HUBUNGAN PENGETAHUAN PILIHAN KARIER KEDOKTERAN DENGAN MOTIVASI AKADEMIK

Latar Belakang: Motivasi akademik merupakan salah satu prediktor pembelajaran dalam pendidikan kedokteran. Lulusan pendidikan kedokteran akan berkarier dalam bidang kedokteran meliputi karier klinis dan non klinis. Pengetahuan tentang pilihan karier kedokteran didapat dari informasi-informasi yang diperoleh selama masa pendidikan. Penelitian ini bertujuan untuk mengetahui adanya hubungan antara pengetahuan pilihan karier kedokteran dengan motivasi akademik pada Mahasiswa Program Studi Kedokteran Fakultas Kedokteran Universitas Sebelas Maret Surakarta. Metode Penelitian: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Subjek penelitian adalah Mahasiswa Program Studi Kedokteran Fakultas Kedokteran Universitas Sebelas Maret sebanyak 147 sampel yang diambil dengan teknik pengambilan sampel stratified random sampling. Data pengetahuan pilihan karier kedokteran diambil dengan Kuesioner Pengetahuan Pilihan Karier Kedokteran yang telah diuji validitas dan reliabilitasnya. Data motivasi akademik diambil dengan Skala Motivasi Akademik yang dialih bahasa dan telah diuji validitas reliabilitasnya. Analisis data menggunakan uji korelasi Spearman. Hasil: Rata-rata skor pengetahuan pilihan karier kedokteran paling rendah pada mahasiswa tahun pertama, secara berurutan meningkat hingga tertinggi pada mahasiswa tahun keempat. Rata-rata skor motivasi akademik tahun kedua adalah yang paling rendah dibanding tahun lainnya. Hasil uji korelasi Spearman menunjukkan korelasi (r=0,077) yang tidak signifikan (p=0,355) antara pengetahuan pilihan karier kedokteran dengan motivasi akademik. Simpulan: Terdapat korelasi sanag lemah yang tidak signifikan secara statistik antara pengetahuan pilihan karier kedokteran dengan motivasi akademik pada Mahasiswa Program Studi Kedokteran Fakultas Kedokteran Universitas Sebelas Maret. Kata Kunci: Motivasi Akademik, Pengetahuan Pilihan Karier Kedokteran, Karier Kedokteran

PENGARUH DEPRESI PADA AWAL STROKE (MINGGU I) TERHADAP WAKTU PERBAIKAN DEFISIT NEUROLOGIS PENDERITA STROKE NON HEMORAGIK

Introduction : Depression is the most common type of psychiatric disorder among stroke patients. It is considered as a usual reaction that frequently ignored by family and paramedic. It had been agreed that depression will hampered the neurological deficits recovery of stroke patients. The research was aimed to examine the influence of depression to the recovery time of neurological deficits in infarct stroke patient. Methods : An observation research with prospective study of 70 infarct stroke subjects. The subjects were infact stroke patients hospitalized in B1 neurology ward Dr. Kariadi hospital, January 2005 until December 2005. Neurological deficits were examined with National Institute of Health Stroke Scale (NIHSS) and the depression was diagnosed with Hamilton Depression Rating Scale (HDRS) . Neurological deficits recovery was examine in II, III, IV, V and VI with NIHSS. The patient has recovered if the score of NIHSS is 5 and not recovered if not reach the score of NIHSS 5. The result of the research is shown as graphics and survival analysis tables to know the difference of time recovery. The confounding factor was controlled with logistic regression analysis. The level of significant used this research is with p < 0.05). Results : Subjects without depressed mental state recovered in 3.88 weeks (95% CI 3.37; 4.39) and subjects with depressed mental state recovered in 5.78 weeks (95% CI 5.05; 6.06). Confounding factors that influence to recovery time of improve neurological deficits were age with p = 0.021 and course result of neurological deficit examination at first week with p = 0.001. Conclusions : Stroke patients with depression require more time to recover from neurological deficits compared with non depression stroke patients. Key Words : Post stroke depression – NIHSS – survival analysi

Hubungan Pembelajaran Keterampilan Klinis Secara Online dengan Kelulusan OSCE Pada Mahasiswa Angkatan 2019 Fakultas Kedokteran Universitas YARSI Serta Tinjauan Dalam Islam

Latar belakang: Keterampilan klinis adalah metode pembelajaran atau model pembelajaran untuk melatih pengetahuan (kognitif), sikap (afektif) dan keterampilan (psikomotor) melalui pemanfaatan fasilitas laboratorium yang dapat dilakukan secara online untuk mengurangi penyebaran penyakit COVID-19 yang dapat dinilai dengan Objective Structured Clinical Examination. Menurut pandangan islam, belajar merupakan sebuah kewajiban bagi setiap manusia, karena dengan media online manusia bisa meningkatkan kemampuan dirinya. Tujuan penelitian ini adalah untuk mengetahui hubungan antara pembelajaran keterampilan klinis secara online, usia, dan jenis kelamin dengan kelulusan OSCE online dan offline serta tinjauan dalam Islam. Metode: Jenis penelitian berupa deskriptif analitik dengan desain penelitian cross sectional. Kuesioner didistribusikan melalui google form. Penelitian ini dilakukan pada Mahasiswa Fakultas Kedokteran Universitas YARSI Angkatan 2019 dengan jumlah sampel sebanyak 145 responden. Analisis data menggunakan uji Kolmogorov-Smirnov. Hasil: Berdasarkan hasil uji statistik tidak terdapat hubungan yang bermakna antara pembelajaran keterampilan klinis secara online, jenis kelamin, usia dengan kelulusan OSCE online dan offline pada Mahasiswa Angkatan 2019 Fakultas Kedokteran Universitas YARSI. Kesimpulan: Tidak terdapat hubungan antara pembelajaran keterampilan klinis secara online, usia dan jenis kelamin dengan kelulusan OSCE online serta offline

POLA KLINIK TUBERKULOSIS EKSTRA PARU DI RSUP Dr. KARIADI SEMARANG PERIODE JULI 2013- AGUSTUS 2014

Backgrounds : Extrapulmonary Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis mostly attacks the organs out of the lungs. According to the WHO in the year 2012 the number of cases of extrapulmonary TB were 17.420 cases of all TB 331.424. Diagnosis of extrapulmonary TB is very difficult to be established, it means needs strong clinical symptoms to eliminate another diagnose. Accuracy of diagnosis highly dependent on the method of examination materials collection, the availability of diagnostic tools, such as anatomical pathology, microbiology, and radiology. The purpose of this study was to determine the clinical pattern of Extrapulmonary tuberculosis were treated in the department of Internal Medicine Ward dr. Kariadi Semarang Methods: The study design was a retrospective descriptive study, using 68 medical records of hospitalized patients in the Internal Medicine Ward period July2013- August 2014 as the sample. The data was described in the form of tables and figures. Results : Number of patients with extrapulmonary TB total of 68 patients, larger proportion is male 64,7% and most age group that 18-28 years. According the location of infection, it is more common at tuberculosis of pleurisy TB 30,9%. Most of clinical symptom are cough for pleurisy TB and limfadenitis TB, back pain for Bone TB, abdominal pain for peritonitis TB and headache for meningitis TB. Most of clinical signs are dyspneu fot pleurisy TB, Swelling of lymph nodes for limfadenitis TB, motor weakness for bone TB, muscle tension for peritonitis TB and loss of consciousness for meningitis TB. Extra-pulmonary TB cases with microbiology examination was found as many as 72,5% cases. Biopsy 67,6%, radiology 85,3%, and hematology 69,1%. A majority complication of pleurisy TB is fibrosis, abscess for limfadenitis tb, paraplegy for bone TB, acites for peritonitis TB, and hydrocephalus for meningitis TB. For length of stay patients is over 2 weeks and with treatment outcome 76,5% recovered. Conclusions: Proper diagnosis, adequate treatment can be decreased prevalence of extrapulmonary TB Keywords: Extrapulmonary TB, Description of Extrapulmonary TB

EFEKTIVITAS SALEP JINTAN HITAM (Nigella Sativa) PADA PROSES PENYEMBUHAN LUKA PERINEUM RUPTURE IBU NIFAS

Latar Belakang : Penyebab kematian maternal di Indonesia terkait persalinan adalah infeksi 11% berawal dari penatalaksanaan ruptur perineum yang kurang baik. Sekitar 85% wanita yang melahirkan spontan pervaginam mengalami trauma perineum, sebanyak 1% mengalami infeksi. Ruptur perineum perlu mendapatkan perhatian karena dapat menyebabkan disfungsi organ reproduksi wanita menyebabkan kematian karena perdarahan atau sepsis. Prosedur perawatan luka perineum saat ini masih menggunakan cairan desinfektan Povidon Iodin 10%, belum ada yang berbentuk obat herbal salep sebagai tambahan perlindungan luka dan mengurangi ketidaknyamanan luka perineum. Sehingga penulis tertarik untuk melakukan penelitian efektivitas Salep Jintan Hitam 5 % dan 10 % dalam penyembuhan luka perineum rupture ibu nifas di RSUD Puruk Cahu, Kabupaten Murung Raya, Kalimantan Tengah. Metode : 21 ibu nifas dengan luka Perineum rupture derajat II, dibagi menjadi 3 kelompok secara random menggunakan Rancangan penelitian Randomised pre-post test control group design. Salep jintan hitam 5% dan 10% dioleskan pada luka Perineum rupture setiap hari, selama 7 hari postpartum sesuai kelompok perlakuan. Penilaian luka menggunakan skala REEDA dilakukan pada hari 1 (pre test), hari 3, 5 dan 7 (post test). Hasil : Salep jintan hitam efektif mempercepat proses penyembuhan luka Perineum rupture pada ibu nifas sejak hari ke-3 dilihat dari penurunan nilai Redness, Oedema, Ecchymosis secara signifikan dibanding kelompok kontrol (p0,05), tetapi secara deskriptif Salep jintan hitam 10% lebih efektif dalam proses penyembuhan luka Perineum rupture pada ibu nifas dibandingkan Salep jintan hitam 5%. Kesimpulan : Salep jintan hitam berperan pada fase inflamasi dengan menghambat pembentukkan kinin dan prostglandin secara tidak langsung, sedangkan pada fase proliferasi Salep jintan hitam berperan dalam angiogenesis, sintesis kolagen, dan kontraksi luka. Salep jintan hitam 10% lebih efektif dibandingkan Salep jintan hitam 5%. Kata kunci : Salep jintan hitam 5% dan 10%, Redness, Oedema, Ecchymosis Discharge, Aprroximation, Luka. Background: The main cause of maternal mortality in Indonesia in the bearing process is infection. Eleven per cent of the infection come from bad treatment of perineum rupturee. There are about 85% women bearing through spontaneuous pervaginam experience perineum trauma and 1% of them are infected. Perineum rupture needs serious attention since it can cause woman reproduction organ disfunction and dead as the consequence of bleeding or sepsis. The procedure of perineum treatment still uses desinfectant lotion Povidon Iodin 10%, herbal oinment as additional wound protector and perineum pain killer. Because of this, the researcher is interested in studying the effectiveness of nigella sativa 5% and 10% in curing perineum rupture of postpartum mothers at General Hospital RSUD Puruk Cahu, Murung Raya District, Central Kalimantan Method: Using Randomised pre-post test control group design, the 21 women suffering from perineum rupture stadium II are grouped into three. The black cumin (nigella sativa) oinment is rubbed on the wound Perineum rupture everyday during seven days of postpartum ranging from treatment group. The evaluation is done in the day 1 (pre test), the day 3, 5 and 7 (post test) by using REEDA scale. Result: The black cumin (nigella sativa) oinment is effective in fastening wound healing of perineum rupture since the day 3. This can be seen from the significantly downgrading score of redness, Oedema, and Ecchymosis compared to control group (p<0,05). The day 5 and 7 show significantly downgrading score of Discharge, Approximation and wound compared to control group (p<0,05). Descriptively, black cumin (nigella sativa) 10% is more effective than 5% in the process of healing perineum rupture on postpartum mothers. Conclusion: The black cumin oinment (nigella sativa) functions in the phase of inflamation by postponing kinin and postglandin forming indirectly, this functions in the phase of proliferation by angiogenesis, collagen, and wound contraction. The black cumin oinment 10% is more effective than 5%. Key words: black cumin (nigella sativa) 5% and 10%, Redness, Oedema, Ecchymosis Discharge, Approximation, and wound

Perbedaan Kadar Alanine Aminotransferase (Alt) Dalam Serum Dari Darah Yang Disentrifugasi Pada Kecepatan 3000 Rpm Selama 5 Menit Dan 4400 Rpm Selama 3 Menit

Background : Laboratory tests for liver and heart are emergency, so the examination must be carried out quickly including ALT examination. One way is by reducing the time of centrifugation without reducing the quality of serum. Reducing the time of centrifugation to 3 minutes at 4400 rpm is expected to provide the same results by centrifuging for 5 minutes at 3000 rpm. So that, the duration of ALT examination can be faster, reduces Turnaround Time (TAT) or patient waiting time, and saves electrical energy which can reduce the variable cost. Method : This research was a pre-experimental study with Static Group Comparison research design. The examination used IFCC without pyridoxal method. The subjects of research were 22 people. Samples were serum of blood that were frozen for 30 minutes then centrifuged at 3000 rpm for 5 minutes and 4400 rpm for 3 minutes. Samples were examined using A15 biosystem instrument. Data were analyzed by Wilcoxon test. Result : The results showed mean value of ALT centrifuged at 3000 rpm for 5 minutes was 16,32 U/L and 4400 rpm for 3 minutes was 16,50 U/L. Based on Wilcoxon test, there was no difference in ALT level from centrifuged blood samples at 3000 rpm for 5 minutes and 4400 rpm for 3 minutes, p-value (sig) = 0.676 with a significant level (α = 0.05) then p-value (sig. 2 tailed) > 0.025. Conclusion : There was no difference in ALT level in serum from blood that was centrifuged at 3000 rpm for 5 minutes and 4400 rpm for 3 minutes

Hubungan Kadar Apolipoprotein B Dengan Aterosklerosis Arteri Karotis Interna Pada Pasien Pasca Stroke Iskemik

Background: Ischemic stroke is caused by brain artery obstruction or narrowing called atherosclerosis. Its marker is the thickness of tunica intima-media (intima-media thickness / IMT) of the artery. Apolipoprotein B is the indicator of atherosclerosis diseases. Most previous studies find association between apolipoprotein B level with cardiovascular disease, while the association between apolipoprotein B with atherosclerosis in post ischemic stroke patients has not been studied yet. Objective: To investigate association between apolipoprotein B level and internal carotid artery atherosclerosis based on thickness of intima-media in patients post ischemic stroke. Method : This cross-sectional study was done in post ischemic stroke subjects in outpatient clinic of Neurology Department Kariadi Hospital Semarang, during December until February 2011. Apolipoprotein B level was measured with Integra method. The thickness of tunica intima-media of the internal carotid artery was measured by Ultrasonografi Duplex. Result: Fourty four patients post ischemic stroke that met the inclusion and exclusion criteria, comprise of 22 male (50%) and 22 female (50%). Atherosclerosis was defined as tunica intimamedia thickness >0.9 mm, was found in 24 subjects (54.6%). Apolipoprotein B level, which designated as high (apoB >105 mg/dl), was found in 25 subjects (56.8%). Multyvariat logistics regression test proved there was significant correlation between apolipoprotein B level with internal carotid artery atherosclerosis (p = 0.0001). Conclusion: Apolipoprotein B level significantly has correlation with atherosclerosis of internal carotid artery based on thickness of intima-media in patients post ischemic stroke. Key words: apolipoprotein B level, internal carotid artery atherosclerosis, ischemic stroke

RISK FACTORS ASSOCIATED WITH URINARY TRACT INFECTION IN GERIATRIC AND ITS MICROBIOLOGIC CHARACTHERISTICS

Background : Urinary Tract Infections(UTI) is a general understanding to describe invasion of microorganism in urinary tract. The severity of any functional disability, nature of underlying illnesses, anatomic or physiologic abnormalities of the genitourinary (GU) tract, and use of indwelling bladder catheters determine the types of organisms and chronicity of bacteriuria. Purpose : To analyze factors which associated with Urinary Tract Infections in geriatric patients. Methods : Observational retrospective study conducted by reviewing medical record on 2004 of geriatric patients in Dr.Kariadi Hospital. Independent variables consist of sex, catheterization, initial antibiotics, DM and urine stasis. Dependent variable is geriatric patients who are diagnose as UTIs patients based on urine culture result. Statistic analysis is conducted with descriptive analysis and logistic regression using SPSS 13.00 for windows. Results : Sex and catheterization (p<0.05) associated as the risk factors of UTIs in geriatric patient. Intial antibiotics, diabetes mellitus and urine stasis (p≥0.05) were not significant as risk factor of UTIs in geriatric patients. The pattern of microorganism was as follows, Eschericia coli(46.9%), Enterobacter aerogenes(27.1%), Staphylococcus epidermidis(10.4%), Pseudomonas aeruginosa(9.4%), yeast cell(3.1%), Staphylococcus aureus(2.1%) and Candida sp(1.0%). E.coli still be the most prevalent microorganism. Staphylococcus epidermidis should be considered as contamination. The sensitivity test shown that E.coli had antibiotic sensitivity to meropenem(100%), vancomycin(100%) and cefepim(92.9%). Conclusion : Sex and catheterization associated with UTIs in geriatric patients. Initial antibiotics, DM and urine stasis do not associated with UTIs in geriatric patients. Keywords : Urinary Tract Infections, geriatric patients

PERAN FORENSIK DALAM KASUS MALPRAKTEK MENURUT PASAL 133 KUHAP

Tujuan dilakukannya penelitian ini adalah untuk mengetahui bagaimana peran ilmu kedokteran forensik dalam mengusut tindak pidana dan bagaimana bedah  mayat menurut hukum pidana. Dengan  menggunakan metode penelitian yuridis normatif disimpulkan: 1. Ilmu Kedokteran Forensik merupakan cabang ilmu kedokteran yang memanfaatkan Ilmu Kedokteran dan ilmu lain yang terkait untuk kepentingan penegakan hukum. Pasal 133 ayat (1) KUHAP yang menegaskan dalam hal penyidik untuk kepentingan peradilan menangani seorang korban baik luka, keracunan ataupun mati yang diduga karena peristiwa yang merupakan tindak pidana, ia berwenang mengajukan permintaan keterangan ahli kepada ahli kedokteran kehakiman atau dokter dan atau ahli lainnya. 2. Kebijakan hukum di Indonesia berdasarkan hukum positif saat ini tentang masalah bedah mayat diatur dalam Undang-Undang Nomor 36 Tahun 2009 tentang Kesehatan dan Peraturan Pemerintah No. 18 Tahun 1981 tentang Bedah Mayat Klinis dan Bedah Mayat Anatomis serta Transplantasi Alat atau Jaringan Tubuh Manusia. Kata kunci: Forensik, malpraktek