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"Pendahuluan. Pemberian cairan karbohidrat oral prabedah dan mengurangi durasi puasa merupakan salah satu komponen dari enhanced recovery after surgery (ERAS). Namun, data penelitian mengenai pemberian cairan karbohidrat oral prabedah pada populasi anak masih terbatas. Penelitian ini bertujuan untuk membandingkan efek pemberian cairan karbohidrat elektrolit oral dan air putih 1 jam prainduksi terhadap kadar glukosa darah pada anak yang menjalani pembedahan abdomen bagian bawah.Metode. Penelitian ini merupakan uji klinis acak tersamar tunggal yang mengikutsertakan 44 pasien anak yang menjalani pembedahan abdomen bagian bawah. Sampel dilakukan pengelompokan dengan metode randomisasi menjadi dua kelompok. Kelompok pertama adalah anak yang diberikan cairan karbohidrat elektrolit oral prabedah. Kelompok kedua adalah anak yang diberikan cairan air putih prabedah. Kedua kelompok dilakukan tiga kali pemeriksaan glukosa darah, yaitu pascainduksi, akhir pembedahan, dan hari I pascabedah, serta elektrolit darah saat pascainduksi. Kedua kelompok dilakukan uji hipotesis untuk melihat perbedaan rerata kadar glukosa darah dan general linear model (repeated measure) untuk melihat tren perubahan kadar glukosa darah selama perioperatif. Selain itu, kedua kelompok dilakukan uji hipotesis untuk melihat perbedaan kadar elektrolit darah pascainduksi sebagai luaran tambahan.Hasil. Tidak terdapat perbedaan kadar glukosa darah yang bermakna antara kelompok anak dengan pemberian cairan karbohidrat elektrolit oral 1 jam prainduksi dan kelompok anak dengan pemberian air putih oral 1 jam prainduksi saat pascainduksi, akhir pembedahan, dan hari I pascabedah (nilai p >0,05). Tidak terdapat perbedaan kadar elektrolit yang bermakna antara kelompok anak dengan pemberian cairan karbohidrat elektrolit oral 1 jam prainduksi dan kelompok anak dengan pemberian air putih oral 1 jam prainduksi saat pascainduksi (nilai p >0,05). Terdapat perbedaan yang bermakna antara volume pemberian cairan pada kelompok pemberian karbohidrat elektrolit oral (median 300 mL, IQR 150 mL) dan air putih (median 200 mL, IQR 200 mL) (nilai p <0,05). Tidak ditemukan kejadian regurgitasi dan aspirasi pneumonia pada kedua kelompok saat induksi anestesia.Kesimpulan. Tidak terdapat perbedaan kadar glukosa darah perioperatif yang bermakna antara kelompok anak dengan pemberian cairan karbohidrat elektrolit oral 1 jam prainduksi dan kelompok anak dengan pemberian air putih oral 1 jam prainduksi.

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Introduction. Preoperative oral carbohydrate electrolyte administration and reducing of clear fluid fasting duration are components of enhanced recovery after surgery (ERAS). However, studies related to preoperative oral carbohydrate electrolyte administration in pediatric elective surgery patients are still limited. This study aimed to evaluate the effects of 1 hour preoperative oral carbohydrate electrolyte fluids on blood glucose in pediatric lower abdominal surgery.

Methods. Fourty four patients were randomly allocated to either carbohydrate electrolyte fluids (intervention group) or water fluids (control group). Blood glucose of both groups were analysed at three time points; postinduction, end of surgery, and postoperative day 1. Electrolytes of both groups were also analysed at postinduction. The results were analysed to evaluate mean differences of blood glucose and general linear model to evaluate the trend of blood glucose consecutively as primary outcome, and electrolytes as secondary outcome.

Results. There are no significant differences on blood glucose levels between group with 1 hour preoperative oral carbohydrate electrolyte fluids and 1 hour preoperative oral water fluids postinduction, end of surgery, and day I postsurgery (p value >0,05). There are no significant differences on electrolyte levels between group with 1 hour preoperative oral carbohydrate electrolyte fluids and 1 hour preoperative oral water fluids postinduction (p value >0,05). There are significant differences on preoperative volume fluids between group with carbohydrate electrolyte fluids (median 300 mL, IQR 150 mL) and water fluids (median 200 mL, IQR 200 mL) (p value <0,05). There are no regurgitation and pneumonia aspiration events on both groups.

Conclusion. There are no significant differences on perioperative blood glucose levels between group with 1 hour preoperative oral carbohydrate electrolyte fluids and 1 hour preoperative oral water fluids."

"Prediktor keparahan pankreatitis bilier yang telah banyak digunakan seperti kriteria Ranson, Imrie modifikasi, dan APACHE II membutuhkan waktu pengumpulan data hingga 48 jam dengan variabel diagnostik multipel sehingga sulit untuk diterapkan. Studi ini bertujuan untuk mencari prediktor keparahan tunggal agar dapat segera ditentukan tatalaksana terbaik bagi tiap pasien.Penelitian ini menggunakan data sekunder dari rekam medis pasien-pasien pankreatitis bilier akut di RSCM tahun 2008-2016. Kadar glukosa darah sewaktu GDS awal, derajat keparahan, dan mortalitas dicatat dan dianalisis menggunakan SPSS 20.0.Sebanyak 41 pasien pankreatitis bilier dari 140 pasien pankreatitis akut memenuhi kriteria inklusi dari studi ini. Rerata usia pasien 49,2 tahun, 24 58,5 laki-laki dan 17 41,5 perempuan. Median kadar GDS kasus ringan, sedang, dan berat adalah 109,5 mg/dL; 131 mg/dL; dan 171 mg/dL. Terdapat perbedaan bermakna antara kadar GDS pada pankreatitis bilier ringan dengan berat, nilai p 0,008.Pada kurva ROC GDS terhadap pankreatitis bilier berat didapatkan AUC 0,885 IK 95 0,743 ndash; 1,000 . Nilai cut-off GDS 154,5 mg/dL memiliki sensitivitas dan spesifisitas yang optimal dalam memprediksi pankreatitis bilier akut berat, yaitu 75 dan 91,8 . Kadar GDS tersebut memiliki nilai prediksi positif dan negatif sebesar 50 dan 97,1 . Tidak didapatkan hubungan antara kadar GDS dengan mortalitas, nilai p 0,249. Didapatkan hubungan antara derajat keparahan dengan mortalitas dengan nilai p 0,021 dan OR 0,028. Dari penelitian ini dapat disimpulkan bahwa kadar GDS 154,5 mg/dL dapat memprediksi pankreatitis bilier akut berat dengan akurasi yang baik.

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The established severity predictors of gallstone pancreatitis such as Ranson criteria, modified Imrie, and APACHE II usually require several days and multiple diagnostic variable to be fulfilled so that they are not convenient to use. This study was held to find a simple severity predictor of gallstone pancreatitis to immediately choose the best management for each patient.The data were derived retrospectively from the medical records of acute gallstone pancreatitis patients during 2008 2016. Random blood glucose RBG level on admission, severity grading, and mortality were recorded and analyzed using SPSS 20.0.Forty one gallstone pancreatitis out of 140 acute pancreatitis patients were included in this study. The mean age was 49,2 years old, 24 58,5 were male and 17 41,5 were female. The median RBG level in mild, moderately severe, and severe disease were 109,5 mg dL 131 mg dL and 171 mg dL respectively. There was a significant difference of RBG level on mild and severe disease, p value 0,008.The ROC curve of RBG and severe gallstone pancreatitis revealed the AUC of 0,885 CI 95 0,743 ndash 1,000 . The cut off point of RBG level 154,5 mg dL had the optimal sensitivity 75 and specificity 91,8 to predict severe disease. The positive and negative predictive value of RBG level 154,5 mg dL were 50 and 97,1 . There was no significant difference between RBG level and mortality, p 0,249. There was a relationship between severity grading and mortality, p 0,021 and OR 0,028. We can conclude that RBG level of 154,5 mg dL can acurately predict severe disease."

"[ABSTRAKLatar Belakang: Hipoglikemia merupakan masalah metabolik yang sering terjadi pada neonatus terutama bayi kurang bulan dan bayi kecil masa kehamilan. Sebagaian besar neonatus kompensasi hipoglikemia fisiologis dengan memproduksi benda keton.Tujuan: Membantu menambahkan data dalam membuat pedoman pemeriksaan glukosa darah pada bayi late preterm dan bayi cukup bulan kecil masa kehamilan.Metode Penelitian: Penelitian cross sectional untuk melihat gambaran kadar gula darah diawal kelahiran pada bayi late preterm dan cukup bulan kecil masa kehamilan dan hubungannya dengan keton darah sebagai respons adaptasi metabolik. Penilaian respons kadar keton darah terhadap perubahan kadar gula darah dengan melakukan uji korelasi pada masing-masing tahap penilaian.Hasil: Sebanyak 53 subyek memenuhi kriteria penelitian. Rerata kadar gula darah pada usia 0-4 jam 69,83±22,19 mg/dL, >4-24 jam 63,02±16,80 mg/dL, >24-48 jam 62,94±14,80 mg/dL ) keseluruhan secara statistik tidak berbeda bermakna (p= 0,117). Median kadar keton darah pada usia 0-4 jam 0,60 (0,10-1,40) mmol/L, >4-24 jam 0,60 (0,30-1,3) mmol/L, >24-48 jam 0,60 (0,10-1,40) mmol/L keseluruhan secara statistik tidak berbeda bermakna (p = 0,326). Hubungan antara perubahan kadar gula darah dengan perubahan kadar keton darah menunjukkan bahwa setiap perubahan satu unit kadar gula darah mengakibatkan perubahan kadar keton darah sebesar 0,0012 secara statistik tidak bermakna (p = 0,192).Simpulan: Pola perubahan glukosa darah bayi late preterm dan bayi cukup bulan kecil masa kehamilan tidak selalu mengalami hipoglikemia, produksi badan keton pada bayi late preterm dan bayi cukup bulan kecil masa kehamilan memadai.

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ABSTRACTIntroduction: Hypoglycaemia is the most common manifestation of failure of metabolic adaptation in the newborn period, especially in premature infants and small for gestational age. Most of the physiological neonatal hypoglycaemia compensate physiologist hypoglycaemia by producing ketone body.Objective: Provide data to establish guidelines blood glucose tests in late preterm infants and term infants small for gestational age.Methods: A cross sectional research to see pattern of blood glucose concentration at the newborn and its relationship with blood ketones as a response to metabolic adaptation. Evaluation of blood ketone concentration to the change of blood glucose is done by correlation test at each evaluation stage.Results: A total of 53 subjects fulfil the study criteria. The mean blood glucose level at the age of 0-4 hours was 69,83 ± 22,19 mg/dL, > 4-24 hours was 63,02 ± 16,80 mg/dL, > 24-48 hours was 62,94 ± 14,80 mg/dL overall was not statistically significant (p = 0.117). Median levels of blood ketones at the age of 0-4 hours was 0.60 (0.10 to 1.40) mmol/L, > 4-24 hours was 0.60 (0.30 to 1.30) mmol/L , > 24-48 hours was 0.60 (0.10 to 1.40) mmol/L overall was not statistically significant (p = 0.833). The relationship between changes in blood glucose levels by changing levels of blood ketones indicate that any change in one unit of blood glucose levels lead to changes in levels of blood ketones at 0.0012 was not statistically significant (p = 0.192) .Conclusion: The change of blood glucose in late preterm infants and term infants small for gestational age not always having hypoglycemia. Production of ketone body at late preterm infants and term infants small for gestational age is not sufficient., Introduction: Hypoglycaemia is the most common manifestation of failure of metabolic adaptation in the newborn period, especially in premature infants and small for gestational age. Most of the physiological neonatal hypoglycaemia compensate physiologist hypoglycaemia by producing ketone body.Objective: Provide data to establish guidelines blood glucose tests in late preterm infants and term infants small for gestational age.Methods: A cross sectional research to see pattern of blood glucose concentration at the newborn and its relationship with blood ketones as a response to metabolic adaptation. Evaluation of blood ketone concentration to the change of blood glucose is done by correlation test at each evaluation stage.Results: A total of 53 subjects fulfil the study criteria. The mean blood glucose level at the age of 0-4 hours was 69,83 ± 22,19 mg/dL, > 4-24 hours was 63,02 ± 16,80 mg/dL, > 24-48 hours was 62,94 ± 14,80 mg/dL overall was not statistically significant (p = 0.117). Median levels of blood ketones at the age of 0-4 hours was 0.60 (0.10 to 1.40) mmol/L, > 4-24 hours was 0.60 (0.30 to 1.30) mmol/L , > 24-48 hours was 0.60 (0.10 to 1.40) mmol/L overall was not statistically significant (p = 0.833). The relationship between changes in blood glucose levels by changing levels of blood ketones indicate that any change in one unit of blood glucose levels lead to changes in levels of blood ketones at 0.0012 was not statistically significant (p = 0.192) .Conclusion: The change of blood glucose in late preterm infants and term infants small for gestational age not always having hypoglycemia. Production of ketone body at late preterm infants and term infants small for gestational age is not sufficient.]"

"Guided imagery sebagai intervensi komplementer untuk mengurangi nyeri diharapkan dapat meningkatkan kenyamanan dan mengurangi kinesiofobia. Tujuan penelitian ini adalah untuk mengidentifikasi efektivitas guided imagery terhadap nyeri, kenyamanan, dan kinesiofobia pada pasien fraktur ekstremitas bawah pasca pembedahan. Desain penelitian yang digunakan adalah quasi eksperimen dengan pre-test dan post-test. Sampel dipilih dengan metode consecutive sampling berjumlah 60 responden, terdiri dari 30 untuk kelompok kontrol dan 30 untuk kelompok intervensi. Kriteria inklusi penelitian ini adalah mengalami fraktur ekstremitas bawah dan telah menjalani pembedahan pada hari pertama, mendapatkan ketorolak, berusia lebih dari 18 tahun, mampu berkomunikasi dengan bahasa Indonesia, tanda vital dalam rentang stabil, sadar penuh, dan bersedia mengikuti penelitian. Kriteria eksklusi penelitian ini adalah ada gangguan pendengaran, multiple fracture, dirawat di ICU, mengalami diabetes mellitus dan neuropati perifer. Kelompok kontrol diberi analgetik, sedangkan kelompok intervensi diberi analgetik dan guided imagery selama 3 hari dengan durasi selama 20 menit. Pengukuran hasil dilakukan sebelum intervensi dan 3 hari setelah intervensi menggunakan Visual Analog Scale (VAS), Shortened General Comfort Questionnaire (SGCQ), dan TAMPA Scale for Kinesiophobia (TSK). Penelitian ini diikuti oleh responden laki-laki (61,7%), berpendidikan SMA (45,0%), memiliki riwayat nyeri pembedahan sebelumnya (68,3 %), dan mengalami fraktur femur (46,7 %). Hasil penelitian ini menunjukkan adanya perbedaan yang bermakna selisih rerata skala nyeri, skor kenyamanan, dan skor kinesiofobia sebelum dan setelah intervensi antara kelompok intervensi dengan kelompok kontrol (p < 0,05; α 0,05). Selisih rerata skala nyeri, skor kenyamanan, dan kinesiofobia sebelum dan setelah intervensi pada kelompok intervensi lebih besar dibandingkan dengan kelompok kontrol. Disimpulkan, guided imagery dapat menurunkan skala nyeri dan skor kinesiofobia, serta meningkatkan skor kenyamanan, sehingga perawat dapat mengimplementasikan guided imagery pada pasien fraktur ekstremitas bawah pasca pembedahan.

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Guided imagery as a complementary intervention can reduce post-operative pain, increase comfort, and reduce kinesiophobia. The purpose of this study is to identify the effectiveness of guided imagery on pain, comfort, and kinesiophobia in post-operative lower extremity fracture patients. The research design used was quasi-experiment with pre-test and post-test. Samples were selected by consecutive sampling method totaling 60 respondents, consisting of 30 for control groups and 30 for intervention groups. The inclusion criteria were having a lower extremity fracture and had undergone surgery on the first day, received ketorolac, were more than 18 years old, able to communicate in Indonesian, vital signs in the stable range, fully conscious, and willing to participate in the study. The exclusion criteria for this study were hearing loss, multiple fractures, being treated in the ICU, had diabetes mellitus and peripheral neuropathy. The control group was given analgesics, while the intervention group was given analgesics and guided imagery for 3 days with a duration of 20 minutes. Outcome measurements were taken before the intervention and 3 days after the intervention using Visual Analog Scale (VAS), Shortened General Comfort Questionnaire (SGCQ), and TAMPA Scale for Kinesiophobia (TSK). This study was attended by male respondents (61.7%), high school education (45.0%), had a history of previous post-operative pain (68.3%), and had femur fracture (46.7%). The results of this study showed a significant difference in the mean difference in pain scale, comfort score, and kinesiophobia score before and after the intervention between the control group and the intervention group (p < 0.05; α 0.05). The mean difference in pain scale, comfort score, and kinesiophobia before and after treatment in the intervention group was greater than that in the control group. It was concluded that guided imagery can reduce pain scales and kinesiophobia scores, and increase comfort scores, so nurses can implement guided imagery in post-operative lower extremity fracture patients."

"Latar Belakang: Tingginya pajanan tekanan dan beratnya aktivitas fisik saat bekerja menyebabkan nelayan berisiko kehilangan cairan dan elektrolit tubuh. Kehilangan elektrolit ini dapat menyebabkan berbagai gangguan kesehatan dan mempengaruhi produktivitas. Salah satu cara mencegahnya adalah dengan mengkonsumsi cairan isotonik. Air kelapa merupakan cairan isotonik alami yang mudah didapat dan banyak beredar dalam bentuk kemasan dipasaran. Disisi lain mengkonsumsi air kelapa berisiko meningkatkan tekanan darah akibat peningkatan asupan harian natrium. Sehingga diperlukan adanya studi untuk mengungkap pengaruh suplementasi air kelapa kemasan terhadap kadar elektrolit darah dan tekanan darah pada nelayan Metode: Penelitian true experimental pada populasi nelayan penangkap ikan dan pencari kerang dengan total subjek sebesar 37 yang dibagi secara random dan blinding menjadi 18 subjek untuk kelompok intervensi dan 19 subjek untuk kelompok kontrol. Subjek secara single blind diberikan cairan intervensi berupa air kelapa kemasan yang diberikan bersama dengan air mineral sebagai cairan kebutuhan dasar. Pengambilan data kadar elektrolit darah dan tekanan darah dilakukan sebelum dan sesudah bekerja. Hasil: Dari hasil analisa statistik sebelum dan sesudah intervensi pada kelompok suplementasi air kelapa terdapat penurunan bermakna kadar natrium darah (p 0.012) dan klorida darah (p 0.011), sedangkan kadar kalium dan tekanan darah tidak mengalami perubahan bermakna. Perbandingan kadar elektrolit darah dan tekanan darah setelah intervensi antara dua kelompok tidak menunjukan adanya perbedaan bermakna. Kesimpulan. Secara statistik konsumsi air kelapa kemasan sebagai cairan suplementasi menyebabkan penurunan kadar natrium dan klorida darah mesikipun tidak bermakna secara klinis. Disisi lain jika dibandingkan dengan kelompok kontrol, air kelapa tidak berbeda dalam mempengaruhi kadar elektrolit darah dan tekanan darah.

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Background: Being expose to heat stress and heavy physical work make fishermen at risk of losing body fluid and electrolyte. This condition can cause serious health problem and affect productivity. Consuming isotonic water will prevent those risk. Coconut water is a natural isotonic solution that widely available on commercial packaged. In other hand, consuming coconut water can increase daily sodium intake and increase blood pressure. Further study is needed to reveal the effect of packaged coconut water on blood electrolyte level and blood pressure among fisherman.

Method: True experimental study was conducted among fisherman and clam seeker. A total of 37 subjects was divided randomly into interventional group (18 subjects) and control group (19 subjects). Subject was single blindedly given packaged coconut water as interventional solution accompenied by mineral water as basic fluid needs. Blood electrolyte and blood pressure was obtained before and after work.

Result:Statistically analysed on pre and post intervention of packaged coconut water supplementation group, showed a significant decrease of blood sodium level (p 0.012) and blood chloride level (p 0.011). While post interventional comparison between two groups show no difference neither blood electrolyte level nor blood pressure.

Conclusion: Statistically consuming packed coconut water as supplementation resulting on a decrease of blood sodium and chloride level, eventhough the decrease is not clinically significant. In other hand comparing to control group, packed coconut water has no difference on affecting blood electrolyte level and blood pressure."

"Nyeri pasca pembedahan masih menjadi masalah utama diseluruh dunia, nyeri ini menimbulkan ketidaknyamanan pasien, memperlambat penyembuhan, memperpanjang waktu perawatan dan menimbulkan komplikasi lainnya. Penelitian ini untuk mengetahui hubungan tingkat pengetahuan perawat tentang nyeri dan penatalaksanaanya terhadap sikap perawat dalam menurunkan nyeri pada pasien pasca pembedahan di ruang perawatan RSUP Perasahabatan. Desain yang digunakan dalam penelitian ini adalah Analitik Korelatif dengan pendekatan cross sectional. Jumlah sampel yang diambil 102 orang dengan Simple Random Sampling. Analisis pada penelitian ini menggunakan analisis Spearman. Hasil penelitian ini Terdapat Hubungan antara Tingkat Pengetahuan Perawat tentang Nyeri dan Penatalaksanaaanya terhadap Sikap Perawat dalam Menurunkan Nyeri pada Pasien Pasca Pembedahan di RSUP Persahabatan Jakarta dengan nilai P=0,003 ?=0,05. Disarankan perawat untuk tetap meningkatkan pengetahuan dan sikapnya dalam penatalaksanaan nyeri pada pasien pasca pembedahan sehingga dapat menjaga kualitas pelayanan keperawatan di Rumah Sakit.

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Pain post operative is still recognized as a main problem in the world. The pain generally leads to a state of discomfort feeling, delay healing, prolonge length of stay. This study examined the correlation between nurses knowledge regarding pain and its management towards nurses attitude to reduce pain in patients post operative in ward RSUP Persahabatan. The design of this study using correlational descriptive with cross sectional approach. This participants of this study consisted of 102 nurses with simple random sampling method.

The result of Spearman analysis indicates that there is a correlation between nurses knowledge regarding pain and its management towards nurses attitude to reduce pain in patients post operative in ward RSUP Persahabatan Jakarta, with p value 0,003 0,05. Recomendation for nurses is to keep improving knowledge and atttude regarding pain and its management towards patients post operative in order to improve the quality of health care service in hospital."

"ABSTRAKLatar Belakang. Meskipun kemajuan dalam desain dan bentuk fiksasi pada implant total knee replacement (TKR) meningkatkan kesintasan dan fungsi TKR secara dramatis, jumlah perdarahan prosedur ini hingga kini masih merupakan masalah penting yang belum dapat teratasi dengan baik.Metode. Penelitian ini adalah randomized controlled trial. Terdapat 28 pasien yang menjalani TKR periode Agustus 2014 hingga Februari 2016 di Rumah Sakit Cipto Mangunkusumo, 22 diantaranya memenuhi kriteria inklusi dan dibagi menjadi tiga kelompok. Kelompok kontrol, kelompok asam tranexamat intraartikular intraoperatif dan kelompok asam traneksamat intravena preoperatif. Perdarahan intraoperatif, kadar hemoglobin (Hb) preoperasi hingga hari kelima pasca operasi, total produksi drain, jumlah transfusi total dan hari pencabutan drain dicatat dan dibandingkan.Hasil. Jumlah transfusi pada kelompok intraartikular (200 +/- SB 100 ml) dan intravena (238 ± SB 53 ml ) secara signifikan berbeda dengan kelompok kontrol (1016 ± SB 308.2 ml) (p = 0.001). Total produksi drain pada kelompok intraartikuler (328 ml ± SB 193 ml) maupun intravena (391 ml ± SB 185 ml) berbeda bermakna dengan kelompok kontrol (652 ± SB 150 ml) (p = 0.003). Tidak terdapat perbedaan yang bermakna antara jumlah transfusi antara grup intravena dengan grup intraartikuler. Tidak terdapat perbedaan yang bermakna antara kadar Hb baik preoperasi maupun pascaoperasi, jumlah perdarahan intraoperatif, maupun hari drain dicabut pada setiap kelompok.Simpulan. Pemberian asam traneksamat menghasilkan total transfusi dan total produksi drain yang secara signifikan berbeda dibandingkan dengan kontrol, namun tidak terdapat perbedaan yang bermakna antara jumlah transfusi antara grup intravena dengan grup intraartikuler. Pemberian asam traneksamat baik intravena maupun intraartikuler dapat mengurangi jumlah transfusi dan total produksi drain secara efektif pada pasien yang menjalani prosedur TKR

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ABSTRACTIntroduction. This is a randomized controlled trial study. From 28 patients who underwent TKR from August 2014 to Februari 2016 at Cipto Mangunkusumo Hospital, 22 patients met the inclusion criteria and were divided into three groups. The control group,tranexamic acid intraarticular-intraoperative group, and intravenous tranexamic acid preoperative group. Intraoperative bleeding, hemoglobin (Hb) level on pre-operative to fifth day post surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared.Method. This is a randomized controlled trial study. From 28 patients who underwent TKR from August 2014 to Februari 2016 at Cipto Mangunkusumo Hospital, 22 patients met the inclusion criteria and were divided into three groups. The control group,tranexamic acid intraarticular-intraoperative group, and intravenous tranexamic acid preoperative group. Intraoperative bleeding, hemoglobin (Hb) level on pre-operative to fifth day post surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared.Result. The amount of blood transfusions needed both in the intra-articular group (200 +/- SD 100ml) and in the intra-venous group (238 ± SD 53 ml) was significantly different compared with those in the control group (1016 ± SD 308.2 ml) (p = 0.001), but there is no significant difference between the amount of blood transfusion needed in the intra-articular group and the amount needed in the intra-venous group. The total drain production in the intra-articular group (328 ml ± SD 193 ml) and intra-venous group (391 ml ± SD 185 ml) was significantly different compared to those in the control group (652 ± SD 150 ml) (p = 0.003). There is no significant difference between the levels of both preoperative and postoperative hemoglobin, the amount of intraoperative bleeding, as well as the duration of drain usage on each group.Consclusion. Tranexamic acid used both intra-articularly and intra-venously significantly reduce the amount of blood transfusion needed dan total drain production compared to control, but there is no significant difference between the intra-articular group and intra-venous group."

"Latar Belakang : Kejadian AKI Acute Kidney Injury pascabedah akan meningkatkan morbiditas, mortalitas dan lama perawatan di rumah sakit. Diagnosis AKI ditegakkan berdasarkan kriteria AKIN. Kondisi dan manajemen perioperatif sangat mempengaruhi kekerapan AKI pascabedah.Tujuan : Mengetahui hubungan faktor komorbiditas prabedah dan jenis operasi sebagai prediktor AKI pascabedah elektif yang dirawat di ICU RSCM.Metode : Penelitian kohort retrospektif menggunakan data dari rekam medis pasien yang dirawat di ICU pascabedah elektif antara Januari 2014 hingga Desember 2015. Seratus satu pasien diikutkan dalam penelitian dari total 1739 data pasien yang didapatkan. Diagnosis AKI ditegakkan dengan keriteria AKIN. Data diolah menggunakan perangkat lunak SPSS dengan uji Chi Square dan Independent T test.Hasil : Analisis dilakukan pada 101 pasien dari 1739 populasi terjangkau. Insiden AKI didapatkan sebesar 44,6 . Diagnosis AKI ditegakkan dengan penurunan jumlah urin sesuai dengan Stage 1 AKI berdasarkan AKIN. Rata-rata usia AKI didapatkan sebesar 50,44 13,7 tahun p=0,304 . Analisis berdasarkan masing-masing variabel didapatkan kekerapan AKI pada diabetes melitus sebesar 50 p=0,633 , penyakit jantung sebesar 40,7 p=0,641 , hipertensi sebesar 46,9 p=0,749 , dan operasi intraabdomen sebesar 61,9 p=0,072 .Kesimpulan : Dari variabel yang diteliti tidak ada hubungan faktor komorbiditas prabedah dan jenis operasi sebagai prediktor AKI pascabedah elektif yang dirawat di ICU RSCM.

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Background Postoperative Acute Kidney Injury AKI will increase the risk of patient rsquo s morbidity, mortality and or prolonged the hospital stay. In this study, the diagnosis of AKI was made based on The Acute Kidney Injury Network AKIN criteria. Perioperative patient condition and management influenced the incidence of postoperative AKI.Aim To determine the relationship between preoperative patient rsquo s comorbidities and surgical procedure with the incidence of postoperative AKI in patients who were admitted in ICU RSCM immediately after surgery.Methods A retrospective cohort study using consecutive patients who underwent elective surgery with postoperative ICU admission from January 2014 to December 2015. A total of 1739 patients were collected from medical record, and 101 patients were included for the study. The included patients were segregated using AKIN diagnosis criteria and the relationship variables were analyzed using Chi Square test and Independent T test.Results The incidence of AKI in this study were 44.6 , in which all of them were diagnosed as AKI Stage I, based on decrease in urine output as stipulated by AKIN criteria. The average age was 50.44 13.7 years old p 0.304 . The incidence of AKI in patients with diabetes mellitus was 50 p 0.633 , heart disease 40.7 p 0.641 , hypertension 46.9 p 0.749 , and intra abdominal surgery 61.9 p 0.072 .Conclusion There were no relationship between patient rsquo s preoperative comorbidities and surgical procedure with the incidence of AKI postoperatively in patients admitted in ICU RSCM."

"Penentuan Kadar Glukosa menggunakan sensor Non-Enzimatik pada saat ini banyak dikembangkan, sebagai alternatif sensor glukosa non-Enzimatik dengan perangkat yang lebih praktis dan sederhana, digunakan Screen Printed Electrode (SPE) sebagai solusinya. Pada penelitian ini, digunakan oksida tembaga sebagai sensor non- Enzimatik yang terdeposit pada permukaan SPE dengan metode elektrodeposisi menggunakan larutan CuSO4 0.01 M dalam 0.1 M H2SO4. Variasi potensial dan waktu deposisi dilakukan untuk mendapatkan deposit CuSPE yang optimum. Uji deteksi glukosa dilakukan pada potensial +0.7 V vs Ag/AgCl. Deposit CuSPE dengan variasi potensial dan waktu -0.4 V selama 300 detik merupakan yang paling optimum karena mempunyai sensitifitas tertinggi sebesar 1063.452 μA mM-1 cm-2, batas deteksi terendah sebesar 0.485 x 10-3 M, dan linearitas paling baik sebesar R20.987. CuSPE optimum digunakan pada sistem alir, didapatkan laju alir optimum 25 mL/menit, konsentrasi NaOH optimum 1 M dilihat dari %RSD sebesar 1.19%. Pada variasi konsentrasi glukosa dihasilkan linearitas sebesar R2 0.982 dengan LOD sebesar 4.273 x 10-3 M. Sensor memiliki repeatabilitas yang baik dengan %RSD = 1.39% (n=10). Deteksi glukosa pada sampel darah dengan batch dan sistem alirmemiliki perbedaan jika dibandingkan dengan hasil deteksi pada glukosameter.

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Determination of glucose concentration using Non-Enzymatic sensor has been developed, as an alternative to Non-Enzymatic glucose sensors with a device that is more practical and simple to use, Screen Printed Electrode (SPE) as a solution. In this study, use of copper oxide as a non-Enzymatic sensors are deposited on the surface of the SPE by electrodeposition method using a solution of 0.01 M CuSO4 in 0.1 M H2SO4. Variations potential and deposition time taken to obtain optimum CuSPE deposit. Glucose detection test conducted on the potential +0.7 V vs Ag/AgCl. Deposit CuSPE which was deposited in -0.4 V for 300 seconds was the optimum because it has the highest sensitivity 1063.452 μ𝐴𝑚𝑀-1𝑐𝑚-2, the lowest limit of detection0.458 x 10-3M, and most excellent linearity R2= 0.987. CuSPE optimum use of the system flow, obtained the optimum flow rate of 25 mL/ min, the concentration of 1 M NaOH optimum views of% RSD for 1.19%. In the glucose concentration variations resulting linearity of R2 0.982 with LOD of 4.273 x 10-3M. The sensor has a good repeatability with% RSD = 1.39% (n=10). Detection of glucose in the blood sample using batch and flow systemhave differences when compared with the results of the detection in glukosameter."