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eJurnal Kedokteran Indonesia
Published by Universitas Indonesia
ISSN : 23501426     EISSN : 23386037     DOI : 10.23886
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Elektronik Journal Kedokteran Indonesia (eJKI) is a peer-reviewed and open access journal that prioritize the publication manuscript of students (medical education program, magister/specialist, doctoral). This journal publishes editorial, research article, reviews, evidence-based case report, and also interesting case reports/case study. eJKI published three times a year (April, August, December) and published by Faculty of Medicine Universitas Indonesia
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Search results for , issue "Vol 3, No 2 (2015): Agustus" : 12 Documents clear
From Evidence-Based Medicine to Value-Based Practice in Cancer Care: To Answer the Gap between Patient’s Expectation and Reality Nadra Septiadi; Nicolaus N. Wahjoepramono
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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The Association Between LH Serum Levels at the time of hCG Injection and Clinical Pregnancy during IVF Budi Wiweko; Bram Pradipta; Muharam Natadisastra; Kanadi Sumapraja; Eliza Mansyur; Tita Yuningsih; Andon Hestiantoro
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Some studies showed that recombinant follicle stimulating hormone (r-FSH) administration without LH supplementation has a good success rate on in vitro fertilization (IVF). However, LH role in IVF has been controversial. This study was conducted to evaluate the association between serum LH levels at the time of hCG injection and clinical pregnancy during IVF. This retrospective study included 136 patients underwent long protocol IVF from January 2005 to December 2009 in Yasmin Clinic, Cipto Mangunkusumo Hospital, Jakarta. The controlled ovarian hyper-stimulation protocol used in this study was gonadotropin-releasing hormone (GnRH) agonist and r-FSH. Serum LH level was measured on the day of hCG administration and the outcome evaluated was the clinical pregnancy following IVF cycles. There were 32 IVF cycles resulted in pregnancy out of 136 cycles (23.5%). There was significant difference between serum LH levels on the day of hCG administration and clinical pregnancy outcome (p=0.036). LH serum level cut-off value of ≥1.050 IU/l was the best value to predict pregnancy outcome with 62.5% sensitivity, 59.4% specificity, 83.3% positive predictive value, and 32.76% negative predictive value. It was concluded that there was an association between serum LH levels at the time of hCG injection and clinical pregnancy during IVF. Keywords: IVF cycles, LH levels serum, hCG administration Hubungan Kadar LH saat Penyuntikan hCG dengan Kejadian Kehamilan pada Fertilisasi In vitro Abstrak Pemberian follicles stimulating hormone rekombinan (r-FSH) tanpa suplementasi LH memiliki tingkat keberhasilan fertilisasi in vitro (FIV) yang baik namun, peran LH pada FIV masih kontroversial. Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara kadar serum LH pada hari penyuntikan hCG dengan kehamilan klinis selama FIV. Penelitian retrospektif ini melibatkan 136 perempuan yang menjalani FIV siklus pertama dengan protokol panjang mulai bulan Januari 2005 sampai Desember 2009 di klinik Yasmin, Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Protokol hiperstimulasi ovarium yang digunakan adalah agonis gonadotropin-releasing hormone (GnRH) dan r-FSH. Kadar LH serum diukur pada hari pemberian hCG dan outcome penelitian yang dievaluasi adalah kehamilan klinis. Kehamilan terjadi pada 32 siklus FIV dari 136 siklus (23,5%). Terdapat perbedaan bermakna antara kadar serum LH pada hari penyuntikan hCG dengan kehamilan klinis (p = 0,036). Titik potong kadar serum LH ≥1,050IU/l adalah nilai terbaik untuk memprediksi hasil kehamilan dengan sensitivitas 62,5%, 59,4% spesifisitas, nilai prediksi 83,3% positif, dan nilai prediksi 32,76% negatif. Disimpulkan bahwa terdapat hubungan antara kadar serum LH pada hari penyuntikan hCG dengan kehamilan klinis selama FIV. Kata kunci: siklus IVF, kadar LH serum, pemberian hCG
Pengaruh Akupunktur Pergelangan Tangan dan Kaki terhadap Nyeri Punggung Bawah Indra T. Hidayat; Adiningsih Srilestari; Christina Simadibrata; Jan S. Purba
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Nyeri punggung bawah (NPB) adalah nyeri yang dirasakan di daerah punggung bagian bawah. Akupunktur memiliki efek analgesi. Banyak metode dan teknik rangsang dalam akupunktur, salah satunya akupunktur pergelangan tangan dan kaki. Penelitian ini bertujuan untuk mengetahui pengaruh akupunktur pergelangan tangan dan kaki terhadap nyeri punggung yang diukur dengan skor numeric analog scale (NAS) pada pasien NPB. Desain penelitian adalah uji klinis acak tersamar tunggal dengan kontrol yang mengikutsertakan 42 pasien NPB. Pasien dibagi menjadi 2 kelompok yaitu kelompok perlakuan (n=21) yang dilakukan akupunktur pergelangan tangan dan kaki area 5 dan 6 pergelangan kaki; kelompok kontrol (n=21) yang dilakukan akupunktur tubuh pada titik BL23 Shenshu, BL40 Weizhong, dan LI4 Hegu. Akupunktur dilakukan 2x seminggu selama 3 minggu. Di akhir terapi Terdapat penurunan skor NAS pada kedua kelompok setelah terapi ke-6. Perubahan skor NAS setelah terapi ke-6 pada kelompok perlakuan berbeda bermakna bila dibandingkan dengan kelompok kontrol (p=0.041). Akupunktur pergelangan tangan dan kaki memiliki pengaruh terhadap penurunan nyeri yang signifikan. Kata kunci: nyeri punggung bawah, akupunktur pergelangan tangan dan kaki, Numeric Analog ScaleEffect of Wrist and Ankle Acupuncture for Low Back Pain Abstract Low back pain (LBP) is pain felt in the lower back area. Acupuncture has an analgesic effect There are many methods and stimulation techniques used in acupuncture, one of which is wrist and ankle acupuncture (WAA). This study aimed to assess the efficacy of WAA in the treatment of pain in LBP. The Numeric Analog Scale (NAS) score was used to assess pain. The design was a single-blinded randomized control trial. The study involved 42 patients with LBP who were divided into 2 groups: treatment group (n = 2) which underwent wrist and ankle acupuncture to the Lower 5 and Lower 6 bilaterally; control group (n = 21) which underwent body acupuncture BL23 Shenshu, BL40 Weizhong, and LI4 Hegu. The treatment was applied twice a week for 3 weeks. The results showed a decline in the NAS scores significantly in both group after 6th therapy. Changes in the NAS score after 6th therapy in the treatment group was significantly different when compared with the control group (p = 0.041). Wrist and ankle acupuncture has significant effect on reducing LBP. Key words: low back pain, wrist and ankle acupuncture, Numeric Analog Scale
Efek Antioksidan Kombinasi Ekstrak Etanol Acalypha indica dan Centella asiatica pada Fungsi Hati Tikus Pascahipoksia Sistemik Agnes Frethernety; Melva Louisa; Novi S. Hardiany; Adisti Dwijayanti; Erni H. Purwaningsih
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Hipoksia adalah defisiensi suplai oksigen ke dalam sel atau jaringan karena gagalnya sistem respirasi yang membawa oksigen sehingga mengakibatkan kerusakan jaringan. Hati merupakan organ yang sensitif terhadap hipoksia. Tanaman Acalypha indica dan Centella asiatica memiliki efek antioksidan dan dapat melindungi banyak organ dari hipoksia. Tujuan penelitian ini menganalisis pengaruh pemberian kombinasi ekstrak etanol A.indica dan C.asiatica pascahipoksia sistemik terhadap fungsi hati, stres oksidatif dan aktivitas antioksidan hati. Sebanyak 28 tikus spraquedawley dibagi secara acak menjadi 7 kelompok. Kelompok kontrol adalah perlakuan tanpa hipoksia, perlakuan enam kelompok lainnya pascahipoksia 7 hari diberikan zat uji sebagai berikut: air, kombinasi dosis 1 dan 2, dosis tunggal A.indica, dosis tunggal C. asiatica dan dosis tunggal vitamin C selama 7 hari. Parameter yang diukur adalah aktivitas ALT dan AST, kadar MDA, rasio GSH/GSSG. Tidak ada perbedaan aktivitas ALT dan AST yang bermakna pada semua kelompok. Kadar MDA meningkat pada kelompok pascahipoksia 7 hari dibanding kontrol (p=0,007). Kelompok kombinasi 1 memiliki MDA yang rendah, rasio GSH/GSSG dan aktivitas SOD yang meningkat dibandingkan kelompok pascahipoksia 7 hari. Pemberian zat uji kombinasi 1 memiliki efek perlindungan pada hati tikus terhadap pascahipoksia 7 hari melalui mekanisme stres oksidatif dan antioksidan. Kata kunci: Acalypha indica, Centella asiatica,hipoksia sistemik, antioksidan The Effect of A. Indica and C.Asiatica Ethanol Extract Combination on Rats Liver Function Post-Hypoxic Condition Abstract Hypoxia occurs due to the deficiency of oxygen supply to cells or tissue caused by the failure of the respiratory system that carries oxygen which results in cell or tissue damage. Liver is an organ sensitive to hypoxia. Acalypha indica and Centella asiatica are proven to have antioxidant effects and can protect many organs from hypoxic conditions. This study was aimed to analyse the effect of A. indica and C.asiatica ethanol extract combination on post-hypoxic condition towards liver function, oxidative stress and antioxidant activity of the liver. Twenty-eight spraque-dawley rats divided randomly into 7 groups. Control group was treated without hypoxia and the other six groups were given substances as follows on the 7th day of hypoxia: water, combination of dose 1 and 2, single dose of A. indica, single dose of C.asiatica, and single dose of vitamin C for 7 days. Parameters measured were activities of ALT and AST, MDA, GSH / GSSG ratio and SOD activity. There was no significant difference in the activity of ALT and AST in all groups. MDA levels was increased in the 7-days post-hypoxic group compared to control (p=0,007). The combination 1 group had low MDA and increased GSH/GSSG ratio and SOD activity compared to the post-7days-hypoxic group. The substance of combination 1 has protective effect on the rats’ liver on post-7-days-hypoxic through oxidative stress and antioxidant mechanisms. Keywords: Acalypha indica, Centella asiatica, systemic hypoxia, antioxidant
Profil Gangguan Kognitif pada Tumor Intrakranial Primer dan Metastasis Kartika Maharani; Andira Larasari; Tiara Aninditha; Yetty Ramli
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Gangguan kognitif sering menyertai pasien tumor intrakranial dan menjadi penyebab utama disabilitas. Perbedaan patofisiologi tumor intrakranial primer (TIP) dan metastasis (TM) menyebabkan perbedaan gambaran klinis dan derajat gangguan kognitif. Tujuan penelitian ini untuk mengetahui prevalensi dan profil gangguan kognitif pasien TIP dan TM. Disain penelitian potong-lintang retrospektif menggunakan data sekunder dari Poliklinik Saraf RSCM pada bulan Januari 2011-Desember 2013. Subjek berusia 18-65 tahun yang didiagnosis TIP dan TM berdasarkan anamnesis, pemeriksaan fisik, CT scan atau MRI kepala, dan atau histopatologi. Terdapat 121 subjek, 79 TIP dan 27 TM; usia rerata TIP 43,7 tahun dan TM 50,9 tahun. Pada kelompok TM mayoritas (40,7%) memiliki lesi di kedua hemisfer sedangkan TIP hanya di satu hemisfer. Lokasi tumor pada TM lebih dari 1 lobus (51,9%). Gangguan kognitif lebih banyak pada TM (81,5%) dibandingkan TIK (52,5%) dengan domain tersering gangguan visuospasial. Subjek TM mengalami gangguan kognitif lebih berat dibandingkan TIP (rerata MMSE 20,96 dan 22,61). Gangguan kognitif lebih banyak pada kelompok TM dibandingkan TIP dengan gangguan kognitif lebih berat karena mayoritas lesi tumor mengenai lebih dari 1 lobus. Kata kunci: gangguan kognitif, tumor intrakranial, neuro-onkologi. Cognitve Impairment in Primary and Metastatic Brain Tumors Abstract Brain tumor patients are often accompanied by a wide range of cognitive impairment as a major cause of disablility. The different pathophysiology of primary and metastatic brain tumor influences patients’ clinical signs and symptoms, and also the severity of cognitive impairment. To determine the prevalence and profile of cognitive impairment in patients with primary and metastatic brain tumors, this cross-sectional study was done on subjects of 18 to 65 years old with the diagnosis of primary and metastatic brain tumors based on anamnesis, physical examination, imaging modalities, and/or histopathology results. Subjects underwent cognitive and neuropsychology assessment in Neurology Outpatient Clinics, Cipto Mangunkusumo Hospital, from January 2011 to December 2013. From 121 subjects, 79 were primary and 27 were metastatic brain tumor patients. The metastatic tumor group mean of age were older than the primary tumor group (50,9 and 43,7 years respectively). In metastatic group, majority of subjects had bilateral lesion (40,7%) and localized in more than 1 lobe (51,9%), compared to primary tumor who had single lobe and one hemispheric lesion. Cognitive impairment was mostly found in metastatic brain tumor group (81,5%) rather than primary (52,5%) and also more severe in metastatic group (MMSE mean 20,96 and 22,61 respectively) with visuospatial impairment as the most common disorder. Cognitive impairment was much higher in metastatic brain tumor compared to primary brain tumor, with more severe degree of cognitive impairment because majority of lesion affected more than 1 lobe. Keywords: cognitive impairment, brain tumors, neuro-oncology
Korelasi Kadar Magnesium Serum dengan Albuminuria pada Pasien Diabetes Melitus Tipe 2 Tri Juli Edi Tarigan; Maruhum B.H. Marbun; Kuntjoro Harimurti
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Tujuan penelitian ini adalah untuk mengetahui peran magnesium pada nefropati diabetes dan mendapatkan proporsi albuminuria pada pasien DM tipe 2 dengan hipomagnesemia dan magnesium normal serta mendapatkan korelasi kadar Mg dengan albuminuria. Penelitian menggunakan desain cross sectional dengan consecutive sampling pada pasien DM tipe 2 yang terdiagnosis nefropati diabetes di Poliklinik Diabetes RSCM pada bulan Maret-Juni 2014. Dilakukan anamnesis faktor risiko, pemeriksaan fisik, kadar magnesium, albumine creatinine ratio dan A1C. Terdapat 38 subjek yang diikutsertakan dalam penelitian yang sebagian besar berusia lebih 50 tahun dan memiliki kontrol glikemik yang buruk (81,6%). Pada subjek penelitian yang memiliki kadar Mg<1,7 mg/dl 80% mengalami albuminuria, sedangkan pada subjek yang memiliki kadar Mg &ge; 1,7 mg/ dl sebanyak 63,6% mengalami albuminuria. Didapatkan koefisien korelasi sebesar 0,006 yang menunjukkan hubungan yang lemah antara kadar magnesium dalam darah dengan albuminuria. Disimpulkan tidak terdapat korelasi antara kadar magnesium dengan derajat albuminuria. Kata kunci: kadar magnesium, albuminuria, diabetes melitus tipe 2 Correlation between Magnesium Level and Albuminuria in Patients with Type 2 Diabetes Abstract The purposes of this study are to know: the role of magnesium in diabetic nephropathy, the proportion of albuminuria in type 2 DM with hypomagnesemia and normal magnesium level, and correlation between magnesium level and albuminuria. This cross-sectional study was done in Diabetes Clinic RSCM from March to June 2014 with consecutive sampling for type 2 DM patients who had been diagnosed with diabetic nephropathy. History taking, physical exam, albumin creatinine ratio test, and A1c level were done. Thirty eight subjects included in this study were mostly more than 50 years old and had poor glycemic control (81,6%). 80% of subjects with Mg level < 1.7 mg/dl experienced albuminuria and 63.6% of subjects with Mg level &ge; 1.7 mg/dl experienced albuminuria. The coefficient correlation was 0.006, which means that there is weak correlation between blood magnesium level and albuminuria. In conclusion, no correlation between magnesium level and severity of albuminuria were found in this study. Keywords: magnesium concentration, albuminuria, type-2 diabetes mellitus
Perubahan Ketebalan Jaringan Fibroglandular pada Pemeriksaan Ultrasonografi Payudara Perempuan Menopause yang Mendapat Terapi Hormon Tibolon Viscanita Viscanita; Sawitri Darmiati; R. Muharam; Adiningsih Sri Lestari; Aria Kekalih
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Penggunaan terapi hormon memiliki efek samping pada payudara yang dapat terdeteksi pada ultrasonografi (USG) berupa peningkatan ketebalan jaringan fibroglandular yang berhubungan dengan peningkatan risiko kanker payudara. Hingga saat ini masih terdapat kontroversi mengenai efek samping terapi hormon tibolon terhadap payudara. Penelitian ini bertujuan untuk mengetahui perubahan ketebalan jaringan fibroglandular setelah terapi hormon tibolon. Penelitian ini berlangsung dari bulan Desember 2013 hingga Agustus 2015 di Departemen Radiologi RSUPN dr. Cipto Mangunkusumo dengan desain penelitian berupa studi kuasi eksperimental dengan amandemen berupa pengambilan data USG payudara sebelum dan sesudah terapi hormone tibolon. Pengukuran dengan USG payudara dilakukan di empat regio (superior, inferior, medial dan lateral) yang kemudian dilakukan analisis terhadap rerata perubahan ketebalan jaringan fibroglandular sebelum dan sesudah terapi hormone tibolon. Dari 40 subjek yang dianalisis, terdapat 36 subjek yang mengalami peningkatan ketebalan jaringan fibroglandular. Terdapat perbedaan bermakna (p<0,001) pada ketebalan jaringan fibroglandular payudara sebelum dan sesudah 3 bulan pemberian tibolon. Indeks massa tubuh (p = 0,020) dan riwayat kontrasepsi hormonal (p=0,015) merupakan faktor yang memengaruhi peningkatan ketebalan jaringan fibroglandular payudara sesudah terapi hormon tibolon. Sedangkan paritas, usia melahirkan anak pertama, riwayat menyusui, usia menarke, usia menopause dan riwayat kontrasepsi hormonal tidak berhubungan. Kata kunci: terapi hormon, tibolon, ketebalan jaringan fibrogandular payudara Changes in Fibroglandular Tissue on Breast Ultrasound in Postmenopausal Women Undergoing Tibolon Hormone Abstract Theuse of hormone therapy has side effects in the breast which detected on ultrasound by increasing the thickness of breast fibroglandular tissue associated with increased risk of breast. Until now there is still controversy regarding the side effects of tibolon on the breast tissue. This study aims to determine the thickness changes of the fibroglandular tissue due to tibolon hormone therapy. This research was done between December 2013 untill August 2015 in Department of Radiology, dr. Cipto Mangunkusumo Hospital. Design of this research is a quasi-experimental study with the amendment in the form of data retrieval breast ultrasound before and after tibolon hormone therapy. Measurements with breast ultrasound was done in four regions (superior, inferior, medial and lateral) then the average change in fibroglandular thickness was analyzed. Of the 40 subjects were analyzed, there were 36 subjects showed significant increase (p <0.001) of breast fibroglandular tissue thickness after 3 months of tibolon hormone therapy. The body mass index (p = 0.02) and a history of hormonal contraception (p = 0,01) were factors that influence the increase of fibroglandular thickness post tibolon hormone therapy. While parity, age of first child, history of breastfeeding, age of menarche, age of menopause and history of hormonal contraception were not related. Key word: hormone therapy, tibolon, thickness of breast fibroglandular tissue
Profil Pasien HIV di Klinik VCT Sehati RSUD Dr. T.C. Hillers Maumere Tahun 2014 Lidwina Anissa; Asep Purnama; Hanny Nilasari
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Infeksi HIV merupakan masalah kesehatan dunia. Terdapat peningkatan jumlah infeksi baru di Indonesia. Penelitian ini bertujuan untuk mengetahui profil pasien HIV di area rural. Studi ini merupakan studi potong lintang dengan data register pasien dalam periode Januari &ndash; Desember 2014. HIV di Klinik VCT Sehati RSUD Dr.TC Hillers Maumere, Kabupaten Sikka. Terdapat 104 pasien yang terdiagnosis HIV positif, 64,4% di antaranya adalah laki-laki. Tingkat pendidikan terbanyak adalah tingkat pendidikan menengah (46,2%) dan rendah (44,2%). Rute transmisi terbanyak adalah hubungan seksual heteroseksual (74%). Gejala terbanyak yang dikeluhkan pasien adalah batuk lama, penurunan berat badan dan demam naik turun. Infeksi oportunistik terbanyak adalah TB paru dan kandidosis oral. Infeksi HIV membutuhkan penangan secara holistik yang menjamin kualitas hidup pasien baik dari aspek fisik dan psikis. Edukasi kesehatan reproduksi terutama HIV dan infeksi menular seksual lainnya memegang peranan penting dalam rangka upaya meningkatkan wawasan mengenai HIV sekaligus sebagai upaya pencegahan infeksi baru dan pemutusan rantai penularan. Dukungan peer group memiliki peranan penting dalam peningkatan kualitas hidup pasien. Kata kunci: HIV, heteroseksual, homoseksual, infeksi oportunistik, rute transmisi. HIV Patients&rsquo; Profile in Sehati VCT Clinic Dr.T.C. Hillers Maumere in 2014 Abstract HIV infection is one of global health problems. The number of new infection is increasing in Indonesia. This research aims to study the profile of HIV patients in rural area. This reasearch is a cross-sectional study on patients registers in Sehati Voluntary Counseling Testing / HIV care unit in Dr.TC Hillers District General Hospital, Sikka Regency during January untill December 2014 period. There were 104 subjects diagnosed as HIV positive and 64.4% of them were male. The most common education level was middle school (46.2%) and elementary school (44.2%). The most frequent transmission route is heterosexual intercourse (74%). The most usual symptoms suffered by subjects are coughing, weight loss, and fever. The most prevalent opportunistic infection are pulmonary tuberculosis and oral candidosis. HIV infection is a complex problem therefore it needs a holistic treatment. Education plays an essential role in improving sexual health literacy, preventing new infection and breaking the infection chain. Peer group support plays an important role in improving the quality of life HIV patients. Keywords: HIV, heterosexual, homosexual, opportunistic infection, route of transmission
Penggunaan ACE-Inhibitor untuk Mengurangi Proteinuria pada Sindrom Nefrotik Oryza Gryagus Prabu; Hamzah Shatri
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Proteinuria merupakan faktor prognostik penting dalam progresivitas sindrom nefrotik. Penggunaan ACE-inhibitor dapat mengurangi proteinuria dengan menurunkan tekanan hidrolikglomerular pada kelainan ginjal. Tujuan evidence base case report (EBCR) ini adalah mengevaluasipenggunaan ACE inhibitor terhadap proteinuria pada sindrom nefrotik. Dilakukan pencarianpada database daring di Pubmed&reg;, Cochrane&reg;, Sciencedirect&reg;, Clinical Key&reg;, EBSCO&reg;, danProquest&reg;. Selanjutnya dilakukan skining dengan kriteria inklusi dan eksklusi yang spesifik sertamembaca full text artikel tersebut. Dari pencarian tersebut didapatkan tiga artikel yang relevan.Pada ketiga artikel didapatkan hasil penurunan proteinuria pada pasien sindrom nefrotik secarasignifikan. Pada artikel pertama didapatkan CER 0%, AER 50%, RRR 50%, dan NNT 1,81dengan 95% CI 0,11&ndash;0,89. Pada artikel kedua didapatkan ekskresi protein urin setelah 4,8,dan 12minggu pemberian fosinopril menurun secara signifikan terhadap plasebo (p<0,05). Pada artikelketiga didapatkan pemberian lisinopril selama 12 bulan menghasilkan ekskresi protein urin yangsignifikan terhadap baseline (p<0,0001). Pemberian ACE-inhibitor pada pasien dengan sindromnefrotik dapat mengurangi protein urin secara signifikan.Kata kunci: ACE-inhibitor, proteinuria, sindrom nefrotikThe Usage of ACE Inhibitor in Reducing Proteinuria in Nephrotic SyndromeAbstractProteinuria is an important prognostic factor in progressivity of nephrotic syndrome. ACE inhibitor could reduce proteinuria by decreasing glomerular hydraulic pressure in renal disease. To determine the usage of ACE-inhibitor in reducing proteinuria in nephrotic syndrome. The search wasconducted in various online databases such as Pubmed&reg;, Cochrane&reg;, Sciencedirect&reg;, ClinicalKey&reg;, EBSCO&reg;, and Proquest&reg;, after defining the inclusion and exclusion criteria then screeningthe titles and abstracts and the authors found three relevant articles. All articles were have thesignificant reduction of proteinuria in nephrotic syndrome. In the first article, CER 0%, AER 50%,ARR 50% and NNT 1.81 with 95% CI 0.11&ndash;0.89. In second article, the urinary protein excretionafter 4,8, and 12 weeks treated with fosinopril were significantly reduced compared to the placebo(p<0.05). In the third article, the group that receive lisinopril were significantly reducing urinaryprotein excresion compared to the baseline value (p<0.0001). ACE inhibitor could signficantlyreduce proteinuria in nephrotic syndrome.Keywords: ACE inhibitor, nephrotic syndrome, proteinuria
Akupunktur Manual sebagai Terapi pada Pasien Depresi Asniyati Almi; Kemas Abdurrohim
eJournal Kedokteran Indonesia Vol 3, No 2 (2015): Agustus
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Depresi adalah gangguan kejiwaan pada alam perasaan (affective/mood disorder), yang ditandai dengan kemurungan, ketiadaan gairah hidup, perasaan tidak berguna dan putus asa. Prevalensi gangguan depresi di dunia sekitar 8-20% dan perempuan lebih banyak menderita depresi dari pada laki-laki. Tatalaksana gangguan depresi dilakukan secara komprehensif berupa terapi farmakologis, terapi somatik, psikoterapi, psikoreligius dan akupunktur. Penelitian terakhir menunjukkan akupunktur dapat menimbulkan efek antidepresan dengan meningkatkan pelepasan serotonin dan norepinefrin di celah sinaps. Pada makalah ini dilaporkan pasien perempuan berusia 65 tahun yang menderita gangguan depresi selama 8 tahun dan mengalami perbaikan skor hamilton rating scale for depression 17 (HAM-D 17) setelah terapi akupunktur. Kata kunci: depresi, akupunktur, serotonin, norepinefrin Manual Acupuncture as Treatment for Depression Abstract Depression is a psychiatric disorder in the form of mood (i.e. affective or mood disorder), characterized by moodiness, lack of passion, feeling of uselessness and hopelessness. The prevalence of depressive disorder is 8-20% of the world population, with a higher prevalence in female than male. Treatment of depression is comprehensive and consists of pharmacologic therapy, somatic therapy, psychotherapy, psychoreligious theraphy and acupuncture. Recent research shows acupuncture can give antidepressant effect by increasing the release of serotonin and norepinephrine in the synaptic cleft. This paper reported a case of 65-year-old female patient who suffered from depression for eight years and had improved the hamilton rating scale for depression 17 (HAM-D 17) after acupuncture therapy. Key words: depression, acupuncture, serotonin, norepinephrine

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