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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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Kecurigaan rapid progressive glomerulonephritis akibat nefropati IgA : Sebuah laporan kasus Kadek Anggiswari Pradnya Angela; I Nyoman Sutarka
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Introduction: Clinical features of IgA nephropathy (IgAN) vary widely from asymptomatic hematuria, gross hematuria, and nephrotic range proteinuria to Rapid Progressive Glomerulonephritis (RPGN). RPGN is a challenge in itself in its diagnostic and treatment, especially in conditions of inadequate resources and facilities Case Description: Male, 52 years old, with complaints of uremia, oliguria, and leg edema. Obtained hypertension with blood pressure 159/91 mmHg. Urinalysis found +4 protein, full erythrocyte sediment, and positive erythrocyte cast. Albumin to Creatinine Ratio (ACR) levels 2163.10 g/mg creatinine. Blood Urea Nitrogen levels were 78.3 mg/dL, serum creatinine 5.11 mg/dL, serum IgA 546 mg/L, albumin, lipid profile and urological ultrasound were normal. The patient was diagnosed with acute glomerulonephritis due to IgA nephropathy with RPGN. The therapy was given Methylprednisolone 2x16mg for one month, followed by alternating days, Lisinopril 1x5mg, and Atorvastatin 1x20mg. One month of treatment follow-up showed general condition improvement, normal blood pressure, serum creatinine 1.69 mg/dL, urinalysis of erythrocyte sediments 5-10/LPB with ACR levels of 486.44 µg/mg creatinine. Discussion: RPGN is acute glomerulonephritis with a sudden, rapid, and progressive decline in renal function, accompanied by oliguria, edema, hypertension, and active urine sediment. The suspicion of RPGN, in this case, was based on the findings of nephritic symptoms and signs in the form of microscopic hematuria, erythrocyte casts, subnephrotic proteinuria, hypertension, edema, oliguria, uremia and serum creatinine increased more than two times normal. With the administration of corticosteroids, kidney function improved rapidly. A kidney biopsy was not performed due to limited human resources and facilities. Conclusion: We report a case of a 52-year-old man with acute glomerulonephritis whose clinical picture is suspected of being RPGN due to IgAN. The response to therapy is quite good with the administration of corticosteroids, ACE-I and statins. Pendahuluan : Gambaran klinis nefropati IgA (IgAN) sangat bervariasi dari hematuria asimptomatik, gross hematuria, nephrotic range proteinuria hingga Rapid Progressive Glomerulonephritis (RPGN). RPGN merupakan tantangan tersendiri dalam diagnostik dan penanganannya, khususnya pada kondisi sumber daya serta fasilitas yang tidak memadai Deskripsi Kasus: Laki-laki, 52 tahun dengan keluhan uremia, oligouria, dan edema tungkai. Didapatkan hipertensi dengan tekanan darah 159/91 mmHg. Urinalis didapatkan protein +4, sedimen eritrosit penuh, eritrosit cast positif. Kadar Albumin to Creatinine Ratio (ACR) 2163,10 µg/mg kreatinin. Kadar Blood Urea Nitrogen (BUN) 78,3 mg/dL, serum kreatinin 5,11 mg/dL, IgA serum 546 mg/L, serta albumin, lipid profil dan USG urologi normal. Penderita didiagnosis dengan glomerulonefritis akut oleh karena nefropati IgA dengan RPGN. Pasien diberikan metilprednisolon 2x16mg selama 1 bulan dilanjutkan alternating day, lisinopril 1x5mg, dan atorvastatin 1x20mg. Hasil follow-up 1 bulan pengobatan menunjukkan kondisi umum membaik, tekanan darah normal, serum kreatinin 1,69 mg/dL, urinalisis sedimen eritrosit 5-10 /LPB dengan kadar ACR 486,44 µg/mg kreatinin. Diskusi: RPGN adalah salah satu jenis glomerulonefritis akut dengan manifestasi penurunan fungsi ginjal mendadak, cepat, dan progresif, disertai oliguria, edema, hipertensi, serta urin sedimen aktif. Kecurigaan RPGN pada kasus ini didasarkan atas ditemukannya gejala dan tanda nefritik berupa hematuria mikroskopik, eritrosit cast, proteinuria subnefrotik, hipertensi, edema, oligouria, uremia dan serum kreatinin meningkat lebih 2 kali normal, serta dengan pemberian kortikosteroid fungsi ginjal cepat membaik. Biopsi ginjal tidak dilakukan karena keterbatasan tenaga dan sarana. Simpulan: Dilaporkan kasus laki-laki 52 tahun dengan glomerulonefritis akut yang gambaran klinisnya dicurigai sebagai RPGN karena IgAN. Respon terapi cukup baik dengan pemberian kortikosteroid, ACE-I dan statin.

Geriatric Patient Outcomes of Major Burn due to High-Voltage Electrical Injury: A Case Report Vincent Anggriant; Ratna Rayeni Natasha Roosseno; Daniel Puguh Pramudyo; Yoseph Chandra
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Introduction: Electrical burns are uncommon but result in high morbidity and mortality due to severe tissue damage. Geriatrics are vulnerable to aggressive burns because of skin atrophy, comorbidities, diminished host defence mechanisms and reduced mobility. A high-voltage electrical injury has complex complications, especially long-term complications. This study aimed to present the case of geriatric patient outcomes of major burn due to high-voltage electrical injury. Case Presentation: This is a case report of electrical burn injuries; a 70 years old man came to the emergency room approximately 1 hour after the incident, and a chief complaint was burning due to electrical shock. The patient had a history of electrical shock when fishing on the side of the river bank, where there is a high-voltage electrical central behind him. When he threw his fishing line, the fishing line caught on the exposed high-voltage transformer cable causing an electric shock. The examination showed that the patient was conscious of burns on the right chest to the abdomen and palm to the right hand, as well as on both soles of the feet. Another complaint was a pain in the wound due to electrical shock without a history of fainting, shortness of breath, chest pain, headache, and vomiting. The patient’s previous medical history showed uncontrolled hypertension. Conclusion: Our study demonstrates a rare geriatric patient discharged without complications due to a high-voltage injury. Strict multi-specialty management and rehabilitation are required to treat electrical injuries properly.

Personal hygiene genitalia wanita Made Hermina Laksmi; Ni Made Dwi Puspawati; Aurelia Stephanie; Putu Gde Hariwangsa
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Since the beginning, genital hygiene has become a concern for women susceptible to infections of the urinary tract and reproductive system where the vagina is an unsterile organ related to external exposure and close to the anus. Several problems related to the personal hygiene of female genitalia arise due to a lack of understanding and literature discussing this matter. This literature review will discuss the normal flora of the female genitalia and procedures for daily vaginal care, which aims to increase understanding of female genital personal hygiene. Sejak dahulu hygiene genetalia sudah menjadi perhatian kaum wanita, karena wanita sangat rentan terkena infeksi traktus urinarius dan sistem reproduksi dimana vagina merupakan organ yang tidak steril yang berhubungan dengan dunia luar serta berdekatan dengan anus. Beberapa masalah terkait personal hygiene genitalia wanita timbul akibat kurang pemahaman dan sedikitnya literatur yang membahas tentang hal ini. Tinjauan pustaka ini akan membahas mengenai flora normal genitalia wanita dan tata cara perawatan vagina sehari-hari yang bertujuan untuk meningkatkan pemahaman terhadap personal hygiene genitalia wanita.

Kadar Urine Urea Nitrogen (UUN) sebagai prediktor mortalitas pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah Denpasar Grace Inriani Rongre; I Gusti Putu Hendra Sanjaya; Agustinus I Wayan Harimawan; Sianny Herawati
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Urine urea nitrogen (UUN) is an examination of nitrogen balance with the concept of calculating the amount of urea excreted through urine. The amount of urea that comes out of the urine is in line with the amount of protein breakdown in the body and the amount of protein that enters the body. This study aimed to evaluate UUN levels on days 1, 3 and 7 as a predictor of mortality in burn patients >20%. Methods: This study was an observational analytic retrospective study. Data were collected from January 2020 to December 2021. This study used secondary data from medical records of patients with IIAB-III degree burns with burn area > 20% TBSA treated at Prof. Dr. I. G. N. G. Ngoerah General Hospital for 2020-2021. Data were analyzed using SPSS version 21 for Windows. Results: The majority of burn patients were male, about 73.9%. The average age of burn patients is 48.26±15.95 years. On the first examination day, the UUN value was still low (29.4 mg/24 hours). Then on the 3rd day, there was an increase in the average UUN level, namely the maximum value of 61,987 mg/24 hours. Examination on the 7th day showed an increase in line with the previous day, namely the maximum value of 57,489 mg/24 hours. On day 1, the mean UUN value was higher in patients who died, while on days 3 and 7 the mean UUN level in patients with living outcomes was higher than in patients who died, but not significantly (p>0.05). Conclusion: Urine urea nitrogen levels on days 1, 3 and 7 in burn patients >20% at Prof. Dr. I. G. N. G. Ngoerah General Hospital showed an increasing trend. Urine urea nitrogen levels cannot be used to predict mortality in burn patients because the results were insignificant. Latar Belakang: Urin urea nitrogen (UUN) merupakan pemeriksaan keseimbangan nitrogen yang berkonsep pada perhitungan jumlah urea yang dieksresikan lewat urin. Jumlah urea yang keluar bersama urine sejalan dengan jumlah pemecahan protein dalam tubuh serta jumlah protein yang masuk dalam tubuh. Penelitian ini bertujuan untuk mengevaluasi kadar UUN hari ke-1,3, dan 7 sebagai prediktor mortalitas pasien luka bakar >20%. Metode: Studi ini merupakan studi retrospektif analitik observasional. Data dikumpulkan dari Januari 2020 hingga Desember 2021. Studi ini menggunakan data sekunder dari catatan rekam medis pasien luka bakar derajat IIAB-III dengan luas luka bakar > 20% TBSA yang dirawat di RSUP Prof. Dr. I. G. N. G. Ngoerah periode 2020-2021. Data dianalisis dengan SPSS versi 21 untuk Windows. Hasil: Mayoritas pasien luka bakar berjenis kelamin laki-laki yaitu sebesar 73,9%. Usia rata-rata pasien luka bakar yaitu 48,26±15,95 tahun. Pada pemeriksaan hari pertama didapatkan nilai UUN masih rendah (29,4 mg/24 jam). Kemudian pada hari ke-3 didapatkan peningkatan rata-rata kadar UUN yakni nilai maksimum 61.987 mg/24 jam. Pemeriksaan pada hari ke-7 menunjukkan peningkatan yang sejalan dengan hari sebelumnya yakni nilai maksimum 57.489 mg/24 jam. Pada hari ke-1, nilai rerata UUN lebih tinggi pada pasien meninggal, sedangkan pada hari ke 3 dan 7 kadar rerata UUN pasien dengan luaran hidup lebih tinggi dibandingkan pasien yang meninggal, namun tidak bermakna secara signifikan (p>0,05). Simpulan: Kadar UUN pada hari ke-1, 3 dan 7 pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah menunjukkan adanya trend peningkatan. Kadar UUN tidak dapat dipakai sebagai prediktor mortalitas pada pasien luka bakar karena hasil tidak signifikan.

A neglected case of blunt eye injury leading to pediatric cataract: a lifetime consequence case report Jelly Vianti Fransisca Oeiyano; Raymond Oliver Mantu; Samuel Samatara
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: A pediatric traumatic cataract is one of the children's main causes of unilateral visual impairment. It is defined as a permanent opacification of the lens caused by penetrating or blunt trauma to the eye, which might damage the vision. A traumatic pediatric cataract is preventable and treatable. This case study aims to evaluate a neglected case of blunt eye injury leading to pediatric cataracts. Case Description: A 15-year-old boy came with chief complaints of decreased visual acuity in his left eye for the last 2 years. He has a history of blunt eye injury around 3 years prior in the left eye but left untreated. The patient's visual acuity was 1 per light perception in the left eye. An ophthalmologic examination of the left eye showed an opacity in the lens. The posterior segment cannot be examined. The patient was assessed with a traumatic cataract and was planned to be operated on, but the parents refused. Conclusion: Prompt first aid and timely surgical intervention are necessary for optimal results. Parents play a critical role in the patient's prognosis by observing closely after eye trauma and bringing their children to the right medical facility.

Efektivitas vaksin influenza terhadap kejadian rawat inap pada anak dengan influenza: sebuah tinjauan sistematik dan meta analisis Dewa Ayu Ketut Oka Sadnyani; I Gusti Agung Ayu Novi Wiraningrat; Romy Windiyanto
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Influenza is a respiratory infection that is often experienced by children. Influenza particularly happens in developing countries with a high number of cases. Global influence on influenza vaccine research has now been carried out to reduce the incidence of inpatient and severe influenza complications.Objective: To examine the effectiveness of the influenza vaccine (EVI) on inpatient events related to influenza disease in children.Methods: Search for published scientific articles using the prism method (preferred reporting, items for systematic reviews and meta-analysis). The search was carried out on a PubMed database, Cochrane Library and Medline published in the last 10 years until 1st May 2022, about influenza vaccines on inpatient events related to influenza in children. All types of studies are included if the result is inpatient, respondents under the age of 18 and influenza infections are confirmed for the laboratory results. All analyses in our research were conducted using STATA V13.1 (Stata Corporation, College Station, TX)Results: A randomized meta-analysis of 34 studies that use seasonal cohort and cross-sectional designs assesses the effectiveness of influenza vaccine (EVI) on inpatient events in children by 52.6% (95% CI: 50.9 -54,2) for all influenza. It was found that EVI was higher in influenza A/H1N1PDM09 at 70.0% (95%CI: 66.3-73.6) compared to Influenza A/H3n2 (38.9%; 95%CI: 31.8-46.1) and influenza B (46.7%; 95%CI: 41.9-51.4). According to the type of vaccine, EVI is obtained in the higher QIV type, which is 60.4% (95% CI: 55.3-65.5) compared to other types of vaccines.Conclusion: Based on the results of this meta-analysis reinforces evidence that shows that influenza vaccination is generally an effective action to prevent inpatient events related to influenza in children. Latar belakang: Penyakit influenza merupakan salah satu penyakit infeksi pernapasan yang sering dialami anak-anak. Influenza khususnya terjadi negara berkembang dengan kondisi jumlah kasus yang masih tinggi. Untuk menurunkan kejadian rawat inap dan komplikasi penyakit infuenza yang berat, saat ini telah dilakukan penelitian vaksin influenza secara global.Tujuan: Untuk menelaah efektivitas vaksin influenza (EVI) terhadap kejadian rawat inap terkait penyakit influenza pada anak-anak.Metode: Penelusuran artikel-artikel ilmiah terpublikasi menggunakan metode PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta Analysis). Pencarian dilakukan dengan basis data PubMed, Cochrane library dan Medline yang diterbitkan pada 10 tahun terakhir hingga bulan Mei 2022, tentang vaksin influenza terhadap kejadian rawat inap terkait penyakit influenza pada anak-anak. Semua jenis studi dimasukkan jika hasilnya adalah rawat inap, responden yang berumur di bawah 18 tahun dan infeksi influenza dikonfirmasi atas hasil laboratorium. Semua analisis dalam penelitian kami dilakukan dengan menggunakan Stata v13.1 (Stata Corporation, College Station, TX)Hasil: Sebuah meta-analisis efek acak dari 34 studi yang menggunakan desain cohort dan cross-sectional musiman yang dikumpulkan menilai efektivitas vaksin influenza (EVI) terhadap kejadian rawat inap pada anak-anak sebesar 52,6% (95%CI: 50,9-54,2) untuk semua influenza. Diperoleh bahwa EVI lebih tinggi terhadap influenza A/H1N1pdm09 sebesar 70,0% (95%CI: 66,3-73,6) dibandingkan influenza A/H3N2 (38,9%; 95%CI: 31,8-46,1) dan influenza B (46,7%; 95%CI: 41,9-51,4). Berdasarkan jenis vaksin, diperoleh EVI pada jenis QIV lebih tinggi yaitu sebesar 60,4% (95%CI: 55,3-65,5) dibandingkan dengan jenis vaksin lainnya.Simpulan: Berdasarkan hasil meta-analisis ini menguatkan bukti yang menunjukkan bahwa vaksinasi influenza umumnya adalah tindakan efektif untuk mencegah kejadian rawat inap terkait penyakit influenza pada anak-anak.

Alopesia universalis pada anak yang berespon baik dengan terapi kombinasi: sebuah laporan kasus I Gusti Ayu Agung Praharsini; I Gusti Ayu Agung Dwi Karmila; Ratih Purnamasari Nukana; Henny Wijaya
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Alopecia universalis is an autoimmune disease of the hair follicles, which results in complete loss of head and body hair. Until now there is no proven effective therapy in dealing with this disease. We report a case of alopecia universalis that responded well to combination therapy. Case: Female, 22 months old, complained by her parents due to hair loss on her head, eyebrows and eyelashes that had not grown back since the age of 8 months. On the fingernails and toenails found pitting nails, trachonycia. On scalp dermoscopy examination, multiple yellow dots were found. Severity of Alopecia Tool Score (SALT) was 100%. The patient was treated with minoxidil 5%, mometasone 0.1%, triamcinolone 12 mg and excimer laser. Administration of minoxidil increases prostaglandin production and maintains the anagen phase. Corticosteroids are immunosuppressive which suppress the immune attack of T cells on hair follicles. UV light on the excimer laser can reduce the proliferation of T lymphocytes, thereby reducing perifollicular inflammation and hair follicle damage. In this case, after 4 months of observation, the growth of terminal hair and vellus hair on the scalp, eyebrows and eyelashes was seen. On the patient's nails, the trachonycia was improved, with pitting nails remaining. SALT decreased to 58%. Conclusion: The combination therapy of minoxidil, corticosteroid and excimer laser gave good results in this case. During treatment, there were no side effects or recurrences. Latar belakang : Alopesia universalis adalah penyakit autoimun pada folikel rambut, yang mengakibatkan kerontokan seluruh rambut kepala dan tubuh. Hingga saat ini belum ada terapi yang terbukti efektif dalam menangani penyakit ini. Berikut dilaporkan kasus alopesia universalis yang memberikan respon baik dengan terapi kombinasi. Kasus: Pasien perempuan, 22 bulan, dikeluhkan orang tuanya mengalami rambut kepala, alis dan bulu mata yang rontok dan tidak tumbuh kembali sejak usia 8 bulan. Pada kuku tangan dan kaki didapatkan adanya pitting nails, trachonycia. Pada pemeriksaan dermoskopi kulit kepala didapatkan adanya multiple yellow dots. Severity of Alopecia Tool Score (SALT) 100%. Pasien diberikan terapi minoksidil 5%, mometason 0.1%, triamsinolone 12 mg dan laser excimer. Pemberian minoksidil meningkatkan produksi prostaglandin dan mempertahankan fase anagen. Kortikosteroid bersifat imunosupresif yang menekan serangan imunitas sel T pada folikel rambut. Sinar UV pada laser excimer dapat menurunkan proliferasi sel T limfosit sehingga mengurangi peradangan perifolikular dan kerusakan folikel rambut. Pada kasus, setelah pengamatan selama 4 bulan nampak adanya pertumbuhan rambut terminal dan rambut vellus pada kulit kepala, alis dan bulu mata. Pada kuku pasien nampak trachonycia membaik, tersisa pitting nails. SALT menurun menjadi 58%. Simpulan: Terapi kombinasi minoksidil, kortikosteroid dan laser excimer memberikan hasil yang baik pada kasus ini. Selama pengobatan tidak didapatkan adanya efek samping dan rekurensi.

Anosmia dan ageusia sebagai faktor prognosis baik pada pasien COVID-19 rawat inap di RSUP Sanglah Denpasar Senja Decy Ningrum; Ida Bagus Ngurah Rai; I Gede Ketut Sajinadiyasa; Anak Agung Raka Sudewi; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; Ni Luh Putu Eka Arisanti
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Anosmia and ageusia are early symptoms that are widely reported in COVID 19 patients and are associated with low rates of intensive care and mortality, so the hypothesis arises that anosmia and ageusia can be good prognostic factors in COVID-19 patients. This study aims to examine anosmia and ageusia as prognostic factors in COVID-19 patients. Methods: This study is an observational analytic study with a retrospective cohort design conducted at Sanglah General Hospital Denpasar from January to June 2022. Results: obtained a total of 1048 subjects with 344 subjects experiencing anosmia, 210 subjects experiencing ageusia, and 474 subjects experiencing a combination of anosmia and ageusia. Variable symptoms of anosmia and ageusia were statistically significant predictors for the recovery of COVID-19 patients (p<0.05). The cure rate in the group of patients with symptoms of anosmia was 1.8 times (RR = 1.783, 95% CI = 1.667-1.908) and the group of patients with symptoms of ageusia experienced 1.6 times higher recovery (RR = 1.564, 95% CI = 1.478 -1,655). After adjusting for other variables as confounders, the combination of symptoms of anosmia and ageusia in patients was a significant predictor of recovery for COVID-19 patients by 1.5 times compared to patients who did not experience the combination of symptoms of anosmia and ageusia (ARR = 1.523, 95% CI = 1.245- 1.864, p<0.05). Conclusion: Anosmia, ageusia and the combination of both, indicate protective factors against possible mortality and indicate a good prognosis in COVID-19 patients. Latar belakang: Anosmia dan ageusia merupakan gejala awal yang banyak dilaporkan pada pasien COVID-19 serta dikaitkan dengan tingkat rawat intensif dan mortalitas yang rendah sehingga muncul hipotesis bahwa anosmia dan ageusia dapat menjadi faktor prognosis yang baik pada pasien COVID-19. Penelitian ini bertujuan untuk meneliti anosmia dan ageusia sebagai faktor prognosis pada pasien COVID- 19. Metode: Penelitian ini merupakan studi analitik observasional dengan rancangan kohort retrospektif yang dilakukan di RSUP Sanglah Denpasar pada bulan Januari hingga Juni 2022. Hasil: Didapatkan total 1048 subjek dengan 344 subjek mengalami anosmia, 210 subjek mengalami ageusia, serta 474 subjek mengalami kombinasi anosmia dan ageusia. Variabel gejala anosmia maupun ageusia secara statistik merupakan prediktor signifikan untuk kesembuhan pasien COVID-19 (p<0,05). Tingkat kesembuhan pada kelompok pasien bergejala anosmia mencapai 1,8 kali (RR = 1,783, IK 95% = 1,667-1,908) lebih tinggi dan kelompok pasien bergejala ageusia mengalami kesembuhan 1,6 kali lebih tinggi (RR = 1,564, IK 95% = 1,478-1,655). Setelah disesuaikan dengan variabel lain sebagai perancu, kombinasi gejala anosmia dan ageusia pada pasien menjadi prediktor kesembuhan pasien COVID-19 secara signifikan sebesar 1,5 kali lipat dibandingkan pasien yang tidak mengalami kombinasi gejala anosmia dan ageusia (ARR = 1,523, IK95% = 1,245-1,864, p<0,05). Simpulan: Anosmia, ageusia, dan kombinasi keduanya menunjukkan adanya faktor protektif terhadap kemungkinan mortalitas serta menandakan adanya prognosis yang baik pada pasien COVID-19

Keloid yang diterapi dengan kombinasi bedah eksisi dan injeksi kortikosteroid intralesi: sebuah laporan kasus Ketut Wida Komalasari; Ketut Kwartantaya Winaya; Putu Gde Hari Wangsa; I Dewa Made Rendy Sanjaya
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Keloids are soft solid tumors with a smooth surface that extend beyond the wound margins and invade adjacent normal tissue. Appears at the age of 10-30 years, occurs as a result of an imbalance between increased collagen synthesis and extracellular matrix. There are several types of therapeutic modalities such as intralesional or topical corticosteroids, surgical excision, electrosurgery, frozen surgery, radiotherapy and laser therapy. Combination therapy of surgical excision and intralesional corticosteroids used for this case. Case Description: A woman, 43 years old, complained since 3 years ago, in the lower left abdomen there is a lump, which has been getting bigger over the past 1 year, sometimes feels pain and itching. In the left inferior abdominal region, multiple tumors were found to be erythematous to hyperpigmented, with firm boundaries, oval in shape, 0.2 cm to 0.5 cm in diameter, with a length and width of 0.3 cm and 0.5 cm, respectively. 1 cm and 1.5 cm, the surface feels smooth and shiny. On palpation, the tumor was fixed and firm in consistency. Surgical excision was performed and continued with intralesional injection of triamcinolone acetonide once a week on keloid and post-excision lesions. There was clinical improvement of keloids, on the 21st day of observation. Conclusion: Surgical excision is minimally invasive and can be combined with weekly intrakeloid triamcinolone acetonide injection therapy for keloid lesions and post-excision area to reduce the risk of new keloids appearing. On follow-up observation of keloids in the left inferior abdominal region, the lesion was getting smaller and softened and there was no new keloid growth in the post-excision area. Latar belakang: Keloid adalah tumor yang padat lunak, dengan permukaan licin berkembang melebihi batas luka dan menginvasi jaringan normal yang berdekatan. Muncul pada usia 10-30 tahun, terjadi akibat dari ketidakseimbangan antara peningkatan sintesis kolagen dan matriks ekstraseluler. Terdapat beberapa macam modalitas terapi seperti kortikosteroid intralesi atau topikal, bedah eksisi, bedah listrik, bedah beku, radioterapi dan terapi laser. Kasus ini membahas terapi kombinasi bedah eksisi dan kortikosteroid intralesi. Kasus: Seorang wanita, berusia 43 tahun, mengeluh sejak 3 tahun yang lalu, pada perut kiri bawah terdapat benjolan, yang semakin lama semakin membesar selama 1 tahun terakhir, rasa nyeri dan gatal terkadang dirasakan. Pada regio abdominalis inferior sinistra ditemukan tumor multipel berwarna eritema sampai hiperpigmentasi, dengan batas yang tegas, berbentul bulat oval, berdiameter 0,2 cm sampai 0,5 cm, dengan panjang dan lebar masing-masing 0,3 cm dan 0,5 cm serta 1 cm dan 1,5 cm, permukaan teraba licin dan mengkilat. Pemeriksaan palpasi ditemukan tumor terfiksir dan konsistensinya keras. Dilakukan tindakan bedah eksisi dan dilanjutkan dengan injeksi triamsinolon asetonid intralesi seminggu sekali pada lesi keloid dan lesi paska eksisi. Terdapat perbaikan klinis keloid, pada pengamatan hari ke-21. Simpulan: Tindakan invasif minimal seperti bedah eksisi dapat dikombinasi dengan injeksi triamsinolon asetonid intrakeloid seminggu sekali pada lesi keloid dan daerah paska eksisi untuk mengurangi risiko munculnya keloid baru. Pada pengamatan lanjutan keloid pada regio abdominalis inferior sinistra, didapatkan lesi semakin mengecil dan melunak dan tidak terdapat pertumbuhan keloid baru pada daerah paska tindakan eksisi.

Gambaran tingkat kecemasan dalam menghadapi UTBK SBMPTN pada calon mahasiswa baru angkatan 2020/2021 di Denpasar Dhanira Mahaliana Bramantya Suanda Putri; Luh Made Indah Sri Handari Adiputra; Ketut Tirtayasa; Indira Vidiari Juhanna
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Introduction: Such tight competition is suspected to cause anxiety in prospective new students in facing the computer-based written examination of the joint selection to enter state universities (UTBK SBMPTN). Anxiety is a combination of various responses that include intense networking, feeling worried and disturbing. Preparation for exams can create a high level of anxiety. However, anxiety can also be a positive energy when it is still at a low level. So, it is important when knowing the level of anxiety in prospective students facing the UTBK SBMPTN Methods: This study is a descriptive study with a retrospective approach. Anxiety was measured using the Hamilton Anxiety Rating Scale (HARS) questionnaire which was distributed to prospective students graduating from SMAN 4 Denpasar and SMA PGRI 2 Denpasar in 2021 who registered for the UTBK SBMPTN with a sample of 88 people. Results: The level of anxiety of respondents in this study had a relatively mild level of anxiety, namely 35 people (28%), 25 people (28%) experienced moderate anxiety and only 2 people (2%) experienced severe anxiety. Symptoms experienced by many respondents were difficulty concentrating (55 people), easily distracted (72 people), lethargic (60 people), restless (65 people). Conclusion: The level of anxiety of most of the respondents in this study had a relatively mild level of anxiety, namely as many as 35 people (40%). Pendahuluan: Persaingan yang begitu ketat diduga menimbulkan rasa cemas pada calon mahasiswa baru dalam menghadapi ujian tulis berbasis komputer seleksi bersama masuk perguruan tinggi negeri (UTBK SBMPTN). Kecemasan merupakan kombinasi dari berbagai respon mencakup ketakutan yang intens, merasa khawatir dan bersifat mengganggu. Persiapan untuk ujian dapat menciptakan tingkat kecemasan yang tinggi. Namun, kecemasan juga bisa menjadi energi positif ketika masih pada tingkatan rendah. Maka, penting mengetahui tingkatan kecemasan pada calon mahasiswa ketika menghadapi UTBK SBMPTN Hasil: Tingkat kecemasan responden dalam penelitian ini memiliki tingkat kecemasan yang tergolong ringan yaitu sebanyak 35 orang (40%), 25 orang (28%) mengalami cemas sedang dan hanya 2 orang (2%) yang mengalami cemas berat. Gejala yang banyak dialami oleh responden adalah sulit konsentrasi (55 orang), mudah terganggu (72 orang), lesu (60 orang), gelisah (65 orang). Simpulan: Tingkat kecemasan sebagian besar responden dalam penelitain ini memiliki tingkat kecemasan yang tergolong ringan yaitu sebanyak 35 orang (40%).

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Bali

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