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Translokasi Alat Kontrasepsi Dalam Rahim ke Kandung Kemih: Sebuah Laporan Kasus
No full textLatar Belakang: Alat Kontrasepsi Dalam Rahim (AKDR) merupakan metode kontrasepsi reversibel yang paling banyak digunakan secara global. Meskipun efektif, metode ini memiliki risiko komplikasi serius seperti perforasi uterus dan migrasi alat ke organ di rongga panggul. Perforasi yang berujung pada migrasi AKDR ke dalam kandung kemih (intravesikal) merupakan fenomena yang sangat jarang terjadi dan dokumentasi kasus serupa dalam literatur medis masih sangat terbatas.
Deskripsi Kasus: Kami melaporkan kasus translokasi AKDR ke vesika urinaria pada seorang perempuan berusia 40-an tahun dengan keluhan Infeksi Saluran Kemih (ISK) berulang selama satu tahun. Pasien memiliki riwayat pemasangan AKDR empat tahun pasca persalinan anak ketiga, namun mengalami kehamilan anak keempat satu tahun kemudian dengan posisi AKDR yang tetap terpasang (in situ). Pemeriksaan ultrasonografi urologi awal mengidentifikasi adanya batu kandung kemih. Konfirmasi diagnosis dilakukan melalui foto polos abdomen yang memvisualisasikan keberadaan AKDR ektopik. Tata laksana dilakukan melalui prosedur minimal invasif berupa sistoskopi dan vesikolitotripsi untuk ekstraksi alat serta fragmentasi batu.
Simpulan: Kasus ini menekankan pentingnya kewaspadaan klinis terhadap kemungkinan translokasi AKDR pada pasien dengan riwayat kehamilan saat penggunaan kontrasepsi yang disertai gejala ISK berulang. Pemeriksaan radiografi polos merupakan modalitas penunjang yang efektif untuk lokalisasi benda asing, dan intervensi endoskopi seperti sistoskopi dan vesikolitotripsi terbukti efektif sebagai metode manajemen terapeutik.
Kata kunci: translokasi AKDR; kandung kemih; infeksi saluran kemih berulang; sistoskopi; vesikolitotripsi; benda asing intravesikal
Diagnosis dan Tatalaksana Demam Tifoid pada Pasien Lansia dengan Komorbiditas Hipertensi dan Diabetes Melitus Tipe 2: Sebuah Laporan Kasus
No full textDiagnosis dan Tatalaksana Demam Tifoid pada Pasien Lansia disertai Hipertensi dan Diabetes Melitus Tipe 2
Background: Typhoid fever is a systemic infectious disease that remains prevalent in developing countries, including Indonesia. In elderly patients with comorbidities such as hypertension and type 2 diabetes mellitus, typhoid fever may present with atypical clinical manifestations and an increased risk of complications, requiring accurate diagnosis and comprehensive management.
Objective: This paper aims to describe the diagnosis and management of typhoid fever in an elderly patient with concomitant hypertension and type 2 diabetes mellitus.
Methods: This study is presented as a case report. Data were collected through history taking, physical examination, laboratory investigations, and evaluation of the management provided during the patient’s hospitalization.
Results: The elderly patient exhibited atypical clinical features of typhoid fever, supported by positive serological findings. The patient received appropriate antibiotic therapy according to current guidelines, along with optimal management of hypertension and type 2 diabetes mellitus, resulting in clinical improvement during treatment.
Conclusion: The diagnosis of typhoid fever in elderly patients with comorbid hypertension and type 2 diabetes mellitus requires a high index of clinical suspicion. Appropriate and integrated management of both the infection and comorbid conditions can lead to favorable clinical outcomes.
Keywords: Typhoid fever; Elderly; Hypertension; Type 2 diabetes mellitus; Management
Latar Belakang: Demam tifoid merupakan penyakit infeksi sistemik yang masih menjadi masalah kesehatan endemik di negara berkembang, termasuk Indonesia. Pada populasi pasien lanjut usia (lansia) dengan komorbiditas seperti hipertensi dan diabetes melitus tipe 2, penyakit ini sering kali bermanifestasi dengan gejala klinis yang atipikal serta memiliki risiko komplikasi yang lebih tinggi. Kondisi ini menuntut ketajaman diagnosis dan pendekatan tata laksana yang komprehensif.
Deskripsi Kasus: Kami melaporkan kasus seorang pasien lansia yang menunjukkan gambaran klinis demam tifoid yang tidak khas. Penegakan diagnosis dilakukan melalui anamnesis mendalam, pemeriksaan fisik, serta dikonfirmasi dengan temuan serologis positif. Pasien mendapatkan terapi antibiotik yang sesuai dengan pedoman terkini, bersamaan dengan manajemen optimal untuk mengontrol hipertensi dan diabetes melitus tipe 2 yang dideritanya. Evaluasi selama perawatan menunjukkan adanya perbaikan klinis yang signifikan.
Simpulan: Penegakan diagnosis demam tifoid pada pasien lansia dengan multipatologi memerlukan indeks kecurigaan klinis yang tinggi mengingat manifestasinya yang sering tersamar. Tata laksana yang tepat dan terintegrasi antara penanganan infeksi akut serta kontrol kondisi komorbid terbukti mampu menghasilkan luaran klinis yang baik.
Kata kunci: demam tifoid; lansia; hipertensi; diabetes melitus tipe 2; tata laksana terintegrasi
National energy governance in the implementation of energy intensity, carbon emissions, and general energy fuel
No full textThis study aims to provide an understanding of national energy governance in the implementation of energy intensity, carbon emissions, and general energy fuel (coal and oil and gas minerals) in Indonesia. This study analyzes national energy governance in the implementation of energy intensity, carbon emissions, and general energy fuel (coal and oil and gas minerals). The study was conducted using a qualitative descriptive research approach, focusing on transportation modes, in this case, as they generate carbon emissions during movement.The study results indicate that the implementation of carbon emissions generated by transportation modes has a reciprocal impact on national energy governance in the implementation of energy intensity, carbon emissions, and general energy fuel (coal and oil and gas minerals) in Indonesia.Estimated CO2 emissions from transportation modes. Estimated CO2 emissions for a trip from Yogyakarta to Jakarta: by train, 7.43 kg CO2 is produced, by car, 27.12 kg CO2 is produced, and by airplane, 65.17 kg CO2 is produced. These carbon emissions results indicate that the lowest is the train mode. Transportation carbon emissions originate from general energy fuel sources (coal and oil and gas), specifically from the combustion of fuels (gasoline, diesel, aviation fuel). The relative energy intensity of cars compared to trains is about ≈ 3.6 times and the relative energy intensity of airplanes compared to trains is about ≈7.9 times. The relative carbon emission of cars compared to trains is about ≈ 3.6 × and the relative carbon emission of airplanes compared to trains is about ≈ 8.7 ×These fuel sources are still entirely dependent on the oil and gas sector. Every increase in mobility means an increase in demand for petroleum. This demonstrates the need for energy governance policies that integrate the transportation and upstream mining sectors. The implementation of transportation modes in producing carbon emissions is inseparable from the use of energy intensity. The dynamics of energy intensity are directly proportional to the type of fuel and the efficiency of the engine system
Analysis of income tax management article 23 and income tax article 4 paragraph 2 implementation in 2024: a case study of CV Aman Jaya
No full textIncome tax is a type of tax that has an important role in tax revenue in Indonesia. Several types of income tax are Income Tax Article 23 and Income Tax Article 4 Paragraph 2. This study aims to analyze the management of Article 23 Income Tax and Article 4 Paragraph 2 Income Tax on CV Aman Jaya. The management includes tax calculation, payment, and reporting. Income Tax Article 23 is imposed on the payment of consultant services at a rate of 2%, while Income Tax Article 4 Paragraph 2 is imposed on land and/or building leases at a rate of 10%. This research uses a qualitative method. The data taken for this study uses secondary data obtained from documents on a client company that uses consulting services at the Berkah Selalu Tax Consultant. Secondary data in this study is in the form of proof of payment of Income Tax Article 23 and Income Tax Return Article 23 as well as proof of payment of Income Tax Article 4 Paragraph 2 and Income Tax Return Article 4 Paragraph 2. The results of this study explain that the management of Article 23 Income Tax and Article 4 Paragraph 2 Income Tax from calculation, payment to reporting on CV Aman Jaya is in accordance with applicable tax provisions
Evaluasi dampak risiko perubahan iklim terhadap volatilitas pasar saham: Peran moderasi risiko ESG
No full textPurpose – This study aims to evaluate the impact of climate change risk on stock market volatility, with ESG risk serving as a moderating variable.Methods – The sample is selected using purposive sampling and consists of firms listed in the IDX ESG Leaders index during the period 2019–2024. The analysis employs a dynamic panel regression approach using the System Generalized Method of Moments.Findings – The results indicate that climate change risk has a negative effect on stock market volatility. ESG risk has a positive and significant effect on stock market volatility. Furthermore, the moderating analysis shows that ESG risk significantly moderates the relationship between climate change risk and stock market volatility.Implication – Theoretically, this study highlights the importance of adopting a dynamic approach and clearly distinguishing between ESG performance and ESG risk in analyzing stock market volatility. In practice, the findings suggest that ESG risk is a source of market uncertainty; therefore, investors, firms, and regulators should integrate ESG risk management and enhance the quality of climate risk disclosure to reduce stock market volatility.Originality – This study uses Natural Language Processing to measure climate change risk and the application of a dynamic panel data approach to analyze the effect of climate change risk on stock market volatility with ESG risk as a moderating variable.
AbstrakTujuan – Penelitian ini bertujuan untuk mengevaluasi dampak risiko perubahan iklim terhadap volatilitas pasar saham: peran moderasi risiko ESG. Metode – Sampel pada penelitian ini diambil dengan metode purposive sampling. Penelitian ini menggunakan regresi data panel dinamis Sys GMM yang terdiri dari perusahaan yang terdaftar di IDX ESG Leaders selama periode 2019-2024. Temuan – Hasil penelitian menunjukkan bahwa risiko perubahan iklim berpengaruh negatif terhadap volatilitas pasar saham. ESG risk berpengaruh positif dan signifikan terhadap volatilitas pasar saham. Variabel moderasi menunjukkan bahwa ESG risk secara signifikan memoderasi hubungan antara risiko perubahan iklim dan volatilitas pasar saham. Implikasi – Secara teoretis, penelitian ini menegaskan pentingnya pendekatan dinamis dan pembedaan yang jelas antara kinerja kinerja ESG dan risiko ESG dalam analisis volatilitas pasar saham. Secara praktis, temuan ini menunjukkan bahwa ESG Risk merupakan sumber ketidakpastian, sehingga investor, perusahaan, dan regulator perlu mengintegrasikan pengelolaan risiko ESG dan peningkatan kualitas pengungkapan risiko perubahan iklim untuk menekan volatilitas pasar. Orisinalitas – Penelitian ini menggunakan Natural Language Processing untuk mengukur climate change risk serta penerapan data panel dinamis dalam menganalisis pengaruh climate change risk terhadap volatilitas pasar saham dengan ESG risk sebagai variabel moderasi
Pengelompokan Kabupaten/Kota di Provinsi Jawa Tengah Berdasarkan Indikator Pendidikan Menggunakan K-Medoids: Pengelompokan Kabupaten/Kota di Provinsi Jawa Tengah Berdasarkan Indikator Pendidikan Menggunakan K-Medoids
No full textPendidikan berperan penting dalam meningkatkan kualitas sumber daya manusia dan daya saing bangsa, sejalan dengan Tujuan Pembangunan Berkelanjutan (SDGs) poin 4 serta visi Indonesia Emas 2045. Namun, Jawa Tengah masih menghadapi tantangan besar, terutama karena memiliki tingkat penyelesaian pendidikan jenjang SMA terendah di Pulau Jawa. Penelitian ini bertujuan mengelompokkan dan menggambarkan kabupaten/kota di Jawa Tengah berdasarkan indikator pendidikan, yaitu Rata-Rata Lama Sekolah (RLS), Angka Partisipasi Sekolah (APS), Angka Partisipasi Kasar (APK), dan Angka Partisipasi Murni (APM), dengan menggunakan metode K-Medoids Clustering. Data sekunder tahun 2023 dari BPS dianalisis secara deskriptif, diuji multikolinearitas menggunakan Variance Inflation Factor (VIF), serta ditentukan jumlah klaster optimal menggunakan metode Elbow. Hasil menunjukkan bahwa APK memiliki nilai rata-rata tertinggi (89,51%) dan RLS terendah (minimum 6,4 tahun), serta tidak ditemukan multikolinearitas antar variabel. Metode Elbow mengidentifikasi tiga klaster optimal, yaitu klaster pertama (14 kabupaten/kota) dengan indikator "sedang", klaster kedua (9 kabupaten/kota) dengan indikator "rendah", dan klaster ketiga (12 kabupaten/kota) dengan indikator "tinggi", yang kemudian divisualisasikan secara spasial menggunakan QGIS. Hasil pengelompokan ini diharapkan menjadi dasar dalam penyusunan kebijakan pendidikan yang lebih inklusif dan tepat sasaran di Jawa Tengah, guna mendukung pencapaian SDGs dan visi Indonesia Emas 2045
Perlindungan Hukum bagi Pengemudi Gocar atas Pesanan Semu oleh Penumpang
Full text linkThis research examines the legal protection provided for Gocar drivers against fake orders made by passengers and to identify possible legal remedies when losses occur. The main issues examined are the effectiveness of legal rules and partnership agreements in ensuring certainty and justice for drivers. The research employs a normative juridical method using statutory, contractual, and case study approaches, with data collected through literature review and analyzed qualitatively. The findings reveal that legal protection is actually regulated under the Indonesian Civil Code, the Consumer Protection Law, and the partnership agreement with PT Gojek Indonesia. However, in practice, such protection has not been effective since fake orders remain widespread, passengers often act in bad faith, and compensation mechanisms provided by PT Gojek are inadequate, leaving drivers to bear most of the losses. Steps that can be taken include settlement through PT Gojek’s internal system, dispute resolution via the Consumer Dispute Settlement Agency (BPSK), and civil lawsuits based on unlawful acts. The study concludes that existing legal protection remains weak, thus strengthening company policies and improving access to dispute resolution mechanisms are necessary to ensure more effective protection of drivers’ rights
Kontaminasi Gas CO di Terminal Jombor Yogyakarta: Indonesia
No full textThe risk of air pollution originating from the transportation sector constitutes a primary concern in this study. Terminal Jombor Yogyakarta, a Type B public transportation terminal with high vehicular activity serving Intercity–Interprovincial (AKAP), Intercity–Intraprovinical (AKDP), and Trans Jogja routes, has the potential to contribute significantly to ambient air pollution due to vehicle emissions.
This study focuses on identifying carbon monoxide (CO) concentrations and analyzing the spatial distribution of CO levels within the Terminal Jombor area. A quantitative approach was employed through direct observation and measurements at three monitoring points. The results indicate that the highest CO concentration was recorded at Point 1 on the third day of observation (weekday), reaching 10,883.2 µg/Nm³, exceeding the ambient air quality standard of 10,000 µg/Nm³. Meanwhile, the highest average CO concentration was observed at Point 3, with a value of 2,446 µg/Nm³. This point is located near the terminal exit area, where vehicles tend to idle before accelerating, thereby increasing CO emissions. Furthermore, CO concentrations on weekdays were found to be higher than those recorded on weekends. Spatial distribution analysis revealed that Points 2 and 3 fall into the moderate to high concentration categories. These findings indicate the need for intervention by relevant authorities to mitigate potential health impacts associated with carbon monoxide exposure in the Terminal Jombor area.Risiko pencemaran udara dari sektor transportasi menjadi perhatian utama dalam kajian ini. Terminal Jombor Yogyakarta, sebagai fasilitas umum tipe B dengan tingkat aktivitas kendaraan yang tinggi, melayani jalur Antar Kota-Antar Provinsi (AKAP), Antar Kota Dalam Provinsi (AKDP) serta Trans Jogja. Kondisi tersebut berpotensi meningkatkan pencemaran udara ambien akibat emisi kendaraan. Kajian ini berfokus pada identifikasi konsentrasi karbon monoksida (CO) dan analisis sebaran konsentrasi yang dihasilkan pada area Terminal Jombor. Pendekatan yang digunakan bersifat kuantitatif dengan observasi dan pengukuran langsung pada tiga titik pengamatan. Hasil menunjukkan bahwa konsentrasi CO tertinggi terdeteksi pada Titik 1 di hari ketiga pengamatan (hari kerja) yaitu sebesar 10.883,2 µg/Nm³, melebihi ambang batas kualitas udara ambien sebesar 10.000 µg/Nm³. Sementara itu, konsentrasi rata-rata CO tertinggi tercatat di Titik 3 sebesar 2.446 µg/Nm³. Titik ini berada di area dekat pintu keluar terminal, di mana kendaraan cenderung berhenti dalam kondisi idle sebelum akhirnya berakselerasi keluar, yang menyebabkan peningkatan emisi CO. Selain itu, konsentrasi CO pada hari kerja (weekdays) tercatat lebih tinggi dibandingkan akhir pekan (weekend). Distribusi spasial menunjukkan bahwa Titik 2 dan Titik 3 tergolong dalam kategori konsentrasi sedang hingga tinggi. Temuan ini mengindikasikan perlunya intervensi dari pihak terkait guna menekan potensi dampak kesehatan akibat paparan karbon monoksida di kawasan Terminal Jombor
Analysis of Building Orientation and Window to Wall Ratio (WWR) Influence on Indoor Air Temperature Case Study FMIPA and FIAI Buildings, Universitas Islam Indonesia
Full text linkBuilding orientation and the window-to-wall ratio (WWR) are two critical factors affecting thermal comfort in educational buildings located in tropical climates. This study aims to examine how orientation and variations in WWR influence indoor air temperature through case studies of the FMIPA and FIAI buildings at Universitas Islam Indonesia. Simulations were conducted using Computational Fluid Dynamics (CFD) to assess airflow and temperature distribution across different orientation and WWR scenarios. The results reveal that a north–south orientation yields a more stable temperature distribution, while a 40% WWR is optimal for balancing daylight and heat gain. The findings underscore the importance of passive design strategies in enhancing energy efficiency and thermal comfort in tropical educational facilities. Keywords: Building Orientation, Indoor Air Temperature, Thermal Comfort, Window-to-Wall Ratio (WWR), Educational Building
Religious Autonomy and the Existential Process of Agency: A Comparative Analysis of the Foundations of Women’s Moral Agency in Kant’s Philosophy and Shi’i Islam
No full textThis study conducts a comparative analysis of women’s moral agency within two intellectual frameworks: Kant’s practical philosophy and Shi’i Islam. The central research question is: How is the structure of women’s moral agency formulated in these systems, and how does each address the gap between inner subjectivity and the external actualization of agency? In the Kantian section, employing conceptual analysis, the contradiction between the transcendental autonomous subject and the empirical subject of woman characterized by deficient rationality is analyzed as the primary obstacle to the objective realization of women’s agency. In the Shi’i Islamic section, drawing on Quranic foundations such as fiṭrah (primordial nature) and khilāfah (vicegerency), and mediated by the views of Mullā Ṣadrā on substantial motion, Ṭabāṭabāʾī on credal perceptions, and Muṭahharī on psycho-emotional differences, a model of “situated agency” is presented. In this model, women’s psycho-physical differences are regarded not as deficiencies, but as existential gradations and a basis for the wise distribution of responsibilities. The legal institutions of Shi’i Islam, including mahr, nafaqah, and independent property rights, function as structural supports for agency, facilitating the transition from inner subjectivity to external actualization. The novelty of this research lies in its formulation of “religious autonomy” in contrast to Kantian autonomy