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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

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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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Gambaran trigliserida, kolesterol total, LDL, dan HDL pada pasien Diabetes Mellitus tipe 2 dengan hipertensi di Rumah Sakit Daerah Mangusada, Badung tahun 2018-2019 I Nyoman Hery Sumertayasa; Anak Agung Wiradewi Lestari; Sianny Herawati
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Diabetes mellitus (DM) is a chronic condition that occurs when the body can not produce enough insulin or can not use insulin, resulting in an increase of glucose in the blood. The prevalence of diabetes mellitus continues to increase in most countries which then shows that diabetes mellitus has become a global threat. Indonesia is ranked 5th as the largest number of people with diabetes mellitus. Metabolic syndrome can increase the risk of type 2 DM and cardiovascular disease. As for the main components of the metabolic syndrome include insulin resistance, central obesity, hypertension, and dyslipidemia. Improvement of lipid profile also influences the incidence of hypertension.Objective: The purpose of this study was to determine the description of triglycerides, total cholesterol, LDL, and HDL in patients type 2 diabetes mellitus accompanied by hypertension.Methods: This research was conducted at the Mangusada Badung Hospital, in 2019 with a total sample of 52 people from the total sampling method that met the inclusion and exclusion criteria. The design of this study is a cross-sectional study analyzed descriptively.Results: From the medical record sample of 52 people who visited the Internal Medicine Poly Hospital in Mangusada Regional Hospital, it was found that age > 45 years, female sex, body mass index above overweight had a picture of higher dyslipidemia in the type of lipid profile in the form of total cholesterol and triglycerides. Further research needs to be done to determine the relationship of lipid profile with age, sex, and body mass index and antilipidemic administration as a bias in this study. Latar Belakang: Diabetes melitus (DM) merupakan kondisi kronik yang terjadi ketika tubuh tidak dapat menghasilkan insulin yang cukup atau tidak dapat menggunakan insulin, sehingga terjadi peningkatan glukosa dalam darah. Prevalensi dari diabetes melitus sendiri terus meningkat di sebagian besar negara yang kemudian hal ini menunjukkan bahwa diabetes melitus telah menjadi ancaman global. Negara Indonesia mendapatkan peringkat ke-5 sebagai jumlah masyarakat yang mengalami diabetes melitus terbanyak. Sindrom metabolik dapat meningkatkan resiko dari DM tipe 2 dan penyakit kardiovaskular. Adapun komponen utama dari sindrom metabolik meliputi resistensi insulin, obesitas sentral, hipertensi, dan dislipidemia. Peningkatan profil lipid juga berpengaruh terhadap kejadian hipertensi.Tujuan: Tujuan penelitian ini adalah untuk mengetahui gambaran trigliserida, kolesterol total, LDL, dan HDL pada pasien diabetes melitus tipe 2 yang disertai hipertensi.Metode: Penelitian ini dilakukan di RSD Mangusada Badung, pada tahun 2019 dengan jumlah sampel 52 orang dan metode total sampling yang telah memenuhi kriteria inklusi dan eksklusi. Desain penelitian ini adalah studi potong lintang yang dianalisis secara deskriptif.Hasil: Dari sampel rekam medis 52 orang yang melakukan kunjungan ke Poli Penyakit Dalam RSD Mangusada didapatkan karakteristik berupa umur > 45 tahun, jenis kelamin perempuan, indeks massa tubuh di atas overweight memiliki gambaran angka dislipidemia yang lebih tinggi pada jenis profil lipid berupa kolesterol total dan trigliserida. Perlu dilakukan penelitian lebih lanjut untuk mengetahui hubungan profil lipid dengan umur, jenis kelamin, dan indeks massa tubuh serta pemberian antilipidemik sebagai bias dalam penelitian ini.

Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report Francis Celeste; I Made Yudi Mahardika; Wifanto Saditya Jeo
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm.There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach.Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes.Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair.Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intra-abdominal location of the gastroesophageal junction (GEJ).

Gastroschisis: five cases after primary closure at Sanglah General Hospital, Bali, Indonesia Nyoman Gina Henny Kristianti; I Wayan Darma Artana; I Made Kardana; Putu Junara Putra; Made Sukmawati; Kadek Deddy Ariyanta; Made Darmajaya
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Gastroschisis is a congenital anterior abdominal wall defect characterized by intra-abdominal organs evisceration without covering the membrane. Several risk factors affect the outcome of a gastroschisis patient. Considering these risk factors might also increase the chance of better prognosis and survival. We report five neonates with gastroschisis after primary closure in Sanglah General Hospital, Denpasar, Bali, in 2017. This case series aims to describe the clinical characteristics and outcome of different babies with gastroschisis managed by primary closure surgery.Case Presentation: Four of our cases were detected during pregnancy with fetal gastroschisis at the age of 32, 19, 23, 25 weeks of gestation, respectively. We reserve cesarean delivery for the patient who did antenatal care in our hospital, but one of our patients was born by spontaneous labor due to lack of antenatal care. Four cases had the primary closure of less than 2 hours and one of them after 10 hours. Good outcome was found in three cases that started enteral feeding on the 7th day after post closure. Other cases started oral feeding on the 3rd day and 12th day—both of them shown poor outcomes. Three cases survive, but two others died because of sepsis.Conclusion: We found poor outcomes in both cases, which neonatal sepsis as a significant cause. One of our cases with poor outcome was referred from another hospital without antenatal care and had a long duration of entering the operating room. Diagnosing these babies in their early prenatal period and transferring them to an experienced medical centre containing multidisciplinary working facilities will contribute to both the mother and the baby's health.

Factors associated with unfavourable outcome after Burr Hole drainage in Subdural Hematoma (SDH) at Sanglah General Hospital, Bali, Indonesia I Gusti Ngurah Purnomo; I Wayan Niryana; Nyoman Golden
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Subdural hematoma is a neurosurgical disorder that often occurs in the elderly with simple, relatively fast and minimally invasive surgical therapy, but has a high postoperative mortality rate due to unfavourable outcome. This study aims to evaluate factors associated with unfavourable outcome after burr hole drainage in a subdural hematoma (SDH) at Sanglah General Hospital, Bali, Indonesia.Method: A prospective cohort study was conducted among 60 respondents to determine factors influencing the outcome of patients with subdural hematoma after burr hole drainage.Â The independent variables in this study included age, comorbid factors, trauma onset, GCS, hematoma thickness, and midline shift.Â Dependent variables include the Glasgow Outcome Scale (GOS), which is divided into 2 groups, favourable outcome, and unfavourable outcome. Data were analyzed using SPSS version 17 for Windows.Results: There were 19 respondents (31.7%) had unfavourable outcomes and 41 respondents (68.3%) had favourable outcomes.Â From the bivariate analysis, significant associated risk factors were found in the onset of trauma (p=0.048), GCS (p=0.000), hematoma thickness (p = 0.000), and midline shift (p=0.000).Â From the multivariate analysis, it was found that low GCS was the most dominant risk factor for the unfavourable outcome following burr hole drainage (OR=22.30; 95% CI= 2.22-223.80; p=0.008) Conclusion: This study concludes that low GCS was the most dominant risk factor for unfavourable outcome in patients with subdural hematoma after burr hole drainage

Gambaran karakteristik pasien kondiloma akuminata dengan infeksi HIV/AIDS di RSUP Sanglah, Denpasar, Indonesia tahun 2011-2015 Ida Bagus Gede Jayadharma; Anak Agung Gde Putra Wiraguna
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Condyloma acuminata, known as genital warts, is a sexually transmitted infection caused by a virus, namely Human Papilloma Virus (HPV). HPV infections are related to other sexually transmitted infections such as the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). This study aims to know the patient characteristics of condyloma acuminata in patients with HIV infection in Sanglah General Hospital, Denpasar, from January 2011 to December 2015.Methods: This research is a retrospective descriptive study with a cross sectional method. This research analyzed 58 patients of condyloma acuminata with HIV infection in Sanglah Public Hospital from January 2011 to December 2015. Research variables were based on age, sex, level of education, marital status, and work level. Data were analyzed using SPSS version 17 for Windows.Results: This study found that the prevalence of condyloma acuminata with HIV infection based on age was 15-24 years old (17.2%), 25-44 years old (81.0%), and 45-64 years old (1.7%). The results based on sex were 91.4% for males and 8.6% for females. The results based on education level were elementary school (8.6%), high school (53.4%), higher education (37.9%). The results based on work level were government employee (3.4%), private employee (77.6%), entrepreneur (10.3%), and do not have a job (8.6%). And the results based on marital status were married (13.8%) and single (86.2%).Conclusion: The highest prevalence of condyloma acuminata with HIV infection based on age was 25-44 years old, males gender, high school level of education, and working in the private sector. Latar Belakang: Kondiloma akuminata atau dikenal sebagai genital wart (kutil kelamin) adalah infeksi menular seksual yang disebabkan oleh virus, yaitu Human papilloma virus (HPV). Infeksi HPV kerap dikaitkan dengan infeksi menular seksual lainnya seperti Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS). Tujuan penelitian ini untuk mengetahui karakteristik pasien kondiloma akuminata pada pasien yang terinfeksi HIV di Rumah Sakit Umum Pusat Sanglah Denpasar dari bulan Januari 2011 sampai dengan bulan Desember 2015.Metode: Penelitian ini merupakan penelitian deskriptif retrospektif, dengan metode cross sectional. Penelitian ini menganalisis 58 pasien dengan kondiloma akuminata dengan HIV di Poliklinik RSUP Sanglah pada periode Januari 2011 sampai dengan Desember 2015. Variable pada penelitian ini yaitu berdasarkan umur, jenis kelamin, tingkat pendidikan, status perkawinan, dan tingkat pekerjaan. Data dianalisis dengan SPSS versi 17 untuk Windows.Penelitian: Hasil dari penelitian ini didapatkan bahwa berdasarkan umur 15-24 tahun (17,2%), 25-44 tahun (81,0%), dan 45-64 tahun (1,7%). Berdasarkan jenis kelamin, yaitu laki-laki (91,4%) dan perempuan (8,6%). Hasil penelitian berdasarkan tingkat pendidikan, kelompok pendidikan dasar (8,6%), pendidikan menengah (53,4%), dan pendidikan tinggi (37,9%). Berdasarkan pekerjaan, yaitu kelompok PNS (3,4%), pegawai swasta (77,6%), wiraswasta (10,3%), dan kelompok tidak bekerja (8,6%). Dan berdasarkan status perkawinan didapatkan hasil yaitu kelompok menikah (13,8%) dan yang belum menikah (86,2%).Kesimpulan: Prevalensi kondiloma akuminata dengan HIV paling banyak berdasarkan kelompok umur yaitu kelompok usia 25-44 tahun, jenis kelamin laki-laki, kelompok pendidikan menengah, dan bekerja di sektor swasta.

Spontaneous intracerebellar haemorrhage and hydrocephalus: a case report Yovi Eko Azhra; M Ihsan Z Tala; M Deni Nst
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Hemorrhagic strokes affect more than 1 million people every year worldwide and are the most frequent type of stroke with high mortality and morbidity rates. Spontaneous Intracerebral Hemorrhage (SICH) often affects the basal ganglia, thalamus, cerebral lobes, pons, and cerebellum.Case Description: In this report, we present a 63-year-old female with sudden onset loss of consciousness and computed tomography (CT) of head demonstrated an intracranial haemorrhage in the cerebellum with hydrocephalus. The existence of hydrocephalus and the development of chronic hydrocephalus is a problem, awaiting a solution in patients who didnâ€™t undergo surgical treatment for cerebellar haemorrhage; however, it can easily be treated effectively by surgical evacuation.Conclusion: A general practitioner should be able to carry out appropriate initial management to reduce morbidity and mortality.

Analisis kesesuaian pemakaian obat pada pasien asma dewasa dengan Peraturan Menteri Kesehatan Nomor 5 tahun 2014 di Badan Rumah Sakit Umum Daerah Kabupaten Tabanan tahun 2018 Desak Gede Vicsilia Mahambara Gita; Desak Ketut Ernawati; Agung Nova Mahendra
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Regulation of the Minister of Health of the Republic of Indonesia No. 5 of 2014 concerning asthma mentions the presence of types of asthma, medication controller, alternatives such as drugs and substances that have been determined and also other alternatives such as additional drugs. The drugs used in the guidelines were glucocorticosteroids, theophylline, chromolin, leukotriene modifiers, ventolin, and formeterol. Nowadays, the number of asthmatic patients who received asthma therapy according to that regulations had not been clearly distributed.Aim: The study aims to describe the pattern of drug use in adult asthma patients in accordance with the regulations in Tabanan General Hospital.Methods: A retrospective observational study with medical record data without providing intervention or treatment to samples in the Tabanan General Hospital in March-June 2019 aged 18-65 years and receiving asthma medication.Results and Conclusions: The three types of asthma, based on the type of drug, dosage, and dosage form are not in accordance with Regulation of Minister of Health No. 5 of 2014. Peraturan Menteri Kesehatan (PMK) Republik Indonesia No 5 Tahun 2014 tentang asma menyebutkan adanya jenis asma, medikasi pengontrol, alternatif seperti obat dan zat yang telah ditentukan dan juga alternatif lain seperti tambahan obatnya. Obat yang digunakan pedoman PMK No 5 Tahun 2014 yaitu glukokortikosteroid, teofilin, kromolin, leukotrien modifiers, ventolin, formeterol. Sampai sekarang jumlah pasien asma yang mendapatkan terapi asma sesuai dengan PMK masih belum terdistribusi dengan jelas.Tujuan: untuk mendeskripsikan pola penggunaan obat pada pasien asma dewasa sesuai dengan PMK No 5 Tahun 2014 yang berlaku di Badan Rumah Sakit Umum Daerah (BRSUD) Kabupaten Tabanan.Metode: Penelitian observasional retrosprektif dengan data rekam medis tanpa memberikan intervensi atau perlakuan pada sampel di BRSUD Kabupaten Tabanan pada bulan Maret-Juni 2019 berusia 18-65 tahun dan mendapatkan terapi obat asma.Hasil dan Simpulan: Ketiga jenis asma, berdasarkan jenis obat, dosis, dan bentuk sediaan tidak sesuai dengan PMK No 5 Tahun 2014.

Glutathione administration reduces the DNA fragmentation index in sperm preparation with the Swim-Up (SU) and mini-Density Gradient Centrifugation (mini-DGC) methods at Doctor Soetomo General Hospital, Surabaya, Indonesia Lutfi Hardiyanto; Amarudin Amarudin; Indra Gusti Mansur; Supardi Supardi; Wahyuning Ramelan; Hamdani Lunardhi
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Spermatozoa requires Reactive Oxygen Species (ROS) in physiological quantities for capacitation for fertilization purposes. However, if the balance between ROS production and antioxidant capacity is disrupted, it can result in oxidative stress, negatively affecting chromatin spermatozoa, leading to male infertility. This study evaluates the glutathione administration reduces the DNA fragmentation index in sperm preparation with the Swim-Up (SU) and mini-Density Gradient Centrifugation (mini-DGC) methods at Doctor Soetomo General Hospital, Surabaya, Indonesia.Methods: A true experimental study by post-test only control group was conducted using ejaculate fluid of 9 infertile patients with normozoospermic at the Department of Medical Biology, Faculty of Medicine, Universitas Indonesia, Jakarta in January - February 2019 period. The spermatozoa DNA fragmentation was examined by following the instructions for using Spermfunc® DNAf Kit for Determination of the DNA Fragmentation Level in Spermatozoa by Sperm Chromatin Dispersion (SCD) for both preparation methods. Data were analyzed using SPSS version 16.0 for Windows.Results: SU vs. SU+glutathione method gave a lower but insignificant DNA fragmentation effect (p>0.05). The mini-DGC vs. mini-DGC+glutathione method showed significant results (p<0.05). SU+glutathione vs mini-DGC+glutathione showed no significant results (p>0.05). Meanwhile, the SU vs. mini-DGC method showed significant results (p <0.05). The recovery rate (RR) of the mini-DGC method has a higher value and is even better if glutathione is given compared to the SU method.Conclusion: Spermatozoa preparation in the SU method gives a lower DNA fragmentation effect than the mini-DGC method. The administration of glutathione can be a particular consideration in carrying out spermatozoa preparation to protect spermatozoa from damage during preparation.

Potential combinations of Platelet Rich Plasma (PRP) and chitosan in burn wound management: a review Gede Wara Samsarga; I Gusti Putu Hendra Sanjaya; Agus Roy Rusly Hariantana Hamid; Komang Januartha Putra Pinatih; Ni Made Ratih Purnama Dewi
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background:Â The development of new modality for burn wound healing is necessary to reduce morbidity and mortality of burn injury. PRP (Platelet Rich Plasma) is one of potential modality for burn injury because of its ability to deliver various growth factors to initiate and accelerate tissue healing and regeneration. Clinical efficacy of PRP is frequently disturbed because inconsistency and inefficiency of growth factor release in PRP. To increase the effectiveness of PRP in wound healing and increase the bioavailability of growth factor, PRP can be combined with a carrier that can control continuous release of growth factors. Chitosan is one of biomaterial that potential to use because of its biodegradability characteristic and biological activity that important for burn wound healing and prevent the formation of scar tissue in a burn injury. Researches have shown that chitosan is an effective carrier to facilitate growth factor release continuously to burn wound.Aims: This review aims to review potential Combinations of PRP (Platelet Rich Plasma) & Chitosan in Burn WoundConclusion:Â With chitosan ability to facilitate burn wound healing and as an effective carrier, combination of PRP and chitosan is a promising modality for burn wound healing.

Ekstrak buah makasar (Brucea Javanica (L) Mer.) meningkatkan kadar enzim Superoksida Dismustase (SOD) mencit (Mus musculus) Swiss Webster jantan yang diinduksi paraquat Maria Eka Patri Yulianti
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Aging is a biological process where one of the contributing factors is oxidative stress due to free radicals in the body. Paraquat is an example of free radicals that are often used by oil palm plantation farmers in Bengkulu, which can trigger the aging process by reducing the enzyme Superoxide Dismutase (SOD). The provision of fruit extract of Makassar (Brucea javanica (L) Mer) contains bioactive compounds that can function as antioxidants by increasing SOD levels in the body. This study aims to prove that the fruit extract can increase the levels of SOD of male Swiss Webster mice induced by paraquat.Methods: In vivo experimental research with randomized pretest-posttest control group design was conducted on 14 Swiss Webster mice (Mus musculus) as research subjects. The research subjects were then divided into 2 groups, namely the control and the treatment group (20 mg/kgBW/day (P1) for 14 days). Data were analyzed using SPSS version 17 for Windows.Results: The results showed that there was no significant increase in the mean of SOD levels either before (16.97Â±1.45 U/ml) or after (17.07Â±1.89 U/ml) treatment in the P0 group (p> 0.05). However, in the P1 group that was given paraquat induction coupled with Makassar fruit extract at a dose of 20 mg/kgBW/day for 14 days, it showed that there was a significant increase in the mean SOD levels from 17.18Â±1.69 U/ml to 67.56Â±3.65 U/ml (p <0.05).Conclusion: Provision of Makasar fruit extract at a dose of 20 mg/kgBW/day for 14 days was found to significantly increase the mean SOD levels in Swiss Webster male mice induced by paraquat.Â Latar Belakang: Penuaan adalah suatu proses biologi dimana salah satu faktor penyebabnya adalah stres oksidatif akibat radikal bebas yang terjadi di dalam tubuh. Paraquat merupakan salah satu contoh radikal bebas yang sering digunakan oleh petani perkebunan sawit di Bengkulu dimana dapat memicu proses penuaan melalui penurunan kadar enzim Superoksida Dismutase (SOD). Pemberian ekstrak buah makasar (Brucea javanica (L) Mer) mengandung senyawa bioaktif yang dapat berfungsi sebagai antioksidan dengan meningkatkan kadar SOD dalam tubuh. Penelitian ini bertujuan untuk membuktikan bahwa ekstrak buah makasar dapat meningkatkan kadar SOD mencit jantan swiss Webster yang diinduksi paraquat.Metode: Penelitian eksperimental secara in vivo dengan rancangan randomized pretest-posttest control group design dilakukan terhadap 14 ekor mencit (Mus musculus) swiss Webster sebagai subjek penelitian. Subjek penelitian kemudian dibagi menjadi 2 kelompok, yaitu kelompok kontrol dan kelompok perlakuan (20 mg/kgBB/hari (P1) selama 14 hari). Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Hasil penelitian menunjukan bahwa tidak terdapat peningkatan bermakna rerata kadar SOD baik sebelum (16,97Â±1,45 U/ml) atau setelah (17,07Â±1,89 U/ml) perlakuan pada kelompok P0 (p>0,05). Akan tetapi, pada kelompok P1 yang diberikan induksi paraquat ditambah dengan ekstrak buah makasar dengan dosis 20 mg/kgBB/hari selama 14 hari menujukkan terdapat peningkatan secara bermakna rerata kadar SOD dari 17,18Â±1,69 U/ml menjadi 67,56Â±3,65 U/ml (p<0,05).Kesimpulan: Pemberian ekstrak buah makasar dosis 20 mg/kgBB/hari selama 14 hari diketahui dapat meningkatkan rerata kadar SOD secara bermakna pada mencit jantan swiss Webster yang diinduksi paraquat.

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