scholarly journals PERBEDAAN LUARAN FUNGSIONAL PASIEN STROKE ISKEMIA AKUT DENGAN KONDISI HIPOALBUMINEMIA DAN TANPA HIPOALBUMINEMIA

2018 ◽  
Vol 1 (1) ◽  
pp. 32-39
Author(s):  
Dewa Ayu Citra Mahardina ◽  
Ismail Setyopranoto ◽  
Kusumo Dananjoyo ◽  
Anton Darmawan

Latar Belakang: Pasien yang memiliki hipoalbuminemia saat masuk rumah sakit berisiko tinggi mengalami komplikasi, luaran fungsional yang buruk dan berhubungan dengan peningkatan risiko kematian. Penilaian luaran fungsional dengan Index Barthel dianggap sensitif untuk menilai disabilitas serta mudah untuk dikerjakan. Tujuan: Untuk membandingkan luaran fungsional pasien stroke akut dengan kondisi hipoalbuminemia dan tidak hipoalbuminemia. Metode Penelitian: Penelitian analitik observasional menggunakan rancangan cross-sectional. Subjek penelitian diambil dari rekam medis pasien stroke infark dengan kondisi hipoalbuminemia dan tanpa hipoalbuminemia. Diagnosis stroke ditegakkan berdasarkan gejala klinis dan hasil Computed Tomography Scan. Metode statistik uji Mann Whitney digunakan untuk membandingkan luaran fungsional pasien stroke iskemia akut dengan kondisi hipoalbuminemia dan tanpa hipoalbuminemia. Hasil: Rerata skor Indeks Barthel kelompok hipoalbuminemia sebesar 40,33 ± 24,81 sedangkan kelompok tanpa hipoalbuminemia sebesar 87,67 ± 24,1. Uji Mann-Whitney menunjukkan perbedaan yang bermakna (p= 0,00). Simpulan: Terdapat perbedaan nilai luaran fungsional pada pasien stroke akut dengan kondisi hipoalbuminemia dan tanpa hipoalbuminemia.

2019 ◽  
Vol 48 (2) ◽  
pp. 165
Author(s):  
Putranti Dyahayu Roziaty ◽  
Soehartono Soehartono ◽  
Hendradi Surjotomo

Latar Belakang: Karsinoma nasofaring (KNF) merupakan keganasan yang tersering ditemukan, dan berdampak pada penurunan kualitas hidup serta memiliki mortalitas tinggi. Penanganan KNF selama ini terkendala oleh waktu tunggu yang cukup lama dalam menentukan staging KNF terutama untuk antrian pemeriksaan computed tomography scan (CT scan) dan Ultrasonography (USG). Pemeriksaan kadar DNA EBV (Deoxyribonucleic acid Epstein-Barr Virus) pada pasien yang relatif lebih mudah dan terjangkau dapat digunakan untuk memprediksi stadium dan prognosis KNF. Dengan mengetahui prognosis KNF lebih dini, maka diharapkan penanganan terhadap KNF dapat segera dilakukan. Tujuan: Mengetahui apakah kadar DNA EBV dapat dipakai untuk memprediksi stadium dan prognosis KNF dengan cara mencari hubungan antara kadar DNA EBV dengan stadium KNF. Metode: Penelitian cross sectional melibatkan 15 subjek penelitian yang terdiagnosis KNF WHO tipe 3 kemudian dilakukan staging dengan CT scan, USG abdomen, dan foto toraks, serta diambil sampel darah untuk diukur kadar DNA EBV. Hasil: Seluruh subjek penelitian mengalami peningkatan kadar DNA EBV sesuai dengan peningkatan stadium KNF. Peningkatan stadium KNF berhubungan signifikan dengan peningkatan kadar DNA EBV (p=0,001). Ukuran tumor (T) berhubungan signifikan dengan kadar DNA EBV (p=0,023), ukuran nodul (N) berhubungan signifikan dengan kadar DNA EBV (p=0,005), ada tidaknya metastasis tidak berhubungan signifikan dengan kadar DNA EBV (p=0,398). Nilai cut off kadar DNA EBV sebesar 952 kopi/ml. Kesimpulan: Terdapat hubungan yang signifikan antara kadar DNA EBV dengan stadium klinis, dengan demikian kadar DNA EBV dapat dipertimbangkan untuk digunakan sebagai prediktor stadium dan prognosis KNF. Background: Nasopharyngeal carcinoma (NPC) is the predominant tumor type arising in the nasopharynx,  with a high mortality and affecting quality of life.  NPC treatment  management is hindered by long queues of Computed Tomography Scan (CT scan) and Ultrasonography (USG) examinations to ascertain the NPC staging. The examination of Epstein-Barr Virus (EBV) DNA level is relatively simpler and inexpensive  to predict the NPC staging and prognosis, thus, it can speed up NPC treatment. Objective: To determine whether EBV DNA level can be used to predict the NPC  stage and prognosis by finding a correlation between EBV DNA level and NPC stage. Method: This was  a cross-sectional study involving 15 respondents who were diagnosed as WHO type 3 NPC, and examined by CT scan, abdominal ultrasound, chest X-ray,  and blood  test for measuring the levels of EBV DNA to determine the stage. Results: All respondents had elevated levels of EBV DNA in accordance with NPC stage elevation. Increased NPC stages were significantly correlated with elevated levels of EBV DNA (p=0.001). The size of tumor (T) was significantly correlated with EBV DNA (p=0.023), the size of nodule (N) was significantly correlated with EBV DNA (p=0.005).  The presence or absence of metastasis did not significantly correlate with EBV DNA (p=0.398). The EBV DNA cut off value was 952 copies/ml. Conclusions: There  was a significant correlation between EBV DNA levels and clinical stages, hence EBV DNA can be considered to be used as NPC staging and prognosis predictor.   


2020 ◽  
Vol 48 (1) ◽  
pp. 3-14
Author(s):  
Joko Suprayitno ◽  
Reno Budiman ◽  
Tommy Ruchimat

Latar Belakang. Insidensi apendisitis perforasi di dunia mencapai 2 per 10.000 kelahiran hidup, untuk proporsi apendisitis perforasi sekitar 25%. Kasus apendisitis di Indonesia berdasarkan data Kementerian Kesehatan RI pada tahun 2009 sebesar 596.132 kasus dengan persentase 3.36% dan meningkat pada tahun 2010 menjadi 621.435 kasus dengan persentase 3.53%. Sedangkan insidensi  di RS Hasan Sadikin  pada tahun 2017 mencapai 83% pasien yang datang dengan keluhan apendisitis telah mengalami perforasi. Pemeriksaan radiologik seperti computed tomography scan (CT), magnetic resonance imaging (MRI) ataupun ultrasonography (USG) memiliki sensitifitas dan spesifitas yang tinggi untuk mendiagnosis perforasi apendisitis, tetapi alat–alat ini tidak selalu tersedia di institusi–institusi kesehatan negara berkembang. Fibrinogen sebagai  faktor koagulasi yang pertama kali ditemukan dalam beberapa penelitian berpotensi digunakan sebagai prediktor perforasi pada pasien apendisitis, pemeriksaan fibrinogen dapat dilakukan sewaktu-waktu, memberikan hasil yang lebih cepat dengan harga yang lebih murah dibandingkan dengan pemeriksaan penunjang lain. Metode. Penelitian observasional analitik dengan pendekatan cross-sectional. Subjek pasien apendisitis periode 1 April 2018 – 31 Desember 2018 yang datang ke Installasi Gawat Darurat RSUP Dr. Hasan Sadikin Bandung dan bersedia mengikuti penelitian. Pasien yang didiagnosis kerja awal sebagai apendisitis akut atau pasien dengan appendisits perforasi dengan gejala peritonitis lokal atau peritonitis difus setelah dilakukan pemeriksaan klinis dan laboratorium. Pasien dilakukan  pemeriksaan fibrinogen serum preoperatif, lalu dilakukan operasi dan dicatat hasil temuan operasi yaitu yang mengalami perforasi dan yang tidak mengalami perforasi. Dilakukan pengelompokkan data setelah jumlah subyek penelitian terpenuhi. Hasil. Sebanyak 40 pasien (25 laki-laki, 15 perempuan) terdiagnosis apendisitis berdasarkan Alvarado Score, yang terdiri dari 20 pasien apendisitis akut dan 20 pasien apendisitis perforasi. Akurasi kadar fibrinogen serum dalam memprediksi terjadinya perforasi sebesar 85%. Nilai sensitivitas 90%, nilai spesifisitas 80%. Berdasarkan analisis kurva ROC diperoleh nilai Area Under Curve (AUC) sebesar 0,865 (p = 0,001). Menunjukkan bahwa kadar fibrinogen serum memiliki kemampuan diskriminasi yang tinggi dalam memprediksi terjadinya perforasi pada pasien apendisitis. Kesimpulan. Kadar fibrinogen serum yang meningkat dapat digunakan sebagai prediktor terjadinya perforasi pada pasien apendisitis. Kata kunci. Apendisitis perforasi, fibrinogen, prediktor (ISSN 2723-7494 J Bedah Indonesia. 2020;48:3-14)


2020 ◽  
Vol 9 (1) ◽  
pp. 49-55
Author(s):  
Dil Islam Mansur ◽  
Subindra Karki ◽  
Dilip Kumar Mehta ◽  
Pragya Shrestha ◽  
Sunima Maskey

Background: The vertebral column is the central pillar of the body which has cervical, thoracic, lumbar, sacral and coccygeal parts. Out of these, the lumbar part is made up of five lumbar vertebrae which lies between the thoracic part above and the sacral part below.  Objective: The study aimed to measure pedicle dimensions of lumbar vertebrae by using computed tomography scan. Methodology: This is a descriptive cross-sectional study which was conducted on 115 images of computed tomography scan collected from the Department of Radio-Diagnosis, Dhulikhel Hospital between May and October 2019 after receiving ethical approval from the Institutional Review Committee. All the scans available in the department were taken for the study. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data analysis was done in the Statistical Package for the Social Sciences version 16 (SPSS 16.0). Results: The pedicle chord length and breadth progressively decrease from L1 to L5 vertebral levels and pedicle thickness gradually increases from L1 to L5 vertebrae on both sides in both genders. The pedicle chord lengths were found significantly different whereas breadth and thickness were insignificantly different between males and females at all lumbar vertebral levels except at L1 for breadth. Conclusions: The pedicle chord length and breadth gradually decreases whereas thickness increases from L1 to L5 vertebral levels amongst Nepalese population.


2019 ◽  
Vol 26 (12) ◽  
pp. 2058-2063
Author(s):  
Usman Shahid ◽  
Faiza Farooq ◽  
Khawaja Khursheed ◽  
Ishfaq Ahmad Shad ◽  
Hira Babar

High resolution computed tomography scan, in modern years, is more effective than standard computed tomography scan and conventional chest radiography in localization of diseases in the lobule of lung and in the appraisal of pulmonary parenchymal diseases because of high-resolution power and minimal partial volume effect. Objectives: To identify pulmonary tuberculosis in clinically suspected patients by high resolution computed tomography scan of chest. Study Design: Cross Sectional Descriptive study. Setting: Department of Radiology, Mayo Hospital, Lahore. Period: 15th February 2018 to 15th November 2018. Material & Methods: After taking consent, fifty patients, fulfilling inclusion and exclusion criteria, were selected by convenient sampling in this cross sectional descriptive study. Demographic details, clinical history and High resolution tomographic scan findings were documented. Data analysis was performed on Microsoft excel and statistical package for social sciences (SPSS v21) and reported by descriptive statistics. Results: Out of 50 patients, pulmonary tuberculosis was diagnosed in 44(88%) patients, acute on chronic tuberculosis in 2(4%), healed tuberculosis in 2(4%), interstitial lung disease in 1(2%) & post tubercular sequela in 1(2%) patient. Majority were males (n=29, 58%) and most patients belonged to fifth decade of life (n=19, 38%). Overall mean age of patients was 45.14±12.16 years and mostly belonged to lower socioeconomic status (n=38, 76%). Most common symptom and High resolution computed tomography finding were low grade fever in 45(95%) & consolidation in 39(78%) patients, respectively. Conclusion: High resolution computed tomography scan is valuable in diagnosis of pulmonary tuberculosis & its related spectrum of diseases in patients having clinical suspicion of pulmonary tuberculosis.


2021 ◽  
Vol 15 (12) ◽  
pp. 3433-3434
Author(s):  
Mahwash Mansoor ◽  
Rizwana Rahman Bazai

Objective: To determine the effectiveness of computed tomography in pediatric patients referred to radiology department for computed tomography scan brain Study Design: Cross sectional study Place and Duration of Study: Radiology Department, Sandmen Provincial Hospital Quetta form 1st January 2018 to 30th March 2018. Methodology: Sixty pediatric patients included in the study who referred from Pediatric OPD for computed tomography scan of brain. Patients with trauma were excluded while all other patient’s age between 1 month to 4 years were included. Findings were divided with normal and abnormal findings. Results: Twenty five (41.7%) were boys and 35 (58.3%) were girls. Only 25% were negative and 75% were positive and showed significant pathology. Major complaint was fits accompanied with fever and unconsciousness was also one of the reasons. Conclusion: Computed tomography scan is quick and now-a-days with easy access it is an effective diagnostic method in sick children with cases of neurological disease in spite of its radiation exposure child. Key word: Computed tomography (CT), Effectiveness, Children


KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 3-8
Author(s):  
Momotaj Begum ◽  
Sabina Yiasmeen ◽  
Mahmud Hossain ◽  
Shafi Ahmed ◽  
Salahuddin Al Azad ◽  
...  

Background. Cerebral palsy is one of the common childhood neurological problem which occurs due to defect or lesion in immature brain. The worldwide incidence of cerebral palsy is approximately 2-2.5 per 1000 live births. There have been many works on the role of computed tomography scan in the diagnosis of cerebral palsy. Objective: The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. Materials and Methods: This cross sectional study was carried out in the department of Radiology and Imaging, BSMMU and department of Paediatric Neurology unit over a period of 12 months from January 2019 to December 2019. We calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan in diagnosis of CP in children. Results: This cross sectional study was carried out on consecutively selected 94 children below 15 years having clinical evidence of cerebral palsy. Among the study subjects 86.2% were diagnosed as cerebral palsy through CT scan. Conclusion: The sensitivity and specificity of CT scan of present study was found to be quite high in children which suggests a CT scan as an effective investigation for the diagnosis of cerebral palsy. KYAMC Journal Vol. 11, No.-1, April 2020, Page 3-8


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