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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
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.
Arjuna Subject : -
Articles 34 Documents
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Search results for , issue "Vol. 13 No. 3 (2022): (In Press 1 December 2022)" : 34 Documents clear
Wide eksisi dan flap rhomboid pada karsinoma basal sel regio facial Kadek Nopy Arianti; Made Oka Sastrawan; Fatur Reyhan Muradi; Muhammad Aflah; Casvin Jus
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1505

Abstract

Background: Basal cell carcinoma is one of the most common classifications of non-melanoma skin cancer (75% - 80%) of all cancers. Basal cell carcinoma causes widespread local destruction including soft tissue, cartilage, and bone, thus impairing function and aesthetics, especially for the facial area. One of the most common reconstructive techniques for Basal Cell Carcinoma is the Rhomboid flap. This case report aims to report the use of the rhomboid flap reconstruction technique in post-wide excision of basal cell carcinoma. Case Description: A man, 54 years old, ethnic Balinese, came to the General Surgery Clinic of RSUD Klungkung with a complaint that a mole on the patient's left eye appeared enlarged with itching and bleeds easily. These complaints began to be felt since about 2 weeks before entering the hospital. Initially the patient's mole had been there for 5 years, previously the patient had no complaints about the mole, the initial lesion was in the form of a small brownish lump which was then felt to be getting bigger with itching and bleeding easily. The patient did not complain of pain. Examination of the localized status on the lateral periorbital sinistra showed blackish nodules with hyperpigmented macules, solitary, 2cm x 1cm in size, visible erosions, well-defined borders, irregular shape. Conclusion: The provisional diagnosis of Suspected Malignant Skin Tumor was established based on history, physical examination, with management therapy wide excision and reconstruction with Rhomboid Flap followed with biopsy.   Latar Belakang : Karsinoma Sel Basal (KSB) adalah salah satu kanker kulit  yang paling sering ditemukan dari seluruh kanker kulit non melanoma.  Karsinoma Sel Basal dapat mengakibatkan kerusakan local dengan infiltrasi yang luas sehingga mengganggu fungsi dan estetika, terutama untuk daerah wajah. Salah satu pilihan  teknik rekonstruksi yang bisa dilakukan pada Karsinoma Sel Basal di regio wajah  adalah Rhomboid flap. Laporan kasus ini bertujuan untuk melaporkan penggunaan tehnik rekonstruksi dengan flap rhomboid pada pasca eksisi luas pada karsinoma sel basal. Deskripsi Kasus: Seorang laki-laki, 54 tahun, suku Bali,  datang ke Poliklinik bedah Umum RSUD Klungkung dengan keluhan tahi lalat pada sebelah mata kiri pasien tampak membesar disertai gatal dan mudah berdarah. Keluhan tersebut mulai dirasakan sejak sekitar 2 minggu sebelum masuk RS. Awalnya tahi lalat pasien sudah ada sejak 5 tahun yang lalu, sebelumnya pasien tidak ada keluhan pada tahi lalat tesebut, lesi awal berupa benjolan kecil berwarna kecoklatan yang kemudian makin lama dirasakan makin membesar disertai rasa gatal dan mudah berdarah. Keluhan nyeri tidak dikeluhkan oleh pasien.  Pemeriksaan status lokalis pada periorbital lateral S tampak nodul kehitaman disertai makula hiperpigmentasi, soliter, ukuran 2cm x 1cm, tampak erosi, batas tegas, bentuk tidak beraturan. Kesimpulan: Diagnosis sementara Tumor Kulit Suspek Malignant ditegakkan berdasarkan anamnesis, pemeriksaan fisik dengan terapi eksisi luas + biopsi + rekonstruksi dengan Rhomboid Flap.
Variations of dengue shock syndrome cases and their management: report of three cases Gede Bagus Mahendra Wirajaya; Ayu Agung Pradnya Paramitha Dwi Sutanegara; Desak Nyoman Desy Lestari
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1507

Abstract

Background: Dengue hemorrhagic fever (DHF) occurs due to plasma leakage due to increased vascular permeability, which is also supported by an active complement system, which makes DHF fall into complications such as shock or dengue shock syndrome (DSS). The comprehensive management of DSS could prevent morbidity and mortality in patients. We aimed to report three variations of dengue shock syndrome cases and their management. Case presentation: Three cases of DSS from our hospital. Two case reports with clinical dengue fever patients with shock and one case report with clinical dengue patients with shock and complications of acute liver failure. The first case was a 24 years olds male patient with classic signs of dengue fever plus spontaneous bleeding in the form of nosebleeds accompanied by hemodynamic disturbances. Laboratory examination revealed severe thrombocytopenia. In the second case, a male patient with dengue shock syndrome accompanied acute liver failure. The patient complains of heartburn and nausea accompanied by tea-like urine. Dengue patients with abdominal pain typical of liver disorders, nausea, vomiting and anorexia, and hepatomegaly with or without jaundice are typical of liver disorders. The third case, a male patient with dengue shock syndrome, accompanied the suspicion of ascites. The main treatment is the administration of isotonic crystalloid fluids according to body weight. While in cases of acute liver failure, NAC can be given. Conclusion: We found three cases of DSS with some complications. It is important to know the right treatment immediately so that complications do not occur.
Studi deskriptif kasus malaria sebelum dan sesudah gempa di Kecamatan Gunung Sari, Lombok Barat, Indonesia Ni Luh Made Mirah Rahayu; Indah Sapta Wardani; Dewi Suryani; Ni Luh Putu Harta Wedari
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Indonesia is the country where malaria transmission still occurs. Malaria disease transmission has increased, for example when an earthquake occurred in Lombok. This research aims to explore the comparison of malaria cases in Gunung Sari District before and after the Lombok earthquake. Methods: Primary data were obtained by filling in the online google form by the interviewees and then continued by interviewing on telephone. Secondary data were obtained from online medical records from the information section of Gunung Sari and Penimbung Health Center, West Lombok. Results: Malaria incidence 6 months before the earthquake was 16 cases with the dominant type of malaria, namely P. falciparum malaria, and 6 months after the earthquake was 830 cases with the dominant type of malaria, namely mixed Plasmodium malaria (P. falciparum and P. vivax). Malaria incidence 1 year after the earthquake was 8 cases with the dominant type of malaria, namely P. falciparum. Efforts to reduce malaria cases include eradicating mosquitoes, increasing public awareness, early diagnosis of malaria, monitoring treatment, and using bed nets. Conclusion: Malaria incidence has increased in the 6 months after the earthquake because of loss of homes and post-disaster ecological changes. Malaria incidence 1 year after the earthquake has decreased. Efforts to reduce cases include eradication of mosquitoes, public knowledge, and environment restoration.   Latar Belakang: Indonesia merupakan salah satu negara dimana masih terjadi transmisi malaria. Penularan penyakit malaria meningkat pada populasi yang terkena bencana contohnya gempa yang terjadi di Lombok. Penelitian ini bertujuan mengetahui perbandingan kasus malaria di Kecamatan Gunung Sari sebelum dan sesudah gempa Lombok. Metode: Data primer diperoleh dengan pengisian google form secara daring oleh narasumber lalu dilanjutkan wawancara melalui sambungan telepon. Data sekunder diperoleh dari data rekam medis secara daring dari bagian informasi Puskesmas Gunung Sari dan Penimbung, Lombok. Hasil: Angka kasus malaria 6 bulan sebelum gempa adalah 16 kasus dengan jenis malaria dominan yakni malaria P. falciparum. Sedangkan angka kasus malaria 6 bulan sesudah gempa adalah 830 kasus dengan jenis malaria dominan yakni malaria Plasmodium campuran (P. falciparum dan P. vivax). Angka kasus malaria 1 tahun pasca gempa tersebut adalah 8 kasus dengan jenis malaria dominan yakni P. falciparum. Upaya penurunan kasus malaria meliputi pemberantasan nyamuk, peningkatan wawasan masyarakat, diagnosis dini malaria, pemantauan pengobatan, dan penggunaan kelambu. Simpulan: Angka kasus malaria mengalami peningkatan pada 6 bulan sesudah gempa Lombok. Faktor yang meningkatkan penularan penyakit malaria ini adalah kehilangan rumah dan perubahan ekologi pasca bencana. Sedangkan angka kasus malaria 1 tahun pasca gempa Lombok mengalami penurunan. Upaya penurunan kasus yakni pemberantasan nyamuk, pengetahuan masyarakat, dan pemulihan lingkungan tempat tinggal korban bencana.
Luaran kualitas hidup pasien lansia pasca tatalaksana operatif fraktur osteoporotik: Sebuah laporan kasus Anak Agung Davyn Anantha Rheja; I Putu Agni Rangga Githa; Anak Agung Ngurah Ronny Kesuma
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1516

Abstract

Background: Fractures in the elderly population arise primarily from fall injuries and low bone density. Osteoporosis fracture is a condition with comorbid osteoporosis that can occur due to minor trauma. Osteoporosis fractures are associated with significant morbidity. Osteoporosis fracture recovery takes a long time and increases the risk of complications. Many patients lose independence and require full daily activity care from caregivers. Case: A 66-year-old female patient came to the hospital emergency room in July 2022 complaining of pain and swelling in her right leg after a fall in her home. Local examination of the patient's right leg showed edema, deformity, shortening without visible open wound, and palpable stiffness with normal arterial pulsation. The patient has limited movement due to pain. The patient was diagnosed with Closed Fracture Right Subtrochanter Femur Russel Taylor Type 1B with Severe Osteoporosis. The patient underwent open elective reduction and internal fixation percutaneous surgery (ORIF PS). After treatment, the patient's family assists the patient's daily activities. A month later, the patient fell back in her yard. The patient came to the emergency room complaining of pain in the left hip. Local examination found swelling in the proximal left thigh and decreased ROM in the hip joint. The patient received operative management of bipolar hemiarthroplasty. The patient's daily activities still depend on the patient's family due to the patient's limited mobility. Conclusion: Patients with comorbid osteoporosis are highly susceptible to fracture and have worse long-term morbidity and increased dependence on others for long-term rehabilitation.   Latar belakang: Fraktur pada populasi lanjut usia muncul terutama dari kombinasi cedera akibat jatuh dan kepadatan tulang yang rendah. Fraktur osteoporotik merupakan kondisi fraktur pada populasi dengan komorbid osteoporosis yang dapat terjadi akibat trauma ringan. Fraktur osteoporotik dikaitkan dengan morbiditas yang signifikan. Pemulihan fraktur osteoporotik memerlukan waktu yang lama dan meningkatkan risiko komplikasi. banyak pasien kehilangan kemandirian dan membutuhkan perawatan penuh dari orang lain. Laporan Kasus: Pasien perempuan dengan usia 66 tahun datang ke IGD Rumah Sakit pada Juli 2022 dengan keluhan nyeri dan bengkak pada kaki kanan setelah terjatuh di halaman rumah. Pemeriksaan lokalis pada kaki kanan pasien menunjukkan pada regio femur kanan ditemukan edema, deformitas, pemendekkan tanpa adanya luka terbuka yang terlihat, teraba kaku dengan pulsasi arteri yang masih baik. Pasien mengalami keterbatasan pergerakan karena nyeri. Berdasarkan pemeriksaan fisik dan penunjang, pasien didiagnosis dengan Closed Fracture Right Subtrochanter Femur Russel Taylor Type 1B dengan Severe Osteoporosis. Pasien menjalani tatalaksan operatif open reduction and internal fixation percutaneous surgery (ORIF PS) elektif. Pasca tatalaksana, aktivitas harian pasien dibantu oleh keluarga pasien. Sebulan kemudian pasien kembali terjatuh dihalaman rumahnya. Pasien datang ke IGD RS dengan keluhan nyeri pada pinggul kiri. Pada pemeriksaan lokalis ditemukan pembengkakan pada paha kiri proksimal dan penurunan ROM pada sendi panggul. Pasien mendapatkan tatalaksana operatif bipolar hemiarthoplasty. Aktivitas harian pasien masih tergantung pada keluarga pasien akibat keterbatasan mobilitas pasien. Simpulan: Pasien dengan komorbid osteoporosis memiliki kerentanan yang tinggi untuk terjadinya fraktur dan meningkatkan luaran morbiditas yang lebih buruk panjang dan meningkatkan ketergantungan terhadap orang lain untuk proses rehabilitasi dalam waktu yang panjang.
a case report Right femur malunion treated with open osteotomy and open reduction with internal fixation percutaneous surgery (ORIF PS): A case report Pande Putu Agung Willa Kesawa Putra; Anak Agung Ngurah Ronny Kesuma
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1519

Abstract

Introduction: Fracture femur distal third is a common orthopedic problem in patients of all ages. Malunion is common due to neglected conditions; an osteotomy plus ORIF PS procedure is required in the management. Surgery is currently the treatment of choice for distal femoral malunion fractures. Malunion requires deep fixation of compression using lag screws, cortical screws or cancellous screws depending on the type of fracture. Patients with distal femoral malunion are also treated with grafting using bone graft, allograft, autograft, synthetic graft and blade plate with screws in combination with a safe quadriceps approach. Case description: A 16-year-old female patient complained of unbalanced walking and cramps in the right leg for the last 3 months. The patient had a history of traffic accidents and then suffered  femur fracture 9 months ago, debridement and a plaster cast. The physical examination found that the right leg was shorter than the left, and the  AVN and active ROM distal right leg were still good. Then X-Ray examination obtained the results of his Malunion fracture of the middle 1/3 right femur and then decided to do an osteotomy + ORIF PS. The patient returned home in good condition and then controlled through the outpatient polyclinic. Conclusion: In most malunion patients, osteotomy and PS ORIF are surgical methods. Corrective osteotomy with ORIF PS should be regarded as a salvage procedure for treating distal third malunion.
Myeloma Multipel pada Pasien dengan Fraktur Patologis: Laporan Kasus I Putu Agni Rangga Githa; Anak Agung Davyn Anantha Rheja
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1521

Abstract

Background: Multiple myeloma (MM) is a haematological malignancy characterized by destructive bone lesions, renal injury, anemia and hypercalcemia. Multiple myeloma is a neoplasm that often occurs in adults to the elderly. Complications of pathological fractures occur as a result of lytic lesions of the bone. Complications of MM can appear as a clinical manifestation of the patient so that further examination is needed in patients with pathological fractures to establish MM. Case: A 67-year-old female patient came to the hospital emergency room accompanied by her family in August 2022 with complaints of pain in her right thigh after falling on the homestairs. The patient has a history of heart disease and hypertension. The patient then underwent an examination and found anemia, an increase in serum creatinine and a complete fracture of the distal 1/3 of the right femur with multiple lytic lesions with decreased bone trabeculation in the skull and pelvis, clavicle, humerus, and femur bilaterally, left costae 7-8th  with suspected multiple myeloma, differential diagnosis of malignant metastases and vertebral body compression 12th. Bone survey examination and sampling for histopathological examination were then carried out during the operative management of fractures with the impression of plasmacytosis so that the patient was diagnosed with Post ORIF PS, bone graft and post biopsy e.c. pathological fracture right supracondylar femur with multiple lytic lesions e.c. multiple myeloma. The patient was then referred to the orthopedic oncology department. Conclusion: Patients with pathological fracture manifestations need to be investigated further regarding the underlying cause of the condition. Multiple myeloma is one of the hematological malignancies that can cause bone lesions due to an imbalance of bone destructive factors so that it can increase the risk of pathological fracture complications. Knowing the complications, clinical manifestations and supporting characteristics of multiple myeloma can help in making the diagnosis of myeloma in patients with pathological fractures.   Latar belakang: Mieloma multipel (MM) adalah keganasan hematologi yang ditandai dengan lesi tulang yang destruktif, cedera ginjal, anemia dan hiperkalsemia. Mieloma multipel merupakan neoplasma yang sering terjadi pada orang dewasa hingga lanjut usia. Komplikasi fraktur patologis terjadi akibat lesi litik pada tulang. Komplikasi MM dapat muncul sebagai manifestasi klinis pasien sehingga perlu dilakukan pemeriksaan lanjutan pada pasien fraktur patologis untuk menegakkan MM. Laporan Kasus: Pasien perempuan berusia 67 tahun datang ke IGD Rumah Sakit diantar oleh keluarganya pada Agustus 2022 dengan keluhan nyeri pada paha kanan setelah terjatuh di tangga rumah. Pasien memiliki Riwayat penyakit jantung dan hipertensi. Pasien kemudian melakukan pemeriksaan dan ditemukan kondisi anemia, peningkatan serum kreatinin dan fraktur komplit 1/3 distal os femur kanan dengan lesi litik multipel dengan penurunan trabekulasi tulang pada skull dan pelvis, os klavikula, humerus, dan femur bilateral, costae 7-8 kiri dengan suspek mieloma multipel diagnosis banding metastasis keganasan dan kompresi korpus vertebra 12. Pemeriksaan survei tulang dan pengambilan sampel untuk pemeriksaan histopatologi kemudian dilakukan saat tatalaksana operatif penanganan fraktur dengan kesan plasmasitosis sehingga pasien didiagnosis  dengan Post ORIF PS dan pemasangan bone graft dan pasca biopsi e.c. pathological fracture right supracondylar femur with multiple lytic lesion e.c. multiple myeloma. Pasien kemudian dirujuk ke bagian orthopaedi onkologi. Simpulan: Pasien dengan manifestasi fraktur patologis perlu dilakukan pemeriksaan lebih lanjut mengenai penyebab yang mendasari keadaan tersebut. Mieloma multipel menjadi salah satu keganasan hematologi yang dapat menimbulkan lesi tulang akibat ketidakseimbangan faktor destruktif tulang sehingga dapat meningkatkan risiko komplikasi fraktur patologis. Mengetahui komplikasi, manifestasi klinis dan penunjang yang menjadi karakteristik dari mieloma multipel dapat membantu dalam menegakkan diagnosis mieloma pada pasien dengan fraktur patologis.
Perbandingan kerusakan saraf perifer melalui pemeriksaan elektroneuromiografi pada kusta tipe multibasiler I Dewa Made Rendy Sanjaya; Luh Made Mas Rusyati; Ketut Kwartantaya Winaya; I Komang Arimbawa; I Gusti Ayu Agung Praharsini; Ni Made Dwi Puspawati
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1523

Abstract

Background: Leprosy is a bacterial infection that is still a neglected disease. This disease leads to peripheral neuropathy despite routine treatment. Moreover, early detection of peripheral neuropathy in leprosy patients is very important. ENMG is known to have fairly good sensitivity and specificity in detecting it. Therefore, this study aims to determine the relationship between type 2 leprosy reactions and the risk of peripheral neuropathy through ENMG examination. Methods: The study design was a prospective, cross-sectional observational study. The research was conducted in July-September 2022 at Prof. dr. I G.N.G. Ngoerah General Hospital, Denpasar. The sample will be selected based on inclusion and exclusion criteria and then divided into two groups as a group with type 2 leprosy reaction and a group without type 2 leprosy reaction. The data were analyzed using SPSS version 25. The analysis was carried out in the form of descriptive and analytical analyses. The analytical analysis used is fisher's exact. Results: This study obtained 20 samples with an average age of 36.2±13.3 years. There were 40% of patients with type 2 leprosy reactions. All patients had polyneuropathy with 30% axonal type polyneuropathy and 70% mixed type. Bivariate analysis showed that there was no significant relationship between type 2 leprosy reaction to the type of peripheral neuropathy and the number of nerves involved based on ENMG examination (p=0.64). Conclusion: From this study, it can be concluded that there was no statistically significant relationship between the type 2 leprosy reaction to the type of peripheral neuropathy and the number of nerves involved based on the ENMG examination.   Latar belakang: Kusta merupakan infeksi bakteri yang masih menjadi  penyakit terbengkalai. Penyakit ini dapat menimbulkan terjadinya neuropati perifer meskipun telah melakukan pengobatan yang rutin. Untuk itu deteksi dini neuropati perifer pada pasien kusta sangat penting. ENMG diketehui memiliki sensitivitas dan spesifisitas yang cukup baik dalam mendeteksi hal tersebut. Maka dari itu, penelitian ini bertujuan untuk mengetahui hubungan antara reaksi kusta tipe 2 dengan resiko neuropati perifer melalui pemeriksaan ENMG. Metode: Disain penelitian ini merupakan observasional prospektif, potong lintang. Penelitian dilakukan pada bulan Juli-September 2022 di RSUP Prof. dr. I G.N.G. Ngoerah, Denpasar. Sampel akan diseleksi berdasarkan kriteria inklusi dan eksklusi kemudian di bagi menjadi dua kelompok yaitu, kelompok dengan reaksi kusta tipe 2 dan kelompok tanpa rekasi kusta tipe 2. Data dianalisis menggunakan SPSS versi 25. Analisis yang dilakukan berupa analisis deskriptif, dan analitik. Analisis analitik yang digunakan berupa fisher’s exact. Hasil: Pada penelitian ini mendapatkan 20 sampel dengan rata-rata berusia 36,2±13,3 tahun. Terdapat 40% pasien dengan reaksi kusta tipe 2. Seluruh pasien mengalami polineuropati dengan 30% merupakan polineuropati tipe aksonal dan 70% tipe campuran. Analissi bivariat menunjukkan tidak ditemukannya hubungan yang signifikan antara rekasi kusta tipe 2 terhadap jenis nauropati perifer dan jumlah saraf yang terlibat berdasarkan pemeriksaan ENMG (p=0,64). Simpulan: Dari penelitian ini dapat disimpulkan bahwa tidak ditemukannya hubungan yang signifikan secara statistik antara rekasi kusta tipe 2 terhadap jenis nauropati perifer dan jumlah saraf yang terlibat berdasarkan pemeriksaan ENMG.
Preeklampsia dengan gambaran berat sebagai faktor risiko kejadian asfiksia neonatorum I Putu Gede Danika Adikarya; Gede Alit Wardana
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1525

Abstract

Background: Asphyxia neonatorum is one of the most frequent perinatal issues caused by preeclampsia, which is one of the most common prenatal disorders. Neonatal asphyxia is one of the health problems that is very important to pay attention to because this condition is associated with perinatal morbidity and mortality. Several maternal conditions are thought to be associated with neonatal asphyxia, including maternal age, gestational age, obstetric history, degree of preeclampsia, and method of delivery. This study aims to confirm this hypothesis. Methods: This study used an observational analytic design with a cross sectional design conducted between June 2021 and June 2022 at the Department of Obstetrics and Gynecology at Wangaya Hospital Denpasar, 97 pregnant women with preeclampsia were included. The research data were obtained through direct recording from medical records. The data collected were maternal age, gestational age, gravida, parity, history of abortion, degree of preeclampsia and method of delivery. Results: Pregnant women with preeclampsia who had gestational age <37 weeks [p = 0.021; OR = 3.27 (1,2-8.8)], has a gravida of 1 and > 3 [p = 0.019; OR = 2.97 (1,2-7,1)], has a parity of 1 and > 3 [p = 0.033; OR = 2.62 (1.1-6.1)], had preeclampsia with severe features [p = 0.002; OR = 5.62 (1.7-17.8)], and delivered by SC [p = 0.005; OR = 6.9 (1.5-31.9)] had a higher probability of having a child with asphyxia neonatorum. Meanwhile, the mother's age at delivery [p = 0,516; OR = 0.72 (0.3-1.7)] and history of abortion [p = 0.074; OR = 2.53 (0.9-6.7)] is not a factor that causes asphyxia neonatorum. Conclusions: Factors related to the incidence of asphyxia neonatorum in pregnant women with preeclampsia are gestational age, gravida, parity, degree of preeclampsia, and method of delivery.   Latar Belakang: Preeklampsia merupakan salah satu penyulit kehamilan yang sangat umum ditemukan dan menyebabkan berbagai masalah perinatal, salah satunya asfiksia neonatorum. Asfiksia neonatorum merupakan salah satu masalah kesehatan yang sangat penting untuk diperhatikan karena kondisi ini terkait dengan morbiditas dan mortalitas perinatal. Beberapa kondisi maternal diduga terkait dengan asfiksia neonatorum, antara lain usia ibu, usia kehamilan, riwayat obstetri, derajat preeklampsia, dan metode persalinan. Penelitian ini bertujuan untuk mengkonfirmasi hipotesis tersebut.   Metode: Penelitian ini menggunakan rancangan analitik observasional dengan desain cross sectional yang melibatkan 97 orang ibu hamil dengan preeklampsia di Departemen Obstetri dan Ginekologi RSUD Wangaya Denpasar periode bulan Juni 2021 sampai Juni 2022. Data penelitian diperoleh melalui pencatatan langsung dari rekam medis. Data yang dikumpulkan adalah usia ibu, usia kehamilan, gravida, paritas, riwayat abortus, derajat preeclampsia dan metode persalinan Hasil: Ibu hamil dengan preeklampsia yang memiliki usia kehamilan < 37 minggu [p = 0,021; OR = 3,27 (1,2-8,8)], memiliki gravida 1 dan > 3 [p = 0,019; OR = 2,97 (1,2-7,1)], memiliki paritas 1 dan > 3 [p = 0,033; OR = 2,62 (1,1-6,1)], mengalami preeklampsia dengan gambaran berat [p = 0,002; OR = 5,62 (1,7-17,8)], dan bersalin secara SC [p = 0,005; OR = 6,9 (1,5-31,9)] memiliki kemungkinan lebih besar untuk memiliki anak yang mengalami asfiksia neonatorum. Sedangkan usia ibu saat bersalin [p = 0,516; OR = 0,72 (0,3-1,7)] dan riwayat abortus [p = 0,074; OR = 2,53 (0,9-6,7)] bukanlah faktor yang menyebabkan terjadinya asfiksia neonatorum. Kesimpulan: Faktor yang berhubungan dengan kejadian asfiksia neonatorum pada ibu hamil dengan preeklampsia adalah usia kehamilan, gravida, paritas, derajat preeklampsia, dan metode persalinan
Tatalaksana laser CO2 pada hiperplasia kelenjar sebasea: laporan kasus Maylita Sari; Arisia Fadila; Muhammad Yulianto Listiawan; Bagus Haryo Kusumaputra; Irmadita Citrashanty
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1543

Abstract

Background: Sebaceous gland hyperplasia is a benign skin disorder in the form of macules or papules which are generally < 1 mm in size, skin color or yellowish at the mouth of the pilosebaceous gland follicle.1 This disorder can cause cosmetic morbidity and psychosocial impacts for patients. There are various treatment modalities for sebaceous gland hyperplasia associated with the risk of pain, depigmentation, bleeding during the procedure, scarring, and recurrence. CO2 laser is one of the therapeutic approaches that are considered effective and safe. Case: A female patient came with the chief complaint of lumpy skin-colored lumps on the back of the ear to the left neck that had increased in number and had not been painful since about 4 years ago. Histopathological examination was performed on the lump showing hyperplasia of the sebaceous glands. The patient was treated with 2 CO2 Laser sessions with an even skin surface result. Observations made within 9 months after the procedure did not reveal any recurrence of the lesion. Conclusion: CO2 laser can be an effective and safe alternative therapy for sebaceous gland hyperplasia.   Latar Belakang: Hiperplasia kelenjar sebasea adalah kelainan jinak kulit berupa makula atau papula yang umumnya berukuran < 1 mm sewarna kulit atau kekuningan di muara folikel kelenjar pilosebasea.1 Kelainan ini dapat menimbulkan morbiditas kosmetik dan dampak psikososial bagi pasien. Terdapat berbagai modalitas tatalaksana hiperplasia kelenjar sebasea yang berhubungan dengan risiko nyeri, depigmentasi, perdarahan selama prosedur, skar, hingga kekambuhan. Laser CO2 merupakan salah satu pendekatan terapi yang dianggap efektif dan aman. Kasus: Pasien wanita datang dengan keluhan utama benjolan bergerombol sewarna kulit pada telinga bagian belakang hingga leher kiri yang bertambah banyak dan tidak nyeri sejak kurang lebih 4 tahun yang lalu. Pemeriksaan histopatologi dilakukan pada benjolan menunjukkan hasil hiperplasia kelenjar sebasea. Pasien diterapi dengan 2 sesi Laser CO2 dengan hasil permukaan kulit rata. Observasi yang dilakukan dalam 9 bulan paska tindakan tidak didapatkan rekurensi pada lesi. Simpulan: Laser CO2 dapat menjadi alternatif terapi pada hiperplasia kelenjar sebasea yang efektif dan aman.
Faktor Yang Mempengaruhi Rekurensi Pada Pasien Kanker Payudara Pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah Made Revina Chandradewi; Ida Bagus Tjakra Wibawa Manuaba; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1544

Abstract

Background: In Indonesia, the incidence of breast cancer is 42,1 per 100,000 people, whereas the average mortality rate is 17 per 100,000 people. 8-10% of women with breast cancer will experience locoregional recurrence, and 15-30% may develop distant metastases. This study aimed to examine if cancer subtypes, histological grading, and LVI were linked with breast cancer recurrence in patients after Modified Radical Mastectomy at Prof. RSUP. Dr. I G.N.G. Ngoerah. Methods: Medical record data are used as the study data source to discover the factors that impact breast cancer recurrence in patients who have had a modified radical mastectomy. This research was done using a sequential sampling method. This study's sample utilized inclusion and exclusion criteria to generate 363 patients. The data obtained were analyzed using SPSS ver 22. Results: The results revealed that 327 patients, or 90.1%, did not have a recurrence, whereas 36 patients, or 9.9%, did. There were 50 Luminal A subtype patients, 127 Luminal B subtype patients, 61 Luminal-Her2 subtype patients, 65 Her2 subtype patients, and 60 TNBC subtype patients. 231 individuals were found to have a negative LVI, whereas 132 patients had a positive LVI. Forty-seven individuals were diagnosed with grade I, 174 with grade II, and 142 with grade III. Breast cancer recurrence was significantly impacted by LVI (p<0.05). Conclusion: LVI is strongly related to breast cancer recurrence in patients undergoing Modified Radical Mastectomy, but subtype and histological grading are not.   Latar Belakang: Angka kejadian kanker untuk kanker payudara di Indonesia sebesar 42,1 per 100.000 penduduk dengan rata-rata kematian sebesar 17 per 100.000 penduduk. Antara 8-10% wanita yang didiagnosis dengan kanker payudara akan mengalami kekambuhan locoregional dan 15-30% akan mengalami metastasis jauh. Tujuan penelitian ini dilakukan yaitu untuk mengetahui apakah subtipe kanker, grading histopatologi dan LVI menjadi faktor yang berhubungan dengan terjadinya rekurensi kanker payudara pada pasien pasca Modified Radical Mastectomy di RSUP Prof. Dr. I G.N.G Ngoerah. Metode: Desain penelitian cross sectional digunakan dalam penelitian ini, dimana data rekam medis menjadi sumber data penelitian. Penelitian menggunakan pengambilan sampel secara konsekutif. Sampel dalam penelitian menggunakan kriteria inklusi dan eksklusi dan diperoleh jumlah sampel 363 pasien. Data yang didapatkan dianalisis dengan menggunakan SPSS ver 22. Hasil: Hasil penelitian menunjukkan sebanyak 327 pasien atau sebesar 90,1% tidak rekuren, sedangkan 36 pasien atau sebesar 9,9% mengalami rekurensi. Terdapat 50 pasien dengan subtipe Luminal A, 127 pasien dengan subtipe Luminal B, 61 pasien dengan subtipe Luminal-Her2, 65 pasien dengan subtipe Her2, dan 60 pasien dengan subtipe TNBC. Dari 231 pasien didapatkan dalam kategori LVI negatif, sedangkan 132 pasien memiliki LVI positif. Sebanyak 47 pasien didapatkan dengan grade I, 174 pasien dengan dengan grade II, dan 142 pasien memiliki grade III. LVI memiliki pengaruh signifikan (p<0,05) terhadap rekurensi kanker payudara. Simpulan: LVI berhubungan signifikan terhadap rekurensi kanker payudara pada pasien pasca Modified Radical Mastectomy, sedangkan subtipe dan grading histopatologis tidak.

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