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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
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The relationship between urine specific gravity, urine pH, and blood uric acid levels to the type of urinary stones of patients with urolithiasis at Sanglah Hospital, Bali, Indonesia Jetty Kalembang; Anak Agung Gde Oka; I Gede Raka Widiana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.158 KB) | DOI: 10.15562/ism.v11i2.744

Abstract

Background: Urine specific gravity, urine pH, and blood uric acid levels are risk factors for urinary tract stones. The urinary tract stones are formed due to the concentration of a solute exceeds its ability to remain in solution, resulting in supersaturation and crystallization. This study aims to determine the relationship between urine specific gravity, urine pH, and blood uric acid levels to the urinary stone's types in patients with urolithiasis at Sanglah HospitalMethods: A retrospective cross-sectional study was conducted among 95 subjects by using secondary data from the medical records in the period June 2017-2018 at Sanglah Hospital. The urolithiasis patient who met the inclusion and exclusion criteria were enrolled in this study. Data were analyzed by the Mann-Whitney Test and Kruskal-Wallis Test using SPSS version 17 for Windows.Results: The average age was 55±11 years old. Most of respondents were male (70.5%), normal Body Mass Index (BMI) (89.5%), urine pH <7 (75.7%), and mixed type of urinary stones (48.4%). There was a statistically significant relationship between the type of uric acid stone (p=0.029), blood uric acid levels (p=0.003), phosphate stone type (p=0.026), and magnesium stone (p=0.010) with urine pH. Besides, there was a statistically significant relationship between ammonium stone and blood uric acid levels types (p=0.022). A statistically significant difference was also found between stone types based on urine pH (p=0.013) in multivariate analysis.Conclusion: There is a significant relationship between urine pH and stone type on the incidence of urolithiasis in Sanglah Hospital in June 2017-2018, thereby increasing the incidence of urolithiasis.
Revascularization limb salvage in chronic limb-threatening ischemia: does open surgery still the best option in the era of endovascular therapy? Ashabul Anhar; Yopie Afriandi Habibie
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (537.536 KB) | DOI: 10.15562/ism.v11i1.745

Abstract

Introduction: Chronic limb-threatening ischemia (CLTI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels who suffered from diabetes mellitus type 2, and also associated with physical, as well as psychosocial, consequences such as amputation and depression. Successful revascularization decreases the major amputation rate in patients with CLTI. The efficacy of peripheral bypass grafts and percutaneous transluminal angioplasty in accomplishing limb salvage has been recognized.Case Description: A 42-year-old man came to the RSUZA emergency room with chief complaints claudication above the right thigh and continuous pain (rest pain) at the right lower extremity since 9 months ago. History of finger amputation 2nd, 3rd and 4th right foot since 10 months ago at local hospital, and now there are necrotic wounds on his toes. Patients suffered from type 2 diabetes mellitus and have bad habits such as smoking 3 packs a day all the time. Physical examination has a wound in the lower leg area of more than 10 cm x 8 cm. Right ankle-brachial index (ABI) 0.6 and left ABI 1.3. CT-angiography (CTA) shows infra inguinal type D TASC II classification. A revascularization procedure is performed to salvage the limb with the right femoro-popliteal bypass technique with graft R-SVG and debridement in the right lower leg area so that chronic right lower limb ischemia can be overcome. Systemic heparinization was given post operatively and complaints of pain in the right lower limb begin to disappear. Patient was discharged on the 5th day of treatment with good results.Conclusion: Open surgical bypass continues to be a primary treatment of choice, durable approach in a significant proportion of patients. Lower extremity bypass grafting is most successful with a good quality, long, single-segment autogenous vein of at least 3.5mm diameter. 
COVID-19: Respon imunologis, ketahanan pada permukaaan benda dan pilihan terapi klinis Komang Siska Lestari Sugitha
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.628 KB) | DOI: 10.15562/ism.v11i2.746

Abstract

The massive spread of SARS-CoV-2 infection marks the introduction of the third highly pathogenic corona virus after SARS-CoV and MERS-CoV infections that have caught the world's attention. In Indonesia alone, as of 9 April 2020, 3,512 cases have been confirmed, 282 recovered, and 306 of them died. Covid-19 CFR varies in each country, and CFR increases with age, especially if the patients have comorbid disease. SARS-CoV-2 can be detected in various specimens, such as oropharyngeal, BAL, sputum, faeces, and blood, but not detected in urine. SARS-CoV-2 infects populations of various ages, but severe symptoms are not reported in children. The host immune response is the key in eradicating the virus, as well as playing a role in the uncontrolled inflammatory response or cytokine storm. This may be due to the lack of corona virus-specific T memory cells in children so that when infected with SARS- CoV-2, the immune and inflammatory response is not as severe as in adults or the elderly. The long-term immune response of COVID-19 is still a big question. There is no specific vaccine and therapy COVID-19 approved by the FDA.Aim: The literature review this time aims to provide the general features the infection of SARS-CoV-2.Conclusion: From all of the patients who confirmed Covid-19, most of them were adults and elderly, with an increased risk of mortality in elderly with comorbidities. To reduce false negative diagnostic, specimens should be taken from different sites, such as nasal, throat, faeces, blood, and BAL. Until now, there’s no specific therapy and vaccines against SARS-CoV-2 infection. Infeksi SARS-CoV-2 yang penyebarannya begitu masif menandai perkenalan virus corona ketiga yang sangat patogen setelah infeksi SARS-CoV dan MERS-CoV yang menyita perhatian dunia. Di Indonesia sendiri, per tanggal 9 April 2020, 3.512 kasus telah terkonfirmasi, 282 sembuh, 306 diantaranya meninggal dunia. CFR COVID-19 bervariasi di setiap negara, dan CFR meningkat seiring bertambahnya usia, terutama  bila memiliki penyakit komorbid. SARS-CoV-2 dapat dideteksi di berbagai spesimen, seperti orofaringeal, BAL, sputum, feses, dan darah, tetapi tidak terdeteksi pada urin. SARS-CoV-2 menginfeksi populasi dari berbagai usia, tetapi gejala berat tidak dilaporkan pada anak-anak. Respon imun host merupakan kunci dalam eradikasi virus, sekaligus memegang peranan terjadinya respon inflamasi tidak terkontrol atau badai sitokin. Hal ini mungkin disebabkan oleh sedikitnya sel T memori spesifik virus corona pada anak-anak sehingga ketika terinfeksi SARS-CoV-2, respon imunitas dan inflamasi yang terjadi tidak separah pada dewasa atau usia lanjut. Respon kekebalan jangka panjang COVID-19 saat ini masih menjadi pertanyaan besar. Belum ada vaksin dan terapi spesifik COVID-19 yang disetujui FDA.Tujuan: Literatur ini dibuat bertujuan untuk memberikan gambaran umum mengenai infeksi virus SARS-CoV-2.Simpulan: Dari keseluruhan pasien yang terkonfirmasi Covid-19, sebagian besar adalah pasien dewasa dan usia tua, dengan resiko mortalitas semakin meningkat pada pasien usia tua yang memiliki komorbid. Untuk mengurangi hasil negatif palsu, diagnosis Covid-19 data ditegakkan dengan mengambil spesimen dari berbagai tempat, seperti nasal, faring, fees, Sarah, dan BAL. Hingga saat ini belim ada terapi dan vaksin spesifik untuk indeksi SARS-CoV-2.
Perbandingan nyeri akut, status hemodinamik, dan efek samping pada pasien low back pain pascalaminektomi antara pemberian terapi adjuvan oksikodon intravena dengan fentanil patch Sunanda Naibaho; Tjok GB Mahadewa; Tjok Gde Agung Senapathi
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (342.583 KB) | DOI: 10.15562/ism.v11i2.747

Abstract

Introduction: Good control of postalaminectomy pain is a determining factor for the success of laminectomy. Although intravenous opioids are widely used, lately fentanyl patches have begun to be considered with the same effectiveness and lower side effects. In this study, an acute comparison of hemodynamic status and side effects in low back pain patients postlaminectomy with intravenous oxycodone adjuvant therapy was compared with fentanyl patches.Methods: This research is a prospective cohort study by taking a subject of low back pain postlaminectomy at Sanglah General Hospital. The research subjects who approved informed consent, then observed visual analogue scale differences, hemodynamic status, and side effects between groups who received intravenous oxycodone and fentanyl patches. Data were recorded, tabulated, and analyzed with SPSS 16.Results: This study included 22 subjects who received intravenous oxycodone and fentanyl patch. From VAS 0, 30 and 60 minutes, only in the 60th minute after analgesic administration had significant differences were observed (p=0.005). In this case intravenous oxycodone was significantly better at reducing pain (0.5 vs 1.23) than fentanyl patches. From hemodynamic status, only respiration rates were found that were significantly higher in the intravenous oxycodone group (p=0.037) although not clinically significant (14.73 vs. 15.50). No side effects were found in either group.Conclusion: There is a difference in pain in low back pain patients with the use of intravenous oxycodone with fentanyl patch, where the effect appears only after 60 minutes. There were no side effects of tightness, nausea and vomiting between the two groups. Pendahuluan: Kontrol nyeri pascalaminektomi yang baik menjadi suatu faktor penentu keberhasilan laminektomi. Walaupun opioid intravena banyak digunakan,  belakangan ini fentanil patch mulai dipertimbangkan dengan efektivitas yang sama dan efek samping yang lebih rendah. Dalam penelitian ini, akan dilakukan perbandingan akut, status hemodinamik, dan efek samping pada pasien low back pain pascalaminektomi dengan pemberian terapi adjuvan oksikodon intravena dibandingkan dengan fentanil patch.Metode: Penelitian ini berupa studi kohort prospektif dengan mengambil subjek low back pain pascalaminektomi di  RSUP Sanglah. Subjek penelitian yang telah menyetujui informed consent, kemudian diobservasi perbedaan visual analogue scale, status hemodinamik, dan efek samping antara kelompok yang menerima oksikodon intravena dan fentanil patch. Data dicatat, ditabulasi, dan dianalisis dengan SPSS 16.Hasil: Penelitian ini mencakup masing-masing 22 subjek yang mendapatkan oksikodon intravena dan fentanil patch. Dari VAS 0,30, dan 60 menit, hanya ditunjukkan perbedaan signifikan pada menit ke-60 setelah pemberian analgesik (p=0,005). Dalam hal ini oksikodon intravena secara signifikan lebih baik dalam menurunkan nyeri (0,5 vs 1,23) dibandingkan fentanil patch. Dari status hemodinamik, hanya ditemukan laju respirasi yang secara signifikan lebih tinggi pada kelompok oksikodon intravena (p=0,037) walaupun tidak bermakna secara klinis (14,73 vs 15,50). Tidak ditemukan efek samping pada kedua kelompok.Simpulan: Ada perbedaan nyeri pada pasien low back pain dengan penggunaan oksikodon intravena dengan fentanil patch, dimana efeknya baru muncul setelah 60 menit. Tidak terdapat adanya efek samping sesak, mual, dan muntah antara kedua kelompok.
Asosiasi sikap dan pengetahuan orang tua terhadap perilaku dalam menangani anak saat diare di Kecamatan Seririt, Kabupataen Buleleng, Bali tahun 2018 Putu Andrie Setiawan; Ryan Tan; Derryl Komala Putra; Andy Halim; Nelvina Ginting; Maria Pricilla Siboe; Dyah Kanya Wati
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.548 KB) | DOI: 10.15562/ism.v11i2.748

Abstract

Introduction: To date, diarrhea is still a global burden that implicate children especially in development country. Seririt, as a  peripheral subdistrict in Buleleng regency, Bali face this problem also. The knowledge and the attitude of parents is really important to reduce morbidity and mortality of dehydration to be caused by diarea.Objective: This research was aimed to knowing the association of parents knowledge and attitude to behaviour when facing diarrhea.Method: Cross-sectional method with consecutive sampling method was used to answer the objective. This research has done in 2018 of August at community health canter (Puskesmas) Seririt 1, Buleleng Regency, Bali Province. Collected data was analysed with SPSS version 17 for Windows.Result: A statistically significant result was found between attitude and behaviour (p= 0,000; 95%CI=1,484-9,387). Contrary, insignificant result was found among attitude and parent behaviour when face diarrhea (p=0,093; 95% CI=0,900-3,155).Conclusion: Parrents knowledge associate to parent behaviour, in other hand attitude does not associate to parent behaviour.  Pendahuluan: Diare saat ini masih merupakan permasalahan utama pada balita. Hal ini juga merupakan masalah yang diahadapi didaerah perifer utamanya di Kecamatan Seririt, Kabupaten Buleleng, Bali. Pengetahuan dan sikap orang tua saat menangani diare berperan untuk mengurangi kesakitan dan kematian utamanya akibat dehidrasi.Tujuan : Tujuan dari penelitian ini adalah untuk mencari tahu asosiasi pengetahuan dan sikap terhadap perilaku orang tua saat anak mengalami diare di Kecamatan Seririt, Kabupaten Buleleng, Bali.Metode : Metode potong lintang dan consecutive sampling diterapkan pada penelitian ini. Penelitian dilaksanakan pada bulan Agustus 2018 di Puskesmas Seririt 1, Buleleng. Data yang  sudah dikumpulkan dianalisis dan disajikan dalam tabel dan narasi menggunakan perangkat lunak SPSS 17 for Windows.Hasil : Secara statistik terdapat perbedaan antara tingkat pengetahuan dengan perilaku (p= 0,000; IK=1,484-9,387). Sedangkan, tidak didapatkan perbedaan antara sikap dan perilaku subjek sehari-hari (p=0,093; IK=0,900-3,155).Kesimpulan : Terdapat hubungan yang bermakna antara tingkat pengetahuan orang tua terhadap perilaku saat menghadapi anak dengan diare. Namun, hal ini berbanding terbalik dengan sikap orang tua yang dinyatakan tidak berhubungan secara statistik terhadap perilaku saat anak mengalami diare.
Characteristics retinometry pre and post cataract surgery on senile cataract patients in Sanglah Hospital, Bali-Indonesia Ni Made Ari Suryathi; Wayan Gede Jayanegara; Ida Bagus Putra Manuaba
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.479 KB) | DOI: 10.15562/ism.v11i3.752

Abstract

Background: WHO, with program Vision 2020-the Right to Sight, has a responsibility to control the most cause of blindness, which is a cataract. General-purpose of this research is to identify the retinometry pre and post cataract surgery on senile cataract patients.Method: This study design is an analytical cross sectional study. All data were collected retrospectively from the medical report of retinometry of pre and post cataract surgery in Sanglah General Hospital.Results: A total number of 60 eyes from 59 patients were included in this study. The majority of the patients were male (63.3%), aged 61-70, and came from Denpasar District (38.3%). The grading of cataract (Burrato) in this study is Burrato III (60%). A nuclear cataract is common in this study (41.7%). There were relationships between the differences of retinometry post dan pre cataract surgery with the grading of cataract (Burrato) (p<0.05), but there is no relationship with the type of cataract (p>0.05).Conclusions: There is a significant difference between retinometry pre and post cataract surgery, no significant difference between retinometry post-cataract surgery with BCVA and type of cataract. Higher grades of cataract (Burrato V) significantly correlate with higher retinometry pre and post-cataract surgery.
Interval waktu iskemia, derajat iskemia, dan sindrom kompartemen merupakan faktor risiko amputasi pada pasien acute limb ischemia yang dilakukan tindakan trombektomi terbuka di RSUP Sanglah Denpasar Dea Emmanuel; Ketut Putu Yasa; Ida Bagus Putra Manuaba; I Nyoman Semadi; Ketut Widiana; Gede Wirya Kusuma Duarsa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (309.598 KB) | DOI: 10.15562/ism.v11i2.753

Abstract

Introduction: Acute Limb Ischemia (ALI) is a sudden decrease in perfusion in the extremities that causes the threat of tissue viability and is still one of the causes of disability. The purpose of this study was to determine the factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy.Methods: This was a retrospective observational study with case-control studies. As many as 40 patients with acute limb ischemia who underwent thrombectomy were seen as an outcome of amputation. Matching was done based on age and sex in the case (amputation) and control (without amputation) groups. Data collection is based on medical records from 2014 to 2019. Bivariate analysis uses Chi-Square or Fisher's Test while multivariate analysis uses logistic regression.Results: In this study we found that the time interval of ischemia and the degree of ischemia is a risk factor of amputation in person with ALI (p<0.05) but compartment syndrome was not significantly related to amputation in ALI. Multivariate analysis shows degree of Rutherford IIB / III ischemia to be a the most dominant factor for amputation (OR = 6.84; 95% CI = 1.19-39.35; p = 0.03).Conclusion: The time interval of ischemia and the degree of ischemia are factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy. The degree of ischemia is the most dominant risk factor affecting amputation. Latar Belakang: Acute Limb Ischemia (ALI) adalah penurunan secara tiba-tiba perfusi di ekstremitas sehingga menyebabkan ancaman viabilitas jaringan dan masih menjadi salah satu penyebab disabilitas Tujuan dari penelitian ini adalah untuk mengetahui faktor faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi.Metode: Penelitian ini merupakan penelitian observasional retrospektif dengan studi kasus kontrol. Sebanyak 40 pasien acute limb ischemia yang dilakukan trombektomi dilihat outcomenya dari amputasi. Dilakukan matching berdasarkan usia dan jenis kelamin pada kelompok kasus (amputasi) dan kontrol (tanpa amputasi). Pengambilan data berdasarkan catatan medis dari tahun 2014 hingga 2019. Analisa bivariat menggunakan Chi-Square atau Uji Fisher sedangkan analisa multivariat menggunakan regresi logistik.Hasil: Berdasarkan analisa statistik didapatkan didapatkan interval waktu iskemia dan derajat iskemia mempengaruhi amputasi (p<0,05) namun sindrom kompartemen tidak berhubungan secara signifikan. Hasil multivariat dengan regresi logistik ditemukan derajat iskemia Rutherford IIB/III menjadi faktor dominan terjadinya amputasi (OR = 6.84; IK 95% = 1,19-39,35; p = 0,03).Simpulan: Interval waktu iskemia dan derajat iskemia merupakan faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi. Derajat iskemia merupakan faktor risiko yang paling dominan mempengaruhi amputasi.
Hubungan antara Platelet Lymphocyte Ratio (PLR) dan respon Neoadjuvant Chemotherapy (NAC) CAF pada pasien Locally Advanced Breast Cancer Aryo Wibisono; I Nengah Wiadnyana Steven Christian; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.635 KB) | DOI: 10.15562/ism.v11i2.754

Abstract

Background: The incidence of LABC (Locally Advanced Breast Cancer) in Indonesia is estimated more than 50%, and in Bali as many as 76.3% from all of breast cancer cases. Response of NAC (Neoadjuvant chemotherapy) in LABC case is not the same on each patient. Currently, there are several biomarkers that can be a predictor of NAC response on LABC. One of them is PLR (platelet lymphocyte ratio). PLR is an easy, cheap and fast marker to be counted, but not all clinicians know its role. Lack of research in the relationship of PLR to NAC CAF (Cyclophospamide, Adriamycin, 5 Flourouracil) response in patients with LABC are currently making researchers interested in studying it.Method: This research is observational analytics, using a retrospective cohort study.  The number of samples was 62 (consecutive sampling), obtained from the medical records of patients who had undergone NAC CAF from 2015-2019 at Sanglah Hospital Denpasar.  PLR value  and initial tumor size were calculated before undergoing chemotherapy, then assessed the NAC CAF response to tumors after undergoing 3 cycles of chemotherapy. Positive response if tumor size is reduced and  negative response if the tumor size is persists or enlarges. In this study use a cut off point of PLR 150.Results: From 62 respondents obtained PLR value ≤ 150 had a positive response of 77.1% and 22.9% had a negative response. From these results obtained a correlation between PLR value with responses to NAC CAF in LABC patients, where low PLR values had  positive responses 1.6 times (IK 95; 1.04 - 2.47) with an output value of p = 0.018.Conclusion: There is a correlation between PLR and NAC CAF response, where a low PLR value (PLR ≤ 150) has a positive response to NAC CAF in LABC patients. Latar Belakang: Angka kejadian LABC (Locally Advanced Breast Cancer) di Indonesia diperkirakan lebih dari 50%, dan di Bali sebanyak 76,3% dari semua kasus kanker payudara. Respon NAC (neoadjuvant chemotherapy) pada kasus LABC tidak sama pada setiap penderita. Saat ini terdapat beberapa biomarker yang dapat menjadi prediktor terhadap respon NAC pada LABC, salah satunya adalah PLR (platelet lymphocyte ratio). PLR merupakan suatu marker yang mudah, murah dan cepat untuk dinilai tetapi masih banyak klinisi yang belum mengetahui perannya. Kurangnya penelitian mengenai hubungan PLR terhadap respon NAC CAF (Cyclophospamide, Adriamycin, 5 Flourouracil) pada pasien LABC saat ini membuat peneliti tertarik untuk meneliti hal tersebut.Metode: Jenis penelitian analitik observasional menggunakan studi kohort retrospektif, dengan 62 responden (consecutive sampling), yang didapatkan dari rekam medis pasien yang telah menjalani NAC CAF dari tahun 2015-2019 di RSUP Sanglah Denpasar. Nilai  PLR  dan ukuran tumor awal dihitung sebelum kemoterapi, kemudian dinilai respon NAC CAF terhadap tumor setelah menjalani 3 siklus kemoterapi. Respon positif  yaitu jika terjadi reduksi ukuran tumor ≥ 30% dari ukuran tumor awal dan respon negatif  jika terjadi reduksi ukuran tumor < 30%. Penelitian ini menggunakan cut off point  PLR 150,0 yang didapatkan dari penelitian sebelumnya.Hasil: Dari 62 responden didapatkan nilai PLR ≤ 150 mempunyai respon positif sebanyak 77,1% dan 22,9% respon negatif. Dari hasil tersebut didapatkan hubungan antara nilai PLR dengan respon terhadap NAC CAF pada pasien LABC, dimana nilai PLR rendah mempunyai respon positif sebanyak 1.6 kali (IK 95; 1.04 – 2.47) dengan hasil output nilai p = 0.018.Kesimpulan: Terdapat hubungan antara PLR terhadap respon NAC CAF, dimana nilai PLR yang rendah (≤ 150) mempunyai respon positif terhadap NAC CAF pada pasien LABC.  
Rasio Mean Platelet Volume (MPV) terhadap hitung trombosit dan Interleukin-6 (IL-6) sebagai prediktor awal kematian pada sepsis neonatal di RSUP Sanglah, Bali, Indonesia I Putu Sidhi Rastu Karyana; Ni Nyoman Mahartini; I Made Kardana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (335.571 KB) | DOI: 10.15562/ism.v11i2.755

Abstract

Background: Neonatal sepsis is a clinical syndrome in infants aged less than 28 days that arises from a systemic inflammatory response (SIRS) by various infectious causes. Both Interleukin-6 (IL-6) and Mean Platelet Volume (MPV) levels are known to play an important role in worsening neonatal sepsis. This study aims to determine the relationship between MPV ratio to platelet count and IL-6 as an early predictor of death in neonatal sepsis at Sanglah General Hospital, Bali, Indonesia.Methods: This prospective observational cohort study was conducted from November 2019 to February 2020 at Sanglah General Hospital Denpasar, involving 54 pediatric patients diagnosed with neonatal sepsis for less than 28 days. The research samples were collected consecutively. Statistical analysis is the survival analysis, Receiver Operating Characteristic (ROC) curve, linear regression, and Fisher exact test using SPSS software version 20 for Windows.Results: Most of the respondents had an average age of 3.46 ± 7,065 days, followed by male gender (72.22%), SNAD type of sepsis (88.89%), birth weight 2,126.6 ± 794.1 grams, normal birth weight (38.89%), and premature birth (61.11%). The mean MPV level in all subjects was 7.11 ± 1.85 fL, followed by a platelet count (218.511 ± 121.085) cells / µL, MPV / PLT ratio (5.404 ± 5.351), IL-6 levels (215.32 ± 444, 48 pg / mL), and as much as 12.95% died within 28 days of treatment. The results of the survival analysis showed a significant relationship between the MPV value (Cut-off: 6.745 (AUC: 0.650: HR: 4.353; p = 0.033) and the MPV / PLT ratio (Cut-off: 3.73; AUC: 0.690; HR: 4.535; p = 0.033) as an early predictor of mortality in neonatal sepsis at Sanglah General Hospital, Bali, Indonesia.Conclusion: MPV / PLT and MPV ratios can be used as predictors of early mortality within 28 days in patients with clinical neonatal sepsis at Sanglah General Hospital, Bali, Indonesia. Latar Belakang: Sepsis neonatal adalah sindrom klinis pada bayi berumur kurang dari 28 hari yang timbul akibat respon inflamasi sistemik (SIRS) oleh berbagai penyebab infeksi. Kadar Interleukin-6 (IL-6) maupun Mean Platelet Volume (MPV) diketahui berperan penting terhadap perburukan pada sepsis neonatal. Penelitian ini bertujuan untuk mengetahui  hubungan rasio MPV terhadap hitung trombosit maupun IL-6 sebagai prediktor awal kematian pada sepsis neonatal di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian Kohort prospektif observasional dilakukan sejak November 2019 sampai Februari 2020 di RSUP Sanglah Denpasar dengan melibatkan 54 pasien anak yang terdiagnosis sepsis neonatal kurang dari 28 hari. Sampel penelitian dikumpulkan secara konsekutif. Analsis statistik yaitu dengan analisis kesintasan, kurva Receiver Operating Characteristic (ROC), regresi linier, dan tes Fisher exact menggunakan piranti lunak SPSS versi 20 untuk Windows..Hasil: Sebagian besar responden rata-rata berusia 3.46±7.065 hari, diikuti dengan jenis kelamin laki-laki (72,22%), jenis sepsis tipe SNAD (88,89%), berat lahir 2.126,6±794,1 gram, berat badan lahir normal (38,89%), dan lahir prematur (61,11%). Rerata kada MPV pada seluruh subjek adalah 7,11±1,85 fL, diikuti dengan hitung trombosit (218.511±121.085) sel/µL, rasio MPV/PLT (5,404±5,351), kadar IL-6 (215,32±444,48 pg/mL), dan sebanyak 12,95% meninggal dalam 28 hari perawatan.  Hasil analisis kesintasan menunjukkan hubungan bermakna antara nilai MPV (Cut-off: 6,745 (AUC: 0,650: HR: 4,353; p=0,033) dan rasio MPV/PLT (Cut-off: 3,73; AUC: 0,690; HR: 4,535; p=0,033) sebagai prediktor awal kematian pada sepsis neonatal di RSUP Sanglah, Bali, Indonesia.Kesimpulan: Rasio MPV/PLT dan MPV dapat digunakan sebagai prediktor awal kematian dalam 28 hari pada pasien dengan klinis sepsis neonatal di RSUP Sanglah, Bali, Indonesia
Karakteristik infeksi Acinetobacter baumannii pada anak yang dirawat di RSUP Sanglah, Bali, Indonesia periode Januari 2017-Desember 2018 Gusti Ayu Putu Sri Satya Mahayani; I Wayan Gustawan; I Made Gede Dwi Lingga Utama; Ida Bagus Gede Suparyatha; I Made Arimbawa; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.529 KB) | DOI: 10.15562/ism.v11i3.756

Abstract

Background: Acinetobacter baumannii is a gram-negative bacterium that can cause nosocomial infections in humans. An increased incidence of A. baumannii infection is accompanied by increased antibiotic resistance and mortality from this bacterial infection. This study aims to determine the characteristic Acinetobacter baumannii infection and the pattern of germ sensitivity of antibiotics in children treated at Sanglah Hospital.Methods: A cross sectional study was conducted in the Pediatric Ward Sanglah Hospital. We performed a retrospective review of medical records from pediatric patients who were proven to have Acinetobacter baumannii infection through microbiological examination from blood culture samples while undergoing treatment in Pediatric Ward Sanglah Hospital from January 2017 to December 2018. Data were analyzed using SPSS version 20 for Windows.Results: A total of 33 pediatric patients were proven to have Acinetobacter baumannii bloodstream infection through microbiological examination. Most of them are males (72.7%) and 57.57% are neonates. Laboratory results obtained mean leukocyte levels 16.2±8.6 x 103/?L, median platelets 113.8 (3.7-464) x 103/?L, and mean procalcitonin 20.0±3.11 ng/ml. The average length of stay before Acinetobacter baumannii infection was 7 days, with the average total length of stay was 29.7 days. Patients who died during treatment were relatively high (45.5%) and 84.8% of them were treated in the intensive care unit, with 30 out of 33 patients infected with A. baumannii multidrug-resistant (MDR). Most patients use medical devices with an average usage time of more than 7 days.Conclusion: Most patients infected by Acinetobacter baumannii are treated in the intensive care unit with a high mortality rate. The A.baumannii bacteria identified were mostly MDR with a history of long-term use of antibiotics and medical devices. Latar Belakang: Acinetobacter baumannii adalah bakteri gram negatif yang dapat menyebabkan infeksi nosokomial pada manusia. Terdapat peningkatan insiden infeksi A. baumannii yang disertai peningkatan kejadian resistensi terhadap antibiotik, serta mortalitas akibat infeksi bakteri ini. Penelitian ini bertujuan untuk mengetahui bagaimana gambaran infeksi Acinetobacter baumannii serta pola sensitifitas kuman terhadap antibiotik pada anak yang dirawat di RSUP Sanglah yang merupakan rumah sakit rujukan di wilayah Indonesia bagian timur.Metode: Studi ini merupakan studi deskriptif dengan pendekatan potong lintang. Studi ini menggunakan data sekunder dari rekam medis pasien anak yang terbukti terinfeksi Acinetobacter baumannii melalui pemeriksaan kultur darah selama dirawat di RSUP Sanglah periode Januari 2017-Desember 2018. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat 33 pasien dengan kultur darah positif Acinetobacter baumannii. Sebagian besar berjenis kelamin lelaki (72,7%) dan 57,57% merupakan neonatus kurang bulan. Hasil laboratorium didapatkan rerata kadar leukosit 16,2±8,6 x 103/?L, median trombosit 113,8 (3,7- 464) x 103/?L, dan rerata procalcitonin 20,0±3,11 ng/ml. Median lama perawatan sebelum terjadinya infeksi adalah 7 hari dengan rerata lama perawatan 29,7 hari. Pasien yang meninggal selama perawatan cukup tinggi (45,5%) dan 84,8% dari pasien dirawat di ruang intensif dengan 30 dari 33 pasien terinfeksi multidrug resistant (MDR) A. baumannii. Sebagian besar pasien menggunakan alat medis dengan rerata lama pemakaian lebih dari 7 hari.Simpulan: Sebagian besar pasien yang terinfeksi Acinetobacter baumannii dirawat di ruang intensif dengan angka kematian yang cukup tinggi. Kuman A.baumannii yang teridentifikasi sebagian besar bersifat MDR dengan riwayat penggunaan antibiotika serta alat medis dalam jangka waktu lama. 

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