scholarly journals KORELASI UKURAN KETEBALAN KORTEKS DAN RESISTIVE INDEX GINJAL BERDASARKAN PEMERIKSAAN ULTRASONOGRAFI PADA PASIEN HIDRONEFROSIS

2019 ◽  
Vol 12 (2) ◽  
pp. 183
Author(s):  
Ferawati Dakio ◽  
Nurlaily Idris ◽  
Mirna Muis ◽  
Andi Alfian ◽  
Hasyim Kasim ◽  
...  

Hidronefrosis dapat terjadi pada satu atau kedua ginjal yang menyebabkan aliran urine menjadi lemah dan mengganggu fungsi dari ginjal itu sendiri.Penelitian ini bertujuan mengetahui korelasi ketebalan korteks ginjal dan resistive index ginjal berdasarkan pemeriksaan ultrasonografi pada pasien hidronefrosis. Penelitian ini dilakukan di bagian Radiologi Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar dari Mei sampai dengan Agustus 2018. Desain penelitian yang digunakan adalah observasional dengan rancangan potong lintang.Sampel penelitian sebanyak empat puluh orang yang memiliki klinis hidronefrosis. Pemeriksaan ultrasonografi grayscale terhadap pasien dilakukan untuk mengukur ketebalan korteks ginjal yang dilakukan di bagian tengah ginjal pada potongan longitudinal dan diukur dari puncak piramid tegak lurus ke arah kapsul, kemudian dilanjutkan pemeriksaan ultrasonografi doppler di arteri interlobar atau arcuata pada pole superior, median, dan inferior ginjal untuk menilai  renal resistiveindex. Data dianalisis dengan analisis statistik melalui uji korelasi Spearman dan Pearson.Hasil penelitian menunjukkan bahwa rerata sampel penelitian mengalami hidronefrosis derajat ringan. Mean tebal korteks ginjal kanan pada penelitian ini 0,9 cm (0,26-1,79cm) dan ginjal kiri 0,84 cm (0,22-1,57cm). Terdapat korelasi yang bermakna antara derajat hidronefrosis dengan ketebalan korteks ginjal kanan dan kiri dengan arah korelasi negatif (p=0,0001). Kecenderungan peningkatan derajat hidronefrosis, meningkatkan nilai resistive index meskipun secara statistik tidak bermakna. Tidak terdapat korelasi antara ketebalan korteks dan resistive index  ginjal berdasarkan pemeriksaan ultrasonografi.   Hydronephrosis can occur in one or both kidneys which causes the flow of urine to become weak and interfere with the function of the kidney. This research aimed to investigate the correlation between the cortex thickness and the resistive index of kidney based on the ultrasonography examination in hydronephrosis patients.  The research was conducted in Radiology Department of Dr. Wahidin Sudirohusodo General Hospital, Makassar from May through August 2018. The research design used was observational using the cross sectional design. The total samples comprised 40 samples with clinical hydronephrosis. The examination of ultrasonography grayscale was carried out in order to measure the cortex thickness of the kidneys in the central parts of kidneys and the longitudinal cut was measured from the pyramid top straight down the capsule, then it was continued with the Doppler ultrasonography examination in the interlobare artery or arcute at superior pole, median and inferior kidney in order to evaluate the renal resistive index. The data were analyzed using the statistical analysis through the correlation tests of Spearman and Pearson. The research results indicated that the mean research samples had experienced the light hydronephrosis. The mean cortex thickness of the right kidney was 0.9 cm (0.26 - 1.79 cm), and that of the left kidnet was 0.84 cm (0.22 - 1.57 cm). There was a significant correlation between the degree of hydronephrosis and the cortex thickness of the right and the left kidneys, with the direction of the negative correlation (p=0.0001). There was a tendency of the increase of hydronephrosis degree to increase the value of resistive index, though statistically it was insignificant. There was no correlation between the cortex thickness and the resistive index of kidney based on the ultrasonogrphy examination.  

2017 ◽  
Vol 89 (4) ◽  
pp. 305
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini ◽  
Vanni Giovannelli ◽  
Giuseppe Romano

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Cabac-Pogorevici ◽  
V Revenco

Abstract Purpose In arterial hypertension (HTN), vascular structural changes develop as a consequence of haemodynamic as well as neurohumoral factors. Indeed, in the peripheral vessels a decrease in arterial compliance and, in the heart remodelling occurs respectively. The significant impact of HTN on left heart remodelling and its interconnection with intrarenal hemodynamics (IRH) has been widely studied. In the same time, there is lack of data concerning the affinity of HTN, IRH and right heart remodelling, as another important cluster of factors for prediction of mortality and morbidity in this group of patients. Methods The study included 104 patients (50 females and 54 males, mean age 48,26±11,2 years) with grade I-III arterial hypertension. All subjects underwent careful clinical history and physical examination to reveal risk factors, cardiovascular history and treatments. Blood test, echocardiography focused on right heart evaluation, intrarenal Doppler measurements were repeated in three parts of both kidneys (superior, median, and lower) untill three reproducible waveforms were obtained. The following IRH parameters were obtained: renal resistive index (RRI), renal pulsatile index (RPI), acceleration time (AT), renal volume (RV) and RV/RRI ratio. Results The mean RRI was 0,6672±0,0452, mean RPI 1,2533±0,178, mean AT 66,68±2,324 ms, mean RV 129,67±23,79 ml and mean RV/IRR ratio 195,52±41,587 ml. Mean 24 hours SBP was 146,12±13,96 mmHg, mean 24 hours DBP 86,59±6,78 mmHg. The mean pulse pressure (PP) was 59,10±22,90 mmHg. The mean 24 hours heart rate (HR) was 75,14±26,86 beats/minute. Mean value for the right ventricular (RV) basal diameter (4Ch) was 29,5±3,71 mm, right atrium (RA) diameter 39,71±3,38 mm, RA area 16,98±2,89 mm2, Sm RV 0,11±0,05 mm/sec, TAPSE 19,2±1,66 mm, SPAP 28,3±5,321 mmHg. We found an important positive correlation between RA diameter and RA area with RRI (r=0,364, p<0,01), (r=0,371, p<0,01), RPI (r=0,296, p<0,01), (r=0,320, p<0,01) and AT (r=0,155, p<0,05), (r=0,148, p<0,05), and negative correlation of RV Sm with RRI (r=−0,259, p<0,01), RPI (r=−0,232, p<0,01), AT (r=−0,162, p<0,05), meanwhile PASP showed an important positive connection with RRI (r=0,354, p<0,01), RPI (r=0,330, p<0,01) and AT (r=0,218, p<0,01). Conclusions The assumption that cardiac structural changes are progressing in parallel with extracardiac target damage could have an important scientific substrate, emphasizing the potential connection of IRH and the heart remodelling, including the right heart in HTN, and the eventual strengthening the IRH positions as a predictor of cardiovascular outcomes in this subset of population.


2016 ◽  
Vol 41 (3) ◽  
pp. 125-130
Author(s):  
Mahbuba Shirin ◽  
Mofazzal Sharif ◽  
Ayeshna Gurung ◽  
Anindita Datta

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (? 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.


2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Ireine S. Waworuntu ◽  
John . Porotu'o ◽  
Olivia A. Waworuntu

Abstract: Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis). In Indonesia, there are about 430.000 new cases, of which 61.000 cases ended in death. This disease has many clinical varieties, therefore, a gold standard for the right and exact diagnosis is needed. The examination of sputum by using Ziehl-Neelsen staining must be more improved for public health service. This study aimed to determine the profile of Mycobacterium tuberculosis (acid-fast bacteria) among patients with coughing ≥2 weeks at Ranotana, Wenang and Sario Primary Health Cares (PHCs) by using Ziehl-Neelsen staining. This was a descriptive study with a cross sectional design. Samples were obtained by using total sampling method during the period of September 2015 - December 2015. The results showed that there were 38 cases of coughing ≥2 weeks as follows: 15 cases at Wenang PHC, 13 cases at Ranotana PHC, and 10 cases at Sario PHC. The examination of acid-fast bacteria from the 38 cases of three PHCs showed that 1 case (2.7%) had acid-fast bacteria (++). Conclusion: In this study, there was only one case (2,7%) with positive Mycobacterium tuberculosis. Keywords: cough more than two weeks, tuberculosis, BTA Abstrak: Tuberkulosis adalah suatu penyakit infeksi yang disebabkan oleh Mycobacterium tuberculosis (M. tuberculosis). Indonesia memiliki sekitar 430.000 kasus baru dimana 61.000 kasus berakhir dengan kematian. Penyakit ini memiliki gejala klinis yang bervariasi sehingga perlu ditetapkan standar baku untuk menegakkan diagnosis lebih cepat dan akurat. Pemeriksaan sputum dengan pewarnaan Ziehl-Neelsen harus lebih ditingkatkan pada pelayanan kesehatan masyarakat. Penelitian ini bertujuan untuk mendapatkan gambaran Mycobacterium tuberculosis (basil tahan asam, BTA) dengan pewarnaan Ziehl-Neelsen pada pasien batuk ≥2 minggu di Puskesmas Wenang, Puskesmas Ranotana, dan Puskesmas Sario Kota Manado. Jenis penelitian ini deskriptif dengan desain potong lintang. Pengambilan sampel menggunakan cara total sampling pada kurun waktu September 2015 - Desember 2015. Hasil penelitian mendapatkan 38 kasus batuk ≥2 minggu yaitu 15 kasus di Puskesmas Wenang, 13 kasus di Puskesmas Ranotana dan 10 kasus di Puskesmas Sario. Pada pemeriksaan (BTA) di Puskesmas Wenang, Puskesmas Ranotana dan Puskesmas Sario didapatkan BTA (++) 2,7% sedangkan BTA (-) 97,3%.Simpulan: Pada penelitian ini didapatkan 1 kasus (2,7%) Mycobacterium tuberculosis positif


2021 ◽  
Vol 5 (1) ◽  
pp. 66
Author(s):  
Ni Putu Lydya ◽  
Ni Putu Aryati Suryaningsih ◽  
Ni made Umi Kartika Dewi

Latar Belakang: Nyeri merupakan keluhan terbanyak yang mendorong masyarakat untuk melakukan praktek swamedikasi. Analgesik efektif dan memiliki indeks terapi yang luas, namun dapat berpotensi untuk menimbulkan efek samping yang serius bahkan ketika digunakan dalam dosis yang tepat. Penelitian ini bertujuan untuk mengetahui gambaran terkait rasionalitas penggunaan analgesik dalam swamedikasi nyeri di Kota Denpasar. Metode: Studi ini menggunakan desain cross-sectional dan melibatkan 196 responden yang dipilih dengan consecutive sampling. Data dikumpulkan dengan menyebarkan kuesioner pada enam apotek di wilayah Kota Denpasar dan dianalisis secara deskriptif. Hasil: Penelitian ini menemukan bahwa 50,5% responden menggunakan analgesik secara tidak rasional dalam praktek swamedikasi nyeri. Mayoritas responden yang menggunakan analgesik dalam swamedikasi nyeri adalah perempuan, usia 17-25 tahun, tingkat pendidikan tinggi, bekerja dan memiliki tingkat pendapatan yang rendah. Kesimpulan: Setengah dari total responden menggunakan analgesik secara tidak rasional dalam praktek swamedikasi nyeri. Tingginya ketidakrasionalan penggunaan analgesik dapat menyebabkan peningkatkan biaya pengobatan dan dapat menimbulkan kondisi yang berbahaya. Kata kunci: Penggunaan analgesik, rasionalitas, swamedikasi AbstractBackground: Pain is the most complaints of illness that encourage communities to use analgesics in self-medication practice. Analgesics are effective and have a broad therapeutic index, but may have potentially serious side effects even when they used in the right dosage. This study aimed to determine the rationality of analgesic use in pain self-medication in Denpasar City. Method: A cross-sectional design was used, and involved 196 respondents selected through consecutive sampling. Data were collected from questionnaire distribution in six pharmacies in Denpasar City and analyzed by using descriptive statistics. Result: This study found that 50,5% respondents used analgesics irrationally in pain self-medication practice. The majority of respondents who used analgesics in pain self-medication were females, aged 17-25 years old, high education level, employed, and had low income. Conclusion: Half of the total respondents used analgesics irrationally in pain self-medication practice. High of irrational analgesic use can increase medical costs and lead to dangerous conditions. Keywords:  Analgesic use, pain, rationality, self-medication


2019 ◽  
Vol 4 (1) ◽  
pp. e000302 ◽  
Author(s):  
Xinxin Zhang ◽  
Yueh Lee ◽  
Daniel Olson ◽  
David Fleischman

ObjectiveWe aim to describe the anatomy and symmetry patterns of the optic canal in patients having undergone maxillofacial CT imaging.MethodsIn this retrospective chart review, we included all patients who received sinus and maxillofacial CT at the University of North Carolina hospitals between 2008 and 2016, without facial or cranial fractures or other medical conditions that would affect optic canal size. We measured the length of ≥75% enclosed canal, minimum cross-sectional area and minimum diameter bilaterally using iNtuition TeraRecon (Durham, North Carolina) and compared bilateral symmetry using a 20 % difference threshold. Each parameter above was compared among white, black, non-white and non-black patients.ResultsOf 335 patients, the mean canal length was 5.61±2.22 mm. The mean minimum area was 11.84±3.11 mm2. The mean minimum diameter was 3.28±0.55 mm. A total of 39.4% (132/335) of patients had asymmetric canal lengths, 18.8% (63/335) had asymmetric minimum areas, and 12.5% (42/335) had asymmetric minimum diameters. No differences were found between racial groups. The right optic canal was larger than the left (right: 12.12 mm vs left: 11.55 mm, p<0.0001).ConclusionOptic canal asymmetry is not uncommon. It may affect risk of papilloedema severity, explain cases of unilateral or asymmetric papilloedema and possibly asymmetric glaucoma.


Author(s):  
Diah Wulandari ◽  
Mohamad Sulchan ◽  
Syarief Thaufik Hidayat

Background: Angiogenic and antiangiogenic imbalances play a major role in the pathogenesis of preeclampsia. Increased production of sFlt-1 by the placenta causes free circulating PIGF and VEGF concentrations to lower because it is bound by sFlt-1. Measuring levels of angiogenic and antiangiogenic proteins as biomarkers indicates placental dysfunction and distinguishes preeclampsia from other disorders. This study aims to analyze the levels of angiogenic and antiangiogenic molecules in pregnant women at risk for preeclampsia.Methods: The study with a cross-sectional design was carried out in 11-15 weeks gestational age whom had a risk of preeclampsia with 30 samples in primary health care starting April-August 2018. Blood serum was measured by molecular levels of VEGF, PlGF, sFlt-1, and sFlt-1/PlGF ratio using the ELISA method. Data analysis used Pearson product moment test.Results: The mean of VEGF levels are 15.5±21.6, PlGF 89.7±55.5, sFlt-1 11519.4±5126.0 and the ratio sFlt-1/PlGF 166.7±102.1. Correlation value of risk factors for preeclampsia with molecular levels of VEGF r= -0.05; p = 0.76, PlGF r= -0.21; p = 0.26, sFlt r= 0.01; p =0.99 and ratio sFlt-1/PlGF r = 0.10; p = 0.58.Conclusions: The higher the total score of preeclampsia risk factor, the lower the molecular level of VEGF and PlGF is. Moreover, the higher the total score of preeclampsia risk factor, the higher the molecular level sFlt-1 and the sFlt-1/PlGF ratio is. There are no significant correlation between total score of preeclampsia risk factor and levels of molecule VEGF, PlGF, sFlt-1 and sFlt-1/PlGF ratio.


2015 ◽  
Vol 9 (1) ◽  
pp. 11-16
Author(s):  
Fatema Johora ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Sunjida Shahriah ◽  
Rukshana Ahmed ◽  
Shamim Ara

Background: Controversies still prevail on glomerular changes of kidney whether due to normal aging or its association with diseases Objective: The aim of the present study was to see the variation in number and size of the glomeruli of kidney with increasing age in a Bangladeshi population based on autopsy. Methods: This cross-sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from July 2008 to June 2009, based on collection of 140 post mortem human kidneys collected from 70 unclaimed dead bodies from the morgue. All the samples were divided into three age-groups: 10-19 years, 20-39 years and 40-59 years. Histological slides were prepared by using routine Harris’ Haematoxylin and Eosin (H & E) stain. The number of glomeruli was measured by point counting technique, while the size (diameter) was measured by using ocular and stage micrometer. Results: The mean ± SE number of glomeruli per sq. mm found in the right and left kidney were 8.45±0.52 and 8.67±0.80 in group 10-19 years, 9.90±0.42 and 9.92±0.47 in 20-39 years, and 8.52±0.18 and 8.55±0.16 in 40-59 years respectively. Besides, the size (mean ± SE diameter) of glomeruli was found in the right and left kidney were 43.96±3.01ìm and 143.92±2.90ìm in group 10-19 years, 153.69±5.18ìm and 153.61±5.24ìm in 20-39 years, and 140.48±0.95ìm and 140.78±0.88ìm in 40-59 years respectively. Conclusion: No difference was found in number and size of glomeruli between right and left kidney in any group. Similarly, no difference was also evident among different age groups. DOI: http://dx.doi.org/10.3329/jbsp.v9i1.22788 Bangladesh Soc Physiol. 2014, June; 9(1): 11-16


Author(s):  
Dang Thi Hong Khanh ◽  
Nguyen Thi Ut ◽  
Nguyen Thi Chien ◽  
Giang Thi Thanh Ha ◽  
Vu Thi Thuy Linh

Objectives: To measure the waiting time for medical visit at the Outpatient Department 2, NationalChildren’s Hospital in 2018.Study method: Cross sectional design combines quantitative study.Result:The study on waiting time for medical visit of2060 patients showed that: the mean follow- up time was 32.5minutes. Average time for 01 technique was 137 minutes. The median time for medical consultation and 2techniques implemented was 162 minutes. The median time for the medical consultation and 03 techniquesimplemented was 208 minutes. Among sub- clinical techniques, blood test took the maximum time (137minutes).Conclusion: The waiting time for medical consultation was standardized according to the Decision 1313 /QĐ-BYT in 2013; Approximately 70 patients per visit / 8 hours.


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