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"Latar Belakang dan Tujuan: Meskipun PCNL tradisional memiliki stone-free rate yang tinggi, kadang-kadang dikaitkan dengan morbiditas pengobatan yang signifikan. Di seluruh dunia, versi miniatur dari PCNL konvensional (Mini-PCNL) telah digunakan. Menurut literatur yang tersedia, Mini-PCNL memiliki morbiditas yang lebih rendah dan stone-free rate yang serupa dengan PCNL konvensional. Dalam penelitian ini kami bertujuan untuk mendeskripsikan karakteristik pasien yang menjalani mini-PCNL di pusat kami di Jambi, Indonesia.Metode: Ini adalah studi deskriptif yang melibatkan pasien batu ginjal yang diobati dengan mini- PCNL selama 2017 – 2021 di Jambi, Indonesia. Pemilihan subjek penelitian menggunakan metode total sampling. Semua pasien memiliki riwayat medis yang diambil dan pemeriksaan fisik dilakukan sebelum operasi. Prosedur dilakukan oleh tiga operator di satu rumah sakit kabupaten rujukan. Hasil: Selama periode 2017 hingga 2021, pusat kami telah melakukan 188 prosedur mini-PCNL untuk pengangkatan batu ginjal. Namun, hanya 186 kasus yang dimasukkan dalam studi ini setelah mengesampingkan 2 kasus karena data yang tidak lengkap. Dari 186 kasus tersebut, sebanyak 165 pasien menjalani prosedur mini-PCNL. Usia rata-rata pasien dalam penelitian ini adalah 49,3 tahun (berkisar antara 12-87 tahun) dengan mayoritas laki-laki (101/165). [61,21%]). Waktu operasi rata- rata adalah 113,5 ± 50,5 menit, dan rata-rata lama tinggal di rumah sakit adalah 2,8 ± 1,3 hari. Dari 186 kasus, sebanyak 175 kasus tidak memiliki sisa batu dan hanya 11 yang memiliki sisa batu (stone- free rate [SFR] 94,08%). Sebagian besar pasien mengalami hidronefrosis, dan penempatan DJ stent dilakukan pada 44 dari 186 kasus. SFR menurun seiring dengan peningkatan ukuran batu Kesimpulan: Mini-PCNL terbukti menjadi pilihan yang baik untuk mengelola batu ginjal, terutama untuk batu berukuran sedang dan keras, memberikan hasil yang lebih baik dan mengurangi komplikasi pasca-operasi.

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Background and Aim: Although traditional PCNL has a high stone-free rate, it is sometimes associated with significant treatment morbidity. Worldwide, a miniaturized version of a conventional PCNL (Mini-PCNL) has been used. According to the available literature, Mini-PCNL has lower morbidity and a similar stone-free rate to conventional PCNL. In this study we aim to describe the characteristics of patients undergoing mini- PCNL at our center in Jambi, Indonesia.

Methods: This is a descriptive study involving patients with kidney stones treated with mini-PCNL during 2017 – 2021 in Jambi, Indonesia. The selection of the study subjects was using total sampling method. All patients had a medical history taken and a physical examination performed prior to surgery. The procedure was performed by three operators in one referral district hospital.

Results: From 2017 to 2021, a total of 188 mini-PCNL procedures were performed at our center for the removal of kidney stones. However, only 186 cases were included in this study after excluding 2 due to incomplete data. The mean age of patients in this study was 49.3 years old (ranging from 12–87 years old) with the majority being a male (101/165 [61.21%]). Of 186 cases, a total of 175 cases having no residual stone and only 11 having residual stone (stone-free rate [SFR] 94.08%). Most patients presented with hydronephrosis, and DJ stent placement was performed in 44 out of 186 cases. The SFR decreased as the stone size increased.

Conclusion: Mini-PCNL proves to be a valuable choice for managing kidney stones, especially for medium-sized and hard stones, leading to enhanced patient results and reduced post-operative complications."

"Latar Belakang: Pandemi Corona Virus Disease 2019 (COVID-19) yang disebabkan oleh Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) berawal dari Wuhan, Cina sejak Desember 2019. Jakarta menjadi salah satu episentrum pandemic COVID-19 di Indonesia. Data penelitian COVID-19 di Indonesia masih sangat terbatas, sehingga diperlukan penelitian untuk mengetahui karakterisik klinis, radiologis, laboratorium dan derajat klinis. Metode Penelitian: Penelitian ini diambil dari 1070 pasien yang dirawat di Rumah Sakit Darurat Wisma Atlet yang menjalani skrining gejala klinis, radiologi toraks, laboratorium dan serologi SARS-CoV-2kemudian dilanjutkan dengan pemeriksaan swab RT-PCR. Hasil skrining swab RT PCR pada 1070 pasien terdapat 836pasien terkonfirmasiCOVID-19, lalu diskrining dari 836 pasien yang memiliki radiologi toraks dan laboratorium lengkap ada 413 pasien. Hasil Penelitian: Pasien terkonfirmasi COVID-19 derajat ringan-sedang didominasi oleh pasien laki-laki(55,4%) dengan kelompok usia < 60 tahun (91,8%) dan rerata umur 39,94±14,17 tahun. Sebagian besar pasien tidak memiliki komorbid, tetapi komorbid paling banyak adalah hipertensi (4,1%). Derajat klinis pasien yang dirawat paling banyak kasus asimtomatik (46%), sedang (31,5%) dan ringan (22,5%). Gejala yang sering muncul adalah batuk (22,5%), demam (14,3%),sesak napas (6,5%), nyeri tenggorok (5,3%) dan pilek (4,8%). Gambaran radiologis sebagian besar pasien normal (41,9%), sesuai pneumonia (31,5%) dan corakan meningkat (26,6%). Hasil pemeriksaan laboratorium didapatkan limfopenia (10,9%), trombositopenia (1,7%) dan peningkatan NLR (18,4%). Serologi SARS-CoV-2sebagian besar pasien reaktif (48,8%). Sebagian besar pasien dirawat ≥20 hari (63,9%), masa konversi ≥14 hari (52,5%) dan luaran akhir pasien sembuh (99,3%). Terdapat hubungan bermakna antara komorbid dengan lama rawat (p= 0,03) dan lama konversi (p= 0,03), status awal masuk RS dengan lama konversi (p= 0,00) dan lama rawat (p= 0,00). Kesimpulan: Proporsi pasien terkonfirmasi COVID-19 dari keseluruhan pasien yang dirawat sebesar 78,13%, sebagian besar laki-laki dan gambaran radiologis normal. Terdapat kenaikan NLR dan kebanyakan serologi SARS-CoV-2reaktif. Sebagian besar pasien yang dirawat kasus asimtomatik dan luaran akhir perawatannya sembuh.

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Background: Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated from Wuhan, China since December 2019. Jakarta is among of the epicenter of COVID-19 pandemic in Indonesia. Research data on COVID-19 in Indonesia is still very limited while there is an urgent need of disease characterization from the perspective of clinical features, radiological finding, laboratory profile, and severity.

Methods: This retrospective cohort study involved 1070 patients treated at an emergency hospital in Jakarta, Indonesia. Patients were screened for their clinical symptoms, radiological finding, laboratory profile, including the SARS-CoV-2 immunoserology, and then proceed with the SARS-CoV-2 RT-PCR examination. The screening resulted in 836 patients were confirmed COVID-19, and 413 patients had a complete medical record to be further studied.

Results: The mild-moderate cases were dominated by males (55.4%) of age groups <60 years-old (91.8%). The mean age was 39.94±14.17 years-old. Most subjects presented without comorbidities, although hypertension was common (4.1%). Most subjects were asymptomatic (46%) followed by moderate case (31.5%), and mild case (22.5%). Symptoms were cough (22.5%), fever (14.3%), shortness of breath (6.5%), sore throat (5.3%), and runny nose (4.8%). Radiological findings were normal (41.9%), pneumonia (31.5%), and increased opacity (26.6%). Laboratory tests showed lymphopenia (10.9%), thrombocytopenia (1.7%), and increased NLR (18.4%). The SARS-CoV-2 immunoserology was mostly reactive (48.9%). Length of stay (LoS) was ≥20 days (63.9%), conversion period was ≥14 days (52.5%), and most were recovered (99.3%). There were correlations between existing comorbidities and LoS (p=0.03) and conversion time (p=0.03). There were correlations between initial condition during hospital admission with conversion time (p=0.00) and LoS (p=0.00).

Conclusion: The proportion of patients with COVID-19 confirmed from all patients treated was 78.13%, whom male, normal radiological finding, increased NLR, reactive SARS-CoV-2 immunoserology, and asymptomatic predominated. Most of the patients were moderate cases and well recovered."

"Keterbatasan glomerulus filtration rate (eGFR) dan urine albumin creatinine ratio (uACR) sebagai acuan menyebabkan keterlambatan diagnosis dan prognosis penyakit ginjal diabetes. Perkembangan diabetes mengarah pada kerusakan ginjal dicerminkan oleh penanda (biomarker) yang ditemukan dalam spesimen biologis. Penelitian ini bertujuan mencari metabolit potensial sebagai biomarker pada populasi Indonesia dengan membandingkan metabolit dalam urin pasien diabetes dengan risiko ginjal rendah (n=16) dan tinggi (n=16) menurut klasifikasi KDIGO2022. Analisis metabolomik dilakukan menggunakan liquid chromatography/mass spectrometry quadrupole time-of-flight (LC/MS-QTOF) dengan analisis statistik data menggunakan software Metaboanalyst5,0. Metabolit diidentifikasi menggunakan database Human Metabolome Database (HMDB), Metlin, dan Pubchem. Diskriminasi antar 2 kelompok divisualisasikan dengan Principal Component Analysis (PCA) dan Partial Least Squares-Discriminant Analysis (PLS-DA). Signifikansi metabolit antar 2 kelompok ditentukan dengan T-test (p<0,05), variable importance for projection (VIP>1), dan fold change (log2(FC)>1,2). Metabolit yang dipilih hanya metabolit endogen yang diketahui jalur metabolismenya. Dari berbagai parameter tersebut, metabolit yang potensial sebagai biomarker harus memenuhi nilai area under curve (AUC)>0,65. Berdasarkan karakteristik dasar dan klinis, tidak terdapat perbedaan bermakna karakteristik dasar (usia, jenis kelamin, indeks massa tubuh, durasi menderita DMT2, frekuensi olahraga, kebiasaan merokok, penyakit lain, kepatuhan minum obat, regimen terapi metformin-glimepirid) dan pemeriksaan klinis (HbA1c, tekanan darah sistol, dan diastol) antara kedua kelompok (p>0,05). Ditemukan 23 metabolit yang memenuhi parameter VIP, p-value, dan fold change. Disimpulkan, tiga metabolit teratas dengan AUC>0,65 merupakan biomarker potensial yang membedakan kedua kelompok, yaitu indoksil glukuronida, N-asetilserotonin glukuronida, dan gliserofosfokolin. Indoksil glukuronida dan N-asetilserotonin glukuronida terlibat dalam metabolisme triptofan dan glukuronat, sedangkan gliserofosfokolin terlibat dalam jalur metabolisme gliserofosfolipid dan eter lipid.

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The limited utility of glomerulus filtration rate (eGFR) dan urine albumin creatinine ratio (uACR) as the gold standard lead to late diagnosing and prognosing of diabetic kidney disease. Diabetes progression contributes to kidney damage and is reflected by biomarkers in patients' biological samples. This study aims to identify potential endogenous metabolite biomarkers for improved diagnosis and prognosis by comparing metabolites in the urine of diabetic patients with low (n=16) and high (n=16) kidney disease risk in the Indonesian population according to the KDIGO2022 classification. Metabolomic analysis was conducted using liquid chromatography/mass spectrometry quadrupole time-of-flight (LC/MS-QTOF) with Metaboanalyst5.0 software. Metabolites were identified using the Human Metabolome Database, Metlin, and PubChem. Discrimination between the two groups was visualized using principal component analysis (PCA) and Partial Least squares discriminant analysis (PLS-DA). Based on patients' characteristics, no significant differences were observed in baseline characteristics (age, gender, body mass index, duration of type 2 diabetes mellitus, exercise frequency, smoking habits, comorbidities, medication adherence, metformin-glimepiride therapy regimen) and clinical characteristics (HbA1c, systolic and diastolic blood pressure) between two groups (p>0.05). According to the findings of the T-test (p<0.05), fold change (log2(FC)>1.2), and variables important for the projection (VIP>1), there were 23 metabolites substantially different between the two groups. In conclusion, the top 3 metabolites with the area under curve (AUC) value>0.65 demonstrated potential biomarker differentiating among two groups; these are indoxyl glucuronide, N-acetylserotonin glucuronide, and glycerophosphocholine. Indoxyl glucuronide and N-acetylserotonin glucuronide involved in tryptophan metabolism and glucuronate interconversion. Glycerophsophocholine involved in glycerophospholipid and ether lipid metabolism."

"It has been proposed that minor oral surgery can be performed safely in patients taking antithrombotic therapy without interrupting treatment; however, there is little evidence-based guidance about how to manage postoperative hemorrhage in patients taking antithrombotics, and few randomized trials that help to inform the risk–benefit ratio of continuing or suspending antithrombotic therapy. The aim of this study was to identify risk factors for postoperative hemorrhage to create a protocol for patients undergoing minor oral surgery with antithrombotic therapy. One hundred and two patients were enrolled, who subsequently underwent 142 minor oral surgical procedures while taking antithrombotic therapy. Demographic details including age and sex, laboratory coagulation investigations, and episodes of postoperative hemorrhage were recorded. The prothrombin time-international normalized ratio (PT-INR) of participants taking warfarin was <3.0 in all cases (mean 1.89 ± standard deviation 0.52; range 1.11–2.82). The activated partial thromboplastin time (APTT) was significantly associated with postoperative hemorrhage, which was significantly increased in patients taking warfarin alone or in combination with an antiplatelet agent compared with an antiplatelet agent alone. In 7 cases, postoperative hemorrhage continued for 4 days and more, requiring additional local hemostatic management. Our findings suggest that minor oral surgery can be performed under antithrombotic therapy without the need of discontinuing the antithrombotic agents. Local hemostatic materials did not suppress postoperative hemorrhage. APTT is a possible prediction factor for postoperative hemorrhage in such patients and, therefore, should be determined prior to minor oral surgery in addition to PT-INR value."

"ABSTRAKBackground Rheumatoid arhtirtis is a chronic autoimmune disease that mainly attacks joints. It may causes joint deformities which leads to lower quality of life of RA patients. RA is treated with metothrexate which inhibiting disease progression. MTX is known for its hepatotoxicity side effect, which is described by an elevation of aspartate aminotransferase and/or alanine aminotransferase beyond the upper normal limit. Factors that may enhance hepatotoxicity are gender, age, cummulative dose of MTX, and duration therapy of MTX. Prevalence of hepatotoxicity caused by MTX therapy in RA patients in Indonesia is still unknown. The objective of this research is to know the proportion of hepatotoxicity and its associations with the factors that may enhance hepatotoxicity caused by MTX therapy in RA patients in RSCM.Method Data about gender, age, cummulative dose and duration therapy of MTX are obtained from 115 RA patients medical records.Result Proportion of hepatotoxicity in RA patients treated with MTX in RSCM is 42.60 percent. Gender, age, cummulative dose and duration therapy of MTX do not significantly enhance hepatotoxicity p>0.05. Conclusion In conclusion gender, age, cummulative dose and duration therapy of MTX do not have association with hepatotoxicity in RA patients treated with MTX."

"Background: older people contributed to 38.6% of death cases related to COVID-19 in Indonesia. Data regarding clinical profile of hospitalised elderly with COVID-19 in Indonesia were still lacking. Older people are at-risk population in the pandemic, whom we should pay attention to. Methods: this single centre descriptive study utilised complete data of elderly inpatients with COVID-19 in Indonesia’s national general hospital from April to late August 2020. The data consisted of clinical characteristics, symptoms, comorbidities, multimorbidity, and mortality outcome. Results: among elderly patients (n=44), a majority of patients were aged 60-69 years (68%), were male (66%), and had no history of close contact with COVID-19 patient (86%). The most common symptoms were fever, cough and shortness of breath (classic symptoms of COVID-19), whereas the most common chronic diseases were diabetes mellitus, hypertension, and malignancy. Multimorbidity was only found in 14% of patients, all of whom remained alive following SARS-CoV-2 infection. The death rate among elderly inpatients with COVID-19 in this study was 23%, and male older adults contributed to 90% of death cases. Conclusion: male patients dominated both confirmed cases and death cases among elderly with COVID-19. Classic symptoms of COVID-19 were only found in about half of the study patients. Non-survivors had higher percentage of the classic symptoms of COVID-19 than survivors. Atypical COVID-19 presentations are possible in older adults. We postulated that immunosenescence and sex-specific immunoregulatory function play an important role in causing death in this study cohort."

"Batu ginjal merupakan salah satu masalah kesehatan yang terjadi di daerah perkotaan. Pasien yang sudah pernah mengalami batu ginjal memiliki risiko kekambuhan batu ginjal sekitar lima puluh persen pada lima tahun pertama dan tujuh puluh persen pada sepuluh tahun berikutnya. Tingginya angka kekambuhan tersebut dapat dicegah sejak dini yakni melalui discharge planning. Tujuan penulisan ini adalah untuk melakukan analisis evidence based mengenai discharge planning terutama mengenai terapi diet dalam upaya pencegahan batu ginjal berulang. Hasilnyanya pasien memiliki peningkatan kognitif dan juga psikomotor yang baik dalam upaya pencegahan batu ginjal berulang. Rekomendasi kepada pasien dengan batu ginjal untuk memberikan discharge planning sejak pasien dirawat.

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Nephrolithiasis is one of the problems in urban health nursing. Patient with nephrolithiasis have a risk recurrent nephrolithiasis about fifty percent in five year and seventy percent in ten year. It can be prevent early by using discharge planning. This article has purpose to analysis evidence based about discharge planning to prevent recurrent nephrolithiasis. The result of discharge planning showed that this can increase patient’s cognitive and good pshycomotor for preventing recurrent nephrolithiasis. Recommendation for next writer is using discharge planning take care patient since first day they are in hospital."

"Pragnosis buruk pada penderita KNF dapat disebabkan oleh resistensi terhadap efek induksi apoptosis radioterapi dan / atau kemoterapi. Apoptosis bergantung pada aktifasi tepat kaspase 3 yang menghasilkan pembelahan protein-protein kunci seperti PARP-1. Untuk meneliti apakah disrupsi jalur apoptosis menghasilkan sel-sel tumor yang resisten terhadap terapi, dalam penelitian ini dipelajari apakah ketiadaan aktifasi kaspase 3 dalam biopsi tumor para penderita KNF berkaitan dengan hasil pengobatan klinik yang buruk. Selain itu dalam studi terakhir ini akan diteliti apakah tiadanya aktifasi kaspase 3 berkaitan dengan hilangnya ekspresi pro-kaspase 3 dan XIAP."

"Pneumonia menjadi salah satu penyakit yang paling sering terjadi pada anak-anak berusia kurang dari 5 tahun. Gejala yang paling umum muncul pada anak dengan pneumonia adalah batuk, berdahak yang sulit dikeluarkan. Menurut beberapa penelitian fisioterapi dada menjadi intervensi keperawatan yang dapat diterapkan pada anak untuk membantu mengeluarkan sekret yang menghambat jalan napas. Tujuan penulisan ini adalah untuk menganalisis asuhan keperawatan pada pasien anak dengan pneumonia yang mengalami masalah bersihan jalan napas tidak efektif melalui penerapan intervensi fisioterapi dada. Terdapat 2 pasien yang diintervensi, masing-masing berusia 1 tahun 5 bulan dan 1 tahun 1 bulan. Intervensi dilakukan selama selama 3 hari. Setiap hari dilakukan fisioterapi dada sebanyak 2 kali (pagi dan sore) dengan durasi masing-masing 15 sampai 20 menit. Dari hasil evaluasi didapatkan adanya perbaikan status pernapasan pada pasien meliputi penurunan frekuensi napas dan denyut nadi, serta peningkatan saturasi oksigen. Selain itu, hasil auskultasi paru juga menunjukkan adanya penurunan suara ronchi.

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Pneumonia is one of the most common diseases in children under five years old. Coughing and phlegm that is difficult to expel are the most common symptoms of pneumonia in children. Chest physiotherapy can be applied to children to help expel secretions that block airways, according to several studies. The purpose of this paper is to analyze nursing care in pediatric patients with pneumonia who have problems with ineffective airway clearance through the application of chest physiotherapy interventions. There were 2 patients who intervened, each aged 1 year 5 months and 1 year 1 month. The intervention was carried out for 3 days. The chest physiotherapy was conducted twice a day for 15 to 20 minutes each. According to the evaluation results, the patient's respiratory status improved, including a decrease in respiratory rate and pulse, as well as an increase in oxygen saturation. In addition, the results of auscultation of the lungs also showed a decrease in the sound of rhonchi."