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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.
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Articles 1,063 Documents
Hubungan antara ekspresi Epidermal Growth Factor Receptor (EGFR) dengan berbagai parameter klinik dan patologis Triple Negative Breast Cancer (TNBC) di RSUP Sanglah, Bali, Indonesia Volman Tampubolon; Ni Putu Sriwidyani; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; Ni Made Mahastuti; I Made Muliarta
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 (543.529 KB) | DOI: 10.15562/ism.v12i3.1189

Abstract

Background: Triple Negative Breast Cancer (TNBC) is a heterogeneous group of breast cancer. Some cases show a good outcome; others show higher recurrence and metastasis. There are several molecular subtypes of TNBC. Basal-like 2 (BL-2) subtype involves Epidermal Growth Factor (EGF) signaling pathway, enriched with many growth factor receptors such as EGFR. This study aims to determine the association between EGFR expression and various clinicopathological parameters in TNBC patients in Sanglah Hospital Denpasar.Methods: This study was an analytical cross-sectional study involving 35 patients TNBC who were examined histopathologically at the Anatomical Pathology Laboratory in Sanglah Hospital Denpasar from January 1st 2016 to December 31st 2020. Re-evaluation of the specimen was conducted to assess histopathological diagnosis, grade, tumor size (T), Lymphovascular Invasion (LVI) and nodal status (N). EGFR expression was evaluated by immunohistochemistry staining and then interpreted based on the intensity and continuity of the stained cell membrane. The association between EGFR expression and clinicopathological parameters was analyzed with a Chi-Square test with a 0.05 significance level.Result: The result of this study showed the age range of TNBC patients was 29-70 years with mean age was 49.7±11.4 years. There were significant association between EGFR expression with T (p=0.008; PR = 2.7; 95%CI 1.4-5.1), LVI (p=0.018; PR = 3.0; CI95% 1.300-7.137) and N (p=0.033; PR=2.7; CI95% 1.121-6.543). There were no significant association between EGFR expression with age (p=1.000), grade (p=0.689) and Ki67 index (0.689).Conclusion: It can be concluded that there are associations between EGFR expression with T, LVI and N. There was no association between EGFR expression with age, grade and Ki67 index.  Latar Belakang: Triple negative breast cancer (TNBC) merupakan kelompok kanker payudara yang heterogen. Sebagian kasus menunjukkan survival yang baik, namun sebagian lainnya dengan rekurensi dan metastasis yang lebih tinggi. Terdapat beberapa subtipe molekuler dari TNBC, salah satunya subtipe Basal-like 2 (BL2) yang melibatkan jalur pensignalan Epidermal Growth Factor (EGF), melalui berbagai reseptor factor pertumbuhan, salah satunya EGFR. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi EGFR dengan berbagai parameter klinikopatologi pada kasus TNBC di RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan studi analitik potong lintang dengan besar sampel 35 kasus TNBC yang diperiksa histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah Denpasar dari 1 Januari 2016 hingga 31 Desember 2020. Evaluasi ulang preparat dilakukan untuk menilai diagnosis histopatologi, grade, ukuran tumor (T), Lymphvascular Invasion (LVI) dan status nodal (N). Ekspresi EGFR dinilai dengan pewarnaan imunohistokimia selanjutnya di interpretasi berdasarkan intensitas dan kuntinuitas membran  sel yang terpulas. Hubungan antara ekspresi EGFR dengan parameter klinikopatologi dianalisis dengan uji Chi-Square dengan nilai kemaknaan p<0,05.Hasil: Hasil penelitian ini menunjukkan rentang usia pasien TNBC 29-70 tahun dan rerata 49,7±11,4 tahun. Terdapat hubungan bermakna antara ekspresi EGFR dengan T (p=0,008; RP=2,7; IK95% 1,4-5,1), LVI (p=0,018; RP = 3,0; IK 95% 1,300-7,137), dan N (p=0,033; RP=2,7; IK95% 1,121-6,543). Tidak terdapat hubungan bermakna antara umur (p=1,000), grade (p=0,689) dan indeks Ki67 (p=0,689).Simpulan: Hasil dari penelitian ini adalah terdapat hubungan antara ekspresi EGFR dengan ukuran tumor, LVI dan status nodal (N). Tidak terdapat hubungan antara ekspresi EGFR dengan umur, grade dan indeks Ki67.          
Effect of prone positioning for improving oxygenation in awake non-intubated COVID-19 patient: a systematic review I Made Yoga Prabawa; Dedi Silakarma; Sisca Susantio
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 (614.244 KB) | DOI: 10.15562/ism.v12i3.1191

Abstract

Background. The rapid rise of COVID-19 cases in many regions impacted on increasing needs of intensive care units and oxygen supplementation. The exponential COVID-19 infection with moderate to severe hypoxia that needs oxygen supplementation causes medical oxygen shortage in most hospitals and swamped the health care system. Prone positioning can be an alternate way for non-hospitalized COVID-19 patients, especially in the region facing oxygen and ward shortage in hospitals. This systematic review will describe the impact of the prone positioning method for improving oxygenation in awake non-intubated COVID-19 patients.Method. A systematic review using PubMed and Google Scholar was conducted based on PRISMA guidelines. We used inclusion criteria such as observational study with cross sectional, cohort, case-control or clinical trial study design regarding the effect of prone positioning for improving oxygenation in COVID-19 patients. Exclusion criteria were a letter to the editor, commentary reports, systematic review or meta-analysis, study involving non-awake and or intubated patients and study not available in full-text. Result. We gathered eleven studies consisting of six retrospective observational studies, three prospective observational studies and two clinical trials comprised of one randomized controlled trial and one interventional study. There are 791 awake non-intubated COVID-19 patients as the study sample. The measured outcomes are changes in SaO2, P/F ratio, S/F ratio, ROX index, intubation and mortality rate. The prone positioning duration varies between 29 minutes until 12 hours and helps improve oxygenation, reducing intubation and mortality.  Conclusion. Prone positioning is feasible to apply in awake non-intubated COVID-19 patients. It can improve oxygenation, reduce intubation, mortality rate and be beneficial to overcome oxygen and mechanical intubation shortage during the COVID-19 pandemic.
Pengaruh dukungan sosial dan regulasi emosi terhadap kecenderungan depresi di Surabaya Harir Putriana; Elly Yuliandari Gunatirin
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 (430.405 KB) | DOI: 10.15562/ism.v12i3.1192

Abstract

Background: Cases of depression are increasing during the pandemic. It is necessary to understand the various things that can prevent the possibility of depression. A person's mental health condition is affected because they have to adjust to different needs and situations they experience, where their lives will never be the same again. This study aims to determine the effect of social support and emotional regulation on depression tendencies.Methods: This research is a cross-sectional study with quantitative research using a survey. The measuring instrument used is the PHQ-9 to measure the tendency to depression, PSQ to see social support and ERQ to see the ability to manage emotions. There were 291 informants included in this study—selection of informants by purposive sampling method. Analysis of the data using regression analysis showed the social support model and emotional regulation of depression tendencies.Results: The result showed a significant correlation in the social support and emotional regulation model on depression tendencies (R=0918, p<0.01). The higher the emotional support and emotional regulation, the smaller the risk of experiencing depression. These two variables contribute 84% to the likelihood of depression.Conclusion: Emotional support and emotion regulation are two significant variables to keep someone from experiencing depression. Efforts to maintain relationships and social communication, and emotional management still need to be done to maintain the risk of experiencing depression. Pendahuluan: Kasus depresi semakin meningkat pada saat pandemi berlangsung. Masalah tersebut harus diberikan perhatian untuk mencegah kemungkinan timbulnya depresi. Kondisi kesehatan mental seseorang terpengaruh karena harus menyesuaikan berbagai kondisi dan situasi yang dialaminya, dimana kehidupan yang dijalani tidak akan pernah sama lagi. Penelitian ini bertujuan untuk mengetahui pengaruh dukungan sosial dan regulasi emosi terhadap kecenderungan depresi.Metode: Penelitian ini merupakan penelitian dengan desain studi cross-sectional dengan menggunakan survey. Alat ukur yang digunakan adalah PHQ-9 untuk mengukur kecenderungan depresi, PSQ untuk melihat dukungan sosial dan ERQ untuk melihat kemampuan pengelolaan emosi. Responden yang disertakan dalam penelitian ini sejumlah 291 orang.  Pemilihan responden dengan metode purposive sampling. Analisa data menggunakan analisis regresi yang diperoleh menunjukkan bahwa model dukungan sosial dan regulasi emosi terhadap kecenderungan depresi.Hasil: Penelitian ini menunjukkan adanya korelasi yang signifikan pada model dukungan sosial dan regulasi emosi terhadap kecenderungan depresi (R=0.918, p <0.01). Semakin tinggi dukungan emosi dan regulasi emosi maka semakin kecil risiko mengalami depresi. Kedua variabel ini memberikan sumbangan 84% terhadap kemungkinan depresi.Simpulan: Dukungan emosi dan regulasi emosi merupakan dua variabel yang signifikan untuk menjaga seseorang dari kemungkinan mengalami depresi. Upaya untuk bisa menjaga relasi dan komunikasi sosial serta pengelolaan emosi tetap perlu dilakukan untuk menjaga risiko mengalami depresi.
Korelasi nilai Homeostasis Model Assesment for Insulin Resistance (HOMA-IR) dan kadar vitamin D pada remaja dengan obesitas di Kota Denpasar, Bali, Indonesia Luh Gede Yuliadewi NS; I Made Arimbawa; Ketut Suarta; I Gde Raka Widiana; Made Kardana; Ni Putu Veny Kartika Yantie; Komang Ayu Witarini
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 (363.024 KB) | DOI: 10.15562/ism.v12i3.1193

Abstract

Background: Obesity during adolescence can developed into obesity in adulthood and will increase the risk of metabolic dissease sush as insulin resistance. Recent years the role of vitamin D begin to be connection with insulin resistance. Vitamin D plays a role in regulation of synthesis dan insulin secretions from pancreatic beta cells, increase peripheral and hepatic glucose uptake. In obesity there is decrease in vitamin D bioavailability that causes low levels of vitamin D. This study aimed to proves a correlation between insulin resistance and vitamin D levels in adolescents with obesity.Methods: A observational analytic research with crossestional design has been done in junior and senior high school in Denpasar. Adolescennts performed anthropometric screening covers weight, height, body mass index (BMI), obesity if BMI  > 95th percentile of CDC 2000 curve. Examined vitamin D levels and insulin resistance through calculation of HOMA-IR levels. Sample size calculation with ? 0,05, correlation coefficient (r) set to 0,5 with minimum sampel size 50. Data were analyzed using SPSS versin 17 for Windows.Results: Anthropometric screening performed obtained 135 students (3,3%) with obesity. Mean of vitamin D levels was 18,9 ng/mL, 10 (20 %) classified as vitamin D insufficiency and 39 (78 %) vitamin D deficiencies. The average of HOMA-IR levels 3,84, 24 (48 %) with insulin resistance based on HOMA-IR levels. Correlation coefficient between HOMA-IR levels and vitamin D was obtained – 0,37 (p=0,007). There was significant difference of prevalence of insulin resistance between obese adolescent with vitamin D deficiency compared with insuficiency and suficiency group (OR=5.8; 95%CI=1.1-30.6; p=0.025).Conclusion: This study concluded that There is a moderate negative correlation between HOMA-IR levels and vitamin D in obese adolescents. Latar Belakang: Obesitas pada masa remaja berisiko menjadi obesitas pada masa dewasa dan meningkatkan risiko penyakit metabolik seperti resistensi insulin. Beberapa tahun terakhir peran vitamin D mulai dihubungkan dengan resistensi insulin. Vitamin D berperan dalam regulasi sintesis dan sekresi insulin oleh sel beta pankreas, meningkatkan uptake glukosa perifer dan hepatik. Pada obesitas terjadi penurunan bioavaibilitas vitamin D yang menyebabkan rendahnya kadar vitamin D. Penelitian ini bertujuan untuk membuktikan adanya korelasi antara kadar vitamin D dengan resistensi insulin pada remaja dengan obesitas.Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang pada remaja SMP dan SMA di kota Denpasar. Remaja dilakukan skrining antropometri meliputi berat badan, tinggi badan, Indeks Masa Tubuh (IMT). Diagnosis obesitas jika IMT > persentil 95 kurva CDC 2000. Dilakukan pemeriksaan kadar vitamin D darah dan resistensi insulin melalui perhitungan kadar HOMA-IR. Perhitungan besar sampel dengan ? 0,05 ( tingkat kemaknaan 0,95), koefesien korelasi (r) ditetapkan 0,5 dengan jumlah sampel minimal 50. Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Skrining antropometri dilakukan pada 135 subyek (3,3%) dengan obesitas. Rerata kadar vitamin D 18,9 ng/mL, dimana 10 ( 20 %) tergolong insufiseiensi vitamin D dan 39 (79%) defisiensi vitamin D. Rerata kadar HOMA-IR 3,84, 24 (48 %) mengalami resistensi insulin berdasarkan kadar HOMA-IR. Besar koefesien korelasi antara kadar HOMA-IR dan kadar vitamin D didapatkan – 0,37 (nilai p 0,007). Terdapat perbedaan bermakna kejadian resistensi insulin antara kelompok remaja obesitas dengan status defisiensi vitamin D dan kelompok dengan status vitamin D pada kelompok sufisien dan insufisien (OR=5,8; 95%IK=1,1-30,6; p=0,025).Kesimpulan: Penelitian ini menyimpulkan terdapat korelasi negatif sedang antara kadar HOMA-IR dan kadar vitamin D pada remaja dengan obesitas.
Karakteristik gambaran Tuberkulosis (TB) paru pada foto toraks pasien Human Immunodeficiency Virus (HIV) tahun 2017-2021 di RSUP Sanglah, Bali, Indonesia Tiffany Rebecca; Dewa Gde Mahiswara Suadiatmika; Ni Nyoman Margiani
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 (336.074 KB) | DOI: 10.15562/ism.v12i3.1194

Abstract

Background: Tuberculosis is a disease caused by Mycobacterium tuberculosis that mostly attacks the lungs. HIV is a virus that causes damage to the immune system. HIV infection increases the risk of developing pulmonary TB because TB is an opportunistic disease; vice versa TB infection increases HIV progression. This study is about researching the characteristics of TB in HIV patients radiologically at Sanglah Hospital Denpasar.Methods: This study is a cross-sectional descriptive study conducted retrospectively. The data in this study used medical records of HIV-infected pulmonary TB patients from Sanglah Hospital, especially the characteristics of chest radiographs in the medical records and chest X-rays of patients. For the data collecting technique, a total sample is used to analyze all 47 cases. Data were analyzed using SPSS version 25 for Windows.Results: Most HIV patients with pulmonary TB coinfection at Sanglah Hospital, Denpasar, were obtained from as many as 47 people. It was found that the age between 30 - 39 recorded to be the highest at 31.3%, men were the most dominant with 81.3%, most of the patients diagnosed with HIV stage 4 were 72.9%, and the most dominant characteristics of the chest radiograph are 41.7% consolidation.Conclusion: Most cases of pulmonary TB with HIV coinfection at Sanglah Hospital Denpasar in 2017 - 2021 are male around 30 - 39 years. In addition, most of them were diagnosed with HIV stage 4 and finally almost all the patients had consolidation characteristics on chest radiographs.  Latar Belakang: Tuberkulosis adalah penyakit yang disebabkan oleh Mycobacterium tuberculosis yang paling banyak menyerang paru-paru. HIV adalah virus yang menyebabkan kerusakan pada sistem kekebalan tubuh. Infeksi HIV meningkatkan risiko berkembangnya TB paru karena TB adalah penyakit oportunistik sebaliknya infeksi TB meningkatkan perkembangan HIV. Penelitian ini bertujuan untuk mengetahui karakteristik TB pada pasien HIV secara radiologis di RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan penelitian deskriptif potong lintang yang dilakukan secara retrospektif. Data dalam penelitian ini menggunakan rekam medis pasien TB paru terinfeksi HIV dari RSUP Sanglah, terutama karakteristik foto toraks pada rekam medis dan foto rontgen dada pasien. Untuk teknik pengumpulan data, sampel total digunakan untuk menganalisis semua 47 kasus. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Pasien HIV koinfeksi TB paru terbanyak di RS Sanglah Denpasar didapatkan sebanyak 47 orang. Didapatkan usia antara 30-39 tahun tercatat paling tinggi 31,3%, laki-laki paling dominan dengan 81,3%, sebagian besar pasien terdiagnosis HIV stadium 4 sebanyak 72,9%, dan karakteristik foto toraks yang paling dominan adalah konsolidasi 41,7%.Kesimpulan: Kasus TB paru koinfeksi HIV terbanyak di RSUP Sanglah Denpasar tahun 2017 – 2021 adalah laki-laki berusia sekitar 30–39 tahun. Selain itu, sebagian besar terdiagnosis HIV stadium 4 serta hampir semua pasien memiliki karakteristik konsolidasi pada radiografi dada.
Bronkiolitis akut pada bayi: laporan kasus Peter Prayogo Hsieh; Florencia Christina Sindhu; Fricillia Mapantow
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (332.441 KB) | DOI: 10.15562/ism.v13i1.1197

Abstract

Introduction: Acute respiratory tract infection (ARI) is the major cause of mortality and morbidity in low – and middle–income countries. Bronchiolitis is the most common respiratory tract infection in <2 years old individuals but is often confused with bronchial asthma. This report aims to describe the difference between those two diseases. Case: Eight–month–old baby girl presented with shortness of breath, abnormal breathing sound, productive cough, fever, nasal discharge, and vomiting for 3 days. She’s got a history of abnormal breathing sound at 4 months old. Parents had no history of allergy or asthma. On examination, she was alert, weighed 6,8 kg, had an axillary temperature of 37°C, heart rate of 128/min, respiratory rate of 56/min with subcostal retraction, rhonchi, and wheezing on both chests. Laboratory findings showed hemoglobin of 11,2 g/dL, hematocrit of 32,3%, leukocyte count of 10.810/mm³, thrombocyte count of 361.000/mm³. Serum electrolytes and blood sugar levels were within normal limits. Chest radiograph showed patchy perihilar infiltrates on both lungs and hyperinflation. She was diagnosed with bronchiolitis and was treated with KAEN3B 700 cc/24 hours, nasal oxygen 2 L/min, 3 x 200 mg ampicillin, 2 x 15 mg gentamicin, 3 x 1 mg dexamethasone, ipratropium bromide and albuterol nebulization 3 times daily, 3 x 70 mg oral paracetamol. Her condition improved, and she was discharged after 7 days of hospitalization. Conclusion: There are fundamental differences in clinical profiles between bronchiolitis and bronchial asthma, which have to be carefully examined to prevent misdiagnosis.   Latar Belakang: Infeksi saluran pernafasan akut (ISPA) merupakan masalah utama penyebab mortalitas dan morbiditas di negara berpenghasilan menengah ke bawah. Bronkiolitis merupakan salah satu infeksi saluran nafas tersering pada anak berusia di bawah 2 tahun yang sering dikira sebagai asma bronkial. Laporan ini bertujuan untuk memberi gambaran perbedaan antara kedua penyakit tersebut. Kasus: Bayi perempuan berusia 8 bulan datang dengan keluhan sesak, suara nafas abnormal, batuk berdahak, demam, pilek, dan muntah selama 3 hari. Pasien memiliki riwayat suara nafas abnormal pada usia 4 bulan. Baik pasien maupun orangtua tidak memiliki riwayat alergi maupun asma bronkial. Pada pemeriksaan fisik, pasien sadar, berat badan 6,8 kg, suhu aksila 37° C, nadi 128 kali/menit, laju pernafasan 56 kali/menit, dan didapatkan retraksi subkostal, ronkhi, serta wheezing pada kedua lapang paru. Hasil laboratorium menunjukkan kadar hemoglobin 11,2 g/dL, leukosit 10.810/mm3, trombosit 361.000/mm3, hematokrit 32,3% dengan kadar elektrolit normal. Pemeriksaan foto toraks menunjukkan gambaran hiperinflasi serta patchy infiltrates pada perihilar kanan dan kiri. Pasien didiagnosis menderita bronkiolitis dan mendapatkan terapi cairan dengan KAEN3B 700 cc/ 24 jam, injeksi ampisilin 3 x 200 mg, injeksi gentamicin 2 x 15 mg, injeksi dexamethasone 3 x 1 mg, nebulisasi ipratropium bromide dan albuterol 3 kali/ hari, serta parasetamol oral 3 x 70 mg. Pada hari ke 7, pasien dipulangkan dalam kondisi sehat. Simpulan: Terdapat perbedaan mendasar pada gejala klinis bronkiolitis dan asma bronkial yang jika tidak dicermati dengan hati – hati akan menyebabkan kesalahan diagnosis.
Sindroma Steven–Johnson terinduksi carbamazepine: laporan kasus Peter Prayogo Hsieh; Nurmawatin Nurmawatin; Nur Khalisah; Nurjannah Nurjannah; Olivia Iriani Tantu; Orlando Pikatan; Pradita Zulfi Karisma Diana
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 (270.218 KB) | DOI: 10.15562/ism.v12i3.1198

Abstract

Background: Steven-Johnson syndrome (SJS) is characterized by skin, mucosal, and eyes lesions caused by complex immune mechanisms or hypersensitivity reactions. In children, SJS incidence isn’t well–known because its clinical profiles aren’t well–recognized. One of the causes of SJS is due to the use of drugs. This report aims to describe carbamazepine–induced SJS. Case: Twelve–year–old girl came with oral lesions for 1 week preceded by vesicles all over her body. This happened 3 days after taking carbamazepine, and it was her first time consuming it. On examinations, she was alert but weak with good nutritional status, had an axillary temperature of 37.7°C. Both her eyes were red and watery. She developed multiple ulcers in her mouth with a hyperemic pharynx. There were vesicles all over her body, but no abnormalities were found on thorax and abdomen examinations. Laboratory tests results showed neutrophilia, lymphocytopenia, eosinophenia, and hyponatremia. She was then diagnosed with SJS and was hospitalized. The doctor advised her to stop taking carbamazepine, and she received D5 ½ NS 2,000 cc/ 24 hours, dexamethasone injection 3 x ½ ampule, paracetamol injection 3 x 500 mg, betamethasone cream, triamcinolone oral-based cream, and oral cetirizine 1 x 10 mg. After 8 days she was discharged in good condition. Conclusion: SJS is characterized by skin, mucosal, and eyes lesions which are mostly caused by drugs. One of the most common drugs causing SJS is antiepileptic such as carbamazepine.   Latar Belakang: Sindroma Steven - Johnson (SSJ) ditandai dengan berbagai tanda diantaranya kelainan kulit, mukosa orifisium, dan lesi pada mata yang disebabkan oleh reaksi kompleks imun atau hipersensitivitas. Angka kejadian SSJ pada anak tidak diketahui dengan pasti, hal ini kemungkinan disebabkan oleh manifestasinya yang kurang dikenali. Salah satu sebab timbulnya SSJ adalah oleh karena penggunaan obat-obatan. Laporan kasus ini ditulis dengan tujuan untuk memberi gambaran mengenai SSJ pada remaja akibat obat carbamazepine. Kasus: Remaja perempuan berusia 12 tahun datang dengan luka pada mulut dan lidah sejak 1 minggu sebelumnya yang didahului oleh mata merah dan bintik merah berisi cairan di seluruh tubuh. Keluhan timbul 3 hari setelah mengkonsumsi carbamazepine dan ini adalah pertama kalinya pasien mengkonsumsi obat tersebut. Pada pemeriksaan ditemukan pasien sadar, tampak sakit berat, didapatkan status gizi baik, suhu tubuh 37,7°C, kedua mata hiperemis difus, hiperlakrimasi, ulkus multipel berkrusta pada bibir dan lidah disertai faring hiperemis. Ditemukan adanya vesikel generalisata namun tidak ditemukan kelainan pada pemeriksaan thoraks dan abdomen. Hasil laboratorium menunjukkan neutrofilia, limfopenia, eosinopenia, dan hiponatremia. Pasien didiagnosis dengan SSJ. Pasien disarankan untuk menghentikan carbamazepine dan mendapatkan terapi cairan D5 ½ NS 2.000 cc/24 jam, injeksi deksametason 3 x ½ ampul, injeksi parasetamol 3 x 500 mg, krim betametason, sediaan krim oral triamsinolon, dan cetirizine oral 1 x 10 mg. Setelah dirawat selama 8 hari pasien dinyatakan sembuh dan dipulangkan. Simpulan: SSJ memiliki gambaran klinis yang melibatkan lesi pada kulit, mukosa orifisium, mata, dan sebagian besar dicetuskan oleh obat. Salah satu obat yang sering menyebabkan SSJ adalah obat antikonvulsan pada pasien yang memiliki kecenderungan genetik.
Small group training as an effort to reduce stunting on toddlers in the working area of Puskesmas Kandang Sapi, Pasuruan Peter Prayogo Hsieh; Christianto Samuel Pieter Tangkau; Helviansyah El Farizqi; Ahmad Shohib
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.616 KB) | DOI: 10.15562/ism.v13i2.1199

Abstract

Background: The World Health Organization (WHO) said that South East Asia has a high stunting prevalence, where it is estimated that 22.2% of toddlers are stunted globally. The reality is that there are still many cases of inaccurate measurement methods, which question the validity of stunting prevalence. This study aims to know if small group training is effective in reducing stunting prevalence in toddlers. Methods: This descriptive study was done at all Posyandu in Bugul Lor from August to September 2019. Populations in this study were all helpers at Posyandu. Samples in this study were all helpers who met inclusive criteria but didn’t meet exclusive criteria. The inclusion criteria were helpers who attended when the study was conducted (5 helpers in each Posyandu), and the exclusive criteria were illiterate helpers. We used measurement guidelines from IDAI. The Group workshop started with a briefing about making sure that all tools were correctly set. Next, all helpers were asked to do height measurements, and if there was any error, we showed them how to do it correctly and let them do it again. We then compared the data before and after the intervention. Data from February 2019 were used as data before the intervention. Results: No helper in 10 Posyandu measured correctly. But after the group workshop, a helper from 8 Posyandu could measure correctly. Stunting prevalence in Bugul Lor decreased by about 4%. Conclusion: Group workshop seems to be effective in reducing stunting prevalence in toddlers.
Uji aktivitas antibakteri ekstrak kulit batang tanaman kenanga (cananga odorata) terhadap bakteri penyebab infeksi kulit Staphylococcus aureus in vitro Putu Gitanjani Mahadewi Semadhi; Ketut Indah Karina Mahardika; Rena Sari Megayanthi; Ni Wayan Prabasiwi Kirana; I Dewa Gde Bagus Panji Palaguna; Made Agus Hendrayana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (340.316 KB) | DOI: 10.15562/ism.v13i1.1201

Abstract

Background: Staphylococcus aureus resistance to antibiotics or Methicillin Resistance Staphylococcus Aureus (MRSA) is a severe problem worldwide with high morbidity and mortality rates, so it is necessary to identify alternative new antibacterial compounds to overcome this problem, especially those that derived from natural ingredients. One of these natural ingredients is the ylang plant (Cananga odorata) because the phytochemical test results show that this plant contains various bacteriostatic compounds. This study aims to determine whether the bark extract of the ylang plant (Cananga odorata) can inhibit the growth of S. aureus.Methods: In vitro experimental research using ylang bark extract (Cananga odorata) with concentrations of 20%, 60%, and 100% with 96% ethanol diluent. Inhibition test was carried out using the disc diffusion test method with five repetitions.Results: The average zone of inhibition of the growth of Staphylococcus aureus bacteria was as follows: 20% extract (P1) 11.8 mm; extract 60% (P2) 12.2 mm; extract 100% (P3) 18.2 mm; positive control (K2) 32.4 mm; and negative control (K1) 0 mm. The statistical analysis results showed that the bark extract of the Cananga plant affected the inhibition of S. aureus bacteria at concentrations of 20%, 60%, and 100%.Conclusion: Ylang plant (Cananga odorata) bark extract with concentrations of 20%, 60%, and 100% was effective in inhibiting the growth of S. aureus bacteria. Latar Belakang: Resistensi bakteri Staphylococcus aureus terhadap antibiotik atau Methicillin Resistance Staphyloccus Aureus (MRSA) merupakan salah satu masalah serius di dunia kesehatan, sehingga perlu diidentifikasi alternatif senyawa antibakteri baru untuk mengatasi masalah tersebut, khususnya yang berasal dari bahan alami. Adapun salah satu bahan alami tersebut yakni tanaman kenanga (Cananga odorata) karena hasil uji fitokimia menunjukkan bahwa tanaman ini mengandung berbagai senyawa bakteriostatik. Penelitian ini bertujuan untuk mengetahui apakah ekstrak kulit batang tanaman kenanga (Cananga odorata) dapat menghambat pertumbuhan bakteri S. aureus.Metode: Penelitian eksperimental in vitro menggunakan ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi sebesar 20%, 60%, dan 100% dengan pengencer etanol 96%. Pengujian daya hambat dilakukan dengan menggunakan metode uji difusi cakram sebanyak lima kali pengulangan.Hasil: Rerata zona hambat pertumbuhan bakteri Staphylococcus aureus adalah sebagai berikut: ekstrak 20% (P1) 11,8 mm; ekstrak 60% (P2) 12,2 mm; ekstrak 100% (P3) 18,2 mm; kontrol positif (K2) 32,4 mm; dan kontrol negatif (K1) 0 mm. Hasil analisis statistik menyatakan bahwa ekstrak kulit batang tanaman kenanga berpengaruh terhadap daya hambat bakteri S. aureus pada konsentrasi 20%, 60%, dan 100%.Kesimpulan: Ekstrak kulit batang tanaman kenanga (Cananga odorata) dengan konsentrasi 20%, 60%, dan 100% efektif untuk menghambat pertumbuhan bakteri S. aureus
Perbandingan skor Middle Ear Risk Index (MERI) pada pasien Otitis Media Supuratif Kronis (OMSK) dengan komplikasi intrakranial dan ekstrakranial di RSUD dr. Saiful Anwar, Malang, Indonesia Ahmad Dian Wahyudiono; David Santoso
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.195 KB) | DOI: 10.15562/ism.v13i1.1203

Abstract

Background: Chronic Suppurative Otitis Media (CSOM) is a chronic infection in the middle ear mucosa with tympanic membrane perforation and causes complications in the form of intracranial and extracranial. In previous studies, CSOM mortality rates were different between intracranial and extracranial complications. That prompted the researchers to determine the middle ear postoperative prognosis in CSOM with intracranial complications compared to the extracranial. Postoperative prognosis is measured by Middle Ear Risk Index (MERI). This study aims to evaluate the comparison of MERI scores in CSOM patients with intracranial and extracranial complications. Methods: The research was conducted with an observational analytic design involving 40 research subjects from medical records of CSOM patients at RSUD dr. Saiful Anwar Malang in January 2017 – July 2021. The samples were divided into CSOM with intracranial and extracranial complications, including 12 and 28 subjects, respectively. Those samples are taken using consecutive sampling techniques and tested using an Independent T-test. Data were analyzed using SPSS version 25 for Windows.Results: The mean of MERI scores in CSOM patients with intracranial complications was 9.170±2.517, and that in extracranial complications was 7.570±1.854. The p-value of 0.031 (P<0.05) was obtained using an Independent T-test, indicating a significant difference of MERI scores mean between CSOM patients with intracranial and extracranial. Conclusion: There is a significant difference in MERI scores between CSOM with intracranial and extracranial complications. Latar Belakang: Otitis Media Supuratif Kronis (OMSK) adalah infeksi kronis yang terjadi pada mukosa telinga tengah yang ditandai dengan perforasi membran timpani dan dapat menyebabkan komplikasi intrakranial maupun ekstrakranial. Penatalaksanaan OMSK dengan komplikasi bertujuan untuk menyelesaikan komplikasi, infeksi di telinga tengah dan perbaikan fungsi. Perbaikan fungsi pendengaran bukan tujuan utama tapi tetap menjadi harapan dari pasien. Prognosis fungsi pendengaran pada operasi mastoid dapat dinilai dengan memperhatikan Middle Ear Risk Index (MERI). Penelitian ini bertujuan untuk mengevaluasi perbandingan skor MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial.Metode: Penelitian dilakukan dengan desain penelitian observasional analitik yang melibatkan 40 subjek penelitian berupa rekam medis pasien OMSK di RSUD dr. Saiful Anwar Malang bulan Januari 2017 – Juli 2021. Sampel terbagi menjadi dua kategori yaitu OMSK dengan komplikasi intrakranial dan ekstrakranial dengan jumlah secara berurutan yaitu 12 dan 28 sampel. Sampel diambil menggunakan teknik konsekutif dan diuji menggunakan Independent T-Test. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Didapatkan rerata pasien OMSK dengan komplikasi intrakranial sebesar 9,170±2,517 dan ekstrakranial sebesar 7,570±1,854. Pada uji Independent T-Test didapatkan nilai p sebesar 0,031 (p<0,05) yang menunjukkan terdapat perbedaan rerata MERI pada pasien OMSK dengan komplikasi intrakranial dan ekstrakranial secara bermakna.Kesimpulan: Terdapat perbedaan skor MERI yang bermakna antara OMSK dengan komplikasi intrakranial dan ekstrakranial.

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