E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Cerebral Palsy Parents’ Knowledge, Attitude, and Behavior at Dr. Hasan Sadikin General Hospital Bandung 2014
No full textBackground: Cerebral palsy (CP) as a non-progressive syndrome of motor function and posture disturbance is caused by the abnormality or damage on the brain during its development. Children with CP usually have motor, sensory, communication, and intellectual disturbances. Medical rehabilitation is important; however, the environmental aspect is also crucial for their development. Parents as their caregivers may have good knowledge to assist their children during rehabilitation. This study aimed to explore the knowledge, attitude, and behavior among parents with CP children.Methods: This study was descriptive quantitative study and conducted at the Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital Bandung during September to October 2014. Parents of CP children were asked to complete a questionnaire that was specifically designed for this study after their consent was obtained.Results: From a total of 31 parents, 51.6% had good knowledge about CP; 58.1% had good attitude toward CP children, and 51.6% had good behavior while taking care of their children.Conclusions: The majority of parents with CP children have good knowledge, attitude, and behavior towards CP children. The knowledge of risk factors of cerebral palsy are poor, therefore, it is necessary for doctors and therapists to provide more education sessions on the risk factors and other related topics about cerebral palsy
PERBANDINGAN KEJADIAN POSTOPERATIVE COGNITIVE DYSFUNCTION (POCD) FASE AKUT PADA JOINT ARTHROPLASTY DENGAN ANESTESI UMUM DAN ANESTESI EPIDURAL PADA PASIEN USIA LANJUT
No full textUsia lanjut merupakan faktor risiko terjadinya postoperative cognitive dysfunction (POCD). Pemilihan teknik anestesi yang tepat pada usia lanjut akan menurunkan risiko kejadian POCD. Penelitian ini bertujuan untuk membandingkan angka kejadian POCD pada pasien usia lanjut yang menjalani operasi joint arthroplasty antara anestesi umum dan anestesi epidural. Penelitian berlangsung pada bulan Juli–Oktober 2019 di RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan menggunakan metode randomized control trial dengan melibatkan 48 pasien yang menjalani tindakan joint arthroplasty. Subjek penelitian dibagi menjadi kelompok anestesi umum (GA) dan anestesi epidural (EA) menggunakan bilangan acak. Penilaian status mental pasien dilakukan menggunakan Mini mental state examination (MMSE) pada saat preoperasi dan tujuh hari pascaoperasi. Perbandingan proporsi kajadian POCD pada kedua kelompok dianalisis dengan menggunakan uji chi-square. Kejadian POCD pada kelompok GA (37,5%) lebih tinggi dari kelompok EA (8,3%) dan secara statistik perbedaan proporsi kejadian POCD pada kedua kelompok bermakna signifikan p=0,016 (p<0,05). Simpulan penelitian bahwa kejadian postoperative cognitive dysfunction (POCD) pada pasien usia lanjut yang menjalani joint arthroplasty dengan anestesi epidural lebih kecil dibanding dengan anestesi umum. Comparison of General Anesthesia on Postoperative Cognitive Dysfunction (POCD) in Joint Arthroplasty with Epidural Anesthesia in Elderly PatientsOld age is a risk factor for postoperative cognitive dysfunction (POCD). Elder people often have to undergo many surgeries, one of which is joint arthroplasty surgery. Selecting appropriate anesthetic techniques for elderly patients to reduce POCD is always controversial. The study aimedto compare the POCD incidence in elderly patients who underwent joint arthroplasty surgery using the general anesthesia and epidural anesthesia. The study was conducted in July–October 2019 at the RSUP Dr. Hasan Sadikin Bandung. This study used a randomized control trial method involving 48 elderly patients who underwent joint arthroplasty using randomized control trial method. Research subjects were divided into the General Anesthesia group (GA) and the Epidural Anesthesia group (EA) using random numbers. Both groups mental status was assessed using the mini mental state examination (MMSE) during preoperative and seven days postoperatively. A comparison of the proportion of POCD incidence in the two groups were analyzed using the chi-square test. The result showed that the proportion of POCD incidence in the GA group (37.5%) was higher than the EA group (8.3%), and the difference was statistically significant p=0.016 (p<0.05). The study concludes that epidural anesthesia in the joint arthroplasty procedure of elderly patients is superior vs. general anesthesia.Usia lanjut merupakan faktor risiko yang konsisten menyebabkan terjadinya postoperative cognitive dysfunction (POCD). Pasien usia lanjut seringkali harus menjalani tindakan operasi salah satunya adalah operasi joint arthroplasty. Pemilihan teknik anestesi yang tepat pada usia lanjut untuk menurunkan risiko kejadian POCD masih menjadi kontroversi. Penelitian ini bertujuan untuk membandingkan angka kejadian POCD pada pasien usia lanjut yang menjalani operasi joint arthroplasty dengan anestesi umum dan anestesi epidural. Penelitian dilakukan menggunakan metode randomized control trial dengan melibatkan 48 pasien yang menjalani tindakan joint arthroplasty. Subyek penelitian dibagi menjadi kelompok tindakan anestesi umum (GA) dan anestesi epidural (EA) menggunakan bilangan acak. Penilaian status mental pasien dilakukan dengan menggunakan Mini mental state examination (MMSE) pada kedua kelompok pasien pada saat preoperasi dan tujuh hari pascaoperasi. Perbandingan proporsi kajadian POCD pada kedua kelompok dianalisis dengan menggunakan uji chi-square. Kejadian POCD pada kelompok GA (37,5%) lebih tinggi dari kelompok EA (8,3%) dan secara statistik perbedaan proporsi kejadian POCD pada kedua kelompok bermakna signifikan 0,016 (p<0,05). Simpulan penelitian bahwa tindakan anestesi epidural pada tindakan joint arthroplasty pasien usia lanjut lebih baik dibandingkan anestesi umu
Comparison of Interpretation between Pyrosequencing and Xpert MTB/RIF Assay in Multidrug-Resistant Tuberculosis
Get PDFIndonesia is one of the countries with the highest multidrug-resistant tuberculosis cases in the world. Rapid molecular test using the Xpert MTB/RIF assay is one of the detection methods for MDR-TB. Early detection of MDR-TB is crucial for early initiation of treatment. However, Xpert MTB/RIF assay only detects the rpoB gene mutations associated with Rifampicin resistance. Recently, WHO recommends the use of Pyrosequencing, a DNA sequencing method that can detect not only the rpoB gene but also katG and/or inhA gene mutations associated with Isoniazid resistance. The aims of this study were to compare the interpretation between the two methods and to determine the differences in codon mutation position detection of the rpoB gene and mutation detection of the katG and/or inhA gene. This was a cross-sectional comparative observational study on patients ≥18 years old interpreted as RR-TB patients based on Xpert MTB/RIF assay results who had not received MDR-TB drugs at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Results showed there were 40 Rifampicin-resistant TB subjects interpreted by Xpert MTB/RIF assay while Pyrosequencing interpreted 30 MDR-TB, 9 RR-TB and one Isoniazid-resistant TB subjects in January - February 2020. The detection of rpoB gene codon mutation position between Xpert MTB/RIF assay and Pyrosequencing methods was not significantly different (p=0.389). Pyrosequencing had detected 27 katG gene mutations, 3 inhA gene mutations, one katG and inhA gene mutation. To conclude, Pyrosequencing can be used for accurate detection of Rifampicin and Isoniazid resistance in MDR-TB. Perbandingan Hasil Interpretasi antara Pyrosequencing dengan Xpert MTB/RIF Assay pada Multidrug-Resistant TuberculosisIndonesia merupakan salah satu negara dengan kasus multidrug-resistant tuberculosis terbanyak. Penegakan diagnosis MDR-TB saat ini menggunakan tes cepat molekular Xpert MTB/RIF assay sehingga pasien segera mendapatkan pengobatan. Namun Xpert MTB/RIF assay hanya mendeteksi mutasi gen rpoB penyandi resistansi Rifampisin. World Health Organization merekomendasikan Pyrosequencing, metode sequencing nukleotida yang dapat mendeteksi mutasi gen rpoB, gen katG dan/atau inhA penyandi resistansi Isoniazid. Tujuan penelitian ini adalah menentukan apakah kedua alat ini memberikan hasil interpretasi yang sama, apakah ada perbedaan deteksi posisi mutasi kodon gen rpoB dan apakah ditemukan mutasi gen katG dan/atau inhA. Penelitian ini merupakan studi observasional komparatif dengan rancangan cross-sectional. Subjek penelitian adalah pasien usia ≥18 tahun yang diinterpretasi RR-TB berdasarkan Xpert MTB/RIF assay di RSUP Dr. Hasan Sadikin Bandung dan belum mendapat pengobatan. Xpert MTB/RIF assay menginterpretasi 40 subjek Rifampicin-resistant TB sedangkan Pyrosequencing menginterpretasi 30 subjek MDR-TB, 9 subjek RR-TB dan satu subjek Isoniazid-resistant TB pada bulan Januari-Februari 2020. Deteksi posisi mutasi kodon gen rpoB antara Xpert MTB/RIF assay dan Pyrosequencing tidak berbeda bermakna (p=0,389). Pyrosequencing mendeteksi 27 mutasi gen katG, 3 mutasi gen inhA, satu mutasi gen katG dan inhA. Kesimpulan, Pyrosequencing dapat digunakan untuk deteksi resistansi Rifampisin dan Isoniazid pada MDR-TB secara lebih akurat
Survival Analysis of Chronic Kidney Disease Patients with Hemodialysis in West Java. Indonesia, Year 2007 - 2018
Get PDFThe prevalence of chronic kidney disease on dialysis or CKD5D is increasing with a significant impact on disease burden in many countries. Patients are usually listed in the national renal registries, which report demographic data, incidence, prevalence, and outcome. The survival rate is an important outcome measure to characterize the impact of treatment in the CKD5 patient population in the national and international renal registries. Indonesian Society of Nephrology (InaSN) has the Indonesian Renal Registry program to collect data that was endorsed to monitor dialysis treatment quality in Indonesia. IRR releases an annual report, but there is no survival analysis yet. This study aimed to discover the five-year survival rate of CKD5D patients in West Java between 2007–2018 and its factor based on the IRR database. A retrospective cohort study was performed by gaining all patients' data from the IRR database, then data on all of the patients from West Java province who completed a 5-year follow-up on December 31, 2018. Kaplan-Meier analysis and Cox proportional hazard's model were used to analyze the risk factors. There were 3,199 data included in this study. In total, the 1, 2, 3, 4, and 5 year survival rates are 82%, 70%, 62%, 58%, and 55 %, respectively. Patients whose age is above 55 years and with unknown underlying kidney disease have a worse survival rate with a hazard ratio of 1.28 and 1.50, respectively. Further exploration of IRR data will provide better information on dialysis treatment in Indonesia. Ketahanan Hidup Pasien Penyakit Ginjal Kronis dengan Hemodialisis di Jawa Barat Indonesia tahun 2007-2018Prevalensi penyakit ginjal kronis pada dialisis atau PGK5D meningkat dan memberi beban penanganan penyakit di banyak negara. Pasien biasanya terdaftar dalam register ginjal nasional yang melaporkan data demografis, insiden, prevalensi dan luaran klisis. Tingkat ketahanan hidup merupakan parameter penting dalam registrasi ginjal untuk menggambarkan kualitas terapi pada populasi pasien PGK stadium 5. Perhimpunan Nefrologi Indonesia (Pernefri) memiliki program Registri Ginjal Indonesia yang disebut Indonesian Renal Registry (IRR) untuk mengumpulkan data pasien PGK5D untuk memantau kualitas pengobatan dialisis di Indonesia. IRR merilis laporan tahunan tetapi belum dilengkapi dengan analisis ketahanan hidup. Tujuan penelitian ini adalah mengetahui angka ketahanan hidup lima tahun pasien PGK5D di Jawa Barat antara tahun 2007-2018 dan faktor risikonya berdasarkan basis data dari IRR. Studi kohort retrospektif dengan mengambil semua data pasien dari basis data IRR kemudian ditentukan data pasien Jawa Barat yang lengkap dan di follow up selama 5 tahun pada 31 Desember 2018. Analisis Kaplan-Meier dan model proporsional hazard Cox digunakan untuk menganalisis faktor risiko. Subjek berjumlah 3199 data yang dimasukkan dalam penelitian ini. Kesimpulannya, angka harapan hidup satu, 2, 3, 4, dan 5 tahun berturut-turut adalah 82%, 70%, 62%, 58%, dan 55%. Usia lebih dari 55 tahun dan penyakit ginjal yang mendasari memiliki kelangsungan hidup yang lebih buruk dengan hazard ratio 1,28 dan 1,50. Eksplorasi lebih lanjut dari data IRR akan memberikan informasi yang lebih baik tentang perawatan dialisis di Indonesia
Serum Albumin Levels of Oral Candidiasis Immunosuppressed Rats Treated With Hyperbaric Oxygen
Get PDFObjective: To investigate serum albumin levels in oral candidiasis immunosuppressed rats treated with hyperbaric oxygen. One of the predisposing factors for oral candidiasis was the use of immunosuppressive drugs continuously. It can also affect the work of the liver because it’s one of the organs responsible for drug metabolism. Hyperbaric oxygen therapy was used not only to suppressing fungal infections, but also to improve liver function by evaluating the serum albumin levels.Methods: This study used a post-test only control group design. Fifteen Wistar rats were divided into 3 groups(n=5/3): G1 (healthy group), G2 (oral candidiasis immunosuppressed rats group without hyperbaric oxygen therapy), and G3 (oral candidiasis immunosuppressed rats group with hyperbaric oxygen therapy). G2 and G3 groups were immunosuppressed by giving dexamethasone 0,5mg/day/rat orally for 14 days, added with tetracycline 1 mg/day/rat. Hyperbaric oxygen therapy was given to the G3 group in 5 days. Blood serum of rats in all groups was taken to calculate albumin levels.Results: The average value of albumin levels in G2 group showed a decrease compared to the G1 group, while G3 showed the highest level. One way Anova test showed a significant difference among groups (p<0,05). To compare the difference between each group we used LSD test and showed a significant difference (p<0,05) between G1 compared to G2, G1 compared to G3, and G2 compared to G3.Conclusion: Liver albumin levels of oral candidiasis immunosuppressed rats treated with hyperbaric oxygen therapy showed higher levels than those without therapy
Body Profile and Arthroscopic Anterior Cruciate Ligament Reconstruction Using Autograft Hamstring Tendon
Get PDFThe incidence of obesity in Indonesia has increased from 14.8% in 2013 to approximately 21.8% in 2018. There is no published data regarding assessments on functional outcomes and complication after Anterior Cruciate Ligament (ACL) reconstruction in patients with different Body Mass Index (BMI) in Indonesia. The aim of this study was to describe the distribution of ACL injury and compare the functional outcomes after ACL reconstruction using hamstring tendon autograft in patients with different BMI categories.This was a retrospective study in 2 groups of patients with different BMI categories: normal BMI group (18.5 to 24.99) and high BMI group (≥25), who had undergone surgeries for ACL injury in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, during the period of 2017 to 2018. Data were collected from medical records and direct examination on functional outcome measurement using Lysholm score.This study comprised of 71 patients who were followed for a minimum of 6 months. Of 71 patients, 43 were in the normal BMI group and 28 were in the high BMI group. No significant differences in postoperative functional outcome between the groups when assessed using Lysholm score. In normal BMI group 95% were graded as excellent to good while5% were in the fair functional category. Meanwhile, in the high BMI group, 86% were graded as excellent to good and 14% were graded as having fair functional results. ACL reconstruction with Hamstring tendon autograft results in a good functional score and a high succes rate in both BMI groups. High BMI does not adversely affect functional outcomes as both BMI groups gain equal benefits. Rekonstruksi Anterior Cruciate Ligament Menggunakan Autograft Tendon HamstringInsidensi obesitas di Indonesia meningkat dari 14.8% pada tahun 2013 menjadi 21.8% pada tahun 2018. Tidak ada publikasi data yang menilai hasil akhir fungsional dan komplikasi setelah operasi rekonstruksi Anterior Cruciate Ligament (ACL) pada pasien dengan indeks massa tubuh (IMT) yang berbeda di Indonesia. Tujuan dari penelitian ini membandingkan hasil akhir fungsional menggunakan skor Lysholm setelah rekonstruksi ACL pada pasien dengan IMT yang berbeda. Penelitian ini bersifat retrospektif yang dibagi menjadi 2 kelompok penelitian dengan IMT yang berbeda; yaitu IMT normal (18.5–24.99) dan IMT yang tinggi (≥25), yang dilakukan operasi cedera ACL di Rumah Sakit Hasan Sadikin periode tahun 2017-2018. Penelitian ini terdiri dari 71 pasien dan dilakukan pengamatan selama minimal 6 bulan dengan jumlah pasien kelompok IMT normal sebesar 43 pasien, sedangkan 28 pasien pada kelompok IMT yang tinggi. Tidak ada perbedaan signifikan diantara kedua kelompok pada hasil akhir fungsional pasca operasi ACL. Kelompok IMT normal terdiri dari 95% dinilai sebagai excellent sampai good dan 5% dinilai sebagai fair, sedangkan untuk kelompok IMT yang tinggi terdiri dari 86% dinilai sebagai excellent sampai good dan 14% dinilai sebagai fair hasil fungsional. Simpulan, operasi rekonstruksi ACL memiliki skor akhir fungsional yang bagus dan angka kesuksesan yang tinggi pada kedua kelompok IMT
Propolis of Trigona spp. Protects Mucosa from Aspirin-Induced Gastric Mucosal Damage in Rats
Get PDFBackground: Helicobacter pylori and non-steroid anti-inflammatory drugs are the major causes of peptic ulcer in the world. Indonesian native stingless bee species, Trigona spp., produces propolis that might be effective to protect mucosal damage. The aim of the study was to determine the protective effect of Trigona spp. propolis on aspirin-induced gastric mucosal damage in rats.Methods: This experimental study was conducted from September–November 2013 at Animal Laboratory of Department of Pharmacology and Therapy Faculty of Medicine Universitas Padjadjaran. Healthy male Wistar rats (n=24) aged 2–3 months old and weighed 200–250 grams were randomly divided into three groups. The first group was control negative, the second group was given 100 mg/kg body weight of aspirin, and the third group was given 200 mg/kg body weight of Trigona spp. propolis, one hour before administration of 100 mg/kg body weight of aspirin. After two weeks of treatment, rats were sacrificed by laparotomy to obtain gastric tissues, followed by processing for the paraffin section for histopathological analysis. The grade of gastric mucosal damage was determined under a light microscope. Data were then compared between groups using the Mann-Whitney test.Results: Oral administration of aspirin-induced gastric mucosal damage ranging from grade 0 to grade IV; whereas administration of propolis showed a reduction of gastric mucosal damage’s grade when compared to the aspirin group (p<0.05).Conclusions: Trigona spp. propolis has a protective effect on aspirin-induced gastric mucosal damage. Further study is encouraged to study an optimal dose of aspirin after propolis administration.
Kita adalah Klinisi, bukan Sekedar Penghobi Ultrasonografi: Keterbatasan Ultrasonografi Point-Of-Care Jantung dalam Memandu Resusitasi Cairan
Get PDFPemeriksaan penunjang ultrasonografi point-of-care (POCUS) jantung sangat berguna dalam memandu resusitasi pasien kritis dengan penyakit penyerta jantung. Namun, POCUS jantung memiliki keterbatasan dan harus tetap dipandu pemeriksaan fisis klinis. Seorang perempuan berusia 84 tahun, mendapatkan perawatan di ruang intensif atas indikasi hemodinamik tidak stabil pascaperdarahan akut gastrointestinal bawah. Pasien tampak somnolen, takipnea, hipotensi disertai distensi vena jugularis. Pemeriksaan laboratorium hanya menunjukkan tanda anemia akut, sedangkan pada rontgen toraks didapatkan kardiomegali dan pacu jantung-tanam. Pasien ditemukan di bangsal dalam kondisi hipotensi dan diberikan bolus cairan. Evaluasi pascabolus cairan, pasien menunjukkan tanda hemodinamik stabil yang transien akibat perdarahan yang terus menerus. Dengan kecurigaan awal bahwa terdapat gangguan fungsi jantung maka ekokardiografi digunakan untuk memandu resusitasi cairan. Pada pemeriksaan tidak didapatkan variasi left ventricular outflow tract velocity time integral (VTi) disertai regurgitasi aorta (AR) moderat dan parameter lain yang membatasi fungsi ultrasonografi POCUS jantung dalam memandu uji responsivitas cairan. Penulis akhirnya melakukan resusitasi cairan dengan panduan pemeriksaan klinis secara berulang semata disertai pemeriksaan ultrasonografi inferior vena cava (IVC). Pasien berhasil diresusitasi dengan bolus cairan intravena dalam jumlah besar tanpa komplikasi sekunder. Penilaian klinis tetap diperlukan terutama pada kondisi patologis tertentu yang membatasi utilisasi POCUS jantung. We are Clinicians, not Ultrasound Geeks: when Cardiac Point-of-Care Ultrasonography Meets its Limitation in Guiding Fluid ResuscitationCardiac point-of-care ultrasonography (POCUS) has shown its superiority in guiding resuscitation of compromised critically ill patients. Despite its emerging usage, cardiac POCUS has limitations that should involve physical examination during its interpretation. An 84-year-old woman was admitted to the intensive care unit with hemodynamic instability following acute lower gastrointestinal bleeding. The patient appeared somnolent with physical examination revealed tachypnea, hypotension, and jugular venous distention. Laboratory data underlined no other than acute anemia. Chest radiography revealed cardiomegaly and implanted pacemaker. The patient was found hypotensive in her ward and treated with fluid bolus. In clinical reevaluation, the patient showed transient hemodynamic stability, for she underwent persistent lower gastrointestinal bleeding. Due to suspected compromised cardiac function, a cautious fluid resuscitation guided by echocardiography was commenced revealing no visible variation of the left ventricular outflow tract (LVOT) velocity-time integral (VTi), moderate aortic regurgitation (AR), and other parameters that might limit cardiac POCUS utility to assist fluid responsiveness test. We decided to administer fluid based on a regular reassessment of clinical hemodynamic parameters combined with inferior vena cava (IVC) ultrasound, Finally, the patient survived and did not suffer any complication following a large intravenous volume bolus. Intensivists' clinical assessment is paramount, especially in particular pathological conditions that limit cardiac POCUS utilization
Efek Granisetron Intravena terhadap Perubahan Tekanan Darah pada Seksio Sesarea dengan Anestesi Spinal
Get PDFHipotensi merupakan komplikasi paling sering pada seksio sesarea dengan anestesi spinal. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, obat-obatan, pengurangan dosis obat anestesi lokal, dan intervensi mekanik. Granisetron sebagai antagonis reseptor 5hydroxytryptamine3 (5HT3) dapat digunakan untuk mencegah hipotensi pada seksio sesarea dengan anestesi spinal. Penelitian ini bertujuan mengetahui pengaruh pemberian granisetron 1 mg intravena terhadap perubahan tekanan darah pada seksio sesarea dengan anestesi spinal. Penelitian ini dilakukan periode Desember 2019–Februari 2020 di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian ini adalah uji klinis tersamar ganda pada 34 pasien ASA II yang menjalani seksio sesarea dengan anestesi spinal. Subjek penelitian dibagi secara acak menjadi 2 kelompok, yaitu kelompok kontrol diberikan NaCl 0,9% dan kelompok granisetron diberikan granisetron 1 mg intravena pada 5 menit sebelum anestesi spinal. Tekanan darah diperiksa setiap 1 menit selama 20 menit setelah anestesi spinal, kemudian setiap 2,5 menit sampai operasi selesai. Data dianalisis dengan uji t, Uji Mann Whitney, dan Uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna. Kejadian hipotensi pada kelompok kontrol (79%) lebih tinggi dari kelompok granisetron (29%). Penurunan tekanan darah pada kelompok kontrol lebih besar dibanding dengan kelompok granisetron dengan perbedaan signifikan (p<0,05). Simpulan, pemberian granisetron 1 mg intravena dapat mengurangi kejadian hipotensi pada seksio sesarea dengan anestesi spinal.Effect of Intravenous Granisetron on Blood Pressure in Cesarean Section under Spinal AnesthesiaHypotension is the most frequent complication in cesarean section with spinal anesthesia. The prevention of hypotension includes fluid and drugs administration, lower local anesthetic doses, and mechanic interventions. Granisetron is a 5HT3 receptor antagonist that can be used to prevent hypotension in cesarean section with spinal anesthesia. This study aimed to determine the effects of intravenous administration of 1 mg granisetron on blood pressure in patients undergoing cesarean section with spinal anesthesia. This study was a double blinded clinical study on 34 patients ASA II undergoing cesarean sections with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of December 2019 to February 2020. Subjects were divided randomly into 2 groups; a control group that received 0.9% NaCl and a granisetron group that received 1 mg intravenous granisetron 5 minutes before spinal anesthesia. Blood pressure was evaluated every minute for 20 minutes after the spinal anesthesia, and then every 2.5 minutes until the surgery was completed. Data were analyzed using t-test, Mann Whitney test, and Kolmogorov-Smirnov test with p value<0.05 considered significant. Incidence of hypotension in the control group was higher than the granisetron group (79%vs29%) with blood pressure decrease significantly higher in the control group (p<0.05). Thus, administration of intravenous 1 mg granisetron may reduce the incidence of hypotension in cesarean sections with spinal anesthesia.Hipotensi merupakan komplikasi paling sering pada seksio sesarea dengan anestesi spinal. Pencegahan hipotensi dapat dilakukan dengan pemberian cairan, obat-obatan, pengurangan dosis obat anestesi lokal dan intervensi mekanik. Granisetron sebagai antagonis reseptor 5hydroxytryptamine3 (5HT3) dapat digunakan untuk mencegah hipotensi pada seksio sesarea dengan anestesi spinal. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian granisetron 1 mg intravena terhadap perubahan tekanan darah pada seksio sesarea dengan anestesi spinal. Penelitian ini dilakukan periode Desember 2019 - Februari 2020 di RSUP Dr. Hasan Sadikin Bandung. Metode penelitian ini adalah uji klinis tersamar ganda pada 34 pasien ASA II yang menjalani seksio sesarea dengan anestesi spinal. Subjek penelitian dibagi secara acak menjadi 2 kelompok yaitu kelompok kontrol diberikan NaCl 0,9% dan kelompok granisetron diberikan granisetron 1 mg intravena pada 5 menit sebelum anestesi spinal. Tekanan darah diperiksa setiap 1 menit selama 20 menit setelah anestesi spinal, kemudian setiap 2,5 menit sampai operasi selesai. Data dianalisis dengan uji t test, Uji Mann Whitney dan uji kolmogorov-smirnov, nilai p<0,05 dianggap bermakna. Kejadian hipotensi pada kelompok kontrol (79%) lebih tinggi dari kelompok granisetron (29%). Penurunan tekanan darah pada kelompok kontrol lebih besar dibanding dengan kelompok granisetron dengan perbedaan signifikan (p<0,05). Simpulan penelitian bahwa pemberian granisetron 1 mg intravena dapat mengurangi kejadian hipotensi pada seksio sesarea dengan anestesi spinal
Role of Cystatin-C as Serum Biomarkers in Predicting Glomerular Function-Associated with Copper-Induced Acute Kidney Injury
Get PDFCystatin C is a 13 kD molecular-weight protein synthesized by all nucleated cells which functions as a cysteine protease inhibitor. Cystatin C is detectable when kidney function decreases due to the excessive accumulation of nephrotoxic substances such as copper. Previous studies have proven that white turmeric rhizome can act as a nephroprotector agent at a dose of 500mg/BW. The purpose of this study was to compare Cystatin-C marker and serum creatinine as biomarkers in the examination of acute kidney injuries induced by nephrotoxic substance. This was a post-test only controlled experimental study on wistar strain male rats that were divided randomly using simple random sampling approach into three groups: normal control group, treatment control group (Curcumin for 2 weeks followed by CuSO4 for 3 days at each weekend), and CuSO4 pentahydrate control group. This study was conducted in Faculty of Pharmacy and Faculty of Medicine of the University of North Sumatera in May to August 2019. Results were normally distributed with significant differences in levels of Cystatin-C, creatinine, and protein serum due to differences in the treatment of each group (p<0.05). Serum Cystatin-C is proven to be a more sensitive biomarker for detecting acute kidney damage compared to serum creatinine. Peran Cystatin-C sebagai Biomarker Serum dalam Memprediksi Fungsi Glomerulus-Terkait dengan Cedera Ginjal Akut yang Dipicu TembagaCystatin C adalah protein dengan berat molekul 13 kD disintesis oleh setiap sel yang memiliki inti berfungsi sebagai inhibitor protease sistein. Cystatin C terdeteksi ketika fungsi ginjal menurun oleh zat nefrotoksik seperti tembaga. Tembaga merupakan salah satu logam yang dapat menjadi zat nefrotoksik bila terakumulasi berlebihan. Ekstrak rimpang kunyit putih memiliki manfaat sebagai nefroprotektor dengan dosis mg/kgBB. Penelitian ini dilakukan untuk mengetahui perbandingan Cystatin-C dan kreatinin serum sebagai biomarker dalam pemeriksaan kerusakan ginjal akut akibat zat nefrotoksik. Penelitian eksperimental ini menggunakan the post test only control group design dengan teknik simple random sampling. Penelitian ini dilakukan di Fakultas Farmasi dan Fakultas Kedokteran Universitas Sumatera Utara pada bulan Mei hingga Agustus 2019. Tikus jantan dengan galur wistar dibagi tiga kelompok; kontrol normal, kontrol kunyit putih (500 mg/kgBB) sebagai pre-treatment (curcumin selama 2 minggu diikuti CuSO4selama 3 hari di setiap akhir pekan), dan kontrol CuSO4 pentahidrat. Hasil analisis data terdistribusi normal dan terdapat perbedaan yang signifikan kadar Cystatin-C, kreatinin dan protein serum pada setiap kelompok dimana nilai p<0.05. Cystatin-C serum sebagai biomarker lebih sensitif dalam mendeteksi kerusakan ginjal akut dibanding dengan kreatinin serum