Claim Missing Document
Check
Articles

Found 17 Documents
Search

Comparison of the effects of treadmill and ergocycle exercise on the functional capacity and quality of life of patients with chronic obstructive pulmonary disease Turnip, Helena; Ratnawati, Anita; Tulaar, Angela; Yunus, Faisal; Kekalih, Aria
Medical Journal of Indonesia Vol 23, No 1 (2014): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (527.296 KB) | DOI: 10.13181/mji.v23i1.726

Abstract

Background: Physical excercises are hoped to improve functional capacity and quality of life of patients with chronic obstructive pulmonary disease (COPD). This study is aimed to assess the differences between treadmill and ergocycle exercise on changes in functional capacity and quality of life in patients with stable COPD.Methods: This is an experimental study with complete randomization and repeated pre- and post-intervention observation. The study was conducted on 44 subjects with COPD who were presented at Persahabatan Hospital, Medical Rehabilitation Clinic, consisting of 22 subjects undergoing ergocycle exercise and 22 subjects undergoing treadmill exercise test. Functional capacity was assessed by using the 6 minutes walking test (6 MWT) performed at week I, V and IX. Quality of life was measured using the St. George’s Respiratory Questionnaire (SGRQ) at week I and IX. Training program was conducted for 8 weeks with exercise dosage based on the results of exercise test on week I.Results: Treadmill and ergocycle exercise produce significant improvement in both the 6 MWT and SGRQ test since week I to IX. But in comparison, treadmill exercise improves 6 MWT distance better than ergocycle consistently at week I-V, V-IX and I-IX (p < 0.001). For the SGRQ score, both exercises did not differ significantly. Conclusion: Treadmill exercise is associated with significantly better improvement in functional capacity compared to ergocycle exercise in stable COPD subjects. Concerning quality of life, both exercises gave an equivalent improvement in stable COPD subjects.Keywords: chronic obstructive pulmonary disease, ergocycle exercise, functional capacity, treadmill exercise, quality of life
Kinerja Akseleran dalam Rotasi Klinik: suatu Kajian terhadap Pencapaian Kompetensi Klinik Mahasiswa Kedokteran Wardhani, Sri Linuwih Susetyo; Kekalih, Aria; Dwiprahasto, Iwan; Emilia, Ova; Prabandari, Yayi Suryo; Kumara, Amitya
Jurnal Psikologi Vol 41, No 1 (2014)
Publisher : Fakultas Psikologi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.903 KB)

Abstract

Sebagian kecil mahasiswa fakultas kedokteran adalah mahasiswa dengan riwayat pernah mengikuti program akselerasi ditingkat pendidikan dasar dan menengah, dan kelompok ini disebut sebagai akseleran. Akseleran merupakan siswa berbakat dan memiliki inteligensi serta kemampuan akademik yang tinggi, namun, akseleran umumnya imatur baik sosial, emosional maupun fisik. Dengan demikian dapat diprediksi akan mengalami penurunan kompetensi ketika berada pada tahap rotasi klinik. Tujuan penelitian ini adalah untuk melakukan evaluasi kinerja akseleran dalam pencapaian kompetensi di rotasi klinik. Penelitian ini menggunakan rancangan penelitian campuran, dengan pendekatan kualitatif lebih dominan. Responden penelitian ialah mahasiswa fakultas kedokteran di semester tujuh dan delapan dengan riwayat pernah mengikuti program akselerasi. Hasil penelitian ini mendapatkan bahwa kemampuan dasar akseleran berada pada skala baik dan baik sekali; sikap kerja cukup hingga baik, sedangkan kepribadian pada komponen stabilitas emosi serta daya tahan stres berada pada skala kurang hingga cukup. Nilai median kompetensi klinik akseleran sedikit lebih tinggi dibandingkan non-akseleran, tetapi secara satistik perbedaannya tidak bermakna. Kesimpulan penelitian adalah, kinerja akseleran dalam rotasi klinik cukup baik, namun akseleran menghadapi masalah non-akademik terutama aspek kepribadian yang dapat memengaruhi nilai akademik. Perlu pertimbangan seleksi calon mahasiswa kedokteran terhadap akseleran dengan menggunakan pemeriksaan psikologik untuk menilai kematangan kepribadian. Kata kunci: akseleran, kompetensi klinik, seleksi calon mahasiswa
Correlation between peripapillary retinal nerve fiber layer thickness and visual function changes in patients receiving ethambutol Dialika, Dialika; Sidik, Muhammad; Nusanti, Syntia; Kekalih, Aria
Medical Journal of Indonesia Vol 24, No 1 (2015): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (414.289 KB) | DOI: 10.13181/mji.v24i1.1065

Abstract

Background: Recent animal studies revealed the decreased amount of retinal ganglion cells after treatment with ethambutol. The aim of this study was to evaluate the changes of peripapillary retinal nerve fiber layer (RNFL) thickness in patients receiving ethambutol therapy, as well as to know the correlation of RNFL thickness changes with the changes of visual function.Methods: This was a cohort study on 29 subjects at one tuberculosis treatment center, Jakarta. Subjects underwent RNFL thickness measurement using optical coherence tomography (OCT) and several visual function parameters (visual acuity, contrast sensitivity, color sensitivity and visual field) before and two-months following ethambutol therapy. Statistical comparison between pre- and post- ethambutol measurements were done using either paired T-test or Wilcoxon test. Correlations between anatomical and functional changes were assessed with Spearman correlation test. Results: There were significant changes of peripapillary RNFL thickness in superior (147 and 141 μm, p = 0.001), nasal (92 and 88 μm, p = 0.045) quadrants and average RNFL thickness (116.77 and 112.65 μm, p = 0.001). No significant correlation between RNFL thickness changes and the changes of visual function parameters (p > 0.05).Conclusion: Ethambutol consumption for two months in recommended dose is still considered safe to human retina and visual status.
Microscopic Examination of Fecal Leukocytes as a Simple Method to Detecting Infective Colitis in Children Susanti, Nuraini I; Reynaldo, Reynaldo; Kekalih, Aria; Karuniawati, Anis; Hegar, Badriul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, August 2017
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (495.275 KB) | DOI: 10.24871/182201773-79

Abstract

Various pathogenic bacteria are reported as the cause of infectious colitis in children. Infectious colitis does not have a specific sign, therefore an accurate examination is required. The implementation of fecal cultures accompanied with drug resistance tests often have constraints, beside the relatively expensive costs, longer times are needed, and not all health care facilities have required instruments. On the other hand, this condition requires an immediate antibiotic therapy, so that the infection should not be continued. In daily practice, it is not uncommon to find diarrhea with the amount of fecal leukocyte < 10/hpf with pathogenic bacteria on the examination of the fecal culture.Cross-sectional study was conducted to observe the pattern of bacterial distribution in children’s fecal who have acute diarrhea and  the correlation between the existence of pathogenic bacteria and the number of leukocytes in the fecal, as well as antibiotic resistance patterns. The population of this study is children with age of 6 months old - 18 years old who were suffering from acute diarrhea with the  amount of  fecal leucocyte  ≥ 5/hpf, who recruited from polyclinic or patient admitted at Cipto Mangunkusumo Hospital and Fatmawati  General Hospital, Jakarta. Based on examinations of fecal cultures and PCR, Salmonella sp and C. dificille were found subsequently in 2 children (33.3%), Enterophatogenic E. Coli(EPEC) and Shigella were found subsequently in 1 child (16.7%). Based on the ROC curve, it was found that there was no intersection of maximum and  minimal leukocyte value with the midline, whereas the best sensitivity and specificity value was found at the cut-off point of 8.5, hence the cut-off  point  of leukocytes was determined at < 8 and > 8. The sensitivity value was 83.3% and the specificity value was 45.1%. The antibiotic sensitivity test showed that one child infected  by EPEC was sensitive to ciprofloxacin. Two children infected  by Salmonella, were still sensitive to chloramphenicol, cotrimoxazole, cefixime, and ceftriaxone. Two children infected by C. Difficile were sensitive to ceftriaxone, and 1 child infected by Shigella was sensitive to cefixime, ceftriaxone and ciprofloksazine.
Risk Factors in Descending Necrotizing Mediastinitis Following Submandibular Abscess at dr. Cipto Mangunkusumo Hospital in January 2012 – July 2016 Putra, Muhammad Arza; Pratama, Raditya; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Descending necrotizing mediastinitis (DNM) encountered problem of a high mortality rate. The increasing number of incidence and the need of immediate intervention DNM cases urge surgeons to manage early preventions and adequate therapy. The purpose of thisstudy is to find risk factors that correlate to the incidence of DNM in submandibular abscess patients. Method. Cross sectional study conducted enrolling all patients diagnosed with submandibular abscess that developed to DNM and treated surgically in emergency operating theater in period of January 2012 to July 2016 were reviewed. Mediastinitis which was not following submandibular abscess, those were not treated surgically or treated by other than the division of thoracic and cardiovascularsurgery, and those of pediatrics were not included on the study. The incidence of DNM was the dependent variable on the study; risk factors such as gender, age, body mass index (BMI), comorbid(s), leukocyte counts, and microorganism(s) were independent variables on the study. Results. There were 68 subjects enrolled on the study. The met the inclusion and exclusion criteria. Subjects characteristics are shown in table 1. Septic condition, surgical intervention, postoperative complications, and mortality are shown in table 2. There was no correlation between gender (p = 0.656), age (p = 0.763), comorbid(s) (p = 0.767 and 0.952). It also found that leukocyte counts, and cultured microorganism(s) showed no significant correlation. Conclusion. Not a single risk factor specifically correlatesto the incidence of DNM in subjects with submandibular abscess. Thus, so those with submandibular abscess have a same risk to have DNM developed.
Perianal Condyloma Acuminata: Factors that Contribute to the Recurrence Jeo, Wifanto S.; Sugiharto, Bobby; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Condyloma Acuminata (CA) is the most common sexually transmitted disease caused by HPV with high recurrence rate up to 70%. Factors contribute to the recurrence such as age, site of predilection, previous treatment, HIV infection and sexual behavior were noted in perianal CA. To date the correlation of these factors to the recurrence remains unknown. Method. A cross sectional study was conducted. Patients with history of CA managed in clinic of surgery during period of January 2010 to June 2015 were reviewed. Subject characteristics, i.e. age, infected site, previous treatment, HIV infection and sexual behavior and recurrence were the variables of the study. Data collected from medical record were statistically analyzed. Significant correlation found if p value <0.05. Results. There were 48 subjects with the history of CA. On the analysis, age variable has a significant correlation with the recurrence p = 0.008 (OR = 5.83; 95% CI 1.66–20.56;). The recurrence was higher in productive age compared to non–productive age. Previous anal CA and high risk negative sexual behavior showed a higher recurrence risk than previous non–anal CA and positive sexual behavior (OR = 1.89 and 2.14, respectively). Conclusion. There was significant correlation between age and CA recurrence, anal CA and negative sexual behavior showing 1.89 and 2.14 times, respectively more likely to have recurrence (New Ropanasuri J Surg.2018;3(2):e218).
Hepatic Reperfusion Injury following Remote Ischemia: Experimental Study on Oryctolagus cuniculus Maulanisa, Sinta C.; Moenadjat, Yefta; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Ischemia/reperfusion (I/RI) injury following limb ischemia is realized to be responsible for remote organs injury which is found in vary, commence with mild injury to a severe one. Nevertheless, liver is an organ susceptible to such an injury. There were studies on I/RI, where ischemia in those studies were induced by direct ligation of hepatic vessels. However, study of remote ischemia was infrequently found. Thus, we run a study aimed to find out hepatic injury following ischemia induced by ligation of an artery with a significant anatomical distance. Method. An experimental study was conducted on New Zealand white rabbit. Ischemia was induced by ligation of right common femoral artery under anesthesia. Ligation was maintained for four hours period. Afterwards, ligation was released, and rabbit was set free in the cage for eight hours period. Laparotomy was carried out to take liver specimens of three different area, namely central, midzonal, and peripheral. These specimens were subjected to study histopathology and biochemical examination for malondialdehyde as well as HIF–1α. In addition, liver function test was carried out for serum bilirubin and transaminases. Results. The study on histomorphologyshowed hepatic injury of central, midzonal and peripheral of the ischemic/reperfusion injury group, which was mostly sinusoidal dilatation. There was a significant statistical different of the three hepatics–zones (central, p = 0.028, midzonal, p = 0.012, and peripheral, p = 0.030). MDA levels showed a significant increase in the ischemic/reperfusion group (p = 0.012, sig α <0.05). Tissue HIF–1α level increased denoted tissue hypoxia in the treatment group. Liver function test showed no abnormality. Conclusion. Oxidative stress and sinusoidal changes were found in three zones, i.e. central, midzonal and peripheral following ischemic of a significant anatomical distance.
Effect of Preconditioning and Hypothermia in Ischemia–Reperfusion Injury to the Endothelial Cells of Blood Vessels in Oryctolagus cuniculus Ismet, Mohamad F.; Moenadjat, Yefta; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Ischemia/reperfusion injury (I/RI) remain a problem in post–hypoxia period, leading to remote organ injury. Studies showed that ischemic preconditioning (IPC) and hypothermia (HI) let destructive effect of ischemia to be minimized. The aim of study was to find out the impacts of interventions such as IPC and HI on morphology and function of the endothelial distal to ligation (ischemia) and contralateral vessel (I/RI). Method. An experimental study carried out by ligation the right common femoral artery of Oryctolagus cuniculus to induce ischemia. Endothelial cells distal to ligation and contralateral side was subjected to investigation. The effect of IPC and HI were investigated and compared to those in I/RI. Results. Morphological study showed significant difference scores between endothelial damage in ipsilateral vessels in interventional subjects with control, and intervention with I/RI group (p 0.05). Conclusion. Ischemia may lead to remote endothelial dysfunction; IPC and HI showed the efficacy to minimize the impact of reperfusion.
Effect of Ischemia Preconditioning and Hypothermia to Gastric Mucosal Reperfusion Injury Post Ischemia in Lower Extremities of Oryctolagus cuniculus Ngatio, Benjamin; Moenadjat, Yefta; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Immediate revascularization of ischemic tissue does not always produce positive results since various reactions following formation of reactive oxygen species and activation of complement system might lead to ischemia/reperfusion injury (I/RI). It was hypothesized that ischemia preconditioning (IPC) and hypothermia (HI) have a role to reduce the impact of (I/RI). Method. An experimental study was carried out on Oryctolagus cuniculus (New Zealand White rabbit) to find out the efficacy of IPC and HI. Subjects were divided into four groups; a control (consist of two subjects) and three treatment groups (each consist of six subjects), namely I/RI group, IPC group, and HI group. In I/RI group, right common femoral artery was ligated under anesthesia and ligation was maintained for four hours, and then released for eight hours. In IPC group, arterial ligation for two minutes and released for three minutes protocol was carried out in two cycles. In HI group, right lower extremity was wrapped with iced aluminum foil. In the last two groups mentioned, the ligation released after 4 hours and treated as in I/RI group. Subjects were sacrificed, and samples of stomach was taken through laparotomy. Histopathology exam and tissue malondialdehyde (MDA) were variables of interests. Statistical analysis was carried out using SPSS ver. 20, and significance met if p
Implementation of revised Baux Score to Predict Mortality Burn Injured Patients in Burn Unit of dr. Cipto Mangunkusumo General Hospital, Jakarta Wardhana, Aditya; Mulyantara, Irwan; Kekalih, Aria
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction. Implementation of stratification in burn injured patients referred to a very helpful approach for surgeon distinguishing severity of problems as well as predicting the outcome and lead a surgeon to make an accurate decision and a guidance to deliver patient’s condition to his/her family. A stratification tools for prediction should be simple and applicable in clinical setting. It also feasible to be applied for clinical use, research purpose, and system audit. Amongst scoring systems in burn surgery, revised Baux score is the one. The study is aimed to run validation in our burn characteristics. Method. A study run to find out validation for revised Baux score, prior to its use for application in our setting. We run cohort study enrolled burn injured patient treated during period of January 2010 to December 2012, retrospectively. Total body surface area involved, age and inhalation injury referred to variables subjected to statistical analysis. Results. Out of 442 burn injured patient, there were 234 subjects included in the study. Statistical analysis using Hosmer and Lemeshow test addressed to evaluate calibration of scoring performance showed p value of p = 1 (> 0.05), and for its precision we found the performance of discrimination of r–Baux score showed the area under curve (AUC) of 0.87 (CI 95%; 0.825–0.915), showing a p value of <0.001, and sensitivity 77.9% and specificity 76.9%. Conclusion. On validation, revised Baux score provide a good performance and likely would provide a merit of its clinical application.