eJournal Kedokteran Indonesia
Not a member yet
287 research outputs found
Sort by
The Predictors of Mortality among Critically Ill Patients in Emergency Department, dr. Cipto Mangunkusumo Hospital
No full textAbstractIdentifying the severity of patient’s condition is very important to be done in emergency department. The severity can be predicted by assessing vital signs of patients. Factors and scoring system in predicting mortality of critically ill patients in Indonesia remain unclear. We aimed to evaluate vital signs as predictors of mortality and determine whether Modified Early Warning Score(MEWS) can be used to predict mortality among Indonesian patients. We conducted a retrospective study of all patients admitted to the dr. Cipto Mangunkusumo Hospital’s emergency department (ED) from January-December 2011. Physiological parameters including consciousness, heart rate, respiratory rate, and blood pressure were obtained from medical records. MEWS were calculated from the data and non-parametric test was performed to identify predictors of 30-days mortality. Total of 579 patients were registered. The most common indication at admission was decrease in level of consciousness. Abnormal vital signs were associated with the increased odds of death. Patientswith bradypnea were the most likely to die compared to the other factors (OR 48.405; 95%CI 6.28373.12). The odds of death for in patient increased significantly as the MEWS increased >4 (OR 3.815; 95% CI 2.70-5.40). Decrease in level of consciousness, abnormal heart rate, abnormal respiratoryrate, and MEWS >4 increase the odds of death among critically ill patients in EDKeywords: predictors, death, critically ill patients, emergency department, MEWSAbstrakIdentifikasi severitas kondisi pasien sangat penting dilakukan di Instalasi Gawat Darurat (IGD). Tingkat severitas dapat diprediksi dengan menilai tanda vital pasien. Faktor dan sistem skoring prediktor mortalitas pasien kritis di Indonesia belum jelas. Penelitian ini bertujuan mengevaluasi tanda vital sebagai predictor mortalitas dan menentukan apakah skoring Modified Early Warning Score (MEWS) dapat digunakan untuk memprediksi mortalitas pasien di Indonesia.Penelitian dilakukan retrospektif dengan subjek semua pasien yang dirawat di IGD RS dr. Cipto Mangunkusumo (RSCM) pada 1 Januari-31 Desember 2011. Tingkat kesadaran, frekuensi nadi, frekuensi napas, dan tekanan darah didapatkan dari rekam medis. MEWS dihitung dan tes nonparametrik dilakukan untuk mengidentifikasi prediktor kematian 30 hari. Sebanyak 579 pasien menjadi subjek. Indikasi rawat inap tersering adalah penurunan kesadaran.Tanda vital abnormal diasosiasikan dengan peningkatan angka kematian. Bradipnea menjadi prediktor kematian utama dibanding faktor yang lain (OR 48.405; 95%CI 6.28-373.12). Angka kematian pasien rawat inap meningkat bila nilai MEWS >4 (OR 3.815; 95% CI 2.70-5.40). Penurunan kesadaran, frekuensi nadi dan napas abnormal, dan MEWS >4 meningkatkan angka kematian pasien kritis di IGD.Kata kunci: prediktor, kematian, pasien kritis, gawat darurat, MEW
The Trend of Malaria in 2011-2013 and its Relationship to Age, Gender, and Season in Kodi Utara Subdistrict, Sumba Barat Daya
No full textAbstractMalaria is a public health problem in Indonesia, especially in East Nusa Tenggara. Factors, such as age, gender, and season, are considered to be related with malaria. The objective of this study is to know the trend and proportion of malaria in 2011-2013 and its relationship with age, gender, and season in Kodi Utara Subdistrict, Sumba Barat Daya (SBD). The design of this study is cross-sectional and using secondary data which is obtained from Kodi Utara Primary Health Care Center on June 25th 2014. The data is all recorded data of patients who came to Kodi Utara Primary Health Care Center and underwent diagnostic test for malaria in 2011-2013. As a result, it is found that the trend of malaria in 2011-2013 is unstable, but it shows that the highest average number is found in 2011 (170.3 people) and the lowest one is found in 2013 (103.3 people). It is also found that there is a significant difference between the proportion of malaria with age, gender, and season (p<0.05). The conclusion is that the number of malaria patients decrease from 2011 to2013 and there is a relationship between the proportion of malaria and age, gender, and season.Keywords: malaria, trend, proportion, age, gender, season, Kodi Utara, Sumba Barat DayaAbstrakMalaria merupakan masalah kesehatan di Indonesia khususnya di Nusa Tenggara Timur. Faktor-faktor seperti umur, jenis kelamin, dan musim dianggap berkaitan dengan malaria. Tujuan penelitian ini adalah mengetahui trend dan proporsi malaria tahun 2011-2013 serta kaitannya dengan umur, jenis kelamin, dan musim di Kecamatan Kodi Utara, Kabupaten Sumba Barat Daya (SBD), Nusa Tenggara Timur. Desain penelitian adalah potong lintang menggunakan data sekunder yang diperoleh dari Pusat Kesehatan Masyarakat (Puskesmas) Kodi Utara pada tanggal 25 Juni 2014 berupa data pasien yang berobat ke Puskesmas Kodi Utara dan didiagnosis malaria pada tahun 2011-2013. Hasilnya didapatkan bahwa trend malaria pada tahun 2011-2013 tidak stabil, namun didapatkan angka rata-rata tertinggi pada tahun 2011 (170,3 orang) dan terendah pada tahun 2013 (103,3 orang). Terdapat perbedaan bermakna antara proporsi malaria dengan usia, jenis kelamin, dan musim (p<0,05). Disimpulkan bahwa angka rata-rata penderita malaria menurun dari tahun 2011 sampai 2013 dan terdapat hubungan proporsi malaria dengan usia, jenis kelamin, dan musim. Kata kunci: malaria, trend, proporsi, usia, jenis kelamin, musim, Kodi Utara, Sumba Barat Day
Bilateral Spermatic Vein Microligation and Human Chorionic Gonadotropin and Recombinant Folicle Stimulating Hormone Combination Therapy in Patient with Azoospermia
No full textAzoospermia, the absence of spermatozoa in ejaculate due to testicular failure or reproductive tract obstruction, is the most unfavorable form of male infertility and is found in approximately 15% of infertile men. We report a 34 years old man with primary infertility for 4 years due to azoospermia. There were bilateral varicoceles grade 2, low level of serum testosterone and luteinizing hormone and normal level of serum folicle stimulating hormone (FSH) on the low margin. The patient underwent sperm extraction (PESA and TESEmethod) with result there were no motile spermatozoa. On the spermatogenesis examination, it was revealed that the spermatogenesis process stopped on the spermatid phase. We decided to perform bilateral spermatic vein microligation followed by hormonal injection (HCG and FSH recombinant) for 4 months. On the evaluation, there was motile spematozoa on the left PESA. This finding suggested the effectiveness of the therapy, there was a spermatogenesis on this patient after bilateral spermatic vein microligation and combination hormonal therapy of HCG and FSH recombinant for 4 months.Keywords: primary infertility, azoospermia, HCG, recombinant FSH, spermatic vein microligation 
Effects of High-sugar and High-fat Diet on Fat Deposition and Blood Vessel Wall on Sprague Dawley Rats Liver
No full textPeople nowadays tend to consume more fast food and sweetened beverages. These foods usually contain high amount sugar and fat that have effects on the body including liver.This study was conducted to explore the effects of extensive intake of sugar and fat on blood glucose and cholesterol level as well as changes in liver. Research was conducted with experimental method using 20 Sprague Dawley rats which were divided into 4 groups; 2 controls and 2 treatments. Rats were given 5 ml sugar or lard alternatively every 2 consecutive days for 1-month and 2-month respectively. Data was retrieved include blood glucose and cholesterol level, fatty liver percentage and blood vessel thickening after intervention through HE staining. The results showed that both 1-month and 2-month intervention group has significant increase in blood glucose and cholesterol level. However, the enhancement of fatty liver percentage and number of thickened blood vessels (p<0.05) were only foundsignificant (p<0.05) in 1-month intervention group. We concluded that high intake of sugar and fat within 1-monthintervention have significant effects on the rat body including liver. Nevertheless, it was not found significant in 2-months intervention. Further studies are still needed to analyze this incongruent result.Key words: high-sugar diet, high-fat diet, fatty liver, atherosclerosis 
Hubungan Antropometri, Aktivitas Fisik, dan Pengetahuan Gizi dengan Asupan Energi dan Komposisi Makronutrien pada Remaja
No full textPerubahan gaya hidup menyebabkan ketidakseimbangan asupan energi dan aktivitas fisik yang berujung pada obesitas. Tujuan penelitian ini untuk mengetahui hubungan antropometri,aktivitas fisik, dan pengetahuan gizi dengan asupan energi dan komposisi makronutrien padaremaja. Studi potong lintang dilakukan dari Juni 2011 hingga Juni 2013 pada mahasiswa salahsatu fakultas kedokteran di Jakarta. Pengukuran tinggi badan, berat badan, dan tebal lipatankulit menggunakan staturemeter mictotoise, timbangan SECA, dan skinfold calliper. Aktivitas fisikdinilai menggunakan kuesioner B3D dan pengetahuan gizi dengan isian. Penelusuran asupanenergi dan makronutrien menggunakan kuesioner FFQ. Sejumlah 75 mahasiswa ikut sertadengan rerata usia 17,7±0,6 tahun. Rerata asupan energi, karbohidrat, protein, dan lemak adalah2.443 (761-5.109) kkal, 316 (106-734) gram, 84,3 (25,2-224) gram, dan 82 (14,8-211,3) gram.Baik indeks massa tubuh, tebal lipatan kulit, lingkar pinggang, dan tingkat pengetahuan gizi tidakberhubungan dengan asupan energi dan makronutrien (p>0,05). Aktivitas fisik tingkat sedang dantinggi dikaitkan dengan perbedaan pola asupan energi (p=0,007) dan lemak (p=0,005), tetapi tidakuntuk aktivitas rendah ataupun makronutrien lainnya. Oleh karena itu, peningkatan aktivitas fisikakan memengaruhi asupan energi dan lemak.Kata kunci: asupan energi, asupan makronutrien, pengetahuan gizi, tingkat aktivitas fisik, indeksmassa tubuh, tebal lipatan kulit, remaja, obesita
Efek Neuroprotektif Ekstrak Akar Acalypha indica 500 mg/kgBB terhadap Perubahan Inti Sel Saraf Hipokampus Pascahipoksia Serebri
No full textStroke merupakan manifestasi klinis gangguan sirkulasi darah di otak yang menyebabkan defisit neurologis. Delapan puluh persen stroke merupakan stroke non-hemoragik akibat oklusi pembuluh darah otak sehingga terjadi kerusakan sel saraf yang diinduksi oleh hipoksia. Kerusakan tersebut dapat dicegah oleh tanaman akar kucing (Acalypha indica) yang mengandung antioksidan. Penelitian ini bertujuan untuk membuktikan efek neuroprotektif ekstrak akar A. indica terhadap hipokampus sprague dawley pascahipoksia. Terdapat tiga kelompok yaitu (1) kontrol negatif dengan akuades, (2) kontrol positif dengan vitamin B1 dosis 30 mg/kgBB, dan (3) kelompok perlakuan dengan ekstrak akar A. indica dosis 500 mg/kgBB. Setelah tujuh hari perlakuan,dilakukan ligasi arteri karotis komunis sprague dawley selama satu jam untuk menciptakan kondisi hipoksia. Selanjutnya, dibuat sediaan hipokampus untuk menghitung jumlah sel normal. Penelitian ini menggunakan desain eksperimental dengan uji One Way Anova. Hasil uji One Way Anova menunjukkan rerata persentase jumlah sel normal tidak berbeda bermakna terhadap CA1 (p=0,343), CA3 (p=0,174), lapisan dalam girus dentatus (p=0,270), dan lapisan luar girus dentatus (p=0,422) pada ketiga kelompok. Namun secara kuantitatif, rerata persentase jumlah sel normal paling banyak ditemukan pada kelompok yang mendapatkan ekstrak akar A indica.Kata kunci: Acalypha indica, efek neuroprotektif, hipokampus, hipoksi
Maternal Anaemia and Neonatal Outcomes
No full textThis cross-sectional study aims to determine whether maternal anaemia would affect birth outcome – birth weight and length – of the baby and compare this with that of non-anaemicmothers. We used secondary data from Puskesmas Kecamatan Ciracas medical records. Alldelivery records from October – November 2012 were collected and analysed; samples weredivided into two group: Group 1 included anaemic pregnant women and Group 2 non-anaemicpregnant women. Inclusion criteria was all pregnant women 16 years and older and a singletonpregnancy with a complete medical record. All women with a past history of preterm delivery,obstetrical complications or any medical illness, except anaemia, were excluded from the study inorder to control for the confounding factors. Out of one hundred and one records, 79 non anaemicsubjects and 22 anaemic subjects, were included for the analysis. No significant difference wasfound in both groups in terms of baby’s birth weight and birth length.Keywords: maternity anaemia, birth weight, birth lengt