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Medical Scope Journal (MSJ)
Published by Universitas Sam Ratulangi
ISSN : -     EISSN : 27153312     DOI : https://doi.org/10.35790/msj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health
Medical Scope Journal (MSJ) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia (PAAI) Komisariat Manado bekerjasama dengan Fakultas Kedokteran Universitas Sam Ratulangi dua kali setahun pada bulan Juni dan Desember. Tulisan yang dimuat dapat berupa artikel telaah (review article), hasil penelitian, dan laporan kasus dalam bidang ilmu kedokteran baik dalam bahasa Indonesia maupun dalam bahasa Inggris.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 10 Documents
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Search results for , issue "Vol 2, No 2 (2021): Medical Scope Journal" : 10 Documents clear
Gagal Ginjal Kronik Hemodialisis dengan Kadar Eritropoietin dan Hemoglobin Normal: Laporan Kasus Amudi, Tulus; Palar, Stella
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32547

Abstract

Abstract: Generally, chronic kidney disease (CKD) is associated with anemia due to decrease of erythropoietin that plays an important role in erythropoiesis. We reported a patient, 61-year-old male, suffered from chronic hemodialysis kidney disease with coinfection of viral hepatitis C, albeit, had normal hemoglobin and erythropoietin levels. The patient was diagnosed as CKD in March 2014 with laboratory results, as follows: hemoglobin (Hb) 9.9 g/dl; ureum 223 mg/dl; creatinine 7.5 mg/dl, and was confirmed with ultrasonography. The patient underwent hemodialysis and was treated with erythropoiesis stimulating agent (ESA) for the first time in April 2014. The last ESA was given in June 2015 and the laboratory results were serum iron 61 µg/dl, total iron binding capacity (TIBC) 173 µg/dl, ferritin 1431 ng/ml, and the qualitative anti HCV test was reactive. Afterwards, the patient was not treated with ESA anymore since his Hb level was normal without ESA or blood transfusion. Moreover, the erythropoietin (EPO) level was tested in December 2018 resulted within normal level. Until now, the patient is still undergoing hemodialysis without ESA or transfusion. This is a rare condition, and there is still no certain pathophysiology to explain. It is assumed that the mechanism is related to hepatitis C infection that stimulates the hepatocyte regeneration, therefore, the cells produce endogen erythropoietin resulting in increased Hb level.Keywords: chronic kidney disease (CKD), erythropoietin and hemoglobin level Abstrak: Umumnya penyakit ginjal kronik (PGK) disertai dengan anemia akibat penurunan eritropoietin yang berperan penting dalam proses eritropoiesis. Kami melaporkan kasus seorang laki-laki 61 tahun dengan PGK hemodialisis disertai ko-infeksi hepatitis C namun dengan kadar hemoglobin dan eritropoietin normal. Pasien dinyatakan PGK sejak Maret 2014 dengan kadar hemoglobin (Hb) 9,9 g/dL; ureum 223 mg/dl; kreatinin 7,5 mg/dl, dan didukung oleh hasil ultrasonografi. Pasien diberikan hemodialisis dan terapi ESA pertama kali pada bulan April 2014. Terapi ESA terakhir diberikan pada bulan Juni 2015 dengan hasil serum iron 61 µg/dl, total iron binding capacity (TIBC) 173 µg/dl, feritin 1431 ng/ml, dan anti HCV kualitatif reaktif, Setelah itu pasien tidak mendapat terapi ESA lagi karena pada pemeriksaan laboratorium ditemukan kadar hemoglobin normal tanpa terapi ESA atau transfusi darah. Pemeriksaan kadar eritropoietin (EPO) pada bulan Desember 2018 mendapatkan hasil 16 mIU/ml (nilai normal 2,6-18,5 mIU/ml). Hingga saat ini pasien masih rutin menjalani hemodialisis dan tidak pernah mendapat terapi ESA atau transfusi darah. Keadaan tersebut jarang ditemukan, dan tidak ada patofisologi yang pasti untuk menjelaskan penyebab keadaan tersebut. Mekanisme keadaan ini dikaitkan dengan infeksi hepatitis C yang merangsang regenerasi hepatosit, sehingga sel-sel tersebut menghasilkan hormon ertiropoietin endogen, dengan hasil akhir ialah peningkatan hemoglobin.Kata kunci: penyakit ginjal kronik (PGK), kadar eritropoietin dan hemoglobin
Pengaruh Kafein terhadap Tekanan Intraokular Juanito, Julian; Supit, Wenny P.; Rares, Laya M.
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.31851

Abstract

Abstract: High intraocular pressure (IOP) is one of the risk factors of glaucoma or worsening of its prognosis. There are a lot of external factors that can affect IOP inter alia exercise, as well as some food and drinks. One of the drinks that could affect IOP is coffee that contains caffeine. This study was aimed to evaluate whether caffeine had an effect on IOP. This was a literature review study using 4 data bases, as follows: Clinical Key, Pub-med, Google Scholar, and Science Direct. The keywords were Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Based on inclusion and exclusion criteria, 10 literatures were selected. The results showed that some literatures reported an increase in IOP after caffeine consumption, the others reported a decrease in IOP, meanwhile some others did not find any change of IOP. In conclusion, the effect of caffeine on IOP was acute. People who had high intensity of caffeine consumption had a more significant increase in IOP after consuming caffeine.Keywords: caffeine, intraocular pressure (IOP)  Abstrak: Peningkatan tekanan intraokular (TIO) merupakan salah satu faktor risiko untuk terjadinya glaukoma atau memperburuk prognosis glaukoma. Terdapat banyak faktor eksternal yang dapat memengaruhi TIO, antara lain olahraga, minuman, dan makanan. Salah satu minuman yang dapat memengaruhi TIO ialah kopi yang mengandung kafein. Penelitian ini bertujuan untuk mengetahui adanya pengaruh kafein pada tekanan intraokular. Jenis penelitian ialah literature review. Pencarian data menggunakan empat database yaitu Clinical key, PubMed, Google scholar, dan Science direct. Kata kunci yang digunakan yaitu Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Seleksi data berdasarkan kriteria inklusi dan ekslusi mendapatkan 10 literatur. Hasil kajian mendapatkan bahwa beberapa penelitian melaporkan adanya peningkatan TIO setelah konsumsi kafein, penelitian lain melaporkan penurunan TIO, dan terdapat pula penelitian yang tidak menemukan perubahan apapun. Simpulan penelitian ini ialah pengaruh kafein pada TIO hanya berlangsung akut. Individu yang memiliki intensitas konsumsi kafein lebih tinggi menunjukkan peningkatan TIO yang lebih nyata setelah mengonsumsi kafein.Kata kunci: kafein, tekanan intraokular (TIO) 
Perbandingan Leukosituria, Nitrit, Leukosit Esterase dengan Kultur Urin dalam Mendiagnosis Infeksi Saluran Kemih pada Anak Sabriani, Jehan; Umboh, Adrian; Manoppo, Jeanette I. Ch.
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32596

Abstract

Abstract: Urinary tract infection (UTI) in children is the most common infection after upper airway infection. The diagnosis of UTI is based on urine culture, however, this examination takes a longer time and is quite expensive. Therefore, the diagnosis of UTI can also be confirmed by using leukocyturia, nitrite, and leukocyte esterase tests although they can not replace urine culture as the gold standard. This study was aimed to determine the accuracy of positive leukocyturia, positive nitrite, positive leukocyte esterase examination, combination of positive leukocyturia and nitrite examinations, positive leukocyturia and leukocyte esterase, and leukocyturia, nitrite, positive leukocyte esterase in diagnosing UTI. This was a literature review study. The results of the literature review showed that the range of accuracy of UTI diagnosis using positive leukocyte esterase examinations was 9-6.8%, positive nitrite was 2.8-100%, leukocyte esterase was 13.7-86%, combination of positive leukocyturia and nitrite had a sensitivity value of 33 %, and specificity of 94%, combination of positive leukocytic and leukocytic esterase had a sensitivity value of 70% and a specificity of 90%, and combination of leukocyturia, nitrite, and leukocyte esterase had an accuracy range of 100%. In conclusion, these examinations coul be used to confirm the diagnosis of UTI in children especially if the urine culture can not be performed on them.Keywords: urinary tract infection (UTI), leukocyturia, nitrite, leukocyte esterase, urine culture, children Abstrak: Infeksi saluran kemih (ISK) merupakan infeksi yang paling sering terjadi pada anak setelah infeksi saluran napas atas. Diagnosis ISK ditegakkan berdasarkan hasil pemeriksaan kultur urin, namun pemeriksaan ini membutuhkan waktu yang lama dan biaya yang cukup mahal. Pemeriksaan leukosituria, nitrit, dan leukosit esterase juga membantu dalam mendiagnosis ISK, namun ketiga pemeriksaan ini belum dapat menggantikan kultur urin sebagai baku emas untuk mendiagnosis ISK. Penelitian ini bertujuan untuk mengetahui seberapa besar ketepatan pemeriksaan leukosituria positif, nitrit positif, leukosit esterase positif, gabungan pemeriksaan leukosituria dan nitrit positif, leukosituria dan leukosit esterase positif, dan gabungan leukosituria, nitrit, leukosit esterase positif dalam mendiagnosis ISK. Jenis penelitian ialah literature review. Hasil penelitian menunjukkan kisaran ketepatan diagnosis ISK menggunakan pemeriksaan leukosituria positif yaitu 9-6,8%, nitrit positif sebesar 2,8-100%, leukosit esterase sebesar 13,7-86%, gabungan leukosituria dan nitrit positif memiliki nilai sensitivitas 33%, dan spesifisitas sebesar 94%, gabungan leukosituria dan leukosit esterase positif memiliki nilai sensitivitas 70% dan spesifisitas sebesar 90%, serta gabungan pemeriksaan leukosituria, nitrit, dan leukosit esterase memiliki kisaran ketepatan sebesar 100%. Simpulan penelitian ini ialah pemeriksan-pemeriksaan tersebut dapat membantu menegakkan diagnosis ISK pada anak terutama bila kultur urin tidak memungkinkan dilakukan.Kata kunci: infeksi saluran kemih (ISK), leukosituria, nitrit, leukosit esterase, kultur urin, anak
Karsinoma Sel Basoskuamosa Palpebra Rekuren: Laporan Kasus Supit, Wenny
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.33546

Abstract

Abstract: Basosquamous carcinoma (BSCC) is a rare type of skin cancer with an incidence of less than 2% of all skin cancers and the risk of local recurrence ranges between 15% and 50%. We reported a male, aged 57 years old, working as a civil employee, came to the eye clinic with a recurrent BSCC in the right lower palpebral since a month ago. The patient was previously diagnosed as BSCC and had undergone a surgery to remove cancer cells in 2017. However, in 2019, a scan of the axial incision of the head revealed a tumor mass in the right infraorbital area with T4N0Mx. The hypodense structured tumor mass showed increased contrasting. The opera-tive management performed was extensive excision and deep excision with rotational flaps and drainage attached. Histopathological examination of the tumor tissue and excision margins, optic nerve tissue, as well as infraorbital bone tissue indicated a BSCC. Diagnosis of BSCC was confirmed based on anamnesis, physical examination, ophthalmic examination, head CT scan with contrast, and histopathological examination. This case report was aimed to explore BSCC especially in palpebra due to the lack of data of similar cases as well as the potential for diagnosis and promising management.Keywords: basosquamous carcinoma (BSCC), palpebral, reccurent  Abstrak: Karsinoma basoskuamosa (BSCC) merupakan jenis kanker kulit yang langka dengan kejadian kurang dari 2% dari semua jenis kanker kulit namun dengan risiko kekambuhan lokal berkisar 15% dan 50%. Kami melaporkan kasus seorang laki-laki berusia 57 tahun, bekerja sebagai ASN, datang ke klinik mata dengan BSCC palpebra kanan bawah berulang sejak satu bulan lalu. Pasien sebelumnya didiagnosis dengan BSCC dan telah menjalani operasi untuk mengangkat sel kanker pada tahun 2017. Namun, pada tahun 2019, pemindaian kepala sayatan aksial menunjukkan adanya massa tumor di area infraorbital kanan dengan T4N0Mx. Massa tumor berstruktur hipodens dengan kontras yang meningkat. Manajemen operatif dilakukan eksisi ekstensif dan eksisi dalam dengan flap rotasi dan drainase terpasang. Pemeriksaan histopatologik dilakukan terhadap jaringan tumor dan margin eksisi, jaringan saraf optik, serta jaringan tulang infraorbital dengan simpulan suatu BSCC. Pada kasus ini diagnosis BSCC ditegakkan berdasarkan anamnesis, pemeriksaan fisik, pemeriksaan oftalmologi, pemeriksaan penunjang berupa CT scan kepala dengan kontras, dan pemeriksaan histopatologik. Laporan kasus ini bertujuan untuk mendalami BSCC khususnya di palpebra karena minimnya data mengenai kasus yang serupa, serta potensi diagnosis dan penatalaksanaan yang menjanjikannya.Kata kunci: karsinoma basoskuamosa (BSCC), palpebra, rekuren
Gangguan Fungsi Hati pada Coronavirus Disease 2019 Salsabila, Tasha; Waleleng, Bradley J.; Pandelaki, Karel
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.31959

Abstract

Abstract: The incidence and death rate of COVID-19 in North Sulawesi Province continues to increase and data regarding abnormal liver function in COVID-19 is not yet available. This study was aimed to obtain the liver function in COVID-19 patients. This was a literature review study using two databases, namely Pubmed and ClinicalKey. Keywords used were abnormal liver function AND COVID-19, elevated alanine aminotransferase AND COVID-19, elevated aspartate aminotransferase AND COVID-19, elevated gamma-glutamyl transferase AND COVID-19, elevated alkaline phosphatase AND COVID-19, elevated total bilirubin AND COVID-19. After being selected, 10 literatures were obtained based on inclusion and exclusion criteria. The results showed that increased liver function often occurred in cases of COVID-19, but the increase did not reach twice of the normal value. The most frequent increases were in GGT, followed by ALT and AST, total bilirubin, and the least was the increase in ALP. All literatures reported that increased liver function was more common in males, and in severe COVID-19 patients reported by eight literatures. Five literatures reported that elevated liver function increased mortality in COVID-19 cases. In conclusion, there are increases in ALT, AST, ALP, GGT, and total bilirubin levels in COVID-19 patients.Keywords: abnormal liver function, COVID-19 Abstrak: Angka kejadian dan angka kematian COVID-19 di Provinsi Sulawesi Utara terus bertambah sedangkan data mengenai gambaran gangguan fungsi hati pada COVID-19 belum tersedia. Penelitian ini bertujuan untuk mengetahui gambaran fungsi hati pada COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan dua database yaitu Pubmed dan ClinicalKey. Kata kunci yang digunakan yaitu abnormal liver function AND COVID-19, elevated alanine aminotransferase AND COVID-19, elevated aspartate aminotransferase AND COVID-19, elevated gamma-glutamyl transferase AND COVID-19, elevated alkaline phosphatase AND COVID-19, elevated total bilirubin AND COVID-19. Setelah diseleksi, didapatkan 10 literatur berdasarkan kriteria inklusi dan eksklusi. Penelitian ini mendapatkan bahwa peningkatan fungsi hati sering terjadi pada kasus COVID-19 namun peningkatannya tidak mencapai dua kali nilai normal. Peningkatan paling sering terjadi pada GGT, diikuti oleh ALT dan AST, bilirubin total, dan paling sedikit yaitu pada peningkatan ALP. Seluruh literatur melaporkan peningkatan fungsi hati lebih sering terjadi pada laki-laki dan pada kasus COVID-19 gejala berat dilaporkan oleh delapan literatur. Lima literatur melaporkan peningkatan fungsi hati meningkatkan mortalitas pada kasus COVID-19. Simpulan penelitian ini ialah, terdapat peningkatan kadar ALT, AST, ALP, GGT, dan bilirubin total pada penderita COVID-19.Kata kunci: gangguan fungsi Hati, COVID-19
Hubungan Lingkar Pinggang, Homeostasis Model Assessment of Insulin Resistance, dan Prostaglandin-I2 dengan Test Agregasi Trombosit pada Subyek Obesitas Sentral Renata, Lucrezia; Pandelaki, Karel; Rotty, Linda W. A.
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32597

Abstract

Abstract: Overweight and obese are global health problems and tend to increase in Indonesia. Central obesity is associated with inflammation, insulin resistance, and increased reactive oxidative stress. Insulin resistance can cause a decrease in prostaglandin I2 (PGI2) and nitric oxide (NO) levels, and an increase in platelet aggregation. Its effect in platelet aggregation may increase thrombus formation in blood vessels. This study was aimed to determine the relationship between waist circumference (WC) with HOMA-IR, PGI2 and platelet aggregation test (PAT) in central obese subjects. This was an observational and analytical correlational study with a cross-sectional design conducted at Prof. dr. R. D. Kandou Hospital, Manado. Samples were 33 central obese subjects, 19 were male and 14 were female. Insulin resistance was measured by using HOMA- IR, urine PGI2, and PAT. The Spearmann and Pearson correlation test showed a positive correlation between WC and HOMA-IR (r=0.366, p=0.036). There was a negative correlation but not significant between WC and PGI2 (r=-0.169, p=0.347); between WC and PAT (r=0.094, p=0.603); between HOMA-IR and PGI2 (r=-0.218, p=0.223); and between HOMA-IR and PAT (r=0.080, p=0.658). In conclusion, in central obese people, there  is a relationship between WC and HOMA-IR, but there is no relationship between WC, PGI2, and PAT.Keywords: central obesity, HOMA-IR, prostaglandin-I2, platelet aggregation test Abstrak: Berat badan berlebih atau obesitas merupakan masalah kesehatan global dan terus meningkat di Indonesia. Pada obesitas sentral terjadi inflamasi, resistensi insulin, dan mening-katnya reaktif oksidatif stress. Resistensi insulin mampu menyebabkan penurunan kadar prostaglandin I2 (PGI2) dan nitrik oksida (NO). Penurunan kadar PGI2 dapat menyebabkan peningkatan agregasi trombosit yang selanjutnya meningkatkan kemungkinan terjadinya trombus dalam pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan antara lingkar pinggang dengan HOMA-IR, PGI2, dan test agregasi trombosit (TAT) pada subyek obes sentral. Jenis penelitian ialah observasional analitik bentuk korelasional dengan desain potong lintang. Penelitian dilakukan di RSUP Prof. dr. R. D. Kandou Manado. Total sampel 33  subyek dengan obesitas sentral, 19 laki-laki dan 14 perempuan. Pengukuran resistensi insulin menggunakan HOMA-IR, PGI2 urin, dan TAT. Uji korelasi Spearmann dan Pearson. mendapatkan korelasi positif antara LP dengan HOMA-IR (r=0,366; p=0,036). Terdapat korelasi negatif tidak bermakna pada hubungan antara LP dengan PGI2 (r=-0,169; p=0,347); hubungan antara LP dengan TAT (r=0,094; p=0,603); hubungan antara HOMA-IR dengan PGI2 (r=-0,218;p=0,223); dan hubungan antara HOMA-IR dengan TAT (r=0,080; p=0,658). Simpulan penelitian ini ialah pada subyek obes sentral terdapat hubungan antara lingkar pinggang dengan HOMA-IR, tetapi tidak terdapat hubungan antara lingkar pinggang dengan PGI2 dan TAT.  Kata kunci: obesitas sentral, HOMA-IR, prostaglandin-I2, tes agregasi trombosit
Kelainan Refraksi Mata pada Anak Saiyang, Bella; Rares, Laya M.; Supit, Wenny P.
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32115

Abstract

Abstract: Refractive errors (ametropia) is caused by abnormality of the axial length or abnormality of refractive power of the eye. In children, refractive errors could cause blindness dure to lack of family attention. This study was aimed to obtain the general view of refractive errors among children. This was a literature review study using data of Google Search, ClinicalKey, and Google Scholar. Data were selected based on inclusion and exclusion criteria. There were 10 literatures selected, consisting of 2 case control studies and 8 cross-sectional studies. The results showed that refractive errors in children -myopia, hypermetropia, and astigmatism- were increasing not only in Indonesia. Refractive errors in children were classified according to sex and age with different disorders. Each child was examined by using gold standar. In conclusion, refractive errors in children were myopia, hypermetropia, and astigmatism. There was no significant difference between male and female. In children, studies of various age groups ranging from elementary to high school. This disorder could also occur based on the children’s activities, therefore, family attention was really needed.Keywords: refractive errors, children Abstrak: Kelainan refraksi (ametropia) dapat diakibatkan adanya kelainan axial length atau daya refraksi mata. Pada anak, gangguan refraksi menjadi salah satu penyebab kebutaan terbesar tanpa adanya perhatian dari keluarga. Penelitian ini bertujuan untuk mendapatkan gambaran umum kelainan refraksi mata pada anak. Jenis penelitian ialah literature review. Pencarian data didapatkan dari Google Search, ClinicalKey dan Google Scholar. Seleksi data berdasarkan kriteria inklusi dan ekslusi, dan didapatkan 10 literatur yang terdiri dari 2 case control dan 8 studi potong lintang. Hasil penelitian mendapatkan bahwa kelainan refraksi pada anak berupa miopia, hipermetropia, dan astigmatisma yang meningkat bukan hanya di Indonesia. Kelainan refraksi pada anak digolongkan berdasarkan jenis kelamin dan usia dengan kelainan yang berbeda-beda. Setiap anak dilakukan pemeriksaan dengan menggunakan baku emas. Simpulan penelitian ini ialah kelainan refraksi pada anak dapat berupa miopia, hipermetropia, dan astigmatisma. Tidak terdapat perbedaan bermakna antara jenis kelamin laki-laki dan perempuan. Penelitian pada anak dilakukan pada berbagai golongan usia mulai dari sekolah dasar sampai sekolah menengah. Kelainan refraksi dapat pula terjadi berdasarkan aktivitas yang dilakukan anak sehingga perhatian dari keluarga sangat dibutuhka.Kata kunci: kelainan refraksi, anak
Hipernatremia dan Penatalaksanaanya Setyawan, Yuswanto
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32693

Abstract

Abstract: Hypernatremia could be caused by loss of water (increased loss or decreased intake), and although rarely, due to over intake of natrium. Patients who are at risk of hypernatremia are those with disturbance of thirst or limited access of water. Several factors that could cause hypernatremia especially among geriatric patients are, as follows: change of thirst stimuli, decreased ability to concentrate urine, and decreased total body water. Clinical signs of hypernatremia are usually not specific, however, patients tend to become symptomatic if hypernatemia occurs acutely. Hypernatremia clinical signs are mostly neurological related to the severity and the change of serum sodium concentration. Complications of hypernatremia are inter alia shrinkage of brain tissue due to the movement of water from intracellular to extracellular fluid which results in injury of brain vessels, bleeding in the brain, and a variety of neurological signs due to brain involovement which could lead to death. Management of hypernatremia has to be carried out accurately and thoroughly because inaccurate or too-rapid correction could risk the occurrence of cerebral edema.Keywords: hypernatremia, total body water  Abstrak: Hipernatremia dapat disebabkan oleh kehilangan air (peningkatan kehilangan atau penurunan asupan) dan, walaupun jarang, karena kelebihan asupan natrium. Yang berisiko tinggi untuk hipernatremia ialah mereka dengan gangguan mekanisme rasa haus atau keterbatasan akses terhadap air. Berbagai faktor dapat menyebabkan hipernatremia terutama pada geriatri seperti perubahan rangsangan haus, berkurangnya kemampuan pemekatan urin, dan berkurangnya total body water. Gejala klinis hipernatremia biasanya tidak spesifik namun pasien cenderung menjadi simtomatik saat hipernatremia terjadi secara akut. Gejala hipernatremia terutama bersifat neurologik terkait dengan tingkat keparahan dan kecepatan perubahan konsentrasi natrium serum. Komplikasi hipernatremia ialah antara lain penyusutan otak akibat perpindahan cairan intrasel ke ekstrasel yang dapat merobek pembuluh darah otak, pendarahan otak, dan berbagai gejala neurologik akibat keterlibatan otak, yang dapat berakhir fatal. Penatalaksanaan hipernatremia perlu dilakukan dengan cermat karena penanganan yang tidak tepat atau koreksi yang terlalu cepat dapat berisiko terjadinya edema serebri.Kata kunci: hipernatremia, total body water
Gambaran Fungsi Kognitif Pasien Pasca Stroke Boletimi, Reinaldi O.; Kembuan, Mieke A. H. N.; Pertiwi, Junita M.
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32546

Abstract

Abstract: Stroke or brain attack occurs directly and its incidence is still very high until now. It is reported that two-thirds of stroke patients suffered from cognitive impairment leading to dementia within three months after stroke that can interfere with one’s daily activities if left untreated. This study was aimed to obtain the description of cognitive function in post-stroke patients. This was a literature review study using three databases, as follows: Goggle Scholar, Pubmed, and Clinical Key, and the keywords were cognitive impairment, cognitive decline, post-stroke, and MoCA. There were 10 literatures that met the inclusion and exclusion criteria. The results showed that many post-stroke patients showed cognitive function decline in the visuospatial/executive, memory, language, attention, and abstract domains. Cognitive impairment occured mostly in male patients, age 60 years and over, low education, ischemic stroke, left hemisphere lesion, with a history of hypertension. In conclusion, there is a relationship between post-stroke cognitive impairment and the location of lesion, age, and education level, albeit, there was no relationship between the cognitive impairment and gender as well as diabetes mellitus.Keywords: cognitive impairment, post-stroke, MoCA Abstrak: Stroke menyerang otak secara langsung dengan angka kejadian yang masih sangat tinggi sampai saat ini. Dua pertiga pasien stroke dilaporkan mengalami gangguan fungsi kognitif yang berujung pada demensia dalam tiga bulan pasca stroke serta dapat mengganggu aktivitas sehari-hari bila dibiarkan. Penelitian ini bertujuan untuk mendapatkan gambaran fungsi kognitif pasien pasca stroke. Jenis penelitian ialah literature review, dengan pencarian literatur pada tiga database yaitu Goggle Scholar, Pubmed, dan Clinical Key. Kata kunci yang digunakan ialah penurunan fungsi kognitif, pasca stroke, dan MoCA. Hasil seleksi mendapatkan 10 literatur yang memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan bahwa pada pasien pasca stroke sering terjadi penurunan fungsi kognitif dengan domain visuospasial/eksekutif, memori, bahasa, atensi, dan abstrak yang paling sering terganggu. Penurunan fungsi kognitif banyak ditemukan pada pasien laki-laki, usia 60 tahun ke atas, jenjang pendidikan rendah, stroke iskemik, lesi hemisfer kiri, dengan riwayat hipertensi. Simpulan penelitian ini ialah adanya hubungan antara penurunan fungsi kognitif dengan lokasi lesi, usia, dan jenjang pendidikan namun tidak terdapat hubungan dengan jenis kelamin dan diabetes melitus.Kata kunci: gangguan kognitif, pasca stroke, MoCA
Penilaian Jaringan Parut Paska Insisi Kulit Menggunakan Patient and Observer Scar Assessment Scales (POSAS): Perbandingan Hasil Penggunaan Monopolar Electrosurgery dan Pisau Bedah Barends, David; Hatibie, Mendy; Manginstar, Christian; Rawung, Rangga; Langi, Fima FL
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32731

Abstract

Abstract: Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been used as a substitute for scalpels but has not been accepted as standard due to burns and injuries. Patient and observer scar assessment scale (POSAS) is a subjective scar assessment of the patient as well as the observer. This study was aimed to compare post-skin-incision scarring of monopolar electrosurgery and scalpel, and evaluate the appropriateness of scar assessments of the observer and the patient by using POSAS. This was a self-controlled trial design. Post-incision scar tissue assessment was carried out simultaneously by the observer and the patient in the third month after the operation was completed. The paired t test or Wilcoxon rank sum test showed that the differences of assessments of either patient or observer or both were not significant (p=0.05). The correlation test between the total POSAS scores of the patient and observer assessments showed a moderate linear relationship (r=0.51; p<0.001). In conclusion, the use of monopolar electrosurgery and scalpel in performing skin incisions resulted in the formation of equally good scar tissues. The POSAS assessments of patient and observer showed a moderate degree of similarity.Keywords: electrocautery, scar tissue, surgery scalpel, patient and observer scar assessment scale (POSAS)  Abstrak: Pisau bedah dahulu dianggap sebagai standar emas dalam insisi pembedahan. Electrosurgery telah digunakan sebagai pengganti pisau bedah namun belum diterima sebagai standar karena luka bakar dan cedera. Patient and observer scar assessment scale (POSAS) merupakan instrumen penilaian jaringan parut yang bersifat subyektif baik dari pasien maupun observer. Penelitian ini bertujuan untuk membandingkan jaringan parut pasca insisi kulit antara monopolar electrosurgery dan pisau bedah serta mengevaluasi kesesuaian penilaian jaringan parut hasil insisi kulit dari dokter pengamat dan pasien saat keduanya meng-gunakan POSAS. Desain penelitian ialah self-controlled trial. Setiap subjek mendapat dua macam perlakuan secara bersamaan: operasi dengan monopolar electrosurgery dan pisau bedah. Penilaian jaringan parut pasca insisi dilakukan bersamaan oleh observer dan pasien pada bulan ketiga setelah operasi selesai. Hasil paired t test atau Wilcoxon rank sum test terhadap penilaian dalam bentuk skor baik dari pasien atau observer ataupun keduanya terhadap perbedaan jaringan parut oleh penggunaan kedua modalitas tidak bermakna (p>0,05). Uji korelasi antara skor total POSAS dari pasien dan observer menunjukkan adanya hubungan linear sedang (r=0,51; p<0,001). Simpulan penelitian ini ialah penggunaan monopolar electrosurgery mau-pun pisau bedah untuk insisi kulit menghasilkan pembentukan jaringan parut yang sama baik. Penggunaan POSAS dalam penilaian jaringan parut memperlihatkan tingkat kesamaan sedang antara pasien dan observer.Kata kunci: electrocautery, jaringan parut, pisah bedah, patient and observer scar assessment scale (POSAS)

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