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All Journal Medical Journal of Indonesia Jurnal Kedokteran Meditek Gadjah Mada Journal of Psychology Majalah Kedokteran Sriwijaya Universa Medicina Paediatrica Indonesiana Jurnal Respirologi Indonesia The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Indonesia Journal of Physical Medicine and Rehabilitation Cermin Dunia Kedokteran Ophthalmologica Indonesiana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy IJRETINA - International Journal of Retina Occupational and Environmental Medicine Journal of Indonesia Jurnal Kedokteran Meditek
Aria Kekalih
Departemen Ilmu Kedokteran Komunitas, FK Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health

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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

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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
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

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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.
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

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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).
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

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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.
Postoperative Wound Irrigation Using Distilled Water in Preventing Surgical Site Infection in a Tertiary Hospital: A retrospective Cohort and Cost-effective Study Jeo, Wifanto S.; Pratama, Dennis W.; Vanto, Yoni; Kekalih, Aria; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery
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Background. The incidence of surgical site infections (SSIs) is reducing following the global campaign that requires all the stakeholder involvement. However, of all hospital-acquired infection prevention programs, wound irrigation is hard to be implemented in our hospital. There is a belief that the wound irrigation procedure leading to the spreading of infection. In contrast, the use of antiseptic and topical antibiotic, as well as systemic antibiotic, is uncontrolled high. Thus, we run a cost-effective study of wound irrigation to change the practice. Method. We carried out a prospective cohort study comparing wound irrigation and the standard protocol in wound care in those underwent median laparotomy during the period of January to July 2018. A total of 80 subjects enrolled in this study, which divided into two groups, 40 for each group. The first group was those treated using antiseptics (povidone-iodine) and antibiotic contained paraffin tulle, while the second group was those treated using irrigation. This study performed in the digestive surgery division, which initiated irrigation protocol for wound irrigation. Stitch specimen taken for bacterial culture proceeded on 7th day postoperative and clinical signs of infection following CDC criteria was observed then statistically analyzed. The committee of ethics Faculty of Medicine Universitas Indonesia approved the study. Results. The bacterial culture showed no significant difference (p = 0.82) between the two groups. Clinical signs are showing no significant difference between the two groups (p = 1.00). In the cost perspective, the application of wound irrigation saving IDR 57,500,00 or four USD per subject. Conclusion. Wound irrigation using distilled water efficiently prevent SSIs.
Validasi Kuesioner EORTC QLQ-CR29 untuk Menilai Kualitas Hidup Pasien Kanker Kolorektal di Indonesia Pramaningasih, Maelissa; Basir, Ibrahim; Jeo, Wifanto Saditya; Kekalih, Aria
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.19

Abstract

Latar Belakang: Saat ini di Indonesia tidak ada kuesioner standar untuk menilai kualitas hidup pasien dengan kanker kolorektal. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ColoRectal 29 (EORTC QLQ-CR29), adalah sebuah kuesioner yang terstandarisasi untuk menilai kualitas hidup yang umum digunakan pada negara maju. Penelitian ini mencoba membuktikan bahwa EORTC QLQ-CR29 adalah kuesioner yang valid dan reliabel untuk digunakan di Indonesia. Metode: Kuesioner EORTC QLQ-CR29 diterjemahkan kedalam bahasa Indonesia, dan diterjemahkan kembali ke bahasa Inggris. Dilakukan sebuah studi pilot terlebih dahulu, kemudian studi utama ke pasien kanker kolorektal pada poliklinik Bedah Digestif di RSUPN dr.Cipto Mangunkusumo. Desain studi cross-sectional, digunakan intraclass correlation coeficient (ICC) untuk menilai test-retest realiability. Konsistensi internal dievaluasi menggunakan Cronbach’s α coefficient. Validitas konvergen dan diskriminan dianalisa dengan multi-trait scaling. Validitas klinis dievaluasi berdasarkan perbedaan klinis yang telah diketahui sebelumnya menggunakan known-group comparisons. Hasil: Sebanyak lima puluh dua pasien yang berpartisipasi pada penelitian ini. Proses penterjemahan membutuhkan sedikit perubahan akibat adanya perbedaan budaya. Uji test-retest dilakukan pada 17 subjek, yang menunjukkan nilai yang dapat diterima (0.67-1.00). Nilai Cronbach’s α coefficient 0,77-0,86, nilai ini melebihi kriteria 0,7. Pada multi-trait scaling analysis menunjukkan skala multi-item memenuhi standar validitas konvergen dan diskriminan. Pada uji known group comparison menunjukkan kualitas hidup yang berbeda berdasarkan lokasi tumor. Simpulan: Dibutuhkan adaptasi budaya dalam proses penterjemahan. Kuesioner EORTC QLQ-CR29 yang telah diterjemakan merupakan kuesioner yang valid dan reliabel untuk menilai kualitas hidup pasien kanker kolorektal di Indonesia.
Hiperbilirubinemia sebagai Prediksi terhadap Appendisitis Perforasi Siregar, Sun Parkuseg; Putranto, Agi Satria; Kekalih, Aria
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.22

Abstract

Latar Belakang: Penegakkan diagnosis apendisitis perforasi sebelum tindakan operasi akan berpengaruh terhadap morbiditas pasien. Dengan anamnesis, pemeriksaan fisik dan pemeriksaan penunjang sederhana berupa peningkatan nilai lekosit, dan netrofil segmen dan peningkatan nilai bilirubin total pre-operatif diharapkan dapat memprediksi diagnosis apendisitis perforasi. Metode: Dari 128 pasien apendisitis akut yang dating ke IGD dilakukan pemeriksaan penunjang tambahan nilai bilirubin total dan dilakukan apendektomi dikumpulkan secara retrospektif dari Januari – Juli 2016. Data dasar karateristik pasien, hasil penunjang laboratorium darah dan laporan operasi diambil dari rekam medik, lalu dilakukan analisis multivariate untuk melihat korelasinya. Hasil: Dari 128 pasien yang didiagnosis awal sebagai apendisitis akut sebanyak 68,8% dan apendisitis perforasi sebanyak 31,3% didapatkan temuan intra operatif apendisitis non perforatif sebanyak 46,9% dan apendisitis perforasi sebanyak 53,1% dengan nilai rata-rata bilirubin total adalah 1,19 mg/dL dan nilai cut off adalah 1,00 mg/dL. Laki-laki dengan apendisitis perforasi 66,1% dan perempuan 33,9% .Dengan lama sakit di rumah sebelum dating ke IGD rata-rata 3,5 hari. Dengan nilai sensitivitas 77,94%; spesifitas 76,67%, nilai prediktif positif 79,1% dan nilai prediksi negative 75,41%. Pada uji analisis multivariate didapat kan nilai bilirubin total ( odds ratio 5,016; 95% confidence interval 2,092-12,026; P = &lt; 0,0001), leukosit ( odds ratio 1,993; 95% confidence interval 0,893-4,451; P = 0,092) dan alvarado score ( odds ratio 3,193; 95% confidence interval 1,542-6,611; P = 0,002) yang secara statistic signifikan untuk memprediksi diagnosis apendisitis perforasi pre-operatif. Simpulan: Hiperbilirubinemia secara satitistik signifikan untuk memprediksi diagnosis apendisitis perforasi pre-operatif.
Assessment of compliance to standard precautions among nurses using the Health Belief Model Rusli, Noer Triyanto; Mansyur, Muchtaruddin; Kekalih, Aria; Sulistomo, Astrid; Werdhani, Retno Asti
Universa Medicina Vol. 39 No. 3 (2020)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2020.v39.199-206

Abstract

BACKGROUNDThe application of Standard Precautions (SP) has become a significant challenge for healthcare workers, especially in developing countries, endangering their safety and increasing their exposure to blood-related pathogens. This study was aimed at exploring the factors related to nurses’ compliance with the practice of SP.METHODSA cross-sectional study was conducted on 120 nurses working at a hospital in Palembang. Health Belief Model components of the subjects were recorded through questionnaires. A 12-point observation form assessed the nurses’ SP compliance. Multiple logistic regression models were used to explore factors associated with nurses’ compliance.RESULTSThe results showed that 56.7% of participants had good compliance, although the five moments of hand hygiene still needed to be improved. The study revealed that the proportion of the operating room and emergency room nurses who complied with the SP was larger than the proportion of those who worked at the other wards (OR=2.57, 95% CI 1.51-4.36). The nurses who had received training also showed a larger proportion of compliance with SP than those who had not been trained (OR=2.70, 95% CI 1.07-6.79).CONCLUSIONNurses’ behavior to SP was significantly associated with the adequacy of the training and work unit. It is suggested that the practice of SP was also influenced by enabling factors and subjective norms. Adequate training of nurses, provision of infection prevention equipment, and assessment of occupational exposures need to be introduced.
Validity and Reliability of the Indonesian Version Gross Motor Function Measure to Measure Gross Motor Function in Cerebral Palsy Children Selly C Anggoro; Amendi Nasution; Luh K Wahyuni; Aria Kekalih
Indonesian Journal of Physical Medicine & Rehabilitation Vol 1 No 1 (2012): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (223.511 KB) | DOI: 10.36803/ijpmr.v1i1.214

Abstract

Objectives: Cerebral palsy (CP) is the most physical disabling disease in children. Gross motor capacity in CP usually measured and evaluated by Gross Motor Function Measure (GMFM), a standardizedobservational instrument to evaluate gross motor function. Studies showed GMFM reliable, valid, and responsive to change of CP gross motor function. This research aims to examine validity and reliabilityof GMFM translated into Indonesian.Methods: Cross sectional study with consecutive sampling of CP children aged 2-­15 years came to pediatric rehabilitation clinic at RSCM Medical Rehabilitation Department or YPAC Jakarta. Subjects classified by age, type, anatomical distribution, and severity.Gross motor function evaluated with 88 GMFM items translated into Indonesia. Inter-­rater evaluated gross motor function through video records. Criterion validity tested by correlation coefficient, construct validity tested by comparing GMFM item with dimension total scores and GMFM total score with corrected Spearman correlation. Inter-­rater reliability tested by unpaired T-­test, internal consistency by alpha Cronbach.Results: Thirty one CP children with mean age 7 years 11 months, mean GMFM score 58.40 (SD=49.09).No significant difference of all GMFM dimensions; almost all GMFM items obtained from inter-rater evaluation. Good internal consistency (alpha Cronbach 0.884) and good criterion validity of all dimensions;; inter-­item and total correlations good to strong (r=0.523-­0.859).Conclusion: GMFM Indonesian has good to strong criterion validity. Construct validity of all dimensions was quite good. Internal consistency was good. No significant difference between inter-raters showed GMFM inter-­rater reliability good enough.Keywords: Cerebral palsy, gross motor function, gross motor function measure, validity, reliability.
Hamstring Muscle Flexibility among KONI Volleyball Players of DKI Jakarta Province – A Pilot Study for Sport Injury Prevention. Hendriko; Tirza Z Tamin; I Nyoman Murdana; Aria Kekalih
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (496.504 KB) | DOI: 10.36803/ijpmr.v2i01.233

Abstract

Objectives: To find hamstring muscle flexibility among KONI Propinsi DKI Jakarta’s volleyball players,based on age, sex and playing position particularly.Methods: A cross sectional study performed in 25 female and 24 male athletes using Sit and Reach Test (SRT) box had done 3 times trial with the best score was recorded.Results: Hamstring muscle’s mean value score was 18.21 (SD 6.5) cm, male athletes was 17.6 (SD 6.5) cm, female athletes was 18.8 (SD 6.6) cm, middle adolescence 14-16 years old was 15.55 (SD 6.1) cm,late adolescence 17-20 years old was 19.91 (SD 6.9) cm, young adulthood 21-24 years old was 18.79 (SD 4.6) cm, hitter was 18.8 (SD 6.6) cm, center was 15.5 (SD 6.3) while allround players was 20.4 (SD5.9).Conclusions: Average value of hamstring flexibility among volleyball athletes of KONI DKI Jakarta based on SRT was 18.21 ± 6.5 cm, particularly within middle adolescence (14-16 years old) was 15.55± 6.1 cm, late adolescence (17-20 years old) was 19.91 ± 6.9 cm, and young adulthood (21-24 year old) was 18.79 ± 4.6 cm. While by sex was 17.6 ± 6.5 cm among male and 18.8 ± 6.6 cm among female.Based on playing position, hitters were 18.8 ± 6.6, setters were 15.5 ± 6.3 and all-round player were 20.4 ± 5.9 cm.Keywords: Flexibility, Hamstring muscle, SRT
Co-Authors Adiningsih Sri Lestari Agi Satria Putranto Alma Thahir Pulungan Amendi Nasution Amir Shidik Amitya Kumara Angela BM Tulaar Anis Karuniawati ANIS KARUNIAWATI Anita Ratnawati Arthur Garson Aziza G. Icksan Badriul Hegar Badriul Hegar Bambang Supriyatno Benjamin Ngatio, Benjamin Bondan Harmani Boy Hidayat Budhi Antariksa Damayanti Rusli Sjarif Danny Rasjiid Garna Dewi Friska Dialika Dialika Elisna Syahruddin Elisna Syahruddin Faisal Yunus Feni Fitriani Harsono, Hasto Helena Turnip Hendriko Herqutanto Herqutanto Hidayat, Boy I Nyoman Murdana Ibrahim Basir Idqan Fahmi Ika Citra Susanti Iris Rengganis Isep Supriyana Ismet, Mohamad F. Iwan Dwiprahasto Jeo, Wifanto S. Jeo, Wifanto Saditya Johan, Anita Judith N. Anastasia Kamil, Radhita F. Kusnadi, Dana S. Luh K Wahyuni M. Sidik Maelissa Pramaningasih Maulanisa, Sinta C. Maulia Fitra Purnama Moretta Damayanti Muchtaruddin Mansyur Muhammad Ilyas Muhammad Sidik Mulyantara, Irwan Nuraini I Susanti Nury Nusdwinuringtyas Ova Emilia Pramaningasih, Maelissa Pratama, Dennis W. Purwito Adi, Nuri Putra, Muhammad Arza Putranto, Agi S. R. Muharam Raditya Pratama Rahayu, Tri Retno Asti Werdhani Reynaldo Reynaldo Reynaldo Reynaldo, Reynaldo Rini Andriani Risky Dwi Rahayu Rosa Tatun Roy Dwi Indra Rusli, Noer Triyanto S. Soemarko, Dewi Saunar, Rofi Y. Sawitri Darmiati Selly C Anggoro Siregar, Sun Parkuseg Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo Sugiharto, Bobby Sulistomo, Astrid Sun Parkuseg Siregar Susanti, Nuraini I Susanti, Nuraini I Syntia Nusanti Syntia Nusanti Syska Widyawati Tirza Z Tamin Toar JM Lalisang Tresia Fransiska Ulianna Tambunan Tri Rahayu Vanto, Yoni Viscanita Viscanita W. Roestam, Ambar Wibowo, Suryo Wifanto Saditya Jeo Winata, Vera Yayi Suryo Prabandari Yefta Moenadjat Yoga Devaera Yundari, Yundari