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Published By Universitas Sam Ratulangi

2337-5949

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 561
Author(s):  
Feldy Deki ◽  
Mendy Hatibie ◽  
Maximillian Ch. Oley ◽  
Fredrik G. Langi

Abstract: Application of CLEFT-Q score instrument in the assessment of surgical outcomes for cleft lip and/or cleft palate based on patient reports is still relatively new. This study was aimed to establish the normative value of the Indonesian version of CLEFT-Q score in post-cleft lip surgery patients and to differentiate the results of cleft lip surgery according to the score based on the type of cleft, age, and sex. This was a preliminary study using the Indonesian CLEFT-Q instrument. Patients were interviewed for filling out the Indonesian version of CLEFT-Q after surgery. There were 75 samples in this study. Significant results were found in the association between age and CLEFT-Q score (p<0.05 and R>0.35). Variable selection for multi-variable analysis included cleft type and age in the model, where age alone indicated a significant relationship. The linear regression model involved the relationship between CLEFT-Q scores and gender, age, and cleft type as covariates. The correlation shown was classified as having moderate strength (R=0.46) for all covariates. In conclusion, the normative value of the Indonesian version of CLEFT-Q score with an approach to post-cleft lip surgery patients got a value that was in accordance with the highest standard in the literature, namely 91. The results of cleft lip surgery according to the Indonesian version of CLEFT-Q score based on the type of cleft, age and gender can be applied according to the literature.Keywords: cleft lip; cleft palate; cleft lip and palate; Indonesian version of CLEFT-Q Abstrak: Penerapan skor CLEFT-Q dalam penilaian luaran operasi bibir sumbing dan/atau langit-langit terbelah berdasarkan laporan pasien masih relatif baru. Penelitian ini bertujuan untuk mene-gakkan nilai normatif skor CLEFT-Q berbahasa Indonesia pada pasien pasca operasi bibir sum-bing serta membedakan hasil operasi bibir sumbing menurut skor tersebut berdasarkan tipe cleft, usia, dan jenis kelamin. Jenis penelitian ialah studi pendahuluan penggunaan CLEFT-Q berbahasa Indonesia. Pasien diwawancarai untuk melakukan pengisian CLEFT-Q berbahasa Indonesia setelah operasi. Hasil penelitian mendapatkan total 75 sampel. Hasil bermakna ditemukan pada hubungan antara usia dan skor CLEFT-Q (p <0,05 dan R > 0,35). Seleksi variabel untuk analisis multivariabel mengikutsertakan tipe cleft dan usia di dalam model, dan variabel usia saja yang mengindikasikan adanya hubungan bermakna (95% CI 1,15-2,33; p=0,006). Model regresi linear melibatkan hubungan antara skor CLEFT-Q dengan jenis kelamin, usia, dan tipe cleft sebagai kovariat dan mendapatkan korelasi kekuatan sedang (R=0,46) untuk semua kovariat. Simpulan penelitian ini ialah nilai normatif skor CLEFT-Q berbahasa Indonesia dengan pendekatan terhadap pasien pasca operasi bibir sumbing mendapatkan nilai yang sesuai dengan standar tertinggi pada kepustakaan yaitu 91. Hasil operasi bibir sumbing menurut skor CLEFT-Q berbahasa Indonesia berdasarkan tipe cleft, umur dan jenis kelamin dapat diterapkan sesuai kepustakaan.Kata kunci: cleft lip; cleft palate; cleft lip and palate; skor CLEFT-Q berbahasa Indonesia


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 556
Author(s):  
Hanni Djunadi ◽  
Maximillian Ch. Oley ◽  
Eko Prasetyo ◽  
Mendy Hatibie ◽  
Fredrik G. Langi

Abstract: Patients with end-stage glioblastoma multiforme (GBM) that cannot be operated or treated with chemotheraphy and radiotheraphy have increased clinical complaints, thus affecting the patients’ quality of lifes (QoL). Hyperbaric oxygen therapy (HBOT) could alters hypoxic condition in tumor tissue with a different cascade from wound healing process. This study was aimed to assess whether the QoL of end-stage GBM patients could improve with the administration of HBOT assessed by decreased clinical complaints based on NANO score. The study was carried out at the Surgery Department of Prof. Dr. R. D. Kandou Hospital Manado, using pre and posttrial design. Each sample was assessed for the NANO score before HBOT, after one time, three times, five times, and 10 times of HBOT. The results showed that there was a change in the NANO score before and after 10 times of HBOT. The decrease in the NANO score occurred more quickly after the therapy. In the last two measurements, the NANO score according to the RVC model decreased from one to two units. The decreased NANO score occurred quite regularly with variations in the score that changed from time to time. In conclusion, HBOT can improve the QoL of patients with end-stage GBM and reduce the NANO score which is an assessment of clinical complaints of the patients.Keywords: glioblastoma multiforme; hyperbaric oxygen therapy; NANO score Abstrak: Penderita glioblastoma multiforme (GBM) stadium akhir yang tidak dapat dilakukan operasi, kemoterapi dan radioterapi memiliki keluhan klinis yang semakin meningkat sehingga memengaruhi kualitas hidup. Terapi oksigen hiperbarik (TOHB) dapat mengubah kondisi hipoksia pada jaringan tumor dengan kaskade yang berbeda dari proses penyembuhan luka. Penelitian ini bertujuan untuk menilai apakah kualitas hidup pasien GBM stadium akhir dapat membaik dengan pemberian TOHB, dinilai dengan menurunnya keluhan klinis berdasarkan NANO score. Penelitian dilakukan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado, dengan menggunakan pre and posttrial design. Pada setiap sampel dilakukan penilaian NANO score sebelum TOHB, setelah satu kali, tiga kali, lima kali, dan 10 kali TOHB. Hasil penelitian mendapatkan adanya perubahan NANO score sebelum TOHB dan setelah 10 kali TOHB. Penurunan NANO score berlangsung lebih cepat pasca terapi tersebut. Dalam dua pengukuran terakhir, NANO score menurut model RVC turun dari satu hingga dua satuan. Pada grafik, hasil penurunan NANO score terjadi cukup beraturan dengan variasi score yang berubah dari waktu ke waktu. Simpulan penelitian ini ialah TOHB dapat meningkatkan kualitas hidup penderita GBM stadium akhir dan menurunkan NANO score yang menjadi penilainan keluhan klinis penderita.Kata kunci: glioblastoma multiforme; terapi oksigen hiperbarik; NANO score


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 550
Author(s):  
Nidia Limarga ◽  
Mendy Hatibie ◽  
Maximillian Ch. Oley

Abstract: Gnatoschizis is a congenital disorder due to complex causes involving many genetic and environmental factors. The shape and complexity of the cleft varies greatly, which will determine the final outcome of the reconstruction. The management involves a multidisciplinary approach including orthodontics, prosthodontics, as well as speech and psychological therapist. Bone grafting materials such as iliac crest (corticocancellous autogenous), bone morphogenetic proteins and recombinant human proteins have shown good long-term results. An additional method that is considered effective in accelerating bone growth is the administration of hyperbaric oxygen therapy (HBOT) which has been reported to increase the accumulation of minerals needed for osteogenesis, such as calcium, magnesium, and phosphorous. We reported a case of a 14-year-old girl with gnatoschizis who underwent an alveolar bone graft surgery and one day after the operation was immediately followed by administration of (HBOT) to improve the bone healing process. cleft location. Autogenous iliac bone graft was used for closure of the bony defect at the site of the cleft. Follow up at day-14 showed a satisfying result. In conclusion, in this patient continuity of upper dental arch was achieved as well as optimal alar basis, no fistula, stabile upper dental arch for orthodontic treatment, and ideal alveolar morphology that supported the ultimate goal of cleft palate treatment - improvement of quality of life.Keywords: gnatoschizis; alveolar bone graft; hyperbaric oxygen therapy  Abstrak: Gnatoschizis merupakan kelainan kongenital dengan penyebab kompleks yang meli-batkan banyak faktor genetik dan lingkungan. Bentuk dan kompleksitas sumbing sangat bervariasi, yang akan menentukan hasil akhir rekonstruksi. Tatalaksananya melibatkan pendekatan multi-disiplin termasuk ortodontik, prostodontik, serta terapi wicara dan psikologis. Bahan pencang-kokan tulang seperti krista iliaka (corticocancellous autogenous), protein morfogenetik tulang dan protein manusia rekombinan telah menunjukkan hasil jangka panjang yang baik. Salah satu metode tambahan yang dianggap efektif mempercepat pertumbuhan tulang ialah pemberian terapi oksigen hiperbarik (TOHB) yang telah dilaporkan meningkatkan akumulasi mineral yang dibutuh-kan untuk osteogenesis, seperti kalsium, magnesium, dan fosfor. Kami melaporkan kasus seorang anak perempuan berusia 14 tahun dengan gnatoschizis yang menjalani operasi cangkok tulang alveolar dan satu hari setelah operasi langsung dilanjutkan pemberian TOHB untuk meningkatkan proses penyembuhan tulang. Cangkok tulang iliaka autogenous digunakan untuk penutupan defek tulang di lokasi sumbing. Follow up pada hari ke 14 di poliklinik dengan pemeriksaan fisik pada defek lokasi sumbing mendapatkan hasil yang memuaskan. Simpulan laporan kasus ialah pada pasien ini diperoleh kontinuitas lengkung rahang atas, basis alar yang optimal, fistula dihilangkan, segmen rahang atas yang stabil untuk perawatan ortodontik, dan morfologi alveolar yang ideal yang menyokong tujuan akhir tatalaksana sumbing yaitu perbaikan kualitas hidup.Kata kunci: gnatoschizis; cangkok tulang alveolar; terapi oksigen hiperbarik


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 541
Author(s):  
Leonardo V. Sagay ◽  
Maximillian Ch. Oley ◽  
Mendy J. Hatibie ◽  
Eko Prasetyo ◽  
Filma L. F. G. Langi

Abstract: Hyperbaric oxygen therapy (HBOT) uses 100% oxygen at a pressure of more than 1 ATM in a chamber, therefore, it can improve the state of tissue hypoxia. This study was aimed to prove that TOHB could increase the MoCA-INA score in mild traumatic brain injury (mTBI). This study was carried out at the Surgery Department of Prof. Dr. R. D. Kandou Hospital, Manado using the pre and post trial design. Subjects were 20 patients with mTBI divided into two groups: treated with HBOT and control group (without HBOT). Each patient involved would be examined for MoCA-INA before and after treatment or with HBOT added. The results showed that before treatment, the MoCA-INA scores tended to be evenly distributed around 36 (SD 5). The score increased to 71 (SD 10) at post-injury management or a mean increase of 35 points (p<0.001 in the paired two-sample t-test). However, there was no significat difference in MoCA-INA scores between the first and the second measurements. The density of the two groups clearly overlapped even though the variation of MoCA-INA scores of the HBOT group was much wider than that of the control group (p=0.302 and 0.297 in the first and second measurements, respectively). There was no cognitive disturbance either mild, moderate, or severe in all patients. In conclusion, there was an increase of the MoCA-INA value in mTBI patients after treatment. The patients treated with HBOT showed wider variation of MoCA-INA score of pre and post HBOT than those without HBOT Keywords: HBOT; mTBI; MoCA-INA; cognitive function Abstrak: Terapi oksigen hiperbarik (TOHB) menggunakan oksigen 100% pada tekanan lebih dari 1 ATM dalam sebuah chamber sehingga dapat memperbaiki keadaan hipoksia jaringan. Penelitian ini bertujuan untuk membuktikan bahwa TOHB dapat meningkatkan nilai MoCA-INA pada pasien cedera otak traumatik ringan (COTr). Penelitian dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou, Manado dengan menggunakan pre and posttrial design. Subyek penelitian ialah 20 pasien COTr dibagi dalam dua kelompok: dengan dan tanpa TOHB (kelompok kontrol). Setiap subyek diperiksa MoCA-INA sebelum dan sesudah penatalaksanaan cedera/disertai TOHB. Sebelum penatalaksanaan cedera, rerata skor MoCA-INA sekitar 36 (SD 5) dan nilai tersebut meningkat menjadi 71 (SD 10) pasca penatalaksanaan cedera atau kenaikan rerata 35 poin (p<0,001 pada uji t dua sampel berpasangan). Tidak tampak perbedaan skor MoCA-INA baik pada pengukuran pertama maupun kedua. Densitas kedua kelompok terlihat jelas tumpang tindih sekalipun variasi skor MoCA-INA group TOHB jauh lebih lebar daripada group kontrol (p=0,302 dan 0,297 masing-masing pada pengukuran pertama dan kedua). Tidak terlihat adanya gangguan kognitif ringan sedang maupun berat pada semua pasien. Simpulan penelitian ini ialah terdapat peningkatan nilai MoCA-INA pada pasien COTr. Pasien dengan TOHB memperlihatkan variasi skor MoCA-INA yang lebih besar pada pre dan pasca TOHB.Kata kunci: TOHB; COT; MoCA-INA; gangguan kognitif


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 532
Author(s):  
Mario L. Mewengkang ◽  
Gustaaf A. E. Ratag ◽  
Jimmy Posangi

Abstract: Hospitals as the health referral facilities play an important role in decreasing the maternal mortality rate (MMR) since they also belong to the personal health service as a whole including mother child health care. This study was aimed to analyze the implementation opportunities and challenges of developing ‘hospital without walls’ program in obstetrics and gynaecology services at RSUD (Rumah Sakit Umum Daerah) Noongan. This was a qualitative study. Informants in this study were taken from three places, as follows: the hospital, namely the Director of the Hospital and obstetrician-gynaecologist doctors; puskesmas (primary health center), namely the heads of puskesmas; and the community. Data were collected through in-depth interviews and direct observation. The results indicated that ‘hospital without walls’ in obstetrics and gynaecology services at RSUD Noongan had the opportunity to be implemented because this program had been partly applied by the hospital and it had a good impact on the hospital, health center, and the community as well as PONED-PONEK collaboration. The challenges of imple-menting this program at RSUD Noongan were the existence of cold cases caused by gatekeeper failure, lack of health facilities and human resources at the puskesmas, and insubstantial collaboration between PONED-PONEK. In conclusion, ‘hospital without walls’ program in obste-trics and gynaecology services can be implemented at RSUD Noongan with awareness to the possible challenges in its development.Keywords: opportunity and challenge; hospital without walls; obstetrics and gynecology services Abstrak: Rumah sakit sebagai fasilitas kesehatan rujukan paripurna berperan penting dalam menurunkan angka kematian ibu (AKI) termasuk pelayanan kesehatan ibu dan anak (KIA). Penelitian ini bertujuan untuk menganalisis peluang pelaksanaan dan tantangan pengembangan program hospital without walls pada pelayanan kebidanan dan kandungan di RSUD Noongan. Jenis penelitian ialah kualitatif. Informan penelitian diambil dari tiga tempat yaitu: RSUD Noongan (Direktur Rumah Sakit dan dokter spesialis obstetri dan ginekologi); puskesmas (kepala puskesmas); dan masyarakat. Data dikumpulkan melalui wawancara mendalam dan observasi langsung. Hasil penelitian memperlihatkan bahwa hospital without walls pada pelayanan kebi-danan dan kandungan di RSUD Noongan berpeluang untuk dilaksanakan karena sebagian pro-gram ini telah diterapkan oleh rumah sakit dan juga berdampak baik bagi rumah sakit, puskesmas dan masyarakat, serta kolaborasi PONED-PONEK. Tantangan pelaksanaan program ini di RSUD Noongan yaitu adanya cold case yang merupakan kegagalan gatekeeper, fasilitas kesehatan dan sumber daya manusia (SDM) yang masih kurang di puskesmas, serta kolaborasi PONED-PONEK belum optimal. Simpulan penelitian ini ialah program hospital without walls pada pelayanan kebidanan dan kandungan berpeluang untuk dilaksanakan di RSUD Noongan dengan memperhatikan tantangan pengembangan.Kata kunci: peluang dan tantangan; hospital without walls; pelayanan kebidanan dan kandungan


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 524
Author(s):  
Raven C. P. Maubanu ◽  
Rizaldy T. Pinzon ◽  
M. M. A. Dewi Lestari

Abstract: There are several types of medications that can be used to relieve pain in low back pain (LBP) cases, inter alia non-steroidal anti-inflammatory drugs (NSAIDs), opioids, non-opioid analgesics, antidepressants, and muscle relaxants. This study was aimed to compare the functional status of patients treated with combination of ibuprofen and eperisone hydrochloride and those treated with ibuprofen only. This was a randomized controlled trial. Samples were taken by using purposive sampling with a total of 100 samples as subjects, divided into two groups: group 1 as the experimental group treated with combination therapies of ibuprofen and eperisone hydrochloride and group 2 as the control group treated with ibuprofen only. The therapy was performed for three times with a span of two weeks between each visit. The functional status was measured with finger-to-floor distance (FFD) test and the analysis was performed by using the chi-square test. The results showed 39 males and 61 females as subjects. There was no meaningful difference on the basic characteristics. The functional status of the subjects improved as the intensity of pain decreased. The results of the FFD test indicated that there was improvement of functional status of each group on the second visit, as follows: group 1 had 30 subjects (62.5%) with a distance of <10 cm and group 2 had 24 subjects (55.8%) with a distance of <10 cm. In conclusion, the functional status of non-specific acute lower back pain patients treated with combination of ibuprofen and eperisone hydrochloride was better than those treated with ibuprofen only.Keywords: low back pain; functional status; ibuprofen; eperisone hydrochloride combination  Abstrak: Terdapat beberapa jenis obat yang dapat digunakan untuk menghilangkan nyeri pada nyeri punggung bawah (NPB), antara lain golongan obat anti inflamasi non steroid (OAINS), opioid, analgesik non-opioid, antidepresan, dan pelemas otot. Hasil penelitian menunjukkan bahwa OAINS tidak cukup memadai sehingga perlu tambahan pelemas otot. Penelitian ini bertujuan untuk mendapatkan perbandingan status fungsional pasien yang diberikan terapi kombinasi ibuprofen dan eperison dengan yang diberikan terapi ibuprofen saja. Penelitian ini menggunakan randomized controlled trial. Sampel diambil menggunakan purposive sampling dengan total 100 sampel sebagai subjek. Subjek dibagi menjadi dua kelompok, yaitu kelompok 1 sebagai kelompok eksperimental yang diberikan terapi kombinasi ibuprofen dan eperison dan kelompok 2 sebagai kelompok pembanding yang diberikan terapi ibuprofen. Terapi dilakukan sebanyak 3 (tiga) kali dengan rentang waktu dua minggu antara setiap kunjungan. Status fungsional diukur dengan finger-to-floor distance test (FFD). Data penelitian dianalisis dengan uji chi-square. Hasil penelitian mendapatkan 39 laki-laki dan 61 perempuan sebagai subyek penelitian. Tidak terdapat perbedaan bermakna pada karakteristik dasar. Status fungsional subjek semakin membaik bila intensitas nyeri semakin berkurang. Hasil FFD test menunjukkan adanya perbaikan status fungsional setiap kelompok pada kunjungan kedua, yaitu pada kelompok 1 terdapat 30 subjek (62,5%) yang memiliki jarak <10 cm dan pada kelompok 2 terdapat 24 subjek (55,8%) yang memiliki jarak <10 cm. Simpulan penelitian ini ialah status fungsional pada pasien NPB akut non-spesifik yang diberikan pengobatan terapi kombinasi ibuprofen dan eperison lebih baik daripada yang diberikan pengobatan ibuprofen saja.Kata kunci: nyeri punggung bawah; status fungsional; ibuprofen; eperison


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 517
Author(s):  
Hafsia K. N. Mokodompit ◽  
Lydia E. N. Tendean ◽  
Max F. J. Mantik

Abstract: Health worker is everyone who devotes him/herself in the health sector and has knowledge and skills through education in the health sector, such as nurse and midwife. The maximum service of a health worker can be achievd if the level of satisfaction is good. Various factors can affect the satisfaction of nurses and midwives working in an hospital organization, such as welfare, responsibility, and work motivation. This study was aimed to assess the relation-ship between welfare, responsibility, work motivation and satisfaction among nurses and mid-wives. This was an analytical, observational, and quantitative study with a cross sectional design. There were 119 health workers of General Hospital GMIBM Monompia Kotamobagu involved in this study consisting of 107 nurses and 12 midwives obtained by using the total sampling method. The multiple linear test showed that the level of welfare affected job satisfaction (p=0.000), while responsibility and motivation did not affect job satisfaction (p=0.371 and p=0.415). The simultaneous test resulted in an F-value of 6.112 where welfare/income, respon-sibility, and motivation simultaneously affected the job satisfaction of nurses and midwives. In conclusion, welfare significantly influenced the satisfaction of nurses and midwives meanwhile responsibility and motivation did not.Keywords: level of welfare; responsibility; motivation and job satisfaction Abstrak: Tenaga kesehatan adalah setiap orang yang mengabdikan diri dalam bidang kesehatan serta memiliki pengetahuan dan keterampilan melalui pendidikan di bidang kesehatan seperti perawat dan bidan. Pemberian pelayanan yang maksimal dari tenaga kesehatan dapat tercapai bila tingkat kepuasan kerja perawat dan bidan baik. Berbagai faktor dapat mempengaruhi kepuasan kerja pada perawat dan bidan dalam suatu organisasi rumah sakit, di antaranya tingkat kesejahteraan, tanggung jawab, dan motivasi kerja. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat kesejahteraan, tanggung jawab, dan motivasi dengan kepuasan kerja pada perawat dan bidan. Jenis penelitian ialah kuantitatif dan analitik observasional dengan desain potong lintang. Subyek penelitian berjumlah 119 orang tenaga kesehatan Rumah Sakit Umum GMIBM Monompia Kotamobagu, terdiri dari 107 perawat dan 12 bidan diperoleh dengan teknik total sampling. Hasil penelitian uji linear berganda mendapatkan tingkat kesejahteraan memengaruhi kepuasan kerja (p=0.,00), sedangkan tanggung jawab dan motivasi tidak meme-ngaruhi kepuasan kerja (p=0,371 dan p=0,415). Pada hasil uji simultan didapatkan nilai F=6,112 dimana kesejahteraan/pendapatan, tanggung jawab, dan motivasi secara serempak memengaruhi kepuasan kerja. Simpulan penelitian ini ialah kesejahteraan/pendapatan mempunyai pengaruh bermakna terhadap kepuasan kerja perawat dan bidan sedangkan tanggung jawab dan motivasi tidak mempunyai pengaruh terhadap kepuasan kerja perawat dan bidan.Kata kunci: kesejahteraan; tanggung jawab; motivasi kerja dan kepuasan kerja


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 509
Author(s):  
Harris J. Tampubolon ◽  
Adrian Tangkilisan ◽  
Wega Sukanto ◽  
Grace E. C. Korompips

Abstract: Diabetic foot ulcer (DFU) prevalence tends to increase every year. Within 30 seconds it is predicted that one leg will be amputated due to DFU. New blood formation triggered by adjuvant extracorporeal shock wave therapy (ESWT) on increasing VEGF level is expected to promote DFU healing. This study was aimed to prove whether ESWT as an adjuvant therapy could stimulate DFU healing by increasing VEGF serum level. This was a quasi-experimental study using two groups, the ESWT and the control groups. Two repeated measurements of VEGF levels and PEDIS scores were performed. The ESWT group (17 patients) received the adjuvant ESWT and the control group (7 patients) received conventional wound care therapy. Both groups received 8-time treatment for 4 weeks. Measurements of VEGF levels and PEDIS scores were performed at baseline and after 4 weeks. The results showed that the PEDIS score of the ESWT group decreased, albeit, not in the control group. The VEGF level of the ESWT group significantly increased (mean rank=13.24) compared to the control group (mean rank=7.33). The Wilcoxon signed-ranks test indicated that the PEDIS score in ESWT group had a significant decrease compared to the control group (mean rank=7.50), Z=-3.372, p=<.001. The Pearson correlation test showed a significant relationship between VEGF value and the PEDIS score reduction (81.4%).  In conclusion, the adjuvant ESWT therapy could promote DFU healing (reduced PEDIS score) and increase VEGF levels in DFU patients.Keywords: ESWT; VEGF; diabetic foot ulcer (DFU) Abstrak: Prevalensi ulkus kaki dibetik (UKD) terus meningkat setiap tahunnya dan dalam 30 detik diprediksi terdapat satu kaki yang diamputasi karena UKD. Pembentukan pembuluh darah baru yang dipicu oleh penggunaan adjuvan ESWT terhadap peningkatan kadar VEGF diharapkan dapat memper-cepat penyembuhan UKD. Penelitian ini bertujuan untuk membuktikan terapi adjuvan ESWT dapat meningkatkan kadar VEGF dalam penyembuhan UKD. Jenis penelitan ialah kuasi-eksperimental yang membandingkan dua kelompok perlakuan (ESWT vs kontrol) melalui dua pengukuran berulang terhadap kadar VEGF dan skor pedis. Kelompok ESWT (17 pasien) mendapatkan terapi adjuvan ESWT dan kelompok kontrol (7 pasien) mendapatkan terapi konvensional perawatan luka. Kedua kelompok mendapatkan perlakuan 2 kali per minggu selama 4 minggu. Pengukuran kadar VEGF dan skor pedis pada baseline dan setelah selesai 4 minggu perlakuan. Hasil penelitian mendapatkan penurunan skor PEDIS hanya pada kelompok ESWT (14 pasien), Kadar VEGF kelompok perlakuan didapatkan meningkat bermakna (mean rank=13,24) dibandingkan kelompok kontrol (mean rank=7,33) (p<0,001). Wilcoxon Signed-Ranks Test mengindikasikan bahwa nilai skor PEDIS kelompok ESWT mengalami penurunan bermakna dibandingkan kelompok kontrol (mean rank=7,0), Z=-3,372, p=<0,001. Uji korelasi Pearson menunjukkan hubungan bermakna antara perubahan nilai VEGF dengan skor pedis (81,4%). Simpulan penelitian ini ialah terapi adjuvan ESWT dapat memicu penyembuhan UKD (menurunkan skor PEDIS) dan meningkatkan kadar VEGF pada pasien UKDKata kunci: ESWT; VEGF; ulkus kaki diabetik (UKD)


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 504
Author(s):  
Akbar S. Putera ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley ◽  
Fima L. F. G. Langi

Abstract: Traumatic brain injury (TBI) could result in disorders of central nervous system (CNS). Serum laminin level and the FOUR score have both been suggested as predictors for the outcomes after TBI. This study was aimed to evaluate the relationship between serum laminin level and the FOUR score in TBI patients. This was an observational and analytical study with a cross-sectional design. Subjects were 32 patients with TBI and FOUR scores of 0-16 admitted at the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital. Venous blood sample for laminin was taken less than 24 hours after trauma. Assessment of the level of consciousness was determined by using the FOUR score at Emergency Surgery Installation admission <24 hours and observation after >24 hours. Proportional regression model was used to assess changes in FOUR score associated with laminin level. The results obtained 32 patients with TBI, mean laminin level was 818.4 pg/mL with range IQR 597.4-1235.4 pg/mL. In final regression model, each increase of one unit of pre-24 hours FOUR score decreased serum laminin level by 54.4 pg/mL (95% CI -76.3; 32.1 pg/mL, p<0.001). Same as the relationship occurred for the FOUR score after 24 hours, but the decrease was slightly smaller, at 37.2 pg/mL (95% CI -50.2; -24.3 pg/mL, p<0.001). FOUR scores with a high risk of mortality were more likely to be found in relatively high serum laminin levels. In conclusion, there is a relationship between serum laminin level and the FOUR score. Increase in serum laminin level is a potential alternative to lower FOUR score and to predictof poorer outcome in patient with TBI.Keywords: laminin; FOUR score; traumatic brain injury (TBI) Abstrak: Pada cedera otak akibat trauma (COT) sering terjadi gangguan saraf pusat. Laminin serum dan skor FOUR disarankan sebagai prediktor luaran setelah COT. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dan skor FOUR pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Penelitian dilaksanakan pada 32 pasien dengan COT dan skor FOUR 0-16 yang masuk ke Instalasi Rawat Darurat Bedah (IRDB) RSUP Prof. Dr.R. D. Kandou, Manado. Sampel darah vena untuk pemeriksaan serum laminin diambil kurang dari 24 jam setelah trauma. Penilaian tingkat kesadaran ditetapkan dengan skor FOUR saat masuk IRDB <24 jam dan observasi setelah >24 jam. Model regresi proporsional digunakan untuk menilai hubungan kadar laminin serum dengan skor FOUR. Hasil penelitian mendapatkan 32 pasien dengan COT. Rerata kadar laminin serum 818,4 pg/mL dengan range IQR 597,4-1.235,4 pg/mL. Pada model regresi akhir, setiap peningkatan satu unit skor FOUR pra 24 jam rata-rata menurunkan kadar laminin serum sebesar 54,4 pg/mL (95% CI -76,3; 32,1 pg/mL, p<0,001). Hubungan sejenis terjadi untuk skor FOUR pasca 24 jam, tetapi nilai penurunannya sedikit lebih kecil, yakni 37,2 pg/mL (95% CI -50,2; -24,3 pg/mL, p<0,001). Skor FOUR dengan risiko mortalitas tinggi lebih cenderung ditemukan pada kadar laminin serum relatif tinggi. Simpulan penelitian ini ialah terdapat hubungan antara kadar laminin serum dengan skor FOUR. Peningkatan kadar laminin serum merupakan alternatif potensial skor FOUR yang lebih rendah untuk memrediksi luaran yang lebih buruk pada pasien COT.Kata kunci: laminin; skor FOUR; cedera otak akibat trauma (COT)


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 492
Author(s):  
Ade J. Nursalim ◽  
Elbetty Simanjuntak ◽  
Vera Sumual

Abstract: Age-related macular degeneration (AMD) is a neurodegenerative disease that affects the macula and is characterized by age-related loss of the central visual field. AMD contributes greatly to blindness for people over 50 years old in the world. The prevalence of AMD is increasing from year to year. Albeit, during the Covid-19 pandemic the number of patient visits to health facilities tends to decrease. This study was aimed to report the clinical characteristics of patients with AMD in tertiary health facilities during the covid 19 pandemic and to compare them with previous reports. This was a retrospective and descriptive study using medical record data of the Ophthalmology Clinic of Prof. Dr. R. D. Kandou Hospital Manado from March 2020 to June 2021. There were 12 patients in this study consisting of 10 males and two females. Age range of 56-75 years had the highest percentage (58%). The non-neovascular subtype were found in 7 patients (58.3%) meanwhile the neovascular type in 5 patients (41.7%). The identified risks were hypertension (50%), diabetes mellitus (DM) (8.3%), and DM associated with hypertension (16,7%), meanwhile no risk factor was found in 8.3% of patients. The number of patient visits decreased in the study period compared to previous reports conducted before the pandemic. In conclusion, the majority of AMD patients were male, age group of 56-75 years, and had non-neovascular subtype. The identified risk factors were hypertension and diabetes mellitus.Keywords: age related macular degeneration (AMD); characteristics of patients Abstrak: Age-related macular degeneration (AMD) adalah penyakit neourodegeneratif yang mengenai bagian makula dan ditandai dengan hilangnya lapang pandang sentral yang berhu-bungan dengan usia. AMD berkontribusi besar terhadap angka kebutaan untuk usia di atas 50 tahun di dunia. Prevalensi AMD pun semakin meningkat dari tahun ketahun. Pandemi Covid 19 diketahui mengurangi angka kunjungan pasien ke fasilitas kesehatan. Penelitian ini bertujuan untuk melaporkan karakteristik klinik pada pasien AMD pada fasilitas kesehatan tersier di masa pandemi covid 19 dan membandingkannya dengan laporan sebelumya. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik di Poliklinik Mata RSUP Prof. Dr. R. D. Kandou Manado periode Maret 2020-Juni 2021. Hasil penelitian mendapatkan sebanyak 12 pasien AMD; sebagian besar berjenis kelamin laki-laki (83,3%), berada dalam rentang usia 56-75 tahun (58%), dengan subtipe AMD non neovaskular (58,3%). Faktor risiko yang teridentifikasi ialah hipertensi (50%), diabetes melitus (DM) (8,3%), dan DM disertai hipertensi (16,7%), sedangkan yang tanpa faktor risiko hanya 8,3%. Jumlah kunjungan pasien berkurang di periode waktu penelitian dibandingkan dengan laporan yang dilakukan sebelum masa pandemi. Simpulan penelitian ialah mayoritas pasien AMD berjenis kelamin laki-laki, usia 56-75 tahun, dengan subtipe non neovaskular. Faktor risiko teridentifikasi ialah hipertensi dan diabetes melitus.Kata kunci: age-related macular degeneration (AMD); karakteristik pasien


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