Lupus Eritematosus Sistemik pada Pria

Introduction: Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by presence of nucleus autoantibody and affected multiple organ. Systemic lupus erythematosus is more common in women than men with ratio 2:1 to 15:1. Men with SLE often have a more aggressive clinical course, lead to a poorer prognosis compared with women with SLE. Case Report: A man, 29 years old came to hospital with main complain joint pain increased since 1 week ago, accompanied with red spot on face, trunk, hands, foot, and back, hair loss, swollen leg, mouth ulcer, and fatique. Malar rash and discoid rash were identified from physical examination. From laboratorium, ANA profile was positive for RNP/Sm, Sm, dsDNA, and histone. Skin biopsy showed a lupus discoid. Conclusion: The patient was treated with pulse-dose methylprednisolone for 3 days and showed a good response clinically.

Persepsi Mahasiswa Tahap Profesi Kedokteran terhadap Interprofessional Education

Introduction: The introduction of the concept of collaborative health education that has been launched by WHO aims to improve health services. Collaborative media initiated by WHO is Interprofessional Education (IPE). Professional stage students are expected to cooperate with other health professions. A positive perception of IPE acceptance is expected to be taken into consideration by institutions for the development of the IPE concept at the Faculty of Medicine at Universitas Baiturrahmah. Aims: The purpose of this study was to determine perceptions of medical professional stage students towards IPE. Method: This type of research is quantitative with a descriptive analysis design with a cross-sectional approach. The research sample was used in consecutive sampling. Retrieval data with a modified IEPS (Interprofessional Education Perception Scale) questionnaire. Results: The results showed the reliability of the IEPS questionnaire 0.890. The modified IEPS questionnaire has 12 statements. The majority of the perception of medical professional stage students is positive 92.3%. The subcategory of competence and autonomy are good at 89.7%, the need to work together is good at 97.4% and perceptions about collaboration are good at 89.7%. Conclusion: The majority of students' perceptions of interprofessional education are good and need strategies and communication from educational institutions and teaching hospitals in its implementation.

Korelasi Lingkar Pinggang dengan Kadar Gula Darah Puasa, Kadar Trigliserida, dan Tekanan Darah pada Mahasiswa Fakultas Kedokteran Universitas HKBP Nommensen

Introduction: Cardiovascular disease is the number one cause of death globally with an incidence of adolescents and young adults in Indonesia as many as 153.705 cases. Central obesity is associated with the risk of cardiovascular disease due to increase in fasting blood glucose levels, cholesterol and triglyceride levels, and blood pressure. Aims: to determine the correlation between waist circumference and fasting blood glucose levels, triglyceride levels, and blood pressure in young adults. Method: This analytic study with a cross-sectional approach involved 53 young adult subjects (18-25 years old). Waist circumference is measured using a tape measure. Blood sugar and triglyceride levels were measured using Cobas® 6000 analyzer machine from blood samples of subjects after fasting for 8-12 hours. Blood pressure data are obtained by measurement using aneroid sphygmomanometer. Results: In this study, the mean waist circumference of the research subjects was 77,4 cm. No correlation was found between waist circumference and fasting blood sugar levels (p = 0,159). However, a positive correlation was found between waist circumference and triglyceride levels (p = 0,008; r = 0,332), between waist circumference and systolic blood pressure (p = 0,049; r = 0,230), and between waist circumference and diastolic blood pressure (p = 0,017; r = 0,293). Conclusion: waist circumference is positively correlated with triglyceride levels and blood pressure, but does not correlate with fasting blood sugar levels.

Bullous Systemic Lupus Erythematosus Mimicking Bullous Pemphigoid: A Case Report

Introduction: Bullous systemic lupus erythematosus (BSLE) is an infrequent but distinct presentation of systemic lupus erythematosus (SLE) in less than 5% of lupus cases. It is characterized by vesicobullous skin eruption in SLE that can develop either before or after SLE diagnosis has been established. Distinguish between BSLE with other autoimmune blistering diseases such as bullous pemphigoid (BP), dermatitis herpetiformis, linear IgA, etc., is very important to prevent misdiagnosis. The physician must be able to combine clinical, histological and immunofluorescence finding for the diagnosis approach. We report a case of blistering skin eruption in SLE patient. Case Report: A 19-year-old female patient complained of tense blistering on her lip, face and wrists since one month ago. She was diagnosed with SLE two weeks ago. The dermatological state showed bullae and vesicle on erythematous/ normal base, erosions, excoriation and blackish red crust on the lip, face, armpit, neck, abdomen and wrists. Histopathological examination of the lesion showed sub-epidermal bullae containing PMN leukocytes consist of abundant neutrophils, only occasional eosinophils and the presence of keratotic plugs. Direct immunofluorescence (DIF) of the skin showed linear deposition of IgG, IgA, IgM and C1q at the dermo-epidermal junction. This patient exhibited similar features to both BSLE and BP with tensed clear blisters and subepidermal cleft. BSLE differ from BP by abundant neutrophils found on histopathological examination, whereas BP has abundant eosinophils. Conclusion: Immunofluorescence examination shows linear IgG in BP, whereas linear or granular IgG in BSLE. Establishing the correct diagnosis is important to prevent misdiagnosis and mistreatment.

Elder Mistreatment: a Clinical, Social, and Legal Concern

Elder mistreatment is all activities carried out by other people towards the elderly which are classified as dangerous and causing harm, such as physical, verbal, financial or material abuse and or neglect, and violation of human rights. The incidence ranges from 3.2% to 27.5% of the elderly population, where this population is predicted to be 1.2 billion people by 2025. The main risk factors are under-reporting, individual factors, relationship factors, community factors and social factors. The diagnosis includes anamnesis of the patient, family or caregiver. Detection begins by confirming any cognitive impairment, using the Mini-Cog or Mini Mental State Examination (MMSE) form. Followed by screening, which can be done using the Elder Abuse Suspicion Index (EASI) instrument, then a physical examination looks for evidence of acts of abuse or neglect. Intervention is carried out by providing medical treatment for physical injuries, temporary protection, keeping the perpetrator away from the victim, and education on patterns of mistreatment that can involve social services and law enforcement. Management includes a complete and focused examination of mistreatment, preparing a safety plan, which is providing plans to improve patient protection, as well as education on treatment goals. Patient management should use a multidisciplinary team consisting of doctors, nurses, social workers, legal representatives and administrative officers. Complete data and clear laws and regulations regarding mistreatment are needed, such as in America and Britain where absolute mistreatment is legally reported.

Pankolitis Akibat Kolitis Ulseratif

Introduction: Ulcerative colitis is a chronic disease affecting large intestine, characterized by rectal bleeding, diarrhea, abdominal pain, and could be accompanied by extraintestinal manifestation such as fever, anemia, and weight loss. Ulcerative colitis is causing an inflammation even ulceration of the rectum which can extend to proximal colon. The incidence of this disease is increasing worldwide and its frequency is variable depend on age, race and geographic area. Thorough history and examination are needed in diagnosing ulcerative colitis, since its symptoms are similar to many other gastrointestinal diseases. Definitive diagnosis of ulcerative colitis can be obtained by colonoscopy and histopathology. Case Report: We reported a case of 53 years old man who suffered from diarrhea and weight loss for one month before admission. There were also blood and mucus in his stool. The result of colonoscopy was hyperemia and ulcers along the rectum to the caecum. Histopathology examination showed pieces of intestinal mucosal tissue covered by columnar epithelium, with goblet cell and round-oval core. The lamina propria is densely packed with lymphocyte cells, plasma cells and PMN leukocytes. This result represents chronic colitis with acute exacerbation. Conclusion: Patient was treated with mesalazine 3x1000 mg per oral, methyl prednisolone 3x16 mg per oral, and low fiber diet to achieve remission.

PERBEDAAN INSIDENSI DIABETES MELITUS TIPE 2 DAN HBA1C PADA POPULASI TERPAPAR-TIDAK TERPAPAR EMISI PABRIK SEMEN PADANG

Background: Cement factory emission disrupt blood glucose control through insulin resistance mechanism, thus increasing incidence of type 2 diabetes mellitus (DM type 2). Aim: Aim of this study is to determine incidence’s differences of DM type 2 and mean HbA1c patients with DM type 2 within population exposed and unexposed cement Padang factory emission. Method: This was a cross sectional analytic study with cluster sampling that conducted on June-December 2015 with 129 and 125 participant from exposed and unexposed areas. Age of participants are 20-79 years old. Incidence is total new cases per total sample in exposed or unexposed area. HbA1c were measured with immunoturbidimetry method. Data were analyzed by chi-squared test to asses differences of two proportions and t test to asses differences of two averages. Results: The incidence DM type 2 are 3,9% and 7,2% respectively in exposed and unexposed areas, without significant difference (p>0,05). The mean HbA1c patients DM type 2 are 10,0(2,4)% and 8,8(1,6)% in exposed and unexposed areas, without significant difference (p>0,05). Conclusions: There were no significant differences incidence of DM type 2 and mean HbA1c patients DM type 2 in the populations exposed and unexposed cement Padang factory emission. Cohort studies is required to see the effects of cement factory emission

Tes Toleransi Glukosa Oral (TTGO) Pasca Pemberian Suspensi Kedelai Dibanding Suspensi Tempe pada Tikus (Rattus norvegicus Galur Wistar) Diabetik

Introduction: Genistein, daidzein and glicytein are soybean’s isoflavones which have been known having anti diabetic effect. Fermentation process of soybean can lead to formation aglycan isoflavones which have higher bioavailability than unfermented-soybean. Aims: This research was aimed to evaluate the effect of soybean and tempeh (fermented-soybean) administration to oral glucose tolerance test (OGTT) in diabetic rats. Method: Twenty male Rattus norvegicus Wistar strains were used in this experiment, divided into 4 groups: standard, negative control, soybean and tempeh group. Type 2 diabetes in rats was induced by giving streptozotocin (50 mg/kgBW) and nicotinamide (110 mg/kgBW) intraperitoneally. Blood glucose were measured by using blood glucose test meter and classified into diabetes if its level above 200 mg/dL. Soybean (200 mg/kgBW/day) and tempeh (200 mg/kgBW/day) suspension were given by using gastric tube for 30 days. Results: The results showed the means of either fasting blood glucose (FBG) or 2 hours post prandial blood glucose (2hPP) of negative control were persistent above 200 mg/dL on day 15th and 30th (p> 0,05). In soybean group there was a decrease the mean of FBG on day 15th (p<0.05) but did not reach the normal level, and on day 30th the mean of FBG was <200 mg/dL (p<0.05) however 2hPP blood glucose was still >200 mg/dL (p<0.05). Furthermore, in tempeh group, the means of either FBG or 2hPP blood glucose reached the normal level in day 15th and 30th (p <0.05). Conclusion: the provision of tempeh was better in controlling blood sugar levels than soybean.

Perbandingan Tingkat Kepatuhan Pengobatan Pasien Epilepsi antara Monoterapi dan Politerapi di Poliklinik Saraf RSUP Dr. M. Djamil Padang

Background: Epilepsy is one of the most common chronic neurological disorders affecting people worldwide. People with epilepsy have higher mortality rate than general population. Medication adherence is predictor for epilepsy outcome. Number of medication is one of contributing factors to therapy adherence. Aims: to determine antiepileptic drug adherence between monotherapy and polytherapy at Neurology Clinic Dr. M. Djamil Hospital. Methods: This study conducted at Neurology Clinic Dr. M. Djamil Hospital from May to June 2019. Medication adherence was assessed by using Morisky Medication Adherence Scale (MMAS) 8. Data was analyzed and level of significance was if p value ≤ 0.05. Result: We recruited 30 participants which consist of 14 (46.7%) female and 16 (53.5%) male. Median of age 31 (13-77) and 22 (73.3%) patients have high educational level. From 30 patient, 14 (46.7%) in monotherapy and 16 (53.3%) in polytherapy. Patient with high medication adherence 4 (13.3%), moderate 7 (23.3%) and poor 17 (56.7%). Statistical analysis showed no differences on medication adherence between monotherapy and polytherapy (p=0.79). Conclusion: There are no differences on medication adherence between monotherapy and polytherapy at Neurology Clinic Dr. M. Djamil Hospital.

Perilaku Waspada Stroke Pengidap Hipertensi

Introduction: Non infectious disease is a major health problem especially in developing countries. Among those, stroke always be the leading one that occurs followed by health burden. Some factors in increasing of mortality and disability due to stroke are lack of understanding of risk factors and awareness to early signs especially among people with hypertension. If the factors those influence the knowledge, awareness, and others stroke alert behaviors are known, promotive or prevention acts could be done by health workers. Aims: The aim of this study is to find out the stroke alert behavior among them that conducted at Puskesmas Cengkareng of West Jakarta on July and August 2020. Method: 116 patients were participated to fill the questionnaire and analyzed with cross-sectional design. Results: Our study revealed that knowledge, perception of utility, and perception to level of disease severity is the most influenced factor to stroke alert behavior.