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All Journal Berkala Ilmu Kesehatan Kulit dan Kelamin Gadjah Mada Journal of Psychology PERFORMA : Media Ilmiah Teknik Industri Journal of General Procedural Dermatology and Venereology Indonesia Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Majalah Patologi Indonesia MDJ (Makassar Dental Journal) Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation eJournal Kedokteran Indonesia Jurnal Psikologi Universitas Gadjah Mada
Sri Linuwih Susetyo Wardhani, Sri Linuwih Susetyo
Departemen Dermatologi Dan Venereologi FKUI-RSCM
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Physics Public Health Social Sciences

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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 : Faculty of Psychology, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.903 KB) | DOI: 10.22146/jpsi.6956

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 clinical and histopathological findings of five puzzling cases of cutaneous tuberculosis Eliza Miranda; Sandra Widaty; Sondang Pandjaitan Sirait; Luddwi Achmad Rizky; Henry Wan-Peng Lim; Sri Linuwih SW Menaldi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 1 (2020): December 2020
Publisher : Universitas Indonesia

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Abstract

Background: Cutaneous tuberculosis refers to the clinical manifestation of extrapulmonary tuberculosis affecting the skin. Determining the type of cutaneous tuberculosis from a patient afflicted with is challenging because clinical and histopathological similarities exist between types. Moreover, confirming a diagnosis of cutaneous tuberculosis is difficult because of its similarity with other diseases. For instance, typical and atypical cutaneous tuberculosis may have similar manifestations, but each disease is managed by completely different approaches. Microbiological examination with polymerase chain reaction and bacterial culture are the gold standard methods used to confirm a diagnosis of cutaneous tuberculosis. However, results often demonstrate negative findings.Case Illustration: Five cases of cutaneous tuberculosis, which include two cases of tuberculosis verrucosa cutis, two cases of scrofuloderma, and one case of lupus vulgaris were presented in this article. Four of the five cases demonstrated significant improvement after initiation of an antituberculosis drug regimen.Discussion: Diagnosis of cutaneous tuberculosis in these cases was confirmed through clinical findings and histopathological and microbiological examination.Conclusion: A negative result following microbiological examination does not completely exclude the diagnosis of cutaneous tuberculosis. Investigating the pathognomonic findings of cutaneous tuberculosis through histopathological examination is important to differentiate among its types correctly. Therefore, correlations between clinical and histopathological results are essential to establish a diagnosis of cutaneous tuberculosis.
Lucio’s phenomenon: A report on six patients in a tertiary referral hospital in Indonesia Melani Marissa; Rahadi Rihatmadja; Danny Surya; Henry Lim; Sri Linuwih Menaldi
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 1 (2020): December 2020
Publisher : Universitas Indonesia

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Abstract

Background: Lucio's phenomenon (LP) is a rare variant of leprosy reaction, with the clinical manifestation of “necrotizing erythema.” LP was observed in patients with lepromatous leprosy who have not received or completed the treatment, and it is especially evident in patients with diffuse lepromatous leprosy (DLL), known as Lucio-Latapi’s leprosy. LP occurs due to M. leprae invading the blood vessels, causing endothelial damage that leads to thrombosis, ischemia, infarction, and tissue necrosis. The clinical features of the disease are erythematous lesions that can be accompanied by vesicles or bullae, with ulcers forming scar tissues. Histopathological examination can help establish the diagnosis of LP. Until now, there is still controversy about LP management. Multidrug therapy for multibacillary leprosy (MDT-MB) is the preferred line of treatment. Lucio-Latapi’s leprosy and LP are commonly found in Mexico and Central America, but rarely reported in Indonesia.Case Illustration: We report here the clinical description and development of six patients with LP observed in the tertiary referral hospital in Indonesia over a five-year period from 2013 to 2017.Discussion: All patients were diagnosed using clinical and histopathological examination, and all of them presented with ulceration and vasculitis. They were treated with MDT-MB WHO regimens and systemic corticosteroids. Five patients were alive, and one died due to extensive cutaneous lesions that lead to sepsis.Conclusion: Early diagnosis and prompt institution of multidrug therapy with systemic corticosteroids may improve the prognosis and outcome of LP. Keywords: Indonesia, Lucio-Latapi’s phenomenon, leprosy, reaction
Purpuric lesion in a patient with leprosy: Was it a Lucio’s phenomenon or an epiphenomenon? Sri Linuwih Menaldi; Melani Marissa; Inadia Putri Chairista; Henry W. Lim; Rahadi Rihatmadja
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 1 (2020): December 2020
Publisher : Universitas Indonesia

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Abstract

Background: Lucio’s phenomenon (LP) is a severe necrotizing cutaneous reaction that occurs in patients with Lucio’s leprosy. The exact pathomechanism is not fully understood, but typically abundant acid-fast bacilli in the walls of blood vessels point to direct perturbation of blood supply to the epidermis. We report a case of LP where epidermal necrosis occurred in the absence of vascular invasion by mycobacteria, raising the question whether this was an epiphenomenon or a true LP.Case Illustration: A 34-year-old male was referred for an episodic swelling of his hands and feet that persisted for two years. There were signs of leprosy (diffuse shiny skin lesions, anesthesia, and anhidrosis of the extremities) with purpuric patches on lower extremities. The slit-skin smear test revealed a high index of acid- fast bacilli. Histopathological examination revealed epidermal necrosis and leukocytoclastic vasculitis without demonstrable bacillus. WHO multidrug regimen for leprosy and corticosteroids successfully cured the patient and prevented ulcer development.Discussion: Despite the presence of classical LP characteristics clinically and histologically, mycobacterium was absent in the vessels’ walls. We hypothesized that, in LP, vascular impairment might also be secondary due to antigen–antibody reaction and hypercoagulable state.Conclusion: Purpuric patches in Lucio’s leprosy might be the first sign of skin necrosis or vascular damage (purpura and ulceration). Besides the antimycobacterial drugs, anti-inflammatory drugs should be administered. Laboratory test for hemostasis might be advised.Keywords: Lucio’s phenomenon, mycobacteria, histopathology, vasculitis
Impact of scabies on Indonesian public boarding school students’ quality of life: A mixed-method analysis Sri Linuwih Menaldi; Melani Marissa; Danny Surya; Valensia Vivian The
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 5, No 2 (2021): June 2021
Publisher : Universitas Indonesia

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Abstract

Background: Scabies is a neglected tropical disease in which people affected primarily presents with intense pruritus. The disease is often recurrent, especially in people living in close contacts, such as in a community; thus, it negatively impacts their quality of life (QoL).This study analyzes the impact of pruritus in scabies on the QoL of patients living in a public boarding school (PBS) in West Java, Indonesia. Methods: This study is a mixed-method study conducted on 39 subjects. TheQoL was examined using the Indonesian version of the dermatology life quality index (DLQI) questionnaire and in-depth interviews.Results: Most subjects were female, grade 9 students, had a duration of symptoms between six months to one year, had been infected more than twice, and with no family member affected by the same symptoms. We found that sex, duration of symptoms, disease frequency, and affected family members did not significantly affect subjects’ QoL. In-depth interviews revealed that pruritus affected social relationships, quality of learning, and sleeping.Conclusion: Holistic and comprehensive community management is needed to treat and prevent scabies transmission, as its symptoms negatively impact the QoL of students in PBS. Keywords: pruritus, boarding school, QoL, scabies
Recurrent perianal wart therapy with 90% trichloroacetate (TCA) solution in AIDS patients Sri Linuwih Menaldi; Ika Anggraini; Hanny Nilasari
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 3, No 2 (2019): June 2019
Publisher : Universitas Indonesia

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Abstract

Background: Being the most commonly found sexually-transmitted infection (STI), anogenital warts are mainly caused by human papilloma virus (HPV) type 6 and 11. These infections are often recurrent, leading to loss of time and medical expenses. Various therapeutic modalities can be chosen singularly or in combination with varying results. Treatments with less responsive results usually occur when acquired comorbidities are present, such as HIV infection. Case Illustration: A 28-year-old homosexual male was reported to have a recurrent perianal wart for the duration of eight months. He was also diagnosed with AIDS and pulmonary tuberculosis. Initially, patient was treated with 25% podophyllin tincture, but there was no improvement. Patient was known to still practicing high-risk sexual behavior. After six treatments of TCA, the warts shrank gradually and no new warts had grown. Discussion: It was found that there is a strong relationship between high incidences of genital warts with reduced immune function due to by HIV infection. Patients infected with HIV will often experience recurrence and needs longer treatment. In this case ARV treatment is given and followed by increase in CD4 count, thereby increasing the effectiveness of the treatment of perianal warts. Conclusion: As recommended by clinical guideline in Indonesia, 90% TCA is proven to be effective in treating recurrent anogenital warts in this case. It is important to counsel the patient regarding the sexual behavior for him and his sexual partner, as it will affect the patient’s prognosis significantly. Keywords: perianal warts, sexually-transmitted infection (STI), TCA solution, immunocompromised
Occupational skin cancer and precancerous lesions Fifinela Raissa; Githa Rahmayunita; Sri Linuwih Menaldi; Dewi Soemarko
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 1, No 3 (2016): December
Publisher : Universitas Indonesia

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Abstract

Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit), ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of the skin are actinic keratosis and Bowen’s disease. Particular diagnostic criteria to diagnose occupational diseases has been developed. Early detection of occupational skin cancer and precancerous lesion is necessary. An effective prevention program consists of primary prevention such as prevention of hazardous material exposure, secondary prevention such as early detection of disease for early intervention, and tertiary prevention such as minimizing long-term impact of the disease. Keywords: occupational, skin cancer, precancerous lesion, radiation, carcinogen
Tingkat Kesesuaian Gambaran Klinik dan Histopatologik Serta Positivitas CD4 dan CD8 pada Spektrum Penyakit Kusta Menurut Klasifikasi Ridley-Jopling . Lenti Perangin Angin*, Sri Linuwih Menaldi**, Santoso Cornain*, Mpu Kanoko
Majalah Patologi Indonesia Vol 20 No 2 (2011): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

ABSTRAK Latar Belakang Kusta adalah suatu penyakit kronik yang disebabkan oleh Mycobacterium leprae. Manifestasi penyakit kusta bergantung kepada respon imun seluler seseorang. Ridley-Jopling membuat klasifikasi menjadi Tuberculoid leprosy (TT), Borderline tuberculoid (BT), Mid-borderline (BB), Borderline lepromatous (BL), Lepromatous leprosy (LL) berdasarkan gambaran klinik, histopatologik, bakteriologik dan imunologik. Pada umumnya Pusat Kesehatan Masyarakat di Indonesia belum memiliki fasilitas pemeriksaan histopatologik dan imunologik, sehingga diagnosis kusta hanya ditegakkan berdasarkan jumlah lesi dan jumlah kuman. Tujuan penelitian ini adalah untuk mengetahui tingkat kesesuaian antara gambaran klinik dan histopatologik penyakit kusta dan melihat gambaran respon imun penderita melalui pemeriksaan CD4+ dan CD8+ pada limfosit sel T, serta korelasi antara indeks bakteriologik pada masing-masing tipe kusta. Bahan dan Cara Penelitian potong lintang terhadap 159 kasus kusta baru tanpa reaksi tahun 2007-2009 di Departemen Ilmu Kesehatan Kulit dan Kelamin RSUPN Dr. Cipto Mangunkusumo. Secara sistematic sampling dilakukan pemeriksaan Hematoksilin-Eosin, Fite Faraco dan immunohistokimia CD4 dan CD8 pada 30 kasus masing-masing mewakili tipe kusta. Hasil Dari 159 kasus kusta baru tanpa reaksi terdiri atas 88 laki-laki dan 71 perempuan, dengan kelompok umur paling banyak pada rentang 16-30 tahun. Tingkat kesesuaian diagnosis kusta secara klinik dan histopatologik adalah 52.2%, dengan ketidaksesuaian mayor ditemukan 22% dan ketidaksesuaian minor 25.8%. Tidak terdapat hubungan yang bermakna antara positivitas CD4 dan CD8 dengan tipe kusta sedangkan Indeks Bakteriologik memiliki hubungan yang bermakna dengan spektrum tipe kusta. Kesimpulan Tingkat kesesuaian penegakan diagnostik secara klinik dan histopatologik adalah 52.2%. Terdapat korelasi dengan kekuatan sedang pada hubungan diagnosis klinik dan indeks bakteriologik sedangkan pada diagnosis histopatologik terdapat korelasi kuat dengan indeks bakteriologik. Kata Kunci : Mycobacterium leprae, kusta, indeks bakteriologik, diagnosis klinik, diagnosis histopatologik, klasifikasi Ridley-Jopling, CD4+, CD8+. ABSTRACT Background Leprosy (Hansen’s Disease) is a chronic infectious disease caused by Mycobacterium leprae. The varied manifestations of the disease might depend on the immune status of the host. Ridley-Jopling classified cases based on clinical, histopathological, bacteriological and immunologicalfeatures as TT (tuberculoid leprosy), BT (borderlinetuberculoid), BB (mid-borderline), BL (borderline lepromatous), LL (lepromatousleprosy). Because many centres of health in this country lack the fascility to perform laboratory diagnostic, so clinical diagnostic based on WHO (World Health Organization) classification Paucibacillary and Multibacillary dichotomy may be sufficient. The purpose of this study is to analyze the concordance level between clinical and histopathological diagnosis and correlation of the immunological respons represented by the expression of CD4+ and CD8+T lymphocyte among the spectrum of leprosy. Material and methods A cross sectional study was performed in 159 new leprosy patients with no reaction phase in the National General Central Hospital, Jakarta during 2007-2009 and the archival slides were reviewed. They were stained with Hematoxylin dan Eosin and modified Fite- Faraco staining for identification of Mycobacterium leprae. Immune status of the patients was determined by immunohistochemistry staining with expression of CD4+ and CD8+ T cell lymphocyte. Results 159 new cases of leprosy with no reaction phase consisted of 88 males and 71 females. Discrepancy between clinical and histopathological diagnosis was seen in 47.8% of cases. Major discrepanciescomprised 22%, and minor discrepancies 25.8%. There was no statistically significant relationship between positivity of CD4+ (p>0.05) and CD8+ (p>0.05) with respect to leprosy spectrum.There was statistically significant relationship between Bacteriological Index (BI) and spectrum of leprosy (p
Epidemiology of Leprosy in Indonesia: a Retrospective Study Ramona Sari Lubis; Qaira Anum; Fifa Argentina; Sri Linuwih Menaldi; Hendra Gunawan; Renni Yuniati; Nur Rachmat Mulianto; Agnes Sri Siswati; Dhelya Widasmara; Luh Made Mas Rusyati; Enricco Hendra Mamuaja; Vitayani Muchtar; Regitta Indira Agusni; Muhammad Yulianto Listiawan
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 34 No. 1 (2022): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V34.1.2022.29-35

Abstract

Background: According to WHO data, the number of new cases of leprosy has decreased in 2019. However, Indonesia continues to provide a significant number of cases. According to statistics, India, Brazil, and Indonesia account for 79 percent of all instances. Purpose: This study aims to describe the profile of leprosy patients, and involves all Dermatology and Venereology Academic Hospitals in Indonesia. Methods: This study was a retrospective study of 2461 patients from Dermatology and Venereology Outpatient Clinic at 13 Academic Hospitals in Indonesia between January 2018 and December 2020. Result: Subjects in this study were dominated by males (66.8%) and aged > 14 years (95.3%). The most common type of leprosy was multibacillary (MB) (86.2%), and erythema nodosum leprosum (ENL) was the most leprosy reaction (20.3%). Majority of the subjects experienced disability in the hands (26.6%), in grade 1. Conclusion: Leprosy cases in Indonesia are mostly experienced by adult males. The most common type of leprosy is MB, with ENL being the most common leprosy reaction. Grade 1 disability is the most prevalent, therefore proper education is necessary to keep patients from progressing to grade 2 disability.
BLENDED LEARNING AS A METHOD FOR IMPROVING STUDENTS’ ACHIEVEMENT IN DERMATOTHERAPY: A PRELIMINARY STUDY Sri Linuwih Menaldi; Hanny Nilasari; Githa Rahmayunita; Siti Farida; Nanda L. Prasetya
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 9, No 3 (2020): November
Publisher : Asosiasi Institusi Pendidikan Kedokteran Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.55485

Abstract

Background: Dermatotherapy is an important topic in Dermatology and Venereology module. The time allocated for dermatotherapy topic is limited, so that the development of learning method is needed to achieve the learning objectives. Blended learning is a combination of e-learning and face to face lecture session. This method is often used when there is less time available for lecturing and limited number of teachers. This learning method is expected to be more effective and efficient for the students and also the teachers. This study was conducted to examine the effectiveness of blended learning method used in dermatotherapy topic, and to identify the obstacle of using this method. Methods: This study is a cross sectional study, using quantitative and qualitative approach, involving 22 fifth-year medical students of Faculty of Medicine Universitas Indonesia who enrolled in dermatology and venereology module. We collected data from questionnaire, pre and post-test, and feedback from the students. Comparison of pre-test and post-test results were analysed using paired T test, and followed by bivariate test of students’ characteristic, gadget usage and e-learning activities associated with the increased post-test score.Results: An increased in post-test score was found to be statistically significant (p<0.05). Approximately 95,4% of students passed the final exam on the dermatotherapy subject. Bivariate analysis revealed that the number of gadgets owned, digital usage and e- learning activities did not have a significant effect on the post-test score. Based on the students’ feedback, blended learning had a positive impact on helping their learning process; however, the materials of e-learning must be interactive, informative and comprehensive. Face-to-face lecture is still an important component in learning hence it is irreplaceable. Conclusion: Blended learning is an effective method of learning and should be considered if there is limitation of lecture time and number of teachers available. By using this method, medical students are more flexible in their study and it can be adjusted to their own learning style hence heling them understand better. Further development and improvement are needed for this method as to achieve the learning objectives.  Keywords: blended learning, dermatotherapy, medical students
Co-Authors Agnes Sri Siswati Amitya Kumara Amitya Kumara Anum, Qaira Aria Kekalih Aria Kekalih Danny Surya Danny Surya Dewi Sumaryani Soemarko Dhelya Widasmara Edbert Wreksoatmojo Eliza Miranda Enricco Hendra Mamuaja Estivana Felaza Fakhrina Fahma Fifa Argentina Fifinela Raissa Githa Rahmayunita Githa Rahmayunita Hanny Nilasari Hanny Nilasari Hendra Gunawan Henry Lim Henry W. Lim Henry Wan-Peng Lim Ika Anggraini Inadia Putri Chairista Inosensia Diajeng Kusumo Iwan Dwiprahasto Iwan Dwiprahasto Luddwi Achmad Rizky Luh Karunia Wahyuni Luh Made Mas Rusyati Melani Marissa Melani Marissa Melani Marissa Melinda Harini Muhammad Yulianto Listiawan Nanda L. Prasetya Natalia Putri Handayani Nur Rachmat Mulianto Ova Emilia Ova Emilia Rahadi Rihatmadja Ramona D. Lubis Regitta Indira Agusni Renni Yuniati Roni Zakaria R Sandra Widaty Satyanaya Widyaningrum Siti Farida Sondang Pandjaitan Sirait Steven Setiono Valensia Vivian The Valensia Vivian The Vitayani Muchtar Yayi Suryo Prabandari Yayi Suryo Prabandari