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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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Gangguan pola bangun-tidur setelah cedera kepala Moses Kharisma Setyawan; Sri Maliawan; Tjokorda Gde Bagus Mahadewa; I Wayan Niryana; Dewa Putu Wisnu Wardhana
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Traumatic brain injury is a common trauma. Traumatic brain injury is commonly followed by sleep disorder such as insomnia, hypersomnia and circadian rhythm disturbance. Sleep disorder can cause many complications, including the worsening of the brain injury prognosis. Insomnia occurs in 29% traumatic brain injury patient. Insomnia suspected due injury in inferior frontal, anterior temporal including basal forebrain, also sympathetic nerve hyperactivity. Insomnia increase the risk of stroke, disability and mood disturbance. Hypersomnia occurs in 28% traumatic brain injury patients. Hypersomnia suspected due orexin decrease and injury in sleep promoting area. Hypersomnia suspected related to recovery, less activity time and accident due sleepiness. There are no prevalence data of circadian rhythm disturbance after traumatic brain injury. This disturbance is caused by injury in supra-chiasmatic nucleus and related to global worsening on the patient. Insomnia and circadian rhythm disturbance are highly linked with injury area, but hypersomnia is not particularly linked to any area and only related to orexin decrease. Insomnia and circadian rhythm disturbance are highly related to the worsening condition on the patient, but hypersomnia is associated with recovery and not particularly related to any disturbances. It is hoped that understanding the sleep disorder after traumatic brain injury can rise the alertness of this matter and encourage clinicians to increase the quality of sleep disorder due to traumatic brain injury management. Cedera kepala merupakan salah satu cedera yang umum terjadi. Cedera ini sering diikuti dengan gangguan tidur seperti insomnia, hipersomnia dan gangguan ritme sirkadian. Gangguan ini sering dapat menyebabkan berbagai komplikasi termasuk memperparah penyembuhan cedera kepala. Insomnia setelah cedera kepala terjadi sebanyak 29%. Insomnia diduga disebabkan oleh cedera pada daerah inferior frontal, anterior temporal termasuk basal otak depan, juga peningkatan kerja saraf simpatis. Insomnia meningkatkan resiko stroke, disabilitas dan gangguan suasana hati. Hipersomnia setelah cedera kepala terjadi sebanyak 28%. Hipersomnia diduga akibat penurunan orexin dan akibat kerusakan pada area yang mempertahankan bangun. Hipersomnia diduga berhubungan dengan penyembuhan, waktu tersita akibat tidur dan kecelakaan akibat mengantuk. Belum ada data prevalensi gangguan ritme sirkadian setelah cedera kepala. Gangguan ini disebabkan oleh cedera pada nukleus suprakiasmatik dan sering dikaitkan dengan perburukan kondisi pasien. Insomnia dan gangguan ritme sirkadian sering dihubungkan dengan lokasi tertentu dari cedera, namun hipersomnia berhubungan dengan kadar orexin dan tidak terlalu dikaitkan terhadap area tertentu. Insomnia dan gangguan ritme sirkadian berhubungan dengan perburukan, namun hipersomnia bisa menandakan perbaikan dan tidak berhubungan signifikan dengan gangguan lainnya. Diharapkan dengan memahami gangguan tidur ini dapat meningkatkan kewaspadaan bagi para klinisi dan mendorong untuk penelitian berikutnya sehingga penanganan pasien gangguan tidur akibat cedera kepala dapat menjadi lebih baik.

Pansinusitis kronis dengan komplikasi abses serebri dan selulitis preseptal: laporan kasus Iriana Maharani; David Santoso
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Rhinosinusitis is an inflammation of the sinuses of the paranasal mucosa, while pansinusitis is an inflammatory process in several sinuses. Rhinosinusitis is one of the most prevalent health problems in the world. Although rare, rhinosinusitis can also lead to serious complications, including intracranial complications such as a cerebral abscess. This case report attempts to evaluate a cerebral abscess and preseptal cellulitis caused by chronic pansinusitis.Case Presentation: A 56 years old woman, after trepanation, was consulted by the neurosurgery department to the ear, nose, throat, head, and neck department at dr. Saiful Anwar Hospital. Patients with complaints of decreased consciousness. A gradual decrease in consciousness was felt 3 weeks before admission to the hospital (SMRS). CT scan showed a cerebral abscess with a single lesion located in the frontal (unilocular) lobe as a complication of chronic pansinusitis. In this case, there was also preseptal cellulitis due to the spread of infection from the ethmoid sinus to the orbit. Treatment with ceftriaxone, metronidazole, omeprazole, ketorolac, Levemir, Apidra, Levocin, and anterior ethmoidectomy showed clinical improvement.Conclusion: Cerebral abscess is a rare complication of chronic pansinusitis but has a high morbidity and mortality rate. Medical intervention and anterior ethmoidectomy showed clinical improvement in patients. Latar Belakang: Rinosinusitis adalah peradangan sinus mukosa paranasal sedangkan pansinusitis merupakan proses inflamasi pada beberapa sinus. Rinosinusitis adalah salah satu masalah kesehatan yang memiliki prevalensi besar di dunia. Meskipun jarang terjadi, rinosinusitis juga dapat mengakibatkan komplikasi serius termasuk komplikasi intrakranial seperti abses serebri. Laporan kasus ini berupaya untuk mengevaluasi abses serebri dan selulitis preseptal yang disebabkan oleh pansinusitis kronis.Presentasi Kasus: Seorang wanita berusia 56 tahun pasca trepanasi dikonsultasikan oleh departemen bedah saraf ke departemen telinga hidung tenggorok kepala leher (THT-KL) RSUD dr. Saiful Anwar Pasien dengan keluhan terjadi penurunan kesadaran. Penurunan kesadaran secara gradual dirasakan semenjak 3 minggu sebelum masuk rumah sakit (SMRS). Pemeriksaan CT-Scan menunjukkan keberadaan abses serebri dengan lesi tunggal yang terletak pada lobus frontalis (unilokuler) sebagai komplikasi pansinusitis kronis. Pada kasus ini juga didapatkan selulitis preseptal akibat penyebaran infeksi dari sinus ethmoidalis ke orbita. Pengobatan dengan pemberian ceftriaxone, metronidazole, omeprazole, ketorolac, Levemir, Apidra, Levocin, dan etmoidektomi anterior menunjukkan perbaikan klinis.Kesimpulan: Abses serebri adalah komplikasi yang jarang pada pansinusitis kronis tetapi memiliki angka morbiditas dan mortalitas yang tinggi. Intervensi medikamentosa dan etmoidektomi anterior menunjukkan perbaikan klinis pada pasien.

Efek pemberian propolis pada fungsi ginjal dan hepar tikus putih (Rattus Norvegicus) yang diinduksi cisplatin Novriantika Lestari; Fajrianti Haniyah; Annisa Puspa Sari; Liya Agustin Umar; Elvira Yunita
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Cisplatin as an anticancer drug results in nephrotoxicity and hepatotoxicity. Accumulation of cisplatin in the body will produce reactive compounds in the form of free radicals which induce oxidative stress that affects kidney and liver functions. Propolis contains flavonoids, phenolic acid, and Caffeic Acid Phenethyl Ester (CAPE) which have the ability to prevent free radical formation and improve kidney and liver function. This study aims to determine the effect of propolis administration to ameliorate of BUN, creatinine, ALT and AST levels in cisplatin-induced rats (Rattus norvegicus).Methods: The experimental study was conducted with the pre-post-test with control group design approach. The research sample used 30 white rats which were divided into normal (aquadest), Cisplatin (5mg/kg i.p), and cisplatin+propolis groups. Propolis was given at a dose of 50mg/kg, 100mg/kg and 200mg/kg orally for seven days, four days after cisplatin induction. Rat blood was taken for analysis of Bloof Urea Nitrogen (BUN), Creatinine, ALT, and AST levels. Data were analyzed using SPSS version 26 for Windows.Results: The results showed that there were significant differences in levels of BUN, Creatinine, ALT and AST between groups (p<0.05). Propolis treatment at doses of 50 mg/kg, 100mg/kg and 200mg/kg can reduce levels of BUN/urea, creatinine, ALT, and AST in rats that have been induced by cisplatin significantly (p<0,05).Conclusion: Propolis has a therapeutic effect on cisplatin drug-induced nephrotoxicity and hepatotoxicity by affecting the BUN, creatinine, ALT, and AST levels in rats. Latar Belakang: Penggunaan cisplatin sebagai obat antikanker menghasilkan efek nefrotoksisitas dan hepatotoksisitas imbas obat. Akumulasi cisplatin di dalam tubuh akan menghasilkan senyawa reaktif berupa radikal bebas yang menginduksi terjadinya stress oksidatif sehingga akan berpengaruh ke fungsi ginjal dan hepar. Propolis mengandung flavonoid, asam fenolat, dan Caffeic Acid Phenethyl Ester (CAPE) yang memiliki kemampuan mencegah pembentukan radikal bebas dan memperbaiki fungsi ginjal dan hepar. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian propolis terhadap pemulihan kadar ureum, kreatinin, ALT dan AST darah pada tikus putih (Rattus norvegicus) yang telah diinduksi cisplatin.Metode: Penelitian eksperimental ini dilakukan dengan pendekatan pre-post-test with control group design. Sampel penelitian menggunakan 30 ekor tikus putih yang dibagi menjadi kelompok normal (aquadest), Cisplatin (5mg/kgbb i.p) dan kelompok cisplatin+propolis. Propolis diberikan dengan dosis 50mg/kgbb, 100mg/kgbb dan 200mg/kgbb secara oral selama tujuh hari, empat hari setelah induksi cisplatin. Darah tikus diambil untuk analisis kadar Blood Urea Nitrogen (BUN), Kreatinin, ALT, dan AST. Data dianalisis dengan SPSS versi 26 untuk Windows.Hasil: Hasil penelitian menunjukkan terdapat perbedaan kadar BUN, Kreatinin, ALT, dan AST yang bermakna antar kelompok (p<0,05). Pemberian propolis dengan dosis 50 mg/kgBB, 100 mg/kgBB dan 200 mg/kgBB dapat menurunkan kadar BUN/ureum, kreatinin, ALT, dan AST pada tikus yang telah diinduksi cisplatin secara bermakna (p<0,05).Kesimpulan: Propolis memiliki efek terapi pada nefrotoksisitas dan hepatotoksisitas akibat obat cisplatin dengan mempengaruhi kadar BUN/ureum, kreatinin, ALT, dan AST pada tikus.

Acute thromboembolic ischemic stroke in rural hospital, the role of early treatment in reducing brain damage Munzirul Akbar; Yopie Afriandi Habibie; Mursyida Mursyida
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: Stroke has a high mortality and disability rate, and the main cause of physical disability in productive age and elderly. In developed countries stroke is the number one cause of admission of patients to hospital, with a mortality proportion of 20% within the first 28 days of treatmentCase Report: A 45-year-old man came to the neurology polyclinic of RSUD Aceh Besar on March 21st, 2021 with chief complaints of the general weakness of the left limb, complete numbness and heavy feeling in the left limb since 4 hours of before admission which is felt to be getting weaker from time to time, happened suddenly when the patient was working collecting stones. He complained of dizziness as well, and did not decrease while resting. After the attack, the patient remains conscious with no headache, no nausea and vomiting, no double images were seen. On Siriraj score showed result of -4. The patient was hospitalized with injection of Citicolin 1000 mg and then discharged 5 days later with significant improvement.Conclusion: Ischemic Stroke requires fast, precise and accurate handling to prevent and avoid disability and even death. One of the effective efforts is to organize health promotion and preventive programs starting from the First Level Health Facility (FKTP) on an ongoing basis to the community.

Dietary management in colorectal cancer prevention: a review Yudi Kristanto; Angeline Rosa Hartono
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Colorectal cancer (CRC) is still a health problem with a high incidence worldwide. Genetic factors and environmental factors are the etiology of colorectal cancer. Eating habits are one of the environmental factors that can be regulated so as to prevent colorectal cancer. Diet food in the development of colorectal cancer has an important role. Several studies in the last decade have shown an association between the consumption of several foods and nutrients and the risk of colorectal cancer in epidemiological and experimental studies.

Hubungan antara Stromal Tumor Infiltrating Lymphocytes (TIL) dengan ekspresi Programmed Death-Ligand 1 (PD-L1) pada karsinoma payudara invasif tipe tidak spesifik subtipe Human Epidermal Growth Factor Receptor-2 (HER-2) enriched di RSUP Sanglah, Bali, Ind Popi Imelda Margareth Sitompul; Herman Saputra; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Breast cancer is the most common malignancy cancer in women. This malignancy is molecularly heterogeneous, where overexpression of the HER-2 growth factor receptor generally has a more aggressive nature. The role of immune system interaction, namely Tumor Infiltrating Lymphocytes (TIL) and Programmed Death-Ligand 1 (PD-L1) expression, is associated with prognostic and predictive factors. Therefore, this study aims to investigate the association between stromal TIL with PD-L1 expression in invasive breast carcinoma non-specific type HER-2 enriched subtype.Methods: This study was an observational analytical study with cross-sectional design from January 1st 2015 to December 31st 2019. The samples were taken from a paraffin block of patients with invasive breast carcinoma non-specific type, that has performed histopathological examination, ER, PR, HER-2 and FISH/CISH immunohistochemistry examination at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar. The samples obtained were stained with PD-L1 immunohistochemistry. The preparation was evaluated to assess TIL. Data were analyzed using SPSS version 20 for Windows.Results: The study found a statistically significant association between stromal TIL with PD-L1 expression in tumor cells (p = 0.018). There is statistically significant association between stromal TIL with PD-L1 expression in TIL (p = 0.001). There is statistically significant association between stromal TIL with PD-L1 expression in total tumor cells and TIL (p = 0.007) in invasive breast carcinoma non-specific type HER-2 enriched subtype at Sanglah Hospital, Denpasar.Conclusion: In conclusion, there is an association between stromal TIL with the expression of PD-L1 in tumor cells and TIL in invasive breast carcinoma non-specific type HER-2 enriched subtype. Latar Belakang: Kanker payudara merupakan keganasan tersering pada wanita. Keganasan ini bersifat heterogen ditinjau dari aspek molekuler, dimana overekspresi HER-2 umumnya memiliki sifat yang lebih agresif. Peranan sistem imun, yakni ekspresi Tumor Infiltrating Lymphocytes (TIL) dan Programmed Death-Ligand 1 (PDL-1) dihubungkan dengan faktor prognostik. Oleh karena itu, penelitian ini bertujuan untuk mengevaluasi hubungan antara stromal TIL dengan ekspresi PD-L1 pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched.Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan studi potong lintang mulai dari 1 Januari 2015 sampai 31 Desember 2019. Sampel adalah blok parafin penderita karsinoma payudara invasif tipe tidak spesifik yang telah dilakukan pemeriksaan histopatologi, imunohistokimia ER, PR, HER-2 dan FISH/CISH di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar. Sampel yang diperoleh dilakukan pulasan imunohistokimia PD-L1 Preparat sampel digunakan untuk menilai TIL. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Pada penelitian ditemukan hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada sel tumor (p=0,018). Terdapat hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada TIL (p=0,001). Terdapat hubungan yang signifikan secara statistik antara stromal TIL dengan ekspresi PD-L1 pada total sel tumor dan TIL (p=0,007) pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched di RSUP Sanglah Denpasar.Kesimpulan: Hasil penelitian ini menunjukkan terdapat hubungan bermakna antara stromal TIL dengan ekspresi PD-L1 sel tumor dan TIL pada karsinoma payudara invasif tipe tidak spesifik subtipe HER-2 enriched.

Hubungan antara ekspresi c-MET dengan derajat diferensiasi histologi dan tingkat kedalaman invasi pada infiltrating urothelial carcinoma kandung kemih di RSUP Sanglah, Bali, Indonesia Kadek Agus Suhardinatha Putra; I Gusti Ayu Sri Mahendra Dewi; Herman Saputra; Ni Wayan Winarti; Anak Agung Ayu Ngurah Susraini; Ni Putu Ekawati; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: c-MET is a tyrosine kinase receptor that binds specifically to its ligand, namely hepatocyte growth factor (HGF). c-MET signaling deviations play a role in the progressivity of a wide variety of malignancies including bladder cancer. This study aims to determine the relationship between c-MET expression with the histological differentiation and depth of invasion in infiltrating urothelial carcinoma of bladder.Methods: This study was a cross-sectional analytical study with 42 sample sizes. The samples were taken from a paraffin block of patients with infiltrating urothelial carcinoma of the bladder, that has performed resection and histopathological examination who were examined at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar from 2015-2020. The c-MET expression was examined by immunohistochemical staining of c-MET and evaluated using the H-score method. Data were analyzed using SPSS version 20 for Windows.Results: Fisher's Exact test showed a statistically significant association between c-MET expression and the histological differentiation grade (p = 0.000). There was also a significant association between c-MET expression and depth of invasion with the Chi-Square test (p = 0.016), the Prevalence Ratio (PR) was 2.0 (95% CI = 1.2-3.6).Conclusion: In conclusion, there is an association between c-MET expression with the histological differentiation grade and depth of invasion in the infiltrating urothelial carcinoma of bladder. High c-MET expression had twice the risk of developing advanced invasion. Latar Belakang: c-MET merupakan reseptor tirosin kinase yang berikatan secara spesifik dengan ligannya, yaitu faktor pertumbuhan hepatosit (HGF). Penyimpangan c-MET signaling diketahui berperan dalam agresivitas berbagai macam keganasan termasuk kanker kandung kemih. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi c-MET dengan derajat diferensiasi histologi dan tingkat kedalaman invasi pada infiltrating urothelial carcinoma kandung kemih.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 42, yang berasal dari blok parafin penderita infiltrating urothelial carcinoma kandung kemih yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 2015-2020. Ekspresi c-MET diperiksa dengan pengecatan imunohistokimia c-MET dan dievaluasi menggunakan metode H-score. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Uji Fisher’s Exact menunjukkan hubungan yang bermakna secara statistik antara ekspresi c-MET dengan derajat diferensiasi histologi (p=0,000). Didapatkan juga hubungan yang bermakna antara ekspresi c-MET dengan tingkat kedalaman invasi dengan uji Chi-Square (p=0,016), prevalence ratio 2,0 (IK 95%=1,2-3,6).Kesimpulan: Sebagai simpulan terdapat hubungan antara ekspresi c-MET dengan derajat diferensiasi histologi dan tingkat kedalaman invasi pada infiltrating urothelial carcinoma kandung kemih. Ekspresi c-MET tinggi memiliki risiko dua kali lebih besar mengalami invasi lanjut. c-MET diharapkan dapat menjadi faktor prognostik yang bermanfaat dalam penatalaksanaan infiltrating urothelial carcinoma kandung kemih.

Hubungan antara ekspresi Vascular Cell Adhesion Molecule-1 (VCAM-1) dengan tipe dan stadium T karsinoma epitel permukaan ovarium di RSUP Sanglah, Bali, Indonesia I Made Wirya Sastra; Luh Putu Iin Indrayani Maker; Anak Agung Ayu Ngurah Susraini; I Wayan Juli Sumadi; I Gusti Ayu Sri Mahendra Dewi; Herman Saputra; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Vascular Cell Adhesion Molecule-1 (VCAM-1) is an important protein in oncogenesis, angiogenesis, tumor development, and metastasis. Studies regarding the expression of VCAM-1 in ovarian carcinoma have found both supportive and contradictory results. Therefore, this study evaluates the relationship between VCAM-1 expression and the type and stage of ovarian surface epithelial carcinoma at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a cross-sectional analytical study with a sample size of 36, which came from paraffin block of patients with ovarian surface epithelial carcinoma who were examined histopathologically at the Anatomical Pathology Laboratory of Sanglah Hospital Denpasar from 1 January 2017 to 31 December 2019. Samples are grouped into type I and type II, then the stage I or II and III groups. After that, the VCAM-1 immunohistochemical streak was performed to assess high or low expression in these groups and analyzed its relationship with the type and stage T of ovarian surface epithelial carcinoma. Data were analyzed using SPSS version 25 for Windows.Results: The analysis results using the Chi-Square test showed a statistically significant relationship (p=0.001) between the VCAM-1 expression with type and stage surface epithelial ovarian carcinoma (p=0.007). The results of the mean difference test are 0.48 (95% CI=0.33-0.70) and showed a statistically significant difference (p=0.001) between VCAM-1 expression with a type of ovarian carcinoma.Conclusion: In conclusion, there is an association between expression VCAM-1 with the type of surface epithelial ovarian carcinoma and at a stage, with a 2.3 times higher probability of VCAM-1 expression in the stage III group than in stage I or II group. Latar Belakang: Vascular Cell Adhesion Molecule-1 (VCAM-1) merupakan salah satu protein yang penting dalam onkogenesis, angiogenesis, perkembangan tumor dan metastasis. Penelitian-penelitian mengenai ekspresi VCAM-1 pada karsinoma ovarium mendapatkan hasil yang pro dan kontra. Oleh karena itu, penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi VCAM-1 dengan tipe dan stadium T karsinoma epitel permukaan ovarium di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 36, yang berasal dari dari blok parafin penderita karsinoma epitel permukaan ovarium yang diperiksa secara histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2017 sampai 31 Desember 2019. Sampel dikelompokkan menjadi tipe I dan tipe II, kemudian kelompok stadium I atau II dan III. Setelah itu dilakukan pulasan imunohistokimia VCAM-1 untuk menilai ekspresi tinggi ataupun rendah pada kelompok-kelompok tersebut dan dianalisis hubungannya dengan tipe dan stadium T karsinoma epitel permukaan ovarium. Data dianalisis dengan uji Chi-Square dengan nilai p <0,05.Hasil: Hasil penelitian menunjukkan terdapat hubungan yang bermakna secara statistik (p=0,001) antara ekpresi VCAM-1 dengan tipe karsinoma dan stadium T (p=0,007). Hasil uji beda rerata adalah 0,48 (IK 95%=0,33-0,70) dan menunjukkan perbedaan bermakna secara statistik (p=0,001) antara ekspresi VCAM-1 dengan tipe karsinoma ovarium.Kesimpulan: Sebagai simpulan, terdapat hubungan antara ekspresi VCAM-1 dengan tipe karsinoma epitel permukaan ovarium dan pada stadium, dengan kemungkinan 2,3 kali terjadi ekspresi VCAM-1 yang tinggi pada kelompok stadium III dibandingkan stadium I atau II.

Satu Kasus Langka: Harlequin Ichthyosis I Gusti Ayu Sattwika Pramita; Ni Luh Putu Ratih Vibriyanti Karna
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: Harlequin ichthyosis is a genetic skin disease due to mutations in the ABCA12 gene inherited in an autosomal recessive manner. It is a severe form of ichthyosis characterized by a distinct clinical appearance of a thick stratum corneum. Harlequin ichthyosis is rarely found, and patients generally die a few days after birth.Case description: We reported a baby girl aged one day with thick and cracked skin since birth. Physical examination revealed eclabium, ectropion, microtia, hyperflexion of the arms and legs, and hypoplasia of the fingers and toes. Dermatological examination showed thick yellowish-white scales separated by deep and erythematous fissures. The patient was placed in an incubator and was given supportive care, including nutrition and fluid through an orogastric tube, oleum olivarum as a moisturizer, gentamicin cream 0.1%, and gentamicin eye ointment 0.3%. The patient died after 21 days of treatment.Conclusion: Harlequin ichthyosis has a poor prognosis and a high mortality rate due to impaired skin barrier functions that lead to dehydration, impaired thermoregulation, respiratory problems, and infections. Management of harlequin ichthyosis needs a multidisciplinary team and supportive care, consisting of fluid, electrolyte, and nutrition management, maintaining skin hydration, eye care, and preventing respiratory failure or sepsis. Pendahuluan: Harlequin ichthyosis adalah penyakit kulit genetik yang diturunkan secara resesif autosomal dan merupakan bentuk berat dari iktiosis akibat adanya mutasi pada gen ABCA12. Penyakit ini ditandai dengan adanya gambaran klinis yang khas berupa penebalan stratum korneum. Harlequin ichthyosis jarang ditemukan dan umumnya pasien meninggal beberapa hari setelah kelahiran.Kasus: Dilaporkan seorang bayi perempuan berumur 1 hari dengan keluhan kulit tebal dan pecah-pecah sejak lahir. Pada pemeriksaan fisik ditemukan eklabium, ektropion, mikrotia, hiperfleksi lengan dan kaki, serta hipoplasia jari-jari tangan dan kaki. Berdasarkan pemeriksaan status dermatologikus didapatkan skuama tebal berwarna putih kekuningan yang dipisahkan fisura. Pasien diberikan perawatan suportif berupa perawatan dalam inkubator, pemberian nutrisi melalui OGT, pelembab topikal oleum olivarum, antibiotik topikal gentamisin krim 0,1 %, dan salep mata gentamisin 0,3%. Pasien meninggal setelah perawatan selama 21 hari. Simpulan: Harlequin ichthyosis memiliki prognosis yang buruk dan angka kematian yang tinggi akibat gangguan dari barier kulit yang menyebabkan dehidrasi, gangguan termoregulasi, gangguan nafas dan infeksi. Penatalaksanaan pasien harlequin ichthyosis adalah multidisiplin dan bersifat suportif, terdiri atas manajemen cairan dan elektrolit, perawatan secara intensif dalam inkubator, pemberian nutrisi, menjaga hidrasi kulit, perawatan mata, dan pencegahan terjadinya gangguan napas, atau sepsis.

Alat ukur untuk menilai kemampuan fungsional pasien dengan osteoartritis lutut: tinjauan pustaka Sayu Aryantari Putri Thanaya; Stanisela Agatha; Luh Putu Ratna Sundari
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Osteoarthritis is a common disease that has become one of the main causes of disability and is ranked fourth as a contributing factor of disability. In Indonesia, many healthcare professionals, including physiotherapists, treat patients with various stages of osteoarthritis. Physiotherapists have a crucial role in improving the functional ability of patients with knee osteoarthritis. However, many of them do not use appropriate outcome measures to document patients’ improvements.Objective: This literature review aimed to summarize the available outcome measures that can be used to measure the functional ability of patients with knee osteoarthritis, in order to increase the awareness and knowledge of healthcare professionals, particularly physiotherapists, regarding the use of available outcome measures.Methods: The method used was literature review. Literature search was conducted in PubMed and Google Scholar databases using the main keywords: “outcome measure”, “scale”, “questionnaire”, “knee”, “osteoarthritis”, “functional ability”, “validity” and “reliability”.Result: This review identified 7 outcome measures in the form of questionnaires that can be used to measure the functional ability of patients with knee osteoarthritis. The most commonly used measure is the Western Ontario and McMaster University osteoarthritis index, which has been translated and validated in various languages. All measuring instruments were established in developed countries, except for the Ibadan Knee Osteoarthritis Outcome Measure. None of the 7 outcome measures have been translated and validated into Indonesian.Conclusion: This literature review has summarized measuring tools that can be used to measure the functional ability of patients with knee osteoarthritis. To date, no tools have been translated and validated into Indonesian. In the future, it is hoped that further research can be conducted in the form of cross-cultural adaptations studies on the validity and reliability of these outcome measures into Indonesian to support the effectiveness of using these measures to assess the functional ability of patients with knee osteoarthritis. Latar belakang: Osteoartritis merupakan penyakit umum yang menjadi salah satu penyebab utama kecacatandan menempati urutan keempat untuk faktor penyebab kecacatan. Di Indonesia, banyak tenaga kesehatan, termasuk fisioterapis, yang merawat pasien dengan bebagai stadium osteoartritis. Fisioterapis sangat berperan dalam meningkatkan aspek fungsional pasien dengan osteoartritis lutut. Namun, banyak yang masih belum menggunakan alat ukur yang sesuai untuk mendokumentasikan kemajuan pasien.Tujuan: Tujuan tinjauan pustaka ini adalah untuk merangkum alat ukur yang dapat digunakan untuk mengukur kemampuan fungsional pasien dengan osteoartritis lutut, guna meningkatkan pengetahuan dan kesadaran tenaga kesehatan, terutama fisioterapis, dalam penggunaan alat ukur yang tersedia.Metode: Metode penelitian yang digunakan adalah tinjauan pustaka. Penelusuran artikel dilakukan pada database PubMed dan Google Scholar dengan kata kunci utama: “outcome measure”, “scale”, “questionnaire”, “knee”, “osteoarthritis”, “validity” dan “reliability”. Hasil: Tinjauan pustaka ini menemukan 7 alat ukur dalam bentuk kuisioner yang dapat digunakan untuk mengukur kemampuan fungsional pasien dengan osteoartritis lutut. Alat ukur yang paling sering digunakan adalah Western Ontario and McMaster University osteoarthritis index, yang sudah diterjemahkan dan divalidasi ke dalam berbagai bahasa. Semua instrumen pengukuran dibuat oleh negara maju, kecuali Ibadan Knee Osteoarthritis Outcome Measure. Dari 7 kuisioner, belum ada yang diterjemahkan dan divalidasi ke dalam Bahasa Indonesia.Kesimpulan: Tinjauan pustaka ini telah merangkum alat ukur yang dapat digunakan untuk mengukur kemampuan fungsional pasien dengan osteoartritis lutut. Sampai saat ini, belum ada kuisioner yang sudah diterjemahkan dan divalidasi ke dalam bahasa Indonesia. Diharapkan adanya pengembangan penelitian berupa studi adaptasi lintas budaya terhadap validitas dan realibilitas kuisioner lainnya ke dalam bahasa Indonesia untuk menunjang efektivitas penggunaan alat ukur dalam menilai kemampuan fungsional pasien dengan osteoartritis lutut.

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