E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Perbedaan Efek Tramadol Infus Kontinyu dan Bolus Intermiten terhadap Numeric Rating Scale (NRS) Pasien Pasca Multipel Odontektomi
Get PDFPenggunaan tramadol bolus berulang secara teratur atau sesuai dengan permintaan adalah bentuk administrasi analgesia dalam terapi nyeri pascaoperasi. Penelitian ini bertujuan membandingkan efek tramadol infus kontinu dengan bolus intermiten terhadap numeric rating scale pascamultipel odontektomi. Penelitian ini dilaksanakan RSUD Dr. Moewardi, Surakarta dan RSUD KET Setjonegoro, Wonosobo mulai bulan September–November 2018 menggunakan uji klinik acak tersamar tunggal pada 36 pasien yang dilakukan multipel odontektomi dan memenuhi kriteria inklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok I tramadol bolus awal 100 mg selanjutnya infus kontinu 0,25 mg/kg/jam ditambah parasetamol 500 mg/8 jam bolus dan kelompok II tramadol bolus awal 100 mg, selanjutnya 50 mg/8 jam bolus ditambah parasetamol 500 mg/8 jam. Semua pasien mendapatkan perlakuan anestesi umum sesuai dengan standar dan kemudian dilakukan penilaian skala nyeri jam ke-2, 6, 12, 24 pascaoperasi. Selain itu juga dinilai efek mual muntah pascaoperasi. Hasil uji statistik didapatkan nilai p=0,240 (p>0,05) jam ke-2, p=0,007 (p0,05) jam ke-12, p=0,219 (p>0,05) jam ke-24 yang berarti terdapat perbedaan signifikan NRS pada jam ke-6 pascaoperasi antara kelompok I dan II. Hasil uji statistik didapatkan nilai p=0,743 (p>0,05) yang berarti tidak terdapat perbedaan efek samping mual-muntah pascamultipel odontektomi pada kedua kelompok. Simpulan, terdapat perbedaan efektivitas analgetik yang diukur dengan NRS pascamultipel odontektomi dengan diberikan tramadol infus kontinu dibanding dengan tramadol bolus intermiten pada 6 jam pascaoperasi. Differences of Continuous Infusion and Intermittent Tramadol Effect on Numeric Rating Scale in Post Multiple Odontectomy PatientsThe use of regular or on-demand repeated bolus tramadol is a form of analgesia administration in the treatment of postoperative pain. This study aimed to find better ways of analgesic administration after multiple odontectomy. This research was conducted in Dr. Moewardi General Hospital, Surakarta, and KET Setjonegoro General Hospital, Wonosobo, from September to November 2018, using a single-blind randomized clinical trial in 36 patients who had multiple odontectomy and met the inclusion criteria. Samples were divided into two groups. Group I received: an initial bolus of tramadol 100 mg, then a continuous infusion of 0.25 mg/kg/hour plus paracetamol 500 mg/8 hours bolus, and group II received initial bolus tramadol 100 mg, then 50 mg/8 hours bolus plus paracetamol 500 mg/8 hours. All patients received standard general anesthetic treatment and then postoperative pain assessment at 2, 6, 12, and 24 hours. Besides, the effects of postoperative nausea were also assessed. Statistical test results p = 0.240 (p>0.05) at the second hour, p = 0.007 (p0.05) at the 12th hour, p = 0.219 (p>0.05) at the 24th hour, meaning there was a difference in NRS at the 6th hour postoperatively between groups I and II. Statistical test results were p = 0.743 (p> 0.05), meaning there were no differences in the side effects of nausea post multiple odontectomy in the two groups. In conclusion, there is a significant difference in analgesic efficacy as measured by NRS post multiple odontectomy with continuous tramadol infusion compared with intermittent tramadol boluses at the 6th hour postoperatively.Nyeri adalah salah satu gejala peradangan akut yang biasanya terjadi setelah odontektomi, dengan derajat nyeri sedang menurut Numeric Rating Scale (NRS). Penggunaan tramadol bolus berulang secara teratur atau sesuai permintaan adalah bentuk administrasi analgesia yang paling sering dalam terapi nyeri pasca operasi. Penelitian ini bertujuan untuk menemukan cara pemberian analgesik yang lebih baik pasca multipel odontektomi. Penelitian ini menggunakan uji klinik acak tersamar tunggal pada 36 pasien yang dilakukan multipel odontektomi dan memenuhi kriteria inklusi. Sampel dibagi menjadi 2 kelompok yaitu kelompok I tramadol bolus awal 100 mg selanjutnya infus kontinyu 0,25 mg/kg/jam ditambah paracetamol 500 mg / 8 jam bolus dan kelompok II tramadol bolus awal 100 mg selanjutnya 50 mg / 8 jam bolus ditambah paracetamol 500 mg / 8 jam. Semua pasien mendapatkan perlakuan anestesi umum sesuai standar dan kemudian dilakukan penilaian skala nyeri jam ke 2, 6 , 12, 24 pasca operasi. Selain itu juga dinilai efek mual-muntah pasca operasi. Hasil uji statistik didapatkan nilai p=0,240 (p>0,05) jam ke 2, p=0,007 (p0,05) jam ke 12, p=0,219 (p>0,05) jam ke 24, yang berarti bahwa terdapat perbedaan yang signifikan NRS pada jam ke 6 pasca operasi antara kelompok I dan II. Hasil uji statistik didapatkan nilai p=0,743 (p>0,05) yang berarti bahwa tidak terdapat perbedaan efek samping mual-muntah pasca multiple odontektomi pada kedua kelompok. Kesimpulannya, terdapat perbedaan yang signifikan efektivitas analgetik yang diukur dengan NRS pasca multipel odontektomi dengan diberikan tramadol infus kontinyu dibandingkan dengan tramadol bolus intermiten pada 6 jam pasca operasi
Glasgow Outcome Scale Assessment in Patients with Cerebral Toxoplasmosis
Get PDFBackground: Cerebral toxoplasmosis is a Toxoplasma gondii infection affecting the brain. Assessment of the functional outcome after treatment is needed as an evaluation for therapeutic management. One of the instruments used is the Glasgow Outcome Scale (GOS). This study aimed to assess the functional outcome of cerebral toxoplasmosis patients using GOS.Methods: A Cross-sectional descriptive study with total sampling method was conducted. Medical records were retrieved from patients with cerebral toxoplasmosis registered at the Department of Neurology, Dr. Hasan Sadikin General Hospital, Bandung during year 2017–2019. Inclusion criteria were patients with cerebral toxoplasmosis aged >18 years and had a positive HIV serological test. The GOS was assessed and presented in frequency, using Microsoft Excel and SPSS software ver. 25.0.Results: Of 87 patients, 68% had somnolent on admission to the hospital, 51% had hemiparesis/hemiplegia, and 76% had GOS 3, indicating severe disability. Almost one third (28%) of patients died during hospitalization with non-neurological complications as the most common cause of death (63%). On discharge from the hospital, 82% of the survivors were fully alert, 40% had hemiparesis/hemiplegia, and 33% had GOS 4 (mild disability).Conclusions: Most of the cerebral toxoplasmosis patients come to the hospital with severe disability. During the treatment, one third of patients died, and those who survived had mild disability. GOS has improved after hospitalization, suggesting that GOS is useful for assessment of therapeutic management.
Knowledge and Perception of Diabetes Mellitus among Patients with Type 2 Diabetes Mellitus in Five Public Health Centers in Karawang, West Java, Indonesia
Get PDFBackground: Diabetes mellitus (DM) is a chronic metabolic disease that causes various complications, leading to a high mortality rate and high medical costs. Good knowledge and perception are essential for patients in understanding the disease and how to prevent the complications. This study aimed to assess the knowledge and perceptions of DM among patients with type 2 DM from the Public Health Centers (Pusat Kesehatan Masyarakat, Puskesmas), the primary health care facility in West Java.Methods: The research design was quantitative observational with a cross-sectional method and descriptive approach. Data were collected in 2019 from all DM patients living in five working areas of the Puskesmas in Karawang Regency, West Java, Indonesia. Data collection was performed by trained interviewers, using a validated translation of the Diabetes Knowledge Questionnaire (DKQ) (Cronbach’s alpha 0.723) and the Brief Illness Perception Questionnaire (BIPQ) (Cronbach’s alpha 0.74) to measure knowledge (24 questions) and to explore perception (8 questions), respectively. Results: Of the 211 respondents, 165 were predominantly female (76.4%) and aged 52–61 years old (35.2%). Knowledge was moderate (55.8%), however, they had a negative perception of the disease (50.9%).Conclusions: Although most of the respondents have a moderate level of knowledge, their perception of DM is still negative. Therefore, education for patients and the community needs to be evaluated to enhance knowledge and perceptions about diabetes mellitus
Knowledge, Attitude, and Perception about Autopsy among Community in Bandung
Get PDFBackground: Autopsy is a comprehensive evaluation of the body and the circumstances surrounding an individual’s death. Currently, autopsy rates in various countries have been decreased in recent years. This decrease was due to the rejection by people who had inadequate knowledge, attitudes, and perceptions about autopsies. This study aimed to determine the knowledge, attitudes, and perceptions of Bandung residents about autopsies.Methods: This cross-sectional descriptive observational study involved people in the Bandung City who were over the age of 20 during the period August to September 2020. The sample was obtained using a snowball system. Research subjects filled out a questionnaire through a Google form containing questions about knowledge, attitudes, and perceptions. The results were categorized based on the median for each variable.Results: Subjects with questionnaire data obtained were 378 people with an average age of 30.30±13.48 years, and most (66.9%) were female. A total of 259 people had adequate knowledge (68.5%), 254 people (67.2%) had a positive attitude, and 249 people (65.9%) had a positive perception, with a median value of 7, 6, and 12, respectively. However, 95 people did not agree to do an autopsy on their relatives or family to determine the cause of death.Conclusion: The subject as a whole showed adequate knowledge, positive attitude, and perception. However, there are still some people who show inadequate knowledge and poor attitudes and perceptions about autopsies. It is recommended that the government and other institutions intervene in the community to increase knowledge and attitudes and improve public perception
Trends in Determinants of Birth Interval based on Data from the Indonesian Demographic Health Survey in 2007, 2012, and 2017
Get PDFBackground: Fertility is the main component of population dynamics that determines the population structure of a country. One method to measure fertility is to analyze the birth interval. This study aimed to identify determinants of birth interval based on the Indonesian Demographic and Health Survey (IDHS) data in 2007, 2012, and 2017.Methods: This study design was descriptive using IDHS data from 2007, 2012, and 2017 with a cross-sectional study design. Samples were mothers who gave birth to their last living child in the last five years.Results: In the IDHS 2007, the birth interval at risk (<24 months) was 11.8%, increased in the 2012 IDHS to 12.1%, and decreased in the 2017 IDHS to 9.8%. In the three-period IDHS, the same determinants of the birth interval were discovered, such as the age of the woman, duration of breastfeeding, use of contraception, the status of the child before the last child, mother’s education level, and wealth quintile. However, in 2007, the sex of the child before the last child and the number of surviving children also influenced the birth interval. In 2017 the number of children who were still alive also affected the birth interval. The most dominant factor influencing the occurrence of short birth intervals after controlling for other variables was the survival status of the previous child.Conclusion: The short birth interval is the most prevalent in the 2012 IDHS. Optimal birth interval has the potential to improve maternal, neonatal, and infant health
Level of Knowledge, Attitude, and Practices of General Physicians in West Java, Indonesia on Middle Ear Inflammation
Get PDFBackground: The prevalence of middle ear inflammation in West Java is still relatively high. General practitioners are at the forefront who see and treat the patients directly; thus, the number of cases can be reduced by increasing the competence of general practitioners. This study aimed to determine the level of knowledge, attitude, and practices of general practitioners in West Java towards middle ear inflammation, as an evaluation for improving health services in the community.Methods: This research was a descriptive study with a questionnaire conducted in August–December 2021 conducted online with a probability sampling technique of at least 368 general practitioners in West Java. The level of knowledge, attitude, and practices were calculated using the Guttman scale. The data were presented as a frequency distribution.Results: The results showed that the majority of the general practitioners still had poor knowledge of middle ear inflammation (n=325; 84.6%) as well as the attitude (n=333; 86.7%) and the level of practice (n=340; 88.5%).Conclusions: The level of knowledge, attitude, and practices of general practitioners in West Java towards middle ear inflammation is poor. Special interventions and approaches are needed to improve the competence of general practitioners in West Java based on the Standard Competency of Indonesian Doctors
Relationship between the Risk of Eating Disorders and the Concentration Capacity of High School Students
Get PDFBackground: Eating disorder is a change in eating behaviour that affects daily activities, resulting in a vulnerability towards diseases that have several effects on the organ systems, including the neurological system. In teenagers, these disturbances, including a decline in memory, cognitive function, and concentration, will significantly affect daily activities, especially in their studies. The objective of this study was to determine the relationship between the risk of eating disorders and the concentration capacity of high school students aged 12–19 years old. Methods: This study was an observational analytic study conducted cross-sectionally among high school students. Data were collected from September to October 2019. Data were taken using Eating Disorder Examination (EDE) Questionnaire filled out by the respondents, followed by a Stroop test. Data analysis was performed by the chi-square test.Results: Of 294 students, 56.5% had a risk of eating disorder, of whom 66.7% did eating restrain. Of all respondents, 54.8% had poor concentration capacity. There was a relationship between the risk of eating disorder and concentration capacity (p=0.002).Conclusion: The risk of eating disorders has a significant relationship with concentration capacity. An urgent measurement is needed to promote an eating behaviour among adolescents to increase good and productive daily activity
Knowledge and Attitude among Doctors towards Use of Prophylactic Vitamin K in Neonatal Bleeding Disorders in Department of Obstetrics and Gynecology: Experience from Haj El-Safi Hospital, Sudan
Get PDFBackground: Vitamin K is crucial for neonates to prevent bleeding disorders. Raising awareness of vitamin K use would show positive outcomes. This study aimed to assess the knowledge and attitude of prophylactic use of vitamin K for bleeding disorders in neonates among doctors working in the Department of Obstetrics and Gynecology at Haj El-Safi Hospital, Sudan.Methods: A descriptive cross-sectional study was conducted in February 2019, involving 36 doctors selected by convenience sampling. Data were collected by an interview-based questionnaire designed to measure the knowledge level of doctors toward vitamin K deficiency classification and interactions, guidelines availability and adherence, and parents counseling. Data were analyzed and presented in tables. Results: The doctors involved in this study were 36, including 7 registrars, 6 medical officers, 23 house officers, mostly aged 20–25 years (n=29), and female (n=27). The level of knowledge about the classification of vitamin K deficiency and the interaction of vitamin K with other drugs among doctors was mostly good (n=14 and n=15, respectively). Registrars were the most in the good category (n=6, and n=7, respectively). Most doctors (n=23) were aware of vitamin K guidelines, while only 15 have continuous adherence, 16 of doctors counseled parents about the importance of prophylactic vitamin K.Conclusion: The level of knowledge towards prophylactic vitamin K use in neonatal bleeding disorders among doctors in the Department of Obstetrics and Gynecology at Haj El-Safi Hospital is good
Kejadian Nyeri Kronis dan Kualitas Hidup Pascaoperasi Jantung Terbuka di Rumah Sakit DR. HAsan Sadikin Bandung Periode Januari 2019-Desember 2019
No full textOperasi merupakan salah satu penyebab tersering nyeri kronis, salah satu operasi yang paling sering menimbulkan nyeri kronis pascaoperasi adalah tindakan operasi di regio jantung (sebesar 55%). Nyeri kronis pascaoperasi dapat menyebabkan gangguan kesehatan mental dan menurunnya kualitas hidup yang signifikan. Tujuan penelitian ini adalah mengetahui angka kejadian nyeri kronis dan kualitas hidup pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian deskriptif dengan melakukan studi potong lintang melalui pengisian kuesioner yang dilakukan melalui wawancara jarak jauh dengan telepon terhadap pasien pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung periode Januari sampai Desember 2019. Hasil penelitian menyatakan angka kejadian nyeri kronis pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung masih tinggi 78% (45 dari 58 orang) dengan nyeri intensitas ringan sebanyak 31 orang dan intensitas sedang sebanyak 14 orang, sedangkan kualitas hidup pasien pascaoperasi jantung terbuka pada 58 pasien secara keseluruhan baik. Skor SF-36 pada kelompok yang tidak mengalami nyeri kronis lebih tinggi dibanding dengan kelompok yang mengalami nyeri kronis, skor SF-36 pada kelompok yang mengalami nyeri intensitas ringan lebih tinggi dibanding dengan kelompok nyeri intensitas sedang. Simpulan penelitian ini adalah angka kejadian nyeri kronis pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung pada Januari sampai dengan Desember 2019 masih tinggi, namun memiliki kualitas hidup yang baik. Chronic Pain and Quality of Life Post Open Heart Surgery at Dr. Hasan Sadikin, General Hospital Bandung in January–December 2019Surgery is one of the most common causes of chronic pain, one of the operations that most often causes postoperative chronic pain is surgery in the heart region (55%). Postoperative chronic pain can lead to mental health problems and significantly reduced quality of life. This study aimed to determine the incidence of chronic pain and quality of life after open heart surgery at Dr. Hasan Sadikin, General Hospital Bandung. This descriptive study is conducting a cross-sectional study by filling out questionnaires through long-distance telephone interviews with patients after open heart surgery at Dr. Hasan Sadikin, General Hospital Bandung from January to December 2019. The study results stated that the incidence of chronic pain after open heart surgery at Dr. Hasan Sadikin Bandung was still high at 78% (45 out of 58 people), with mild-intensity pain in 31 people and moderate intensity in 14 people. At the same time, the overall quality of life for patients after open heart surgery in 58 patients was good. The SF-36 score in the group that did not experience chronic pain was higher than in the group that experienced chronic pain. The SF-36 score in the group that experienced mild-intensity pain was higher than the moderate-intensity pain group. This study concludes that the incidence of chronic pain after open heart surgery at Dr. Hasan Sadikin Bandung from January to December 2019 is still high; however, it has a good quality of life.Operasi merupakan salah satu penyebab tersering nyeri kronis, salah satu operasi yang paling sering menimbulkan nyeri kronis pascaoperasi adalah tindakan operasi di regio jantung (sebesar 55%). Nyeri kronis pascaoperasi dapat menyebabkan gangguan kesehatan mental dan menurunnya kualitas hidup yang signifikan. Tujuan penelitian ini adalah untuk mengetahui angka kejadian nyeri kronis dan kualitas hidup pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian deskriptif dengan melakukan studi potong lintang melalui pengisian kuesioner yang dilakukan melalui wawancara jarak jauh dengan telepon terhadap pasien pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung periode Januari 2019 sampai Desember 2019. Hasil penelitian mengungkapkan angka kejadian nyeri kronis pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung masih tinggi 77,6% (45 dari 58 orang) dengan nyeri intensitas ringan sebanyak 31 orang dan intensitas sedang sebanyak 14 orang sedangkan kualitas hidup pasien pascaoperasi jantung terbuka pada 58 pasien secara keseluruhan baik. Skor SF-36 pada kelompok yang tidak mengalami nyeri kronis lebih tinggi dibanding dengan kelompok yang mengalami nyeri kronis, skor SF-36 pada kelompok yang mengalami nyeri intensitas ringan lebih tinggi dibanding dengan kelompok nyeri intensitas sedang. Simpulan penelitian ini adalah angka kejadian nyeri kronis pascaoperasi jantung terbuka di RSUP Dr. Hasan Sadikin Bandung pada Januari 2019 sampai dengan Desember 2019 masih tinggi namun memiliki kualitas hidup yang baik
Shear Bond Strength of Dental Cements on Titanium Alloy: Use of Different Restorative Materials
Get PDFDifferent dental cements and restorative materials may have various impacts on the shear bond strength (SBS) to titanium alloy of dental implants, and some fluoride-containing cements may destroy the oxide layer of Ti alloys. The aim of this study was to evaluate the retention and SBS of different dental cements to titanium alloy using different restorative materials and also the corrosive effect of dental cements on titanium alloy. In this in-vitro study, a total of ninety titanium alloy discs (10×3 mm) and restorative material discs (7×3mm) consisting of Co-Cr soft metal, zirconia, and Ni-Cr were constructed. Three dental cement of 2 different compositional classes, glass ionomer (GI) and zinc phosphate (ZP), were used to cement the discs (n=10 in each paired disks). SBS was evaluated using a universal testing machine with a cross-head speed of 1mm/min. A stereomicroscope (×32) and a scanning electron microscope were used to determine the fracture pattern and titanium corrosion, respectively. Data were then analyzed statistically using one-way ANOVA and Tamhane comparison test (P<0.05). The mean SBS of studied groups ranged from 0.12±0.07 to 6.2±0.97 Mpa, with the Ni-Cr and zirconia were demonstrated as the materials with the highest and lowest SBS to GI and ZP, respectively. The cements created a strong bond to the Co-Cr soft metal while the GI cement remained on restorative material disc surfaces in all samples, except in the zirconia sample. Mixed patterns were mostly seen in ZP cement groups. To conclude, applying fluoride-containing cements have no effect on titanium