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Manual Acupuncture Using the Wide Rotation Method in Treating Adhesive Capsulitis
No full textAdhesive capsulitis (AC), is one of the disorders commonly encountered in clinical practice which caused great disability in performing daily activities. The cause of AC is unknown, but its pathogenesis involves shoulder joint capsule synovial tissue inflammation that produces pain and the formation of fibrotic tissue. The forming of fibrotic tissue causes the shrinkage of joint space and limitation in the shoulder range of motion (ROM). Many modalities of treatment had been used to treat AC, but there has been no consensus regarding the best treatment. Acupuncture had been used in the treatment of AC and showed good results, especially in reducing pain and improving ROM. This paper showcased the effects of manual acupuncture using the wide rotation stimulation method, a rarely used technique that has never been published before, in the treatment of AC. In this case report, the wide rotation stimulation method showed great results in reducing pain and improving ROM
Kepadatan Aedes sp. dan Hubungannya dengan Faktor Habitat di Kelurahan Patunas, Kabupaten Tanjung Jabung Barat
No full textHabitat larva Aedes sp. di setiap wilayah mempunyai karakteristik berbeda. Penelitian ini bertujuan untuk mengetahui kepadatan larva Aedes sp. dan hubungannya dengan faktor habitat. Penelitian cross sectional ini dilakukan pada bulan Oktober–November 2017 di Kelurahan Patunas, Kecamatan Tungkal Ilir, Kabupaten Tanjung Jabung Barat, Provinsi Jambi. Larva diambil dari kontainer air yang terdapat di dalam dan luar rumah dengan metode single larvae. Larva yang dikoleksi digunakan untuk menghitung house index (HI), container index (CI), breteau index (BI), dan density figure (DF). Pada pemeriksaan 100 rumah, diperoleh 163 kontainer yang berisi larva Aedes sp. dan paling banyak ditemukan di drum daripada kontainer lain. Diperoleh HI=59%, CI=34%, BI=163, dan density figure (DF)=8. Letak, warna, kondisi kontainer, sumber air, volume air, dan pemberian larvasida berhubungan dengan kepadatan larva Aedes sp. (p<0,05). Bahan kontainer dan pemeliharaan ikan tidak berhubungan dengan kepadatan larva Aedes sp. (p>0,05). Diperoleh DF 8 yang menunjukkan kepadatan larva Aedes sp. yang tinggi sehingga Kelurahan Patunas berisiko dalam penularan DBD. Kata kunci: Demam berdarah dengue (DBD), Jambi, kontainer, larva Aedes sp. Density of Aedes sp. and its Relationship to Habitat Factors in Patunas Village, Tungkal Ilir Subdistrict, Tanjung Jabung Barat District Abstract Habitat of Aedes sp. larvae in each region has different characteristics. This study aims to determine the density of Aedes sp. larvae and its relationship to habitat factors. The study was conducted in October- November 2017 in Patunas Village, Tungkal Ilir Subdistrict, Tanjung Jabung Barat District, Jambi Province. Larvae were collected from water containers in the indoor and outdoor using the single larvae methods. The collected larvae were used to calculate the value of House Index (HI), Container Index (CI), Breteau Index (BI), and Density Figure (DF). There were 163 containers containing Aedes sp. larvae and the most are found in drums rather than other containers. HI=59%, CI=34%, BI=163, and density figure (DF)=8. Location, color, condition of container, source of water, volume of water, and larvacide are related with density of Aedes sp. larvae (p<0.05). Container material and fish are not related to the density of Aedes sp. larvae (p>0.05). Density of Aedes sp. larvae have a high DF so that the Patunas Village is at risk in dengue transmission. Keywords: Dengue hemorraghic fever (DHF), Jambi, container, Aedes sp. Larvae
Hubungan Tipe Motivasi terhadap Kejadian Burnout pada Mahasiswa Fakultas Kedokteran Universitas Indonesia pada Masa Transisi dari Pendidikan Preklinik ke Klinik Tahun 2018
No full textMahasiswa kedokteran mengalami berbagai tahap transisi, salah satunya transisi dari tahap pendidikan preklinik ke klinik yang memberikan tantangan dan tekanan serta mengakibatkan stres bagi mahasiswa. Bila mahasiswa tidak memiliki mekanisme coping yang baik, akan terjadi distress yang menyebabkan depresi, burnout, dan kecemasan. Motivasi adalah faktor penting agar mahasiswa dapat menghadapi stres dan burnout. Penelitian ini bertujuan untuk menilai hubungan tipe motivasi dengan burnout pada mahasiswa tahap transisi preklinik ke klinik. Penelitian ini dilakukan di FKUI menggunakan desain potong lintang dengan melibatkan mahasiswa tahun pertama transisi dari preklinik ke klinik. Mahasiswa dibagi empat tipe motivasi berdasarkan analisis motivasi intrinsik dan terkontrol menggunakan kuesioner academic motivation scale. Tipe motivasi mahasiswa dinilai hubungannya dengan komponen burnout. Burnout dinilai dengan kuesioner Maslach Burnout Inventory HSS. Sebanyak 164 mahasiswa diikutsertakan sebagai responden penelitian. Hasilnya didapatkan bahwa tipe motivasi mahasiswa adalah tipe termotivasi minat-status 79,2% (n=130), termotivasi minat 13,41% (n=22), termotivasi rendah 6,09% (n=10), dan termotivasi status 1,2% (n=2) dari populasi. Mahasiswa dengan tipe termotivasi minat memiliki komponen persepsi terhadap prestasi yang lebih tinggi (p=0,03) dan depersonalisasi lebih rendah (p<0,026) dibandingkan tipe termotivasi minat-status. Tipe termotivasi minat berhubungan dengan rendahnya kemungkinan burnout yang ditunjukkan dengan rendahnya depersonalisasi dan tingginya kepuasan terhadap prestasi diri selama pendidikan. Kata kunci: Burnout, FKUI, mahasiswa tahap transisi preklinik ke klinik, tipe motivasi. The Relationship between Type of Motivation and Burnout in Medical Student during Transition from Preclinical to Clinical Stages in Universitas Indonesia 2018 Abstract Medical students should undergo several stages in their education, one of them is transition from preclinical to clinical year. This transition introduces new challenges, environment, and pressures that can cause stress for medical students. If stress cannot be overcome properly, it may cause depression, burnout, and anxiety. Motivation is important for student to cope with stress and burnout. This study hence aimed to assess the relationship between type of motivation and burnout in medical student during the transition period from preclinical to clinical phases. This study was cross-sectional and conducted in FMUI, among medical students in the first year of transition from preclinical to clinical year. Students were categorized into four subgroups through analysis of intrinsic and controlled motivation using Academic Motivation Scale. Group membership is used as an independent variable to assess burnout components. Burnout was measured using Maslach Burnout Inventory. A total of 164 students participated in the study. Four groups were identified: students who were interest-status motivated (n=130, 79,2%), interest-motivated students (n=22, 13.41%), low motivated students (n=10, 6,09%), and status-motivated students (n=2, 1.2%). Interest-motivated students had higher personal accomplishment (p=0.03) and lower depersonalization (p=0.026) compared to interest-status motivated students. The present study shows that students with interest-motivated profile is associated with low burnout which is reflected from low depersonalization and high personal accomplishment in medical training. Keywords: Burnout, FMUI, type of motivation, student, transition from preclinical to clinical year
Profile of Hypertensive Patients in Indonesia National Referral Hospital
No full textHypertension as a prevalent chronic disease requires lifelong therapy and cost inefficiency. Nephrology and hypertension department outpatient clinic in national referral hospital is often burdened with overwhelming number of patients. This study is aimed to identify the rate of controlled blood pressure and related factors of patients in dr. Cipto Mangunkusumo National Hospital (CMNH). A cross-sectional study was conducted in CMNH. Data were obtained from medical record of patients admitted for hypertension on May to July 2018. Data reviewed include blood pressure, sociodemographic, medication history, comorbidities, and supporting examinations. Among 301 medical record of patients admitted with hypertension, 37.5% of those patients have uncontrolled hypertension. Chi-square test reveals grade II hypertension (OR: 5.46 95% CI 3.03—9.83), low adherence (OR: 2.94 95% CI 1.46—5.92), combination of 3 drugs (OR: 4.80 95% CI 1.18—19.415), CKD grade IIIa (OR: 0.33 95% CI 0.10—1.01), grade IV (OR: 0.22 95% CI 0.80—0.61), and grade V (OR: 0.25 95% CI 0.08—0.70) to be significant difference. Multivariate analysis showed that on linear regression model, grade II hypertension is an independent variable to uncontrolled blood pressure while higher eGFR is a strong predictor of controlled blood pressure. Keywords: Indonesia, hypertension, national referral hospital. Profil Pasien Hipertensi di Rumah Sakit Rujukan Nasional Indonesia Abstrak Hipertensi sebagai penyakit kronik membutuhkan pengobatan seumur hidup dan biaya. Klinik rawat jalan nefrologi dan hipertensi di rumah sakit rujukan nasional sering dibebani dengan jumlah pasien yang sangat banyak. Penelitian ini bertujuan untuk mengidentifikasi tekanan darah terkontrol dan faktor-faktor yang berhubungan dengan pasien di RS Pusat Rujukan Nasional dr. Cipto Mangunkusumo (RSCM). Studi cross-sectional dilakukan di RSCM dengan sumber data dari rekam medis pasien hipertensi yang datang berobat pada bulan Mei hingga Juli 2018 meliputi tekanan darah, sosiodemografi, riwayat pengobatan, komorbiditas, dan pemeriksaan penunjang. Dari 301 catatan medis pasien hipertensi, sebanyak 37,5% pasien menderita hipertensi tidak terkontrol. Uji chi-square menunjukkan perbedaan bermakna pada hipertensi derajat II (OR: 5,46 95% CI 3,03-9,83), kepatuhan rendah (OR: 2,94 95% CI 1,46-55,92), kombinasi 3 obat (OR: 4,80 95% CI 1,18—19,415), CKD derajat IIIa (OR: 0,33 95% CI 0,10-1,01), derajat IV (OR: 0,22 95% CI 0,80-0,61), dan derajat V (OR: 0,25 95% CI 0,08-0,70). Analisis multivariat menunjukkan bahwa pada model regresi linier, hipertensi derajat II merupakan variabel independen terhadap tekanan darah yang tidak terkontrol dan eGFR yang lebih tinggi merupakan prediktor kuat pada tekanan darah terkontrol. Kata kunci: Indonesia, hipertensi, rumah sakit rujukan nasional
Comparison of Ovalbumin Sensitized Mice Model for Allergy: A Preliminary Study
No full textAllergy diseases tend to increase with variety of clinical manifestations. To date, pharmacotherapy do not treat the underlying disease. Many researches concerned to study new approach of allergy therapy which need allergy mouse model for evaluation. This study was aimed to compare the effectiveness of two treatment methods by using ovalbumin for allergy sensitization. This study was conducted in PT.Bimana Indomedical animal facility Bogor on June until September 2016. Six mice were divided into 2 groups. First group was sensitized by ovalbumin 100ug subcutaneous (sc) day-0, 50 ug intra peritoneal (ip) day-14 and 100 ug intranasal (in) day-21. Second group was sensitized by ovalbumin 10 ug ip day-0 and day-7, 10 ug in day-21, 22, and 23. Body weight, hematology parameters (red blood cells, white blood cells, hemoglobin and hematocrit) and total IgE concentration of day-0 (pre-treatment) and day 24 (post-treatment) were measured. The results showed that there was an increase of mice body weight of both treatment group, while hematology changes of pre and post treatment were not significantly different (paired t-test). Whereas the increase in total IgE pre and post treatment was significantly different between the two groups (paired t-test). In conclusion, the second allergy sensitization method is better than the first allergy sensitization method. 
Pengaruh Lingkungan Mikro terhadap Perkembangan Jaringan Tumor/Kanker: Peran Sel Punca Mesenkimal
No full textSalah satu potensi terapi sel punca mesenkimal (SPM) adalah kemampuannya memodulasi sistemkekebalan tubuh terhadap tumor atau kanker. Studi mengenai SPM sebagai terapi penyakit sudah banyakdilakukan, namun hasil penelitiannya masih kontradiksi. Sebagai bagian dari lingkungan mikro di dalam tubuhmanusia, terutama di jaringan tumor atau kanker, SPM memiliki karakteristik dapat berdiferensiasi secaramulti-lineage menjadi berbagai sel. Perbedaan jenis dan sumber SPM, mekanisme angiogenesis dan transisiepitel mesenkim (TEM), serta berbagai sitokin di lingkungan mikro tumor mengakibatkan efek akhir SPMdi jaringan tumor atau kanker menjadi berbeda. Oleh karena potensi dualitas, peran SPM dalam memicuatau menghambat pertumbuhan tumor sama-sama kuat. Sebaiknya penggunaan SPM ditunda terlebihdahulu untuk kasus tumor atau kanker, terutama untuk kanker yang solid, sampai bukti-bukti penelitian dapatmenunjukkan keamanan SPM. Kata kunci: sel punca mesenkimal, lingkungan mikro, kanker. The Effect of Microenvironment to Tumor Growth: Role of Mesenchymal Stem Cell AbstractOne of stem cell therapy benefits, Mesenchymal Stem Cell (MSC) therapy, is its ability to modulateimmune system in tumor or cancer. Scientific studies of MSC therapy have been widely practiced, butcontradictions regarding the outcome and safety of the therapy remain. As part of microenvironment,particularly in tumor or cancer tissues, MSC has characteristics that can differentiate multi-lineage into variouscells.The ultimate effect of MSC is closely related to the microenvironment conditions where MSC is located,including different type and source of MSC used, mechanism of angiogenesis and epithelial mesenchymaltransition, and also various cytokines in tumor microenvironment. Finally, due to the unclear advantagesand benefits of MSC infused therapy in cancer patients and its potential to promote tumor growth, we call forcaution for MSC therapeutic use in tumor or cancer, especially solid cancer, until evidence might show MSCsafety in malignancy cases. Keywords: mesenchymal stem cell, microenvironment, cancer
Parasitic Diseases in A Boarding School Children in Bogor Regency
No full textInductionThis study was aimed to determine the prevalence of parasitic diseases in boarding school children followed by eradication. Parasites consist of ecto and endo parasites. This study was conducted in Daarul Mustaqiem Boarding School, Pamijahan Village, Bogor Recency on May 2018 with the subject of all students. Diagnosis of intestinal parasite was done by microscopic stool examination with lugol staining while diagnosis of pediculosis and scabies by dermatological examination. The number of students attending the parasitic examination from PAUD to Aliyah was 501 students. Based on stool examination, the prevalence of intestinal parasitic infections was 57%. The most parasitic infections are B. hominis (128 students), followed by G. lamblia (13 students) and O. vermicularis (6 students). Students with positive worms were treated with albendazole 400 mg three days in a row and positive protozoa was treated with metronidazole. As many as 107 of the 121 (88.4%) students found live head lice. Students who are positive for pediculosis are treated with permethrin 1%. On examination of 159 male students, the prevalence of scabies was (7.5%). Students positive for scabies were treated with permethrin cream 5%. It was concluded that the prevalence of intestinal parasitic infections in santri was 59.4% with the highest infection in B. hominis; other intestinal parasites was relatively low. The prevalence of pediculosis capitis in female student was very high (88.4%) and the prevalence of scabies is low. All children treated according to the diagnosis and followed by health education on parasitic diseases and healthy hygiene behavior
The Importance of Maintaining High Pre-Transfusion Hemoglobin Level in Thalassemia Major Patients
No full textThalassemia patients who do not receive adequate transfusion are at risk of splenomegaly and growth impairment. This study was conducted to evaluate the relation between pre-transfusion hemoglobin (Hb) level with spleen size and body height, also the relation between spleen size and the risk of neutropenia and thrombocytopenia. This was a retrospective study involving 171 non-splenectomized children with thalassemia major. The study was conducted in Dr Cipto Mangunkusumo National Hospital, Jakarta and used data from the past year (2017-2018). Mean pre-transfusion Hb level, neutrophil and thrombocyte count was measured for one year. Mean pre-transfusion Hb level was divided into high (Hb ≥9 g/dL) and low (Hb <9 g/dL). The results showed significant difference of spleen size between subject with high and low pre-transfusion Hb level, but not for the prevalence of stunted. Moderate to massive splenomegaly (spleen size greater than Schuffner 2) increases risk of thrombocytopenia (OR 9.40, p<0.0001), but not for neutropenia (p=0.477). Therefore, it is concluded that maintaining high pre-transfusion Hb level ≥9 g/dL brings many benefits because it prevents the occurrence of complications in children with thalassemia major.  
Leech Therapy for a Non-Surgical Method of Flap Salvaging after a Free Flap Transfer
No full textLeech therapy has been accepted in clinical settings to salvage a flap with vein congestion. We did leech therapy for 7 days with 10 days broad-spectrum prophylaxis antibiotics and applied 2 leeches with gradual decrement of frequency. The patient got vital fibular flap with partial necrotized distal part of skin paddle. The clinical question is how leech therapy can be applied in vein congestion or venous compromised after free flap transfer. Articles search was conducted on October 28th, 2014, in PubMed, using “leech therapy AND flap” as keywords. Initial search discovered 95 articles. A total of 4 articles that emphasized flap salvaging were included. Following outcomes: frequency and duration, number of leeches, sucked blood volume, antibiotics prophylaxis during therapy, and complications, were extracted and analyzed. Leech therapy is an alternate method for salvaging a flap without any secondary invasive and complex procedure. Leech therapy can be used 2-12 times in 24 hours for 3-10 days. A leech can suck 2.45-8 ml blood. Board spectrum antibiotic has been used for prophylaxis, however infection of Aeromonas hydrophilia is recorded during the application. Further study is needed to give stronger evidences and explanations in using this method in clinical application. Keywords: Leech therapy, flap salvaging, vein congestion. Terapi Lintah sebagai Tata Laksana Non-Operatif Penyelamatan Flap Pasca Pemindahan Flap Bebas Abstrak Terapi lintah sudah diterima sebagai tatalaksana penyelamatan flap dengan kongesti vena. Peneliti melakukan terapi lintah selama 7 hari dengan penggunaan antibiotic spektrum luas selama 10 hari dan menggunakan 2 ekor lintah dengan frekuensi yang diturunkan bertahap. Pasien yang terpilih memiliki fibular flap yang vital dengan bagian nekrosis di distal. Pertanyaan klinis riset ini adalah bagaimana terapi lintah dapat digunakan untuk kongesti vena setelah pemindahan flap bebas. Pencarian artikel dilakukan pada 28 Oktober 2014 di PubMed dengnan kata kunci “leech therapy AND flap”. Terdapat 95 artikel pada awal pencarian. Total 4 artikel yang membahas tentang penyelamatan flap dimasukkan kedalam studi ini. Data seperti frekuensi, durasi, jumlah lintah, volume darah terhisap, antibiotik profilaksis dan komplikasi dikumpulkan dan dianalisis lebih lanjut. Terapi lintah menjadi pilihan tatalaksana untuk penyelamatan flap tanpa adanya tindakan sekunder yang invasif dan kompleks.Terapi lintah bisa dilakukan 2-12 kali dalam 24 jam untuk 3-10 hari perawatan. Seekor lintah bisa menghisap 2,45-8 ml darah. Profilaksis antibiotik spektrum luas dipergunakan selama penelitian, namun masih terdapat infeksi Aeromonas hydrophilia. Riset lebih lanjut diperlukan untuk memberikan bukti dan penjelasan lebih kuat mengenai penggunaan tatalaksana ini di praktik klinis. Kata kunci: Terapi lintah, penyelamatan flap, kongesti vena