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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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Efektivitas multi drug therapy pada transmisi morbus hansen transplasental Dhelya Widasmara; Santosa Basuki; Dea Florensia; Ade Setyagraha; Nugrahanti Prasetyorini
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction:Â The evidence of transplancental transmission of Morbus Hansen (MH) in animal models is a challenge for MH treatment in pregnancy because it brings anxiety for patients and their fetuses.Â Case:Â A 31-year-old pregnant woman, first trimester, came with complaints of reddish numbness rash on her hands since 2 years ago. Dermatological examination showedÂ erythematousÂ plaque, multiple,Â well-defined, irregular borders withÂ hypoaesthesia. There were right and left ulnar nerve enlargement. Acid Fast Bacteria (AFB) fromÂ ear lobesÂ andÂ lesionÂ revealed Bacterial Index +2 and Morphological Index 10%.Â HistopathologicalÂ examination showedÂ grenÂ zone which indicate MH type BL. PatientÂ was diagnosedÂ with MH MultiÂ BasilerÂ (MB) onÂ G3P2002Ab000 and given MDT MHMB. Postpartum IgM and IgGÂ anti-PGL-1Â examination of cord blood and infant blood, alsoÂ PCRÂ examination of cord blood and amnion showed negative results. Histopathological examination found no AFB on the umbilical cord and placenta.Â Conclusion:Â MDT is effective in preventing transplacental transmission of MH from mother to fetus.

Faktor-faktor risiko yang berperan terhadap terjadinya infeksi luka operasi pada pasien post appendectomy di RSUP Sanglah Denpasar Danny Zefanya Mooy; I Gede Suwedagatha; Nyoman Golden
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Surgical wound infection (SWI) is one of the three most common hospital-acquired infections, with an average of 14-16% and which is the most common infection in postoperative patients. This study aims to look for factors associated with post-operative wound infection in the appendectomy procedure at Sanglah General Hospital Denpasar.Methods: This study used a retrospective cohort design, which was carried out at the Medical Record Installation Sanglah General Hospital Denpasar, Bali-Indonesia during the January 2017 to September 2018. Data analysis used chi-square tests, relative risk calculations, and logistic regression.Results: This study used 108 respondents, and there were 17 people who experienced SWI, the final analysis using logistic regression showed a diagnosis of perforated appendicitis (RR: 9.57; 95% CI: 2.09-43.64; p = 0.004) and operator guidance resident (RR: 1.75; 95% CI: 1.49-22.3; p = 0.011) is a risk factor for the occurrence of the SWI.Conclusion: The diagnosis of perforated appendicitis is the most important factor in the occurrence of surgical wound infection after appendectomy.Â Latar Belakang: Infeksi luka operasi (ILO) merupakan salah satu dari tiga infeksi tersering yang didapat di rumah sakit, dengan rata-rata mencapai 14-16% dan yang merupakan infeksi yang paling sering terjadi pada pasien pasca operasi. Penelitian ini bertujuan untuk mencari faktor-faktor yang berhubungan dengan infeksi luka operasi pasca prosedur appendectomy di RSUP Sanglah Denpasar.Metode: Penelitian ini menggunakan rancangan kohort retrospektif, yang dilakukan di Instalasi Rekam Medis RSUP Sanglah Denpasar, Bali-Indonesia selama periode Januari 2017 hingga September 2018. Analisis data menggunakan uji chi-square, perhitungan risiko relatif, dan regresi logistik.Hasil: Penelitian ini menggunakan 108 responden, dan terdapat 17 orang yang mengalami ILO, analisis akhir menggunakan regresi logistik menunjukkan diagnosis appendisitis perforasi (RR: 9,57; IK 95%: 2,09-43,64; p=0,004) dan operator residen bimbingan (RR: 1,75; IK 95%: 1,49-22,3; p=0,011) merupakan faktor risiko terjadinya ILO.Simpulan: Diagnosis appendisitis perforasi merupakan faktor yang paling berperan terhadap terjadinya infeksi luka operasi pasca appendectomy.

Acute thoracic aortic dissection: a case report Dewa Ayu Ratna Dewi; Made Dwija Putra Ayusta
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Aortic dissection (AD) is the most common aortic emergency, result in a catastrophic outcome. Patients usually asymptomatic, some of them present with sudden severe, tearing or sharp back or anterior chest pain and haemodynamic disturbance. Early and accurate diagnosis and treatment determine the patient outcome.Case Report: A case of 40 years old man complained of acute, sharp, chest pain since 4 days before admission which worsen instead of medical treatment, with a history of smoking since a few years ago. A vital sign was within normal limit. Laboratory result showed high CKMB, troponin T, LDH result. Occasional ventricular extrasystoles and inferior ischaemic was found in the ECG examination. From echocardiography, the patient suspected to have aortic dissection Stanford type A since an intimal flap on ascending aorta was found, with left ventricle hypertrophy, dilatation of right atrium and right ventricle, severe aortic regurgitation, moderate mitral regurgitation, severe tricuspid regurgitation, moderate pulmonary regurgitation and moderate pulmonary hypertension. From plain radiography, the patient showed mediastinum widening and cardiomegaly, CT angiography showed Stanford type A aortic dissection (DeBakey type I).Â The patient refused to seek further treatment for operation as suggested.Conclusion: It is still challenging to differentiate aortic dissection (AD) and another acute chest emergency. Since clinical presentation and laboratory result may be similar between those illnesses. Therefore careful history taking and further imaging examination should be considered to increase the patient outcome.

The low level of plasma vitamin C as a risk factor of preterm premature rupture of membrane Muhammad Freddy Candra Sitepu; Ketut Suwiyoga; Anak Agung Ngurah Jaya Kusuma; I Gusti Putu Mayun Mayura; Made Darmayasa; I Wayan Artana Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Preterm premature rupture of membrane (PPROM) still becomes a problem related with perinatal morbidity and mortality which is caused by multifactorial risk factor; especially strength of foetal membrane. Collagen is the main component of foetal membraneâ€™s extracellular matrix whereas plasma vitamin C roles as a collagen biosynthesis enzyme-dependent co-factor, down-regulator activity of MMP-1, MMP-2, and MMP-9 and also as antioxidant in remodelling and preventing structural damage extracellular matrix. The purpose of this study is to prove the low plasma level of vitamin C as a risk factor for PPROM on preterm pregnancy.Method: This study was an analytical observational unpaired case-control performed from March 23rd until August 23rd 2018 at Polyclinic and Emergency Unit of Obstetrics and Gynaecology Sanglah Central General Hospital, Buleleng General Hospital, Mangusada General Hospital, Sanjiwani General Hospital, Wangaya General Hospital, and Prodia Clinical Laboratory Denpasar. The samples were preterm pregnancy women with premature rupture of membrane (PROM) as a case group and without premature rupture of membrane as a control group. The samples were taken from peripheral venous blood and level of plasma vitamin C is measured by HPLC method. The data were analysed by SPSS for Windows 20.0 version program then presented as table and narrative.Result: Forty subjects were divided into 2 groups, 20 preterm pregnancy with PROM as a case group and 20 preterm pregnancy without PROM as a control group. Characteristic subject based on maternal age, gestational age, parity of both groups was 27.4 and 26.1 years old, 31 and 31 weeks, and also 1 and 1 time (p>0.05), not significantly different. The mean level of plasma vitamin C on case and control group were 3.90 Â± 1.61 dan 9.24 Â± 2.31 mg/L (p=0.001). On the case group the low level of plasma vitamin C was 51 times (OR= 51; CI 95% = 7.57â€“343.73; p=0,001) higher than the control group.Conclusion: The low level of plasma vitamin C is a risk factor of PPROM.

Perbedaan cost-effectiveness pengangkatan drain kurang dari 3 hari dengan lebih dari 3 hari pada modified radical mastectomy Dewa Nyoman Putra Adiwinata; Ketut Widiana; I Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Modified radical mastectomy (MRM) is a therapeutic choice for operable breast cancer. The most frequent post-surgery complication is seroma formation, and this can be circumvented by the use of drainage. There is still a debate over the use of drainage time on the effectiveness and cost efficiency used. The purpose of this study is a more in-depth study of the cost-effectiveness of removing drainage in less than three days with more than three days, in patients post-MRM.Method: This research is a cost-effectiveness analysis using a decision tree, with a cross sectional analytic research design. Data collection was performed retrospectively by comparing direct medical cost to evaluate the difference in cost-effectiveness of drain removal for less than three days and for more than three days for modified radical mastectomy (MRM).Results: 36 samples were collected that met the exclusion and inclusion criteria, consisting of 19 samples in the group with drain removal â‰¤ 3 days, and 17 samples in the group with drain removal> 3 days. Analysis of the cost of removing the drain less than three days showed the average direct medical cost of the patient was Rp. 700,578.00. Whereas patients with drain removal for more than three days showed a direct medical cost of Rp. 981,000.00. The average difference in average cost-effectiveness ratio between the two groups is Rp. 2,599.00.Conclusion: In this study, patients with drain removal â‰¤ 3 days had better cost-effectiveness compared to drain removal> 3 days.Â Pendahuluan: Modified radical mastectomy (MRM) adalah pilihan terapi pada kanker payudara dapat dioperasi. Komplikasi pasca tindakan yang paling sering terjadi adalah terbentukya seroma, dan hal tersebut dapat disiasati dengan penggunaan drain. Masih terjadi suatu perdebatan terhadap lama pemakian drain terhadap efektifitas dan efisiensi biaya yang digunakan. Tujuan dari penelitian ini adalah pengkajian lebih mendalam tentang cost-effectiveness pada pengangkatan drain kurang dari tiga hari dengan lebih dari tiga hari, pada pasien pasca tindakan MRMMetode: Penelitian ini merupakan penelitian cost-effectivness analisis menggunakan decision tree, dengan rancangan metode penelitian analytic cross sectional. Pengambilan data dilakukan secara retrospektif dengan membandingkan direct medical cost (biaya medis langsung) untuk mengevaluasi perbedaaan cost-effectiveness pengangkatan drain kurang dari tiga hari dan lebih dari tiga hari pada modified radical mastectomy (MRM).Hasil: Dikumpulkan 36 sampel yang memenuhi kriteria ekslusi dan inklusi, terdiri dari 19 sampel pada kelompok dengan pengangkatan drain â‰¤ 3 hari, dan 17 sampel pada kelompok dengan pengangkatan drain > 3 hari. Analisis biaya pada pengangkatan drain yang kurang dari tiga hari menunjukkan rerata direct medical cost pasien adalah Rp. 700,578,00. Sedangkan untuk pasien dengan pengangkatan drain lebih dari toga hari menunjukkan direct medical cost sebesar Rp. 981.000,00. Rerata perbedaan average cost-effectiveness ratio antara kedua kelompok adalah Rp. 2,599,00.Simpulan: Pada penelitian ini didapatkan pasien dengan pengangkatan drain â‰¤ 3 hari memiliki cost-effectiveness lebih baik dibandingkan dengan pengangkatan drain > 3 hari.

Mobile Voluntary Counseling Testing (VCT) pada Perkumpulan Keluarga Berencana Indonesia (PKBI) Daerah Bali: studi empiris dalam upaya penanganan HIV-AIDS I Gusti Ngurah Pramesemara; Ninik Andrias; Dyah Pradnyaparamita Duarsa
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Nowadays, the transmission of HIV-AIDS is mostly due to risky sexual activity and found in the heterosexual group, around 76.5%. The high rate may be due to stigma and discrimination in society, so risk people are reluctant to come for a check-up or treatment. This study aims to evaluate the comprehensive approach from the upstream to downstream and culture based in dealing with HIV-AIDS in the form of Mobile Voluntary Counseling Testing (VCT) that has been carried out by the Indonesian Planned Parenthood Association (IPPA) Bali, Indonesia.Methods: This descriptive cross sectional study was conducted in the 2016-2018 period in all regions of Bali, Indonesia, by convenience sampling technique. There are differences in the total number of services that have been performed which include Post-Test (+) counselling, Post-Test Counseling (-), rapid test evaluation, HIV counselling and prevention measures, as well as VCT Pre-Test counselling. The medical team and counsellor came together to meet directly with groups at risk of HIV-AIDS infection called key populations, such as commercial sex workers, transvestites, drug users, and homosexuals. The data obtained were analyzed descriptively using Microsoft Excel for Windows.Results: The results of this descriptive empirical study show that the overall Post-Test (+) counselling was conducted 9 times in 2016 (2 times), 2017 (3 times), and 2018 (4 times). Whereas in Post-Test (-) counselling there were 161 examinations in 2016, 105 times (2017), and 125 (2018). In the last 3 years, 1,472 investigations have been carried out, of which 652 times were in 2016, 367 times in 2017, and 453 times in 2018.Conclusion: Mobile VCT of IPPA Bali may be one of the effective efforts in responding to the challenges of people who tend to be taboo and less concerned about sexual and reproductive health issues. Latar Belakang: Saat ini penularan HIV-AIDS sebagian besar disebabkan oleh aktivitas seksual yang berisiko dan ditemukan pada kelompok heteroseksual sekitar 76,5%. Tingginya angka tersebut mungkin disebabkan oleh stigma dan diskriminasi di masyarakat, sehingga orang yang berisiko enggan datang untuk melakukan pemeriksaan atau perawatan. Penelitian ini bertujuan untuk mengevaluasi pendekatan komprehensif dari hulu ke hilir dan budaya berbasis dalam berurusan dengan HIV-AIDS dalam bentuk Pengujian Konseling Sukarela Seluler (VCT) yang telah dilakukan oleh PKBI Bali, Indonesia.Metode: Penelitian deskriptif dengan pendekatan potong lintang ini dilakukan dalam rentang periode 2016-2018 di seluruh daerah Bali, Indonesia dengan menggunakan teknik convenience sampling. Terdapat perbedaan jumlah total layanan yang telah dilakukan dimana meliputi konseling Post-Test (+), Konseling Post-Test (-), evaluasi rapid test, konseling HIV dan tindakan pencegahan, maupun konseling VCT Pre-Test. Tim medis dan konselor datang bersama untuk bertemu langsung dengan kelompok yang berisiko terinfeksi HIV-AIDS yang disebut populasi kunci, seperti pekerja seks komersial, waria, pengguna narkoba, dan homoseksual. Data yang diperoleh dianalisis secara deskriptif menggunakan Microsoft Excel untuk Windows.Hasil: Hasil studi empiris deskriptif ini menunjukkan bahwa telah dilakukan 9 kali konseling Post-Test (+) baik pada tahun 2016 (2 kali), 2017 (3 kali), dan 2018 (4 kali). Sedangkan pada konseling Post-Test (-) terdapat 161 kali pemeriksaan pada tahun 2016, 105 kali (2017), dan 125 (2018). Secara keseluruhan dalam 3 tahun terakhir telah dilakukan sebanyak 1.472 pemeriksaan dimana sebanyak 652 kali pada tahun 2016, 367 kali pada tahun 2017, dan 453 kali pada tahun 2018.Kesimpulan: Mobile VCT PKBI Bali dapat menjadi salah satu upaya efektif dalam menanggapi tantangan orang-orang yang cenderung tabu dan kurang peduli tentang masalah kesehatan seksual dan reproduksi.

Foto polos abdomen megaureter kongenital pada kecurigaan cystoma ovari maligna: Laporan kasus Rein Matondang; Ni Nyoman Margiani
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Megaureter defined as dilated ureter with or without dilatation of the renal pelvis and calyces.Â Megaureter is a common diagnosis in children, representing 23% of children with urinary tract obstruction. The diagnosis is more common in boys than girls, and more often is on the left side.Case description: A 17-year-old female was referred with a suspicion of malignant ovarian cystoma. On examination, the abdomen was distended.Â Plain radiograph of the abdomen revealed ground glass appearance in abdominal-pelvic cavity suspected of abdominal mass. An ultrasound of the abdomen revealed moderate right hydronephrosis and severe left hydronephrosis. Abdominal CT Scan with contrast demonstrated grade II right hydronephrosis with proximal hydroureter and grade III-IV left hydronephrosis, no solid mass in abdomen. Gynecologyst suspected this patient with left ovarian cystic mass. During the operation, evaluation to obtained ovarian cystic mass was done, yet no mass was obtained. They found a left mega ureter from proximal to distal suspected of a congenital giant mega ureter, followed by left nefrectomy and ureterectomy.Conclusion: A ground glass appearance in plain x-ray may mimicking as hydronephrosis or gynecological mass, particularly in young female patients with suspicion of abdominal mass.Â Latar belakang: Megaureter didefinisikan sebagai ureter yang melebar dengan atau tanpa dilatasi pelvis renalis dan calix ginjal. Megaureter adalah diagnosis yang umum pada anak-anak, mewakili 23% diagnosis pada anak-anak dengan obstruksi saluran kemih. Diagnosis ini lebih sering terjadi pada anak laki-laki daripada anak perempuan, dan lebih sering di sisi kiri.Deskripsi kasus: Seorang wanita berusia 17 tahun dirujuk dengan kecurigaan sistoma ovarium maligna. Pada pemeriksaan, perut tampak distensi. Foto polos abdomen menunjukkan ground glass appearence di rongga perut-panggul yang diduga massa abdomen. Ultrasonografi abdomen menunjukkan hidronefrosis kanan sedang dan hidronefrosis kiri berat. CT-Scan abdomen dengan kontras menunjukkan hidronefrosis kanan derajat II dengan hidroureter proksimal dan hidronefrosis kiri derajat III-IV, tidak tampak massa padat di perut. Dicurigai suatu massa kistik ovarium kiri. Selama operasi, dilakukan evaluasi untuk menemukan massa kistik ovarium, namun tidak didapatkan. Ditemukan megaureter kiri dari proksimal ke distal yang diduga sebagai giant megaureter kongenital, dilanjutkan nefrektomi kiri dan ureterektomi.Kesimpulan: Suatu gambaran ground glass appearance pada foto polos dapat menyerupai hidronefrosis atau masa ginekologi terutama pada wanita muda yang dicurigai massa abdomen.

Faktor-faktor yang berhubungan dengan terjadinya hipertensi intraabdominal pada pasien dengan peritonitis di RSUP Sanglah Denpasar dari bulan Januari 2017 - Desember 2018 Krishna Kurnia Pratama; Ketut Sudiasa; Nyoman Golden
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background and aim: Peritonitis is an emergency condition in the field of surgery due to its several complications. The most challenging is intraabdominal hypertension which can develop into abdominal compartment syndrome. There are several factors that cause intraabdominal hypertension in patients with peritonitis. This study aims to found factors that are associated with the occurrence of intraabdominal hypertension in peritonitis patients at Sanglah General Hospital in January 2017-December 2018.Method: This research used cross sectional analitic with total sampling technique with 136 peritonitis patients in Sanglah Hospital from Januari 2017 until December 2018 as respondents. Data source obtained from medical report. Bivariat analysis done to find factors related with intraabdominal hypertension in peritonitis patients with chi square method and multivariate analysis with logistic regression.Result: The majority of respondents are male, aged 15-64 years, organs involved in peritonitis in the form of solid organs, peritonitis that occurs through trauma mechanisms, experiencing sepsis, leukocytosis, and not hypoalbumin. Three variables were found to be significantly related they are, peritonitis caused by hollow organ perforation, sepsis condition, and hypoalbumin conditions. Only the sepsis condition has significant relationship with the occurrence of intraabdominal hypertension. Sepsis is 0.262 times more likely to cause intraabdominal hypertension in patients with peritonitis compared to patients without sepsis.Suggestion: Closely monitoring intraabdominal pressure should be carried out, especially in patients with sepsis, hypoalbumin, and those suspected of having perforations in hollow organs and further research is needed with a larger number of samples and more superior research methods.Â Latar belakang dan tujuan: Peritonitis merupakan kondisi kegawatdaruratan di bidang bedah karena dapat menyebabkan terjadinya beberapa komplikasi salah satu yang terberat adalah hipertensi intraabdominal yang dapat berkembang menjadi sindrom kompartemen abdomen. Terdapat beberapa faktor yang menyebabkan hipertensi intraabdominal pada pasien peritonitis. Penelitian ini bertujuan untuk melihat faktor-faktor yang berhubungan dengan terjadinya hipertensi intraabdominal pada pasien peritonitis di RSUP Sanglah bulan Januari 2017-Desember 2018.Metode: Penelitian analitik cross sectional dilakukan menggunakan teknik total sampling dengan melibatkan 136 responden yang merupakan pasien peritonitis yang dirawat di RSUP Sanglah bulan Januari 2017-Desember 2018. Sumber data berupa rekam medis pasien. Analisis dilakukan untuk melihat faktor yang berhubungan dengan hipertensi intraabdominal pada pasien peritonitis secara bivariat dengan metode chi square dan multivariat dengan regresi logistik.Hasil: Mayoritas responden berjenis kelamin laki-laki, berusia 15-64 tahun, organ terlibat dalam peritonitis berupa organ padat, peritonitis yang terjadi melalui mekanisme trauma, mengalami sepsis, leukositosis, dan tidak hipoalbumin. Tiga variabel ditemukan signifikan berhubungan yakni peritonitis diakibatkan oleh perforasi organ berongga, kondisi sepsis, dan kondisi hipoalbumin. Hanya kondisi sepsis yang memiliki hubungan murni dengan terjadinya hipertensi intraabdominal. Kondisi sepsis berisiko 0,262 kali lebih besar menyebabkan terjadinya hipertensi intraabdominal pada pasien peritonitis dibandingkan dengan pasien yang tidak mengalami sepsis.Saran: Sebaiknya dilakukan pemantauan tekanan intraabdominal secara ketat, terutama pada pasien dengan sepsis, hipoalbumin, dan yang dicurigai mengalami perforasi pada organ berongga serta diperlukan penelitian lanjutan dengan jumlah sampel yang lebih besar serta metode penelitian yang lebih superior.Â

Indikasi ibu melakukan persalinan seksio sesarea di RSUP Sanglah Denpasar tahun 2018 Tamara Olivia Wiguna; I Gede Harry Wijaya Surya; Ida Bagus Gde Fajar Manuaba; Jaqueline Sudirman
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Sectio caesarea is a method of labor in which a fetus with a capability to live (along with placenta and amniotic membrane) transabdominally via uterine incision. Caesarean section is usually done whether there is any medical indication and a final choice for difficulty on laboring.Aim: The study aims to know the indications of caesarean section that is done in RSUP Sanglah Denpasar in 2018.Â Method: This descriptive qualitative study was conducted using total sampling method. About 205 pregnant ladies had undergone caesarean section among a total of 914 patients who were in labour in RSUP Sanglah Denpasar in 2018, and around 157 of them have underlying medical indication that they couldnâ€™t perform normal labour.Result and Conclusion: The rupture membrane was the most frequent indication (18,7%), previous scar (13,9%), PEB (8,3%).Â Â Latar Belakang: Seksio sesarea merupakan melahirkan janin yang sudah mampu hidup (beserta plasenta dan selaput ketuban) secara transabdominal melalui insisi uterus). Seksio sesarea pada umumnya dilakukan apabila terdapat indikasi medis sebagai tindakan akhir dalam mengakhiri kesulitan persalinan.Tujuan: Untuk mengetahui indikasi seksio sesarea dari total persalinan di RSUP Sanglah Denpasar pada tahun 2018.Metode: Penelitian deskriptif dengan pendekatan kualitatif ini dilakukan dengan metode total sampling. Sebanyak 205 wanita hamil menjalani persalinan seksio sesarea dari total persalian sebanyak 914 kejadian persalinan di RSUP Sanglah, dan 157 di antaranya memiliki indikasi medis sehingga persalinan normal tidak memungkinkan.Hasil dan Simpulan: Ruptur membran atau pecahnya ketuban merupakan indikasi yang paling sering muncul (18,7%), lalu disusul oleh riwayat operasi sesar sebelumnya atau previous scar (13,9%), PEB (8,3%),

Korelasi antara parameter faal hemostasis dan kadar serum laktat sebagai indikator mortalitas pada pasien multiple trauma di Rumah Sakit Umum Pusat Sanglah Denpasar, Bali-Indonesia Hizkia Robinson Junsen Lumban Gaol; Ketut Wiargitha; Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Trauma is now the most frequent cause of death in the first four decades of life and is still a major public health problem in every country. Trauma that occurs often involves several regions of the body. This condition is called multiple trauma. In multiple trauma, coagulopathy often occurs. In the last four decades it was mentioned that in multiple trauma conditions also occur acidosis and coagulopathy which will also increase the mortality of multiple trauma patients with multiple trauma, serum lactate is superior to base deficit. The purpose of this study is to obtain the correlation of each prothrombin time (PT) value, activated partial prothrombin time (aPTT) value and international normalized ratio (INR) value with serum lactate levels as indicators of mortality in multiple trauma cases.Methods: This study was an observational study with an analytic cross-sectional design to determine the correlation between physiological parameters of hemostasis and serum lactate in multiple trauma patients.Results: From the 60 samples studied there were 43 male patients (71.7%) and 17 female patients (28.3%) with an average age of 37 Â± 19.61 years. 7 (11.7%) cases died. Logistic regression test with each conducted on the APPT and INR variables and lactate levels obtained aPTT was the most influential risk factor for mortality with a p-value of 0.005 <0.05 OR 0.023 (CI 95%: 0.002-0.332)Conclusion: Serum lactate levels and physiological hemostasis are not only indicators that explain a patient in a state of shock, but can also be used as an indicator in determining morbidity and mortality in multiple trauma patients.Latar belakang : Trauma saat ini merupakan penyebab kematian paling sering dalam empat dekade pertama kehidupan dan masih menjadi masalah kesehatan masyarakat yang utama di setiap negara. Trauma yang terjadi seringkali melibatkan beberapa regio tubuh. Kondisi ini disebut dengan multipel trauma. Pada multipel trauma, sering terjadi koagulopati.Â Pada empat decade terakhir disebutkan bahwa pada multipel trauma juga terjadi keadaan asidosis serta koagulopati yang juga akan meningkatkan mortalitas pasien multipel trauma multipel trauma, serum laktat lebih superior dibanding defisit basa. Tujuan dari penelitian ini adalah didapatkan korelasi masing â€“ masing nilai prothrombin time (PT), nilai activated partial prothrombin time (aPTT) dan nilai international normalized ratio (INR) dengan kadar serum laktat sebagai indikator mortalitas pada kasus multipel trauma.Metode: Penelitian ini merupakan studi observasional dengan rancangan potong lintang analitik untuk mengetahui korelasi antara parameter faal hemostasis dan serum laktat pada pasien multiple trauma.Hasil: Dari 60 sampel yang diteliti dijumpai penderita laki-laki sebanyak 43 orang (71,7 %) dan perempuan 17 orang (28,3 %) dengan rata-rata usia 37 Â± 19,61 tahun. Penderita yang meninggal sebanyak 7 (11,7%)Â kasus. Uji regresi logistik dengan masing masing dilakukan pada variabel APPT dan INR serta kadar laktat didapatkan aPTT merupakan faktor risiko yang paling berpengaruh terhadap terjadinya mortalitas dengan p-value 0,005 < 0,05 OR 0,023 (IK: 0,002-0,322)Simpulan: Kadar serum laktat dan faal hemostasis tidak hanya sebagai indikator yang menerangkan pasien dalam keadaan syok, tapi juga dapat digunakan sebagai indikator dalam menentukan morbiditas dan mortalitas pada pasien multipel trauma.

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Bali

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name -

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Phone -

Journal Mail Official -

Editorial Address -

Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA