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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Articles 1,063 Documents

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Penatalaksanaan liken amiloidosis dengan desoksimetason dan asam salisilat topikal: laporan kasus Harry Gunawan; Flora Anisah Rakhmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Cutaneous amyloidosis is characterized by the deposition of amyloid material in the dermis or epidermis, usually limited to the dermal papillae in local cutaneous amyloidosis. Dermal involvement could lead to skin thickening with a waxy surface. The prevalence of cutaneous amyloidosis is relatively rare, only 0.2 – 0.3 % and is more common in individuals with darker skin phototype. The aim of this study is to report a case of lichen amyloidosis associated with its treatment using a combination of desoxymethasone and salicylic acid.Case Report: We report a 27-year-old woman who came with multiple hyperpigmented papules, which were based on sharp-bordered brown macules with scales and lichenification that felt very itchy on both of her lower legs since 5 years ago. The same lesions also appeared on both her arms 2 years ago. She had skin phototype IV. She denied any history of chronic friction in those areas. On histopathological examination with hematoxylin and eosin (H&E) staining, amorphous deposits were found in the papillae dermis surrounded by melanophages. The patient was treated with topical therapy of 0.25% desoximetasone and 3% salicylic acid and was educated to avoid friction on the lesions. The patient admitted that the itchiness was reduced, but the lesion did not improve.Result: Based on the patient’s age and sex, she belonged to a less common group affected by lichen amyloidosis. Phototype skin IV was the risk factor identified in this case. She denied any history of chronic friction on her skin. Lichen amyloidosis was diagnosed based on a typical lesion found at the predilection sites and was confirmed with histopathological examination with H&E staining. Topical desoximetasone and salicylic acid didn’t result in clinical improvement.Conclusion: The diagnosis of lichen amyloidosis was confirmed with histopathological examination. H&E staining could demonstrate amyloid deposit clearly. Treatment of cutaneous amyloidosis is generally unsatisfactory and may require a combination of therapeutic modalities. Latar Belakang: Amiloidosis kutaneus merupakan deposisi material amiloid pada lapisan dermis atau epidermis, umumnya terbatas hingga papilla dermis pada kasus amiloidosis kutaneus lokal. Keterlibatan dermis dapat menyebabkan penebalan kulit dengan permukaan seperti lilin. Prevalensi amiloidosis kutaneus relatif jarang yaitu hanya 0,2-0,3 % dan lebih sering terjadi pada individu dengan fototipe kulit lebih gelap. Tujuan penelitian ini untuk melaporkan kasus liken amiloidosis terkait dalam penatalaksanaannya menggunakan kombinasi desoksimetason dan asam salisilat. Laporan Kasus: Dilaporkan pasien perempuan berusia 27 tahun memiliki papul multipel dengan hiperpigmentasi, dasar kulit makula kecoklatan berbatas tegas disertai skuama dan likenifikasi yang terasa sangat gatal pada area kedua tungkai bawah sejak 5 tahun yang lalu. Lesi yang sama juga muncul pada kedua lengan sejak 2 tahun yang lalu. Pasien memiliki fototipe kulit IV. Pasien menyangkal riwayat gesekan kronis pada area tersebut. Pada pemeriksaan histopatologis dengan pewarnaan hematoxylin dan eosin (H&E), didapatkan deposit amorf di dalam papilla dermis dikelilingi melanofag. Pasien mendapatkan terapi krim topikal desoksimetason 0,25 % dan asam salisilat 3 %, serta diedukasi untuk menghindari gesekan pada lesi. Pasien mengaku gatal berkurang, namun tidak didapatkan perbaikan pada lesi.Hasil: Berdasarkan usia dan jenis kelamin, pasien termasuk kelompok yang jarang terjadi liken amiloidosis. Kulit pasien tergolong dalam fototipe IV merupakan faktor risiko pada pasien. Pasien menyangkal adanya riwayat gesekan kronis. Diagnosis liken amyloidosis didasarkan lesi yang khas dengan lokasi sesuai predileksi dan diagnosis ditegakkan melalui pemeriksaan histopatologis dengan pewarnaan H&E. Terapi desoksimetason dan asam salisilat topikal tidak menunjukkan perbaikan secara klinis.Kesimpulan: Pewarnaan H&E dapat mendemonstrasikan deposit amiloid dengan baik. Terapi amiloidosis kutaneus umumnya tidak memuaskan dan mungkin membutuhkan kombinasi berbagai modalitas terapi.

Hubungan antara terapi statin dengan kadar gula darah puasa dan profil lipid pada pasien coronary artery disease di RSUD Sanjiwani I Gusti Ayu Inten Heny Pratiwi; Ketut Erna Bagiari; I Gede Bagus Gita Pranata Putra
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Statin therapy has an important role to coronary artery disease (CAD) which can lowered cholesterol levels and give pleiotropic effects to inhibit inflammatory reactions. Statin have some side effects and new onset diabetes is one of them, where diabetes is also a risk factor for CAD. This study aims to know the correlation of statin therapy and fasting blood glucose levels of CAD patient in Sanjiwani Hospital.Methods: The design of this study was analytic cross-sectional study that started from November 17th 2020 until January 31st 2021 in Sanjiwani Hospital. A total of 68 patients were included in this study. The data source of this study was secondary data from patient’s medical record. The inclusion criteria was all CAD patients with statin therapy who had history of fasting blood glucose test that visited cardiology department of Sanjiwani Hospital at year 2020. Normality test, bivariate, and multivariate analysis was done in this study.Results: Bivariate analysis using Spearman showed a weak positive correlation between duration of statin therapy with fasting blood glucose levels (r=0,353; p= 0,003), and Kruskal Wallis analysis showed no correlation between statin type with fasting blood glucose levels.Conclusion: Duration of statin therapy has a weak correlation with fasting blood glucose levels so that statin still can be given with concerns to its benefit of reduced mortality. Prevention of new onset diabetes should be done by lifestyle modification and periodic blood glucose monitoring. Latar Belakang: Terapi statin memiliki peranan penting terhadap coronary artery disease (CAD) yang mampu menurunkan kadar kolesterol serta memberikan efek pleiotropik untuk menghambat reaksi inflamasi. Statin memiliki beberapa efek samping, salah satunya adalah risiko diabetes onset baru dimana diabetes merupakan salah satu faktor risiko CAD. Penelitian ini dilakukan untuk mengetahui hubungan antara terapi statin dengan kadar gula darah puasa pasien CAD di RSUD Sanjiwani.Metode: Desain penelitian yang digunakan adalah analitik cross-sectional yang dilakukan dari 17 November 2020 sampai 31 Januari 2021 di RSUD Sanjiwani. Sebanyak 68 pasien diikutkan dalam penelitian ini. Sumber data pada penelitian ini berupa data sekunder yang didapatkan dari rekam medis pasien dengan kriteria inklusi yaitu semua pasien CAD dengan terapi statin dan memiliki riwayat pemeriksaan kadar gula darah puasa yang melakukan kontrol di poli jantung RSUD Sanjiwani tahun 2020. Uji normalitas, analisis bivariat, dan multivariat dilakukan pada penelitian ini.Hasil: Analisis bivariat dengan Spearman menunjukan adanya korelasi positif lemah antara durasi terapi statin dengan kadar gula darah puasa (r=0,353; p= 0,003), sedangkan hasil analisis Kruskall Wallis menunjukan tidak ada korelasi antara jenis statin dengan kadar gula darah puasa.Simpulan: Durasi terapi statin memiliki hubungan lemah dengan kadar gula darah puasa sehingga terapi statin masih dapat diberikan dengan memperhatikan keuntungan terapi yang lebih besar. Pencegahan terhadap risiko diabetes onset baru tetap dilakukan dengan modifikasi gaya hidup serta pemantauan gula darah berkala.

Case report of acute epiglottitis in a 44-year-old man: a rare case I Gusti Ayu Putu Wahyu Widiantari; Nyoman Dian Permatasari; Ida Bagus Semara Putra
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Acute epiglottitis, also known as supraglottitis or supraglottic laryngitis, is an acute inflammation of the supraglottic area of the larynx. The diagnosis can be made based on clinical signs and symptoms as well as several investigations.Case Description: We reported a case of a 44-year-old man who presented to our emergency department and whose condition was ultimately diagnosed as epiglottitis. Indirect laryngoscopy and lateral soft tissue neck radiograph had an important role in determining the diagnosis. The patient was treated conservatively by giving a high dosed antibiotic, anti-inflammatory, and analgesic drugs.Conclusion: Acute epiglottitis can be a life-threatening condition because it can cause sudden upper airway obstruction. Therefore, management must be given quickly and precisely so as not to fall into a life-threatening condition.

Efektivitas terapi inhibitor janus kinase pada vitiligo: tinjauan pustaka Harry Gunawan; Flora Anisah Rakhmawati
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Vitiligo is an autoimmune disease that causes progressive skin melanocyte destruction, clinically seen as asymptomatic depigmentation macule and poliosis. CD8+ T cell is the primary effector of melanocyte destruction, and the activities of CD8+ T cell are driven by interferon-? (IFN-?). The current vitiligo treatment options are often not satisfied with many limitations and a high recurrence rate. Janus Kinase (JAK) inhibitor is one of the emerging vitiligo therapies which has a more specific target with a direct effect on CD8+ T cell cytotoxicity and IFN-?.Methods: In writing this article, the literature review method was used, and sources consist of relevant journals obtained through online search engines.Result: Several studies show that repigmentation in the facial area increases between 51-92%. Repigmentation occurs better in areas exposed to sunlight or a combination of phototherapy because repigmentation in vitiligo lesions requires suppression of the autoimmune process and melanocyte regeneration.Conclusion: Many studies showed the results of vitiligo therapy using JAK inhibitors were very promising and safe. The vitiligo therapy using JAK inhibitor showed higher efficacy on the facial area and combined with ultraviolet exposure. Latar belakang: Vitiligo merupakan penyakit autoimun yang menyebabkan destruksi melanosit secara progresif pada kulit, menimbulkan makula depigmentasi asimtomatik dan poliosis. Sel T CD8+ merupakan efektor primer yang menyebabkan kematian melanosit dan aktivitasnya ditingkatkan oleh interferon-? (IFN-?). Pilihan terapi vitiligo saat ini seringkali tidak memuaskan, memiliki keterbatasan, dan memiliki tingkat kekambuhan yang tinggi. Inhibitor Janus Kinase (JAK) merupakan salah satu terapi baru vitiligo yang memiliki target lebih spesifik dengan efek langsung terhadap sitotoksisitas sel T CD8+ dan IFN-?.Metode: Dalam penulisan artikel ini digunakan metode tinjauan pustaka dengan bersumber pada artikel relevan yang didapatkan melalui pencarian secara daring. Hasil: Beberapa studi menunjukkan adanya repigmentasi pada area wajah meningkat antara 51-92%. Repigmentasi terjadi lebih baik pada area terpapar sinar matahari atau kombinasi fototerapi disebabkan karena repigmentasi pada lesi vitiligo membutuhkan supresi dari proses autoimun dan regenerasi melanosit.Simpulan: Berbagai studi menunjukkan hasil terapi inhibitor JAK terhadap vitiligo sangat menjanjikan dan cukup aman. Terapi inhibitor JAK menunjukkan efektivitas lebih tinggi pada area wajah dan dengan kombinasi paparan ultraviolet.

Perbandingan efektivitas ketorolac, deksketoprofen, dan parasetamol dalam mengurangi rasa nyeri dengan menggunakan penilaian visual analogue scale (VAS) pada pasien pasca pembedahan ortopedi ekstremitas inferior di RSUD Nganjuk, Jawa Timur, Indonesia Andini Febriana; I Putu Indra Ade Janiartha; Kiki Megasari; Bambang Priyatno; Christanto Nugroho
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Pain is an unpleasant emotional and subjective sensory experience which is associated with real tissue damage, potentially damaging, or describing the conditions in which the damage occurred. The use of non-steroidal anti-inflammatory drugs (NSAIDs) as an analgesic to treat postoperative pain is one of the standard therapies. This study aims to examine various types of analgesics in pain management in patients after orthopedic surgery of the inferior extremities at Nganjuk Hospital, East Java.Methods: This cross-sectional experimental study was conducted on 15 patients after inferior limb surgery at Nganjuk Hospital in the period May 2015 - June 2015. Data on the effectiveness of ketorolac, dexketoprofen, and paracetamol in reducing pain through VAS assessment were analyzed by SPSS version 20 for Windows.Results: Most of the men in this study (66.70%). There was a decrease in the mean VAS value between examination II (24 hours) and I (8 hours) both in the group that received ketorolac injection 30 mg/ml (3.80±0.44), dexketoprofen 50 mg/2 ml (3.00±1.00), and paracetamol 1000 mg/100 ml (2.40±5.40).Conclusion: The results of this study indicate that the decrease in the mean VAS value as a parameter of pain was found to be greatest in the group with 30 mg / ml ketorolac injection within 24 hours. Latar Belakang: Nyeri adalah pengalaman sensoris subjektif dan emosional yang tidak menyenangkan dimana terkait dengan kerusakan jaringan yang nyata, berpotensi merusak, atau menggambarkan kondisi terjadinya kerusakan. Penggunaan obat golongan Non-Steroid Anti Inflammatory Drugs (NSAID) sebagai analgesik untuk mengatasi nyeri pasca pembedahan merupakan salah satu standar terapi. Penelitian ini bertujuan untuk mengkaji berbagai jenis analgesik dalam manajemen nyeri pada pasien pasca pembedahan ortopedi ekstremitas inferior di RSUD Nganjuk, Jawa Timur.Metode: Penelitian eksperimental potong-lintang ini dilakukan terhadap 15 pasien pasca bedah ekstremitas inferior di RSUD Nganjuk pada periode Mei 2015 – Juni 2015. Data tentang efektivitas ketorolac, deksketoprofen, dan parasetamol dalam mengurangi rasa nyeri melalui penilaian VAS dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Sebagian besar pada penelitian ini berjenis kelamin laki-laki (66,70%). Terdapat penurunan rerata nilai VAS antara pemeriksaan II (24 jam) dan I (8 jam) baik pada kelompok yang mendapatkan injeksi ketorolac 30 mg/ml (3,80±0,44), deksketoprofen 50 mg/2 ml (3,00±1,00), dan parasetamol 1000 mg/100 ml (2,40±5,40).Kesimpulan: Hasil penelitian ini menunjukkan bahwa pemberian penurunan nilai rerata VAS sebagai parameter terhadap nyeri ditemukan paling besar pada kelompok dengan injeksi ketorolac dosis 30 mg/ml dalam waktu 24 jam.

Management of pregnant women with Refractory Immune Thrombocytopenia Purpura (ITP) receiving eltrombopag therapy at Sanjiwani Hospital, Gianyar, Indonesia Anak Agung Raka Budayasa; Cokorda Gede Angga Ary Nugraha
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Immune Thrombocytopenia Purpura (ITP) is an autoimmune disease characterized by a low level of platelets in the blood caused by accelerated platelet destruction or disruption of the thrombopoiesis due to antibodies to platelets. Drugs with similar functions to thrombopoietins (TPO) such as eltrombopag and romiplostim have been widely used and have been shown to be quite successful in treating ITP in nonpregnant patients. This case study aims to evaluate eltrombopag therapy's role in managing the refractory ITP in pregnant women.Case Presentation: A 25-year-old patient, a housewife, presented to the obstetrics clinic at Sanjiwani Hospital for the first time at a gestational age of 13 weeks for her third pregnancy, with a history of two abortions. ITP was diagnosed in 2017 during the second abortion treatment. The platelet examination results were between 32,000-66,000/?l, with platelet count during delivery planning at 34 weeks of 41,000/?l. The patient was diagnosed with chronic refractory ITP and was considered for second-line drug administration. Intravenous Immunoglobulin Therapy (IVIG) and anti-D administration as second-line drugs were not possible due to cost. The patient was given 50 mg eltrombopag per day for a week. The platelet counts increased to 202,000/?l a week after therapy. The patient then underwent vaginal delivery with a baby weight of 2,850 gram, Apgar Score of 8-10. The baby was exclusively breastfed and subjected to clinical monitoring and laboratory tests. The patient's clinical condition was favorable and the platelets fell to 20,000/?l nineteen days after delivery.Conclusion: In this case, the patient with chronic ITP refractory to steroid therapy showed an immediate response to eltrombopag. However, the platelet level decreased two weeks after the treatment cessation. More studies are needed on the use of eltrombopag in pregnant women.

Refractive lens exchange on keratoconus patient: a case report Ivane Jessica Buddyman; Cokorda Istri Dewiyani Pemayun; Ariesanti Tri Handayani
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction. Keratoconus is a vision disorder that occurs when the cornea becomes thin and irregularly (cone) shaped. Instead of being focused correctly on the retina, this abnormal shape causes the light entering the eye to improperly refracted and manifested as a distortion of vision. Refractive Lens Exchange is one type of Invasive therapy in Keratoconus. Here we describe a case of Keratoconus managed by the Refractive Lens Exchange procedure in our Center.Case Description. A male, 25 years old, visited the clinic due to blurry vision since ten years ago. Every six months or a year, he needs to adjust his lens power. Ophthalmology examination found visual acuity in the right eye was 2/60 PH 6/60, and if using S-9.00, visual acuity improved to 6/30. Meanwhile, visual acuity in the left eye was 1/60 PH 6/60 and if using S–11.75, visual acuity improved to 6/48. Corneal topography supports the finding of Keratoconus. Management for this patient was Refractive Lens Exchange + Intraocular Lens + Capsular Tension Ring. Initially, This advised was differ from the patient expectation, as he wanted a LASIK procedure. An important reminder was given, that Keratoconus is contraindicated for LASIK and any corneal surface ablation procedure. After series of procedure, the VA of the right eye was 6/15 PH 6/6, with C - 4.00 x 1800 VA became 6/6. VA left eye was 6/18 PH 6/9, with C - 4,00 x 1800 VA became 6/9. Binocular vision was 6/6. For near vision, S +3.00 was added for both eyes.Conclusions. Refractive Lens Exchange + Intraocular lens implantation is effective and safe procedures to treat high myopia in keratoconus cornea.

Diagnosis dan manajemen pada blefaritis anterior dan posterior Gusti Ayu Dian Listyani Utami
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: Blepharitis is a chronic inflammatory condition of the eyelid margin. Blepharitis can be distinguished based on its location, namely anterior and posterior blepharitis. Anterior blepharitis is bilateral inflammation that occurs in the area around the base of the eyelashes and on the edge of the eyelid. Anterior blepharitis generally has two main types, namely, staphylococcal blepharitis and seborrheic blepharitis. Posterior blepharitis is inflammation of the eyelid on the posterior side due to dysfunction of the meibomian gland, chronic and bilateral.Aim: The aim of the study is to describe the comprehensive review regarding diagnosis and management of blepharitisConclusion: The general management used to relieve symptoms of blepharitis are warm compresses, cleaning the eyelids, including massage of the meibomian glands in cases of posterior blepharitis, antibiotic therapy (topically or systemically), topical anti-inflammatory, combination of antibiotics and topical corticosteroids, calcineuric inhibitor and Intensed Light Pulse (IPL) therapy. The treatment of blepharitis is done in combination to increase its effectiveness and get better treatment results. However, further research is still needed to select the regimen that has the highest efficacy and safety because blepharitis is a chronic disease with a high recurrence rate. Pendahuluan: Blefaritis merupakan peradangan yang bersifat kronis atau menahun dan pada umumnya berlokasi pada tepi kelopak mata. Blefaritis dapat dibedakan berdasarkan lokasinya yaitu blefaritis anterior dan posterior. Blefaritis anterior adalah peradangan bilateral yang terjadi di daerah sekitar dasar bulu mata dan pada tepi kelopak mata. Blefaritis anterior pada umumnya memiliki dua jenis utama yaitu, blefaritis stafilokokus dan blefaritis seboroik. Blefaritis posterior adalah peradangan kelopak mata pada bagian posterior akibat disfungsi dari kelenjar meibom, bersifat kronis dan bilateral.Tujuan: Tujuan dari tinjauan pustaka ini adalah untuk memberikan gambaran komperhensif akan diagnosis dan tatalaksanan dari bleparitis posterior.Simpulan: Manajemen umum yang gunakan untuk meringankan gejala blefaritis adalah kompres hangat, pembersihkan kelopak mata, termasuk didalamnya adalah pemijatan pada kelenjar meibom dalam kasus blefaritis posterior, terapi antibiotika (secara topical maupun sistemik), anti inflamasi topikal, kombinasi antibiotika dan kortikosteroid topikal dan calcineuric inhibitor serta intense light pulse therapy (IPL). Penanganan blefaritis dilakukan secara kombinasi untuk meningkatkan efektifitas dan mendapatkan hasil pengobatan yang lebih baik. Namun masih diperlukan penelitian lebih lanjut guna memilih regimen yang memiliki efikasi dan keamanan yang paling tinggi karena blefaritis merupakan penyakit kronis dengan tingkat kekambuhan yang tinggi.

Kimura's disease: a neoplasm mimicking, a rare benign form of chronic inflammatory disorder Harley Septian; Made Widhi Asih; Nyoman Srie Laksminingsih; Anak Agung Ayu Ngurah Susraini
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Kimura's Disease (KD) is a benign, rare form of chronic inflammatory disease of unknown origin, almost exclusively found in Asian males in their second to fourth decades of life. This rare condition is mostly present as soft tissue mass consists of multiple painless solitary subcutaneous nodules mostly localized in the head and neck region, with coexisting lymph node enlargement and eosinophilia. This case study aims to describe Kimura's Disease (KD) characteristics and give an insight into the role of Computed Tomography (CT) scan in identifying KD and its imaging characteristics.Case Presentation: We reported a case of an Asian man with a history of 18 years left-sided painless facial mass, gradually increase in size with no history of hoarseness, epistaxis, previous facial mass or malignancy, and familial malignancy. CT scan findings showed an inhomogeneous contrast enhancement soft tissue mass located on the left parotid-submandibular region with multiple neck lymphadenopathy and left parotid gland involvement. Eosinophilia was found persistently in the laboratory outcomes, and this mass had been confirmed with histological findings consistent with KD features.Conclusion: Recognizing the characteristics of KD and the imaging findings on Ultrasound and CT-scan as accessible and first-line diagnostic tools, might help in facilitating the diagnosis, making a decision and sparing the patient from unnecessary and harmful procedures.

Hubungan konsentrasi serum C-Reactive Protein dan D-dimer dengan derajat keparahan dan mortalitas pasien COVID-19 Kadek Surya Atmaja; Anak Agung Gede Oka Suta Wicaksana; I Wayan Angga Suarmerta Putra; Wayan Wahyu Semara Putra
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Clinical features of COVID-19 are variably from asymptomatic, to severe symptoms including acute respiratory distress syndrome (ARDS), multiple organ failure, and death. A specific biomarker is needed to predict the possibility of COVID-19 patients fall into severe complications and disease severity. D-dimer and C-Reactive Protein (CRP) are biomarkers that are elevated in COVID-19 patients.Method: This is an observational analytic study. The purpose of this research is to explore the correlation between D-dimer serum concentration and CRP with disease severity and mortality in hospitalized COVID-19 patients. This research used secondary data from a medical record with inclusion criteria patient more than 18 years old, confirmed COVID-19 by real-time Polymerase chain reaction (rt-PCR), that hospitalized in Wangaya General Hospital during July 2020 until December 2020.Result: Statistical analysis show that there is significant mean difference between D-dimer and CRP concentration based on COVID-19 disease severity (p <0.001 dan p <0.001). AUC value on ROC curve for CRP and D-dimer concentration in predict the mortality of COVID-19 patient are 0.88 (p <0.001, 95% CI: 0.829 – 0.48) and 0.88 (p < 0.001, 95% CI = 0.821 – 0.950) respectively. In this research, serum D-dimer with concentration more than 4,181 ng/mL statistically significant affect the mortality of COVID-19 patient (OR = 11.713; CI = 1.620 - 84.682; p = 0.015). CRP concentration statistically is not significant affect the mortality of COVID-19 patient.Conclusion: There is a statistically mean difference in both D-dimer and CRP concentration based on COVID-19 disease severity. D-dimer concentration of more than 4,181 ng/mL significantly affects the COVID-19 mortality. CRP concentration is not correlated with COVID-19 mortality Latar Belakang: Fitur klinis pasien dengan COVID-19 bervariasi dari tanpa gejala maupun dengan gejala ringan hingga terjadinya acute respiratory distress syndrome (ARDS), gagal multi organ, dan kematian. Dibutuhkan suatu biomarker yang dapat digunakan dalam memprediksi kemungkinan pasien yang akan jatuh kedalam derajat penyakit maupun komplikasi yang berat. D-dimer dan C-Reactive Protein (CRP) merupakan biomarker yang diketahui meningkat pada pasien COVID-19.Metode: Penelitian ini merupakan penelitian analitik observasional, yang bertujuan untuk mengetahui hubungan konsentrasi D-dimer serum dan CRP dengan derajat keparahan dan mortalitas pasien COVID-19 yang dirawat inap. Penelitian ini menggunakan data sekunder yang bersumber dari rekam medis dengan kriteria inklusi pasien usia diatas 18 tahun dengan diagnosis terkonfirmasi COVID-19 dengan real-time Polymerase chain reaction (rt-PCR), yang dirawat inap di RSUD Wangaya Denpasar periode Juli 2020 hingga Desember 2020.Hasil: Hasil uji statistik menunjukan terdapat perbedaan rerata konsentrasi D-dimer dan CRP berdasarkan derajat keparahan pasien COVID-19 yang bermakna secara statistik (p <0,001 dan p <0,001). Nilai AUC kurva ROC konsentrasi CRP dan D-dimer dalam memprediksi mortalitas pasien secara berturut-turut didapatkan sebesar 0.88 (p <0,001, 95% IK: 0,829 – 0,48 ) dan 0.88 (p <0,001, 95% IK: 0,821 – 0,950). D-dimer serum dengan konsentrasi diatas 4.181 ng/mL pada penelitian ini terbukti secara statistik bermakna mempengaruhi mortalitas pasien COVID-19 (OR OR 11,713; IK:1,620-84,682; p=0,015). Konsentrasi CRP serum tidak terbukti secara statistik bermakna dalam mempengaruhi mortalitas pasien COVID-19.Simpulan: Terdapat perbedaan rerata yang bermakna secara statistik konsentrasi serum D-dimer dan CRP berdasarkan derajat keparahan penyakit COVID-19. Konsentrasi serum D-dimer diatas 4.181 ng/mL terbukti mempengaruhi mortalitas pasien dengan COVID-19 secara bermakna. Konsentrasi CRP tidak berhubungan terhadap mortalitas pada pasien COVID-19.

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Bali

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name -

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Phone -

Journal Mail Official -

Editorial Address -

Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA