bluuebunny/crossref_metadata_2025 huggingface dataset:
Noma management in a 47-years-old female patient using estlander flap: a case report
Authors: Brahmananta Anak Agung Bagus Satria , Wibawa Ida Bagus Adiguna , Asmarajaya Anak Agung Ngurah
Published: November 2020

Background: Noma or cancrum oris is an uncommon disease that results in loss of tissue in the oronasal region secondary to gangrenous slough. As most patients with noma do not report until the disease is at an advanced stage, its onset and progression remain a mystery. Survivors of this disease suffer severe facial deformity due to loss of facial tissues and scarring. Reconstruction of such type of defects was aimed to maintain oral competence, sufficient oral access, and preservation of sensation.Case: A woman, 47 years old, experience with a chief complaint of the deformed right upper lip for the past 45 years. The patient is known to have a history of deformity on the right upper lip region when the patient was two years old. The patient stated that it originally started with swelling on the right cheek accompanied by redness and painful sensation.Result: An extensive scar along with half of the upper lip missing was found in the physical examination, causing exposure of anterior maxillary teeth. A full-thickness defect of half of the upper lip with severe scar contracture was also found in the further examination, thereby constricting the oris. The patient was planned for surgical management under general anesthesia. Lip reconstruction using an Estlander flap was done.Conclusion: Reconstruction must be planned carefully to restore the natural contours of the lip. The Estlander flap is one of the treatment choices used for labial defects that include the commissure.
Stevens-Johnson Syndrome (SJS)-Toxic Epidermal Necrolysis (TEN) overlap in a 61-year old woman: a case report
Authors: Sari Luh Gede Melia Puspita , Pemayun Tjok Dalem
Published: November 2020

Background: Epidermal necrolysis (EN) is a rare life-threatening reaction. The exact cause of this disease is unknown. However, the drug is one of the main factors as a cause. EN differentiated based on the extent of skin detachment limited to less than 10% of the body surface area (BSA) in SJS, 10%-30% BSA in SJS/TEN overlap, and greater than 30% of the BSA in TEN. SJS and TEN can occur at various ages, but more often occur at the age of 40 years. Mortality was almost 30% in SJS/TEN overlap patients. Management for SJS and TEN is the cessation of drugs that are thought to be the cause and other supportive therapies.Case presentation: A 61-year-old female with SJS-TEN overlap, who presented epidermal detachment, is about 10-30% with a positive Nikolsky sign. She had a history of taking medication, such as paracetamol, amoxicillin, and buscopan, before lesion appeared. There were multiple lesions widespread, macula hyperpigmentation multiple, erosion from the bullae that has broken, there also erosion covered by black crust, and various erosions covered with black, brown crusts on lip mucosa and also secret on both eyes. The management of this patient was a cessation of suspected drug and supportive therapy. The patientâ€™s condition was improved within a few weeks, and no sequelae found.Conclusion: SJS-TEN overlap is one of the epidermal necrolysis in which skin detachment 10-30% BSA. The management was a cessation of all suspected drugs, administering high doses of steroids and other supportive therapies.
Karakteristik kasus otitis eksterna di RSUP Sanglah Denpasar periode April 2015-April 2016
Authors: Wulandari N.P Mirah Ayunda Kartika , Sudipta I Made
Published: November 2020

Background: External Otitis (OE) is one of the most common cases in ENT. There are an estimated 8.1 visits with an OE diagnosis per 1,000 annually. The low understanding of the community about OE caused the cases to become frequent. This study aims to increase public understanding of OE by knowing the characteristics of OE in Sanglah Hospital.Methods: A study with descriptive cross sectional method. Samples were taken from Sanglah Hospital's medical record data on period 2015-2016 with total sampling method.Results: A total of 84 samples were successfully analyzed, and found: OE was most common in the 15-49 years age group (55.9%). Gender dominating is female (52.4%). The most clinical symptoms of OE patients were ear pain (67.9%), followed by ear discharge (55.9%), ear that felt full (22.6%), itchiness (20.2%), ringing (21.4%), hearing loss (15.5%), and accompanied (4.8%). The most frequent cause of OE is due to trauma (58.3%), followed by fungi or bacterial infection (20.3%), combined causes (11.9%), and the least caused by systemic disease (9.5%).Conclusions: The OE case at Sanglah Hospital is most commonly found in the female population, age group 15-49 years, with the most common symptom of earache and caused by mechanical trauma.Â Latar Belakang: Otitis Eksternal (OE) merupakan salah satu kasus yang sering ditemukan dalam bidang THT. Diperkirakan terdapat 8.1 kunjungan dengan diagnosis OE per 1.000 per tahunnya. Rendahnya pemahaman masyarakat mengenai OE menyebabkan kasus ini menjadi sering terjadi. Studi ini bertujuan untuk meningkatkan pemahaman masyarakat mengenai OE dengan mengetahui gambaran kejadian OE di RSUP Sanglah.Metode: Sebuah studi dengan metode deskriptif potong lintang. Sampel diambil dari data rekam medis RSUP Sanglah pada periode 2015-2016 dengan metode total sampling .Hasil: Sebanyak 84 sampel berhasil di analisis, dan ditemukan: OE paling sering terjadi pada kelompok umur 15-49 tahun, (55,9%). Jenis kelamin yang mendominasi adalah perempuan (52,4%). Gejala klinis penderita OE terbanyak adalah nyeri telinga (67,9%), diikuti berair atau keluar cairan dari telinga (55,9%), terasa penuh (22,6%), rasa gatal (20,2%), berdenging (21,4%), gangguan pendengaran (15,5%), dan yang disertai (4,8%). Penyebab OE terbanyak adalah karena trauma (58,3%), diikuti karena jamur atau bakteri (20,3%), penyebab gabungan (11,9%), dan paling sedikit disebabkan oleh penyakit sistemis (9,5%).Simpulan: Kasus OE di RSUP Sanglah paling sering ditemui pada populasi wanita, kelompok umur 15-49 tahun, dengan gejala tersering berupa nyeri telinga dan disebabkan oleh trauma mekanis. Â
Anemia and metabolic acidosis are a predictor for mortality in children with severe acute malnutrition at Sanglah General Hospital, Bali
Authors: Kluniari Ni Putu Andina , Sidiartha I Gusti Lanang
Published: November 2020

Background: Severe acute malnutrition (SAM) is one of the leading causes of morbidity and mortality in children in developing countries.Â  Nutritional disorders are frequent in hospitalized patients, of which malnutrition is the most prevalent Anemia and PH disturbance was commonly found in this condition. This study aims to determine the association between anemia and metabolic acidosis with the mortality among children with severe acute malnutrition.Methods: A retrospective cohort study was conducted among 135 severe acute malnutrition children in the pediatric care unit of Sanglah General Hospital from the 2017-2018 period. The inclusion criteria were children aged 1 month to 18 years diagnosed with SAM. Exclusion criteria were a patient diagnosed with a hematological disorder or renal disorder. Data were analyzed using SPSS version 20 for Windows.Results: Anemia was diagnosed in 89 (65.9%) subjects in this study. Anemia increases the risk of death significantly by 3.98 times (95% CI 2.167-10.389; p<0.001). Metabolic acidosis was found in 35 (25.9%) subjects; this condition was also shown to significantly increase the risk of death by 1.5 times (95% CI 1.005-2.145; p=0.018).Conclusion: Anemia and metabolic acidosis can be used as predictors for mortality in severe acute malnutrition patient significantly.
Steven-Johnson Syndrome associated with anti-tuberculosis drugs: a case reports
Authors: Pramita I Gusti Ayu Risma , Pemayun Tjokorda Dalem
Published: November 2020

Introduction: Steven-Johnson syndrome (SJS) is an acute reaction to the skin and mucous membranes that is characterised by damage and flaking of the skin, accompanied by pain and can cause death. Treatment with anti-TB drugs sometimes results in side effects including SJS Â as one of the skin rash reaction and liver dysfunction. Steven-Johnson syndrome incidence and mortality due to anti-TB is quite rate and here we present a case with SJS and some other drugs side effect symptoms who passed away on the ninth day of treatment.Â Case description: A 53-year-old woman admitted to our emergency department with dyspnea, fatigue, erosion on oral mucosa, and erythema appears in the whole body accompanied by itch since two weeks ago, she also has yellowish sclera. She is in ongoing therapy of anti-tuberculosis drugs. History of hepatitis B, on admission there was marked elevation of leukocyte and liver function test (AST and ALT). Systemic corticosteroid was given as characterised therapy with topical steroid and antibiotics regimen for maculopapular rash.Conclusion: SJS is an emergency requiring high attention and intensive care evaluation with administration of intravenous systemic steroids as primary immunosuppressive therapy.
A jejunal atresia type I in newborn: a case report
Authors: Suryaningrat Anak Agung Adi , Ariyanta Kadek Deddy
Published: November 2020

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Jejunal atresia occurs more frequently than duodenal or colonic atresias, while single atresias are most commonly encountered. This case report aims to evaluate the recent management of jejunal atresia type I in newborn.Case Description: We report one case of jejunal atresia types I. A 8-days old newborn was born with signs of upper gastrointestinal obstruction. Bile-stained vomiting was reported on the third day of life. Postnatal abdominal X-ray showed the triple bubble sign. Laparotomy was performed at 9th days of life when it revealed the type of jejunal atresia type 1. The resection procedure on the atresia, such as tapering and end to end anastomosis, was performed. Laparotomy revealed the type I Jejuno-ileal atresia 20 cm from Treitz ligament then resection on the atresias, tapering, and end to end anastomosis was performed. Post-operative, the baby was admitted to NICU with total parenteral nutrition and continued antibiotics due to sepsis.Conclusion: The case was referred to the neonatal intensive care unit post-surgery with a carefully monitored fluid balance, temperature, and sign of sepsis. A definitive antibiotic was given due to sepsis, as well as total parenteral nutrition.Â
Gambaran karakteristik kanker anak di RSUP Sanglah, Bali, Indonesia periode 2008-2017
Authors: Adinatha Yohannes , Ariawati Ketut
Published: November 2020

Background: Childhood cancer is estimated to increase every year. Child cancer divided into leukemia and solid tumors. In RSCM Jakarta, the most common cancers are Acute Leukemia, Brain Tumor (10-15%), Retinoblastoma (10-12%), and other malignancies. This study aims to determine the characteristics of childhood cancer at Sanglah General Hospital Denpasar in the period 2008-2017.Method: A cross-sectional retrospective descriptive study was conducted by taking patient's medical records of leukemia and solid tumors data in children admitted to Sanglah General Hospital during 2008-2017. The parameters assessed in this study were the type of cancer in children, age, sex, or residence domicile. Data were analyzed with SPSS software version 17 for Windows.Results: The results obtained 410 pediatric cancer patients during the 2008-2017 time period, which consisted of 240 cases of leukemia (58.5%) and 170 cases of solid tumors (41.5%). Most cases were 0-5 years old (61.5%), males (50.7%), and domiciled in Bali (72.4%). Acute lymphoblastic leukemia (LLA) is the most common hematologic malignancy in children, which occupies 41.0% of total cancers proportion, followed by retinoblastoma (14.0%), malignant lymphoma (9.0%), and neuroblastoma (5.0%).Conclusion: Most cancers in children occur at the age of 0-5 years, male sex, and domicile in Bali. Besides, acute lymphoblastic leukemia (LLA) is the most common hematologic malignancy in children.Â Latar Belakang: Penyakit kanker anak diperkirakan meningkat setiap tahunnya. Kanker anak secara garis besar dibagi dua, yaitu keganasan darah (leukemia) dan tumor padat. DI RSCM Jakarta, kanker tersering yaitu Leukemia Akut, Tumor Otak (10-15%), Retinoblastoma (10-12%), dan keganasan lainnya.Penelitian ini bertujuan untuk mengetahui karakteristik kanker anak di RSUP Sanglah Denpasar dalam perioder 2008-2017.Metode: Penelitian deskriptif retrospektif potong lintang dilakukan dengan pengambilan data rekam medis pasien leukemia dan tumor padat anak yang menjalani perawatan di RSUP Sanglah Denpasar periode tahun 2008-2017. Parameter yang dinilai pada penelitian ini adalah jenis kanker pada anak, usia, jenis kelamin, maupun domisili tempat tinggal. Data dianalisis dengan piranti lunak SPSS versi 17 untuk Windows. Hasil: Hasil penelitian mendapatkan 410 pasien kanker anak selama rentang waktu 2008-2017 dimana terdiri atas 240 kasus leukemia (58,5%) dan 170 kasus tumor padat (41.5%). Sebagian besar kasus berusia 0-5 tahun (61,5%), berjenis kelamin laki-laki (50,7%), dan berdomisili di Bali (72,4%). Leukemia Limfoblastik Akut (LLA) merupakan keganasan hematologi tersering pada anak dimana menempati proposi 41,0% dari total kanker, diikuti Retinoblastoma (14,0%), Limfoma maligna (9,0%), dan Neuroblastoma (5,0%).Kesimpulan: Sebagian besar kanker pada anak terjadi pada usia 0-5 tahun, berjenis kelamin laki-laki, dan domisili di Bali. Di samping itu, Leukemia Limfoblastik Akut (LLA) merupakan keganasan hematologi anak tersering pada anak.
Tatalaksana peritonitis bakteri Staphylococcus Epidermidis pada seorang pasien dengan continuous ambulatory peritoneal dialysis (CAPD)
Authors: Dewi I Gusti Agung Ayu Indira Nirmala , Kandarini Yenny
Published: November 2020

Background: Peritonitis is a common CAPD related infection. It can cause discontinue dyalisis peritoneal and conversion to hemodyalisis.Case description: This article reported a 54-year-old man on 5 years dialysis peritoneal with a complaint of abdominal pain since 1 week before admission. The complaint accompanied by fever and nausea. On abdominal examination there are mild distention, weak of bowel sound, pressure pain, and defans muscular. Dialisat examination found cloudy fluid, effluent white blood cell count 961 cells/mm3 composed of 85% polymorphonuclear leucocytes. Peritoneal dialysis effluent gram stain, routine culture found isolated Staphylococcus epidermidis with methicillin resistant, significant as infectious agent depend on patientâ€™s clinical and infectionâ€™s marker. Performed a definitive antibiotic with Linezolid 600 miligram intravena and Gentamicin 40 miligram intraperitoneal during 14 days showed clinical and laboratorium improvement.Conclusion: Peritonitis remains a major cause of technique failure in peritoneal dialysis and affects patientâ€™s morbidity and mortality. Management should be definitive antibiotic as dialysat culture result. Catheter removal indicated if there were refractory peritonitis, relapsing peritonitis, refractory exit-site and tunnel infection, fungal peritonitis.Â Latar belakang: Peritonitis merupakan komplikasi infeksi pada pasien CAPD yang umum terjadi. Peritonitis dapat menjadi penyebab utama penghentian dialisis peritoneal dan dikonversi ke hemodialisis.Deskripsi kasus: Laporan kasus ini melaporkan laki-laki berusia 54 tahun yang telah menjalani CAPD selama 5 tahun mengeluh nyeri perut sejak 1 minggu yang lalu SMRS. Nyeri perut disertai dengan demam dan mual. Pemeriksaan abdomen didapatkan distensi ringan, bising usus terdengar lemah, adanya nyeri tekan, dan defans muskuler. Pemeriksaan analisis cairan dialisat didapatkan warna keruh/berawan dengan jumlahÂ  961 sel/uL dengan dominan polymononuklear sebesar 85%. Pemeriksaan kultur/ biakan cairan peritoneum didapatkan terisolasi bakteri Staphylococcus epidermidis yang bersifat Methicillin resistant, significan sebagai agen penyebab infeksi tergantung keadaan klinis dan marker infeksi pasien. Dilakukan tatalaksana terapi antibiotik definitif dengan Linezolid 600 miligram setiap 12 jam intravena dan Gentamicin 40 miligram intraperitoneal, intermiten dose saat penggantian cairan malam hari. Pemberian terapi antibiotik definitif dan intraperitoneal dilanjutkan selama 14 hari dan pada pasien didapatkan perbaikan secara klinis dan laboratorium. Simpulan: Peritonitis merupakan penyebab utama kegagalan teknik pada dialisis peritoneal dan mempengaruhi morbiditas serta mortalitas pasien CAPD. Diagnosis peritonitis terkait CAPD sedini mungkin serta pemberian terapi yang cepat dan tepat dapat menghindarkan pasien dari komplikasi yang lebih berat dan kegagalan dialisis peritoneal.
Perbedaan petanda osteoporosis dan inflamasi pada pasien diabetes melitus tipe 2 terkontrol dan tidak terkontrol
Authors: Setianingsih Emi , Budiwiyono Imam , Hendrianingtyas Meita
Published: November 2020

Background: Prolonged hyperglycemia cause further complications in patients with Type 2 Diabetes Mellitus (T2DM). Examination of HbA1c as a glycemic control can determine the risk of complications. N-Mid osteocalcin (N-Mid Oc) is used as a marker for early detection of osteoporosis. Increased neutrophil lymphocyte ratio (NLR) is a sign of simple inflammation that contributes to the progression and chronic complications in T2DM. The aim of the study is to analyze the differences between osteoporosis and inflammation markers in controlled and uncontrolled T2DM.Methods: Analityc observational study withÂ  cross sectional approach was conducted in June â€“ July 2019 involving 58 DMT2 patients at Diponegoro National Hospital Semarang. The level of N-Mid Oc level were measured by ELISA method and NLR was measured by hematology analyzer, NLR values were obtained after manually calculated. Different test between research variables were using Mann-Whitney U testResults: The median (min - max) N-Mid Oc levels of controlled and uncontrolled T2DM patients were 16.17 (4.98 â€“ 37.28) ng / ml and 12.29 (3.54 â€“ 37.28) ng/ml with a value of p = 0.004. Median (min - max) NLR of DMT2 patients controlled and uncontrolled were 1.82 (0.64 â€“ 3.94) and 2.41 (1.08 â€“ 6.46) with p = 0.007.Conclusion: There is a significant differences between N-Mid O level and NLR in controlled and uncontrolled T2DM patients.Â Latar belakang: Hiperglikemia berkepanjangan dapat menimbulkan komplikasi lebih lanjut pada pasien Diabetes Melitus Tipe 2 (DMT2). Pemeriksaan HbA1c sebagai kontrol glikemik dapat mengetahui risiko komplikasi. N-Mid osteocalcin (N-Mid Oc) dipakai sebagai salah satu petanda deteksi dini osteoporosis. Peningkatan neutrophil lymphocyte ratio (NLR) merupakan petanda inflamasi sederhana untuk memantau progresivitas dan komplikasi kronik pada DMT2. Tujuan dari penelitian ini adalah untuk membuktikan adanya perbedaan petanda osteoporosis dan inflamasi antara DMT2 terkontrol dan tidak terkontrol.Metode: Penelitian observasional analitik dengan pendekatan belah lintang dilakukan pada bulan Juni - Juli 2019 melibatkan 58 pasien DMT2 di Rumah Sakit Nasional Diponegoro Semarang yang memenuhi kriteria inklusi dan eksklusi. Pemeriksaan N-Mid Oc diperiksa dengan metode ELISA dan Pemerikasaan NLR menggunakan hematology analyser, nilai NLR didapatkan setelah dihitung secara manual. Uji beda antar variabel penelitian mengunakan Mann-Whitney U testâ€™s. Hasil: Median (min â€“ maks) kadar N-Mid Oc pasien DMT2 terkontrol dan tidak terkontrol berturut-turut adalah 16,17 (4,98 â€“ 37,28) ng/ml dan 12,29 (3,54 â€“ 37,28) ng/ml dengan nilai p=0,004. Median (min â€“ maks) NLR pasien DMT2 terkontrol dan tidak terkontrol berturut-turut adalah 1,82 (0,64 â€“ 3,94) dan 2,41 (1,08 â€“ 6,46) dengan nilai p=0,007.Simpulan: terdapat perbedaan bermakna dari N-Mid Oc dan NLR antara pasien DMT2 terkontrol dan tidak terkontrol.
Gambaran kepatuhan terapi antiretroviral pada lelaki-seks-lelaki di Klinik Bali Medika
Authors: Indriani Phebe , Yuliyatni Putu Cintya Denny , Ani Luh Seri , Weta I Wayan
Published: November 2020

Background: HIV prevalence in Indonesia and Bali is quite large. The main factor in achieving success in the treatment of HIV / AIDS virus infections is compliance.Aim: This study aims to determine the adherence of ARV therapy to MSM based on the characteristics and clinical stage in one of the CST clinics, the Bali Medika clinic. This descriptive study with cross sectional design used simple random sampling from the register of HIV patients at the Bali Medika Clinic so as to get 90 MSM (male-sex-male) patients. Data sources were taken from medical records regarding the characteristics, clinical stage, and treatment compliance of the study subjects. The data obtained were analyzed and displayed in the form of frequency tables and cross tables.Results: The majority of MSM sufferers with HIV are less than 31 years old; single (95.6%); low education (52.2%); have a job (94.4%); are in clinical stage I (77.8%); do not have coinfection (86.7%); use FDC drugs (92.2%); and suffered side effects from dizziness (90.0%). Most (66.7%) adhere to the Bali Medika Clinic.Conclusion: MSM at the Bali Medika Clinic tend to have high compliance in carrying out ARV therapy.Â Latar Belakang: Prevalensi HIV di Indonesia dan Bali cukup besar. Faktor utama dalam mencapai keberhasilan pengobatan infeksi virus HIV/AIDS adalah kepatuhan.Tujuan: Penelitian ini bertujuan untuk mengetahui kepatuhan terapi ARV pada LSL (lelaki-seks-lekali) berdasarkan karakteristik dan stadium klinis di salah satu klinik CST, yaitu klinik Bali Medika.Metode: Desain penelitian dengan rancangan potong lintang ini menggunakan simple random sampling dari daftar register pasien HIV di Klinik Bali Medika sehingga mendapatkan 90 pasien LSL. Sumber data diambil dari rekam medis mengenai karakteristik, stadium klinis, dan kepatuhan terapi dari subjek penelitian. Data yang diperoleh dianalisis dan ditampilkan dalam bentuk tabel frekuensi dan tabel silang.Hasil: Sebagian besar LSL penderita HIV berusia kurang dari sama dengan 31Â  tahun; belum menikah (95,6%); berpendidikan rendahÂ  (52,2%); memiliki pekerjaan (94,4%); berada dalam stadium klinis I (77,8%); tidak memiliki koinfeksi (86,7%); menggunakan jenis obat FDC (92,2%); dan menderita efek samping pusing (90,0%). Sebagian besar (66,7%) patuh berkunjung ke Klinik Bali Medika.Simpulan: LSL di Klinik Bali Medika cenderung memiliki kepatuhan yang tinggi dalam menjalankan terapi ARV.
The correlation between location and size of infarction toward the quality of life in acute ischemic stroke patients at Sanglah General Hospital, Bali, Indonesia
Authors: Yusrika Mirani Ulfa , Nuartha Anak Agung Bagus Ngurah , Wijayanti Ida Ayu Sri , Asih Made Widhi , Sujatmiko Skolastika Savitri
Published: November 2020

Background: Location and size of infarction in acute ischemic stroke can cause different levels of neurological deficits and disabilities according to the function of the area of brain whose blood flow is disrupted, thus affecting the quality of life in patients. This study was aimed to explore the correlation between location and size of infarction toward the quality of life in acute ischemic stroke patients in Sanglahà¹€Generalà¹€Hospitalà¹€Denpasar.Methods: A cross-sectional study was conducted among 41 acute ischemic stroke patients at Neurologyà¹€Care Unit, Sanglahà¹€General Hospital Denpasar duringà¹€May-September 2019. The location of the infarct was grouped by the cerebral area. The largest diameter of infarction determined the size of the infarct. Data were taken from head Computedà¹€Tomography (CT) scan results to assess the location and size of infarction and Barthel Index (BI) to measure the quality of life-based on Activity of Daily Living (ADL). Data were analyzed using univariate and bivariate analysisà¹€(Chi-Squareà¹€testà¹€withà¹€Cramerâ€™sà¹€V for location and BI scores, Spearmanà¹€test for size and BI scores) on SPSSà¹€version 23 for Windows.Results: Most of the respondents were males 59.0%, the average age of 60.03Â±14.4 years, ischemic thrombus stroke (71.8%), subcortical infarction (41.0%), small size (â‰¤ 1.5 cm) of infarction (48.7%), and independent criteria for Barthel Index Scores (23.1%). There were significant correlations between the location of infarction and BI scores (r=0.636; p<0.000) and the size of infarction and BI scores (r=0.553; p<0.000).Conclusion: Infarct that located in the cortical area with small size are related to independent or mild dependency outcome. Conversely, infarct that located and associated with a subcortical area with larger size are related to severe or total dependency.
Profil penderita katarak traumatika di Rumah Sakit Umum Pusat Sanglah Kota Denpasar, Bali-Indonesia
Authors: Aroean Maria Septiana Parmonang , Sutyawan I Wayan Eka , Budhiastra Putu , Jayanegara I Wayan Gede
Published: November 2020

Background: Traumatic cataract is a cataract that occurs as a result of injury to the eye which can be a sharp or blunt trauma that is seen after a few days or several years. This traumatic cataract can occur acute, subacute, or residual symptoms of eye trauma, often due to an injury caused by a foreign object that hits the lens or blunt trauma to the eyeball. The purpose of this study was to determine the profile of traumatic cataract sufferers which included the characteristics of age, sex, and occupation at the Sanglah Central Hospital in Denpasar, Bali.Method: This study was descriptive with a cross-sectional study design. This research is retrospective and uses secondary data obtained from medical records.Result: Results of the study with cross sectional descriptive test showed that 58.3% of cases occurred in the male sex and 41.7% in women. The age ranges from 5 years to 69 years with an average sample age of 38.25 + 2.6 years. The occupations that dominated were students and farmers with a percentage of 25% each, followed by housewives with a percentage of 16.7%.Conclusion: In this study traumatic cataracts were found to be more common in male rice, with an average age of 38 years and occupations as students and farmers. Based on clinical characteristics, the eyes most affected by traumatic cataracts are the left eye and the most common cause is blunt trauma.Â Â Latar Belakang: Katarak traumatika merupakan katarak yang terjadi sebagai akibat cedera pada mata yang dapat merupakan trauma tajam ataupun tumpul yang terlihat sesudah beberapa hari ataupun beberapa tahun. Katarak traumatika ini dapat terjadi akut, subakut, atau pun gejala sisa dari trauma mata, sering terjadi karena adanya cedera yang disebabkan oleh benda asing yang mengenai lensa atau trauma tumpul pada bola mata. Tujuan penelitian ini adalah untuk mengetahui profil penderita katarak traumatika yang meliputi karakteristik usia, jenis kelamin, dan pekerjaan di Rumah Sakit Umum Pusat Sanglah Kota Denpasar, Bali.Metode: Penelitian ini adalah deskriptif dengan rancangan penelitian potong lintang (cross-sectional). Penelitian ini bersifat retrospektif Â dan menggunakan data sekunder yang diperoleh dari rekam medis.Hasil: Hasil penelitian dengan uji deskriptif cross sectional menunjukkan bahwa 58,3% kasus terjadi pada jenis kelamin laki-laki dan 41,7% pada perempuan. Usia berkisar dari 5 tahun hingga 69 tahun dengan usia sampel rata-rata 38,25 + 2,6 tahun. Pekerjaan yang mendominasi adalah siswa dan petani dengan persentase masing-masing 25%, diikuti oleh ibu rumah tangga dengan persentase 16,7%.Simpulan: Pada studi ini ditemukan katarak traumatika lebih sering terjadi padi laki-laki, dengan rata-rata usia 38 tahun dan pekerjaan sebagai pelajar dan petani. Berdasarkan karakteristik klinis, mata yang paling banyak terkena katarak traumatika adalah mata kiri dan penyebab tersering adalah trauma tumpul.
Dislipidemia pada penderita nefropati diabetik di Rumah Sakit Umum Pusat Sanglah Denpasar, Bali tahun 2018
Authors: Wijaya I Nyoman Santa , Santhi Desak Gde Diah Dharma , Lestari Anak Agung Wiradewi
Published: November 2020

Background: Diabeticcnephropathy isaa commonacomplication of diabetes and the main cause of chronic kidney disease in developed countries. Diabetics develop toward nephropathy in about 40% of cases. This condition is characterized by increased albuminuria or decreased glomerular filtration levels. Patient with diabetic nephropathy and dyslipidemia have higher renal parameters such as blood ureum and serum creatinine.Aim: Â The study aims to determine gender, age, blood pressure, smoking habit, and lipid profile, ureum and creatinine characteristic in patients with diabetic nephropathy.Method: This research was descriptive cross-sectional approach applying 40 patient with diabetic nephropaty who visited Sanglah General Hospital Denpasar in Januari-Desember 2018. The sampling technique used consecutive sampling techniques and used secondary data in the form of medical records.Â Results and Conclusion: Most of diabetic nephropathy patients was male (55%), belong to age range of 51 to 60 years (50%), had hypertension (55%) and smoking history (15%).Â  Lipid profile parameter found that diabetic nephropathy patients had 52% increase in triglycerides and 62.5% decrease in HDL levels.Â  Results for urea levels found that 57.5% samples had urea levels >23 mg/dL and 80% had creatinine levels >0.90 mg/dL.Â Â Latar Belakang: Nefropati diabetik adalahh komplikasi umum dari diabetes dan penyebab utama penyakit ginjal kronis di negara maju. Sekitar 40% penderita diabetes berkembang ke arah nefropati, dimana kondisi ini ditandai dengan peningkatan albuminuria atau penurunan tingkat filtrasi glomerulus. Penderita nefropati diabetik dengan dislipidemia memiliki parameter ginjal seperti ureum darah dan serum kreatinin yang lebih tinggi.Tujuan: Untuk mengetahui untuk mengetahui gambaran jenis kelamin, usia, tekanan darah dan riwayat merokok serta profil lipid, ureum dan keratinin padaapenderitaadiabetes mellitusstipe 2 (DMT2)ddengan nefropatii diabetik.Metodee: PenelitianNini bersifat deskritif dengann metode crosss-sectional. Sampel penelitiann adalah 40 orang penderita nefropati diabetik yang mmelakukan perawatann di RumahSSakit UmumPPusat (RSUP) SanglahDDenpasar pada bulan jJanuari â€“ Desember 2018. Teknik pengambilan sampel dalam penelitian ini menggunakan teknik consecutive samplingg dann menggunakann dataasekunder berupaarekam medis.Hasil dan Simpulan: Mayoritas pasien nefropati diabetik adalah berjenis kelamin laki-laki (55%), dengan umur bekisar 51 â€“ 60 tahun (50%), mengalami hipertensi (55%) dan memiliki riwayat merokok (15%). Gambaran profil lipid pasien nefropati diabetik didapatkan peningkatan trigliserida (52%) dan penurunan kadar HDL (62,5%). Hasil untuk parameter kadar ureum mendapatkan sebanyak 57,5% pasien memiliki kadar ureum >23 mg/dL dan sebanyak 80% memiliki kadar keratinin >0,90 mg/dL.
Hubungan perilaku penggunaan gadget terhadap miopia pada anak sekolah dasar kelas 6 di Kota Denpasar
Authors: Permana Gede Anantha Restu , Sari Komang Ayu Kartika , Aryani Putu
Published: November 2020

Introduction: Myopia is a state of vision in which light fall in front of retina that causes blurred appearance of distant objects. The prevalence of myopia in Indonesia reaches 25% in adults and 10-12% in children.Method: This study aimed to identify the relationship of gadget usage behavior and myopia on sixth grade of elementary school children in Denpasar. This study was conducted by analytical method with cross-sectional design. Gadget usage behavior included position, visibility, and duration of gadget usage which were measured by questionnaire. Myopia was measured by snellen chart.Â  Samples of this study were 100 sixth grade children of Saraswati 2 Elementary School in Denpasar which were selected by simple random sampling technique.Result: Results of this study showed that there was no relationship between position of gadget usage and myopia (p value=0.059).Â  There was a relationship between eye to gadget distance and myopia (p value=0.000). Â Duration of gadget usage per day was not related to myopia with (p value=0.490).Conclusion: The results of this study are useful for early prevention to children about risk factors of the gadget usage behavior towards myopia.Â  Researchers suggest to other researchers to examine using other research methods and besides examining factors related to myopia such as genes, light intensity, and outdoor or indoor activities.Â Â Latar Belakang: Miopia merupakan keadaan penglihatan dimana cahaya jatuh di depan retina yang menyebabkan objek jauh terlihat kabur. Prevalensi miopia di Indonesia mencapai 25% pada orang dewasa dan 10-12% pada anak-anak. Penelitian ini bertujuan untuk mengidentifikasi dan menguraikan hubungan perilaku penggunaan gadget terhadap miopia pada anak sekolah dasar kelas 6 di Denpasar.Metode: Penelitian ini dilakukan dengan metode analitik menggunakan desain potong-lintang. Perilaku penggunaan gadget meliputi posisi, jarak pandang, dan durasi penggunaan gadget dinilai dengan menggunkan kuisioner. Status miopia sendiri diukur menggunakan snellen chart. Sampel penelitian adalah 100 orang anak kelas 6 di SD Saraswati 2 Denpasar yang dipilih melalui teknik simple random sampling.Hasil: Hasil penelitian ini menunjukkan bahwa tidak terdapat hubungan antara posisi penggunaan gadget terhadap miopia dengan nilai p=0,059. Terdapat hubungan antara jarak pandang penggunaan gadget terhadap miopia dengan nilai p=0,000. Durasi penggunaan gadget perhari tidak berhubungan terhadap miopia dengan nilai p=0,490.Simpulan: Hasil dari penelitian ini bermanfaat untuk melakukan pencegahan sejak dini kepada anak-anak tentang faktor risiko dari perilaku penggunaan gadget terhadap miopia. Peneliti menyarankan agar penelitian selanjutnya dilakukan dengan menggunakan metode penelitian lain serta meneliti pula faktor yang berhubungan dengan miopia seperti gen, intensitas cahaya, aktivitas luar ruangan dan dalam ruangan.
Acute thoracic aortic dissection: a case report
Authors: Dewi Dewa Ayu Ratna , Putra Ayusta Made Dwija
Published: November 2020

Introduction: Aortic dissection (AD) is the most common aortic emergency, result in a catastrophic outcome. Patients usually asymptomatic, some of them present with sudden severe, tearing or sharp back or anterior chest pain and haemodynamic disturbance. Early and accurate diagnosis and treatment determine the patient outcome.Case Report: A case of 40 years old man complained of acute, sharp, chest pain since 4 days before admission which worsen instead of medical treatment, with a history of smoking since a few years ago. A vital sign was within normal limit. Laboratory result showed high CKMB, troponin T, LDH result. Occasional ventricular extrasystoles and inferior ischaemic was found in the ECG examination. From echocardiography, the patient suspected to have aortic dissection Stanford type A since an intimal flap on ascending aorta was found, with left ventricle hypertrophy, dilatation of right atrium and right ventricle, severe aortic regurgitation, moderate mitral regurgitation, severe tricuspid regurgitation, moderate pulmonary regurgitation and moderate pulmonary hypertension. From plain radiography, the patient showed mediastinum widening and cardiomegaly, CT angiography showed Stanford type A aortic dissection (DeBakey type I).Â  The patient refused to seek further treatment for operation as suggested.Conclusion: It is still challenging to differentiate aortic dissection (AD) and another acute chest emergency. Since clinical presentation and laboratory result may be similar between those illnesses. Therefore careful history taking and further imaging examination should be considered to increase the patient outcome.
Indikasi ibu melakukan persalinan seksio sesarea di RSUP Sanglah Denpasar tahun 2018
Authors: Wiguna Tamara Olivia , Surya I Gede Harry Wijaya , Manuaba Ida Bagus Gde Fajar , Sudirman Jaqueline
Published: November 2020

Background: Sectio caesarea is a method of labor in which a fetus with a capability to live (along with placenta and amniotic membrane) transabdominally via uterine incision. Caesarean section is usually done whether there is any medical indication and a final choice for difficulty on laboring.Aim: The study aims to know the indications of caesarean section that is done in RSUP Sanglah Denpasar in 2018.Â Method: This descriptive qualitative study was conducted using total sampling method. About 205 pregnant ladies had undergone caesarean section among a total of 914 patients who were in labour in RSUP Sanglah Denpasar in 2018, and around 157 of them have underlying medical indication that they couldnâ€™t perform normal labour.Result and Conclusion: The rupture membrane was the most frequent indication (18,7%), previous scar (13,9%), PEB (8,3%).Â Â Latar Belakang: Seksio sesarea merupakan melahirkan janin yang sudah mampu hidup (beserta plasenta dan selaput ketuban) secara transabdominal melalui insisi uterus). Seksio sesarea pada umumnya dilakukan apabila terdapat indikasi medis sebagai tindakan akhir dalam mengakhiri kesulitan persalinan.Tujuan: Untuk mengetahui indikasi seksio sesarea dari total persalinan di RSUP Sanglah Denpasar pada tahun 2018.Metode: Penelitian deskriptif dengan pendekatan kualitatif ini dilakukan dengan metode total sampling. Sebanyak 205 wanita hamil menjalani persalinan seksio sesarea dari total persalian sebanyak 914 kejadian persalinan di RSUP Sanglah, dan 157 di antaranya memiliki indikasi medis sehingga persalinan normal tidak memungkinkan.Hasil dan Simpulan: Ruptur membran atau pecahnya ketuban merupakan indikasi yang paling sering muncul (18,7%), lalu disusul oleh riwayat operasi sesar sebelumnya atau previous scar (13,9%), PEB (8,3%),
Factors associated with unfavourable outcome after Burr Hole drainage in Subdural Hematoma (SDH) at Sanglah General Hospital, Bali, Indonesia
Authors: Purnomo I Gusti Ngurah , Niryana I Wayan , Golden Nyoman
Published: November 2020

Background: Subdural hematoma is a neurosurgical disorder that often occurs in the elderly with simple, relatively fast and minimally invasive surgical therapy, but has a high postoperative mortality rate due to unfavourable outcome. This study aims to evaluate factors associated with unfavourable outcome after burr hole drainage in a subdural hematoma (SDH) at Sanglah General Hospital, Bali, Indonesia.Method: A prospective cohort study was conducted among 60 respondents to determine factors influencing the outcome of patients with subdural hematoma after burr hole drainage.Â  The independent variables in this study included age, comorbid factors, trauma onset, GCS, hematoma thickness, and midline shift.Â  Dependent variables include the Glasgow Outcome Scale (GOS), which is divided into 2 groups, favourable outcome, and unfavourable outcome. Data were analyzed using SPSS version 17 for Windows.Results: There were 19 respondents (31.7%) had unfavourable outcomes and 41 respondents (68.3%) had favourable outcomes.Â  From the bivariate analysis, significant associated risk factors were found in the onset of trauma (p=0.048), GCS (p=0.000), hematoma thickness (p = 0.000), and midline shift (p=0.000).Â  From the multivariate analysis, it was found that low GCS was the most dominant risk factor for the unfavourable outcome following burr hole drainage (OR=22.30; 95% CI= 2.22-223.80; p=0.008) Conclusion: This study concludes that low GCS was the most dominant risk factor for unfavourable outcome in patients with subdural hematoma after burr hole drainage
Spontaneous intracerebellar haemorrhage and hydrocephalus: a case report
Authors: Azhra Yovi Eko , Z Tala M Ihsan , Nst M Deni
Published: November 2020

Background: Hemorrhagic strokes affect more than 1 million people every year worldwide and are the most frequent type of stroke with high mortality and morbidity rates. Spontaneous Intracerebral Hemorrhage (SICH) often affects the basal ganglia, thalamus, cerebral lobes, pons, and cerebellum.Case Description: In this report, we present a 63-year-old female with sudden onset loss of consciousness and computed tomography (CT) of head demonstrated an intracranial haemorrhage in the cerebellum with hydrocephalus. The existence of hydrocephalus and the development of chronic hydrocephalus is a problem, awaiting a solution in patients who didnâ€™t undergo surgical treatment for cerebellar haemorrhage; however, it can easily be treated effectively by surgical evacuation.Conclusion: A general practitioner should be able to carry out appropriate initial management to reduce morbidity and mortality.
Potential combinations of Platelet Rich Plasma (PRP) and chitosan in burn wound management: a review
Authors: Samsarga Gede Wara , Sanjaya I Gusti Putu Hendra , Hamid Agus Roy Rusly Hariantana , Pinatih Komang Januartha Putra , Dewi Ni Made Ratih Purnama
Published: November 2020

Background:Â  The development of new modality for burn wound healing is necessary to reduce morbidity and mortality of burn injury. PRP (Platelet Rich Plasma) is one of potential modality for burn injury because of its ability to deliver various growth factors to initiate and accelerate tissue healing and regeneration. Clinical efficacy of PRP is frequently disturbed because inconsistency and inefficiency of growth factor release in PRP. To increase the effectiveness of PRP in wound healing and increase the bioavailability of growth factor, PRP can be combined with a carrier that can control continuous release of growth factors. Chitosan is one of biomaterial that potential to use because of its biodegradability characteristic and biological activity that important for burn wound healing and prevent the formation of scar tissue in a burn injury. Researches have shown that chitosan is an effective carrier to facilitate growth factor release continuously to burn wound.Aims: This review aims to review potential Combinations of PRP (Platelet Rich Plasma) & Chitosan in Burn WoundConclusion:Â With chitosan ability to facilitate burn wound healing and as an effective carrier, combination of PRP and chitosan is a promising modality for burn wound healing.
The relationship between urine specific gravity, urine pH, and blood uric acid levels to the type of urinary stones of patients with urolithiasis at Sanglah Hospital, Bali, Indonesia
Authors: Kalembang Jetty , Oka Anak Agung Gde , Widiana I Gede Raka
Published: November 2020

Background: Urine specific gravity, urine pH, and blood uric acid levels are risk factors for urinary tract stones. The urinary tract stones are formed due to the concentration of a solute exceeds its ability to remain in solution, resulting in supersaturation and crystallization. This study aims to determine the relationship between urine specific gravity, urine pH, and blood uric acid levels to the urinary stone's types in patients with urolithiasis at Sanglah HospitalMethods: A retrospective cross-sectional study was conducted among 95 subjects by using secondary data from the medical records in the period June 2017-2018 at Sanglah Hospital. The urolithiasis patient who met the inclusion and exclusion criteria were enrolled in this study. Data were analyzed by the Mann-Whitney Test and Kruskal-Wallis Test using SPSS version 17 for Windows.Results: The average age was 55Â±11 years old. Most of respondents were male (70.5%), normal Body Mass Index (BMI) (89.5%), urine pH <7 (75.7%), and mixed type of urinary stones (48.4%). There was a statistically significant relationship between the type of uric acid stone (p=0.029), blood uric acid levels (p=0.003), phosphate stone type (p=0.026), and magnesium stone (p=0.010) with urine pH. Besides, there was a statistically significant relationship between ammonium stone and blood uric acid levels types (p=0.022). A statistically significant difference was also found between stone types based on urine pH (p=0.013) in multivariate analysis.Conclusion: There is a significant relationship between urine pH and stone type on the incidence of urolithiasis in Sanglah Hospital in June 2017-2018, thereby increasing the incidence of urolithiasis.
Asosiasi sikap dan pengetahuan orang tua terhadap perilaku dalam menangani anak saat diare di Kecamatan Seririt, Kabupataen Buleleng, Bali tahun 2018
Authors: Setiawan Putu Andrie , Tan Ryan , Putra Derryl Komala , Halim Andy , Ginting Nelvina , Siboe Maria Pricilla , Wati Dyah Kanya
Published: November 2020

Introduction: To date, diarrhea is still a global burden that implicate children especially in development country. Seririt, as aÂ  peripheral subdistrict in Buleleng regency, Bali face this problem also. The knowledge and the attitude of parents is really important to reduce morbidity and mortality of dehydration to be caused by diarea.Objective: This research was aimed to knowing the association of parents knowledge and attitude to behaviour when facing diarrhea.Method: Cross-sectional method with consecutive sampling method was used to answer the objective. This research has done in 2018 of August at community health canter (Puskesmas) Seririt 1, Buleleng Regency, Bali Province. Collected data was analysed with SPSS version 17 for Windows.Result: A statistically significant result was found between attitude and behaviour (p= 0,000; 95%CI=1,484-9,387). Contrary, insignificant result was found among attitude and parent behaviour when face diarrhea (p=0,093; 95% CI=0,900-3,155).Conclusion: Parrents knowledge associate to parent behaviour, in other hand attitude does not associate to parent behaviour.Â Â Pendahuluan: Diare saat ini masih merupakan permasalahan utama pada balita. Hal ini juga merupakan masalah yang diahadapi didaerah perifer utamanya di Kecamatan Seririt, Kabupaten Buleleng, Bali. Pengetahuan dan sikap orang tua saat menangani diare berperan untuk mengurangi kesakitan dan kematian utamanya akibat dehidrasi.TujuanÂ : Tujuan dari penelitian ini adalah untuk mencari tahu asosiasi pengetahuan dan sikap terhadap perilaku orang tua saat anak mengalami diare di Kecamatan Seririt, Kabupaten Buleleng, Bali.MetodeÂ : Metode potong lintang dan consecutive sampling diterapkan pada penelitian ini. Penelitian dilaksanakan pada bulan Agustus 2018 di Puskesmas Seririt 1, Buleleng. Data yang Â sudah dikumpulkan dianalisis dan disajikan dalam tabel dan narasi menggunakan perangkat lunak SPSS 17 for Windows.HasilÂ : Secara statistik terdapat perbedaan antara tingkat pengetahuan dengan perilaku (p= 0,000; IK=1,484-9,387). Sedangkan, tidak didapatkan perbedaan antara sikap dan perilaku subjek sehari-hari (p=0,093; IK=0,900-3,155).KesimpulanÂ : Terdapat hubungan yang bermakna antara tingkat pengetahuan orang tua terhadap perilaku saat menghadapi anak dengan diare. Namun, hal ini berbanding terbalik dengan sikap orang tua yang dinyatakan tidak berhubungan secara statistik terhadap perilaku saat anak mengalami diare.