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"Introduction: Hyaluronic acid is a substance of human connective tissues and is reported to have important role in wound healing process, facitating the migration and cell differentiation during the development process of embryo, and the tissue repairing. Objectives: To study the effectiveness of Hyaluronic Acid 0.1% on the healing process of traumatic ulcer caused by fixed orthodontic appliances based on the size, redness and pain perception of the ulcer. Material and Methods: Thirty two subjects with fixed orthodontic appliance who had traumatic ulcer on buccal or labial mucosa due to the presence of fixed appliance on the examination day were included and divided into 2 groups. The first group (K1) was instructed to gargle with 10 ml hyaluronic acid 0,1 %-contained mouthwash for 2 minutes after tooth brushing, twice a day for 4 days in a row. The second group (K2) is given the same instructon but with placebo. The size and colour (redness) of the ulcer were measured before and after treatment using a caliper and costumized redness measurement index. The pain perception was measured after treatment using a questionnaire. Results: The percentage of changes (decline) in wound size and redness changes (decline) in K1 were more significant compared to K2 (p< 0.05). The change of pain perception in K1 was not significant compared to K2 (p> 0.05). Conclusion: Hyaluronic acid 0.1 % -contained mouthwash seemed to be effective in accelerating the wound healing, in size and colour of the ulcer, but might not be effective in reducing pain of the traumatic ulcer compared to placebo."

"ABSTRAKLuka tekan merupakan luka yang terjadi karena adanya kematian jaringan karena tekanan yang lama pada kulit dan jaringan. Luka tekan sering dijumpai pada pasien dengan gangguan mobilisasi yang mendatangkan akibat serius yaitu sepsis, perpanjangan waktu rawat, peningkatan biaya perawatan dan juga peningkatan mortalitas. Luka tekan bisa dicegah dengan melakukan deteksi terhadap risiko terjadinya luka tekan dengan menggunakan alat screening. Alat yang sudah diuji validitas dan reliabilitasnya adalah skala Braden. Penelitian ini bertujuan untuk mengidentifikasi keefektifan skala Braden dalam memprediksi kejadian luka tekan di bangsal bedah-dalam RSU. Prof. Dr. W.Z. Yohannes Kupang. Penelitian ini merupakan penelitian kuantitatif dengan metode prospektif, dengan jumlah sampel sebanyak 28 orang yang dipilih menggunakan teknik consecutive sampling. Pengujian validitas prediksi skala Braden dengan menghitung nilai sensitifitas, spesifitas, PPV dan NPV serta luas area di bawah kurva. Hasil penelitian menunjukan bahwa skala Braden mempunyai validitas prediksi yang baik pada cut of point 15, memiliki nilai sensitifitas 88.2%, spesifitas 72.7%, PPV 11.8% dan NPV 27.3% dan luas area di bawah kurva ROC adalah 0.880. Kesimpulan yang didapatkan yaitu skala Braden efektif dalam memprediksi kejadian luka tekan di bangsal bedah dan penyakit dalam RSU Prof.Dr.W.Z. Yohannes Kupang. Sehingga disarankan untuk menggunakan skala Braden sebagai alat skrining terhadap resiko terjadinya luka tekan pada pasien.

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ABSTRACTPressure Ulcer is a wound which occurs as a result of death cells due to long pressure on skin and tissues. This wound is often found in patients with immobilization that lead to serious impacts such as sepsis, increased length of stay, increased medical cost and increased the possibility of mortality. Pressure ulcer can be prevented by early detection of risk with a screening tool. The tool which has been examined its validity and reliability is Braden scale. The aim of this research was to identify the effectiveness of Braden scale in redicting pressure ulcer in Medical-Surgical Ward at RSU Prof. Dr. W.Z. Yohannes Kupang. This was a quantitative research using prospective method. Twenty eight subjects were participated in this study and selected by using consecutive sampling method. The validity prediction of Braden scale was measured by counting sensitivity and specificity, False positive and False Negative value and also a wide range area under the curve. The result of the study showed that Braden scale has a good validity prediction on cut of point of 15, which demonstrated 88.2% sensitivity, 27.2% specificity, 11.8% FN and 27.3% FP and wide rangearea under the ROC curve is 0.880. The conclusion of the research was that Braden scale is effective in predicting pressure ulcer in Medical-Surgical ward at RSU Prof. Dr. W.Z. Yohannes Kupang. Therefore, using Braden scale as a screening tool to predict risks of pressure ulcer on patients with immobilization is recommended."

"Pendahuluan: Rosela memiliki khasiat antiinflamasi. Ulser merupakan keadaan inflamasi dalam rongga mulut.Tujuan: Menganalisis efektivitas ekstrak etanol terstandar kelopak bunga rosela terhadap penyembuhan ulser.Metode: Penelitian in vivo pada model ulser 12 tikus, dibagi menjadi kelompok kontrol dan perlakuan. Rosela diteteskan 2 kali sehari pada ulser, kemudian hari ke 3 dan 7 dikorbankan. Parameter yang diobservasi adalah kemerahan dan bengkak di sekitar jaringan ulser, diameter ulser, serta skor radang.Hasil: Rosela 7.5% 7 hari dapat menghilangkan kemerahan, sedangkan 3.75% dan 7.5% menurunkan diameter ulser dan skor radang.Kesimpulan: Aplikasi tetes ekstrak terstandar rosela efektif dalam mempercepat penyembuhan ulser.

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Background: Roselle has antiinflammatory effect. Ulcer is an inflammatory condition in oral.Objective: Analyze effectiveness of roselle in healing an ulcer.Methods: This research in vivo on ulcer model 12 rats, divided into control and treatment group. Roselle drops were applied twice a day on ulcer, then day 3 to 7 was sacrificed. Healing process was observed by looking redness and swelling, ulcer diameter, and inflammation score.Results: Roselle 7.5% 7 days can eliminate redness, while 3.75 % and 7.5% reduced ulcer diameter and inflammation score.Conclusion: Application drops of standardized ethanol extract of roselle are effective in ulcer healing."

"Ulser adalah masalah yang sering ditemukan pada rongga mulut. Keluhan sakit seringkali menimbulkan rasa tidak nyaman pada penderita yang dapat memengaruhi kualitas hidupnya, sehingga penderita cenderung mencari pengobatan untuk menangani hal tersebut. Propolis merupakan bahan alami yang memiliki kandungan flavonoid yang dapat bertindak sebagai anti-inflamasi dalam menangani ulser. Mengetahui efektivitas pasta gigi propolis sebagai pengobatan ulserasi traumatik termal pada mukosa bukal. Penelitian dilakukan secara in vivo dengan menggunakan model ulser traumatik termal pada mukosa bukal 16 ekor Mus musculus (SwissWebster) yang terbagi dalam penelitian pendahuluan dan penelitian lanjutan. Penelitian menggunakan 3 kelompok dengan kelompok pasta gigi propolis, pasta gigi kontrol dan larutan saline (NaCl 0,9%). Dilakukan pemaparan trauma termal dengan ballpointed bersuhu 80oC selama 5 detik. Pengamatan dilakukan secara klinis berupa perubahan diameter ulser, pembengkakan dan kemerahan di sekitar ulser, berat badan serta persentase penyembuhan ulser, dan secara histopatologis berupa perubahan skor radang. Mus musculus kemudian dikorbankan pada hari pertama terbentuk ulser, hari puncak ulser dan hari sembuhnya ulser pada setiap kelompok. Pada pengamatan makroskopis, persentase penyembuhan kelompok pasta gigi propolis lebih cepat dibanding kelompok pasta gigi kontrol dan saline, serta rata-rata waktu penyembuhan ulser juga lebih cepat, yaitu sembuh pada hari ke-8. Pada pengamatan mikroskopis, semua kelompok perlakuan mengalami perubahan skor radang dibandingkan ketika hari pertama terbentuknya ulser. Pasta gigi propolis efektif terhadap penyembuhan ulser traumatik termal pada mukosa bukal Mus musculus (Swiss Webster).

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Ulcer is a problem which is mainly found in the oral cavity. The pain resulted often causes discomfort towards the patients hence affecting their life quality. As a result, they tend to seek treatment to deal with it. Propolis is a natural ingredient that contains flavonoid which can act as an anti-inflammatory to treat the ulcer. To determine the efficacy of propolis toothpaste as a treatment for thermal traumatic ulcer of the buccal mucosa. The study was conducted in vivo by using the thermal traumatic ulcer model of the buccal mucosa of 16 Mus musculus (Swiss Webster) and divided into preliminary test and continuous test. There are 3 groups in the study, using propolis toothpaste, control toothpaste and saline (NaCl 0,9%) groups. The thermal trauma is exposed by a 80oC ballpointed for 5 seconds. Observations are made clinically (difference in ulcer diameter, swelling and redness around the ulcer, weight and percentage of ulcer healing) and histopathologically in the form of changes in inflammation score. Mus musculus was then sacrificed on the first day of ulcer formation, ulcer peak day and ulcer healing day in each group. In the macroscopic observation, the ulcer healing percentage in propolis toothpaste group was faster than the control groups, and the ulcer healing time was also faster, which was healed on the 8 day. In the microscopic observation, all treatment groups show changes in inflammation score compared to the first day of ulcer formation. Propolis toothpaste is effective towards the healing of thermal traumatic ulcer in the buccal mucosa of Mus musculus (Swiss Webster)."

"Latar Belakang: Peningkatan insiden tukak peptikum perforasi (TPP) Divisi Bedah digestif RSUPN Dr. Cipto Mangunkusumo Jakarta. Selama enam bulan awal pandemi Covid-19, naik empat kali lipat, dibandingkan enam bulan sebelum pandemi Covid-19. Penelitian ini bertujuan untuk menilai peran stres psikologis sebagai faktor risiko tukak peptikum perforasi.Metodologi: Merupakan studi retrospektif potong lintang, membandingkan 2 kelompok subjek penelitian, TPP pandemi Covid-19 Maret 2020 hingga Maret 2021 dan non-pandemi Covid-19 Juli 2017 hingga Februari 2020. Data demografi, klinis, dan tingkat stres psikologis yang diukur dengan Perceived Stress Scale (PSS-10) merupakan variabel yang diperiksa. Hasil: Tercatat 53 TPP, 28 subjek pada pandemi, pria 11, wanita 17, rerata usia 63 tahun, pemakaian obat antiinflamasi nonsteroid atau jamu 80%, komorbid 92,8%, lama rawat 23,6 hari, morbiditas 78,5%, infeksi daerah operasi 17%, pneumonia 38,9%, dan mortalitas 46,4%. 25 subjek pada non-pandemi, pria 21, wanita 4, rerata usia 53 tahun, penggunaan obat antiinflamasi nonsteroid atau jamu 85%, komorbid 48%, rerata skor boey 1,3, PULP 6,8, ASA 3, lama rawat 16,2 hari, morbiditas 52%, infeksi daerah operasi 12%, pneumonia 36%, dan mortalitas 28%. Penilaian PSS-10 pada 37 subjek, pada pandemi, stres berat delapan, stres sedang tujuh, stres ringan empat. Pada non-pandemi stres berat satu, stres sedang delapan, stres ringan sembilan. Uji Fischer exact didapatkan perbedaan antara stres ringan-sedang dengan stres berat pada kedua kelompok, p = 0,019. Uji Spearman didapatkan korelasi moderat (rs = 0,422) antara stres psikologis dengan pandemi, p = 0,009.Simpulan: Pandemi Covid-19 memperberat stres psikologis, meningkatkan morbiditas dan mortalitas tukak peptikum perforasi.

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Background: Increased incidence of perforated peptic ulcer (PPU) Digestive Surgery Division, Dr. Cipto Mangunkusumo Hospital, Jakarta. During early of six months Covid-19 pandemic, increased four times, compared to six months before Covid-19 pandemic. This study aims to evaluate the role of psychological stress as a risk factor for perforated peptic ulcer.

Methodology: a cross-sectional retrospective study, compare 2 groups on the PPU subjects of COVID-19 pandemic March 2020 to March 2021 and non-pandemic Covid-19 July 2017 to February 2020. Demographic, clinical, and psychological stress data as measured by Perceived Stress Scale (PSS-10) were variables to be evaluated.

Results: Registered 53 PPU, 28 subjects in Covid-19 pandemic, 11 males, 17 females, 63 years mean age, 80% used of nonsteroidal anti-inflammatory drugs or Indonesian herbs, 92.8% comorbidities, 23.6 days length of stay, 78,5% morbidity, 17% surgical site infection, 38.9% pneumonia, and 46,4% mortality. 25 subjects in non-pandemic, 21 males, 4 females, 53 years mean age, 85% non-steroidal anti-inflammatory drugs or Indonesian herbs, 48% comorbidity, 1.3 mean boey score, 6.8 PULP, 3 ASA, 16.2 days length of stay, 52% morbidity, 12% surgical site infection, 36% pneumonia, and 28% mortality. PSS-10 evaluated on 37 subjects, in pandemic, eight severe stress, seven moderate stress, four mild stress. In non-pandemic, one severe stress, eight moderate stress, and nine mild stress. Fischer's exact test found a difference between mild-moderate stress and severe stress in both groups, p = 0.019. Spearman's test found a moderate correlation (rs=0.422) between psychological stress and the pandemic, p = 0.009.

Conclusion: Covid-19 pandemic exacerbates psychological stress, increasing morbidity and mortality of perforated peptic ulcer."

"Latar Belakang: DM merupakan salah satu penyebab morbiditas dan mortalitas tertinggi di dunia, dengan 15-25% pasien akan berkomplikasi menjadi DFU. Data pada tahun 2003 di RSCM menunjukkan bahwa angka kematian akibat DFU adalah 16% dan angka amputasi mencapai 25%. Hingga saat ini belum terdapat strategi tatalaksana DFU yang efektif karena patogenesis molekular yang menyebabkan kegagalan penyembuhan luka masih belum sepenuhnya dipahami. Selain itu pengendalian kadar glukosa darah dalam pengobatan DFU masih belum jelas dan menjadi perdebatan dalam berbagai studi.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan HbA1c dan GDS dengan faktor angiogenesis HIF-1α, sehingga dapat dijadikan dasar dalam melakukan tata laksana yang tepat untuk pasien DFU.Metode: Desain penelitian potong lintang. Subjek penelitian pasien DFU yang berobat ke RSCM, diambil data dasar (jenis kelamin dan usia), pemeriksaan klinis (TB, BB, dan IMT), pemeriksaan laboratorium (GDS, HbA1c). HIF-1α diperiksa dari sampel biopsi jaringan luka DFU saat operasi debridemen dan amputasi dengan pemeriksaan ELISA. Data dilakukan uji normalitas Saphiro-Wilk dan uji normalitas Kolmogorov Smirnov, dilanjutkan uji korelasi Spearman. Pengaruh variabel perancu dianalisa dengan uji mann whitney dan tes regresi linear sederhana.Hasil: Terdapat 64 pasien yang memenuhi kriteria inklusi dan dilakukan pemeriksaan kadar HiF1α dari sampel jaringan biopsi. Data karakteristik didapatkan hasil kelompok dominan perempuan (54.7%) dengan usia rerata 55.7 ± 10.4 tahun, IMT median 24.9 kg/m² (overweight 48.2%, obesitas 34.6%), dan komorbid anemia (84.3%). Karakteristik laboratorium, GDS median 220 (14-705)mg/dL dengan kelompok kondisi hiperglikemik >200 mg/dL sebanyak 54.7%. HbA1c median 7.7(4.1-13.7)% dengan kelompok kontrol gula darah buruk HbA1c >6.5% sebanyak 85.8%. Tidak didapatkan korelasi bermakna antara GDS dengan HIF-1α p 0.523(p>0.05). Tidak didapatkan korelasi yang bermakna antara HbA1c dengan HIF-1α p 0.792(p>0.05). Didapatkan variable perancu yang bermakna pada kondisi derajat luka DFU p 0.03 (p< 0,05).Kesimpulan: Hasil penelitian ini menunjukkan bahwa baik HbA1c atau GDS tidak mempunyai hubungan yang bermakna dengan kadar HiF-1α. Variabel perancu kondisi derajat luka DFU berpengaruh secara signifikan terhadap ekspresi HIF-1α

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Background: DM is one of the leading causes of morbidity and mortality in the world, with 15-25% of patients developing complications of DFU. Results data in 2003 at the RSCM showed that the mortality rate from DFU was 16% and the amputation rate was 25%. There is no effective DFU management strategy because the molecular pathogenesis that causes wound healing failure is still not fully understood. In addition, the control of blood glucose levels in the treatment of DFU is still unclear and has been debated in various studies.

Objective: This study aims to analyze the relationship between HbA1c and GDS with the angiogenesis factor HIF-1α, so that it can be used as a basis for appropriate management of DFU patients.

Methods: The research design was cross sectional. Body mass index, comorbid disease status were recorded. The laboratory parameters GDS, HbA1c and HiF-1a expression examined in the laboratory. Test the normality data by the Saphiro-Wilk test and the Kolmogorov Smirnov test, followed by the Spearman correlation test. The effect of confounding variables was analyzed by Mann Whitney test and simple linear regression test.

Results: There were 64 patients who met the inclusion criteria and were examined for HiF1α levels from biopsy tissue samples. Characteristic data showed that the dominant group was female (54.7%) with a mean age of 55.7 ± 10.4 years, median BMI 24.9 kg/m² (overweight 48.2%, obesity 34.6%), and comorbid anemia (84.3%). Laboratory characteristics, the median GDS of 220 (14-705)mg/dL with the hyperglycemic condition group >200 mg/dL as much as 54.7%. The median HbA1c was 7.7(4.1-13.7)% with the bad blood sugar control group HbA1c >6.5% as much as 85.8%. There was no significant correlation between GDS and HIF-1α p 0.523 (p>0.05). There was no significant correlation between HbA1c and HIF-1α p 0.792 (p>0.05). A significant confounding variable was found in the condition of the degree of wound DFU p 0.03 (p < 0.05).

Conclusion:The results of this study showed that neither HbA1c nor GDS had a significant correlation with HiF-1α . The confounding variable of DFU wound degree had a significant effect on the expression of HIF-1α"

"ABSTrAKPenyakit ulkus diabetikum menyebabkan penurunan fungsi fisik dan psikologis yang berdampak pada kualitas hidup. Penelitian ini bertujuan untuk mengetahui faktor yang mempengaruhi kualitas hidup pasien ulkus diabetikum. Adapun variabel independen dalam penelitian ini adalah umur, jenis kelamin, pendidikan, penghasilan, lama menderita ulkus diabetikum, depresi, nyeri, koping, dukungan sosial dan kondisi luka. Penelitian ini menggunakan analitik korelasi dengan desain cross sectional. Jumlah sampel dalam penelitian ini ada 100 responden. Pada analisis regresi linier ganda didapat 3 variabel yang berpengaruh terhadap kualitas hidup yaitu penghasilan depresi dan nyeri. Hasil penelitian lebih lanjut didapatkan depresi sebagai faktor yang paling berhubungan dengan kualitas hidup (p=0.000). Berdasarkan hal tersebut perawat perlu mendeteksi secara dini depresi yang dialami oleh pasien dan memberikan pendidikan kesehatan.

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ABSTRACTDiabetic ulcer can decline in physical function and psychological impact on quality of life. This study aims to examine the factors that affect the quality of life of diabetic ulcer patients. The independent variables in this study were age, gender, education, income, long suffering from diabetic ulcers, depression, pain, coping, social support and wound conditions. This research used analytic correlation with cross-sectional design. Samples in this research there were 100 respondents. In the multiple linear regression analysis obtained 3 variables that affect the quality of life of the income depression and pain. The results obtained further depression as factors most related quality of life (p = 0.000). Based on that nurses need early detection of depression experienced by patients and providing health education."