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Persistence Detection of Sars-Cov-2 RNA in Healthcare Workers with COVID-19: A Case Report
Get PDFCoronavirus Disease 2019 (Covid-19) has now become a concern around the world. Until 6 September 2020, there were 190,665 cases in Indonesia, and it was in the third rank of most cases in the Asian region. It is important to determine the criteria of return to work for healthcare workers with Covid-19 positive in Indonesia. This case report discussed a female patient, 32 years old with chief complaint of fever and itchy throat since 2 days ago. She is a health care worker in the hospital, with a history of treating patients with positive confirmation of Covid-19 for 2 days in the ordinary ward before the case was confirmed with a history of contact approximately 5 days ago. The patient was diagnosed with positive confirmation of Covid-19 and was required for self-isolation. The patient still had positive results of RT-PCR Covid-19 up to the third examination in 30 days after the initial RT-PCR testing, although received specific antiviral treatment with oral oseltamivir and oral supplementation. Based on growing evidence that Sars-Cov-2 may not infectious for more than ten days in the mild-moderate disease, this case report is strengthening the use of symptom-based strategic approach to determine when to return to work in Indonesian healthcare workers with positive COVID-19
Simple Risk Index Score and Hospitalization Mortality in Patients with ST-Elevation Myocardial Infarction
Get PDFIntroduction: Hospitalization mortality in ST-elevation Myocardial Infarction (STEMI) patients areaffected by several factors, including initial identification of the risks at hospital admission. Riskscore tools as a predictor of STEMI complication and death event in STEMI patients is a simple riskindex score. The aim of this study was to determine the association between simple risk index scoreand hospitalization mortality in STEMI patients.Methods: We retrospectively enrolled 60 consecutive patients who were admitted to our hospitaldiagnosed with STEMI. The simple risk index score was calculated for each patient using equation:heart rate x [age/10]2/systolic blood pressure. The patients were assigned into 2 groups according tothis score, high score and low score group. Incidence of death during hospitalization in STEMIpatients was recorded.Results: The total subjects were 60 people. The subjects consisted of 30 patients with low score and30 subjects with high score. The incidence of death during hospitalization in the group of high simplerisk index score were 26 patients, and in the group of low simple risk index score were 13 patients.The association between the simple risk index score and the deaths during hospitalization in STEMIpatients based on statistical analysis was significant (p= 0.00) and value of risk relative (RR) is 2.167;95% CI: 1.368-3.433; (p=0.000).Conclusion: Simple risk index score is associated with hospitalization mortality in ST-elevationmyocardial Infarction (STEMI) patients
Relations of Food Pattern and Physical Activity with Academic Achievement and Cognitive Function
Get PDFIntroduction: The results of the initial survey showed that there were seven children with low food pattern and moderate physical activity was having a cognitive function and low academic achievement at school, and three children with good food pattern and moderate physical activity were having good cognitive and high academic achievement in school. This study was to determine the relations of food patterns and physical activity with academic achievement and cognitive function.
Methods: This study was a cross-sectional study that was conducted at Elementary School 2 Blangkeujeren, West Labuhanhaji Sub-district, South Aceh District from March 2017 to June 2017. This study used a total sampling design is 81 students. Subjects are all students in grade five (42 students) and six (39 students). Data were collected by using questionnaires include Food Frequency Questionary (FFQ), Food Recall 24 hours, Physical Activity Level (PAL). Last year's report card value and the Mini-Mental State Examination (MMSE) were used to assess cognitive children.
Results: The relationship between the type and the amount of macro and micronutrient intake obtained p-value<0.05. This study also showed a relationship between food patterns and cognitive function in children. Based on the research results, there is a relationship between physical activity and academic achievement (p<0.05). There is a relationship between physical activity and cognitive function in children.
Conclusion: There is a relationship between food patterns, physical activity, academic achievement, and cognitive function.Introduction: The results of the initial survey showed that there were seven children with low food pattern and moderate physical activity was having a cognitive function and low academic achievement at school, and three children with good food pattern and moderate physical activity were having good cognitive and high academic achievement in school. This study was to determine the relations of food patterns and physical activity with academic achievement and cognitive function.
Methods: This study was a cross-sectional study that was conducted at Elementary School 2 Blangkeujeren, West Labuhanhaji Sub-district, South Aceh District from March 2017 to June 2017. This study used a total sampling design is 81 students. Subjects are all students in grade five (42 students) and six (39 students). Data were collected by using questionnaires include Food Frequency Questionary (FFQ), Food Recall 24 hours, Physical Activity Level (PAL). Last year's report card value and the Mini-Mental State Examination (MMSE) were used to assess cognitive children.
Results: The relationship between the type and the amount of macro and micronutrient intake obtained p-value<0.05. This study also showed a relationship between food patterns and cognitive function in children. Based on the research results, there is a relationship between physical activity and academic achievement (p<0.05). There is a relationship between physical activity and cognitive function in children.
Conclusion: There is a relationship between food patterns, physical activity, academic achievement, and cognitive function
Oligoasthenoteratozoospermia After Trial of Testicular Salvaging Surgery in Testicular Torsion: A Case Report
Get PDFTesticular torsion (TT) is an emergency in urology that happens because of the spermatic cord’s rotation. Decreased of overall sperm parameters after TT often happens in which can endanger the patient’s fertility status. Approach on how to salvage the testicle and to prevent unwanted complications remains as the doctor’s greatest priority. We report a case of oligoasthenoteratozoospermia after surgical detorsion without orchidectomy in testicular torsion. A 19-year-old male, presenting with sudden, progressive, and continuous pain in the right testicle for 4 hours. The right testicle was larger in volume on physical examination, there were a negative phren sign and negative cremasteric reflex. Gray scale ultrasound without Doppler showed changes suggestive of testicular torsion. Emergency surgery revealed a dark-bluish right testicle with a 360o rotation of the spermatic cord. Detorsion without orchidectomy was performed with clinical judgment hoping for the restoration of testicular viability. Sperm analysis was done after one month and oligoasthenoteratozoospermia was found. Although some patients experience decreased overall sperm parameters after TT that perhaps making them infertile, interestingly there is no difference in pregnancy rates among couples with TT men when compared to the general population. The best testicular salvage surgery method to prevent testicular atrophy also has not been determined yet. Thus, the patient should be carefully counseled about the good outcome of pregnancy rate and the chance for testicular atrophy, regardless of what is the surgical choice
Proteinuria Pasien Diabetes Melitus dan Obesitas Poli Penyakit Dalam RS Ibnu Sina Makassar
Get PDFBackground: The prevalence of diabetes mellitus in the world has increased which is certainly accompanied by a rapid increase in the incidence of its chronic complications like kidney disorders. Insulin resistance, the patophysiology of diabetes mellitus, also associated with obesity, which both are the main risk factors for cardiovascular events. Obesity also known as a risk factor for kidney disease that proved by the presence of proteinuria in obesity patients. Objective: To determine the correlation of obesity with occurrence of proteinuria in patients with type 2 DM in internal medicine polyclinic Ibnu Sina Hospital Makassar. Method: A cross sectional study on 32 type 2 DM patients at Ibnu Sina Hospital as measured by body weight, height and waist circumference. Urinalysis examination is also performed at that time. Results: In this study, there were 4 patients (12,5%) patients with proteinuria (+), 1 patient (3.1%) with proteinuria (++), 2 patients (6.3%) with proteinuria (+++) and 1 patient (3.1%) with proteinuria (++++). According to BMI, we found that 17 patients (53.1%) were overweight, 5 patients (15.6%) were class 1 obesity, no class 2 obesity patient, and 1 patients (3.1%) were class 3 obesity. In Waist circumference examination we found that in normal waist circumference group there is 1 patient that did not has proteinuria while in the abnormal waist circumference group, 8 patients out of 31 patients have proteinuria. After doing statistical analysis to assess the correlation of obesity with proteinuria obtained p value> 0.05. Similarly, the correlation analysis waist circumference with proteinuria obtained p value> 0.05. Conclusion: There is no correlation between obesity and proteinuria as well as waist circumference and proteinuria correlation in type 2 DM patients.Prevalensi diabetes melitus di dunia mengalami peningkatan pesat dibarengi meningkatnya angka kejadian komplikasi kronik gangguan ginjal. Resistensi insulin yang mendasari diabetes melitus pada obesitas dimana keduanya merupakan faktor risko utama kejadian kardiovaskuler. Tujuan penelitian untuk mengetahui hubungan obesitas dengan terjadinya proteinuria pada pasien diabetes melitus tipe 2 di poli penyakit dalam Rumah Sakit Ibnu Sina Makassar. Metode Penelitian cross sectional pada 32 orang pasien DM di RS Ibnu Sina yang diukur berat badan, tinggi badan dan lingkar pinggangnya. Selain itu juga dilakukan pemeriksaan urinalisis lengkap dalam satu waktu. Hasil penelitian ini didapatkan kategori proteinuria (+) 4 orang (12,5%), kategori proteinuria (++) 1 orang (3,1%), kategori proteinuria (+++) 2 orang (6,3%), dan kategori proteinuria (++++) 1 orang (3,1%). Pada kategori obesitas didapatkan untuk kategori overweight ada 17 orang (53,1%), obesitas I 5 orang (15,6%), obesitas II tidak ada dan obesitas III sebanyak 1 orang (3,1%). Sedangkan berdasarkan pemeriksaan lingkar pinggang didapatkan pada kelompok lingkar pinggang normal sebanyak 1 orang tidak didapatkan proteinuria dan pada kelompok dengan lingkar pinggang tidak normal sebanyak 31 orang didapatkan proteinuria sebanyak 8 orang. Setelah dilakukan uji statistik untuk menilai hubungan obesitas dengan proteinuria didapatkan nilai p>0,05. Begitu pula pada analisis hubungan lingkar pinggang dengan proteinuria didapatkan nilai p>0,05. Tidak ada hubungan antara obesitas dan proteinuria begitu pula dengan hubungan lingkar pinggang dan proteinuria
Hubungan IMT dengan Osteoporosis Wanita 50-60 Tahun Subras Deutero Melayu Etnis Bugis/Makassar
Get PDFOsteoporosis is a condition in which bone mass is reduced so that the tissue microarchitecture changes that lead to the risk of bone fragility fracture easily. This study aims to find out if there is a relationship between Body Mass Index (BMI) and osteoporosis in women of 50-60 years old. This study uses research methods Cross Sectional. Assessment of body weight and height was conducted on 29 subjects. The BMI was then determined. The subjects had thoracolumbal rontgen to assess the osteoporosis grading based on Genant method. Most of the subjects (13 or 44.8%) had normal BMI. Only a few samples had underweight and obesity condition (5 samples or 17.2% for each case). As for osteoporosis grading, most of the samples (15 or 51.7%) had 0 grading; and only 2 samples (6.9%) had 3 grading. It can be concluded that there is a significant relationship between BMI, and osteoporosis grading based on Genant method. The higher the BMI, the lower the Genant score will be.Osteoporosis adalah suatu keadaan dimana massa tulang berkurang sehingga terjadi perubahan mikroarsitektur jaringan yang menyebabkan terjadinya kerapuhan tulang dengan resiko mudah patah. Penelitian ini bertujuan untuk mengetahui hubungan antara indeks massa tubuh dengan osteoporosis pada wanita usia 50-60 tahun. Penelitian ini menggunakan metode penelitian Cross Sectional. Pada penelitian ini dilakukan pengukuran berat badan dan tinggi badan pada 29 subjek, lalu menilai indeks massa tubuhnya. Selanjutnya, dilakukan foto tulang belakang torakolumbal untuk menilai grading osteoporosis menurut Genant. Hasil penelitian menunjukkan bahwa indeks massa tubuh normal paling banyak ditemukan, yaitu 13 sampel (44,8%) dan indeks massa tubuh underweight-obesitas paling sedikit, yaitu masing-masing 5 sampel (17,2%). Untuk grading osteoporosis, grading 0 paling banyak ditemukan, yaitu 15 sampel (51,7%) dan grading 3 paling sedikit, yaitu 2 sampel (6,9%). Dengan demikian, dapat disimpulkan bahwa ada hubungan signifikan antara nilai indeks massa tubuh dengan grading osteoporosis menurut Genant. Semakin tinggi nilai indeks massa tubuh, semakin rendah skor Genant.
Kata kunci : Indeks massa tubuh; foto torakolumbal; grading mosteoporosis menurut genan
Hubungan Tingkat Pengetahuan Ibu Terhadap Pemberian Imunisasi Dasar Pada Bayi Di Wilayah Kerja Puskesmas Kassi-Kassi Makassar
Get PDFBased on Basic Health Research 2018, showed that children with aged 12-23 months who did not get complete basic immunizations in South Sulawesi were 31.7%. There are still different understanding in society about immunization, so there are still a lot of babies and toddlers who do not get immunization services. The purpose of this study is to determine the relationship between the level of mother's knowledge with basic immunization in infants at the working area of Public Health Center Kassi-Kassi Makassar. This study was an analytic observational study with a cross sectional design. This research was conducted at the working area of Public Health Center Kassi-Kassi Makassar with a sample of 55 mothers who had a ≥9 month old baby who were selected by accidental sampling. The research data was obtained through primary data from interviews and checking the KIA book. The results of this study indicate that 60% of respondents have less knowledge level with incomplete infants basic immunization status and 40% with complete infants basic immunization status, 11.1% of respondents have sufficient level of knowledge with incomplete infants basic immunization status and 88,9% with complete infants basic immunization status and 100% of respondents have a high level of knowledge with complete infants basic immunization status. The results of the analysis using the Chi-Square test obtained a significant value of 0,000 (p<0.05). The results of this study indicate that there is a significant relationship between the level of mother's knowledge of basic immunization in infants at the working area of Public Health Center Kassi-Kassi Makassar.Data Riset Kesehatan Dasar 2018, menunjukkan bahwa anak usia 12-23 bulan yang tidak mendapatkan imunisasi dasar lengkap di Sulawesi Selatan yaitu 31,7%. Masih adanya pemahaman yang berbeda di masyarakat mengenai imunisasi, sehingga masih banyak bayi dan balita yang tidak mendapatkan pelayanan imunisasi. Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat pengetahuan ibu terhadap pemberian imunisasi dasar pada bayi di wilayah kerja Puskesmas Kassi-Kassi Makassar. Penelitian yang dilakukan adalah penelitian observasional analitik dengan rancangan cross sectional. Penelitian ini dilakukan di wilayah kerja Puskesmas Kassi-Kassi Makassar dengan sampel 55 ibu yang memiliki bayi ³9 bulan yang dipilih secara accidental sampling. Data penelitian ini diperoleh melalui data primer dari hasil wawancara dan mengecek buku KIA. Hasil penelitian ini menunjukkan bahwa 60% responden memiliki tingkat pengetahuan kurang dengan status imunisasi dasar bayi tidak lengkap serta 40% dengan status imunisasi dasar bayi lengkap, 11,1% responden memiliki tingkat pengetahuan cukup dengan status imunisasi dasar bayi tidak lengkap serta 88,9% dengan status imunisasi dasar bayi lengkap dan 100% responden memiliki tingkat pengetahuan tinggi dengan status imunisasi dasar bayi lengkap. Hasil analisis dengan menggunakan uji Chi-Square didapatkan nilai signifikan 0,000 (p<0,05). Hasil penelitian ini menunjukkan bahwa terdapat hubungan yang signifikan antara tingkat pengetahuan ibu terhadap pemberian imunisasi dasar pada bayi di wilayah kerja Puskesmas Kassi-Kassi Makassar
Gagal Napas Akut dengan Hipoksemia Refrakter pada Preeklampsi Berat Aplikasi “PEEP Tinggi dan Balans Cairan Negatif” di ICU
Get PDFIntroduction: Acute pulmonary edema in pregnancy due to preeclampsia is a life-threatening event and a form of maternal morbidity. The hypoxemia is clinical manifestation feature. Refractory hypoxemia is an increasing in the partial pressure of oxygen in the arteries (PaO2) <5 mmHg with a 10% increase in FiO2 or PaO2 <60 mmHg or P/F ratio <100 on FiO2 80-100% with PEEP> 10-20 cmH20 at more than 12- 24 hours. In this case, a 35-year-old female patient entered to the ICU Wahidin Sudirohusodo General Hospital from the emergency room operating teater with acute pulmonary edema ec PEB + Post Sectio cesarian, mechanical ventilation (VM) PCV+ Pins 20 mode, PEEP 10, PS 15, RR 20, Vt 350 – 400 ml, FiO2 100% was performed and maximum SpO2 produced only up to 96%, P/F ratio 95,2. After 11 hours of mechanical ventilation, blood gas analysis obtained pH 7.52, PaCO2 28.5, sat 89.6%, PaO2 50.1 HCO3 23.2 BE 2.2 P/F ratio 62 with 100% FiO2 and airway pressure 30 cmH2O and was diagnose refractory hypoxemic.
Therapy: Sedation, administration of muscle relaxants, changes in high PEEP ventilator settings and fluid evacuation. setting high PEEP up to 25 cmH2O by increasing the A / W pressure every 2 minutes periodically until 55 cmH2O hold for 2 minutes and setting ventilator PCV: Pinsp 20, PEEP 15-20, FiO2 80%. and fluid evacuation with diuretics is carried out.
Results: Improvement of P / F ratio up to 139 at the time of recruitment maneuver and P / F ratio improved up to 244 after 6 hours of the maneuver. the patient was weaning from the ventilator at 5th day care with P / F ratio 313 and tranfer to ward care on the 6th day care.Pendahuluan: Edema paru akut pada kehamilan akibat preeklampsia merupakan kejadian yang mengancam jiwa dan merupakan bentuk morbiditas maternal. Manifestasi klinis yang ditakutkan adalah hypoxemia. Refrakter hipoksemia adalah apabila peningkatan tekanan parsial oksigen dalam arteri (PaO2) < 5 mmHg dengan peningkatan FiO2 10% atau PaO2 < 60 mmHg atau P/F rasio < 100 pada FiO2 80 – 100% dengan PEEP > 10 - 20 cmH20 lebih dari 12-24 jam. Pada kasus ini, seorang pasien perempuan usia 35 tahun masuk ICU RSUP Wahidin Sudirohusodo dari Kamar operasi instalasi gawat darurat dengan udema paru akut ec PEB + Post SSTP, kemudian dilakukan ventilasi mekanik (VM) mode PCV+ Pins 20, PEEP 10, PS 15, RR 20, Vt 350 - 400ml, FiO2 100% SpO2 maksimal yang dihasilkan hanya sampai dengan 96%, P/F rasio 95,2. Setelah dilakukan ventilasi mekanik selama 11 jam, dari analisa gas darah didapatkan pH 7,52, PaCO2 28,5, sat 89,6%, PaO2 50,1 HCO3 23,2 BE 2,2 P/F ratio 62 dengan FiO2 100% dan airway pressure 30 cmH2O dan disimpulkan mengalami refrakter hipoksemia.
Terapi: Sedasi, pemberian pelumpuh otot, perubahan setting ventilator PEEP tinggi dan evakuasi cairan. Pemberian PEEP tinggi sampai dengan 25 cmH2O dengan cara meningkatkan A/W pressure setiap 2 menit secara berkala sampai dengan 55 cmH2O tahan selama 2 menit dan diturunkan perlahan dilanjutkan dengan PCV: Pinsp 20, PEEP 15-20, FiO2 80%. serta dilakukan evakuasi cairan dengan diuretik.
Hasil: Perbaikan P/F ratio sampai 139 pada saat maneuver rekruitmen dan P/F ratio membaik sampai dengan 244 setelah 6 jam pasca maneuver selanjutnya pada hari ke-5 pasien dibebaskan dari ventilator dengan P/F ratio 313 dan Pindah perawatan pada hari perawatan ke 6
Hubungan Derajat Spondylolisthesis Dengan Nyeri Pasien Low Back Pain Rumah Sakit Ibnu Sina Makassar
Get PDFThe incidence of Low Back Pain was reviewed based on patient visits to several hospitals in Indonesia ranging from 3-17%. Low Back Pain also ranks second which is often complained by people after headaches. In the United States more than 80% of the population have complained of Low Back Pain while in Indonesia around 15 million people suffer from Low Back Pain in various hospitals in Makassar obtained 10% of patients experience Low Back Pain. This study aims to determine the relationship between the degree of spondylolisthesis with the degree of pain in patients with Low Back Pain at the Ibnu Sina Hospital in Makassar. This research uses analytic correlation design with cross sectional approach. The sample in this study were all Low Back Pain patients diagnosed as spondylolisthesis in Ibnu Sina Makassar Hospital as many as 51 people who met the inclusion and exclusion criteria. Sampling technique is total sampling, this study uses secondary data in the form of medical records. The results of the study there is a relationship between the degree of spondylolisthesis and the degree of pain in patients with Low Back Pain at the Ibnu Sina Hospital in Makassar. So it can be concluded that the degree of pain based on Visual Analog Scale which is most commonly found is the degree of pain 3 and the degree of spondylolisthesis based on Meyerding Grading which is most commonly found is spondylolisthesis grade25%Insiden Low Back Pain ditinjau berdasarkan kunjungan pasien ke beberapa rumah sakit di Indonesia berkisar 3-17% Low Back Pain juga menempati urutan kedua yang sering dikeluhkan orang setelah nyeri kepala. Di Amerika Serikat lebih dari 80% penduduk pernah mengeluhkan Low Back Pain sedangkan di Indonesia sekitar 15 juta penduduk menderita Low Back Pain di berbagai rumah sakit di Makassar diperoleh 10% pasien mengalami Low Back Pain. Penelitian ini bertujuan untuk mengetahui hubungan antara derajat spondylolisthesis dengan derajat nyeri pada pasien Low Back Pain di Rumah Sakit Ibnu Sina Makassar. Penelitian ini menggunakan desain korelasi analitik dengan pendekatan cross sectional. Sampel dalam penelitian ini adalah seluruh pasien Low Back Pain yang terdiagnosis sebagai spondylolisthesis di Rumah Sakit Ibnu Sina Makassar sebanyak 51 orang yang memenuhi kriteria inklusi dan eksklusi. Teknik sampling adalah total sampling, penelitian ini menggunakan data sekunder berupa rekam medik. Hasil penelitian terdapat hubungan antara derajat spondylolisthesis dan derajat nyeri pasien Low Back Pain di Rumah Sakit Ibnu Sina Makassar. Sehingga dapat disimpulkan bahwa derajat nyeri berdasarkan Visual Analog Scale yang paling banyak ditemukan adalah derajat nyeri 3 dan derajat spondylolisthesis berdasarkan Meyerding Grading yang paling banyak ditemukan adalah spondylolisthesis grade25
Penatalaksanaan Anestesi pada Pasien Labiognatopalatoschizis dengan Tetralogy of Fallot
Get PDFTelah dilaporkan sebuah kasus general anestesi dengan teknik GA intubasi pada operasi labioplasty pasien pediatri dengan diagnosis labiognatopalatoschizis dengan TOF pada anak umur 8 bulan. Operasi berjalan selama 1 jam dengan pemberian premedikasi sulfas atropin 0,1 mg, midazolam 0,5 mg. Preemptive analgesia diberikan Fentanyl 15 mcg, induksi dengan ketamin 15 mg, pemeliharaan durante operasi menggunakan O2 60 %, Sevoflurane 2-2,5 vol %, fentanyl 4 mcg/jam/sp. Teknik anestesi dengan General Anesthesia Intubasi, ETT ID no. 3 mm. Target manajemen anestesi pada TOF untuk mencegah shunt dari kanan ke kiri yang dipengaruhi oleh, 1. Penurunan resistensi vaskuler sistemik, 2. peningkatan vaskuler paru, 3. peningkatan kontraktilitas jantung, dapat tercapai sehingga selama operasi hemodinamik stabil. Postoperasi pasien tampak tenang dan tidak kesakitan. Selama 1 Jam di ruang pulih (recovery room) dengan hemodinamik stabil dan saturasi 97-99