Pengetahuan, Sikap, dan Kepatuhan Pasien Hipertensi di Puskesmas Kediri I Tabanan

Hipertensi merupakan masalah yang perlu diwaspadai, karena tidak ada tanda gejala khusus, dan beberapa orang masih merasa sehat untuk tetap beraktivitas seperti biasa. Penelitian bertujuan untuk mengetahui gambaran perilaku minum obat pada pasien hipertensi di Puskesmas. Survei cross-sectional dilakukan terhadap 115 pasien hipertensi dewasa yang berobat ke Puskesmas Kediri I, Tabanan-Bali, pada bulan Maret-Mei 2022. Wawancara menggunakan kuesioner yang divalidasi. Data dianalisis menggunakan software SPSS versi 25.0. Sebanyak 115 pasien berpartisipasi dalam penelitian (tingkat respon 100%). Usia rata-rata responden adalah 59,7 tahun ± 6,86. Separuh responden berusia pada kisaran 55-64 tahun (58 [50.4%]). Lebih dari setengahnya (75 [65.2%]) adalah perempuan. Mayoritas berpendidikan menengah (66 [57.4%]). Seluruh responden mengalami hipertensi grade 2 dan mendapatkan Amlodipine, serta mayoritas terdiagnosa hipertensi kurang dari 5 tahun (70 [60,9%]). Hasil penelitian menunjukkan kriteria pengetahuan responden baik, sikap pada kategori cukup; namun sebagian besar responden tidak patuh dalam pengobatan. Hasil uji Rank Spearman menunjukkan terdapat hubungan yang kuat antara pengetahuan dan kepatuhan (Sig. 2-tailed= 0,000; p<0,05; Correlation Coefficient = 0,675). Sedangkan hubungan sedang ditunjukkan antara sikap dan kepatuhan (Sig. 2-tailed =0,001; p< 0,05; Correlation Coefficient = 0,452). Kepatuhan minum obat hipertensi pada pasien dipengaruhi oleh pengetahuan dan sikap

Psychopharmacology in myasthenia gravis patients with focus on depression

Myasthenia gravis is an autoimmune disease with a potential to disrupt brain function and cause depression as a result of the disease itself or treatment side effect. Some biological and psychological mechanisms have been proposed for the correlations between myasthenia gravis and depression. Depression might present in patients myasthenia gravis, and it might complicate the course of the disease. Adequate treatment might not only improve the depression but might also impact the myasthenia gravis in general

Unplanned surgery increases the morbidity of patients with solitary plasmacytoma of femoral bone: a case report

Solitary skeletal plasmacytoma is a malignant plasma cell tumour that accounts for 3-5% of all monoclonal gammopathies. Lytic bone disease is a hallmark, and a substantial percentage of patients develop pathologic fractures. For lesions involving the femur, internal fixation frequently fails; therefore, prosthetic reconstruction may be the optimal choice for treatment. A 52-year-old male patient with pathological fracture of right femoral bone. Patient was undergone surgery with internal fixation. The pain had been continuing for several months and giant masses has developed on affected side. Further test was done and showed solitary plasmacytoma of proximal femur. The patient was treated with cemented modular prosthesis following tumor excision. Treatment of pathological fracture often challenging. Unplanned surgery could be devastating for the patient. Compare to internal fixation, cemented modular prosthesis is designed as a modular system that can be used to replace diseased or deficient bone in the femur following wide excision. Treatment of pathological fractures in solitary plasmacytoma with modular prosthesis appears to be a feasible option. They were able to mobilize early with good pain relief and had a useful functional limb. Further diagnostic test should be done for fracture of proximal femoral bone that considered pathologic. Limb salvage surgery with modular prosthesis can be considered as a viable option for treating painful pathological fractures in solitary plasmacytoma. It provides pain relief, early mobilization, and good functional outcome with improved quality of life

Functional outcome following coracoclavicular ligament reconstruction using a gracilis tendon graft for acute type III acromioclavicular dislocation: a case report

The acromioclavicular joint is stabilized by two ligaments: the acromioclavicular ligaments and coracoclavicular ligaments. AC joint dislocations account for 9% to 10% of all shoulder injuries. Tossy and Allman classified acromioclavicular dislocations into three types (I, II and III). This classification was modified by Rockwood (types IV, V, and VI). Type I and II dislocations are treated conservatively. Surgery is indicated for certain Rockwood type III and for all type IV, V, and VI injuries. A 45 years old man yoga trainer presented to our emergency department with a chief complaint of pain over his left shoulder after had traffic accident 3 hours prior to admission. Physical examination revealed left lateral clavicular end prominent and tenderness over the left shoulder with limited range of motion due to pain. A Zanca view X-Ray of left shoulder was performed and revealed dislocation of acromioclavicular joint. The patient was diagnosed with suspect Left AC joint disruption grade III. We performed coracoclavicular ligament reconstruction using a gracilis tendon graft 2 days after the accident. Before the surgery, constant score of the patient left shoulder was 25 (Fair). The constant score measured was 63 after 10 month follow up. Coracoclavicular ligament reconstruction with an autogenous gracilis tendon graft was feasible and safe in physically active patients with acute type-III acromioclavicular joint dislocation

ERGONOMIC REDESIGN OF WORKING TOOLS INCREASES PERFORMANCE OF TRADITIONAL COCONUT OIL MAKERS IN THE DISTRICT OF DAWAN, KLUNGKUNG

The business of producing coconut oil in the district of Dawan, Klungkung is oneexample of small-scale home industries in the rural area. The level of working productivityof the oil makers can be categorized as relatively low, as viewed from the aspect of thefollowing indicators: (a) level of working burden, (b) musculoskeletal complaints, (c) levelof fatigue or tiredness, and (d) level of productivity. One factor that causes the lowproductivity is the fact that the working tools used in this industry are non-ergonomicallydesigned such as: (1) tool for peeling off the coconut fibers, (2) tool for taking the coconutflesh, (3) tool for grating the coconut flesh, (4) tool for extracting milk from the watermixedgrated coconut, (5) stove for boiling the coconut milk. Based on the above problemsbackground, it is necessary to make more ergonomic new design or redesign of the toolsthat are used by the coconut oil makers in the district of Dawan in order to increase theirworking performance or productivity.This research was carried out using treatment by subject design by comparing beforeand after treatment involving 22 female subjects selected by simple random method fromall female coconut oil makers in the studied area. Before treatment the research subjectswere asked to make coconut oil as usual with their traditional tools. After an interval ofwashing out period was given, the subjects entered the treatment phase in which they wereasked to make coconut oil by using the tools already redesigned ergonomically. The dataobtained from the research were analyzed by t-paired test at a significance level of 5%.Results of the analysis showed as follows: (1) average of working heart rate beforetreatment was 108.49 ± 0.95 pulse /minute and after treatment 91.92 ± 1.91 pulse /minute,indicating a decrease of workload from moderate to mild one (decrease of working heartrate of 16.59 pulse/minute or 14.69%); (2) average of musculoskeletal complaints beforetreatment was 51.73 ± 1.36 and after treatment 36.79 ± 0.83 (a decrease of 14.94 or26.17%); (3) average of fatigue before treatment was 66.75 ± 3.60 and after treatment49.50 ± 3.28 (a decrease of 17.19 or 25.83%); (4) average of working productivity beforeand after treatment was 35.86 ± 1.09 and 48.66 ± 1.10, respectively (an increase of 12.81 or35.71%). Based on evaluation of investment yield, the NVP value in a five-year period Rp.11.503.431,- &gt; 0, PBP 9.22 months &gt; 0, and RoI 32.54 &gt; 13% (rate of interest commonlyapplied in 2008).It is concluded that redesign of working tools to be more ergonomic has proven to beable to increase the working performance of coconut oil makers and hence worth investing.Novelty of this research is in the positive results related to ergonomic redesigning of thetools for making coconut oil in the district of Dawan, Klungkung by approaches to being systemic, holistic, interdisciplinary, participatory, and appropriate technology usage.Further studies on similar related working issue should focus on the aspects of workingenvironment, especially on how to overcome smoke pollutant in the kitchen area, on moreproper work station and working organization or on that related to production quality of thecoconut oil by generating maximally all the potential already in existence among the localtraditional coconut oil makers.</p

Minimally Invasive Surgery vs. Open Surgery for Infectious Spondylodiscitis: A Systematic Review and Meta-Analysis

Objective Minimally Invasive Spinal (MIS) Procedure has long been used for treating degenerative spinal disorders, however its usage for infectious diseases of the spine has not been described a lot in literatures. Through this meta-analysis, we aim to objectively describe the efficacy of MIS as compared to traditional open surgery (OS) in treating infectious spondylodiscitis. Methods A systematic search was conducted based on PRISMA guideline to identify relevant studies through PubMed, Google Scholar, and Cochrane database. A total of 4 studies (301 patients) were included, divided into 8 meta-analysis, processed using Review Manager 5.3. Results OS requires significantly longer hospital length of stay (p=0.0009, I2=0%, MD=–6.64) and higher blood loss (p<0.00001, I2=40%, MD=–264.31) as well as more postoperative blood transfusion (p<0.00001, I2=0%, MD=–1.58). Moreover, MIS has benefit in significantly shorter operation time (p<0.00001, I2=46%, MD=–30.07) and less complication rate (p=0.0002, I2=38%, MD=0.32). However, the two procedures do not differ significantly in terms of neurological improvement, recurrence rate, and mortality rate. Conclusion Current systematic review and meta-analysis suggest that MIS offers comparable efficacy as well as less hospital length of stay, blood loss, operation time, and complication rate compared to OS

Fenomena Global Warming Dalam Patung Potrait Keramik Post Modern

Dewasa ini merupakan zaman serba instan terbukti dari perkembangan teknologi dari berbagai macam produk fungsional dengan sangat cepat. Berbagai macam iklan-iklan di tv maupun media internet berlomba-lomba untuk mempromosikan produk mereka mencakup produk kebutuhan primer, sekunder dan tersier, yang tidak jarang membuat kita merasa tergoda untuk menikmatinya atas dasar kenyamanan dan perlahan mengubah mindset tentang kenikmatan dan kebahagiaan itu sendiri. Secara tidak langsung hal ini berdampak pada konsep Tri Hita Karana dalam ajaran agama Hindu. Budaya untuk menjaga keharmonisan dengan alam “Palemahan” telah berubah menjadi suatu budaya konsumtif, budaya pencemar, dan budaya perusak lingkungan sebagai pemicu rusaknya alam dan terjadinya pemanasan global. Adapun masalah yang ingin dipecahkan pada proses penciptaan karya ini: (1) mengenai cara menyajikan ide dan gagasan dalam menciptakan karya yang dapat berkontribusi dalam menyadarkan masyarakat terhadap global warming,(2) mencakup teknik pembuatan karya seni keramik dalam wujud kondisi alam dalam transformasi manusia. Proses penciptaan karya ini dibuat berlandaskan metode ilmiah melalui observasi, wawancara, studi pustaka dan eksperimen. dalam konteks ini penulis mencoba untuk menciptakan karya seni patung dari keramik dengan menampilkan kondisi alam yang ditransformasikan menggunakan kode-kode semiotika pada anatomi manusia dengan gaya post modern, yang diharapkan dapat menumbuhkan rasa empathy terhadap kondisi alam saat ini, dan sebagai ajang promosi media keramik bahwa keramik tidak hanya terbelenggu dalam produk dishware dan tableware. Kata Kunci: Palemahan, Global Warming, keramik, Postmoder

Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care

Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in children requiring intensive care. Objective To determine the association between multiple organ dysfunction syndrome (MODS) in children requiring intensive care and hyperglycemia with blood sugar level higher than 140 mg/dl. Methods This case control study without matching was conducted on children aged 1 month-12 years from pediatric ward at Sanglah hospital during June-August 2012. We used consecutive sampling to recruit subjects, which then were screened by Pediatric Risk of Hospital Admission (PRISA) 2 score. All subjects were enrolled for blood sugar test, then divided into 2 groups; hyperglycemia with blood sugar level > 140 mg/dl as case and normoglycemia as control. We used organ dysfunction criteria to determine multiple organ dysfunction. The association between MODS and hyperglycemia was assessed by Chi-square test with 95% confidence interval and a statistical significance value of P < 0.05. Results Fifty two subjects were enrolled in this study. We excluded two subjects, hence each group consisted of 25 subjects. We found 18 subjects under and 7 subjects above five years old in hyperglycemia group. The association between multiple organ dysfunction and hyperglycemia was significant with an odds ratio of 10 (95% CI 3 to 38), P < 0.0001. Conclusion Multiple organ dysfunction syndrome had a significant association with hyperglycemia. Multiple organ dysfunction syndrome with hyperglycemia occurs ten times greater than with normoglycemia

Analisis Yuridis terhadap Tindak Pidana Penggelapan Dalam Jabatan yang dilakukan Secara Berlanjut

&nbsp;In Indonesia, there is a classification of criminal acts that occur in social life, one of which is the crime of embezzlement committed by someone who is in a certain agency by using his position. This crime is closely related to morals and belief in someone's honesty which leads to a lie about that belief that takes advantage of the position itself. This research aims to determine the legal regulation of the crime of embezzlement in office, and to know the law enforcement against the perpetrators of the crime of embezzlement in office in Decision Number 58/pid.B/2021/PN Gin. This research uses normative research type. Sources of legal materials consist of primary, secondary and tertiary with statutory and conceptual approaches. Data were collected by recording and documenting, and analyzed descriptively analytically. The criminal act of embezzlement in office is continuously regulated in articles 372 to 376 of the Criminal Code. In Article 374 of the Criminal Code, the perpetrator is threatened with a maximum imprisonment of 5 (five) years. Meanwhile, criminal acts are continuously regulated in Article 64 paragraph (1), the perpetrators can be punished. And according to Decision No. 58/Pid.B/2021/PN.Gin, the perpetrator was sentenced to prison for 3 (three) years and charged him with paying court fees in the amount of IDR 5,000 (five thousand rupiah)

Multiple Segments Thoracal Spinal Canal Stenosis Caused by Ossification of Ligamentum Flavum: A Case Report

Background: Thoracal spinal canal stenosis (SCS) that refers to multiple segments of the thoracic spine is a peculiar clinical condition. Various factors can cause thoracic SCS, including ossification of the ligamentum flavum (OLF). The aim of this study is to explain about the diagnosis for multiple segment thoracal spinal canal stenosis and management properly to prevent further complications.Case Presentation: A 58-year-old male came to Orthopaedic Outpatient Clinic in Prof. I.G.N.G Ngoerah Hospital, complaining back pain since one year prior to admission. Pain aggravated when he was bending his back. The patient was diagnosed with Thoracal Spinal Canal Stenosis Th 8-9, Th9-10, Th10-11. Patient underwent decompression, stabilization, fusion and biopsy surgery.Results: Patient underwent decompression, stabilization, fusion and biopsy surgery at RSUP Prof. I.G.N.G Ngoerah. In durante operation, already done laminectomy and eight pieces of pedicle screw was applied in Th8-Th11 (55mm x 40 mm Monoaxial on right side Th8, 55mm x 40 mm Polyaxial on left side Th8; 55mm x 40 mm Monoaxial on right side Th9, 55mm x 35 mm Monoaxial on left side Th9; 55mm x 40 mm Monoaxial on right and left side Th10; 55mm x 40 mm Monoaxial on right and left side Th11). There were no complications found in this patient after 4th day following surgery.Conclusion: The goal of surgical intervention for SCS is decompression by removing the calcific areas that are responsible for the spinal canal narrowing and subsequent cord compression. Although the diagnosis and choice of intervention can be difficult, early detection and management are critical to postoperative success. Postoperative results are variable and often unsatisfactory.Keywords: Spinal canal stenosis, ligamentum flavum, spine, surgeryCorrespondence: I Gusti Lanang Ngurah Artha Wiguna. Division of Spine, Department of Orthopaedic and Traumatology, Prof. I.G.N.G Ngoerah Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. Email:[email protected]. Mobile: 0811388859.Indonesian Journal of Medicine (2022), 07(03): 278-288https://doi.org/10.26911/theijmed.2022.07.03.0