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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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Diagnosis dan tatalaksana tromboangitis obliterans/penyakit buerger dengan fenomena raynaud Tjok Ngurah Prasanta Adityaputra; Bagus Ari Pradnyana Dwi Sutanegara; Agung Pradnyana Suwirya
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (360.655 KB) | DOI: 10.15562/ism.v12i2.999

Abstract

Introduction: Thromboangitis obliterans (TAO) is segmental, non-atherosclerotic inflammatory disease involving small to moderate arteries, veins, and nerves of extremities. TAO or Buerger's disease has very strong association with tobacco use. The adoption of stricter diagnostic criteria and reduced tobacco use have led to a decline in the number of new TAO patients in United States, Europe, and Asia. Typical TAO patients are young men with history of heavy smoking who present with limb ischemic symptoms before age 45 years. The most common symptoms are due to arterial occlusion disease, secondary vasospasm (Raynaud’s phenomenon), and superficial thrombophlebitis. Clinical diagnosis of TAO requires exclusion of diseases that mimic this diseases such as atherosclerotic vascular disease, thromboembolic disease, and autoimmune diseases such as scleroderma. Therapeutic foundation for TAO is complete cessation of any tobacco use. The use of vasodilators is largely for palliative. Therapeutic anticoagulants have not been shown to be effective in the treatment of TAO. Nonetheless, some physicians have used anticoagulants in attempt to delay amputation and increase collateral flow in severe critical limb ischemia.Case report: A 56 year old man complained of bluish and pain on the finger tips of both right and left hand. Smoking four packs a day. Dupplex ultrasound and CT scan of the superior limb angiography showed no abnormalities in the proximal artery. Echocardiography showed result within normal limit.Conclusion: These findings suggest diagnosis of thromboangitis obliterans with Raynaud's phenomenon, even if he is over 45 years of age.  Pendahuluan: Tromboangitis obliterans (TAO) adalah penyakit inflamasi nonaterosklerotik segmental yang melibatkan arteri, vena, dan saraf kecil dan sedang pada ekstremitas. TAO atau penyakit Buerger memiliki hubungan yang sangat kuat dengan penggunaan tembakau. Penerapan kriteria diagnostik yang lebih ketat dan pengurangan penggunaan tembakau telah menyebabkan penurunan jumlah pasien baru TAO di Amerika Serikat, Eropa, dan Asia. Tipikal pasien TAO adalah pria muda dengan riwayat perokok berat yang muncul dengan gejala iskemik ekstremitas sebelum usia 45 tahun. Gejala paling umum akibat penyakit oklusi arteri, vasospasme sekunder (fenomena Raynaud), dan tromboflebitis superfisial. Diagnosis klinis TAO membutuhkan eksklusi penyakit yang menyerupai penyakit tersebut seperti penyakit pembuluh darah aterosklerotik, penyakit tromboemboli, dan penyakit autoimun seperti scleroderma. Landasan terapi untuk TAO adalah penghentian total setiap penggunaan tembakau. Penggunaan vasodilator pada pasien dengan TAO sebagian besar bersifat paliatif. Antikoagulan terapeutik belum pernah terbukti secara efektif dalam pengobatan TAO. Meskipun demikian, beberapa dokter telah menggunakan antikoagulan dalam upaya untuk menunda amputasi dan meningkatkan aliran kolateral pada iskemia ekstremitas kritis yang berat.Laporan kasus: Seorang laki-laki berusia 56 tahun mengeluh kebiruan dan nyeri pada ujung kedua jari tangan kanan dan kiri. Merokok empat bungkus sehari. Temuan dupplex ultrasound dan CT scan angiografi ekstremitas superior menunjukkan tidak ditemukan kelainan pada arteri proksimal. Pemeriksaan ekokardiografi juga menunjukkan hasil dalam batas normal.Simpulan: Dari temuan-temuan tersebut mengarahkan diagnosis pasien dengan tromboangitis obliterans dengan fenomena Raynaud, walaupun usia sudah lebih dari 45 tahun.
Gejala konjungtivitis pada pasien dengan COVID-19: sebuah tinjauan sistematis Anggari Purnama Dewi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (768.709 KB) | DOI: 10.15562/ism.v12i2.1000

Abstract

Background: Infection of severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) or Coronavirus disease 2019 (COVID-19) has become a global pandemic. The clinical symptoms are not typical, making clinical diagnosis difficult to do. A number of studies have stated that ocular involvement in the form of conjunctivitis can be one of the symptoms of COVID-19 infection. The purpose of this systematic review is to determine the symptoms of conjunctivitis in patients with COVID-19 infection.Methods: A systematic literature review was carried out by searching the literature on the Cochrane Library, Pubmed, and Google Scholar, also selecting the literature using the PRISMA diagram. The inclusion criteria used were studies that examined the symptoms of conjunctivitis in COVID-19 patients published in the range of 2020-2021. Studies in the form of editorials, commentaries, reviews or meta-analyses, articles are not available in full-text, not available in English or Indonesian, do not discuss ocular manifestations of COVID-19 infection, or only discuss the detection of the SARS CoV-2 virus in conjunctival secretions. So that there were 12 studies that met the eligibility criteria.Results: There were 12 studies that carried out synthetic analysis, namely 4 cross-sectional studies, one case-control study, one case series study, and six case reports. The prevalence of conjunctivitis symptoms in COVID-19 infection ranges from 5.04-31.75%. Conjunctivitis is more common in male COVID-19 patients, with mild to moderate symptoms and duration of illness ranging from 5-26 days. Conjunctivitis in COVID-19 patients was reported as an early symptom of COVID-19 infection and the data became the sole symptom of COVID-19 infection. The habit of rubbing the eyes, impaired smell and taste were found to be significantly associated with conjunctivitis symptoms.Conclusion: Although conjunctivitis is found in only a minority of COVID-19 cases, the conjunctiva can be one of the routes of transmission of COVID-19 infection. The use of goggles and face shields is important as an effort to prevent infection transmission. Latar Belakang Infeksi severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) atau Coronavirus disease 2019 (COVID-19) telah menjadi pandemi global. Gejala klinisnya yang tidak khas membuat penegakkan diagnosis klinis sulit dilakukan. Sejumlah studi menyebutkan keterlibatan okuler berupa konjungtivitis dapat menjadi salah satu gejala infeksi COVID-19. Tujuan dari systematic review ini adalah untuk mengetahui gejala konjungtivitis pada pasien dengan infeksi COVID-19.Metode: Tinjauan pustaka sistematis dilakukan dengan pencarian literatur pada Cochrane Library, Pubmed dan Google Scholar, juga pemilihan literatur menggunakan diagram PRISMA. Kriteria inklusi yang digunakan adalah studi yang meneliti gejala konjungtivitis pada pasien COVID-19 yang terpublikasi pada rentang tahun 2020-2021. Studi berupa editorial, commentary, review maupun meta analisis, artikel tidak tersedia secara full-text, tidak tersedia dalam Bahasa Inggris atau Indonesia, tidak membahas manifestasi okuler pada infeksi COVID-19, atau hanya membahas mengenai deteksi virus SARS CoV-2 pada sekresi konjungtiva dilakukan eksklusi sehingga didapatkan 12 studi yang memenuhi kriteria eligibilitas.Hasil: Terdapat 12 studi yang dilakukan analisis sintesis, yakni 4 studi cross sectional, satu studi kasus kontrol, satu studi serial kasus dan enam laporan kasus. Prevalensi gejala konjungtivitis pada infeksi COVID-19 berkisar 5,04-31,75%. Konjungtivitis lebih banyak ditemukan pada pasien COVID-19 berjenis kelamin laki-laki, dengan gejala ringan sedang dan durasi penyakit berkisar 5-26 hari. Konjungtivitis pada pasien COVID-19 dilaporkan sebagai gejala awal infeksi COVID-19 dan data menjadi gejala tunggal infeksi COVID-19. Kebiasaan menggosok mata, gangguan penciuman dan pengecap ditemukan signifikan berhubungan dengan gejala konjungtivitis.Simpulan: Meskipun konjungtivitis ditemukan hanya pada sebagian kecil kasus COVID-19, konjungtiva dapat menjadi salah satu rute transmisi infeksi COVID-19. Penggunaan goggles dan face shield penting dilakukan sebagai upaya pencegahan transmisi infeksi.
Pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal pada tikus Wistar galur murni Slamet Rahardja; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.982 KB) | DOI: 10.15562/ism.v12i2.1001

Abstract

Background: Electrical trauma can cause injury to the body tissues it passes through, causing death. The injury is part of the process of cell damage, including the digestive organs. This study aims to determine the effect of the duration of electrical trauma on the nervous system of the gastrointestinal tract histopathologically.Methods: This study was experimental with the research subjects were 24 pure strain Wistar rats, which were divided into 4 groups. The first group is the control group (K) without treatment. Then, group (X) was exposed to electricity for 15 seconds, group (Y) was given exposure for 30 seconds, and group (Z) was exposed to 60 seconds. From the preparations, the number of nerve cells was counted. Data were analyzed with SPSS version 20 for Windows.Results: There was a significant effect on the duration of electrical trauma on the number of the gastrointestinal tract nervous system histopathologically (p<0.05). In the control group (K), the number of nerve cells for the stomach was 91.33±0.60, followed by the ileum (89.50±07.09), and colon (94.33±6.18). In group (X), the number of nerve cells in the stomach was 79.50±11.823, followed by the ileum (62.00±15.31), and colon (78.83±5.04). In group (Y), the number of nerve cells for gastric was 45.33±7.66, followed by ileum (34.00±16.27), and colon (47.17±9.56). Meanwhile, in the group (Z), the number of nerve cells for the stomach was 2.40±0.55, followed by the ileum (1.40±1.52), and colon (1.80±1.10). Thus, there was a significant difference between the study groups (p<0.001).Conclusion: The duration of electrical trauma significantly affects the number of the gastrointestinal tract nervous system histopathologically.  Latar Belakang: Trauma listrik dapat menimbulkan perlukaan pada jaringan tubuh yang dilewatinya hingga menyebabkan kematian. Perlukaan tersebut merupakan bagian dari proses kerusakan sel, termasuk pada organ digestif. Penelitian ini bertujuan untuk mengetahui pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal secara histopatologi. Metode: Penelitian ini bersifat eksperimental dengan subyek penelitian adalah 24 ekor tikus Wistar galur murni, yang terbagi dalam 4 kelompok. Kelompok pertama merupakan kelompok kontrol (K) tanpa perlakuan. Kelompok (X) diberi paparan listrik selama 15 detik, kelompok (Y) diberi paparan selama 30 detik, dan kelompok (Z) diberi paparan selama 60 detik. Dari preparat, dilakukan penghitungan terhadap jumlah sel saraf. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat pengaruh yang bermakna pada lama trauma listrik terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologis (p<0,05). Pada kelompok kontrol (K), jumlah sel saraf untuk gaster adalah 91,33±0,60, diikuti dengan ileum (89,50±07,09), dan kolon (94,33±6,18). Pada kelompok (X), jumlah sel saraf pada gaster adalah 79,50±11,823, diikuti dengan ileum (62,00±15,31), dan kolon (78.83±5.04). Pada kelompok (Y), jumlah sel saraf untuk gaster adalah 45,33±7,66, diikuti dengan ileum (34,00±16,27), dan kolon (47,17±9,56). Sedangkan pada kelompok (Z), jumlah sel saraf untuk gaster adalah 2,40±0,55, diikuti dengan ileum (1,40±1,52), dan kolon (1,80±1,10). Didapatkan perbedaan bermakna  antara kelompok penelitian (p<0,001).Kesimpulan: Lama trauma listrik memiliki pengaruh secara bermakna terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologi.
Karakteristik metastasis tulang belakang di Rumah Sakit Umum Pusat Sanglah P. Gde Daniswara Raditya Rahman; Ni Putu Witari; Anak Agung Ayu Putri Laksmidewi; I Made Oka Adnyana
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (298.139 KB) | DOI: 10.15562/ism.v12i3.1002

Abstract

Introduction: Spinal metastases constitute 90% of spine tumors. Primary tumors  originate from a variety of malignancies. However, there are no data on the characteristics of spinal metastases in the local population. This study collected data from one of the Tertiary hospitals in Bali to be used as a reference for the initial description regarding the characteristics of spinal metastases.Methods: A cross-sectional descriptive study was conducted by collecting medical record data of patients with spinal metastases at the Sanglah General Hospital for a year (January–December 2019) by total sampling.Results: This study obtained 39 samples. Most primary cancers that metastasize to the spine were lung cancers (30.77%), followed by multiple myeloma (10.26%), prostate cancer (7.69%), and colorectal cancer (5.13%). There were also contributions from breast, cervix, bladder, thyroid, lymphoma, nasal cavity, acute myeloid leukemia, and plasmacytoma. There were 25.64% cases where the primary cancer was unknown. Most of the metastases were in the thoracic segment (35.90%), followed by the lumbar region (28.21%) and the cervical region (12.82%). There were still many lesions that were less visible or unclear (38.46%). Patients generally experienced sensory (94.87%) and motor (92.31%) deficit. Sensory disturbances include paresthesia, hypesthesia and pain. Meanwhile, motor deficit include parapharesis, paraplegia, and tetrapharesis depending on the location of the lesion. Other disorders were related to the autonomic nerves (56.41%) such as defecation and urination problem.Conclusion: Most of the patients aged ?60 years and male. Spinal metastases frequently found in lung cancer patient. There was a high percentage cases with unknown primary origin. In general, the lesions were found in the thoracic and lumbar segments. There were many lesions which unclear or less visible in location. Almost all patients had sensory and motor deficit and only about half of patients had autonomic disorders.  Pendahuluan: Metastasis tulang belakang merupakan 90% kasus tumor pada tulang belakang. Tumor primer dapat berasal dari berbagai keganasan. Akan tetap, belum ada data karakteristik metastasis tulang belakang di populasi lokal. Penelitian ini mengumpulkan data dari salah satu rumah sakit Tersier di Bali untuk dapat menjadi acuan gambaran awal terkait karakteristik metastasis tulang belakang.Metode: Penelitian deskriptif potong lintang dilakukan dengan mengumpulkan data rekam medis pasien dengan metastasis tulang belakang di Rumah Sakit Umum Pusat Sanglah selama satu tahun (bulan Januari - Desember 2019) secara total sampling.Hasil: Penelitian ini mendapatkan 39 sampel. Kanker primer terbanyak yang bermetastasis ke tulang belakang adalah kanker paru (30,77%), lalu disusul dengan multiple myeloma (10,26%), kanker prostat (7,69%), dan kanker kolorektal (5,13%). Terdapat pula kontribusi dari kanker payudara, serviks, buli, tiroid, limfoma, cavum nasi, leukemia myeloid akut, dan plasmasitoma. Terdapat 25,64% kasus tidak ditemukan lokasi kanker primernya. Lokasi metastasis paling banyak pada segmen thorakal (35,90%) kemudian regio lumbal (28,21%) dan regio servikal (12,82%). Masih banyak lesi yang kurang terlihat atau tidak jelas (38,46%). Pasien secara umum mengalami gangguan sensorik (94,87%) dan motorik (92,31%). Gangguan sensorik termasuk parestesia, hipestesia, dan rasa nyeri. Sedangkan gangguan motorik termasuk paraparesis, paraplegia, dan tetraparesis tergantung dari letak lesi. Gangguan lainnya yaitu gangguan pada saraf otonom (56,41%) dengan kelainan seperti gangguan buang air besar dan berkemih.Simpulan: Sebagian besar pada pasien usia ?60 tahun dan berjenis kelamin laki-laki. Metastasis tulang belakang cenderung lebih sering pada penderita kanker paru. Selain lokasi primer tersebut, terdapat persentase tinggi dimana tidak ditemukannya dari lokasi kanker primer. Pada umumnya hasil lesi terdapat pada segmen thorakal dan segmen lumbal. Masih banyak pula lesi ini masih kurang terlihat atau tidak jelas lokasinya. Pada umumnya pasien memiliki gangguan sensorik dan motorik serta hanya sekitar setengah pasien mengalami gangguan otonom.
Hubungan Platelet- Lymphocyte Ratio (PLR) dan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Terjadinya Sindrom Koroner Akut di RSUD Sanjiwani Gianyar Tahun 2020 Dwi Masu Putra; Bagus Gita Pranata; Ketut Erna Bagiari
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (296.869 KB) | DOI: 10.15562/ism.v12i2.1003

Abstract

Background: Inflammatory processes in atherosclerosis play an important role of the acute coronary syndrome (ACS). Inflammatory markers such as platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) are known to provide a progressivity of the worsening atherosclerosis process rapidly and simple. This study aims to evaluate the relationship of PLR and NLR in ACS. Method: This is a retrospective study with a total of 102 ACS patients during 2020. PLR and NLR are calculated based on the ratio of absolute platelet, neutrophil, and leukocyte values from the results of regular blood tests. The ACS samples were divided into three groups UAP, NSTEMI, and STEMI. Result: Based on a total of 102 patients, 66.7% of men and 33.3% of women with the most age ranges of 50-59 years (52%). One-Way Anova Test showed significant differences between PLR (p = 0.002) and NLR (p = 0.017) against ACS. The Posthoc test showed meaningful results in most test groups (p< 0.05). Spearman's correlation test showed positive coleration of PLR (r = 0.508) and NLR (r = 0.500) against the diagnosis of ACS (p = 0.000). Conclusion: PLR and NLR can be used as a simple hematological marker in determining the severity of atherosclerosis in ACS.   Latar Belakang: Proses inflamasi pada aterosklerosis memiliki peranan penting terhadap terjadinya sindrom koroner akut (SKA). Marker inflamasi seperti platelet-lymphocyte ratio (PLR) dan neutrophil-lymphocyte ratio (NLR) diketahui mampu memberikan gambaran progresifitas keparahan aterosklerosis dengan cepat dan sederhana. Penelitian ini bertujuan untuk menilai hubungan PLR dan NLR terhadap terjadinya SKA. Metode: Penelitian ini merupakan studi retrospektif dengan jumlah 102 pasien SKA selama tahun 2020. Nilai PLR dan NLR dihitung berdasarkan rasio nilai absolut platelet, neutrofil, dan leukosit dari hasil pemeriksaan darah rutin. Sampel penelitian kemudian dibagi menjadi tiga kelompok yaitu UAP, NSTEMI, dan STEMI. Seluruh data dianalisis menggunakan uji One-Way Anova dan Spearman’s Correlation. Hasil: Berdasarkan total 102 pasien, didapatkan 66.7% laki-laki dan 33.3% perempuan dengan rentang usia terbanyak 50-59 tahun (52%). Uji One-Way Anova menunjukkan adanya perbedaan signifikan antara PLR (p = 0.002) dan NLR (p = 0.017) terhadap SKA. Uji Posthoc menunjukkan hasil bermakna pada sebagian besar kelompok uji (p< 0.05). Uji korelasi Spearman’s menunjukkan adanya korelasi positif PLR (r = 0.508) dan NLR (r = 0.500) terhadap diagnosis SKA (p = 0.000). Kesimpulan: PLR dan NLR dapat dijadikan sebagai marker hematologi sederhana dalam menentukan derajat keparahan aterosklerosis pada pasien SKA.
Kolesterol non-HDL yang tinggi berhubungan dengan derajat stenosis arteri koroner berat pada pasien sindroma koroner kronis di RSUP Sanglah I Made Gunarsa; Wayan Aryadana; I Made Junior Rina Artha
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1004

Abstract

Introduction: Non-HDL cholesterol is a lipid parameter that describes the overall component of atherogenic lipids and is strongly correlated with apoB and sdLDL (small-dense LDL). There has been no study linking non HDL cholesterol (high density lipoprotein) with the degree of coronary stenosis based on the assessment of the previous syntax score. This study aims to prove the relationship between high non-HDL cholesterol and the degree of severe coronary artery lesions in patients with chronic coronary syndrome who underwent coronary angiography at Sanglah Hospital Denpasar.Methods: This analytical observational study was conducted at Sanglah General Hospital from June to November 2020. Sampling was carried out by consecutive sampling. Non HDL cholesterol was calculated by subtracting total cholesterol with HDL and divided into 2 categories based on ROC analysis. The syntax score was calculated based on the results of coronary angiography and was divided into 2 categories (cut off 22). The relationship between non-HDL cholesterol and the degree of coronary stenosis was assessed by chi-square test analysis.Results: Seventy-two subjects were included in this study with a mean age of 59.43±8.9 years. At the cut-off point of 104.5 mg/dL based on the ROC curve, non-HDL cholesterol had an AUC of 0.846, a sensitivity level of 80% and a specificity of 78.1% (p < 0.001). The results of bivariate analysis showed that high non-HDL cholesterol was associated with the degree of severe coronary stenosis with a prevalence ratio of 3.385 (p<0.001). Multivariate logistic regression analysis showed that high non-HDL cholesterol proved to be an independent predictor of severe coronary artery stenosis in patients with chronic coronary syndrome at Sanglah Hospital.Conclusion: High non-HDL cholesterol was shown to be independently associated with severe coronary artery stenosis in SKK subjects at Sanglah Hospital.  Pendahuluan: Kolesterol non HDL merupakan parameter lipid yang menggambarkan keseluruhan komponen lipid atherogenik dan berkorelasi kuat dengan apoB dan sdLDL (small-dense LDL). Belum ada penelitian yang menghubungkan kolesterol non HDL (high density lipoprotein) dengan derajat stenosis koroner berdasarkan penilaian skor syntax sebelumnya. Penelitian ini bertujuan untuk membuktikan hubungan kolesterol non HDL  yang tinggi dengan derajat lesi arteri koroner yang berat pada penderita sindroma koroner kronis yang dilakukan tindakan angiografi koroner di RSUP Sanglah Denpasar.Metode: : Penelitian observasional analitik ini dilakukan di Rumah Sakit Umum Sanglah dari Juni hingga November  2020. Pengambilan sampel dilakukan secara concecutive sampling. Kolesterol non HDL dihitung dengan cara mengurangi total kolesterol dengan HDL dan dibagi menjadi 2 kategori berdasarkan analisis ROC. Skor syntax dihitung berdasarkan hasil angiografi koroner dan dibagi menjadi 2 kategori (cut off 22). Hubungan antara kolesterol non HDL dan derajat stenosis koroner dinilai dengan analisis chi-square test.Hasil: Tujuh puluh dua subyek dilibatkan dalam penelitian ini dengan dengan rerata usia 59,43±8,9 tahun. Pada nilai titik potong 104.5 mg/dL berdasarkan kurva ROC, kolesterol non HDL memiliki AUC 0.846, tingkat sensitifitas 80% dan spesifisitas 78,1% (p <0.001). Hasil analisis bivariat menunjukkan kolesterol non HDL yang tinggi berhubungan derajat stenosis koroner berat dengan rasio prevalens 3,385 (p<0.001). Analisis multivariat regresi logistik menunjukkan kolesterol non HDL yang tinggi terbukti sebagai prediktor independen stenosis arteri koroner berat pada penderita sindroma koroner kronis di RSUP Sanglah.Simpulan: Kolesterol non HDL yang tinggi terbukti berhubungan secara independen dengan stenosis arteri koroner berat pada subyek SKK di RSUP Sanglah.
Faktor risiko kejadian berat bayi lahir rendah di RSUP Sanglah, Denpasar, Bali, Indonesia I Gusti Ngurah Yuda Bagus Aryana; Komang Ayu Kartika Sari; Putu Aryani
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (349.584 KB) | DOI: 10.15562/ism.v12i2.1006

Abstract

Introduction: Maternal and child health has become a primary health focus in Indonesia and the maternal and child mortality rate in Indonesia is higher than those in South-East Asia countries. The incidence of Low Birth Weight (LBW) contributes to more than 50% of all neonatal mortality of all births in Indonesia. Therefore, identification of the risk factors that contributes to the incidence of LBW is important.Method: This retrospective case-control study involved 50 cases of LBW and 50 controls (baby with normal birth-weight), The data were analyzed using SPSS version 22.Result: The results of multivariate analysis showed that the factors significantly associated with LBW incidence were maternal blood pressure (p=0.000), history of giving birth to LBW babies (p=0.000), and the mode of current labor (p=0.034). The maternal age, maternal education level, maternal occupation, maternal anemia, parity, history of smoking, history of alcohol consumption, history of abortion, parity distance, and maternal BMI had no significant association (p>0.005).Conclusion: Thus, the incidence of LBW can be prevented through maternal blood control during the pregnancy. Careful history taking of past history of giving birth to LBW babies and the mode of delivery must be done to reduce the incidence of LBW.  Pendahuluan: Kesehatan ibu dan anak merupakan salah satu fokus utama kesehatan di Indonesia. Kasus kematian ibu dan anak di Indonesia lebih tinggi dibandingkan dengan negara-negara di Asia Tenggara. Kejadian bayi berat lahir rendah (BBLR) berkontribusi terhadap lebih dari 50% total kematian neonatal di seluruh kelahiran di Indonesia. Oleh karena itu, identifikasi faktor-faktor risiko yang mendasari kejadian BBLR menjadi penting untuk dilakukan.Metode: Penelitian kasus kontrol retrospektif ini melibatkan 50 kasus (BBLR) dan 50 kontrol (bayi lahir dengan berat badan normal. Data yang diperoleh kemudian dianalisis menggunakan perangkat SPSS versi 22.Hasil: Hasil analisis multivariat didapatkan faktor-faktor yang memiliki hubungan signifikan dengan kejadian BBLR adalah tekanan darah ibu (p=0,000), riwayat melahirkan bayi BBLR (p=0,000), dan tipe persalinan bayi saat ini (p=0,034). Sebaliknya, faktor usia ibu, tingkat pendidikan ibu, pekerjaan ibu, anemia pada ibu, jumlah paritas, riwayat merokok, riwayat konsumsi alkohol, riwayat abortus, jarak paritas, dan IMT ibu tidak memiliki hubungan yang signifikan (p>0,005).Simpulan: Pencegahan kejadian BBLR dapat dilakukan dengan mengontrol tekanan darah ibu selama kehamilan. Penggalian riwayat melahirkan bayi BBLR sebelumnya dan pemilihan metode persalinan juga harus dilakukan dengan seksama untuk mengurangi kejadian BBLR.
Kematian janin dalam kandungan pada ibu hamil dengan infeksi sifilis laten: laporan kasus Hani Lusyana; Lina Damayanti; Agus Walujo
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (465.893 KB) | DOI: 10.15562/ism.v12i2.1009

Abstract

Background: Pregnant women and newborns are a group that is prone to contracting sexually transmitted infections, although they do not directly engage in high-risk sexual behavior. One that has an unexpected impact on pregnant women and newborns is syphilis by the bacterium Treponema pallidum. Transmission of syphilis from mother to fetus is usually worse when the infection in pregnant women is not detected or not appropriately treated early in pregnancy. This case report aims to evaluate fetal death in the womb in pregnant women with latent syphilis infectionCase Presentation: A 19-year-old pregnant woman aged 31-32 weeks diagnosed with late postpartum spontaneous Intrauterine Fetal Death (IUFD) with early latent syphilis. The diagnosis of syphilis was made based on the Veneral Disease Research Laboratory (VDRL) serological test (1:64), Treponema Pallidum Hemagglutination Assay (TPHA) (1:1,280), and without any mucocutaneous complaints. The patient received Benzathine Penicillin G 2.4 million IU single dose intramuscularly. The diagnosis of IUFD was made one day after the administration of therapy and the baby was born with multiple congenital abnormalities.Conclusion: Undiagnosed and adequately treated syphilis in pregnant women can result in perinatal death caused by multiple congenital abnormalities. Latar Belakang: Ibu hamil dan bayi baru lahir merupakan kelompok rawan tertular infeksi menular seksual, walaupun tidak secara langsung berperilaku seksual resiko tinggi. Salah satu yang memiliki dampak kelahiran yang tidak diharapkan pada ibu hamil dan bayi baru lahir adalah Sifilis oleh bakteri Treponema pallidum. Transmisi sifilis dari ibu ke janin biasanya berakibat buruk ketika infeksi pada ibu hamil tidak terdeteksi atau tidak diobati secara benar di awal kehamilan. Laporan kasus ini bertujuan mengevaluasi kematian janin dalam kandungan pada ibu hamil dengan infeksi sifilis latenPresentasi Kasus: Seorang wanita hamil berusia 19 tahun usia kehamilan 31-32 minggu dengan diagnosis akhir postpartum spontan Intrauterine Fetal Death (IUFD) dengan sifilis laten dini. Diagnosis sifilis ditegakkan berdasarkan tes serologis Veneral Disease Research Laboratory (VDRL) (1:64), Treponema Pallidum Hemagglutination Assay (TPHA) (1:1.280), dan tanpa adanya keluhan mukokutaneus. Pasien mendapatkan terapi Benzatin Penisilin G 2.4 juta IU single dose secara intramuskular. Diagnosis IUFD ditegakkan satu hari setelah pemberian terapi dan bayi yang dilahirkan memiliki kelainan kongenital multipel.Kesimpulan: Sifilis pada ibu hamil yang tidak terdiagnosis dan diterapi dengan adekuat dapat mengakibatkan terjadinya kematian perinatal yang disebabkan oleh kelainan kongenital multipel.
Gambaran anemia pada kehamilan trimester III di bagian obstetri dan ginekologi RSUD Waikabubak, Nusa Tenggara Timur periode 2019–2020 Edwin Aryanto; Andre Dominggus Sugiarto; Putu Heri Darmawan; Ni Putu Yuni Anggreni Pande
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (313.902 KB) | DOI: 10.15562/ism.v12i2.1010

Abstract

Background: Anemia is still a global public health problem. It is estimated that one third of women of childbearing age suffer from anemia and more than 40% of pregnant women suffer from anemia worldwide. Anemia in pregnancy can cause complications that affect both the mother and the fetus. This study aims to determine the description of anemia in the third trimester of pregnancy in the Obstetrics-Gynecology section of the Waikabubak Hospital during the 2019-2020 period.Methods: A descriptive cross-sectional study on 355 pregnant women in the third trimester with anemia was conducted in the Obstetrics and Gynecology Section of Waikabubak Hospital for the period 1 July 2019 – 30 June 2020, who met the inclusion and exclusion criteria. Data were taken from the patient's medical record such as maternal age, gestational age, hemoglobin (Hb) level, erythrocyte index and pregnancy outcome. Data were analyzed with SPSS version 25 for Windows.Results: The results of the examination of hemoglobin (Hb) levels showed that 49.58% of pregnant women in the third trimester at Waikabubak Hospital suffered from anemia. Based on the majority of respondents aged 20-35 years (76.62%), term (72.96%), moderate anemia (54.37%), microcytic hypochromic anemia (63.10%), and had an Appropriate for gestational Age (AGA) (83.98%) in pregnancy outcomes.Conclusion: The third trimester pregnant women with anemia in Waikabubak Hospital mostly suffered at the age of 20-35 years, at term gestational age, with moderate degree of anemia, the most common type was microcytic hypochromic and with AGA pregnancy outcomes.  Latar Belakang: Anemia masih menjadi masalah kesehatan masyarakat global. Diperkirakan sepertiga wanita usia subur menderita anemia dan lebih dari 40% ibu hamil menderita anemia diseluruh dunia. Anemia dalam kehamilan dapat menyebabkan komplikasi yang berdampak pada ibu maupun janin. Penelitian ini bertujuan untuk mengetahui gambaran anemia pada kehamilan trimester III di bagian Obstetri–Ginekologi RSUD Waikabubak selama periode 2019-2020.Metode: Penelitian deskriptif potong lintang pada 355 ibu hamil trimester III dengan anemia dilakukan pada Bagian Obstetri – Ginekologi RSUD Waikabubak periode 1 Juli 2019 – 30 Juni 2020, yang memenuhi kriteria inklusi dan eksklusi. Data yang diambil dari rekam medis pasien adalah usia ibu, usia kehamilan, kadar hemoglobin (Hb), indeks eritrosit dan luaran kehamilan. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Hasil pemeriksaan kadar hemoglobin (Hb) didapatkan 49,58% ibu hamil trimester III di RSUD Waikabubak menderita anemia. Berdasarkan usia, sebagian besar responden  berusia 20-35 tahun (76,62%), aterm (72,96%), anemia sedang (54,37%), anemia hipokrom mikrositer (63,10%), dan memiliki luaran kehamilan Sedang Masa Kehamilan (SMK) (83,98%).Simpulan: Ibu hamil trimester III dengan anemia di RSUD Waikabubak paling banyak diderita pada usia 20–35 tahun, pada usia kehamilan aterm, dengan derajat anemia sedang, tipe tersering hipokrom mikrositer dan dengan luaran kehamilan SMK.
Aberrant expression of CD5 in a B-lineage Acute Lymphoblastic Leukemia (ALL): a case report Ni Ketut Puspa Sari; Ni Nyoman Mahartini; Ni Kadek Mulyantari; Anak Agung Ayu Lydia Prawita; Ni Komang Krisnawati; I Putu Yuda Prabawa; Sianny Herawati; Made Minarti Witarini Dewi; Ekarini Katharina Yunarti Nabu
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (522.872 KB) | DOI: 10.15562/ism.v12i2.1011

Abstract

Background: CD5 is expressed in several B-lymphocyte malignancies, including Chronic Lymphocytic Leukemia (CLL), Mantle Cell Lymphoma (MCL), but CD5 positive B-cell lineage Acute Lymphoblastic Leukemia (ALL) is extremely rare. Aberrant T-cell antigen expression is associated with poor prognosis and is a useful marker to identify patients at increased risk. This case report aims to elaborate on the aberrant expression of CD5 in B-lineage ALL.Case Presentation: A 16-years-old male presented with a history of gum bleeding and abdominal pain of 7 days with associated fever, weakness and bone pain of 2-month duration. The bone marrow aspiration showed lymphoblast 30 % with the positive vacuole. In addition, the immunophenotyping test indicates for leukemia B-lineage with expression CD19, CD10, HLA-DR, CD 34, and there is the aberrant expression of CD5.Conclusion: Aberrant expression CD5 in cases of ALL B lineage is very rare. This can be associated with a poor prognosis.

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