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Korelasi antara Neutrophil-to-Lymphocyte Ratio dan Kadar Carcinoembryonic Antigen Pra-Pasca Operasi pada Kanker Kolorektal Michael Iskandar; Michael Tendean; Billy Salem; Fredrik G. Langi
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46621

Abstract: Colorectal cancer is the third most common cancer in Indonesia with a mortality rate at fourth rank. A balance between systemic inflammation and immunity is necessary in the stratification of risk, treatment, and prognosis of various cancers. This study aimed to determine the relationship between neutrophil-to lymphocyte ratio (NLR) and carcinoembryonic antigen (CEA) in the survival of post-operative colorectal cancer patients. This was a retrospective hospital-based cohort study using the R statistical analysis tool version 4.2.2. The results obtained 88 colorectal cancer patients with histopathologically confirmed. Most were nearly 60 years old, with a relatively balanced proportion of men and women. The median of resected mass size was around 6 cm, 80% of tumors located in the rectum and rectosigmoid, a balanced proportion of stage II and III (44%), moderate differentiation (86%), with decreased NLR post-operation (median of 3,8 to 2,6), and decrased CEA post-operation (median 8,6 to 6,3). In conclusion, there is a positive correlation between NLR and CEA level, however, it is limited until three months post operation. After three months, the correlation is undetected anymore. Keywords: neutrophil-to-lymphocyte ratio; carcinoembryonic antigen; colorectal cancer; pre and post operation Abstrak: Kanker kolorektal merupakan keganasan ketiga terbanyak di dunia dengan angka mortalitas urutan ke-empat. Keseimbangan antara peradangan sistemik dan imunitas diperlukan dalam stratifikasi risiko, pengobatan, dan prognosis berbagai jenis keganasan. Penelitian ini bertujuan untuk mengetahui hubungan antara neutrophil-to lymphocyte ratio (NLR) dan kadar carcinoembryonic antigen (CEA) pada kesintasan pasien kanker kolorektal pasca operasi. Jenis penelitian ialah kohort retrospektif berbasis rumah sakit dengan alat analisis statistik R versi 4.2.2. Hasil penelitian mendapatkan 88 pasien terkonfirmasi histopatologik kanker kolon rektal, berusia hampir 60 tahun, proporsi laki-laki dan perempuan relatif berimbang, median ukuran masa yang direseksi sekitar 6 cm, 80% tumor terletak di daerah rektum dan rektosigmoid, stadium II dan III presentasi berimbang (44%), diferensiasi sedang (86%), NLR menurun pada pasca operasi (median 3,8 menjadi 2,6), dan CEA menurun pada pasca operasi (median 8,6 menjadi 6,3). Simpulan penelitian ini ialah terdapat hubungan positif antara neutrophil-to-lymphocyte ratio (NLR) dan kadar carcinoembryonic antigen (CEA), tetapi hanya terbatas sampai tiga bulan pasca operasi. Korelasi keduanya tidak terdeteksi lagi setelah tiga bulan pasca operasi. Kata kunci: neutrophil-to-lymphocyte ratio; carcinoembryonic antigen: kanker kolon rektal; pre dan pasca operasi

Physical Medicine and Rehabilitation Management in Pediatric Patient with Postural (Positional) Clubfoot: A Case Report Gloria Rondonuwu; Joudy Gessal; Patricia Kalangi
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46886

Abstract: Clubfoot, talipes equinovarus, is a common term used to describe several kinds of ankle or foot deformities present at birth. This condition is one of the most treatable birth defects, often leading to normal or near-normal athletic activities later in life. We reported a patient with positional clubfoot treated with serial casting, passive manipulation, and stimulation. Male, 6 days old, lived in Sonder, with a chief complaint of right foot that bent inward since birth. Patient was consulted by pediatrician to physiatrist since the birth day. The bent inward foot was not accompanied by swelling and redness, and patient was seen calm when the foot being moved. Patient was treated by physiatrist with passive manipulation, four times weekly with serial casting, and everyday stimulation for feet. During treatment session, patient’s deformity was getting improved. After treatment, the deformity was corrected and patient’s foot was in normal position without any complication. The aim of medical rehabilitation of clubfoot was to reduce the deformity with the success criteria that foot could be functional, free of pain, good mobility, and did not require correction shoes, therefore, the patient could carry out normal activities after growing up. In conclusion, to produce the maximum correction results, good cooperation is required with the patient’s parents. Even though correction is optimal and done as soon as possible, if bone growth has not stopped, the clubfoot problem can reappear. The first element of management is correction of the cavus deformity by positioning the forefoot in proper alignment with the hindfoot. Keywords: postural clubfoot; physical medicine and rehabilitation; children; passive manipulation; serial casting; everyday stimulation for feet

Amplatzer Vascular Plug in Renal Artery Embolization: Case Serial and Review of the Literature Billy Karundeng; Richard Sumangkut; Yuansun Khosama; Djonny E. Tjandra; Michael D. Winarto
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.48476

Abstract: Embolization constitutes a safe and effective therapeutic possibility in the treatment of numerous renal pathologies whether election or urgency. The use of Amplatzer vascular plug (AVP) constitutes a more recent and less widespread therapeutic choice, and its use in the renal district is not yet widespread although potentially very valid. Perioperative renal artery embolization has been introduced to reduce the risk of oncological spread and intraoperative bleeding, in order to facilitate surgery, thus decreasing perioperative morbidity. Nevertheless, in recent literature the real usefulness of perioperative renal artery embolization is still debated. Some authors agree that the advantages of perioperative renal artery embolization are to decrease intraoperative bleeding with a lower transfusion rate and to reduce operative time. Therefore, we presented five cases of renal arterial embolizations (RAEs) performed with AVP from July to August 2022 at Prof. Dr. R. D. Kandou Hospital, Manado. In all cases, a single plug was used which perfectly adapted to the target artery resulting in complete occlusion of the vessel within a short period of time. Renal artery embolization was generally performed the day before surgery under local anesthesia. After confirmation of the tumor vascularization with a contrast study, the selective renal artery embolization was performed. In our experience, the use of AVP for the treatment of renal arteriovenous fistula and neoplastic masses had given excellent results without any complications during and after the treatment. In conclusion, RAE performed with AVP has growing potential and numerous advantages in terms of the time of the procedure, speed of embolization, and precision of occlusion, but with a relative increase in costs. Keywords: amplatzer vascular plugs; vascular surgery; endovascular surgery; renal artery embolization

Analisis Pemberian Propolis terhadap Kadar CA 15-3 Kasus Kanker Payudara Stadium Lanjut Filandy Pai; Christian Manginstar; Marselus Merung; Fredrik G. Langi
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.48478

Abstract: Breast cancer is the first rank of cancer incidence and the second mortality rate in Indonesia. Propolis is already known as a potential anticancer agent. This study aimed to evaluate the effect of propolis administration on CA 15-3 level in breast cancer patients. This was a quasi experimental study with a pre and post test design. Subjects were patients with advanced breast cancer at the Surgery-Oncology polyclinic and Surgery nursing room at Prof. Dr. R. D. Kandou Hospital Manado from June 2022 to March 2023. There were 20 patients with breast cancer in this study, divided into two groups (treatment and control groups) with age and cancer location. Data were analyzed with th independent t-test. The results showed that the increase of CA 15-3 level in treatment group was 8.3±3.5 U/mL meanwhile in the control group was 11.4±3.4 U/mL. There was no significant difference in the increased level of CA 15-3 in the two groups (p=0.069). In conclusion, propolis administration has descriptive effect on breast cancer patients with lower increase of CA 15-3 level compared to the control group, however, there is no significant difference between the two groups. Keywords: propolis; breast cancer; CA 15-3 marker Abstrak: Kanker payudara menduduki peringkat pertama insidensi kanker dan angka mortalitas kedua di Indonesia. Propolis telah dikenal sebagai agen antikanker yang potensial. Penelitian ini bertujuan untuk mengevaluasi efek pemberian propolis terhadap kadar plasma CA 15-3 penderita kanker payudara. Penelitian ini menggunakan metode kuasi eksperimental pre dan post tes dengan desain potong lintang. Subjek penelitian ialah pasien kanker payudara stadium lanjut di Poliklinik Bedah-Onkologi dan Ruang Perawatan Bedah RSUP Prof. Dr. R. D. Kandou Manado sejak bulan Juni 2022 hingga Maret 2023. Jumlah subjek penelitian sebanyak 20 pasien, dibagi atas dua kelompok (kelompok uji dan kontrol) dengan data demografi usia dan lokasi kanker. Uji satistik yang digunakan ialah uji t tidak berpsangan. Hasil penelitian mendapatkan peningkatan kadar CA 15-3 kelompok uji ialah 8,3±3,5 U/mL sedangkan pada kelompok kontrol sebesar 11,4±3,4 U/mL. Tidak didapatkan perbedaan bermakna untuk kenaikan CA 15-3 pada kelompok uji dan kelompok kontrol (p=0,069). Simpulan penelitian ini ialah pemberian propolis pada pasien kanker payudara stadium lanjut secara deskriptif berefek dengan kadar peningkatan CA 15-3 yang lebih rendah dibandingkan kelompok kontrol tetapi secara statistik tidak terdapat perbedaan bermakna antara kedua kelompok penelitian. Kata kunci: propolis; kanker payudara; penanda CA 15-3

Perbandingan Efektivitas Daya Antibakteri Minyak Seith dengan Minyak Bawang Putih (Allium sativum) terhadap Pertumbuhan Pseudomonas aeruginosa Siti N. Aihena; Yuniasih M. J. Taihuttu; Halidah Rahawarin
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.48723

Abstract: Pseudomonas aeruginosa is an opportunistic bacterium and has the ability to withstand several types of antibiotics (antibiotic resistance). Garlic oil contains active substances such as flavonoids, alkaloids, saponins, tannins, and curcumin which function as antibacterial. This study aimed to compare the antibacterial effectiveness of Seith oil with of garlic oil (Allium sativum) against P. aeruginosa bacteria. The oil concentrations were 10%, 15%, 20%, 25%, 50%, 75%, and 100%. Antibacterial activity test against P. aeruginosa bacteria was assessed using the disk diffusion method. The results showed that Seith oil could not inhibit the growth of P. aeruginosa, meanwhile garlic oil of 50%, 75%, and 100% inhibited the growth of P. aeruginosa with the mean inhibition zone diameters of 1.38 mm, 1.88 mm, and 3.13 mm, respectively. The Kruskal-Wallis test showed a p-value of <0.01 indicating significant difference in the diameters of inhibition zones between Seith oil and garlic oil (Allium sativum) against P. aeruginosa bacteria. The Mann-Whitney U test showed significant differences between garlic oil (Allium sativum) of 100% and 75% against Pseudomonas aeruginosa bacteria, and between garlic oil of 75% and 50%. In conclusion, garlic oil (Allium sativum) is more effective than Seith oil against Pseudomonas aeruginosa bacteria. Keywords: Seith oil; garlic oil (Allium sativum); Pseudomonas aeruginosa; antibacterial effect Abstrak: Pseudomonas aeruginosa merupakan bakteri oportunistik dengan kemampuan bertahan terhadap beberapa jenis antibiotik (resisten antibiotik). Minyak bawang putih memiliki kandungan zat aktif seperti flavonoid, alkaloid, saponin, tanin, dan kurkumin yang berfungsi sebagai antibakteri. Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas daya antibakteri antara minyak seith dengan minyak bawang putih (Allium sativum) terhadap bakteri Pseudomonas aeruginosa. Konsentrasi minyak yang digunakan ialah 10%, 15%, 20%, 25%, 50%, 75%, dan 100%. Uji aktivitas antibakteri terhadap bakteri P. aeruginosa menggunakan metode difusi cakram. Hasil penelitian memperlihatkan bahwa minyak Seith tidak dapat menghambat pertumbuhan bakteri P. aeruginosa. Minyak bawang putih menghambat pertumbuhan bakteri P. aeruginosa pada konsentrasi 50%, 75%, dan 100% dengan masing-masing rerata diameter zona hambat ialah 1,38 mm, 1,88 mm, dan 3,13 mm. Hasil uji Kruskal-Wallis menunjukkan nilai p<0,001 yang berarti terdapat perbedaan diameter zona hambat yang bermakna antara minyak Seith dan minyak bawang putih (Allium sativum). Efektivitas daya antibakteri minyak bawang putih (Allium sativum) lebih besar dibanding minyak Seith. Hasil uji Mann-Whitney U menunjukkan bahwa minyak bawang putih dengan konsentrasi 100% dan 75% memiliki perbedaan bermakna (p=0,015), serta konsentrasi 75% dan 50% (p=0,040). Simpulan penelitian ini ialah daya antibakteri minyak bawang putih (Allium sativum) lebih efektif dibandingkan daya antibakteri minyak Seith terhadap bakteri Pseudomonas aeruginosa. Kata kunci: minyak Seith; minyak bawang putih (Allium sativum); Pseudomonas aeruginosa; efek antibakteri

Correlation of Plasma Iron Profile and Intradialytic Hypotension in Hemodialysis Patients Tisa Rombot; Stella Palar; Pearla Lasut
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.49567

Abstract: Intradialytic hypotension (IDH) has been a common complication which should be aware of, in hemodialysis procedure. Its pathogenesis is multifactorial, and severe anemia is considered as one of the most notable risk factors on IDH. This study aimed to evaluate the correlation between plasma iron profile and intradialytic hypotension in hemodialysis patients. This was an analytical and retrospective study using medical records of hemodialysis patients at Prof. Dr. R. D. Kandou Hospital, Manado from January to May 2022. Sampling was conducted through consecutive sampling method, on available records. Patients with CKD grade 5 which undergoes routine HD twice a week for >3 weeks, aged 18-60 years old were included, while subjects with sepsis, malignancy, autoimmune disease, crisis hypertension, and unstable congestive heart failure were excluded for further studies. The details on iron profile and blood pressure measurement were then extracted, which then analyzed with descriptive analysis and Pearson correlation using IBM SPSS Statistics 26.0. The results obtained a total of 35 patients; 57.1% were male. The Pearson correlation analysis on all variables reported several notable significant results, with a correlation between iron profile and blood pressure measurement were seen in TIBC and systole pre- and post-procedure (-.496 and -.611 respectively) with strong negative relationship; and serum ferritin value with systole post-procedure (.373) implying moderate positive relationship. The results suggested that the increase of ferritin value and decrease of TIBC value were correlated with the increase of systole blood pressure. Meanwhile, the TIBC had a strong positive correlation with systolic changes (.473) meanwhile serum iron had a moderate negative correlation with diastolic changes (-.365). In conclusion, there is a significant correlation between iron profile and changes in blood pressure, with higher iron profile value (lower TIBC) is positively correlated with the increase of both systole and diastole measurement; also negatively correlated with the reduction of blood pressure in hemodialysis patients Keywords: iron; ferritin; intradialytic hypotension; hemodialysis; transferrin; total iron binding capacity

Kolumna Vertebral sebagai Parameter Estimasi Usia dan Determinasi Jenis Kelamin Roben S. Pasaribu; Ria Puspitawati; Ayu Rahmadhani
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.49892

Abstract: Age estimation and sex determination using bone parameters have high accuracy. Vertebral column is a group of five types of bones; each type has specific characteristics, shape, and properties. The unique and specific characteristics of each type of vertebra differ between sexes and change with age. This phenomenon makes the vertebral column as a potential parameter for age estimation and sex determination. This was a literature review study aimed to discuss about using vertebral column as the parameter of age estimation and sex determination. The results showed that age estimation using vertebral column parameters by observing osteophyte formation had a correlation of r=0.7 and p<0.01. Maturation of the vertebral column and age showed a correlation of r=0.695 and p<0.001. Age estimation by observing the vertebral column maturation in the age group 15-22 years showed 95% accuracy. Sex determination using vertebral column parameters showed high accuracy, reaching 93% in the lumbar vertebrae and 86-89.7% in the cervical vertebrae. In conclusion, vertebral column has great potential in the forensic investigation since it can be used as a parameter for age estimation and sex determination. Keywords: vertebral column; age; sex; bone maturation; osteophyte; forensic identification Abstrak: Estimasi usia dan determinasi jenis kelamin dengan menggunakan parameter tulang memiliki akurasi yang baik. Kolumna vertebral tersusun dari lima kelompok jenis tulang yang memiliki ciri, bentuk, dan karakteristik yang spesifik. Karakteristik unik dan spesifik dari masing-masing jenis tulang vertebra dapat menunjukkan perbedaan antar jenis kelamin dan perubahan seiring bertambahnya usia. Fenomena demikian menjadikan kolumna vertebral berpotensi sebagai parameter dalam estimasi usia dan determinasi jenis kelamin. Studi ini merupakan suatu literature review yang bertujuan untuk mengetahui penggunaan kolumna vertebral sebagai parameter estimasi usia dan determinasi jenis kelamin. Hasil studi mendapatkan estimasi usia menggunakan parameter kolumna vertebral dengan melihat pembentukan osteofit menunjukkan korelasi r=0,7 dan signifikansi p<0,01. Maturasi kolumna vertebral dan usia menunjukkan korelasi r=0,695 dan p<0,001. Estimasi usia dengan melihat maturasi kolumna vertebral pada rentang usia 15-22 tahun memberikan akurasi mencapai 95%. Determinasi jenis kelamin menggunakan parameter kolumna vertebral menunjukkan akurasi tinggi mencapai 93% pada kolumna vetebral bagian lumbar dan 86-89,7% pada bagian servikal. Simpulan studi ini ialah kolumna vertebral merupakan salah satu jenis tulang yang memiliki potensi besar dalam dunia forensik untuk dijadikan sebagai parameter estimasi usia dan determinasi jenis kelamin. Kata kunci: kolumna vertebral; usia; jenis kelamin; maturasi tulang; osteofit; identifikasi forensik

Manifestasi Hepatik sebagai Prediktor Mortalitas COVID-19 pada Anak Suryadi N.N Tatura; Meliana Sulistio
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.50323

Abstract: Coronavirus disease-19 (COVID-19) has been associated with hepatic involvement in children, often manifesting as elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels during infection. Some retrospective cohorts and case series have shown various degrees of ALT/AST elevation in with a worse disease’s outcome. Yet, the mechanism was still unknown. This study aimed to determine the association of liver involvement with the outcome of COVID-19 infection in infants and children. This was a prospective and observational study. Subjects were 96 infants and children with confirmed COVID-19 at Prof. Dr. R. D. Kandou Hospital from 1 until 31 January 2022. Patient with pre-existing liver diseases or other infections like malaria and hepatitis, were excluded. The results showed that most respondents were aged between 0 days to 17 years; 75.0% had not any comorbidities. The analysis showed that most subjects with normal ALT levels had a survived outcome (97.5%), while most subjects with abnormal ALT levels had a demise outcome (32.1%). However, about 91.5% of the subjects with normal AST levels had a survived outcome. There was a statistically significant relationship between the elevated of ALT (p=0.006) and of AST (p=0.047) variables with the outcome of infants and children with COVID-19 infection. In conclusion, liver enzyme test is a potential parameter for predicting the mortality of pediatric patients with COVID-19. Keywords: COVID-19; pediatric patients; transaminase enzymes; mortality predictor Abstrak: Kasus Coronavirus disease-19 (COVID-19) pada populasi anak sering dikaitkan dengan manifestasi pada hepar, yang ditandai dengan peningkatan enzim alanin aminotransferase (ALT) dan aspartat aminotransferase (AST). Studi-studi observasional maupun laporan kasus sebelumnya telah menghubungkan manifestasi hepar pada infeksi SARS-CoV-2 dengan luaran penyakit yang lebih buruk, namun mekanisme dibalik keterlibatan hepar tersebut belum dapat dipastikan. Penelitian ini bertujuan untuk mengetahui hubungan antara keterlibatan hepar terhadap luaran mortalitas penyakit COVID-19 pada anak. Jenis penelitian ialah prospektif dan observasional. Subyek penelitian ialah 96 bayi dan anak yang terkonfirmasi COVID-19 di RSUP Prof. Dr. R. D. Kandou selang 1-31 Januari 2022. Pasien dengan riwayat penyakit hepar sebelumnya atau memiliki tanda-tanda infeksi akut hepar, seperti malaria dan hepatitis, dieksklusi dari studi ini. Hasil penelitian mendapatkan subjek didominasi anak usia 0-17 tahun; 75% tidak memiliki komorbiditas. Pada kelompok dengan luaran hidup, mayoritas (97,5%) memiliki nilai ALT normal, sebaliknya pada kelompok dengan luaran meninggal, 32,1% memiliki nilai ALT meningkat. Terdapat hubungan bermakna antara peningkatan kadar ALT (p=0,006) dan AST (p=0,047) terhadap luaran penyakit COVID-19. Simpulan penelitian ini ialah kadar enzim transaminase hepar dapat menjadi salah satu parameter dalam memrediksi luaran mortalitas anak yang terkonfirmasi COVID-19. Kata kunci: COVID-19; pasien anak; enzim transaminase hepar; prediktor mortalitas

Analisis Pelaksanaan Sistem Pengelolaan Limbah Medis di Rumah Sakit Daerah Kepulauan Christin Andolo; Diana V. D. Doda; Lydia E. N. Tendean
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.50621

Abstract: In general, developing countries have not yet implemented optimal management of medical waste, which causes the accumulation of medical waste. Research on medical waste management in hospitals located in the Archipelago area is still lacking, so research like this needs to be carried out. This study aims to analyze the implementation of the medical waste management system at the Islands Regional Hospital. The research method used is a qualitative method with eight informants. The research results show that in terms of human resources, there is still a lack, especially for the medical waste management section, of budgetary and financial resources to facilitate the training of medical staff, cleaning staff, procurement and maintenance of infrastructure, and investment in better waste management technology. Inadequate medical waste management methods also affect the effectiveness of medical waste management itself and can lead to an increasing amount of medical waste. The amount of medical waste generated can affect the capacity and method of treatment required. The observation results show that there are problems in sorting and containerizing medical waste where the trash for non-medical waste has been mixed with medical waste. In the temporary storage area, medical waste has accumulated a lot and has not been processed or recycled. Treatment of medical waste uses an autoclave and also incinerates medical waste manually. This is done because the incinerator is not functioning optimally. The conclusion of this study is that the medical waste management system is not yet optimal. It is hoped that the hospital, as well as health workers and cleaners, can implement an optimal medical waste management system to avoid things that can cause health problems, environmental disturbances, and ecosystem disturbances. Keywords: Waste, Medical, Non-Medical, Management. Abstrak : Secara umum pada negara berkembang belum menerapkan pengelolaan limbah medis yang optimal sehingga menyebabkan penumpukan limbah medis. Penelitian tentang pengelolaan limbah medis di Rumah Sakit yang berada di daerah Kepulauan masih sangat kurang sehingga penelitian seperti ini perlu untuk dilakuan. Penelitian ini bertujuan untuk menganalisis pelaksanaan sistem pengelolaan limbah medis di Rumah Sakit Daerah Kepulauan. Metode penelitian yang digunakan metode kualitatif dengan jumlah informan 8 orang. Hasil penelitian menunjukkan bahwa dari segi sumber daya manusia masih kurang khususnya untuk bagian pengelolaan limbah medis, kurangnya sumber anggaran dan keuangan untuk memfasilitasi pelatihan tenaga medis, petugas kebersihan, pengadaan, perawatan sarana prasarana, serta investasi dalam teknologi pengelolaan limbah yang lebih baik. Metode pengelolaan limbah medis yang kurang memadai juga berpengaruh terhadap efektivitas pengelolaan limbah medis itu sendiri serta dapat menyebabkan jumlah limbah medis yang semakin banyak. Jumlah limbah medis dihasilkan dapat mempengaruhi kapasitas dan metode pengolahan yang dibutuhkan. Hasil observasi menunjukan bahwa adanya masalah dalam pemilahan dan pewadahan limbah medis, dimana tempat sampah untuk limbah non medis sudah tercamur dengan limbah medis . Di tempat penyimpanan sementara limbah medis sudah sangat menumpuk dan belum di olah ataupun di daur ulang. Pengolahan limbah medis menggunakan autoclave dan juga melakukan pembakaran limbah medis secara manual hal ini dilakukan karena incinerator belum berfungsi secara optimal. Kesimpulan penelitian ini yaitu belum optimalnya sistem pengelolaan limbah medis. Diharapkan kepada pihak rumah sakit dan juga petugas kesehatan serta petugas kebersihan dapat menerapkan sistem pengelolaan limbah medis secara optimal untuk menghindari hal-hal yang dapat menyebabkan gangguan kesehatan, gangguan lingkungan dan juga gangguan ekosistem. Kata Kunci : Limbah, Medis, Non Medis, Pengelolaan.

Role of Colonoscopy in Foreign Body (Needle) Ingestion in Children: A Case Report and Literature Review Harsali F. Lampus; Candy Candy; Leo Rendy; Ronald Sorongku; Sabrandi P. Saputra
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51636

Abstract: Foreign body (FB) ingestion is one of the most complex and serious emergency conditions for diagnosis that often occurs in children. Most ingested FBs, intentionally or unintentionally, pass through the gastrointestinal tract without complications, and only a small proportion require surgical intervention inter alia colonoscopy. However, if the patient complains of abdominal pain, complications may occur, especially perforation with peritonitis, and in this case a laparotomy is needed. We reported a case of a 13-year-old girl with the chief complaint of needle ingestion two weeks ago. Patient complained of abdominal pain and was unable to defecate. Plain abdominal radiographs showed needle-shaped metal density in the lower intestinal; therefore, the patient was referred to Prof. Dr. R. D. Kandou Hospital for further treatment. An endoscopy was initially performed but no foreign body was found because they might had been in the intestine. Colonoscopy revealed a foreign body in the proximal ascending colon, transverse position. Extraction of the foreign body, along with pulling the scope and evaluating the transverse, descending, sigmoid and rectum colon which were within normal limits was carried out. Monitoring after removal of the foreign body for two days found no complaints of abdominal pain and bowel movements were normal, therefore, the patient was discharged from the hospital. In conclusion, since a sharp foreign body (a needle) was still in the proximal ascending colon, a colonoscopy was performed with successful removal of the needle. Keywords: foreign body; needle; endoscopy; colonoscopy

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Contact Name
Sunny Wangko

Contact Email
sunnypatriciawangko@gmail.com

Phone
+628124455733

Journal Mail Official
sunnypatriciawangko@gmail.com

Editorial Address
medscopej@gmail.com

Location
Kota manado,

Sulawesi utara

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Sunny Wangko

Contact Email sunnypatriciawangko@gmail.com

Phone +628124455733

Journal Mail Official sunnypatriciawangko@gmail.com

Editorial Address medscopej@gmail.com

Location Kota manado, Sulawesi utara INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Sunny Wangko

Contact Email
sunnypatriciawangko@gmail.com

Phone
+628124455733

Journal Mail Official
sunnypatriciawangko@gmail.com

Editorial Address
medscopej@gmail.com

Location
Kota manado,

Sulawesi utara

INDONESIA