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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
Published by Universitas Udayana
ISSN : 25033638     EISSN : -     DOI : -
Core Subject : Health, Science,
Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.
Arjuna Subject : -
Articles 1,063 Documents
Perbedaan ekspresi Vascular Endothelial Growth Factor (VEGF) pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia Ivana Juliarty Sitanggang; Ni Putu Sriwidyani; I Wayan Juli Sumadi; I Gusti Ayu Sri Mahendra Dewi; Luh Putu Iin Indrayani Maker; I Made Muliarta
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 (507.348 KB) | DOI: 10.15562/ism.v12i2.1027

Abstract

Background: Vascular Endothelial Growth Factor (VEGF) is an angiogenic factor that plays an important role in tumor angiogenesis. VEGF in meningioma is up-regulated and indicates its role as a proangiogenic factor. It has an association with tumor recurrence and progression. This study aims to determine the differences in VEGF expression in low-risk and high-risk meningiomas at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a cross-sectional analytical study with a sample size of 52, which came from meningioma patients examined histopathologically at the Anatomical Pathology Laboratory of Sanglah General Hospital from January to December 2019. The VEGF immunohistochemical staining was performed and interpreted using Histo score (H-score). VEGF expression was categorized into high and low expression, with the cut-off value determined based on the median value. Data were analyzed using SPSS version 20 for Windows.Methods: The results showed that out of 52 meningioma samples, 37 (71.1%) cases of low-risk meningiomas with low VEGF expression, 6 cases (11.5%) of low-risk meningiomas with high VEGF expression, and 9 cases (17.3%) of high-risk meningiomas with high VEGF expression. There was no high-risk meningioma with low VEGF expression. There was a significant difference in VEGF expression between the low-risk and high-risk meningioma groups (p = 0.00), and high VEGF expression had a prevalence risk for the incidence of high-risk meningioma by 2.5 times (95% CI=1.3-4.6).Conclusion: Based on the results of this study, it was concluded that there was a VEGF expression difference between low-risk and high-risk meningiomas in Sanglah General Hospital Denpasar and high VEGF had a prevalence risk for the occurrence of high-risk meningiomas by 2.5 times. Latar Belakang: Vascular Endothelial Growth Factor (VEGF) merupakan faktor angiogenik yang berperan penting dalam angiogenesis tumor. VEGF pada meningioma mengalami up-regulation yang menunjukkan perannya sebagai faktor proangiogenik yang berkaitan dengan rekurensi dan perkembangan tumor. Penelitian ini bertujuan untuk menentukan perbedaan ekspresi VEGF pada meningioma risiko rendah dan risiko tinggi di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel adalah 52, yang berasal dari blok parafin penderita meningioma yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari Januari - Desember 2019. Dilakukan pulasan imunohistokimia VEGF dan penilaiannya menggunakan Histo score (H-score). Ekspresi VEGF dikategorikan menjadi tinggi dan rendah dengan nilai cut-off yang ditentukan berdasarkan nilai median. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian ini menunjukkan bahwa dari 52 sampel meningioma, terdapat 37 kasus (71,1%) meningioma risiko rendah dengan ekspresi VEGF rendah, 6 kasus (11,5%) meningioma risiko rendah dengan ekspresi VEGF yang tinggi, dan 9 kasus (17,3%) meningioma risiko tinggi dengan ekspresi VEGF tinggi. Tidak didapatkan meningioma risiko rendah dengan ekspresi VEGF rendah. Didapatkan perbedaan ekspresi VEGF yang bermakna antara kelompok meningioma risiko rendah dan risiko tinggi (p=0,00) dan ekspresi VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali (95% IK=1,3-4,6).Kesimpulan: Berdasarkan hasil penelitian ini didapatkan perbedaan ekspresi VEGF antara meningioma risiko rendah dan risiko tinggi di RSUP Sanglah Denpasar dan pada VEGF tinggi mempunyai risiko prevalensi untuk terjadinya meningioma risiko tinggi sebesar 2,5 kali.
Obesitas sebagai faktor risiko terjadinya peningkatan kadar trigliserida dalam darah: tinjauan pustaka Baiq Rissa Khaerawati Salim; Desak Made Wihandani; Ni Nyoman Ayu 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 (479.946 KB) | DOI: 10.15562/ism.v12i2.1031

Abstract

Obesity is considered a major factor in the emergence of various diseases such as coronary heart disease, stroke ischemia, and type 2 diabetes mellitus in developed and developing countries. Obesity is defined as an increase in body weight above 20% of normal limits and is associated with abnormal serum lipoprotein levels. Obese people are more at risk for diseases such as Diabetes Mellitus type 2, stroke and other diseases. Excessive fat accumulation in obese people results in increased amounts of free fatty acids hydrolyzed by endothelial lipoprotein lipases. This increase triggers the production of oxidants that have a negative effect on the endoplasmic reticulum and mitochondria. The free fatty acids released due to excessive fat accumulation also inhibit lipogenesis, resulting in an increase in triglyceride levels in the blood. This literature study aims to determine whether obesity is a risk factor for increased blood triglyceride levels based on the relevant literature.  Obesitas dianggap sebagai faktor utama munculnya berbagai macam penyakit seperti penyakit jantung koroner, stroke iskemik, dan diabetes mellitus tipe 2 yang terjadi di negara maju maupun negara berkembang. Obesitas diartikan sebagai peningkatan berat badan di atas 20% dari batas normal dan berhubungan dengan kadar lipoprotein serum tidak normal. Orang obesitas lebih berisiko untuk mengalami penyakit seperti Diabetes Mellitus tipe 2, stroke dan penyakit lainnya. Penumpukan lemak yang berlebihan yang terjadi pada orang obesitas mengakibatkan meningkatnya jumlah asam lemak bebas yang dihidrolisis oleh lipoprotein lipase endotel. Peningkatan ini memicu produksi oksidan yang berefek negatif terhadap retikulum endoplasma dan mitokondria. Asam lemak bebas yang dilepaskan karena adanya penimbunan lemak yang berlebihan juga menghambat terjadinya lipogenesis sehingga mengakibatkan peningkatan kadar trigliserida dalam darah. Tinjauan pustaka ini bertujuan untuk mengetahui apakah obesitas sebagai faktor risiko peningkatan kadar trigliserida dalam darah berdasarkan pada studi literatur yang relevan.
Hubungan ASI eksklusif dengan angka kejadian diare pada anak usia 6 – 24 bulan di RSUD Wangaya Andrew Permana Suliarta; I Wayan Bikin Suryawan; Anak Agung Made Sucipta
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 (290.74 KB) | DOI: 10.15562/ism.v12i2.1032

Abstract

Background: Diarrhea is a gastrointestinal tract disease with the highest incidence rate and the most common cause of death in children under five years old. Based on Riskesdas 2013, the prevalence of diarrhoea in Indonesia is between 1 – 4 years old. Diarrhea is particularly common in developing countries due to inadequate sanitation and hygiene, including a lack of safe, clean water for drinking and a lack of concern for nutrition and overall health. The risk of diarrhoea in children is also influenced by the pattern of breastfeeding. Exclusive breastfeeding in infants is known to protect the babies against diarrhea.Methods: This is an observational study where the data was collected from inpatient medical records between January – December 2019. This study was conducted analytically using a retrospective cross-sectional design. For sampling, a systematic random sampling technique was used. In this study, univariate analysis was used to get the distribution and the proportion of each variable. The relationship between exclusive breastfeeding and the incidence of diarrhea was analyzed using chi-square. Statistical analysis was performed in a 95% coefficient interval (alpha = 0.05).Results: Fifty-six patients were enrolled after meeting the inclusion criteria; 58.3% are male. The number of children who had diarrhea was 36 (64.3%), from that number 38.9% are aged 6 to 12 months, and 61.1% are aged 13 to 24 months. Children who have received exclusive breastfeeding were 22 children (39.3%).  There is a relationship between exclusive breastfeeding to the incidence rate of diarrhea in children aged 6-24 months (p= 0.003). To determine the relative risk estimation using prevalence ratio (RP), with the study calculation obtained 0.51 (< 1).Conclusion: There is a significant relationship between exclusive breastfeeding and the incidence of diarrhea in children aged 6-24 months. The prevalence ratio results in 0.51 it tells that exclusive breastfeeding is a protective factor against diarrhea.  Latar Belakang: Diare adalah salah satu penyakit sistem pencernaan yang memiliki angka kejadian tertinggi dan paling sering menyebabkan kematian pada anak berusia dibawah lima tahun. Faktor risiko diare pada anak juga dipengaruhi oleh pola pemberian ASI eksklusif. ASI eksklusif diketahui memiliki efek perlindungan pada bayi terhadap diare. Penelitian ini bertujuan untuk membuktikan adanya hubungan antara pemberian ASI eksklusif dengan angka kejadian diare pada anak usia 6 – 24 bulan.Metode: Penelitian ini merupakan penelitian observasional yang mengambil data dari rekam medis pasien anak berusia 6 – 24 bulan yang rawat inap bulan Januari – Desember 2019 di ruang Kaswari RSUD Wangaya. Penelitian ini dilakukan secara analitik menggunakan desain cross-sectional retrospektif. Untuk pengambilan sampel menggunakan cara systematic random sampling. Pengolahan dan analisis data dilakukan secara bertahap yaitu dengan melakukan analisis univariat untuk memperoleh distribusi dan proporsi dari variabel-variabel yang diteliti serta analisis bivariat dengan uji statistik chi-square. Analitik yang dilakukan menggunakan interval kepercayaan 95% (alpha = 0,05).Hasil: Terdapat lima puluh enam sampel yang memenuhi kriteria inklusi, 58,3% diantaranya adalah laki-laki. Angka kejadian diare yang terjadi pada anak sebanyak 36 (64,3%), dari angka tersebut 38,9% berusia 6 – 12 bulan dan 61,1% berusia 13 – 24 bulan. Anak yang mendapat ASI eksklusif sebanyak 22 anak (39,3%). Dari hasil penelitian ini didapatkan hubungan antara ASI Eksklusif dengan angka kejadian diare pada anak usia 6 – 24 bulan (p = 0,003). Rasio prevalensi pada penelitian ini didapatkan sebesar 0,51 (< 1).Kesimpulan: Terdapat hubungan yg signifikan antara ASI eksklusif dengan angka kejadian diare pada anak usia 6 – 24 bulan. Dari hasil rasio prevalensi 0,51, menunjukkan bahwa anak yang mendapatkan ASI eksklusif memiliki risiko mengalami diare lebih rendah yaitu 0,51 kali apabila dibandingkan dengan anak yang tidak mendapat ASI eksklusif.
Tuberculosis cases comparison in developed country (Australia) and developing country (Indonesia): a comprehensive review from clinical, epidemiological, and microbiological aspects Ni Luh Putu Harta Wedari; I Wayan Adi Pranata; Ni Nyoman Sri Budayanti; I Dewa Made Sukrama
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (898.853 KB) | DOI: 10.15562/ism.v12i2.1034

Abstract

Background: Tuberculosis (TB) is one of most crucial public health issues around the world. TB is an entity of a complex disease with the socio-economic aspect that has very strong correlation in regard to combat this disease. Migration from developing country to developed country inevitably possesses big influence on global epidemiologic of TB. In Australia, TB still becomes the main threat not only in native population but also regarding the migrant movement into Australia. Indonesia is one of among the TB endemic countries with high TB cases, in which not merely due to its high TB prevalence and incidence but also influenced by very high and dense population.Aim: This literature aims to review the clinical, epidemiological, and microbiological aspects of tuberculosis as a comparison between developed country (Australia) and developing country (Indonesia).Conclusion: Tuberculosis cases in Australia remains low compared to Indonesia, however, the close proximity to adjacent developing countries with high endemic of TB contributes significantly to increase number of TB in Australia. Tuberculosis can be cured by following the treatment guidelines with proper monitoring. Moreover, the collaboration between public and private sector along with active collaboration from the family or people surrounding the patients is required to eliminate TB disease.
Is a high concentration of high-density lipoprotein cholesterol still relevant? Hanselim Hanselim
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 (324.875 KB) | DOI: 10.15562/ism.v12i2.1036

Abstract

The importance of cholesterol management, particularly high-density lipoprotein (HDL) cholesterol, has always been believed to be essential in preventing and managing cardiovascular disease (CVD). While HDL has long been accepted as the 'good' cholesterol, various studies have started to challenge this paradigm. Most of these studies found that HDL cholesterol concentrations did not linearly translate into a reduction in CVD risk. There is a suspicion of dysfunctional HDL particles leading to the loss of HDL's cardioprotective function. Some of these dysfunctions were caused by changes in the structure of HDL particles due to an underlying disease or genetic mutations, causing defects in the reverse cholesterol transport (RCT) mechanism and vascular inflammation inhibition. Therefore, therapies that focus on these two mechanisms are expected to be one of the new cornerstones in reducing CVD. Simultaneously, cholesterol efflux capacity (CEC) assay could become the new therapeutic target as it has an inverse correlation with CVD risk regardless of HDL cholesterol concentration, increasing the accuracy in stratifying CVD risk in patients. However, standardization and a more thorough study on CEC assay and various subcellular cholesterol metabolism should be conducted before stepping further.
Hubungan Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia Katrin Rotua Simbolon; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
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 (724.217 KB) | DOI: 10.15562/ism.v12i2.1037

Abstract

Background: Lymph Node Metastasis (LNM) is considered the most important prognostic factor in breast cancer. The progress of lymphatic metastasis is thought to involve the proliferation of lymphatic vessels (lymphangiogenesis), Lymph Vessel Invasion (LVI), and lymph node metastasis step by step. This study aims to evaluate the association between LVD with LVI and regional LNM in invasive breast carcinoma of no special type.Methods: This study used a cross-sectional analytical study, using a sample of 38 paraffin-embedded tissue from the patient with invasive breast carcinoma of no special type in Sanglah General Hospital, Bali, Indonesia, in 2018. The sample will be used to assess LVD and LVI by D2-40 immunohistochemistry. Expression of D2-40 with vigorous-intensity was evaluated on the membrane and cytoplasm of lymphatic endothelial cells to determine the definition of lymphatic vessels. Lymph vessel density was determined by counting the number of lumens of peritumoral lymphatic vessels in five fields of view with the densest lymphatic vessel lumen using a Leica microscope (DM750, 400x, area 0.225mm2). Data were analyzed using SPSS version 24 for Windows.Results: The LVD cut-off value is 16.5 lymphatic vessel lumens/0.225 mm2 (65.4% for sensitivity and area Under the Curve (AUC)=70.2%). Then cases were classified into the category of high LVD (?16,5 lymphatic vessel lumen/0,225 mm2) and low LVD (<16.5 lymphatic vessels lumen/0,225 mm2). The study found a statistically significant association between LVD and lymph vessel invasion (PR=3.6; p=0.043; 95%CI=0.88-14.78) and regional lymph node metastases (PR =1.7; p=0.02; 95%CI=1.03-2.79).Conclusion: This study proved an association between LVD with lymph vessel invasion and regional lymph node metastases.  Latar Belakang: Metastasis Kelenjar Getah Bening (KGB) dianggap sebagai faktor prognostik yang paling penting pada kanker payudara. Perkembangan metastasis limfatik diduga melibatkan proliferasi pembuluh limfatik (limfangiogenesis), Lymph Vessel Invasion (LVI) atau invasi limfatik, dan metastasis kelenjar getah bening secara bertahap. Penelitian ini bertujuan untuk mengevaluasi hubungan antara Lymph Vessel Density (LVD) dengan invasi limfatik dan metastasis kelenjar getah bening regional pada karsinoma payudara invasif tipe tidak spesifik.Metode: Penelitian ini menggunakan metode analitik potong lintang dengan sampel 38 blok parafin dari pasien karsinoma payudara invasif tipe tidak spesifik di RSUP Sanglah, Bali, Indonesia tahun 2018. Penilaian LVD dan LVI dengan pulasan imunohistokimia D2-40. Ekspresi D2-40 dengan intensitas yang kuat dievaluasi pada membran dan sitoplasma sel endotel limfatik untuk menetapkan definisi pembuluh limfatik. Lymph vessel density ditentukan dengan menghitung jumlah lumen pembuluh limfatik peritumoral pada lima lapangan pandang yang memiliki lumen pembuluh limfatik terpadat, menggunakan mikroskop Leica (DM750, 400x, luas area 0,225mm2). Data dianalisis dengan SPSS versi 24 untuk Windows.Hasil: Nilai cut-off LVD adalah 16,5 lumen pembuluh limfatik/0,225 mm2 (sensitivitas 65,4% dan Area Under the Curve (AUC)=70,2%). Kemudian kasus dikategorikan menjadi LVD tinggi (?16,5 lumen pembuluh limfatik / 0,225 mm2) dan LVD rendah (<16,5 lumen pembuluh limfatik / 0,225 mm2). Hasil analisis statistik menunjukkan bahwa terdapat hubungan antara LVD dengan invasi limfatik (PR=3,6; p=0,043; IK 95%=0,88-14,78) dan metastasis KGB regional (PR=1,7; p=0,02; IK 95%=1,03-2,79).Kesimpulan: Penelitian ini membuktikan bahwa terdapat hubungan antara LVD dengan invasi limfatik dan metastasis KGB regional. 
Kesesuaian pewarnaan gram dengan kultur darah sebagai prediktor nilai kritis kasus bakteremia di Rumah Sakit Umum Pusat Sanglah, Denpasar Putu Yoska Arya Harindana; Ida Sri Iswari; Indramawan Setyojatmiko; Ni Nengah Dwi Fatmawati
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 (481.58 KB) | DOI: 10.15562/ism.v12i2.1038

Abstract

Background: One of the considerations for giving empiric antibiotics in bacteremia cases is gram staining (GS) results. Accurate and fast results are required in distinguishing infection-caused bacteria. However, the data on how much the corresponding gram stain results with bacterial growth in blood cultures are still insufficient.Aim: The study aims to compare Gram stain results with bacterial growth in positive blood cultures.Methods: A cross-sectional analytic study obtained data from the VITEK® 2 Compact (bioMérieux) results for six months (January - June 2020). Data involved all blood cultures examined as many as 509.Results: Of the 509 blood samples, 46 were reported as critical values for bacteremia. Gram-negative bacillus bacteria were identified in 39.13% of the gram staining (GS) and 45.65% of the blood culture (BC) samples. Gram-positive bacteria appeared in 56.52% of GS and 52.17% of BC. MBRO (multidrug-resistant organisms) bacteria were identified in the proportion of 11%, then 13% from ESBL (extended-spectrum beta-lactamase) bacteria, and they remain as 4% MRSA (methicillin-resistant Staphylococcus aureus) bacteria. The higher result, 76% of the data was confirmed from the non-ICU patients.Conclusion: GS can be used as a reference for empiric antibiotic therapy due to its effectiveness, and it has a high degree of similarity with positive blood culture results.  Latar belakang: Salah satu pertimbangan pemberian antibiotika empiris pada kasus bakteremia adalah berdasarkan hasil pewarnaan gram. Dibutuhkan hasil yang akurat dan cepat dalam membedakan bakteri penyebab infeksi. Namun sedikit data tentang berapa besar kesesuaian hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah. Untuk membandingkan hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah yang positif.Metode: Penelitian ini merupakan penelitian analitik cross-sectional. Data diperoleh dari hasil VITEK® 2 Compact (bioMérieux) selama enam bulan (Januari – Juni 2020). Sampel penelitian adalah semua kultur darah yang diperiksa pada periode penelitian berjumlah 509.Hasil: Dari 509 sampel spesimen darah, 46 sampel dilaporkan sebagai nilai kritis prediktor bakteremia. Bakteri batang gram negatif teridentifikasi pada 39,13% sampel pewarnaan gram dan 45,65% sampel hasil kultur darah. Bakteri gram positif muncul pada 56,52% sampel pewarnaan gram dan 52,17% sampel hasil kultur darah. Bakteri MDRO (multidrug resistant organisms) teridentifikasi sebanyak 11%, 13% bakteri ESBL (extended spectrum beta lactamase), dan 4% bakteri MRSA (methicillin-resistant Staphylococcus aureus). Proporsi 76% sampel berasal dari pasien non-ICU.Simpulan: Hasil pewarnaan gram dapat digunakan sebagai acuan terapi antibiotika empiris karena memiliki tingkat kesesuaian yang tinggi dengan hasil kultur darah positif.
Comparison of albumin 4%, gelatine, and ringer lactate as volume expander post-resuscitative phase on cardiac output and lactate serum after Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized prospective study Prieta Adriane; Ni Luh Kusuma Dewi; Ardiyan Ardiyan
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.67 KB) | DOI: 10.15562/ism.v13i1.1043

Abstract

Background. The use of protein colloid in fluid management post-cardiac surgery is debatable whether it is more beneficial than non-protein colloid or crystalloid. Patients who still need more volume after the resuscitative phase might benefit from optimal fluid management by choosing the most beneficial fluid. This study compared albumin 4% administration to gelatine and ringer lactate as a volume expanders post-resuscitative phase after coronary artery bypass grafting (CABG) on-pump.Methods. We conducted a single-centered, single-blind, randomized controlled study that assigned 120 patients undergoing elective CABG on-pump. Subjects who met inclusion criteria received 125 ml/hour of either albumin 4%, gelatine colloid, or Ringer's lactate (RL) as the only infusion fluid for 4 hours after the first assessment post-resuscitative phase,  after intensive care unit (ICU) admission. After fluid administration, patients were reassessed. The assessment included cardiac output and lactate serum as the primary outcome, while the duration of mechanical ventilation, ICU, and hospital stay were recorded as secondary outcomes.Results. The mean of cumulative cardiac output improvement differed between the group albumin 4% 1.18 L/min, gelatine 0.88, and RL 0.74 (p=0.002). Lactate serum decreased in the albumin 4% group as much as 3.31 gr/dl compared to gelatine 2.13 and RL group 2.37 (p=0.005). Duration of mechanical ventilation, length of stay in ICU, and hospital post-operative were shorter in the albumin group than in other groups. Conclusions. Albumin 4% used as a volume expander in the post-resuscitative phase still improved cardiac output and tissue micro-perfusion than gelatine and ringer lactate.
Hubungan homosistein dan Mean Platelet Volume (MPV) terhadap skor modifikasi Gensini pada pasien Coronary Artery Disease (CAD) stabil Made Kris Budiman; Bagus Ari Pradnyana Dwi Sutanegara; Anak Agung Wiradewi Lestari
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 (353.747 KB) | DOI: 10.15562/ism.v12i2.1044

Abstract

Background: Stable Coronary Artery Disease (CAD) is one of Indonesia's most common cardiovascular diseases. One of the most influential risk factors of CAD is homocysteine and Mean Platelet Volume (MPV) levels. Research in Acute Coronary Syndrome (ACS) showed that the increase of homocysteine and MPV positively correlates with coronary artery stenosis showed by angiography. This study evaluates the relationship between MPV and homocysteine to the modified Gensini score in stable CAD.Methods: This is a cross-sectional observational study conducted in Integrated Heart Service (IHS) Sanglah General Hospital, Bali, Indonesia. Homocysteine and MPV levels were measured and correlated with the Gensini score using the Pearson correlation test. Data were analyzed using SPSS version 20 for Windows and considered statistically significant if the p-value less than 0.05.Results: The results showed that most of the patients were male (88.2%), non-obese (94.2%), comorbid hypertension (61.1%), taking statins (98.0%), Ejection Fraction (EF) >40% (84.3%), Glomerular Filtration Rate (GFR) > 60 ml/min/1.7 m2 (86.27%), MPV value < 9.4 (86.3%), and homocysteine levels < 15 (64.7%). There was no significant correlation between homocysteine (r = 0.071; p > 0.05) and MVP (r = 0.088; p > 0.05) on the Gensini score. Meanwhile, Pearson correlation analysis showed a significant negative correlation between serum creatinine levels and Gensini score (r = -0.383; p = 0.006) and also statistically significant in logistic regression analysis (p = 0.022).Conclusion: The results of this study indicate that there is no significant correlation between the examination of homocysteine levels and MPV on the Gensini score in patients with stable CHD. Latar Belakang: Penyakit Arteri Koroner (PJK) stabil merupakan salah satu penyakit kardiovaskular yang paling umum di Indonesia. Salah satu faktor risiko PJK yang paling berpengaruh adalah kadar homosistein dan Mean Platelet Volume (MPV). Penelitian pada Sindrom Koroner Akut (SKA) menunjukkan bahwa peningkatan kadar homosistein dan MPV berkorelasi positif dengan stenosis arteri koroner yang ditunjukkan oleh angiografi. Penelitian ini bertujuan untuk mengevaluasi hubungan antara MPV dan homosistein terhadap skor Gensini termodifikasi pada pasien dengan PJK stabil.Metode: Studi observasional potong lintang dilakukan pada Pelayanan Jantung Terpadu (IHS) RSUP Sanglah, Bali, Indonesia. Kadar homosistein dan MPV diukur dan dikorelasikan dengan skor Gensini menggunakan uji korelasi Pearson. Data dianalisis menggunakan SPSS versi 20 untuk Windows dan dianggap bermakna secara statistik jika nilai p kurang dari 0,05.Hasil: Hasil penelitian menunjukkan bahwa sebagian besar pasien berjenis kelamin laki-laki (88,2%), non-obese (94,2%), komorbid hipertensi (61,1%), mengonsumsi statin (98,0%), Ejection Fraction (EF) >40% (84,3%), Glomerular Filtration Rate (GFR) > 60 ml/min/1,7 m2 (86,27%), nilai MPV < 9,4 (86,3%), dan kadar homosistein < 15 (64,7%). Tidak ditemukan korelasi yang bermakna antara homosistein (r = 0,071; p > 0,05) dan MVP (r = 0,088; p > 0,05) terhadap skor Gensini. Sedangkan analisis korelasi Pearson menunjukkan korelasi negatif lemah bermakna antara kadar serum kreatinin dengan skor Gensini (r = -0,383; p = 0,006) dan juga bermakna secara statistik pada analisis regresi logistik (p=0,022).Simpulan: Hasil penelitian ini menunjukkan bahwa bahwa tidak terdapat korelasi yang bermakna terhadap pemeriksaan kadar homosistein dan MPV terhadap skor Gensini pada pasien dengan PJK stabil.
Hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi pada adenokarsinoma kolorektal Ni Kadek Ayu Maya Damayanti; Ni Wayan Winarti; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; Herman Saputra; I Made Muliarta
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 (607.077 KB) | DOI: 10.15562/ism.v12i2.1045

Abstract

Background: Colorectal carcinoma is a malignant epithelial tumor of the large bowel that occurs due to extrinsic and intrinsic factors. BRAF V600E gene mutation was found in about 10-15% of colorectal carcinoma. This mutation was associated with aggressive biologic behaviors, metastasis and lesser responsiveness to EGFR inhibitors therapy. This study aims to determine the association between BRAF V600E expression with metastasis and the degree of differentiation of colorectal adenocarcinoma.Methods: This cross sectional study involved 43 samples of adenocarcinoma colorectal patients who had histopathological examinations in the period 2018-2019. Immunohistochemical were performed to assess the expression of BRAF V600E. This expression was concluded positively if 75% or more tumor cells showed intense cytoplasmic staining. Data were analyzed using SPSS version 20 for Windows.Results: Within 43 colorectal adenocarcinoma cases, it was found 7 cases (16.3%) had a positive expression of BRAF V600E. This expression was found in metastasis cases (7/25), not found in cases without metastasis (0/18). There was an association between BRAF V600E expression and metastasis (p=0.014). The positive expressions of BRAF V600E were only found in low-grade differentiation (7/35 cases), were not found in high-grade differentiation (0/8 cases), and no association between BRAF V600E mutation and the degree of differentiation (p=0.167).Conclusion: There was an association between BRAF V600E expression and metastasis of colorectal adenocarcinoma. There was no significant association between BRAF V600E expression and the degree of differentiation of colorectal adenocarcinoma. Latar Belakang: Karsinoma kolorektal merupakan suatu tumor ganas epitelial usus besar yang terjadi akibat pengaruh dari faktor ekstrinsik dan intrinsik. Mutasi gen BRAF V600E ditemukan pada sekitar 10-15% kasus karsinoma kolorektal. Mutasi ini berkaitan dengan perilaku biologik agresif, metastasis, serta kurangnya respon terhadap terapi dengan inhibitor EGFR. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara ekspresi BRAF V600E dengan metastasis dan derajat diferensiasi adenokarsinoma kolorektal.Metode: Penelitian menggunakan rancangan analitik potong lintang dengan 43 sampel penderita adenokarsinoma kolorektal yang telah dilakukan pemeriksaan histopatologi pada periode tahun 2018-2019. Pulasan imunohistokimia dikerjakan untuk menilai ekspresi BRAF V600E. Ekspresi BRAF V600E dinyatakan positif jika 75% atau lebih sel tumor mununjukkan pulasan sitoplasma dengan intensitas kuat. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Dari 43 kasus, ditemukan 7 kasus (16,3%) dengan ekspresi BRAF V600E positif. Ekspresi ini hanya dijumpai pada kasus dengan metastasis (7 dari 25 kasus), tidak dijumpai pada kasus tanpa metastasis (0 dari 18 kasus). Didapatkan hubungan bermakna antara ekspresi BRAF V600E dengan metastasis (p=0,014). Ekspresi BRAF V600E positif hanya ditemukan pada kasus derajat diferensiasi rendah (7 dari 35 kasus), tidak ditemukan pada derajat tinggi (0 dari 8 kasus), dan hubungan tersebut tidak bermakna secara statistik (p=0,167).Kesimpulan: Terdapat hubungan antara ekspresi BRAF V600E dengan metastasis pada adenokarsinoma kolorektal. Tidak terdapat hubungan antara ekspresi BRAF V600E dengan derajat diferensiasi pada adenokarsinoma kolorektal.

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