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"ABSTRAKLatar BelakangPenelitian ini membahas tentang hubungan antara posisi kerja berdiri dengan varises tungkai pada perawat perempuan. Kejadian varises tungkai diduga berkaitan dengan posisi kerja berdiri dan lebih sering terjadi pada perempuan (dalam populasi umumnya) serta berdampak cukup besar secara ekonomi pada perusahaan untuk pengobatan penyakit ini.TujuanTujuan penelitian ini untuk mengetahui prevalensi varises tungki di kalangan perawat perempuan dan mengetahui hubungan antara posisi kerja berdiri dengan kejadian varises tungkai serta status demografi seperti umur, riwayat varises dalam keluarga, status gizi, penggunaan KB hormonal, jumlah anak dan lama kerja pada perawat perempuan di RS X.MetodePenelitian ini dilakukan dengan menggunakan metode potong lintang. Data yang dikumpulkan pada bulan Maret-April 2016. Subyek penelitian 171 orang perawat perempuan di RS X yang dipilih berdasarkan kriteria inklusi. Data dikumpulkan dengan wawancara, pemeriksaan fisik tungkai bawah dan observasi posisi kerja berdiri selama waktu bekerja.HasilPrevalensi varises tungkai sebanyak 63,16%. Masa kerja (ORa=4,84 95%CI= 1,67-14,01), lokasi kerja (ORa=4,02 95%CI= 1,82-8,89) dan jumlah anak lebih dari satu (ORa=3,60 95%CI=1,13-11,43) merupakan faktor dominan terhadap kejadian varises tungkai.KesimpulanPrevalensi varises tungkai pada perawat perempuan adalah 63,16%. Jumlah anak dan masa kerja menjadi faktor dominan terhadap kejadian varises tungkai. Bagi karyawan yang menderita varises tungkai disarankan melakukan modifikasi gaya hidup untuk memperbaiki kualitas hidup dengan cara melakukan elevasi tungkai pada saat beristirahat, mengurangi berat badan dengan diet tinggi serat dan olah raga teratur serta menghindari posisi berdiri statis yang terlalu lama. Pencegahan primer terhadap semua derajat varises dengan menggunakan stoking kompresi.

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ABSTRACT

Background

This study discussed about correlation between standing work position and varicose veins in female nurses. Varicose veins was assumed to be associated with long standing work positions which risks in women are higher than men. Varicose veins also contributed in company budgeting for the treatment.

Purpose

Focus on this study was to know about prevalence of varicose veins in female nurses in hospital and correlation between standing work positions, ages, family history of varicose veins, nutrient, hormonal contraseptives, number of children, places of works and years of services.

Method

This study was held in one of hospital with design of study was cross sectional survey. Data were collected to 171 respondents from March to April 2016 which choosen by inclution criteria; by interviewed, leg physical examination and observation of standing work positions.

Result

There was 63,16% prevalence of varicose veins. Years of services (ORa=4,84 95%CI= 1,67-14,01), places of work (ORa=4,02 95%CI= 1,82-8,89) and has more than one children (ORa=3,60 95%CI=1,13-11,43) are dominant factors of varicose veins.

Conclusion

The prevalence of varicose veins in female nurses are 63,16%. Years of services, places of work and number of children are suggested to be dominant factors in varicose veins. Employees that have varicose veins are suggested to modified their life style to improved quality of life condition such as elevated leg at rest, reduce weight by consumpt high fiber diet, regularly exercise and avoid long standing position in long period. Primary prevention in all degree of varicose veins are using pressure stocking."

"Kejadian varises vena banyak terjadi pada profesi perawat. Salah satu faktor penyebabnya adalah akibat berdiri lama. Saat berdiri lama terjadi peningkatan tekanan vena dan disfungsi katup-katup vena yang dapat menimbulkan varises vena. Penelitian ini merupakan penelitian cross-sectional yang melibatkan 92 perawat poliklinik sebagai responden. Instrumen yang digunakan adalah kuesioner yang dimodifikasi dari kuesioner penelitian Tuchsen (2005) serta dilakukan pemeriksaan varises vena dengan Venous Clinical Severity Score (VCSS). Hasil penelitian menunjukkan bahwa 70.7% responden menunjukkan aktivitas berdiri lama dan 72.8% responden mengalami varises vena. Hasil uji chi-square menunjukkan adanya hubungan antara berdiri lama dengan kejadian varises vena dengan p value = 0.001 (OR= 9.051). Deteksi dini varises vena pada perawat perlu dilakukan untuk menekan peningkatan prevalensi varises vena.

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Incidence of varicose veins often occurs on outpatient nurse. Prolonged standing at work is associated with a high prevalence of varicose veins. In the standing position, the venous and capillary pressures increases and damages function of venous valves can leads to incidence of varicose veins. This study was a cross-sectional study that used 92 outpatient nurses for the sample. The instrument of this research was a questionnaire modified from a Tuchsen’s questionnaire (2005) and lower extremity examination using Venous Clinical Severity Score (VCSS).

The result shows that 70.7% of respondents indicated a prolonged standing activity and 72.8% of respondents experienced varicose veins on the lower limbs. The results of chi-square test shows the relationship between prolonged standing and the incidence of varicose veins on the lower limbs with the p value = 0.001 (OR = 9,051). Early detection varicose veins on nurses needs to be done to decrease prevalence of varicose veins."

"Laser telah menjadi teknologi yang bermanfaat dalam tatalaksana inkompetensi katup vena terutama pada vena-vena superfisial. Ablasi termal endovena menggunakan teknologi laser yang dipandu oleh ultrasonografi memberikan alternatif terapi selain tindakan bedah vena saphena. Tingkat keberhasilan yang tinggi, komplikasi kecil, dan teknik invasif minimal merupakan kelebihan dari teknik ini dibandingkan dengan pengobatan terdahulu. Pada ilustrasi kasus ini, kami jabarkan terapi laser endovena untuk pengobatan varises vena saphena magna. Pengembangan terapi laser endovena masih diperlukan,melalui pemantauan jangka panjang dan sistem pelaporan yang seragam maka hal ini dapat terwujud.

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Laser has become a useful technology in treating venous incompetence especially superficial venous disease. Introduction of endovenous thermal ablation through endovenous laser therapy helped by duplex ultrasound guidance has provided an alternative for traditional saphenous vein stripping. High success rate, minor complications, and minimally invasive technique provide the advantages over traditional treatment. In this case illustrated, the endovenous laser therapy used for great saphenous varicose vein. Yet, future development in endovenous laser therapy is still needed and only long term follow-up and uniform reporting standards will provide the answers."

"ABSTRAK Latar belakang Tindakan ablasi endovenous untuk varises tungkai di Indonesia mulai dikerjakan tahun 2010 EVLT dikerjakan di RSCM tahun 2013 dan MOCA dikerjakan di RSUP Fatmawati tahun 2014 Belum ada evaluasi terhadap rekanalisasi pasca tindakan MOCA dan EVLT di Indonesia Metode Studi ini merupakan penelitian deskriptif analitik dengan desain cross sectional Subjek pasca MOCA atau EVLT dengan rentang waktu 3 18 bulan pasca tindakan diwawancara dan dilakukan pemeriksaan USG vaskular pada tungkai yang dioperasi untuk menilai rekanalisasi Data sekunder praoperasi diambil dari rekam medis Dicari karakteristik klinis subjek membandingkan kecenderungan rekanalisasi pasca tindakan MOCA dan EVLT dicari hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi Data diolah dengan SPSS ver 20 0 Hasil Didapatkan 43 sampel tungkai terdiri dari 24 tungkai pasca MOCA dan 19 tungkai pasca EVLT Karakteristik subjek MOCA terbanyak usia 7 mm 13 19 tungkai Pada MOCA rekanalisasi total didapatkan 2 24 dan partial 8 24 tungkai sedangkan pada EVLT rekanalisasi total 1 19 dan partial 3 19 tungkai Hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi p 0 05 Kesimpulan Kecenderungan rekanalisasi MOCA lebih tinggi dibandingkan EVLT Tidak ada hubungan bermakna antara karakteristik klinis subjek dengan kejadian rekanalisasi secara statistik namun diameter terbesar VSM 7 mm sebelum operasi secara proporsional lebih tinggi MOCA 3 4 tungkai dibandingkan EVLT 3 13 tungkai ABSTRACT Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities "

"Latar Belakang: Dalam diagnosis varises vena tungkai bawah (VVTB), venous clinical severity score (VCSS) merupakan alat bantu diagnosis VVTB yang praktis, cepat, dan dapat dikerjakan oleh semua tenaga kesehatan termasuk perawat. Hingga saat ini belum ada peneliti yang melakukan validasi eksterna penilaian VCSS yang dikerjakan oleh perawat di Indonesia.Tujuan: Mengetahui tingkat ketepatan metode skor VCSS oleh perawat dibandingkan dengan komponen klinis (C) klasifikasi clinical-etiology-anatomy-pathophysiology (CEAP) oleh dokter spesialis bedah vaskular.Metode: Studi cross-sectional ini mengikutsertakan 63 orang perawat instalasi bedah pusat RS Dr. Cipto Mangunkusumo tanpa varises sebelum menjadi perawat sebagai sampel yang diambil secara consecutive Penilaian VCSS dilakukan dengan komponen klinis klasifikasi CEAP sebagai pembanding. Variabel dianalisis dengan uji Chi-square, dilanjutkan dengan uji nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), likelihood ratio dan akurasi skor diagnostik, termasuk analisis uji diagnostik menggunakan indeks Youden.Hasil: Prevalensi VVTB pada studi ini berdasarkan skor VCSS adalah 9,5%. Korelasi antara klasifikasi CEAP dan VCSS ditemukan bermakna (p<0,05). Derajat VVTB antara klasifikasi CEAP dan VCSS berhubungan secara signifikan (p <0,05). Pada cut-offVCSS 2 didapatkan nilai sensitivitas 66,67%, spesifisitas 66,67 %, NDP 32,0%, NDN 89,47%, likelihood ratio (+) sebesar 2,00, likelihood ratio (-) sebesar 0,50, dan akurasi 66,67%.Kesimpulan: Skor VCSS memiliki akurasi lemah terhadap komponen klinis (C) klasifikasi CEAP untuk menegakkan diagnosis VVTB.

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Background: In the diagnosis of lower leg varicose veins (LLVV), the venous clinical severity score (VCSS) is practical, fast, and can be done by all health workers including nurses. Until now there has been no researcher who has conducted external validation of the VCSS assessment carried out by nurses in Indonesia.

Aim: To determine the accuracy of the VCSS scoring method by nurses compared to clinical component (C) of the clinical-etiology-anatomy-pathophysiology (CEAP) classification by vascular surgeons.

Method: This cross-sectional study included 63 nurses at the central surgical installation of Cipto Mangunkusumo Hospital without varicose veins before becoming a nurse as a consecutive sample. The VCSS assessment was carried out with the clinical component of CEAP classification as a comparison. Variables were analyzed by the Chi-square test. Followed by testing the value of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio, and accuracy of diagnostic scores, along with the ROC analysis using Youden Index.

Results and Discussion: The prevalence of LLVV in this study is 9,5%. Bivariate analysis of CEAP and VCSS has a significant correlation (p <0,05). The degree of LLVV with CEAP and VCSS is related significantly (p <0,05). With VCSS cut off at scores of 2, the sensitivity is 66.67%, the specificity is 66.67%, the PPV is 32,0%, the NPV is 89.47%, the positive and negative likelihood ratio are 2.00 and 0.50, and the accuracy value is 66.67%.

Conclusion: The VCSS score has weak level of accuracy against the clinical component (C)  of CEAP classification for diagnosing VVTB."

"Latar Belakang: Penderita sirosis hati sering mengalami gangguan sistem hemostasis yang kompleks dan komplikasi perdarahan akut varises gastroesofageal. Peran gangguan sistem hemostasis dalam perdarahan akut varises gastroesofageal penderita sirosis hati masih belum jelas.Tujuan: Mengetahui perbedaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C penderita sirosis hati yang mengalami dan yang tidak mengalami perdarahan akut varises gastroesofageal. Metode: Penelitian ini merupakan studi potong lintang pada penderita sirosis hati. Subjek penelitian diperoleh dari penderita yang berobat di RS Cipto Mangunkusumo, Jakarta. Seluruh penderita dilakukan pemeriksaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C. Penderita dengan gejala perdarahan akut saluran cerna bagian atas dilakukan pemeriksaan Esofago-Gastro-Duodenoskopi EGD. Diagnosis perdarahan akut varises gastroesofageal ditentukan dari hasil pemeriksaan EGD. Untuk mengetahui perbedaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C penderita sirosis hati yang mengalami dan yang tidak mengalami perdarahan akut varises gastroesofageal dipakai uji T indepedent dan uji Mann-Whitney. Hasil: Terdapat total 63 penderita sirosis hati yang ikut serta dalam penelitian, 21 penderita mengalami perdarahan akut varises gastroesofageal dan 42 penderita tidak mengalami perdarahan akut varises gastroesofageal. Perbedaan jumlah trombosit penderita sirosis hati yang mengalami perdarahan dan yang tidak mengalami perdarahan akut varises gastroesofageal mempunyai nilai p>0,05. Jumlah trombosit.

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Background Patients with liver cirrhosis have complex hemostatic system disturbances and acute gastroesophageal varices bleeding frequently. The role of hemostatic system disturbances in acute gastroesophageal varices bleeding has not been yet clear in liver cirrhosis.Objective To know the difference of thrombocyte count, PT, APTT and protein C level in liver cirrhosis patients with and without acute gastroesophageal varices bleeding.

Methods: This was a cross sectional study. Patients with liver cirrhosis were enrolled from Cipto Mangunkusumo Hospital, Jakarta. All patients underwent examination for thrombocyte count, PT, APTT and protein C level. Patients with acute upper gastrointestinal bleeding underwent examination for esophago gastro duodenoscopy EGD. Diagnosis of acute gastroesophageal varices bleeding based on the result of EGD examination. To know the difference of thrombocyte count, PT, APTT and protein C level in liver cirrhosis patients with and without acute gastroesophageal varices bleeding, T independent test and Mann Whitney test were used for statistical analysis.

Results There are 63 patients with liver cirrhosis in this study, 21 patients with acute gastroesophageal varices bleeding and 42 patients without acute gastroesophageal varices bleeding. The difference of thrombocyte count in liver cirrhosis patients with and without acute gastroesophageal bleeding has p value 0,05. Thrombocyte count. "

"Penyakit TB lebih berkembang pada masyarakat dengan status sosial ekonomi yang rendah, kelompok terpinggirkan dan populasi rentan lainnya. Salah satu yang termasuk populasi rentan adalah komunitas penderita kusta. Penyakit TB dan kusta banyak ditemukan di daerah beriklim tropis dengan kelembapan udara tinggi, tingkat sosial ekonomi penduduk yang rendah serta status gizi dan higienitas yang buruk. Infeksi kedua penyakit ini dapat terjadi bersamaan pada satu individu dan biasanya terjadi pada pasien imunokompromais. Koinfeksi TB paru pada penderita kusta dapat meningkatkan mortalitas.Penelitian ini bertujuan untuk mengetahui proporsi TB Paru pada penderita kusta yang berobat di Poliklinik Kulit dan Kelamin RSUPN Dr. Cipto Mangunkusumo serta mengetahui faktor risiko yang dapat memengaruhi. Desain penelitian adalah cross sectional dengan jenis penelitian deskriptif analitik berdasarkan hasil pemeriksaan laboratorium, foto toraks dan kuesioner. Penelitian dilakukan di Poliklinik Kulit dan Kelamin serta Poliklinik Penyakit Dalam – Pulmonologi RSUPN Dr. Cipto Mangunkusumo pada tahun 2022. Sampel penelitian ini adalah pasien kusta baik sedang dalam pengobatan multi drugs therapy (MDT) maupun telah dinyatakan release from treatment (RFT) yang memenuhi kriteria penelitian dan bersedia untuk berpartisipasi dalam penelitian. Besar sampel yang diperlukan untuk penelitian ini adalah 105 orang. Data yang diperoleh diolah dan dianalisis secara univariat, bivariat dan multivariat dengan perangkat lunak SPSS.Dari total 109 subjek, terdapat 3 orang (2,75%) yang didiagnosis TB paru yang mencakup 1 orang TB paru bakteriologis terkonfirmasi TCM dan 2 orang TB paru klinis. Mayoritas subjek dengan TB paru berusia kurang dari 40 tahun (66,7%), didominasi laki-laki (66,7%) dan seluruhnya berpendidikan rendah. Dari subjek yang memberikan informasi, sebanyak 50% memiliki pendapatan kurang dari 3,5 juta per bulan. Seluruh subjek dengan TB paru mengaku tidak pernah mendapat vaksinasi BCG dan mayoritas mengaku memiliki riwayat merokok (66,7%). Sebanyak 66,7% mengaku tidak ada riwayat kontak fisis, tidak pernah menggunakan barang dan berbincang dengan penderita TB paru. Hanya 33,3% penderita koinfeksi TB paru pada kusta yang memiliki status gizi kurang. Seluruh penderita TB paru pada kusta didiagnosis kusta tipe multibasiler. Dari hasil analisis bivariat, faktor pendidikan memiliki hubungan yang bermakna dengan luaran TB paru. Namun pada analisis multivariat tidak dapat mengeluarkan hasil.

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TB disease develops more in communities with low socio-economic status, marginalized groups, and other vulnerable populations. One of the vulnerable populations is the leprae community. TB and leprosy are often found in tropical climates with high air humidity, low socio-economic levels of the population, and poor nutritional and hygiene status. Infection with these two diseases can occur simultaneously in one individual and usually occurs in immunocompromised patients. Pulmonary TB coinfection in leprosy sufferers can increase mortality.This study aims to determine the proportion of pulmonary TB in leprosy sufferers who seek treatment at the Skin and Venereology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, and the risk factors that can influence it. The research design was cross-sectional with a descriptive analytical research type based on the results of laboratory examinations, chest x-rays, and questionnaires. The research was conducted at the Skin and Venereology Polyclinic and the Internal Medicine- Pulmonology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, in 2022. The sample for this study was leprosy patients who were either undergoing multidrug therapy (MDT) or had been declared released from treatment (RFT) and who met the research criteria and were willing to participate in the research. The sample size required for this research is 105 people. The data obtained was processed and analyzed univariately, bivariately, and multivariately with SPSS software.Of the total 109 subjects, there were 3 people (2.75%) who were diagnosed with pulmonary TB, including 1 person with bacteriological pulmonary TB confirmed by TCM and 2 people with clinical pulmonary TB. The majority of subjects with pulmonary TB were less than 40 years old (66.7%), dominated by men (66.7%), and all had low education. Of the subjects who provided information, 50% had an income of less than 3.5 million per month. All subjects with pulmonary TB admitted that they had never received BCG vaccination, and the majority admitted to having a history of smoking (66.7%). As many as 66.7% admitted that they had no history of physical contact, had never used items, or talked to pulmonary TB sufferers. Only 33.3% of people with pulmonary TB co-infection with leprosy have poor nutritional status. All patients with pulmonary TB in leprosy were diagnosed with multibacillary-type leprosy. According to the results of the bivariate analysis, educational factors have a significant relationship with pulmonary TB outcomes. However, multivariate analysis could not produce results."