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"Latar Belakang: Enterokolitis nekrotikans (EKN) adalah penyakit peradangan berat pada dinding usus menyebabkan cedera dan nekrosis usus. Foto polos abdomen (FPA) serial masih dianggap sebagai standar diagnosis dan evaluasi penyakit ini, namun pemeriksaan ini tidak akurat dan sering terlambat dalam pelaksanaannya serta mengakibatkan neonatus sangat prematur terpapar dengan radiasi. Karenanya diperlukan alat diagnostik yang lebih aman, non-invasif mudah pelaksanaannya dan akurat. Dua dekade terakhir pemeriksaan ultrasonografi abdomen (USGA) semakin berkembang dan memperlihatkan hasil yang baik dalam diagnosis EKN, akan tetapi penggunaan modalitas ini di Indonesia dan khususnya di RSCM masih belum banyak dilakukan.Tujuan: Mendapatkan akurasi gambaran ultrasonografi abdomen (USGA) dibandingkan dengan foto polos abdomen (FPA) dalam menegakkan diagnosis EKN pada bayi sangat prematur tersangka EKN.Metode: Penelitian uji diagnostik potong lintang ini dilakukan pada 40 neonatus sangat prematur berusia antara 28-32 minggu yang dirawat di RSCM Jakarta pada bulan November sampai Desember 2023. Pada Neonatus sangat prematur tersangka EKN yang memenuhi kriteria inklusi dan eksklusi dilakukan pemeriksaan USGA dan FPA. Kedua hasil pemeriksaan dibandingkan menggunakan tabel kontigensi 2x2. Didapatkan sensitivitas 83% dan spesifisitas 43%. Hasil nilai prediksi positif 38% dan nilai prediksi negatif 86%, dan rasio kemungkinan positif (LR+) 1,45 dan rasio kemungkinan negatif (LR-)  0,39.Kesimpulan: Ultrasonografi abdomen lebih akurat untuk penapisan (screening) menengakkan diagnosis EKN pada Neonatus sangat prematur dibandingkan foto polos abdomen.

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Background: Necrotizing enterocolitis (NEC) is a condition characterized by severe inflammation of the intestinal wall leading to intestinal injury and necrosis. Plain abdominal radiography has long served as the standard for the diagnosis and evaluation of NEC despite its low diagnostic accuracy, impracticality, and the risk this modality poses from exposing neonates to ionizing radiation. Therefore, a safer, non-invasive, easy-to-implement, and more accurate diagnostic tool is necessary for diagnosing NEC. Over the past two decades, knowledge about abdominal ultrasound has developed greatly and has been shown to be an excellent modality in diagnosing NEC. However, in Indonesia this modality is still not widely used for diagnosing NEC, especially at Cipto Mangunkusomo National Public Hospital (RSCM) Jakarta.

Objective: This study aimed to assess the accuracy of abdominal ultrasonography in diagnosing NEC compared to plain abdominal radiography in very premature neonates suspected of NEC.

Methods: A cross-sectional diagnostic test study was conducted on 40 very premature neonates aged between 28-32 weeks, who were treated at RSCM Jakarta from November to December 2023. Neonates suspected of NEC who met the inclusion and exclusion criteria underwent both abdominal ultrasound and plain abdominal radiography. The findings from these two examinations were compared using a 2x2 contingency table to establish the sensitivity and specificity. A sensitivity of 83% and a specificity of 43% were found for abdominal ultrasound. The study also found a positive predictive value (PPV) of 38%, a negative predictive value (NPV) of 86%, a positive likelihood ratio (LR+) of 1.45, and a negative likelihood ratio (LR-) of 0.39.

Conclusion: Abdominal ultrasonography was found to be a more accurate for screening  NEC in very premature neonates compared to plain abdominal radiography."

"[Pendahuluan: Luka penetrasi akibat kekerasan tajam merupakan temuan yang umum dalam pemeriksaan luar tindakan autopsi. Namun, sebagian besar mayat korban kekerasan tidak menjalani pemeriksaan dalam karena beragam alasan. Dengan demikian, temuan luka luar dapat berperan sebagai salah satu pertimbangan ahli forensik dalam memperkirakan kerusakan organ dalam walau tidak memiliki kekuatan secara hukum. Penelitian ini dilakukan untuk menghasilkan bukti empiris terkait kerusakan organ dalam yang ditimbulkan kekerasan tajam. Metode: Peneliti mengambil sampel 5 luka penetrasi ke rongga peritoneal pada masing-masing area abdomen dari 36 subjek penelitian yang diotopsi di Departemen Forensik dan Medikolegal FKUI-RSCM, kemudian mencari tahu organ yang terlibat melalui data pemeriksaan baku emas. Hasil: Melalui uji hipotesis menggunakan uji Fisher, didapatkan nilai yang bermakna (p< 0,05) pada beberapa korelasi terkait temuan luka dan kerusakan organ dalam, yakni pada luka penetrasi di epigastrik dengan kerusakan hati (p= 0,01), luka penetrasi di hipokondriak kanan dengan kerusakan hati (p= 0,01), luka penetrasi di hipokondriak kiri dengan kerusakan lambung (p= 0,002), luka penetrasi di umbilikal dengan kerusakan pembuluh darah abdomen mayor (p= 0,004), serta luka penetrasi di iliaka kiri dan kerusakan pankreas (p= 0,01). Pembahasan: Korelasi yang bermakna pada temuan luka luar dan kerusakan organ dalam terkait regio anatomi dan arah luka. Besaran gaya yang diberikan turut mempengaruhi organ-organ yang terlibat;Introduction: Penetrating wounds from sharp force injuries are common findings in external examination of autopsy. Unfortunately, the majority of the victims do not undergo the internal examination part due to various reasons. Even though the forensic doctors do not perform the autopsy completely, the external findings can prove to be useful to predict the resulted organ damages. Therefore, they would still be able to release their expertise opinions based on evidence based medicine. The aim of this study is to produce the empirical evidence related to penetrating wound and organ damage. Method: Five penetrating wounds into peritoneal cavity for each abdominal region from 36 corpses, that had already been autopsied in Forensic and Medicolegal Department FKUI-RSCM, was analyzed to identify organ damage by using gold standard examination (e.g. internal examination in forensic practice), and then to find the correlation between them. Result: The results from hypothesis testing Fisher shows that the p< 0,05 appeared in some correlation findings between variables (penetration wound in epigastric and right hypochondriac and liver damage (p= 0,01), penetration wound in left hypochondriac and stomach damage (p= 0,002), penetration wound in umbilical and major abdomen blood vessel (p= 0,004), and penetration wound in left iliaca and pancreas damage (p= 0,01), thus made them statistically significant. Discussion: The significant results strongly associated with anatomical region and the direction of the wound. The amount of force applied to each wound affected the outcome of the damaged organs, Introduction: Penetrating wounds from sharp force injuries are common findings in external examination of autopsy. Unfortunately, the majority of the victims do not undergo the internal examination part due to various reasons. Even though the forensic doctors do not perform the autopsy completely, the external findings can prove to be useful to predict the resulted organ damages. Therefore, they would still be able to release their expertise opinions based on evidence based medicine. The aim of this study is to produce the empirical evidence related to penetrating wound and organ damage. Method: Five penetrating wounds into peritoneal cavity for each abdominal region from 36 corpses, that had already been autopsied in Forensic and Medicolegal Department FKUI-RSCM, was analyzed to identify organ damage by using gold standard examination (e.g. internal examination in forensic practice), and then to find the correlation between them. Result: The results from hypothesis testing Fisher shows that the p< 0,05 appeared in some correlation findings between variables (penetration wound in epigastric and right hypochondriac and liver damage (p= 0,01), penetration wound in left hypochondriac and stomach damage (p= 0,002), penetration wound in umbilical and major abdomen blood vessel (p= 0,004), and penetration wound in left iliaca and pancreas damage (p= 0,01), thus made them statistically significant. Discussion: The significant results strongly associated with anatomical region and the direction of the wound. The amount of force applied to each wound affected the outcome of the damaged organs]"

"Sirosis hepatis adalah penyakit kronik progresif pada hati yang memiliki karakteristik degenerasi dan kerusakan yang luas pada sel parenkim hati. Salah satu komplikasi pada pasien dengan sirosis hepatis adalah konstipasi. Konstipasi yang berlangsung lama dapat memicu terjadinya ensefalopati hepatikum. Salah satu intervensi keperawatan yang dapat dilakukan untuk mengatasi masalah konstipasi adalah dengan melakukan massage abdomen. Tujuan dari penulisan karya ilmiah ini adalah untuk menganalisis praktik klinik keperawatan kesehatan masyarakat perkotaan pada pasien sirosis hepatis dengan masalah konstipasi dengan melakukan massage abdomen. Intervensi ini dilakukan pada pagi hari sebanyak satu kali per hari selama tiga hari. Hasil karya ilmiah ini menunjukkan bahwa massage abdomen dapat mengatasi masalah konstipasi pada pasien dengan sirosis hepatis. Dari penulisan karya ilmiah ini perawat diharapkan dapat memberikan terapi massage abdomen untuk mengurangi konstipasi yang terjadi pada pasien sirosis hepatis.

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Liver cirrhosis is a chronic progressive disease of liver, characterized with degeneration and extensive damage of the liver parenchymal cells. Patients with liver cirrhosis frequently experience chronic constipation, contributing to higher risk of hepatic encephalopathy. One of the nursing interventions that can be done to treat constipation is abdominal massage. This study aimed to analyse the implementation of abdominal massage in liver cirrhosis patients with constipation. Abdominal massage was performed daily in the morning to a patient within three consecutive days. The results showed that abdominal massage effectively relieved constipation in the patient. This study suggested nurses to provide abdominal massage therapy as a part of nursing interventions for liver cirrhosis patients with constipation.;"

"ABSTRAKKonstipasi merupakan gangguan pada sistem pencernaan lansia yang paling sering terjadi. Faktor risiko terjadinya konstipasi pada lansia antara lain faktor usia, pola diet, aktivitas fisik, lingkungan, masalah fisik dan psikologis. Konstipasi yang tidak segera ditangani dapat menyebabkan berbagai komplikasi. Terdapat beberapa penatalaksanaan nonfarmakologi dalam mengatasi masalah konstipasi, salah satunya dengan massase abdomen. Massase abdomen dengan prinsip tensegrity merupakan intervensi keperawatan yang dapat dilakukan untuk mengatasi konstipasi. Tujuan dari intervensi ini untuk mengetahui efektivitas massase abdomen dengan prinsip tensegrity dalam mengatasi masalah konstipasi pada lansia. Modifikasi intervensi massase abdomen dengan prinsip tensegrity yang dilakukan 9 kali dalam 3 minggu selama 20 menit, peningkatan asupan cairan, latihan dasar otot pelvis dapat meningkatkan frekuensi defekasi, penurunan usaha mengejan, serta mengurangi nyeri saat defekasi. Terjadi perubahan Constipation Scoring System (CSS) yang signifikan pada lansia setelah diberikan intervensi massase abdomen dengan prinsip tensegrity. Berdasarkan pada hasil intervensi ini, massase abdomen dengan prinsip tensegrity dapat dijadikan sebagai intervensi unggulan dalam mengatasi masalah konstipasi pada lansia.

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ABSTRACTConstipation was one of the most frequently diagnosed gastrointestinal disorders on older people. The Risk of constipation in elderly were age factor, diet pattern, physical activity, environment, physical and psychology problems. Constipation were not immediately addressed can cause various complications. There were several non-pharmacological management in overcome constipation, one with abdominal massage. Nursing intervention with abdominal massage tensegrity principle can be done to overcome constipation. The purpose of this intervention to knowed the effectiveness of abdominal mass with the principle of tensegrity in overcoming the problem of constipation in the elderly. Modification of abdominal mass intervention by tensegrity principle performed 9 times in 3 weeks for 20 minutes, increased fluid intake, pelvic floor exercises can increase the frequency of defecation, decreased effort, and reduce pain during defecation. There was a significant change in Constipation Scoring System (CSS) in the elderly after given abdominal masage tensegrity principle. Based on the results, abdominal massase with tensegrity principle can be used as a superior intervention in overcoming the problem of constipation in the elderly."