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INDONESIA
Jurnal Kedokteran Indonesia
Published by Universitas Sebelas Maret
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Core Subject : Health,
Medicine & Pharmacology
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Articles 61 Documents
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Hubungan Pemakaian Alat Kontrasepsi Dalam Rahim dengan Kejadian Kehamilan Ektopik Ayu, Rosalina Pradana; Darto, ; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background:Ectopic pregnancy is a problem in gynecologic area that causes high maternal morbidity and mortality. Use of intrauterine device (IUD) is a hypothetic risk factor forectopic pregnancy. Progesterone content in the IUD can increase tubal implantation. Changes in theendometrium condition, leukocyte infiltration in the uterus, and  accumulation of macrophages induced by IUD can cause extrauterine pregnancy when ovulation occurs. This study aimed to determine the relationship between IUD use and the risk for ectopic pregnancy, controlling for the effect of age. Methods:This study was analytic observational using case-control design. Thirty patients with ectopic pregnancy sampled by fixed disease sampling were compared with 60 patients with normal pregnancy at the Dr. Moewardi Hospital Surakarta. The data were collected from the medical records, then were analyzed for the relationship using multiple logistic regression model on SPSS 17 for Windows. Results:Women who used IUD had 9.33 times higher risk of ectopic pregnancy than women who did not use IUD (OR= 9.33; CI95%= 1.01 to 86.36; p = 0.049). The analysis has controlled for age as a confounding factor. Conclusion:There is relationship between IUD use and the risk for ectopic pregnancy, after controlling for age. Keywords:Intra-uterine device (IUD), ectopic pregnancy.
Pengaruh Dukungan Keluarga Dan Paritas Terhadap Kecemasan Ibu Hamil Trimester III Dalam Menghadapi Persalinan Di Rumah Bersalin Harapan Bunda Surakarta Susilowati, Dewi; Suryani, Nunuk; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background: Pregnancy yields happiness to pregnant women and their husbands. But it can worry them. The support of family gives pregnant women composure, secure feeling, and comfort thereby reducing pregnant woman’s anxiety. This study aimed to determine the effect of family support and parity on anxiety level among third trimester pregnant women in dealing with delivery. Methods:This analytical observational study usedcross sectional design. The reference population was third trimester pregnant women visiting HarapanBunda Maternal Clinic, Surakarta, from June to July 2012. The independent variableswere family support and parity. The dependent variable was anxiety. The data were analyzed using multiple linear regression model. Results:There were statistically significant effects of family support (b = -0.48; p = 0.017) and parity (b = -3.40; p = 0.007) on pregnant women’s anxiety in dealing with delivery. Conclusion:Family support and parity reduce anxiety among pregnant women of trimester pregnancy. The stronger the family support the lower is the anxiety of pregnant women. Multipara, on the average, had lower anxiety than primipara. Key words: Anxiety, family support, parity, pregnant woman
Hubungan Antara Pengetahuan, Sikap Pasien, Dan Dukungan Keluarga Dengan Keteraturan Pengobatan Pasien Tuberkulosis Paru Di Kabupaten Klaten Erawati, Lely; Suryani, Nunuk; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background : Regularity of pulmonary tuberculosis treatment are affected by many factors such as knowledge, attitudes of patients, and family support.This study aimed to analyze the relationship between knowledge, attitudes of patient, andfamily support, and regularity of tuberculosis treatment. Methods : This was an analytic observational study using a cross sectionaldesign.A sample of 57 pulmonary tuberculosis patients who had been undertaking anti-tuberculosis direct observed treatment short course in Klatendistrict, Central Java, for the past two years were studied. The data on the independent variables including knowledge, patient attitude, and family support, were collected using questionnaire. The secondary data on regularity of tuberculosis treatment were taken from the reporting and recording system at health center and district health office. The relationshipbetween knowledge, patient attitude,and family support and regularity of treatment were analyzed using multiple logistic regression model. Odds Ratio and its 95CI% were estimated. Results : Tuberculosis patientswho had high tuberculosis knowledge had four timeshigher probability to undertake regular treatment than those with low knowledge(OR =4.40 ; CI 95 % = 1.08 to 17.89 ; p = 0.030). Patients with good attitude had three timeshigherprobability to undertake regular treatment than those with poor attitude (OR = 3.67 ; CI95 % = 1.02 to 13.42 ; p = 0.043). Patients with strong family support were twice more likely to undertake regular treatment than those with weak family support (OR = 2.22; CI 95 % = 0.54 to 9.14; p = 0.261). Conclusion: There is a positive relationship between knowledge, patient attitude, and  family support, and regularity of pulmonary tuberculosis treatment. Keywords: Pulmonary tuberculosis, knowledge, patient attitude, family support, regular treatment
Penambahan Dexmedetomidine Memperpanjang Lama Kerja Anestesi Blok Aksilaris Osi, ; Sudjito, Hadi; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background:Dexmedetomidine is alpha 2 adrenergic receptor agonist that produces analgesia by suppressing norepinephrin secretion and blocking nerve action potential in alpha 2 receptor. This study aimed to determine if addition of dexmedetomidineof  25 µg  dexmedetomidine into 30 mL bupivacaine 0.25% shortens onset and prolongs duration of axillary block anesthesia. Methods: This phase III clinical study used double blinded randomized controlled trial design. A sample of 22 adult patients of ASA I and II were scheduled for lower arm surgery with axillary block. Patients were randomized into 2 groups. Patients in group B ( n = 11) were given 30 mL bupivacaine 0.25% and normal saline. Patients in group D (n = 11) were given 30 mL bupivacaine 0.25% and dexmedetomidine 25 µg. Results: The onset of sensory (p=0.765) and motor (p=0.748) blockade was not significantly different. But, the duration of sensory (p<0.001) and motor (p<0.001) blockade was significantly longer in group D than group B. The side effect of dexmedetomidine administration is bradycardia. Conclusion: The addition of 25 µg dexmedetomidine into 30 mL bupivacaine 0.25%does not shorten onset, but prolongs duration of sensory as well as motor blockade in axillary block anesthesia. Keywords: Dexmedetomidine, bupivacaine, axillary block, onset of sensory and motor blockade, duration of sensory and motor blockade.
Efikasi Premedikasi Klonidin dan Diazepam Peroral Terhadap Level Sedasi dan Respons Hemodinamik Pediatrik Yudha, Sandhi; Santoso, Sugeng Budi; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background: Anxiety and pain cause emotional stress in pediatric patients. The right choice of per oral premedication is essential to achieve adequate level of sedation and hemodynamic stability during anesthesia and surgery for pediatric patients. This study aimed to compare the relative efficacy of per oral clonidine and diazepam premedication on the sedation level and hemodynamic response in pediatric patients. Methods: This was a phase II clinical trial, using double blinded randomized controlled trial design. A sample of 18 pediatric patients aged 2-12 years with ASA I and II physical status were divided at random into 2 groups, each group received either per oral clonidine premedication 4μg/kgBW (n=9) or diazepam 0.2mg/kgBW (n=9). Sedation level and hemodynamic response (heart rate) were measured before drug administration (HR1), after drug administration (HR2), before intubation laryngoscopy (HR3), third (HR4) and five minutes after (HR5) treatment before laryngoscopy intubation, immediately after skin incision started. Results: Sedation level in clonidine group (3.11 ± 0.60) was deeper than diazepam group (2.33 ± 0.50) with p=0.013. Heart rate after per oral premedication (HR1) among clonidine group was lower (100.44 ± 11.38 times/minute) than diazepam group (110.22 ± 12.29 times/minute) with p=0.099. Heart rate at time HR2, HR3, HR4, and HR 5among clonidine group was lower than diazepam group at p<0.05. Bradycardia effect was found in 2 patients in the clonidine group but none in the diazepam group. Conclusion: Per oral 4μg/kgBWclonidine premedication leads to deeper sedation level than 0.2mg/kgBWdiazepam. The hemodynamic response (heart rate) was more stable in the clonidine group than diazepam group. Keywords: Per oral premedication, clonidine, diazepam, sedation level, hemodynamic response, pediatrics
Pengaruh Pemberian Propofol Intravena 10mg/KgBB, 25 mg/KgBB dan 50 mg/KgBB Terhadap Ekspresi Kaspase 3 Hipokampus pada Mencit Balb/ C Dengan Cedera Kepala Yusriyani, ; Sudjito, Mulyo Hadi; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background:Head injury is one of the leading causes of death and disability. In head injury there is biomolecularand biochemical pathologic process that can cause necrosis and apoptosis via caspase 3 activation. Propofol is an intravenous anesthetic drug that has neuroprotective mechanism by regulating caspase 3. This study aimed to determine the inhibitory effect of intravenous propofol 10 mg/kgBW, 25 mg/kgBW and 50 mg/kgBW oncaspase 3expression in mice balb/c with head injury. Methods: This was a laboratory experiment using randomized controlled trial design. Asample of 32 Balb/c mices were divided into 4 groups. All groups underwent head injury procedure using weight drop technique. Group 1 did not received propofol. Group 2, 3, and 4 received intravenous 10 mg, 25 mg, and 50 mg/kgBB propofol, respectively. Caspase 3 activation was stained and identified by immunohistochemical technique 6 hours afteradministration of propofol. Difference in mean between groups was tested by One Way Anova and mean pair-wise groups by Post Hoc Test on SPSS 12. Results: Mean caspase 3 expresion in each group was as follow: Group 1=4.08, Group 2= 2.95, Group 3= 2.52, Group 4=1.77. One way Anova showed statistically significant difference in mean caspase 3 expression between groups (p<0.001). The higher dose of propofol, the lower caspase 3. The pair-wise mean difference were as followsGroup1-Group2 (p<0.001), Group1-Group3 (p<0.001), Group1-Group4 (p<0.001), Group2-Group4 (p<0.001), Group3-Group4 (p<0.001), and Group2-Group3 (p=0.232). Conclusion:Administration of intravenous propofol with 10,25,50 mg/kgBW doses were effective to inhibit caspase 3 activity expression in mices with head injury. Higher doses give stronger inhibitory effect, with 50mg/kgBW being the recommended optimal dose. Keywords: caspase 3 expression, propofol, mice, head injury
Pengaruh Suplementasi Vitamin C, Vitamin E, dan Kombinasinya Terhadap Penurunan Kadar Low Density Lipoprotein Serum pada Pasien Penyakit Ginjal Kronis Stadium V yang Dilakukan Hemodialisis Dewi, Ayu Kusuma; Purwanto, Bambang; Wiboworini, Budiyanti
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background:Low density lipoprotein (LDL) cholesterol is a prognostic factor for hemodialysis mortality through atherosclerosis mechanism. Vitamin C and E have been well known as anti-oxidants that reduced LDL cholesterol. However, there were no studies have been done to address the effectiveness of vitamin C, E, and its combination on lowering LDL in patients with hemodialysis. This study aimed to determine the effect of vitamin C, E, and C and E combination on LDL cholesterol. Methods:A randomized controlled trial was conducted in 64 patients receiving hemodialysis at RSUD Dr.Moewardi(RSDM) Surakarta. The sample was taken at random and then divided into 4 groups: placebo, vitamin C (500 mg), vitamin E (400 mg), and vitamin C + E combination. The treatment lasted for 30 days. LDL cholesterol before and after treatment were analyzed at the Clinical Pathology division, RSDM. The reduction in LDL cholesterol before and after treatment was analyzed using One Way Anovaand (pair-wise) Post-Hoc Test. Results:One Way Anovashowed statistically significant reduction in LDL cholesterol between groups (p<0.001). Post hoc testshowed that vitamin C, vitamin E, or its combination reduced LDL cholesterol more than the placebo (p<0.001). Vitamin C and E administered in combination led to statistically significant lower LDL cholesterol than administered alone (p=0.002). There was no statistically difference in LDL cholesterol level between those provided with vitamin C and vitamin E. Conclusion: Vitamin C and E, individually or in combination, reduces LDL cholesterol. The highest reduction was achieved by vitamin C and E combination.Keywords: vitamin C, vitamin E, LDL cholesterol
Hubungan Antara Derajat Sesak Napas Dengan Nilai Arus Puncak Ekspirasi Pada Pasien Asma Terkontrol Sebagian Putri, Pritania Prameswara; Reviono, ; Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 3, No 1 (2012)
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Background: Asthma is one of the most common chronic diseases and a serious global health problem. Exercise-induced asthma (EIA) is typically characterized by history of shortness of breath with exercise. However, the symptoms are not usually specific to asthma. Therefore there is a need to develop another testsuch as lung function measurement of peak expiratory flow (PEF) by using a spirometer. This study aimed to determine the correlation between perception of dyspnea and peak expiratory flow in partially controlled asthma patient. Methods:This study was a descriptive analytical research using cross sectional approach. It was conducted in April – May 2012 at Pulmonology Clinic, Dr. Moewardi General Hospital Surakarta. A sample of 35 patients was selected by purposive and random sampling with some inclusion and exclusion criteria. The sample was excluded if the result of Asthma Control Test was not below 15-19. The study subjects filled in (1) curriculum vitae form, (2) asthma control test, (3) Borg scale to find out the perception of dyspnea score. The subjects were asked to (1) Measure the peak expiratory flow by using a spirometer, (2) Exercise for 5-10 minutes. The data were analyzed using Spearman correlation on SPSS 17. Results:The study showed strong negative and statistically significant correlation of r=-0.60 (p<0.001) between perception of dyspnea and peak expiratory flow in partially controlled asthma patients. Conclusion: There is a negative correlation between perception of dyspnea and peak expiratory flow in partially controlled asthma patients. Keywords:Perception of dyspnea, peak expiratory flow (PEF), partially controlled asthma
Editorial : Mendesak, Kebutuhan untuk Memperbaiki Pelayanan Intensif Bayi dan Anak Murti, Bhisma
Jurnal Kedokteran Indonesia Vol 1, No 1 (2009)
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Dalam beberapa dekade terakhir telah terjadi penurunan yang signifikan mortalitas bayi dan anak balita di seluruh dunia. Meskipun demikian kesimpulan umum tersebut mengabaikan disparitas pencapaian indikator mortalitas antara negara maju dan negara berkembang, dan antara negara kaya dan negara miskin. Di samping itu, jika pisau analisis diarahkan kepada angka absolut, kematian bayi dan anak balita masih merupakan problem serius yang memprihatinkan. Setiap hari terjadi dua puluh tiga ribu kematian anak yang tak perlu terjadi di seluruh dunia (Argent et al., 2009). Setiap tahun lebih dari 10.8 juta anak balita meninggal di seluruh dunia (jadi hampir sama dengan penduduk Jakarta), 3.9 juta di antaranya terjadi pada 28 hari pertama kehidupannya (WHO, 2010). Kematian bayi dan anak balita terjadi sebelum anak mengakses pelayanan kesehatan formal, pada tingkat pelayanan primer, maupun tingkat pelayanan sekuder di rumahsakit. (Argent et al., 2009).
Kualitas Spermatozoa dan Aktivitas Enzim Katalase dalam Darah Tikus Jantan Galur Sprague Dawley (SD) yang Diradiasi Sinar Ultraviolet Panghiyangani, Roselina; Mashuri, .
Jurnal Kedokteran Indonesia Vol 1, No 1 (2009)
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Background: The damage of ozone layer in the atmosphere has reached to a serious extent, due to the increasing ultraviolet (UV) radiation, stemming from the green-house effect and the ozone hole. The increasing UV radiation is associated with the risk of some diseases or conditions, e.g. male infertility. The increasing UV radiation triggers the existence of reactive oxygen species (ROS)- free radicals that contain the oxygen atom – that are deemed to have an important role in male infertility. The excessive concentration of ROS causes oxidative stress as indicated by the activity of catalytic enzyme. This study aimed to examine the quality of spermatozoa and and the Activity of catalytic enzyme in the blood of male Sprague Dawley (SD) mice radiated by ultraviolet light of = 200-400 nm.Method: The study subjects were grouped into a group receiving UV radiation (P1) and a control group (Po). The UV radiation was carried out for 3 hours/ day for 60 days. The parameters for spermatozoa included motility perecentage, viability, while normality of the spermatozoa morphology was observed by microscope. The activity of catalytic enzyme in the blodd plasma was measured by spectrophotometry at = 240 nm.Results: The mean of catalytic enzyme for Po was: 75.2 ± 6.9 % and P1: 47.1± 4.9%. The mean of spermatozoa motility percentage for Po was: 64.2± 11.3% and P1 : 0.7± 0.7%. The mean of spermatozoa viability percentage for Po was: 72.1 ± 18.3% and P1: 28.4± 8.4%. The mean of normal spermatozoa morphology for Po was: 91.3±9.0% and P1: 95.2± 4.2%. All these differences were statistically significant.Conclusion: Ultra-violet radiation impairs the quality of spermatozoa and the activity of catalytic enzyme in the blood of male Sprague Dawley (sd) mice. Jurnal Kedokteran Indonesia: 1 (1): 4-7Keywords: ROS, catalytic enzyme, the quality of spermatozoa

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