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Richard M. Sumangkut, Richard M.
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Biochemistry, Genetics & Molecular Biology Health Professions

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HUBUNGAN ANKLE BRACHIAL INDEX DENGAN KEPARAHAN ULKUS PADA PENDERITA KAKI DIABETIK Kristiani, Amelia L.; Sumangkut, Richard M.; Limpeleh, Hilman P.
Jurnal Biomedik : JBM Vol 7, No 3 (2015): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.7.3.2015.9488

Abstract

Abstract: This study aimed to determine the relationship between ankle brachial index (ABI) and the severity of ulcer using Wagner classification among patients with diabetic foot in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational study with a cross-sectional design conducted at the Department of Surgery and Department of Internal Medicine of Prof. Dr. R.D. Kandou Manado Hospital from January to June 2015. The results showed that there were 38 patients with diabetic foot ulcers. The highest proportion was the group of patients with Wagner grade 4 (10 patients - 26.3%), followed by grade 1 (9 patients - 23.7%), grade 2 and 3 (each of 8 patients - 21.05%), and grade 5 (3 patients - 7.9%). There were 22 patients (57.9%) with normal ABI values, followed by moderate ischemia in 8 patients (21.1%), mild ischemia in 7 patients (18.4%), and only 1 patient (2.6%) with severe vascular obstruction. The Spearman test showed a P value of 0.008 which meant that there was a significant correlation between ABI and the severity of ulcer. The lower the ABI value, the more severe the ulcer of diabetic foot cases Conclusion: ABI value had a significant relationship with the severity of ulcers of diabetic foot patients.Keywords: ABI, diabetic footAbstrak: Penelitian ini bertujuan untuk mengetahui hubungan Ankle Brachial Index (ABI) dengan derajat keparahan ulkus pada penderita dengan kaki diabetik yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado. Penelitian berupa studi observasional dengan desain potong lintang yang dilakukan di Bagian Bedah dan Bagian Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado selama periode Januari sampai Juni 2015. Hasil penelitian mendapatkan 38 penderita kaki diabetik dengan proporsi terbanyak yaitu penderita dengan ulkus Wagner grade 4 sebanyak 10 pasien (26,3%), diikuti grade 1 sebanyak 9 pasien (23,7%), grade 2 dan 3 masing-masing sebanyak 8 pasien (21,05%), dan terakhir ulkus Wagner grade 5 sebanyak 3 pasien (7,9%). Nilai ABI normal didapatkan paling banyak yaitu pada 22 pasien (57,9%), diikuti oleh obstruksi vaskular sedang sebanyak 8 pasien (21,1%) dan iskemi ringan sebanyak 7 pasien (18,4%), dan hanya 1 pasien (2,6%) dengan obstruksi vaskular berat. Hubungan ABI dan keparahan ulkus diuji dengan analisis koefisien koreksi Spearman dan mendapatkan nilai P = 0,008 yang menunjukkan makin rendah nilai ABI maka nilai keparahan ulkus semakin besar. Simpulan: Nilai ABI memiliki hubungan bermakna dengan keparahan ulkus penderita kaki diabetik.Kata kunci: ABI, kaki diabetik
Hubungan kadar fibrinogen dengan apendisitis akut Tampi, Hendrik M. J. M. J.; Sapan, Heber B.; Sumangkut, Richard M.
Jurnal Biomedik : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12668

Abstract

Abstract: Acute appendicitis is one of the most frequent emergency conditions in surgery. Early diagnosis is very important since patients’ morbidity will increase in perforated or abscess appendicitis. Clinical evaluation of patients suspected acute appendicitis is very important to prevent the occurence of appedix perforation and other complications as well as to minimize the occurence of negative appendectomy. Plasma fibrinogen is assumed to have a predictive value of preoperative diagnosis of acute appendicitis. This study aimed to evaluate the relationship between fibrinogen level and acute appendicitis cases. There were 40 patients with abdominal pain suspected acute appendicitis at the Surgey Department of Prof. Dr. R. D. Kandou Hospital and its collaborating hospitals. Plasma fibrinogen and histopathological examination of appendix tissue were performed on them. The results showed that of the 40 patients, there were 19 cases of acute appendicitis, 10 cases of chronic appendicitis with acute exacerbation, and 11 cases of chronic appendicitis. Increased fibrinogen level was found in all cases. The Pearson Chi-Square test evaluating the relationship between plasma fibrinogen level and appendicitis cases showed a P value of 0.038. Conclusion: There was a significant relationship between fibrinogen level and appendicitis cases as a whole, however, the increased fibrinogen level was not specific to acute appendicitis.Keywords: fibrinogen, aappendisitis akutAbstrak: Apendisitis akut adalah salah satu kegawat daruratan bedah yang paling sering. Diagnosa dini apendisitis penting karena morbiditas pasien meningkat setelah terjadi perforasi atau abses. Evaluasi klinis pasien suspek apendisitis akut bermanfaat untuk mencegah terjadinya perforasi dan komplikasi sambil meminimalisasian apendektomi negatif. Fibrinogen plasma diasumsikan mempunyai makna prediktif untuk diagnosis preoperatif apendisitis akut. Penelitian ini bergtujuan untuk menilai hubungan antara nilai fibrinogen dan kasus apendisitis akut. Dari 40 pasien dengan keluhan nyeri perut sugestif apendisitis akut di Bagian Bedah RSUP Prof. Dr. R. D. Kandou dan RS jejaring diperiksakan kadar fibrinogen plasma dan histopatologi jaringan apendiks. Hasil penelitian menunjukkan dari 40 pasien terdapat 19 kasus apendisitis akut, 10 kasus apendisitis kronik eksaserbasi akut (KEA), dan 11 kasus apendisitis kronik. Peningkatan kadar fibrinogen ditemukan baik pada apendisitis akut maupun pada apendisitis kronik eksaserbasi akut dan apendisitis kronik. Hasil uji Pearson Chi-Square terhadap hubungan antara kadar fibrinogen dan apendisitis secara keseluruhan memperlihatkan nilai P = 0,038. Simpulan: Terdapat hubungan bermakna antara kadar fibrinogen dan apendisitis secara keseluruhan. Walaupun demikian, peningkatan kadar fibrinogen tidak spesifik terjadi pada apendisitis akut saja.Kata kunci: fibrinogen, aappendisitis akut
Perbandingan efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik Wagiu, Angelica M. J.; Sumangkut, Richard M.; Sapan, Heber B.; Waworuntu, Louise A. J.
Jurnal Biomedik : JBM Vol 8, No 1 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.1.2016.12335

Abstract

Abstract: Diabetic ulcer is a condition of infection, ulceration, and or destruction of inner skin tissue related to neurological disorders and degrees of peripheral arterial disease (PAD) in diabetic patients. Diabetic ulcer is prone to infection due to decreased immune response, therefore, opportunistic microbes can become pathogens. Infection is sttill a serious problem in diabetic ulcer since the high cost and long duration of treatment lead to complicated neclected ulcer. This study aimed to obtain the present profile of microbes in diabetic ulcers and the effectivitveness of peracetic acid dan feracrylum in the treatment of diabetic ulcers. This was a descriptive analytical study. The ulcer degree was determined by using PEDIS criteria. Pus specimen was taken with a sterile technique using a transport media, cultured in the Baxtec machine, and the microbes were identified and further tested for sensitivity to peracetic acid dan feracrylum 1%. The results showed that of the 57 patients there were 36 females with a mean age of 58.77+ 9.077 years. Most of the patients (30 patients) had diabetic ulcers of 4th degree. The result of pus culture showed Gram negative Proteus mirabilis as the most frequent microbe (17.5%). The sensitivity test showed that 100% of 12 types of microbes, 83.3% of Citrobacter diversus, and 60% of Proteus mirabilis samples were sensitive to peracetic acid, meanwhile, all microbes were resistant to feracrylum 1% dan NaCl as controls,. Conclusion: Peracetic acid was more effective than feracrylum 1% as topical antimicrobial for diabetic ulcer.Keywords: diabetic ulcer, microbe, topical antimicrobial agentAbstrak: Ulkus diabetik adalah suatu kondisi adanya infeksi, ulserasi dan atau kerusakan jaringan kulit yang lebih dalam yang berhubungan dengan kelainan neurologik serta berbagai tingkatan peripheral arterial disease (PAD) pada penderita diabetes melitus (DM). Ulkus diabetik lebih mudah terinfeksi karena respons kekebalan tubuh penderita DM biasanya menurun, bahkan kuman oportunistik juga dapat menjadi patogen. Infeksi masih menjadi masalah yang paling serius dialami penderita ulkus diabetik oleh karena biaya pengobatan yang besar dan waktu perawatan yang lama sehingga ulkus sering dibiarkan terinfeksi dengan komplikasi tanpa perawatan adekuat. Penelitian ini bertujuan untuk memperoleh data terkini pola kuman penderita ulkus diabetik dan untuk mengetahui efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jenis penelitian ini ialah deskriptif analitik. Derajat ulkus dinilai dengan kriteria PEDIS. Spesimen pus diambil secara steril dengan media transpor, ditanam dalam mesin Baxtec, kemudian dilakukan identifikasi kuman dan uji sensitivitas terhadap asam perasetik dan feracrylum 1%. Hasil penelitian memperlihatkan dari 57 penderita ulkus diabetik terbanyak ialah perempuan (36 penderita) dengan rerata usia 58,77+9,077 tahun. Sebagian besar ulkus diabetik (30 penderita) termasuk derajat 4. Hasil kultur memperlihatkan Proteus mirabilis (Gram negatif) yang tersering (17,5%). Hasil uji sensitivitas pola kuman memperlihatkan 100% sampel dari 12 jenis kuman, 83,3% dari Citrobacter diversus, dan 60% dari Proteus mirabilis sensitif terhadap asam perasetik, sedangkan terhadap feracrylum 1% dan NaCl sebagai kontrol, seluruh kuman telah resisten. Simpulan: Asam perasetik lebih efektif dibandingkan feracrylum 1% sebagai antimikroba topikal pada ulkus diabetik.Kata kunci: ulkus diabetik, mikroba, antimikroba topikal
Korelasi Blood Flow Rate Intraoperasi dan Enam Minggu Pascaoperasi Arteriovenous Fistula Brakiosefalika Dihubungkan dengan Maturitas di RSUP Prof. Dr. R. D. Kandou Manado Palin, Aubrey W.; Tjandra, Djony E.; Sumangkut, Richard M.
Jurnal Biomedik : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23325

Abstract

Abstract: American National Kidney Foundation (2002) states that end-stage kidney disease is an indication for renal replacement therapy, one of which is hemodialysis. Vascular access comprises a fundamental component of hemodialysis therapy (HD), facilitating the patient’s blood flow to the dialyzer. However, there are some factors affecting the maturity of an arteriovenous fistula (AVF), inter alia the patient, comorbidities, and anatomical and functional conditions of the blood vessels involving the blood flow rate (BFR). This study was aimed to establish the differences between intra-operative BFR and BFR six weeks after surgery as well as any correlations between intraoperative BFR, venous diameter, and skin to vein distance with maturity of brachiocephalic AVF. This was prospective cohort study conducted at the Department of Surgery, Prof. Dr. R. D. Kandou General Hospital Manado. Subjects were 41 CKD patients who underwent brachiocephalic AVF surgery. The vein diameter, skin to vein distance, and BFR were measured immediately as intra-operative data using a Doppler USG and all were re-measured at six-week-follow-up examination as six-week-postoperative data. The results showed that there was a significant increase in BFR at six weeks postoperation compared to intraoperation (t=-19.215; P <0.0001). Bi-serial point correlation analysis revealed that there was a significant correlation between intraoperative venous diameter and maturity (rpb=0.276; P=0.04) as well as a significant correlation between intraoperative BFR and maturity (rpb=0.615; P=0.002). No significant correlation was observed between intra-operative skin to vein distance and maturity (rpb=0.093; P=0.281). Conclusion: There was a significant difference in BFR between intraoperation and 6 weeks postoperation in the mature AV fistula. There was a significant relationship between intraoperative BFR and maturity as well as between intraoperative venous diameter and maturity, while no significant relationship between skin-vein distance and maturity was found.Keywords: brachiocephalic AVF, BFR, maturityAbstrak: American National Kidney Foundation (2002) menyatakan bahwa penderita dengan penyakit ginjal tahap akhir diindikasikan untuk dilakukan terapi pengganti ginjal, salah satunya hemodialisis (HD). Akses vaskular merupakan komponen penting pada terapi HD karena melalui akses vaskular darah dari tubuh pasien dapat dialirkan menuju dialyzer. Terdapat banyak faktor yang memengaruhi maturitas suatu arteriovenous fistula (AVF), yaitu pasien itu sendiri, komorbid, serta keadaan anatomi dan fungsional pembuluh darah termasuk nilai blood flow rate (BFR). Penelitian ini bertujuan untuk mengetahui perbedaan BFR intraoperasi dan BFR enam minggu pascaoperasi serta adanya korelasi antara BFR intraoperasi, diameter vena, dan jarak kulit-vena dengan maturitas AVF brakiosefalika. Penelitian ini dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado dengan desain kohort prospektif. Subyek penelitian ialah 41 pasien PGK yang menjalani operasi pembuatan AVF brakiosefalika. Setelah selesai operasi dihitung diameter vena, jarak kulit-vena, dan BFR sebagai data intraoperasi menggunakan USG Doppler. Penghitungan dilakukan kembali 6 miggu pascaoperasi. Hasil penelitian mendapatkan peningkatan BFR yang sangat bermakna pada enam minggu pascaoperasi dibandingkan intraoperasi (t =-19,215, P<0,0001). Dengan analisis korelasi point biserial didapatkan hubungan bermakna antara diameter vena intraoperasi dengan maturitas (rpb=0,276; P=0,04), tidak terdapat hubungan bermakna antara jarak kulit-vena intraoperasi dengan maturitas (rpb=0,093; P=0,281), dan terdapat hubungan bermakna antara BFR intraoperasi dengan maturitas (rpb=0,615; P=0,002). Simpulan: Terdapat perbedaan bermakna antara BFR intraoperasi dan BFR 6 minggu pascaoperasi pada AVF matur. Terdapat hubungan bermakna antara BFR intraoperasi dan diameter vena intraoperasi dengan maturitas namun tidak terdapat hubungan bermakna antara jarak kulit-vena dengan maturitas.Kata kunci: AVF brakiosefalika, BFR, maturitas
Co-Authors Amelia L. Kristiani, Amelia L. Angelica M. J. Wagiu, Angelica M. J. Heber B. Sapan, Heber B. Hendrik M. J. M. J. Tampi, Hendrik M. J. M. J. Hilman P. Limpeleh, Hilman P. Louise A. J. Waworuntu, Louise A. J. Palin, Aubrey W. Tjandra, Djony E.