Medical Scope Journal

Profil Acute Kidney Injury pada Anak yang Dirawat di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Manado

Putri C. Ango, Adrian Umboh, Praevilia M. Salendu — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Acute kidney injury (AKI) is a clinical condition as evidenced by elevated levels of creatinine and urea, as well as a decrease in glomerular filtration rate (GFR). This study aimed to determine the profile of AKI in children admitted to the Pediatric Department of Prof. Dr. R. D. Kandou General Hospital, Manado, during the period from January 2020 to August 2023. This was a retrospective and descriptive study with an observational approach and a cross-sectional design. Samples included all children who were diagnosed with AKI. The results obtained 121 patients with AKI, aged 1 month to 18 years, comprising 53.7% males, 46.3% females. Pre-renal AKI accounted for 61.1%, while renal AKI was 38.9%. Common clinical features included fever (75.3%), respiratory distress (61.2%), edema (49.7%), oliguria (93.3%), proteinuria (54.5%), azotemia (100.0%), microscopic hematuria (61.2%), leukocyturia (43.8%), hyponatremia (53.0%), hypocalcemia (47.2%), hypochloremia (48.0%), sepsis (42.1%), septic shock (17.3%), and metabolic acidosis (2.4%). In conclusion, AKI was most commonly found in the age group of 11-15 years, with a higher prevalence in males than females. The most common etiology was pre-renal AKI, with oliguria, fever, and respiratory distress being the most common clinical symptoms. Laboratory examinations commonly showed azotemia, hematuria, proteinuria, and leukocyturia.

Keywords: acute kidney injury; children; clinical features; complication

Abstrak: Acute Kidney Injury (AKI) adalah sebuah keadaan klinis dimana terjadi peningkatan kreatinin dan urea serta penurunan laju filtrasi glomerulus (LFG). Penelitian ini bertujuan untuk mengetahui profil AKI pada anak yang dirawat di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2020-Agustus 2023. Jenis penelitian ialah deskriptif retrospektif dan observasional dengan desain potong lintang. Sampel penelitian ini ialah semua anak yang dirawat dan didiagnosis AKI. Hasil penelitian mendapatkan 121 pasien dengan diagnosis AKI, usia 1 bulan-18 tahun, laki-laki 53,7%, perempuan 46,3%. AKI pre-renal 61,1%, AKI renal 38,9%. Demam 75,3%, sesak napas 61,2%, edema 49,7%, oliguria 93,3%, proteinuria 54,5%, azotemia 100,0%, hematuria mikroskopis 61,2%, leukosituria 43,8%, hiponatremia 53,0%, hipokalsemia 47,2%, hipokloremia 48,0%, sepsis 42,1%, syok sepsis 17,3%, dan asidosis metabolik 2,4%. Simpulan penelitian ini ialah AKI ditemukan tersering pada rentang usia 11-15 tahun, lebih sering pada laki-laki dibandingkan perempuan, etiologi terbanyak ialah AKI pre-renal, gejala klinis tersering ialah oliguria, demam dan sesak napas. Pemeriksaan laboratorium tersering ditemukan azotemia, hematuria, proteinuria, serta leukosituria.

Kata kunci: acute kidney injury; anak; gangguan ginjal akut; komplikasi

Gambaran Pengetahuan, Sikap, dan Tindakan Penggunaan Tabir Surya pada Mahasiswa Program Studi Kedokteran Umum Fakultas Kedokteran Universitas Sam Ratulangi

Angel R. F. Siregar, Tara S. Kairupan, Ferra O. Mawu — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Excessive exposure of skin to sunlight without protection can lead to skin damage such as sunburn, pigmentation disorders, premature aging, and increased risk of skin cancer. Sunscreen application is an effective method to protect the skin from adverse effects of sunlight. The proper selection and correct application of sunscreen significantly influence its effectiveness in protecting the skin. This study aimed to assess the knowledge, attitude, and action related to sunscreen usage among medical students of Universitas Sam Ratulangi. This was a descriptive study with a cross-sectional design. Primary data were collected by distributing questionnaires to the medical students. The results showed that the knowledge level of the respondents was categorized as fair (44.2%); the attitude towards sunscreen usage was considered good (57.4%); and the action of sunscreen application was poor (48.6%). In conclusion, related to sunscreen usage, medical students of Universitas Sam Ratulangi have fair knowledge and action meanwhile the attitude is in the good category.

Keywords: sunscreen; ultraviolet radiation; medical students

Abstrak: Paparan sinar matahari berlebihan pada kulit tanpa perlindungan dapat menimbulkan kerusakan kulit seperti sunburn, gangguan pigmentasi, penuaan dini, serta meningkatkan risiko kanker kulit. Tabir surya merupakan salah satu cara yang dapat dilakukan untuk melindungi diri dari dampak negatif sinar matahari. Cara pemilihan tabir surya yang ideal dan penggunaan tabir surya yang baik dan benar sangat memengaruhi efektivitas tabir surya dalam melindungi kulit. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan, sikap, dan tindakan penggunaan tabir surya pada mahasiswa Program Studi Kedokteran Umum Fakultas Kedokteran Universitas Sam Ratulangi (FK Unsrat). Jenis penelitian ialah deskriptif dengan desain potong lintang. Data primer dikumpulkan dengan membagikan kuesioner kepada mahasiswa FK Unsrat. Hasil penelitian mendapatkan tingkat pengetahuan responden berada di kategori cukup (44,2%), tingkat sikap penggunaan tabir surya responden berada di kategori baik (57,4%) dan tingkat tindakan penggunaan tabir surya responden berada di kategori cukup (48,6%). Simpulan penelitian ini ialah pengetahuan serta tindakan responden berada pada kategori cukup, sedangkan sikap responden pada kategori baik.

Kata kunci: tabir surya; sinar ultraviolet; mahasiswa kedokteran

Hubungan Emotional Quotient dengan Indeks Prestasi Kumulatif Mahasiswa Angkatan 2020 Fakultas Kedokteran Universitas Sam Ratulangi

Livia C. Winengko, Heriyannis Homenta, Siemona L. E. Berhimpon — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Emotional quotient (EQ) is the ability to understand and control emotions in oneself and others. The essentials to develop EQ are superior in medical students due to future work professions that require skills to maintain interactions with patients and other medical workers. This study aimed to evaluate the correlation between EQ and the Cumulative Achievement Index in medical students class of 2020, Faculty of Medicine, Universitas Sam Ratulangi. This was an observational and analytical study with a cross-sectional design. Samples were 160 students from the class of 2020 at the Faculty of Medicine, Universitas Sam Ratulangi. The EQ value was measured using the TEIQue-SF instrument, while the Cumulative Achievement Index was obtained from the student transcripts. The result showed that most of the students have moderate EQ (77.5%) and Cumulative Achievement Index that predicated with a compliment (55%). There was an insignificant correlation between EQ and the Cumulative Achievement Index (p=0.506; r=0.053), and the correlation was positive and very weak. In conclusion, there is a positive but insignificant correlation between EQ and Cumulative Achievement Index among students class of 2020, Faculty of Medicine, Universitas Sam Ratulangi.

Keywords: Emotional Quotient; Cumulative Achievement Index; Trait Emotional Intelligence Questionnaire-Short Form

Abstrak: Emotional Quotient (EQ) adalah kemampuan memahami dan mengendalikan emosi pada diri sendiri dan orang lain. Kebutuhan untuk mengembangkan EQ yang lebih tinggi pada mahasiswa Fakultas Kedokteran karena profesi kinerja ke depannya membutuhkan keterampilan guna membangun interaksi dengan pasien dan tenaga medis lainnya. Penelitian ini bertujuan untuk mengevaluasi hubungan EQ dengan Indeks Prestasi Kumulatif (IPK) mahasiswa angkatan 2020 Fakultas Kedokteran Universitas Sam Ratulangi (FK Unsrat). Penelitian ini menerapkan pendekatan observasional analitik dan studi potong lintang. Sampel penelitian ialah 160 mahasiswa angkatan 2020 FK Unsrat. Nilai EQ diukur menggunakan instrumen TEIQue-SF dan nilai IPK diperoleh dari transkip nilai mahasiswa. Hasil penelitian memperlihatkan bahwa sebagian besar mahasiswa memiliki EQ kategori sedang (77,5%) dan predikat IPK dengan pujian (55%). Terdapat hubungan tidak bermakna antara EQ dengan IPK kekuatan korelasi sangat lemah dan arah korelasi positif (p=0,506; r=0,053). Simpulan penelitian ini ialah terdapat hubungan positif yang tidak bermakna antara Emotional Quotient dengan Indeks Prestasi Kumulatif mahasiswa angkatan 2020 Fakultas Kedokteran Universitas Sam Ratulangi.

Kata kunci: Emotional Quotient; Indeks Prestasi Kumulatif; Trait Emotional Intelligence Questionnaire-Short Form

Gambaran Ultrasonografi Ginjal pada Penderita Penyakit Ginjal Kronis dengan Diabetes Melitus di RSUP Prof. Dr. R. D. Kandou Periode Juli 2022 hingga Juli 2023

Wiwi Bolong, Joan F. J. Timban, Alfa G. E. Y. Rondo — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Chronic kidney disease (CKD) occurs due to a long-lasting and irreversible decline in kidney function. This disease has a close relationship with diabetes mellitus (DM). Diabetic patients tend to experience microvascular complications, namely diabetic nephropathy which is the main cause of CKD. This study aimed to obtain the description of renal ultrasound in CKD patients with DM at Prof. Dr. R. D. Kandou Hospital from July 2022 to July 2023. This was a descriptive and retrospective study with a cross sectional design using proportional random sampling. The results obtained 68 samples of CKD patients with DM, dominated by females (57.4%), age group >65 years (32.4%), and had hemodialysis treatment (54.4%). The majority of CKD patients with DM were at level 2 severity based on the results of kidney ultrasound examination, where many had normal kidney size, increased parenchymal echogenicity, normal cortex thickness, clear echo cortex and medulla boundaries, normal pelvicalyceal system, and cysts as well as stones. In conclusion, the majority of chronic kidney disease patients with diabetes mellitus are females, aged over 65 years, have hemodialysis treatment, and are at level 2 severity.

Keywords: renal ultrasound; chronic kidney disease; diabetes mellitus

Abstrak: Penyakit ginjal kronis (PGK) terjadi karena penurunan fungsi ginjal yang berlangsung lama dan bersifat ireversibel. Penyakit ginjal kronis memiliki hubungan erat dengan diabetes melitus (DM). Penyandang DM akan mengalami komplikasi mikrovaskular yaitu nefropati diabetik yang menjadi penyebab utama terjadinya PGK. Penelitian ini bertujuan untuk mengetahui gambaran ultrasonografi ginjal pada penderita PGK dengan DM di RSUP Prof. Dr. R. D. Kandou periode Juli 2022 hingga Juli 2023. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang dengan menggunakan teknik proportional random sampling. Hasil penelitian mendapatkan 68 sampel penderita PGK dengan DM, didominasi oleh jenis kelamin perempuan (57,4%), usia >65 tahun (32,4%), dan melakukan perawatan hemodialisis (54,4%). Mayoritas penderita PGK dengan DM berada pada derajat keparahan tingkat 2 berdasarkan hasil pemeriksaan USG ginjal, dimana banyak ditemukan ukuran ginjal normal, ekogenisitas parenkim meningkat, ketebalan korteks normal, batas echo korteks dan medula jelas, sistem pelvicalyceal normal, terdapat kista dan batu. Simpulan penelitian ini ialah mayoritas penderita penyakit ginjal kronis dengan diabetes melitus mayoritas ialah perempuan, kelompok usia >65 tahun, melakukan perawatan hemodialisis, dan berada pada derajat keparahan tingkat 2.

Kata kunci: ultrasonografi ginjal; penyakit ginjal kronis; diabetes melitus

Hubungan Usia, Pendidikan dan Pekerjaan dengan Kasus Kekerasan dalam Rumah Tangga di Kota Manado

Yunita Hutahaean, Erwin G. Kristanto, Nola T. S. Mallo — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Violence often occurs in personal relationships where the abuser is the person closest to the victim, and can involve anyone, including wife, children, and even people who live with the perpetrator. This study aimed to evaluate the relationship between age, education, and occupation with cases of domestic violence in Manado. The results showed that there were 49 victims of domestic violence cases with the overall gender of the victims was female (100%). Majority of victims were aged 15-64 years (87.76%), had high educational background (83.7%) and occupation status not working (81.6%). The chi-square analysis showed that age (p=0.016), education level (p=0.05), and occupational status (p=0.011) had significant relationships with the incidence of domestic violence cases in Manado city. In conclusion, there is a significant relationship between age, education, and occupation with the incidence of domestic violence in Manado.

Keywords: age; education; occupation; domestic violence

Abstrak: Kekerasan kerap terjadi dalam hubungan personal dimana pelaku kekerasan ialah orang terdekat dengan korban, dan bisa melibatkan siapa saja termasuk istri, anak-anak, dan bahkan orang yang tinggal bersama pelaku. Penelitian ini bertujuan untuk mengevaluasi hubungan usia, pendidikan dan pekerjaan terhadap kasus kekerasan dalam rumah tangga (KDRT) di Manado. Hasil penelitian memperlihatkan sebanyak 49 korban kasus KDRT dengan keseluruhan jenis kelamin korban yaitu perempuan (100%). Mayoritas korban tergolong kategori usia produktif yaitu 15-64 tahun (87,76%) dengan latar belakang pendidikan yang tinggi (83,7%) dan status pekerjaan tidak bekerja (81,6%). Hasil uji chi-square menunjukkan bahwa usia (p=0,016), tingkat pendidikan (p=0,05), dan status pekerjaan (p=0,011) memiliki hubungan bermakna terhadap kejadian kasus KDRT di Kota Manado. Simpulan penelitian ini ialah terdapat hubungan bermakna antara usia, pendidikan, dan pekerjaan dengan kejadian kasus kekerasan dalam rumah tangga di Kota Manado.

Kata kunci: usia; pendidikan; pekerjaan; kekerasan dalam rumah tangga

Reconstruction of Lower Eyelid in Basal Cell Carcinoma Case with Adjunctive Hyperbaric Oxygen Therapy: A Case Report

Yulius A. M. Chietra, Mendy J. Hatibie, Ramli Dali — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Basal cell carcinomas (BCCs) are the most common cancers in humans, caused by exposure to ultraviolet light and are associated with PTCH1 gene mutation. Its incidence rate significantly increases per year especially in elderly people. Several modalities are available for BCC treatment but surgery is still considered as the gold standard. Oxygen is mandatory for almost all wound healing processes, and oxygen substitution can be delivered in the form of hyperbaric oxygen (HBO) therapy. We presented a 70 years old woman with a major complaint of a tumor located in the left infrapalpebral region, below the left lower lash line with 5 years of evolution. Patient had clinical presentation of solid nodular basal cell carcinoma which was the most common clinical subtype. Patient was diagnosed as having BCC based on history taking, clinical findings, and histopathological examination. Surgical wide excision, skin flap, and HBO as the adjunctive therapy were performed on this patient. With these techniques, healing time was reduced, complications rates were low, and cosmetic outcome was much better. In conclusion, closing defects of BCC case with surgical wide excision and flap yields a remarkable outcome and an adjunctive HBO therapy after surgery optimizes the oxygenation, thus, the healing potential of tissue prior to surgery, and accelerates wound healing post operatively. A good result with short healing duration was observed.

Keywords: basal cell carcinoma; hyperbaric oxygen therapy; flap; wound healing

Gambaran Faktor yang Memengaruhi Tren Angka Kejadian dan Keparahan Demam Berdarah Dengue pada Anak di RSUP Prof. Dr. R. D. Kandou Manado Periode 2020-2022

Siti C. Windhasari, David S. Waworuntu, Suryadi N. N. Tatura — Sat, 01 Jun 2024 00:00:00 +0800

Abstract: Dengue infection remains as a significant global health issue due to its rapid spread and increasing number of cases each year. Dengue hemorrhagic fever (DHF) and its severity, dengue shock syndrome (DSS), can be caused by various factors, namely the host, behavior, environment, vectors, health services, and agents. This study aimed to determine the factors that influenced the trend of incidence and severity of DHF at Prof. R. D. Kandou Hospital, Manado. This was a descriptive and analytical study with a cross sectional design. The statistical analysis showed a significant correlation with a negative direction between air temperature and DHF incidence rate (p = 0.029, r = -0.363). Air humidity and rainfall did not have a significant relationship with DHF incidence. Based on the place of residence, a significant association was found with the severity of DHF (p=<0.001, OR=234.103). No significant association was found between economic level and the severity of the disease. In conclusion, there are significant relationships between air temperature and the incidence of DHF, and between the place of residence and the severity of the disease. It is expected that the government and the community can include these factors as indicators in efforts to prevent and control DHF and its severity.

Keywords: dengue hemorrhagic fever; dengue shock syndrome; risk factors; children

Abstrak: Infeksi dengue masih menjadi salah satu isu kesehatan global yang signifikan oleh karena penyebarannya yang cepat serta peningkatan jumlah kasus tiap tahunnya. Demam berdarah dengue (DBD) dan keparahannya yakni dengue shock syndrome (DSS) dapat diakibatkan oleh berbagai faktor, yakni faktor pejamu, perilaku, lingkungan, vektor, pelayanan kesehatan, dan agen. Penelitian ini bertujuan untuk mengetahui gambaran dari faktor-faktor yang memengaruhi tren angka kejadian dan keparahan DBD di RSUP Prof. R. D. Kandou Manado. Jenis penelitian ialah analitik deskriptif dengan desain potong lintang. Hasil analisis menunjukkan adanya korelasi bermakna dengan arah negatif antara suhu udara dengan angka kejadian DBD (p=0,029; r=-0,363). Kelembaban udara dan curah hujan tidak memiliki hubungan bermakna terhadap angka kejadian DBD. Berdasarkan tempat tinggal, didapatkan hubungan bermakna dengan tingkat keparahan DBD (p=<0,001; OR=234,103). Tidak terdapat hubungan bermakna antara tingkat ekonomi dengan tingkat keparahan penyakit. Simpulan penelitian ini ialah terdapat hubungan bermakna antara suhu udara dengan kejadian DBD, dan antara tempat tinggal dengan tingkat keparahan penyakit. Diharapkan bagi pemerintah dan masyarakat dapat mengikutsertakan faktor-faktor tersebut sebagai indikator dalam upaya pencegahan maupun penanggulangan DBD serta keparahannya.

Kata kunci: demam berdarah dengue; dengue shock syndrome; faktor risiko; anak

Impact of Calorie Intake on Cardiovascular Disease Risk Factors for Young Adults Working from Home During the COVID-19 Pandemic

Diniwati Mukhtar, Karina A. D. A. Ridwan, Hasna L. Fitriani — Tue, 04 Jun 2024 00:00:00 +0800

Abstract: During the COVID-19 pandemic, working from home (WFH) led to increased passivity, potentially affecting body mass index (BMI), waist circumference (WC), and blood pressure (BP) values, which are risk factors for cardiovascular disease (CVD). This study aimed to determine the impact of calorie intake on these risk factors in young adults working from home during the COVID-19 pandemic. This experimental study employed a one-group pre- and post-test design conducted over two months. Respondents' daily physical activities were recorded using Bouchard's questionnaire, and a food record method was used to document all foods consumed over three days. The study followed up with respondents for two months. The results indicated that respondents with good physical activity levels experienced a decrease in BMI: 53.3% of men and 37.5% of women. Adequate calorie intake also contributed to a decrease in BMI, with 53.3% of men and 57.1% of women showing reductions. However, the t-test showed p-values >0.05 for the correlations between calorie intake and BMI, WC, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In conclusion, there was no significant impact of calorie intake on risk factors for CVD, such as obesity and high blood pressure. Nonetheless, it was observed that appropriate calorie intake could potentially prevent the increase of these risk factors.

Keywords: calorie intake; cardiovascular disease; COVID-19 pandemic

Torsades de Pointes Akibat Bradikardia

James C. Kurniawan, Benny M. Setiadi, Starry H. Rampengan — Wed, 05 Jun 2024 00:00:00 +0800

Abstract: Torsades de pointes (TdP) is a fatal tachyarrhythmia that has the potential to degenerate into ventricular fibrillation. The occurrence of TdP is associated with prolongation of the QT interval on the electrocardiogram (ECG), which is often found in bradycardia patients. We reported an 86-year-old female who experienced recurrent fainting episodes in the past month. From the ECG we recorded sinus rhythm was bradycardia with a heart rate of 43 bpm with a high degree of atrioventricular block, with a prolongation of the QT interval reaching 640 milliseconds. The patient was not taking any medications known to have the effect of prolonging the QT interval. The patient underwent a series of examination. Blood and electrolyte tests were within normal limit. Echocardiography examination showed good heart pump function and no structural abnormalities were found. The 24-hour Holter examination recorded a TdP rhythm with a heart rate of 180 bpm which was spontaneos termination. The patient underwent a permanent dual chamber pacemaker implantation. At post-insertion follow-up, the patient never experienced another fainting episode. In conclusion, bradycardia on ECG is known to prolong the QT interval thereby predisposing to torsades de pointes. Implantation of a permanent pacemaker was done and was successful in treating bradycardia, shortening the QT interval thereby suppressing the occurrence of torsades de pointes.

Keywords: torsades de pointes; bradycardia; atrioventricular block

Abstrak: Torsades de pointes (TdP) merupakan takiaritmia fatal yang berpotensi berdegenerasi menjadi fibrilasi ventrikel. Kejadian TdP dikaitkan dengan pemanjangan interval QT pada elektrokardiogram (EKG), yang seringkali dijumpai pada pasien bradikardia. Kami melaporkan kasus seorang pasien wanita berusia 86 tahun yang mengalami episode pingsan berulang dalam satu bulan terakhir. Dari gambaran EKG didapatkan irama sinus bradikardia dengan laju jantung 43x per menit dengan blok atrioventrikular derajat tinggi, dengan pemanjangan interval QT mencapai 640 milidetik. Pasien tidak mengonsumsi obat-obatan yang diketahui memiliki efek memperpanjang interval QT. Pasien menjalani serangkaian penunjang. Pemeriksaan darah dan elektrolit hasilnya normal. Pemeriksaan ekokardiografi menunjukkan fungsi pompa jantung baik dan tidak ditemukan adanya abnormalitas struktur jantung. Pemeriksaan Holter 24 jam berhasil merekam irama TdP dengan laju jantung 180x per menit yang mengalami terminasi spontan. Pada pasien dilakukan pemasangan alat pacu jantung permanen dual chamber. Pada follow up paska pemasangan, pasien tidak pernah mengalami episode pingsan lagi. Simpulan kasus ini ialah bradikardia pada elektrokardiogram diketahui memperpanjang interval QT sehingga memredisposisi terjadinya TdP. Pemasangan alat pacu jantung permanen pada pasien dipilih sebagai langkah tatalaksana, dan terbukti berhasil mengatasi bradikardia, memperpendek interval QT sehingga mensupresi terjadinya torsades de pointes.

Kata kunci: torsades de pointes; bradikardia; blok atrioventrikular

Pengaruh Suhu dan Lama Penyimpanan Urine Pasien Infeksi Saluran Kemih terhadap Jumlah Bakteri

Vidayatul Aziza, Chylen S. Rini, Andika Aliviameita, Jamilatur Rohmah — Thu, 13 Jun 2024 00:00:00 +0800

Abstract: Urinary tract infection (UTI) is caused by the growth of microorganisms in the urinary tract. The gold standard in diagnosing UTI is bacterial count. This study aimed to determine the effects of temperature and storage time for urine of patients with UTI on the number and the species of bacteria, which is important in supporting the diagnosis of UTI. This was a laboratory and experimental study using accidental sampling techniques in accordance with the inclusion criteria. The results showed that at room temperature (20-25^oC) the number of bacteria increased faster and was higher than the number of bacteria stored at cold temperature (2-8^oC). The number of bacterial colonies was the highest at storage time of 5 hours (5.3x10⁴ CFU/ml) meanwhile the lowest was in fresh urine (3.4 x 10⁴ CFU/ml). The Friedman test showed that there was an effect of temperature and storage time for urine of patients with UTI on the number of bacteria with a sig p-value of 0.001 (p<0.05). In conclusion, the average number of bacteria at room temperature (20-25^oC) increased faster than at cold temperature (2-8^oC) during a storage time of five hours.

Keywords: urinary tract infection; number of bacteria; storage time; urine

Abstrak: Infeksi saluran kemih (ISK) diakibatkan adanya pertumbuhan mikroorganisme di dalam saluran kemih. Baku emas dalam mendiagnosis ISK ialah menghitung jumlah bakteri dalam urin. Penelitian ini bertujuan untuk mengetahui pengaruh suhu dan lama penyimpanan urin pada pasien ISK terhadap jumlah dan jenis bakteri yang penting dalam menunjang diagnosis ISK. Penelitian ini menggunakan metode eksperimental laboratorik dengan teknik pengambilan sampel accidental sampling sesuai dengan kriteria inklusi. Hasil penelitian mendapatkan bahwa pada suhu ruang (20-25^oC) jumlah bakteri meningkat lebih cepat dan lebih banyak dibandingkan jumlah bakteri pada suhu dingin (2-8^oC). Rerata jumlah koloni bakteri yang tertinggi yaitu sebesar 5,3x10⁴ CFU/ml didapatkan pada waktu penyimpanan 5 jam di suhu ruang, dan yang terendah pada urin segar sebesar 3,4 x 10⁴ CFU/ml. Hasil uji Friedman menunjukkan terdapat pengaruh suhu dan lama penyimpanan urin pada pasien ISK terhadap jumlah bakteri dengan nilai p=0,001 (p<0,05). Simpulan penelitian ini ialah rerata jumlah bakteri pada suhu ruang (20-25^oC) meningkat lebih cepat dibandingkan pada suhu dingin (2-8^oC) selama waktu penyimpanan 5 jam.

Kata kunci: infeksi saluran kemih; jumlah bakteri; lama penyimpanan; urin

Hubungan Kadar Alpha Fetoprotein dengan Derajat Keparahan Karsinoma Hepatoseluler

Favian R. Fadillah, Linda W. A. Rotty, Cerelia E. C. Sugeng — Sun, 23 Jun 2024 00:00:00 +0800

Abstract: Hepatocellular carcinoma (HCC) is the most common primary liver tumor and ranks third as the highest cause of cancer-related mortality. Hepatitis B virus infection is a risk factor found in 50% of subjects, while the remaining 50% have non-hepatitis B and non-hepatitis C etiologies. Alpha-fetoprotein (AFP) and the Barcelona Clinic Liver Cancer (BCLC) are the most widely used biological marker and disease staging system. This study aimed to determine the relationship between AFP levels and BCLC stages in HCC patients at Prof. Dr. R. D. Kandou Hospital, Manado. This was a retrospective and analytical study with a cross-sectional approach using patient medical records as samples. The results showed a total of 56 HCC patients, consisting of 43 males and 13 females, obtained using consecutive sampling techniques. Each variable was categorized into two groups: ≤200 ng/ml and >200 ng/ml for AFP; and operable (BCLC 0/A) and non-operable (BCLC B/C/D) for BCLC staging. There were two patients (3.6%) in the operable category and 54 patients (96.4%) in the non-operable category. Fisher's exact test results showed no significant relationship between AFP levels and disease severity in HCC patients (p=0.228). In conclusion, there is no significant relationship between alpha-fetoprotein levels and disease severity in hepatocellular carcinoma patients.

Keywords: alpha-fetoprotein levels; hepatocellular carcinoma; BCLC staging

Abstrak: Karsinoma hepatoseluler (KHS) merupakan tumor primer pada hati yang paling umum terjadi dan menyandang peringkat ke-3 sebagai penyumbang angka kematian tertinggi yang disebabkan oleh kanker. Infeksi virus hepatitis B merupakan faktor risiko yang ditemukan pada 50% subjek dan sisanya (50%) memiliki etiologi non hepatitis B dan non hepatitis C. Alpha fetoprotein (AFP) dan Barcelona Clinic Liver Cancer (BCLC) merupakan penanda biologis dan sistem pemeringkatan derajat penyakit yang paling banyak digunakan saat ini. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar AFP dengan derajat BCLC pada subjek KHS di RSUP. Prof. Dr. R. D. Kandou Manado. Penelitian ini merupakan retrospektif analitik dengan pendekatan potong lintang yang menggunakan rekam medis pasien sebagai sampel penelitian. Hasil penelitian mendapatkan 56 pasien KHS terdiri dari 43 laki-laki dan 13 perempuan dengan menggunakan teknik consecutive sampling. Masing-masing variabel dikategorikan menjadi dua kelompok, yaitu ≤200 ng/ml dan >200 ng/ml untuk AFP, serta operable (BCLC 0/A) dan non-operable (BCLC B/C/D) untuk staging BCLC. Terdapat dua subjek (3,6%) untuk kategori operable dan 54 subjek (96,4%) untuk kategori non-operable. Hasil uji Fisher’s exact menunjukkan bahwa tidak terdapat hubungan bermakna antara kadar AFP dengan derajat keparahan penyakit pada pasien KHS (p=0,228). Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara kadar alpha fetoprotein dengan derajat keparahan penyakit pada pasien karsinoma hepatoseluler.

Kata kunci: kadar alpha-fetoprotein; karsinoma hepatoseluler; BCLC staging

Outcomes of Endovascular Intervention for Salvage of Failing Hemodialysis Access

Billy Karundeng, Djony Tjandra, Richard Sumangkut, Michael D. Winarto — Sun, 07 Jul 2024 00:00:00 +0800

Abstract: Chronic kidney disease (CKD) is a worldwide public health problem. Hemodialysis accesses are prone to failure due to thrombosis and stenosis over the anastomosis or outflow vein. This study aimed to obtain the outcomes of endovascular intervention for salvage of failing hemodialysis access. This was a retrospective and descriptibe study. Data were collected from all patients who underwent endovascular intervention for failing hemodialysis access starting from January 2021 – June 2023 at Prof. Dr. R. D. Kandou Hospital, Manado. The results showed that 136 subjects were included in this study. The highest comorbidities were found in patients with a history of hypertension (52.9%). The most common arteriovenous fistulas (AVF) hemodialysis access was at the brachiocephalic location (75.7%). The most frequent cause of access dysfunction was simple stenosis (64.7%). Pseudoaneurysm was occurred in two subjects (1.4%), and ruptured outflow vein was occurred in one subject (0.7%). The patency rate at three months was 77.6%, but the primary patency rate would decrease to less than 50% over six months. Endovascular intervention in the form of balloon angioplasty is currently the main line of choice in dealing with problematic AVFs in principle what is being done is to intraluminaly dilate the narrowed or blocked lumen of the outflow vein. The complication rate from the procedure performed was 2.2% where in two patients a pseudoaneurysm occurred at the puncture site, namely the brachial artery and the radial artery then another patient had rupture of the AVFs outflow vein, therefore, an additional procedure was performed to close the AVFs with ligation. In conclusion, endovascular intervention for failing hemodialysis access has good results, but the primary patency rate will decrease to less than 50% over six months.

Keywords: chronic kidney disease; hemodialysis access; endovascular intervention

Gambaran Kejadian Miopia pada Mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi

Ananda P. Sambulele, Imelda H. M. Najoan, Wenny P. Supit — Sat, 13 Jul 2024 00:00:00 +0800

Abstract: Myopia is a condition in which incoming light is focused in front of the retina, causing distant objects to appear blurred. The prevalence of myopia is increasing rapidly and becoming a challenge to quality of life. Myopia is on the rise not only in children, but also in young adults. If left untreated, it can lead to serious complications and even blindness. This study aimed to determine the incidence of myopia among students of the Faculty of Medicine, Universitas Sam Ratulangi. This was a quantitative and descriptive study using a cross-sectional design. Subjects were students of the Faculty of Medicine, Universitas Sam Ratulangi who suffered from myopia taken by purposive sampling technique. The results showed that 31 students suffered from myopia, of which 26 students (83.9%) had low myopia. Myopia was more prevalent in the age group of 21 years with 13 students (41.9%), and in females with 24 students (77.4%). Myopia was found to be high in students with a family history of myopia with 17 students (56.4%). In conclusion, the highest incidence of myopia is found in individuals with low myopia, female, 21 years of age, and a family history of myopia.

Keywords: myopia; degree of myopia; age; sex; family history

Abstrak: Miopia adalah suatu kelainan dimana cahaya yang masuk ke mata difokuskan di depan retina sehingga objek yang jauh terlihat buram. Prevalensi miopia mengalami peningkatan pesat baik pada anak maupun dewasa yang menjadi tantangan bagi kualitas hidup masyarakat. Jika tidak tangani, myopia dapat menyebabkan komplikasi serius bahkan kebutaan. Penelitian ini bertujuan untuk mengetahui gambaran kejadian miopia pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi. Jenis penelitian ialah deskriptif kuantitatif dengan desain potong lintang. Subjek penelitian ialah mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi yang menderita miopa diambil dengan teknik purposive sampling. Hasil penelitian ini menunjukkan jumlah subjek yang menderita miopia ialah 31 mahasiswa; 26 mahasiswa (83,9%) memiliki derajat ringan. Miopia lebih banyak terjadi pada usia 21 tahun dengan jumlah 13 mahasiswa (41,9%). Kejadian miopia ditemukan paling banyak pada perempuan sebanyak 24 mahasiswa (77,4%). Kejadian miopia ditemukan tinggi pada mahasiswa dengan riwayat keluarga miopia, yakni 17 mahasiswa (56,4%). Simpulan penelitian ini ialah kejadian miopia tertinggi didapatkan pada miopia derajat ringan, jenis kelamin perempuan, usia 21 tahun, dan memiliki riwayat keluarga dengan miopia.

Kata kunci: miopia; derajat miopia; usia; jenis kelamin; riwayat keluarga

Hubungan Durasi Tidur dengan Agresivitas Mahasiswa Program Studi Pendidikan Dokter Universitas Sam Ratulangi

Revand Purba, Jehosua S. V. Sinolungan, Lydia E. V. David — Tue, 16 Jul 2024 00:00:00 +0800

Abstract: Sleep issues can impact the emotional well-being and behavior of students, particularly in medical education environments. Factors such as stress, physical violence, and increased academic workload may contribute to aggressive behavior among medical students. This study aimed to evaluate the relationship between sleep duration and the level of aggression among third semester students of Medical Education Program Universitas Sam Ratulangi. This was an analytical study with a cross-sectional design. Primary data were collected using the Buss Perry Aggression Questionnaire and sleep duration was categorized based on the recommendation of the National Sleep Foundation. The results showed that the majority of students had not-recommended sleep duration (45.1%), and they exhibited a moderate level of aggression (51.8%). The Spearman test for the relationship between sleep duration and the level of aggression showed a correlation coefficient of 0.095 with a p-value of 0.185. In conclusion, there is no significant relationship between sleep duration and the level of aggression among third semester students of Medical Education Program, Universitas Sam Ratulangi.

Keywords: sleep duration; aggression; medical students

Abstrak: Masalah tidur dapat memengaruhi kesejahteraan emosional dan perilaku mahasiswa, khususnya dalam lingkungan pendidikan kedokteran. Faktor-faktor seperti stres, kekerasan fisik, dan beban akademik yang bertambah dapat berkontribusi pada perilaku agresif mahasiswa kedokteran. Penelitian ini bertujuan untuk mengetahui hubungan antara durasi tidur dengan agresivitas pada mahasiswa semester 3Program Studi Pendidikan Dokter Universitas Sam Ratulangi. Jenis penelitian ialah analitik korelasi dengan desain potong lintang. Data primer dikumpulkan menggunakan Buss Perry Aggression Questionnaire dan durasi tidur dikategorikan menurut National Sleep Foundation. Hasil penelitian mendapatkan bahwa sebagian besar mahasiswa semester 3 Prodi Pendidikan Dokter Universitas Sam Ratulangi tidur dalam durasi yang tidak direkomendasikan (45,1%) dan memiliki tingkat agresivitas sedang (51,8%). Hasil uji Spearman terhadap hubungan antara durasi tidur dan tingkat agresivitas mendapatkan nilai koefisien korelasi sebesar 0,095 dan nilai signifikansi p=0,185. Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara durasi tidur dan tingkat agresivitas pada mahasiswa semester 3 Prodi Pendidikan Dokter Universitas Sam Ratulangi.

Kata kunci: durasi tidur; agresivitas; mahasiswa kedokteran

Hubungan Tingkat Pengetahuan dan Sikap Pria terhadap Penggunaan Kontrasepsi Kondom di Kecamatan Tuminting Tahun 2023

Derren D. C. H. Rampengan, Grace L. A. Turalaki, Lidya E. N. Tendean — Wed, 17 Jul 2024 00:00:00 +0800

Abstract: The government's efforts to control the rate of population growth is inter alia the family planning program using contraceptives; one of the them is condom. This study aimed to determine the relationship between men’s knowledge and attitudes with condom use at Tuminting in 2023. This was a quantitative and descriptive study with a cross-sectional design. Data were analyzed using the Pearson correlation test and regression analysis. The results showed that there were 394 men as respondents. Knowledge and attitude scores were higher in the group using condoms (46.8±0.79 and 20.11±2.39). Based on education level, the highest knowledge score was in the respondents of senior high school (4.67±0.91). Meanwhile, the highest behavior score was in the respondents of elementary school education (21.80±2.59). The correlation test obtained an r-value of 0.542 and a p-value of <0.005, indicating that there was a positive moderate significant correlation between knowledge and attitude towards the use of condom as contraceptive. In conclusion, there is a significant positive correlation between level of knowledge and attitude towards condom use among men at Tuminting in 2023.

Keywords: condom contraception; knowledge; attitude

Abstrak: Upaya pemerintah untuk mengendalikan laju pertumbuhan pendudukan ialah antara lain melalui program Keluarga Berencana (KB) dengan menggunakan kontrasepsi; salah satunya ialah penggunaan kondom. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan dan sikap pria dengan penggunaan kontrasepsi kondom di Kecamatan Tuminting tahun 2023. Jenis penelitian ialah kuantitatif dengan pendekatan deskriptif analitik dan desain potong lintang. Uji statistik menggunakan uji korelasi Pearson dan regresi linier. Hasil penelitian mendapatkan 394 pria dewasa sebagai responden. Skor pengetahuan dan perilaku lebih tinggi pada kelompok responden yang menggunakan kontrasepsi kondom (46,8±0,79 dan 20,11±2,39). Berdasarkan tingkat pendidikan, skor pengetahuan paling tinggi berada pada kelompok responden dengan tingkat pendidikan tertinggi SMA/SMK (4,67±0,91), sedangkan skor perilaku paling tinggi berada pada kelompok responden dengan tingkat pendidikan SD (21,80±2,59). Hasil uji korelasi Pearson mendapatkan nilai r=0,542 dengan nilai p<0,005, yang menunjukkan terdapat korelasi positif kekuatan sedang yang bermakna antara pengetahuan dan sikap terhadap penggunaan kontrasepsi kondom. Simpulan penelitian ini ialah terdapat korelasi positif yang bermakna antara tingkat pengetahuan dan sikap terhadap penggunaan kontrasepsi kondom pada pria di Kecamatan Tuminting tahun 2023.

Kata kunci: kontrasepsi kondom; pengetahuan; sikap

Gambaran Perilaku Penggunaan dan Perawatan Lensa Kontak pada Mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado

Emily N. Gowidjaya, Laya M. Rares, Anne M. S. Umboh — Sun, 21 Jul 2024 00:00:00 +0800

Abstract: The use of contact lens is currently increasing, especially among young people. Contact lens is safe to use, however if behavior and contact lens care are not appropriate it can pose a risk of complications. This study aimed to obtain the overview of behaviors in using and taking care of contact lenses among students of Medical Faculty Universitas Sam Ratulangi Manado. This was a descriptive study with a cross sectional design involving 57 students. The results showed that based on age, the highest percentage of contact lens users was 20 years (35.1%) and the lowest percentage was 17 and 23 years (each of 1.8%). Based on sex, female students were predominant than male students (80.7% vs 19.3%). The most common behavior was removing contact lenses while sleeping (100%) and the least frequently performed was taking medication reducing tear production (3.5%). In conclusion, more than half of the students who wear contact lenses have good behavioral category in using and taking care of contact lenses.

Keywords: contact lens; use; taking care; behavior of contact lens user

Abstrak: Penggunaan lensa kontak saat ini meningkat terutama di kalangan anak muda. Lensa kontak aman digunakan namun jika perilaku dan perawatan lensa kontak tidak tepat dapat menimbulkan risiko komplikasi. Penelitian ini bertujuan untuk mendapatkan gambaran perilaku penggunaan dan perawatan lensa kontak pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang, yang melibatkan 57 mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado. Hasil penelitian mendapatkan mahasiswa pengguna lensa kontak terbanyak berusia 20 tahun (35,1%) dan paling sedikit yang berusia 17 dan 23 tahun (masing-masing 1,8%), sedangkan berdasarkan jenis kelamin lebih banyak mahasiswa perempuan yang menggunakan lensa kontak (80,7%) dibandingkan mahasiswa laki-laki (19,3%). Perilaku yang paling banyak dilakukan oleh mahasiswa yaitu melepas lensa kontak saat tidur (100%) dan paling sedikit dilakukan yaitu mengosumsi obat yang menurunkan produksi air mata (3,5%). Simpulan penelitian ini ialah lebih dari setengah mahasiswa pengguna lensa kontak memiliki perilaku pengguaan dan perawatan lensa kontak termasuk dalam kategori baik.

Kata kunci: lensa kontak; penggunaan; perawatan; perilaku pengguna

Hubungan Kebahagiaan dengan Prestasi Akademik pada Mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi

Ray Harrison, Hendri Opod, Jehosua S. V. Sinolungan — Sun, 21 Jul 2024 00:00:00 +0800

Abstract: Academic success and achievement are important goals for students in higher education. Feeling happy in individual life can help students to achieve their academic goals. This study aimed to determine the relationship between happiness and academic achievement in students at the Faculty of Medicine, Universitas Sam Ratulangi. This was a quantitative and analytical study. Respondents were students of class 2020 at Faculty of Medicine, Universitas Sam Ratulangi. Data were obtained by using the Oxford Happiness Questionnaire (OHQ) and grade point average (GPA). The Pearson correlation test showed that from 145 students, a significant positive relationship (p=0.033) with a weak correlation (r=0.178) was found between happiness and academic achievement. In conclusioin, there is a positive relationship between happiness and academic achievement in students at the Faculty of Medicine, Universitas Sam Ratulangi.

Keywords: happiness; academic achievement; medical students

Abstrak: Keberhasilan dan prestasi akademik merupakan tujuan penting bagi mahasiswa dalam jenjang pendidikan yang lebih tinggi. Perasaan bahagia dan puas akan kehidupan individu dapat membantu mahasiswa mencapai tujuan akademiknya. Penelitian ini bertujuan untuk mengetahui hubungan antara kebahagiaan dengan prestasi akademik pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi dengan angkatan 2020 sebagai responden penelitian. Jenis penelitian ialah analitik kuantitatif. Data diperoleh menggunakan Oxford Happiness Questionnaire (OHQ) dan indeks prestasi kumulatif (IPK). Hasil uji korelasi Pearson menunjukkan bahwa dari 145 mahasiswa, didapatkan hubungan positif yang bermakna (p=0,033), dengan kekuatan lemah (r = 0,178), antara kebahagiaan dengan prestasi akademik. Simpulan penelitian ini ialah terdapat hubungan positif antara kebahagiaan dengan prestasi akademik pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi angkatan 2020.

Kata kunci: kebahagiaan; prestasi akademik; mahasiswa kedokteran

Gambaran Tingkat Pengetahuan Penggunaan Kacamata Presbiopi Pada Satuan Kerja Balai Pelaksanaan Jalan Nasional Wilayah 2 Sulawesi Utara

Abraham Dotulung, Rillya D. P. Manoppo, Laya M. Rares — Sun, 21 Jul 2024 00:00:00 +0800

Abstract: Presbyopia is a condition where the eyes begin to lose their vision at a close distance, usually appears at the age of 40 and over. The World Health Organization (WHO) states that presbyopia is a huge burden to developing countries due to the lack of access to eye health services and the low level of knowledge of the people. This study aimed to determine the overview of the level of knowledge of the employees at Satuan Kerja Balai Pelaksanaan Jalan Nasional (BPJN) Wilayah 2 Sulawesi Utara about the use of presbyopic glasses. This was a descriptive and quantitative study with a cross-sectional design, involving 77 respondents. The results showed 68 respondents (88.3%) had good level of knowledge, (11.7%) had sufficient level of knowledge; no respondents (0%) had poor level of knowledge. In conclusion, the majority of employees of Satuan Kerja Balai Pelaksanaan Jalan Nasional Wilayah 2 Sulawesi Utara have good level of knowledge about the use of presbyopic glasses.

Keywords: eyeglasses; presbyopia; level of knowledge

Abstrak: Presbiopi merupakan kondisi di mana mata mulai kehilangan penglihatan dengan jelas pada jarak dekat yang biasanya muncul saat umur 40 tahun ke atas. World Health Organization (WHO) menyatakan bahwa presbiopi memberi beban besar kepada negara berkembang karena tidak terpenuhinya koreksi gangguan penglihatan ini akibat akses pelayanan kesehatan mata dan tingkat pengetahuan masyarakat yang masih kurang. Penelitian ini bertujuan untuk mengetahui gambaran tingkat pengetahuan tentang penggunaan kacamata presbiopi pada pegawai di Satuan Kerja Balai Pelaksanaan Jalan Nasional (BPJN) Wilayah 2 Sulawesi Utara. Jenis penelitian ialah kuantitatif deskriptif dengan menggunakan desain potong lintang, melibatkan 77 responden. Hasil penelitian mendapatkan 68 responden (88,3%) memiliki tingkat pengetahuan kategori baik, 11 responden (11,7%) dengan tingkat pengetahuan kategori cukup, dan tidak ada responden (0%) dengan tingkat pengetahuan kategori kurang. Simpulan penelitian ini ialah mayoritas pegawai Balai Pelaksanaan Jalan Nasional Provinsi Sulawesi Utara memiliki tingkat pengetahuan yang baik tentang penggunaan kacamata presbiopi.

Kata kunci: kacamata; presbiopi; tingkat pengetahuan

Cangkok Aurikular Kondrokutaneus Komposit sebagai Alternatif untuk Rekonstruksi Defek Dorsum Nasal dengan Ketebalan Penuh Ketika Septal Hinge Flap Tidak Tersedia: Laporan Kasus

Nico A. Lumintang, Sherly Tandililing, Nuzly Q. Akmal — Thu, 25 Jul 2024 00:00:00 +0800

Abstract: Nose is an important structure of the face because it is centrally located and prominent, however, it is also weak and vulnerable to trauma. Nasal trauma, if not treated properly, can lead to functional and esthetic deformities. A full-thickness defect in dorsum nasal and septal area, caused by a traffic accident, can present a challenging reconstruction scenario. We present a case of a 21-year-old male with full-thickness defect in the dorsum nasal and septal area due to a traffic accident. The septal hinge flap is a common option for cartilage and lining reconstruction, but it may not always be available. Considering the complexity of the defect, we decided to perform a reconstruction using an auricular chondrocutaneous graft. A series of post-operative follow-ups were carried out from two months to four months postoperatively to evaluate in depth the function and aesthetic aspects of the patient. The results of the evaluation conducted showed that the patient had achieved a high level of satisfaction related to the restoration of his function and aesthetic appearance. This evaluation was essential to ensure that the interventions carried out had been functionally and aesthetically successful.

Keywords: nasal fracture; nasal reconstruction; full-thickness graft; auricular graft; septal hinge flap

Abstrak: Hidung merupakan struktur penting pada wajah karena letaknya di tengah dan menonjol, namun, struktur ini juga lemah dan rentan terhadap trauma. Trauma hidung, jika tidak ditangani dengan baik, dapat menyebabkan kelainan bentuk baik fungsional maupun estetika. Defek dengan hilangnya ketebalan penuh pada area dorsum hidung dan septum, yang disebabkan oleh kecelakaan lalu lintas, dapat menghadirkan skenario rekonstruksi yang menyulitkan. Kami menyajikan laporan kasus seorang laki-laki berusia 21 tahun dengan defek ketebalan penuh pada area dorsum nasal dan septum akibat kecelakaan lalu lintas. Septal hinge flap ialah pilihan umum untuk rekonstruksi tulang rawan dan lapisannya, tetapi mungkin tidak selalu tersedia. Dengan mempertimbangkan kompleksitas defek tersebut, diputuskan untuk melakukan rekonstruksi menggunakan cangkok aurikular kondrokutaneus. Serangkaian tindak lanjut pasca-operasi dilakukan sejak dua bulan hingga empat bulan pasca operasi untuk mengevaluasi secara mendalam aspek fungsi serta estetik pada pasien. Hasil evaluasi menunjukkan bahwa pasien telah mencapai tingkat kepuasan tinggi terkait dengan pemulihan fungsi dan penampilan estetiknya. Evaluasi ini sangat penting untuk memastikan bahwa intervensi yang dilakukan telah berhasil secara fungsional dan estetis.

Kata kunci: fraktur nasal; rekonstruksi hidung; full-thicknes graft; auricular graft; septal hinge flap

Profil Gangguan Pendengaran Berdasarkan Pemeriksaan Audiometri di Instalasi Rawat Jalan Telinga Hidung Tenggorok dan Bedah Kepala Leher RSUP Prof. Dr. R. D. Kandou

Septiana Firdaus, Valentini M. Pontoh, Olivia C. P. Pelealu — Mon, 29 Jul 2024 00:00:00 +0800

Abstract: Hearing loss is a person's inability to hear sound in one or both ears in either part of the auditory system or the whole. Hearing loss can occur in all age groups due to organ structure damage or certain medical conditions. This study aimed to obtain the profile of outpatiens’ hearing loss based on audiometry examination at Installation of Ear Nose Throat and Head Neck Surgery Prof. Dr. R. D. Kandou Hospital. This was a retrospective and descriptive study with a cross sectional design. The results showed that there were 207 patients with hearing loss based on audiometry examination. The highest number of cases was in 2022 (59%). Hearing loss was more frequently experienced by males (55%), and occured at the age of 20-60 years (57%). Symptoms that arised in hearing loss patients include decreased hearing, ear pain, difficulty in communicating, and tinnitus. The most common type of hearing loss was conductive hearing loss (CHL) (43.6%). In conclusion, hearing loss is often experienced by male patients, and occurs at the age of 20-60 years. The most common causes of hearing loss are untreated wax buildup in the ear canal and exposure to high-intensity noise. Using audiometric examination can determine advanced management according to the type of hearing loss.

Keywords: hearing process; hearing loss; audiometry

Abstrak: Gangguan pendengaran merupakan ketidakmampuan seseorang untuk mendengarkan suara pada salah satu atau kedua telinga baik pada sebagian sistem pendengaran atau keseluruhan. Gangguan pendengaran dapat terjadi pada semua kelompok usia, akibat kerusakan struktur organ atau kondisi medis tertentu. Penelitian ini bertujuan untuk mendapatkan profil gangguan pendengaran berdasarkan pemeriksaan audiometri di Instalasi Rawat Jalan Telinga Hidung Tenggorok dan Bedah Kepala Leher RSUP Prof. Dr. R. D. Kandou tahun 2020-2022. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Hasil penelitian mendapatkan sampel 207 penderita gangguan pendengaran yang dilakukan pemeriksaan audiometri. Penderita terbanyak pada tahun 2022 (59%). Gangguan pendengaran lebih sering dialami oleh laki-laki dengan total 114 kasus (55%), dan terjadi pada usia 20-60 tahun sebanyak 117 kasus (57%). Gejala yang sering timbul pada penderita gangguan pendengaran antara lain penurunan pendengaran, nyeri telinga, sulit berkomunikasi, dan telinga berdenging. Jenis gangguan pendengaran tersering yaitu conductive hearing loss (CHL) (43,6%). Simpulan penelitian ini ialah gangguan pendengaran sering dialami oleh laki-laki dan terjadi pada usia 20-60 tahun. Penyebab tersering gangguan pendengaran yaitu penumpukan serumen pada saluran telinga dan paparan dari kebisingan intensitas tinggi. Dengan pemeriksaan audiometri maka dapat ditentukan manajemen lanjutan sesuai jenis gangguan pendengaran.

Kata kunci: proses mendengar; gangguan pendengaran; audiometri

Hubungan Status Imunologis dengan Stadium Klinis pada Pasien Human Immunodeficiency Virus (HIV)

Rio S. A. Viyani, Kurniasari Kurniasari — Wed, 07 Aug 2024 00:00:00 +0800

Abstract: Human Immunodeficiency Virus (HIV) infection is still quite common in Indonesia. The clinical stage of HIV determines HIV prognosis. Opportunistic infections are one of the criteria for assessing the clinical stage of HIV. Level of CD4 influence the incidence of opportunistic infections. This study aimed to analyze the relationship between immunological status and HIV clinical stage. This was an descriptive and analytical study with a cross-sectional design using 73 medical records of HIV patients who sought treatment at one of the hospitals in Jakarta between January 2022 and May 2023. Data on sex, body mass index, CD4 levels, clinical stage, and opportunistic infections were collected from medical records. The sample selection technique was consecutive non-random sampling. HIV patients that received antiretroviral therapy (ARV) were included in this study. The chi-square test was used for analysis with a significance level of 5%. The results showed that the majority subjects were male (63.0%), underweight (49.3%), CD4 <200 cells/mm3 (46.6%), had opportunistic infection of pulmonary TB (23.3%), and clinical stage III (45.2%). The chi-square test obtained a p-value of <0.001 for the relation between CD4 level and clinical stage of HIV. In conclusion, immunological status based on CD4 levels can be one of the factors used to assess the severity of HIV disease clinically in patients receiving ARV therapy.

Keywords: human immunodeficiency virus; CD4; clinical stage; opportunistic infection

Abstrak: Infeksi Human Immunodeficiency Virus (HIV) masih cukup banyak ditemukan di Indonesia. Prognosis HIV dipengaruhi oleh stadium klinis HIV. Infeksi oportunistik dinilai dalam penentuan stadium klinis HIV. Kejadian dan jenis infeksi oportunistik tergantung pada kadar CD4. Penelitian ini bertujuan menganalisis hubungan status imunologis dengan stadium klinis pada pasien HIV. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang dengan menggunakan 73 rekam medis pasien HIV yang berobat di salah satu RSUD di Jakarta antara Januari 2022 - Mei 2023. Data berupa jenis kelamin, indeks masa tubuh, kadar CD4, stadium klinis dan jenis infeksi oportunistik dikumpulkan dari rekam medis. Tehnik pemilihan sampel adalah consecutive non-random sampling. Penelitian ini hanya mengikutsertakan rekam medis dari pasien yang mendapatkan terapi antiretroviral (ARV). Analisis statistik menggunakan uji chi-square dengan tingkat kemaknaan 0,05. Hasil penelitian mendapatkan mayoritas pasien HIV berjenis kelamin laki-laki (63,0%), memiliki IMT underweight (49,3%), CD4 <200 sel/mm³ (46,6%), infeksi oportunistik TB Paru (23,3%), dan berada pada stadium klinis III (45,2%). Analisis hubungan antara kadar CD4 dengan stadium klinis HIV memperoleh nilai p<0,001. Simpulan penelitian ini ialah status imunologis yang diukur berdasarkan kadar CD4 dapat menjadi salah satu faktor yang digunakan untuk menilai derajat beratnya penyakit HIV secara klinis pada pasien yang menerima terapi ARV.

Kata kunci: human immunodeficiency virus; CD4; stadium klinis; infeksi oportunistik

Relation of Pre-operative Ureteral Catheter Use and Complications of Intraoperative Ureteral and Bladder Trauma in Gynecologic Oncology Patients Undergoing Major Surgical Procedures

Bintang Sinurat, Christof Toreh, Ari Astram, Eko Arianto, Fima Langi — Wed, 07 Aug 2024 00:00:00 +0800

Iatrogenic injury to the urinary tract is a potential complication of all surgical procedures performed in or retroperitoneum and pelvis. Gynecological surgery in particular has a risk of urinary tract injury due to the close anatomy of the urinary tract and the reproductive system in women. This study aimed to evaluate the relation between pre-operative ureteral catheter use and complications of intraoperative ureteral and bladder trauma in gynaecologic oncology patients undergoing major surgical procedures. This study used cohort data of patients undergoing major surgical procedures at Prof. Dr. R. D. Kandou Hospital, Manado, recorded in medical records from January 1, 2023 to June 30, 2023. The bivariate test showed that patients who received pre-operative ureteral catheter insertion had fewer urological trauma events (4.5%) compared to patients who did not get pre-operative ureteral catheter (95.5%). The relations between pre-operative ureteral catheters and the incidence of urological trauma was found to be statistically significant with a p-value of 0.019 and the history of chemotherapy had a p-value of 0.036, meanwhile the relations with other variables showed p-values of >0.05. Therefore, the use of pre-operative catheters could not significantly eliminate the occurrence of ureteral trauma because many of the confounding factors were accompanied by several other conditions that were also studied in the multivariate analysis. In conclusion, there is no association between the use of pre-operative ureteral catheters and complications of intraoperative ureteral trauma in gynecologic oncology patients undergoing major surgical procedures. Future studies using samples from more sources are expected to assess the relation between pre-operative ureteral catheter use and the incidence of urological trauma more accurately, and to assess the ease of use of pre-operative ureteral catheter.

Keywords: ureteral catheter; ureteral trauma; gynaecologic oncology patients

Identifikasi Pola Bakteri dan Uji Sensitivitas Antibiotik di Kamar Bersalin Rumah Sakit Umum GMIM Pancaran Kasih Manado

Mujahida S Elmadany, Fredine E. S. Rares, Heriyannis Homenta — Mon, 19 Aug 2024 00:00:00 +0800

Abstract: Delivery room of Rumah Sakit Umum (RSU) GMIM Pancaran Kasih Manado is one of the delivery service centers in Manado which has the potential to be a place of transmission of nosocomial infections due to bacteria that are resistant to antibiotics. These bacteria do not respond to curative treatment with antibiotics, resulting in high morbidity and mortality in hospitals, especially in patients with immunodeficiency, including patients with birth injuries. This study aimed to identify bacteria found in the delivery room of RSU GMIM Pancaran Kasih Manado and determine their sensitivity to certain antibiotics. This was a descriptive and observational study with a cross-sectional design. Samples were taken in the delivery room of RSU GMIM Pancaran Kasih Manado, followed by identification of bacteria according to standard procedures and antibiotic sensitivity test using the Kirby Bauer method (disc diffusion) at the Microbiology Laboratory, Faculty of Medicine, Universitas Sam Ratulangi. Most bacteria found were Gram positive (90%), meanwhile 10% were Gram negative. There were three types of bacteria identified, namely Staphylococcus sp. (70%), Streptococcus sp. (20%), and Neisseria sp. (10%). Each of these bacteria was sensitive to certain antibiotics. In conclusion, the most common bacteria found in the delivery room was Staphylococcus sp. which was 100% sensitive to gentamicin.

Keywords: bacteria; antibiotic; antibiotic sensitivity test; antibiotic resistance; delivery room

Abstrak: Kamar bersalin Rumah Sakit Umum (RSU) GMIM Pancaran Kasih Manado menjadi salah satu pusat pelayanan persalinan di kota Manado yang berpotensi menjadi tempat penularan infeksi nosokomial akibat bakteri yang resistan terhadap antibiotik. Bakteri-bakteri ini tidak lagi merespon penanganan kuratif dengan antibiotik sehingga berdampak pada tingginya morbiditas bahkan mortalitas di rumah sakit terutama pada pasien-pasien dengan kondisi imunodefisiensi termasuk pasien dengan perlukaan persalinan. Penelitian ini bertujuan untuk mengidentifikasi bakteri yang terdapat di kamar bersalin RSU GMIM Pancaran Kasih Manado dan mengetahui kepekaannya terhadap antibiotik tertentu. Penelitian ini menggunakan metode deskriptif observasional melalui desain potong lintang. Pengambilan sampel dilakukan di kamar bersalin RSU GMIM Pancaran Kasih Manado, dillanjutkan identifikasi bakteri sesuai prosedur standar dan uji sensitivitas antibiotik menggunakan metode Kirby Bauer (difusi cakram) di Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Sam Ratulangi. Hasil penelitian mendapatkan bakteri Gram positif sebanyak 90%, Gram negatif sebanyak 10% dan teridentifikasi tiga jenis bakteri yaitu Staphylococcus sp. (70%), Streptococcus sp. (20%), dan Neisseria sp. (10%) yang masing-masing memiliki kepekaan terhadap antibiotik tertentu. Simpulan penelitian ini ialah bakteri terbanyak yang ditemukan ialah Staphylococcus sp. yang 100% sensitif terhadap gentamicin.

Kata kunci: bakteri; antibiotik; uji sensitivitas antibiotik; resistensi antibiotik; kamar bersalin

Fetus in Fetu at Prof. Dr. R. D. Kandou Hospital: A Rare Case Report

Harsali F. Lampus, Candy Candy, Leo Rendy, Ronald Sorongku, Sabrandi P. Saputra — Wed, 04 Sep 2024 00:00:00 +0800

Abstract: Fetus in fetu (FIF) is a rare congenital disorder in which a malformed fetus-like structure is inside the actual body of the fetus. We reported a 3-day old female baby, born through sectio caesaria with a lump on her right abdomen. On physical examination, a rounded mass of 8x8 cm was palpable in the right hypochondrium. CT-scan of the abdomen with contrast revealed a heterogeneous mass of mixed cystic and solid accompanied by calcification in the form of vertebrae and extremities in the upper right abdomen (size ±5,6 x 6 x 6 cm). The mass appeared to be abutting with the liver, gallbladder, pancreas, and right kidney by pressing the intestinal loops to the left. A laparotomy was performed with extensive tumor excision, and a malformed fetus-shaped mass with good differentiation characterized by a hand-like structure, fairly complete toes and skin on its surface was found. The tumor was diagnosed as a FIF since the benchmark for diagnosing FIF was the shape of a fetus-like mass, a mature bone structure with components such as cranium, vertebrae, pelvis, extremities and even fingers as found in this patient. The patient was carried out a 5-day treatment after surgery, and then was referred to the Pediatric Surgery polyclinic for a follow-up on the histopathological result to confirm the diagnosis but the patient did not come for further treatment.

Keywords: fetus in fetu; fetal tumor; aberrant monozygotic twinning; CT-scan abdomen

Gambaran Fungsi Ginjal Pasien PJK dengan Oklusi Total Kronik yang Menjalani IKP di RSUP Prof. Dr. R. D. Kandou Manado Periode Januari-Desember 2022

Ni Made Anjani, Agnes L. Panda, Edmond L. Jim — Thu, 05 Sep 2024 00:00:00 +0800

Abstract: Accumulation of fat on the walls of blood vessels can affect blood flow to the heart muscles which has an impact on heart and kidney functions. This study aimed to obtain the description of kidney function in patients with coronary artery disease (CAD) with chronic total occlusion (CTO) who underwent percutaneous coronary intervention (PCI). This was a retrospective and descriptive study with a cross-sectional design. Samples were CAD patients with CTO registered in medical records of Prof. Dr. R. D. Kandou Hospital from January to December 2022. The results showed that there were 95 cases of CTO who underwent PCI. There were 36 (37.9%) patients with increased creatinine levels and decreased eGFR including 33 (34.7%) males, 20 (43.5%) aged 45-59 years, seven (7.4%) with hypertension. There were six patients (16.7%) with contrast induced nephropathy (CIN) including five (13.9%) males, three (8.3%) aged ≥70 years, and two (5.6%) with dyslipidemia. In conclusion, elevated creatinine levels and decreased eGFR are more common in males, pre-elderly, and with hypertension, meanwhile contrast induced nephropathy is more common in males, high-risk elderly, and with dyslipidemia as comorbid.

Keywords: kidney function; coronary heart disease; chronic total occlusion; percutaneous coronary intervention

Abstrak: Penumpukan lemak pada dinding pembuluh darah dapat memengaruhi aliran darah ke otot jantung yang berdampak pada fungsi jantung dan ginjal. Penelitian ini bertujuan untuk mengetahui gambaran fungsi ginjal pasien penyakit jantung coroner (PJK) dengan oklusi total kronik (OTK) yang menjalani intervensi koroner perkutan (IKP). Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Sampel penelitian ialah pasien PJK dengan OTK yang tercatat di Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2022. Hasil penelitian mendapatkan 95 kasus OTK yang menjalani IKP. Terdapat 36 (37,9%) mengalami peningkatan kadar kreatinin dan penurunan eGFR di antaranya 33 (34,7%) laki-laki, 20 (43,5%) berusia 45-59 tahun, tujuh (7,4%) dengan hipertensi. Terdapat enam pasien (16,7%) yang mengalami contrast induced nephropathy (CIN) diantaranya lima (13,9%) laki-laki, tiga (8,3%) berusia ≥70 tahun, dan dua (5,6%) dengan dislipidemia. Simpulan penelitian ini ialah peningkatan kadar kreatinin dan penurunan eGFR sering terjadi pada laki-laki, kelompok pra lanjut, dengan hipertensi sedangkan contrast induced nephropathy sering terjadi pada pasien laki-laki, usia lanjut berisiko tinggi dan penyakit penyerta dislipidemia.

Kata kunci: fungsi ginjal; penyakit jantung koroner; oklusi total kronik; intervensi koroner perkutan

Comparison of Scoring Systems in Predicting Stone-Free Rate in Flourless Retrograde Intrarenal Surgery

Eko Arianto, Ari Astram, Christof Toreh, Frendy Wihono, Mahesa Krishna — Sun, 15 Sep 2024 00:00:00 +0800

Abstract: Thus far, there is no standardised method for predicting outcomes from fluoro-less retrograde intrarenal surgery (RIRS) procedure. This study aimed to compare scoring systems in predicting stone-free rate (SFR) in RIRS patients This was an observational and analytical study with a retrospective cohort design. Samples were obtained from medical records of Dr. J. H. Awaloei Hospital from March 2022 to October 2023. This study only analyzed three scoring systems: Guy's Stone Score (GSS), Resorlu-Unsal Stone Score (RUSS), and Seoul National University Renal Stone Complexity Score (S-ReSC). The results obtained 219 patients with an average age of 55 years, GSS grade I in 108 patients, and grade II in 50 patients. Related to RUSS score, 43 patients got a score of 1, 108 got a score of 2, and 60 got a score of 60. Meanwhile, S-ReSC score was at a high level with a percentage of 65.3%, 20.4% at the medium level, and 14.4% at the low level. Moreover, GSS sensitivity 76%, specificity 75%, PPV 93.2%, NPV 41.1%, AUC 75%; RUSS score sensitivity 75.4%, specificity 62.2%, PPV 90%, NPV 36.2%, AUC 70%; S-ReSC score sensitivity 71%, specificity 77.5%, PPV 93.4%, NPV 37.3%, AUC 72%. In conclusion, Guy's Stone Score, Resorlu-Unsal Stone Score, and Seoul National University Renal Stone Complexity Score have similar abilities in predicting stone-free rate. Further research is needed with a larger sample size or population to confirm the findings of this study.

Keywords: nephrolithiasis; stone-free rate; scoring system; retrograde intrarenal surgery

Hubungan Faktor Risiko Penyakit Jantung Koroner dengan Insidens Kejadian Kardiovaskular Mayor pada Pasien STEMI yang Menjalani IKP Primer di RSUP Prof Dr. R. D. Kandou Manado Periode Januari - Desember 2022

Feiby C. Toliu, Victor F. F. Joseph, Starry H. Rampengan — Thu, 19 Sep 2024 00:00:00 +0800

Abstract: Major adverse cardiovascular events (MACE) are adverse outcomes in ST elevation myocardial infarction (STEMI) patients, such as death, recurrent myocardial infarction, stroke, rehospitalization, and recurrent revascularization. The occurrence of MACE depends on the patient's age, gender, and lifestyle. This study aimed to determine the relationship between coronary heart disease risk factors and the incidence of MACE in STEMI patients undergoing primary PCI (PPCI). Samples were STEMI patients undergoing PPCI at Prof. Dr. R. D. Kandou Hospital, from January to December 2022. This was a retrospective cohort study using the consecutive sampling method. Data were analyzed using the chi-square test and Fisher's exact test. The results obtained 169 cases STEMI patients undergoing PPCI; 80 of them fulfilled the inclusion criteria. The majority of patients did not experience MACE. The most common type of MACE was rehospitalization. The bivariate analysis, it showed that there was no significant relationship between coronary heart disease risk factors and MACE in STEMI patients undergoing PPCI. In conclusion, there is no significant relationship between coronary heart disease risk factors and major adverse cardiovascular events.

Keywords: major adverse cardiovascular events; coronary heart disease; risk factors

Abstrak: Kejadian kardiovaskular mayor (KKM) merupakan hasil akhir yang merugikan pada pasien dengan ST elevation myocardial infarction (STEMI), berupa kematian, infark miokard berulang, stroke, rehospitalisasi, dan revaskularisasi berulang. Terjadinya KKM bergantung pada usia, jenis kelamin, dan faktor gaya hidup pasien. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor risiko penyakit jantung koroner dengan insidens KKM pada pasien STEMI. Sampel penelitian ialah pasien STEMI yang menjalani IKP Primer di RSUP Prof. Dr. R. D. Kandou Manado periode Januari - Desember 2022. Jenis penelitian ialah cohort retrospektif dengan metode consecutive sampling. Uji statistik ialah analisis univariat dan analisis bivariat menggunakan uji chi square dan uji Fisher’s exact. Hasil penelitian mendapatkan 169 penderita STEMI yang menjalani IKP primer dengan 80 sampel yang memenuhi kriteria inklusi. Sebagian besar pasien tidak mengalami KKM. Jenis KKM yang paling banyak ditemukan ialah rehospitalisasi. Berdasarkan analisis bivariat, tidak didapatkan hubungan bermakna antara faktor risiko penyakit jantung koroner dengan kejadian kardiovaskular mayor pada pasien STEMI yang menjalani IKP Primer. Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara faktor risiko penyakit jantung koroner dengan kejadian kardiovaskular mayor.

Kata kunci: kejadian kardiovaskular mayor; penyakit jantung coroner; faktor risiko

Fungsi Kognitif Skala MOCA-INA pada Peserta PPDS Anestesiologi dan Terapi Intensif: Perbandingan Sebelum dan Setelah Jaga di Rumah Sakit

Tesalonika Wonggo, Barry I. Kambey, Diana C. Lalenoh — Mon, 23 Sep 2024 00:00:00 +0800

Abstract: Shift duty can negatively impact cognitive function among residents of Specialist Program. This study aimed to obtain the differences in cognitive function of Anesthesiology and Intensive Therapy (ATI) residents at Universitas Sam Ratulangi before and after on-call duty at Prof. Dr. R. D. Kandou General Hospital Manado. This was a descriptive observational study with a cross-sectional design. Samples were residents of ATI who completed the Indonesian version of the Montreal Cognitive Assessment (MoCA-INA) before and 24 hours after on-call duty. The results showed a total of 31 residents as samples with a proportion of 24 (77.4%) males and seven (22.6%) females. There was a decline in most cognitive domains, with a statistical analysis demonstrating a decrease in the mean MoCA-INA score from 26.8387 to 25.0000, accompanied by a p-value of 0.000 (<0.05) and a Z-score < -2 obtained from the Wilcoxon test. In conclusion, there is a significant difference in cognitive function of residents of Anesthesiology and Intensive Therapy Specialist Program of Universitas Sam Ratulangi before and after on-call duty at the hospital. This is possibly due to cognitive overload caused by the shift duty.

Keywords: cognitive function; MoCA-INA; shift duty; specialist program

Abstrak: Tugas jaga yang berat dapat berdampak negatif terhadap fungsi kognitif peserta Program Pendidikan Dokter Spesialis (PPDS). Penelitian ini bertujuan melihat perbedaan fungsi kognitif PPDS Anestesiologi dan Terapi Intensif (ATI) Universitas Sam Ratulangi sebelum dan sesudah jaga di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif observasional dengan desain potong-lintang pada PPDS ATI yang mengisi Montreal Cognitive Assesment versi Indonesia (MoCA-INA) sebelum dan 24 jam setelah jaga. Penelitian ini bertujuan untuk mengidentifikasi apakah terdapat perbandingan antara fungsi kognitif pada PPDS sebelum dan setelah menjalani tugas jaga 24 jam. Hasil penelitian mendapatkan 31 sampel dengan proporsi laki-laki sebanyak 24 (77,4%) orang dan perempuan sebanyak tujuh (22,6%) orang. Penurunan pada sebagian besar domain kognitif dengan hasil analisis statistik menunjukkan penurunan rerata skor MoCA-INA dari 26,8387 menjadi 25,0000 disertai dengan nilai p<0,05 (p=0,000) dan Z-score <-2 yang diperoleh melalui uji Wilcoxon. Simpulan penelitian ini ialah terdapat perbedaan fungsi kognitif PPDS Anestesiologi dan Terapi Intensif Universitas Sam Ratulangi yang bermakna antara sebelum dan setelah jaga di rumah sakit. Hal ini diduga disebabkan kelebihan beban kognitif akibat tugas jaga.

Kata kunci: fungsi kognitif; MoCA-INA; tugas jaga; residen pendidikan dokter spesialis

Pediatric Pleomorphic Adenoma of Parotid Gland: A Case Report

Vincent Suryoprabowo, Harsali F. Lampus, Candy Candy, Denny Saleh — Thu, 10 Oct 2024 00:00:00 +0800

Abstract: Pleomorphic adenoma is a type of tumor that affects the parotid glands. It is also called a benign mixed tumor (BMT) because it has both epithelial and myoepithelial cells. This type of tumor is the most frequent parotid gland tumor, making up about 66% of all such tumors in parotid glands. We reported a case of 12-year-old male patient with a lump on his parotid gland, measured 7x3x3cm at Prof. Dr. R. D. Kandou Hospital Manado. CT Scan results of neck region of the patient revealed that there was a mass in the right side colli area and right frontal sinusitis A histopathological examination of the tumor tissue showed that it was encapsulated by connective tissue and composed of proliferating epithelial and myoepithelial tumor cells, some with clear nuclei, arranged in solid and microcystic patterns, and interspersed with fibromyxoid stroma. The patient was diagnosed as parotid gland adenoma, therefore, a parotidectomy was performed on him. He was discharged home and advised to return for a check-up one week later to remove the stitches. At the two-month follow-up visit, he was stable and did not require any additional therapy. In conclusion, a parotidectomy shows good result in the patient with parotid gland adenoma. However, due to the recurrence rate of parotid gland malignancies, several oncologists prefer to observe the patient periodically trough follow up at policlinic. Early detection and right management are required to achieve the best prognosis.

Keywords: pleomorphic adenoma; pediatric patient; parotid gland

Gambaran Penggunaan Telepon Seluler sebagai Faktor Risiko Nyeri Kepala Primer pada Siswa SMA Negeri 1 Langowan

Christina Lantang, Finny Warouw, Junita M. Pertiwi — Sun, 10 Nov 2024 00:00:00 +0800

Abstract: In this modern era, the use of cell phones has grown significantly. The duration of screen time can be a trigger or aggravating factor for headache sufferers. This study aimed to determine the description of cell phone use as a risk factor for primary headache in high school students. This was a descriptive and quantitative study with a cross-sectional design. Samples were of students of SMA Negeri 1 Langowan obtained by using simple random sampling method. Questionnaires were distributed through google form link during September 2023 with 288 students as respondents, consisting of 108 men and 180 women. The results showed that 282 students experienced headaches. Based on precipitating factors, 63.5% of respondents experienced headaches caused by cell phones. The most frequent neck position was 30 degrees with a percentage of 39% in the total number of men and women. The most reported length of use was 5-7 hours (58.5%). The most frequently used application was social media (80.9%). In conclusion, cell phone use is a risk factor for primary headache pain with a head position of 30 degrees, duration of use of 5-7 hours, and social media is reported to be the most frequently used application.

Keywords: cell phone; primary headache; high school student

Abstrak: Di era modern penggunaan telepon seluler telah sangat berkembang. Durasi menatap layar dapat menjadi pemicu atau faktor yang memperburuk bagi penderita nyeri kepala. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan telepon seluler sebagai faktor risiko nyeri kepala primer pada siswa SMA Negeri 1 Langowan. Jenis penelitian ialah deskriptif kuantitatif dengan desain potong lintang. Pengambilan sampel menggunakan metode simple random sampling yang dilakukan dengan membagikan kuesioner melalui link google form selama bulan September 2023 dengan jumlah responden 288 siswa. Hasil penelitian mendapatkan dari 288 responden yang terdiri atas 108 laki-laki dan 180 perempuan, sebanyak 282 mengalami nyeri kepala. Berdasarkan faktor pencetus, sebanyak 63.5% responden mengalami nyeri kepala diakibatkan oleh telepon seluler. Posisi leher paling sering yaitu 30 derajat dengan persentase 39% pada total keseluruhan laki-laki dan perempuan. Lama penggunaan yang paling banyak dilaporkan yaitu 5-7 jam (58,5%). Aplikasi yang paling sering digunakan yaitu media sosial (80,9%). Simpulan penelitian ini ialah penggunaan telepon seluler sebagai faktor risiko nyeri kepala primer yaitu dengan posisi kepala 30 derajat, lama penggunaan 5-7 jam, serta media sosial dilaporkan menjadi aplikasi yang paling sering digunakan.

Kata kunci: telepon seluler; nyeri kepala primer; siswa SMA

Profil Penyandang Diabetes Melitus Tipe 2 Disertai Anemia di Poli Endokrin RSUP Prof. Dr. R. D. Kandou Manado Periode September-November 2023

Gardenia G. E. Rumengan, Bisuk P. Sedli, Linda W. A. Rotty — Sun, 10 Nov 2024 00:00:00 +0800

Abstract: Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by elevated blood sugar level. Anemia is a hematological disorder that often occurs in T2DM patients due to complication of secondary diseases, such as kidney dysfunction. The potential for anemia in T2DM patients can worsen the complications. This study aimed to determine the profile of T2DM patients with anemia at the endocrine polyclinic of Prof. Dr. R. D. Kandou Hospital from September to November 2023. This was a prospective and descriptive study with a cross-sectional design, using medical records at the endocrine polyclinic. The results showed that T2DM patients with anemia in this study (n=40) were dominated by females (55%) and age group of 45-60 years (62.5%). The average levels in laboratory examination were, as follows: HbA1c was 8.683, hemoglobin was 9.583, creatinine was 3.080, and eLFG was 23.38. Classification of anemia types based on erythrocyte morphology was dominated by hypochromic microcytic anemia, experienced by females (47.5%) and in the age group of 45-60 years (55%). In conclusion, the majority of type 2 diabetes mellitus patients with anemia are females aged 45-60 years who experience hypochromic microcytic anemia.

Keywords: type 2 diabetes mellitus; anemia; HbA1c glomerular filtration rate

Abstrak: Diabetes melitus tipe 2 (DMT2) adalah gangguan metabolisme yang ditandai adanya peningkatan gula darah. Anemia merupakan gangguan hematologi yang sering terjadi pada penyandang DMT2 yang disebabkan oleh komplikasi penyakit sekunder, seperti gangguan fungsi ginjal. Potensi anemia pada pasien DMT2 dapat memperburuk komplikasi. Penelitian ini bertujuan untuk mengetahui profil penyandang DMT2 disertai anemia di Poli Endokrin RSUP Prof. Dr. R. D. Kandou periode September–November 2023. Jenis penelitian ialah deskriptif prospektif dengan desain potong lintang, menggunakan data rekam medis Poli Endokrin. Hasil penelitian mendapatkan bahwa pasien DMT2 disertai anemia di RSUP Prof. Dr. R. D. Kandou (n=40), didominasi oleh perempuan (55%) dan kelompok usia 45-60 tahun (62,5%). Rerata nilai HbA1c 8,683, Hb 9,583, kreatinin 3,080, dan eLFG 23,38. Klasifikasi jenis anemia berdasarkan morfologi eritrosit didominasi oleh jenis anemia hipokrom mikrositik yang dialami oleh perempuan (47,5%) dan pada kelompok usia 45-60 tahun (55%). Simpulan penelitian ini ialah mayoritas pasien diabetes melitus tipe 2 disertai anemia terjadi pada perempuan dan kelompok usia 45-60 tahun yang mengalami anemia hipokrom mikrositik.

Kata kunci: diabetes melitus tipe 2; anemia; HbA1c; laju filtrasi glomerulus

Penggunaan Telemedicine untuk Penilaian Luaran Fungsi pada Pasien Osteoartritis Pinggul yang Telah Dilakukan Total Hip Arthroplasty

Stefan A. G. P. Kambey, Jastin W. Ngabalin, Harsali F. Lampus — Sun, 10 Nov 2024 00:00:00 +0800

Abstract: The most common arthritis in the hip joint is due to joint wear and tear, osteoarthritis (OA). One of the most effective types of surgery to perform on hip OA is total hip arthroplasty (THA). This study aimed to determine the functional results of total hip arthroplasty surgery in cases of hip arthritis at Prof. Dr. R. D. Kandou Hospital Manado by using telemedicine. This was a descriptive study interviewing patients who underwent total hip arthroplasty in the period of January-November 2023 via video call. The Harris hip score (HHS) was measured before and after THA. The results showed that from five patients who underwent HHS evaluation before THA, all of them had poor scores (100%). Meanwhile, the HHS after THA showed that one patient had a poor score (20%), one patient had a fairly good score (20%), two patients had good scores (40%), and one patient had a very good score (20%), indicating increased HHS after THA in all patients. In conclusion, total hip arthroplasty is effective in hip arthritis patients. The telemedicine can be an alternative for evaluating patients with hip osteoarthritis after total hip arthroplasy who are difficult to be reached.

Keywords: hip osteoarthritis; Harris hip score; total hip arthroplasty; telemedicine

Abstrak: Artritis yang paling umum terjadi pada sendi pinggul diakibatkan oleh keausan sendi atau disebut osteoartritis (OA). Salah satu jenis operasi yang paling efektif untuk OA pinggul ialah total hip arthroplasty (THA). Penelitian ini bertujuan untuk mengetahui hasil fungsional pembedahan THA pada kasus OA pinggul di RSUP Prof. Dr. R. D. Kandou Manado menggunakan telemedicine. Jenis penelitian ini ialah deskriptif dengan mewawancarai pasien yang dilakukan total hip arthroplasty periode Januari-November 2023 via panggilan video. Nilai Harris hip score (HHS) diukur sebelum dan setelah dilakukan THA. Hasil penelitian memperlihatkan bahwa dari lima pasien yang dilakukan evaluasi HHS sebelum dilakukan THA, didapatkan semuanya memiliki skor kurang baik (100%). Setelah dilakukan THA dan dievaluasi menggunakan HHS didapatkan satu orang memiliki skor kurang baik (20%), satu orang memiliki skor cukup baik (20%), dua orang memiliki skor baik (40%), dan satu orang memiliki skor baik sekali (20%). Dengan kata lain terdapat peningkatan skor HHS setelah dilakukan THA pada semua pasien. Simpulan penelitian ini ialah total hip arthroplasty efektif dilakukan pada pasien dengan osteoartritis pinggul. Penggunaan telemedicine dapat menjadi alternatif untuk mengevaluasi pasien osteoartritis pinggul setelah total hip arthroplasty yang memiliki keterbatasan jarak untuk dijangkau.

Kata kunci: osteoartritis pinggul; Harris hip score; total hip arthroplasty; telemedicine

Hubungan Lama Menyandang Diabetes Melitus dengan Kualitas Hidup Pasien Klub Prolanis Maleosan Tomohon

Vera D. Tombokan, Hengki E. Salibana — Tue, 12 Nov 2024 00:00:00 +0800

Abstract: Data of the 2018 Riset Kesehatan Dasar (Riskesdas) showed that North Sulawesi was ranked 4th in the highest prevalence of diabetes mellitus. In Tomohon City, cases of diabetes mellitus also increase continually from year to year and are one of the five most common metabolic diseases. Prolanis (chronic disease control program) is expected to be a forum to improve health and quality of life of patients with chronic diseases such as diabetes mellitus. This study aimed to determine the relationship between the length of time suffering from diabetes and the quality of life of Prolanis Maleosan Club patients in Tomohon. This was a correlation and analytical study. Samples were 45 prolanis patients of Maleosan club. Data were collected using the WHOQOL-BREF questionnaire and were analyzed using the chi-square test. The results showed that there was no relationship between the length of time suffering from diabetes mellitus and the quality of life of Prolanis patients with a p-value of 0.322. In conclusion, there is no relationship between the length of time suffering from diabetes mellitus and the quality of life among patients of Prolanis Maleosan Club in Tomohon.

Keywords: diabetes mellitus; length of suffering; quality of life

Abstrak: Data Riskesdas 2018 menunjukkan bahwa Sulawesi Utara menempati peringkat ke 4 angka prevalensi diabetes melitus tertinggi. Di Kota Tomohon kasus diabetes melitus juga terus mengalami peningkatan dari tahun ke tahun dan merupakan 1 dari 5 penyakit metabolik terbanyak. Prolanis diharapkan dapat menjadi wadah untuk meningkatkan derajat kesehatan dan kualitas hidup pasien penyakit kronis seperti diabetes melitus. Penelitian ini bertujuan untuk mengetahui hubungan antara lama menyandang diabetes dengan kualitas hidup pasien prolanis klub Maleosan Tomohon. Jenis penelitian ialah analitik korelasi dengan sampel 45 pasien. Pengambilan data menggunakan kuesioner WHOQOL- BREF dan data dianalisis menggunakan menggunakan uji chi-square. Hasil penelitian menunjukkan bahwa tidak terdapat hubungan antara lama menyandang diabetes dengan kualitas hidup pasien dengan nilai p= 0,322. Simpulan penelitian ini ialah tidak terdapat hubungan antara lama menyandang diabetes melitus dengan kualitas hidup pasien prolanis Maleosan Tomohon.

Kata kunci: diabetes melitus; lama menyandang; kualitas hidup