Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya最新文献

{"title":"Overview of Survey Results of the Healthy Indonesia Program with a Family Approach In the area of Penggaron Lor, Semarang","authors":"Aisyah Lahdji","doi":"10.30651/JQM.V3I2.2612","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2612","url":null,"abstract":"ABSTRACT Health Development Index (HDI) greatly influences health status. Efforts to achieve healthy development are carried out by implementing Healthy Indonesia Program with A Family Approach (Program Indonesia Sehat dengan Pendekatan Keluarga or PIS-PK). The implementation of the PIS-PK was established with 12 main indicators, which aimed at improving the quality of life. The purpose of this study was to find out family health problems by identifying problems and analyzing the causes of health problems in the working area of Bangetayu Public Health Care (RW I, RT 5, 6, 7, 8, and 9) in Penggaron Lor, Semarang. This research is observational descriptive with a cross-sectional approach through interviews and filling in family health profile data in RW I, RT 5, 6, 7, 8, and 9. The problem obtained from the interview was an analysis of the causes of the problem using the L-Green Theory. The survey results showed that the health indexes with healthy categories consisted of 29 families, pre-healthy 113 families, and unhealthy 14 families, with three lowest indicators of PIS-PK are hypertension without regular medication (22%), no family members smoke (39%) and families join the family planning program (37%). In conclusion, there are three problems from 12 healthy family indicators occur in Penggaron Lor, which are families who participate in the family planning program, hypertensive patients who take regular medication, and no family members who are smokers. Keywords                   : PIS-PK, healthy family, Penggaron LorCorrespondence          : lahdjiaa@yahoo.com ABSTRAKDerajat Kesehatan merupakan salah satu unsur penting dalam meningkatkan Indeks Pembangunan Manusia (IPM). Upaya  mencapai pembangunan kesehatan dilakukan dengan melaksanakan Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK). Penyelenggaraan PIS-PK ditetapkan dengan adanya 12 indikator utama yang bertujuan untuk meningkatkan kualitas hidup masyarakat Indonesia, dengan mengutamakan pelayanan promotif dan preventif. Tujuan penelitian ini adalah untuk mengetahui masalah kesehatan keluarga dengan mengidentifikasi masalah dan menganalisis penyebab masalah kesehatan di wilayah kerja Puskesmas Bangetayu, RW 1 (RT 5, 6, 7, 8, dan 9), Kelurahan Penggaron Lor, Semarang. Penelitian ini termasuk deskriptif observasional dengan pendekatan cross sectional melalui wawancara dan pengisian data profil kesehatan keluarga di wilayah RW I (RT 5, 6, 7, 8, dan 9). Penyebab pada masalah yang didapatkan dari wawancara dianalisis menggunakan Teori L-Green. Hasil survei menunjukkan warga wilayah RW I (RT 5, 6, 7, 8, dan 9), Kelurahan  Penggaron Lor, Semarang berindeks kesehatan dengan kategori sehat sebanyak 29 Kepala Keluarga (KK), pra sehat 113 KK, dan tidak sehat 14 KK,  dengan 3 indikator terendah PIS-PK yaitu hipertensi yang tidak melakukan pengobatan secara teratur (22 %), anggota keluarga tidak ada yang merokok (39 %) dan keluarga mengikuti program KB (37%).  Kesimpulan penelitian ini adala","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85194349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between IFNγ+ and CTLA-4+ Tumor Infiltrating Lymphocytes In Luminal And Non-Luminal Breast Carcinoma","authors":"I. L. Parengkuan, S. Mustokoweni, Nila Kurniasari","doi":"10.30651/JQM.V3I2.2778","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2778","url":null,"abstract":"ABSTRACT The role of tumor infiltrating lymphocytes (TIL) in breast carcinoma depends on the molecular subtype, especially the expression of the estrogen receptor. A greater mutation load in the non-luminal subtype leads to continuous activation of the immune system resulting in exhausted T lymphocytes. Observational research with a cross-sectional approach was conducted on 40 formalin fixed paraffin-embedded tissue from breast carcinoma at the Anatomical Pathology Laboratory of Dr. Soetomo General Hospital Surabaya during January 2017 -  December 2018. Samples were divided into two groups based on their status of ER expression. The parameter was a positive percentage of TIL immunoreactivity against IFNγ and CTLA-4 antibodies. Percentage of IFNγ+ TIL is higher in the luminal subtype (p =0.001), whereas the percentage of CTLA-4+ TIL is higher in the non-luminal (p =0.001). These expressions were significantly correlated with the molecular subtype of breast carcinoma (p=0.001). A significant correlation between IFNγ+ and CTLA-4+ TIL were found (rs=-0.350, p=0.027). Exhausted T lymphocytes express some inhibitor molecules such as CTLA-4. CTLA-4 (Cytotoxic T-Cell Lymphocyte Associated Protein-4) suppresses immune system function including the activity of IFN-γ as an important molecule in anti-tumor immunity and forms an immunosuppressive and pro-tumor microenvironment. Different level of expressions of IFNγ+ (p=0.001) and CTLA-4 + (p=0.001) TIL were proven to be related to the molecular subtype of breast carcinoma (rs=-0.683, p=0.001; rs=0,501, p=0.001, respectively). The negative correlation between IFNγ+ and CTLA-4+ TIL shows the role of CTLA-4 as an inhibitory molecule to the immune system (rs=-0.350, p=0.027).Keywords : tumour infiltrating lymphocytes, IFNγ, CTLA-4, breast carcinoma,  luminal molecular subtypeCorrespondence to: lingkan.parengkuan@gmail.com ABSTRAK Peran tumour infiltrating lymphocytes (TIL) pada karsinoma payudara berhubungan erat dengan subtipe molekuler, terutama ada atau tidaknya ekspresi reseptor estrogen. Beban mutasi yang besar pada subtipe non-luminal menyebabkan pengaktifan sistem imun terjadi terus menerus dengan hasil akhir terbentuknya subset limfosit T yang kelelahan. Penelitian observasional analitik dengan pendekatan potong lintang ini menggunakan sampel 40 blok parafin dari penderita karsinoma payudara di Laboratorium Patologi Anatomi RSUD Dr. Soetomo Surabaya periode 1 Januari 2017 – 31 Desember 2018 yang dibagi menjadi 2 kelompok berdasarkan ada atau tidaknya ekspresi reseptor estrogen. Parameter penilaian adalah jumlah persentase TIL area tumor invasif yang terpulas positif dengan antibodi IFNγ dan CTLA-4. Ekspresi IFNγ+ TIL didapatkan lebih tinggi pada subtipe luminal (p=0,001), sedangkan ekspresi CTLA-4+ TIL didapatkan lebih tinggi pada subtipe non-luminal (p=0,001). Analisis statistik menunjukkan adanya korelasi signifikan antara ekspresi IFNγ+ TIL dengan CTLA-4+ TIL (rs=-0,350, p=0,027). Salah satu sifat dar","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83476118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance cholangiopancreatography as a diagnostic tools to diagnose biliary atresia at Dr.Soetomo hospital","authors":"Gina Noor Djalilah, Reny Widayanti, Bagus Setyoboedi, S. Arief","doi":"10.30651/JQM.V3I2.2131","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2131","url":null,"abstract":"ABSTRACT Cholestasis jaundice results from diminished bile flow and/or excretion, and caused by a number of disorders such as biliary atresia (BA). Magnetic resonance cholangiopancreatography (MRCP) is widely accepted as one of the modalities for biliary system imaging; however, liver biopsy still generally used for BA diagnosis, especially in developing countries. This aim study was to evaluate the diagnostic value of biliary atresia from MRCP compared to the result of a liver biopsy. A cross-sectional for diagnostic study documented of hospitalized patients from June 2014 to June 2015. All patients had MRCP and liver biopsy examination. The collection of data including age, gender, clinical manifestation and the result of MRCP and liver biopsy with ROC to evaluate the sensitivity and specificity was done. Liver biopsy revealed of biliary atresia was made based on proliferation, degeneration, and fibrosis of bile ducts. ROC to evaluate the sensitivity and specificity was done. The sensitivity, specificity, negative predictive value, positive predictive value of MRCP in diagnosing BA were calculated. There were 16 patients enrolled in this study with a median age of diagnosis was 6 months old (range 3-11). There were nine female patients out of the 16 patient. The median age of jaundice onset was 5 days (range 2-14 days). All patients had hepatomegaly and splenomegaly. Histopathology from liver biopsy revealed biliary atresia in 12 patients. From the ROC curve, the sensitivity of MRCP was 87.5% and specificity 62.5% with PPV 70% and NPV 80%. Five patients underwent a Kasai procedure and revealed biliary atresia. MRCP is sensitive but not specific for diagnosing BA, and MRCP has moderate sensitivity and specificity for BA diagnosis.Keyword: biliary atresia, magnetic resonance cholangiopancreatography, liver biopsy, diagnostic test.Correspondence: geendjk@gmail.com ABSTRAKIkterus dikarenakan kolestasis terjadi akibat berkurangnya aliran empedu dan/ atau ekskresi, dan dapat disebabkan oleh sejumlah gangguan seperti atresia biliaris (BA). Magnetic resonance cholangiopancreatography (MRCP) secara luas diterima sebagai salah satu modalitas untuk pencitraan sistem empedu, namun biopsi hati masih secara umum digunakan untuk diagnosis BA, terutama di negara berkembang. Studi ini bertujuan untuk mengevaluasi nilai diagnostik atresia biliaris dari MRCP ke hasil biopsi hati. Sebuah cross sectional untuk studi diagnostik didokumentasikan pasien rawat inap dari Juni 2014 hingga Juni 2015. Semua pasien menjalani MRCP dan pemeriksaan biopsi hati. Data usia, jenis kelamin, manifestasi klinis dan hasil MRCP dan biopsi hati dengan ROC untuk mengevaluasi sensitivitas dan spesifisitas dilakukan. Biopsi hati mengungkapkan atresia biliar dibuat berdasarkan proliferasi, degenerasi dan fibrosis saluran empedu. ROC untuk mengevaluasi sensitivitas dan spesifisitas yang dilakukan. Dilakukan perhitungan sensitivitas, spesifisitas, nilai prediktif negatif, nilai prediksi posi","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79929528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Large Atrial Thrombus Due To Rheumatic Heart Disease And Present Of Atrial Fibrillation With No Sign Of Stroke: How Is It Possible?","authors":"R. Alfaray, D. Ayomi, Y. Sembiring","doi":"10.30651/JQM.V3I2.2327","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2327","url":null,"abstract":"ABSTRACT  Atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism. Thromboembolism is the major complication also in patients of mitral stenosis with atrial fibrillation. A 54-year-old woman with uncontrollable movements in the right arm, stomach, right leg and painful swelling at right ankle joint was admitted to the emergency department. Transesophageal echocardiogram revealed rheumatic heart disease affecting two valves and thrombus in left atrial extending towards left atrial appendage. Heart rate was 120 beats per minute. ECG showed atrial fibrillation. A patient has undergone mitral and aortic valves replacement surgery and left atrial thrombus evacuation. Despite the involvement of two heart valves and the presence of large thrombus, the patient did not show any sign of brain infarction. This is a contradiction with a theory which implies that atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism and become stroke. This study evaluates many factors founded in the patient that make this anomaly may happen.Keywords                   : atrial fibrillation, rheumatic heart disease, thromboembolism strokeCorrespondence to      : rickyindraalfaray@gmail.comABSTRAK Atrial fibrilasi merupakan jenis aritmia yang berkaitan erat dengan stroke dan cenderung menyebabkan thromboembolism. Thromboembolism merupakan komplikasi mayor dari mitral stenosis dengan atrial fibrilasi. Seorang wanita berusia 54 tahun masuk ke unit gawat darurat dengan keluhan utama gerakan tak terkendali pada lengan kanan, perut, kaki kanan, serta bengkak yang menyakitkan di sendi pergelangan kaki kanan. Echocardiogram transesophageal menunjukan gambaran penyakit jantung rematik pada dua katup dan trombus di atrium kiri meluas menuju valve atrium kiri. Detak jantung 120 kali per menit. EKG menunjukkan fibrilasi atrium. Pasien menjalani operasi penggantian katup mitral dan aorta serta evakuasi trombus pada atrium. Meskipun terdapat abnormalitas pada dua katup jantung ditambah dengan ditemukan adanya trombus besar pada atrium, pasien tidak menunjukkan tanda-tanda infark otak. Ini bertentangan dengan teori yang mengimplikasikan bahwa atrial fibrilasi adalah aritmia paling umum yang berhubungan dengan stroke dan pada penyakit jantung reumatik. Pasien dengan fibrilasi atrium dapat dengan mudah terjadi tromboemboli hingga bermanifestasi stroke. Studi ini mengevaluasi berbagai faktor yang memungkinkan anomali kasus seperti ini dapat terjadi.Kata kunci                  : fibrilasi atrium, penyakit jantung rematik, stroke thromboemboliKorespondensi             : rickyindraalfaray@gmail.com ","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79379500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevation of Bcl2 expression in artery spiralis of pregnant Rattus novergicus infected with Tachyzoite of Toxoplasma gondii with hyperbaric oxygen therapy","authors":"Arif Rahman Nurdianto, A. Aryati, M. G. Suryokusumo, M. Mufasirin","doi":"10.30651/JQM.V3I2.2706","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2706","url":null,"abstract":"ABSTRACTSpiral artery apoptosis plays a role in the process of abortion. Low Bcl2 expression found in abortion and in spiral artery. In pregnancy, Toxoplasmosis infection is found to increase apoptosis in spiral arteries. Hyperbaric Oxygen Therapy (HBOT) improves the expression of Bcl-2. This study aims to determine the effects of Hyperbaric Oxygen therapy in enhancing the expressions of Bcl2 in artery spiralis of pregnant rats infected with tachyzoite of Toxoplasma gondii. This is an experiment with a ‘randomized control group of post-test only design’ on 37 Rattus novergicus Sprague Dawley rats. Rats were divided into four groups. The group A is pregnant rats infected with 103 tachyzoites via intraperitoneal injection and received 10 sessions of HBOT 2.4 ATA in 3x30 minutes. Group B is pregnant only and received HBOT. Group C is pregnant and infected with tachyzoite but did not received HBOT. And the last, Group D is pregnant rats with no infection and did not received HBOT. Examinations of Bcl2 expressions were performed on day-5 after HBOT (twice a day). The Bcl2 expression was measured with immunohistochemistry. All data were tested with One-way ANOVA from SPSS 21.  There is an increased expression of Bcl2 spiralis artery in the Group A. There was a significant difference between Group A and Group C with a value of p=0.042. HBOT can increase the expression of Bcl2 from the spiral arteries of rats, in the provision of HBOT 2.4 ATA for 3x30 minutes, 10 times in 5 days.Keywords: Toxoplasma gondii, tachyzoite, Hyperbaric Oxygen Therapy, Bcl2, spiralis arteryCorrespondence to: didins99@gmail.com  ABSTRAK Apoptosis arteri spiralis berperan dalam proses aborsi. Ekspresi Bcl2 rendah ditemukan pada aborsi dan di arteri spiral. Pada kehamilan, infeksi Toxoplasmosis ditemukan meningkatkan apoptosis pada arteri spiralis. Terapi Oksigen Hiperbarik (HBOT) meningkatkan ekspresi Bcl-2. Ini adalah penelitian eksperimental dengan desain post-test only pada 37 hamil Rattus novergicus Sprague Dawley, maka tikus dibagi menjadi 4 kelompok. Grup A HBOT adalah tikus hamil yang terinfeksi tachyzoite yang menerima terapi 10 sesi HBOT 2.4 ATA dalam 3x30 menit; kelompok B adalah Hamil saja dan tidak mendapat HBOT; kelompok C Hamil dan terinfeksi tachyzoite T.gondii tetapi tidak menerima HBOT; dan kelompok D adalah tikus hamil normal. Setiap tikus hamil yang terinfeksi diberi 103 Tachyzoite Toxoplasma gondii melalui intraperitoneal. Pemeriksaan ekspresi Bcl2 dilakukan pada hari ke-5 setelah HBOT (dua kali sehari). Tikus terbunuh dan kadar Bcl2 Arteri spiralis diukur dengan pemeriksaan Immunohistokimia. Semua data dianalisis dengan uji ANOVA dengan Program SPSS 21. Pada studi ini menunjukkan terapi Oksigen Hiperbarik dapat meningkatkan Ekspresi Bcl2 Arteri Spiralis dengan dosis 2.4 ATA selama 3x30 menit dalam 10 sesi selama 5 hari terapi. Studi ini menyimpulkan bahwa HBOT dapat meningkatkan ekspresi Bcl2 dalam arteri spiralis, dalam pemberian HBO 2.4 ATA selama 3x30 meni","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89183237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical and histopathological aspect of the liver, lung, and kidney in Malaria","authors":"Syafarinah Nur Hidayah Akil","doi":"10.30651/JQM.V3I2.2833","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2833","url":null,"abstract":"Malaria is an infectious disease with worldwide distribution. The symptom ranges from asymptomatic to severe malaria that could cause mortality. Sequestration and rosetting in the capillaries of several organs in combination with the host inflammatory and immune response could cause multi-organ dysfunction including brain, liver, lung, kidney, etc. This review is to summarize the clinical and histopathological aspect of the disease, especially in lung, liver, and kidney. The clinical importance of severe malaria in the lung are acute lung injury or acute respiratory distress syndrome, jaundice in the liver, and acute kidney injury in the kidney. The histopathological change, in general, is the sequestration of infected erythrocytes in the capillaries of the organ. In the lung, the main changes are seen especially the septa. While in the liver, there are various changes including Kupffer cells hyperplasia, the proliferation of portal tract and bile duct, etc. In the kidney, the changes are in the glomerulus, tubules, and interstitial.","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84740818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Hypersensitivity in Daily Practice","authors":"Gatot Soegiarto","doi":"10.30651/JQM.V3I2.2781","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2781","url":null,"abstract":"ABSTRACTAdverse drug reactions can affect up to 25% of outpatients and 10–20% of hospitalized patients. They are an important public health issue due to the potential of fatal outcomes. They are increasingly common in daily practice, but ascertaining whether the adverse reaction is a true allergic reaction to the drug is not easy. Drug hypersensitivity encompasses a spectrum of immunologically and non-immunologically-mediated reactions with varying mechanisms and clinical presentations. Factors associated with an increased risk of developing a drug hypersensitivity include patient-related factors, treatment regimen-related factors, and drug-related factors.  Diagnosis of drug hypersensitivity relies on a careful history and physical examination and, in some instances, in vivo and in vitro testing and drug provocation tests. The most effective strategy for the management of drug allergy is avoidance and discontinuation of the offending drug(s). Alternative medications with unrelated chemical structures should be given. Additional therapy is largely supportive which includes nutritional support, fluid replacement, and symptomatic which may include topical corticosteroids, oral antihistamines and, in severe cases, systemic corticosteroids. This article will discuss the classification of adverse reactions to drugs, professional steps that can be taken by a physician in prescribing drugs, minimizing the risk of adverse drug reactions, approach to diagnosis, and managing drug hypersensitivity cases in daily practice.Keywords: drug reaction, drug hypersensitivity, drug allergyCorrespondence to: gatotsby@yahoo.com ABSTRAKReaksi efek samping obat dapat mengenai sekitar 25% pasien rawat jalan dan 10-20% pasien rawat inap. Reaksi efek samping obat adalah masalah kesehatan masyarakat yang penting karena berpotensi fatal. Hal tersebut semakin umum dijumpai dalam praktek sehari-hari, tetapi memastikan apakah reaksi efek samping tersebut adalah reaksi alergi yang sebenarnya terhadap obat itu tidaklah mudah. Hipersensitivitas obat mencakup spektrum reaksi yang dimediasi secara imunologis dan non imunologis dengan berbagai mekanisme dan presentasi klinis. Faktor-faktor yang terkait dengan peningkatan risiko terjadinya hipersensitivitas obat meliputi faktor terkait pasien, faktor terkait regimen pengobatan, dan faktor terkait obat. Diagnosis hipersensitivitas obat bergantung pada anamnesis dan pemeriksaan fisik yang cermat dan, dalam beberapa kasus, tes in vivo dan in vitro dan tes provokasi obat. Strategi yang paling efektif untuk pengelolaan alergi obat adalah penghindaran dan penghentian obat-obatan tersebut. Obat-obatan alternatif dengan struktur kimia yang tidak terkait harus diberikan. Terapi terapi suportif yang mencakup dukungan nutrisi, penggantian cairan, dan gejala yang mungkin termasuk kortikosteroid topikal, antihistamin oral dan, dalam kasus yang parah, kortikosteroid sistemik dapat diberikan. Artikel ini akan membahas klasifikasi reaksi efek samping","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83170853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015","authors":"Suyenci Limbong, D. Utomo","doi":"10.30651/JQM.V3I2.2590","DOIUrl":"https://doi.org/10.30651/JQM.V3I2.2590","url":null,"abstract":"ABSTRACT Osteoarthritis (OA) of the knee is a disruption in the knee joint which is characterized by pathological changes in the structure in the knee joint that occur progressively. High Tibial Osteotomy (HTO) is a therapeutic option for treating isolated medial compartment OA in varus genu and one of the routine surgical procedures performed in the orthopedic field. As the number of OA cases increases, the number of high tibial osteotomy (HTO) procedures also increases, so clinical evaluation is needed to see whether HTO can meet patient expectations. This study was a retrospective descriptive study with a sample of patients who had undergone the 2010 to 2015 open wedge high tibial osteotomy (OWHTO) procedure. The evaluation used the Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, and Modified Hospital instruments for Special Surgery Knee Scoring. The data obtained are then grouped and analyzed to calculate the average of each instrument. The results showed a sample of 6 knees consisting of 2 male samples (33.3%) and 4 female samples (66.7%). All samples are over 35 years old. The evaluation results using KOOS scores obtained the mean value of the pain component was 77.7; complaint component = 70.3; daily activity component = 76.2; sports and recreation components = 47.9; and components of quality of life = 74.1. On the SSC score, the average knee score was 70.8 and the average functional score was 61.6. Whereas the HSS score obtained by the average functional score is 81.5. This study produced each score with a good average value. This shows that the choice of the High Tibial Osteotomy operating technique provides satisfactory operating results. So that the High Tibial Osteotomy surgery technique can be an option in the case of Osteoarthritis. With the many choices of types of surgery in patients with Osteoarthritis, the High Tibial Osteotomy can be a good choice for patient satisfaction. Keywords: Osteoarthritis, High Tibial Osteotomy, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, Modified Hospital for Special Surgery Knee ScoringCorrespondence to: liliosanci@gmail.com ABSTRAK Osteoartritis (OA) lutut adalah gangguan pada sendi lutut yang ditandai oleh perubahan patologis pada struktur di dalam sendi lutut yang terjadi secara progresif. High Tibial Osteotomy (HTO) merupakan pilihan terapi untuk penanganan isolated medial compartement OA pada genu varus dan salah satu prosedur operasi yang rutin dilakukan di bidang orthopedi. Dengan meningkatnya jumlah kasus OA meningkat pula jumlah prosedur high tibial osteotomy (HTO), sehingga perlu dilakukan evaluasi klinis untuk melihat apakah HTO dapat memenuhi harapan pasien. Penelitian ini merupakan penelitian deskriptif retrospektif dengan sampel pasien yang telah menjalani prosedur open wedge high tibial osteotomy (OWHTO) 2010 sampai 2015. Evaluasi menggunakan instrument Knee Society Score, Knee Injury and Ostoarthritis Outcome Score, dan Modified Hospital for Spe","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87226298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role Of Denosumab","authors":"R. Utama, Hesty Rohmatul Fajri","doi":"10.30651/jqm.v3i2.2807","DOIUrl":"https://doi.org/10.30651/jqm.v3i2.2807","url":null,"abstract":"ABSTRACT  Osteoporosis is one of the most common chronic diseases. This condition makes bones in a person to become more porous and fragile, therefore greatly increase their risk of suffering a fracture. In Asia, the mortality rate that are associated with these fractures occurred between 10–20% of cases within a year.  Osteoporosis is a condition in which there is an imbalanced activity between osteoblast and osteoclast. Osteoblast and osteoclast are two types of bone cells that majorly involve in bone remodelling process. Osteoclasts adhere to the bone surface once it mature, after that osteoclast both produce and secrete chloride acid (HCl), which will acidify bones and dissolve the bone mineral. Receptor Activator of Nuclear Factor kappa B Ligand (RANKL) is one of the necessary  factors in bone remodelling process. It will activate and mature the osteoclast. Denosumab is a monoclonal antibody that will inhibit  the binding of RANKL to its receptor, decreasing osteoclastogenesis and bone-resorbing activity.  This inhibiting activity will theoretically increase the bone mass density in ones’ body, ergo will treat and prevent osteoporosis. Denosumab showed favourable effect on bone metabolism without having serious adverse events compared to control group. This paper reviews the clinical pharmacology, pharmacokinetic and pharmacodynamic properties, and tolerability in the denosumab in the management of osteoporosis.Keywords                   : Denosumab, RANKL, osteoporosis, treatmentCorrespondence to      : radityapu@gmail.comABSTRAK  Osteoporosis adalah salah satu jenis dari penyakit kronis yang sering terjadi. Penyakit ini menyebabkan tulang seseorang menjadi lebih berongga dan rapuh, kondisi ini meningkatkan risiko patah tulang pada orang-orang tersebut. Di Asia, mortality rate yang berhubungan dengan kejadian patah tulang ini berkisar antara  10 – 20% dalam satu tahun. Osteoporosis adalah suatu kondisi dimana terjadi ketidakseimbangan antara osteoblast dan osteoklas. Osteoblas dan osteoklas adalah dua tipe dari sel tulang yang berperan pada proses bone remodelling. Setelah matang, osteoklas akan menempel pada tulang untuk menghasilkan dan menyekresi HCl, yang dimana zat ini akan mengasamkan tulang dan meluruhkan mineral di tulang.  Receptor Activator of Nuclear Factor kappa B Ligand (RANKL) adalah salah satu faktor yang dibutuhkan dalam proses remodelling tulang. RANKL akan mematangkan dan mengaktifkan osteoklas. Denosumab adalah antibody monoclonal yang menghambat ikatan dari RANKL kepada reseptor dari RANKL, menurunkan proses osteoklasogenesis dan aktivitas penyerapan tulang. Secara teori proses ini akan meningkatkan massa dari tulang dan mencegah osteoporosis. Denosumab menunjukan efek yang sbaik pada metabolisme tulang tanpa menunjukkan efek samping yang serius. Makalah ini akan meninjau tentang farmakologi klinis, farmakodinamik , dan farmakokinetik, serta tolerabilitas dari denosumab dalam terapi osteoporosis.Kata kunci               ","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87885090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faktor-Faktor yang Memengaruhi Kejadian Plebitis di Ruang Marwah RSU Haji Surabaya","authors":"Sukadiono Sukadiono, Ika Novianti, Musrifatul Uliyah, Dede Nasrullah","doi":"10.30651/jqm.v3i1.9175","DOIUrl":"https://doi.org/10.30651/jqm.v3i1.9175","url":null,"abstract":"Intravenous therapy is the installation of an invasive device into a vein during a patient undergoing treatment in the hospital. One of the complications of intravenous therapy 5% - 70% is the incidence of plebitis. The incidence of plebitis in government hospitals is 50.11%. In Haji Hospital Surabaya, the incidence of plebitis is a problem in patients who receive intravenous therapy in the hospital. The purpose of this study is to analyze the existence of factors that influence the incidence of plebitis. Methods: this study uses analytic design that is observational. The population was all patients who received intravenous therapy in the Marwah Room of the Hajj Hospital Surabaya. The sample of the research by probabability sampling is simple random sampling design with 82 respondents. Research variables include age, location of installation, type of fluid and duration of infusion. The instruments used were interviews and document studies. Data analysis using Linear Regression test with R Square = 0.3 and significance significance α = 0.05. Result & Discussion: The results of the study of age (0.345), and the type of infusion fluid (0.305) had no influence on the incidence of plebitis, whereas the location of infusion (0.020), and the length of day of infusion (0.000) influenced the incidence of plebitis. Conclusions from the study of the location of the installation factors and the duration of infusion installation affect the incidence of plebitis. Thus it is necessary to hold training related to how to prevent plebitis.","PeriodicalId":31682,"journal":{"name":"Qanun Medika Jurnal Kedokteran Fakultas Kedokteran Universitas Muhammadiyah Surabaya","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87996809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}