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PENURUNAN JUMLAH LEUKOSIT SEBAGAI PREDIKTOR PERBAIKAN KLINIS PENDERITA STROKE HEMORAGIK SELAMA PERAWATAN Harkitasari, Saktivi; Nuartha, Anak Agung Bagus Ngurah; Purwata, Thomas Eko
Medicina Vol 46 No 2 (2015): Mei 2015
Publisher : Medicina

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Prognosis penderita stroke hemoragik dipengaruhi oleh banyak faktor, salah satunya adalah jumlahleukosit. Berbagai penelitian menyatakan bahwa peningkatan jumlah leukosit sebagai prediktorperburukan klinis dan kematian pada penderita stroke hemoragik, tetapi sampai saat ini masihbelum jelas apakah penurunan jumlah leukosit setelah terjadi leukositosis dapat sebagai prediktorperbaikan klinis penderita stroke hemoragik. Penelitian ini menggunakan rancangan kohort prospektif.Subjek penelitian adalah penderita stroke hemoragik dengan awitan datang d”24 jam denganleukositosis saat masuk rumah sakit yang dirawat di Sanglah Denpasar. Kelompok yang mengalamipenurunan jumlah leukosit dibandingkan dengan kelompok yang tidak mengalami peningkatan atautanpa perubahan jumlah leukosit. Penilaian luaran klinis menggunakan perubahan skor NIHSS yangdinilai pada hari ketujuh. Total sebanyak 44 subjek dimasukkan dalam penelitian, 19 subjekmeunjukkan perbaikan skor NIHSS. Penurunan jumlah leukosit memiliki hubungan yang signifikandengan perbaikan klinis (RR=5,33; IK95%: 1,81 sampai 15,74; P<0,0001). Hasil penelitianmenunjukkan hanya penurunan jumlah leukosit memiliki hubungan yang independent dengan perbaikanskor NIHSS. Disimpulkan bahwa pada penderita stroke hemorgaik dengan leukositosis, penurunanjumlah leukosit dapat menjadi prediktor perbaikan klinis selama perawatan yang diukur denganskala NIHSS. [MEDICINA 2015;46:92-8].The prognosis of hemorrhagic stroke patients is associated with many factors, leucocyte count is one ofthem. Many studies indicated that elevated leucocyte count is a predictor for bad clinical outcome anddeath in patients with hemorrhagic stroke, however, there is remain unclear whether leucocyte reductionafter leucocytosis could be a predictor for better clinical outcome of patients with hemorrhagic stroke.Thisis a prospective cohort study. Subject were hemorrhagic stroke patients who were arrival time d”24hours onset with leucocytosis admitted in Sanglah hospital Denpasar. Group with leucocyte countreduction were compared with group leucocyte count elevation or without changing. Clinical outcomewere measured with NIHSS score changing at day 7.A total of 44 subjects were recruited, 19 of themhad better NIHSS score. Leucocyte count reduction was significantly associated with better clinicaloutcome (RR=5,33; 95%CI: 1,81 to 15,74; P<0,0001). Leucocyte count reduction was the onlyindependently associated with better NIHSS score. It was concluded that in hemorrhagic stroke patientswith leucocytosis, leucocyte count reduction could be a predictor for better clinical outcome duringhospitalization measured with NIHSS.[MEDICINA 2015;46:92-8].

Diagnosis dan Terapi Miastenia Gravis pada Anak Harkitasari, Saktivi
Cermin Dunia Kedokteran Vol 42, No 3 (2015): Nyeri
Publisher : PT. Kalbe Farma Tbk.

Miastenia gravis merupakan penyakit autoimun paut saraf otot yang didapat. Manifestasi klinis penyakit ini adalah gejala kelemahan yang berfluktuasi dan bervariasi pada otot-otot okuler, anggota gerak, pernafasan, dan bulbar. Miastenia gravis tipe okuler lebih banyak dijumpai dan memiliki usia awitan lebih awal. Pengobatan miastenia gravis menggunakan penghambat asetilkolinesterase, kortikosteroid, azathioprine, plasmaferesis, dan imunoglobulin intravena serta timektomi. Prognosis miastenia gravis pada anak-anak lebih baik daripada dewasa.Myasthenia gravis is an acquired autoimmune neuromuscular junction disease. The clinical manifestations are fluctuating weaknesses of ocular, limbs, respiratory, and bulbar muscles. Ocular myasthenia is the most frequent type with earlier age of onset. Treatment of myasthenia gravis uses acetylcholinesterase inhibitors, corticosteroids, azathioprine, plasmapheresis, intravenous immunoglobulin and thymectomy. Prognosis in children are better than in adults.Â

Functional Gait Assessment to Predict the Risk of Falls in Elderly Saktivi Harkitasari; Cokorda Agung Wahyu Purnamasidhi; RA Tuty Kuswardhani
WMJ (Warmadewa Medical Journal) Vol 3 No 1 (2018): May 2018
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.3.1.369.6-14

Aging process represents the natural process which is inevitable. It is caused by a biological factor that goes naturally resulting in the anatomical, biochemical and physiological changes. The natural changes contribute to falling in elderly. The objective of this study was to assess the falling prediction in elderly by using Functional Gait Assessment. This study used a cross-sectional research design with falling prediction as the variable. Forty-three elderly in Panti Werdha Wana Seraya (aged 60-103 years, - mean of 77.48 ± 1.61), selected according to the inclusion criteria, were included in the study. The data were collected using Functional Gait Assessment and analyzed both descriptively and statistically. The results showed that the elderly had a high risk of falls. Functional Gait Assessment showed that 41 of 43 subjects scored

Beban Tas Siswa di Sekolah Dasar Saraswati 5 Denpasar Saktivi Harkitasari; Ida Ayu Laxmi Ananda Dewi Manuaba; I Dewa Ayu Inten Dwi Primayanti; Cokorda Agung Wahyu Purnamasidhi
Jurnal Ergonomi Indonesia (The Indonesian Journal of Ergonomic) Vol 6 No 2 (2020): Volume 6 No 2 Desember 2020
Publisher : Program Studi Magister Ergonomi Fisiologi Kerja Pascasarjana Universitas Udayana Denpasar Bekerjasama dengan Perhimpunan Ergonomi Indonesia (PEI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JEI.2020.v06.i02.p09

The use of school bags without ergonomics design, miscarriage school bag, excessive bag load and carrying bags with long duration could be risk of disrupting the musculoskeletal system. The aim of this research is to know the frequency of bag load category of elementary students at SD Saraswati 5 Denpasar according to class, age, gender and weight of respondent. This research method was a descriptive cross-sectional study conducted at SD Saraswati 5 Denpasar. The sample in this study was selected by systematic random sampling. There were 86 respondents who carried load of bag of medium category amounted to 40 (46.5%) student, heavy bag category tend to carried by grade 3 student amounted to 12 (54.5%), male and female students carried the same bag load that is the moderate category 40 (46.5%) and the group with the mildest weight among other groups tend to carried heavy bag category amounted to 16 (55.2%). The conclusion is Students of Elementary School Saraswati 5 Denpasar more often carry the bag burden of the medium category. More heavy bag load categories are carried by students aged 7 years - 9 years. Groups of students with the lightest weight tend to carry heavy bag loads.

Diagnosis dan Terapi Miastenia Gravis pada Anak Saktivi Harkitasari
Cermin Dunia Kedokteran Vol 42, No 3 (2015): Nyeri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v42i3.1030

Miastenia gravis merupakan penyakit autoimun paut saraf otot yang didapat. Manifestasi klinis penyakit ini adalah gejala kelemahan yang berfluktuasi dan bervariasi pada otot-otot okuler, anggota gerak, pernafasan, dan bulbar. Miastenia gravis tipe okuler lebih banyak dijumpai dan memiliki usia awitan lebih awal. Pengobatan miastenia gravis menggunakan penghambat asetilkolinesterase, kortikosteroid, azathioprine, plasmaferesis, dan imunoglobulin intravena serta timektomi. Prognosis miastenia gravis pada anak-anak lebih baik daripada dewasa.Myasthenia gravis is an acquired autoimmune neuromuscular junction disease. The clinical manifestations are fluctuating weaknesses of ocular, limbs, respiratory, and bulbar muscles. Ocular myasthenia is the most frequent type with earlier age of onset. Treatment of myasthenia gravis uses acetylcholinesterase inhibitors, corticosteroids, azathioprine, plasmapheresis, intravenous immunoglobulin and thymectomy. Prognosis in children are better than in adults.

Indikasi Tindakan Sectio Caesarea di RSUD Sanjiwani Gianyar Tahun 2017-2019 Ida Bagus Giri Sena Putra; I Made Wandia; Saktivi Harkitasari
AMJ (Aesculapius Medical Journal) Vol. 1 No. 1 (2021): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

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Abstrak Sectio Caesarea (SC) merupakan tindakan pembedahan untuk melahirkan janin dengan cara membuat sayatan untuk membuka dinding perut dan dinding uterus atau suatu histerotomi untuk mengeluarkan janin yang berada di dalam rahim ibu. Angka persalinan SC di Indonesia terus mengalami peningkatan pada tahun 2018. Persalinan dengan metode SC menunjukan angka 17,6 % dari seluruh jumlah persalinan di Indonesia, angka ini melebihi standar WHO yaitu 15 %. Menurut data tahun 2018, Bali menempati posisi kedua terbesar di Indonesia untuk persalinan melalui metode SC dengan persentase 30.2%. Jumlah ini meningkat hampir dua kali lipat dibandingkan data 2013 sebanyak 17.3%. Tujuan dari penelitian ini untuk mengetahui proporsi indikasi tindakan SC di RSUD Sanjiwani Gianyar Tahun 2017-2019. Proporsi ini mencakup gambaran responden yang melakukan tindakan SC berdasarkan indikasi SC, usia, pendidikan, dan pekerjaan. Penelitian ini menggunakan desain deskriptif dengan pendekatan cross-sectional. Hasil penelitian ini didapatkan usia responden terbanyak pada rentang usia 30-34 tahun sebanyak 65 (26,0%) orang, pendidikan responden bersalin dengan metode SC terbanyak adalah SMA sebanyak 123 (49,2) orang, pekerjaan terbanyak responden bersalin dengan metode SC adalah tidak bekerja sebanyak 124 (49,6%) orang, dan proporsi tertinggi indikasi SC yaitu persalinan SC berulang sebanyak 79 (31,6%) orang. Saran diharapkan untuk penelitian selanjutnya agar dapat memuat lebih banyak indikasi SC khususnya yang dilakukan di RSUD Sanjiwani Gianyar. Kata kunci: Sectio Caesarea, Indikasi, RSUD Sanjiwani,Bali Abstract [Indications for Sectio Caesarea at the Sanjiwani Hospital, Gianyar in 2017-2019] Sectio Caesarea (SC) is a surgical procedure to give birth to a fetus by making an incision to open the abdominal wall and uterine wall or a hysterotomy to remove the fetus in the mother's womb. The SC delivery rate in Indonesia continues to increase in 2018, with the SC method showing the rate of SC in 2018 was 17.6% of the total number of deliveries in Indonesia, this figure exceeds the WHO standard of 15%. The data from 2018 showed that Bali occupies the second largest position in Indonesia with deliveries through the SC method with a percentage of 30.2%, this number has almost doubled compared to data from 2013, which was 17.3%. The purpose of this study was to determine the proportion of indications for SC at Sanjiwani Hospital, Gianyar in 2017-2019. This proportion includes the description of respondents who perform SC based on SC indications, age, education level, and occupation. This study was a descriptive design with a cross-sectional approach. This research sample must meet the inclusion criteria of maternity women using the SC method recorded in the medical records at Sanjiwani Hospital in 2019 and the exclusion criteria of incomplete medical records data. The results of this study found that the most respondent were in the age range of 30-34 years old as many as 65 (26.0%) people, the level education of respondents who gave birth using the SC method was high school graduates as many as 123 (49.2%) people, the occupation of most of the respondents who gave birth with the SC method were unemployed as many as 124 (49.6%) people, and the highest proportion of CS indications, namely repeated CS deliveries as many as 79 (31.6%) people. Suggestions are expected for further research so that it can contain more SC indications, especially those carried out at the Sanjiwani Hospital, Gianyar. Keywords: Sectio Caesarean, Indication, Sanjiwani Hospital, Bali

Hubungan antara Sikap Kerja dengan Keluhan Musculoskeletal Disorders pada Pekerja Angkut Barang Toko Grosir Komodo di Denpasar Dewa Ayu Sri Shita Meliani; Suyasning Hastiko Indonesia; Saktivi Harkitasari
AMJ (Aesculapius Medical Journal) Vol. 2 No. 3 (2022): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

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The working activities of carrying load workers in Komodo whole sale shop in Denpasar are considered traditional work posture with repetitive movement and some time do poor work posture. The carrying posture triggers the complaint of Musculosceletal disorders ( MSDs). This study aims to distinguish the correlation between work posture and MSDs. The method of the study was analyzed observational which cross sectional approach. The work posture was measured using REBA (Rapid Entire Body Asessment) and MSDs were measured using Nordic Body Map with Likert Scale. The samples were carried out on 41 workers and the data were analyzed using SPSS 22. The results were showed as follows: there was a significant relationship between work posture and MSDs (r=0.85) The conclusion could be drawn that the relationship between work posture and MSDs was significantly. It could be recommended that the work posture should be ergonomic approach.

Hubungan antara Frekuensi Bangkitan Epileptik dengan Kualitas Hidup Pasien Epilepsi di RSUD Mangusada Tahun 2021-2022 I Gusti Ngurah Agung Cahyadi Putra; Saktivi Harkitasari; Komang Triyani Kartinawati
AMJ (Aesculapius Medical Journal) Vol. 2 No. 3 (2022): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

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Epilepsy is an abnormal condition in the brain characterized by the continuous emergence of predisposing factors in the occurrence of an epileptic seizure, which is also characterized by the presence of neurobiological, cognitive, psychological, and social consequences of the condition. Epileptic seizures are signs and/or symptoms that appear briefly due to abnormal and synchronous neuronal activity in the brain. This study aims to determine the correlation between the frequency of epileptic seizures with the quality of life in epileptic patients at the Mangusada Hospital. This research is an analytic observational study with a cross sectional research design and uses a consecutive sampling technique. The subjects of this study were 52 epileptic patients who came to the neurosurgery polyclinic at RSUD Mangusada in the period of December 2021 to February 2022. The data were collected by questionnaires, collecting secondary data from patient medical records, and interviews. This research was conducted for 3 months, from December 2021 to Febuary 2022. Data were analyzed by Spearman test. The level of significance in this study obtained results (p) <0.001 which means it has a significant correlation between frequency of epileptic seizures with quality of life. The value (r) in this study is -0.705, the correlation is strong with a negative direction, meaning that the more frequent epileptic seizures occur, the lower the quality of life in epileptic patiens.

Pencegahan Stunting Melalui Perbaikan Gizi di Banjar Gadungan, Desa Bresela, Kecamatan Payangan Komang Trisna Sumadewi; Asri Lestarin; Saktivi Harkitasari
Warmadewa Minesterium Medical Journal Vol. 1 No. 3 (2022): September 2022
Publisher : Warmadewa University Press

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Abstrak Di Indonesia kekurangan gizi kronik menjadi salah satu fokus pemerintah. Stunting merupakan gangguan tumbuh pada anak balita ditandai dengan anak terlalu pendek untuk usianya. Pada tahun 2019, angka prevalensi kasus stunting pada balita di kabupaten Gianyar sebesar 12,1%. Hal ini menyebabkan perlunya pembinaan pada desa dengan angka stunting yang cukup tinggi termasuk Desa Bresela. Berdasarkan wawancara dan observasi, didapatkan minimnya pengetahuan mitra mengenai stunting, gizi seimbang dan cara mengolah makanan untuk memenuhi gizi seimbang. Melalui program pengabdian kepada masyarakat diharapkan terdapat peningkatan pengetahuan mitra mengenai stunting dan gizi seimbang serta cara mengolah makanan untuk memenuhi gizi anak sesuai usianya. Metode yang digunakan adalah focus group discussion (FGD ) untuk mengidentifikasi masalah yang dihadapi oleh mitra, dialog interaktif bertujuan memberikan edukasi mengenai solusi permasalahan yang dihadapi oleh mitra serta pelatihan dan pendampingan dilakukan untuk meningkatkan keterampilan mitra dalam menyusun menu makanan yang dilakukan secara berkelanjutan disertai monitoring dan evaluasi setiap bulannya. Program ini terlaksana dengan baik berdasarkan waktu pelaksanaan, partisipasi dan kerjasama yang baik antara mitra dan tim pelaksana. Sarana yang dibutuhkan dan bahan kegiatan juga tersedia dengan baik dengan jumlah yang memadai selama kegiatan. Kegiatan praktek simulasi, pelatihan dan pendampingan pengolahan makanan juga berlangsung baik. Mitra terlihat sangat antusias dan telah berpartisipasi aktif serta kehadiran 100% dalam setiap kegiatan. Peningkatan pengetahuian mitra mengenai stunting dan pencegahannya dapat dilihat dengan peningkatan nilai posttest dibandingkan nilai pretest. Dari hasil observasi, didapatkan peningkatan keterampilan mitra dalam menyusun menu makan anak. Kata kunci: Pencegahan, Stunting, Desa Bresela Abstract Malnutrition is one of the Indonesian government's focuses. Stunting knows as a growth disorder in toddlers characterized by the child being too short for his age. In 2019, the prevalence rate of stunting in children under five in Gianyar district was 12.1%. This considering direct guidance is needed at 10 villages in Gianyar district which have a fairly high stunting rate, including Bresela Village. Based on interviews and observations, it was found that community lack of knowledge about stunting, balanced nutrition and how to process food in order to meet balanced nutrition. Through the community service program, it is expected to be able to increase partners knowledge and skills regarding stunting and balanced nutrition and how to process food to meet children's nutrition according to their age. The method to be used is focus group discussion (FGD) to investigateproblems faced by partners, interactive dialogue to provide information about handling problems experienced by partners, as well as training and mentoring to improve partner skills in preparing food menus that are carried out constantlyaccompanied by monthly monitoring and evaluation. This program was perfectly implemented rated by consistent time implementation of activities, involvement and good cooperation from the partners. Partners, the Implementation Team, the availability of adequate tools and materials during the activity, as well as the implementation of simulation activities, training and mentoring which also went well. Partners have played an active role in every activity with 100% attendance and active participation. Increased knowledge of partners about stunting and its prevention can be seen by the enhacment of posttest score compared to the pretest one. From the results of observations, found that partners' skills increased in compiling children's menus. Keywords: prevention, stunting, Bresela Village

Edukasi Kesehatan Gigi dan Mulut serta Cara Menggosok Gigi pada Anak Sekolah Dasar di Banjar Bukian, Desa Pelaga Komang Trisna Sumadewi; Saktivi Harkitasari
Warmadewa Minesterium Medical Journal Vol. 2 No. 1 (2023): Januari 2023
Publisher : Warmadewa University Press

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Abstract One of the most prevalent oral and dental conditions in children aged 7 to 12 is dental caries. In Indonesia, oral and dental health are not yet given high emphasis, and if complaints do not get in the way of daily activities, people are inclined to disregard them. A person's social life, quality of life, and sense of self-worth can all be impacted by having a clean, healthy mouth, which can also have an impact on school-age children's growth and development. It is crucial to adopt a clean and healthy lifestyle early on because the school-age years are a crucial time for shaping children's habits that will last into adulthood. Correct tooth brushing is a part of living a clean and healthy lifestyle. Teaching kids how to properly brush their teeth can lower their risk of developing cavities or dental caries. This community service project aims to improve the ability of parents and elementary school students to correctly brush their teeth as well as their awareness and comprehension of dental and oral health. Based on these issues, a program was implemented that included teaching kids about dental and oral health, showing them how to clean their teeth properly, and helping them brush their teeth. It is believed that this training will help with the issues raised and improve knowledge and abilities for brushing teeth effectively. At Bukian Banjar, Pelaga Village, the program for teaching dental and oral health awareness and the appropriate way to clean your teeth went off without a hitch, with every participant in attendance. The pretest and posttest findings show that the participants' knowledge increased by 100%. Based on the findings of mentoring observations, it was discovered that elementary school students had improved tooth-brushing abilities. Such actions ought to be taken on a regular basis with broader objectives in order to lower the frequency of dental caries and enhance each person's quality of life.

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