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"ABSTRAKLatar belakang dan tujuan: Pioderma superfisialis (PS) masih menjadi masalahkesehatan di Indonesia dengan jumlah kunjungan yang masih tinggi di PoliklinikKulit dan Kelamin Rumah Sakit Cipto Mangunkusumo (PKK-RSCM). Saat inipengobatan topikal lini pertama adalah asam fusidat 2% sedangkan penggunaanmupirosin 2% dibatasi. Beberapa penelitian terdahulu memperlihatkan resistensiterhadap asam fusidat 2% dan mupirosin 2%. Penelitian ini bertujuan untukmembandingkan efektivitas mupirosin 2% dengan asam fusidat 2% terhadapkesembuhan klinis PS di PKK-RSCM.Metode: Uji klinis acak buta ganda dilakukan terhadap 42 pasien PS usia 12-59tahun di PKK-RSCM. Setelah pemeriksaan bakteriologis, setiap subjekmendapatkan satu jenis krim antibiotik untuk dioleskan selama tujuh hari. Evaluasiklinis didasarkan pada pengurangan luas lesi dan skala nyeri. Pemeriksaan biakandan resistensi dilakukan di Laboratorium Mikrobiologi Klinik UniversitasIndonesia.Hasil: Efektivitas krim mupirosin (kelompok M) adalah 83,3% dan krim asamfusidat (kelompok AF) 40% (p=0,048), sedangkan persentase penurunan luas lesikelompok M sebesar 83,5% dan kelompok AF 60,7% (p=0,041). Tidak ditemukanefek samping subjektif maupun objektif pada kedua kelompok. Pada biakan kuman,54,8% sampel ditemukan 2 jenis kuman, jenis terbanyak adalah S.aureus danS.pyogenes. Sebagian besar S.aureus (78,8%, 75,8%) dan S.pyogenes (50%,94,4%)memiliki kepekaan intermediet terhadap mupirosin 2% dan asam fusidat 2%.Kesimpulan: Krim mupirosin 2% lebih efektif daripada krim asam fusidat 2%terhadap PS.Kata kunci: mupirosin 2%, asam fusidat 2%, kesembuhan klinis, luas lesi, skalanyeri

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ABSTRACTBackground and objectives: Superficial pyodermas (SP) are common healthproblem in Indonesia with high incidence in the Dermatovenereology OutpatientClinic Dr. Cipto Mangunkusumo Hospital (DV-CMH). Current guidelines endorses2% fusidic acid as the first line topical therapy, while 2% mupirocin is reserved forcertain condition. Past studies demonstrated increasing resistance to 2% fusidic acidand 2% mupirocin. This study aims to compare the effectiveness of 2% mupirocinand 2% fusidic acid in SP treatment in our institution.Methods: A double-blind randomized controlled trial was conducted on 42 SPpatients aged 12-59 years old in DV-CMH. Following bacteriologic examination,each subject received a random antibiotic cream for seven days. Clinical evaluationwas determined by reduction of lesion size and pain scale. Bacteriologic culture andsusceptibility test were performed in Clinical Microbiology Laboratory Universityof Indonesia.Results: The effectiveness in 2% mupirocin group (M) was 83,3% and in 2%fusidic acid group (FA) 40% (p=0,048). Lesion size decrease was 83.5% in M groupand 60.7% in FA group (p=0,041). No side effects were observed in both treatmentgroups. At the bacteria culture , 54.8 % of the samples found two types of bacteria,most types are S.aureus and S.pyogenes. Most of S.aureus (78,8%, 75,8%) andS.pyogenes (50%,94,4%) have an intermediate susceptibility to 2 % mupirocin and2% fusidic acid.Conclusion: The 2% mupirocin cream was more effective than 2% fusidic acidcream in SP treatment.Keywords: 2% mupirocin, 2% fusidic acid, clinical cure, lesion size, pain scale"

"Dampak dari hospitalisasi pada anak diantaranya adalah stres. Stres ini timbul karena anak takut akan tindakan invasif, cemas berpisah dengan orang tua serta karena nyeri. Tindakan invasif yang didapat anak selama hospitalisasi sering menimbulkan trauma berkepanjangan. Salah satu prosedur invasif yang dilakukan bagi anak adalah terapi melalui intra vena.Tindakan ini menimbulkan nyeri. Upaya untuk managemen nyeri ada farmakologis dan non farmakologis. Tindakan non farmakologis yang bisa dilaksanakan oleh perawat diantaranya dengan memberikan stimulasi kulit. Stimulasi kulit yang diupayakan antara lain dengan menggunakan kompres es batu. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian kompres es batu terhadap tingkat nyeri anak usia pra sekolah yang dilakukan prosedur pemasangan infus. Penelitian ini menggunakan studi quasi eksperimen dengan rancangan Nonequivalent control group, after only design. Sampel penelitian berjumlah 64 anak yang dilakukan pemasangan infus di rumah sakit dr. Cipto Mangunkusumo Jakarta. Sampel dibagi menjadi 2 kelompok, 32 anak sebagai kelompok intervensi, 32 anak sebagai kelompok kontrl. Instrumen yang digunakan dalam pengumpulan data berupa 1 kuesioner dan 1 lembar observasi dengan menggunakan skala Wong Baker Pain Faces. Instrumen berupa lembar kuesioner.

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Distress is a negative effect during hospitalization on children. invasive procedures, separation anxiety and painful which cause considerable child distress. Invasive procedures during hospitalization continuesly distress. Intrusive proce ures such as venipuncture are well understood as a stressfull event for children. Pain management were pharmacological and non pharmacological. Cutaneus stimulation is a non pharmacological theraphy to reduce venipuncture related pain and can be performed by nurses. Ice cube is cutaneus stimulation. The purpose of this study was determining the effect of ice cube prior to venipuncture on pain related responses in preschool age child. This study is quasi experiment with nonequivalent control group after only design. The subject were 64 preschool child selected by purposive sampling. Two groups were chosen for this study: 32 the test and 32 control group. Pain responses were measured using Wong Baker faces Pain Scale and confounding factor were measured using quesionaire. After homogeneity test this study analyzed with chi square. Result showed that ice cube reduced pain on preschool age child who were venipuncture, 83,3% mild pain with icecube and 16,7% mild pain without ice cube on p=0.01, α < 0,05. Ice cube efficient and effective for cutaneus stimulation. Pediatric nurse could apply ice cube for atraumatic care on venipuncture procedures. Sex, ethnic, member of family present, and child experience did not effect pain relieve in children. Child fear significantly effect for pain relieve in preschool age child ."

"Nyeri merupakan salah satu permasalahan yang banyak dialami populasi geriatri di dunia dan menimbulkan penurunan kualitas hidup, fungsionalitas, serta beban sosioekonomi yang besar. Polifarmasi, tingginya angka kejadian demensia dan gangguan kognitif lain, serta meningkatnya sensitivitas terhadap obat analgesi menyebabkan rentannya populasi geriatri mendapatkan penanganan nyeri yang tidak adekuat. Penanganan nyeri yang tidak adekuat ini disertai berbagai perubahan fisiologis pada populasi geriatri meningkatkan risiko terbentuknya nyeri kronik, kerentaan, depresi dan ansietas, peningkatan morbiditas, serta penurunan kualitas hidup dan fungsionalitas. Populasi geriatri diperkirakan terus meningkat tiap tahunnya baik di Indonesia dan dunia; hal ini disertai dengan sulitnya pemberian analgesi yang adekuat menyebabkan perlunya penanganan nyeri yang efektif dan aman. Berbagai penelitian menunjukkan akupunktur dapat menurunkan nyeri pada populasi geriatri. Studi berupa telaah sistematis ini bertujuan untuk memaparkan peran akupunktur dalam menurunkan skala nyeri pada pasien geriatri dengan nyeri akut. Dilakukan pencarian literatur secara sistematis pada sumber data Google Scholar dan PubMed menggunakan kata kunci acupuncture, manual acupuncture, electroacupuncture, laserpuncture, laser acupuncture, ear acupuncture, battlefield acupuncture, pain, dan acute pain. Setelah studi yang didapatkan disingkirkan duplikasinya serta dipilah berdasarkan kriteria inklusi dan eksklusi, didapatkan tujuh studi yang digunakan dalam pembahasan; dengan skala nyeri yang digunakan mencakup Visual Analog Scale (VAS), Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), dan Brief Pain Inventory (BPI). Dilakukan penilaian kualitas studi menggunakan Cochrane Risk of Bias Tool ver. 2, dan metode Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) dan didapatkan secara umum studi yang didapatkan memiliki kualitas yang baik. Berdasarkan hasil dari ketujuh studi tersebut didapatkan bahwa pemberian akupunktur dapat menimbulkan penurunan skala nyeri VAS, NRS, MPQ, dan BPI yang signifikan baik secara statistik maupun klinis. Selain itu, didapatkan pula akupunktur dapat menurunkan kebutuhan obat-obat analgesi terutama opioid, serta aman untuk digunakan pada pasien geriatri dengan nyeri akut.

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Pain is one of the problems commonly found in geriatric population in the world; pain caused reduction in quality of life and functionality, and increase in socioeconomic burden. Polypharmacy, increase in dementia and other cognitive impairments, and increased sensitivity to analgesics side effects made the geriatric population vulnerable to inadequate analgesia. Inadequate analgesia coupled with various physiological changes in geriatric population increase the risk of forming chronic pain, frailty, depression and anxiety; increase morbidity, and reduce quality of life and functionality. It is estimated that the number of geriatric population will continue to increase in the future, whether in the world or in Indonesia. With the continuously increasing population and difficulty in giving an adequate analgesia, a form of pain management that is effective and safe for geriatric patients with acute pain is required. Many studies showed that acupuncture is effective and safe in the pain management of geriatric patients. This systematic review was done in order to explain the role of acupuncture in reducing pain scale scoring in geriatric patients with acute pain. Systematic literature searching was done using the keyword acupuncture, manual acupuncture, electroacupuncture, laserpuncture, laser acupuncture, ear acupuncture, battlefield acupuncture, pain, and acute pain. with Google Scholar and PubMed as database. After eliminating duplications and applying the inclusion and exclusion criteria, seven studies was found and used for analysis. The studies used in the analysis used Visual Analog Scale (VAS), Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), and Brief Pain Inventory (BPI). Quality assessment of the studies used in analysis was done using Cochrane Risk of Bias Tool ver. 2 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE); it was found that overall the quality of the studies used was good. Based on the analysis acupuncture was found to reduce pain scale scoring of VAS, NRS, MPQ, and BPI significantly, whether statistically or clinically. Acupuncture was also found to reduce analgesic requirements, especially opioids, and is safe to be given in geriatric patients with acute pain."

"ABSTRAKHambatan mobilitas fisik merupakan terbatasnya pergerakan pada satu atau lebih anggota tubuh. Hambatan mobilitas fisik berdampak pada penurunan status fungsional, sehingga lansia menjadi ketergantungan. Model intervensi Lentera Yoga Aktif merupakan bentuk intervensi keperawatan yang dapat mencegah dan mengatasi masalah hambatan mobilitas fisik pada lansia. Penulisan bertujuan memberikan gambaran pelaksanaan model intervensi Lentera Yoga Aktif yang terintegrasi dalam pelayanan dan asuhan keperawatan komunitas melalui integrasi teori dan model community as partner, family centered nursing, konsekuensi fungsional, dan fungsi manajemen pada lansia dengan masalah hambatan mobilitas fisik di Kelurahan Curug, Kecamatan Cimanggis, Kota Depok. Metode yang digunakan adalah studi kasus dan evidence based practice. Hasil intervensi menunjukkan model intervensi Lentera Yoga Aktif berpengaruh signifikan dalam meningkatkan status fungsional dan kekuatan otot p=0,000 , menurunkan risiko jatuh dan skala nyeri p=0,000 , meningkatkan pengetahuan, sikap, dan tindakan p=0,000 . Model ini merupakan peluang bagi perawat komunitas untuk mengembangkan upaya promotif dan preventif. Model intervensi ini direkomendasikan untuk lansia karena gerakan telah dimodifikasi sesuai dengan kondisi dan keadaan lansia, bisa dilakukan secara mandiri ataupun berkelompok. Kata Kunci: hambatan mobilitas fisik, status fungsional, kekuatan otot, risiko jatuh, skala nyeri, lansia

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ABSTRACTImpaired physical mobility is the limited physical movement of the body or of one or more extremities. Constraints of physical mobility have an impact on the decline in functional status, so the older people become dependent. The intervention model of ldquo Lentera Yoga Aktif rdquo is a form of nursing intervention that can prevent and overcome the problem of physical mobility barriers in the older people. The aims of this report to provide an overview of the implementation of Lentera Yoga Aktif model integrated in community care and nursing care through integration of theories and models of community as partners, family centered nursing, functional consequences, and management functions in the elderly with problems of impaired physical mobility in Curug, Cimanggis, Depok City. The case study and evidence based practice was used. The results of the intervention showed that the Lentera Yoga Aktif model significantly improving functional status and muscle strength p 0,000 , decreased risk of fall and pain scale p 0,000 , increased knowledge, attitude, and skill p 0,000 . This model an opportunity for community health nurses to develop promotive and preventive interventions. This intervention model is recommended for the older people because the sequences has been modified suitable and fit with the conditions of the older people, can be done independently or in groups. Keywords impaired physical mobility, functional status, muscle strength, risk of fall, pain scale, older people"

"ABSTRAK Menemukan suatu metode pengukuran objektif mengenai rasa sakit pada anak merupakan tantangan bagi dokter gigi anak selama melakukan perawatan. Wong Baker Faces Pain Scale adalah instrumen pengukur rasa sakit metode self report yang telah teruji validitas dan reliabilitasnya. Alfa amilase saliva adalah biomarker dalam saliva yang dipengaruhi oleh sistem saraf simpatis dalam eksresi nya. Prosedur anestesi lokal injeksi dapat menimbulkan rasa sakit pada anak. Rasa sakit menstimulasi sistem saraf simpatis akibat adanya stimulus noksius pada reseptor. Tujuan penelitian ini adalah untuk menganalisa hubungan kadar alfa amilase saliva dengan skor Wong Baker Faces Pain Scale pada anak saat mendapatkan anestesi lokal injeksi selama prosedur ekstraksi gigi sulung. Kadar alfa amilase saliva diukur dengan menggunakan portable device Nipro Cocoro meter, yang teruji memiliki nilai pengukuran mendekati analisis laboratoris. Kadar Alfa amilase saliva pertama diukur sesaat setelah injeksi anestesi lokal, dilanjutkan dengan pengukuran kedua pada waktu 10 menit setelah injeksi. Anak diminta menunjukkan rasa sakit yang dirasakan pada saat injeksi anestesi lokal dengan menggunakan instrumen Wong Baker Faces Pain Scale. Analisis data menggunakan uji Spearman. Nilai alfa amilase saliva ditemukan berkorelasi positif dengan skor Wong Baker Faces Pain Scale p le;0,05 dengan koefisien korelasi r=0.445 . Penelitian ini menunjukkan bahwa alfa amilase saliva berkorelasi dengan rasa sakit pada saat pemberian anestesi lokal injeksi sehingga diharapkan alfa amilase saliva dapat digunakan sebagai biomarker akan rasa sakit.ABSTRACT Finding an objective measurement of pain is a challenge for pediatric dentist. Wong Baker Faces Pain Scale is commonly used instrument to assess pain intensity in children. Salivary alpha amylase is biomarker in saliva which secreted by stimulation of sympathetic nervous system. Local anesthesia injection procedure stimulate pain in children. The aim of this study was to analyze the correlation between Wong Baker Faces Pain Scale and Salivary Alpha Amylase level during primary tooth extraction procedure with local anesthetic injection in children aged 6 12 years. From all children, saliva was collected with a disposable saliva strip, shortly after local anesthetic injection and at 10 minutes after injection. Level of salivary alpha amylase then determined using portable Nipro Cocoro Meter device. The Wong Baker Faces Pain Scale was measured at the same time. The correlation between Wong Baker Faces Pain Scale and salivary alpha amylase level was analyzed with Spearman Correlation test. There was a significant correlation between Wong Baker Faces Pain Scale and Salivary Alpha Amylase level p le 0,05 with correlation coefficient r 0.445 . This study showed that salivary alpha amylase was correlated with pain during procedure of anesthesia local injection. Our data suggest that salivary alpha amylase level might be a good index for objective pain intensity assessment."

"Latar Belakang : Metastasis tulang merupakan masalah pada pasien kanker paru karena memperburuk prognosis dan kualitashidup. Nyeri merupakan salah satugejala yang paling umum. Tatalaksana metastasis tulang pada pasien kanker paru meliputi terapi pada tumor primer, radioterapi pada lesi metastasis dan pemberian ibandronic acid.Metode : Penelitian ini merupakan studi retrospektif. Kami mencatat pasien kanker paru bermetastasis tulang dan dirawat di rumah sakit pusat rujukan respirasi nasional Persahabatan Jakarta dari tanggal 1 Januari 2016 sampai 30 Juni 2018. Tujuan penelitian ini untuk mengevaluasi penurunan nyeri kanker yang berhubungan dengan metastasis tulang. Semua pasien menerima terapi ibandronic acid 6 mg intravena setiap bulan dan diukur skala nyerinya dengan menggunakan Visual Analogue Scale (VAS). Selain mendapat terapi ibandronic acid, setiap pasien juga mendapatkan modalitas terapi nyeri kanker lain seperti analgetik, radioterapi atau kombinasi keduanya. Hasil : Lokasi lesi kanker paru bermetastasis ke tulang paling sering (dari 51/71 pasien) adalah vertebra 74 (43,79%), toraks 55 (32,54%) dan pelvis 28 (17,75%). Rerata jumlah pemberian ibandronic acid adalah 8 kali pemberian. Rentang waktu pemberian ibandronic acid dari tegak jenis adalah 6 bulan. Nyeri VAS setelah pemberian ibandronic acid berturut-turut nyeri VAS ringan (VAS 1-3) 14 (27,54%), nyeri VAS sedang (VAS 4-6) 37 (72,46%) dan nyeri berat (VAS 7-10) 0 (0%). Total waktu penurunan nyeri setelah pemberian ibandronic acid adalah 4 bulan. Rerata penurunan nyeri VAS pada grup nyeri VAS ringan-sedang terjadi setelah 5 kali pemberian sedangkan rerata penurunan grup nyeri VAS berat setelah 1 kali pemberian (p = 0.0001). Terdapat beberapa kejadian efek samping setelah pemberian ibandronic acid yang ditemukan pada 9 dari 51 subjek antara lain 2 (3,9%) ruam kulit, 3 (5,9%) mual dan muntah, 3 (5,9%) sakit kepala dan 1 (2,0%) demam.Kesimpulan : Terapi ibandronic acid sangat bermanfaat untuk menurunkan nyeri kanker pada pasien kanker paru bermetastasis ke tulang

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Background: Bone metastasis (BM) is one of the problems in lung cancer because it affects the prognosis and quality of life. Pain is most common symptom. The management of bone metastasis (BM) in lung cancer are treatment of primary cancer lesion, radiotherapy on the metastatic lesions and ibandronic acid.

Method : In this retrospective study, lung cancer patients with BM and treated in Persahabatan National Respiratory Referral Hospital, Jakarta, between January 1st 2016 and June 30th 2018 were enrolled. The aim of study was to evaluate the efficacy of ibandronic acid in the treatment of cancer pain caused by BM. All of patients received ibandronic acid 6 mg (intravenously) monthly and Visual Analogue Scale (VAS) was used to evaluate pain. All patients received other management cancer pain such as analgesics, radiotherapy or combination.

Results : Most BM lesions (51/71 cases) were located in vertebra 74 (43,79%), thoracic cage 55( 32,54%) and pelvic 28 (17,75%). The averages of administration of ibandronic acid 6 mg iv was 8 times. The mean time-to-treat of ibandronic acid since the first time of lung cancer diagnosis was 6 months. VAS pain scale after administration of ibandronic acid was classified to mild pain (VAS 1-3) 14 cases (27,54%), moderate pain (VAS 4-6) 37 cases (72,46%) and severe pain (VAS 7-10) 0 cases. Overall the decrease in VAS scale was seen after 4 times ibandronic acid administration. Pain was significantly improved after the fifth administration in patients which initially suffered from moderate to mild pain and was significantly improved immediately after the first administration in patients which initially suffered from severe pain (p=0,0001). The side effects caused by ibandronic acid was observed in 9 patients, in which 2 subjects (3,9%) had a rash skin, 3 subjects (5,9%) suffered nausea and vomiting, 3 subjects (5,9%) had headache, and 1 subject (2,0%) fever.

Conclusion : Ibandronic acid treatment was useful to relieve metastatic bone pain in lung cancer patients."