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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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Brittle bone brothers: osteogenesis imperfecta conventional serial case Marsha Ruthy Darmawan; Elysanti Dwi Martadiani
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Osteogenesis Imperfecta (OI) is a heredity connective tissue disorder due to COL1A1/2 gene mutation, causing a defect in encoding proteins to metabolize collagen. One of OI’s manifestations to musculoskeletal is bone incompetence, hence the name Brittle bone disease. We report three cases of OI type IV in adults with pathognomonic radiology findings.Case Presentation: In Case 1, a 40-year-old Indonesian male came to the hospital with small stature and unsuited with his age. Conventional radiology examination found OI on all four extremities, anterior dislocation of left shoulder, and old fracture with an acute angle in the left radial shaft. In Case 2, a 41-year-old Indonesian male came to the hospital with short stature, causing limitation to his activities, and he confessed always to be shorter than people his age. Radiology evaluation suggests an OI in bilateral superior and inferior extremities, old fractures in the right humeral shaft also the left clavicle, acute angles right radius-ulna shaft, and osteoporosis in all visualized bones. In addition, in Case 3, a 42-year-old Indonesian male came to the hospital with short stature and pain within his bones, causing limitation to his activity. Conventional radiology imaging shows bilateral superior and inferior extremities, old fracture in the medial third of the left humerus and bilateral femur, acute-angled bilateral antebrachial-femur-cruris, and osteoporosisConclusion: Based on OI categorization, only type I and IV can live to adulthood, and the same type of OI can be found in siblings. Conventional radiology imaging provides a great help in diagnosing OI.

Manifestasi klinis dan penanganan demam berdarah dengue grade 1: sebuah tinjauan pustaka Desak Putu Rendang Indriyani; I Wayan Gustawan
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Introduction: Dengue Hemorrhagic Fever (DHF) is a disease caused by the Dengue virus from the Flavivirus genus, Flaviviridae family, with four serotypes (DEN-1. DEN-2, DEN-3, and DEN-4). Primary dengue fever Grade 1 should receive serious attention by monitoring the patient's clinical manifestations so that patients get the right therapy immediately. If it is not treated quickly and adequately, the patient can experience an emergency with signs of shock and cause death.Method: The writing methodology used is a literature review. The literature source consists of relevant journals and books from the search engines PubMed, Google Scholar, and Proquest.Results: Dengue virus infection can be asymptomatic and symptomatic. Symptomatic dengue virus infection generally has a clinical spectrum grouped into 3, namely undifferentiated fever, dengue fever, and dengue hemorrhagic fever. Dengue fever (DD) patients who have no comorbidities and social indications can be treated as outpatients. Patients are given symptomatic treatment in the form of antipyretics such as paracetamol at a dose of 10-15 mg/kg/body weight, repeated 4-6 hours if fever. The management of dengue hemorrhagic fever (DHF) is symptomatic and supportive. Supportive therapy in the form of fluid replacement, which is the main point in managing DHF.Conclusion: In patients with dengue hemorrhagic fever grade I, close monitoring is needed regarding their clinical condition. This is because grade 1 dengue has the potential to be a more critical clinical condition. Early treatment will determine a better outcome.Â Â Pendahuluan: Demam Berdarah (DB) disebabkan oleh vÃrus Dengue (genus Flavivirus), dengan empat serotipe utama, yaitu DEN1. DEN2, DEN3 dan DEN4. Penyakit DB utamannya Demam berdarah dengue (DBD) Grade 1 harus mendapat perhatian serius, salah satunya dengan melakukan monitoring manifestasi klinis pasien agar pasien mendapatkan terapi yang tepat dengan segera. Apabila tidak diatasi dengan tepat dan cepat pasien dapat mengalami kegawatan dengan tanda-tanda syok dan dapat menyebabkan kematian. Tinjauan Pustaka ini bertujuan untuk memberikan informasi terbaru mengenai tanda-tanda klinis DBD grade 1 agar praktisi dapat memberikan penanganan terbaik sebelum jatuh pada kondisi kritisMetode: Dalam penulisan ini digunakan metode tinjauan pustaka. Sumber bacaan berasal jurnal-jurnal dan buku-buku yang relevan dan sesuai dari PubMed dan Google Scholar.Hasil: Manifestai klinis DB dapat tidak bergejala (asimtomatik) dan bergejala simtomatik. Pasien dengan gejala dengue secara umum memiliki tiga jenis spektrum klinis yaitu demam yang tidak terdiferensiasi, demam dengue, dan demam berdarah dengue.. Pasien demam dengue (DD) yang tidak memiliki komorbiditas dan indikasi sosial dapat diperlakukan sebagai pasien rawat jalan. Pasien diberikan pengobatan simptomatik berupa anitpiretik seperti parasetamol dengan dosis 10-15 mg/kg/BB/dosis, diulang 4-6 jam bila demam. Tatalaksana demam berdarah dengue (DBD) diberikan secara simtomatis (sesuai gejala) dan suportif. Penanganan suportif dapat diberikan berupa cairan tambahan yang merupakan poin utama dalam penatatalaksanaan DBD.Kesimpulan: Pada pasien demam berdarah dengue derajat I diperlukan pemantauan yang ketat terkait kondisi klinis pasien. Hal ini dikarenakan DBD grade 1 berpontensi menjadi kondisi klinis yang lebih kritis. Penanganan dini akan menentukan outcome yang lebih baik.

Penanganan terkini diare pada anak: tinjauan pustaka Desa Putu Rendang Indriyani; I Gusti Ngurah Sanjaya Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Diarrhea still ranks third as the leading cause of death for children under five years. It is estimated that as many as 800,000 deaths under five years were caused by diarrhea in 2010; 11% of the total deaths were under five yearsâ€”about 80% of these deaths occurring in Africa and Southeast Asia.Methods: This manuscript's writing used the literature review method in which a detailed search was carried out on the document in national and international databases.Results and Discussion: The leading cause of diarrhea in children is a virus. The most commonly known virus is Rotavirus (40â€“60%). Viruses that enter through food and drink to enterocytes will cause infection and damage to the small intestine villi. According to WHO, there are five lines of diarrhea management, namely: adequate rehydration, zinc, nutrition, appropriate antibiotics, and education.Conclusion: With good diarrhea management, diarrhea has a good prognosis. Death in sufferers of diarrhea is caused by severe dehydration and secondary malnutrition.Â Â PendahuluanÂ : Diare masih menempati urutan ketiga sebagai penyebab kematian terbanyak untuk anak-anak dibawah lima tahun. Diperkirakan sebanyak 800.000 kematian dibawah lima tahun disebabkan oleh diare pada tahun 2010, yang merupakan 11% dari total kematian dibawah lima tahun. Dengan sekitar 80% kematian ini terjadi di Afrika dan Asia tenggara.Metode: Penulisan naskah ini menggunakan metode tinjauan pustaka dimana dilakukan penelusuran terdahap naskah pada database nasional dan internasional.Hasil dan Diskusi: Penyebab utama diare pada anak oleh virus, virus terbanyak yang diketahui adalah jenis Rotavirus (40â€“60%). Virus dapat masuk kedalam tubuh melaui makanan dan minuman yang dikonsumsi. Setelah sampai sampai ke enterosit, virus akan menimbulkan infeksii dan kerusakan pada villii usus, terutama usus halus. Menurut badan kesehatan dunia (WHO) dipublikaskan lima lintas penatalaksanaan diare, diantaranyai: pemberian carian yang adekuat, pemberian suplement zinc, lanjutkan nutrisi sesuai, pemberian antibiotik bila diperlukan, dan edukasi orang tua.Kesimpulan: Dengan penatalaksanaan diare yang baik, diare memiliki prognosis yang baik. Dominan, angka kematian anak yang mengalami diare disebabkan oleh karena dehidrasi berat serta malnutrisi sekunder yang tidak tertangani dengan baik.

Evaluation of modified unilateral nasoplasty in patient with post operation of unilateral labioplasty at Malahayati Hospital Banda Aceh: a cohort study from 2017-2019 Devyana Enggar Taslim; Muhammad Taufik; Muhammad Jailani; Syamsul Rizal; Mirnasari Amirsyah
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Nasal deformity associated with a cleft lip has been viewed as one of the most challenging reconstructive rhinoplasty problems.The common clinical features associated with cleft lip nasal deformity are its lack of symmetry, alar collapse on the affected side, short nasal length, loss of tip definition, obtuse nasal labial angle, and altered columella show among others. This study aims to evaluate the modified unilateral nasoplasty in a patient with post-operation of unilateral labioplasty at Malahayati Hospital Banda Aceh as a cohort study.Methods: We conducted a retrospective cohort study involving 139 patients who completed the unilateral rhinoplasty operation at Malahayati Hospital from January 2017 to November 2019. Demographic information was recorded, such as the ratio between pre–operation and post–operation, gender, and age. Data were analyzed using SPSS version 20 for Windows.Results: Our results have shown the comparison between cleft nose before rhinoplasty and cleft nose after rhinoplasty is 0.26 vs. 0.58 cm. The patients who came to the hospital to do the unilateral rhinoplasty surgery are 81.00%. Females (61.20%) experienced rhinoplasty more dominant compare to man (38.80%), and the highest age average is between 1 year old until 7 years old (71.00%)Conclusion: Improvement in procedure’s duration and better positioning of both nasal tip and nostril. Expected improvements in terms of aesthetics and functions were observed, but further documentation is still needed.

Hubungan antara pengetahuan dengan praktik pemenuhan gizi seimbang oleh ibu pada anak usia 1-5 tahun di Desa Pepelegi Kecamatan Waru Kabupaten Sidoarjo Maria Natalia Indawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Practice of balanced nutrition fulfillment is an action to meet the nutritional needs of a person according to the needs of the body that can ultimately prevent the emergence of nutritional problems. Practice itself can be influenced by various factors, one of which is knowledge of balanced nutrition fulfillment.Aim: The study aims to determine a correlation between knowledge and the practice of balanced nutrition fulfillment.Methods: The observational analytic study involved randomly 63 samples of 882 maternal who had children aged 1-5 years in Pepelegi Village of Waru Sub-district, Sidoarjo Regency. The data consist of a knowledge group and practice one.Results: There was a correlation between knowledge and practice of balanced nutrition fulfillment of the participants (p<0.05). Most of them aged 31-40 years, with the majority of highest education level was senior high school. Most participants had sufficient levels of knowledge and good balanced nutrition fulfillment practices.Conclusion: Knowledge supplies a great practice of balanced nutrition fulfillment so either health promotion or counseling should be provided by the community health service. Latar Belakang: Praktek pemenuhan gizi seimbang merupakan suatu tindakan untuk memenuhi nutrisi seseorang sesuai dengan kebutuhan tubuh yang pada akhirnya dapat mencegah timbulnya permasalahan gizi. Praktik sendiri dapat dipengaruhi oleh berbagai faktor, salah satunya pengetahuan tentang pemenuhan gizi seimbang.Tujuan: untuk mengetahui hubungan antara pengetahuan dengan praktik pemenuhan gizi seimbang oleh ibu pada anak usia 1-5 tahun di Desa Pepelegi, Kecamatan Waru Kabupaten Sidoarjo.Metode: Penelitian analitik observasional ini melibatkan 63 sampel dari 882 ibu yang memiliki anak usia 1-5 tahun di Desa Pepelegi yang diambil secara acak. Mereka dibagi sebagai kelompok pengetahuan dan kelompok praktek pemenuhan gizi seimbang.Hasil: Terdapat hubungan antara pengetahuan dan praktik pemenuhan gizi seimbang (p<0,05). Sebagian besar responden berusia antara 31-40 tahun dengan mayoritas tingkat pendidikan terakhir adalah sekolah menengah atas (SMA). Sebagian besar responden memiliki tingkat pengetahuan yang cukup serta praktek pemenuhan gizi seimbang yang baik.Simpulan: Pengetahuan turut mempengaruhi praktik pemenuhan gizi seimbang sehingga perlu penyuluhan berkesinambungan serta praktek pemenuhan gizi seimbang yang diberikan oleh puskesmas.

Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka Andre Hendrajaya
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Management of type II diabetes mellitus is a science that continues to develop. Treatment of type II diabetes mellitus can affect various organ functions, one of which is the kidneys, which function to excrete glucose, namely SGLT II inhibitors. The class of sodium-glucose transport protein 2 (SGLT2) inhibitors has a new mechanism of action and is complementary to the older drugs used to treat type II diabetes. The sodium-glucose cotransporter-2 (SGLT2) protein is expressed in the proximal tubule of the renal convolution. These transporters are ideal targets for the treatment of diabetes because they account for approximately 90% of filtered glucose reabsorption SGLT2 inhibitors can be a useful option in obese and hypertensive patients because of their weight loss and antihypertensive benefits and thus benefit cardiovascular function. Patients at high risk for hypoglycemia may benefit from a combination of metformin and SGLT2 inhibitors because the risk of hypoglycemia with SGLT2 inhibitors is small when compared with insulin and sulfonylurea. Tatalaksana DM mellitus tipe II merupakan ilmu yang terus berkembang. Pengobatan DM tipe II dapat mempengaruhi berbagai fungsi organ, salah satunya adalah ginjal yang berfungsi untuk mengeksreksikan glukosa yakni penghambat SGLT II. Kelas obat penghambat sodium-glukosa transport protein 2 (SGLT2) memiliki karakteristik ini, dan mekanisme aksi yang baru melengkapi obat yang lebih lama yang digunakan untuk mengobati DM tipe II. Protein sodium-glukosa cotransporter-2 (SGLT2) diekspresikan dalam tubulus proksimal konvolusi ginjal. Transporter ini adalah target yang ideal untuk pengobatan diabetes karena mereka bertanggung jawab atas sekitar 90% dari reabsorpsi glukosa yang difiltrasi Inhibitor SGLT2 dapat menjadi pilihan yang berguna pada pasien obesitas dan hipertensi karena penurunan berat badan dan manfaat antihipertensi sehingga memberikan manfaat terhadap fungsi kardiovaskular. Pasien yang berisiko tinggi untuk hipoglikemia dapat mengambil manfaat dari kombinasi metformin dan inhibitor SGLT2 karena risiko hipoglikemia dengan inhibitor SGLT2 kecil jika dibandingkan dengan insulin dan sulfonylurea.

Incidence report of traumatic brain injury in Mimika Public Hospital Papua Kevin Kristian Putra; Putu Ayu Indra Shanti Wardani; I Wayan Niryana
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: Traumatic brain injury is a functional brain disorder caused by an external force, which giving persistent consequences, progressive, long-term care, and rehabilitation might be needed. It is also called a “silent epidemic” due to the increased global incidence rate, socio-economic burden, and quality of life. The major cause of TBI was road traffic injury, fall, and blunt trauma.Methods: This research was conducted with a descriptive research design using a prospective cross-sectional design. The research sampling was using medical records in accordance with inclusion and exclusion criteria from 2018 to 2019.Result: The collected sample was 393 cases. There were 66.16% and 67.18% cases occurred to man and productive age with incidence rate 178.89 in 100.000 people. The major cause of TBI was road traffic injury and intentional injury with 58.52% and 24.17% consecutively. The involvement of alcohol in TBI cases was found in 24.42% of cases. The usage of the helmet was not found in 96.6% of cases of RTI.Conclusion: The majority of TBI patients at Mimika Public Hospital in 2018-2019 occurred in men and in the productive age, which was majorly caused by road traffic injury and intentional injury.

Profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal rumah sakit tersier Godfried Erycesar Yeremia Saragih; I Dewa Nyoman Wibawa; I Ketut Mariadi; Gde Somayana
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Investigating constipation requires careful evaluation of general examinations cascaded into specifics to identify treatable or significant causes for early detection. This study aims to determine patients' clinical profile with symptoms of motility disorders, predominantly constipation, in the gastrointestinal endoscopy unit of the tertiary hospital.Methods: This descriptive cross-sectional study involved 82 participants collected through consecutive sampling. Patients with predominant constipation symptoms who underwent colonoscopy in Sanglah Hospital Endoscopy Unit from 2017 to 2018 were recruited. Primary data comprising clinical assessments, laboratory test results, and colonoscopy and histopathology interpretation were analyzed accordingly. Constipation and fecal incontinence severity was indicated by Patient Assessment of Constipation – Symptoms (PAC-SYM) and Jorge-Wexner score. Data was analyzed using SPSS version 25 for Windows.Results: Most of the respondents were male (62.2%). The PAC-SYM and Jorge-Wexner Score were relatively low, with mean values of 2.44±0.73 and 2.18±0.99, respectively. The prevalence of patients initially assessed with chronic constipation (57.32%) remained high (26.83%) despite adjustment being done after colonoscopic exclusion.Conclusion: Diagnostic challenges of constipation exceeded the exhaustive efforts utilizing extensive diagnostic modalities. Suboptimal treatment would be inevitable in the absence of a good-quality management algorithm. Latar Belakang: Investigasi konstipasi memerlukan kecermatan dalam mengevaluasi pemeriksaan umum yang berjenjang menjadi spesifik untuk mengidentifikasi kausa yang dapat ditangani atau bermakna terhadap deteksi dini. Penelitian ini bertujuan untuk mengetahui profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal Rumah Sakit Tersier.Metode: Penelitian deskriptif potong lintang ini melibatkan 82 responden yang dikumpulkan melalui pengambilan sampel secara konsekutif. Pasien dengan gejala dominan konstipasi yang menjalani kolonoskopi di Unit Endoskopi RSUP Sanglah selama tahun 2017 hingga 2018 direkrut. Data primer yang terdiri dari penilaian klinis, hasil tes laboratorium, dan interpretasi kolonoskopi maupun histopatologi dianalisis. Tingkat keparahan konstipasi dan inkontinensia feses ditunjukkan pada skor Patient Assessment of Constipation – Symptoms (PAC-SYM) dan Jorge-Wexner. Data dianalisis menggunakan SPSS versi 25 untuk Windows.Hasil: Sebagian besar atau responden berjenis kelamin laki-laki (62,2%). Skor PAC-SYM dan Jorge-Wexner relatif rendah dengan nilai rata-rata masing-masing 2,44±0,73 dan 2,18±0,99. Prevalensi pasien yang awalnya dinilai dengan konstipasi kronis (57,32%) tetap tinggi (26,83%) meskipun penyesuaian dilakukan setelah eksklusi kolonoskopi.Simpulan: Tantangan diagnostik konstipasi melebihi upaya maksimal dengan memanfaatkan modalitas diagnostik yang luas. Terapi yang kurang optimal tidak dapat dihindari jika tidak ada algoritma manajemen yang berkualitas baik.

Chorioangioma in pregnancy: a case report Rio Yoga Erlambang; I Wayan Artana Putra
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Placental chorioangioma is a rare benign non-trophoblastic tumor of the placenta, derived from primitive chorionic mesenchyme. It can cause adverse outcomes on the mother and fetus, depending on its size. Most of the cases are accidentally detected during ultrasonography because small size tumors are usually asymptomatic. However, larger size of tumor can cause complications such as fetal anemia, fetal hydrops, polyhydramnios, premature birth, intrauterine growth restriction, and fetal death.Case report: A 27-year-old primigravida presented at Sanglah Hospital gynecology polyclinic at 27th-28th week of gestation. She was referred by an obstetric and gynecologist due to polyhydramnion since 26th-27th week of gestation. A 7.86 x 8.19 cm hypoechoic cysts with hyperechoic border were found during fetal scanning. Chorioangioma was suspected with SDP 9.11 cm. Amniocentesis was planned, however the patient had a premature uterine contraction. By this time, the fundal height was accordant with 31st-32nd week of gestation, and speculum examination showed rupture of membrane with 4 cm cervix dilation. Spontaneous vaginal delivery was performed and a boy neonate with 4/6 Apgar score and birth weight of 1150 g was delivered. Placenta was extracted out completely. There was no complication after delivery process. Macroscopic and microscopic placental examination confirmed the initial diagnosis, chorioangioma.Conclusion: Early management in determining the cause of polyhydroamnion is challenging and needs comprehensive investigation. Ultrasonography is a choice of method in initial detection of polyhydroamnion. Serial ultrasonography is needed to evaluate the amount of amniotic fluid and detect the probable cause of complications for mother, fetus, and delivery process. One of the complications is premature uterine contraction that causes premature birth. As a result, the fetus may not be viable and this remains one of the biggest challenges for clinicians. There are several possible causes that cannot be ruled out from polyhydroamnion differential diagnoses, such as a rare placental tumor chorioangioma.

The role of mean platelet volume (MPV) level as an independent predictor for varicocele in late adolescent Ryuu Damara Parisudha; I Gede Suwedagatha
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Recent studies have reported significant associations between varicocele and platelet volume indices (PVIs). PVIs are inexpensive and widely used indicators consisting of mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) and are related to platelet volume and function. The possibility of PVIs as a predictor for varicocele is yet to be exposed. This study aimed to assess the role of PVIs as a predictor for varicocele in the late adolescent.Methods: This retrospective case-control study involved 89 varicocele subjects (group I) and 89 healthy controls (group II) of similar age, stature, and body mass index. The data were consecutively taken from medical records at Bhayangkara Denpasar Hospital between January 2017 and May 2019. The diagnosis of varicocele was based on the findings from both physical examination and color doppler ultrasound (CDU). PVIs indicators were analyzed among the two groups. Statistical analysis was performed using receiver operating characteristic (ROC) curve to determine optimum cut-offs, bivariate chi-square test, and multivariate analysis using binary logistic regression, with p<0.05 considered statistically significant.Results: ROC curve analysis showed optimum cut-offs of 8.05, 12.05, and 15.1 for MPV, PDW and P-LCR respectively (Youden index: 0.494, 0.326, 0.292; p < 0.001, p <0.001, p=0.001 respectively). Chi-square test showed significant associations between the PVIs indicators and varicocele (p < 0.001). Binary logistic regression analysis revealed that MPV level of â‰¥ 8.05 is an independent predictor for late adolescent varicocele (OR=6.001; 95%CI 2.547-14.139; p < 0.001).Conclusion: MPV can be used as an independent predictor for assessing varicocele in the late adolescent.

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