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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
Published by Universitas Udayana
ISSN : 25033638     EISSN : -     DOI : -
Core Subject : Health, Science,
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
Risk factors and novel prognostic score for predicting the 14-day mortality of severe traumatic brain injury patients Nyoman Golden; Putu Eka Mardhika; Wayan Niryana; I Made Sukarya; I Putu Yuda Prabawa
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 (484.992 KB) | DOI: 10.15562/ism.v11i3.831

Abstract

Introduction: The mortality of severe traumatic brain injury (TBI) is contributed by the severity of the head injury, associated trauma, and complication during treatment. This study aimed to develop a prognostic scoring system of risk factors that contribute to the 14-day mortality of severe TBI.Methods: This was a prospective cohort study including 105 severe TBI patients recruited consecutively from March to October 2016. Multivariate analysis with logistic regression was performed to determine the most contributing risk factors. The validation of prognostic factor was performed with ROC, sensitivity and specificity analysis.Result: There were five significant risk factors of 14-day mortality, which were age > 60 years old (RR: 15.6, 95% CI: 1.88 – 129.95), hypoxia (RR: 17.78, 95% CI: 2.05 – 154.11), GCS 3 – 5 (RR: 34.71, 95% CI: 6.85 – 175.98), effacement of basal cistern (RR: 12.71, 95% CI: 2.61 – 61.95), and traumatic subarachnoid hemorrhage (tSAH) (RR:7.57, 95% CI: 1.19 – 48.36). The prognostic score ranged from 0 to 6 with the best cut-off point of 1. The best predictive AUC with ROC analysis was 0.817, 81.2% of sensitivity, and 75.0% of specificity.Conclusion: The proposed prognostic score has shown good predictive ability.
Hubungan antara platelet lymphocyte ratio (PLR) dengan subtipe kanker payudara pada pasien kanker payudara di Rumah Sakit Umum Pusat Sanglah, Denpasar I Gusti Ngurah Ari Aditya Satriya Wibawa; Ida Bagus Suryawisesa; I Ketut Widiana; I Gede Budhi Setiawan
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 (409.082 KB) | DOI: 10.15562/ism.v11i3.834

Abstract

Background: Breast cancer is one of the most diagnosed malignancies, as well as the leading cause of cancer mortality in women worldwide. The research objective was to analyze the relationship between PLR and breast cancer subtypes in breast cancer patients in Bali.Methods: This study used a cross sectional design to assess how PLR could predict cancer subtypes in breast cancer patients involving 52 respondents by consecutive sampling.Result: age ? 51 years is the most respondents, 69.7% with p-value 0.218. The location of the left breast tumor was found to be more than 63.2% with a p-value of 0.416. The best cut-off point lies at 162.1. PLR ? 162.1 with the luminal subtype of breast cancer, there were 22 respondents 66.7% with an OR of 4.3 (CI: 1.29-14.50) and a p-value of 0.015. The results of logistic regression analysis showed that PLR is the dominant factor causing the luminal subtype of breast cancer.Conclusion: Age and location of the tumor were not associated with breast cancer subtypes. PLR was significantly positive, and the strength of the association was moderate with the non-luminal subtype of breast cancer. PLR values tended to be higher in non-luminal cancer subtypes compared to luminal cancer subtypes. PLR has a dominant effect on the age and location of the tumor on the non-luminal subtype of breast cancer. Latar Belakang: Kanker payudara adalah salah satu keganasan yang paling banyak didiagnosis, serta penyebab mortalitas akibat kanker terbanyak pada wanita di seluruh dunia. Tujuan penelitian untuk menganalisis hubungan PLR dengan subtipe kanker payudara pada penderita kanker payudara di bali.Metode: Penelitian ini menggunakan rancangan cross sectional untuk menilai bagaimana PLR dapat memprediksi subtipe kanker pada pasien kanker payudara yang melibatkan 52 responden secara consecutive sampling.Hasil: umur ? 51 tahun merupakan responden terbanyak (69,7%) dengan p-value 0,218. lokasi tumor mammae kiri didapatkan lebih banyak (63,2%) dengan p-value 0,416. Cutt off point terbaik terletak pada angka 162,1. PLR ? 162,1 dengan subtipe luminal kanker payudara didapatkan sebanyak 22 responden (66,7%) dengan OR 4,3 (IK: 1,29-14,50) dan p-value 0,015. Hasil analisis regresi logistik didapatkan PLR merupakan faktor dominan yang menyebabkan subtipe luminal kanker payudara.Kesimpulan: Umur dan lokasi tumor tidak berhubungan dengan subtipe kanker payudara. PLR berhubungan positif secara signifikan dan kekuatan hubungan moderate dengan subtipe non luminal kanker payudara. Nilai PLR cenderung tinggi didapatkan pada subtipe kanker non luminal dibandingkan dengan subtipe kanker luminal. PLR mempunyai pengaruh dominan dibandingkan dengan umur dan lokasi tumor terhadap subtipe non luminal kanker payudara. 
Peranan sirkumsisi dalam pencegahan infeksi menular seksual Putu Ayu Dewita Ganeswari; Luh Made Shanti Maheswari; Ni Made Dwi Puspawati
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 (370.457 KB) | DOI: 10.15562/ism.v11i3.835

Abstract

Sexually transmitted infections (STIs) are a threat to society in the era of global health. Data from the World Health Organization (WHO) states, more than 1 million cases of STIs are found every day worldwide. The increase number of STI cases requires health workers to think about various preventive measures so that the cases do not increase. Prevention of STIs can be done with several conventional steps including being faithful to one partner and using a condom during sexual intercourse. There was a consideration in the quantity and quality of scientific evidence documenting the safety and health benefits of circumcised men as a method of preventing STIs. Male circumcision has emerged as a means of reducing the transmission of sexually transmitted infections. In recent decades, several studies have produced evidence on the effects of male circumcision on HIV transmission. Circumcision in men is recommended as an effective preventive strategy against sexually transmitted infections, in addition to several methods such as increasing screening and counseling, delivering education related to abstinence, using condoms, reducing the habit of changing sexual partners, and testing for HIV early so that it can start immediately antiretroviral therapy. There were a lot of controversy surrounding male circumcision. The correct procedure for circumcision can be beneficial, although short-term surgical complications and suspected long-term harm are also possible. Infeksi menular seksual (IMS) merupakan ancaman bagi masyarakat pada era kesehatan global. Data World Health Organization (WHO) menyatakan bahwa lebih dari 1 juta kasus IMS ditemukan setiap hari di seluruh dunia. Peningkatan jumlah kasus IMS mengharuskan tenaga medis untuk memikirkan berbagai tindakan preventif agar semakin hari kasus tidak semakin bertambah. Pencegahan terhadap adanya IMS dapat dilakukan dengan beberapa langkah konvensional diantaranya setia pada satu pasangan dan menggunakan kondom saat berhubungan seksual. Terdapat pertimbangan dalam kuantitas dan kualitas bukti ilmiah yang mendokumentasikan keamanan dan manfaat kesehatan pada pria yang telah disirkumsisi sebagai salah satu metode pencegahan IMS. Sirkumsisi pada pria telah muncul sebagai sarana dalam mengurangi transmisi infeksi menular seksual. Dalam beberapa dekade terakhir, beberapa penelitian telah menghasilkan bukti mengenai efek sirkumsisi pada pria dalam transmisi human immunodeficiency virus (HIV). Sirkumsisi pada pria dianjurkan sebagai strategi pencegahan yang efektif terhadap infeksi menular seksual, selain dengan beberapa metode seperti meningkatkan skrining dan konseling, penyampaian edukasi terkait dengan abstinensia, penggunaan kondom, mengurangi kebiasaan berganti-ganti pasangan seksual, dan tes HIV lebih dini sehingga dapat segera memulai terapi antiretroviral. Banyak kontroversi seputar sirkumsisi pada pria. Prosedur tindakan sirkumsisi yang benar bisa membawa manfaat, meskipun komplikasi bedah jangka pendek dan dugaan kerugian jangka panjang juga masih mungkin terjadi.
Kehamilan dengan miastenia gravis: laporan kasus Anthonyus Gracius Bima Pakasi; Made Bagus Dwi Aryana; Anna Marita Gelgel
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 (349.694 KB) | DOI: 10.15562/ism.v11i3.838

Abstract

Introduction: Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission characterized by weakness of the skeletal muscles. Pregnancy with myasthenia gravis must have particular concern because of changes in body physiology and potential myastenic attack which can be dangerous if it is not recognized quickly and received adequate treatment. The aim of this case report is to provide an overview of the treatment of pregnancies with myasthenia gravis.Case: A case report of a 32 year old woman who came with complaints of dyspnoea, and was known to have a history of myasthenia gravis that had been experienced for seven years and received pyridostigmine therapy 4x60 mg orally. Severe tightness was accompanied by coughing and caused the saturation to fall below 95%, and it was decided to give intravenous neostigmine, and the tightness dramatically improved. Ultrasound evaluation of pregnancy showed, gestational age 33 weeks and estimated fetal weight 2525 grams and decided for monitoring and conservative therapy and administration of 12 grams of dexamethasone intra-muscular for maturation of fetal lungs. At 36 weeks of gestation the patient came back because of vaginal discharge and an examination was carried out so that non-reactive non-stress test results were found and it was decided to do a caesarian section immediately, until finally a baby boy weighing 3000 grams APGAR 8-9 was born, without any abnormalities. The mother was discharged in good condition and was still receiving pyridostigmine 4x60 mg orally.Conclusion: Myasthenia gravis in pregnancy is something that is rarely found, but it requires special attention to mothers and babies because it can cause mortality if not handled properly. Precautions and proper handling during myastenic attacks will give a better clinical outcome. Pendahuluan: Miastenia gravis (MG) adalah gangguan autoimun dari transmisi neuromuskuler yang ditandai dengan kelemahan otot skeletal. Kehamilan dengan miastenia gravis menjadi perhatian khusus oleh karena perubahan fisiologi tubuh dan adanya ancaman serangan miastenik yang dapat membahayakan apabila tidak diketahui secara cepat dan mendapatkan penanganan yang adekuat. Tujuan dari laporan kasus ini adalah memberikan gambaran penangnan terhadap kehamilan dengan miastenia gravis.Kasus: Laporan kasus perempuan usia 32 tahun yang datang dengan keluhan sesak, dan diketahui memiliki riwayat miastenia gravis yang sudah dialami semenjak tujug tahun dan mendapat terapi piridostigmin 4x60 mg per oral. Sesak yang berat disertai dengan batuk dan menyababkan saturasi turun hingga dibawah 95%, dan diputuskan untuk memberikan neostigmine intravena, dan secara dramatis sesak membaik. Evaluasi ultrasonografi kehamilan menunjukkan, usia kehamilan 33 minggu dan tafsiran berat janin 2525 gram dan diputuskan untuk monitoring dan terapi konservatif dan pemberian deksamethason 12 gram intra muskular untuk pematangan paru janin. Pada usia kehamilan 36 minggu pasien kembali datang oleh karena keluar air pervaginam dan dilakukan pemeriksaan sehingga ditemukan hasil non stress test non reaktif dan diputuskan untuk melakukan tindakan caesarian section segera, hingga akhirnya lahir bayi laki-laki berat 3000 gram APGAR 8-9, tanpa kelainan kongenital. Kondisi ibu dipulangkan dengan keadaan baik dan tetap mendapat terapi piridostigmin 4x60 mg per oral.Simpulan: Miastenia gravis pada kehamilan merupakan suatu hal yang jarang ditemukan, namun memerlukan perhatian khusus pada ibu juga pada bayi karena dapat menimbulkan mortalitas bila tidak tertangani dengan baik. Kewaspadaan dan penanganan yang tepat saat serangan miastenik akan meberikan luaran klinis yang lebih baik.
Staphylococcus aureus sebagai agen penyebab infeksi pada kasus erisipelas kruris dekstra dengan liken simpleks kronikus Anak Agung Indah Jayanthi; Ni Made Adi Tarini; I Gusti Ayu Agung Praharsini
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 (1114.512 KB) | DOI: 10.15562/ism.v11i3.839

Abstract

Background: Erysipelas is a skin and soft tissue infection that affects the epidermis and superficial dermis as well as superficial lymphatic vessels. Erysipelas can occur due to the entry of bacteria through the skin barrier that is not intact and can occur in other medical conditions such as in patients with lichen simplex chronicus.Case presentation: A man, aged 62, Javanese, came to the Sanglah Hospital Emergency Room because of swelling, redness, and pain in the right calf since 2 days ago and complained of itching in the right lower leg since 1 week ago. The patient has a 1-year history of lichen simplex chronicus and has received medication. Physical examination found the presence of erythema patch efflorescence, warm palpation of the touch, non-pitting edema, pain on pressure, and diascopy test of blanching on pressure. The results of the wound bed culture examination showed the isolation of S. aureus. Intravenous fluids, open compresses, antibiotics, pain relievers, and anti-inflammatory creams were given to patients who experienced improvement on day 8.Discussion: The diagnosis of erysipelas is determined from the patient's complaints and the clinical picture from the results of the physical examination. In erysipelas, microbial pathogens enter through skin damage, then spread locally and systemically. Antibiotics have become the standard in the management of erysipelas by bacterial infections. The administration of ceftriaxone antibiotics was carried out based on the results of the sensitivity test also obtained on the results of the isolation of sensitive S. aureus bacteria.Conclusion: Diagnosis of erysipelas is based on history, physical examination, and investigation. Management of patients includes open compresses, administration of fluids, antibiotics, pain relief, and use of anti-inflammatory creams.
Hubungan derajat keparahan preeklamsia dengan kejadian asfiksia neonatorum di Rumah Sakit Umum Negara periode Januari 2019 - Januari 2020 I Gde Ketut Fendy Indrapermana; Iswara Somadina Duarsa
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 (296.854 KB) | DOI: 10.15562/ism.v11i3.840

Abstract

Background: Preeclampsia is one of complication in pregnancy and the causal of maternal morbidity and mortality. There is an impairment of blood flow to placenta vascularization which lead to tissue hypoxia and increase the chance to develop asphyxia neonatorum. The aim of this study is to know the correlation between severity of preeclampsia and asphyxia neonatorum in Negara General Hospital on January 2019-January 2020.Methods: The design of this study was observational analytic cross-sectional. Woman who was diagnosed with preeclampsia and delivered in Negara General Hospital, Jembrana between January 2019-January 2019 were included by total sampling. Data, such as maternal age, parity, mode of delivery, severity of preeclampsia and asphyxia neonatorum, were collected from medical record. Then, data was analyzed bivariate using chi-square test and prevalence ratio (PR) analysis was conducted. The value of p<0,05 was considered significant.Results: As many as 170 women with preeclampsia were recruited in the study. The prevalence of birth asphyxia was 71,2% in this study. Majority of women were 20-35 years old (67,1%), parity 2-3 (50,6%), had assisted-delivery (74,7%) and severe preeclampsia (72,9%). A bivariate analysis showed the prevalence of asphyxia neonatorum was significantly higher in assisted-delivery (PR=2,541, p=0,036; 95% CI=1,044-6,188) and severe preeclampsia (PR=2,346, p=0,045; 95% CI=1,044-5,486).Conclusion: Mode of delivery and severity of preeclampsia is associated with asphyxia neonatorum. Early identification and proper antepartum management were essential to prevent asphyxia neonatorum in mother with risk factors.  Latar Belakang: Preeklampsia adalah salah satu komplikasi kehamilan dan penyebab morbiditas dan mortalitas maternal. Kondisi ini menyebabkan gangguan aliran darah ke vaskularisasi plasenta sehingga dapat menimbulkan hipoksia jaringan dan berpotensi menyebabkan asfiksia neonatorum. Penelitian ini bertujuan untuk mengetahui hubungan antara derajat keparahan preeklampsia dan kejadian asfiksia neonatorum di Rumah Sakit Umum (RSU) Negara.Metode: Penelitian ini menggunakan rancangan analitik observasional desain potong-lintang. Sampel penelitian adalah wanita yang terdiagnosis dengan preeklampsia dan menjalani persalinan di RSU Negara, Jembrana dalam kurun waktu Januari 2019 – Januari 2020 yang dikumpulkan secara total sampling. Data berupa usia maternal, paritas, metode persalinan, derajat preeklampsia, dan kejadian asfiksia neonatorum didapatkan dari rekam medis. Data kemudian dianalisis secara bivariat dengan uji chi-square dan dilakukan analisis prevalence ratio (PR). Hubungan dikatakan signifikan apabila diperoleh nilai p<0,05.Hasil: Penelitian ini mengikutsertakan 170 pasien yang memenuhi kriteria inklusi dan eksklusi. Sebanyak 71,2% kejadian asfiksia neonatorum tercatat dalam penelitian ini. Mayoritas ibu berusia 20-35 tahun (67,1%), memiliki paritas 2-3, melakukan persalinan dengan tindakan (74,7%), dan mengalami preeklampsia berat (72,9%). Berdasarkan hasil uji bivariat, prevalensi kejadian asfiksia neonatorum lebih tinggi pada persalinan dengan tindakan (PR=2,541, p=0,036; Confidence interval (CI) 95% 1,044-6,188) dan preeklampsia berat (PR=2,346, p=0,045; CI 95% 1,044-5,486).Simpulan: Metode persalinan dan derajat preeklampsia berhubungan dengan kejadian asfiksia. Deteksi dini dan penanganan anterpartum yang tepat dapat membantu mencegah kejadian asfiksia neonatorum pada ibu yang berisiko.
Sindroma emboli lemak pada kasus trauma orthopedi: sebuah tinjauan pustaka Angga Dharmayuda; Anak Agung Ngurah Ronny Kesuma; Komang Mahendra Laksana
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 (433.715 KB) | DOI: 10.15562/ism.v11i3.841

Abstract

Fat embolism (FE) is defined as fat embolism circulating in the bloodstream, with or without symptoms. Fat embolism syndrome (FES) is a circulatory fat embolism which is a secondary complication and causes specific clinical manifestations in the lungs, brain, skin. This incident is often found in orthopedic trauma, especially in long bone trauma, pelvis, and multiple trauma. In non-traumatic cases, such as hip or knee arthroplasty, FES may also be present. Gurd and Wilson's current criteria can help guide the diagnosis, but at this time there are no standardized diagnostic tests. There is no definitive therapy for FES and only supportive therapy.  Emboli lemak (FE) didefinisikan sebagai emboli lemak yang beredar di aliran darah, dengan atau tanpa gejala. Fat Embolism Syndrome (FES) adalah emboli lemak peredaran darah yang merupakan komplikasi sekunder dan menyebabkan manifestasi klinis spesifik di paru-paru, otak, kulit. Kejadian ini sering ditemukan pada trauma ortopedi, terutama pada trauma tulang panjang, trauma panggul, dan trauma multipel. Dalam kasus non-traumatis, seperti artroplasti pinggul atau lutut, FES juga mungkin dapat ditemukan. Kriteria Gurd dan Wilson saat ini dapat membantu memandu diagnosis, tetapi saat ini belum ada tes diagnostik standar. Tidak ada terapi definitif untuk FES dan hanya terapi suportif.
Kesesuaian hasil pengukuran Low Density Lipoprotein Cholesterol menggunakan persamaan Friedewald, Hopkins, dan Homogeneous Enzymatic Colorimetric Assay di RSUP Sanglah, Bali, Indonesia I Made Dharma Pramana; Ida Ayu Putri Wirawati; Ni Nyoman Mahartini
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (327.587 KB) | DOI: 10.15562/ism.v12i1.842

Abstract

Background: LDL-C concentration can be obtained by calculation from equations and measurement methods. There are many LDL-C equations, but the most commonly used is the Friedewald equation, and the most recent is the Hopkins equation. This study aims to determine LDL-C measurements' agreement using the Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay.Methods: This was a cross-sectional study, from January-February 2020, with 570 samples LDL-C examination results by Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay divided into 3 groups based on TG levels. Data were analyzed by SPSS version 17 for Windows.Results: Spearman correlation test found a near-perfect correlation between LDL-C using Friedewald and Hopkins equations to direct examinations with values r =0.921 and r =0.907. Limit of agreement from the Bland-Altman test shows an average of >90% for both equations with direct measurements. Mann-Whitney test showed a significant difference between LDL-C direct measurement and Friedewald equation in Total Group, TG 200-400 mg/dL and TG> 400 mg/dL while for Hopkins equation only in TG group> 400 mg/dL (p<0.05). Based on Total Allowable Error (TAE) analysis, LDL-C from Hopkins equation in TG group 200-400 mg/dL appears to be superior to the Friedewald equation.Conclusion: Friedewald equation and Hopkins equation give good concordance at TG levels <200 mg/dL while at triglyceride levels 200-400 mg/dL Hopkins equation gives better concordance than the Friedewald equation. At triglyceride levels,> 400 mg/dL Friedewald and Hopkins equations show low accuracy, so it is recommended to use the direct method. Latar Belakang: Konsentrasi low density lipoprotein cholesterol (LDL-C) dapat diperoleh dengan 2 cara yaitu menggunakan perhitungan dengan persamaan dan metode pengukuran langsung (direct). Banyak persamaan perhitungan LDL-C tetapi yang paling umum digunakan adalah persamaan Friedewald dan yang terbaru adalah persamaan Hopkins. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil pengukuran LDL-C menggunakan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assayMetode: Penelitian menggunakan rancangan analitik potong lintang dari bulan Januari-Pebruari 2020 dengan 570 sampel hasil pemeriksaan LDL-C dengan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assay yang dibagi 3 kelompok berdasarkan kadar trigliserida (TG). Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Uji statistik Spearman didapatkan korelasi mendekati sempurna antara  LDL-C menggunakan persamaan Friedewald dan Hopkins terhadap pemeriksaan direct dengan nilai r=0,921 dan r=0,907. Limit of agreement dari uji Bland-Altman menunjukkan rata-rata > 90% untuk kedua persamaan dengan pengukuran direct. Uji Mann-Whitney menunjukkan perbedaan bermakna antara LDL-C pengukuran direct dengan persamaan Friedewald pada Kelompok Total, TG 200-400 mg/dL dan TG >400 mg/dL sedangkan untuk persamaan Hopkins perbedaan hasil yang bermakna hanya pada kelompok TG >400 mg/dL (p<0,05). Berdasarkan analisis Total Allowable Error (TAE), LDL-C persamaan Hopkins pada kelompok TG 200-400 mg/dL lebih unggul dari persamaan Friedewald.Kesimpulan: Persamaan Friedewald dan persamaan Hopkins memberikan kesesuaian yang baik pada kadar TG <200 mg/dL sedangkan pada kadar trigliserida 200-400 mg/dL, persamaan Hopkins memberikan kesesuaian yang lebih baik daripada persamaan Friedewald. Pada kadar TG >400mg/dL persamaan Friedewald dan Hopkins menunjukkan akurasi yang rendah sehingga disarankan untuk menggunakan metode direct.
Comparison between negative pressure and conventional wound dressing for diabetic foot ulcer: A systematic review I Gusti Ayu Agung Bella Jayaningrum; Anak Agung Istri Ayu Detritha Sarasmartha Putri; Pretty Clarresa
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (375.986 KB) | DOI: 10.15562/ism.v11i3.844

Abstract

Background: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus (DM), resulting in loss of limb or life. Negative pressure wound therapy (NPWT) is an emerging therapeutic option in the management of DFU. This study aims to compare the efficacy of NPWT to conventional moist wound dressing in the management of DFU.Methods: Literature was searched from online public scientific databases, including PubMed, Google Scholar, ScienceDirect, and Portal Garuda. Our review included clinical trials and analytic studies comparing NPWT and conventional moist dressing to treat DFU published in 2017 or later. Outcome measures include the proportion of wound healing, healing time, ulcer size reduction, granulation time, amputation, infection, and bleeding.Results: We include 11 articles, including eight randomized clinical trials (RCTs), two retrospective analytic studies, and one non-random clinical trial. There was methodological variation between studies on the application of NPWT, outcome measures reported, and length of follow up. Results mostly showed NPWT yielded a higher proportion of complete wound healing, shorter healing time, granulation time, and faster ulcer size reduction rate. However, NPWT was not associated with a reduction of amputation risks.Conclusions: Our review found NPWT was superior in short-term treatment outcomes such as granulation time and wound closure; however, there was no difference in reducing amputation risk between NPWT and conventional moist dressing. Results are inconclusive due to variation in methodologies of included articles.
Constipation that needs attention: late Hirschsprung disease Kristin Agustina; Ni Nyoman Margiani; Pande Putu Yuli Anandasari; Ni Made Mahastuti
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (920.816 KB) | DOI: 10.15562/ism.v12i1.845

Abstract

Background: Hirschprung disease (HD) or congenital aganglionic megacolon is an intestinal motor disorder that occurs in approximately 1 in 5000 live births. It makes colon fail to relax, mainly producing the symptoms of constipation. Approximately 90% of cases are diagnosed in the first year of life. Most of the remaining 10% are made in early childhood, with less than 1% being made in teenagers or adulthood.Case report: A 13 years old girl reported to the pediatric surgical outpatient department complaining constipation since birth. There was no history of delayed passage of meconium. A contrast enema study with water-soluble contrast showed high probability of ultrashort segment HD. Histopathological examination revealed neither nerve fibers with ganglion cells nor hypertrophy of nerve fibers were seen confirming the aganglionosis. Surgical treatment was performed with good clinical progression. Conclusion: Despite of its rarity, the possibility of HD should be considered in teenagers with chronic refractory constipation, especially when there was a history of delayed or non-passage of meconium after birth. An accurate diagnosis is mainly based on collective assessment of medical history, clinical examination, contrast enema study, and rectal biopsy as a gold standard. 

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