Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKLatar belakang: Strategi tatalaksana hemoroid interna derajat dua dan tiga terdiri dari tatalaksana non bedah dan bedah. Apabila tatalaksana non bedah tidak berhasil, maka pilihan terapi disarankan minimal invasi atau pembedahan tergantung kondisi klini. Seiring dengan perkembangan IPTEK, dikenal teknik rubber band ligation RBL dan stapled hemorrhoidopexy SH . Di Indonesia, belum ada data yang menggambarkan distribusi angka komplikasi pascaoperasi.Metode penelitian: Studi potong lintang komparatif dilakukan dengan mengambil data rekam medis subjek yang telah menjalankan RBL atau SH periode 2011-2014 pada tiga rumah sakit di Jakarta. Dilakukan analisis univariat untuk menilai komplikasi pascaoperasi RBL dan SH subjek hemoroid interna derajat dua dan tiga. Kami menggunakan uji chi square untuk menilai faktor-faktor yang mempengaruhi komplikasi variabel kategorik, t-test untuk variabel numerik, dan uji fisher bila syarat chi square tidak terpenuhi.Hasil penelitian: Didapatkan 183 subjek yang menjalani RBL 49,2 dan SH 50,8 , hemoroid interna derajat dua 40 dan derajat tiga 60 . Komplikasi pascaoperasi terdiri dari nyeri RBL 4,4 , SH 8,8 , perdarahan RBL 2,3 , SH 4,9 , retensi urin RBL tidak ada, SH 2,7 , infeksi RBL 0,5 , SH 1,6 dan stenosis RBL tidak ada, SH 0,5 . Komplikasi pascaoperasi subjek hemoroid interna derajat dua 8,2 dan derajat tiga 13,1 p = 0,71 . Subjek hemoroid interna derajat tiga, komplikasi pasca RBL 2,8 , SH 19,4 p = 0,03 .Kesimpulan: Komplikasi hemoroid interna derajat dua dan tiga pasca RBL tidak berbeda dengan SH. Pada hemoroid interna derajat tiga, komplikasi pasca RBL lebih rendah secara signifikan dibandingkan SH.

---

ABSTRACTBackground The management of second and third degree internal hemorrhoid consists of non surgical and surgical treatments. If non surgical treatment does not succeed, then the recommended therapy is minimal invasive or surgery, depends on the clinical condition. Along with the development of science and technology, a technique known as rubber band ligation RBL and stapled hemorrhoidopexy emerges. In Indonesia, there is no data that can describe the distribution of postoperative complication rate. Method A comparative cross sectional study was conducted by gathering short term outcomes data from the subjects 39 medical records that underwent RBL or SH between 2011 to 2014 in three different hospitals in Jakarta. A univariate analysis was conducted to assess postoperative complications of RBL and SH subjects of third and second degree internal hemorrhoids. We use chi square test to assess the factors that influence the complications of categorical variables and t tests for numerical variables, and Fisher test if the chi square condition is not met. Results Among 183 subjects, 49,2 underwent RBL and 50,8 SH. Second degree internal hemorrhoids were 40 and third degree were 60 . Postoperative complications consist of pain RBL 4,4 , SH 8,8 , hemorrhage RBL 2,3 , SH 4,9 , urinary retention RBL 0, SH 2,7 , infection RBL 0,5 , SH 1,6 and stenosis RBL 0, SH 0,5 . Postoperative complications on second degree internal hemorrhoidal was 8,2 and third degree 13,1 p 0,71 . Complication of subject with third degree internal hemorrhoids after RBL 2,8 , SH 19,4 p 0,03 . Conclusion Complications of second and third degree internal hemorrhoids post RBL are no different with SH while for third degree internal hemorrhoid, complications after RBL ware significantly lower than SH. "

"Kehamilan trimester 3 akan mengalami perubahan baik secara fisik ataupun psikologis. Perubahan tersebut dapat menyebabkan rasa ketidaknyamanan, salah satunya adalah dengan semakin bertambah usia janin maka ukuran rahimpun akan membesar sehingga menekan pembuluh darah pada anus yang mengakibatkan anus menjadi menonjol atau terjadi hemoroid. Hemoroid bukanlah hal yang mengancam jiwa dan bahkan seringkali tidak menimblkan keluhan atau gejala. Walaupun demikian, perlu dilakukan perawatan pada ibu hamil karena dapat berdampak pada aktivitas ibu sehari-hari jika sudah menimbulkan keluhan seperti nyeri, BAB berdarah. Bahkan perdarahan pada hemoroid yang berlangsung lama dapat mengakibatkan anemia. Pada kali ini, ibu hamil timester 3 mengalami hemoroid grade 3 sehingga mengakibatkan ketidaknyamanan terutama setelah BAB, hemoroid keluar dan perlu dimasukkan kembali sehingga merasa tidak nyaman saat duduk. Rasa ketidaknyamanan tersebut dapat berkurang dengan intervensi rendam duduk. Karya tulis ilmiah ini bertujuan untuk melakukan analisis asuhan keperawatan pada ibu hamil trimester 3 yang mengalami hemoroid grade 3 dengan penerapan rendam duduk untuk mengurangi ketidaknyamanan . Rendam duduk dengan air hangat efektif mengurangi ketidaknyamanan yang ditimbulkan akibat hemoroid, selain itu juga intervensi rendam duduk mudah dilakukan, tidak membutuhkan banyak biaya dan tidak memiliki efek samping. Karya tulis ilmiah ini menggunakan metode laporan kasus. Pada hasil intervensi keperawatan ditemukan bahwa ketidaknyamanan yang dirasakan oleh ibu S berkurang 10 menit lebih cepat daripda sebelum dilakukan rendam duduk. Selain itu juga Ibu S merasakan bahwa ukuran dari hemoroidnya berkurang.

---

The third trimester of pregnancy will experience changes both physically and psychologically. These changes can cause discomfort, one of which is the increasing age of the fetus, the size of the uterus will enlarge so that it compresses the blood vessels in the anal which causes the anal to protrude or hemorrhoids occur. Hemorrhoids are not life threatening and often do not cause symptoms or complaints. However, it is necessary to treat pregnant women with hemorrhoids because they can have an impact on the mother's daily activities if they cause complaints such as pain, bloody stools. Even prolonged bleeding in hemorrhoids can lead to anemia. At this time, the third time pregnant woman experienced grade 3 hemorrhoids, causing discomfort, especially after defecating, the hemorrhoids came out and needed to be re inserted so, they felt uncomfortable when sitting. This discomfort can be reduced with a sitz bath intervention. This scientific paper aims to analyze nursing care in third trimester pregnant women who experience grade 3 hemorrhoids with the application of sitz bath to reduce discomfort. Sitz bath with warm water are effective in reducing the discomfort caused by hemorrhoids, besides that, sitz bath interventions are easy to do, do not require a lot of money and have no side effects. This scientific paper uses the case report method. In the results of the nursing intervention, it was found that the discomfort felt by Mrs. S decreased 10 minutes faster than before the sitz bath. In addition, Mrs. S also felt that the size of her hemorrhoids had decreased."

"Tesis ini menganalisis efektifitas biaya yang dikeluarkan pasien hemoroid interna grade 3-4 yang menjalani tindakan haemorrhoidectomy Stapled dan konvensional. Penelitian ini menggunakan perhitungan Activity Based Costing dengan simple distribution untuk mendapatkan cost lalu dibandingkan dengan nilai output, sehingga didapatkan Cost Effectiveness Ratio (CER). Nilai CER kemudian dibandingkan dan mana yang lebih kecil adalah yang lebih efektif. Hasil penelitian menunjukkan bahwa alternatif Stapled menghasilkan nilai CER yang lebih kecil dibandingkan dengan CER alternatif konvensional. Maka dapat disimpulkan bahwa tindakan haemorrhoidectomy Stapled lebih efektif dibandingkan dengan alternatif konvensional.

---

This thesis was analysing the effectiveness of cost that spent by patients with internal hemorrhoid grade 3 to 4 underwent haemorrhoidectomy Stapled and conventionals. This research was using Activity Based Costing with simple distribution method to calculate the cost then divided by output value to get Cost Effectiveness Ratio (CER). CER values were then compared and the lower is the more effective. Result of this research showed that value of CER of Stapled alternative were smaller compared with CER of conventionals alternative. It can be concluded that Stapled haemorrhoidectomy is more effective than conventionals alternative."

"Latar Belakang: Peningkatan prevalensi penderita diabetes melitus (DM) meningkatkan risiko aterosklerosis arteri karotis interna (internal carotid artery, ICA). Di negara maju, 85% kasus stroke terjadi akibat aterosklerosis karotis. Short chain fatty acid (SCFA) adalah produk metabolisme bakteri yang terutama disintesis di usus besar dan berperan mengurangi aktivasi endotel oleh mediator proinflamasi. Sehingga mencegah progresi aterosklerosis ICA. Penelitian ini bertujuan mengetahui hubungan SCFA feses dengan gambaran ultrasonografi ICA pada penderita DM tipe 2 di RS Dr. Cipto Mangunkusumo (RSCM).Metode: Desain penelitian ini adalah observasional analitik jenis potong lintang. Data diperoleh dari seluruh pasien DM tipe 2 di Divisi Bedah Vaskular dan Endovaskular RSCM. Meliputi kadar SCFA sampel feses dan gambaran ultrasonografi (carotid intima-media thickness (IMT), diameter lumen, peak systolic velocity (PSV), end diastolic velocity (EDV), dan flow volume). Uji korelasi Spearman dilakuan untuk memperoleh koefisien korelasi. Nilai p <0,05 bermakna signifikan.Hasil: Dari 30 subjek DM tipe 2, terdapat 12 laki-laki (40,0%) dan setengah populasi berusia >60 tahun. Hasil pemeriksaan IMT berhubungan signifikan dengan jenis kelamin (p=0,048). Kadar SCFA berhubungan signifikan dengan usia, yaitu asetat (p=0,029), proprionat (p=0,005), butirat (p=0,039), dan SCFA total (p=0,024). Kadar SCFA valerat berkorelasi signifikan dengan IMT (r = -0,237; p=0,034) dan diameter lumen (r = -0,243; p=0,031).Kesimpulan: Kadar SCFA feses berkorelasi dengan gambaran ultrasonografi arteri karotis interna. Nilai kadar SCFA feses pada pasien DM tipe 2 di RSCM lebih tinggi dibandingkan penelitian lain. Peningkatan kadar SCFA menurunkan risiko penyempitan arteri sklerosis interna

---

Background: The increasing prevalence of diabetes mellitus (DM) increases the risk of atherosclerosis of the internal carotid artery (ICA). In developed countries, 85% of stroke cases occur due to carotid atherosclerosis. Short-chain fatty acids (SCFA) are products of bacterial metabolism which are mainly synthesized in the large intestine and play a role in reducing endothelial activation through pro-inflammatory mediators, thus preventing the progression of ICA atherosclerosis. This study aims to determine the correlation between faecal SCFA and ICA ultrasonography in patients with type 2 diabetes at Dr. Cipto Mangunkusumo General Hospital (CMGH).

Methods: This study is cross-sectional. Data were obtained from all type 2 DM patients in the Vascular and Endovascular Surgery Division. Data that were collected included faecal SCFA levels and ultrasonography examination (carotid intima-media thickness (IMT), lumen diameter, peak systolic velocity (PSV), end-diastolic velocity (EDV), and flow volume). Spearman correlation test was conducted to obtain the correlation coefficient. The p-value <0.05 was significant.

Results: Of the 30 subjects, 12 were male (40.0%) and half the population was >60 years old. BMI examination results were significantly related to gender (p=0.048). SCFA levels were significantly related to age, including acetate (p=0.029), proprionate (p=0.005), butyrate (p=0.039), and total SCFA (p=0.024). SCFA valerate levels were significantly correlated with BMI (r = -0.237; p=0.034) and lumen diameter (r = -0.243; p=0.031).

Conclusion: Fecal SCFA levels correlated with ultrasound images of the internal carotid artery. The value of faecal SCFA levels in type 2 DM patients at CMGH was higher than in other studies. Elevated SCFA levels decrease the risk of ICA narrowing or stenosis."

"Pendahuluan: Deep Vein Thrombosis (DVT) memiliki kecenderungan terus meningkat dengan koinsidensi mortalitas jangka pendek dan morbiditas jangka panjang. COVID-19 dapat menyebabkan hypercoagulable state dan menjadi predisposisi terjadinya DVT. Penelitian ini bertujuan untuk menganalisis hubungan kadar fibrinogen, D-Dimer, dan dosis heparin teraupetik berdasarkan kadar APTT dengan adanya COVID-19 pada pasien DVT. Metode: Desain penelitian komparatif dan kohort prospektif digunakan untuk membandingkan kadar fibrinogen, D-Dimer, dan dosis heparin terapeutik antara pasien COVID-19 dan non COVID-19 yang menderita DVT di RSPN Cipto Mangunkusumo pada bulan Maret 2020 – Maret 2022. Penegakan diagnosis DVT dilakukan dengan pemeriksaan ultrasonografi dan/atau computed tomography angiography (CTA) fase vena. Data variabel utama dan lainnya diperoleh dari rekam medis pasien. Uji T independen atau Mann-Whitney digunakan untuk menganalisis perbedaan nilai variabel antara kedua kelompok. Hasil: Dari total 253 sampel, tidak terdapat perbedaan karakterisitik awal antara kelompok DVT COVID-19 (n=44) dan DVT non COVID-19 (n=209), kecuali pada parameter Wells Score. Kelompok DVT COVID-19 memiliki kadar Fibrinogen, D-Dimer, dan aPTT yang lebih tinggi daripada kelompok DVT non COVID-19, baik sebelum terapi maupun sesudah terapi heparanisasi (semua nilai p =0,000). Pada akhir pengamatan, didapatkan dosis heparin terapeutik pada kelompok DVT COVID-19 lebih tinggi dibanding pada kelompok DVT non COVID-19 (30,00 (20,00-40,00)x103 U vs. 25,00 (20,00-35,00)x103 U, p=0,000). Kesimpulan: Kadar fibriongen, D-Dimer, dan dosis heparin terapeutik pada pasien DVT yang menderita COVID-19 lebih tinggi dibandingkan pada pasien DVT yang tidak menderita COVID-19. Inisiasi pemberian dosis heparin terapeutik dosis tinggi dapat dipertimbangkan pada pasien DVT dengan komorbid COVID-19 dan dipandu oleh hasil pemeriksaan biomarker koagulasi darah.

---

Introduction: Deep Vein Thrombosis (DVT) has an increasing trend with a coincidence of short-term mortality and long-term morbidity. COVID-19 can cause a hypercoagulable state and predispose to DVT. This study aims to analyze the relationship between fibrinogen levels, D-Dimer, and therapeutic heparin doses based on APTT levels in the presence of COVID-19 in DVT patients. Methods: A comparative study design and a prospective cohort were used to compare levels of fibrinogen, D-Dimer, and therapeutic heparin doses between COVID-19 and non-COVID-19 patients suffering from DVT at Cipto Mangunkusumo Hospital in March 2020 – March 2022. Diagnosis of DVT was performed by ultrasound examination and/or computed tomography angiography (CTA) venous phase. The primary variable data and others were obtained from the patient's medical record. An Independent T-test or Mann-Whitney was used to analyze the differences in variable values between the two groups. Results: Of 253 samples, there was no difference in initial characteristics between the DVT COVID-19 (n=44) and non-COVID-19 DVT groups (n=209), except for the Wells Score parameter. The COVID-19 DVT group had higher levels of fibrinogen, D-Dimer, and aPTT than the non-COVID-19 DVT group, both before and after heparinization therapy (all p-values = 0.000). At the end of the follow-up period, the therapeutic dose of heparin in the COVID-19 DVT group was higher than in the non-COVID-19 DVT group (30.00 (20.00-40.00)x103 U vs. 25.00 (20.00-35.00)x103 U, p-value=0.000). Conclusion: The levels of fibrinogen, D-Dimer, and therapeutic doses of heparin in DVT patients who have COVID-19 are higher than in DVT patients who do not have COVID-19. Initiation of a higher therapeutic dose of heparin can be considered in DVT patients with comorbid COVID-19 and guided by the results of blood coagulation biomarkers."

"Latar Belakang : Prevalensi ansietas dan depresi serta faktor risiko pada penyintas COVID-19 di seluruh dunia dan Indonesia masih tinggi dan berbeda beda dari setiap negara. Di Indonesia faktor risiko ansietas dan depresi belum pernah diteliti. Penelitian ini dilakukan untuk menentukan prevalensi dan faktor risiko gejala ansietas dan depresi pasca rawat inap COVID-19 di rumah sakit Cipto Mangunkusumo.Metode : Desain penelitian ini adalah Kohort retrospektif. Subjek penelitian diambil dari pasien pasca perawatan inap COVID-19 pada periode Januari 2022 sampai Maret 2023. Gejala ansietas dan depresi dinilai menggunakan Hospital Anxiety Depression Scale. Analisa bivariat digunakan menentukan faktor risiko dari variabel kategorik dan dilanjutkan ke analisa multivariat regresi logistik sampai didapatkan nilai P: 0,05.Hasil : Terdapat 209 subjek yang dilibatkan dalam penelitian ini dengan prevalensi gejala ansietas 20,57% dan gejala depresi 13,40%. Faktor risiko gejala ansietas adalah wanita RR (IK95%) 1,805 (1,017 – 3,204), p=0,043, Dukungan sosial sedang dan rendah dengan RR (IK95%) 1,935 (1,028 – 3,643), p=0,041 untuk dukungan sosial sedang dan RR (IK95%) 3,325 (1,314 – 8,411), p=0,011 untuk dukungan sosial rendah, Komorbid dengan RR (IK95%) 1,742 (1,019 – 2,977), p=0,042, Anosmia atau hipogeusia dengan RR (IK95%) 1,894 (1,045 – 3,433), p=0,035, gejala menetap pasca COVID-19 dengan nilai RR (IK95%) 2,885 (1,553 – 5,359), p=0,001. Faktor risiko gejala depresi adalah gejala menetap pasca COVID-19 RR (IK95%) 2,738 (1,300 – 5,770), p=0,008, kedia adalah aktifitas fisik ringan RR (IK95%) 6,556 (1,577 - 27,244), p=0,010.Kesimpulan : Faktor risiko gejala ansietas pasca perawatan COVID-19 yang bermakna adalah wanita, dukungan sosial, komorbid, anosmia atau hipogeusia, gejala menetap sedangkan faktor risiko gejala depresi adalah gejala menetap pasca COVID-19 dan aktifitas fisik ringan.

---

Background: The prevalence of anxiety and depression, as well as risk factors for COVID-19 survivors worldwide and in Indonesia, is still high and varies from country to country. In Indonesia, the risk factors for anxiety and depression have not been studied. This study was conducted to determine the prevalence and risk factors for symptoms of anxiety and depression after hospitalization for COVID-19 at Cipto Mangunkusumo hospital.

Methods: The study design was a retrospective cohort. The study subjects were taken from post-hospitalized COVID-19 patients from January 2022 to March 2023. Symptoms of anxiety and depression were assessed using the Hospital Anxiety Depression Scale. Bivariate analysis was used to determine risk factors from categorical variables and proceeded to multivariate logistic regression analysis until a P value of 0.05 was obtained.

Results: There were 209 subjects involved in this study, with a prevalence of 20.57% anxiety symptoms and 13.40% depressive symptoms. Risk factors for anxiety symptoms are women RR (95% CI) 1.805 (1.017 – 3.204), P=0.043, Medium and low social support with RR (95% CI) 1.935 (1.028 – 3.643), P=0.041 for moderate social support, RR (95% CI 3.325 (1.314 – 8.411), P=0.011 for low social support, Comorbid with RR (95% CI) 1.742 (1.019 – 2.977), P=0.042, Anosmia or hypogeusia with RR (95% CI) 1.894 (1.045 – 3.433 ), P=0.035, persistent symptoms after COVID-19 with a RR (95% CI) 2.885 (1.553 – 5.359), P=0.001. Risk factors for depressive symptoms are persistent symptoms after COVID-19, RR (95% CI) 2.738 (1.300 – 5.770), P=0.008, lastly light physical activity RR (95% CI) 6.556 (1.577 - 27.244), P=0.010.

Conclusion: Significant risk factors for anxiety symptoms post hospitalization for COVID-19 are women, social support, comorbidities, anosmia or hypogeusia, and persistent symptoms, while risk factors for depressive symptoms are persistent symptoms after COVID-19 and light physical activity"