bluuebunny/crossref_metadata_2025 huggingface dataset:
HUBUNGAN JARAK DAN LAMA PAPARAN SINAR BIRU PESAWAT TELEVISI TERHADAP FUNGSI REFRAKSI PADA ANAK DI SEKOLAH DASAR GEREJA MASEHI INJILI DI MINAHASA 20 MANADO
Authors: Toar Eunike D. , Rumampuk Jimmy , Lintong Fransisca
Published: July 2019

Abstract: Nowadays, watching television has become an integral part of children's daily activities. Albeit, TV can have a negative impact on their eyes due to the produced blue light. In the spectrum of light, this blue light is acceptable to the eye but it can cause eye damages by the free radicals produced. The risk of the damage depends on the light length and the exposure intensity. This study aimed to determine whether there is a correlation between the distance of watching TV and the duration of exposure to the blue light from TV with the refraction by measuring visual acuity. This was a cross-sectional study. The population was students of grade 1 to grade 5 of the GMIM 20 elementary school, Manado. Samples were 30 students who underwent visual acuity measurement. The results showed a P-value > 0.05 by using a linear regression. The correlation of the distance of watching TV and the duration of exposure to the blue light with the visual acuity of the right eyes showed a P-value of 0.184 and of the left eyes a P-value of 0.967. Conclusion: Among the GMIM 20 elementary school students in Manado there was no correlation between the distance of watching TV and the duration of exposure to the blue light of the television with eye refraction. Keywords: television, blue light, exposure.     Abstrak: Dewasa ini, televisi telah merupakan alat informasi dan hiburan yang terintegrasi dalam aktivitas keseharian anak-anak. Televisi bisa berdampak buruk bagi kesehatan mata akibat sinar biru yang dihasilkan. Sinar biru terdapat pada spektrum yang masih dapat diterima oleh mata, namun dapat menyebabkan kerusakan mata akibat oleh radikal bebas yang dihasilkannya. Risiko kerusakan mata tergantung pada panjang cahaya dan intensitas paparan. Penelitian ini bertujuan untuk mengetahui hubungan antara jarak dan lama paparan sinar biru pesawat televisi terhadap fungsi refraksi dengan melakukan pengukuran tajam penglihatan. Penelitian ini menggunakan cross-sectional design, dan mengikutsertakan siswa kelas 1 sampai kelas 5 SD GMIM 20 Manado sebagai populasi. Pada sampel sebanyak 30 siswa dilakukan pengukuran tajam penglihatan. Hasil penelitian dengan regresi linier memperlihatkan nilai P > 0,05. Korelasi jarak dan lama paparan sinar biru televisi terhadap tajam penglihatan mata kanan memperlihatkan nilai P = 0,184, dan terhadap tajam penglihatan mata kiri P = 0,967. Simpulan: Tidak terdapat hubungan antara jarak dan lama paparan sinar biru pesawat televisi terhadap fungsi refraksi siswa di SD GMIM 20 Manado. Kata kunci: televisi, sinar biru, paparan.
HUBUNGAN TINGGI BADAN DENGAN PANJANG KAKI PADA MAHASISWA FAKULTAS KEDOKTERAN UNSRAT
Authors: Paluta Reniwaty S. , Tanudjaja George N. , Pasiak Taufiq F.
Published: July 2019

Abstract: Identification of a dead body is important in determining the clarity of one’s identity. Height is an important parameter in the process of identification and is one of the fields of study of physical anthropology. It is expected that the height can be determined by using the measurements of long bones, such as metatarsal bones and phalanges. This study aimed to find out the relationship between the height and foot length in the students of Faculty of Medicine University of Sam Ratulangi, Manado. This was a descriptive analytic study with cross-sectional design. Samples were selected by using systematic sampling methods. As samples, we used 74 students (registered in 2010) comprising 37 males and 37 females. Data were analyzed with a Pearson correlation analysis as well as a simple linear regression analysis. The results showed that there was a strong correlation between height and foot length with the correlation coefficients (r) of 0.846 for all samples, 0.520 for male students, and 0.711 for female students. The simple linear regression analysis resulted in three formulas: male height = 112.930 + 2.361 × foot length; female height = 4.223 + 64.241 × foot length; and overall height = 4.717 + 54.729 × foot length. Conclusion: There was a strong relationship between the heights and the foot lengths of students at the Faculty of Medicine University of Sam Ratulangi University Manado. Keywords: identification, height, foot length.   Abstrak: Identifikasi ialah pemeriksaan penting dalam menentukan kejelasan identitas seseorang. Tinggi badan merupakan parameter penting dalam proses identifikasi dan bidang telaah antropologi ragawi. Tinggi badan diharapkan dapat ditentukan dengan menggunakan pengukuran tulang-tulang panjang, diantaranya tulang metatarsal dan falang. Penelitian ini bertujuan untuk mengetahui hubungan antara tinggi badan dengan panjang kaki pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado. Penelitian ini bersifat deskriptif analitik dengan rancangan cross-sectional. Sampel berjumlah 74 mahasiswa yang terdaftar pada tahun 2010, terdiri dari 37 laki-laki dan 37 perempuan. Sampel dipilih menggunakan cara systematic sampling. Data dianalisis dengan uji korelasi Pearson dan analisis regresi linier sederhana.  Hasl penelitian memperlihatkan terdapatnya hubungan kuat antara tinggi badan dan panjang kaki dengan koefisien korelasi (r) keseluruhan 0,846, pada laki-laki 0,520, dan pada perempuan 0,711. Dari hasil analisis regresi linier sederhana didapatkan rumus Tinggi Badan (TB) laki-laki = 112,930 + 2,361 × panjang kaki, TB perempuan = 64,241 + 4,223 × panjang kaki, dan secara keseluruhan TB = 54,729 + 4,717 × panjang kaki. Simpulan: Terdapat hubungan antara tinggi badan dan panjang kaki pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado. Kata kunci: identifikasi, tinggi badan, panjang kaki.
HUBUNGAN KADAR HEMATOKRIT DENGAN KEJADIAN INFARK MIOKARD AKUT PADA PASIEN GAGAL JANTUNG KONGESTIF DI BLU/RSUP PROF. DR. R.D. KANDOU MANADO
Authors: Muabuay Mita E. D. , Wantania Frans E. , Rotty Linda W. A.
Published: July 2019

Abstract: Acute myocardial infarction (AMI) occurs due to a decrease of myocardial blood flow following a coronary arterial occlusion caused by an atherosclerotic plaque. This study aimed to determine the correlation between the hematocrit level and the occurence of AMI among patients with congestive heart failure (CHF). This was an observational analytic study with a cross sectional design. The population was both CHF patients with old myocardial infarction in the Cardiology Clinic and all AMI patients with CHF histories in the Intensive Cardiac Care Unit (ICCU) of Prof. Dr. R.D. Kandou Hospital, Manado, from November through December 2012. Samples were selected by using a purposive sampling method. Data were statistically analyzed by using a chi-square test. The results showed that the total samples were 41 patients. The chi-square test showed that there was a correlation between the hematocrit level and the occurence of AMI among CHF patients with a P-value of 0.008. Conclusion: Hematocrit levels were significantly correlated with the occurence of AMI among CHF patients in Prof. Dr. R.D. Kandou Hospital, Manado Keywords: CHF, AMI, hematocrit     Abstrak: Infark miokard akut (IMA) terjadi oleh karena penurunan aliran darah miokard akibat oklusi arteri koroner oleh plak aterosklerotik. Penelitian ini bertujuan untuk mengetahui hubungan kadar hematokrit dengan kejadian infark miokard akut (IMA) pada pasien gagal jantung kongestif (CHF). Penelitian ini bersifat analitik observational dengan cross-sectional design. Populasi penelitian ialah semua pasien CHF di Poliklinik Jantung dan semua pasien IMA dengan riwayat CHF di Intensive Cardiac Care Unit (ICCU) BLU/RSUP Prof. Dr. R.D. Kandou, Manado, periode November-Desember 2012. Sampel penelitian diambil dengan teknik purposive sampling. Kriteria inklusi yaitu pasien CHF et causa old  myocardial infarction (OMI) dan pasien IMA dengan riwayat CHF, sedangkan kriteria eksklusi yaitu pasien IMA dengan penyakit infeksi dan pasien CHF dengan keganasan hematopoietik. Data hasil penelitian dianalisis dengan uji chi-square. Hasil penelitian memperlihatkan jumlah sampel sebanyak 41 pasien. Uji chi-square terhadap hubungan hematokrit dan infark miokard akut pada pasien gagal jantung menunjukkan nilai P = 0.008. Simpulan: Terdapat hubungan bermakna antara kadar hematokrit dan infark miokard akut pada pasien gagal jantung kongestif di BLU/RSUP Prof Dr. R.D. Kandou Manado. Kata kunci: CHF, IMA, Hematokrit
REHABILITASI MEDIK PADA ANAK DENGAN LEUKEMIA LIMFOBLASTIK AKUT
Authors: Yenni .
Published: July 2019

Abstract: Acute lymphoblastic leukemia (ALL) is oftenly found in children as well as in adolescents. ALL occurs in 3-4 cases of 100,000 children. The specific etiology of ALL is still unknown, but it is related to a multifactorial process associated with genetic, immunology, environment, toxic substances, viral exposures, and ionization radiation. Clinical manifestations of ALL may include fatigue and weakness, palor, infections and febris that are not improved with antibiotics, easy bleeding or bruising, joint or bone pain, loss of appetite, weight loss, enlarged lymph nodes, cough, or difficulty of breathing, enlargement of the liver or spleen, swelling of the face and hands, headaches, and vomiting. Functional improvement is a goal for medical rehabilitation in patient with LLA. In general, cancer rehabilitation management aims to maintain body functions including mobilization and activity, nutrition, social support systems, and pain control. Moreover, the program is implemented in conjunction with specific interventions based on the affected organ systems.Keywords: ALL, medical rehabilitationAbstrak: Leukemia limfoblastik akut (LLA) merupakan kanker yang sering terjadi pada anak-anak dan remaja. LLA terjadi pada 3-4 kasus dari 100.000 anak. Etiologi spesifik LLA belum diketahui, tetapi berhubungan dengan proses multifaktorial yang berkaitan dengan genetik, imunologi, lingkungan, toksik, paparan virus, ionization radiation. Manifestasi klinik leukemia dapat berupa kelelahan dan kelemahan, kulit pucat, infeksi dan demam yang tidak sembuh dengan antibiotik, mudah berdarah atau memar, nyeri sendi atau tulang, hilangnya nafsu makan dan turunnya berat badan, pembesaran kelenjar limfe, batuk atau kesulitan pernafasan, pembesaran hati atau limpa, pembengkakan muka dan tangan, sakit kepala, dan muntah Perbaikan status fungsional merupakan tujuan utama rehabilitasi medik pasien LLA. Penanganan rehabilitasi kanker secara umum ialah untuk memelihara fungsi meliputi mobilisasi, aktivitas, nutrisi, sistem pendukung sosial dan pengendalian rasa nyeri. Keseluruhan program ini diterapkan bersamaan dengan intervensi spesifik berdasarkan sistem organ yang terkena.Kata kunci: LLA, rehabilitasi medik
VAGINITIS GONORE PADA ANAK
Authors: Kapari Judith , Pandaleke Herry E. J.
Published: July 2019

Abstract: Gonorrhoeae is a common human sexually transmitted infection caused by Neisseria gonorrhoeae. Vaginitis gonorrhoeae is a gonorrhoeae infection which commonly occurs in children after the neonatal period. Its manifestation in girls can be asymptomatic as well as some urethral or vaginal discharge. A Gram staining, culture and a serologic test should be performed for confirming the diagnosis. A gonorrhoeae suspected case in prepubertal girls may lead to a sexual abuse. We reported a 9-year-old girl complaining yellowish and large amount leukorrhea since 3 weeks ago. The Gram stain showed intracellular and extracellular negative Gram diplococcus with abundance of polymorphonuclear leucocytes >30/high magnification. Treatment with a single dose of cefixime 200 mg orally showed significant improvement aftter 3 days. Conclusion: A case of vaginitis gonorrhoeae was established based on the anamnesis, physical examination, and laboratory test. Treatment with a single dose of cefixime gave a satisfactory result. Keywords: vaginitis gonorrhoeae, Neisseria gonorrhoeae, cefixime   Abstrak: Gonore merupakan penyakit infeksi menular seksual yang disebabkan oleh kuman Neisseria gonorrhoeae. Vaginitis gonore merupakan bentuk gonore pada anak yang paling sering terjadi setelah masa neonatus. Manifestasi klinis infeksi gonore pada anak perempuan dapat asimtomatik maupun simtomatik berupa adanya duh tubuh dari uretra dan vagina, yang meninggalkan bekas di celana dalam. Pemeriksaan penunjang yang dapat dilakukan ialah pewarnaan Gram, kultur, dan tes serologik. Bila dicurigai adanya infeksi gonore pada anak perempuan prapubertas maka kekerasan atau pelecehan seksual harus dipikirkan. Kami melaporkan satu kasus vaginitis gonore pada seorang anak perempuan berusia 9 tahun dengan keluhan keputihan berwarna kuning kental dalam jumlah cukup banyak sejak 3 minggu lalu. Pada pewarnaan Gram didapatkan kuman diplokokus intrasel dan ekstrasel serta leukosit PMN >30/LPB. Perbaikan signifikan terlihat dalam 3 hari setelah pemberian terapi sefiksim 200 mg dosis tunggal. Simpulan: Telah dilaporkan kasus vaginitis gonore dengan diagnosis berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang. Terapi sefiksim dosis tunggal memberikan hasil yang memuaskan. Kata kunci: vaginitis gonore, Neisseria gonorrhoeae, sefiksim
CONDYLOMA LATA IN A 21-YEAR-OLD MALE TREATED WITH DOXYCYCLINE: A CASE REPORT
Authors: Minarto Hendra
Published: July 2019

Abstrak: Kondiloma lata merupakan salah satu manifestasi sifilis sekunder yang disebabkan oleh Treponema pallidum. Manifestasi klinis kondiloma lata berupa papul-papul berwarna putih atau keabuan pada daerah tubuh yang hangat dan lembab. Sifilis memerlukan perhatian serius karena penyakit ini merupakan salah satu faktor risiko transmisi human immunodeficiency virus (HIV) di seluruh dunia. Kami melaporkan satu kasus kondiloma lata pada seorang laki-laki berusia 21 tahun di daerah penis, skrotum, perineal, dan perianal sejak 2 bulan lalu, yang diterapi dengan doksisiklin 2 x 100 mg selama 30 hari. Pada pemeriksaan serologik awal didapatkan hasil reaktif untuk tes VDRL (1/256), tes RPR (1/512) dan tes TPHA (1/5120). Perbaikan signifikan terlihat setelah 30 hari terapi doksisiklin dimana semua lesi menghilang. Pemeriksaan serologik 3 bulan setelah awal terapi menunjukkan penurunan titer sebanyak empat kali lipat untuk tes VDRL (1/64), tes RPR (1/128), dan enam kali lipat untuk tes TPHA (1/640). Simpulan: Telah dilaporkan kasus kondiloma lata dengan diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan serologik. Terapi doksisiklin selama 30 hari memberikan hasil yang memuaskan. Pemeriksaan serologik harus dilakukan pada bulan ke-6 dan 12 untuk monitoring keberhasilan terapi. Kata kunci: kondiloma lata, sifilis sekunder, Treponema pallidum, doksisiklin   Abstract: Condyloma lata is one manifestation of secondary syphilis caused by Treponema pallidum. It is described clinically as multiple whitish or gray papules found in warm and moist areas. Syphilis requires serious attention since it still remains a risk factor of human immunodeficiency virus (HIV) transmission all around the world. We reported a case of a 21-year-old male suffered from condyloma lata on his penile, scrotal, perineal, and perianal regions for 2 months and treated with 30 days course of 100 mg doxycyline two times daily. Early serologic examinations revealed reactive values of VDRL test (1/256), RPR test (1/512), and TPHA test (1:5120). Significant improvement was observed after 30 days course of doxycyline therapy where all lesions have resolved. Further serologic examinations as follow up showed a fourfold titre decrease of VDRL test (1/64), RPR test (1/128) and sixfold titre decrease of TPHA test (1/640) 3 months after the initial therapy. Conclusion: The diagnosis of condyloma lata in this case was established based on anamnesis, physical examination, and serologic findings. Treatment with doxycycline gave satisfactory result. Serologic examination as follow up needs to be performed at 6 and 12-months after the initial treatment to monitor the success of therapy. Keywords: condyloma lata, secondary syphilis, Treponema pallidum, doxycycline.
GANGGUAN KESEIMBANGAN AIR DAN NATRIUM SERTA PEMERIKSAAN OSMOLALITAS
Authors: Rambert Glady I.
Published: July 2019

Abstract: Water distribution in each compartment of the body involves concentration of solutes in body fluids, and the amount of dissolved substance in a solvent called osmolality. Electrolyte that has the biggest contributor in determining the serum osmolality is sodium, which is osmotically active. Hipoosmolality actually describes the state of hyponatremia, and hyperosmolality describes the state of hypernatremia. Examination of plasma and urine osmolality is very helpful in the management of patients with water and electrolyte imbalance, in addition to assess the antidiuretic hormone (ADH) abnormalities. Urine osmolality is important in evaluating the ability of the kidney to concentrate the urine, in addition to monitor the fluid and electrolyte balance. There are two ways of osmolality examination: 1) indirectly, by using osmometer (osmolality measurement) with a freezing point depression method; 2) directly, by using a formula (osmolality count).Keywords: water, sodium, osmolality, freezing point depression, osmolality countAbstrak: Distribusi air pada setiap kompartemen tubuh melibatkan kadar zat terlarut di dalam cairan tubuh, dan jumlah zat terlarut dalam suatu pelarut yang disebut osmolalitas. Elektrolit pemberi kontribusi terbesar dalam menentukan besarnya osmolalitas serum ialah natrium, yang aktif secara osmotik. Keadaan hipoosmolalitas sebenarnya menggambarkan keadaan hiponatremia, sebaliknya hiperosmolalitas menggambarkan keadaan hipernatremia. Pemeriksaan osmolalitas plasma dan urin sangat membantu penatalaksanaan pasien dengan gangguan keseimbangan air dan elektrolit, selain menilai kelainan antidiuretic hormone (ADH). Osmolalitas urin penting untuk mengetahui kemampuan ginjal memekatkan urin, selain memonitor keseimbangan cairan dan elektrolit. Terdapat dua cara pemeriksaan osmolalitas yaitu: 1) secara tidak langsung menggunakan osmometer (osmolalitas ukur) dengan metode freezing point depression; 2) secara langsung dengan menggunakan rumus (osmolalitas hitung).Kata kunci: air, natrium, osmolalitas, freezing point depression, osmolalitas hitung
OSTEOSARKOMA
Authors: Loho Lily L.
Published: July 2019

Abstract: Osteosarkoma is defined as a neoplasma in which the osteoid tissue is synthesized by malignant cells. It belongs to the most frequent nonhemapoietic skeletal malignancy with a bimodal age distribution. The causes are still unknown, however, a variety of agents and diseases are related to the development of this disease. Early signs and symptoms are not specific, mostly manifests as pain with or without palpable mass. Around 5-10% of cases undergone pathological fractures. Most osteosarcoma tumor develop in the distal part of femur in the metaphysis. Hematogen metastasis often occurs at the early stage of this disease mostly to lungs and bones. Radiological examination is important in early evaluation of osteosarcoma. Morphologically, there are several types of osteosarcoma. The most frequent type is osteosarcoma in the long bone metaphysis, primary, intramedullary, with high gradation of osteoblasts. Macroscopically, it manifests as a big, sandy, whitish grey tumor, which is often with bleeding areas and cysts; meanwhile, microscopically it varies. Malignant osteoblasts that produce osteoid matrix is the diagnostic tool. The prognosis of such cases depends on the tumor size, necrosis degree, dissemination to cortex and soft tissue, and metastasis. A teenager with a painful mass around the knee has to undergo further examination for early detection of osteosarcoma.Keywords: osteosarcoma, osteoblastAbstrak: Osteosarkoma didefinisikan sebagai suatu neoplasma dimana jaringan osteoid disintesis oleh sel ganas. Penyakit ini termasuk keganasan sistem skeletal nonhematopoetik yang tersering dengan distribusi usia bimodal. Penyebab osteosarkoma tidak diketahui, namun berbagai agen dan status penyakit dihubungkan dengan perkembangan penyakit ini. Gejala awal tidak spesifik yaitu nyeri dengan atau tanpa teraba massa. Sekitar 5-10% kasus mengalami fraktur patologik. Umumnya tumor tumbuh pada distal femur di bagian metafisis. Penyebaran hematogen sering terjadi pada awal penyakit, biasanya ke paru-paru dan tulang. Pemeriksaan radiologik berperan penting dalam evaluasi awal osteosarkoma. Secara morfologik terdapat beberapa jenis osteosarkoma, yang tersering ialah osteosarkoma pada metafisis tulang panjang, primer, intrameduler, dengan osteoblas bergradasi tinggi. Gambaran makroskopik yaitu tumor besar, berpasir, berwarna abu-abu keputihan, dan sering terdapat area perdarahan dan kiste sedangkan gambaran mikroskopik bervariasi. Osteoblas maligna yang memroduksi matriks osteoid merupakan gambaran diagnostik. Prognosis penyakit ini dipengaruhi oleh ukuran tumor, derajat nekrosis, penyebaran ke korteks dan jaringan lunak, serta adanya metastasis. Pada kasus usia belasan dengan massa yang nyeri di sekitar lutut perlu dilakukan pemeriksaan lanjut untuk deteksi dini osteosarkoma.Kata kunci: osteosarkoma, osteoblas
DISFUNGSI MIOKARD PADA SEPSIS DAN SYOK SEPTIK
Authors: Rampengan Starry H.
Published: July 2019

Abstract: Sepsis and septic shock are serious clinical problems causing increased morbidity and mortality, which are highly associated with the event of myocardium dysfunction. Compared to previous data of four decades ago, there is an increase of mortality rate due to sepsis which is recorded based on the age from 0.5 to 7 per 100,000 sepsis episodes. The most common cause of sepsis is bacteria, which currently has shifted from negative to positive Gram bacteria. The most common organs affected by infection are lung (40%), followed by abdomen (30%) and urinary tract (10%). Sepsis begins with an infection (nidus), which has to be present although finding the clinical evidence may be difficult or the evidence may not be found. Shock is a condition of inadequate blood flow to the tissues to maintain high-energy phosphates at the necessary level to keep normal cellular function. Patients with septic shock who did not survive were found to have progressive hypotension or being unresponsive and had multi-organ dysfunction. The most common effect of septic shock on cardiovascular system is defined by the characteristics of hemodynamic profiles including increased cardiac index and reduced systemic vascular resistance. Myocardium dysfunction is an important variable for sepsis and septic shock. Keywords: myocardium dysfunction, sepsis, shock.   Abstrak: Sepsis dan syok septik merupakan masalah klinik serius yang banyak menyebabkan peningkatan morbiditas maupun mortalitas, yang erat kaitannya dengan kejadian disfungsi miokard. Dibandingkan dengan empat dekade yang lalu, tercatat angka mortalitas berdasarkan usia akibat sepsis meningkat dari 0,5 menjadi 7 per 100.000 episode sepsis.  Sepsis paling sering disebabkan oleh bakteri yang saat ini penyebabnya telah bergeser dari bakteri Gram negatif ke bakteri Gram positif. Organ yang paling sering terjadi infeksi ialah paru (40%) diikuti abdomen (30%) dan traktus urinarius (10%). Sepsis dimulai dengan infeksi (nidus) yang harus ada walau sulit dibuktikan secara klinis bahkan mungkin tidak dapat ditemukan. Syok adalah tidak cukupnya aliran darah jaringan dalam mempertahankan fosfat energi tinggi pada tingkat yang dibutuhkan untuk mempertahankan fungsi sel. Pasien syok septik yang tidak selamat didapati mengalami hipotensi progresif atau tidak responsif serta disfungsi multi organ. Efek syok septik yang tersering pada sistem kardiovaskular ialah karakteristik pada profil hemodinamik berupa peningkatan indeks jantung dan penurunan resistensi vaskular sistemik. Disfungsi  miokard merupakan variabel penting pada sepsis dan syok septik. Kata kunci: disfungsi miokard, sepsis, syok.
PERAN VISUM ET REPERTUM DALAM PENEGAKAN HUKUM PIDANA PADA KASUS KEMATIAN TIDAK WAJAR DI KOTA MANADO
Authors: Langie Yuke N. , Tomuka Djemi , Kristanto Erwin G.
Published: July 2019

Abstract: Crimes related to life and body of human being such as homicides, suicides, and traffic accidents are commonly encountered in daily life. Death often occurs suddenly and sometimes in unexpected and unnatural ways. In order to obtain the chronology of a death case acurately, law enforcers perform several methods; one of them is the assistance of a forensic expert. Visum et repertum is a written report made by a doctor at the request of an authority for the benefit of the court upon what can be seen and found from the crime evidences. In this study, we used data of unnatural death cases in 2013-2014 obtained from the police, the court, and the Department of Forensic and Medicolegal of Prof Dr R. D. Kandou Hospital, Manado. The results showed that several  kinds of criminal offences, in this case unnatural deaths, tended to increase from 2013 (39 cases) to 2014 (107 cases). Of the 39 cases in 2013 there were only 7 autopsies (17,9%) and of the 107 death cases in 2014 there was only 1 autopsy (0.9%). However, data of unnatural death cases of the court of Manado showed a decrease of death case numbers from 2013 (108 cases) to 2014 (58 cases). Conclusion: There was an increase of the unnatural death case number from 2013 to 2014 in Manado, however, the roles of visum et repertum and autopsy in these cases were still low. Keywords: criminal offense, visum et repertum     Abstrak: Tindak pidana adalah suatu kejahatan yang telah diatur dalam Kitab Undang-undang Hukum Pidana (KUHP). Peristiwa pelanggaran hukum yang menyangkut tubuh dan nyawa manusia seperti kasus pembunuhan, bunuh diri, dan kecelakaan lalu lintas (KLL) sering ditemukan dalam kehidupan sehari-hari. Kematian sering terjadi tanpa diduga, tiba-tiba, dan dengan cara yang terkadang tampak tidak wajar. Penengak hukum melakukan berbagai cara untuk dapat mengetahui dengan jelas kronologi kasus pembunuhan tersebut; salah satu cara ialah dengan bantuan ahli forensik. Visum et repertum adalah laporan tertulis yang dibuat oleh seorang dokter mengenai segala sesuatu yang dilihat dan ditemukan pada pemeriksaan barang bukti atas permintaan yang berwenang untuk kepentingan peradilan. Hasil penelitian memperlihatkan bahwa data Polresta Kota Manado terdapat peningkatan berbagai macam tindak pidana yang terjadi serta sebab pembunuhan dari tahun 2013 ke tahun 2014. Dari 39 kasus kematian pada tahun 2013 Polresta Manado hanya meminta 7 kasus (17,9%) untuk diautopsi, dan dari 107 kasus kematian pada tahun 2014 hanya 1 kasus untuk di autopsi (0,9%). Data dari kasus pembunuhan yang diterima di Kejaksaan Negeri Manado tahun 2013 dan tahun 2014 memperlihatkan terjadinya penurunan dari tahun 2013 (108 kasus) ke tahun 2014 (58 kasus) yang berbeda dengan data Polresta Manado.  Simpulan: Walaupun terdapat peningkatan kasus kematian tidak wajar di kota Manado dari tahun 2013 ke tahun 2014 peran visum et repertum dan autopsi pada kasus tersebut masih rendah. Kata kunci: tindak pidana, visum et repertum
KASUS KROMOBLASTOMIKOSIS PADA SEORANG PEREMPUAN
Authors: Lasut Mariani V. , Tanamal Rita S. , Kapantow Grace M.
Published: July 2019

Abstract: Chromoblatomycosis is a chronic fungal infection in the skin and subcutaneus tissue caused by pigmented fungi. It occurs most in males in tropical and subtropical countries. The causal fungi were found isolated in woods, decomposed plants, and soil.  Early lesions manifest as papules that become hypertrophy plaques, and in years they develop to become hyperkeratotic masses. Chromoblastomycosis is difficult to treat. We reported a female of 37 years with lesions on the right foot for 20 years in the forms of plaques, papulonodules, multiple verrucous lesions. Lesions had hard consistency and were associated with erosion, crustae, and minimal pus. Several supporting tests were carried out. KOH 20% test resulted in sclerotic bodies; fungal culture revealed Fonsecaea pedrosoi; and histopathological examination showed chronic granulomatous inflamation. The patient was treated with itraconazole 2 x 200 mg daily, which was planned for 8-12 months. After 2 months of treatment, the lesions improved. Conclusion: Based on anamnesis, physical examination, KOH test, tissue culture, and histopathology examination, this case was diagnosed as chromoblatomycosis. Fonsecaea pedrosoi was found as the causative agent. Oral antimycotic itrakonazole 2 x 200 mg/day showed lesion improvement after 2 months of treatment. The patient will be evaluated until full treatment  has been achieved. Keywords: chromoblastomycosis, Fonsecaea pedrosoi, itrakonazole     Abstrak: Kromoblastomikosis merupakan infeksi jamur kronis pada kulit dan jaringan subkutan, disebabkan jamur berpigmen, umumnya pada laki-laki, banyak ditemukan di daerah tropis/subtropis, terisolasi di lingkungan dari kayu, sisa tanaman, dan tanah. Lesi awal berupa papul yang membesar membentuk plak hipertrofi dalam beberapa tahun menjadi massa hiperkeratotik. Kromoblastomikosis sukar disembuhkan. Kami melaporkan seorang perempuan 37 tahun dengan lesi pada kaki kanan sejak 20 tahun lalu berupa plak, papulonodul, verukous multipel, konsistensi keras, disertai erosi, krusta, pus yang minimal. Pada pemeriksaan KOH 20% didapatkan badan sklerotik, pemeriksaan kultur jamur ditemukan Fonsecaea pedrosoi, histopatologis menunjukkan radang kronik granulomatik. Terapi itrakonazole 2x200 mg/hari akan diberikan selama 8–12 bulan. Setelah 2 bulan pengobatan terdapat perbaikan. Simpulan: Pada kasus ini, diagnosis kromoblastomikosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang berupa KOH, kultur jaringan, dan histopatologi. Hasil kultur menunjukkan Fonsecaea pedrosoi sebagai penyebab kromoblastomikosis. Pemberian antimikotik oral itrakonazole 2 x 200 mg/hari menunjukkan perbaikan setelah 2 bulan pengobatan. Evaluasi akan terus dilanjutkan sampai pengobatan selesai. Kata kunci: kromoblastomikosis, Fonsecaea pedrosoi, itrakonazole
MIKRODERMABRASI
Authors: Pandaleke Thigita A. , Kapantow Grace M.
Published: July 2019

Abstract: Microdermabrasion is a skin rejuvenation procedure with a superficial abrasion mechanism to remove the outermost skin layer of the epidermis, exfoliation. The principle of skin rejuvenation with microdermabrasion is based on the principle of wound healing. Wounding and removing the outermost layer of the skin can stimulate the regeneration of new healthy cells from the epidermis and dermis. Microdermabrasion is usually used for a variety skin problems inter alia acne scars, hyperpigmentation, stretch marcks, and photodamaged skin. Microdermabrasion can be used on several areas of the skin, including the face, neck, chest, and hands.Keywords: microdermabrasion, rejuvenation, exfoliativeAbstrak: Mikrodermabrasi adalah prosedur peremajaan kulit superfisial dengan mekanisme abrasi yaitu membuang lapisan paling luar dari epidermis, dikenal sebagai eksfoliasi. Prinsip peremajaan kulit dengan mikrodermabrasi didasarkan pada prinsip penyembuhan luka. Melukai dan menghilangkan lapisan kulit paling luar dapat menstimulasi regenerasi pembentukan sel-sel baru yang sehat dari epidermis dan dermis. Mikrodermabrasi biasanya digunakan untuk berbagai permasalahan kulit seperti skar akne, hiperpigmentasi, stretch marck, serta photodamaged. Mikrodermabrasi dapat digunakan pada area kulit termasuk wajah, leher, dada, maupun tangan.Kata kunci: mikrodermabrasi, peremajaan kulit, pengelupasan
FASIITIS NEKROTIKAN TIPE II
Authors: Sondakh Oktavia R. L. , Tangkidi Damayanti , Pandaleke Herry E. J.
Published: July 2019

Abstract: Necrotizing fasciitis, often called flesh eating bacteria, is a progressive necrosis in subcutaneous fat and fascia. Type II necrotizing fasciitis caused by Acinetobacter baumannii is rarely found. Predisposing factors of necrotizing fasciitis include elderly, immunocompromised condition, chronic diseases, alcoholism, and trauma. We reported a case of a 68-year-old male complained of dark red swelling accompanied by pain in the left thigh. On examination of the left femoral region, there was a diffuse macula, plaque sized, erythematous to black colored, with erosion, excoriation, and necrotic tissue. Hematological examination showed the LRINEC score of 6. The pus culture result was Acinetobacter baumannii. The patient was given systemic antibiotics and debriedement was performed. The lesion did not extend anymore and the patient's general condition became better. Post debridement, the ulcer was treated with hydrogel wound dressings containing honey. After 60 days, the ulcer healed with a hypertrophic scar. Conclusion: This case was diagnosed as type II necrotizing fasciitis caused by Acinetobacter baumannii based on anamnesis, physical examination, hematological examination, and pus culture which were typical for this diagnosis.Keywords: type II necrotizing fasciitis, LRINEC scoreAbstrak: Fasiitis nekrotikan (FN) atau sering disebut “flesh eating bacteria” adalah nekrosis progresif di lemak sub kutan dan fasia. Fasiitis nekrotikan tipe II yang disebabkan oleh Acinetobacter baumanii jarang ditemukan. Faktor predisposisi FN antara lain usia lanjut, imunokompromais, penyakit kronik, alkoholisme, dan trauma. Kami melaporkan seorang laki-laki berusia 68 tahun dengan bengkak merah kehitaman yang disertai nyeri di paha kiri. Pada pemeriksaan regio femoralis sinistra terdapat makula difus, ukuran plakat, eritem sampai kehitaman, disertai erosi, eskoriasi, dan jaringan nekrotik. Pemeriksaan hematologik menunjukkan skor LRINEC 6. Hasil kultur pus ialah Acinetobacter baumanii. Pasien mendapatkan antibiotik sistemik dan dilakukan debrideman. Lesi tidak meluas dan keadaan umum pasien baik setelah penanganan dengan antibiotik dan debrideman. Ulkus paska debrideman dirawat dengan balutan luka hidrogel mengandung madu. Ulkus sembuh dengan meninggalkan skar hipertrofik setelah 60 hari. Simpulan: Pada kasus ini, diagnosis fasiitis nekrotikan tipe II yang disebabkan oleh Acinetobacter baumanii ditegakkan berdasarkan anamnesis, pemeriksaan fisik, pemeriksaan hematologik, dan kultur pus yang khas.Kata kunci: fasiitis nekrotikan tipe II, skor LRINEC
DUKUNGAN PSIKOLOGIS UNTUK PASIEN KANKER ANAK YANG KRITIS
Authors: Boas Esther
Published: July 2019

Abstract: Regardless of age, malignant diseases and deaths can occur even in children. About 100 of one million children suffering from cancer every year. Indonesian laws do not allow the children to give any decision or refusal about the medical treatment directed to them. Moreover, there are posibilities that they do not get any information from the medical staff. The children know that something wrong is going to happen to them although their parents and doctors tell them nothing. Lack of information make them frightened and anxious. These feelings can give a long term impact if they finally being cured from their diseases. Medical staffs and family members have very important roles in giving the right information to the children concerning the current problem and the worst possibility, and also in giving physicological support.Keywords: dying child, cancer, communicationAbstrak: Kematian tidak memilih usia; anak-anak pun tidak luput dari kanker dan kematian. Sekitar 100 dari 1 juta anak terkena kanker setiap tahunya. Menurut undang-undang yang berlaku di Indonesia, anak-anak tidak diperbolehkan memberikan persetujuan atau penolakan atas tindakan kedokteran yang akan dilakukan padanya. Bahkan, informasi dari petugas kesehatan bisa saja tidak pernah mereka dengar. Anak-anak dapat mengetahui singkatnya harapan hidup mereka meskipun orangtua dan dokter tidak menceritakannya. Kurangnya informasi yang mereka dapatkan bisa menimbulkan rasa takut dan cemas, bahkan bisa berdampak panjang jika ternyata mereka dapat sembuh dari sakitnya. Tenaga medis dan keluarga berperan penting untuk memberikan informasi tentang masalah yang dihadapi, kemungkinan terburuk yang akan mereka hadapi, serta memberikan dukungan secara psikologis.Kata kunci: anak masa kritis, kanker, komunikasi
MORBUS HANSEN MULTIBASILER RELAPS DENGAN REAKSI ERITEMA NODOSUM LEPROSUM BULOSA PADA SEORANG ANAKMORBUS HANSEN MULTIBASILER RELAPS DENGAN REAKSI ERITEMA NODOSUM LEPROSUM BULOSA PADA SEORANG ANAK
Authors: Tangkidi Damayanti , Sondakh Oktavia R. L. , Kandou Renate T.
Published: July 2019

Abstract: The clinical manifestations of ENL bullous reaction are generally in the form of nodes and erythematous plaques, but in a severe reaction, bullae, ulcerations, and necrosis may occur. Relapses occur one year or more after the RFT whilst the symptoms emerge slowly and gradually. We reported a case of multibacillary leprosy relapse with ENL bullous reaction in a 14-year-old boy. The clinical picture consisted of reddish nodes and thickening red plaques since 10 days before admission to the hospital, followed by fluid-filled blisters associated with fever. The dermatological status showed multiple erythematous nodes and plaques, as well as multiple bullae. The laboratory tests indicated AFB (+), MI 6.5%, and BI 4+. The patient was stated as RFT after 1 year of MDT-MB treatment. The patient was treated with methylprednisolone 1x40 mg intravenous injection for 10 days, followed by oral methylprednisolone 4 mg in reduced dosage. Conclusion: This case was diagnosed as MHMB relapse with ENL bullous reaction based on the anamnesis, clinical features such as multiple erythematous nodules and plaques with bullae, and laboratory tests. Treatment with corticosteroids and MDT-MB resulted in good improvement.Keywords: ENL bullous reaction, relapseAbstrak: Manifestasi klinis reaksi ENL bulosa umumnya berupa nodi dan plak eritematosa, namun pada reaksi berat dapat berupa bula, ulserasi, dan nekrosis. Relaps terjadi 1 tahun atau lebih setelah RFT, dimana gejala timbul lambat dan bertahap. Kami melaporkan suatu kasus MHMB relaps dengan reaksi ENL bulosa pada seorang anak berusia 14 tahun. Gambaran klinis didapatkan bentol kemerahan dan bercak merah meninggi sejak 10 hari lalu, kemudian timbul lepuh berisi cairan disertai demam badan. Status dermatologis generalisata ditemukan nodul dan plak eritematosa multipel serta bula multipel. Pemeriksaan laboratorium menunjukkan BTA (+), MI 6,5%, dan BI 4+. Pasien dinyatakan RFT setelah 1 tahun pengobatan MDT-MB. Pasien diobati dengan metilprednisolon injeksi 1x40 mg intravena selama 10 hari, dilanjutkan dengan metilprednisolon oral 4mg dengan dosis diturunkan. Lesi bulosa pada kusta merupakan manifestasi dari reaksi ENL berat dengan MI dan BI yang tinggi. Simpulan: Pada kasus ini, diagnosis MHMB relaps dengan reaksi ENL bulosa ditegakkan berdasarkan anamnesis, gambaran klinis berupa nodul dan plak eritematosa multipel disertai bula, dan pemeriksaan laboratorik. Pengobatan dengan kortikosteroid dan MDT-MB memberikan hasil yang baik.Kata kunci: reaksi ENL bulosa, relaps
MALT lymphoma in terminal ileum a case report
Authors: Indrawati Yeti
Published: July 2019

Abstrak: Mucosa associated lymphoid tissue lymphoma (MALToma) merupakan subtipe ketiga tersering dari limfoma non-Hodgkin. Gejala klinis sering insidius sebagai lesi yang low grade dan cenderung terlokalisasi untuk waktu lama. Saluran cerna, terutama lambung, merupakan lokasi ekstranodal tersering. MALToma dari ileum jarang ditemukan dengan patogenesis yang tidak diketahui pasti. Mengenai 5-year survival untuk MALToma dilaporkan 81%. Kami melaporkan kasus seorang laki-laki berusia 80 tahun dirawat di Bagian Emergensi RS Siloam Manado dengan nyeri abdomen dan adanya massa dalam abdomen. Pemeriksaan radiologi abdomen dan USG memperlihatkan adanya massa pada area usus halus. Pada pasien ini dilakukan laparotomi. Hasil histopatologik menunjukkan suatu MALT limfoma dari ileum terminalis.Kata kunci: MALT limfoma, ileum terminalis.Abstract: Mucosa associated lymphoid tissue lymphoma (MALToma) is the third most common non-Hodgkin’s lymphoma subtype. Clinical presentation is often insidious as a low grade lesion and the disease tends to remain localized for a long period of time. The gastrointestinal tract, but in particular the stomach, is by far the most common extra-nodal site. MALToma of ileum, however is rare. Little is known with certainty about the pathogenesis of the disease but overall 5-year survival for MALToma is reported as 81%. We reported an 80-year-old male presented to the Emergency Department of Siloam Hospital Manado with abdominal pain and an abdominal mass. He underwent an abdominal radiology and abdominal ultrasound which showed a mass in the small intestinal area. A laparotomy and a tumor biopsy were performed on him. The histopathological result was consistent with MALT lymphoma of terminal ileum.Keywords: MALT lymphoma, terminal ileum
Ambliopia anisometropia
Authors: Rares Laya
Published: July 2019

Abstract: Anisometropic amblyopia is blurred vision due to refractive anomaly without any anatomical disorders of the eyes. It is frequently found among children in their growth and development periods. The prognosis depends on the ambylopia severity, management, patient’s obedience to the management, and age. We report a case of anisometropic amblyopia in a 8-year-old boy with his main complaint was blurred vision of both eyes. The ophthalmological examination showed the visual acuity of both eyes 6/40, PH 6/9. Several tests that showed normal results were as follows: eyeball movements to all directions; pupil responses to light; Hischberg test; cover test dan cover uncover test at near and far distance fixation; alternate cover test; and worth four dots and Maddox rod tests. Cyclopegical refraction with streak retinoscopy at 50 cm distance resulted in right eye S-4.00 C-3.00 x1800 6/9 and left eye S-1.25 C-3.25 x1800 6/7.5; autorefraction of right eye S-4.50 C-3.25 x70 and of left eye S-1.25 C-4.25 x1710. Anterior and posterior segments of both eyes were normal. Conclusion: In this case, the diagnosis was confirmed as anisometropic amblyopia and compound myopic astigmatism of the right and left eyes. The prognosis was dubia ad bonam. The patient was treated with maximal correction glasses and observed for the first four weeks, and then would be evaluated continuously untill the vision was normal. Keywords: amblyopia anisometropia, vision, refraction anomalyAbstrak: Ambliopia anisometropia merupakan gangguan penglihatan akibat kelainan refraksi tanpa disertai adanya kelainan anatomik pada mata yang sering terjadi pada masa perkembangan anak. Prognosis sangat tergantung pada derajat ambliopia, penanganan, kepatuhan pasien terhadap penanganan, dan usia pasien. Kami melaporkan kasus ambliopia anisometropia pada seorang anak berusia 8 tahun, dengan keluhan utama penglihatan kedua mata kabur. Dari pemeriksaan oftalmologik didapatkan visus ODS 6/40, PH 6/9. Beberapa pemeriksaan yang dilakukan memperlihatkan hasil normal, yaitu: pergerakan bola mata ke segala arah; respon pupil terhadap cahaya; Hischberg test; cover test dan cover uncover test pada fiksasi jarak dekat dan jauh; alternate cover test; serta worth four dots test dan Maddox rod test. Pemeriksaan refraksi sikloplegik dengan streak retinoscopy pada jarak 50 cm didapatkan mata kanan S-4,00 C-3,00 x1800 6/9 dan mata kiri S-1,25 C-3,25 x1800 6/7,5 dan pemeriksaan autorefraksi mata kanan S-4,50 C-3,25 x70 dan mata kiri S-1,25 C-4,25 x1710. Pemeriksaan segmen anterior dan posterior mata kanan dan kiri dalam batas normal. Simpulan: Diagnosis pada kasus ini ialah ambliopia anisometropia ODS dan astigmatisma miopikus kompositus ODS, dengan prognosis dubia ad bonam. Terapi yang diberikan ialah kacamata koreksi maksimal dan diobservasi selama 4 minggu pertama, dan akan dievaluasi terus sampai ketajaman penglihatan normaL. Kata kunci: ambliopia anisometropia, ketajaman penglihatan, kelainan refraksi
PENAMBAHAN DAUN GEDI (Abelmoschus Manihot (L) Medik) SEBAGAI “ADDITIVE” DALAM AIR MINUM DAN PENGARUHNYA TERHADAP PERFORMANS AYAM KAMPUNG SUPER
Authors: Kogoya Desben , Mandey J S , Rumokoy L J , Regar M N
Published: July 2019

UTILIZATION OF “GEDI LEAF (Abelmoschus Manihot (L) Medik) AS“ADDITIVE” IN DRINKING WATER RELATED TO THE PERFORMANCE OF INDONESIAN SUPER NATIVE CHICKEN. Research was done to evaluate the performance of Indonesian super native chicken treated with “Gedi” leaf (Abelmoschus Manihot (L) Medik) as“Additive” in drinking water. Study was conducted using hundred individuals of the Indonesian super native day old chicken. The juice of “Gedi” leaf (Abelmoschus Manihot (L) Medik) was given as in forms of the four treatments as follows, drinking water without “Gedi” leaf as control (P0), drinking water with 10 ml juice of “Gedi” leaf per liter of drinking water (P1), drinking water with 20 ml juice of “Gedi” leaf per liter of drinking water (P2), and drinking water with 30 ml juice of “Gedi” leaf per liter of drinking water (P3). Treatments were applied to the birds at 6 weeks old by completely randomized design five replications at each treatment. Data were taken during 5 weeks. Feeds were using 73 percents of commercial feed added by 10 percents of corn and 17 percents of rice bran with nutritional composition of crude protein 19.49 percents, crude fiber 4.66 percents, fat 3.63 percents, Calcium 1.02 percents, Phosphorus 0.66 percents and metabolic energy of 2920 kcal/kg, all given ad libitum. Variables measurement were focused on feed consumption, drinking water consumption, average daily gain, and feed conversion. Results showed that drinking water with 30 ml juice of “Gedi” leaf per liter of drinking water (P3) was not significantly different with other treatments for feed and drinking water consumption, except for average daily gain and feed conversion. The treatments of P1 and P2 were not significantly different for average daily gain, but these treatments were higher in average daily gain compared with control (P0). The highest value of feed conversion was obtained at treatment P3 and the lowest value was found at treatment P1. These values indicated that the best feed conversion was treatment P1. Therefore, it can be concluded that juice of “Gedi” leaf can be used as the alternative additive feed in drinking water up to 20 ml juice of “Gedi” leaf per liter of drinking water in term of high average daily gain and feed conversion of Indonesian super native chicken. Key words: Drinking water, “Gedi” leaf, Indonesian super native chicken.
EFEK PEMBATASAN PAKAN DAN SUMBER SERAT KASAR BERBEDA TERHADAP PERFORMA AYAM PEDAGING
Authors: Binowo Seruni , Tulung Bernat , Londok Jola J.M.R. , Regar Mursye N.
Published: July 2019

EFFECT OF FEED RESTRICTION AND DIFFERENT CRUDE FIBER SOURCES ON THE BORILER PERFORMANCE. The research aim was to determine the performance of Lohman strain broiler were given by food restriction of 20 percent and 10 percent levels of crude fiber from different fiber sources originated from coffee peel, rice bran and coconut pulp. This research was carried out in a poultry house at the Faculty of Animal Husbandry, UNSRAT Manado, during 6 weeks using 48 unsex Lohman strain broilers at 21 days old. The research method was using a Completely Randomized Design (CRD) based on factorial pattern (2x4). Each treatment combination was repeated 3 times. Factor A was a feed restriction consisting of feed without restriction (A0) and restriction of 20% feed for 8 days (A1). Factor B was a source of fiber consisting of control (B0);coffee peel (B1); rice bran (B2) and coconut pulp (B3). In this study, the were 8 treatment combinations of A0B0, A0B1, A0B2, A0B3, A1B0, A1B1, A1B2 and A1B3. Application of feed restriction and source of fiber  were applied during days of 21th to day of 28th. The birds were fed commercial feed until 42 days of age. The variables measured were feed consumption, body weight gain and feed conversion. The results showed that the restriction of feed and different fiber sources had a significant effect (P <0.05) on feed consumption, body weight gain and feed conversion. The results of this study can be concluded that the restriction of feed by 20 percent for 8 days with a source of crude fiber originated from coconut pulp in feed gave the best response compared with crude fiber originated from coffee peel and rice bran on the performance of the Lohman strain of broiler.Keywords: Broiler, feed restriction, crude fiber