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INDONESIA
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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Faktor-faktor yang berhubungan dengan kematian neonatus di RSUD Sanjiwani Gianyar Ni Kadek Risa Astria; Made Ayu Cynthia Windasari
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 (315.589 KB) | DOI: 10.15562/ism.v12i2.1065

Abstract

Introduction: World Health Organization (WHO) data in 2019 estimated around 2.4 million neonates died at the age of 1 month of life worldwide. Indonesia ranked the seventh position out of 10 countries in terms of the highest neonatal mortality rate, which was around 60,000 neonatal deaths in 2019. Among the leading causes of neonatal mortality are asphyxia, low birth weight (LBW) infants, preterm gestational age, neonatal sepsis and parity. This study aimed to determine the factors associated with neonatal mortality in Sanjiwani Hospital, Gianyar.Methods: This study was a cross-sectional analytic study. The data were obtained from secondary data. The sampling technique was consecutive sampling with a total sample of 104 neonates who met the inclusion and exclusion criteria of the study. The dependent variable was neonatal mortality, while the independent variables were asphyxia, low birth weight, preterm gestational age, neonatal sepsis, and parity. The data were analysed with the chi-square test on SPSS version 26. The relationship between variables was determined to be significant if the p value <0.05 with a 95% confidence interval (CI).Results: Risk factors associated with neonatal mortality included asphyxia (p=0.0001; RP=15.47; 95% CI: 5.93-40.39), preterm gestational age (p=0.0001; RP=5.00; 95% CI: 2.15-11.59), LBW (p=0.0001; RP=8.20; 95% CI: 3.39-19.79), and neonatal sepsis (p=0.005; RP=3.23; 95% CI: 1.42-7.33). Meanwhile, parity was found not to be significantly associated with neonatal mortality (p=0.551; RP=1.28; 95% CI: 0.58-2.84).Conclusion: There is a significant relationship between asphyxia, preterm gestational age, low birth weight and neonatal sepsis with neonatal mortality in Sanjiwani Hospital, Gianyar.  Latar Belakang: Berdasarkan data dari World Health Organization (WHO), pada tahun 2019 diperkirakan sekitar 2,4 juta bayi meninggal pada usia 1 bulan kehidupannya di seluruh dunia. Indonesia menduduki posisi ketujuh dari 10 negara dengan angka kematian neonatus tertinggi yaitu sekitar 60.000 kematian neonatus pada tahun 2019. Faktor-faktor yang dapat mempengaruhi kematian neonatus seperti asfiksia, bayi dengan berat lahir rendah (BBLR), usia kehamilan preterm, sepsis neonatorum dan jumlah paritas. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kematian neonatus di RSUD Sanjiwani Gianyar.Metode: Penelitian ini menggunakan metode analitik dengan desain cross-sectional. Data penelitian diperoleh dari data sekunder. Teknik pengambilan sampel berupa consecutive sampling dengan jumlah sampel yang terlibat sebanyak 104 neonatus yang memenuhi kriteria inklusi dan eksklusi penelitian. Variabel terikat penelitian adalah kematian neonatus, sementara variabel bebas berupa asfiksia, BBLR, usia kehamilan preterm, sepsis neonatorum, dan jumlah paritas. Data dianalisis dengan menggunakan uji chi-square pada SPSS versi 26. Hubungan antar variabel dinyatakan bermakna secara signifikan jika nilai p<0,05 dengan interval kepercayaan (IK) 95%.Hasil: Faktor risiko yang berhubungan dengan kematian neonatus meliputi asfiksia (p=0,0001; RP=15,47; 95% IK: 5,93 - 40,39), usia kehamilan preterm (p=0,0001; RP=5,00; 95% IK: 2,15-11,59), BBLR (p=0,0001; RP=8,20; 95% IK: 3,39-19,79), dan sepsis neonatorum (p=0,005; RP=3,23; 95% IK: 1,42-7,33). Sementara jumlah paritas ditemukan tidak berhubungan secara signifikan dengan kematian neonatus (p=0,551; RP=1,28; 95% IK: 0,58-2,84).Simpulan: Terdapat hubungan yang bermakna antara asfiksia, usia kehamilan preterm, BBLR dan sepsis neonatorum dengan kematian neonatus di RSUD Sanjiwani Gianyar. 
Inflammation after corneoscleral rupture and traumatic cataract due to blunt trauma in a child: a case report Clara Verlina Suhardi; Graecia Bungaran; Nashrul Ihsan
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 (501.338 KB) | DOI: 10.15562/ism.v12i2.1068

Abstract

Background: Ocular trauma is the most common cause of acquired monocular blindness in children. It is because of the inflammation following corneoscleral rupture and traumatic cataracts due to blunt trauma. This case study aims to evaluate the corneoscleral rupture and traumatic cataracts due to blunt trauma in a child.Case Presentation: We present a 5-year-old male who sustained blunt trauma to his right eye. He presented with blurry vision, mild pain and watering from the affected eye. His examination revealed visual acuity of 6/60 in the right eye (RE), corneal laceration extending from 3 o’clock towards 11 o’clock with possible extension to the sclera, and cortical lens matter in the anterior chamber. The patient underwent globe rupture repair under general anesthesia immediately. Postoperative day one revealed 2 mm hypopyon thick inflammation cells and fibrin. He was on topical steroids and topical antibiotics. The fourth postoperative day showed reduced inflammation, wound sutures in place and absence of hypopyon, thick membranous in the pupil. The patient is then referred to the Pediatric Ophthalmology department for a follow-up operation of clearing lens particle remnants to reduce inflammation and IOL insertion. Conclusion:  Management of the injury and traumatic cataract is crucial to prevent vision loss and amblyopia, to maintain binocularity, prevent strabismus or even phthisis bulbi. Along with early management, routine follow-up examination for prevention of other unwanted complications is advised.
Peran sirkumsisi sebagai pencegahan infeksi herpes genetalis: suatu studi kohort retrospektif Made Wardhana; Martina Windari; Marrietta Sugiarti Sadeli; Anak Agung Gde Putra Wiraguna; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Pande Agung Mahariski
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 (268.07 KB) | DOI: 10.15562/ism.v12i2.1069

Abstract

Background: Recurrent genital herpes (RGH) is a sexually transmitted infection that is a serious public health problem and is quite prominent in most countries worldwide. Management for this infection is antiviral and circumcision. Male circumcision significantly reduces human immunodeficiency virus (HIV) infection and other sexually transmitted infections. This research aims to evaluate circumcision efficacy as the prevention for herpes simplex virus type 2 (HSV-2) infection compared with oral acyclovir.Methods: This research is an experimental study with a retrospective cohort approach. We included 45 males, 24 subjects circumcised and 21 subjects without circumcision and took oral acyclovir as standard treatment. RGH was diagnosed based on typical clinical manifestation. Follow up treatment every two weeks and continued to 2 months after circumcised and given with oral acyclovir. Successful treatment was stated without recurrent genital herpes.Results: Of 24 circumcised subjects, 19 were cured, and five non-circumcised subjects suffered recurrent genital herpes (not cured). Among 21 subjects without circumcision was cured, and 12 subjects were not cured. Based on these results, the value of NNT= 2.7.Conclusion: Circumcision can be considered effective in reducing the incidence of HGR and prevent recurrence of HGR with the NNT value of 2.7.  Latar Belakang: Herpes genetalis rekuren (HGR) merupakan infeksi menular seksual menjadi masalah kesehatan masyarakat yang serius dan cukup menonjol pada sebagian besar negara di dunia. Penanganannya adalah oral dengan antivirus dan tindakan sirkumsisi. Sirkumsisi pada pria secara signifikan mengurangi insiden infeksi human immunodeficiency virus (HIV) dan penyakit infeksi menular lainnya. Penelitian ini mengevaluasi efikasi sirkumsisi sebagai pencegahan infeksi virus herpes simpleks tipe 2 (HSV-2) dibandingkan dengan pemberian obat asiklovir.Metode: Studi ekperimental dengan pendekatan retrospektif kohort dengan mengikutsertakan 45 subjek pria dewasa, 24 subjek disirkumsisi dan 21 tanpa sirkumsisi dan hanya diberikan asiklovir sebagai obat standar. Diagnosis HGR dilakukan secara klinis dengan yang manifestasi klinis yang khas da pemeriksaan Tzanck. Setelah pemberian terapi dilakukan kontrol setiap 2 minggu sampai 2 bulan. Terapi dinyatakan berhasil bila tidak ada kekambuhan.Hasil: Dari 24 subjek disirkumsisi, 19 subjek dinyatakan sembuh dan 5 subjek mengalami kekambuhan (tidak sembuh). Dari 21 subjek tanpa sirkumsisi, 9 subjek dinyatakan sembuh dan 12 subjek dinyatakan tidak sembuh. Berdasarkan hasil ini didapatkan nilai NNT=2,7.Simpulan: Sirkumsisi dapat dinilai cukup efektif mengurangi angka kejadian HGR dan dapat mencegah kekambuhan HGR dengan nilai NNT 2.7.
Manajemen multidisiplin Oral Squamous Cell Carcinoma (OSCC): laporan kasus Ni Putu Riskayanti; Dahlia Riyanto; Saka Winias
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 (730.761 KB) | DOI: 10.15562/ism.v12i2.1076

Abstract

Background: Oral squamous cell carcinoma (OSCC) is the most common type of oral cancer and represents more than 90% of all head and neck cancers. The etiology of OSCC is multifactorial. The uses of tobacco, heavy alcohol drinking, less consumption of vegetables and fruit, genetics, trauma and viruses are considered possible risk factors of the OSCC. This case study aims to evaluate the multidiscipline management of OSCC at Universitas Airlangga Dental and Oral Hospital, Surabaya, Indonesia.Case Presentation: This case report presents a 45-year-old female patient who came with chief complaints of ulcer on the lateral right of the tongue that persistent for 3 months ago. The patient also complained of pain when speaking, eating, swallowing, and the pain felt into the right head. The patient has no history of tobacco and alcohol consumption, but her sister has a history of breast cancer. No extraoral abnormalities were found. Intraoral examination results showed a single ulcer with induration on the lateral dextra of the tongue and diffuse pseudomembranous on the dorsal of the tongue. Based on history taking and clinical examination, the patient was suspected of OSCC. The management included debridement of the lesion, complete blood count, fasting blood glucose, HbA1c, and anatomical pathology examination. The patient has also been prescribed anesthetics, antiinflammation and antiseptic mouthwash. The patient was then referred to the head and neck oncologist for hemiglossectomy. Two months after the surgery, there is no complaint of the lateral right of the tongue. The patient also has no complaint about eating and swallowing.Conclusion: The dentist plays an important role in identifying OSCC. The early diagnosis and proper multidisciplinary management of OSCC could improve the prognosis of the case and the patient's life quality. Latar belakang: Oral squamous cell carcinoma (OSCC) adalah jenis kanker mulut yang paling umum dan ditemukan hampir pada 90% dari semua kasus karsinoma di rongga mulut. Etiologi OSCC adalah multifaktorial. Penggunaan tembakau, konsumsi alkohol berlebihan, konsumsi sayur dan buah yang lebih sedikit, genetika, trauma dan virus dianggap sebagai faktor risiko OSCC. Laporan kasus ini bertujuan untuk mengevaluasi manajemen multidisipin OSCC pada Rumah Sakit Gigi dan Mulut (RSGM) Universitas Airlangga, Surabaya, Indonesia.Presentasi Kasus: laporan kasus ini menyajikan kasus seorang pasien wanita berusia 45 tahun yang datang dengan keluhan utama ulserasi pada lateral lidah kanan yang menetap sejak 3 bulan yang lalu. Pasien juga mengeluh nyeri saat berbicara, makan, menelan dan nyeri terasa di kepala kanan. Pasien tidak memiliki riwayat konsumsi tembakau dan alkohol tetapi saudara perempuannya memiliki riwayat kanker payudara. Tidak ditemukan kelainan ekstraoral. Hasil pemeriksaan intraoral menunjukkan ulser tunggal dengan indurasi pada lateral lidah dekstra dan pseudomembran difus pada dorsal lidah. Berdasarkan anamnesis dan pemeriksaan klinis, diagnosa sementara adalah OSCC. Penatalaksanaan meliputi debridement lesi, hitung darah lengkap, glukosa darah puasa, HbA1c, dan pemeriksaan patologi anatomi. Pasien juga diresepkan obat kumur anestetikum, antiinflamasi dan antiseptik. Pasien kemudian dirujuk ke Departemen Bedah Onkologi Kepala Leher untuk dilakukan hemiglosektomi. Dua bulan setelah operasi, tidak ada keluhan pada lidah pasien. Pasien juga tidak memiliki keluhan saat makan dan menelan.Simpulan: Dokter gigi memiliki peran yang penting dalam mengidentifikasi OSCC. Diagnosis dini dan manajemen multidisplin tepat dapat meningkatkan prognosis kasus dan kualitas hidup pasien.
Penanganan kandidiasis orofaring pada pasien Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) dengan nilai CD4 dibawah 10 sel/µL: laporan kasus Winda Dwi Malinda Masuku; Dian Angriany; Saka Winias; Adiastuti Endah Parmadiati
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 (1235.71 KB) | DOI: 10.15562/ism.v12i2.1077

Abstract

Background: The oral manifestation of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is an important indicator because it is a disorder that usually appears first when the immune system is suppressed. Oropharyngeal candidiasis is an opportunistic infection that most often occurs in people suffering from HIV infection or AIDS. It is also an important marker in immunosuppressed states with CD4 values below 200 cells/mm3. This case study aims to evaluate the treatment of oropharyngeal candidiasis in patients with HIV/AIDS with CD4 values below 10 cells/µLCase Presentation: A 30-year-old man complained of a thick and uncomfortable feeling in the entire oral cavity felt since 4 months ago. Clinical examination revealed multiple pseudomembranous, which were removed and left a reddish area at the base of most of the oral cavity to the pharynx. The results of the fungal examination showed that the hyphae were not insulated with the results of candida albicans culture, and the absolute CD4 value was 9 cells/µl. On the second visit, the patient admitted that he was HIV positive by bringing a reactive result on the 3-method anti-HIV examination conducted 3 months earlier. This case was handled by administering an antiseptic mouthwash, topical and systemic antifungal, and referred to the IHAN RSUA polyclinic for ARV therapy.Conclusion: The successful treatment of oropharyngeal candidiasis, in this case, depends on integrated therapy between dentists and internists as well as patient compliance in following doctor's instructions. Latar Belakang: Manifestasi oral Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) menjadi indikator penting karena merupakan kelainan yang biasanya muncul pertama kali saat kondisi imun tersupresi. Kandidiasis orofaring merupakan suatu infeksi oportunistik yang paling sering terjadi pada orang yang menderita infeksi HIV atau AIDS. Hal ini juga disadari sebagai suatu pertanda penting pada keadaan imunosupresi dengan nilai CD4 dibawah 200 sel/mm3. Laporan kasus ini bertujuan untuk mengevaluasi penanganan kandidiasis orofaring pada pasien (HIV/AIDS) dengan nilai CD4 dibawah 10 sel/µLPresentasi Kasus: Seorang laki-laki berusia 30 tahun mengeluhkan rasa tebal dan tidak nyaman pada seluruh rongga mulut yang dirasakan sejak 4 bulan yang lalu. Pemeriksaan klinis ditemukan pseudomembran multipel yang dapat dihapus dan meninggalkan area kemerahan di dasarnya pada hampir seluruh rongga mulut hingga ke faring. Hasil pemeriksaan jamur menunjukkan hyphae tidak bersekat dengan hasil biakan candida albicans, dan nilai CD4 absolut 9 cell/µl. Kunjungan kedua Pasien mengakui sebagai pengidap HIV dengan membawa hasil reaktif pada pemeriksaan anti-HIV 3 metode yang telah dilakukan 3 bulan sebelumnya. Penanganan kasus ini dengan pemberian antiseptik kumur, anti jamur topikal dan sistemik serta dirujuk ke poli IHAN RSUA untuk melakukan terapi ARV.Kesimpulan: Keberhasilan penanganan kandidiasis orofaringeal pada kasus ini bergantung pada terapi yang terintegrasi antara dokter gigi dan dokter penyakit dalam serta kepatuhan pasien dalam mengikuti instruksi dokter. 
Sifilis sekunder pada seorang remaja perempuan: laporan kasus Ida Ayu Uttari Priyadarshini; Elice Wijaya; Ni Made Dwi Puspawati
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 (676.688 KB) | DOI: 10.15562/ism.v12i2.1078

Abstract

Introduction: Syphilis is one of the most common sexually transmitted infections worldwide. Syphilis can be acute to chronic. Syphilis is caused by the parasite Treponema pallidum (T. pallidum). Transmitted through sexual contact and blood. In this case, we report a case of secondary syphilis in an adolescent girl.Case report: an 18-year-old girl came with complaints of red spots on the palms of the hands and soles of the feet, with a history of sores in the pubic area that were painless and odorless and then healed on their own so no treatment was given. A history of positive sexual contact approximately one week before the patient came for examination. On dermatological status, right and left palmar and plantar locations found erythematous macules, round to geographical in shape with diameters of 0.5 cm - 1.5 cm and 0.5 cm x 0.7 cm - 0.7 cm x 1 cm, scattered discrete and localized distributions. The patient was differentially diagnosed with secondary syphilis with syphilitic roseola, pityriasis rosea and palmoplantar psoriasis. To confirm the diagnosis, a serological examination was carried out on June 10th 2020, Venereal disease research laboratory test (VDRL) examination with reactive results with a titer of 1:32 and reactive treponema pallidum hemagglutination assay (TPHA) with a TPHA titer of 1:2560. He was given a single dose of intramuscular (IM) injection of benzathine penicillin G 2.4 million international units (IU) and education on further follow up for VDRL laboratory test.Conclusion: A case of secondary syphilis with manifestations of syphilitic roseola has been reported in an 18-year-old teenager. The patient's has a generally good prognosis because in general the patient's condition is good, but considering the patient is still a teenager, it is possible to have irresponsible sexual relations later in life.  Pendahuluan: Sifilis merupakan salah satu penyakit infeksi menular seksual yang sering ditemukan. Sifilis dapat berbentuk akut hingga kronis. Sifilis disebabkan oleh parasit Treponema pallidum (T. pallidum). Menular melalui kontak seksual dan darah. Pada kasus ini dilaporkan sebuah kasus sifilis sekunder pada remaja perempuan.Laporan kasus: remaja perempuan 18 tahun datang dengan keluhan bercak-bercak kemerahan pada telapak tangan dan telapak kaki, dengan riwayat luka pada daerah kemaluan tidak nyeri dan tidak berbau kemudian sembuh sendiri sehingga tidak dilakukan pengobatan. Riwayat kontak seksual positif kurang lebih satu minggu sebelum pasien datang melakukan pemeriksaan. Pada status dermatologi, lokasi palmar dan plantar dekstra et sinistra ditemukan makula eritema, berbentuk bulat hingga geografika dengan ukuran diameter 0,5 cm - 1,5 cm dan 0,5 cm x 0,7 cm – 0,7 cm x 1 cm, tersebar diskret dan distribusi lokalisata. Pasien didiagnosis banding dengan sifilis sekunder dengan roseola sifilitika,  pitiriasis rosea dan palmoplantar psoriasis. Untuk menegakkan diagnosis dilakukan pemeriksaan serologis pada tanggal 10 Juni 2020 yakni pemeriksaan VDRL dengan hasil reaktif dengan titer 1:32 dan TPHA reaktif dengan titer TPHA 1:2560. Diberikan terapi injeksi benzatin penisilin G 2,4 juta international unit (IU) intramuskular (IM) dosis tunggal dan edukasi pemantauan pengobatan yang akan dilakukan yakni pemeriksaan VDRL ulang pada bulan ke-1 setelah terapi.Simpulan: Telah dilaporkan satu kasus sifilis sekunder dengan manifestasi roseola sifilitika pada remaja berusia 18 tahun. Prognosis pasien adalah dubia ad bonam karena pada umumnya kondisi pasien baik, namun mengingat pasien masih remaja, ada kemungkinan untuk melakukan hubungan seksual yang tidak bertanggung jawab di kemudian hari.
Karakteristik malnutrisi rumah sakit pada pasien anak di RSUP Sanglah, Bali, Indonesia Hanzelina Hanzelina; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi
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 (326.682 KB) | DOI: 10.15562/ism.v12i2.1079

Abstract

Background: Hospital Malnutrition (HM) is malnutrition diagnosed while being treated at the hospital either when admitted to the hospital, during treatment or even when discharged from the hospital, which is closely related to hospital care. The incidence of HM is still quite high and can increase morbidity and mortality among inpatient children. This study aims to determine the characteristics of in-hospital malnutrition cases in children undergoing treatment at Sanglah Hospital.Methods: This study used a prospective cohort design using primary data obtained from interviews and anthropometry of 120 children hospitalized at Sanglah Hospital in the 2019-2020 period. HM was defined as a decrease in a Z-score of Weight/Height (W/H) > 0.5 Standard Deviation (SD) at the time of hospital discharge. Data were analyzed using SPSS version 20 for Windows.Results: The incidence of HM was 47.1%, of which 54.0% of patients were female. The incidence of in-hospital malnutrition was primarily found in patients aged 1-3 years (50.0%) and >5 years (42.0%). Approximately 64.0% of children with HM were malnourished before being admitted to the hospital and 14.0% got parenteral nutrition. It was found that 72% of children with HM had a hospital stay length of > 7 days. More than half of children with HM (56.0%) have parents with low levels of education (less than secondary education) and 58.0% have more than 3 siblings.Conclusion: The incidence of hospital malnutrition is more often found in girls, age >5 years old, malnutrition before admitted, get parenteral nutrition, had parents with low education levels, number of siblings > 3, had a single diagnosis and length of stay > 7 days.  Latar Belakang: Malnutrisi rumah sakit (MRS) adalah malnutrisi yang didiagnosis saat dirawat di Rumah Sakit (RS) baik saat masuk RS, selama perawatan atau bahkan saat pasien keluar dari rumah sakit yang erat kaitannya dengan perawatan di RS. Kejadian MRS masih cukup tinggi dan dapat meningkatkan morbiditas dan mortalitas pada anak yang dirawat. Penelitian ini bertujuan untuk mengetahui karakteristik dari kasus MRS pada anak yang menjalani perawatan di RSUP Sanglah.Metode: Studi ini menggunakan desain kohort prospektif dengan menggunakan data primer dari wawancara dan pemeriksaan antropometri terhadap 120 anak yang dirawat inap di RSUP Sanglah pada periode 2019-2020. MRS didefinisikan sebagai penurunan Z-score Berat Badan/Tinggi Badan (BB/TB) > 0,5 Standard Deviation (SD) pada saat keluar RS. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Kejadian MRS ditemukan sebanyak 47,1% dengan 54,0% sampel berjenis kelamin perempuan. Insidens MRS paling banyak ditemukan pada pasien kelompok usia 1-3 tahun (50,0%) dan >5 tahun (42,0%). Sebanyak 64,0% anak dengan MRS sudah mengalami malnutrisi sebelum masuk RS dan 14,0% mendapatkan nutrisi parenteral. Ditemukan bahwa 72,0% anak dengan MRS memiliki lama rawat di RS >7 hari. Lebih dari separuh anak dengan MRS (56,0%) memiliki orang tua dengan tingkat pendidikan rendah (<SMP) dan 58,0% memiliki jumlah saudara lebih dari > 3.Kesimpulan: Insiden MRS lebih sering ditemukan pada anak perempuan, kelompok usia >5 tahun, malnutrisi sebelum masuk RS, mendapatkan nutrisi parenteral, memiliki orang tua dengan tingkat pendidikan rendah, jumlah saudara kandung > 3, serta memiliki diagnosis tunggal serta lama rawat > 7 hari. 
Karakteristik pasien kanker kulit non-melanoma di RSUP Sanglah pada periode tahun 2014 - 2018 I Gusti Agung Ivan Yogiswara; Herman Saputra; Ni Putu Ekawati
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 (270.312 KB) | DOI: 10.15562/ism.v12i2.1080

Abstract

Background: Skin cancer is a disease caused by changes in the properties of the constituent skin cells from normal to malignant. There are 3 most common types of skin cancer: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and malignant melanoma. This study aims to determine the clinicopathological characteristics of non-melanoma skin cancer patients, especially BCC and SCC, at Sanglah General Hospital, Denpasar, in 2014 – 2018.Methods: This study is a retrospective descriptive study. Clinicopathological data of non-melanoma skin cancer patients were obtained from the histopathological examination archive at the Anatomical Pathology Laboratory of Sanglah General Hospital from 2014 – 2018. Data were analyzed using SPSS version 20 for Windows.Results: During 2014 – 2018, there were 100 patients with non-melanoma skin cancer at Sanglah Hospital. Based on histopathological type, there were 39 cases (39.0%) of BCC and 61 cases (61.0%) of SCC. BCC was predominant in the age group above 70 years (33.33%) and the highest type of SCC in the age group 50-59 years (32.79%). Based on gender, BCC is more frequent in women by 53.85% and SCC is more frequent in men by 54.10%.Conclusion: The highest non-melanoma skin cancer cases were SCC with age more than 50 years and were more commonly found in men. Latar Belakang: Kanker kulit adalah salah satu penyakit yang diakibatkan oleh berubahnya sifat-sifat penyusun sel kulit yang awalnya normal menjadi ganas. Terdapat 3 jenis kanker kulit yang tersering, yaitu Karsinoma Sel Basal (KSB), Karsinoma Sel Skuamosa (KSS), dan melanoma maligna. Tujuan penelitian ini adalah untuk mengetahui karakteristik klinikopatologi pasien kanker kulit non-melanoma khususnya karsinoma sel basal dan karsinoma sel skuamosa di RSUP Sanglah Denpasar pada periode tahun 2014 – 2018.Metode: Penelitian ini adalah penelitian deskriptif retrospektif. Data klinikopatologi pasien kanker kulit non-melanoma diperoleh dari arsip pemeriksaan histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar tahun 2014 – 2018. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Selama periode tahun 2014 – 2018 terdapat 100 pasien kanker kulit non-melanoma. Berdasarkan tipe histopatologi, terdapat 39 kasus (39,00%) KSB dan 61 kasus (61,00%) KSS. KSB ditemukan terbanyak pada kelompok usia diatas 70 tahun (33,33%) dan tipe KSS terbanyak pada kelompok usia 50-59 tahun (32,79%). Berdasarkan jenis kelamin, KSB lebih banyak pada perempuan sebesar 53,85% dan KSS lebih banyak pada laki – laki sebesar 54,10%.Kesimpulan: Kasus kanker kulit non-melanoma tertinggi adalah KSS dengan usia lebih dari 50 tahun dan lebih banyak ditemukan pada laki – laki. 
Kelainan elektrolit berulang pada pasien dengan kecurigaan Sindrom Gitelman Beny Surya Wijaya; Kadek Wisnu Segara Karya
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 (387.639 KB) | DOI: 10.15562/ism.v12i3.1082

Abstract

Pendahuluan: Sindrom Gitelman merupakan tubulopati yang terjadi akibat mutasi pada gen Solute Carrier Family 12 Member 3 (SLC12A3), yang mengkode thiazide-sensitive natrium chloride co-transporter (NCCT) pada membran apikal sel tubulus distal. Sindrom ini bersifat autosomal resesif yang ditandai dengan hipokalemia, alkalosis metabolik, hipomagnesemia, dan hipokalsiuria. Gejala yang sering muncul adalah kram dan kelemahan mulai dari keterbatasan aktivitas ringan hingga berat.Laporan kasus: Laki-laki usia 19 tahun datang dengan keluhan lemas disertai kaku otot seluruh anggota gerak dan leher, mual, muntah, nyeri kepala, dan nyeri ulu hati. Pasien memiliki riwayat rawat inap tiga kali dengan keluhan serupa. Pada pemeriksaan fisik ditemukan tanda vital dalam batas normal, serta adanya tanda Chvostek. Pemeriksaan darah lengkap dalam batas normal. Pemeriksaan elektrolit menunjukan kadar natrium 118 mmol/L, kalium 2,16 mmol/L, dan klorida 74 mmol/L. Pasien sudah berulang kali melakukan pemeriksaan elektrolit dengan hasil hipokalemia. Delapan bulan sebelumnya, pasien dirawat akibat penurunan kesadaran dengan gambaran alkalosis metabolik, hipokalemia (2,59 mmol/L), hipomagnesemia (0,76 mg/dL) dan hipokalsemia (8,2 mg/dL). Pemeriksaan fungsi ginjal, urinalisis, dan elektrokardiografi dalam batas normal. Berdasarkan keluhan, riwayat penyakit, dan pemeriksaan penunjang berupa hipokalemia berulang, alkalosis metabolik, dan hipomagnesemia, maka dicurigai suatu Sindrom Gitelman. Pasien diterapi dengan kalium klorida (KCl) intravena 50 mEq dalam natrium klorida (NaCl) 0,9% 500 cc dengan laju 20 tetes per menit, tablet KCl 600 mg tiap 8 jam, kapsul garam dapur 500 mg tiap 12 jam, omeprazole serta ondansetron intravena sesuai keluhan. Pasien dirawat inap satu hari dan dipulangkan setelah kadar kalium terkoreksi (3,1 mmol/L) dan keadaan klinis membaik. Pemeriksaan analisis DNA untuk penegakan diagnosis tidak dilakukan karena keterbatasan fasilitas dan biaya.Kesimpulan: Sindrom Gitelman merupakan tubulopati yang bersifat autosomal resesif ditandai dengan hipokalemia, alkalosis metabolik, hipomagnesemia, dan hipokalsiuria. Tatalaksana sindrom ini tergantung pada klinis dan gangguan laboratorium. Suplemen natrium, kalium, dan magnesium merupakan terapi yang paling sering dibutuhkan. Introduction: Gitelman syndrome is a tubulopathy that occurs due to mutations in the Solute Carrier Family 12 Member 3 (SLC12A3) gene, which encodes thiazide-sensitive sodium chloride co-transporter (NCCT) in the apical membrane of distal tubule cells. This autosomal recessive syndrome characterized by hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalsiuria. Common symptoms are cramps and weakness ranging from mild to severe limitation of activity.Case Report: a 19 years-old-man present a general weakness accompanied by muscle stiffness throughout the limbs and neck, nausea, vomiting, headache, and heartburn. The patient had a history of hospitalization three times with similar complaints. Normal vital signs and Chvostek's sign were found on physical examination. Complete blood count was within normal limits. Electrolyte examination showed sodium 118 mmol/L, potassium 2.16 mmol/L, and chloride 74 mmol/L. The patient had repeated episode of hypokalemia. In the previous eight months, he was admitted due to decreased of consciousness with metabolic alkalosis, hypokalemia (2.59 mmol/L), hypomagnesemia (0.76 mg/dL) and hypocalcemia (8.2 mg/dL). Kidney function, urinalysis, and electrocardiography within normal limits. Based on complaints, medical history, and the results of investigations a Gitelman syndrome was suspected. The patient was treated with 50 mEq intravenous KCL in 500cc NaCl 0,9% at a rate of 20 drops per minute, 600 mg KCl tablets every 8 hours, 500 mg table salt capsules every 12 hours, intravenous omeprazole and ondansetron as needed. The patient discharged after the potassium level was corrected (3.1 mmol/L) and improved clinical condition. Follow-up examination in the form of DNA analysis was not carried out due to limited facilities and funding.Conclusion: Gitelman syndrome is an autosomal recessive tubulopathy characterized by hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. Management of this syndrome in accordance with clinical and laboratory abnormalities that occur. The most frequently needed therapy are sodium, potassium, and magnesium supplement.
The comparison of Body Mass Index (BMI) and Muscle Mass Index (MMI) as a mortality predictor in patients with malignant jaundice at Dr. Sardjito General Hospital, Yogyakarta, Indonesia Briand Iggreinus Pollah; 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 (455.468 KB) | DOI: 10.15562/ism.v12i2.1083

Abstract

Background: Jaundice is found to be a clinical manifestation of malignancy. Around 70% of all jaundice cases are caused by malignancy. Another complication of malignancy is decreasing the Muscle Mass Index (MMI), also called sarcopenia. MMI in malignant jaundice increases the mortality rate. Body Mass Index (BMI) is describing the nutritional status of a person. Due to malnutrition, morbidity and mortality increase. This study aims to compare the MMI and BMI in patients with malignant jaundice to predict the outcome of mortalityMethods: This study is a retrospective cross sectional non-experimental epidemiologic analysis. Samples were taken from medical reports at Sardjito Hospital from April 2019 - March 2020. A CT scan calculated MMI at the third lumbar vertebrae. BMI was evaluated by body weight (kg) divided by height (m) square (kg/m2). Data were analyzed using SPSS version 20 for Windows.Results: Most of respondents were males (55.0%), following by age > 50 (62.5%), stage 3 (62.5%), ASA 2 (92.5%), albumin < 3.5 g/dL (82.5%), CA19-9 > 37 U/ml (57.5%), CEA < 5 ng/ml (62.5%), and total bilirubin > 1.5 mg/dL (90.0%), normal BMI (62.5%), survive (77.5%), and low MMI (72.5%). There was no significant relationship between MMI (OR: 5.71; 95%CI: 0.60-134.12) and BMI (OR: 0.15; 95%CI: 0.02-1.34) to the mortality risk (p>0.05).Conclusion: MMI had a higher incidence of mortality compared to BMI in malignant jaundice. However, there was no significant relationship between MMI and BMI to predict mortality.

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