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"ABSTRAKObjective: To evaluate the effect of 10 % Emblica offcinalis irrigation, which has anti inflammatory, antioxidative, and antimicrobial activities, adjunctive to scaling and root planing (SRP) for treatment of chronic periodontitis. Methods: Sixty six patients were randomly assigned to the negative control group (SRP saline irrigation; n 22), positive control group (SRP chlorhexidine irrigation; n 22), and test group (SRP 10 % E. offcinalis irrigation; n 22). Plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and sulcus bleeding index (SBI) were monitored 3 months post-therapy. Results: There were signifcantly greater reductions in the mean PI, PPD, and SBI but a greater mean CAL at 3 months post therapy in the test group than in the negative control (p 0.05). Compared with the positive control, the test group demonstrated greater reduction in SBI but comparable improvements in PI, GI, CAL, deep pockets (PPD 5 until 6 mm, 7 mm), and sites with CAL 6 mm at 3 months post therapy (p 0.05) but less reduction in the mean PPD (p 0.05). Conclusions: E. offcinalis 10 % irrigant adjunctive to SRP improved periodontal healing without side effects and may be an alternative to chlorhexidine for chronic periodontitis treatment. "

"Lumbar canal stenosis merupakan penyebab utama disabilitas pasien. Selective Nerve Root Block (SNRB) pada area lumbar adalah salah satu metode terapi untuk mengatasi nyeri akibat radikulopati lumbar yang bertujuan mengurangi kebutuhan operasi. Ultrasonografi (USG) muncul sebagai alternatif dengan kelebihan seperti tanpa radiasi, mobilitas tinggi, kemampuan pencitraan jaringan lunak, dan penetrasi jarum real-time jika dibandinagkan menggunakan Floroskopi. Penelitian ini merupakan studi uji klinis acak non-inferiority tersamar tunggal yang dilakukan di 2 Rumah Sakit. 52 subjek penelitian yang terdiri dari 26 subjek yang dilakukan tindakan SNRB dengan panduan fluoroskopi dan 26 subjek yang dilakukan tindakan SNRB dengan panduan USG. Tidak ada perbedaan karakteristik dasar antara kedua kelompok berdasarkan usia, jenis kelamin, IMT, durasi gejala. level lumbar VAS, maupun ODI pre operasi (p > 0,05). Penelitian ini menunjukkan penurunan signifikan pada nilai VAS di kelompok floroskopi dan USG pada 30 menit, 2 minggu, dan 12 minggu setelah tindakan dibandingkan dengan baseline (p < 0,01). Kendati demikian, tidak ada perbedaan VAS dan ODI yang signifikan antara kedua metode panduan pada setiap titik waktu (p > 0,05). Tidak terdapat perbedaan dalam pengurangan nyeri radikular lumbal, skor ODI, dan kejadian komplikasi antara tindakan SNRB dengan panduan fluoroskopi maupun USG. Penggunaan panduan USG pada SNRB terbukti lebih efisien dengan durasi yang lebih singkat dan sama efektifnya dengan fluoroskopi.

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Lumbar canal stenosis is a leading cause of patient disability. Selective Nerve Root Block (SNRB) in the lumbar area is a therapeutic method aimed at alleviating pain from lumbar radiculopathy to reduce disability and surgical needs. SNRB typically employs fluoroscopy but has drawbacks such as radiation exposure. Ultrasonography (USG) has emerged as an alternative offering benefits. This was a randomized single-blind non-inferiority clinical trial conducted at 2 Hospitals. There were 52 subjects, with 26 undergoing SNRB with fluoroscopy guidance and 26 with USG guidance. No baseline characteristic differences were found between the groups in terms of age, gender, BMI, symptom duration, preoperative lumbar level VAS, or ODI (p > 0.05). The study demonstrated significant reductions in VAS scores in both fluoroscopy and USG groups at 30 minutes, 2 weeks, and 12 weeks post-procedure compared to baseline (p < 0.01). However, no significant differences in VAS and ODI were observed between the two guidance methods at any time point (p > 0.05). There was no difference in the reduction of lumbar radicular pain, ODI scores, and complication rates between SNRB procedures guided by fluoroscopy and USG. USG guidance in SNRB proves to be more efficient with shorter duration and equally effective as fluoroscopy."

"Merokok dapat meningkatkan angka morbiditas dan mortalitas.World Health Organization (WHO) memprediksi pada tahun 2020 penyakit yang disebabkan oleh rokok akan menyebabkan kematian sebanyak 8.4 juta orang di dunia dan setengahnya berasal dari Asia. Varenicline, sebagai agonis parsial reseptor α4β2 nikotin asetilkolin, memiliki potensi yang cukup baik pada program berhenti merokok dengan cara melepaskan withdrawal effect dari nikotin dan menurunkan kebutuhan akan nikotin. METODE. Uji acak tersamar ganda antara bulan Juli 2012 sampai dengan Desember 2012 dengan 12 minggu waktu terapi dan 12 minggu waktu pengamatan status merokok. 80 laki-laki perokok yang bersedia mengikuti penelitian dibagi kedalam kelompok varenciline dan kelompok plasebo.Varenicline dititrasi hingga 2x1 mg (n=40) dan plasebo (n=40) ditambah konseling mingguan. HASIL. Pada pengamatan 4 minggu (minggu 1-4) setelah 12 minggu terapi menunjukkan 55% peserta kelompok varenicline berhenti merokok dibandingkan kelompok plasebo sebesar 27,5%. (Prevalence Ratio [PR] 2,0). Pada pengamatan minggu ke 5-8, 52.5% peserta pada kelompok varenicline masih berhenti merokok dibandingkan dengan 20% pada kelompok plasebo (PR, 2,6). Pada pengamatan minggu 9-12, 47,5% peserta pada kelompok varenicline masih berhenti merokok dibandingkan 17,5% pada kelompok plasebo (PR, 2,7). Rerata hari pertama bebas rokok pada kelompok varenicline adalah 40,63 hari, sedangkan pada kelompok plasebo 56,43 hari. Efek samping yang paling banyak pada penggunaan varenicline adalah mual yang terdapat pada 9 peseerta (22,5%). Rerata kadar CO awal adalah 18,46 ppm, rerata Fagerstrom test untuk ketergantungan nikotin adalah 6,4 dan rerata indeks Binkman adalah 317,9. KESIMPULAN. Varenicline memiliki efikasi yang baik, aman dan dapat ditoleransi baik sebagai farmakoterapi program berhenti merokok.

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Smoking has increased risk of morbidity and mortality. World Health Organization predicts that by 2020, disease caused by smoking will result in the deaths of around 8.4 million people in the world and half of these deaths from Asia. Varenicline, a partial agonist at the α4β2 nicotinic acetylcholine receptor, has the potential to aid smoking cessation by relieving nicotine withdrawal symptoms and reducing the rewarding properties of nicotine.

METHOD. A randomized, single-blind, placebo controlled trial conducted between July 2012 and December 2012 with a 12 week treatment period and 12 week follow-up of smoking status. 80 male adult smokers who volunteered for the study divide into varenicline and placebo group. Varenicline titrated to 1 mg twice daily (n=40) or placebo (n=40) for 12 weeks, plus weekly smoking cessation counseling.

RESULT. During 4 weeks (weeks 1-4) after 12 weeks of treatment, 55% of participants in the varenicline group were continuously abstinent from smoking compared with 27.5% in the placebo group (Prevalence Ratio [PR] 2,0). For weeks 5 through 8, 52.5% of participants in the varenicline group were continuously abstinent compared with 20% in the placebo group (PR, 2,6). For weeks 9-12, 47.5% of participants in the varenicline group were continuously abstinent compared with 17.5% in the placebo group (PR, 2,7). Mean of first day free of smoking used Varenicline for smoking cessation was 40,63 days and mean of first day free of smoking used placebo was 56.43 days. The most adverse event with varenicline was nausea, which occurred in 9 Participants (22,5%). Mean of CO level was 18,46 ppm, mean of Fagerstrom score for nicotine dependence was 6,4, and mean of Brinkman index was 317,9.

CONCLUSION. Varenicline is an efficacious, safe, and well-tolerated smoking cessation pharmacotherapy."

"This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had used marijuana at least 9 times in the past month were randomly assigned to either an immediate 2-session MET intervention or to a 3-month delay condition. Two thirds of the sample characterized themselves as in the precontemplation or contemplation stages of change regarding marijuana use. Participants' marijuana use and associated negative consequences were assessed at baseline and at a 3-month follow-up. Analyses revealed that both groups significantly reduced marijuana use at the 3-month follow-up ( p = .001); however, no between-group differences were observed. Despite the absence of a clear effect of MET, this study demonstrated that adolescents could be attracted to participate in a voluntary marijuana intervention that holds promise for reducing problematic levels of marijuana use."

"ABSTRACTThe aim of this study was to compare the immediate postoperative period of participants rehabilitated with dental implants placed with a conventional technique or with a minimally invasive technique, without a mucoperiosteal flap elevation (flapless). Participants who needed implant placement were divided into two groups: one group was operated using a mucoperiosteal flap elevation (GA), and the other with a flapless surgical technique (G B). Objective clinical parameters including oral hygiene, mouth opening, inflammation (facial perimeter), surgical time and analgesic consumption, as well as subjective parameters of pain and degree of satisfaction with the procedure, were evaluated. 48 implants were placed in 30 participants (15 participants per group). Oral hygiene index, maximum interincisal opening, pain and analgesic consumption values had a significant difference between groups favoring the flapless technique at 24 h and 7 days but at the 15 days follow-up the differences were only significant for oral hygiene and pain (P < 0.05); there were no statistically significant differences between groups in terms of facial perimeter values and surgical time (P > 0.05). Average on the degree of satisfaction was of 2.6 (SD 0.8) for G A and 3.6 (SD 1.02) for G B (P = 0.06). One implant placed in G A (2.0%) failed before prosthetic loading due to mobility and pain at 3 months follow-up. Participants operated for implant placement with flapless surgical technique go through less postoperative discomfort. Both techniques show high success rates, but to perform a flapless technique patients must be properly selected."

"Irigasi luka merupakan langkah penting dalam perawatan ulkus untuk menghindari perluasan infeksi. Studi sebelumnya menyebutkan irigasi luka dengan artrihpi efektif untuk penyembuhan ulkus diabetikum ditinjau dari skor penyembuhan ulkus. Penelitian ini bertujuan untuk mengetahui efektivitas artrihpi ditinjau dari jumlah kuman. Metode yang digunakan yaitu randomized controlled trial (RCT) dengan double blind menggunakan desain paralel. Dua puluh dua responden ulkus diabetikum yang masih telah berpartisipasi. Responden dilakukan randomisasi kemudian mendapatkan perlakuan dengan alat irigasi artrihpi (tekanan 10-15psi) atau spuit 12 cc jarum nomor 22 (tekanan 13 psi). Swab ulkus untuk mengetahui jumlah kuman dilakukan sebelum dan sesudah pencucian luka. Analisa untuk melihat perbedaan jumlah kuman dilakukan uji Wilcoxon dan Mann-Whitney. Hasil penelitian menunjukkan ada perbedaan yang bermakna jumlah kuman sebelum dan sesudah perlakuan pada kelompok intervensi (p-value: 0,041) maupun kelompok kontrol (p-value:0,006). Tidak ada perbedaan yang bermakna jumlah kuman sesudah perlakuan pada kelompok intervensi dan kelompok kontrol (p-value: 0,25) serta tidak ada perbedaan selisih jumlah kuman yang bermakna sebelum dan sesudah perlakuan pada kelompok kontrol dan intervensi (p-value:0,25). Rekomendasi penelitian ini adalah irigasi luka dengan artrihpi dapat dijadikan sebagai salah satu intervensi keperawatan dalam perawatan ulkus diabetikum.

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Irrigation is an important step management of diabetic foot ulcer to avoid the expansion of the infection. Previous studies have suggested irrigation the wound with artrihpi (pressure 10-15psi) effective for healing diabetic ulcers. This study aims to determine the effectiveness artrihpi based on the number of bacteri. The method used is the randomized controlled trial (RCT) by using a double-blind and parallel design. Twenty-two respondents diabetic ulcers are still infectious have participated. Respondents randomization then get treated with artrihpi (pressure 10-15psi) or 12 cc syringe needle number 22 (pressure 13 psi). Ulcer swab to determine the number of bacteria before and after cleansing the wound. Analysis to see the difference in the number of bacteri use Wilcoxon and Mann-Whitney test. The results showed significant difference bacteria count before and after treatment in the intervention group (p-value: 0.041) or the control group (p-value: 0.006). However, there was no significant difference in the number of bacteria after treatment intervention group and the control group (p-value: 0.25), and no differences were significant difference in the number of bacteria before and after treatment in the control and intervention group (p-value: 0.25). Recommendations in this study was cleansing the wound with artrihpi can be used as a nursing interventions used to clean wounds in the treatment of diabetic ulcers."

"ABSTRAKPeriode postpartum menuntut ibu beradaptasi terhadap perubahan fisik secara dramatis, sehingga dapat memengaruhi psikologis ibu, salah satunya terjadi kecemasan. Kecemasan postpartum yang berkelanjutan berdampak negatif bagi ibu dan bayinya. Penelitian ini bertujuan untuk mengidentifikasi efektifitas deep breathing dan dzikir untuk menurunkan kecemasan postpartum. Desain penelitian berupa eksperimen dengan pendekatan RCT Randomized Controlled Trial pada 60 ibu postpartum di RSUD Dr. R. Soedjati Soemodiardjo Purwodadi Kabupaten Grobogan pada bulan Juni 2018. Instrument yang digunakan Postpartum Specific Anxiety Scale PSAS dan Pittsburgh Sleep Quality Index PSQI . Hasil penelitian menunjukkan bahwa terapi deep breathing dan dzikir efektif menurunkan kecemasan ibu postpartum, ditunjukkan dengan hasil uji statistik MD 95 CI = -12,167 dan p=0,003. Berdasarkan hasil uji statistik pada alpha 0,05 terdapat perbedaan kecemasan ibu postpartum yang siginifikan pada kelompok intervensi sebelum dan setelah diberikan deep breathing dan dzikir p=0,002 , dan menunjukkan bahwa deep breathing dan dzikir menurunkan kecemasan ibu postpartum sebesar 10,333. Perawat maternitas di klinis maupun komunitas direkomendasikan untuk menerapkan terapi komplementer seperti terapi deep breathing dan dzikir untuk menurunkan kecemasan ibu postpartum.

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ABSTRACT Periode postpartum menuntut ibu beradaptasi terhadap perubahan fisik secara dramatis, sehingga dapat memengaruhi psikologis ibu, salah satunya terjadi kecemasan. Kecemasan postpartum yang berkelanjutan berdampak negatif bagi ibu dan bayinya. Penelitian ini bertujuan untuk mengidentifikasi efektifitas deep breathing dan dzikir untuk menurunkan kecemasan postpartum. Desain penelitian berupa eksperimen dengan pendekatan RCT Randomized Controlled Trial pada 60 ibu postpartum di RSUD Dr. R. Soedjati Soemodiardjo Purwodadi Kabupaten Grobogan pada bulan Juni 2018. Instrument yang digunakan Postpartum Specific Anxiety Scale PSAS dan Pittsburgh Sleep Quality Index PSQI . Hasil penelitian menunjukkan bahwa terapi deep breathing dan dzikir efektif menurunkan kecemasan ibu postpartum, ditunjukkan dengan hasil uji statistik MD 95 CI 12,167 dan p 0,003. Berdasarkan hasil uji statistik pada alpha 0,05 terdapat perbedaan kecemasan ibu postpartum yang siginifikan pada kelompok intervensi sebelum dan setelah diberikan deep breathing dan dzikir p 0,002 , dan menunjukkan bahwa deep breathing dan dzikir menurunkan kecemasan ibu postpartum sebesar 10,333. Perawat maternitas di klinis maupun komunitas direkomendasikan untuk menerapkan terapi komplementer seperti terapi deep breathing dan dzikir untuk menurunkan kecemasan ibu postpartum."

"Penelitian ini bertujuan untuk mengetahui efektifitas penekanan mekanikal bantal pasir 2,3 kg antara 2, 4, 6 jam terhadap komplikasi. Metode penelitian randomized controlled trial, dengan jumlah sampel sebanyak 90 orang. Kelompok intervensi I menggunakan bantal pasir 2,3 kg 2 jam, intervensi II 4 jam, kelompok kontrol 6 jam, pengukuran dilakukan setiap 2 jam. Hasil penelitian tidak ada mengalami perdarahan pada semua kelompok, tidak ada perbedaan insiden haematom diantara kelompok (p= 0,866; α= 0,05). Ada perbedaan rasa nyaman diantara kelompok pada observasi 4 jam (p= 0,003; α= 0,05) dan observasi 6 jam (p= 0,0005; α= 0,05). Rekomendasi penelitian ini adalah perlunya modifikasi Standar Prosedur Operasional penggunaan bantal pasir 2,3 kg sebagai penekan mekanikal dari 6 jam menjadi 2 jam, sebab tidak meningkatkan komplikasi, akan tetapi meningkatkan rasa nyaman klien."

"This study was to determine the effectiveness of the mechanical suppression of sandbag 2.3 kg between the 2, 4, 6 hoursagainst complications. The research design was randomized controlled trial study, where 90 patients as sample. A 2.3 kgsandbag was applied for two hours for the first group, four hours for the second groups, and six hours for the control groups,measurements were taken every 2 hours. The results showed that no patient has any bleeding, not difference the incidence ofhematoma between groups (p= 0.866; α= 0.05). That the differences of discomfort between groups were found after 4 hours(p= 0.003; α= 0.05), and after 6 hours (p= 0.0005; α=0.05). It is recommended that Standard Operational Proceduremodification required from six hours into two hours in using a 2.3 kg sandbag as a mechanical pressure, because there is noincrease of incidence of complications, on the otherhand an improvement of comfort level is detected."