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Medical Scope Journal (MSJ)
Published by Universitas Sam Ratulangi
ISSN : -     EISSN : 27153312     DOI : https://doi.org/10.35790/msj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health
Medical Scope Journal (MSJ) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia (PAAI) Komisariat Manado bekerjasama dengan Fakultas Kedokteran Universitas Sam Ratulangi dua kali setahun pada bulan Juni dan Desember. Tulisan yang dimuat dapat berupa artikel telaah (review article), hasil penelitian, dan laporan kasus dalam bidang ilmu kedokteran baik dalam bahasa Indonesia maupun dalam bahasa Inggris.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 231 Documents
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Liposarcoma of the Thyroid Gland: A Case Report Christian Manginstar; Marselus Merung; Denny Saleh; Leise Limpeleh; Enika Tilaar; Ridel Torar
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.v6i1.51654

Abstract

Abstract: Liposarcoma is one of the most common soft tissue tumors in adults. Liposarcoma is usually found in retroperitoneal organs and extremities, but rarely in the thyroid gland. We presented a case of dedifferentiated liposarcoma in the thyroid gland. A 56-year-old woman with a history of a lump in her neck for ten years. Malignancy was suspected due to the local extension of the tumor, therefore, complete resection of the tumor was performed. Histopathological examination showed a dedifferentiated liposarcoma. Two months post-surgery, the patient suffered from lung and brain metastases and was treated with lenvatinib. The complaints reduced and there was no significant side effect during therapy. The treatments for liposarcoma are surgery, radiotherapy, chemotherapy, and targeted therapy. Surgery followed by radiotherapy and chemotherapy is the option in the treatment of liposarcoma. This patient underwent surgery with the histopathological result of dedifferentiated thyroid liposarcoma. In the nine-month follow-up of therapy, there were no complaint of the patient. In this case, dedifferentiated liposarcoma in the thyroid gland with metastases was treated surgically followed by lenvatinib administration gave satisfactory result. Keyword: liposarcoma; thyroid gland; dedifferentiated liposarcoma; malignant tumor
Non-Vascularized Fibular Bone Graft for Giant Cell Tumor of the Distal Ulna: A Case Report Albertus D. Noersasongko; Haryanto Sunaryo; Tommy Suharso; Andriessanto Lengkong; Rangga Rawung; Stefan Kambey; Patrick S. Arikalang
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.v6i1.51674

Abstract

Abstract: Cases of bone giant cell tumors (GCT) are rarely found, generally benign and locally aggressive tumors. Surgical resection is the universal standard for treatment of bone GCT. Non vascularized fibular graft (NVFG) is useful in the reconstruction of skeletal defects, especially in cases of scarred and avascular recipient sites and patient with tumor surrounded by poor tissue condition. We report a 53-year-old woman, with a lump in her left hand for three years. X-ray examination revealed a mass with firm border and regular edge that reached the epiphysis expansively with thinning of the cortex in the distal region of the left ulna. Tumor excision was performed with open reduction internal fixation (ORIF) and fibular bone graft. To date, GCT is one of the most obscure and intensively examined bone tumors, and its histological images do not predict the clinical outcome. Moreover, many unanswered questions regard to the treatment and prognosis without any consensus regarding the ideal treatment selection. NVFG osteosynthesis shows encouraging results, and adequate therapy, wound care and patient compliance affect the patient’s outcome. In conclusion, NVFG and internal fixation are effective options for post tumor excision, and osteosynthesis has encouraging result. Keywords: non vascularized fibular graft (NVFG); giant cell tumor; bone graft; ulna
Angiomyolipoma in the Temporal Region: A Case Report Calenthia Ekawati; Nico Lumintang; Sherly Tandililing
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.v6i1.51679

Abstract

Abstract: Angiomyolipomas are benign tumors (consisting of fat tissues, smooth muscles, and blood vessels) that are often found in the kidney or liver. However, they are rarely found in the head and neck region and require proper management. We reported a 13-year-old girl presented with a mass in the right temple since last year. Musculoskeletal ultrasound (US) and contrast-enhanced computed tomography (CT) scan showed a well-defined hypoechoic lesion in the right temporal subfascial region, with a suspicion of a hemangioma. The patient underwent resection of the lesion. The diagnosis of angiomyolipoma was confirmed through a histopathological examination. The patient was subsequently discharged on the third postoperative day and had no further treatment. In conclusion, extraperitoneal angiomyolipomas are rarely found, and the diagnosis is confirmed by histopathological examination. The management of temporal angiomyolipomas is tumor resection. Keywords: temporal angiomyolipomas; histopathological diagnosis; surgical treatment
Rasionalitas Penggunaan Antibiotik untuk Pengobatan Infeksi Saluran Pernapasan Akut pada Anak Christi D. Mambo; Angelina S. R. Masengi; Deffianie A. Thomas
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.v6i1.45431

Abstract

Abstract: Acute respiratory infection (ARI) is caused by transmission of pathogens that infect the upper or lower respiratory tract. Worldwide, including Indonesia, ARI is one of the causes of high morbidity and mortality. Antibiotics are the most commonly used drugs to treat infections in the respiratory tract, however, the use of antibiotics is often irrationally; therefore, it needs special attention. This study aimed to determine the rationality of using antibiotics for the treatment of ARI in children. This was a literature study with data searching from Pubmed and Research Gate using the PICOS criteria. The results showed that the most widely used antibiotic was amoxicillin of penicillin class (64%). The Gyssens flow assessment obtained Category V (30%), Category IIA (20%), Category 0 (15%), Category IIB (10%), Category IIIA (10%), Category IVD (5%), Category IVA (5%), and Category IIC (5%) which showed irrational use of antibiotics. In conclusion, according to Gyssens assessment of antibiotics use, 65% are irrational and 35% are rational. Irrational cases are due to incorrect/inaccurate diagnosis and doses, followed by inaccuracy in duration, interval, and route of administration. Antibiotic resistance tends to increase since the irrational use is not well managed. Keywords: rational use of antibiotics; prescription; antibiotics; antimicrobials; acute respiratory tract infection; children   Abstrak: Infeksi saluran pernapasan akut (ISPA) disebabkan oleh penularan patogen yang menginfeksi saluran pernapasan atas atau bawah. Di seluruh dunia, termasuk Indonesia, ISPA menjadi salah satu penyebab tingginya angka kesakitan dan kematian pada anak. Antibiotik merupakan salah satu obat paling umum digunakan untuk mengatasi infeksi saluran pernapasan namun seringkali digunakan secara tidak rasional sehingga perlu mendapat perhatian khusus Penelitian ini bertujuan untuk mengetahui rasionalitas penggunaan antibiotik terhadap pengobatan ISPA pada anak. Desain penelitian yang digunakan ialah suatu literature review. Pencarian data melalui database Pubmed dan ScienceDirect dengan menggunakan kriteria PICOS. Hasil penelitian mendapatkan jenis antibiotik yang paling banyak digunakan ialah golongan penisilin jenis amoksisilin (64%). Hasil tinjauan literatur dengan penilaian alur Gyssens mendapatkan Kategori V (30%), Kategori IIA (20%), Kategori 0 (15%), Kategori IIB (10%), Kategori IIIA (10%), Kategori IVD (5%), Kategori IVA (5%), dan Kategori IIC (5%) yang menunjukan penggunaan antibiotik secara tidak rasional. Simpulan penelitian ini ialah hasil seleksi alur Gyssens mendapatkan 65% irasional dan 35% rasional dalam penggunaan antibiotik. Kasus irasional banyak ditemukan dari ketidaktepatan diagnosis dan pemberian dosis diikuti ketidaktepatan durasi, interval dan rute pemberian antibiotik pada anak. Kejadian resistensi antibiotik akan terus meningkat bila penggunan secara irasional tidak tertangani. Kata kunci: rasionalitas penggunaan antibiotik; peresepan antibiotik; antimikroba; infeksi saluran pernapasan akut; anak
Penentuan Model Prediktif Metastasis Tulang dan Prognosis Kanker Prostat Menggunakan Alkalin Fosfatase dan Skor Gleason Marcella Merung; Christof Toreh; Ari Astram; 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.v6i1.48491

Abstract

Abstract: To date, assessment of the prognostic ability based on the relationship between alkaline phosphatase (ALP) to the Gleason score has not been reported. This study aimed to compare ALP with Gleason score as a predictor of prostate cancer prognosis. This was a hospital-based cross sectional study conducted from January 1, 2019 to December 31, 2021. Prostate cancer patient information included demographics, disease history, clinical characteristics, laboratory and radiology tests, and histopathology results. The results showed that the majority had a poor degree of differentiation (Gleason score: 8-10), which was 85.5%. High serum prostate specific antigen (PSA) levels were associated with the scores. The results of ALP were normal in 59.4%, increased in 34.4%, and decreased in 6.3% of patients. The multivariate regression analysis showed that every 10 U/L increase in ALP in the blood of prostate cancer patients on average was associated with a worse prognosis characterized by an increase in Gleason score of about 0.06 points (95% CI 0.03-0.09; p=0.002). In conclusion, serum alkaline phosphatase can be a predictive factor of bone metastases in prostate cancer with a cut value of 102 IU/L. Each increase of 10 IU/L of serum ALP is associated with a worse prognosis in prostate cancer while the Gleason score cannot be a predictive indicator of bone metastases in prostate cancer. Keywords: alkaline phosphatase; prostate specific antigen; Gleason score; prognostic predictor   Abstrak: Penilaian kemampuan prognostik kanker prostat berdasarkan hubungan alkalin fosfatase (ALP) dengan skor Gleason sampai saat ini belum pernah dilaporkan. Tujuan penelitian ini untuk membandingkan kadar ALP dengan skor Gleason sebagai prediktor prognosis kanker prostat. Penelitian ini menerapkan desain potong lintang berbasis rumah sakit dari 1 Januari 2019 hingga 31 Desember 2021. Informasi pasien kanker prostat mencakup demografik, riwayat penyakit, karakteristik klinik, hasil pemeriksaan laboratorium dan radiologi, serta data histopatologi. Hasil penelitian memperlihatkan proporsi terbesar memiliki tingkat diferensiasi buruk dengan skor Gleason: 8-10 sebesar 85,5%. Data tingginya kadar prostate specific antigen (PSA) serum berhubungan dengan skor Gleason. Pada penelitian ini ALP dengan hasil normal 59,4%, meningkat 34,4%, menurun 6,3%. Hasil analisis regresi multivariat menunjukkan setiap 10 U/L kenaikan ALP dalam darah pasien kanker prostat rata-rata berhubungan dengan prognosis lebih buruk ditandai oleh peningkatan skor Gleason sekitar 0,06 poin (95% CI 0,03-0,09; p=0,002). Simpulan penelitian ini ialah ALP dapat menjadi faktor prediksi metastase tulang pada kanker prostat dengan nilai potong 102 IU/L. Setiap peningkatan 10 IU/L ALP serum berhubungan dengan prognosis yang lebih buruk pada kanker prostat sedangkan skor Gleason tidak dapat menjadi indikator prediksi metastase tulang pada kanker prostat. Kata kunci: alkaline fosfatase; prostate specific antigen; skor Gleason; prediktor prognosis
Gambaran Kasus Forensik Klinik di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022 Pratiwi Hardani; Erwin Kristanto; Nola T. S. Mallo
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.v6i1.48980

Abstract

Abstract: To date, there is lack of available data regarding clinical forensic services in Indonesia, including North Sulawesi. Prof. Dr. R. D. Kandou Hospital in Manado, a referral center in North Sulawesi, was chosen as the research location expecting to obtain the description of clinical forensic cases in North Sulawesi. This study aimed to obtain a description of clinical forensic cases in North Sulawesi in 2022. This was a descriptive study with a cross sectional design. The resukts showed that the cumulative number of clinical forensic cases at Prof. Dr. R. D. Kandou Hospital in 2022 was 250 cases, consisting of 155 cases of traffic accidents, 59 cases of abuse, and one case of sexual violence. Victims consisted of 79% male sand 21% females. Most clinical forensic cases came to Prof. Dr. R. D Kandou Hospital in December (15%) and the least in April (3%). Most of the wound locations were found in the abdominal area (65%), followed in the back area (34%), and the least in the vaginal area (1%). In conclusion, traffic accidents were the most common clinical forensic cases in North Sulawesi. Most injuries were found in the abdominal area and the least in the genital area. Most of the victims were male. December 2022 donated the most clinical forensic cases. Only a few cases of sexual violence were brought to Prof. Dr. R. D. Kandou Hospital, therefore, the victims still need to be outreached and encouraged to report. Keywords: sexual violence; assault; traffic accidents; clinical forensic cases    Abstrak: Hingga saat ini masih belum banyak data yang tersedia mengenai kasus pelayanan forensik klinik baik di Indonesia maupun Sulawesi Utara. RSUP Prof. Dr. R. D Kandou Manado sebagai pusat rujukan di Sulawesi Utara dipilih menjadi lokasi penelitian karena diharapkan dapat menggambarkan kasus forensik klinik di Sulawesi Utara.  Penelitian ini bertujuan untuk memperoleh gambaran kasus forensik klinik di Sulawesi Utara pada tahun 2022. Jensi penelitian ialah deskriptif dengan desain potong lintang. Hasil penelitian mendapatkan angka kumulatif kasus forensik klinik di RSUP Prof. Dr. R. D. Kandou sepanjang tahun 2022 sebanyak 250 kasus, terdiri atas 155 kasus kecelakaan lalu lintas, 59 kasus penganiayaan, dan satu kasus kekerasan seksual. Korban terdiri atas 79% berjenis kelamin laki-laki dan 21 % perempuan. Kasus forensik klinik tertinggi pada bulan Desember (15%) dan paling sedikit pada bulan April (3%). Lokasi luka terbanyak ditemukan pada area abdomen (65%), disusul daerah punggung belakang (34%), dan paling sedikit daerah vagina (1%). Simpulan penelitian ini ialah kasus forensik klinik terbanyak di Sulawesi Utara terjadi pada jenis kelamin laki laki, jenis kasus kecelakaan lalu lintas, dan lokasi luka di bagian abdomen. Bulan Desember menyumbangkan kasus forensik klinik terbanyak. Kasus kekerasan seksual masih sedikit yang dibawa ke RSUP Prof. Dr. R. D. Kandou sehingga masih memerlukan sosialisasi dan dorongan agar korban berani melapor. Kata kunci: kekerasan seksual; penganiayaan; kecelakaan lalu lintas; kasus forensik klinik
Persepsi Masyarakat Kota Manado Terhadap Vaksin Booster Covid-19 sebagai Syarat Berwisata Kevin A. G. Mandak; Damajanty H. C. Pangemanan; Diana V. D. Doda
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.v6i1.45458

Abstract

Abstract: Coronavirus disease 2019 (Covid 19) is an infectious disease that is currently a global pandemic. This situation greatly impacts the tourism sector in Indonesia. Vaccination is expected to be one of the preventive measures used to control the transmission of Covid-19. This study aimed to determine the perception of the people in Manado City towards the Covid-19 booster vaccine as a prerequisite for traveling. This was a qualitative study using interview method. The interview was conducted using in-depth interview technique and guidelines. The results obtained 15 people of Kelurahan Paniki Bawah, Kecamatan Mapanget, Kota Manado as respondents. Most respondents had positive perception towards the Covid-19 booster vaccine as a prerequisite of traveling. Most respondents had good general understanding of the benefits of the Covid-19 vaccine and they agreed with the Covid-19 booster vaccine as a prerequisite of traveling. In conclusion, most people in Manado City have a good and positive perception of the Covid-19 booster vaccine as a prerequisite of traveling. Keywords: Covid-19; booster vaccine; travelling prerequisite   Abstrak: Penyakit infeksi coronavirus 2019 (Covid 19) telah menjadi pandemi global. Situasi tersebut sangat berdampak pada sektor pariwisata di Indonesia. Pemberian vaksin diharapkan dapat menjadi salah satu pencegahan yang digunakan untuk mengendalikan penularan Covid-19. Penelitian ini bertujuan untuk mengetahui persepsi masyarakat Kota Manado terhadap vaksin booster Covid-19 sebagai syarat berwisata. Penelitian ini merupakan penelitian kualitatif dengan metode wawancara secara terstruktur dan menggunakan pedoman wawancara. Hasil penelitian mendapatkan 15 masyarakat Kelurahan Paniki Bawah, Kecamatan Mapanget, Kota Manado sebagai responden penelitian. Persepsi responden terhadap vaksin booster Covid-19 sebagai syarat berwisata menunjukkan bahwa sebagian besar memiliki persepsi positif terhadap vaksin booster Covid-19 sebagai syarat berwisata. Responden memiliki pemahaman umum yang baik mengenai manfaat vaksin covid dan mereka setuju dengan himbauan vaksin bo booster oster Covid-19 sebagai syarat berwisata. Simpulan penelitian ini ialah masyarakat Kota Manado umumnya memiliki persepsi yang baik terhadap vaksin booster Covid-19 sebagai syarat berwisata. Kata kunci: Covid-19; vaksin booster; syarat berwisata
Hubungan Pola Patah Tulang dengan Gejala Klinis pada Patah Tulang Dasar Kepala (PTDK) Anterior Hardianto Musu; Eko Prasetyo; Maximilian C. Oley; 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.v6i1.48479

Abstract

Abstract: Traumatic brain injury can occur due to skull base fracture at the anterior, middle, and posterior parts with life-threatening complications. This study aimed to obtain the relationship between anterior skull base fracture pattern and its clinical signs and symptoms. This was a retrospective chart review with a cross-sectional design. Subjects were 50 patients with anterior skull base fracture based on 3D CT scan, and then their clinical signs and symptoms were evaluated. Data were analyzed bivariately using the Pearson Chi-Square test and the Fisher Exact alternative. The results showed that the most common clinical signs and symptoms in type I was anosmia; in type II, related to eyes; in type III, rhinorrhea; and in type IV, signs and symptoms of all entities. The most common fracture pattern in the subjects was frontolateral type (type III). There was a significant relationship between the pattern of fracture based on the 3D CT scan with the clinical signs and symptoms of  patients including cerebrospinal fluid rhinorrhea, anosmia, racoon eyes, and visual deficit (p<0.001). In conclusion, there is a signifinat relationship between pattern of anterior skull base fracture with clinical signs and symptoms. Keywords: traumatic brain injury; anterior skull base fracture; 3D CT scan; clinical signs and symptoms   Abstrak: Cedera otak akibat trauma (COT) dapat terjadi akibat patah tulang dasar kepala (PTDK) baik pada basis tengkorak anterior, tengah, dan posterior, dengan komplikasi mengancam jiwa. Penelitian ini bertujuan untuk mendapatkan hubungan pola patah tulang dengan gejala klinis pada PTDK anterior. Jenis penelitian ialah retrospektif menggunakan rekam medis dengan desain potong lintang. Subjek penelitian ialah 50 pasien PTDK anterior dengan pola patah tulang sesuai 3D CT scan dan dievaluasi kondisi klinisnya. Uji bivariat menggunakan uji Pearson chi-square dengan alternatif Fisher exact. Hasil penelitian mendapatkan gejala klinis yang paling umum: tipe I yaitu anosmia; tipe II yaitu gejala berhubungan dengan mata; tipe III yaitu rinorea; dan tipe IV memberikan gejala yang mencakup semua entitas. Pola patah tulang terbanyak ialah patah tulang frontolateral (tipe III). Pola patah tulang yang dinilai melalui 3D CT-scan berhubungan bermakna dengan derajat gejala klinis pasien PTDK anterior meliputi rinorea cairan serebrospinal, anosmia, racoon eyes, dan defisit visual (p<0,001). Simpulan penelitian ini ialah terdapat hubungan bermakna antara pola PTDK anterior dengan gejala klinis. Kata kunci: cedera otak akibat trauma; patah tulang dasar kepala anterior; 3D CT scan; gejala klinis
Hubungan antara Tumor-Infiltrating Lymphocytes dengan Stadium dan Derajat Diferensiasi Adenokarsinoma Kolorektal Karina E. Clearesta; Toar Mambu; Ferdinand Tjandra; 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.v6i1.48480

Abstract

Abstract: Colorectal cancer has high incidence and mortality rates. Tumor-infiltrating lymphocytes (TILs) are histopathological findings that depict the individual's immune response to the tumor. This study aimed to investigate the relationship between TILs and the differentiation grade and stage of colorectal adenocarcinoma. This was an analytical and observational study with a cross-sectional design. The results showed 34 patients with colorectal adenocarcinoma who met the criteria. The sample characteristics consisted of male (64.7%), mean age (59.15 ± 10.78), tumor location in the colon (43.9%) and rectum (55.8%), average TILs (25.62 ± 17.39), moderate TILs grade (50%), stage III tumor (50%), and moderately differentiated tumors (70.6%). A significant association was found between TILs and tumor differentiation grade (p=0.024). Post hoc analysis showed a significant difference in TILs between good and poor differentiation (p=0.04; 95% CI: 1.52-64.48). A cut-off value for TILs was identified for good differentiation (TIL>27) and moderate/poor differentiation (TIL≤27) with a sensitivity of 69.2% and specificity of 75.0%. The extent of lymphocytic invasion of tumor tissue reflected the host's immune status. TILs played an important role in tumor development and was a good prognostic factor in colorectal cancer. In conclusion, TILs can be used as a predictor for the differentiation grade of colorectal adenocarcinoma. Keywords: colorectal adenocarcinoma; tumor infiltrating lymphocytes; differentiation grade   Abstrak: Kanker kolorektal memiliki angka kejadian dan mortalitas tinggi. Tumor-infiltrating lymphocytes (TILs) merupakan temuan histopatologik yang menggambarkan respon imunologis individu terhadap tumor. Penelitian ini bertujuan untuk mengetahui hubungan antara TILs dengan derajat diferensiasi dan stadium pada adenokarsinoma kolorektal. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 34 pasien dengan adenokarsinoma kolorektal yang memenuhi kriteria. Karakteristik sampel terbanyak ialah jenis kelamin laki-laki (64,7%), rerata usia (59,15 ± 10,78), lokasi tumor di kolon (43,9%) dan rektum (55,8%), rerata TILs (25,62 ± 17,39), derajat TILs moderate (50%), stadium tumor derajat III (50%) dan derajat diferensiasi tumor sedang (70,6%). Terdapat hubungan bermakna TILs dengan derajat diferensiasi tumor (p=0,024). Analisis post hoc bermakna terhadap derajat TILs baik vs buruk (p=0,04; 95% CI: 1.52-64.48). Nilai cut-off TILs dengan derajat diferensiasi baik (TIL>27) dan sedang/buruk (TIL≤27) dengan sensitivitas 69,2% dan spesifisitas 75,0%. Luasnya invasi limfositik pada jaringan tumor mencerminkan status kekebalan tubuh pejamu. TILs berperan penting dalam perkembangan tumor dan merupakan faktor prognostik yang baik pada kanker kolorektal. Simpulan penelitian ini ialah nilai TILs dapat digunakan sebagai faktor prediktor derajat diferensiasi adenokarsinoma kolorektal. Kata kunci: adenokarsinoma kolorektal; tumor infliltrating lymphocytes; derajat diferensiasi
Analisis Konsep Hospital Without Walls pada Pelayanan Kelainan Refraksi di UPTD Rumah Sakit Mata Provinsi Sulawesi Utara Gabriella O. Mokolensang; Aaltje E. Manampiring; Jimmy Posangi
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.v6i1.49221

Abstract

A hospital without walls or known as a hospital without walls is very useful for patients who come to the hospital for treatment with referrals from the public health center as the entry point for referral diagnosis, this is to minimize the risk of infection transmission and other disease problems. The purpose of this study is to analyze the concept of a hospital without walls and the obstacles and challenges in providing refractive errors. The research was conducted at the UPTD Eye Hospital in North Sulawesi Province, from January to December 2022 using in-depth interviews with five research informants, namely the director, head of medical services, ophthalmologist, family doctor and patient. Instruments in the form of in-depth interview guidelines and a list of questions that have been provided. The stages of data processing are narrating, inferring, reducing, recording, sampling, unitizing. Data analysis is content analysis. The validity of the research results using triangulation of data sources and methods. The results of this study were obtained from the summary of the answers of the research informants that the concept of a hospital without walls all understand and know this concept to mitigate the accumulation of services in hospitals, but this concept has not been implemented because there are several factors such as standard operating procedures, human resources and infrastructure which is not yet possible for some FKTPs to be able to complete services at the community health center or family doctor, the obstacle presented by the informant is that there are still many patients who want to carry out direct services to the hospital without going to the health center or family doctor, another obstacle is the lack of tools for examining refractive errors and competence general practitioners to be able to make referrals in the diagnosis of disease. Hospital income will also increase if implementing this concept, if there is collaboration with related stakeholders such as BPJS Health, the Health Service, and other private parties, so that this will also have a good impact on the quality of service when hospital accreditation is carried out. The sophistication of information technology needs to be implemented as much as possible from the hospital so that it is easier so that patients do not pile up during services by registering online. The conclusion of this study is that the concept of a hospital without walls has not been implemented in the Eye Hospital of North Sulawesi Province because it has not followed standard operating procedures, quality competent resources and adequate infrastructure. FKTP Puskesmas in providing refractive error services have not provided complete supporting tools and the skills of FKTP doctors are still lacking, this will have an impact on assessing hospital accreditation in the quality of health services. Keywords: hospitals without walls, eye refractive error, family doctors

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