Jurnal Kesehatan Andalas
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Korelasi nilai mean platelet volume dengan derajat fibrosis hati pada pasien hepatitis B kronik
Full text linkBiopsi hati merupakan baku emas penentuan derajat fibrosis hati, tetapi bersifat invasif. Metode non invasif yang dikembangkan saat ini untuk mengetahui derajat fibrosis hati adalah fibroscan, tetapi tidak tersedia di semua fasilitas kesehatan. Nilai Mean Platelet Volume (MPV) yang terdapat dalam pemeriksaan darah rutin dapat dijadikan penanda keparahan fibrosis hati pada pasien hepatitis B kronik. Tujuan: Menilai korelasi nilai MPV dan derajat fibrosis hati pada pasien hepatitis B kronik. Metode: Penelitian ini adalah suatu penelitian analitik dengan rancangan potong lintang terhadap 25 orang pasien hepatitis B kronik yang memenuhi kriteria inklusi dan eksklusi. Pasien melakukan pemeriksaan darah rutin dan fibroscan di RSUP Dr. M. Djamil Padang pada bulan April sampai Agustus 2019. Pemeriksaan nilai MPV menggunakan alat analisis hematologi otomatis metode impedensi. Data dianalisis dengan uji korelasi Pearson. Penelitian dilakukan pada 25 orang pasien hepatitis B kronik, terdiri dari 13 orang laki-laki dan 12 orang perempuan. Hasil: Rerata umur adalah 44 ±11,3 tahun. Rerata nilai MPV adalah 9,9 ±0,94 fL. Rerata derajat fibrosis hati adalah 14 ±9,6 kPa (F4). Uji korelasi Pearson menunjukkan korelasi positif lemah antara nilai MPV dan derajat fibrosis hati (r = 0,28) tetapi tidak bermakna secara statistik (p = 0,18). Simpulan: Terdapat korelasi positif lemah antara nilai MPV dengan derajat fibrosis hati pada pasien hepatitis B kronik.Kata kunci: derajat fibrosis hati, hepatitis B kronik, mean platelet volum
Potensi Kombinasi Naringenin-Liposom Sebagai Anti-Viral dan Anti-Fibrotik dalam Penatalaksanaan Hepatitis C
Full text linkPenatalaksanaan hepatitis C yang umum diberikan di Indonesia adalah terapi kombinasi Peg-IFNα dan RBV, namun terapi tersebut mempunyai efek samping seperti depresi, hipotiroidisme, memperlambat motorik, risiko kardiovaskular tinggi, dan lain sebagainya. Berdasarkan hal tersebut, maka dibutuhkan alternatif yang dapat meminimalisir efek samping yang ditimbulkan dalam penatalaksanaan hepatitis C, salah satunya menggunakan bahan herbal naringenin. Naringenin adalah flavanon alami yang diketahui memiliki efek hepatoprotektif sebagai anti-viral dan anti-fibrotik pada penatalaksanaan hepatitis C.  Metode penulisan yang digunakan dalam karya tulis ilmiah ini adalah metode kajian pustaka. Data yang digunakan berasal dari beberapa sumber literatur yang relevan dan sesuai dengan topik masalah yang dibahas. Naringenin berpotensi sebagai modalitas anti-viral dan anti-fibrotik pada penatalaksanaan hepatitis C. Sebagai anti-viral, naringenin mampu menghambat sekresi virus hepatitis C sebanyak 80% melalui penghambatan aktivitas MTP, ACAT2, dan HMGR. Sebagai anti-fibrotik, naringenin mampu menghambat jalur NF-kB dan TGF-β Smad3, tetapi naringenin memiliki bioavailabilitas dan solubilitas yang rendah, sehingga penyerapannya hanya sebesar 15%. Enkapsulasi naringenin dengan liposom dapat meningkatkan jumlah serapannya pada tubuh, meningkatkan waktu paruh, meningkatkan konsentrasi obat di plasma, serta mudah terkonsentrasi di hati.Kata kunci: hepatitis C, naringenin, liposom, anti-viral, anti-fibrotikÂ
Diagnosis dan Penatalaksanaan Low Risk Papillary Thyroid Carcinoma
Full text linkPapillary Thyroid Carcinoma (PTC) adalah jenis tumor ganas kelenjar tiroid yang sering terjadi dengan pola pertumbuhan yang papiler. Standar baku penegakkan diagnosis PTC adalah dengan gambaran histopatologi dan Fine Needle Aspiration Biopsy (FNAB). Penatalaksanaan sesuai dengan indikasinya dapat berupa ismolobektomi ataupun total tiroidektomi. Dilaporkan kasus perempuan berusia 29 tahun dengan diagnosis low risk papillary thyroid carcinoma stadium II (T2N0M0) dan dilakukan ismolobektomi sinistra. Diagnosis low risk papillary thyroid carcinoma ditegakkan dengan pemeriksaan FNAB dan histopatologis. PTC unilateral ditatalaksana dengan ismolobektomi. Sebagian besar PTC memiliki prognosis yang baik,namun tetap dibutuhkan kontrol secara periodik pasca tindakan operatif.Kata kunci: FNAB, ismolobektomi, PTC, resiko renda
Perbandingan Perubahan Luas Luka dan Angiogenesis pada Luka Bakar Derajat IIB Tikus Sprague Dawley yang Diberikan Advanced Platelet-rich Fibrin dan Advanced Platelet-rich Fibrin Plus
Full text linkPlatelet-rich fibrin (PRF) has a lot of benefits in the process of healing. The new generation of PRF, namely advanced PRF plus (A-PRF+), has a different fibrin structure and more growth factors compared to Advanced PRF (A-PRF), the generation before A-PRF+. Objectives:To compared the effects of A-PRF and A-PRF+ on the IIB degree burn. Methods: This experimental study used 20 male Sprague Dawley rats. All rats were given IIB degree burn and divided into four groups. Group 1 was treated with saline, Group 2 was treated with silver sulfadiazine 1%, Group 3 was treated with A-PRF, and Group 4 was treated with A-PRF+. Wound size reduction will be calculated every two days and measured with ImageJ and the wound would be made into a histological slide on day 14 to calculate angiogenesis. Results: Changes in the wound surface area for the group that was given A-PRF dan A-PRF+ are 2,333cm and 4,827cm. The wound surface area’s data were analyzed using Kruskal-Wallis and the results are statistically not significant (p>0,05). The number of angiogenesis for the group that was give A-PRF and A-PRF+ as followed are 5,88 and 4,867. The angiogenesis data were analyzed using one-way ANOVA and the results are statistically not significant (p>0,05). Conclusion: There is no difference between the effect of A-PRF and A-PRF+ towards changes in wound surface area and angiogenesis in IIB degrees burn wounds.Keywords:  A-PRF, A-PRF+, burn wound, angiogenesis, wound surface are
Hubungan Titer Widal Dengan Jumlah dan Indeks Trombosit Penderita Demam Tifoid di Puskesmas Wilayah Lombok Barat
Full text linkThe diagnosis of typhoid fever can be made by hematological examination and the Widal method. Hematologic change that often occurs in typhoid fever is thrombocytopenia. Platelet function can be observed by examining the platelet index, namely the Mean Platelet Volume (MPV), and Platelet Distribution Width (PDW). The titer on the serological examination of the Widal test is a significant diagnostic for infections caused by the bacterium Salmonella typhi. Objectives: To determine the relationship between the Widal titer and the number and index of platelets in patients with typhoid fever at the West Lombok Health Center. Methods: The research methodology used is an analytic observational method with a cross-sectional approach. This study was conducted from February 2021 to April 2021. The population in this study was all patients who underwent laboratory examinations diagnosed as positive for typhoid fever in the Gunungsari Health Center, West Lombok Regency, with a sample of 24 respondents. Data analysis using Spearman correlation. Results: Statistical test results obtained P≥0.05, namely the titer value against platelets p=0.429, the titer against the MPV platelet index p=1,000, PDW p=0.291. Conclusion: there is no relationship between widal titer to the number of platelets and the platelet index in patients with typhoid fever.Keywords:  typhoid fever, platelets, platelet  index, widal tite
Miliary Tuberculosis in Immunocompromised Patient Induced by Imatinib and Steroid
Full text linkMiliary tuberculosis occurs due to the hematogenous spread of Mycobacterium Tuberculosis from the primary complex.  The use of steroid and cytotoxic drugs increases the incidence of miliary tuberculosis.  Typical manifestations of miliary tuberculosis is snowstorm appearance seen on chest x-ray and evidence of tuberculosis microorganism from the microbiological examination.  It has been reported a 33 years old male patient was admitted to the hospital due to breathlessness, chronic coughing, fever, anorexia, weight loss and night sweating with a "damp shadow sign".  Due to chronic myelogenous leukemia and autoimmune hemolytic anemia, the patient is known under imatinib and steroid therapy.  There was no specific sign found from the physical examination.  Chest x-ray showed snowstorm appearance.  The patient underwent GeneXpert MTB/RIF, with the result low MTB detected.  The patient was treated with a 2(HRZE)/4(HR) tuberculosis drugs regimen.  Imatinib and steroid therapy was discontinued. 2-4 weeks of steroid usage with a daily dose equivalent to prednisone 15 mg increases the risk of activating a latent tuberculosis infection.  Imatinib affects the response of T cells to Mycobacterium, thereby triggering tuberculosis reactivation.  In this case, the diagnosis has been made from typical manifestations of tuberculosis, snowstorm appearance from the chest x-ray, and low MTB detected from GeneXpert MTB/RIF.  It has been recommended to detect latent tuberculosis infection before using steroid and cytotoxic drugs.Keywords:  imatinib, miliary tuberculosis, steroi
Peran Petugas Kesehatan dalam Pencegahan dan Penanganan Stunting di Kabupaten Kolaka
Full text linkThe nutritional problem in toddlers today is stunting which can be prevented by various actions that can be taken by health workers. Objectives: To described the role of health workers in all puskesmas in Kolaka Regency in an effort to prevent stunting.Methods: The design of this study was a descriptive survey by providing closed and open question questionnaires. The population was all health workers serving under-five nutrition spread across 14 health centers in Kolaka Regency. The research sample was determined by purposive sampling so that the number of samples was 30. Results: This study showed that 66.7% of health workers had not attended training, 60% were planning to innovate, but only 33.3% are innovating, and 93.3% are cooperating. The innovations that have been made include forming a nutrition-aware family team and a nutrition-smart mother class, while the obstacles experienced are the lack of public knowledge about stunting, the difficulty of changing people's behavior about the importance of nutrition, the lack of accurate tools in measuring children under five, and the lack of health workers who provide services. Conclusion: The role of health workers in preventing stunting in Kolaka Regency is quite good if it is supported by stunting prevention training and supporting tools so it is recommended that adequate training and tools are needed to prevent stunting.Keywords: Â health workers, toddler nutrition, stuntin
Aktivitas Daya Hambat Isolat Actinomycetes dengan Lama Fermentasi yang Berbeda terhadap Pertumbuhan Klebsiella pneumoniae
Full text linkActinomycetes are filamentous, Gram-positive bacteria widely distributed in soil and can produce secondary metabolites useful as antibiotics. The synthesis of secondary metabolites of Actinomycetes is influenced by the growth conditions of each isolate, including the fermentation period. Klebsiella pneumoniae is an opportunistic bacterial pathogen causing lower respiratory tract infection. Objectives: To determined the inhibition activity of Actinomycetes with different fermentation periods against the growth of  K.pneumoniae. Methods: Actinomycetes were isolated from soil in Kebun Raya Bogor and grown on Starch Casein Agar (SCA) medium before being fermented in liquid media consisting of 2% of mannitol, 2% of peptone, and 1% of glucose with an incubation time of 6,7, and 8 days. An antibacterial activity test was conducted on Mueller Hinton Agar (MHA) medium using the well diffusion method. Results: The activity of Actinomycetes isolates with fermentation duration of 6,7 and 8 were able to inhibit the growth of K. pneumoniae with an average inhibition zone of 4,46 mm; 4,94 mm; and 5,04 mm, respectively. Actinomycetes' inhibitory mechanism ranges from inhibition of cell wall synthesis to nucleic acid and protein synthesis. One Way ANOVA test showed significant differences between the inhibition zone produced by each fermentation group. Conclusion: Actinomycetes isolates have antibacterial activity against the growth of K. pneumoniae with the highest activity achieved by Actinomycetes with a fermentation time of 8 days.Keywords:  Actinomycetes, antibacterial, fermentation, Klebsiella pneumonia
Risiko Perdarahan Saluran Cerna pada Pasien COVID-19 berdasarkan Jenis Obat Antivirus di Rumah Sakit Umum Pusat Dr. M. Djamil Padang
Full text linkCoronavirus disease 2019 (COVID-19) has become a global pandemic to date. Some studies reported gastrointestinal tract (GIT) bleeding occurs in several patients hospitalized with COVID-19. Medications known to be associated with an increased risk of GIT bleeding were not associated with GIT bleeding in COVID-19 patients. Objectives: To examined the risk of gastrointestinal tract (GIT) bleeding in COVID-19 patients based on antiviral drugs at Dr. M. Djamil General Hospital Padang. Methods: A nested cohort study was conducted in Dr. M. Djamil General Hospital Padang from May until October 2021. All COVID-19 patients who received antiviral drugs with GIT bleeding with onset days 0 - 7 were included. COVID-19 was confirmed by RT-PCR swab. Data entry and analysis were conducted by computerized. Results: 30 patients were involved in this study. 43,3% COVID-19 Moderate stage and 56,7% Severe stage. 63,3% were treated with remdesivir and 36,7% were treated with favipiravir. Onset on GIT tract bleeding at day 4 (23,3%), day 5 (26.7%), day 6 (30%), and day 7 (20%). The Chi-square test to determine the factors associated with GIT bleeding in COVID-19 patients including COVID-19 severity, type of antiviral drugs, anticoagulant, and corticosteroid revealed that none of all potential factors above related to GI bleeding. Conclusion: The type of antiviral drugs was not related to GIT bleeding in COVID-19 patients.Keywords: antiviral drugs, Â COVID-19, gastrointestinal tract bleedin
Kombinasi Injeksi Triamsinolon Asetat Intralesi dan Propanolol Oral pada Kasus Hemangioma Kapiler Palpebra
Full text linkCapillary hemangioma is a benign tumor developed from the abnormal proliferation of blood vessels. This tumor appears on eyelids and orbit. Around 75% of hemangioma resolves spontaneously in the first 4-5 years of life. Intervention is needed in hemangioma that obstructs the visual axis. It has been reported that a two-year-old girl came to Polyclinic with a mass on the left superior eyelid 1,5 years ago. At first, the left superior eyelid looked puffy, then developed slowly until it covered the left eye. On the examination of the left eye, visual acuity assessment was hard to perform. Mass in superior palpebral was 8mm x 8mm x 8mm, reddish colored (different with adjacent skin), consistency supple, mobile, painful (-), edema (+), horizontal palpebral fissure (FPH) 30 mm, vertical palpebral fissure (FPV) 0 mm. CT scan showed suspected hemangioma. The patient was diagnosed with capillary hemangioma and given an injection of triamcinolone acetate intralesional and oral propranolol under the supervision of a pediatrician. Significant clinical improvement was observed after 40 days of injection, where the mass was resolved completely. The FPV and FPH of the left eye had improved to 9 mm and 30 mm, respectively, with the patient finally able to follow the object. The combination of intralesional triamcinolone acetate and oral propranolol in this case is quite effective in providing complete resolution of capillary hemangioma.Keywords: Â capillary hemangioma, triamcinolone acetate injection, propanolo