: The risk factors associated with high NLR values ​​in COVID-19 patients with type 2 DM at Sanglah Hospital Denpasar are random blood sugar levels, fasting blood sugar levels, HbA1c, CRP levels, leukocyte levels, BUN levels, history of type 2 diabetes before COVID-19 infection and HbA1c control.   Latar Belakang: Infeksi Coronavirus disease (COVID-19) telah menjadi pandemik di seluruh dunia. Diabetes Mellitus merupakan penyakit komorbid yang dapat meningkatkan keparahan. Temuan klinis yang banyak ditemukan pada infeksi COVID-19 berat adalah nilai neutrophil lymphocyte ratio (NLR) yang tinggi. Pada pasien Diebetes Mellitus (DM) tipe 2 juga diketahui nilai NLR yang tinggi memiliki prognosis buruk. Penelitian ini bertujuan untuk menganalisis faktor risiko yang berhubungan dengan nilai NLR tinggi pada pasien DM tipe 2 yang terinfeksi COVID-19 di RSUP Sanglah. Metode: Studi analitik potong lintang dilakukan pada rekam medik 70 pasien dengan infeksi COVID-19 dengan DM tipe 2 yang dirawat di RSUP Sanglah Denpasar periode April 2020-Oktober 2020. Sampel dibagi menjadi dua kelompok yakni NLR tinggi dan normal. Analisis dilakukan untuk melihat faktor risiko yang signifikan berhubungan dengan nilai NLR tinggi pada pasien COVID-19 dengan DM tipe 2. Analisis dilakukan menggunakan uji independent T-test untuk variabel numerik dan chi-square untuk variabel nominal. Hasil: Mayoritas sampel penelitian memiliki kadar NLR tinggi (65,71%). Faktor risiko yang memiliki hubungan signifikan dengan nilai NLR tinggi adalah kadar gula darah acak (p=0,00), kadar gula darah puasa (p=0,00), HbA1c (p=0,002), kadar CRP (p=0,00), kadar leukosit (p=0,00), kadar BUN (p=0,004), riwayat DM tipe 2 sebelum infeksi COVID-19 (p=0,009) dan kontrol HbA1c (0,001). Kesimpulan: Faktor risiko yang berhubungan dengan nilai NLR tinggi pada pasien COVID-19 dengan DM tipe 2 di RSUP Sanglah Denpasar adalah kadar gula darah acak, kadar gula darah puasa, HbA1c, kadar CRP, kadar leukosit, kadar BUN, riwayat DM tipe 2 sebelum infeksi COVID-19 dan kontrol HbA1c.
Hubungan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap parameter laboratorium pada pasien DM tipe 2 yang terkonfirmasi COVID-19 di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia R. Prawira Bayu Putra Dewa; Made Ratna Saraswati; Anak Agung Gde Budhiarta; Ketut Suastika; I Made Pande Dwipayana; I Made Siswadi Semadi; Ida Bagus Aditya Nugraha
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i2.1345

Abstract

Background: The pathogenesis of COVID-19 infection is the occurrence of excessive inflammatory reactions in which one of the markers of inflammation that is easy to work with is the value of the Neutrophil Lymphocyte Ratio (NLR). The NLR value increases in uncontrolled type 2 DM patients and is a prognostic factor for the occurrence of severe symptomatic COVID-19 infection. This study aims to examine the correlation between NLR values ​​and various laboratory parameters of type 2 DM patients with COVID-19 infection at Sanglah Hospital. Methods: This study used a cross-sectional analytical design and involved 70 research samples from the medical records of type 2 DM patients with COVID-19 who were treated at Sanglah Hospital from April 2020 to October 2020. Analysis with Pearson and Spearman tests to see the correlation between NLR values ​​and 12 laboratory parameters such as GDS, GDP, HbA1c, Leukocytes, Hemoglobin, BUN, D-Dimer, CRP, serum creatinine, SGOT, SGPT and Ferritin using SPSS software version 21 for Windows. Results: From the results of the correlation test, laboratory parameters that were found to be significantly positively correlated with NLR values ​​were GDS levels (r=0.451; p=0.000), GDP (r=0.037; p=0.001), leukocytes (r=0.479; p=0.000), BUN (r=0.368; p=0002), D-dimer (r=0.348; p=0.011), CRP (r=0.557; p=0.000), serum creatinine (r=0.313; p=0.009) and ferritin (r=0.337; p=0.011). Conclusion: The NLR value in type 2 DM patients with COVID-19 is positively correlated with glycemic markers, namely GDS and GDP. In addition, it is also positively correlated with leukocytes, BUN, D-dimer, CRP, serum creatinine and ferritin.   Latar belakang: Patogenesis infeksi COVID-19 adalah terjadinya reaksi inflamasi berlebihan dimana salah satu penanda inflamasi yang mudah dikerjakan adalah nilai Neutrophil Lymphocyte Ratio (NLR). Nilai NLR meningkat pada pasien DM tipe 2 yang tidak terkontrol dan menjadi faktor prognostik untuk terjadinya infeksi COVID-19 gejala berat. Penelitian ini bertujuan untuk meneliti korelasi antara nilai NLR dengan berbagai parameter laboratorium pasien DM tipe 2 dengan infeksi COVID-19 di RSUP Sanglah. Metode: Studi ini menggunakan desain analitik potong lintang dan melibatkan 70 sampel penelitian dari rekam medik pasien DM tipe 2 dengan COVID-19 yang dirawat di RSUP Sanglah bulan April 2020 hingga Oktober 2020. Analisis dengan Uji Pearson dan Spearman untuk melihat korelasi antara nilai NLR dengan 12 parameter laboratorium berupa GDS, GDP, HbA1c, Leukosit, Hemoglobin, BUN, D-Dimer, CRP, serum kreatinin, SGOT, SGPT dan Ferritin menggunakan piranti lunak  SPSS versi 21 untuk Windows. Hasil: Dari hasil uji korelasi, parameter laboratorium yang ditemukan signifikan berkorelasi positif dengan nilai NLR adalah kadar GDS (r=0,451; p=0,000), GDP (r=0,037; p=0,001), leukosit (r=0,479; p=0,000), BUN (r=0,368; p=0002), D-dimer (r=0,348; p=0,011), CRP (r=0,557; p=0,000), serum kreatinin (r=0,313; p=0,009) dan ferritin (r=0,337; p=0,011). Kesimpulan: Nilai NLR pada pasien DM tipe 2 dengan COVID-19 berkorelasi positif dengan penanda glikemik yaitu GDS dan GDP. Selain itu berkorelasi positif juga dengan leukosit, BUN, D-dimer, CRP, serum kreatinin dan ferritin.
Myelodysplastic syndromes: Laporan Kasus I Gede Herry Ananta Wijaya
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i2.1383

Abstract

Background: Myelodysplastic syndrome (MDS) is a group of bone marrow disorders characterized by ineffective hematopoiesis resulting in cytopenia and an increased risk of Acute Myeloid Leukemia (AML). MDS is a disease that is often found in elderly patients. The mean age at disease onset was 70 years. Case: A 72-year-old woman complained of feeling tired easily since 5 months throughout the day, not aggravated by activity and starting to gain weight in the last 1 week to interfere with the patient's activities. The patient also complained of intermittent dizziness since 2 months, was not affected by activity or change of position, and was not accompanied by nausea and vomiting. Complaints of fever, prolonged cough, bleeding, yellow body, red skin rash, progressive weight loss, bowel and bladder disorders were denied. Physical examination of the patient revealed vital signs within normal limits. The patient's conjunctiva was anemic, the patient's extremities also looked pale and there was no organ enlargement such as hepatomegaly and splenomegaly. Laboratory examinations at the time of presentation showed an increase in leukocytes, a decrease in erythrocytes, a decrease in hemoglobin, and a decrease in hematocrit. The patient's platelets were still in the normal range and there were no disturbances in kidney and liver function. The results of leukocytes, erythrocytes, and hemoglobin taken consecutively on 3 consecutive days still show an increase in leukocytes despite the downward trend in value. The results of bone marrow examination, namely trephine morphology, showed hypercellular marrow (approximately 80% cellularity) with an increase in blast cells of 10-15%, decreased maturation of myeloid series, erythroid cells and dyserythropoiesis, scattered plasma cells, increased megakaryocytes accompanied by dysmegakaryopoiesis. Patient diagnosed as Myelodysplastic Syndrome with Excess Blast. The therapy given to the patient during hospitalization aims to overcome the symptoms experienced by the patient. Transfusion of PRC (Packed Red Cell) 1 Kolf/day with Furosemide 20 mg by injection before transfusion and administration of Folic Acid 1 x 1 tablet per day provided an improvement in the patient's condition. This is evidenced by the increase in hemoglobin levels during treatment. The patient was referred to a referral hospital for further treatment. Conclusion: Myelodysplastic syndrome (MDS) is a group of bone marrow disorders characterized by ineffective hematopoiesis resulting in cytopenia and an increased risk of acute myeloid leukemia (AML). The patient was diagnosed with MDS with Excess Blast based on bone marrow biopsy. Other investigations, namely complete blood count, found an increase in leukocytes and hemoglobin, this also supports the diagnosis of MDS in this patient. The prognosis in this patient is classified as high risk based on IPSS-R, which means survival for 1-2 years is 13%.   Latar Belakang: Myelodysplastic syndrome (MDS) adalah kelompok penyakit gangguan sumsum tulang ditandai dengan hematopoiesis yang tidak efektif mengakibatkan sitopenia dan peningkatan risiko terjadinya Leukemia Mieloid Akut (AML). MDS merupakan penyakit yang sering ditemukan pada pasien lanjut usia dengan rerata onset penyakit yaitu usia 70 tahun. Kasus: Perempuan berusia 72 tahun mengeluh mudah lelah sejak 5 bulan yang dirasakan sepanjang hari, tidak diperberat dengan aktivitas dan mulai bertambah berat 1 minggu terakhir hingga menganggu aktivitas pasien. Keluhan pusing yang hilang timbul sejak 2 bulan, tidak dipengaruhi oleh aktivitas atau perubahan posisi, dan tidak disertai dengan mual dan muntah. Keluhan demam, batuk lama, perdarahan, badan kuning, ruam merah dikulit, penurunan berat badan yang progresif, gangguan BAB dan BAK disangkal. Pasien didapatkan tanda vital dalam batas normal. Konjungtiva pasien anemis, ekstremitas pasien juga tampak pucat dan tidak didapatkan pembesaran organ seperti hepatomegaly dan splenomegaly. Hasil laboratorium diperoleh leukositosis, eritropenia, anemia, dan penurunan hematokrit. Platelet pasien masih berada pada rentang normal dan tidak terdapat gangguan pada fungsi ginjal dan hati. Hasil leukosit, eritrosit, dan hemoglobin yang diambil berturut-turut pada 3 hari berturut-turut tetap menunjukkan peningkatan leukosit meskipun tren nilai mengalami penurunan. Hasil pemeriksaan sumsum tulang yaitu gambaran morfologi trephine menunjukkan sumsum hiperseluler (kurang lebih 80% selularitas) dengan peningkatan sel blast 10 – 15 %, penurunan maturasi seri myeloid, sel eritroid dan diseritropoiesis, scattered sel plasma, peningkatan megakariosit disertai dismegakariopoiesis. Pasien diagnosa sebagai Myelodysplastic Syndrome with Excess Blast. Terapi yang diberikan pada pasien selama perawatan di rumah sakit bertujuan untuk mengatasi gejala yang dialami pasien. Transfusi PRC (Packed Red Cell) 1 Kolf/hari dengan pemberian Furosemide 20 mg secara injeksi sebelum transfusi dan pemberian Asam Folat 1 x 1 tablet per hari memberikan perbaikan kondisi pada pasien. Hal ini dibuktikan dengan peningkatan kadar hemoglobin selama perawatan. Pasien dirujuk ke rumah sakit rujukan untuk penanganan lebih lanjut. Simpulan: Myelodysplastic syndrome (MDS) adalah kelompok penyakit gangguan sumsum tulang ditandai dengan hematopoiesis yang tidak efektif mengakibatkan sitopenia dan peningkatan risiko terjadinya Leukemia Myeloid Akut (AML). Pasien didiagnosis mengalami MDS with Excess Blast berdasrakan pemeriksaan biopsis sumsum tulang. Prognosis pada pasien ini tergolong high risk berdasarkan IPSS-R yang artinya survival untuk 1 – 2 tahun yaitu 13%.
Pengaruh tingkat pengetahuan, sikap dan perilaku dengan kejadian COVID-19 pada mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warwadewa Agus Santosa; Luh Gde Evayanti; Angga Priyana
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1450

Abstract

Introduction: Efforts in preventing COVID-19 are carried out by increasing knowledge and improving attitudes and behavior. These three components affect the occurrence of COVID-19, especially among medical students. This study aimed to determine the relationship between knowledge, attitudes, and behavior and the incidence of COVID-19 in students of the Faculty of Medicine and Health Sciences (FKIK Unwar). Methods: Analytical design and a cross sectional study were used. The study was conducted from October – November 2021. Several 88 samples were selected by purposive sampling from 2018-2020 class students in the Unwar FKIK environment. Data were analyzed using Fisher Exact test (p<0.05). Results: Medical students have knowledge of 94.3% in the good category, 79.5% positive attitude and 55.7% positive behavior towards COVID-19, although there is no significant relationship (p>0.05). Conclusion: Education and implementation of strict health protocols at FKIK Unwar increase the knowledge, behavior, and attitudes of FKIK Unwar students. Those were related to the low incidence of COVID-19 at FKIK Unwar for the last 3 months.   Latar Belakang: Peningkatan pengetahuan, perbaikan sikap serta perilaku dilaksanakan dalam upaya pencegahan COVID-19. Ketiga komponen tersebut mempengaruhi kejadian COVID-19 terutama dikalangan mahasiswa kedokteran. Penelitian ini bertujuan mengetahui pengaruh tingkat pengetahuan, sikap dan perilaku dengan kejadian COVID-19 pada mahasiswa Fakultas Kedokteran dan Ilmu Kesehatan (FKIK Unwar). Metode: Rancangan analitik ini menggunakan studi cross sectional dan dilaksanakan pada bulan Oktober – November 2021. Sebanyak 88 sampel dipilih dengan purposive sampling dari mahasiswa angkatan 2018-2020 di lingkungan FKIK Unwar. Data dianalisis sengan uji Fisher Exact (p<0,05). Hasil: Mahasiswa kedokteran memiliki pengetahuan persentase 94,3% dalam kategori baik, sikap positif 79,5% dan perilaku positif 55,7% terhadap COVID-19 meskipun tidak terdapat pengaruh bermakna (p>0,05). Simpulan: Edukasi dan penerapan protokol kesehatan yang ketat di FKIK Unwar meningkatkan pengetahuan, perilaku, dan sikap mahasiswa FKIK Unwar. Hal ini terkait rendahnya kejadian COVID-19 di FKIK Unwar selama 3 bulan terakhir.
Sedot lemak pada area wajah dan leher Putu Ayuni Yayas Ramaswari; I Gusti Nyoman Darmaputra; Putu Shinta Widari Tirka; Gusti Ayu Anggawati
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1463

Abstract

Liposuction or liposuction is the most commonly performed aesthetic surgical procedure worldwide. Liposuction is considered a safe, simple, and effective surgical method to improve body contours. The purpose of facial and neck liposuction is to reshape the neck and improve contours, not to remove all fat. Once the fat is removed from liposuction, it is expected that the skin will shrink to take on a new contour. It is important to warn patients that if excessive skin laxity develops after the procedure, they may require additional surgical procedures. Liposuction can be performed on various areas of the body that have excess fat deposits. Liposuction is indicated for the removal and reduction of locally isolated adipose tissue deposits.   Sedot lemak atau liposuction merupakan prosedur bedah estetik yang paling sering dilakukan di seluruh dunia. Sedot lemak dinilai sebagai suatu metode tindakan bedah yang aman, sederhana, dan efektif untuk memperbaiki kontur tubuh. Tujuan dari sedot lemak wajah dan leher adalah untuk membentuk kembali leher dan memperbaiki kontur, bukan untuk menghilangkan semua lemak. Setelah lemak dihilangkan dari sedot lemak, diharapkan kulit menyusut untuk mengambil kontur yang baru. Penting untuk memperingatkan pasien bahwa jika kelemahan kulit berlebih berkembang setelah prosedur, mereka mungkin memerlukan prosedur pembedahan tambahan Sedot lemak dapat dilakukan pada berbagai area tubuh yang memiliki deposit lemak berlebih. Sedot lemak diindikasikan untuk menghilangkan dan mengurangi deposit jaringan adiposa yang terisolasi secara lokal.
A case report: a 38-year-old man with vivax relapse malaria Ayu Agung Pradnya Paramitha; I Putu Gede Putra Darmawan; Rachmawanti Agustina Fitriani
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1488

Abstract

Introduction: Malaria is a parasitic disease caused by blood protozoa of the Plasmodium genus transmitted through the bite of a female Anopheles mosquito. Indonesia is still an endemic area, especially in the eastern regions. About 40% of malaria cases in the world are caused by Plasmodium vivax. Tertiana or vivax malaria can cause relapse because it has a hypnozoite stage that is dormant in the liver. This case report will discuss a case of relapse vivax malaria with thrombocytopenia. Case Illustration: A 38-year-old man came to the emergency room consciously with a fever complaint since 4 days before entering the hospital. Fever occurred throughout the body, disappeared, accompanied by chills and sweating. On the second day the fever began to decrease somewhat but the next day the fever began to increase. The patient has a history of serving in Papua and contracted malaria 3 months before entering the hospital. While in Papua, the patient worked as a supporter for the 2021 PON event and malaria treatment was not complete. A complete blood examination found thrombocytopenia and microscopic examination of thin drops of the presence of ring-shaped Plasmodium vivax. The patient is diagnosed with vivax relapse malaria. The patient was treated with antimalarial therapy with DHP 4 tablets in a day for 3 days and primaquine 2 tablets in a day for 14 days. Monitoring therapy was done on the eighth day, with microscopic examination, and the result was negative malaria plasmodium. Conclusion: This case report discusses vivax relapse malaria and proper management to irradiate the hypnozoite stage which has an important role in the recurrence phase. 
Bilateral femoral agenesis in 3-month-old baby: A case report Emiliana Susanti Foris; Mario Realino Nara; Defranky Theodorus
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1489

Abstract

Background: Bilateral congenital femoral agenesis is a rare congenital anomaly. To our knowledge, there have only been three examples of simple congenital abnormalities linked to the femoral facial syndrome. We present a straightforward case of bilateral femoral agenesis in a 3-month-old female infant who did not have femoral facial syndrome and whose mother did not have diabetes. Discussion: Bilateral femoral agenesis is a rare and unusual anomaly; only six cases have been reported. Other structural are often involved; these include the acetabulum, musculature, vessels, and ligaments of the knee, tibia, fibula, and foot. In our case, there are no other anomalies found. The majority of cases, however, are sporadic; therefore, the parents may be reassured that the risk of further offspring being affected is negligible. The classification by Aitken is widely used. This classification is based on the severity of the hip and femur radiographic findings Case Presentation: A 3-month-old female baby presents with a complaint of short stature. The baby was born full term spontaneous labor, 2570 grams vigorous and started to cry immediately after birth. The mother has no history of diabetes, cigarette smoking, and exposure to teratogens. The parents were not related by blood. X-ray examination showed bilateral agenesis of the femur, normal tibia and fibula, and proximal cruris in lateral acetabula. Conclusion: Bilateral congenital femoral agenesis is a rare congenital anomaly. Although frequently related to maternal diabetes mellitus, there is no recognized cause for most cases.
Profil pasien COVID-19 rawat inap di Rumah Sakit Ari Canti, Gianyar, Bali, Indonesia Ni Putu Nita Wiryandari; Ketut Suardamana
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1497

Abstract

Background: Since March 2020, Coronavirus Disease 2019 (COVID-19) has been declared a pandemic. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) underwent genetic evolution and changes in the nature of the virus, clinical manifestations, and response to treatment. This study aims to determine the profile of hospitalized COVID-19 patients at  Ari Canti Hospital (RSAC), one of the COVID-19 referral hospitals in Gianyar, Bali. Methods: The design was a descriptive cross-sectional retrospective study, using the medical records of confirmed COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) patients selected by a simple random sampling technique. Results: From 290 samples, the majority of COVID-19 patients treated at RSAC were 60.7% male, in the age range of 50-59 years 26.5%, with severe symptoms 45.8% and recovered 83.4%. The dominant symptoms were fever 85.2%, cough 80%, and shortness of breath 60%. The most common comorbidities were >1 comorbidity, hypertension, and diabetes mellitus. Hematological examination at the first time of hospitalization showed leukopenia (4.8%), lymphopenia (14.5%), thrombocytopenia (12.8%),  and anemia (21.7%). The results also showed an increase in Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer  (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP)  (66.6%). Most showed bilateral infiltrates on chest x-ray. The most common treatment for COVID-19 at RSAC uses antiviral remdesivir (77.9%), quinolone antibiotics (73.4%), and Low Molecular Weight Heparin (LMWH) (53.4%).  A total of 56.6% of patients received corticosteroid therapy. Conclusion: Patients hospitalized at RSAC mostly showed severe symptoms and recovered. The treament folowing the standard of inpatient treatment for COVID-19 patients.   Latar belakang: Sejak Maret 2020, Coronavirus Disease 2019 (COVID 19) dinyatakan sebagai pandemi. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mengalami evolusi genetik dan perubahan sifat virus, manifestasi klinis serta respon pengobatan. Penelitian ini bertujuan untuk mengetahui profil pasien COVID-19 yang dirawat di Rumah Sakit Ari Canti (RSAC), salah satu rumah sakit rujukan COVID-19 di Gianyar, Bali Metode: Rancangan penelitian ini adalah cross-sectional deskriptif retrospektif, menggunakan rekam medis pasien terkonfirmasi COVID-19 dengan Real Time Polymerase Chain Reaction (RT-PCR) sejak Juli 2020 - Maret 2022 yang dipilih dengan teknik simple random sampling. Hasil: Dari 290 sampel, mayoritas pasien COVID-19 yang dirawat di RSAC adalah laki-laki 60.7%, berada pada rentang usia 50-59 tahun 26.5%, dengan gejala berat 45.8% dan sembuh 83.4%. Gejala didominasi demam 85.2%, batuk 80%, dan sesak 60%. Komorbid tersering yaitu >1 komorbid, hipertensi, dan diabetes melitus. Gambaran hematologi menunjukkan leukopenia (4.8%), limfopenia (14.5%), trombositopenia (12.8%), dan  anemia (21.7%). Hasil juga menunjukkan peningkatan Neutrophil to Lymphocyte ratio (NLR) (31.4%), Platelet to lymphocyte ratio (PLR) (11.7%), Red Cell Distribution Width (RDW) (40.7%), D-Dimer (73.4% ) dan High sensivity C-Reactive Protein (Hs-CRP) (66.6%). Sebagian besar menunjukkan infiltrat bilateral pada x-ray thorax. Tatalaksana COVID-19 di RSAC tersering menggunakan antivirus remdesivir (77.9%), antibiotik golongan kuinolon (73.4%), dan antikoagulan Low Molecule Weight Heparin (LMWH) (53.4%). Sebanyak 56.6 % pasien mendapat terapi kortikosteroid. Kesimpulan: Pasien COVID-19 yang dirawat di RSAC sebagian besar menunjukkan gejala berat dan sembuh. Terapi yang diberikan mengikuti standar terapi rawat inap pasien COVID-19.
Comparison between serum pleural effusion albumin gradient, total protein, lactate dehydrogenase, and erythrocyte count in malignant and non-malignant pleural effusion Victor Nugroho Wijaya; I Gede Ketut Sajinadiyasa; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Luh Putu Eka Arisanti; I Gusti Ngurah Bagus Artana; Ida Bagus Ngurah Rai
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1502

Abstract

Background: Malignant pleural effusion carries a bad prognosis. Pathologic examination as the gold-standard diagnosis of malignant pleural effusion has sensitivity limitations and may cause delayed diagnosis. Several affordable examinations, such as serum pleural effusion albumin gradient, total protein, lactate dehydrogenase (LDH), and erythrocyte count, might be useful as malignant pleural effusion diagnostic tools. Methods: This is an observational analytic study with a cross-sectional design conducted at Sanglah Central General Hospital in Denpasar from December 2021 to July 2022. Pleural effusion fluid and blood were taken from subjects with malignant and non-malignant pleural effusion. Data were analyzed with SPSS version 25 software for Windows. Results: Total subjects were 47 persons consisting of 26 subjects with malignant pleural effusion and 21 subjects with non-malignant pleural effusion. Results from statistical analysis of malignant and non-malignant pleural effusion were serum pleural effusion albumin gradient median (IQR) 0.91 (0.65) g/dL vs. 1.22 (1.2) g/dL (p=0.129), total protein mean 3.92±0.95 g/dL vs. 3.52±1.67 g/dL (p=0.334), LDH median 535 (840) IU/L vs. 187 (1,016) IU/L (p=0.057), and erythrocyte count median 23,500 (109,250) cells/mm3 vs. 3,000 (11,000) cells/mm3 (p=0.004). The AUC of erythrocyte count from the ROC method was 0.745 (95%CI=0.599-0.890; p=0.004). Using a cut-off point ≥ 4,500 cells/mm3, it had a sensitivity of 80.8%, specificity of 61.9%, and Odds Ratio (OR) of 6.8 (95%CI=1.8-25.4). Conclusion: Erythrocyte count as routine examination showed good validity for diagnosing malignant pleural effusion and expected to reduce diagnosis delay. Meanwhile, albumin gradient, total protein, and LDH delivered no difference.
Wide eksisi dan flap rhomboid pada karsinoma basal sel regio facial Kadek Nopy Arianti; Made Oka Sastrawan; Fatur Reyhan Muradi; Muhammad Aflah; Casvin Jus
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1505

Abstract

Background: Basal cell carcinoma is one of the most common classifications of non-melanoma skin cancer (75% - 80%) of all cancers. Basal cell carcinoma causes widespread local destruction including soft tissue, cartilage, and bone, thus impairing function and aesthetics, especially for the facial area. One of the most common reconstructive techniques for Basal Cell Carcinoma is the Rhomboid flap. This case report aims to report the use of the rhomboid flap reconstruction technique in post-wide excision of basal cell carcinoma. Case Description: A man, 54 years old, ethnic Balinese, came to the General Surgery Clinic of RSUD Klungkung with a complaint that a mole on the patient's left eye appeared enlarged with itching and bleeds easily. These complaints began to be felt since about 2 weeks before entering the hospital. Initially the patient's mole had been there for 5 years, previously the patient had no complaints about the mole, the initial lesion was in the form of a small brownish lump which was then felt to be getting bigger with itching and bleeding easily. The patient did not complain of pain. Examination of the localized status on the lateral periorbital sinistra showed blackish nodules with hyperpigmented macules, solitary, 2cm x 1cm in size, visible erosions, well-defined borders, irregular shape. Conclusion: The provisional diagnosis of Suspected Malignant Skin Tumor was established based on history, physical examination, with management therapy wide excision and reconstruction with Rhomboid Flap followed with biopsy.   Latar Belakang : Karsinoma Sel Basal (KSB) adalah salah satu kanker kulit  yang paling sering ditemukan dari seluruh kanker kulit non melanoma.  Karsinoma Sel Basal dapat mengakibatkan kerusakan local dengan infiltrasi yang luas sehingga mengganggu fungsi dan estetika, terutama untuk daerah wajah. Salah satu pilihan  teknik rekonstruksi yang bisa dilakukan pada Karsinoma Sel Basal di regio wajah  adalah Rhomboid flap. Laporan kasus ini bertujuan untuk melaporkan penggunaan tehnik rekonstruksi dengan flap rhomboid pada pasca eksisi luas pada karsinoma sel basal. Deskripsi Kasus: Seorang laki-laki, 54 tahun, suku Bali,  datang ke Poliklinik bedah Umum RSUD Klungkung dengan keluhan tahi lalat pada sebelah mata kiri pasien tampak membesar disertai gatal dan mudah berdarah. Keluhan tersebut mulai dirasakan sejak sekitar 2 minggu sebelum masuk RS. Awalnya tahi lalat pasien sudah ada sejak 5 tahun yang lalu, sebelumnya pasien tidak ada keluhan pada tahi lalat tesebut, lesi awal berupa benjolan kecil berwarna kecoklatan yang kemudian makin lama dirasakan makin membesar disertai rasa gatal dan mudah berdarah. Keluhan nyeri tidak dikeluhkan oleh pasien.  Pemeriksaan status lokalis pada periorbital lateral S tampak nodul kehitaman disertai makula hiperpigmentasi, soliter, ukuran 2cm x 1cm, tampak erosi, batas tegas, bentuk tidak beraturan. Kesimpulan: Diagnosis sementara Tumor Kulit Suspek Malignant ditegakkan berdasarkan anamnesis, pemeriksaan fisik dengan terapi eksisi luas + biopsi + rekonstruksi dengan Rhomboid Flap.

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