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"Latar Belakang : Frambusia adalah infeksi yang disebabkan oleh spirochetes, yaitu Treponema pallidum subspesies pertenue. Penyakit ini merupakan jenis infeksi non venereal kronis dan menular terutama pada anak-anak dengan usia di bawah 15 tahun. Kementerian Kesehatan Republik Indonesia mencatat sebanyak 7.400 kasus frambusia baru dalam periode Oktober 2008 - Oktober 2009 di propinsi Nusa Tenggara Timur (NTT). Diagnosis frambusia sangat memerlukan pemeriksaan serologis sehingga diperlukan metode pemeriksaan yang sederhana, cepat, dan akurat. Rapid Plasma Reagin (RPR) merupakan pemeriksaan penunjang serologis akurat, ekonomis, cepat, dan dapat diulang dengan hasil yang sama.Tujuan : Mengetahui sensitivitas, spesifisitas, nilai prediksi positif (NPP), dan prediksi negatif (NPN) RPR sebagai penunjang serologis untuk diagnosis frambusia dibandingkan dengan TPHA sebgai baku emas diagnostik frambusia pada anak usia 1-5 tahun.Subyek dan metode : Penelitian ini merupakan uji diagnostik. Subyek penelitian (SP) adalah sebagian dari anak berusia 1 - 5 tahun di kecamatan Kodi dan Kodi Utara, kabupaten Sumba Barat Daya, NTT. Sejumlah 168 SP telah dilakukan anamnesis, pemeriksaan fisis, dan pengambilan spesimen darah. Serum didapatkan melalui proses sentrifugasi pada setiap spesimen yang kemudian disimpan dalam keadaan beku. Pemeriksaan RPR dilakukan di laboratorium poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin. Pemeriksaan TPHA dilakukan di Departemen Patologi Klinik RSUPN Cipto Mangunkusumo Jakarta.Hasil : Nilai sentivitas RPR sebesar 77,8%, nilai spesifitas sebesar 94,7%, NPP sebesar 63,6%, NPN sebesar 97,3%, dan nilai akurasi 92,9%. Lokasi lesi yang paling sering didapatkan adalah di tungkai bawah 85,71%. Jenis lesi kulit yang paling sering didapatkan adalah ulkus 42,85%.Kesimpulan : Dengan hasil-hasil tersebut dapat disimpulkan bahwa pemeriksaan RPR pada anak usia 1 - 5 tahun sebagai pemeriksaan penunjang serologis dalam menegakkan diagnosis frambusia. Jenis dan lokasi lesi tersering yang ditemukan adalah ulkus dan tungkai bawah.

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Background : Yaws is an infection caused by spirochetes, which is Treponema pallidum subspecies pertenue. Yaws is an infectious and chronic non-venereal disease, affecting mostly children between one and five years old. The Indonesian Ministry of Health reported 7,400 new cases of yaws in Nusa Tenggara Province (NTT) between October 2008 and October 2009. Diagnostic of yaws requires serological diagnostic tools. Hence, a simple, accurate and fast was needed. Rapid Plasma Reagin (RPR) was used as a serological diagnostic tool because RPR is considered to be an accurate, fast, cheap, and reliable tool.

Objective : to measure sensitivity, specificity, Positive Prediction Value (PPV), and Negative Prediction Value (NPV) of RPR as a serological diagnostic tool for yaws in children between one and five years old.

Subjects and method : randomized, diagnostic study was conducted among children between one and five years old in Kodi and Kodi Utara sub-districts of Sumba Barat Daya district , NTT province. Anamnesis, physical examination, and blood samples were collected from 168 subjects. Serum was obtained via the centrifugation of each blood sample, after which it was stored in below zero temperature. RPR test was conducted in an outpatient laboratory at the Department of Dermato-venereology while TPHA test was done at the Department of Clinical Pathology at dr. Cipto Mangunkusumo general hospital.

Result : RPR sensitivity result is 77,8%, specificity result is 94,7%, PPV is 63,6%, NPV is 97,3%, accuracy is 92,9%. Lower extremities are the most affected site in 85,71% subjects. Ulcers (42,85%) are the most common skin lesion recorded in this study.

Conclusion : Based from this results, RPR test is a useful serological diagnostic tool for yaws in children between one and five years old. Lower extremities are the most affected site with ulcers as the most common skin lesion recorded."

"Hepatitis B merupakan penyakit yang dapat ditularkan melalui hubungan seksual, sehingga kelompok risiko tinggi seperti WPS rentan terhadap kemungkinan terinfeksi penyakit ini dan juga menularkannya kepada orang lain.Di Sulawesi Utara belum ada penelitian tentang prevalensi hepatitis 8 di kalangan risiko tinggi termasuk WPS.Jumlah WPS di Bitung, Sulawesi Utara cukup tinggi, sehingga perlu diketahui seberapa besar masalah hepatitis B dan hubungannya dengan -pengetahuan, sikap, Berta perilaku mereka terhadap penya kit tersebut.RUMUSAN MASALAHa. Berapakah prevalensi kepositivan serologik HBsAg pada WPS di Bitung ?b. Bagaimana pengetahuan, sikap, dan perilaku WPS di Bitung terhadap hepatitis B?c. Apakah terdapat hubungan antara pengetahuan, sikap, dan perilaku terhadap hepatitis B pada WPS di Bitung dengan kepositivan serologik HBsAg?"

"Sering (10-20%) ditemukan pada pasien MH. Berbagai terapi topikal ulkus neuropatik sederhana MH, antara lain salap seng oksida (ZnO) 10% masih belum optimal dan menunjukkan keterbatasan. Beberapa penelitian memperlihatkan manfaat penambahan faktor pertumbuhan pada penyembuhan berbagai jenis ulkus. Terdapat beberapa metode untuk mengekstraksi faktor pertumbuhan autolog, salah satunya dengan konsentrat fibrin kaya trombosit (FKT). Tujuan : Menilai tingkat kesembuhan ulkus neuropatik sederhana MH yang diobati secara topikal dengan konsentrat FKT dibandingkan dengan menggunakan salap ZnO 10%. Metode : Penelitian ini merupakan suatu uji klinis acak terkontrol, terbuka, dengan desain paralel. Dilakukan randomisasi untuk membagi 50 subyek menjadi dua kelompok, yaitu kelompok uji (konsentrat FKT) dan kelompok pembanding (salap ZnO 10%). Pengobatan dan evaluasi dilakukan tiap minggu selama enam minggu. Hasil : Pada akhir pengobatan, proporsi tingkat kesembuhan baik (pengecilan ulkus > 75%) kelompok uji adalah 40% dan proporsi tingkat kesembuhan baik pada kelompok pembanding adalah 32%. Perbedaan 8% proporsi tingkat kesembuhan baik di antara kedua kelompok tersebut tidak bermakna secara statistik (p = 0,56) (RR 1,3; IK95%: 0,6-2,6). Kesimpulan : Tidak terdapat perbedaan bermakna antara tingkat kesembuhan ulkus neuropatik sederhana MH yang diobati secara topikal menggunakan konsentrat FKT dibandingkan dengan salap ZnO 10%.

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Disability found in leprosy patients. Various topical treatment for simple neuropathic ulcer in leprosy patients, such as 10% zinc oxide (ZnO) ointment is still not optimal and show limitations. Recent studies have shown the benefits of the addition of growth factors in the healing of various types of ulcers. There are several methods for extracting autologous growth factors, one of which is plateletrich fibrin (PRF) concentrate.

Objective : To assess the healing response of simple neuropathic ulcers in leprosy patients treated topically with PRF concentrate compared to 10% ZnO ointment.

Methods : Randomized, open, controlled clinical trials, with parallel design. Fifthy subjects randomly allocated into two trial groups, the intervention group (PRF concentrate) and the control group (10% ZnO ointment). Treatment and evaluation was performed every week for six weeks.

Results : At the end of treatment, the proportion of good healing response (> 75% closure) in the intervention group and the control group was 40% and 32% respectively. The 8% difference in the proportion of good healing response was not statistically significant (p = 0,56) (RR 1,3; 95%CI: 0,6-2,6).

Conclusion : There was no significant difference in the healing response of simple neuropathic ulcers in leprosy patients treated topically with PRF concentrate compared to 10% ZnO ointment."

"Latar belakang: Data kualitas hidup pasien kulit di Indonesia masih terbatas, antara lain disebabkan belum ada instrumen penilai kualitas hidup untuk kelainan dermatologi berbahasa Indonesia yang valid dan reliabel. Tujuan penelitian ini adalah ingin menilai validitas dan reliabilitas Dermatology Life Quality Index (DLQI) berbahasa Indonesia sebagai suatu alat untuk menilai kualitas hidup pasien dengan berbagai penyakit kulit di Indonesia. Metode: Dermatology Life Quality Index orisinal berbahasa Inggris diterjemahkan mengikuti prosedur standar ke dalam bahasa Indonesia. DLQI versi Indonesia yang telah disetujui oleh pihak pembuat DLQI orisinal diisi oleh 100 pasien rawat jalan dengan berbagai diagnosis (akne, dermatitis atopik, kusta, psoriasis, dan vitiligo) di poliklinik Ilmu Kesehatan Kulit dan kelamin Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo Indonesia. Analisis validitas menggunakan validitas konstruksi, dilakukan dengan menghitung korelasi antara tiap pernyataan dengan skor total (korelasi Pearson). Konsistensi internal menggunakan Cronbach α digunakan untuk analisis reliabilitas. Hasil: Usia pasien pada penelitian ini antara 18 hingga 59 tahun (median 30 tahun). Skor DLQI rata-rata yaitu 9,75±6,319. Validitas DLQI berbahasa Indonesia dinilai cukup baik, dengan koefesien korelasi tiap pertanyaan dengan skor total yaitu 0,310 - 0,699. Reliabilitas DLQI berbahasa Indonesia dinilai baik, dengan Cronbach α 0.858. Kesimpulan: DLQI versi Indonesia merupakan instrumen yang valid dan reliabel untuk menilai kualitas hidup pasien dengan berbagai penyakit kulit.

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Background: The dermatology patient’s quality of life data in Indonesia is limited, partly because unavailability of valid and reliable dermatology specific quality of life measuring tool in Indonesian language. The aim of this study is to assess validity and reliability of Dermatology Life Quality Index (DLQI) to measure the quality of life of patients with various skin diseases in Indonesia.

Methods: The English version of DLQI was translated according to standard procedures to Indonesian language. The approved Indonesian version of DLQI by its developer was administered to 100 outpatients with various dermatological diagnoses (acne, atopic dermatitis, leprosy, psoriasis, vitiligo) attending the dermatovenereology clinic at the national general hospital of Indonesia, dr. Cipto Mangunkusumo Hospital. Construct validity analysis was carried out by using item–total score correlations (Pearson correlation). Internal consistency using Cronbach α were used for reliability analysis.

Results: Age of patients in this study ranged from 18 to 59 years (median 30 years). The mean score of DLQI was 9,75±6,319. Validity of Indonesian version of DLQI considered moderate, with item-total score correlation coefficient 0.310-0.699. Reliability of Indonesian version of DLQI considered good, with Cronbach α 0.858.

Conclusion: Indonesian version of the DLQI is a valid and reliable instrument for assessing the quality of life of patients with various skin diseases."

"Latar belakang : Pruritus kronis adalah sensasi tidak menyenangkan yang mencetuskan keinginan untuk menggaruk, berlangsung enam minggu atau lebih. Pruritus sering dihubungkan dengan sejumlah kelainan sistemik. Salah satu kelainan sistemik tersering yang disertai pruritus kronis adalah kelainan hati hepatobilier kolestasis. Patofisiologi terjadinya pruritus kolestasis dihubungkan dengan peningkatan akumulasi mediator pruritogenik salah satunya yaitu asam empedu serum total (AEST) di darah perifer begitu juga di jaringan lunak termasuk kulit, yang secara normal diekskresikan ke empedu. Masih sedikit yang mengetahui kemungkinan peran peningkatan kadar AEST dengan kejadian pruritus. Tujuan : mengetahui perbedaan rerata kadar AEST pada pasien geriatri tanpa dermatosis primer yang mengalami pruritus kronis dan tanpa pruritus kronis Metode : penelitian ini merupakan penelitian potong lintang, dengan subyek penelitian sejumlah 80 orang, terdiri atas perempuan dan laki-laki usia ≥ 60 tahun. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok pruritus terdiri atas 40 pasien pruritus kronis, dan kelompok kontrol yang terdiri atas 40 pasien tanpa pruritus kronis. Kadar AEST dinilai menggunakan metode enzimatik kolorimetri, kemudian dianalisis perbedaan kadar AEST antar kedua kelompok. Hasil: kadar AEST pada kelompok pruritus didapatkan median 4,5 μmol/L, dengan nilai minimum-maksimum yaitu 3-51 μmol/L. Kadar AEST pada kelompok non-pruritus didapatkan median empat μmol/L, dengan nilai minimum-maksimum 3-22 μmol/L, perbedaan ini tidak bermakna (p = 0,095). Kesimpulan: Kadar AEST pada kelompok pruritus lebih tinggi dibandingkan kelompok non-pruritus, namun tidak bermakna secara statistik.

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Background : Chronic pruritus is defined as an unpleasant sensation of the skin leading to the desire to scratch, which lasting six weeks or more. Pruritus is associated with numerous systemic disorders, and it is a common symptom of any cholestatic hepatobiliary disease. Its pathophysiology is attributed to progressive accumulation of pruritogenic mediators such as bile acid in the peripheral blood as well as in soft tissues including the skin, which are normally excreted into the bile. Little is known about the potential contribution of elevated total serum bile acids (TSBA) levels to pruritus.

Objective : to differentiate TSBA levels in geriatrics patients with chronic pruritus and without chronic pruritus.

Methods : this is a cross-sectional study comprising 80 patients men and women aged ≥ 60 years old, consist of 40 patients in chronic pruritic group, and 40 patients in non-pruritic group. The serum levels of bile acid were measured by enzymatic colorimetric methods, and the level TSBA were analyzed from the two groups.

Results : TSBA levels were detected higher in chronic pruritic group patients (median 4,5 μmol/L, minimum-maximum range 3-51 μmol/L), than in the non-pruritic group (median 4 μmol/L, range 3-22 μmol/L), the difference was insignificant (p = 0,095).

Conclusions : the serum bile acid levels are elevated in chronic pruritic patients but statistically insignificant."

"[ABSTRAKLatar belakang dan tujuan: Keloid merupakan pertumbuhan berlebih dari kolagen dermis yang dapat menimbulkan masalah fisis dan psikis bagi penderitanya. Berbagai pilihan terapi telah digunakan untuk pengobatan keloid. Penelitian ini membandingkan efikasi dan efek samping antara kombinasi triamsinolon asetonid (TA) dan 5-fluorouracil (5-FU) dengan TA intralesi pada terapi keloid.Metode: Studi eksperimen dengan desain single blind randomized controlled trial (RCT) terhadap pasien keloid. Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat kombinasi 5-fluorourasil dan triamsinolon asetonid intralesi, dan kelompok kontrol yang mendapat terapi tunggal triamsinolon asetonid intralesi. Kedua kelompok diberi pengobatan 1 kali perminggu selama 8 minggu dan lesi keloid diukur tinggi dan volume.Hasil: Penurunan tinggi dan volume terjadi pada kedua kelompok. Pada penurunan tinggi, respons baik terjadi pada 75% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,403). Sedangkan pada penurunan volume, respons baik terjadi pada 58,3% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,713). Sebanyak 5 dari 24 SP pada kelompok intervensi mengalami efek samping berupa gatal, nyeri ringan, ulkus dangkal, dan telangiektasi. Sedangkan pada kelompok kontrol terdapat 7 dari 22 SP yang mengeluh gatal, nyeri ringan, dan telangiektasi.Kesimpulan: Secara umum, efikasi dan efek samping kombinasi TA dan 5-FU intralesi sebanding dengan TA saja.

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ABSTRACTBackground and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone, Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone]"

"ABSTRAKLatar belakang: Frambusia atau yaws merupakan penyakit akibat infeksi Treponema pallidum subspecies pertenue yang menahun dan terutama mengenai kulit serta tulang. Penegakkan diagnosis berdasarkan klinis dan serologis. Program temuan kasus frambusia didasarkan atas temuan klinis menurut World Health Organization WHO , kemungkinan terdapat frambusia tanpa lesi klinis yang tidak terdiagnosis masih belum dapat disingkirkan. Belum ada penelitian proporsi di suatu desa yang dinyatakan endemis. Tujuan: Mengetahui proporsi kasus frambusia berdasarkan kriteria klinis WHO dan pemeriksaan serologis di desa Sei Berombang pada anak usia 1-12 tahun periode 22-27 Agustus 2016. Metode: Studi potong lintang ini dilakukan pada tanggal 22-27 Agustus 2016 di desa Sei Berombang, Sumatera Utara. Pemilihan sampel dilakukan secara consecutive sampling. Subjek kemudian dilakukan anamnesis, pemeriksaan fisis, dan pemeriksaan rapid diagnostic test RDT . Hasil : Didapatkan total 129 subjek dengan median usia 9 tahun termuda 1 tahun dan tertua 12 tahun . Sebanyak 14 anak dengan lesi klinis suspek frambusia, sedangkan 4 anak dengan RDT yang positif. Hanya 3 anak dari RDT yang positif memiliki temuan klinis. Lesi klinis suspek frambusia yang paling banyak ditemukan adalah makula hipopigmentasi dan skar atrofik, sedangkan lokasi tersering adalah tungkai bawah. Simpulan: Ditemukan proporsi suspek frambusia berdasarkan klinis adalah 10,85 , sedangkan proporsi frambusia konfirmasi berdasarkan klinis dan serologis adalah 2,33 . Dua subjek didiagnosis frambusia laten, sedangkan satu subjek didiagnosis sebagai frambusia primer. Kata kunci: frambusia, proporsi, anak

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ABSTRACTBackground Yaws is a chronic infectious disease caused by Treponema pallidum subspecies pertenue, mainly affecting skin and bone. Diagnosis of yaws is based on clinical manifestation and serologic test. According to WHO, yaws detection program is focused on clinical manifestation. Thus, it is possible that latent yaws without any clinical manifestation is still under diagnosed. Until recently, there is no proportion study performed in remote endemic village.Objective To determine the proportion of yaws based on WHO clinical criteria and serologic test in children age 1 12 years old in Sei Berombang village.Methods This cross sectional study was conducted on 22nd 27th August 2016 in Sei Berombang village, North Sumatra. We recruited the subjects consecutively and performed anamnesis, clinical examination, and rapid diagnostic test RDT .Results A total of 129 subjects were examined with median age of 9 years old 1 12 years old . Yaws was suspected in 14 subjects, but only 4 subjects were reactive to RDT. Three subjects had clinical manifestation and RDT reactive. Hypopigmentation patch and atrophic scar were the most common clinical findings in this study. Most lesions were found in lower extremities. Conclusion Proportion of suspected yaws based on clinical manifestation is 10,85 in this study. Proportion of confirmed yaws based on clinical manifestation and serology is 2,33 . Two subjects diagnosed with latent yaws and one subject was diagnosed with primary yaws. "