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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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Search results for , issue "Vol. 12 No. 3 (2021): (Available online: 1 December 2021)" : 68 Documents clear

Angka insiden dan faktor risiko malnutrisi rumah sakit pada anak rawat inap di RSUP Sanglah, Bali, Indonesia Anak Agung Ratna Purnama Santhi; I Gusti Lanang Sidiartha; I Gusti Ayu Putu Eka Pratiwi
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Nutritional support is an important aspect of the clinical management of hospitalized children. Several factors contribute to prevalence of malnutrition in hospitalized children and it can led to deterioration of nutritional status. Research on factors related to malnutrition in pediatric hospitalized patients is still limited, especially in Indonesia. This study aims to evaluate the incidence rate and risk factors of malnutrition in hospitalized children at Sanglah General Hospital, Bali, Indonesia.Methods: This study was a prospective analytic observational study in children who underwent hospitalization in class II and III inpatient rooms for the period August 2020-February 2021. Inclusion criteria were pediatric patients aged 1 to 18 years who were hospitalized for at least 48 hours and had complete medical records. Samples were taken by consecutive sampling until the number of subjects was met. A significant variable is a variable that has a p-value <0.05. Data were analyzed using SPSS version 20 for Windows.Results: A total of 95 subjects who met the inclusion and exclusion criteria. The incidence of hospital malnutrition was 28%. The risk factors associated with hospital malnutrition were fever, diarrhea and vomiting. Multiple diagnosis, acute and chronic malnutrition, low maternal education, surgical and medical departments also contribute to hospital malnutrition. The results of multivariate analysis were acute malnutrition and length of stay as independent risk factors for hospital malnutrition (OR, 3.843; 95% CI, 1.762-5.431; p=0.005) and length of stay (OR, 5.791; 95% CI, 2.157-6.491; p=0.026)Conclusion: The incidence of patients with hospital malnutrition in children at Sanglah Hospital Denpasar is 28%. Acute malnutrition and length of stay are independent risk factors for malnutrition during hospitalization. Latar belakang: Dukungan nutrisi adalah aspek penting dalam manajemen klinis anak yang dirawat di rumah sakit. Beberapa faktor berkontribusi terhadap meluasnya malnutrisi pada anak yang dirawat di rumah sakit dan menyebabkan eksaserbasi status gizi. Penelitian mengenai faktor-faktor yang berkaitan dengan malnutrisi pada pasien pediatri yang menjalani rawat inap masih sangatlah terbatas khususnya di Indonesia meskipun memiliki urgensi yang tinggi. Penelitian ini bertujuan untuk mengevaluasi angka insiden dan faktor risiko malnutrisi rumah sakit pada anak rawat inap di RSUP Sanglah, Bali, IndonesiaMetode: Penelitian ini merupakan penelitian observasional analitik pada anak dengan metode penelitian kohort prospektif yang menjalani rawat inap di ruang rawat inap kelas II dan III periode bulan Agustus 2020-Februari 2021. Kriteria inklusi yaitu pasien anak berusia 1 hingga 18 tahun, menjalani rawat inap di RS minimal 48 jam, dan memiliki catatan medis yang lengkap. sampel diambil secara konsekutif sampai jumlah subyek terpenuhi. Variabel yang signifikan adalah variabel yang mempunyai nilai p<0,05. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Sebanyak 95 subjek yang memenuhi kriteria inklusi dan eksklusi. Insiden malnutrisi rumah sakit didapatkan sebesar 28%. Faktor RISIKO yang berhubungan dengan malnutrisi rumah sakit adalah demam, diare dan muntah. Diagnosis multipel, kurang gizi akut dan kronis, lama rawat,pendidikan ibu rendah, dan departemen rawat juga sebagai faktor RISIKO malnutrisi rumah sakit. Hasil analisis multivariat dilakukan dengan hasil kurang gizi akut dan lama rawat sebagai faktor risiko independen terjadinya malnutrisi rumah sakit (OR, 3.843; 95% CI, 1.762-5.431; p=0.005) dan lama rawat (OR, 5.791; 95% CI, 2.157-6.491; p=0.026)Simpulan: Insiden pasien dengan malnutrisi rumah sakit pada anak di RSUP Sanglah Denpasar adalah sebesar 28%. Kondisi kurang gizi akut dan lama rawat merupakan faktor risiko independen terjadinya malnutrisi selama perawatan di rumah sakit.

Parametrial hematoma following fetal craniotomy and curettage in intrauterine fetal death: a case report Ida Bagus Yudhistira Anantasurya Vidhisvara; Ida Bagus Putu Widiarsa; Margaret Gabriele Helena; I Putu Ivan Cahya Himawan
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Parametrial hematoma is collection of blood located in the parametrial area, which is a type of hematoma that can occur in the pelvic cavity. Postpartum hematoma is a rare but life-threatening complication of childbirth. Common risk factors to developing parametrial hematomas include multiple pregnancies, traumatic deliveries, operative vaginal delivery, prolonged labour, manual removal of placenta, inadequate hemostasis at Caesarean section, pre-eclampsia, and anticoagulation therapy. We reported a rare case of parametrial hematoma post-craniotomy and curettage of a fetus with intrauterine fetal death (IUFD) in a 28-year-old pregnant woman 24 weeks into her fourth pregnancy. Case report: A pregnant woman with 24 weeks gestation age came to emergency room with complaints of abdominal pain and bloody discharge without clear fluids 9 hours prior. She was diagnosed with preterm delivery and was given tocolytic. The following day, ultrasound examination was done and fetal heart rate (FHR) was not found, suggesting an intrauterine fetal death (IUFD). Termination was carried out with oxytocin induction but due to maternal exhaustion, pain, and lack of cooperation, a craniotomy was done in operating room followed by curettage. Twenty-four hours after curettage, patient complained of an acute lower right abdominal pain and ultrasound showed a complex mass in right adnexa measuring 8 x 8 cm, suggesting a right adnexal hematoma with a differential diagnosis of a right tubo-ovarian abscess. The patient’s haemoglobin was found to decrease to 6.0 g/dl. A laparotomy was performed and a hematoma was found in the right parametrium without active bleeding. Conclusion: Parametrial hematoma is a rare disease that can occur due to trauma (in labor) or spontaneously due to abnormalities of the uterine arteries that supply blood to the uterus. The patient present in this case report had acute abdominal pain with decreased haemoglobin without signs of bleeding after an operative vaginal birth which may or may not be the cause of the parametrial hematoma due to limitations of examination on the patients. Further observation of similar cases will be required to determine the association between parametrial hematoma and operative vaginal birth.

Peran HbA1c dalam progresi dan prognosis COVID-19 pada pasien diabetes mellitus Ni Luh Parameswari Praptika; Kadek Wisnu Segara Karya
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Objective: This systematic review determined the role of HbA1c in the progression and prognosis of COVID-19 in patients with diabetes mellitus from several previously published articles.Method: We searched from an open-access database according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the PICO criteria. The inclusion criteria for the article search included: 1) COVID-19 patients with diabetes mellitus; 2) full articles; 3) English articles; 4) article publication time range from 2016 to 2021. Quality assessment for each article is evaluated using a checklist from Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).Result: We obtained two cohort studies and four cross-sectional studies of all the articles reviewed from 2019-2021. All studies evaluated the role of HbA1c in the progression, prognosis, and mortality of COVID-19 patients with diabetes mellitus. Most of the reported studies showed an association between elevated HbA1c and worsening of the COVID-19 disease prognosis. The association was assessed by the patient's clinical deterioration included lower oxygen saturation, increased NLR (neutrophil-lymphocyte ratio), the tendency to lymphopenia, improved renal function, increased ICU admission, and mechanical ventilation and increased ventilation mortality.Conclusion: A high HbA1c was closely related to a worse COVID-19 prognosis in clinical development and mortality. We found the potential for developing a scoring system to predict the worsening and mortality of COVID-19 and improve the quality of prevention and management of COVID-19, especially in patients with diabetes mellitus. Tujuan: mengkaji peran HbA1c dalam progresi dan prognosis COVID-19 pada pasien diabetes mellitus dari beberapa literatur yang telah dipublikasi sebelumnya.Metode: Pencarian literatur secara sistematis dilakukan pada basis data dengan akses terbuka sesuai dengan pedoman PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) dan kriteria PICO. Kriteria inklusi pencarian artikel antara lain: 1) pasien COVID-19 dengan diabetes mellitus; 2) artikel lengkap; 3) artikel berbahasa Inggris; 4) rentang waktu terbit artikel dari tahun 2016 hingga tahun 2021. Penilaian kualitas pada setiap artikel yang dievaluasi menggunakan checklist dari Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).Hasil: Dari seluruh artikel yang dikaji dari tahun 2019-2021, didapatkan 2 studi kohort dan 4 studi potong lintang. Keseluruhan studi mengevaluasi peran HbA1c dalam progresi, prognosis, maupun mortalitas pada pasien COVID-19 dengan diabetes mellitus. Sebagian besar penelitian yang dilaporkan menunjukkan keterkaitan antara peningkatan HbA1c dan perburukan prognosis penyakit COVID-19 yang dinilai dari perburukan klinis pasien yaitu saturasi oksigen yang lebih rendah, meningkatnya NLR (neutrophil lymphocyte ratio), kecenderungan limfopenia, fungsi ginjal yang meningkat, peningkatan admisi ICU dan pemanfaatan ventilator mekanik serta meningkatnya mortalitas.Simpulan: HbA1c yang tinggi terbukti berhubungan erat dengan prognosis COVID-19 yang lebih buruk ditinjau dari perkembangan klinis hingga tingkat mortalitas yang terjadi. Hal ini menunjukkan potensi berkembangnya sistem skoring untuk memprediksi perburukan dan mortalitas COVID-19 serta peningkatan kualitas pencegahan dan tatalaksana COVID-19 terutama pada pasien diabetes mellitus.

Pemberian pasta ekstrak daun pegagan 10% lebih meningkatkan jumlah sel fibroblas dan reepitelisasi pada soket mandibula daripada pasta ekstrak daun mengkudu 10% pasca pencabutan gigi marmut jantan Ni Made Ista Prestiyanti; I Putu Gede Adiatmika; I Made Muliarta
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: The process of wound healing after a tooth extraction is expected to occur more quickly to restore normal functioning of the tissue and reduce the risk of complications. Pegagan leaf (Centella asiatica) and mengkudu leaf (Morinda citrifolia. L) contain active compounds such as flavonoids, tannins, and triterpenoids that accelerate wound healing. This study aims to evaluate the pegagan leaf extract paste increased the number of fibroblast cells and reepitelization more than mengkudu leaf extract paste after tooth extraction.Methods: This study used a post-test-only control group design to the 30 male guinea pigs. The three groups were the placebo paste group, the pegagan leaf extract paste 10% group, and the mengkudu leaf extract paste 10% group, which were treated for 6 days. Examination of the number of fibroblast cells and reepitelization was carried out by taking tissue of the mandibular socket on day 7, histological preparations with HE staining were made. The data obtained were analyzed by SPSS version 20 for WindowsResults: The average difference in the number of fibroblast cells and reepithelization showed a significant difference (p<0.05) between groups. The highest average for the number of fibroblast cells was found in the group that applied topically with pegagan leaf extract paste 10% was 97.98±25.67 cells followed by the group that applied topically with mengkudu leaf extract paste 10% was 64.28±12.22 cells and the group applied topically with placebo paste was 46.36±14.27 cells. The highest average for the reepithelization was found in the group that applied topically with pegagan leaf extract paste 10% was 69.64±24.53 µm.Conclusion: It was concluded that pegagan leaf extract paste 10% increased the number of fibroblast cells and reepitelization than mengkudu leaf extract paste 10%. Latar Belakang: Proses penyembuhan luka setelah pencabutan gigi diharapkan lebih cepat terjadi sehingga dapat mengembalikan fungsi normal dari jaringan dan mengurangi risiko terjadinya komplikasi. Daun pegagan dan daun mengkudu mengandung senyawa aktif seperti flavonoid, tanin dan triterpenoid yang dapat mempercepat penyembuhan luka. Penelitian ini bertujuan untuk mengevaluasi ekstrak daun pegagan dalam meningkatkan jumlah sel fibroblas dan reepitelisasi daripada pasta ekstrak daun mengkudu pasca pencabutan gigi.Metode: Penelitian ini menggunakan rancangan post-test only control group design terhadap 30 ekor marmut jantan. Terdapat 3 kelompok secara acak yaitu kelompok pasta plasebo, kelompok pasta ekstrak daun pegagan 10% dan kelompok pasta ekstrak daun mengkudu 10% yang diberikan perlakuan selama 6 hari. Pemeriksaan jumlah sel fibroblas dan reepitelisasi dilakukan dengan pengambilan jaringan soket mandibula pada hari ke 7, kemudian dibuat preparat histologis dengan pengecatan HE. Data yang diperoleh dianalisis menggunakan uji SPSS versi 20 untuk Windows.Hasil: Perbedaan rerata jumlah sel fibroblas dan reepitelisasi menunjukkan perbedaan yang signifikan (p<0,05) antar kelompok. Rerata jumlah sel fibroblas tertinggi terdapat pada kelompok yang diolesi pasta ekstrak daun pegagan 10% dengan rerata yaitu sebesar 97,98 ± 25,67 sel diikuti oleh kelompok yang diolesi pasta ekstrak daun mengkudu 10% dengan rerata sebesar 64,28 ± 12,22 sel dan kelompok yang diolesi pasta plasebo dengan rerata sebesar 46,36 ± 14,27 sel. Sedangkan rerata reepitelisasi tertinggi terdapat pada kelompok yang diberi pasta ekstrak daun pegagan 10% dengan rerata yaitu sebesar 69,64 ± 24,53 µm.Kesimpulan: Dapat disimpulkan bahwa pasta ekstrak daun pegagan 10% lebih meningkatkan jumlah sel fibroblas dan reepitelisasi daripada pasta ekstrak daun mengkudu 10%.

Temuan radiologi dalam kelainan kongenital atresia jejunum: serial kasus Listyani Gunawan; Pande Putu Yuli Anandasari; Putu Patriawan
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Jejunoileal atresia is an emergency due to mechanical gastrointestinal obstruction, a rare case with a prevalence rate of 1-3 per 10,000 births. There is no difference in incidence by gender. Delay in treatment results in huge losses in terms of malnutrition, failure to thrive, and even death. These case series aim to evaluate radiological findings in congenital jejunal atresia.Case Presentation: There were 3 patients with the main complaint of bilious vomiting. These three patients underwent a plain abdominal x-ray examination, obtained a picture of a high total obstruction with a triple bubble picture, or had a dilated picture of the proximal obstruction. Partial obstruction based on plain radiographs in one of the patients was found, followed by an examination of contrast meal which filled smoothly up to the jejunum segment with a windsock appearance. The three cases have been proven through surgery, various types of jejunal atresia were obtained. Intestinal resection was performed, followed by an end-to-end jejunal anastomosis.Conclusion: Correct diagnosis determines the appropriate treatment for the patient. Plain abdominal radiograph as an initial examination in assessing total or partial obstruction in the jejunum, with a typical triple bubble or dilated bowel segment proximal to the obstruction. The windsock appearance of the jejunal segment on the contrast meal confirms the diagnosis of the jejunal web. Latar Belakang: Atresia jejunoileal merupakan kegawatdaruratan akibat obstruksi mekanik gastrointestinal, yang merupakan kasus jarang dengan angka prevalensi 1-3 per 10000 kelahiran, tidak ada perbedaan insiden berdasarkan gender. Terlambatnya tatalaksana mengakibatkan kerugian yang besar baik malnutrisi, gagal tumbuh, hingga kematian. Laporan kasus ini bertujuan untuk mengevaluasi temuan radiologi dalam kelainan kongenital atresia jejunum.Laporan Kasus: Terdapat 3 pasien dengan keluhan utama muntah bilosa. Kemudian dari pemeriksaan foto polos abdomen didapatkan gambaran obstruksi total letak tinggi dengan gambaran triple bubble atau memiliki gambaran dilatasi dari proksimal obstruksi. Obstruksi parsial berdasarkan foto polos pada salah satu pasien, dilanjutkan pemeriksaan contrast meal yang mengisi lancar hingga segmen jejunum dengan windsock appearance. Ketiga kasus tersebut telah terbukti melalui hasil operasi, didapatkan atresia jejunum berbagai tipe. Dilakukan reseksi usus dilanjutkan anastomosis end-to-end jejunal.Kesimpulan: Diagnosis yang tepat, menentukan tatalaksana yang sesuai bagi pasien. Foto polos abdomen sebagai pemeriksaan inisial dalam menilai obstruksi total atau parsial pada jejunum, dengan gambaran khas triple bubble atau dilatasi segmen usus proksimal dari obstruksi. Windsock appearance segmen jejunum pada contrast meal mempertajam diagnosis jejunal web.

Karakteristik penderita psoriasis di poliklinik rawat jalan dermatologi dan venereologi Rumah Sakit Umum Daerah Provinsi Nusa Tenggara Barat periode Januari 2016 – Desember 2020 Lisa Alverina; Dedianto Hidajat; I Wayan Hendrawan; I Gusti Agung Ayu Ratna Medikawati
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: Psoriasis is an immunologically mediated chronic disease characterized by skin inflammation and epidermal hyperplasia. The incidence in the total population in the United States is 63.8 per 100,000 person-years. The incidence increases with age and peaks among individuals aged 70 to 79 years at a rate of 92.3 per 100,000 person-years. This research aims to determine the characteristics of psoriasis sufferers in the Dermatology and Venereology Outpatient Polyclinic of the Regional General Hospital of West Nusa Tenggara Province for the period January 2016 - December 2020Method: The research design used was a descriptive retrospective by taking secondary data from medical records in new psoriasis patients for the period January 2016 – December 2020 who came for treatment.Result: The total number of patient visits at the Dermatology and Venereology Outpatient Polyclinic of the Regional General Hospital of West Nusa Tenggara Province for the January 2016 – December 2020 period was 8,524 people. The study found 140 new patients (92.7%), which were dominated by women (52.1%). The incidence of psoriasis in 2016-2020 was 16.42%. The highest age group was found at the age of 41-50 years as many as 33 people (23.6%), the most visits in 2018 were 37 people (26.4%), the predominant diagnosis was psoriasis vulgaris as many as 105 people (75%) with the site of the lession in the trunk as many as 93 people (66.4%). Therapy was dominated by topical therapy as many as 131 people (93.6%) and systemic therapy as many as 108 people (77.1%). Systemic therapy with methotrexate injection was 78 people (72.2%), and the topical combination of steroids and salicylic acid were 79 people (60.3%) were the most frequently used.Conclusion: Psoriasis sufferers in the Dermatology and Venereology Outpatient Polyclinic of the Regional General Hospital of West Nusa Tenggara Province have a tendency to increase every year. The therapy given is topical therapy with the most administration in the form of a combination of topical corticosteroids and salicylic acid, and the most systemic therapy is methotrexate injection. Latar Belakang: Psoriasis merupakan penyakit inflamasi kronik yang diperantarai secara imunologis serta ditandai dengan adanya inflamasi kulit dan hiperplasia epidermal. Insidensi dalam populasi keseluruhan di Amerika Serikat adalah 63,8 per 100.000 orang-tahun. Insiden meningkat dengan usia dan memuncak di antara individu berusia 70 sampai 79 tahun dengan angka 92,3 per 100.000 orang-tahun. Penelitian ini bertujuan untuk mengetahui karakteristik penderita psoriasis di Poliklinik Rawat Jalan Dermatologi dan Venereologi Rumah Sakit Umum Daerah Provinsi Nusa Tenggara Barat periode Januari 2016 – Desember 2020Metode: Desain penelitian yang digunakan adalah retrospektif deskriptif dengan cara mengambil data sekunder dari rekam medis pada pasien psoriasis baru periode Januari 2016 – Desember 2020 yang datang berobat.Hasil: Total kunjungan pasien di poliklinik rawat jalan Dermatologi dan Venereologi Rumah Sakit Umum Daerah Provinsi Nusa Tenggara Barat Periode Januari 2016 – Desember 2020 adalah sebanyak 8.524 orang. Pada penelitian didapatkan 140 pasien baru (92,7%) yang didominasi oleh perempuan (52,1%). Angka insidensi psoriasis pada tahun 2016-2020 didapatkan sebesar 16,42%. Kelompok usia terbanyak didapatkan pada usia 41-50 tahun sebanyak 33 orang (23,6%), kunjungan terbanyak pada tahun 2018 sebanyak 37 orang (26,4%), diagnosis yang mendominasi adalah psoriasis vulgaris sebanyak 105 orang (75%) dengan lokasi lesi badan sebanyak 93 orang (66,4%). Terapi didominasi oleh terapi topikal sebanyak 131 orang (93,6%) dan terapi sistemik sebanyak 108 orang (77,1%). Pemberian terapi sistemik methotrexate injeksi sebanyak 78 orang (72,2%) serta pada topikal kombinasi dari steroid dan asam salisilat sebanyak 79 orang (60,3%) merupakan yang paling sering digunakan.Simpulan: Penderita psoriasis di Poliklinik Rawat Jalan Dermatologi dan Venereologi RSUD Provinsi Nusa Tenggara Barat memiliki kecenderungan meningkat setiap tahunnya. Terapi yang diberikan yaitu terapi topikal dengan pemberian terbanyak berupa kombinasi topikal kortikosteroid dan asam salisilat serta pemberian terapi sistemik terbanyak berupa injeksi metotreksat. Data ini diharapkan dapat menjadi acuan bagi penelitian selanjutnya terkait psoriasis di Nusa Tenggara Barat.

Potential effect of secondary metabolites in Persea americana seeds as an ?-amylase inhibitor on type 2 diabetes mellitus Anak Agung Bagus Putra Indrakusuma; Luh Putu Sudi Wahyuni; I Gede Wikania Wira Wiguna; Anggi Amanda Triana Devy; I Gede Aswin Parisya Sasmana; Agung Wiwiek Indrayani
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Type 2 diabetes mellitus (T2DM) is a disease that has a high prevalence in the world. The development of plants with medicinal potential is an alternative to control blood sugar levels in T2DM disease, such as avocado (Persea americana). Persea americana seeds contain secondary metabolites that have anti-diabetic activity, but their bioavailability is low.Aim: This study aims to review various secondary metabolites in Persea americana seeds that can reduce blood glucose levels in ?-amylase pathway along with the type of potential encapsulation as a delivery system.Review: Secondary metabolites contained in Persea americana seeds which have activity as anti-diabetic are tannin, quercetin, rutin, kaempferol, saponin, triterpenoid, and alkaloid. Each of them has several mechanisms in diabetes, but their role as ?-amylase inhibitor on T2DM be in focus. There are various types of encapsulation that are known to be able to serve as a delivery system for these secondary metabolites. Those encapsulations are SNEDDS, chitosan-alginate nanoparticle, PLGA nanoparticle, lipid carrier, liposome, and polysaccharide-based enteric-coated nanoparticle. All of them showed good results in improving bioavailability.Conclusion: It is known that various secondary metabolites found in Persea americana seeds influence reducing blood glucose levels notably in the ?-amylase pathway. The low bioavailability of secondary metabolites can be improved by several forms of potential encapsulation. Therefore, herbal substances as adjuvant therapy in T2DM might be a viable management option.

Suplementasi seng (Zn) menurunkan kadar IgM anti PGL-1 pada narakontak serumah pasien kusta tipe multibasiler Elice Wijaya; Luh Made Mas Rusyati; I Gusti Ayu Agung Praharsini
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Indonesia ranks third highest of new cases of leprosy after India and Brazil. Transmission of leprosy through inhalation and prolonged close contact. Families who live in the same house have the highest risk for infection. Currently, several studies have found a correlation between IgM anti-PGL-1 levels with micronutrient deficiencies, especially zinc, which is associated with cellular immunity. This study aimed to investigate the effect of 40 mg elemental zinc supplementation per day for four weeks on IgM anti-PGL-1 levels. Methods: An experimental one-group pre-test and post-test design conducted from February to May 2021. The samples were all close contact persons with multibacillary leprosy patients aged 18-65 years who visited the Dermatology and Venereology Outpatient Clinic, Sanglah General Hospital, Denpasar during the study period by consecutive sampling. The history taking, physical examination, and blood sampling were carried out at the to evaluate IgM anti-PGL-1 and zinc levels. Results: Mean serum zinc level before and after supplementation were 79.00±9.67 g/dl and 95.16±31.84 g/dl, mean difference 25.21±32.12 g/dl (p<0.001). IgM anti-PGL-1 mean level before and after supplementation were 843.21±878.51 u/ml and 465.68±735.21 u/ml, mean difference 377.52±309.62 u/ml (p<0.001). Correlation test of different mean levels of zinc with different mean levels of IgM anti-PGL-1 resulted with r=0.630 and p=0.004. Conclusion: Forty mg elemental zinc per day for four weeks may increase serum zinc levels and reduce IgM anti-PGL-1 in close contact with multibacillary leprosy patients (p<0.05). Higher mean increase in serum zinc levels follower by higher mean decrease of IgM anti-PGL-1 levels. Latar Belakang: Indonesia menduduki peringkat ketiga jumlah kasus baru kusta terbanyak setelah India dan Brazil. Keluarga yang tinggal serumah memiliki resiko yang paling tinggi untuk terkena infeksi. Saat ini ditemukan beberapa penelitian yang menghubungkan kadar PGL-1 dengan defisiensi mikronutrien, salah satunya yaitu seng. Penelitian ini bertujuan untuk meneliti efek pemberian suplementasi seng elemental 40 mg per hari selama 4 minggu terhadap kadar IgM anti PGL-1. Metode: Penelitian eksperimental one group pre-test post-test design yang dilakukan pada Februari hingga Mei 2021. Sampel adalah seluruh individu narakontak dengan pasien kusta tipe multibasiler berusia 18-65 tahun yang berkunjung ke Poliklinik Kulit dan Kelamin RSUP Sanglah Denpasar selama periode penelitian berlangsung secara consecutive sampling. Anamnesis, pemeriksaan fisik, dan pengambilan sampel darah dilakukan untuk pemeriksaan IgM anti PGL-1 dan kadar serum seng. Hasil: Rerata kadar serum seng sebelum dan sesudah diberikan suplementasi yaitu 79,00±9,67 µg/dl dan 95,16±31,84 µg/dl dengan beda rerata 25,21±32,12 µg/dl (p<0,001). Rerata kadar IgM anti PGL-1 sebelum dan sesudah diberikan suplementasi yaitu 843,21±878,51 u/ml dan 465,68 ± 735,21 u/ml dengan beda rerata 377,52±309,62 u/ml (p<0,001). Uji korelasi beda rerata kadar seng dengan beda rerata kadar IgM anti PGL-1 yaitu r=0,630 dan p=0,004. Simpulan: Pemberian suplementasi seng elemental 40 mg perhari selama 4 minggu dapat meningkatkan kadar serum seng dan menurunkan kadar serum IgM anti PGL-1 pada narakontak pasien kusta tipe multibasiler (p<0,05). Semakin tinggi selisih rerata peningkatan kadar seng serum, semakin tinggi selisih rerata penurunan kadar IgM anti PGL-1.

Hubungan antara status tumor budding dengan berbagai parameter klinikopatologi pada adenokarsinoma kolorektal di RSUP Sanglah, Bali, Indonesia Luh Putu Iin Indrayani Maker; Ni Putu Sriwidyani
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Colorectal malignancies are common, with adenocarcinoma as the most prevalent type. Recently, studies of specific morphology like tumor budding have already started and related with tumor’s aggressivity as well as several parameters. This study aims to evaluate the association between tumor budding grade with patient age, sex, tumor location, histological grade, depth of invasion, and nodal status in colorectal adenocarcinoma at Sanglah General Hospital.Methods: This cross-sectional descriptive study used samples of intestinal resection specimens accompanied by Regional Lymph Node (RLN) removal of colorectal adenocarcinoma patients at Sanglah Hospital in 2018-2020. The sampling technique was carried out consecutively, which met the inclusion and exclusion criteria. Data on age, sex, tumor location, histologic grade, depth of invasion, and nodal status were obtained from the archives of examination results. At the same time, tumor budding data were obtained from observations of histopathological preparations with Hematoxylin-Eosin (H&E) staining. The results of the observations were tested statistically and presented descriptively. Data were analyzed with Chi-Square using SPSS version 22 for Windows.Results: Most of the study samples were 50 years old (84.0%), followed by male gender (62.0%), tumor location in the left colon (67.0%), low-grade (90.0%), T3-T4 invasion depth (77.0%), negative nodal status (60.0%), and high-tumor budding grade (51.0%). The Chi-Square test showed a significant relationship between the depth of invasion (p=0.001) and nodal status (p=0.009) variables on tumor budding grade.Conclusion: There were significant correlations between tumor budding grade and depth on invasion and nodal status. Latar Belakang: Kanker kolorektal merupakan keganasan yang sering ditemukan dengan adenokarsinoma merupakan tipe histopatologi terbanyak. Dewasa ini telah mulai diteliti morfologi spesifik yaitu tumor budding yang dikaitkan dengan agresivitas tumor maupun parameter lainnya. Penelitian ini bertujuan untuk mengetahui hubungan antara tumor budding grade dengan umur pasien, jenis kelamin, lokasi tumor, grade histopatologi, kedalaman invasi, dan status nodal pada adenokarsinoma kolorektal di RSUP Sanglah Denpasar.Metode: Penelitian deskriptif potong lintang ini menggunakan sampel spesimen reseksi usus disertai pengangkatan Kelenjar Getah Bening (KGB) regional pasien adenokarsinoma kolorektal di RSUP Sanglah tahun 2018-2020. Teknik pengambilan sampel dilakukan secara konsekutif, yang memenuhi kriteria inklusi dan eksklusi. Data umur, jenis kelamin, lokasi tumor, grade histopatologi, kedalaman invasi dan status nodal diperoleh dari arsip hasil pemeriksaan. Sedangkan data tumor budding diperoleh dari pengamatan sediaan histopatologi pewarnaan Hematoksilin-Eosin (H&E). Hasil pengamatan diuji secara statistik dan ditampilkan secara deskriptif. Data dianalisis dengan Chi-Square menggunakan SPSS versi 22 untuk Windows.Hasil: Sebagian besar sampel penelitian berusia ? 50 tahun (84,0%), diikuti dengan jenis kelamin laki-laki (62,0%), lokasi tumor pada kolon kiri (67,0%), low-grade (90,0%), kedalaman invasi T3-T4 (77,0%), status nodal negatif (60,0%), dan high-tumor budding grade (51,0%). Uji Chi-Square menunjukkan bahwa terdapat hubungan yang bermakna antara variabel kedalaman invasi (p=0,001) dan status nodal (p=0,009) terhadap tumor budding grade.Kesimpulan: Terdapat hubungan yang bermakna antara tumor budding grade dengan kedalaman invasi dan status nodal adenokarsinoma kolorektal.

Pria 80 tahun dengan tumor ganas dinding dada: laporan kasus Raissa Andi Soekrisno; Dewa Gde Mahiswara Sudiatmika; Elysanti Dwi Martadiani; Firman Parulian Sitanggang; Herman Suputra
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Malignant tumors that form in bone, soft tissue, or cartilage, are called sarcomas. Symptoms of these tumors vary, and may include shortness of breath, chest pain, and swelling around the tumor. Imaging such as X-rays and CT scans can be helpful, although imaging features of the few malignant chest wall tumors that are less specific, knowledge of the typical radiographic manifestations of these tumors can often make it easier for experts to differentiate between benign and malignant tumors and help lead to a more specific diagnosis.Case presentation: An 80-year-old man complains of a lump in the right chest. The results of laboratory tests showed anemia, decreased kidney function, and hypercalcemia. The CT scan of the thorax with contrast showed a solid mass in the right pleural cavity infiltrating the surrounding chest wall muscles, bilateral pneumonia, and osteolytic lesions on the spine suspected of being a metastatic process or spreading malignancy. The results of the biopsy showed a diffuse morphological appearance of immature plasma cells with an approach to the diagnosis of cutaneous infiltration plasma cell myeloma with a differential diagnosis of plasmablastic lymphoma.Conclusion: The results of X-ray imaging and CT scan of the thorax help narrow the differential diagnosis, where there is an image of a tumor on the chest wall with destruction of the surrounding bone and soft tissue and an image of infiltration into the pleura accompanied by multiple osteolytic images of the vertebrae. Assisted by a biopsy (anatomical pathology), the closest diagnosis in this patient is plasma cell myeloma chest wall. Latar Belakang: Tumor ganas yang terbentuk pada tulang, jaringan lunak, atau kartilago disebut sarcoma. Gejala dari tumor ini bervariasi, dapat berupa sesak nafas, nyeri dada, dan pembengkakan pada sekitar tumor. Pencitraan seperti rontgen dan CT scan dapat membantu, walaupun gambaran pencitraan dari beberapa tumor ganas dinding dada kurang spesifik, pengetahuan tentang manifestasi tipikal pada radilogi dari berbagai tumor ini seringkali dapat memudahkan para ahli untuk membedakan jenis tumor jinak dan ganas dan membantu mengarahkan diagnosis yang lebih spesifik.Kasus: Seorang laki – laki berusia 80 tahun dengan keluhan benjolan di dada sebelah kanan. Hasil pemeriksaan laboratorium didapatkan hasil anemia, penurunan fungsi ginjal, dan hiperkalsemia. Hasil CT Scan thorax dengan kontras menunjukkan adanya massa solid pada cavum pleura kanan yang menginfiltrasi otot dinding dada di sekitarnya, pneumonia bilateral, serta lesi osteolitik pada tulang belakang yang dicurigai sebagai suatu proses metastase atau penyebaran keganasan. Hasil biopsi menunjukkan gambaran morfologi sebaran difus sel plasma imatur-matur dengan pendekatan pada diagnosis cutaneus infiltration plasma cell myeloma dengan diagnosis banding plasmablastic lymphoma.Simpulan: Hasil pencitraan rontgen dan CT scan thorax membantu menyempitkan diagnosis banding, di mana terdapat gambaran tumor pada dinding dada dengan destruksi tulang dan jaringan lunak di sekitarnya serta gambaran infiltrasi ke pleura disertai gambaran osteolitik multipel pada vertebrae. Dibantu dengan pemeriksaan biopsi (patologi anatomi) maka diagnosis yang paling mendekati pada pasien ini adalah plasma cell myeloma dinding dada

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