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eJournal Kedokteran Indonesia
Published by Universitas Indonesia
ISSN : 23381426     EISSN : 23386037     DOI : http://doi.org/10.23886/ejki
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
eJournal Kedokteran Indonesia (eJKI) is a general medical journal, published quadrimester (April, August, December) by Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. eJKI aims to published the manuscript of students (Bachelor of Medicine (S.Ked), study Program of Medical Profession, magister/specialist, doctoral, and fellow). The journal is a general medical journal that covering all areas of biomedical science, basic medical science, clinical science, medical technology, and medical education. The journal accepts editorial, research article, reviews, evidence-based case report, and also interesting case reports/case study. This work was supported by Faculty of Medicine, Universitas Indonesia.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 13 Documents
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Search results for , issue "Vol 10, No. 3 - Desember 2022" : 13 Documents clear
Successful Management of Complex Congenital Cataract and Its Complication: A Case Report: Keberhasilan Tatalaksana Katarak Kongenital Kompleks dan Komplikasinya: Sebuah Laporan Kasus Dian Estu Yulia; Yulika Harniza; Lia Amanda
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.58.265-70

Abstract

Management of cataract and its complication after surgery in a child with complex congenital cataract where accompanied by other ocular abnormality can pose a great surgical challenge. This case report described a case of an 18-year-old girl with slowly decreasing vision after undergoing surgery charity on the right eye (RE) around 4 months ago due to cataract which she had since birth. Best corrected visual acuity (BCVA) preoperatively of the RE and LE was 6/60 and 0,5/60 respectively. Ocular assessment was pseudophakia with Posterior Capsular Opacity (PCO) on the RE and cataract on the left eye (LE) accompanied by microcornea, nystagmus and coloboma of iris and retina on both eyes. Secondary posterior capsulotomy surgery was done on the RE and cataract extraction, Primary Posterior Capsulotomy (PPC) on the LE with Anterior Vitrectomy (AV) on both eyes. Last follow-up postoperatively showed a significant improvement of uncorrected visual acuity on her RE from 0.5/60 preoperatively to 6/30, meanwhile only subjective improvement of VA was found on her LE. This case can achieve visual improvement with promptly surgical treatment without complication and routine monitoring still needs to be done.
Chronic Kidney Disease in Hospital Cooks Rita Ingewaty Wijaya; Dewi Sumaryani Soemarko
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.125.271-5

Abstract

Chronic kidney disease is still a concern for health problems in Indonesia. Complications of chronic kidney disease include hypertension, cardiovascular disease, decreased kidney function to the end stage and even death. One of the potential dangers is heat, which not only causes the risk of kidney and cardiovascular health problems but it can also worsen the condition of the disease. Workplaces such as hospital kitchens have a risk of heat exposure. This shows the importance of fit-to-work assessment based on occupational medicine management. A 55-year-old cook worker with stage IV chronic kidney disease came to the hospital. The result from the last visit suggested that she had dyslipidemia and uncontrolled hypertension. We recommend the worker with job restrictions. She can still work in the nutrition department of the hospital but with restrictions on cooking duties. She can still work in the food filter and serving area. The goal of limiting work assignments is to maintain chronic kidney failure at stage IV. In addition, the hospital is also required to take control measures so that other workers do not have the risk of kidney disease health problems. Keywords: chronic kidney disease, cook, occupational medicine management
Outcomes of Autologous Reconstruction in Comparison with Alloplastic in Microtia Patients Dini Widiarni Widodo; Irfan Irfan; Eka Dian Safitri; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.178.258-64

Abstract

Background: Microtia is a congenital abnormality of the auricle. One of the important comprehensive management of microtia is ear reconstruction. Reconstruction using an auricle framework from autologous material originating from the rib cartilages is still the gold standard. However, currently, some surgeons prefer alloplastic materials which are claimed to reduce morbidity and can be performed at a younger age. Objective: Report a case of a microtia patient who underwent autologous reconstruction followed by a literature search comparing the outcomes of autologous and alloplastic reconstruction. Case: An 11-year-old with grade 3 unilateral microtia who underwent autologous reconstruction surgery using materials from the rib cartilages. Later he complained of pain at the rib grafting site, more than at the surgical wound in the ear. Methods: A literature search based on the clinical question was done in PubMed, EBSCOhost, Cochrane Library, and by hand searching. Results: Three relevant articles that fit the clinical question were included. Autologous reconstruction causes fewer complications, while alloplastic reconstruction is better aesthetically. Further research is needed regarding the quality of life. Conclusion: Auricular reconstruction using autologous material remains the superior material of choice. Alloplastic framework can be an alternative choice with better aesthetic results but greater complication risk.
Profil Klinis dan Radiologis Pasien Stroke dengan Cerebral Small Vessel Disease Di RS Bethesda Yogyakarta Arminta Ni Kadek Aditya Pramesti; Pinzon Rizaldy Taslim; Pramudita Esdras Ardi
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.183.251-7

Abstract

Cerebral Small Vessel Disease (CSVD) merupakan penyebab tersering dari kasus stroke dan bagian utama gangguan kognitif vaskular. Di Indonesia stroke merupakan penyakit penyebab kematian dan disabilitas tertinggi pada tahun 2019, namun data spesifik terkait CSVD di Indonesia masih minim. Melalui tulisan ini, akan di bahas lebih lanjut terkait karakteristik pasien Cerebral Small Vessel Disease. Penelitian ini menggunakan metode deskriptif observasional kuantitatif dengan total 83 subjek penelitian. Ditemukan 73,5% pasien adalah perempuan, dengan 98,8% subjek berusia 50 tahun ke atas. Terdapat beberapa faktor risiko yang ditemukan yaitu: dislipidemia (78,3%), hipertensi (77,1%), diabetes mellitus (39,8%), heart disease (26,5%), dan kidney disease (7,2%). Ditemukan adanya peningkatan pada kadar LDL (143,060±40,469) dan trigliserid (241,024±116,807). Dari 83 subjek penelitian 85,5% mengalami WMH, 59% infark lakunar, dan 51,8% mengalami microbleeds. Lokasi infark lakunar yang ditemukan yaitu: acute frontal, acute parietal, acute fronto parietal, acute fronto temporal, periventricular, pons, dan multiple lacunar, dan 3 manifestasi klinis yaitu pure motoric (43,4%), sensori motoric (50,6%), dan ataxic hemiparesis (6%). Disimpulkan bahwa karakteristik pasien CSVD yaitu perempuan berusia 50 tahun ke atas dengan faktor risiko tertinggi yaitu dislipidemia dengan peningkatan kadar LDL dan trigliserid pasien. Gambaran MRI dan manifestasi klinis terbanyak ditemukan yaitu WMH (85,5%) dan sensori motoric. Kata kunci: Cerebral small vessel disease, faktor risiko, hasil laboratorium, MRI, manifestasi klinis.
Pengaruh Fungsi Ginjal Sebelum Intervensi Koroner Perkutan Primer Terhadap Perbedaan Kesintasan 30 Hari Pasien Infark Miokard Elevasi Segmen ST Fahmi Razi Darkuthni; Sally Aman Nasution; Aida Lydia; Murdani Abdullah; Dono Antono; Cleopas Martin Rumende; Maruhum Bonar Hasiholan Marbun; Hamzah Shatri; Arif Mansjoer; Ika Prasetya Wijaya; Lusiani Lusiani
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.195.204-11

Abstract

Penyakit jantung koroner merupakan penyebab kematian penyakit kardiovaskular utama di Indonesia. Revaskularisasi fase akut secara mekanis maupun farmakologis merupakan tatalaksana utama pada STEMI. Mortalitas paska revaskularisasi masih tinggi. Salah satu faktor penting yang memengaruhi kesintasan pasien STEMI adalah fungsi ginjal. Gangguan fungsi ginjal yang dicerminkan dengan estimated glomerulus filtration rate (eGFR) < 60 diketahui berhubungan dengan perfusi miokard yang buruk paska IKP primer. Penelitian ini bertujuan untuk memberikan gambaran karakteristik pasien STEMI yang menjalani IKP primer berdasarkan fungsi ginjal sebelum IKP dan menganalisa perbedaaan kesintasan dalam 30 hari pasien STEMI-IKP primer berdasarkan fungsi ginjal sebelum IKP. Metode studi observasional kohort retrospektif dan pengukuran fungsi ginjal dikelompokkan berdasarkan eGFR dengan rumus CKD-EPI menjadi dua yaitu eGFR < 60 dan eGFR ≥ 60. IKP primer dilakukan pada 211 pasien STEMI. Insiden mortalitas eGFR < 60 sebesar 14,7%, sedangkan dengan eGFR ≥ 60 sebesar 4,4%. Perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR (p < 0,05) dengan crude HR (IK95%) 3,433 (1,269-9,284). Tidak terdapat perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR setelah di-adjusted. Mortalitas dalam 30 hari pada kelompok eGFR < 60 lebih tinggi dibandingkan dengan kelompok eGFR ≥ 60. Kata kunci: infark miokard akut, intervensi koroner perkutan, fungsi ginjal, mortalitas.
High Urinary Cotinine Levels and Low Academic Performance of Elementary School Students in Families with Careless Smoking Habits Ika Yustisia; Nurdiana Sari; Suryani Tawali; Mutmainah Arif; Sitti Ramliah
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.199.197-203

Abstract

Children are the most vulnerable age group to become passive smokers due to cigarette smoke exposure, especially from family members. In addition, children who smoke passively are at high risk of experiencing declined cognitive performance. This study investigated the effect of cigarette smoke exposure on urinary cotinine levels and its relationship with elementary school students’ academic performance. The observational study with a cross-sectional design was located in Pannampu Village, Tallo District, Kota Makassar. Interviews, collecting academic performance data, and measuring urinary cotinine levels using colorimetric techniques were carried out on elementary school students (n=77). This study found that 88.5% of students stated that they had family members who smoked at home with inappropriate habits of exposing children to cigarette smoke. Urinary cotinine levels showed an average of 121.64 ng/mL. All students with urinary cotinine levels above 200 ng/mL (16.4%) had smoker family members. The urinary cotinine levels in boys were higher (p=0.014) with lower report card average marks than in girls. The smoking habits of family members were still a concern and had not protected children from cigarette smoke exposure, as evidenced by the high average urinary cotinine levels, especially in boys, which might affect their academic performance
Analysis of Internal Nasal Valves Shapes and Angle due to Nasal Obstruction in Asian Nose Tiara Melati; Mirta Hediyati Reksodiputro; Trimartani Koento; Sandi Iljanto
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.203.212-8

Abstract

BACKGROUND Internal nasal valve (INV) is widely discussed because it is believed to have a role in structural nasal obstruction. Caucasian has a rather acute angle of INV due to the known geometric of their nose. Whilst Asian generally has broader, thicker, and bigger anthropometric proportion of nose than Caucasian. Asia is vastly diverse in ethnicity, one can only assume that Asian INV may be differ in shape and larger in angles compare to Caucasian, due to the minimum publication addressing this issue. AIM To report the anatomy of INV and its angle in obstructed Asian noses. METHOD A case control study was conducted. Forty cases of nasal obstruction and 80 controls without nasal obstruction. Both groups were evaluated using Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, rigid nasal endoscopy and active anterior rhinomanometry (AAR). Anatomy and angle of INV was later measured using digital image analysis. RESULT Six basic INV shapes were seen throughout both groups, many has different shape combinations. Most commonly (more than 60%) observed shape in both groups were the occupied by nasal septal body (NSB). The right INV angle in case group was 15,5º ± 10,1º (p = 0,123) and left INV angle was 17,2º ± 9,0º (p = 0,022). In control group, the right INV angle was 19,6º ± 11,8º (p = 0,123) and left INV angle was 23,2º ± 12,5º (p = 0,022). CONCLUSION It is shown that most common shape of Asian INV in both groups, is the occupancy by NSB. Internal nasal valve angle in obstructed nose is narrower in comparison to those without nasal obstruction. This study also demonstrates Asian, particularly Indonesian, has a wider angle than Caucasian.
Level of Evidence Diagnosis Skabies Berdasarkan Oxford Centre for Evidence-Based Medicine Keiko Gunardi; Prof Saleha Sungkar; Sandra Widaty; Yudo Irawan
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.224.276-83

Abstract

Abstrak Skabies merupakan masalah kesehatan komunitas di seluruh dunia dan penyakit ini menjadi infeksi tropis yang sering terabaikan di Indonesia. Manifestasi kulit pada skabies yang tidak khas, namun tetap digunakan sebagai dasar dalam mendiagnosis skabies dengan tambahan pemeriksaan mikroskopik langsung. Tinjauan pustaka ini membahas penegakan diagnostik skabies berdasarkan level of evidence dari berbagai pemeriksaan penunjang. Pemeriksaan penunjang yang dibahas adalah pemeriksaan langsung mikroskopik, pemeriksaan dermoskopi, dan pemeriksaan imunologi antara lain Polymerase Chain Reaction (PCR) dan Enzyme-linked immunosorbent assay (ELISA) yang mempunyai LoE 1B. Pemahaman yang tepat mengenai metode diagnosis skabies akan memberikan tata laksana serta mendukung eradikasi penyakit ini. Abstract Scabies become a public health burden worldwide and the most common neglected tropical skin diseases in Indonesia. However, atypical skin manifestations are frequent and the widely used diagnostic test based on microscopic examinations has limited sensitivity. This literature review discuss about diagnostic method in patient with scabies according to level of evidence. We compared the classical manifestation, the new diagnostic consensus criteria, microscopic examination, dermoscopy examination and immunological assay such as polymerase chain reaction (PCR) and Enzyme-linked immunosorbent assay (ELISA) categorized in LoE 1B. The knowledge about the diagnostic method will give an effective treatment for scabies patient and will eradicate this disease.
Pengaruh Pembelajaran Jarak Jauh Akibat Pandemi COVID-19 Terhadap Tingkat Keparahan Nyeri Kepala Primer Tiara Aninditha; Stefen Weliadi Ali
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.225.219-17

Abstract

Abstrak Pembelajaran jarak jauh (PJJ) selama masa pandemi COVID-19 dapat menyebabkan peningkatan durasi penggunaan gawai, peningkatan stres dan kualitas tidur buruk pada mahasiswa dimana hal-hal tersebut dapat berkaitan dengan kejadian nyeri kepala primer. Penelitian ini bertujuan untuk mengetahui hubungan PJJ dengan tingkat keparahan nyeri kepala primer. Studi ini merupakan studi potong lintang, analitik observasional. Sampel diambil secara konsekutif mulai Desember 2020 sampai Mei 2021 menggunakan kuesioner elektronik kepada mahasiswa preklinik FKUI angkatan 2018, 2019 dan 2020. Tingkat stres diukur dengan PSS-10 dan kualitas tidur dengan PSQI. Terdapat 95 subyek nyeri kepala primer yang memenuhi kriteria (24,1%) dari total 393 responden. Mayoritas subyek (93,7%) mengalami peningkatan durasi penggunaan gawai selama PJJ dengan rerata 12,67±3,28 jam. Peningkatan durasi penggunaan gawai memiliki hubungan signifikan dengan peningkatan tingkat keparahan nyeri kepala primer (p=0,04). Sekitar 80% subyek mengalami stres sedang-berat dan 71,6% memiliki kualitas tidur buruk selama PJJ, namun tidak terdapat hubungan signifikan dengan peningkatan tingkat keparahan nyeri kepala primer (p>0,05). Oleh karena itu, dapat disimpulkan bahwa terdapat hubungan bermakna antara peningkatan durasi penggunaan gawai dengan tingkat keparahan nyeri kepala primer. Kata kunci: durasi penggunaan gawai, kualitas tidur, nyeri kepala primer, pembelajaran jarak jauh, tingkat stres
Development of a Questionnaire Evaluating the Knowledge, Attitude, and Practice on Geriatric Dermatology among Elderly Caregivers Shannaz Nadia Yusharyahya; Valdi Ven Japranata; Christine Lieana; Lili Legiawati; Rinadewi Astriningrum; Wresti Indriatmi
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.228.228-37

Abstract

Information concerning the extent of knowledge, attitude, and practice of elderly caregivers about dermatological care are still limited. This present study aimed to develop a tool with decent validity and reliability to delineate such profiles. A questionnaire was designed by geriatric dermatology experts, followed by content validation and reliability tests using Aiken’s V coefficient, Kuder-Richardson Formula 20 (KR-20) or Cronbach’s α, and Pearson’s correlation. The developed instrument was tested on elderly caregivers, before and after education. Obtained data were analyzed using appropriate inferential statistics. We found that the Aiken’s V coefficient for each item was ≥0.70; KR-20 in knowledge section was 0.81; Cronbach’s α in attitude and practice section were 0.81 and 0.80, respectively; and Pearson’s correlation in all sections was above 0.80. Significant disparities were observed in the initial knowledge (p=0.005) and attitude (p=0.020) based on academic levels. In addition, overall scores generally increased upon education (p<0.001). Therefore, the questionnaire is valid and reliable for assessing elderly caregivers' competencies in geriatric dermatology of which could be improved by education.

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