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Medicina
Published by Universitas Udayana
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Core Subject : Health,
Medicine & Pharmacology
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Articles 234 Documents
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ADAMANTINOMA TIBIA Margaretha, Meiske; Wiratnaya, Eka; Juli Sumadi, I Wayan
Medicina Vol 44 No 3 (2013): September 2013
Publisher : Medicina

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Abstract

Adamantinoma tulang panjang merupakan neoplasma tulang yang jarang dengan histogenesis yangmasih menjadi perdebatan dan gejala klinis yang bervariasi. Insiden tumor ini 0,56% dari seluruhkeganasan tulang primer. Kasus ini dibahas karena insidensinya yang sangat jarang. Pasien adalahseorang wanita, usia 16 tahun dengan keluhan timbul benjolan yang terasa nyeri dan membesarperlahan pada tungkai bawah kiri bagian atas selama 2 bulan terakhir. Radiologis memperlihatkanzona berbatas tegas, eksentrik, ekspansil dan lusen pada bagian atas tibia kiri. Setelah pembedahan,spesimen dikirim ke Laboratorium Patologi Anatomi. Tumor berbatas tegas, lobulated, putih abuabu,kenyal, berukuran 7x4,5x2 cm. Mikroskopis, tumor terdiri dari sel-sel epitel tersusun dalamstrukturcorddan pulau dikelilingi oleh stroma fibrouspadat dengan palisadingpada tepinya. Diagnosisadamantinomaditegakkan berdasarkan gambaran klinis, radiologis, dan histopatologi yang khas.
PANDANGAN BIOETIKA TENTANG KLONING MANUSIA Alit Kamar Adnyana, Tjokorda
Medicina Vol 38 No 3 (2007): September 2007
Publisher : Medicina

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Abstract

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FAKTOR RISIKO INFEKSI KATETER HEMODIALISIS DOUBLE LUMEN NON-TUNNELLED Trianto, Trianto; Widiana, Gde Raka
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Penyakit ginjal kronis merupakan salah satu penyakit yang tidak dapat disembuhkan. Pasien penyakit ginjal kronis dapat bertahan hidup bila dilakukan tindakan dialisis (hemodialisis atau peritoneal dialisis) sebagai pengganti fungsi ginjal. Tindakan hemodialisis memerlukan akses vaskular dan kateter hemodialisis double lumen salah satu akses yang paling sering digunakan. Salah satu komplikasi penggunaan kateter hemodialisis adalah infeksi. Berbagai faktor risiko dapat mengganggu imunitas pasien dan menyebabkan infeksi kateter hemodialisis. Penelitian ini bertujuan untuk mencari hubungan antara berbagai faktor risiko terhadap kejadian infeksi kateter hemodialisis.Penelitian ini bersifat prospektif observasional. Subyek penelitian adalah pasien penyakit ginjal kronis yang dilakukan hemodialisis reguler melalui akses vaskular kateter hemodialisis double lumen non-tunnelled. Dilakukan pencatatan variabel faktor risiko (usia tua, anemia, kadar albumin yang rendah, kadar ferritin yang tinggi dan diabetes mellitus) dan kejadian infeksi kateter hemodialisis. Sampel penelitian ini adalah 62 sampel. Infeksi kateter hemodialisis terjadi pada 13 (21%) pasien. Analisis bivariat faktor risiko terhadap infeksi kateter hemodialisis menunjukkan usia tua RR = 0,314 (IK 0,045 sampai 2,199),P = 0,267; anemia RR = 0,424 (IK 0,167 sampai 1,081), P = 0,122; hiperferritinemia RR = 0,655 (IK 0,100 sampai 4,301),P = 1,000; hipoalbuminemia RR = 0,604 (IK 0,230 sampai 1,591),P = 0,319; dan diabetes mellitus RR = 0,347 (IK 0,050 sampai 2,417), P = 0,431. Usia tua, anemia, hipoalbuminemia, hiperferritinemia, dan diabetes melitus bukan faktor risiko infeksi kateter hemodialisis. [MEDICINA 2015;46:152-55].Chronic kidney disease is disease that not curable.Chronic kidney disease patient can survive if do dialysis (hemodialysis or peritoneal dialysis) as a replacement for kidney function.Hemodialysis requiring hemodialysis vascular access and double-lumen hemodialysis catheter is one of the most commonly used. One of the complications of hemodialysis catheter is infection. Various risk factors can interfere patient’s immunity and cause hemodialysis catheter infection. This study aimed to explore association between risk factors and hemodialysis catheter infection.This study was a prospective, observational. Subjects were patients with chronic kidney disease who do regular hemodialysis with non-tunnelled double-lumen hemodialysis catheter as vascular access. Registration of variable risk factors (older age, anemia, low albumin levels, high levels of ferritin and diabetes mellitus) and the incidence of hemodialysis catheter infection.The sample was 62 sample. Hemodialysis catheter infection occurred in 13 (21%) patients. Bivariate analysis of risk factors and hemodialysis catheter infection: older age RR = 0,314 (CI 0,045 to 2,199), P = 0,267; anemia RR = 0,424 (CI 0,167 to 1,081), P = 0,122; hyperferritinemia 0,655 (CI 0,100 to 4,301), P = 1,000;hypoalbuminemia RR = 0,604 (CI 0,230 to 1,591), P = 0,319; and diabetes mellitus RR = 0,347 (CI 0,050 to 2,417), P = 0,431. Older age, anemia, hypoalbuminemia, hyperferritinemia, and diabetes mellitus not risk factors of hemodialysis catheter infection. [MEDICINA 2015;46:152-55].
NYERI KEPALA DAN GANGGUAN TIDUR Kamelia, Lina; Oka Adnyana, I Made; Budiarsa, IGN
Medicina Vol 44 No 2 (2013): Mei 2013
Publisher : Medicina

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Abstract

Nyeri kepala dan tidur merupakan dua fenomena yang saling mempengaruhi dengan patomekanisme yang kompleks. Nyeri kepala primer, terutama migren, nyeri kepala klaster dan hypnic headache dapat timbul karena pengurangan waktu tidur, parasomnia, maupun gangguan pada regulasi arsitektur tidur terutama fase rapid eye movement. Sebaliknya, adanya nyeri kepala memicu timbulnya berbagai macam gangguan tidur. Studi pencitraan otak dan biokimia menunjukkan peranan penting melatonin dan nukleus suprachiasmatik   yang mengalami disfungsi pada penderita nyeri kepala yang berhubungan dengan gangguan tidur. [MEDICINA 2013;44:101-104].
SECKEL SYNDROME IN A - 2 YEAR OLD GIRL Yulius Malino, Imanuel; Arimbawa, Made; Suryawan, Bikin
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

Seckel syndrome is a frequent autosomal recessive that cause microcephalic osteodysplastic dwarfisms. It characterized with proportionate dwarfism of prenatal onset, dysmorphic features including severe microcephaly and “bird-headed” like appearance, mental retardation and autosomal recessive inheritance, becausedefect on chromosome 3q22.1-q24 (SCKL1), chromosome 18p11.31-q11.2 (SCKL2) and chromosome 14q23 (SCKL3). We reported, 2 years, 8 months female with intrauterine growth restriction, severe proportionately short stature, a “bird-headed” profile with receding forehead, large eyes, breaks like protrusion of the nose, narrow face, receding lower jaw and micrognathia and from bone survey we found a retarded bone age on which was appropriate for 6 months of age.There was no other systems dissorder have been found and no specific medication has been given. Patient was hospitalized to establish diagnosis and was dischargedafter ten days of hospitalization
DIAGNOSIS DAN PENATALAKSANAAN KISTA DUKTUS TIROGLOSUS Mustika, I Made; Nuaba, I Gde Ardika
Medicina Vol 46 No 1 (2015): Januari 2015
Publisher : Medicina

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Abstract

Kista duktus tiroglosus merupakan massa leher kongenital yang paling sering dijumpai pada anak-anak namun dapat  juga dijumpai pada orang dewasa. Kelainan  ini  terjadi oleh karena kegagalanobliterasi  duktus  tiroglosus  selama masa  embriologi. Pada  laporan  kasus  ini  dilaporkan  seorangperempuan berusia 35  tahun dengan kista duktustiroglosus. Keluhan disadari sejak 2 bulan yanglalu. Pemeriksaan  sitologi  aspirasi  jarum halus  preoperasi  suatu  lesi  kistik,  gambaran morfologisesuai  untuk  kista  duktus  tiroglosus.Hasil  tes  fungsi  tiroid  dalam  batas  normal  dan  hasil  ultrasonografi  leher menunjukkan  kesan  suspek  kista  duktus  tiroglosus,  tiroid  kanandankiri normal.Penatalaksanaan kasus ini adalah eksisi seluruh kista dan saluran duktus tiroglosus sampai foramensekum  pada  dasar  lidah  yang  dikenal  dengan  teknik  Sistrunk.Hasil  histopatologi  spesimenpembedahan menunjukkan  kista  duktus  tiroglosus. Perkembang  kasus  ini menunjukkan  hasilpenyembuhan yang baik dan 6 bulan pasca-tindakan eksisi tidak ditemukan adanya kekambuhan.[MEDICINA 2015;46:52-55].Thyroglossal duct cyst (TDC) is common congenital neck mass usually present in young children althoughcan be found in adult. TDC results from a failure in obliteration of the embryogenic duct formationduring thyroid migration. We report a case of a35 year-adult woman with TDC since 2 months ago. Fineneedle  aspiration  citologypreoperative  shows  cystic  lesion, morphological  views  appropriate  asthyroglossal  duct  cyst.  Thyroid  fuction  test was  normal  and  neck  ultrasonography  showedsucpectthyroglossal duct cyst, both of thyroid was normal.Management of this case wascomplete cystexcision until base of hyoid bone, removal of the central portion of the hyoid bone and excision of anyproximal thyroglossal duct as known as Sistrunk procedure.Histopathology finding of post operativespecimen  showed  thyroglossal  duct  cyst. Healing  processinthiscasehas  been  shown  goodresultsand6monthsafter excision there was norecurrences. [MEDICINA 2015;46:52-55].
RELATIONSHIP OF URINARY C-TERMINAL TELOPEPTIDE COLLAGEN TYPE-II (CTX-II) LEVEL WITH THE DEGREE OF JOINT DAMAGE IN PATIENTS WITH KNEE OSTEOARTHITIS Handono, Kusworini; **, Farida; Suryana, BP Putra; Listyawati, Enny
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

Radiography of the knee is used to confirm the diagnosis and classification of knee OA severity. Urinary CTX- II  is a biochemical marker for assessing cartilage degradation of knee OA. This research aimed to analyze the correlation between the level of urinary CTX-II  and the radiographic severity of knee OA. Research was conducted in 40 patients with knee OA ( ACR criteria ) and 40 age and sex matched healthy controls. Wheight bearing anteroposterior and lateral semiflexed radiographs were taken of both knee. The patients were stratified based on the Kellgreen-Lawrence (K-L) score. Urinary CTX-II level was measured using ELISA competitive method. Correlation between urinary CTX-II level and radiographic knee OA severity was analyzed with Spearman Correlation. Statistical significance level at P < 0.05. Mean urinary CTX-II level was significantly higher in patients with OA compared with healthy controls (447.7( SB 316.39) ng/ml vs 289(SB 168.01) ng/mmol respectively, P = 0.023). There was a significant difference between urinary CTX-II level in patients with  grade ? 2 K-L knee OA compared with patients with grade > 2 K-L (240.35 (SB 88.90) ng/mmol vs 728.24 (SB 295.15) ng/mmol respectively; P < 0.001). The urinary CTX-II level was significantly associated with the degree of joint lesion in patients with OA (r = 0.734; P = 0.0001). Urinary level of CTX-II is strongly associated with the degree of radiographic joint lesion of OA
Terapi insulin menurunkan kejadian nyeri neuropati diabetik dibandingkan dengan oral anti-diabetes pada penderita diabetes melitus tipe 2 Lestari, Luh Kadek Trisna; Purwata, Thomas Eko; Putra, IGN Purna
Medicina Vol 47 No 1 (2016): Januari 2016
Publisher : Medicina

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Abstract

Nyeri neuropati diabetik (NND) merupakan salah satu komplikasi yang sering terjadi pada penderita diabetes melitus (DM) tipe 2. Insulin merupakan salah satu terapi DM tipe 2. Insulin memperbaiki status metabolik dengan cepat terutama kadar glukosa darah sehingga kerusakan sel saraf dapat dicegah termasuk kejadian NND. Tujuan penelitian ini adalah untuk mengetahui apakah terapi insulin dapat menurunkan kejadian NND pada pasien DM tipe II dibandingkan dengan oral anti-diabetes (OAD). Subjek penelitian adalah 80 orang penderita DM tipe 2 yang menjalani pengobatan ke Poliklinik Endokrin dan Poliklinik Saraf RSUP Sanglah selama bulan Januari-Maret 2015. Subjek terdiri dari kelompok kasus 40 orang DM dengan NND dan kelompok kontrol 40 orang DM tanpa NND. Adanya NND ditentukan dengan alat bantu douleur neuropathique en 4 questions (DN4). Uji hipotesis menggunakan Chi-square, dan regresi logistik dengan tingkat kemaknaan P<0,05. Hasil penelitian mendapatkan bahwa terapi insulin pada penderita DM tipe 2 menurunkan risiko NND dibanding terapi OAD dengan RO=0,07 (IK95% 0,02 sampai 0,26), P<0,0001. Dari penelitian ini dapat disimpulkan bahwa terapi insulin pada penderita DM tipe 2 dapat menurunkan kejadian NND. Painful diabetic neuropathy (PDN) is one of the most common complications that often occur in diabetes mellitus (DM) patient. Insulin is one of the DM treatment can quickly improve metabolic status, especially blood glucose levels, so prevent damage to nerve cells include NND. The purpose of this study was to determine whether insulin therapy can reduce the risk of NND in patients with type II DM compared to oral anti-diabetic (OAD). Subject of study was 80 samples with type 2-DM underwent treatment to Endocrine and Neurology Outpatient Clinic at Sanglah Hospital from January until March 2015. Subjects consist of 40 subjects in case group with PDN and 40 subjects in control group without PDN. The existence of PDN was determined by douleur neuropathique en 4 questions (DN4) tools. This study found that insulin therapy reduce incidence of PDN on type 2-DM patients compared to OAD therapy with OR=0.07 (95%CI 0.02 to 0.26), P<0.0001. It was concluded that insulin therapy can reduce incidence of PDN in type 2-DM patient.
FIRST UNPROVOKED SEIZURE PADA ANAK Melati, Deborah; Suwarba, IGN Made; Sutriani M, Dewi; Kari, Komang
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

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Abstract

Kejang sangat sering ditemukan pada pasien anak dengan perkiraan kejadian first unprovoked seizuresebesar 2% dan epilepsisebesar 1% pada anak sebelum berusia 16 tahun. First unprovoked seizure adalah kejang yang terjadi tanpa faktor pencetus seperti demam, infeksi sistem saraf pusat, trauma kepala, gangguan metabolik, hipoksia otak, dan obat-obatan.Berulangnya first unprovoked seizure berbeda-beda pada setiap pasien dan dipengaruhi oleh faktor risiko perorangan seperti gambaran EEG epileptiform atau adanya kelainan neurologis sebelumnya.Tatalaksana first unprovoked seizure berupa mengatasi kejang pada saat serangan.Pemberian obat anti-epilepsi pada pasien dengan first unprovoked seizure masih kontroversial.Tujuan utama pemberian obat anti-epilepsi pada pasien dengan first unprovoked seizure adalah mengoptimalisasi kualitas hidup anak dengan mempertimbangkan risiko pemberian obat dan mencegah berulangnya kejang, pemilihan keluarga serta efek samping pemberian obat. [MEDICINA. 2014;45:93-8].    
BREAKFAST HABIT AND ACADEMIC PERFORMANCE AMONG SUBURBAN ELEMENTARY SCHOOL CHILDREN Widyanti, Putu Ayu; Sidiartha, I Gst Lanang
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

Academic performance is affected by a numbers of factors. Age, gender, nutritional status, and breakfast habits are some factors that have relation with academic performance. Nutritional statues among school children still to be concerned. Breakfast habit is important thing to do before school to maintain enough calories to study and work well. The aim of this study was to determine the association of breakfast habits and academic performance especially in suburban elementary school children. An analytic cross sectional study conducted in children aged 6-12 years who studied at SD 1 Taro, Gianyar regency, Bali. There were 178 students participated in this study. We found 3 factors associated with academic performance i.e. breakfast, gender, and age with OR=2.56 (95% CI 1.16 to 5.66), P=0.02; OR=0.32 (95% CI 0.15 to 0.70), P=0.04; OR=6.52 (95% CI 2.73 to 15.53), P<0.0001, respectively. We conclude there was an association between breakfast habits and academic performance.

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