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Lampung
INDONESIA
Juke
Published by Universitas Lampung
ISSN : 20889348     EISSN : -     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Arjuna Subject : -
Articles 20 Documents
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Search results for , issue "Vol 4, No 8 (2014)" : 20 Documents clear
APPLICATION OF PAVLIK HARNESS IN DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH) Aryadi Kurniawan; Ahmad Fauzi
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Developmental dysplasia of the hip (DDH) is a spectrum of pathology ranging from acetabular dysplasia with minor instability until acetabular dysplasia with hip dislocation. The incidence of DDH that require treatment is 5.1 per 1000 live birth. Early detection is important to deliver good outcome and lessen complication. Careful history taking, physical examination and ultrasonography, have increased the sensitivity in establishing diagnose of DDH. Pavlik harness is the mainstay of treatment for infant who has not commenced crawling. Despite the fact of high success rate, the use of Pavlik harness is still uncommon in Indonesia. This paper reports a case of DDH treated with Pavlik harness and assessed regularly with ultrasonography. A 3 months girl with developmental dysplasia of the left hip. The initial ultrasound shows α angle 49.40 and β angle was 50.20, femoral head subluxated to superolateral aspect. The patient had Pavlik harness and followed up with serial ultrasound at 1st, 3rd and 4th month’s time. Having had 4 months of Pavlik harness, the α angle of the left hip became 630, and β angle 490 with good structure of ilium. Femoral head was smooth and no signs of avascular necrosis. The hip has full range of motion. Parents have no difficulty in taking care of their daughter daily activities such as taking a bath, changing napkin, and clothes. This implicates, patient treated using Pavlik harness showed good outcome clinically and ultrasonographically. Pavlik harness has been proven to be a safe, simple and user friendly method for treatment of DDH before crawling age. The good result obtained from this case could initiate application of pavlik harness in larger population of early detected DDH in Indonesia. [JuKe Unila 2014; 4(8):208-217]
CRITICAL LIMB ISCHEMIA IN 27 YEARS OLD HIV PATIENT: A CASE REPORT Ade Yonata; Hayatun Nufus; Teguh Harjono Karjadi
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

The prevalence of peripheral arterial disease (PAD) is high in the HIV-infected population and is much higher than expected in the general population. A 27 years old male patient came to Cipto Mangunkusumo General Hospital (RSCM) with chief complaint of pain on right leg which worsened since 2 days prior admission. Patient was diagnosed HIV positive 8 months prior admission and had already on ARV treatment Duviral (AZT/3TC) and Alluvia (lopinavir/ritonavir) since then. CT angiography showed stenosis of femoral communis artery with total stenosis of right posterior tibialis artery. Patient was diagnosed with criticl limb ischemia and got amputation. Some theories of PAD mechanism in HIV patient have been proposed. Highly ac tive antiretroviral therapy (HAART) has decreased the mortality and illnesses related to HIV infection. However, a variety of atherogenic metabolic abnormalities, including dyslipidemia, lipodystrophy, and also thickened intima-media thickness have been observed after the introduction of HAART, especially using Protease Inhibitors. Human Imunodeficiency Virus itself is also thought to have role in injury to the arterial wall such as via chemokine CCL2/MCP-1, a critical mediator  of  atherosclerosis. All HIV-infected patients candidate to antiretroviral therapy and patients already under treatment should undergo an assessment that includes the evaluation of the cardiovascular risk. [JuKe Unila 2014; 4(8):218-224]
HEART VALVE DISEASE IN HYPERTHYROIDISM Ade Yonata; Elza Febria Sari; Ika Prasetya
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

The incidence of heart valve disease, especially mitral valve prolapse was first reported in hyperthyroid heart disease in 1981. Incidence of heart valve disease in the form of mitral regurgitation (MR) or tricuspid regurgitation (TR) reached 23% in patients with hyperthyroidism. 45 years old male with a chief complaint tightness, worsened since 1 week before entering the hospital. Since 2 years ago patient often feels palpitations and breathless if activity. About 5 months ago, patient was sweating a lot and tremble, increase in appetite but weight going down. Defecation 5-6 times a day. Visible and palpable lump in the neck diameter ±5 cm, soft, ned, part moves while swallowing. Laboratory showed free T4: 7.550, sensitive TSH: 0.010. Thoracic X-ray showed cardiomegaly with cardiac waist disappeared. ECG showed atrial fibrillation. Echocardiography showed LA + LV dilatation TAPSE 1.91, AR Moderate, Severe MR, AML prolapse in A2 and PML with EF: 62.7%. Ultrasonography showed Throid hyperthyroidism and thyroid scan results with the impression difusa bilateral goitre within crease of total thyroid uptake. Patients received digoxin, furosemide, PTU. Patients then performed MV Repair and AV Repair. The mechanism of valvular heart disease relationship in hyperthyroidism has not been completely understood. In patients with MPV, some studies have shown a high prevalence of HLA-Bw35. Increased production and secretion of acid polymukosakarida in Graves can accumulate all the heart valves, especially the mitral valve, causing the valve to thicken (myxomatous). MR in hyperthyroidism is said to be a consequence of mitral annulus dilatation due to the left ventricle is dilated. It has been reported also a gernline mutations of thyrotropin receptor gene in Chinese families with thyrotoxicosis and MVP. In hyperthyroid patients is important to explore the patient's cardiovascular condition, including the possibility of valve disorders. [JuKe Unila 2014; 4(8):225-232]
THE BENEFIT AND WEAKNESS OF ORAL EXAMINATION IN MEDICAL EDUCATION Rika Lisiswanti
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Oral examination was abandoned because a lot of low validity and reliability by many countries around the world who are applying these methods to assess student competency. In Indonesia, there are still many faculty who apply this method in both the stage assessment undergraduate and clinical rotation phase. In this article, we will discuss the existence of an oral examination in medical education. More emphasize at the validity and reliability of oral examination so that it can be accepted as a method that is believed to assess the ability of students in medical education.  Experts of medical education have conducted a study by modifying the traditional oral examination to be more valid and realeabel, example: structured oral examination. Oral examination can still be used as a method of the assessment in medical education and it’s  depends on the policy of institution [JuKe Unila 2014; 4(8):233-239]
HUMAN LEUKOCYTE ANTIGEN (HLA) GENE IN DENGUE INFECTION Ety Apriliana
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

The geographic distribution of the Dengue Virus (DENV) and the incidence of the viral infection have grown fast in recent decades, and dengue fever is considered to be one of the most important reemergent tropical diseases. The majority of dengue infections are subclinical; however, the clinical manifestations of dengue infection range from the benign, self-limited Dengue Fever (DF) to a vasculopathy syndrome known as Dengue Hemorrhagic Fever (DHF) that can lead to hypovolemic Dengue Shock Syndrome (DSS). Several epidemiological studies indicated that genetic factors constitute important components in disease susceptibility. Several human HLA class I and II alleles are associated with development of DHF. The human leukocyte antigen alleles have been implicated as probable genetic markers in predicting the susceptibility and/-or protection to severe manifestations of DENV infection. [JuKe Unila 2014; 4(8):240-244]
EBOLA HEMORRHAGIC FEVER: CLINICAL MANAGEMENT AND PREVENTION Muhammad Aditya
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Ebola hemorrhagic fever is one of at least 30 known viruses capable of causing viral hemorrhagic fever syndrome. It is a severe, often fatal disease in humans and nonhuman primates (such as monkeys, gorillas, and chimpanzees). Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name. The current (2014) Ebola virus outbreak in West Africa has seized the world's attention, because this become the deadliest Ebola outbreak in recorded history and it is significant and primarily involves 4 African countries—Guinea, Liberia, Sierra Leone, and Nigeria. Besides the high mortality rate, the cure for Ebola disease has not been found yet. As of Augustus 31, 2014, 3.707 total suspected or confirmed cases (2.106 laboratory-confirmed) had been reported in these countries, resulting in 1.848 deaths. Based on genetic analysis, the virus is 97% identical to the Zaire ebolavirus identified in recent (earlier in 2014) cases in Gabon and the Democratic Republic of the Congo. Ebola disease management generally in the form of therapeutic support, relieve symptoms, and focus on the early identification of complications. Prognosis is poor, especially Ebolavirus Zaire strain, which has a case fatality rate of up to 89%. [JuKe Unila 2014; 4(8):245-253]
INHERITED VARIATIONS IN DRUGS EFFECT INDEPENDENT IN PHARMACOKINETIC: POLYMORPHISM IN PHASE II BIOTRANSFORMATION ENZYMES Muhammad Ricky Ramadhian
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Phase II enzymes play an important role in the biotransformation of endogenous compounds and xenobiotics to more easily excretable forms as well as in the metabolic inactivation of pharmacologically active substances. The purpose of phase II biotransformation is to perform conjugating reactions. These include glucuronidation, sulfation, methylation, acetylation, glutathione, and amino acid conjugation. In general, the respective conjugates are more hydrophilic than the parent compounds. Polymorphism in Phase II drug metabolism enzymes may have role in diseases, cancer, and others. This review discuss brief about polymorphism in Phase II drug metabolism enzyme. [JuKe Unila 2014; 4(8):254-268]
VISUM ET REPERTUM: A MEDICOLEGAL REPORT AS A COMBINATION OF MEDICAL KNOWLEDGE AND SKILL WITH LEGAL JURISDICTION Winda Trijayanthi Utama
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Visum et Repertum (VeR) is a medicolegal report which is made by a doctor in his capacity as an expert based on the examination of the person or people suspected. Due to an official request from an authorized law officer of what that were seen and found on the examination object while remembering the doctor’s oath. A VeR role as one of the valid evidence for proof of criminal cases against human health and life. Actually there is no reason for a doctor to refuse to make VeR, because this is meant to fulfill the formulation offence in Indonesia’s Penal Code (KUHP). A VeR basically is a compilation and its interpretation of a forensic medical examination as well as a physical examination on a routine medical examination. A VeR should not only fulfill the writing standard, but must also fulfill several terms and conditions for a court system. A good quality VeR has a certain structure and standard. A VeR written down with five main compositions, as opening parts (head of letter and sentence) “PRO JUSTICIA”, introductory data (data on requesting police institution, brief description on personal victim profile, identity of examinating doctor), report on factual findings (whole body character, related sign and symptoms, causal factor identified from victim), medicolegal conclusion (interpretation of report on factual finding in correlation with jurisdiction) and closing pledge statement. [JuKe Unila 2014; 4(8):269-275]
QUALITY CONTROL OF MICROBIOLOGY LABORATORY Tri Umiana Soleha
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

In recent years the establishment of quality standards for goods and services is considered by society at large. One of these is laboratory quality standards. Results of laboratory tests of quality in terms of accuracy, precision, speed, usability, and low cost. In the clinical laboratory, quality control system is one of the steps that must be done in the process of analyzing a sample. [JuKe Unila 2014; 4(8):276-284]
STUDENT’S MOTIVATIONS IN A PEER-ASSISTED CLINICAL SKILLS TRAINING PROGRAM Oktadoni Saputra; Doni Widyandana; Tridjoko Hadianto
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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Abstract

Background: Peer-Assisted Learning (PAL) has been widely used in the clinical skills training in medical education. The study of this area shows that PAL-scheme program has benefits both in student tutors and tutees in mastering their clinical skills. However, student’s motivations in this PAL-scheme program haven’t much been explored. The aim of this study is to explore student’s motivations in a peer-assisted clinical skills training program.Method: This study used exploratory focus group discussion (FGD) of 4 groups of 3rd year students (2 tutors and 2 tutees) Faculty of Medicine, Universitas Gadjah Mada and in-depth interview to 6 faculty staffs which were chosen purposively. The data were then transcribed and analyzed for themes.Result: The results of this study showed that when joining a PAL-scheme program, tutees were motivated extrinsically as a preparation for the end of year Objective Structured Clinical Examination (OSCE), whereas tutors were motivated more intrinsically. Various spectrums of motivations were founds, student’s motivations in a peer-assisted clinical skills training program were different between tutors and tutees. Tutors were motivated intrinsically whereas tutees extrinsically.Conclusion: Improvements in organizing PAL program need to be done to enhance the tutees motivation more intrinsically and also to improve the quality and quantity of clinical skills training. [JuKe Unila 2014; 4(8):194-201] Keywords: clinical skills training, internal motivation, motivations, peer-assisted learning, skills-acquisition

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