21 research outputs found
PENCEGAHAN STUNTING : Pentingnya Peran 1000 Hari Pertama Kehidupan
No full textxviii, 176 hlm., 25,5 cm
Community structure of fish larvae in mangroves with different root types in Labuhan coastal area, Sepulu – Madura
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TERAPI MEDIK GIZI PADA PASIEN SPACE OCCUPYING LESION SEREBELUM METASTASIS DENGAN RISIKO TINGGI SINDROM REFEEDING
No full textMetastasis otak merupakan keganasan terbanyak pada susunan saraf pusat yang dapat menimbulkan penurunan kesadaran, menurunkan asupan nutrisi, meningkatkan risiko malnutrisi serta terjadinya gangguan elektrolit yang dapat meningkatkan risiko terjadinya sindrom refeeding. Laporan kasus ini bertujuan untuk membahas tatalaksana pasien dalam menjaga status nutrisi dan meningkatkan kualitas hidup pada pasien space occupying lesion (SOL) serebelum metastasis dengan risiko sindrom refeeding. Laporan kasus berasal dari pasien rawat inap yaitu perempuan berusia 54 tahun dengan diagnosis hidrosefalus obstruktif ec SOL serebelum suspek metastasis, karsinoma mammae sinistra stadium III T3N3M1 dengan malnutrisi berat, kaheksia kanker, dan risiko tinggi sindrom refeeding. Pasien mengalami kondisi malnutrisi dan terdapat gangguan elektrolit. Pasien menalami penurunan kesadaran dan membutuhkan jalur nutrisi artifisial. Pasien mendapatkan terapi medik gizi berupa peningkatan nutrisi bertahap dan koreksi elektrolit. Namun, kondisi klinis pasien kurang baik ditandai adanya efusi pleura masif dan perdarahan saluran cerna sehingga pasien dalam kasus tersebut meninggal. Pemberian nutrisi pada pasien dengan risiko sindrom refeeding disesuaikan dengan kondisi klinis, ditingkatkan bertahap, dan mengatasi gangguan elektrolit.
kata kunci : kaheksia, kanker, malnutrisi, metastasis, sindrom refeedin
The Enforcement of Emergency Law Number 7 of 1955 Concerning Investigation, Prosecution, and Justice of Economic Crime, in Supporting the Governance Policy of Subsidized Fertilizer
Full text linkSince globalization, law, especially in the realm of criminal law, has undergone many changes, and many developments have even evolved into new forms. The development of crime has implications for the rapid evolution of rules regarding criminal acts. Indonesia is familiar with arrangements regarding economic crimes since the existence of Emergency Law Number 7 of 1955 concerning the investigation, prosecution, and justice of economic crime. This law is the forerunner to the rules of economic criminal law in Indonesia which is an adaptation of Wei op de Economische Delichten 1950 from the Dutch, but has been adapted to the conditions in Indonesia. Economic Crimes are criminal acts or crimes or offenses in the economic field that can harm the state. Indonesia is known as an agrarian country where most of the population depends on the agricultural sector, which is why subsidized fertilizer management is an important matter for attention because the availability of fertilizer is one of the determinants of the sustainability of food production in Indonesia. Subsidized fertilizer from the government has the aim of helping farmers to obtain fertilizer at low prices, the distribution of subsidized fertilizer is monitored by the government so that it is right on target for recipients. However, in reality, there have been irregularities in the management of subsidized fertilizers, one of which was in a case that was decided based on Criminal Decision Number 87/Pid.B/2014/PN.Kds. Emergency Law No. 7 of 1955 is a law that has specificity because it regulates criminal acts in the economic sphere that are not regulated in the Criminal Code (KUHP). This research is to show how the enforcement of Emergency Law Number 7 of 1955 which is in line with the subsidized fertilizer management policy encouraged the progress of the Indonesian economy
Diagnosis of brain metastasis due to lung cancer and affecting factors at “Dr. Cipto Mangunkusumo” General Hospital
Full text linkBackground and objectives. The incidence of brain metastases is higher than primary brain tumors, with lung cancer as a common etiology at “Dr. Cipto Mangunkusumo” General Hospital. Delay in diagnosis can cause brain herniation, resulting in disability and death. We aimed to investigate the compatibility between daily clinical practice and clinical practice guidelines for diagnosing brain metastases due to lung cancer at “Dr. Cipto Mangunkusumo” General Hospital while also examining factors that might influence the duration of the diagnosis. Materials and methods. We conducted a retrospective cohort study to determine the conformity between the duration of diagnosis of metastatic brain tumors due to lung cancer in daily clinical practice with clinical practice guidelines. Secondary data was obtained from medical records from November 2021 until June 2022. Results. Twelve subjects (30%) were diagnosed with brain metastases from lung cancer within two weeks with a median duration of 18.5 days (IQR 12-34 days). The duration of 7 days (IQR 4-11 days) was required to obtain a lung mass, 8 days (IQR 4.5-13 days) to perform a biopsy, and 6 days (IQR 3.5-7 days) to obtain t pathology results. No statistically significant relationship exists between the variables assessed and the duration of diagnosis. Conclusions. The clinical practice guidelines at “Dr. Cipto Mangunkusumo” General Hospital for diagnosing brain metastases from lung cancer within two weeks could only be carried out in 30% of subjects in this study. Collaboration between departments is needed to make the diagnosis faster
Profil Gangguan Kognitif pada Tumor Intrakranial Primer dan Metastasis
Full text linkGangguan kognitif sering menyertai pasien tumor intrakranial dan menjadi penyebab utama disabilitas. Perbedaan patofisiologi tumor intrakranial primer (TIP) dan metastasis (TM) menyebabkan perbedaan gambaran klinis dan derajat gangguan kognitif. Tujuan penelitian ini untuk mengetahui prevalensi dan profil gangguan kognitif pasien TIP dan TM. Disain penelitian potong-lintang retrospektif menggunakan data sekunder dari Poliklinik Saraf RSCM pada bulan Januari 2011-Desember 2013. Subjek berusia 18-65 tahun yang didiagnosis TIP dan TM berdasarkan anamnesis, pemeriksaan fisik, CT scan atau MRI kepala, dan atau histopatologi. Terdapat 121 subjek, 79 TIP dan 27 TM; usia rerata TIP 43,7 tahun dan TM 50,9 tahun. Pada kelompok TM mayoritas (40,7%) memiliki lesi di kedua hemisfer sedangkan TIP hanya di satu hemisfer. Lokasi tumor pada TM lebih dari 1 lobus (51,9%). Gangguan kognitif lebih banyak pada TM (81,5%) dibandingkan TIK (52,5%) dengan domain tersering gangguan visuospasial. Subjek TM mengalami gangguan kognitif lebih berat dibandingkan TIP (rerata MMSE 20,96 dan 22,61). Gangguan kognitif lebih banyak pada kelompok TM dibandingkan TIP dengan gangguan kognitif lebih berat karena mayoritas lesi tumor mengenai lebih dari 1 lobus
Terapi Medik Gizi Pada Pasien Space Occupying Lesion Serebelum Metastasis Dengan Risiko Tinggi Sindrom Refeeding
No full textMetastasis otak merupakan keganasan terbanyak pada susunan saraf pusat yang dapat menimbulkan penurunan kesadaran, menurunkan asupan nutrisi, meningkatkan risiko malnutrisi serta terjadinya gangguan elektrolit yang dapat meningkatkan risiko terjadinya sindrom refeeding. Laporan kasus ini bertujuan untuk membahas tatalaksana pasien dalam menjaga status nutrisi dan meningkatkan kualitas hidup pada pasien space occupying lesion (SOL) serebelum metastasis dengan risiko sindrom refeeding. Laporan kasus berasal dari pasien rawat inap yaitu perempuan berusia 54 tahun dengan diagnosis hidrosefalus obstruktif ec SOL serebelum suspek metastasis, karsinoma mammae sinistra stadium III T3N3M1 dengan malnutrisi berat, kaheksia kanker, dan risiko tinggi sindrom refeeding. Pasien mengalami kondisi malnutrisi dan terdapat gangguan elektrolit. Pasien menalami penurunan kesadaran dan membutuhkan jalur nutrisi artifisial. Pasien mendapatkan terapi medik gizi berupa peningkatan nutrisi bertahap dan koreksi elektrolit. Namun, kondisi klinis pasien kurang baik ditandai adanya efusi pleura masif dan perdarahan saluran cerna sehingga pasien dalam kasus tersebut meninggal. Pemberian nutrisi pada pasien dengan risiko sindrom refeeding disesuaikan dengan kondisi klinis, ditingkatkan bertahap, dan mengatasi gangguan elektrolit.
kata kunci : kaheksia, kanker, malnutrisi, metastasis, sindrom refeedin
Multidisciplinary re-evaluation of neuropsychiatric events to confirm the neuropsychiatric lupus diagnosis at an Indonesian tertiary hospital
No full textObjective Neuropsychiatric SLE (NPSLE) has a broad spectrum and to date, there is no gold-standard biomarker. The diagnosis relies on clinical assessment, supporting examinations and exclusion of other possible aetiologies. One method that can be used to establish NPSLE is to conduct a re-evaluation by involving several fields of medical science. This study aims to reassess SLE cases with neuropsychiatric (NP) manifestations through multidisciplinary re-evaluation and determine the final diagnosis of NPSLE or non-NPSLE.Methods This retrospective cross-sectional study used medical record data from patients with SLE with NP manifestations. Inclusion criteria included patients diagnosed with SLE, who had clinical manifestations of NP and were >18 years old. Multidisciplinary re-evaluation was conducted and agreed upon the diagnosis of NPSLE or non-NPSLE.Results We included 94 subjects with a total of 132 NP events consisting of 69 NPSLE and 63 non-NPSLE. After re-evaluating NPSLE events, 33.3% were still concluded to be NPSLE. Meanwhile, from the non-NPSLE group, 22.2% were then declared as NPSLE. There were no significant differences in demographic characteristics between the NPSLE and non-NPSLE groups. The proportion of NP events in both groups was almost the same except for cerebrovascular disease manifestations which were more common in the NPSLE group. Higher Mexican SLE Disease Activity Index scores with (p<0.001) or without NP (p=0.02) were observed in the NPSLE group compared with the non-NPSLE group, as well as higher proportion of active disease (p=0.03), higher anti-double-stranded DNA titres (p<0.001) and lower values of C3 (p=0.018) and C4 (p=0.001).Conclusions Multidisciplinary re-evaluation can be used as a method to confirm the diagnosis of NPSLE. There is a tendency for overdiagnosis of NPSLE when clinicians are faced with NP events in patients with SLE. Complete clinical and supporting data are needed to determine the final diagnosis of NPSLE
Sensation assessed with 20 Semmes Weinstein monofilament, scored 0–20 from the largest filament (180 g) to the smallest (0,008 g).
No full textAs seen on the figure, Patient 1 and Patient 2 showed improvement in the dorsal branch, while Patient 4 showed improvement in the superficial branch. There was no improvement for Patient 3.</p
