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INDONESIA
eJournal Kedokteran Indonesia
Published by Universitas Indonesia
ISSN : 23381426     EISSN : 23386037     DOI : http://doi.org/10.23886/ejki
Core Subject : Health, Science,
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.
Articles 12 Documents
Search results for , issue "Vol 9, No. 2 - Agustus 2021" : 12 Documents clear
Pars Plana Vitrectomy in Rhegmatogenous Retinal Detachment in Paediatric Patients in Dr. Cipto Mangunkusumo Hospital, Indonesia 2017 Faresa Hilda; Ari Djatikusumo; Elvioza Elvioza; Gitalisa Andayani Adriono; Anggun Rama Yudantha; Mario Marbungaran Hutapea; Andi Arus Victor
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.126 KB) | DOI: 10.23886/ejki.9.4.94

Abstract

In the past decades, indications for PPV in paediatric patients has been rising with large heterogeneity outcomes among studies. Our objective is to present a pilot descriptive study in Indonesia, regarding pars plana vitrectomy (PPV) success rate in paediatric patients with rhegmatogenous retinal detachment (RRD) in Dr. Cipto Mangunkusumo Hospital (CMH). A retrospective study was conducted on 16 paediatric eyes diagnosed for RRD and treated in CMH during the period of January 2017 to December 2017. A total of 16 RRD eyes were identified in 15 individuals. Majority of the patients were male and were in the age group of 12-18 years. There were 13 patients undergone PPV with or without SB. Functional anatomical success rate was determined from the macula status while functional success rate on final BCVA. Among 16 patients, 14 had constant or increased final BCVA and 11 had reattached macula. The success rate of PPV in terms of anatomical outcome was 11 out of 16 eyes and in functional outcome was 8 out of 16 eyes. Keywords: pars plana vitrectomy, paediatric ophthalmology, rhegmatogenous retinal detachment.   Karakteristik dan Hasil Vitrektomi Pars Plana pada Pasien Pediatrik di Divisi Vitreoretina Rumah Sakit Cipto Mangunkusumo Tahun 2017 Abstrak Indikasi tindakan vitrektomi pars plana (PPV) pada pasien pediatrik bertambah secara signifikan dalam beberapa dekade terakhir. Penelitian ini dilakukan sebagai studi awal di Indonesia, terkait tingkat keberhasilan PPV pada pasien anak dengan rhegmatogenous retinal detachment (RRD) khususnya di RS Cipto Mangunkusumo (RSCM). Studi retrospektif dilakukan terhadap 16 mata RRD pada 15 pasien anak di RSCM pada periode Januari 2017 – Desember 2017. Mayoritas pasien merupakan laki-laki dalam kelompok umur 12-18 tahun. Terdapat 13 pasien yang menjalani PPV dengan atau tanpa scleral buckle (SB). Tingkat keberhasilan anatomi dilihat dari status penempelan makula, sementara tingkat keberhasilan fungsional dinilai dari visus akhir. Tingkat keberhasilan anatomi PPV dalam studi ini adalah 11/16 mata, dan tingkat keberhasilan fungsional mencapai 8/16 mata. Kata kunci: vitrektomi pars plana, oftalmologi pediatrik, rhegmatogenous retinal detachment.
Prognostic of Recurrence of Ankle Sprain Injury in Athletes who Return to Sports Early Chikih Chikih; Nani Cahyani Sudarsono; Elina Widiastuti; Anggia Prathama Nasution
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (369.38 KB) | DOI: 10.23886/ejki.9.11.137

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Ankle sprains can occur in all athletes. The injuries are often considered minor but can occur repeatedly which can cause chronic complications. This evidence-based case report aims to determine the prognosis of recurrent ankle sprains resulting from returning to exercise too early. This report uses two databases for evidence collection, namely PubMed and Cochrane. Of the four articles, it was found that recurrent ankle sprains incidence rate was 33%, and neuromuscular training significantly reduced ankle sprain recurrence rates with relative risk 0.63 (95 % CI: 0.34-0.99) and hazard ratio 0.18 (95 % CI: 0.07-0.43). The healing time to the pre-injury state reached 93.8 ± 1.2 days for conventional therapy and 97.6 ± 1.5 days for a surgical procedure, and the time to return to exercise was 46.6 (95 % CI:15.4-70) days for conventional treatment and 55.2 ± 15.8 (95 % CI: 41.7 ± 9.8) days for surgical procedure. Using an ankle brace can help in healing and preventing recurrent injuries. Future more, proper handling and education about injuries and when is the optimal time to return to exercise can prevent relapse. Keywords: ankle sprain, return to sports, recurrence injury.   Prognosis Kekambuhan Cedera Sprain Pergelangan Kaki Olahragawan Setelah Kembali Berolahraga Lebih Awal Abstrak Cedera sprain pergelangan kaki dapat terjadi pada semua atlet. Cedera tersebut sering dianggap ringan namun jika terjadi berulang dapat menyebabkan komplikasi kronik. Laporan kasus berbasis bukti ini bertujuan untuk mengetahui prognosis kejadian berulang cedera sprain pergelangan kaki akibat kembali berolahraga terlalu awal. Dua basis data digunakan dalam pengumpulan bukti, yakni PubMed dan Cochrane. Dari empat artikel didapati cedera sprain pergelangan kaki dapat terjadi berulang dengan incidence rate 33% dan menyatakan neuromuscular training secara signifikan mengurangi tingkat kekambuhan sprain pergelangan kaki dengan relative risk 0.63 (95% CI: 0.34-0.99) dan hazard ratio 0.18 (95% CI: 0.07-0.43). Waktu penyembuhan ke keadaan sebelum cedera 93.8±1.2 hari untuk terapi konvensional, 97.6±1.5 hari untuk tindakan operatif, waktu kembali berolahraga adalah 46.6 (95% CI:15.4-70) hari untuk tindakan konvensional dan 55.2 ± 15.8 (95 % CI: 41.7 ± 9.8) hari untuk tindakan operasi. Penggunaan penyangga pergelangan kaki dapat membantu proses penyembuhan dan pencegahan cedera berulang. Oleh karena itu penanganan dan edukasi yang tepat mengenai cedera dan menetapkan waktu yang tepat untuk kembali berolahraga dapat mencegah kekambuhan. Kata kunci: cedera pergelangan kaki, kembali berolahraga, cedera berulang.
Pengaruh Pemberian Ekstrak Plumeria Rubra terhadap Fungsi Ginjal Tikus Model Hiperurisemia Nahdah Aidah; Muttia Amalia; Tuty Rizkianti
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.439 KB) | DOI: 10.23886/ejki.9.27.105

Abstract

Kadar asam urat tinggi dapat meningkatkan stres oksidatif di ginjal yang menyebabkan kerusakan glomerulus dan iskemia tubular. Ekstrak bunga kamboja (Plumeria rubra) mengandung kadar flavonoid tinggi yang dapat mencegah stres oksidatif dan menurunkan kadar asam urat. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian ekstrak P. rubra terhadap fungsi ginjal pada tikus model hiperurisemia. Penelitian dilakukan pada bulan Februari – Maret 2020 di Laboratorium Farmakologi dan Terapi Fakultas Kedokteran Universitas Padjajaran Bandung. Desain penelitian adalah eksperimental menggunakan tikus Rattus novergicus sebanyak 30 ekor yang dibagi dalam 5 kelompok dengan 6 tikus pada masing-masing kelompok. Kelompok kontrol terdiri atas kelompok 1 (kontrol negatif) dan kelompok 2 (kontrol positif dengan alopurinol ), kelompok 3, 4 dan 5 yang masing-masing mendapatkan dosis ekstrak P. rubra 200, 400 dan 600 mg/KgBB/hari. Penelitian dilakukan selama 14 hari dengan intervensi pada minggu pertama berupa induksi dan seminggu selanjutnya perlakuan. Sampel darah diambil melalui ekor tikus untuk menilai kadar asam urat dan kreatinin. Data dianalisis dengan uji Kruskall-Wallis. Hasil yang berbeda bermakna terdapat pada dosis 200, 400 dan 600 mg terhadap kadar asam urat (nilai p=0,004, 0,008 dan 0,004) sedangkan pada kreatinin perbedaan bermakna terdapat pada dosis 200 dan 400 mg (nilai p=0,004 dan 0,042). Terdapat penurunan signifikan pada kadar kreatinin setelah pemberian ekstrak P. rubra 400 mg/KgBB/hari yang berarti dapat memperbaiki fungsi ginjal tikus hiperurisemia. Kata kunci: fungsi ginjal, P. rubra, hiperurisemia, potasium oksonat dan antioksidan.   The Effect of Plumeria rubra Extract on Kidney Function in Hyperuricemic Rat Model Abstract Hyperuricemia can increase oxidative stress in kidney which will cause glomerular damage and tubular ischemia. Frangipani flower extract (Plumeria rubra) contains high amounts of phenols and flavonoids which can prevent the formation of oxidative stress and can reduce uric acid levels. This study aims to determine the effect of frangipani flower extract on kidney function in white rats induced by potassium oxonate. This research was conducted in February – March 2020 at the laboratory of pharmacology and therapy, faculty of medicine, Universitas Padjajaran, Bandung. The design of this study was experimental using 30 Rattus novergicus rats divided into 5 groups with 6 mice in each group. The control group consisted of group 1 (negative control) and group 2 (positive control with alopurinol ). The treatment group consisted of groups 3, 4, and 5, which were variations in doses of P. rubra extract 200, 400, and 600 mg/KgBB /day. The study was conducted for 14 days with the first week of induction and a week later of treatment. Blood samples are taken through the tail to assess uric acid and creatinine levels. The study was analyzed using Kruskall-Wallis. The results of significant differences were found at doses of 200, 400 and 600 mg of uric acid levels (p-value 0.004, 0.008 and 0.004) while the mean creatinine differences were found at doses of 200 and 400 mg (p-values 0.004 and 0.042). In this study, a significant decrease in creatinine levels after treatment showed that there was an effect of P. rubra extract on kidney function with an effective dose of 400 mg/kg/day. Keywords: kidney function, P. rubra, hyperuricemia, potassium oxonate and antioxidants.
Clinicopathologic and Histomorphological Aspect of Basal Cell Carcinoma in Dr. Cipto Mangunkusumo Hospital: A Retrospective Analysis of Twenty Years Experience Riesye Arisanty; Muhammad Habiburrahman; Maria Angela Putri
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1285.82 KB) | DOI: 10.23886/ejki.9.34.118

Abstract

Basal cell carcinoma (BCC) is the most common skin malignancy, and the incidence increases over time. However, epidemiological data and analysis of the histopathological characteristic of BCC in Asia and Indonesia are limited. This study evaluates the clinicopathological and histomorphological features of BCC cases at Dr. Cipto Mangunkusumo Hospital (CMH) for the last 20 years (2000-2019). This is a cross-sectional retrospective study, using medical records and slides data screened based on inclusion and exclusion criteria. The re-diagnostic assessment was performed independently by two investigators. Data were analyzed statistically by the chi-square test, Kruskal Wallis, and Mann Whitney tests. There were 896 cases of total 20 years, with an increase of 51.4% between the first and second decades, female: male ratio was 1.34: 1, the median age was 63 y.o (0-99), and 54% patient was 60-79 y.o. The majority of cases are located on the head, face, and neck (95.8%), nodular as the most common histological subtypes (49.2%), with adenoid as the highest number of variants (63.1%). Single vs mixed subtype BCC (58.4% vs 41.6%), low-risk vs high-risk BCC (53.9% vs 46.1%). There were different levels of risk and a number of subtypes based on anatomical location. The differences were also found in the number of subtypes, the aggressiveness of subtypes, and risk levels based on gender and histological subtypes based on anatomical location. Residual tumours were present in 2.8% of cases. Thus the cases of BCC in CMH have increased in the last 20 years, and differences are observed in anatomical distribution, gender, age, risk, number of subtypes, histological subtypes, and aggressiveness. Keywords: basal cell carcinoma, retrospective, epidemiology, histomorphological characteristics.   Aspek Klinikopatologis dan Histomorfologikal Karsinoma Sel Basal di Rumah Sakit Dr. Cipto Mangunkusumo: Analisis Retrospektif 20 Tahun Abstrak Karsinoma sel basal (KSB) merupakan keganasan kulit yang paling sering. Namun data epidemiologi dan telaah karakteristik histopatologi KSB di Asia dan Indonesia sangat terbatas. Penelitian ini bertujuan mengevaluasi kasus KSB di Rumah Sakit Dr. Cipto Mangunkusumo (RSCM) dan meninjau gambaran klinikopatologis serta histomorfologinya selama 20 tahun terakhir (2000-2019). Penelitian ini menggunakan desain potong lintang retrospektif dengan mengambil data dari rekam medis dan slide tersimpan. Skrining formulir permintaan patologi berdasarkan kriteria inklusi dan eksklusi. Penilaian diagnosis ulang dilakukan secara independen oleh dua peneliti. Data dianalisis dengan uji chi square, Kruskal Wallis, dan Mann Whitney. Terdapat 896 kasus KSB dalam waktu 20 thn dengan peningkatan 51,4% KSB antara dekade ke-1 dan ke-2, rasio perempuan: laki-laki adalah 1,34:1, median usia 63 tahun (0-99) dan 54% berusia 60-79 tahun. Lokasi anatomis terbanyak di kepala, wajah, dan leher (95,8%), subtipe nodular (49,2%) dengan varian adenoid tertinggi (63,1%). KSB subtipe tunggal vs. campuran (58,4% vs. 41,6%), KSB risiko rendah vs. tinggi (53,9% vs. 46,1%), terdapat beda tingkat risiko dan jumlah subtipe berdasarkan lokasi anatomis, jumlah subtipe, sifat agresivitas subtipe, dan tingkat risiko berdasarkan jenis kelamin, serta beda jenis subtipe dengan lokasi anatomis. Tumor residif terdapat pada 2,8% kasus. Kasus KSB di RSCM meningkat dalam 20 tahun terakhir dan perbedaan diamati pada distribusi anatomi, jenis kelamin, usia, risiko histopatologik, jumlah subtipe, berbagai subtipe histopatologi, dan agresivitasnya. Kata kunci: karsinoma sel basal, retropsektif, epidemiologi, karakter histomorfologi.
Anti-Müllerian Hormone Levels as Predictor of In Vitro Fertilization Outcomes Mila Maidarti; Prini Diandara Garinasih; Aprilia Asthasari Siregar; Gita Pratama; Achmad Kemal Harzif; Kanadi Sumapraja; Budi Wiweko
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (328.455 KB) | DOI: 10.23886/ejki.9.43.87

Abstract

A decrease in serum anti-müllerian hormone (AMH) concentration suggests the reduction of antral follicle number. AMH serum level was correlated with ovarian stimulation outcomes, oocyte quantity and quality, embryo quality and in vitro fertilization (IVF) outcomes. However, the use of AMH to predict pregnancy rates in IVF is still debatable. This study aimed to determine the role of AMH in predicting ovarian response and pregnancy rates in IVF programs. This was a retrospective cohort study involving patients who underwent a short protocol of ovarian stimulation for IVF at the Yasmin clinic, dr Cipto Mangunkusumo General Hospital. from March 2013 to March 2021. A total of 1,527 out of 3,880 IVF cycles were included. Poor ovarian response was determined as a collection of fewer than four oocytes following ovarian stimulation. The data was then analyzed using the Mann Whitney test if the data distribution was not normal or the unpaired t-test if the data distribution was normal. Median AMH levels were higher in the normal (2.5(0.01-32)) compared to poor responder (0.68(0.01-6.86)) group (p<0.05; Mann Whitney). Serum AMH level and age had predictive value for pregnancy rate (p<0.05; Mann Whitney). Keywords: AMH, ovarian response, pregnancy rate, IVF.   Kadar Hormon Anti-Müllerian sebagai Prediktor Luaran Fertilisasi in Vitro Abstrak Penurunan konsentrasi serum hormon anti-müllerian (HAM) menunjukkan penurunan jumlah folikel antral. HAM serum berkorelasi dengan luaran stimulasi ovarium kuantitas dan kualitas oosit serta kualitas embrio dan luaran fertilisasi in vitro (FIV). Namun, penggunaan HAM untuk memprediksi angka kehamilan dengan stimulasi ovarium pada FIV masih diperdebatkan. Tujuan penelitian ini untuk mengetahui peran serum HAM dalam memprediksi respons ovarium dan laju kehamilan pada program FIV. Penelitian ini adalah studi kohort retrospektif yang melibatkan pasien yang menjalani protokol singkat stimulasi ovarium pada program FIV di klinik Yasmin rumah sakit dr Cipto Mangunkusumo.dari bulan Maret 2013 sampai Maret 2021. Sebanyak 1.527 dari 3880 siklus IVF dimasukkan ke dalam penelitian. Dikatakan perespon buruk apabila diperoleh kurang dari empat oosit setelah stimulasi ovarium. Data kemudian dianalisis dengan menggunakan uji Mann Whitney bila sebaran data tidak normal atau uji t tidak berpasangan bila sebaran data normal. Median kadar HAM lebih tinggi pada kelompok perespons baik (2.5 (0.01-32)) dibandingkan perespons buruk (0.68 (0.01-6.86)) (p<0,05; Mann Whitney). Kadar HAM serum dan usia memiliki nilai prediktif terhadap angka kehamilan (p<0,05; Mann Whitney). Kata kunci: hormon anti-Müllerian, respons ovarium, angka kehamilan, FIV.
Penuntasan Stunting pada Anak sebagai Masalah Multi-Faktorial: Medis, Sosial, Ekonomi, Politik, dan Emosional Aman Pulungan
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.425 KB) | DOI: 10.23886/ejki.9.46.76

Abstract

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Mekanisme Penuaan Kulit sebagai Dasar Pencegahan dan Pengobatan Kulit Menua: Mechanism of Skin Aging Shannaz Nadia Yusharyahya
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (447.536 KB) | DOI: 10.23886/ejki.9.49.150

Abstract

Seiring dengan meningkatnya populasi geriatri di Indonesia, masalah penuaan kulit juga turut meningkat. Pada populasi tersebut terjadi berbagai perubahan kulit sehingga kelainan yang ditimbulkan juga berbeda. Stres oksidatif merupakan mekanisme yang diduga kuat sebagai penyebab utama penuaan kulit. Penuaan kulit merupakan proses kompleks yang melibatkan faktor intrinsik dan ekstrinsik. Faktor intrinsik yang berperan adalah genetik, metabolisme sel, dan perubahan hormonal. Selain itu, terdapat faktor ekstrinsik seperti radiasi ultraviolet, inframerah, dan karsinogen lingkungan yang turut berperan pada penuaan kulit. Kedua faktor tersebut menyebabkan perubahan di seluruh lapisan kulit. Untuk mengatasi penuaan kulit, kini telah tersedia berbagai modalitas terapi, namun untuk menentukan terapi yang paling sesuai perlu diketahui fisiologi kulit menua, mekanisme penuaan kulit, dan manifestasi kelainan klinis kulit menua. Secara fisiologi terjadi perubahan permeabilitas, biokimia, vaskularisasi, termoregulasi, respons terhadap iritan, respons imunitas, kapasitas regenerasi, respons terhadap cedera, persepsi neurosensori dan pada tingkat genom. Jumlah sel epidermal dan laju pergantian epidermal menurun sedangkan di adneksa terjadi penurunan jumlah kelenjar sebasea yang mengakibatkan kulit kering dan mudah pecah. Penurunan jumlah melanosit menyebabkan warna rambut menjadi abu-abu keputihan dan muncul pigmentasi atipik di kulit. Folikel rambut kurang aktif sehingga meningkatkan kerontokan dan kebotakan. Di lapisan basal ukuran sel berkurang dan rerata ukuran sel bertambah. Sel keratinosit menjadi lebih pendek dan besar di kulit yang menua. Kata kunci: geriatri, mekanisme penuaan kulit, patofisiologi.   Skin Aging Mechanism as A Basic Prevention and Treatment of Skin Aging Abstract Growing geriatric population generates a rise of aging issues. Process of aging develops multiple skin changes that further emerge other related skin problems. Oxidative stress is believed playing vital role related to aging. The aging process in the skin is complex and influenced by intrinsic and extrinsic factors. Intrinsic factors can be in the form of genetics, cell metabolism, and hormonal changes. Meanwhile, for extrinsic factors, such as exposure to ultraviolet, infrared, and carcinogenic agent also have crucial part in aging process. These factors contribute to all layers of the skin. Nowadays, many treatment modalities available to reverse skin aging, however, better understanding on skin aging mechanism, the pathophysiology, and clinical manifestations of aging skin is important to choose the appropriate treatment for patients. In aging, there are physiological changes in permeability, biochemical structures, vascularisation, thermoregulation, irritative response, immunity response, regenerative capability, inflammatory response, neurosensory perception and in genom level. The number of epidermal cells and epidermal overturn rate decline while there is also reduction of sebaseous glands at adnexa which both are accounted for skin xerosis. Decreasing melanocytes can caused gray hair and atypical pigmentation. Hair follicles also show less activity resulting in hair loss. Basal layer cells are downsizing and rise of average cells size are occured. Keratinocyte becomes shorter and bigger in aging skin. Keywords: geriatric, mechanism, skin aging, pathophysiology.
Efektivitas Pelatihan Kecakapan Hidup Menggunakan Modul Pengelolaan Emosi pada Remaja Perempuan dengan Lupus Eritematosus Sistemik Safira A Tjandrasari; Fransiska Kaligis; Tjhin Wiguna; Raden Irawati Ismail; Dina Muktiarti
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (378.18 KB) | DOI: 10.23886/ejki.9.52.80

Abstract

Lupus eritematosus sistemik (LES) merupakan penyakit kronik yang dapat menyebabkan masalah emosi pada remaja, khususnya perempuan sehingga fokus perawatan pada remaja dengan LES adalah mengatasi gangguan yang dialami secara keseluruhan. Studi ini bertujuan untuk mengetahui masalah emosi pada remaja perempuan dengan LES dan efektivitas pelatihan kecakapan hidup-modul pengelolaan emosi (PKH-MPE) dalam mengatasi masalah emosi. Studi ini menggunakan desain uji klinis teracak dalam 2 grup di RSUPN dr. Cipto Mangungkusumo pada bulan Januari hingga Desember 2019. Subjek adalah 30 remaja perempuan dengan LES yang sudah mendapat terapi dan memiliki skor Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) 0-5. Masalah emosi dinilai dengan Strength and Difficulties Questionnaire (SDQ) pada awal dan 4 minggu pasca perlakuan. Sebanyak 6/30 remaja perempuan memiliki nilai SDQ abnormal pada awal studi. PKH-MPE efektif menurunkan masalah emosi pada kelompok perlakuan dibandingkan kontrol (uji Wilcoxon, p=0,002). Pada kelompok perlakuan terdapat perbaikan total skor SDQ (p=0,001), masalah emosi (p = 0,002), masalah perilaku (p=0,027) dan perilaku hiperaktif (p=0,040) dibandingkan awal studi. PKH-MPE secara bermakna mengurangi keluhan nyeri, kecemasan dan perasaan gugup pada kelompok perlakuan. Disimpulkan PKH-MPE efektif memperbaiki masalah emosi pada remaja perempuan dengan LES, terutama keluhan nyeri, cemas, dan perasaan gugup. Kata kunci: lupus, penyakit kronis, masalah emosi, pelatihan kecakapan hidup, SDQ.   Effectiveness of Life SkillsTraining-Emotional Management Module in Female Adolescent with Systemic Lupus Erythematosus Abstract Systemic lupus erythematosus (SLE) is a chronic disease that can cause emotional problems in adolescents, predominantly female thus, the focus of care in adolescents with SLE is to treat the patients holistic. The study aims to assess the emotional problems in female adolescents with SLE and the effect of life skills training-emotional management module in female adolescents with SLE. This study is a randomized clinical trial with no blinding which located in Cipto Mangunkusumo Hospital Jakarta. Thirty female adolescents with treated SLE and had Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score 0-5 were included. Emotional problems were assessed at the beginning of the study and four weeks after intervention. It was found that there were 6/30 subjects with abnormal SDQ at the beginning of the study. Life skills training was found effective in treating emotional problems, compared to control with (Wilcoxon test, p=0.002). Life skill straining was also found effective in improving SDQ score (p=0.001), emotional problem (p=0.002), conduct problems (p=0.027),and hyperactivity (p=0.040) in the intervention group compared to baseline. Life skill straining reduced physical pain, worries, and nervousness in the intervention group. In conclusion, the life skill straining-emotional management module was effective in improving emotional problems in a female adolescent with SLE, especially physical pain, worries, and nervousness. Keywords: SLE, chronic disease, emotional problems, life skills training, SDQ.
Retroauricular Advancement Flap In Single Stage Auricular Defect Reconstruction Mirta Hediyati Reksodiputro; Trimartani Koento; Dwi Wahyu Manunggal
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (862.689 KB) | DOI: 10.23886/ejki.9.54.145

Abstract

Auricular defects must be treated early and properly because they may interfere with facial symmetry. Retroauricular skin is an ideal flap source for a non-reduction reconstruction procedure of the upper, middle, and lower auricular defects. Auricular reconstruction aims to achieve good anthropometric and aesthetic ear unit. The purpose of this case report is to present a reconstruction of auricular defects using the rectroauricular flap that results in a favorable aesthetic and normal anthropometric dimensions of the auricular. We report a case of auricular defect caused by post-excision of keloid located in the helical and antithetical area of the middle third of the right auricular, using a retroauricular flap. Normal values of the auricular’s anthropometric measurements were achieved, followed by a complete aesthetic ear unit. Retroauricular flaps are suitable for reconstructing partial auricle defects in the helical rim, temporal area, and conchae. Keywords: auricular defect, retroauricular flap, aesthetic ear unit, auricular anthropometry.   Jabir Retroaurikular untuk Rekonstruksi Defek Telinga Abstrak Daun telinga berperan penting pada simetri wajah sehingga defek di daun telinga harus ditangani dengan baik sejak dini. Kulit retroaurikular merupakan sumber jabir ideal untuk rekonstruksi tanpa reduksi pada defek daun telinga bagian atas, tengah, dan bawah. Rekonstruksi daun telinga bertujuan untuk mendapatkan hasil yang baik secara antropometri dan estetika unit telinga. Tujuan laporan kasus ini adalah menunjukkan hasil yang baik berdasarkan unit telinga estetik dan dimensi normal antropometri pada rekonstruksi defek daun telinga menggunakan jabir rektroaurikular. Dilaporkan satu kasus defek telinga pasca-eksisi keloid, di area heliks dan antiheliks sepertiga tengah daun telinga kanan, menggunakan jabir retroaurikular. Didapatkan nilai normal pada pengukuran antropometri telinga dan kelengkapan estetika unit telinga. Jabir retroaurikular baik untuk rekonstruksi defek telinga parsial di lengkung heliks, area temporal, dan konka. Kata kunci: defek aurikular, jabir retroaurikular, unit telinga estetik, antropometri daun telinga.
Three-Delay Model on Maternal Mortality Cases in Tertiary Referral Hospital in Indonesia Junita Indarti; Affan Solihin; Arresta V. Suastika; Dyah P. Wardhani; Muhammad T. Ramadhani; Quamila F. Afdi; Syifa M. Syafitri; Muhammad Ikhsan; Kristian Alda
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (345.671 KB) | DOI: 10.23886/ejki.9.60.99

Abstract

Maternal mortality remains a worldwide concern to this day. Three main causes of maternal mortality during 2010–2013 were hemorrhage, hypertension, and infection, which all of them are the direct causes. The high MMR is also due to the presence of 3 delay which is Delay in seeking assistance (type–1), delay in identifying and accessing medical center (type–2) and delay in having prompt treatment (type–3) . Therefore, this study aims to describe maternal mortality cases in tertiary hospital which is Cipto Mangunkusumo Hospital (CMH) so that the root of problems in maternal deaths can be discovered and improvements can be done in the future. This was a descriptive study conducted in the Department of Obstetrics and Gynecology at CMH, Jakarta. Data collection was taken from 2016 – 2018 where subjects were taken from secondary data on maternal mortality. Based on the data that has been collected in CMH total live births in Emergency Department CMH during 2016-2018 which was 4.226 cases. There was 22 maternal death cases (0.52%). Most deaths were occurred in 2017 (50% of all cases). Indirect causes of maternal mortality were the leading cause in this study, including septic shock, hypovolemic shock due to Dengue Shock Syndrome, cardiogenic shock, and acute respiratory failure. Three delay models were three main factors contributing to maternal mortality interrelated and influenced by other factors with delay in looking for assistance and treatment (31,8%) was the upmost factor of maternal mortality. More than half maternal deaths in CMH during 2016 – 2018 caused by indirect causes. Among three delay models, delay in looking for assistance and treatment was the upmost factor of maternal mortality. Keywords: maternal mortality, three-delay model.   Tiga Model Keterlambatan pada Kasus Kematian Ibu di Rumah Sakit Tersier di Indonesia Kematian ibu masih menjadi perhatian dunia hingga saat ini. Tiga penyebab utama angka kematian ibu (AKI) selama 2010-2013 adalah perdarahan, hipertensi, dan infeksi, yang semuanya merupakan penyebab langsung. Tingginya AKI juga disebabkan oleh adanya 3 keterlambatan yaitu keterlambatan dalam mencari pertolongan, keterlambatan dalam mengidentifikasi dan mengakses pusat kesehatan, dan keterlambatan dalam mendapatkan pengobatan yang tepat. Penelitian ini bertujuan untuk mendeskripsikan kasus kematian ibu di rumah sakit tersier yaitu Rumah Sakit Cipto Mangunkusumo (RSCM) sehingga akar permasalahan kematian ibu dapat ditemukan dan dapat dilakukan perbaikan di masa yang akan datang. Penelitian ini merupakan penelitian deskriptif yang dilakukan di Bagian Obstetri dan Ginekologi RSCM, Jakarta. Pengambilan data diambil dari tahun 2016 – 2018, subjek diambil dari data sekunder kematian ibu. Berdasarkan data yang terkumpul di RSCM jumlah kelahiran hidup di Instalasi Gawat Darurat RSCM selama tahun 2016-2018 sebanyak 4.226 kasus. Terdapat 22 kasus kematian ibu (0,52%). Kematian terbanyak terjadi pada tahun 2017 (50% dari seluruh kasus). Penyebab tidak langsung kematian ibu merupakan penyebab utama dalam penelitian ini, antara lain syok septik, syok hipovolemik akibat dengue shock syndrome, syok kardiogenik, dan gagal napas akut. Tiga model keterlambatan merupakan tiga faktor utama penyebab kematian ibu yang saling berkaitan dan dipengaruhi oleh faktor lain dengan keterlambatan mencari pertolongan dan pengobatan (31,8%) merupakan faktor penyebab kematian ibu yang paling tinggi. Lebih dari separuh kematian ibu di RSCM selama tahun 2016 – 2018 disebabkan oleh penyebab tidak langsung. Di antara tiga model keterlambatan, keterlambatan dalam mencari bantuan dan pengobatan merupakan faktor utama kematian ibu. Kata kunci: kematian maternal, model tiga terlambat.

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