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Abstrak :
Radiology of the post surgical abdomen provides a comprehensive overview of all abdominal operations involving the gastrointestinal tract, pancreas, hepatobiliary and genitourinary systems. Each chapter is fully illustrated with artists' drawings and radiological images of normal post operative anatomy. The complications associated with each procedure are described alongside imaging examples. Written by experts in the field, Radiology of the post surgical abdomen provides the reader with key teaching points emphasising differentiation between normal post-operative anatomy and complications.

Abstrak :
Latar Belakang: Peningkatan tekanan intraabdomen dapat menurunkan perfusi berbagai sistem organ, terutama organ intraabdomen dengan vaskularisasi tinggi seperti ginjal. Indeks resistensi RI dan indeks pulsatilitas PI ginjal adalah parameter kuantitatif ultrasonografi USG Doppler yang mengukur derajat resistensi atau impedansi aliran darah dan dapat berperan sebagai indikator perfusi ginjal. Dalam kepustakaan masih belum terdapat data nilai korelasi antara RI dan PI ginjal terhadap tekanan intraabdomen melalui insuflasi CO2 pada subjek manusia. Tujuan: Mengetahui korelasi antara nilai RI dan PI ginjal dengan tekanan intraabdomen. Metode: Desain penelitian merupakan potong lintang dan menggunakan data sekunder. Sampel berjumlah 36 data pasien yang telah menjalani laparoskopi nefrektomi donor ginjal hidup di RSUPN Cipto Mangunkusumo RSCM dan RSCM Kencana periode Agustus 2017 hingga Januari 2018. Data pengukuran tekanan intraabdomen (mmHg), RI dan PI ginjal intraoperatif baik sebelum insuflasi baseline maupun saat insuflasi CO2 didapatkan dari rekam medik dan laporan operasi. Hasil: Setiap subjek mendapatkan tekanan insuflasi CO2 yang berbeda, dengan nilai tekanan antara 8, 9, 10, 12, 13 atau 14 mmHg saat laparoskopi. Terdapat perbedaan bermakna (p<0,001) antara rerata nilai RI dan PI ginjal baseline (0,574 dan 0,951) dibandingkan rerata RI dan PI ginjal saat insuflasi CO2 (0,660 dan 1,188). Namun tidak didapatkan adanya korelasi maupun kemaknaan secara statistik antara tekanan intraabdomen terhadap RI ginjal (r=0,16 dan p=0,349) ataupun PI ginjal (r=0,14 dan p=0,429) saat dilakukan insuflasi CO2. Kesimpulan: Tidak terdapat korelasi antara RI maupun PI ginjal dengan tekanan intraabdomen saat dilakukan insuflasi CO2 intralaparoskopi.

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Background: Increased intraabdominal pressure may decrease perfusion of various organ systems, especially intraabdominal organs with high vascularization such as kidney. The renal resistance index RI and pulsatility index PI are Doppler ultrasound US quantitative parameters which measure degree of blood flow resistance or impedance and may act as indicators of renal perfusion. Amongst literature yet there is still no data of correlation between renal RI and PI with intraabdominal pressure during CO2 insufflation on human subject. Purpose: To evaluate correlation between renal RI-PI value and intraabdominal pressure. Method: The study design is cross sectional and utilize secondary data. Thirty six samples of renal donor patients data who had undergone laparoscopic nephrectomy procedure in Cipto Mangunkusumo National General Hospital RSCM and RSCM Kencana hospital were acquired from August 2017 to January 2018. Intraoperative measurements data of intraabdominal pressure (mmHg), renal RI and PI, both before baseline and during CO2 insufflation were obtained from medical records and surgery reports. Results: Each subject received a different CO2 insufflation pressure, with a pressure value either 8, 9, 10, 12, 13 or 14 mmHg during laparoscopy. There was a significant difference (p <0.001) between mean of baseline renal RI and PI (0.574 and 0.951) compared to mean renal RI and PI during CO2 insufflation (0.660 and 1.188). There was no correlation between intraabdominal pressure with renal RI (r = 0.16 and p = 0.349) or renal PI (r = 0.14 and p = 0.429) during CO2 insufflation. Conclusion: There was no correlation between renal RI or PI with intraabdominal pressure during CO2 insufflation intralaparoscopy.

Abstrak :
Latar Belakang: Pasien pascabedah abdomen mayor seringkali berhubungan dengan terjadinya general increase permeability sindrom akibat kelebihan cairan selama selama durante operasi dan pada saat perawatan pascabedah. Tujuan dari penelitian ini adalah ingin membuktikan apakah keseimbangan cairan kumulatif, tekanan vena sentral dan rasio albumin-kreatinin urin dapat digunakan sebagai prediktor kebocoran kapiler. Metode: Penelitian ini merupakan penelitian kohort prospektif dengan subjek penelitian adalah pasien dewasa yang menjalani tindakan bedah abdomen mayor. Dilakukan pemeriksaan keseimbangan cairan kumulatif, tekanan vena sentral, rasio albumin-kreatinin urin dan indeks kebocoran kapiler, pada saat sebelum induksi anestesi, 48 jam dan 72 jam pasca bedah. Hasil: Pada penelitian ini didapatkan nilai titik potong dari indeks kebocoran kapiler 155 (AUC 0,013, sensitifitas 100% dan spesifisitas 74,50%. Analisis dengan Generalized Estimating Equations didapatkan tekanan vena sentral menujukan hubungan tidak bermakna dengan indeks kebocoran kapiler (OR 1,62 ; CI 95% = 0,92 – 2,83), sedangkan keseimbangan cairan kumulatif dan rasio albumin kreatinin urin menunjukkan hubungan yang bermakna dengan indeks kebocoran kapiler (OR = 2,561 ; CI 95% = 1,352-4,850 dan OR = 2,017 ; CI 95% = 1,086-3,749). Faktor skor SOFA terkategori sepsis juga mempunyai hubungan dengan indeks kebocoran kapiler (OR = 2,764 ; CI 95% = 1,244-6,140). Kesimpulan: Kelebihan cairan kumulatif, rasio albumin kreatinin urin dan skor SOFA terbukti dapat digunakan untuk memprediksi kebocoran kapiler.

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Background: Patients after major abdominal surgery are often associated with the occurrence of general increase in permeability syndrome due to excess fluid during surgery and during postoperative care. The purpose of this study was to prove whether cumulative fluid balance, central venous pressure and urine albumin-creatinine ratio of urine can be used as predictors of capillary leakage. Method: This study is a prospective cohort study with research subjects as adult patients undergoing major abdominal surgery. Cumulative fluid balance, central venous pressure, urine albumin-creatinine ratio and capillary leak index were examined, before anesthesia induction, 48 hours and 72 hours postoperatively. Result: In this study, a cut-off point from the capillary leak index ≥155 (AUC 0.013, sensitivity 100% and specificity 74.50%) was obtained. Generalized Estimating Equations analysis showed that the central venous pressure showed no significant relationship with the capillary leak index (OR 1.62; 95% CI = 0.92 - 2.83), while cumulative fluid balance and urine albumin : creatinin ratio showed a significant association with capillary leak index (OR = 2.561; 95% CI = 1.352-4.850 and OR = 2.017; 95% CI = 1,086-3,749) Sepsis categorized SOFA score factors also have a relationship with capillary leak index (OR = 2.764; 95% CI = 1,244-6,140). Conclusion: Cumulative fluid overload, urine creatinine albumin ratio and SOFA score have been shown to predict capillary leakage.

Abstrak :
The term ?acute abdomen? refers to a serious, often progressive clinical situation that calls for immediate diagnostic and therapeutic action. Today, diagnosis via imaging has basically replaced the physical examination in the emergency room and the Radiologist has become of primary importance in this setting. However, close co-operation among the various specialists involved is essential for successful patient management, and thus the Radiologist needs to have a full understanding of the imaging modalities and technical skills required, as well as appropriate clinical knowledge of the disorder in order to manage the condition. This book provides a comprehensive review of the multifaceted etiology, pathophysiology and clinical presentation of acute abdominal conditions, focusing on the imaging features that are relevant to a timely management approach. Numerous high-quality images, diagrams and easy-to-read tables are provided.

Abstrak :
Kelebihan lemak perut atau lemak pusat merupakan obesitas sentral. Obesitas sentral dibandingkan obesitas umum lebih berhubungan dengan resiko kesehatan yaitu penyakit kardiovaskular. Menurut data kesehatan dunia (WHO) tahun 2011 tingkat obesitas di dunia telah meningkat lebih dari dua kali lipat dibandingkan tahun 1980. Hampir 43 juta balita mengalami berat badan berlebih pada tahun 2010. Obesitas sentral dapat dinilai secara sederhana dengan melakukan pengukuran lingkar pinggang. Data pemeriksaan kesehatan berkala pekerja perusahaan PT.XYZ pada tahun 2018 menunjukkan 41.42% pekerja berusia 35 - 58 tahun yang kelebihan berat badan dan obesitas. Penelitian ini menganalisis lingkar pinggang pekerja lapangan di perusahaan PT.XYZ sebagai bentuk identifikasi potensi terjadinya risiko penyakit kardiovaskular pekerja. Desain penelitian ini adalah studi cross sectional dengan pendekatan kuantitatif observasional. Data primer mengukur lingkar pinggang, berat dan tinggi badan pekerja serta menyebar kuesioner. Data sekunder berupa hasil pemeriksaan kesehatan berkala. Hasil telitian pada 170 responden mendapatkan ukuran lingkar pinggang berlebih (> 90 cm) sebanyak 54.12%, berat badan berlebih (overweight) sebesar 39.41% dan obesitas menunjukkan 12.35%, ada hubungan faktor risiko seperti usia, tekanan darah, genetik, aktivitas fisik, durasi tidur, dan lingkar pinggang berlebih. Kata kunci: Obesitas sentral; Penyakit kardiovaskular; Ukuran lingkar pinggang; Kuantitatif Observasional; Faktor Resiko.

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Excessive abdominal fat or central fat is central obesity. Central obesity versus general obesity is more associated with health risks, namely cardiovascular disease. According to the World Health Data (WHO) in 2011 the level of obesity in the world has more than doubled compared to 1980. Nearly 43 million children under five experienced excess body weight in 2010. Central obesity can be assessed simply by measuring waist circumference. This study analyzes the waist circumference of field workers in the company PT. XYZ as a form of identifying the potential risk of cardiovascular disease in workers. The design of this study was a cross sectional study with an observational quantitative approach. Primary data measures waist circumference, worker weight, height and distributes questionnaires. Secondary data are the results of periodic health checks. The results of study on 170 respondents obtained an excess waist size (> 90 cm) as much as 54.12%, overweight (overweight) of 39.41% and obesity showed 12.35%. There is correlation between risk factors such as age, blood pressure, genetics, physical activity, sleep duration, and excessive waist circumference. Keywords: Central obesity; Cardiovascular disease; Waist circumference; Quantitative observational; Risk factors.

Abstrak :
ABSTRAK Nyeri pasca bedah abdomen adalah gabungan dari beberapa pengalaman sensori, emosional, dan mental yang tidak menyenangkan akibat trauma bedah. Walaupun nyeri telah dikelola dengan baik, kira-kira 86% pasien mengalami nyeri sedang ke hebat pasca bedah meskipun analgesik ditingkatkan. Penelitian ini bertujuan mendeskripsikan karakteristik responden (exploratory study) dan selanjutnya menjelaskan faktor-faktor yang mempengaruhi intensitas nyeri pasca bedah abdomen (explanatory study). Desain penelitian ini adalah deskriptif analitik dengan pendekatan cross sectional pada 67 orang responden pasca bedah abdomen. Pada penelitian ini digunakan instrumen State Anxiety Inventory (S-AI) Form Y untuk menilai keadaan cemas pasien pasca bedah abdomen, sikap dan keyakinan terhadap nyeri, dan skala nyeri untuk menilai intensitas nyeri pasca bedah menggunakan kombinasi Visual Analog Scale (VAS) dan Numeric Rating Scale (NRS). Hasil penelitian ini menunjukan bahwa faktor-faktor yang mempengaruhi secara signifikan terhadap intensitas nyeri pasca bedah abdomen adalah jenis kelamin (p value = 0,005), letak insisi (p value = 0,0005), dan tingkat kecemasan (p value = 0,0005). Faktor yang paling mempengaruhi intensitas nyeri pasca bedah abdomen adalah tingkat kecemasan (standardized coefficient β 0,501). Hasil penelitian ini bermanfaat bagi praktisi keperawatan sebagai acuan asuhan keperawatan dalam melakukan pengelolaan nyeri pasca bedah abdomen untuk mempertimbangkan faktor tingkat kecemasan, jenis kelamin, dan letak insisi. Rekomendasi hasil penelitian ini perlu adanya penelitian lebih lanjut dengan jumlah sampel yang lebih besar dan faktor-faktor lain yang dapat mempengaruhi nyeri.

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ABSTRACT Abdominal postoperative pain is a combined of several unpleasant sensory, emotional, and mental experience precipitated by the surgical trauma. Pain experience are influenced by many factors and it is difficult to understand and about 86% of patients experience moderate to severe pain following surgery in the hospital. The purpose of this study was to identify the characteristic of respondent (exploratory study) and to explain influencing factors of abdominal postoperative pain intensity (explanatory study). The design was an analytic description using a cross sectional for 67 respondents abdominal postoperative. In the study using State Anxiety Inventory (S-AI) Form Y instrument was used to measure the abdominal postoperative state anxiety, attitudes and beliefs about pain, and pain scale using a combined Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) was used to measure postoperative pain intensity. The finding showed that gender (p value = 0,005), incision site (p value = 0,0005), and anxiety levels (p value = 0,0005) were significantly influencing factors of abdominal postoperative pain intensity. The most influencing factor of abdominal postoperative pain intensity was anxiety levels (standardized coefficient β 0,501). This study information for nursing practitioner as reference in nursing care planning should be considered anxiety levels, gender, and incision site to management of patients with postoperative pain relief. It is recommended to conduct further research using more samples and other factors that also may alter pain reaction.

Abstrak :
Penelitian dilakukan untuk mengetahui pengaruh pemberian infus serai wangi (Cymbopogon nardus (L.) Rendle.) terhadap gambaran histologi ginjal mencit (Mus musculus L.) jantan galur DDY. Sebanyak 28 ekor mencit dibagi secara acak dalam 4 kelompok yang terdiri atas satu kelompok kontrol (KK) dan tiga kelompok perlakuan (KP1, KP2, dan KP3). Kelompok kontrol diberi akuades dan kelompok perlakuan diberi infus serai wangi dengan dosis 2%, 4%, dan 8% (b/v). Masing-masing kelompok perlakuan terdiri atas 7 ekor mencit. Pemberian bahan uji dilakukan selama 5 hari berturut-turut secara oral. Mencit dikorbankan 2 jam setelah pemberian infus terakhir. Organ ginjal diamati secara makroskopik dan mikroskopik. Sediaan histologi diwarnai dengan pewarnaan Hematoksilin Eosin (HE) dan diamati dengan menggunakan mikroskop. Hasil uji statistik menunjukkan bahwa pemberian infus serai wangi pada dosis 2% dan 4% (b/v) tidak berpengaruh terhadap rata-rata diameter kapsula Bowman, glomerulus, jarak ruang Bowman, serta berat basah organ ginjal, sedangkan pada dosis 8% (b/v) terlihat pengaruh yang nyata terhadap diameter kapsula Bowman dan glomerulus, namun tidak berpengaruh terhadap jarak ruang Bowman. ......This research was designed to study the effect of citronella grass (Cymbopogon nardus (L.) Rendle.) infusion on renal histology of DDY male mice (Mus musculus L.). The animals were randomly devided into four groups, consisted of one control group (KK) and three treatment groups (KP1, KP2, and KP3). Control group were given distilled water and the other groups were given doses of citronella grass infusion 2%, 4%, and 8% (w/v) . Each group consisted of 7 mice. The test materials were administered for 5 consecutive days orally. The mice were sacrified at two hours after the last infusion. Kidneys were observed in macroscopic and microscopic. Histology slides stained with Haematoxyline Eosin (HE) and observed with microscope. Statistic study showed that there was no effect of citronella grass infusion at dose of 2% and 4% (w/v) against the average diameter of Bowman?s capsula, glomeruli, diamater of Bowman?s space, and kidneys weight, but there was a significant effect on the average diameter of Bowman?s capsula and glomeruli at a dose of 8% (w/v).