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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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The characteristics of neonatal sepsis in Low Birth Weight (LBW) infants at Sanglah General Hospital, Bali, Indonesia in 2018 Ni Luh Gede Wahyuni Suismaya; I Wayan Dharma Artana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Sepsis is one of the most common causes of mortality and long terms morbidity among infants. It is known to be related to Low Birth Weight (LBW) due to the lack of immunity function to resist the infection. This study aims to identify the characteristics of neonatal sepsis in LBW infants in Sanglah General Hospital.Method: A retrospective cross-sectional study was conducted in the Neonatal Care Unit, Sanglah General Hospital, during January-December 2018 period among 135 neonates. Samples were taken using total sampling for neonates who had LBW and diagnosed with sepsis. Uncompleted data and voluntarily discharge patients were excluded from the study. Data regarding baseline characteristics of respondents, major and minor risk factors, laboratory results of sepsis, as well as blood culture, were analyzed using SPSS version 23 for Windows.Result: Most of respondents were male (54.1%), followed by bodyweight 1,500-2,499 grams (58.5%), and preterm labor (<32 weeks) (86.7%). The average length of stay was 21.30Â±19.28 days. The vast majority of infants diagnosed as Early Onset Sepsis (EONS) (89.6%). Most of the patients had normal leukocyte count (93.3%), neutrophilia (95.6%), low I/T ratio (70.4%), normal platelets (67.4%), and high procalcitonin (98.5%). The blood culture showed the most microorganism was Enterococcus faecalis (6.00%) in gram-positive bacteria.Conclusion: This study found that most of the respondents were male, followed by preterm labor, EONS, normal leukocyte count, low I/T ratio, high procalcitonin, as well as Enterococcus faecalis as the most common gram-positive bacteria.Â

Keloid aurikularis dekstra yang diterapi kombinasi eksisi intralesi dan injeksi kortikosteroid dengan anestesi tumesen: sebuah laporan kasus Ida Ayu Intan Pratiwi; Made Wardhana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Keloid is a skin lesion due to overproduction of collagen and fibroblasts. Has predilection on high tension skin and there are various modalities in handling them. The purpose of this case report is to provide a perspective of auricular keloids treated by a combination of intralesional excision and corticosteroid injection with tumescent anaesthesia.Case: A 28-year-old woman who has a history of small nodules on the right ear that is getting bigger and bigger. Dermatological status shows the right auricular helix region obtained nodules brown, solitary, oval shape, size 5x7 cm, firm boundaries, regular edges, smooth surface and shiny. In palpation hard and fixed fixation is found. Patients were treated with a combination of intralesional excision and corticosteroid injection with tumesent anaesthesia. Corticosteroid injection used was triamcinolone acetonide as much as 0.4 cc intra-lesion on the 3rd day. Control on the 7th day the patient was in good condition and did not appear to have any complications with the condition of the post-surgical wound being treated.Conclusion: Management of auricular keloids by intralesional excision and corticosteroid injection after three days post-surgery provides the satisfactory clinical outcome of keloids.Â Pendahuluan: Keloid merupakan suatu lesi kulit oleh karena produksi berlebihan dari kolagen dan fibroblast. Memiliki predileksi pada kuit yang memiliki tegangan tinggi dan terdapat berbagai modalitas dalam penanganannya. Tujuan dari laporan kasus ini adalah memberikan perspektif keloid aurikularis yang diterapi kombinasi eksisi intralesi dan injeksi kortikosteroid dengan anestesi tumesen.Kasus: Seorang perempuan berusia 28 tahun yang memiliki riwayat bintil kecil pada telinga kanan yang makin lama makin membesar. Status dermatologis menunjukkan regio helix aurikularis dekstra didapatkan nodul berwarna kecokelatan, soliter, bentuk oval, ukuran 5x7 cm, batas tegas, tepi regular, permukaan halus dan mengkilat. Pada palpasi didapatkan kosistensi keras dan terfiksir. Pasien di berikan tatalaksana kombinasi eksisi intralesi dan injeksi kortikosteroid dengan anestesi tumesen. Injeksi kortikosteroid yang digunakan adalah triamcinolone acetonid sebanyak 0,4 cc intra lesi pada hari ke-3. Kontrol pada hari ke-7 pasien dengan kondisi baik dan tidak tampak suatu komplikasi apapun dengan kondisi luka paska bedah yang terawatt.Simpulan: Penanganan keloid aurikularis dengan teknik eksisi intralesi dan injeksi kortikosteroid tiga hari paska bedah memberikan luaran klinis keloid yang memuaskan.

Hubungan antara peningkatan kadar immunoglobulin-e (IgE) dengan matrix metalloproteinase-9 (MMP-9) pada pasien sindrom koroner akut (SKA) di RSUP Sanglah, Denpasar, Bali Anak Agung Yunda Prabundari; Ketut Suardamana; Ketut Suryana; Tjok Istri Anom Saturti
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Introduction. Acute Coronary Syndrome (ACS) is a cardiovascular disease that has a high mortality rate. One of the markers which play a role in the pathophysiology of ACS is Immunoglobulin E (Ig E), one of the antibodies released by B lymphocytes as the result of complex interactions that can activate mast cells. Mast cells will activate Metalloproteinase-9 (MMP-9) then facilitate pathogenesis of acute myocardial infarction or acute coronary syndrome phase. This study aimed to determine the relationship between increasing levels of IgE and MMP-9 in ACS patients at Sanglah Hospital, Denpasar, Bali.Method. This was a cross-sectional analytic study, and the samples were collected from ACS patients at Sanglah Hospital, Denpasar, Bali, using a consecutive sampling method. A total of 73 samples were included in this study, then statistical tests and Pearson correlation test was conducted.Results. Seventy-three samples included in this study contain 59 men (80.8%) and 14 women (19.2%). The IgE level is between 0.5-1000 and MMP-9 levels between 6.91-29.56. There is a statistically significant correlation between IgE levels and MMP-9 levels in Acute Coronary Syndrome patients (p = 0.018: r = 0.277).Conclusion. We found a significant association between increased IgE and MMP-9 in patients with Acute Coronary Syndrome at RSUP Sanglah, Denpasar, Bali. Pendahuluan. Sindrom Koroner Akut (SKA) merupakan penyakit kardiovaskular dengan angka kematian yang sangat tinggi. Salah satu marker yang berperan dalam patofisiologi SKA adalah Immunoglobulin E (IgE). IgE merupakan salah satu antibodi yang dilepaskan oleh limfosit B sebagai interaksi kompleks yang dapat mengaktivasi sel mast. Sel mast yang sudah aktif akan mengaktivasi Metallopriteinase-9 (MMP-9) yang ikut berperan dalam patogenesis miokard infark akut atau sindrom koroner akut. Penelitian ini bertujuan unuk mengetahui hubungan peningkatan kadar IgE dan MMP-9 pasien SKA di RSUP Sanglah, Denpasar, Bali.Metode. Penelitian ini merupakan penelitian potong lintang analitik yang dilakukan pada populasi SKA di RSUP Sanglah, Denpasar, Bali. Sampel keseluruhan berjumlah 73 orang pasien SKA secara konsekutif diikutsertakan dalam penelitian ini, kemudian dilakukan uji statistik dan uji korelasi Pearson.Hasil. Dari hasil penelitian pada 73 sampel tersebut, didapatkan jumlah sampel 59 orang laki-laki (80,8%) dan 14 orang perempuan (19,2%). Adapun kadar IgE dalam rentang antara 0,5-1000 dan kadar MMP-9 antara 6,91-29,56. Terdapat korelasi yang bermakna antara kadar IgE dengan kadar MMP-9 pada pasien Sindrom Koroner Akut (p=0,018; r=0,277).Kesimpulan. Terdapat hubungan yang signifikan antara peningkatan kadar IgE dengan peningkatan kadar MMP-9 pada pasien Sindrom Koroner Akut di RSUP Sanglah, Denpasar, Bali.

Tatalaksana peritonitis bakteri Staphylococcus Epidermidis pada seorang pasien dengan continuous ambulatory peritoneal dialysis (CAPD) I Gusti Agung Ayu Indira Nirmala Dewi; Yenny Kandarini
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Peritonitis is a common CAPD related infection. It can cause discontinue dyalisis peritoneal and conversion to hemodyalisis.Case description: This article reported a 54-year-old man on 5 years dialysis peritoneal with a complaint of abdominal pain since 1 week before admission. The complaint accompanied by fever and nausea. On abdominal examination there are mild distention, weak of bowel sound, pressure pain, and defans muscular. Dialisat examination found cloudy fluid, effluent white blood cell count 961 cells/mm3 composed of 85% polymorphonuclear leucocytes. Peritoneal dialysis effluent gram stain, routine culture found isolated Staphylococcus epidermidis with methicillin resistant, significant as infectious agent depend on patientâ€™s clinical and infectionâ€™s marker. Performed a definitive antibiotic with Linezolid 600 miligram intravena and Gentamicin 40 miligram intraperitoneal during 14 days showed clinical and laboratorium improvement.Conclusion: Peritonitis remains a major cause of technique failure in peritoneal dialysis and affects patientâ€™s morbidity and mortality. Management should be definitive antibiotic as dialysat culture result. Catheter removal indicated if there were refractory peritonitis, relapsing peritonitis, refractory exit-site and tunnel infection, fungal peritonitis.Â Latar belakang: Peritonitis merupakan komplikasi infeksi pada pasien CAPD yang umum terjadi. Peritonitis dapat menjadi penyebab utama penghentian dialisis peritoneal dan dikonversi ke hemodialisis.Deskripsi kasus: Laporan kasus ini melaporkan laki-laki berusia 54 tahun yang telah menjalani CAPD selama 5 tahun mengeluh nyeri perut sejak 1 minggu yang lalu SMRS. Nyeri perut disertai dengan demam dan mual. Pemeriksaan abdomen didapatkan distensi ringan, bising usus terdengar lemah, adanya nyeri tekan, dan defans muskuler. Pemeriksaan analisis cairan dialisat didapatkan warna keruh/berawan dengan jumlahÂ 961 sel/uL dengan dominan polymononuklear sebesar 85%. Pemeriksaan kultur/ biakan cairan peritoneum didapatkan terisolasi bakteri Staphylococcus epidermidis yang bersifat Methicillin resistant, significan sebagai agen penyebab infeksi tergantung keadaan klinis dan marker infeksi pasien. Dilakukan tatalaksana terapi antibiotik definitif dengan Linezolid 600 miligram setiap 12 jam intravena dan Gentamicin 40 miligram intraperitoneal, intermiten dose saat penggantian cairan malam hari. Pemberian terapi antibiotik definitif dan intraperitoneal dilanjutkan selama 14 hari dan pada pasien didapatkan perbaikan secara klinis dan laboratorium. Simpulan: Peritonitis merupakan penyebab utama kegagalan teknik pada dialisis peritoneal dan mempengaruhi morbiditas serta mortalitas pasien CAPD. Diagnosis peritonitis terkait CAPD sedini mungkin serta pemberian terapi yang cepat dan tepat dapat menghindarkan pasien dari komplikasi yang lebih berat dan kegagalan dialisis peritoneal.

Prevalensi dry eye pada pasien diabetes melitus tipe 2 di Rumah Sakit Mata Mencirim 77 Kota Medan Andry Lukandy; Marina Yusnita Albar
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Dry eye syndrome is a multifactorial ocular surface disease with characteristic symptoms such as discomfort, irritation and visual disturbance. Dry eye syndrome increases a significant burden on an individual including social function, work and decreases the quality of life. The Women's Health Study Questionnaire (WHSQ) revealed that the prevalence varies around 4.3% in American men to 21.6% in Asian women. Dry eye prevalence in Southeast Asia is around 20.0% to 52.4%.Methods: This study design was a cross sectional study with total sampling. The population in this study were all polyclinic patients at Mencirim 77 Eye Hospital in August 2019. Sample in this study were patients with Diabetes Mellitus Type 2. The data was analyzed by SPSS using chi-square test.Results: There were 124 subjects included in this study. 62 patients with diabetes mellitus and 62 patients without diabetes mellitus. 60 subjects were males and 64 subjects were females. Based on the analyzed result, it’s confirmed that dry eye has significant result with Diabetes Mellitus type 2 patients (p-value=0.027) (p < 0.05). Dry Eye was found 91.1% in the age group ? 50 years, 51.6% female gender, and 42.7% patients suffered severe dry eye.Conclusions: From the result of this study, it can be concluded that dry eye has a significant result with diabetes mellitus type 2 patients at Mencirim 77 Eye Hospital. Latar belakang: Sindrom mata kering merupakan suatu penyakit permukaan okular multifaktoral dengan karakteristik gejala seperti rasa tidak nyaman, iritasi dan gangguan visual. Sindrom mata kering meningkatkan beban yang signifikan terhadap suatu individu termasuk fungsi sosial, pekerjaan dan menurunkan kualitas hidup. The Women’s Health Study Questionnaire (WHSQ) mengungkapkan bahwa prevalensi bervariasi sekitar 4,3% pada pria Amerika hingga 21,6% pada wanita Asia. Prevalensi Dry Eye di Asia Tenggara sekitar 20,0% hingga 52,4%.Metode: Jenis penelitian ini menggunakan studi cross sectional dengan total sampling. Populasi pada penelitian ini adalah seluruh pasien poliklinik di RS Mata Mencirim 77 pada bulan Agustus 2019. Sampel pada panelitian ini adalah pasien dengan Diabetes Melitus Tipe 2. Data di analisa dengan SPSS menggunakan chi-square test.Hasil: Dari 124 pasien Dry Eye, 62 pasien dengan diabetes melitus dan 62 pasien tanpa diabetes melitus. 60 subjek adalah laki-laki dan 64 subjek adalah perempuan. Berdasarkan hasil analisa data didapatkan bahwa dry eye memiliki hasil yang signifikan dengan pasien diabetes tipe 2 (nilai-p=0.027) (p<0.05). Dry Eye ditemukan sebanyak 91.1% pada kelompok usia ? 50 tahun, 51.6% jenis kelamin perempuan, 42.7% pasien menderita Dry Eye berat.Kesimpulan: Dari hasil penelitian ini dapat disimpulkan bahwa Dry Eye menunjukkan hasil yang signifikan terhadap pasien diabetes melitus tipe 2 di Rumah Sakit Mata Mencirim 77.

Skin lesion of hidradenitis suppurativa mimicking lymphogranuloma venereum: a case report Akbar Pratama; Diany Nurdin
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Hidradenitis suppurativa clinical appearance is painful, deep-seated inflamed lesions, most commonly found on axillary, inguinal, anogenital regions. It should be differentiated with primary cutaneous bacterial infection (abscesses, carbuncles, or furunculosis) and rare conditions such as lymphogranuloma venereum.Case: we report a 50-year-old male presenting with an unusual clinical presentation of hidradenitis suppurativa located in suprapubic such as bilateral fluctuant and suppurative nodules resembling lymphadenitis, led to an initial diagnosis of lymphogranuloma. We excluded lymphogranuloma diagnosis based on the serology test of Chlamydia trachomatis, bacterial cultures, and sensitivity tests. The results were non-reactive for the Chlamydia trachomatis serology test, and Staphylococcus aureus was found in bacterial culture.Conclusion: clinicians must be aware of diagnosis precisely, prevent the recurrent, and improve the prognosis.

Faktor-faktor resiko kejadian pneumonia pada pasien pneumonia usia 12-59 bulan di RSUD Wangaya Susan Natalia Budihardjo; I Wayan Bikin Suryawan
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background:Â Pneumonia is the leading cause of under five childrenâ€™s mortality worldwide. In Indonesia, pneumonia still the second largest cause of mortality in infants (12.3%) and under five children (13.2%) after diarrhea. However, the incidence of pneumonia didnâ€™t receive some attention so itâ€™s often referred as â€œthe forgotten killer of childrenâ€. Therefore, the aim of our study is to control pneumonia in children under five by investigating the risk factors of pneumonia.Methods:Â A case control study was conducted from January 2019 to May 2019 by using the consecutive sampling methods. The subjects were children aged 12-59 months old with pneumonia at Wangaya Hospital for the case and children aged 12-59 months old without pneumonia at Wangaya Hospital for the control. Subjectâ€™s characteristics such as gender, age, weight birth, immunization status, exclusive breastfeeding status, history of asthma, smoke exposure, and nutritional status. Matching was performed on exclusive breastfeeding variable. Will be done the bivariate analysis with McNemar and multivariate analysis with logistic regression.Result:Â Among 96 subjects divided into 48 subjects in each group. Bivariate analysis showed that immunization status (p-value 0.009, OR 5.209) and smoke exposure (p-value 0.008, OR 2.238) were the significant risk factors of pneumonia. While gender, nutritional status, and history of asthma werenâ€™t significant risk factors of pneumonia in children under five at Wangaya Hospital.Conclusion:Â Incomplete immunization status and exposed to cigarette smoke are the risk factors of pneumonia in children aged 12-59 months old at Wangaya Hospital.Â Latar Belakang:Â Pneumonia merupakan pembunuh nomor satu balita di dunia. Di Indonesia, Pneumonia menduduki peringkat kedua penyebab kematian bayi (12,3%) dan balita (13,2%) setelah diare. Sayangnya, kejadian pneumonia tidak begitu banyak mendapat perhatian khusus. Tujuan penulisan laporan kasus ini adalah mempelajari faktor-faktor resiko yang menyebabkan pneumonia.Metode:Â Dengan menggunakan studi kasus-kontrol yang dilakukan pada bulan Januari 2019-Mei 2019 menggunakan metode sampel konsekutif. Subjek penelitian adalah anak berusia 12-59 bulan dengan pneumonia di RSUD Wangaya untuk kasus, dan anak berusia 12-59 bulan tidak dengan pneumonia di RSUD Wangaya untuk kontrol. Karakteristik subjek berupa jenis kelamin, usia, berat badan lahir, status ASI eksklusif, status imunisasi, riwayat asma, paparan asap, dan status gizi. Dilakukan matching pada variabel ASI eksklusif. Dan akan dilakukan analisis bivariat dengan uji McNemar dan multivariat dengan regresi logistik.Hasil: Sebanyak total 96 subjek, dengan 48 subjek untuk masing-masing kelompok penelitian. Didapatkan hasil yang signifikan pada faktor resiko status imunisasi (nilai p 0.009 dan OR 5.209) dan faktor resiko paparan asap (nilai p 0.008 dan OR 2.238). Sedangkan jenis kelamin, status gizi, dan riwayat asma tidak didapatkan hasil yang signifikan sebagai fakto resiko pneumonia di RSUD Wangaya.Simpulan: Status imunisasi yang tidak lengkap dan terpapar asap rokok merupakan faktor resiko terjadinya pneumonia pada anak usia 12-59 bulan di RSUD Wangaya.

Hubungan antara Mean Platelet Volume (MPV) dengan klinis sepsis neonatorum di RSUD Wangaya, Bali, Indonesia Stanley Haryono; I Wayan Bikin Suryawan; Anak Agung Made Widiasa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Neonatal sepsis is a disease that contributes significantly to infant morbidity and mortality, where the diagnosis is not specific to other diseases. In a state of sepsis, it is known that platelet production will increase due to the destruction of platelets so that there is a difference in platelet size or Mean Platelet Volume (MPV). This study aims to determine the relationship between MPV and clinical neonatal sepsis at Wangaya Hospital, Bali, Indonesia.Methods: This study used a cross-sectional study design with 47 patients at Wangaya Hospital, Denpasar, in June-September 2019. The inclusion criteria were neonates with suspicion of sepsis, and the exclusion criteria were neonates who received previous antibiotic therapy, neonates who had previously received blood transfusions. , neonates with severe congenital anomalies were selected using a consecutive sampling technique. The sample was divided into 2 groups: clinical sepsis and non-clinical sepsis, MPV used a limit value of 10.2 fl, and data were analyzed by SPSS version 23 for Windows.Results Most of the patients were male (66.7%), underwent section labor (77.8%), preterm birth (66.7%), birth weight (BBL) <2,500 grams (62.9%), and asphyxia (62.9%) in the non-septic group. Meanwhile, most of the sepsis group underwent labor (85%), preterm birth (70.0%), and asphyxia (75.0%). The results showed that there was a significant relationship between the MPV value and the risk of neonatal sepsis (RR: 8.16; 95% CI: 2.1-30.5; p = 0.003).Conclusion: The results of this study concluded that there was a significant difference between the MPV value and the incidence of neonatal sepsis.Â Latar Belakang: Sepsis neonatorum merupakan penyakit yang berkontribusi besar terhadap angka morbiditas dan mortalitas bayi dimana diagnosisnya bersifat tidak spesifik dengan penyakit lain. Pada keadaan sepsis, produksi trombosit diketahui akan meningkat akibat penghancuran trombosit sehingga adanya perbedaan ukuran trombosit atau Mean Platelet Volume (MPV). Penelitian ini bertujuan untuk mengetahui hubungan antara MPV denganÂ klinis sepsis neonatorum di RSUD Wangaya, Bali, Indonesia.Metode: Penelitian menggunakan rancangan penelitian potong lintang terhadap 47 pasien yang bertempat di RSUD Wangaya, Denpasar pada bulan Juni-September 2019. Kriteria inklusi adalah neonatus dengan kecurigaan sepsis dan kriteria ekslusi adalah neonatus yang mendapat terapi antibiotik sebelumnya, neonatus yang pernah menerima transfusi darah sebelumnya, neonatus dengan anomali kongenital berat yang dipilih menggunakan teknik consecutive sampling. Sampel dibagi menjadi 2 kelompok yaitu klinis sepsis dan bukan klinis sepsis, MPV menggunakan nilai batas 10,2 fl, dan data dianalisis dengan SPSS versi 23 untuk Windows.Hasil Sebagian besar pasien berjenis kelamin laki-laki (66,7), menjalani persalinan seksio (77,8%), lahir preterm (66,7%), berat badan lahir (BBL) < 2.500 gram (62,9%), dan asfiksia (62,9%) pada kelompok tidak sepsis. Sedangkan pada kelompok sepsis sebagian besar menjalani persalinan seksio (85,%), lahir preterm (70,0%), dan asfiksia (75,0%). Hasil penelitian menunjukkan bahwa terdapat hubungan yang bermakna antara nilai MPV terhadap resiko terjadinya sepsis neonataroum (RR: 8,16; 95%IK: 2,1-30,5; p=0,003).Kesimpulan: Hasil penelitian ini menyimpulkan bahwa terdapat perbedaan yang bermakna antara nilai MPV dengan kejadian sepsis neonatarum.Â

Analisis faktor â€“ faktor yang mempengaruhi kejadian Malnutrisi Rumah Sakit (MRS) pada pasien anak di Bangsal Kaswari, RSUD Wangaya, Bali, Indonesia Grace Lydia Budiputri; I Wayan Bikin Suryawan; Made Ratna Dewi
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Hospital malnutrition (MRS) is malnutrition that occurs during hospitalization. The incidence of hospital malnutrition is still high in both developed and developing countries. Hospital malnutrition has a significant impact on mortality and increases the risk of children developing complications. Therefore this study aims to analyze the factors that influence the incidence of MRS in pediatric patients in Kaswari Ward, Wangaya Hospital, Bali, Indonesia.Methods: This prospective cohort study was conducted on 110 pediatric patients who were treated in the Kaswari Ward, Wangaya Hospital, Denpasar City, aged 1 month to 17 years in July-September 2019 using the consecutive technique. The diagnosis of MRS is confirmed if there is weight loss> 2% in children treated> 48 hours to 7 days or weight loss in children treated 8 to 30 days. Data were analyzed using SPSS version 20 for Windows.Results: The results showed that most of the respondents aged 3-24 months (23.6%), male gender (55.5%), had a history of GEA disease (35.5%), nutritional status> -2SD WHZ (77.3%), had a single diagnosis (35.5%), and length of stay ranged from 4-7 days (60.0%). Multivariate analysis showed that the nutritional status at admission to the hospital (RR: 4,155; 95% CI: 1,289-13,392; p = 0.017) and length of stay was more than 7 days (RR: 8,219; 95% CI 1,643-41,098; p = 0, 01) has a significant relationship with the incidence of MRS. However, the number of diagnoses did not have a significant relationship with the incidence of MRS (p> 0.05).Conclusion: This study shows that children who are treated with a length of stay of more than 7 days are more at risk of experiencing MRS.Â Â Latar Belakang: Malnutrisi Rumah Sakit (MRS) merupakan malnutrisi yang terjadi pada selama perawatan di rumah sakit. Angka kejadian Malnutri Rumah Sakit masih tinggi baik di negara maju maupun berkembang. Malnutrisi Rumah Sakit memiliki dampak yang signifikan pada angka mortalitas dan peningkatan resiko anak mengalami komplikasi. Oleh karena itu penelitian ini bertujuan untuk menganalisis faktor â€“ faktor yang mempengaruhi kejadian MRS pada pasien anak di Bangsal Kaswari, RSUD Wangaya, Bali, Indonesia.Metode: Penelitian kohort prospektif dilakukan pada 110 pasien anak yang di rawat di Bangsal Kaswari RSUD Wangaya kota Denpasar dengan usia 1 bulan hingga 17 tahun pada bulan Juli-September 2019 dengan teknik konsekutif. Diagnosis MRS ditegakkan apabila terjadi penurunan berat badan >2% pada anak yang dirawat >48 jam sampai 7 hari atau penurunan berat badan pada anak yang dirawat 8 sampai 30 hari. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian menunjukkan bahwa sebagian besar responden berusia 3-24 bulan (23,6%), jenis kelamin laki-laki (55,5%), memiliki riwayat penyakit GEA (35,5%), status gizi >-2SD WHZ (77,3%), memiliki diagnosis tunggal (35,5%), dan lama rawat inap berkisar 4-7 hari (60,0%). Analisis multivariat menunjukkan bahwa status gizi saat masuk rumah sakit (RR: 4,155; 95% IK: 1,289-13,392; p=0,017) dan lama perawatan lebih dari 7 hari (RR: 8,219; 95% IK 1,643-41,098; p=0,01) memiliki hubungan bermakna dengan kejadian MRS. Akan tetapi, jumlah diagnosis tidak memiliki hubungan yang bermakna dengan kejadian MRS (p>0,05).Kesimpulan: Studi ini menunjukkan bahwa anak yang dirawat dengan lama perawatan lebih dari 7 hari lebih beresiko untuk mengalami kejadian MRS.

Perbedaan petanda osteoporosis dan inflamasi pada pasien diabetes melitus tipe 2 terkontrol dan tidak terkontrol Emi Setianingsih; Imam Budiwiyono; Meita Hendrianingtyas
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Prolonged hyperglycemia cause further complications in patients with Type 2 Diabetes Mellitus (T2DM). Examination of HbA1c as a glycemic control can determine the risk of complications. N-Mid osteocalcin (N-Mid Oc) is used as a marker for early detection of osteoporosis. Increased neutrophil lymphocyte ratio (NLR) is a sign of simple inflammation that contributes to the progression and chronic complications in T2DM. The aim of the study is to analyze the differences between osteoporosis and inflammation markers in controlled and uncontrolled T2DM.Methods: Analityc observational study withÂ cross sectional approach was conducted in June â€“ July 2019 involving 58 DMT2 patients at Diponegoro National Hospital Semarang. The level of N-Mid Oc level were measured by ELISA method and NLR was measured by hematology analyzer, NLR values were obtained after manually calculated. Different test between research variables were using Mann-Whitney U testResults: The median (min - max) N-Mid Oc levels of controlled and uncontrolled T2DM patients were 16.17 (4.98 â€“ 37.28) ng / ml and 12.29 (3.54 â€“ 37.28) ng/ml with a value of p = 0.004. Median (min - max) NLR of DMT2 patients controlled and uncontrolled were 1.82 (0.64 â€“ 3.94) and 2.41 (1.08 â€“ 6.46) with p = 0.007.Conclusion: There is a significant differences between N-Mid O level and NLR in controlled and uncontrolled T2DM patients.Â Latar belakang: Hiperglikemia berkepanjangan dapat menimbulkan komplikasi lebih lanjut pada pasien Diabetes Melitus Tipe 2 (DMT2). Pemeriksaan HbA1c sebagai kontrol glikemik dapat mengetahui risiko komplikasi. N-Mid osteocalcin (N-Mid Oc) dipakai sebagai salah satu petanda deteksi dini osteoporosis. Peningkatan neutrophil lymphocyte ratio (NLR) merupakan petanda inflamasi sederhana untuk memantau progresivitas dan komplikasi kronik pada DMT2. Tujuan dari penelitian ini adalah untuk membuktikan adanya perbedaan petanda osteoporosis dan inflamasi antara DMT2 terkontrol dan tidak terkontrol.Metode: Penelitian observasional analitik dengan pendekatan belah lintang dilakukan pada bulan Juni - Juli 2019 melibatkan 58 pasien DMT2 di Rumah Sakit Nasional Diponegoro Semarang yang memenuhi kriteria inklusi dan eksklusi. Pemeriksaan N-Mid Oc diperiksa dengan metode ELISA dan Pemerikasaan NLR menggunakan hematology analyser, nilai NLR didapatkan setelah dihitung secara manual. Uji beda antar variabel penelitian mengunakan Mann-Whitney U testâ€™s. Hasil: Median (min â€“ maks) kadar N-Mid Oc pasien DMT2 terkontrol dan tidak terkontrol berturut-turut adalah 16,17 (4,98 â€“ 37,28) ng/ml dan 12,29 (3,54 â€“ 37,28) ng/ml dengan nilai p=0,004. Median (min â€“ maks) NLR pasien DMT2 terkontrol dan tidak terkontrol berturut-turut adalah 1,82 (0,64 â€“ 3,94) dan 2,41 (1,08 â€“ 6,46) dengan nilai p=0,007.Simpulan: terdapat perbedaan bermakna dari N-Mid Oc dan NLR antara pasien DMT2 terkontrol dan tidak terkontrol.

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