Pembentukan Karakter Peserta Didik di Lembaga Pendidikan Islam Al-Izzah Kota Sorong

Penelitian ini dilakukan untuk mengetahui usaha-usaha yang dilakukan guru, metode serta hambatan dalam pembentuk karakter peserta didik di Lembaga Pendidikan Islam Al-Izzah Kota Sorong sehingga peserta didik memiliki beberapa karakter seperti religius(rajin shalat, membaca al-Qur’an),disiplin (hadir sekolah tepat waktu, mentaati peraturan sekolah) dan peduli sosial(menumbuhkan empati, memaafkan) tumbuh dan menjadi kebiasaan dalam kehidupan pribadi peserta didik supaya menjadi manusia yang utuh, sebagai hamba Allah dan manusia sosial. Penelitian ini menggunakan pendekatan deskriptif kualitatif, artinyapenelitian yang berusaha menginterprestasi kondisi atau hubungan yang ada,proses yang sedang berlangsung, akibat yang sedang terjadi, atau kecendrunganyang sedang berkembang. Dalam pelitian ini,peneliti memperhatikan fenomena-fenomena yang terjadi di lapangan kemudian ditafsirkan dan diberi makna sesuaiapa adanya dan melalui wawancara sesuai dengan tujuan penelitian. Padapenelitian kualitatif peneliti adalah instrument utama dan tekanan hasil penelitian ada pada prosesnya bukan pada hasil. Berdasarkan analisis yang dilakukan peneliti, guru merupakan faktor utama dalam prose pembentukan karakter peserta didik di LPI Al-Izzah.Bimbingan, arahan, didikan, serta pelatihan yang terus menerus dan terencana diberikan kepada peserta didik berkenanaan dengan penanaman nilai-nilai atauprilakuyang dibutuhkan dan pendidik (guru)benar-benar menjadi model dalam pelaksanaan karakter atau kebiasaan baik. Karakter baik yang diajarkan dan dicontohkan langsung tenaga pendidik ditiru dan dilaksanakan serta terinternalisasi pada setiap pribadi peserta didik. Pembiasaan budaya sekolah dan penegakan disiplin senantiasa dilakukan. Bagi peserta didik yang melakukanpelanggaran diberi sangsi sehingga ada efek jera untuk tidak mengulangikesalahannya. Dukungan orang tua murid seperti keterlibatan pada setiapkegiatan atau wadah IOM (Ikatan Orang tua Murid), memberikan contoh baik dan keteladanan masih rendah dan tidak sesuai dengan apa yang diajarkan disekolah, perhatian peserta yang didikyang cepat berubah untuk mendapatkan pengajaran dan arahan dari para pendidik (guru) serta kematangan spiritual dan penguasaan pembelajaran dari tenaga pendidikan adalah faktor-faktor penghabatimplementasi pembentukan karakter peserta didik.. Adapun implikasi penelitian ini adalah memberikan masukan informasi dalam pengembangan ilmu pengetahuan maupun untuk dijadikan bahan pertimbangan dalam membuat kebijakan terkait masalah pembentukan karakter.Dalam pembentukan karakter untuk peserta didik dibutuhkan kerjasama yang baik antara pihak sekolah dan orang tua serta lingungan yang ada disekitarnya sehinggan anak-anak akan tumbuh menjadi manusia dewasa yang memberi manfaar untuk dirinya, orang lain dan lingkungannya

The Pattern of Microorganism on Adult Acute Leukemia Patients During Bacterial Surveillance and Febrile Neutropenia at Cipto Mangunkusumo Hospital

Introduction. The standard intensive chemotherapy in acute leukemia patients will cause severe neutropenia and infection (febrile neutropenia) with high fatality rate. The availability of accurate data on causative pathogens is essential to the appropriate selection of empirical therapy and usually obtained from bacterial surveillance. This study was intended to evaluate bacterial pathogens found on surveillance and during febrile neutropenia in acute leukemia patients undergoing chemotherapy at Cipto Mangunkusumo Hospital and to provide information for antimicrobial policy in the hospital. Methods. A retrospective study from data of bacterial surveillance of acute leukemia patients undergoing chemotherapy during 2008-2010 in isolation room for acute leukemia patients at 8th floor of ‘Gedung A’ Cipto Mangunkusumo Hospital, Jakarta. The isolates for surveillance data were obtained from cultures from feces culture, nasal and throat swab, preputium swab and other sites (urine, sputum, skin infection - as indicated) from acute leukemia patients before and during intensive chemotherapy. Blood sample for blood culture was collected from central venous catheter and peripheral veins using BactecÒduring febrile neutropenia, and the other specimens (swab, urine, feces cultures) were collected according to the standard laboratory procedure. All specimens were collected by nurses in isolation room and bacterial cultures were performed at microbiology division of Clinical Pathology Department Cipto Mangunkusumo Hospital. Results. There were 1,127 isolates of acute leukemia patients (acute myeloid leukemia - AML or acute lymphocytic leukemia - ALL) that could be analyzed. Gram positive bacteria was significantly higher than gram negative bacteria from all cultures, from respiratory tract (514 out of 675 isolates; 76.1%) and blood culture (Staphylococcus epidermidis and Streptococcus anhemolyticus – 81 out of 103 isolates; 78.7%). Regarding bacterial surveillance in colon, only 8 out of 45 E. coli isolates from feces can be analyzed for sensitivity to ciprofloxacin/cotrimoxazole and the other 37 isolates were sensitive to other antimicrobials that not commonly used for gut decontamination in acute leukemia. The sensitivity pattern of the other isolates could not be analyzed to the antibiotics recommended for the management of febrile neutropenia due to wide range of antibiotics tested. Conclusion. From 1,127 isolates found among acute leukemia patients undergoing intensive chemotherapy at Cipto Mangunkusumo Hospital, it was found that gram positive was the most common bacteria found on upper respiratory tract from bacterial surveillance and from blood culture during febrile neutropenia

Arterial and Venous Thrombosis in Patients with Myeloproliferative Neoplasms

Introduction. Myeloproliferative neoplasm (MPN) is a hematologic disorder that consists of polycythemia vera (PV), essential thrombocythemia (ET and primary myelofibrosis (PMF) and complication of thrombosis is frequently found in patients with MPN. This study was conducted to observe complication of thrombosis in patients with MPN. Methods. A descriptive study was conducted among patients with MPN at MMC Hospital. Clinical data was obtained from medical records of patients with MPN who sought treatment with investigator between 2010 and 2018 and the data was collected consecutively. Evaluation on JAK2 mutation was performed at either the Research and Development Laboratory of Dharmais Cancer Hospital or Kalgen® Laboratory. Complication of thrombosis was found based on radiological data, which could provide evidences on the presence of thrombosis except for complication of sudden deafness and erythromelalgia, which were found based on clinical diagnosis. Results. We found 23 subjects with MPN during the study period, which consisted of 12 subjects with PV, 8 subjects with ET, 2 subjects with PMF and 1 subject with post-ET MF. Evaluation on JAK2 mutation was performed in 16 out of 23 subjects. Thirteen subjects showed mutation of JAK2 gene except in 2 subjects with PMF and 1 subject with ET, who did not show V617F mutation of JAK2 gene. Subject with JAK2 mutation aged between 45 – 71 years. Complications were found in 12 out of 23 MPN subjects including ischemic stroke, DVT, portal vein thrombosis, thrombosis of mesenteric veins and arteries, non-ST elevated myocardial infarction (NSTEMI), peripheral artery disease (PAD), sudden deafness and erythromelalgia. The thrombotic complications occurred in subjects with polycythemia vera, essential thrombocythemia and myelofibrosis, either primary or the post-ET. Ischemic stroke is the most common complication, i.e. in 6 out of 12 (50%) of those with thrombotic complication and in all of subjects with polycythemia vera. There were 2 subjects experienced 2 multiple thromboses at unusual sites with consecutive episodes despites anticoagulant therapy, i.e. thrombosis of portal vein followed by mesenteric artery; and thrombosis of portal vein and mesenteric vein simultaneously followed by non-ST elevated myocardial infarction (NSTEMI) in less than 2 months. Both subjects experienced multiple thromboses during full-dose of anticoagulant therapy. Conclusions. Complication of thrombosis in MPN patients may exist in the form of arterial and venous thrombosis with ischemic stroke as the most common complication in subjects with polycythemia vera. Multiple thrombosis and splanchnic thrombosis as portal vein, mesenteric vein and artery thrombosis can also be found in subjects with MPN

A Case with Pancytopenia: The Role of Cytomorphology

A 63-year year old lady presented with prolonged fever, frequent abdominal pain and a history of melena. Physical findings revealed an anemic appearance and splenomegaly. She was treated by the gastroenterologist and subsequently referred to the hematologist as the peripheral blood count revealed pancytopenia with a hemoglobin level of 6.5 g/dl, WBC 4000/ uL and a platelet count of 50.000 /uL. No blast cells were found. Patient subsequently underwent a marrow aspiration. Cytomorphology assessment of the marrow specimen revealed the presence of abnormal megakaryocytes and leukocytes (see figures) which was in accordance with dyshematopeosis, and the diagnosis of MDS (myelodysplatic syndrome) was established. The patient was then started on thalidomide 100 mg daily. There was no significant complications nor side-effects and after almost 2 years her hemoglobin level is now normal (between 12 and 14 g/dl), a dramatic reversal of her condition

INOVASI PENYELENGGARA PEMILU SERENTAK NASIONAL 2024 YANG KREDIBEL DAN BERINTEGRITAS

Artikel ini bertujuan untuk memberikan kontribusi atau pengayaan terhadap proses demokrasi di Indonesia menjelang pemilu serentak 2014 mendatang. Disadari bahwa demokrasi di Indonesia terus mencari jalan idealnya, formulasi terus dilakukan dengan segala regulasi dibentuk, walau dicermati semua itu tidak terlepas dari proses yang konstitusional dan jalan politis sekalipun, tapi semua berjalan dengan tetap memberikan catatan kritis atas peristiwa yang telah terjadi. Penulisan ini bertujuan untuk mendeskripsikan dua hal yakni untuk mengajukan solusi Inovasi di Jalan Kolaborasi dalam Penyelenggara Pemilu yang kredibel dan integritas adalah jalan Demokrasi Ideal. Metode dalam penelitian ini adalah metode kualitatif dan jenis penelitian deskriptif, penulis mencoba untuk membaca fenomena pemilu, terutama fokus masalah inovasi penyelenggara,kredibilitas dan ber integritas. Untuk tercapai ada kemasan ini penting penyelenggaran benar-benar dilalui dengan Cara independen dan bersih, tapi jika proses penyelenggaran masih dilakukan dengan diplomatis-politis, maka proses demokrasi kita terus dilalui dengan jalan kecurigaan dan prasangka yang tak usai. Temuan penelitian ini menunjukan bahwa inovasi dengan jalan Kolaborasi dan melibatkan publik akan menjadikan demokrasi yang melahirkan pemimpin yang berkualitas di pemilu 2024, selain itu juga kredibilitas dan ber integritas menjadi hal utama bagai seorang penyelenggara, hal itu juga bisa menggerakkan dan kepercayaan publik kepada dunia demokrasi kita.tapi jika proses penyelenggaran masih dilakukan dengan diplomatis-politis, maka proses demokrasi kita terus dilalui dengan jalan kecurigaan dan prasangka yang tak usai. Temuan penelitian ini menunjukan bahwa inovasi dengan jalan Kolaborasi dan melibatkan publik akan menjadikan demokrasi yang melahirkan pemimpin yang berkualitas di pemilu 2024, selain itu juga kredibilitas dan ber integritas menjadi hal utama bagai seorang penyelenggara, hal itu juga bisa menggerakkan dan kepercayaan publik kepada dunia demokrasi kita.tapi jika proses penyelenggaran masih dilakukan dengan diplomatis-politis, maka proses demokrasi kita terus dilalui dengan jalan kecurigaan dan prasangka yang tak usai. Temuan penelitian ini menunjukan bahwa inovasi dengan jalan Kolaborasi dan melibatkan publik akan menjadikan demokrasi yang melahirkan pemimpin yang berkualitas di pemilu 2024, selain itu juga kredibilitas dan ber integritas menjadi hal utama bagai seorang penyelenggara, hal itu juga bisa menggerakkan dan kepercayaan publik kepada dunia demokrasi kita.selain itu juga kredibilitas dan ber integritas menjadi hal utama bagai seorang penyelenggara, hal itu juga bisa menggerakkan dan kepercayaan publik kepada dunia demokrasi kita.selain itu juga kredibilitas dan ber integritas menjadi hal utama bagai seorang penyelenggara, hal itu juga bisa menggerakkan dan kepercayaan publik kepada dunia demokrasi kita.   Kata Kunci: Inovasi Penyelenggara, Kredibel & Ber integritas dan Pemilu Serenta

Integrative Approach in Haemophillic Arthropathy of The Knee: a Case Report

Haemophilic arthropathy is the most prevalent joint disorder in haemophilia. This disorder is characterized by chronic synovitis and progressive destruction of joint cartilage. We report a case of arthroscopic synovectomy to reduce bleeding frequency in haemophilic arthropathy of the knee. Patient was a 15 years old male with haemophilic arthropathy of the left knee. We performed an arthroscopic synovectomy under tightly regulated factor VIII replacement therapy. There were villous synovial hypertrophy at all part of the joint, multiple bone and cartilage defect, and also anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) deficiency found intraoperatively. After 6 month follow up, subjective complain and bleeding frequency decreased significantly. The visual analog scale improved from 5-6 to 1-2, and the International Knee Documentation Committee Score increased from 49 to 66. Bleeding frequency decreased from 4-8 times per month to less than 1 time per month. Arthroscopic synovectomy performed in this case could reduce the pain, decrease the frequency of bleeding, and improve patient’s functional outcome.Key words: arthroscopic synovectomy, haemophilic arthropathy, haemophilia, anterior cruciate ligament, posterior cruciate ligament

The Characteristics of Hemophilic Patients with Decreased Bone Density in Cipto Mangunkusumo Hospital Jakarta

Background: Hemophilia can cause musculoskeletal complications and decreased bone density is one of those complications. The profile of hemophilic patients with decreased bone density in Indonesia is still unknown.Objective: To estimate the proportion of decreased bone density hemophilia and to learn the characteristics of hemophilic patients with decreased bone density.Methods: This is a cross-sectional study done in June - November 2012. Subjects were adult hemophilic patients from 19-50 years old in Hematology- Oncology outpatient clinic Cipto Mangunkusumo Hospital. Estimated variables were bone density mass, age, bodymass index, physical activity, arthropathy, substitution therapy, HIV, and HCV infection.Result: 63 subjects were included in the study with median age of 26 years old. The proportion of decreased bone density in hemophilia was 6.3%. Subjects with decreased bone density were younger (19 years old vs 26 years old), have lower BMI (18,6 + 2,8 kg/m2 vs 21,5 + 3,8 kg/m2), used more substitution therapy (4047 IU/month vs 2000 IU/month), and have better clinical arthropathy score. HCV infection happened on 25% subjects with decreased bone density while HIV was on 1.6% of subjects.Conclusion: Decreased bone density was found in 6.3% of subjects with hemophilia. They were younger, have lower BMI, better joint score, lower infection caused by transfusion, and more bleeding compared with subjects with normal bone density

The Proportion of Acute Transfusion Reaction at Outpatient Blood Transfusion Unit In Tertiary Hospital in Indonesia

Introduction. Acute transfusion reaction (ATR) is an important issue related to patient safety. The prevalence of ATR at tertiary hospital in Indonesia is 0.5%. This study was aimed to determine the proportion of ATR in outpatient blood transfusion unit at tertiary hospital. Method. This retrospective study implemented data from medical records of adult patients who underwent blood transfusion in outpatient blood transfusion unit, Cipto Mangunkusumo Hospital between August – October 2014. The blood components included packed red cells (PRC), thrombocyte concentrate (TC), fresh frozen plasma (FFP), and cryoprecipitate. We recorded the administration of premedication and ATR-related symptoms/signs. The ATR report was based on WHO classification. Results. There were 1,010 blood transfusions during the study period. The distribution of blood components were PRC (n=802, 79.4%), PC (n=74, 7.3%), FFP (n=43, 4.3%), and cryoprecipitate (n=91, 9.0%). The premedication was administered in 21 transfusions (2.1%). There were 11 ATRs with WHO category 1 (1.1%), no other categories were reported. Based on blood component, the ATR occurred predominantly in PRC transfusion (0.6%), followed by FFP (0.3%), cryoprecipitate (0.1%), and TC (0.1%), respectively. Conclusion. The proportion of ATR in outpatients blood transfusion unit at Cipto Mangunkusumo Hospital was 1.1%. All reported ATR were category 1 in this study. The ATR was predominantly in PRC transfusion

Diagnostic Accuracy of Platelet/Lymphocyte Ratio for Screening Complex Coronary Lesion in Different Age Group of Patients with Acute Coronary Syndrome

Background: with the increasing number of patients with acute coronary syndrome (ACS) with complex coronary lesion and the increasing needs of coronary artery bypass grafting (CABG) procedures, there is an increasing need for a tool to perform early stratification in high-risk patients, which can be used in daily clinical practice, even at first-line health care facilities setting in Indonesia. It is expected that early stratification of high-risk patients can reduce morbidity and mortality rate in patients with ACS. This study aimed to identify diagnostic accuracy of platelet/lymphocyte ratio (PLR) and the optimum cut-off point of PLR as a screening tool for identifying a complex coronary lesion in patients ?45 and >45 years old. Methods: this was a retrospective cross-sectional study, conducted at the ICCU of Cipto Mangunkusumo Hospital. Data was obtained from medical records of adult patients with ACS who underwent coronary angiography between January 2012 - July 2015. The inclusion criteria were adult ACS patients (aged ?18 years old), diagnosed with ACS and underwent coronary angiography during hospitalization. Diagnostic accuracy was determined by calculating sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR-). The cut-off point was determined using ROC curve. Results: the proportion of ACS patients with complex coronary lesion in our study was 47.2%. The optimum cut-off point in patients aged ?45 years was 111.06 with sensitivity, specificity, LR+ and LR of 91.3%, 91.9%, 11.27 and 0.09, respectively. The optimum cut-off points in patients aged >45 years was 104.78 with sensitivity, specificity, LR+ and LR of 91.7%, 58.6%, 2.21 and 0.14, respectively. Conclusion: the optimum cut-off point for PLR in patients aged ? 45 years is 111.06 and for patients with age >45 years is 104.78 with diagnostic accuracy, represented by AUC of 93.9% (p<0.001) and 77.3% (p<0.001), respectively for both age groups

Underutilization of Anticoagulant for Venous Thromboembolism Prophylaxis in Three Hospitals in Jakarta

Aim: to assess the current use of anticoagulants and implementation of International Guidelines in venous thromboembolism (VTE) prophylaxis in hospitalized patients with acute medical illnesses in Jakarta, Indonesia. Methods: a multicenter, prospective, disease registry, recruiting patients diagnosed as acutely ill medical diseases and other medical conditions at risk of VTE, with in-hospital immobilization for at least 3 days. Results: of 401 patients, 46.9% received anticoagulants which included unfractionated heparin (64.4%), fondaparinux (11.7%), enoxaparin (9.6%), warfarin (3.7%), and combination of anticoagulants (10.6%). VTE prophylaxis using physical and mechanical method was used in 81.3% of patients, either as a single modality or in combination with anticoagulants. During hospitalization, VTE were found in 3.2% patients; 10 patients (2.5%) had lower limb events and 3 patients (0.75%) had a suspected pulmonary embolism. The main reference international guidelines used were AHA/ASA 2007 (47.4%), followed by ACCP 2008 (21.7%). Conclusion: the study showed underutilization of prophylaxis anticoagulants in which mechanical thromboprophylaxis either alone or combination with anticoagulants was the most commonly used. Unfractionated heparin was the preferable choice. The most commonly used guideline was AHA/ASA 2007. VTE thromboprophylaxis in medically ill patients needs to be encouraged. Key words: venous thromboembolism (VTE), prophylaxis, registry, non-surgery hospitalization