bluuebunny/crossref_metadata_2025_split huggingface dataset:
Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut
Authors: Tersinanda Ni Nyoman Trisna Yuliharti , Suastika Ketut 
Published: December 2022

Introduction. The hyperosmolar hyperglycemic state is a dangerous complication that can arise with diabetes mellitus. The emergent treatment is necessary to reinstate hemodynamic stability, as mortality rates for the hyperosmolar hyperglycemic state are exceptionally high and can have multiple complications.Case. A 40-year-old male presented unresponsive to the emergency department. Upon arrival, the patient examination was consistent with dehydration and tachycardia. Review of systems included a one-week history of epigastrial pain, nausea and vomiting without a history of diabetes. The presenting blood sugar level was 1099 mg/dl with high osmolarity. Abdominal ultrasound revealed peripancreatic fluid suspicious for acute pancreatitis. Following successful treatment of acute pancreatitis and hyperglycemia with fluid and insulin, his serum glucose and pancreatic enzyme level decreased to normal range. The patient recovered and was discharged in stable condition.Conclusion. This case study postulates that the correlation between hyperosmolar hyperglycemic state and pancreatitis may be explained by two causal relationships, one of them is the hyperosmolar hyperglycemic state can be induced by ischemic pancreatitis. This is important because hyperglycemia superimposed on any ischemic insult can increase the risk of multiorgan failure, as with our patient. Thus, recognition and management of resulting complications need to be emergent. Pandahuluan. Status hiperglikemik hiperosmoler merupakan komplikasi berbahaya dari diabetes melitus. Terapi yang cepat sangat penting untuk mengembalikan stabilitas hemodinamik, dimana angka mortalitas untuk status hiperglikemik hiperosmoler sangat tinggi dan memiliki banyak komplikasi.Kasus. Seorang pria usia 40 tahun datang dalam keadaan penurunan kesadaran ke unit gawat darurat. Saat datang, pasien didapatkan dehidrasi dan takikardia dari pemeriksaan tanda vital. Didapatkan riwayat nyeri ulu hati sejak satu minggu, mual dan muntah tanpa riwayat diabetes sebelumnya. Kadar glukosa darah sewaktu saat itu 1099 mg/dl dengan osmolaritas yang tinggi. Dari pencitraan ultrasound abdomen didapatkan cairan peripankreatik yang mengarah ke pankreatitis akut. Dengan berhasilnya terapi cairan dan insulin untuk penanganan pankreatitis akut dan hiperglikemia, kadar glukosa darah dan enzim pankreas pasien ini membaik ke rentang normal. Kondisi pasien membaik dan dipulangkan dalam keadaan yang stabil.Kesimpulan. Laporan kasus ini menggambarkan korelasi antara status hiperglikemik hiperosmoler dan pankreatitis yang dapat dijelaskan dengan hubungan dua arah, dimana salah satunya bahwa status hiperglikemik hiperosmoler dapat dicetuskan oleh pankreatitis iskemik. Hal ini penting karena hiperglikemia yang dicetuskan oleh kondisi iskemik dapat meningkatkan risiko gagal multiorgan, seperti pada kasus ini. Sehingga, deteksi dan penanganan dari komplikasi ini harus dilakukan dengan segera.
Fenomena raynaud sekunder pada seorang penderita kanker kolon
Authors: Kusuma I Gusti Agung Indra Adi , Kambayana Gede 
Published: December 2022

Introduction: Secondary Raynaud's phenomenon (RP) is a transient microvascular spasm associated with other etiologies with clinical features of triphasic manifestations. Malignancy is a rare cause of secondary RP. Case Report: A man, 46 years, came to Sanglah General Hospital with secondary RP and colorectal malignancy. Discoloration white at the distal digits of the right manus and digits 3-5 left and sometimes accompanied thick at the fingertips, involved proximal to the medial phalanges. Laboratory examination showed albumin 2.55 g / dL, globulin 2.12 g / dL, LDH 323 IU / L, CRP 6.5 mg / dL, CEA 5.83 ng / mL plain abdominal radiograph impression of thickening on the part of the wall and show colitis appearance, be suspected ileus in the upper left abdominal region. Base on histopathological examination, ascending colon presents well-differentiated adenocarcinoma, and abdominal CT shows liver metastases. Management of patients with secondary RP with lifestyle and pharmacological interventions and chemotherapy for colorectal adenocarcinoma as the underlying cause. Pharmacological therapy of RP with intraoral amlodipine Conclusion: Malignancy in this patient as a cause of RP and management is carried out to treat primary disease and Raynaud's Pendahuluan: Fenomena Raynaud (RP) sekunder merupakan vasokontriksi transien pada mikrovaskular dikaitkan dengan etiologi lain dengan gambaran manifestasi trifasik. Keganasan menjadi kausa yang jarang pada RP sekunder.Laporan Kasus: Seorang laki-laki, usia 46 tahun, datang ke RSUP Sanglah dengan RP sekunder dan keganasan kolorektal. Dengan pucat pada distal digiti manus dekstra dan digiti 3-5 sinistra dan disertai kadang tebal di ujung jari, meliputi proksimal sampai medial falang. Pemeriksaan laboratorium menunjukkan albumin 2,55 g/dL, dan globulin 2,12 g/dL, LDH 323 IU/L, CRP 6,5 mg/dL, CEA 5,83 ng/mL dengan foto polos abdomen kesan penebalan pada sebagian dinding usus menunjukkan suatu gambaran kolitis yang diduga ileus pada regio abdomen kiri atas, kolon asenden dengan gambaran well differentiated adenokarsinoma pada hasil biopsi histopatologi dan CT abdomen menunjukkan metastasis pada hepar. Penatalaksanaan pasien RP sekunder dengan intervensi gaya hidup dan farmakologis serta kemoterapi untuk adenokarsinoma kolorektal sebagai penyebab dasar. Terapi farmakologis RP dengan pemberian amlodipin intra oral.Simpulan: Kondisi keganasan pada pasien sebagai kausa dari RP dan tatalaksana pengobatan spesifik RP.
Hubungan Platelet- Lymphocyte Ratio (PLR) dan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Terjadinya Sindrom Koroner Akut di RSUD Sanjiwani Gianyar Tahun 2020
Authors: Putra Dwi Masu , Pranata Bagus Gita , Bagiari Ketut Erna 
Published: December 2022

Background: Inflammatory processes in atherosclerosis play an important role of the acute coronary syndrome (ACS). Inflammatory markers such as platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) are known to provide a progressivity of the worsening atherosclerosis process rapidly and simple. This study aims to evaluate the relationship of PLR and NLR in ACS.
Method: This is a retrospective study with a total of 102 ACS patients during 2020. PLR and NLR are calculated based on the ratio of absolute platelet, neutrophil, and leukocyte values from the results of regular blood tests. The ACS samples were divided into three groups UAP, NSTEMI, and STEMI.
Result: Based on a total of 102 patients, 66.7% of men and 33.3% of women with the most age ranges of 50-59 years (52%). One-Way Anova Test showed significant differences between PLR (p = 0.002) and NLR (p = 0.017) against ACS. The Posthoc test showed meaningful results in most test groups (p< 0.05). Spearman's correlation test showed positive coleration of PLR (r = 0.508) and NLR (r = 0.500) against the diagnosis of ACS (p = 0.000).
Conclusion: PLR and NLR can be used as a simple hematological marker in determining the severity of atherosclerosis in ACS.

Latar Belakang: Proses inflamasi pada aterosklerosis memiliki peranan penting terhadap terjadinya sindrom koroner akut (SKA). Marker inflamasi seperti platelet-lymphocyte ratio (PLR) dan neutrophil-lymphocyte ratio (NLR) diketahui mampu memberikan gambaran progresifitas keparahan aterosklerosis dengan cepat dan sederhana. Penelitian ini bertujuan untuk menilai hubungan PLR dan NLR terhadap terjadinya SKA.
Metode: Penelitian ini merupakan studi retrospektif dengan jumlah 102 pasien SKA selama tahun 2020. Nilai PLR dan NLR dihitung berdasarkan rasio nilai absolut platelet, neutrofil, dan leukosit dari hasil pemeriksaan darah rutin. Sampel penelitian kemudian dibagi menjadi tiga kelompok yaitu UAP, NSTEMI, dan STEMI. Seluruh data dianalisis menggunakan uji One-Way Anova dan Spearman’s Correlation.
Hasil: Berdasarkan total 102 pasien, didapatkan 66.7% laki-laki dan 33.3% perempuan dengan rentang usia terbanyak 50-59 tahun (52%). Uji One-Way Anova menunjukkan adanya perbedaan signifikan antara PLR (p = 0.002) dan NLR (p = 0.017) terhadap SKA. Uji Posthoc menunjukkan hasil bermakna pada sebagian besar kelompok uji (p< 0.05). Uji korelasi Spearman’s menunjukkan adanya korelasi positif PLR (r = 0.508) dan NLR (r = 0.500) terhadap diagnosis SKA (p = 0.000).
Kesimpulan: PLR dan NLR dapat dijadikan sebagai marker hematologi sederhana dalam menentukan derajat keparahan aterosklerosis pada pasien SKA.
Seorang penderita syok anafilaksis dengan allergic myocardial infarction (kounis syndrome)
Authors: Wismayana I Putu Ary , Suardamana I Ketut 
Published: December 2022

Background: Kounis syndrome (KS) is defined as the concurrence of acute coronary syndromes associated with mast-cell and platelet activation in the setting of allergic or anaphylactic insults. Prevalence of KS is considered rare, estimated 1.1% of hospitalized allergic reaction patient, with mortality rate 7%.
Case Report: Case of 39 years old male without history of coronary artery disease, having dyspnea, chest discomfort, and pruritus after eating skipjack tuna. 12 lead electrocardiogram showing ST depression segment on lead II, III, and aVF. Patient diagnose as Kounis syndrome variant type I. Treatment of Kounis Syndrome begins with cessation of the causative agent. After therapy using epinephrine and intravenous corticosteroid, clinical improvement was achieved, and ST segment depression on electrocardiogram resolved.
Conclusion: Kounis syndrome is a rare disorder which need careful assessment and swift management. The diagnosis confirmed with sign and symptoms of allergic along with disorder in cardiovascular system.

Latar Belakang: Kounis Syndrome (KS) didefinisikan sebagai sindrom koroner akut yang terjadi bersamaan dengan aktivasi sel mast dan trombosit dalam keadaan alergi atau anafilaksis. Prevalensi KS tergolong jarang, diperkirakan 1,1% dari pasien reaksi alergi yang dirawat di rumah sakit, dengan angka kematian 7%.
Laporan Kasus: Laki-laki 39 tahun tanpa riwayat penyakit jantung koroner, sesak nafas, rasa tidak nyaman di dada, dan pruritus setelah makan ikan cakalang. Elektrokardiogram 12 sadapan menunjukkan segmen depresi ST pada sadapan II, III, dan aVF. Diagnosis pasien sebagai sindrom Kounis varian tipe I. Pengobatan Sindrom Kounis dimulai dengan penghentian agen penyebab. Setelah terapi menggunakan epinefrin dan kortikosteroid intravena, perbaikan klinis dicapai serta depresi segmen ST pada elektrokardiogram teratasi.
Simpulan: Kounis syndrome adalah kelainan langka yang membutuhkan penilaian yang cermat dan penanganan yang cepat. Diagnosis ditegakkan dengan adanya tanda dan gejala alergi disertai gangguan pada sistem kardiovaskular.
Comparison of albumin 4%, gelatine, and ringer lactate as volume expander post-resuscitative phase on cardiac output and lactate serum after Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized prospective study
Authors: Adriane Prieta , Dewi Ni Luh Kusuma , Ardiyan Ardiyan 
Published: December 2022

Background. The use of protein colloid in fluid management post-cardiac surgery is debatable whether it is more beneficial than non-protein colloid or crystalloid. Patients who still need more volume after the resuscitative phase might benefit from optimal fluid management by choosing the most beneficial fluid. This study compared albumin 4% administration to gelatine and ringer lactate as a volume expanders post-resuscitative phase after coronary artery bypass grafting (CABG) on-pump.Methods. We conducted a single-centered, single-blind, randomized controlled study that assigned 120 patients undergoing elective CABG on-pump. Subjects who met inclusion criteria received 125 ml/hour of either albumin 4%, gelatine colloid, or Ringer's lactate (RL) as the only infusion fluid for 4 hours after the first assessment post-resuscitative phase, after intensive care unit (ICU) admission. After fluid administration, patients were reassessed. The assessment included cardiac output and lactate serum as the primary outcome, while the duration of mechanical ventilation, ICU, and hospital stay were recorded as secondary outcomes.Results. The mean of cumulative cardiac output improvement differed between the group albumin 4% 1.18 L/min, gelatine 0.88, and RL 0.74 (p=0.002). Lactate serum decreased in the albumin 4% group as much as 3.31 gr/dl compared to gelatine 2.13 and RL group 2.37 (p=0.005). Duration of mechanical ventilation, length of stay in ICU, and hospital post-operative were shorter in the albumin group than in other groups. Conclusions. Albumin 4% used as a volume expander in the post-resuscitative phase still improved cardiac output and tissue micro-perfusion than gelatine and ringer lactate.
Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019 (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021
Authors: Khrisna Anak Agung Parama Swari , Kirana Ni Luh Jaya 
Published: December 2022

Introduction: COVID-19 is an infectious disease caused by a new virus causes that attacks the upper respiratory tract and the lungs. The numbers of cases and deaths have increased on a daily basis on the scale of a global pandemic. Chest X-ray images have proven useful for monitoring various lung diseases and have recently been used to monitor the COVID-19 disease. Imaging modalities such as chest x-rays have the benefit of providing initial imaging before confirming with RT-PCR examination. The purpose of this study was to determine the value of the diagnostic examination of the chest x-ray compared to the RT-PCR examination which is the gold standard in diagnosing COVID-19.Methods: This study used a diagnostic study design with a retrospective approach at Wangaya Hospital, Denpasar during the period June-November 2021. Analysis of the diagnostic test used cross tabulation and then calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy were performed.Results: Thorax imaging diagnostic test value compared with the gold standard RT-PCR examination in form of sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy was 78%, 23%, 84%, 16.6%, 1.01, 0.95, and 69% respectively.Conclusion: Thorax imaging provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of COVID-19. Pendahuluan: COVID-19 merupakan suatu penyakit menular yang disebabkan oleh virus baru dan menyerang saluran pernapasan bagian atas dan paru-paru. Jumlah kasus dan kematian telah meningkat setiap hari dalam skala pandemik global. Modalitas pencitraan seperti thoraks foto memiliki manfaat untuk memberikan pencitraan awal sebelum mengkonfirmasi dengan pemeriksaan RT-PCR. Tujuan penelitian ini adalah untuk mengetahui nilai pemeriksaan diagnostik yang dimiliki thoraks foto dibandingkan dengan pemeriksaan RT-PCR yang merupakan baku emas dalam mendiagnosis COVID-19.Metode: Penelitian ini menggunakan desain studi diagnostik dengan pendekatan retrospektif di Rumah Sakit Umun Daerah Wangaya Denpasar selama periode Juni-November 2021. Analisis uji diagnostik menggunakan tabulasi silang kemudian perhitungan sensitivitas, spesitifitas, positive predictive value (PPV), negative predictive value (NPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-) dan akurasi dilakukan.Hasil: Nilai uji diagnostik thoraks foto dibandingkan dengan pemeriksaan baku emas RT-PCR berupa sensitivas, spesitifitas, PPV, NPV, LR+, LR-, dan akurasi adalah masing-masing 78%, 23%, 84%, 16.6%, 1.01, 0.95, dan 69%.Simpulan: Thoraks foto memberikan sensitivitas dan akurasi diagnostik yang tinggi secara langsung pada presentasi klinis COVID-19.
Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka
Authors: Hartaningsih Ni Made Dian , Prabawa I Putu Yuda , Putu Benediktus Bosman Ariesta Gusti , Sindhughosa Dwijo Anargha , Manuaba Ida Bagus Amertha Putra , Pramesemara I Gusti Ngurah 
Published: December 2022

Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy. Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien.
Intervensi koroner perkutan pada infark miokard akut disertai elevasi segmen ST awitan lebih dari 12 jam dengan penyulit syok kardiogenik
Authors: Dwipawana I Gusti Bagus Aginda , Pratama Vireza , Callista Mia Amira 
Published: December 2022

Background: Percutaneous coronary intervention (PCI) is the primary therapy in patients with acute myocardial infarction with-ST Segment Elevation (AMI-STE) in the first 12 hours of onset of symptoms. However PCI still needs to be done in patients with onset more than 12 hours who still showed prolonged ischemia process. Case: A man, 49 years old came to the emergency room Central Army Hospital Gatot Subroto (RSPAD) with chest painÂ typically infarction angina since 6 days ago. Patient was referred from Islamic Hospital with anterior AMI-STE-onset 2 hours TIMI 7/14 Killip Class IV without revascularization and acute renal failure. Patient determined to be referred after treated in ICVCU Islamic Hospital, but patient had a progressive chest pain and hemodynamic disturbances. After revascularization in the RSPAD Hospital, clinical and hemodynamic conditions of this patient slowly improved. Discussion: Reperfusion therapy should be given if there is clinical evidence or evidence which showed prolonged ischemic ECG, even if the patient according to the symptoms have lasted more than 12 hours. It is because the onset of actual attack is certainly known. AMI-STE guidelines by ESC and AHA also recommend PCI procedure in patients with signs of prolonged ischemia process. Conclusion: Revascularization in patients with AMI-STE onset more than 12 hours should be performed in patients who still show a prolonged ischemia process and hemodynamic disturbances.
Gambaran Tingkat Pengetahuan pada Wanita Usia Subur dalam Pemakaian Kontrasepsi Pasca Persalinan di Desa Gelgel, Klungkung
Authors: Gunasekaran Sanjivan , Aryani Putu 
Published: December 2022

Tujuan dari keluarga berencana adalah untuk mencegah ledakan penduduk, menurunkan angka kematian ibu melahirkan dan kematian bayi, meningkatkan status gizi ibu dan anak serta meningkatkan perkembangan otak anak manakala kontrasepsi pasca persalinan merupakan pemasangan kontrasepsi dalam jangka waktu 42 hari setelah melahirkan untuk mencegah kehamilan dengan jarak dekat yang terlalu dekat, sehingga bayi yang baru lahir mendapatkan cukup nutrisi,perhatian dan kasih saying dalam perkembangannya. Tujuan dari penelitian ini adalah untuk mengetahui gambaran tingkat pengetahuan pada wanita usia subur dalam pemakaian kontrasepsi pasca persalinan di Desa Gelgel wilayah kerja Puskesmas Klungkung I. Penelitian ini menggunakan rancangan penelitian deskriptif, dengan metode cross-sectional. Pengambilan sampel dilakukan dengan metode total sampling.Â Data yang diperoleh dianalisa secara deskriptif kuantitatif kemudian disajikan dalam bentuk tabel frekuensi dan naratif. Hasil penelitian ini menunjukkan masih kurangnya tingkat pengetahuan wanita usia subur (WUS) di desa Gelgel,Klungkung terhadap penggunaan kontrasepsi pasca persalinan (54,3%). Oleh karena itu, diperlukan optimalisasi penyuluhan untuk meningkatkan tingkat pengetahuan terhadap penggunaan kontrasepsi pasca persalinan untuk mendapat perilaku yang baik.Â
Oral potentially malignant disorder awareness level among elder community in the Belawa Distric, Wajo, South Sulawesi, Indonesia
Authors: Marlina Erni , Sumintarti  , Ilmar Harlina , Yusran Ali , Usman Nur A. , Israyani  , Mauliana Andi A. 
Published: December 2022

Objective: to assess awareness of senior community in the Belawa distric, Wajo, South Sulawesi, Indonesia regarding their oral soft tissue abnormality specifically regard to Oral potentially malignant disorders, and to assess community ability to descript any pain or uncomfortably origin from their oral cavity.
Methods: A self-made questionnaire written in Indonesia language was given to the old aged-adult based on WHO criteria with age range between 45 to 75 years old, who was willing to participate in this study. The questioner consists some picture representing oral mucosal cavity with clinical feature of some ulcers, clinical feature of candida infection, and some clinical appearances of oral potentially malignant disorders.
Results: In term of oral mucosal diseases questions, 22 (55%) participants had history of ulceration, however only 5 (45%) participants could specifically point out its previous ulcer location. However, history of pain only stated by 11 (28%) participants, 24 (60%) did not experienced any pain, and 5 (12%) did not answer the questions.
Conclusion: knowledge and awareness regarding oral health lesion, especially the associated-potentially malignant lesion was far from ideal in the Belawa Community.