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eJurnal Kedokteran Indonesia
Published by Universitas Indonesia
ISSN : 23501426     EISSN : 23386037     DOI : 10.23886
Core Subject : Health,
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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Articles 12 Documents
Search results for , issue "Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December" : 12 Documents clear
The Management of Nocturia by Indonesian Urologist Harrina Erlianti Rahardjo
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

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Nocturia is defined as the number of times urine is passed during main sleep. Prevalence of nocturia is around 70% and 11-44% for age group 70-80 and 20-40 years respectively. Although, it is clearly prevalent, nocturia is just seen as a small part of lower urinary tract symptoms (LUTS). The objective of the study was to review nocturia in terms of diagnostic and management strategies among Indonesian urologists. This was a descriptive cross-sectional study. A self-constructed questionnaire was distributed to Indonesian urologists from August 2017 until August 2018 using consecutive sampling method. 124 urologists out of 400 urologists participated. in this study most of the urologists had to face 1-5 cases nocturia per month. Age of patients were mostly 50-65 years old and affecting more men than women (66.9% vs 16.9% respectively). Only 45% of urologists utilized bladder diary regularly to assess nocturia. Nearly 90% urologist opted for lifestyle intervention to manage nocturia. Desmopressin was used by only 20.2% urologists to treat nocturia. Anti-muscarinic and beta-3 agonist were used more often than desmopressin to treat nocturia. To conclude, diagnostic strategies for nocturia are mostly in line with available guidelines except for bladder diary which was only used routinely by 45% of urologists. As for treatment, desmopressin was still prescribed less frequently than OAB drugs for nocturia. Keywords: nocturia, urology, LUTS, desmopressin, functional. Manajemen Nokturia oleh Urolog di Indonesia Abstrak Nokturia didefinisikan sebagai jumlah berkemih selama waktu tidur. Prevalensi nokturia sekitar 70% dan 11-44% pada kelompok umur 70-80 dan 20-40 tahun. Walaupun nokturia memiliki prevalensi tinggi, diagnosis tersebut hanya dianggap sebagai bagian kecil gejala lower urinary tract (LUT). Tujuan penelitian ini adalah mengetahui strategi diagnostik dan terapi nokturia oleh dokter spesialis urologi di Indonesia. .Studi deskriptif pontong lintang ini menggunakan metode consecutive sampling dan kuesioner yang dibagikan pada dokter spesialis urologi pada bulan Agustus 2017–Agustus 2018. Sebanyak 124 dari 400 spesialis urologi berpartisipasi dalam studi ini. Mayoritas spesialis urologi mendapat 1-5 kasus per bulan. Usia pasien tersering adalah 50-65 tahun dan lebih banyak laki-laki. (66.9% vs 16.9% respectively). Hanya 45% spesialis urologi menggunakan catatan harian berkemih untuk diagnosis nokturia. Kurang lebih 90% responden memilih intervensi gaya hidup sebagai tata laksana. Desmopressin hanya digunakan 20,2% responden untuk mengobati nokturia. Anti-muskarinik dan beta-3-agonis lebih sering digunakan dibandingkan desmopressin untuk tata laksana nokturia. Disimpulkan strategi diagnostik untuk nokturia telah sesuai dengan panduan tatalaksana kecuali untuk catatan harian berkemih. Dalam hal terapi nokturia, desmopressin masih lebih jarang digunakan dibandingkan dengan obat untuk overactive bladder. Kata kunci: nokturia, urologi, LUTS, desmopresin, fungsional.
Feedback Process in The Mini Clinical Evaluation Exercise (Mini-CEX): an Exploratory Study Diantha Soemantri; Agnes Dodds; Geoff Mccoll
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

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In the midst of clinical environment unpredictability, feedback helps students to make the most out of clinical learning opportunities. Mini clinical evaluation exercise (Mini-CEX) is considered to be appropriate for providing feedback to students. This study aims to explore the feedback process within the Mini-CEX at a large Australian medical school. Between year 2011-2012, 23 Mini-CEX sessions, involved 18 final year medical students, were observed, followed by 15-minutes structured interviews. 7 experienced clinical teachers were also interviewed. A questionnaire administered to 274 final year medical students to seek their views on feedback provided in the Mini-CEX. Most feedback has complied with the characteristics of constructive feedback, however the amount of feedback decreased as the quality level of feedback increased. These findings matched students’ perceptions recorded on the questionnaire. The themes derived from the interviews showed that for feedback to be useful, each of feedback process components (feedback provider, types of feedback, feedback recipient and action plans following feedback) need to be attended to. Both tutors and students need to focus on the process of incorporating feedback to inform students’ learning, not only on the feedback characteristics. One of the means to achieve this is by providing reflective feedback where students are considered as active recipients. Keywords: feedback, Mini-CEX, clinical, assessment, learning. Proses Umpan Balik pada Mini Clinical Evaluation Exercise (Mini-CEX): Studi Eksplorasi Abstrak Di tengah ketidakpastian lingkungan klinis, umpan balik membantu mahasiswa memaknai kesempatan belajar di tatanan klinis. Mini clinical evaluation exercise (Mini-CEX) cocok untuk memberikan umpan balik kepada mahasiswa. Studi ini bertujuan untuk mengeksplorasi proses umpan balik pada Mini-CEX di sebuah fakultas kedokteran besar di Australia. Antara tahun 2011-2012, 23 sesi Mini-CEX, melibatkan 18 mahasiswa kedokteran tahap akhir, diobservasi dan dilanjutkan wawancara terstruktur selama 15 menit. 7 dosen klinik berpengalaman juga diwawancara. Kuesioner diberikan kepada 274 mahasiswa kedokteran tahap akhir untuk mengetahui pandangan mereka terhadap umpan balik yang diberikan dalam Mini-CEX. Sebagian besar umpan balik telah memenuhi karakteristik umpan balik konstruktif, namun jumlah umpan balik menurun seiring dengan meningkatnya level kualitas umpan balik. Hal tersebut juga ditemukan dalam persepsi mahasiswa yang tercatat sebagai hasil kuesioner. Tema yang diidentifikasi dari wawancara memperlihatkan bahwa agar umpan balik bermanfaat, setiap komponen dari proses umpan balik (pemberi umpan balik, tipe umpan balik, penerima umpan balik, rencana aksi setelah umpan balik) perlu diperhatikan. Baik dosen maupun mahasiswa harus fokus pada proses untuk memastikan bahwa umpan balik dimanfaatkan dalam pembelajaran, tidak hanya pada karakteristik umpan balik semata. Salah satu cara untuk mencapai hal tersebut adalah dengan memberikan umpan balik reflektif yaitu mahasiswa diperlakukan sebagai penerima aktif. Kata kunci: umpan balik, Mini-CEX, klinik, asesmen, pembelajaran.
Kolaborasi dalam Pengelolaan Tiroid di Indonesia: Fokus pada Pencegahan Oftalmopati pada Penyakit Grave Imam Subekti
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

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The Use of Vaginal Pessary for Pelvic Organ Prolapse’s Treatment Suskhan Djusad; Sulaeman A. Susilo; Alfa P. Meutia
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Pelvic organ prolapse (POP) is the descent of the anterior and/or posterior vaginal wall or vagina apex (uterus or vaginal apex after a hysterectomy) and has negative effects on woman’s daily activities and reduces her quality of life. One of the treatments of POP is pessary that has limited evidence but still commonly used for treatment of genital prolapse and considered as the first line treatment by the American Urogynecologic Society (AUGS). This evidence-based case report (EBCR) is made to critically analyze from the current studies whether the use of pessary improves the symptoms of pelvic organ prolapse or not. A search of literature was performed in two databases, MEDLINE and Cochrane. Eligible articles were observational studies, clinical trials, systematic reviews, or meta-analyses that published within the last 5 years. All studies showed symptoms improvement with four studies using Pelvic Organ Prolapse Distress Inventory (POPDI) score and one study using International Consultation on Incontinence Questionnaire – Vaginal Symptoms (ICIQ-VS). Keywords: pelvic organ prolapse, pessary, treatment. Penggunaan Pesarium Vagina untuk Penatalaksanaan Prolaps Organ Pelvik Abstrak Prolaps organ pelvik (POP) adalah penurunan dinding anterior dan atau posterior vagina atau apeks vagina (uterus atau apeks vagina setelah histerektomi) yang memiliki dampak negatif terhadap aktivitas sehari-hari dan menurunkan kualitas hidup. Salah satu tata laksana POP adalah pesarium yang memiliki bukti ilmiah terbatas tetapi masih digunakan untuk tata laksana prolaps genitalia dan dipertimbangkan sebagai terapi utama menurut American Urogynecologic Society (AUGS). Evidence-based case report (EBCR) dibuat untuk menganalisis secara kritis dari studi yang sudah ada apakah penggunaan pesarium dapat memperbaiki gejala dari prolaps organ pelvik atau tidak. EBCR ini dilakukan dalam dua databases, MEDLINE dan Cochrane. Artikel yang memenuhi syarat merupakan studi observasional, percobaan klinis, ulasan sistematis, atau meta-analisis yang telah dipublikasi pada 5 tahun terakhir. Semua studi menunjukan bahwa terdapat perbaikan dari gejala (POP) dengan empat studi menggunakan pelvic organ prolapse distress inventory (POPDI) score dan satu studi lainnya menggunakan International Consultation on Incontinence Questionnaire – Vaginal Symptoms (ICIQ-VS). Kata kunci: prolapse organ pelvik, pesarium, penatalaksanaan.
Hallux Valgus as an Occupational Disease among Indonesian Female Workers:A Study Using Seven Steps of Occupational Diagnosis Approach Dewi Sumaryani Soemarko; Fita Rahmasari; Dewi Yunia Fitriani
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Shoes are a necessity for female workers. Not only they are used as footwear, they also play role in workers’ appearance. Company policies sometimes require female workers to use high heels, which could consequently lead to frequent foot problems such as hallux valgus (HV). This cross-sectional study was conducted to determine the prevalence of HV as an occupational disease among female workers at M department store, in Bekasi City West Java on May to June 2018, using a seven steps of occupational diagnosis approach. Female workers with HV were included as study subjects and were given questionnaires. Data was analyzed using the seven steps of occupational diagnosis method to establish the diagnosis of HV as an occupational disease or work-related disease or non-occupational disease. A total of 35 subjects were diagnosed with HV by the orthopedic specialist, 19 subjects of whom had an occupational disease and 8 subjects of work-related HV and 8 subjects of non-occupational HV. The majority of HV cases among the female workers at the department store was an occupational disease. Keywords: occupational disease, seven steps of occupational diagnosis, female workers, hallux valgus. Hallux Valgus Akibat Kerja di Pekerja Perempuan Indonesia: Suatu Studi Menggunakan 7 Langkah Diagnosis Okupasi Abstrak Sepatu sangat penting untuk pekerja perempuan, selain sebagai alas kaki, sepatu juga menambah penampilan. Kebijakan perusahaan kadang menghendaki pekerja perempuan menggunakan sepatu berhak tinggi sehingga menimbulkan masalah kaki antara lain hallux valgus (HV). Studi potong lintang ini bertujuan mengetahui prevalensi HV akibat kerja di M departemen store, di Kota Bekasi Jawa Barat pada bulan Mei sampai Juni 2018, menggunakan tujuh langkah diagnosis okupasi. Pekerja perempuan dengan HV dikumpulkan sebagai subjek, diberikan kuesioner dan dikaji dengan metode tujuh langkah diagnosis okupasi untuk menentukan HV akibat kerja atau HV berhubungan dengan pekerjaan atau HV bukan akibat kerja. Terdapat 35 subjek didiagnosis HV oleh spesialis ortopedi; 19 subjek termasuk HV akibat kerja dan 8 subjek masing-masing untuk HV berhubungan dengan pekerjaan dan HV bukan akibat kerja. Sebagian besar HV yang timbul di pekerja perempuan yang bekerja di department store adalah HV akibat kerja. Kata kunci: penyakit akibat kerja, tujuh langkah diagnosis okupasi, pekerja perempuan, hallux valgus.
Clinical Manifestations of Cortical Visual Impairment in Department of Ophthalmology, Dr. Cipto Mangunkusumo National Hospital Julie Dewi Barliana; Elyas Aditya Pradana; Syntia Nusanti; Laura Agnestasia Djunaedi
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Cortical visual impairment (CVI) is one of the primary causes of visual function disorders in children under the age of five years. It requires multi-disciplinary involvement due to its various causes, manifestations, and treatments. However, there are no specific guidelines for detecting and diagnosing CVI. The objective of this study is to provide an overview of clinical characteristics and related medical histories for the diagnosis of CVI. This is a cross-sectional study conducted based on medical records at Cipto Mangunkusumo National Hospital Kirana. Data collection was carried out from January 1 to December 31, 2016. The study employed all the children with CVI who were not accompanied by additional visual abnormalities other than nystagmus and strabismus. The analysis was carried out using the Statistical Package for Social Sciences (SPSS) software. There were 16 patients who meet the inclusion criteria. The history of seizures and retardation of growth and development was experienced respectively 14/16 and 13/16 patients. Intracranial infections and epilepsy were the most common comorbidities. Strabismus is the most common clinical pathology (8/16) and 13/16 patients could not pass the light and object fixation test. Flash visual-evoked-potential (VEP) examination revealed that 5/8 patients had a decrease in amplitude, and 7/8 patients had an extension on the latency period. The knowledge of clinical characteristics e.g. decreased visual function, strabismus, or nystagmus that was accompanied by a history of seizures, or growth and developmental disorders can help to detect CVI. Keywords: cortical visual impairment, epilepsy, nystagmus, strabismus. Manifestasi Klinis dari Cortical Visual Impairment di Departemen Oftalmologi RSUPN dr. Cipto Mangunkusumo Abstrak Cortical Visual Impairment (CVI) merupakan salah satu penyebab utama gangguan fungsi visual pada anak dibawah usia lima tahun. Berbagai macam etiologi, manifestasi, dan tatalaksana pada CVI menyebabkan perlunya keterlibatan berbagai macam disiplin ilmu. Namun hingga saat ini belum terdapat pedoman khusus untuk mendeteksi dan mendiagnosis CVI. Oleh karena itu, penelitian ini diharapkan dapat memberikan gambaran karakteristik klinik dan riwayat kesehatan yang berhubungan untuk membantu mendiagnosis CVI. Studi dilakukan secara cross-sectional berdasarkan data rekam medis di RSUPN Cipto Mangunkusumo Kirana. Pengumpulan data dilakukan sejak tanggal 1 Januari sampai 31 Desember 2016. Seluruh pasien penderita CVI yang datang tanpa disertai dengan kelainan penglihatan tambahan selain nistagmus atau strabismus menjadi sampel. Analisis dilakukan menggunakan program SPSS 23.00. Terdapat 16 pasien yang memenuhi kriteria inklusi. Riwayat kejang dan gangguan pertumbuhan perkembangan dialami masing-masing 14/16 dan 13/16 pasien. Infeksi intrakranial dan epilepsi menjadi penyakit penyerta yang paling banyak. Gambaran klinis berupa strabismus paling banyak ditemukan (8/16) dan sebanyak 13/16 pasien tidak dapat melakukan fiksasi cahaya dan objek. Pemeriksaan penunjang berupa flash VEP menunjukkan penurunan amplitudo pada 5/8 responden dan perpanjangan masa latensi pada 7/8 penderita CVI. Karakteristik klinis berupa penurunan fungsi penglihatan, strabismus, atau nistagmus yang disertai dengan riwayat kejang atau gangguan tumbuh-kembang dapat membantu mendiagnosis CVI. Kata kunci: cortical visual impairment, epilepsy, nistagmus, strabismus.
Seizure and Mild Cognitive Impairment in Tuberous Sclerosis Complex Iswandi Erwin; Aida Fithrie; Alfansuri Kadri
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Tuberous sclerosis complex (TSC) is syndrome characterized by hamartomal growth on multiple organ systemcaused by genetic disturbance especially on TSC1 gene producing hamartin and TSC2 gene producing tuberin, most clinical syndrome are facial angiofibroma, renal angiomyolipoma(AML), pulmonary lymphangiomatosis(LAM) and several other clinical feature of multiorgan distubance while neurological manifestation of TSC usually seizure caused by either intracranial tubers, subependymal nodules (SEN) and subependymal giant cell astrocytoma (SEGA). We report a case ofa girl, 18th years old with main complaint of seizure since 5 years ago. Electroencephalography (EEG) show abnormal epileptiform activity of 4 Hz-spike-wave complex predominantly on left temporal region while head CT scan showed multiple calcification. Neurobehavior assessment revealed mild cognitive impairment on memory, language and visuospatial domain. Chromosom analysis showed no major structural disorders. Seizure is now controlled with valproic acid. Keywords: Tuberous sclerosis complex, epilepsy, neurogenetics. Bangkitan dan Gangguan Kognitif Ringan padaTuberous Sclerosis Complex Abstrak Tuberous sclerosis complex (TSC) merupakan sindrom dengan karakteristik pertumbuhan hamartoma di berbagai organ dan disebabkan oleh gangguan genetik terutama pada gen TSC1 yang memproduksi hamartin dan gen TSC2 yang memproduksi tuberin. Gejala klinis TSC adalah facial angiofibroma, renal angiomyolipoma (AML), pulmonary lymphangiomatosis (LAM) dan gangguan multiorgan lainnya. Manifestasi neurologis TSC umumnya berupa bangkitan yang disebabkan oleh tuber intrakranial, subependymal nodules (SEN) and subependymal giant cell astrocytoma (SEGA). Kami melaporkan kasus perempuan berusia 18 tahun dengan keluhan utama bangkitan yang dialami sejak 5 tahun sebelum masuk rumah sakit. Elektroensefalografi (EEG) menunjukkan aktivitas epileptiform abnormal berupa kompleks paku-ombak 4 spd predominan di regio temporal kiri dan CT-scan kepala menunjukkan kalsifikasi intrakranial multipel. Penjajakan neurobehavior menunjukkan gangguan kognitif ringan pada domain memori, bahasa dan visuospasial. Pada analisis kromosom tidak ada gangguan struktural mayor. Bangkitan kini terkontrol dengan asam valproat. Kata kunci: Tuberous sclerosis complex, epilepsi, neurogenetika.
Correlation of Body Mass Index and Bioelectrical Impedance Analysis of Total Body Fat with Serum Lipid Profile Siti Nurbaya; Yusra Yusra; Fathia Azzahra
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Since dyslipidemia is a known primary factor that can cause cardiovascular disease, it is important to evaluate the parameters of serum lipid profile. Determination of body mass index (BMI) and total body fat using the impedance method can be applied as an indirect strategy to predict body fat. Both these methods are easy to perform and can be used by the community. The aim of this study was to determine the relationship of BMI and total body fat measured using the impedance method with serum lipid profile. Using a cross-sectional study design, 128 subjects were recruited in this investigation and their lipid profiles were evaluated at the Clinical Pathology Laboratory, Cipto Mangunkusumo National Hospital, Jakarta. Body weight, height, and total body fat using the impedance method were measured. Lipid profile data, i.e., the levels of triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol, were obtained from the Clinical Pathology Laboratory information system in April–Juni 2016. Data were analyzed by the Pearson test to determine the relationship of BMI and total body fat measured using the impedance method with serum lipid profile. The results showed no significant correlation between BMI and serum lipid profile (P > 0.5), no significant correlation was found between total body fat and serum lipid profile (P > 0.5) and no correlation was found in each group of subjects with normal and high total body fat. In conclusion there is no association of BMI and total body fat with the lipid profile parameters, including the levels of triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol (p>0.05). Keywords: body mass index, impedance method, serum lipid profile, total body fat. Hubungan Indeks Massa Tubuh dan Lemak Total Menggunakan Metode Bioelectric Impedansi dengan Profile Lipid Serum Abstrak Dislipidemia merupakan faktor primer yang dapat menyebabkan penyakit kardiovaskular, sehingga evaluasi parameter profil lipid serum perlu dilakukan. Indeks massa tubuh (IMT) dan total lemak tubuh metode impedansi merupakan cara untuk memprediksi lemak tubuh secara tidak langsung. Kedua cara ini merupakan metode yang mudah dan dapat digunakan masyarakat. Penelitian bertujuan mencari hubungan IMT dan total lemak tubuh metode impedansi dengan profil lipid serum. Penelitian menggunakan desain penelitian potong lintang pada 128 subyek yang memeriksakan profil lipidnya ke Laboratorium Patologi Klinik, RSUPN dr. Cipto Mangunkusumo (RSUPNCM). Subyek diukur berat badan, tinggi badan, total lemak tubuh dengan metode impedansi. Data profil lipid, yaitu trigliserida, kolesterol total, kolesterol-HDL, dan kolesterol- LDL, diperoleh dari sistem informasi Laboratorium Patologi Klinik RSUPNCM pada bulan April– Juni 2016. Data diolah dengan uji Pearson untuk mengetahui hubungan IMT dan total lemak tubuh metode impedansi dengan profil lipid serum. Hasil tidak terdapat hubungan yang bermakna antara IMT dan profil lipid serum (P > 0,5), tidak ditemukan adanya hubungan yang bermakna antara total lemak tubuh dengan profil lipid serum (P > 0,5) dan tidak didapatkan juga hubungan pada setiap kelompok subyek dengan total lemak tubuh normal dan tinggi. Disimpulkan tidak terdapat hubungan IMT dan total lemak tubuh metode impedansi dengan parameter profil lipid, meliputi trigliserida, kolesterol total, kolesterol-HDL, dan kolesterol-LDL (p>0,05). Kata Kunci: Indeks massa tubuh, metode impedansi, profil lipid serum, total lemak tubuh.
Pajanan Aflatoksin sebagai Faktor Risiko Stunting Eva Yuliana Fitri; Ratna Djuwita; Putri Bungsu; Citra Prasetyawati
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Makanan yang mengandung cemaran kimia dan biologi yang melebihi batas aman dapat menimbulkan gangguan kesehatan. Aflatoksin merupakan metabolit sekunder yang dihasilkan oleh kapang dan dapat mencemari makanan seperti kacang tanah dan jagung. Aflatoksin diduga dapat menghambat pertumbuhan (growth retardation) sehingga mengakibatkan gagal tumbuh atau stunting. Studi ini bertujuan untuk mengetahui asosiasi pajanan aflatoksin sebagai faktor risiko stunting. Metode yang digunakan adalah telaah sistematis menggunakan elemen participants, intervention, comparator, outcome, timeframe, dan setting (PICOTS) untuk menetapkan kriteria inklusi dan eksklusi. Enam literatur yang memenuhi kriteria inklusi dan eksklusi ditelaah pada studi ini. Hasil disampaikan secara kualitatif yaitu metasintesis. Terdapat korelasi antara pajanan aflatoksin dengan kejadian stunting dari tiga studi yang dilakukan di Afrika dan terdapat hubungan dosis-respons. Satu studi menunjukkan korelasi tetapi lemah dan dua studi lainnya tidak ada korelasi pajanan aflatoksin dengan kejadian stunting. Diduga terdapat threshold value aflatoksin dalam mengakibatkan stunting. Adanya korelasi kuat serta dugaan mekanisme biological plausibility dapat dijadikan dasar untuk mulai mempertimbangkan aflatoksin sebagai salah satu faktor risiko penyebab stunting. Kata kunci: aflatoksin, stunting, keamanan pangan. Aflatoxin Exposure as a Risk Factor of Stunting Abstract Foods containing chemical and biological contaminant that exceed safety limit can be a cause of health problems. Aflatoxin is a chemical agent, a secondary metabolite produced by a fungus which commonly contaminates certain types of food including peanuts and corn. Aflatoxin is assumed to inhibit growth (growth retardation) resulting in failure to grow or stunting. This study aims to analyze the relationship between aflatoxin exposure and the risk of stunting through a systematic review using PICOTS elements in defining inclusion and exclusion criteria. The results are presented qualitatively namely meta synthesis. Six literature that met the inclusion and exclusion criteria were reviewed in this study. Consistent results were found in 3 studies conducted in the African region, where there was a correlation between aflatoxin exposure and stunting. This is convinced by the dose-response relationship found in those studies. One study showed a weak correlation and 2 studies showed no correlation between aflatoxin and stunting exposure. It was assumed that there is a threshold value of aflatoxin in causing growth retardation. Further research is needed to study the causal relationship between aflatoxin exposure and stunting. However, the existence of a correlation and on the alleged biological plausibility mechanism can be a preliminary finding to consider aflatoxin as one of the risk factors for stunting. Keywords: aflatoxin, stunting, food safety.
Quaternary Ammonium Compound Disinfectant Efficacy Test on The Patients’ Environment in dr. Cipto Mangunkusumo General Hospital Angky Budianti; Hindra Irawan Satari; Dimas Seto Prasetyo; Anis Karuniawati; Gortap Sihotang; Martin Hartiningsih; Riamin Sitorus; Hana Paraswati Putri; Santya Fatma Dewi; Sari Wiraswasty
eJournal Kedokteran Indonesia Vol 7, No 3 (2019): Vol 7, No. 3 (2019): December
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Abstract

The increasing prevalence of hospital-acquired infection continues to be a global concern until today. The purpose of this study is to determine the efficacies of Caviwipe&reg; and 70% alcohol tissue in the prevention of hospital-acquired infection. This experimental study was conducted on 36 equipment samples in dr. Cipto Mangunkusumo Hospital during April&ndash;August 2015. A total of 144 surface samples were collected before and after the disinfection process by both the disinfectants. The sample equipment used and placed in the agar plate for a short period of time; the plates were then incubated. The colony numbers of grown bacteria and fungi were calculated. The data were numerically reported as the microbial colony count. Data were analyzed by using SPSS for Windows. Paired t-test was used for the statistical analysis. The mean colony counts before disinfection by 70% alcohol tissue and Caviwipe&reg; were 11.75 and 17.58, respectively. Meanwhile, the average colony counts after disinfection with 70% alcohol tissue and Caviwipe&reg; were 0.138 and 0.222, respectively. Statistical analysis showed no significant difference between the mean of the colony count before and after disinfection with both disinfectants (p>0.05). Separately, a significant difference of colony count between before and after the disinfection process for each disinfectant was seen (p<0.05). The mean reduction in the colony counts after disinfection by both disinfectants indicates that there is no significant difference (p>0.05) in the efficacies between the Caviwipe&reg; and 70% alcohol tissue in reducing the amount of bacteria and fungi present on the surfaces of the equipment placed close to the patients in a hospital environment. Keywords: disinfectant, environment, hospital, alcohol, Caviwipe&reg;. Uji Efikasi Disinfektan Quaternary Ammonium Compound Disinfectant di Lingkungan Pasien di RSUPN dr. Cipto Mangunkusumo Abstrak Peningkatan prevalensi infeksi yang didapat di rumah sakit masih menjadi perhatian hingga saat ini. Penelitian ini bertujuan membandingkan efektivitas Caviwipe&reg; dan tisu alkohol 70% dalam upaya pencegahan infeksi yang didapat di rumah sakit. Penelitian eksperimental ini dilakukan pada bulan April&ndash;August 2015 dengan 36 sampel peralatan di rumah sakit dr. Cipto Mangunkusumo (RSCM). Terdapat 144 titik pengambilan sampel permukaan lingkungan dan peralatan, sebelum dan sesudah disinfeksi dengan kedua disinfektan. Sampel diambil dengan contact agar lalu diinkubasi, kemudian dihitung jumlah koloni bakteri dan jamur yang tumbuh. Data jumlah koloni mikroba dilaporkan sebagai data numerik dan dianalisis dengan perangkat lunak SPSS untuk Windows. Analisis statistik menggunakan paired-t-test. Hitung koloni sebelum disinfeksi dengan tisu alkohol 70% dan Caviwipe&reg; adalah 11,7 dan 17,58. Rerata jumlah koloni sesudah disinfeksi dengan tisu alkohol 70% dan Caviwipe&reg; adalah 0,138 dan 0,222. Analisis statistik menunjukkan tidak ada perbedaan bermakna antara rerata jumlah koloni sebelum dan sesudah disinfeksi dengan kedua jenis disinfektan (p>0,05). Masing-masing disinfektan menunjukkan perbedaan bermakna antara jumlah koloni sebelum dan sesudah disinfeksi (p<0,05). Penurunan rerata jumlah koloni sesudah disinfeksi antara kedua disinfektan tidak berbeda bermakna (p>0,05). Efikasi antara Caviwipe&reg; dan tisu alkohol 70% dalam menurunkan jumlah bakteri dan jamur di lingkungan rumah sakit yang dekat dengan pasien juga tidak berbeda bermakna. Kata kunci: disinfektan, lingkungan, rumah sakit, alkohol, Caviwipe&reg;

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