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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Articles 62 Documents

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Search results for , issue "Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)" : 62 Documents clear

Acute Decompensated Heart Failure (ADHF) with aortic dissection Stanford A in middle aged man: a case report Anbiya Khairul Umam; Ida Bagus Wisnu Widiarta; Marwa Humaira Intizam; Aizar Vesa Prasetyo; Ketut Putu Yasa
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Heart failure is a clinical syndrome with shortness of breath, fluid retention, and the heart's structural and functional disorder. Each year, there were 7,2 cases every 1000 people on male and 4,7 cases every 1000 people on the female. Aortic dissection is an emergency disease in which the symptoms are similar to ischemic heart disease, that 38% of patients got misdiagnosed on the first evaluations. Because of the clinical course of heart failure and misdiagnosed aortic dissection that frequently happened, authors are interested in making a case report with both conditions.Case report: A male patient, 39 years old, complained of shortness of breath and epigastrium pain. The patient was diagnosed with Acute Decompensated Heart Failure (ADHF) profile B with emergency hypertension and suspected aortic dissection based on history and physical examination. The patient was also diagnosed with acute kidney injury stage 1. CT angiography showed widening of the aorta ascending until arcus aorta with a Stanford type A aortic dissection diagnosis.Conclusion: The condition of aortic dissection can coincide with acute heart failure. Therefore, a clinician must be aware of the emergency of dissection and know the initial symptoms of dissection. The typical clinical symptoms of dissection lead us to perform imaging studies that ultimately lead to a thoracoabdominal CTA to diagnose the dissection.

Evaluasi penggunaan antibiotik profilaksis pada pasien bedah ortopedi di Rumah Sakit Bangil Yolanda Virgi Firdaus; Abdul Kadir Jaelani; Fauna Herawati; Rika Yulia
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Introduction: Trauma to the bones causes fractures and generally increases the risk of infection. To reduce the risk of infection, prophylactic therapy can be given before surgery. Previous studies have suggested that prophylactic antibiotics were irrational and can increase the incidence of antibiotic resistance. This study aims to determine the compatibility of antibiotics prescription for prophylactic fracture surgery based on hospital antibiotics (PPAB) and ASHP guidelines. In addition, this study also determined the quantity of prophylactic antibiotic used.Methods: This was an observational study by taking data from patient medical records and data on antibiotic sales during the period January to November 2020 at Bangil Hospital retrospectively. The data were analyzed descriptively to determine the suitability of the six indicators of accuracy namely right indication, the right type, the right route, the right dose, the right time of administration and the right duration of administration. Antibiotics quantity analyzed quantitatively by using DDD/100 days patient method and DU 90%.Results: A total of 83 samples were obtained by purposive sampling that met the criteria. The evaluation results of the appropriateness of prophylactic antibiotics based on the guidelines were the right type (28.92%), right indication (100%), right dose (55.42%), right route (100%), right duration of administration (66.27%) and right timing of administration (98.80%). Evaluation of the quantity concluded that the total value of DDD was 86.71 DDD/100 days of patients with the highest value on the use of Cefuroxime and Ceftriaxone.Conclusion: The highest use of antibiotics focuses on the use of Cefuroxime and Ceftriaxone. The appropriateness of the use of prophylactic antibiotics in orthopedic surgery patients is the right indication, right route, and right time of administration based on PPAB and ASHP guidelines. The accuracy of the type, dose, and duration of administration still needs to be improved. Pendahuluan: Trauma pada tulang menyebabkan keretakan tulang (patah tulang atau fraktur). Patofisiologi fraktur terbagi menjadi dua yaitu fraktur tertutup (closed fracture (CF)) dan fraktur terbuka (open fracture (OF)). Kondisi fraktur umumnya dapat memicu resiko infeksi. Untuk mengurangi risiko infeksi, dapat diberikan terapi profilaksis yang dilanjutkan dengan pembedahan. Penelitian terdahulu mencantumkan bahwa penggunaan antibiotik profilaksis digunakan secara irasional pada pasien bedah yang dapat meningkatkan kejadian resistensi antibiotik. Penelitian ini bertujuan untuk mengetahui kesesuaian PPAB dan guideline (ASHP) serta mengetahui kuantitas penggunaan antibiotik profilaksis menggunakan metode DDD/100 hari pasien.Metode: Desain penelitian ini adalah observasional dengan pengambilan data dari rekam medis pasien dan data penjualan antibiotik selama periode Januari hingga November 2020 di Rumah Sakit Bangil secara retrospektif dan dianalisis secara deskriptif. Data dianalisis untuk mengetahui kesesuaian terhadap enam indikator ketepatan yaitu tepat indikasi, tepat jenis, tepat rute, tepat dosis, tepat lama pemberian dan tepat waktu pemberian. Data dianalisis secara kuantitatif dengan metode DDD/100 hari pasien dan DU 90%.Hasil: Total diperoleh 83 sampel penelitian secara purposive sampling yang memenuhi kriteria inklusi. Hasil evaluasi terhadap kesesuaian antibiotik profilaksis berdasarkan PPAB RS Bangil dan pedoman ASHP adalah tepat jenis (28,92%), tepat indikasi (100%), tepat dosis (55,42%), tepat rute (100%), tepat lama pemberian (66,27%) dan tepat waktu pemberian (98,8%). Evaluasi kuantitas disimpulkan bahwa didapatkan total nilai DDD yaitu 86,71 DDD/100 hari pasien dengan nilai tertinggi pada penggunaan Sefuroksim dan Seftriakson.Simpulan: Penggunaan antibiotik tertinggi terfokus pada sefuroksim dan seftriakson. Kesesuaian penggunaan antibiotik profilaksis pada pasien bedah ortopedi adalah tepat indikasi, tepat rute, dan tepat waktu pemberian berdasarkan PPAB dan pedoman ASHP. Ketepatan jenis, dosis, dan lama pemberian masih perlu ditingkatkan.

Efektivitas terapi inhibitor janus kinase pada vitiligo: tinjauan pustaka Harry Gunawan; Flora Anisah Rakhmawati
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Vitiligo is an autoimmune disease that causes progressive skin melanocyte destruction, clinically seen as asymptomatic depigmentation macule and poliosis. CD8+ T cell is the primary effector of melanocyte destruction, and the activities of CD8+ T cell are driven by interferon-? (IFN-?). The current vitiligo treatment options are often not satisfied with many limitations and a high recurrence rate. Janus Kinase (JAK) inhibitor is one of the emerging vitiligo therapies which has a more specific target with a direct effect on CD8+ T cell cytotoxicity and IFN-?.Methods: In writing this article, the literature review method was used, and sources consist of relevant journals obtained through online search engines.Result: Several studies show that repigmentation in the facial area increases between 51-92%. Repigmentation occurs better in areas exposed to sunlight or a combination of phototherapy because repigmentation in vitiligo lesions requires suppression of the autoimmune process and melanocyte regeneration.Conclusion: Many studies showed the results of vitiligo therapy using JAK inhibitors were very promising and safe. The vitiligo therapy using JAK inhibitor showed higher efficacy on the facial area and combined with ultraviolet exposure. Latar belakang: Vitiligo merupakan penyakit autoimun yang menyebabkan destruksi melanosit secara progresif pada kulit, menimbulkan makula depigmentasi asimtomatik dan poliosis. Sel T CD8+ merupakan efektor primer yang menyebabkan kematian melanosit dan aktivitasnya ditingkatkan oleh interferon-? (IFN-?). Pilihan terapi vitiligo saat ini seringkali tidak memuaskan, memiliki keterbatasan, dan memiliki tingkat kekambuhan yang tinggi. Inhibitor Janus Kinase (JAK) merupakan salah satu terapi baru vitiligo yang memiliki target lebih spesifik dengan efek langsung terhadap sitotoksisitas sel T CD8+ dan IFN-?.Metode: Dalam penulisan artikel ini digunakan metode tinjauan pustaka dengan bersumber pada artikel relevan yang didapatkan melalui pencarian secara daring. Hasil: Beberapa studi menunjukkan adanya repigmentasi pada area wajah meningkat antara 51-92%. Repigmentasi terjadi lebih baik pada area terpapar sinar matahari atau kombinasi fototerapi disebabkan karena repigmentasi pada lesi vitiligo membutuhkan supresi dari proses autoimun dan regenerasi melanosit.Simpulan: Berbagai studi menunjukkan hasil terapi inhibitor JAK terhadap vitiligo sangat menjanjikan dan cukup aman. Terapi inhibitor JAK menunjukkan efektivitas lebih tinggi pada area wajah dan dengan kombinasi paparan ultraviolet.

Hubungan konsentrasi serum C-Reactive Protein dan D-dimer dengan derajat keparahan dan mortalitas pasien COVID-19 Kadek Surya Atmaja; Anak Agung Gede Oka Suta Wicaksana; I Wayan Angga Suarmerta Putra; Wayan Wahyu Semara Putra
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Clinical features of COVID-19 are variably from asymptomatic, to severe symptoms including acute respiratory distress syndrome (ARDS), multiple organ failure, and death. A specific biomarker is needed to predict the possibility of COVID-19 patients fall into severe complications and disease severity. D-dimer and C-Reactive Protein (CRP) are biomarkers that are elevated in COVID-19 patients.Method: This is an observational analytic study. The purpose of this research is to explore the correlation between D-dimer serum concentration and CRP with disease severity and mortality in hospitalized COVID-19 patients. This research used secondary data from a medical record with inclusion criteria patient more than 18 years old, confirmed COVID-19 by real-time Polymerase chain reaction (rt-PCR), that hospitalized in Wangaya General Hospital during July 2020 until December 2020.Result: Statistical analysis show that there is significant mean difference between D-dimer and CRP concentration based on COVID-19 disease severity (p <0.001 dan p <0.001). AUC value on ROC curve for CRP and D-dimer concentration in predict the mortality of COVID-19 patient are 0.88 (p <0.001, 95% CI: 0.829 – 0.48) and 0.88 (p < 0.001, 95% CI = 0.821 – 0.950) respectively. In this research, serum D-dimer with concentration more than 4,181 ng/mL statistically significant affect the mortality of COVID-19 patient (OR = 11.713; CI = 1.620 - 84.682; p = 0.015). CRP concentration statistically is not significant affect the mortality of COVID-19 patient.Conclusion: There is a statistically mean difference in both D-dimer and CRP concentration based on COVID-19 disease severity. D-dimer concentration of more than 4,181 ng/mL significantly affects the COVID-19 mortality. CRP concentration is not correlated with COVID-19 mortality Latar Belakang: Fitur klinis pasien dengan COVID-19 bervariasi dari tanpa gejala maupun dengan gejala ringan hingga terjadinya acute respiratory distress syndrome (ARDS), gagal multi organ, dan kematian. Dibutuhkan suatu biomarker yang dapat digunakan dalam memprediksi kemungkinan pasien yang akan jatuh kedalam derajat penyakit maupun komplikasi yang berat. D-dimer dan C-Reactive Protein (CRP) merupakan biomarker yang diketahui meningkat pada pasien COVID-19.Metode: Penelitian ini merupakan penelitian analitik observasional, yang bertujuan untuk mengetahui hubungan konsentrasi D-dimer serum dan CRP dengan derajat keparahan dan mortalitas pasien COVID-19 yang dirawat inap. Penelitian ini menggunakan data sekunder yang bersumber dari rekam medis dengan kriteria inklusi pasien usia diatas 18 tahun dengan diagnosis terkonfirmasi COVID-19 dengan real-time Polymerase chain reaction (rt-PCR), yang dirawat inap di RSUD Wangaya Denpasar periode Juli 2020 hingga Desember 2020.Hasil: Hasil uji statistik menunjukan terdapat perbedaan rerata konsentrasi D-dimer dan CRP berdasarkan derajat keparahan pasien COVID-19 yang bermakna secara statistik (p <0,001 dan p <0,001). Nilai AUC kurva ROC konsentrasi CRP dan D-dimer dalam memprediksi mortalitas pasien secara berturut-turut didapatkan sebesar 0.88 (p <0,001, 95% IK: 0,829 – 0,48 ) dan 0.88 (p <0,001, 95% IK: 0,821 – 0,950). D-dimer serum dengan konsentrasi diatas 4.181 ng/mL pada penelitian ini terbukti secara statistik bermakna mempengaruhi mortalitas pasien COVID-19 (OR OR 11,713; IK:1,620-84,682; p=0,015). Konsentrasi CRP serum tidak terbukti secara statistik bermakna dalam mempengaruhi mortalitas pasien COVID-19.Simpulan: Terdapat perbedaan rerata yang bermakna secara statistik konsentrasi serum D-dimer dan CRP berdasarkan derajat keparahan penyakit COVID-19. Konsentrasi serum D-dimer diatas 4.181 ng/mL terbukti mempengaruhi mortalitas pasien dengan COVID-19 secara bermakna. Konsentrasi CRP tidak berhubungan terhadap mortalitas pada pasien COVID-19.

Problem diagnostik seorang penderita endokarditis infektif dengan komplikasi perdarahan intrakranial: Sebuah laporan kasus Franky Simarmata; Ida Bagus Aditya Nugraha; I Wayan Wita; Dwijo Anargha Sindhughosa
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Introduction: Infective Endocarditis (IE) is a disease frequently affecting heart valves. The diagnosis is relatively simple, however it could be difficult in unspecific symptoms. Intracranial complications of patients with IE rarely happen.Case: The case was a 64 years-old male with sudden decrease of consciousness 12 hours prior to admission and diagnosed as a hemorrhagic stroke. He had a history of heavy smoking for about 10 years. Infective Endocarditis (IE) was diagnosed by Duke Criteria, and from this patient we found the vegetation at mitral valve with diameter 1.09 x 0.73 cm. Treatment for the patient is antibiotic according to sensitivity test of blood culture. The patient was discharged with improvement of condition. However, in approximately three months after discharge, the patient got hospitalized again due to the same condition and passed away.Conclusion: Infective endocarditis is a relatively rare disease. In our case we had a definite IE patient with a spectrum of neurological events complicating this disease. The presence of cerebral hemorrhage complications makes the patient's prognosis worse. Pendahuluan: Endokarditis Infektif (IE) merupakan penyakit yang umumnya menyerang katup jantung. Diagnosis pada umumnya relatif sederhana, namun dapat menjadi sulit gejala yang ditemukan tidak spesifik. Komplikasi intrakranial pasien dengan IE jarang terjadi.Laporan Kasus: Seorang laki-laki 64 tahun dengan penurunan kesadaran mendadak 12 jam sebelum masuk rumah sakit (MRS) dan didiagnosis sebagai stroke hemoragik. Pasien memiliki riwayat perokok berat selama kurang lebih 10 tahun. Endokarditis infektif (IE) di diagnosis dengan kriteria Duke, dan dari pasien ini ditemukan vegetasi pada katup mitral dengan diameter 1,09 x 0,73 cm. Pengobatan untuk pasien adalah antibiotik berdasarkan uji sensitivitas kultur darah. Pasien dipulangkan dengan kondisi perbaikan. Namun, sekitar tiga bulan setelah keluar, pasien kembali dirawat di rumah sakit karena kondisi yang sama dan meninggal dunia.Simpulan: Endokarditis infektif merupakan penyakit yang relatif jarang. Dalam laporan kasus ini, pasien dengan spektrum kejadian neurologis yang menyulitkan penyakit IE. Adanya komplikasi perdarahan otak membuat prognosis pasien semakin buruk.

Hubungan antara rasio neutrofil limfosit dengan derajat klinis COVID-19 pada pasien anak di RSUD Tarakan provinsi Kalimantan Utara Daniel kurniawan Sintoro; Franky Sientoro; Dian Artanti
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Introduction: Coronavirus Disease-19 (COVID-19) is an outbreak that spread in early 2020 caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), this disease has a wide spectrum of symptoms from asymptomatic to severe respiratory symptoms. Neutrophil-lymphocyte ratio (NLR) is widely used as a marker of inflammation against viral infections, including SARS-CoV-2. This study was conducted to determine the relationship between NLR and the clinical degree of COVID-19 in pediatric patients at the Tarakan General Hospital in North Kalimantan Province.Methods: A cross-sectional study was conducted on pediatric patients with COVID-19 infection who were treated in the COVID-19 isolation room at Tarakan Hospital, North Kalimantan for the period March 2020 – February 2021. There were 32 children who met the inclusion and exclusion criteria. Data on age, sex, body weight, neutrophil and lymphocyte counts, as well as the clinical degree of COVID-19 were collected from medical records. The NLR data was then categorized to NLR >3.13 or NLR <3.13 and searched for the relationship with the clinical degree of COVID-19. Spearman correlation test was used for bivariate analysis.Results: The clinical degree of mild COVID-19 was found in 21 children (65.62%). NLR values in mild clinical grade were mostly increased (46.87%) than than which did not increase (21.87%). All children with moderate clinical COVID-19 infection had RNL > 3.13 (18.74%). In asymptomatic infection, no children having an increase in RNL (12.5%). The Spearman correlation test between NLR and the clinical degree of COVID-19 resulted in a correlation coefficient (r) = 0.758 (p < 0.001).Conclusion: There is a strong relationship between the Neutrophil-Lymphocyte ratio and the clinical degree of COVID-19 in pediatric patients at Tarakan Hospital, North Kalimantan Province. Pendahuluan: Coronavirus Disease-19 (COVID-19) adalah wabah yang menyebar pada awal 2020 disebabkan oleh virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), penyakit ini memiliki spektrum gejala yang luas dari asimptomatis hingga gejala respiratori yang berat. Rasio neutrofil-limfosit (RNL) banyak digunakan sebagai penanda inflamasi terhadap infeksi virus, termasuk SARS-CoV-2. Penelitian ini dilakukan untuk mengetahui besar hubungan antara RNL dengan derajat klinis COVID-19 pada pasien anak di Rumah Sakit Umum Daerah (RSUD) Tarakan Provinsi Kalimantan Utara.Metode: Studi potong lintang dilakukan pada pasien anak dengan infeksi COVID-19 yang dirawat di ruang isolasi COVID-19 RSUD Tarakan Kalimantan Utara periode Maret 2020 – Febuari 2021. Terdapat 32 anak yang memenuhi kriteria inklusi dan eksklusi. Data mengenai usia, jenis kelamin, berat badan, jumlah hitung neutrofil dan limfosit, serta derajat klinis COVID-19 dikumpulkan dari rekam medis. Data RNL kemudian dikategorikan berdasarkan adanya peningkatan >3,13 atau tidak adanya peningkatan <3,13 dan dicari hubungan dengan derajat klinis COVID-19. Uji korelasi Spearman digunakan untuk analisis bivariat.Hasil: Derajat klinis COVID-19 ringan ditemukan pada 21 anak (65,62%). Nilai RNL pada derajat klinis ringan sebagian besar meningkat (46,87%) daripada pada derajat klinis ringan dengan RNL yang tidak meningkat (21,87%). Semua anak yang mengalami infeksi COVID-19 dengan derajat klinis sedang memiliki RNL >3,13 (18,74%). Hal ini berbanding terbalik dengan derajat klinis asimtomatik, dengan semua anak tidak mengalami peningkatan RNL (12,5%). Uji korelasi Spearman antara RNL dengan derajat klinis COVID-19 menghasilkan koefisien korelasi (r) = 0,758 (p< 0,001).Kesimpulan: Terdapat hubungan kuat antara rasio Neutrofil-Limfosit dengan derajat klinis COVID-19 pada pasien anak di RSUD Tarakan Provinsi Kalimantan Utara.

Hubungan indeks platelet dengan derajat keparahan penyakit demam berdarah dengue pada anak di RSUD Wangaya Valerie Michaela Wilhelmina; I Wayan Bikin Suryawan; Kadek Suarca
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Indonesia is an endemic country for Dengue Hemorrhagic Fever (DHF). Over 80% of children at age ?10 in Indonesia have been infected with dengue at least once. Dengue shock syndrome (DSS), as a severe clinical manifestation of DHF, has a high risk of mortality. The wide spectrum of dengue clinical manifestations poses a challenge to predict the progression of dengue infection into severe symptoms. Platelet indices (PI) are readily available laboratory parameters that mark the activity and quality of platelets. The purpose of this study is to investigate PI profile on pediatric DHF and the association with disease severity.Methods: This is an analytical observational study with a cross-sectional design. Samples are obtained consecutively from secondary data of children diagnosed with DHF in Wangaya Regional Hospital. Chi-square analysis was used to assess the association between groups of platelet indices; mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) with severity parameter, namely; DHF grade, length of hospitalization, shock, and bleeding. Results: 150 subjects were included in the study. Bivariate analysis shows that MPV, PDW, and P-LCR does not correlate with any of the severity parameters. There is a significant correlation between PCT with the length of hospitalization (p=<0.001), shock (p=<0.001), and DHF grade (p=<0.001). PCT does not correlate with bleeding.Conclusion: There is a significant association between PCT PI and several parameters of DHF severity. PCT can be considered to predict DHF grade, length of hospitalization, and shock. Latar belakang: Indonesia merupakan negara endemis Demam Berdarah Dengue (DBD). Lebih dari 80% anak usia ?10 tahun di Indonesia telah terinfeksi dengue setidaknya satu kali. Sindrom syok dengue (SSD) sebagai manifestasi klinis berat dari DBD memiliki resiko kematian yang tinggi. Spektrum manifestasi klinis yang luas menjadi tantangan untuk memprediksi DBD yang akan berujung menjadi gejala berat. Indeks platelet (IP) merupakan parameter laboratorium yang mudah didapat dan menggambarkan aktivitas dan kualitas platelet. Tujuan dari studi ini adalah untuk mempelajari profil IP pada penyakit DBD anak dan hubungannya terhadap derajat keparahan penyakit.Metode: Studi penelitian merupakan penelitian observasional analitik dengan desain potong lintang. Sampel diambil dari data sekunder pasien anak terdiagnosa DBD di unit rawat inap RSUD Wangaya dengan metode consecutive sampling. Analisis chi-square digunakan untuk menilai hubungan kelompok Indeks Platelet; mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), dan plateletcrit (PCT) dengan parameter derajat keparahan yaitu grade DBD, lama rawat, syok, dan perdarahan.Hasil: Sebanyak 150 subjek masuk dalam kriteria inklusi. Analisis bivariat menunjukkan MPV, PDW, dan PLCR tidak berhubungan dengan parameter derajat keparahan. Terdapat hasil signifikan PCT dengan lama rawat (p=<0,001), syok (p=<0,001), dan grade DBD (p=<0,001). PCT tidak berhubungan dengan perdarahan.Kesimpulan: Terdapat hubungan bermakna antara IP PCT dengan beberapa parameter derajat keparahan DBD. PCT dapat dipertimbangkan untuk memprediksi derajat keparahan penyakit yaitu grade DBD, lama rawat, dan syok.

Mikrobiota usus pada dermatitis atopik Dewi Gotama; Made Wardhana; Adeline Santoso; Sissy Sissy
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Atopic dermatitis (AD) is a multifactorial disease caused by immune dysregulation, genetic susceptibility, environmental factors, and impaired barrier function. The health burden caused by this disease is significant and can impact psychological, social and financial costs, along with systemic comorbidities. Several studies have reported the gut microbiota in AD patients. Several studies have reported the gut microbiota in AD patients. The gut microbiota is thought to play an important role in the development of AD by regulating the immune system's maturation. Intestinal microbiota alteration affects the balance of the immune system through metabolites' production, which will cause the microenvironment to become inflamed. Currently, the close relationship between the gut microbiota and the development of the immune system, especially in maintaining the balance of Th-1 and Th-2 responses, is the rationale for providing probiotic supplements to prevent or treat allergic and atopic diseases. Dermatitis atopik (DA) merupakan penyakit multifaktorial yang diakibatkan disregulasi imun, suseptibilitas genetik, faktor lingkungan, dan gangguan fungsi barier. Beban kesehatan yang diakibatkan penyakit ini bersifat signifikan dan dapat berdampak pada kerugian psikologis, sosial, dan finansial, disertai komorbiditas sistemik. Terdapat beberapa studi yang telah melaporkan mikrobiota usus pada pasien DA. Mikrobiota usus diduga memainkan peran penting dalam perkembangan DA dengan meregulasi maturasi sistem imun. Alterasi mikrobiota usus mempengaruhi keseimbangan sistem imun melalui produksi metabolit, yang akan menyebabkan lingkungan mikro mengalami inflamasi. Saat ini hubungan erat antara mikrobiota usus dan perkembangan sistem imun, khususnya dalam menjaga keseimbangan respon Th-1 dan Th-2 menjadi dasar pemikiran pemberian suplemen probiotik untuk mencegah atau mengatasi penyakit alergi dan atopi.

Terapi non bedah pada karsinoma sel basal Adeline Santoso; I Gusti Ngurah Darmaputra; Dewi Gotama; Sissy Sissy
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Basal cell carcinoma accounts for approximately 75% of non-melanoma skin cancer and 25% of all diagnosed skin cancer in the United States. Epidemiological data show the incidence is increasing significantly by 3% -10% per year worldwide. Changes in life expectancy patterns are associated with an increase in this skin cancer, and the incidence is predicted to increase until 2040. Many factors must be considered in the choice of therapy for a patient, including the patient's general condition, the presence or absence of serious medical problems, the use of antiplatelet or anticoagulant medication. Conservative treatment of asymptomatic and low-risk lesions is recommended, as overly aggressive therapy may have a greater effect than the lesions themselves. Topical therapy and non-surgical therapy are currently quite effective as therapeutic options for low-risk basal cell carcinoma and high-risk basal cell carcinoma. They can be an option in conditions that are contraindicated for surgery. Kasus keganasan karsinoma sel basal (KSB) mencakup sekitar 75% dari kasus kanker kulit non melanoma dan mencakup 25% dari semua kasus kanker yang didiagnosa di Amerika Serikat.Data epidemiologi menunjukkan insiden meningkat signifikan sebanyak 3%-10% per tahun di seluruh dunia. Perubahan pola usia harapan hidup berhubungan dengan peningkatan kanker kulit ini, dan di prediksi insiden akan terus meningkat sampai tahun 2040. Terdapat banyak faktor yang harus dipikirkan dalam pemilihan terapi pada pasien, antara lain keadaan umum pasien, ada atau tidaknya masalah medis serius, penggunaan obat anti platelet atau anti koagulan. Perawatan konservatif pada lesi asimptomatik dan beresiko rendah dianjurkan, dikarenakan terapi yang terlalu agresif mungkin akan memberikan efek yang lebih besar dibandingkan dengan lesi itu sendiri. Saat ini terapi topikal dan terapi non-bedah dikatakan cukup efektif sebagai pilihan terapi untuk KSB resiko rendah dan KSB resiko tinggi serta dapat menjadi pilihan pada kondisi kontraindikasi terhadap tindakan pembedahan.

Effectivity of glutathione and curcumin in hepatic fibrosis induced by cholestasis in Wistar rats Rodijaya Putra; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Cholestasis occurs from the accumulation of bile product in the biliary tract due to obstruction of the hepatobiliary tract. Without early interventions, this condition will be continuing as chronic hepatic injury and form hepatic fibrosis, ending in cirrhosis. Glutathione (GSH) and curcumin were known as antioxidants and anti-inflammatory used as a therapeutic agent for the treatment of hepatopathy. This study aims to determine the effectivity of GSH and curcumin in the hepatic fibrosis mechanism induced by cholestasis. Methods: This is an experimental study using Wistar rats. They are divided into three groups of 5 rats each. All the rats regard the choledochus duct ligation surgery, rats without intervention define as first group (control), other rats treated with GSH as the second group and the third group consist of rats treated with curcumin. Data were analyzed using SPSS version 17 for Windows.Results: There was liver injury and hepatic fibrosis induced by cholestasis from this study. This condition was significantly lower in groups treated with GSH and curcumin (p<0.05). Therefore, there was a different result between GSH and curcumin in reducing the process of liver injury and hepatic fibrosis, but the difference was not statistically significant (p>0.05).Conclusion: GSH and curcumin were statistically effective in reducing liver injury and hepatic fibrosis induced by cholestasis. Despite, there were no significant difference results between them in reducing liver injury and hepatic fibrosis.

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