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"Latar Belakang: Hingga saat ini masih terjadi kerancuan penegakkan diagnosis sepsis pada praktik klinik sehari-hari. Belum diketahui performa seluruh kriteria diagnosis sepsis yang telah ada dan performa modifikasi kriteria diagnosis sepsis berdasarkan kenaikan sistem skor modified Sequential Organ Failure Assessment (MSOFA) sebagai pengganti sistem skor SOFA yang membutuhkan pemeriksaan laboratorium lengkap dalam memprediksi luaran pasien infeksi khususnya di negara berkembang termasuk Indonesia. Belum diketahui pula peran penambahan laktat vena pada performa kriteria diagnosis sepsis. Penelitian ini bertujuan menilai performa dan mengembangkan kriteria diagnosis sepsis dalam memprediksi luaran pasien infeksi dewasa di RS Cipto Mangunkusumo (RSCM). Metode: Penelitian kohort retrospektif dilakukan dengan menggunakan data rekam medik dan registri pasien infeksi Divisi Penyakit Tropik dan Infeksi Departemen Ilmu Penyakit Dalam RSCM pasien berusia lebih dari atau sama dengan 18 tahun yang mendapat perawatan di Unit Gawat Darurat (UGD) RSCM selama tahun 2017. Data yang dikumpulkan meliputi catatan karakteristik sampel, data pemeriksaan klinis dan laboratorium variabel bebas, luaran yang terjadi berupa mortalitas dalam perawatan rumah sakit selama 28 hari pengamatan. Hasil Subyek penelitian terdiri atas 1213 pasien. Sebagian besar (52,5%) merupakan pasien laki-laki, dengan median (rentang interkuartil) usia 51 tahun (38;60). Mortalitas terjadi pada 421 (34,7%) pasien. Performa kriteria diagnosis sepsis terbaik untuk memprediksi mortalitas dalam perawatan ditunjukkan oleh sepsis-3 (area under receiver operating characteristic curve [AUROC] 0,75; interval kepercayaan [IK]95% 0,72-0,78), sementara performa terburuk ditunjukkan oleh kriteria systemic inflammatory response syndrome (SIRS) (AUROC 0,56; IK95% 0,52-0,60). Performa kriteria kadar laktat vena baik (AUROC 0,76; IK95% 0,73-0,79) dalam memprediksi mortalitas dalam perawatan pasien infeksi dewasa di RSCM. Penambahan kriteria kadar laktat vena dapat meningkatkan performa kriteria diagnosis sepsis-3 (AUROC 0,80; IK95% 0,77-0,82) secara bermakna dalam memprediksi mortalitas dalam perawatan pasien infeksi dewasa di RSCM (p <0,0001). Simpulan: Performa kriteria diagnosis sepsis terbaik dalam memprediksi mortalitas dalam perawatan pasien infeksi dewasa di RSCM ditunjukkan oleh kriteria sepsis-3. Performa kriteria kadar laktat vena baik dalam memprediksi mortalitas dalam perawatan pasien infeksi dewasa di RSCM. Penambahan kriteria kadar laktat vena dapat meningkatkan performa kriteria diagnosis sepsis-3 dalam memprediksi mortalitas dalam perawatan pasien infeksi dewasa di RSCM.

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Introduction: There is uncertainty on the use of sepsis diagnostic criteria in daily clinical practice. The performance of all established sepsis diagnosis criteria and modified criteria using increase modified Sequential Organ Failure Assessment (MSOFA) score as a substitute for SOFA score system which need a complete laboratory test in prediciting in-hospital mortality in developing country, including Indonesia, is unknown. The added value of venous lactate concentration on sepsis diagnostic criteria is unknown as well. This study aim to assess the performance and improve sepsis diagnostic criteria in predicting infected adult patients mortality in Cipto Mangunkusumo Hospital. Methods: The retrospective cohort using medical record and infected adult patients (aged 18 years and older) registry of Division of Tropical and Infectious Diseases Internal Medicine Departement Cipto Mangunkusumo Hospital who were hospitalized in Emergency Room on 2017 was done. Sample's characteristics, clinical and laboratory data of independent variables, outcome i.e. 28 days in-hospital mortality were collected.Results: Subjects consist of 1213 patients, predominantly male (52.5%), with median (interquartile range) age of 51 (38;60) years old. Mortality developed in 421 (34.7%) patients. The best performance of sepsis diagnostic criteria in predicting mortality was shown by sepsis-3 criteria (area under receiver operating characteristic curve [AUROC] 0.75; 95% confidence interval [CI] 0.72-0.78). The worst performance of sepsis diagnostic criteria in predicting mortality was shown by systemic inflammatory response syndrome (SIRS) criteria (AUROC 0.56; 95CI% 0.52-0.60). Performance of lactate in predicting mortality was good (AUROC 0.76; 95CI% 0,73-0,79). The addition of lactate criteria significantly improved sepsis-3 criteria performance (AUROC 0.80; 95CI% 0.77-0.82, p <0,0001). Conclusions: The best performance of sepsis diagnostic criteria in predicting infected adult patients mortality in Cipto Mangunkusumo Hospital is shown by sepsis-3 criteria. Performance of lactate in predicting mortality is good. The addition of lactate criteria significantly improved sepsis-3 criteria performance."

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Pada pagi hari yang berbahagia ini perkenankanlah saya memanjatkan puji svukur ke hadirat Allah SWT yang telah melimpahkan rahmat dan karuniaNya kepada kita semua sehingga upacara pengukuhan saya sebagai Guru Besar Tetap di Universitas Indonesia dapat diselenggarakan.

Perkembangan sosial-ekonomi dalam era globalisasi ini telah menambah kompleksnya masalah kesehatan di Indonesia. Pada saat penyakit infeksi masih belum dapat dikendalikan dengan baik. penyakit non infeksi seperti penyakit degeneratif. keganasan jantung dan sebagainya mulai meningkat sehingga terjadi beban ganda.

Pada saat ini kita berada dalam era peralihan pola penyakit. Pada bulan Januari yang lalu Badan Litbang Kesehatan RI. mengadakan diskusi ilmiah mengenai Emerging Infectious Diseases; yaitu penyakit infeksi baru, yang timbul kembali atau resister terhadap obat yang insidensnya telah meningkat dalam 20 tahun terakhir atau berpotensi untuk meningkat di masa yang akan datang.

Apa yang sekiranya dapat dianggap sebagai penyebab fenomena ini ? Perilaku masyarakat modern dengan gaya hidup baru dapat menjadi salah satu penyebabnya. Pertumbuhan penduduk yang tinggi dan terjadinya urbanisasi yang tidak diimbangi dengan sarana dan prasarana, telah menambah luasnya daerah kumuh di perkotaan. Perkembangan teknologi yang cepat dan tuntutan kebutuhan manusia yang meningkat dapat menyebabkan terjadinya perubahan lingkungan sehingga timbul masalah kesehatan lingkungan yang erat hubungannya dengan penyakit infeksi. Kurangnya air bersih, pencernaran tanah dan air oleh limbah industri dan limbah rumah tangga termasuk tinja, menciptakan kondisi lingkungan fisik yang memungkinkan perkembangan vektor dan sumber infeksi. Fenomena tersebut berlaku juga untuk salah satu kelompok penyakit infeksi yaitu penyakit parasitik.

Hadirin yang terhormat,

Sesuai dengan keahlian dan tugas saya sebagai staf pengajar di Fakultas Kedokteran Universitas Indonesia, pada kesempatan ini saya memilih judul pidato pengukuhan :

"Beberapa Infeksi Parasitik Masa Lampau dan Masa Kini di Indonesia"

Pertama, saya ingin menyampaikan mengenai sekelompok penyakit parasit yang sudah lama bercokol di masyarakat, dan masih tetap menjadi bahan pembicaraan yang muncul di berbagai media masa dan masih tetap menjadi masalah hangat yaitu :

Infeksi cacing usus yang ditularkan melalui tanah

Infeksi casing usus yang dimaksud di atas adalah infeksi yang disebabkan oleh cacing yang ditularkan melalui tanah, telur dan larvanya menjadi bentuk infektif di tanah. Dalam bahasa sehari-hari infeksi ini disebut cacingan. Infeksi dengan cacing usus yaitu Ascaris lumbricoides, Trichuris trichiura dan cacing tambang (Necator americanus dan Ancylostoma duodenale) masih merupakan masalah kesehatan masyarakat di daerah tropik, termasuk Indonesia.

Cacingan merupakan penyakit rakyat yang sangat erat kaitannya dengan masalah lingkungan. Lingkungan yang kumuh merupakan tempat subur untuk berkembang biaknya cacing-cacing penyebab cacingan.

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"[Ilmu Kedokteran Gigi merupakan salah satu bidang yang rawan untukterjadinya kontaminasi silang antara pasien-dokter gigi, pasien-pasien dan pasien perawat. Kontrol Infeksi dapat mencegah terjadinya infeksi silang. Tujuan: Melihat hubungan Pengetahuan, Perilaku dan Faktor Lingkungan terhadap keberhasilan upaya Kontrol infeksi pada Mahasiswa Program Profesi Fakultas Kedokteran gigi Univesritas“x” di Jakarta. Metode: Metode penelitian yang digunakan cross sectional dengan Model penelitian Sequential Explonatory design. Penelitian dilakukan pada Mahasiswa Program Profesi Fakultas Kedokteran Gigi Universitas “X” di Jakarta yang sudah melewatipendidikan profesi selama 2 (dua) semester, dengan jumlah sampel sebanyak 101 mahasiswa. Hasil: Upaya Kontrol Infeksi pada Mahasiswa Program Profesi Fakultas Kedokteran gigi universitas “X” di Jakarta masih kurang baik.Ini dipengaruhi oleh pengetahuan, perilaku dan faktor lingkungan masih kurang baik dan mempunyai p value< 0,05 sehingga mempunyai hubungan yang signifikan terhadap upaya kontrol infeksi. Kesimpulan: Pengetahuan dan Perilaku dapat ditingkatkan dengan membentuk program yang berisikan promosi kesehatan dalam bentuk poster-poster, standart operasional prosedur berdasarkan standard precautions dan seminar-seminar bagimahasiswa program profesi fakultas kedokteran gigi;Background: Dentistry is one of a science which has a high sensitivity to causedcross-contamination between the patient-dentist, patient-patient and patient-nurse. Infection control may prevent cross-infection. Objective: Knowing the relationship between Knowledge, Behavior and Environmental Factors with successfull of Infection Control by the students of Professional Program Study of the Faculty of Dentistry, Universitas "x" in Jakarta. Methods: The method used is cross sectional with research model Sequential Explonatory Design. The study which has the total sample of 101 students was conducted and involved thestudents of Professional Program Study of the Faculty of Dentistry, University "X" in Jakarta, which has passed the professional education for two (2) semesters. Results: Infection Control Efforts conducted by the student of Professional Program Study Faculty of Dentistry, University "X" in Jakarta is not maximal. It was affected by the Knowledge, Behavior and Environmental Factors which not good enough and has a p value <0.05 and therefore has a significant relationship which infection control effort. Conclusion: Knowledge and Behavior can be improved by establishing a program containing health promotion in the form of posters, standard operating procedures based on standard precautions and seminars for the students of Professional Program Study of the faculty of dentistry., Background: Dentistry is one of a science which has a high sensitivity to causedcross-contamination between the patient-dentist, patient-patient and patient-nurse.Infection control may prevent cross-infection. Objective: Knowing therelationship between Knowledge, Behavior and Environmental Factors withsuccessfull of Infection Control by the students of Professional Program Study ofthe Faculty of Dentistry, Universitas "x" in Jakarta. Methods: The method used iscross sectional with research model Sequential Explonatory Design. The studywhich has the total sample of 101 students was conducted and involved thestudents of Professional Program Study of the Faculty of Dentistry, University"X" in Jakarta, which has passed the professional education for two (2) semesters.Results: Infection Control Efforts conducted by the student of ProfessionalProgram Study Faculty of Dentistry, University "X" in Jakarta is not maximal. Itwas affected by the Knowledge, Behavior and Environmental Factors which notgood enough and has a p value <0.05 and therefore has a significant relationshipwhich infection control effort. Conclusion: Knowledge and Behavior can beimproved by establishing a program containing health promotion in the form ofposters, standard operating procedures based on standard precautions andseminars for the students of Professional Program Study of the faculty ofdentistry.]"

"Magnetic Resonance Spectroscopy (MRS) membantu ahli radiologi untuk mengetahui apakah pasien mengalami glioma otak atau infeksi otak. Dalam tugas akhir ini dibahas proses klasifikasi terhadap data hasil MRS untuk mengetahui apakah pasien mengalami glioma otak atau infeksi otak. Metode yang digunakan untuk klasifikasi adalah metode AdaBoost dengan base learner K-Nearest Neighbor dan metode K-Nearest Neighbor. Hasil Percobaan yang dilakukan menunjukkan bahwa metode AdaBoost dengan base learner K-Nearest Neighbor dengan K=3 mempunyai nilai akurasi 97% pada data training 80% sementara nilai akurasi dari metode K-Nearest Neighbor 94.4 % pada data training 80%. Hasil akhir dari pembuatan tugas akhir ini adalah sebuah perangkat lunak pendukung keputusan ( Decision Support System) yang membantu memberikan informasi apakah pasien mengalami glioma otak atau infeksi otak.

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Magnetic Resonance Spectroscopy (MRS) helps the experts of radiology to detect the brain glioma or brain infection in patients. In this final project, the classification process on the result of MRS data is discussed to detect the brain glioma or brain infection in patients. The used classification methods are AdaBoost with base learner K-Nearest Neighbor and K-Nearest Neighbor methods. The result of research shows that the AdaBoost method with base learner K-Nearest Neighbor with K=3 has 97% accuracy value on 80% training data, while the accuracy value from K-Nearest Neighbor method is 94.4 % on 80%training data. The result from the writing of this final project is the software for making decision (Decision Support System) that supports the giving of information on the existence of brain glioma or brain infection in patients."

"The study of the patterns of nematode infection on rodents in Lore Lindu,Central Sulawesi was carried out. A total of 52 rodents were examined...."

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Latar belakang: Resistensi antibiotik merupakan masalah penting dan ancaman bagi kesehatan manusia di hampir seluruh negara. Dampak infeksi bakteri multidrug-resistant (MDR) berupa luaran pasien lebih buruk, biaya perawatan lebih besar, dan penggunaan antibiotik spektrum luas yang berpotensi meningkatkan prevalensi resistensi. Surveilans healthcare-associated infection (HAI) dan identifikasi faktor risiko diharapkan bisa menurunkan laju resistensi.

Tujuan: Menilai kekuatan pengaruh dari komorbiditas, riwayat pengobatan dengan antibiotik intravena 15 hari terakhir, tindakan bedah, penggunaan lebih dari 2 indwelling medical device, dan rawat inap lebih dari 7 hari terhadap terjadinya infeksi bakteri MDR pada pasien anak.

Metode: Penelitian retrospektif di Rumah Sakit Cipto Mangunkusumo Jakarta terhadap pasien berusia 1 bulan-18 tahun dengan pertumbuhan bakteri pada hasil kultur. Data diperoleh dari electronic health record yaitu data demografi, komorbid, riwayat terapi antibiotik, tindakan bedah, medical device, lama rawat inap, data mikrobiologi, dan luaran akhir perawatan.

Hasil: Proporsi bakteri MDR pada penelitian ini sebesar 76,3%. Analisis bivariat tidak menunjukkan adanya hubungan antara komorbiditas, riwayat terapi antibiotik, tindakan bedah, dan penggunaan lebih dari 2 indwelling medical device, dengan infeksi bakteri MDR pada pasien anak. Namun rawat inap lebih dari 7 hari akan meningkatkan risiko pasien anak mengalami infeksi bakteri MDR (OR 2,755; 95% IK 1,107-6,857; P = 0,036).

Simpulan: Pasien anak dengan rawat inap lebih dari 7 hari memiliki risiko hampir 2,7 kali lipat untuk mengalami infeksi bakteri MDR dibanding pasien anak dengan rawat inap 7 hari atau kurang.

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Background: Antibiotic resistance is an important problem and threats to human health worldwide. Multidrug-resistant (MDR) bacteria infection is associated with poor outcome, higher treatment cost, and higher rate of broad spectrum antibiotic use which may lead to subsequent antibiotic resistance. Healthcare-associated infection surveillance and identification of risk factors can provide effort to control the development of antibiotic resistance.

Objective: Measure the strength of association between comorbidity, intravenous antibiotic use within the last 15 days, surgery procedure, use of more than two indwelling medical devices, and hospital stay more than 7 days, with MDR bacteria infection in pediatric patient.

Methods: Restrospective study in 1 month - 18 years old pediatric patient at Cipto Mangunkusumo Hospital Jakarta who had bacteria growth on microbiological culture. Demographic data, comorbid condition, history of antibiotic use, surgery, indwelling medical device use, length of hospital stay, microbiological data, and mortality were collected from the electronic health record.

Results: Rate of MDR bacteria infection in this study was 76,3%. Bivariate analysis showed no relationships between comorbidity, intravenous antibiotic use in prior 15 days, surgery, and use of more than two indwelling medical devices, with MDR bacteria infection. Pediatric patients with hospital stay longer than 7 days were more likely to have MDR bacteria infection (OR 2,755; CI 95% 1,107-6,857; P = 0,036) compared to those with hospital stay 7 days or less.

Conclusion: Hospital stay longer than 7 days increase risk pediatric patient to contract MDR bacteria infection by 2,7 fold.

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"ABSTRAK Latar Belakang: Kesinambungan berobat memiliki peran penting dalamkeberhasilan tatalaksana pasien HIV. Hingga saat ini, belum dilakukan penelitianuntuk melihat proporsi pasien yang masih tetap berobat di UPT HIV RSCMmaupun profil dari pasien-pasien tersebut. Tujuan: Mengetahui proporsi dan profil pasien yang masih tetap berobat di UPTHIV RSCM. Metode: Studi dengan metode potong lintang pada pasien HIV yang baruterdiagnosis dan berobat di UPT HIV RSUPNCM dalam periode Januari 2004 -Desember 2013. Data diperoleh melalui ekstraksi data sekunder yang berasal darirekam medik. Penelitian dilakukan terhadap pasien HIV yang berusia diatas 18tahun dan belum menjalani terapi ARV. Pasien yang tetap berobat sampai akhir2014 didefinisikan sebagai pasien yang tetap kontrol ke poliklinik sejak awal pasiendatang ke UPT HIV hingga minimal tiga bulan sebelum akhir Desember 2014. Hasil: Sebanyak 4949 subjek diikutkan dalam penelitian ini. Didapatkan proporsipasien yang tetap berobat sampai akhir 2014 adalah 23% (1136 subjek). Selain itu,subjek dengan jenis kelamin wanita (26,6%), berusia ≥35 tahun (usia 35-44 tahunsebesar 25,5% dan ≥45 tahun sebesar 35,5%), pendidikan terakhir diatas SMU(26,8%), menikah/dengan pasangan (25%), beralamat di Bodetabek (26,1%),stadium klinis IV (28,3%), memiliki angka CD4 awal 201-350 sel/mm3 (35%), danbukan penasun (28%) adalah subjek terbanyak yang tetap berobat sampai akhir2014. Simpulan: Proporsi pasien yang tetap berobat sampai akhir 2014 adalah 23% (1136subjek). Selain itu, pasien dengan jenis kelamin wanita, berusia ≥35 tahun,pendidikan terakhir diatas SMU, menikah/tinggal dengan pasangan, beralamat diBodetabek, stadium klinis IV, memiliki angka CD4 awal 201-350 sel/mm3, danbukan penasun merupakan kelompok subjek terbanyak yang tetap berobat sampai akhir 2014.ABSTRACT Background: Continued medical treatment serves an important role in thesuccessful management of patients with HIV. Until this present day, there has neverbeen any research which seeks to examine the proportion of patients who continuetheir medical treatment at HIV Integrated Service Unit of National Central GeneralHospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.Objectives: To discover the proportion and to generate the profiles of patients whocontinued their medical treatment at HIV Integrated Service Unit, RSUPNCM.Methods: This research was conducted by applying the cross-sectional method onpatients who were diagnosed with HIV and were subsequently undergoing medicaltreatment at HIV Integrated Service Unit, RSUPNCM, during the period of January2004 to December 2013. Data were obtained by extracting secondary data in theform of medical records. The subjects of the research are HIV patients who aremore than 18 years of age and have not undergone anti-retroviral (ARV) treatments.Patients who continued their medical treatment until the end of 2014 are defined aspatients who have undergone medical treatment at the polyclinic starting from theirfirst visit to HIV Integrated Service Unit until at least three months prior to the endof December 2014.Results: As many as 4949 subjects participated in this research. We found that theproportion of patients who continued their medical treatment until the end of 2014is 23% (1136 subjects). In addition to that, we also found that female subjects(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of ageand 35.5% for those ≥45 years of age); whose education is higher than Senior HighSchool level (26.8%); who have married or live with their respective partners(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who havereached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm3(35%); and who are not injecting drug users (IDUs) (28%) constitute the largestgroup of subjects who continued their medical treatment until the end of 2014.Conclusion: The proportion of patients who continued their medical treatment untilthe end of 2014 is 23% (1136 subjects). In addition to that, female patients who are≥35 years of age; whose education is higher than Senior High School level; whohave married or live with their respective partners; who reside in Bogor, Depok,Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whoseinitial CD4 count is 201?350 cells/mm3, and who are not injecting drug users(IDUs) constitute the largest group of subjects who continued their medicaltreatment until the end of 2014.;Background: Continued medical treatment serves an important role in thesuccessful management of patients with HIV. Until this present day, there has neverbeen any research which seeks to examine the proportion of patients who continuetheir medical treatment at HIV Integrated Service Unit of National Central GeneralHospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.Objectives: To discover the proportion and to generate the profiles of patients whocontinued their medical treatment at HIV Integrated Service Unit, RSUPNCM.Methods: This research was conducted by applying the cross-sectional method onpatients who were diagnosed with HIV and were subsequently undergoing medicaltreatment at HIV Integrated Service Unit, RSUPNCM, during the period of January2004 to December 2013. Data were obtained by extracting secondary data in theform of medical records. The subjects of the research are HIV patients who aremore than 18 years of age and have not undergone anti-retroviral (ARV) treatments.Patients who continued their medical treatment until the end of 2014 are defined aspatients who have undergone medical treatment at the polyclinic starting from theirfirst visit to HIV Integrated Service Unit until at least three months prior to the endof December 2014.Results: As many as 4949 subjects participated in this research. We found that theproportion of patients who continued their medical treatment until the end of 2014is 23% (1136 subjects). In addition to that, we also found that female subjects(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of ageand 35.5% for those ≥45 years of age); whose education is higher than Senior HighSchool level (26.8%); who have married or live with their respective partners(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who havereached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm3(35%); and who are not injecting drug users (IDUs) (28%) constitute the largestgroup of subjects who continued their medical treatment until the end of 2014.Conclusion: The proportion of patients who continued their medical treatment untilthe end of 2014 is 23% (1136 subjects). In addition to that, female patients who are≥35 years of age; whose education is higher than Senior High School level; whohave married or live with their respective partners; who reside in Bogor, Depok,Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whoseinitial CD4 count is 201?350 cells/mm3, and who are not injecting drug users(IDUs) constitute the largest group of subjects who continued their medicaltreatment until the end of 2014.;Background: Continued medical treatment serves an important role in thesuccessful management of patients with HIV. Until this present day, there has neverbeen any research which seeks to examine the proportion of patients who continuetheir medical treatment at HIV Integrated Service Unit of National Central GeneralHospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.Objectives: To discover the proportion and to generate the profiles of patients whocontinued their medical treatment at HIV Integrated Service Unit, RSUPNCM.Methods: This research was conducted by applying the cross-sectional method onpatients who were diagnosed with HIV and were subsequently undergoing medicaltreatment at HIV Integrated Service Unit, RSUPNCM, during the period of January2004 to December 2013. Data were obtained by extracting secondary data in theform of medical records. The subjects of the research are HIV patients who aremore than 18 years of age and have not undergone anti-retroviral (ARV) treatments.Patients who continued their medical treatment until the end of 2014 are defined aspatients who have undergone medical treatment at the polyclinic starting from theirfirst visit to HIV Integrated Service Unit until at least three months prior to the endof December 2014.Results: As many as 4949 subjects participated in this research. We found that theproportion of patients who continued their medical treatment until the end of 2014is 23% (1136 subjects). In addition to that, we also found that female subjects(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of ageand 35.5% for those ≥45 years of age); whose education is higher than Senior HighSchool level (26.8%); who have married or live with their respective partners(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who havereached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm3(35%); and who are not injecting drug users (IDUs) (28%) constitute the largestgroup of subjects who continued their medical treatment until the end of 2014.Conclusion: The proportion of patients who continued their medical treatment untilthe end of 2014 is 23% (1136 subjects). In addition to that, female patients who are≥35 years of age; whose education is higher than Senior High School level; whohave married or live with their respective partners; who reside in Bogor, Depok,Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whoseinitial CD4 count is 201?350 cells/mm3, and who are not injecting drug users(IDUs) constitute the largest group of subjects who continued their medicaltreatment until the end of 2014.;Background: Continued medical treatment serves an important role in thesuccessful management of patients with HIV. Until this present day, there has neverbeen any research which seeks to examine the proportion of patients who continuetheir medical treatment at HIV Integrated Service Unit of National Central GeneralHospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.Objectives: To discover the proportion and to generate the profiles of patients whocontinued their medical treatment at HIV Integrated Service Unit, RSUPNCM.Methods: This research was conducted by applying the cross-sectional method onpatients who were diagnosed with HIV and were subsequently undergoing medicaltreatment at HIV Integrated Service Unit, RSUPNCM, during the period of January2004 to December 2013. Data were obtained by extracting secondary data in theform of medical records. The subjects of the research are HIV patients who aremore than 18 years of age and have not undergone anti-retroviral (ARV) treatments.Patients who continued their medical treatment until the end of 2014 are defined aspatients who have undergone medical treatment at the polyclinic starting from theirfirst visit to HIV Integrated Service Unit until at least three months prior to the endof December 2014.Results: As many as 4949 subjects participated in this research. We found that theproportion of patients who continued their medical treatment until the end of 2014is 23% (1136 subjects). In addition to that, we also found that female subjects(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of ageand 35.5% for those ≥45 years of age); whose education is higher than Senior HighSchool level (26.8%); who have married or live with their respective partners(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who havereached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm3(35%); and who are not injecting drug users (IDUs) (28%) constitute the largestgroup of subjects who continued their medical treatment until the end of 2014.Conclusion: The proportion of patients who continued their medical treatment untilthe end of 2014 is 23% (1136 subjects). In addition to that, female patients who are≥35 years of age; whose education is higher than Senior High School level; whohave married or live with their respective partners; who reside in Bogor, Depok,Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whoseinitial CD4 count is 201?350 cells/mm3, and who are not injecting drug users(IDUs) constitute the largest group of subjects who continued their medicaltreatment until the end of 2014.;Background: Continued medical treatment serves an important role in thesuccessful management of patients with HIV. Until this present day, there has neverbeen any research which seeks to examine the proportion of patients who continuetheir medical treatment at HIV Integrated Service Unit of National Central GeneralHospital Cipto Mangunkusumo (RSUPNCM) and the profiles of those patients.Objectives: To discover the proportion and to generate the profiles of patients whocontinued their medical treatment at HIV Integrated Service Unit, RSUPNCM.Methods: This research was conducted by applying the cross-sectional method onpatients who were diagnosed with HIV and were subsequently undergoing medicaltreatment at HIV Integrated Service Unit, RSUPNCM, during the period of January2004 to December 2013. Data were obtained by extracting secondary data in theform of medical records. The subjects of the research are HIV patients who aremore than 18 years of age and have not undergone anti-retroviral (ARV) treatments.Patients who continued their medical treatment until the end of 2014 are defined aspatients who have undergone medical treatment at the polyclinic starting from theirfirst visit to HIV Integrated Service Unit until at least three months prior to the endof December 2014.Results: As many as 4949 subjects participated in this research. We found that theproportion of patients who continued their medical treatment until the end of 2014is 23% (1136 subjects). In addition to that, we also found that female subjects(26.6%) who are ≥35 years of age (25.5% for those between 35 and 44 years of ageand 35.5% for those ≥45 years of age); whose education is higher than Senior HighSchool level (26.8%); who have married or live with their respective partners(25%); who reside in Bogor, Depok, Tangerang, or Bekasi areas (26.1%); who havereached clinical stage IV (28.3%); whose initial CD4 count is 201?350 cells/mm3(35%); and who are not injecting drug users (IDUs) (28%) constitute the largestgroup of subjects who continued their medical treatment until the end of 2014.Conclusion: The proportion of patients who continued their medical treatment untilthe end of 2014 is 23% (1136 subjects). In addition to that, female patients who are≥35 years of age; whose education is higher than Senior High School level; whohave married or live with their respective partners; who reside in Bogor, Depok,Tangerang, or Bekasi areas; who have reached clinical stage IV (28.3%); whoseinitial CD4 count is 201?350 cells/mm3, and who are not injecting drug users(IDUs) constitute the largest group of subjects who continued their medicaltreatment until the end of 2014."

"Latar Belakang : Infeksi odontogenik telah menjadi salah satu penyakit yang paling umum terjadi di daerah oral dan maksilofasial. Tatalaksananya dapat sangat bervariasi, pada infeksi odontogenik yang parah pasien memerlukan rawat inap dan tindakan intervensi bedah dan medis yang luas. Proporsi pasien dengan infeksi odontogenik juga akan memerlukan dukungan ruang perawatan intensif (ICU) segera setelah tindakan bedah. Tingkat keparahan infeksi dan terjadinya komplikasi menyebabkan pasien tinggal di ruang perawatan intensif (ICU) lebih lama.Tujuan : untuk mengetahui apakah ada pengaruh penyebaran infeksi odontogenik yang dikaitkan dengan tatalaksana infeksi odontogenik dengan tindakan bedah, komplikasi dan riwayat penyakit sistemik terhadap lama masa perawatan intensif (ICU) pada pasien dengan infeksi odontogenik di RSUPN Dr. Cipto Mangunkusumo Jakarta.Material dan Metode : Rekam medis pasien infeksi odontogenik, Bedah Mulut dan Maksilofasial RSUPN Dr. Cipto Mangunkusumo selama periode Januari 2014-Desember 2018 dikumpulkan dan didapatkan 84 orang. Setiap sampel di identifikasi adanya tingkat keparahan infeksi odontogenik, riwayat penyakit sistemik, tatalaksana bedah, komplikasi pasca bedah dan lama masa perawatan intensif (ICU). Data diolah dengan uji Chi Square. Uji hipotesis korelatif dilakukan dengan Uji Fishers Exact dan Uji Pearson Chi-Square .Kesimpulan : Ditemukan hubungan yang bermakna antara penyebaran infeksi odontogenik menurut Flynn Score dengan lama masa perawatan intensif (ICU) dengan nilai α = 0.00 (α < 0.05). Tatalaksana bedah dengan α = 0.00 (α < 0.05) dan komplikasi pasca bedah dengan α = 0.03 (α < 0.05) juga memberikan hasil yang signifikan yang menunjukkan adanya hubungan dengan lama masa perawatan intensif (ICU). Selain itu didapatkan kesimpulan bahwa infeksi odontogenik tidak memiliki hubungan yang signifikan dengan jenis kelamin α = 0.64 (α > 0.05), usia α = 0.34 (α > 0.05), maupun riwayat penyakit sistemik α = 0.52 (α > 0.05) dengan lama masa perawatan intensif (ICU).

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Background : Odontogenic infections have become one of the most common diseases in the oral and maxillofacial regions. The treatment can be very variable, in severe odontogenic infections patients require hospitalization and extensive surgical and medical interventions. The proportion of patients with odontogenic infections will also require intensive care support (ICU) immediately after surgery. The severity of infection and the occurrence of complications causes patients longer to stay in intensive care unit (ICU).Objective : To find out whether there is an effect of the spread of odontogenic infections associated with the management of odontogenic infections with surgical procedures, complications and a history of systemic diseases for the duration of intensive care unit (ICU) in patients with odontogenic infections in RSUPN Dr. Cipto Mangunkusumo Jakarta.Materials and Methods : Medical records of patients with odontogenic infections, Oral and Maxillofacial Surgery RSUPN Dr. Cipto Mangunkusumo during January 2014-December 2018 was collected and obtained 84 people. Each sample identified the severity of odontogenic infections, a history of systemic diseases, surgical management, postoperative complications and length of stay of intensive care unit (ICU). Data is processed by Chi Square Test. The correlative hypothesis test is carried out by Fishers Exact Test and Pearson Chi-Square Test.Conclusion : A significant association was found between the spread of odontogenic infections according to Flynn Score with the duration of intensive care unit (ICU) with a value of α = 0.00 (α <0.05). Surgical management with α = 0.00 (α <0.05) and postoperative complications with α = 0.03 (α <0.05) also gave significant results indicating a relationship with the duration of intensive care (ICU). In addition it was concluded that odontogenic infections did not have a significant relationship with gender α = 0.64 (α> 0.05), age α = 0.34 (α> 0.05), or history of systemic disease α = 0.52 (α> 0.05) with length of treatment intensive (ICU)."

"ABSTRAKLatar belakang. Infeksi Cytomegalovirus (CMV) kongenital merupakan faktor non genetik yang paling sering menjadi penyebab terjadinya ketulian sensorineural pada bayi dan anak. Infeksi CMV dapat memberikan tanda dan gejala namun dapat juga tidak memberikan gejala pada yang terinfeksi. Ketulian akibat infeksi CMV kongenital tidak memiliki konfigurasi patognomik sehingga penelitian terhadap infeksi CMV kongenital pada pendengaran masih sangat diperlukan. Pengetahuan tentang ketulian akibat infeksi CMV kongenital di negara-negara luar yang semakin berkembang membuat peneliti ingin mengetahui bagaimana gambaran gangguan pendengaran anak dengan infeksi CMV kongenital di Indonesia, khususnya RS Cipto Mangunkusumo. Tujuan. Mengetahui gambaran gangguan pendengaran pada anak usia 0-5 tahun yang mengalami infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click. Metode. Penelitian cross sectional ini dilakukan di RSUPN Cipto Mangunkusumo pada bulan November 2015-Mei 2016 pada 27 subjek anak usia 0-5 tahun yang telah didiagnosa terinfeksi CMV kongenital. Hasil. Gambaran gangguan fungsi pendengaran pada subjek anak usia 0-5 tahun dengan infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click pada unit telinga adalah tuli sensorineural sebanyak 58,0%. Didapatkan hubungan yang bermakna secara statistik (p = 0,002) antara keterlambatan tumbuh kembang dengan terjadinya tuli sensorineural. Keterlambatan tumbuh kembang memiliki risiko 6,57 (CI 95%; 1,88 – 22,87) kali lebih besar dibandingkan pasien dengan tumbuh kembang normal untuk mengalami gangguan pendengaran sensorineural.

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ABSTRACTBackground. Congenital cytomegalovirus (CMV) infection is a non genetical factor that is most commonly found asthe etiology of sensorineural hearing loss in infants and children. CMV does not always cause signs and symptoms.Hearing loss caused by CMV infection does not have a patognomonic configuration hence further research is needed. The development on the knowledge on hearing loss caused by congenital CMV infection in foreign countriesis the reason the author decide to investigate on the profile of hearing impairment in children with congenital CMV infection in Indonesia, especially in Cipto Mangunkusumo Hospital. Purpose. To know the profile of hearing impairment in children age 0-5 years old with congenital CMV infection based on DPOAE and BERA click. Methods.This cross-sectional study was conducted in Cipto Mangunkusum Hospital since November 2015-May 2016 in 27 subjects, children age 0-5 years old with congenital CMV infection. Results.Hearing impairment in subjects children age 0-5 years old with congenital CMV inefection, based on DPOAE and BERA click on ear unitsis 58,0% with sensorineural hearing loss. There is a significant relationship (p=0,002) between developmental delay and the incidence of sensorineural hearing loss. Developmental delay has a 6,57 times (CI 95%; 1,88 – 22,87) higher the risk for subjects to experience sensorineural hearing loss compared to normal development.;"

"Demam berdarah dianggap sebagai masalah kesehatan utama bukan hanya di Indonesia, tetapi juga banyak negara lain. Penelitian ini bertujuan untuk mengetahui kinetik Non Structural-1 (NS1) dan persen positif antigen NS1 yang dideteksi dengan menggunakan diagnostik dini Strip Ag Bio-rad NS1 pada hari demam ke 1 sampai 3. Uji diagnostik ini dilakukan di Laboratorium Mikrobiologi Universitas Indonesia melalui pemeriksaan laboratorium pada 102 sampel dari pasien yang diduga demam berdarah. Standar baku untuk uji ini adalah Reverse Transcription - Polymerase Chain Reaction (RT-PCR), isolasi virus di cell line C6/36, serta kenaikan titer antibodi. Program SPSS 17.0 digunakan untuk analisis data. Dari total pasien yang terlibat dalam penelitian ini, 68 (68.3%) pasien terinfeksi demam berdarah. Investigasi lebih lanjut dalam mendeteksi keberadaan antigen NS-1 berdasarkan hari demam dilakukan pada penelitian ini. Berdasarkan hasil yang diperoleh, keberadaan NS-1 pada pasien terinfeksi demam berdarah pada hari demam ke 1, 2 dan 3 adalah 100%, 96,36%, dan 94.55% berturut - turut. Kesimpulan penelitian ini adalah bahwa Strip Ag Bio-Rad NS1 dapat digunakan sebagai deteksi dini demam berdarah di Indonesia.

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Dengue is considered as a major health problem in not only Indonesia, but many other countries. The aim of this study was to know the kinetic of Non-Structural-1 (NS1) and positive percentage of NS1 detected by a diagnostic kit Bio-Rad NS1 Ag Strip Test during first until third day of fever. This diagnostic test was conducted in Microbiology Laboratorium of Universitas Indonesia by performing laboratory examination to 102 serum samples of dengue suspected patients. Gold standard of this study was Reverse Transcription - Polymerase Chain Reaction (RT-PCR), virus isolation in C6/36 cell line, and increase of antibody titer. SPSS 17.0 program was used to analyze the data. Based on total patients involved, 68 (68.3%) patients were infected with dengue. Further investigation on detecting presence of NS-1 antigen according to days of fever was done in this study. From the result, presence of NS-1in dengue-infected patients during day 1, 2, and 3 of fever were 100%, 96.36%, and 94.55% respectively. Conclusion of this study was that Bio-Rad NS1 Ag Strip can be used as early detection of dengue fever in Indonesia."