Majalah Kedokteran Andalas
Not a member yet
648 research outputs found
Sort by
PERBEDAAN PENGARUH DIET TINGGI MINYAK SAWIT SEGAR DENGAN MINYAK JELANTAH TERHADAP LEMAK DAN TNF- α DARAH TIKUS
Get PDFAbstrakMasyarakat akhir-akhir ini cenderung memilih minyak sawit sebagai bahan penggoreng, hal ini mungkin karena harganya lebih murah dan mudah didapat dibandingkan minyak lain. Pemakain MS oleh masyarakat biasanya untuk bahan penggoreng bahan makanan. Minyak sawit mengandung asam lemak jenuh dan asam lemak tidak jenuh yang hampir seimbang, asam lemak jenuh meningkatkan lemak darah dan asam lemak tidak jenuh dikatakan dapat menurunkan lemak darah. Asam lemak tidak jenuh disisi lain mudah dioksidasi dengan pemanasan. Penelitian ini bertujuan melihat perbedaan pengaruh diet tinggi minyak sawit segar dan jelantah minyak sawit terhadap lemak darah dan TNF-α.Sudah dilakukan pemberian diet tinggi minyak sawit (50%) pada tikus Wistar selama 8 minggu secara adlibitum. Pengukuran kadar kolesterol total, HDL-kol dan trigliserida melalui serum darah dengan alat spectrophotometer dan pemeriksaan TNF-α darah dengan cara ELISA.Hasil penelitian menunjukkan terdapat peninggian kadar lemak (trigliserida dan kolesterol total) dan TNF-α darah bermakna (p<0,05) pada tikus diet tinggi minyak sawit segar ataupun minyak jelantah bila dibandingkan dengan kontrol namun peninggian lemak dan TNF-α oleh minyak jelantah lebih tinggi bermakna bila dibandingkan dengan minyak sawit segar. Kadar kolesterol darah tikus DMS lebih rendah dari kelompok kontrol positif.Kesimpulan; diet tinggi minyak sawit segar dan minyak jelantah pada tikus dapat meningkatkan kadar kolesterol total, trigliserida dan TNF-α secara bermakna dibandingkan kontrol, sedangkan peningkatan oleh minyak jelantah lebih tinggi bermakna dari minyak sawit segar.Kata kunci : diet tinggi minyak sawit, lemak darah, TNF-αAbstractSociety these days tend to prefer palm oil as raw roaster, this is probably because the price is cheap and easily available than other oils. MS usage by the community generally to material food fryer. Palm oil contains saturated fatty acids and unsaturated fatty acids are nearly balanced, saturated fatty acids increase blood fats and unsaturated fatty acid is said to lower blood fats. Unsaturated fatty acids on the other hand easily oxidized by heating. This study aims to look atARTIKEL PENELITIAN71differences in the influence of a diet high in fresh palm oil and palm oil used cooking oil on blood lipid and TNF-α. Already done giving a diet high in palm oil (50%) in Wistar rats for 8 weeks in adlibitum. Measurement of total cholesterol, HDL-Chol and triglycerides through the blood serum with a spectrophotometer and checking blood TNF-α by ELISA. The results showed there were elevated levels of fats (triglycerides and total cholesterol) and blood TNF-α significantly (p <0.05) in mice a diet high in fresh palm oil or used cooking oil when compared with controls but the elevation of fat and TNF-α by used cooking oil significantly higher when compared with fresh palm oil. DMS rat blood cholesterol levels lower than the positive control group. Conclusion: a diet high in fresh palm oil and used cooking oil in rats can increase total cholesterol, triglycerides and TNF-α significantly compared to controls, whereas the used cooking oil increased by significantly higher than fresh palm oil.Key words : high diet palm oil, blood lipid, TNF-Î
PENDEKATAN PSIKONEUROIMUNOLOGI
Get PDFAbstrakPsikoneuroimunologi merupakan konsep terintegrasi mengenai fungsi regulasi-imun untuk mempertahankan homeostasis. Untuk mempertahankan homeostasis, sistem imun berintegrasi dengan proses psikofisiologik otak, dan karena itu mempengaruhi dan dipengaruhi otak. Melalui pendekatan ini telah mulai dipahami mekanisme interaksi antara perilaku, sistem saraf, sistem endokrin, dan fungsi imun. Komponen perilaku dari interaksi ini melibatkan kondisioning Pavlov pada peningkatan maupun penekanan antibodi dan respon imun seluler. Kondisioning ini berekspresi sebagai efek pengalaman stress terhadap fungsi imun. Selanjutnya diketahui bahwa mekanisme terintegrasi ini berlangsung dalam ritme yang berkaitan dengan ritme lingkungan seperti ritme Sirkadian. Respon stress berkelanjutan berekspresi sebagai sindroma adaptasi umum. Sebagai respon akut dimulai dengan initial brief alarm reaction. Dalam tahap ini peningkatan sekresi cortisol pada aksis Hypothalamic-Pituitary-Adrenal (HPA) menimbulkan supresi pada sebagian besar fungsi imun dan peningkatan aktifitas sistem simpatis. Bila stress tidak dapat diatasi secara efektif, tahap kedua prolonged resistance period akan dimulai, dimana aktivasi aksis HPA akan menurun tetapi tidak pernah mencapai kondisi basal. Kegagalan berkelanjutan untuk mengatasi stress akan berakhir pada terminal stage of exhaustion and death. Aplikasi medis psikoneuroimunologi akan meningkatkan efektifitas terapi penyakit keganasan, gangguan kardiovaskular, penyakit infeksi, trauma fisik, transplantasi, dan gangguan jiwa.Kata kunci: aksis HPA, antibodi, aplikasi medis, cortisol, homeostasis, melawan atau lari, otak, Pavlov, perilaku, psikofisiologik, psikoneuroimunologi, sindroma adaptasi umum, sistem imun, sistem LS-NA, respon stress, ritme SirkadianAbstractPsychoneuroimmunology is an integrated concept of immune-regulatory function. To maintain homeostasis, the immune system is integrated with psychophysiological processes of the brain, and is therefore influenced by and capable of influencing the brain. Mechanism of interaction among behavior, neural, endocrine, and immune functions in adaptation to environmental stressors have come to light. The behavioral components of this interaction involve the Pavlov conditioning both in the enhancement and supression of antibody-and cell-mediated immune responses. This conditioning expressed as effects of stressful experiences on immune function. This integrated mechanism operated in a rhythmTINJAUAN PUSTAKA91related to environmental rhythm such as Circadian rhythm. Prolonged stress response will be expressed as general adaptation syndrome. As an acute response it will begin with initial brief alarm reaction. In this stage increased cortisol secretion in Hypothalamic-pituitary-adrenal (HPA) axis resulted in supression of main immune function and arousal of sympathetic system If the stress can not be coped effectivelly, a second stage of prolonged resistance period will begin, in which HPA axis activation will be decreased but never reach the basal condition. Continued failure to cope with the stress will end in terminal stage of exhaustion and death.Medical application of psychoimmunology can enchance the effectivity of the treatment of malignancy, cardiovascular disorder, infectious diseases, physical trauma, transplantation, and mental disorder.Key word : antibody, behavioral, brain, Circadian rhythm, cortisol, fight or flight, general adaptation syndrome, homeostasis, HPA axis, immune system, LC-NA system, medical application, Pavlov, psychoneuroimmunology, psychophysiological, stress response
PROFIL LEUKOKORIA PADA ANAK DI RSUP Dr. M. DJAMIL PADANG
Get PDFAbstrakTujuan penelitian ini ialah menilai penyebab leukokoria pada pasien anak di RSUP Dr. M. Djamil Padang dengan rancang studi cross sectional. Data dikumpulkan dari medical record pasien dengan riwayat leukokoria atau pupil putih yang berusia kurang dari 13 tahun di bagian mata RSUP Dr M Djamil Padang periode Oktober 2009 Februari 2011. Diagnosis banding disingkirkan melalui pemeriksaan USG dan patologi. Dari 36 pasien dengan leukokoria, 21 orang (58,3%) laki-laki dan umur rata-rata 31,3 bulan. Penyebab leukokoria adalah retinoblastoma 12 pasien (33,4%), tiga diantaranya bilateral, katarak kongenital 11 pasien (30,5%), delapan diantaranya bilateral, katarak traumatika 5 pasien (13,8%), uveitis intra uterin 2 pasien (5,5%), keduanya bilateral, dan ROP 2 pasien (5,5%), satu diantaranya bilateral. Kami juga menemukan penyebab lain, masing-masing satu pasien dengan leukokoria unilateral, antara lain: PHPV (2,7%), endoftalmitis eksogen (2,7%), uveitis anterior (2,7%), dan glioma nervus optikus (2,7%). Sangat krusial mengetahui perbedaan gambaran klinik retinoblastoma dan katarak kongenital, karena pengobatannya berbeda, dan retinoblastoma mengancam kehidupan, sedangkan katarak kongenital mengancam penglihatan.AbstractThe objective of this study was to determine the etiology of leukocoria in children using cross sectional study conducted in eye clinic of Dr. M. Djamil Hospital Padang. Samples were taken from medical records of patients with children leukocoria during the period of October 2009 to February 2011. Differential diagnosis eliminated by USG and pathology examination. There were 36 children with leukocoria in total, 21 of them were boys (58,3%). The mean age was 31.3 months old. The causes of leukocoria were retinoblastoma in 12 patients (33,4%) three of them were bilateral, followed respectively by congenital cataract in 11 patients (30.5%) which 8 of them were bilateral, traumatic cataract in 5 patients (13.8%), intrauterine uveitis in 2 patients (5,5%) both were bilateral, and ROP in 2 patients (5,5%) which one of them was bilateral. We also found one patient each with unilateral leukocoria for following causes: PHPV (2.7%), exogen endophthalmitis (2.7%), anterior uveitis (2,7%), and optic nerve glioma (2.7%). Thus, awareness and clinical knowledge to differentiate retinoblastoma and congenital cataract are crucial for appropriate treatment, since retinoblastoma can cost patient’s life while congenital cataract can threat sight condition
HUBUNGAN DURASI PEMBERIAN ASI DENGAN KEJADIAN BERAT BADAN LEBIH PADA ANAK TAMAN KANAK-KANAK
Get PDFAbstrakTujuan penelitian ini adalah untuk mengetahui hubungan antara durasi pemberian ASIdengan kejadian berat badan lebih pada anak Taman Kanak-kanak (TK) dengan mengontrolcovariat (ASI eksklusif, jenis kelamin, berat badan lahir, urutan kelahiran, berat badan ibu,pendidikan ibu, pekerjaan ibu, pendapatan keluarga dan pola konsumsi makanan). Penelitianini menggunakan desain kasus kontrol. Kasus adalah anak TK yang termasuk dalam kategorigemuk dan kontrol adalah anak TK yang termasuk dalam kategori normal berdasarkan indeksBB/TB. Jumlah sampel dalam penelitian ini sebanyak 366 (kasus 101 dan kontrol 265). Datadianalisis dengan analisis uji regresi logistik ganda. Hasil penelitian menunjukkan adanyahubungan antara durasi pemberian ASI dengan kejadian berat badan lebih. Anak yang diberiASI dengan durasi > 6-12 bulan memiliki risiko 0,54 kali (95% CI: 0,30 - 0,98) dan > 12 bulanmemiliki risiko 0,31 kali (95% CI: 0,16-0,58) untuk terjadinya berat badan lebih dibanding anakyang mendapatkan durasi ASI ≤ 6 bulan (faktor protektif) setelah dikontrol oleh ASI eksklusif,berat badan ibu, dan jenis kelamin. Pemberian ASI merupakan salah satu upaya pencegahansecara dini berat badan lebih dan obesitas pada anak untuk menghindari masalah kesehatanpada usia kehidupan selanjutnya.AbstractThis studi determined the relationship between duration of breastfeeding and theoccurrence of obesity in kindergarten student by controlling covariat (exclusive breastfeeding,sex, birth weight, birth order, maternal weight, maternal education, maternal occupation, familyincome and food consumption patterns). This research had a case control design. The caseswere kindergarten children undercategory overweight and the controls were kindergartenchildren undernormal category based on weight / height index. There were 366 samples (101cases and 265 control). Data was analyzed by logistic regression test. The result showed thatthere was a relationship between duration of breastfeeding and the occurrence of obesity.Children who were breastfed for the duration of >6-12 months had a risk of 0,54 times (95%CI: 0,30-0,98) and breastfed for >12 months had a risk of 0,31 times (95% CI: 0,16-0,58) to beobese than children who were breastfed ≤6 months (protective factor) after being controlled byexclusive breastfeeding, maternal weight and sex. Breastfeeding is one of the efforts to earlyprevent overweight and obesity in children in order to avoid health problems at the later age
FRAKTUR PENIS DENGAN RUPTUR CORPUS CAVERNOSUM DEXTRA TANPA DISRUPSI URETRA
Get PDFAbstrakFraktur penis merupakan kegawatdaruratan urologi yang jarang dan sebagian besarterjadi pada trauma tumpul pada penis yang mengalami ereksi. Fraktur penis sering terjadipada saat hubungan seksual dan jarang terjadi pada trauma tumpul karena benturan. Traumamenyebabkan robekan dan rembesan darah pada tunika albuginea. Intervensi bedah dapatmemberikan hasil penyembuhan yang baik secara fungsional dan kosmetik. Dilaporkankasus pada laki-laki usia 22 tahun yang datang dengan riwayat nyeri dan bengkak pada penissetelah benturan pada stang motor saat kecelakaan lalu lintas satu jam sebelum masuk rumahsakit. Pemeriksaan fisik didapatkan bengkak, hematoma pada batang penis, deformitasberupa angulasi ke kiri disertai nyeri tekan. Pasien masih bisa buang air kecil. Hasil urinalisisdidapatkan eritrosit 60-70/LPB, sedangkan darah rutin dalam batas normal. Kami memutuskanmelakukan eksplorasi, tampak rupture pada corpus cavernosum dan diperbaiki dengan jahitanprimer pada corpus cavernosum yang robek. Pasien dirawat selama 3 hari dan pulang denganfoley-catheter terpasang. Kasus pasien ini adalah salah satu contoh kasus dari fraktur peniskarena trauma tumpul penis secara langsung yang bukan disebabkan karena hubunganseksual.AbstractPenile fracture is a rare urological emergency that occurs almost exclusively due to blunttrauma on erect penis. Penile fracture often occurs during sexual intercourse and is rare in blunttrauma from impact. Trauma caused rupture and hematoma of tunica albuginea. Early surgicalintervention gives good cosmetic and functional outcome. We report the case of 22 -year-oldmale who presented to the emergency department 1 hour following blunt injury of his penisafter traffic accident. In physical examination we found swelling and haematom of penile shaft,angulation to the left and tenderness. Mixturation was normal. There were 60-70 eritrocytes inroutinely urinary examination. There were no abnormality in routinely blood examination. Weperformed an exploration and found rupture at corpus cavernosum. The rupture was repairedwith primary suture. The patient was hospitalized for 3 days and discharged with folley catheterinserted. This patient was an example of penile fracture caused by direct blunt trauma outsidesexual intercourse which is a rare case
DIAGNOSIS DAN TATALAKSANA HEPATOPULMONARY SYNDROME
Get PDFAbstrakSirosis hepatis dan penyakit hati kronik merupakan penyebab kematian terbanyak di seluruh dunia. Tingginya angka morbiditas dan mortalitas sirosis berhubungan dengan komplikasinya yang bersifat sistemik. Salah satu komplikasi sirosis dapat mengenai paru berupa sindrom hepatopulmonar atau hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) didefinisikan sebagai trias yang terdiri dari kegagalan hati stadium lanjut, hipoksemia arterial serta dilatasi intravaskular pulmonar tanpa disertai penyakit kardiopulmonar. Patogenesis HPS masih belum diketahui pasti, namun diduga terjadi gangguan metabolisme zat vasoaktif paru yang menimbulkan vasodilatasi vaskuler paru. Manifestasi klinis HPS berupa dispneu yang khas dengan tanda kegagalan hati dan hipertensi portal. Modalitas diagnostik HPS adalah radiologi thorax, analisa gas darah, contrast enhanced echocardiography (CEE), nuclear scanning dengan Tc-99m dan angiografi paru. Penatalaksanaan HPS terutama bertujuan menurunkan vasodilatasi intrapulmonar, meningkatkan oksigenasi arterial dan mengurangi keluhan. Deteksi dini terhadap komplikasi sirosis mutlak diperlukan dalam mencegah dan mengurangi angka morbiditas dan mortalitas.Abstract Liver cirrhosis and chronic liver disease are the leading cause of death worldwide. The high morbidity and mortality associated with their systemic complications. One of the complications of cirrhosis is hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) is defined as the triad of advanced-stage liver failure, arterial hypoxemia and pulmonary intravascular dilatation without cardiopulmonary disease. The pathogenesis of HPS is still not known for sure, but suspected metabolic disorder pulmonary vasoactive substances that cause pulmonary vascular vasodilatation. The clinical manifestations of HPS is typical dispneu with signs of liver failure and portal hypertension. HPS diagnostic modalities are radiology thorax, blood gas analysis, contrast enhanced echocardiography (CEE), nuclear scanning with Tc-99m and pulmonary angiography. HPS management aims primarily to lower intrapulmonar vasodilation, improving arterial oxygenation and reduce complaints. Early detection of complications of cirrhosis is absolutely necessary in preventing and reducing morbidity and mortality
THE ASIA PACIFIC BIOETHICS PROGRAM OF THE UNESCO CHAIR IN BIOETHICSCAN RESEARCH IN DEVELOPING COUNTRIES BE BOTH ETHICAL AND BENEFICIAL TO LOGAL COMMUNITY ?
Get PDFAbstractln 2005 at the 33rd Session of General Conference at UNESCO, it adapted the Universaldeclaration on Bioethics and Human Rights. Declaration article 1.1 outlines the principals thatrespond to ethical issue related to medicine, life sciences and associated technologies as appliedto human beings. Thus the international standards for Bioethics are grounded in a language ofrights -to safe guard human dignity and human rights. UNESCO made ethics of Science andtechnology one of its 5 priority areas. lt is charged with promoting the education of ethical issuesof Science and Technology. The UNESCO Program in this area aims to strengthen lhe ethicallink between scientific advancement that is taking place and the Cultural, Legal, Philosophicaland religious context in which it occurs.The disparity of health amongst the world's communitiesis largely determined by the wealth of the countries. Developed countries have access to cleanwaters, vaccines and new medical technologies whereas developing countries do not.Researches in these countries are also funded by the wealthy countries and we will need toprotect these countries from exploitation by those with the means in the name of clinicalresearch.Hence, we have to discuss the necessary conditions for models allowing lnstitutionalReview Boards to grani exceptions in low income countries to circumvent the need for "WorldBest Practices" in their research requirements. There are commentators arguing that "World'sBest Practiees sheuld always be used in ali countries, but financial burden in the developingcouniries prevents this. A total ban cn any research other than the world's best practice wouldprevent exploitation, but this may block important research that can improve health care in thesecountries. So is it possibie to address the potentiai for exploitation while allowing research thathas the potential to benefit the host communities.We argue that lnstitutional Review Boardsshould be allowed to grant exceptions for research on grounds that the research satisfies theScientific Necessity, Relevance for the host communities, sufficient host community benefits andSubject and Host Community nonrnaleficence.The argument has focused on the controversialHIV vertical transmission, and the trials used. World Best Practice is currently the long coursetreatment using AZT (zidovudine), but this is expensive involving early prenatal visits, frequentvisits and lV infusions during labour, which is not feasible nor affordable in these countries.However studies in South Africa has identified that apprcximalely 75% of HIV verticaltransmissions occurs ciuring or after delivery. Hence, trials comparing short ccurse AZTtreatment against placebo were done on ihe grounds that it is better than no treatment at all. Thetrials suggested that short course ti'eatment is possibly better than placebo. Yet the variability inthe transmission rate may suggest that the short-course treatment was not woi-th pur"suing.Theknowledge thal.75% of HIV vertical transmission occurs during delivery has led investigators tothe iandmark trials using nevirapine as a single dose given during labour offerring a feasible andaffordable treatment for reducing the rate of vertical transmission.To justify the relevance of theseissues, the Elizabeth Glaser Paediatrics AIDS Foundation has devoted 250 per mother-child treatment using the longcourse AZT would translate to 65,000 fewer HIV infected child. Yet devoting the same money toa single-dose nevirapine, at $4 per mother-child can translate to 270,000 fever HIV infected child,lffrttE Supplemen Majalah Kedokteran Andalas. Vol. 37. No.Supl.1, [/aret 2014potentially saving an additional 200,000 lives. The UNESCO Chair in Bioethics was establishedto coordinate and stimulate an international network of lnstitutes for Medical Ethics Training. lnthis role there is a need to develop an up to date syllabus for Medical ethics education which willsatisfy requirements of the Medical fraternity. These followed Two lnternational Studies in 2001that UNESCO undertook in researching the importance and quality of education in ethics inMedical Colleges and faculties all over the world. The results confirmed that there is an emergingneed for introduction of teaching of Medical ethics as a consequence of several social andscientific processes that have taken place. These included the relationship between health careproviders and their patients, the choice of medical interventions for the individual patient, thechoice of Public health interventions, the evaluation of effects of health care interventions, thecollaboration between teams engaged in health care activities and the choice of goals andmethods of medical reseai'ch.Hence, research using less than the world's best practice can beethical and has the potential to provide sufficient benefit for the host communities and IRB shouldbe given the authority to approve such activities on a case by case basis.Affiliasi Penulis : Director Centre for Asia Pacific Bioethics Studies, Korespondensi : Theong H. Low, email :thlow@bigpond. net.au
ETIKA RUMAH SAKIT DALAM MENJAMIN KESELAMATAN PASIEN MELALUI PENERAPAN MANAJEMEN RESIKO KLINIS
Get PDFAbstrakEtika tidak hanya dimiliki oleh individu atau kalangan profesi tertentu, tapi juga olehsebuah organisasi/institusi yang diterapkan individu yang berada dalam organisasi/intitusitersebut. Contohnya etika dalam pelayanan pelanggan oleh sebuah bank yang diterapkanmelalui performance karyawan dalam melayani setiap nasabah. Tidak semua orang menyadari,bahkan kalangan tenaga kesehatan dan rumah sakit bahwa potensi resiko yang terjadi di rumahsakit lebih tinggi dari jatuhnya pesawat terbang. Menurut lnstitute of Medicine (lOM), potensiresiko pada pelayanan kesehatan sama dengan jatuhnya sebuah pesawat jumbo (360penumpang) setiap dua hari dan menyebabkan semua penumpang meninggal. Resiko di rumahsakit tidak hanya merugikan pasien, tapi juga praktisi kesehatan, maupun rumah sakit sebagaikorporasi. Diperlukan penerapan manajemen resiko klinis di sebuah rumah sakit dalammenjamin keselamatan pasien (patient safety). Tujuan penulisan ini adalah untukmendeskripsikan secara mendalam tentang Etika Rumah Sakit Dalam Menjamin KeselamatanPasien Melalui Penerapan Manajemen Resiko Klinis. Metode Penulisan menggunakan studiliteratur pustaka (literature review) dengan kerangka pengertian resiko, jenis resiko di rumahsakit, definisi manajemen resiko klinis (MRK), kepentingan, tujuan dan manfaat penerapan MRKserta langkah-langkah penerapan MRK di rumah sakit. Manajemen resiko klinis adalahpengelolaan ketidak pastian (resiko) yang berpotensi merugikan, yang bersumber dari perawatanpasien sehingga pasien mendapatkan pelayanan yang bermutu dan berasas keselarnatan(patient safety). Rumah sakit hendaknya mengembangkan system untuk mengidentifikasi resikodengan beberapa pilihan cara yaitu, melalui system oelaporan (incident report), mempelajarirekam medis, analsis penyimoangan clinical pathway, audit medis, audit pembahasan kasusmorbiditas dan mortalitas, keluhan pasien serta surveillance. Analisis resiko dilakukan gunapenilaian i'esiko, dilakukan dengan membuat grading resiko yaitu frekuensi kejadian dikalidampak resiko sehingga dapat dikategorir<an tidak signifikan, resiko minor (dapat diterima),moderat, mayor (tidak dapat diterima), maupun katastropik. Evaluasi resiko dilakukan gunamenentukan apakah resiko akan diterima, diti"ansfer, diintervensi atau ditunda, kemudian dikelolauntuk dipindahkan ke asuransi (apabila resiko ditansfer) atau dibuatkan strategi reduksi/mitigasi.Monitoring dan pengkajian resiko dilakukan untuk keberlanjutan penerapan strategi yangdirencanakan dengan tidak melupakan komunikasi dan konsultasi dengan pihak stakeholdersinternal dan eksternal. Manajemen resiko klinis merupakan langkah-langkah yang harusditerrrpuh rumah sakit guna mengantisipasi kejadian yang berpotensi merugikan sehingga dapatditerapkan dalam pelayanan pasien. Perlu dibentuk Manajemen Resiko ktinit< Oi rumah sakitsehingga pelayanan pasien yang berorientasi mutu dan keselamatan (patient safety) dapatdiwujudkan.Kata kunci: Etika, Rumah Sakit, Manajemen Resiko KlinisAbstractEthics is not only owned by individuals or among ceflain professions, but alsc by anorganization / institution will be appliecl by individuals who are in the organization / institution that.For examples, efhlcs in customer service by a bank employee who applied througti performancein serving each customer. Not everyone is aware of, even among ntedical practitioners andhospitals that the potential risks that occur in hospitals is higher than the plane crash. Accordingto the lnstitute of Medicine (OM), the potential risks of health seryices as much as the fatl of aiumbo aircraft (360passengers) every two days and caused alt of the passengers died. Risk inthe hospital is not only disserve the patient, but also heatth practitioners and hospitats. CtinicatSupplemen Majalah Kedokteran Andalas' Vol' 37 No Supl 1' Maret 2014IEEXRisk Management is required to ensure patient saiety (patient safety) in hospitals 'The purposeof this paper is to describe Hospitat Ethics ti Ensuring Patient Safety Through thelmptementation of crinicat Risk Management. writing metiod using the ribrary riterature(titerature review) with a framework undetrstanding of risk' types of risk in the hospital' thedefinition of ctinicat- risk management (MRK), inierests, goits and benefits as well as theapptication of MRK in hospitats.btinicat ris;k management is the management of uncertainty (risk)that is potentiatty harmfur, which is sourced from patient care, so fhaf patients receive quarity andsafety care (patieni ,ir"tvl Hosprfa/s shoutd deverop a system to identify risks with severaloptionssuch as, *iign a' reporling ,v't"ii'";ident'reports)' sfudied the medical records' theanalysis of irregutariilJs ctinical pathways, iedicat audit' audit of discussio n of morbidity andmortality cases, patient complaints and surveiltance' Risk analysis was conducted to riskassessrnen t, risk grading is done ov ^ui'i lne frequency of occurrence multiplied by the impactthat risks can be categorized so insignicant' minor risk (acceptable)' moderate' maior (notacceptabte), o, ,"t"iiiJpthic.Risk evaluation was conducted to determine whether the risk will beaccepted, transferred, or delayed intervention, then managed to be transferred to the insurance(if the risk transferriil o, made reductio,n itrategiedmitigation. Monitoring and rrsk assessmenfcarried out for the imptementation of sustainabiity strategies pranned without not forgetting thecommunication and consurtation with internat or externar stakehorders.ctinicat risk managementrs fhe sfeps that must be taken by the io,riitut in anticipation of potentiatty adverse events thatcoutd be imptemented in the service of patient. tt is need to estabtish ctinicar Risk Managementin the hospitar, ,o ti",t the quatity and iafety oriented in patient care (patient safety) can berealized.Keywords: Ethics, Hospitals' Clinical Risk Managemen
EARLIER FORMAL ETHICS EDUCATION, THE IMPORTANCE OF MEICAL ETHICS AND EXPECTATION OF ETHICS DOCTOR IN FIRST GRADE MEDICAL STUDENTS OF MEDICAL FACULTY UNIVERSITAS TANJUNGPURA PONTIANAK
Get PDFAbstractHealth care decisions are based not only on clinical and technical grounds, but also onethical grounds. Although we carefully weigh the clinical and technical aspects, ethical issuesinvolved may be overlooked. A legal framework or code of conduct governing doctor's decisionsand behaviour may help overcome this problem but they often provide rigid guidelines for alimited number of situations. Earlier education in ethics might have some advantages to build agood medical character. The perception of the importance of medical ethics could also had aneffect to the expectation of a good medical doctor should be. This research was a cross sectionalstudy in first grade medical students of medical faculty Universitas Tanjungpura Pontianak,conducted in the last week of April, 2014. All of first grade medical students participated in thisstudy. This subjects given questionaire contained several questions : did they ever get a lessonof ethics in their Senior high schcol, how important the medical ethics and after studied medicalethics, what were their expectation ?. 86 subjects participated, 3'1 (36,05%) subjects are maleand 55(63,95%) subjects are female. The Age range from 16-20 years old, median 1B years oldand mode 1B years old. The subject came from 39 senior high school, was spread from papua,java dan kalimantan. Only 10(25,64%) senior high school had been given ethics in theircurriculum and this'1C school all located in Kalinrantan. One subject (1,16%)stated that ethicsjust a common lesson while 35 (40,7A %)subjects stated ihat ethics was inrportani and most ofthe subjects, 50(58,14%) subjects stated that ethics was very important lesson. The expectationafter studying medical ethics are : 39(45,35 o/o) subjects: respect and emphatize the other people,17 (19.77%) subjeets : be a betier person, 14(16,28o/c) subjeets: hospitable docior, 11 (12,79o/o)sub;ects :Apply the basic principle of bioethics and 5 (5,81%) sublects :treat the other like we'dlike to be treated. Twenty five point sixtyfour percent of the prirhary school of first year medicalstudent gave ethics lesson. Most of Subject stated that medical ethics is a very important lesson.The expectation after studying medical ethics varies: respect and emphatize the other people, bea better person, hospitable doctor, Apply the basic principle of bioethics and treat the other likewe'd like to be treated.Affiliasi Penulis: l.Departement of Pharmacology, Medical Faculty Universitas Tanjungpura,2.Depa(ement oftr4icrobiology Medical Faculty Universitas Tanjungpura, 3. Departement of Anatomy Medical Faculty UniversitasTanjungpura, Korespcndensi :Arif Wicaksono, email :drarii,[email protected].*@TEilSupplen-ren Majalah Kedokteran Andalas' Vol' 37' No Supl'1' Maret 2014ETIKoLEGAL,SEcoNDoPINIONDENGANSENGKETAMEDISNoorman HerryadiKorespondensi : Noorman Herryadi' email : noormanherryadi@yahoo'com'oortr"lu,,.anini mencoba mengetengahkan hubungan antara second opinion dengan sengketamedis dari aspek Etikolegal Kedokteran, kaitannya dengan perlindungan bagi dokter dan bagipasien. Second Opinion Jdatan hak pasien dan kewajiban dokter untuk melaksanakannya dalammenjalankan profesi r"oort","nnya. Dalam kenyataan banyak sengketa medis, dimana pasienatau keluarga/ahli warisnya melakukan fenuntutan hukum kepada dokter atau Rumah Sakityang merawatnya, v*g olr"nabkan oten-reterangan atau opini dokter lain atau pihak lain yangdianggap berkompeten-untuf memberi keterangan atau opini'r{nkrar - nerlindunoarKata kunci: second opinion - sengketa medis - perlindungan dokter perlindungan pasle
BASAL CELL CARCINOMA IN XERODERMA PIGMENTOSUM IN AN 18.YEAR.OLD MALE
Get PDFXeroderma pigmentosum (XP) is a rare autosomalrecessiye disorder that occurs becauseof inactivation of the xeroderma pigmentosum protein, which is an important DNA damagerecognition protein involved in DNA nucleotide excision repair (NER). This defect, whichprevents removal of a wide array of direct and indirect DNA /esions, is assocrafe d with adecrease in catalase activity. This photosensifive disarder resulfs in multipte face, neck andhead basal cell carcinomas (BCCs), squamous cell carcinomas (SCCsJ and melanomas whichis characterized by cellular hypersensitivity to ultraviolet radiation, development of cancers at anearly age, severe actinic cancer, and photophobia. As a common sfressor of skin, uttraviotet-B(UVB) induces a biphasic HIF-Iq variation through ROS generation in keratinocytes. Wereported a case of an 18-year-old-male with XP presented with BCC on the teft cheek. Thcpatient had hypo- and hyperpigmented macules since early childhood, throughout the body,more on sun exposed areas.AbstrakXeroderma pigmentosum (XP) adalah kelainan autosomal resesif yang jarang terjadidisebabkan oleh inaktivasi protein xeroderma pigmentosum yang merupakan protein pentingpengenal kerusakan DNA yang terlibat dalam nucleotide excision repair (NER) DNA. Defekini mencegah penghapusan beragam lesi DNA langsung dan tidak langsung, terkait denganpenurunan aktivitas katalase. Kelainan fotosensitivitas ini menyebabkan terjadinya basalkarsinoma sel (BCC), karsinoma sel skuamosa (SCC) dan melanoma pada wajah, leher dankepala yang ditandaidengan hipersensitivitas seluler radiasi ultraviolet, perkembangan kankerpada usia dini, kanker actinic yang berat, dan fot'ofobia. Ultraviolet-B (UVB) merupakan stressorpada kuit yang menginduksi variasi HIF-1q bifasik melalui generasi ROS dalam keratinosit.Kami melaporkan kasus XP dengan BCC di pipi kiri pada laki-laki berusia 18 tahun. Pasienmemiliki makula hipo- dan hiperpigmentasisejak masa kanak-kanak awal, seluruh tubuh, lebihpada daerah yang terpapar sinar matahari