Nilai Diagnostik Leprosy Rapid Test untuk Menegakkan Diagnosis Morbus Hansen

Morbus Hansen (MH) masih merupakan masalah kesehatan serius. Gambaran klinis MH yang luas menyebabkan diagnosis MH sulit dibangun. Penegakan diagnosis MH secara akurat penting dalam memutuskan rantai transmisi dan keterlambatan pengobatan. Leprosy rapid test (LRT) merupakan sarana diagnostik yang cepat dan sederhana untuk mendiagnosis MH secara akurat. Tujuan penelitian ini untuk menentukan nilai diagnostik LRT dalam mendiagnosis MH dibandingkan dengan slit skin smear (SSS) pada pasien presumtif MH di RSUP Dr. Mohammad Hoesin (RSUPMH) Palembang. Uji diagnostik dengan rancangan potong lintang dilakukan dari November 2014 hingga Februari 2015. Total 110 pasien presumtif MH yang berobat ke poliklinik Divisi Dermatologi Infeksi RSUPMH Palembang dan memenuhi kriteria inklusi diikutsertakan dengan metoda consecutive. Seluruh partisipan dilakukan pemeriksaan LRT, SSS dan histopatologi. Sensitivitas, spesifisitas, akurasi dan area under curve of LRT secara signifikan lebih tinggi daripada SSS (98,1% vs 85,71%; 80% vs 60%; 97% vs 85% dan 0,890 vs 0,72; secara berurutan). Leprosy rapid test memberikan nilai diagnostik lebih tinggi secara signifikan dibandingkan SSS di RSUPMH Palembang. Leprosy rapid test dapat digunakan sebagai pengganti SSS sebagai pemeriksaan penunjang MH

Remarks on Risk-Sensitive Control Problems

The main purpose of this paper is to investigate the asymptotic behavior of the discounted risk-sensitive control problem for periodic diffusion processes when the discount factor α goes to zero. If uα(θ, x) denotes the optimal cost function, being the risk factor, then it is shown that limα→0αuα(θ, x) = ξ(θ) where ξ(θ) is the average on ]0, θ[ of the optimal cost of the (usual) in nite horizon risk-sensitive control problem

Advertising and Evaluation of Voice through Digital Media

In this article, the authors propose to apply an innovative methodology (quantitative and qualitative) to evaluate musical performances and telephone sales business techniques, creating commercial artificial speech or voice recognition, tools whose advertising and marketing use can be triggered by chatbots and artificial intelligence, within the Broadband Society and industry 4.0. We use a quantitative methodology, with a statistical sample (non probabilistic convenience sample), to find qualitative results in age and sex targeted people. We propose to apply an innovative methodology to evaluate musical performances, commercials, telephone sales techniques, creating commercial artificial speech or voice recognition. We perform a qualitative final results study based on a questionnaire survey by research staff to causal, through which investigated the impact can be seen through the phone. It tries to explain statistically according to this study see what impact emotionally than others across five variables by calling the questioning. We observe if new technologies and contemporary working practices bringing theatre and performance closer to music in terms of shrinking the separation between the act of performance and the document of performance. We conclude in all the groups after the voice has gone through a mechanical means (telephone), the voice with higher emotional impact is child voice, low male voice, female voice loud, high volumes and serious tones.En este artículo, los autores proponen aplicar una metodología innovadora (cuantitativa y cualitativa) para evaluar los desempeños musicales y las técnicas comerciales de ventas telefónicas, a partir de la voz artificial comercial o reconocimiento de voz, herramientas cuyo uso publicitario y de marketing se puede disparar mediante los chatbots y la inteligencia artificial, dentro de la Sociedad de la Banda Ancha y la industria 4.0. Utilizamos una metodología cuantitativa, mediante una muestra estadística (muestra de conveniencia no probabilística), para encontrar resultados cualitativos en personas de edad y sexo específicos. Proponemos aplicar una metodología innovadora para evaluar interpretaciones o ejecuciones musicales, comerciales, técnicas de venta telefónica, creación de voz artificial comercial o reconocimiento de voz. Realizamos un estudio cualitativo basado en una encuesta realizada previamente, a través de la cual investigamos el impacto que se puede observar a través de llamadas telefónicas. Se intenta explicar estadísticamente el posible impacto emocional en el usuario final a través de cinco variables creadas como indicadores. Observamos si las nuevas tecnologías y medios digitales y los nuevos yacimientos de ocupación contemporáneos surgidos de ello proporcionan a la música rendimiento en términos de reducción de la separación entre la conversación y el anuncio y la obtención de un retorno de la inversión, sea tangible o intangible. Se concluye que en todos los grupos analizados de la muestra, tras recibir el impacto comunicativo de voz a través de un medio mecánico (el teléfono, en este caso), la voz con mayor impacto emocional es la voz infantil, la voz masculina grave, la voz femenina aguda, los volúmenes altos y los tonos graves

Multibacillary Leprosy With Tumor Like Nasal Deformity

BACKGROUND: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae which affects skin, peripheral nerves, and other body parts including bone, ear, eye, and nose. Nasal manifestation of leprosy may be found in the early stage with non-specific symptoms such as nasal congestion. In advanced stage, destruction of bone structures and cartilages may result in deformities. However, nasal manifestation as the only symptom in early stage can lead to delayed diagnosis. CASE REPORT: We reported a case of multibacillary leprosy in a 26-year-old male with tumor like nasal deformity for 1 year and lump in the ear lobes since 8 years ago. Initially, there was nasal discharge, unfrequent epistaxis, followed by loss of smelling perception, without associated pain, or numbness since childhood. Lesions on the trunk, palms, and soles were also noted since 2 years ago. The physical examination revealed tumor with crusts and fissures on the nasal tip; accompanied by saddle nose. Slit skin smear revealed acid-fast bacilli with bacteriological index of 4+ in solid form. Hence, he was diagnosed as multibacillary leprosy with Grade 2 disability. The prognosis was poor due to permanent deformities. CONCLUSION: Early diagnosis and initiation of treatment are crucial in the management of this debilitating and stigmatized disease

Pelaksanaan Penegakan Kode Etik Kedokteran

Penelitian ini dilakukan dengan tujuan untuk mengetahui bagaimana regulasi tentang kode etik kedokteran di Indonesia dan bagaimana tugas MKEK (Majelis Kehormatan Etika Kedokteran) dan MKDKI (Majelis Kehormatan Disiplin Kedokteran Indonesia) dalam mengatasi masalah pelanggaran disiplin dokter. Dengan menggunakan metode penelitian yuridis normatif, maka dapat disimpulkan, bahwa: 1. Maraknya kasus-kasus pelanggaran disiplin kedokteran yang di lakukan oleh dokter, di sebabkan karena kurangnya kedisiplinan berprofesi dan pemahaman mengenai Kode Etik Kedokteran menjadi faktor penyebab terjadinya pelanggaran disiplin yang dilakukan dokter dalam praktik kedokterannya. 2. Dalam penanganan kasus yang dilakukan oleh dokter, MKEK dan MKDKI sangat berperan dalam penegakan setiap kasus yang dilakukan dokter. Majelis Kehormatan Etika Kedokteran Indonesia Ikatan Dokter Indonesia (MKEK IDI) adalah lembaga yang mengeluarkan Kode Etik Kedokteran Indonesia(KODEKI) dan Pedoman Pelaksanaan Kode Etik Kedokteran Indonesia (KODEKI). MKEK (Majelis Kehormatan Etika Kedokteran) adalah lembaga penegak etika profesi kedokteran (kodeki), di samping MKDKI (Majelis Kehormatan Disiplin Kedokteran Indonesia) yakni lembaga yang berwenang untuk menentukan ada tidaknya kesalahan yang dilakukan dokter dan dokter gigi dalam penerapan disiplin ilmu kedokteran dan kedokteran gigi, dan menetapkan sanksi

Rehabilitation and Disability Limitation of Youth 22 Years Old Morbus Hansen

Indonesia is the third contributor to cases of leprosy in the world. Many ways can be done to minimize the incidence of disability and prevent the increased severity of existing defects, like the early diagnosis and early management of diseases. And then the education to the patient about the various things that can cause disability. This study is descriptive. The primary data obtained through anamnesis (autoanamnesis and aloanamnesis of the family which is the patient\u27s father), physical examinations and home visits, complete the family data, and the psychosocial environment. The assesment is based on early holistic diagnosis, the process and the end of quantitative and qualitative studies. Aspect of internal risk was obtained, the transmission source is patient\u27s friend who has the same disease and had been firstly diagnosed leprosy and had been together since childhood (a long and close contact). In patient is found two cardinal sign which is the anesthetic skin lesions and thickening of peripheral nerves. Patient is diagnosed with multibacillary Hansen Morbus type, because the anesthetic patches or lesions of leprosy patients amounted to more than 5. Interventions to patient to perform daily skin care, hand and foot protection and doing physiotherapy exercises as mentioned in the nonmedikamentosa management was done. Patient is expected to keep doing the interventions that have been given (maintenance and skin care, hand and foot protection as well as physiotherapy exercises) and routine control to the clinic. Patient\u27s family is also expected to continue to provide support and care for patient. It is expected that health centers can also educate patient and always detect and prevent new defects

FAKTOR RISIKO KEJADIAN KUSTA DI KOTA MANADO

Penyakit Kusta merupakan salah satu penyakit menular yang masih menjadi permasalahan di dunia baik di negara berkembang maupun di negara maju. Penyakit kusta merupakan infeksi kronik pada kulit yang disebabkan oleh kuman Mycobacterium Leprae yang menyerang saraf perifer, kulit, dan mukosa maupun organ- organ lain pada tubuh. Penyakit kusta dapat ditularkan melalui kontak langsung dengan penderita dalam waktu yang cukup lama maupun melalui saluran pernapasan. Tuminting merupakan salah satu puskesmas dengan kejadian kusta yang cukup tinggi pada tahun 2016 dengan jumlah penderita sebanyak 17 orang, kemudian disusul oleh puskesmas Tikala Baru dengan jumlah penderita sebanyak 7 orang, dan puskesmas Bahu dengan jumlah penderita sebanyak 6 orang. Tujuan penelitian ini adalah untuk mengetahui faktor risiko kejadian kusta meliputi pendidikan, pendapatan, pengetahuan, kepadatan hunian kamar dan personal hygiene. Metode penelitian yang digunakan yaitu studi deskriptif analitik dengan desain case- control study. Sampel yang digunakan adalah penderita penyakit Kusta yang berobat di Puskesmas Tuminting, Tikala Baru, Bahu pada bulan Januari- Desember 2016 dan bukan penderita penyakit Kusta sebagai kontrol. Data dikumpulkan dengan menggunakan alat ukur kuesioner. Analisis data yang digunakan yaitu analisis univariat dan analisis bivariat. Analisis bivariat dilakukan menggunakan uji chi- square dengan nilai α sebesar 0,05 dan CI = 95%. Hasil analisis bivariate menunjukkan bahwa variabel yang menjadi factor risiko kejadian kusta di Kota Manado adalah Pendidikan (OR = 0,4195).Kata Kunci : Penyakit, Kejadian Kusta, Faktor RisikoABSTRACTLeprosy is one infectious diseases which is still considered as a problem in the world, both in developing countries and developed countries. Leprosy is a chronic infection of the skin caused by Mycobacterium Leprae which attacks the peripheral nerves, skin, and mucosa as well as other organs in the body. Leprosy can be transmitted through direct contact with the patients in a long period of time or through the respiratory tract. Tuminting is one of the community health centers with high leprosy incidence in 2016, with the number of patients to as many as 17 people, followed by Tikala Baru Community Health Center with 7 patients, and Bahu Community Health Center with 6 patients. The purpose of this research was to determine the risk factors on the occurrence of leprosy, which includes education, income, knowledge, room density and personal hygiene. The research method used was descriptive analytic study with case-control study design. The sample used was leprosy patients who were treated at Tuminting, Tikala Baru, Bahu Community Health Centers in January - December 2016 and non-leprosy patients as the control sample. Data were collected by using questionnaires. Data analysis used were univariate analysis and bivariate analysis. Bivariate analysis was performed by using chi-square test with α value of 0,05 and CI = 95%. The result of bivariate analysis indicated that the variable which became the risk factor of leprosy occurrence in Manado is Education (OR = 0,4195).Keywords: Disease, Leprosy, Risk Factor

Pengetahuan, Sikap, dan Tindakan Murid Pondok Pesantren Dr. M. Natsir Alahan Panjang Tentang Skabies

Scabies is a skin disease caused by infestation and sensitization to Sarcoptes scabei hominis. The incidence of scabies at the Islamic boarding school Dr M. Natsir Alahan Panjang is as much as 17.5%. The purpose of this activity was to describe the students' knowledge before and after counselling and the attitudes and behaviour of the students in dealing with scabies. The method was observational analytic with a cross-sectional approach with 216 students who met the inclusion and exclusion criteria at the school. Based on the data, 146 respondents met the inclusion criteria, with respondents 16 years old and 29 respondents (19.9%) ranging in age from 12 to 21 years. The education level of the majority came from senior high school, with as many as 89 respondents (56.2%). Respondents did not understand about scabies with 115 (78,8%) but already had good knowledge about scabies with 135 (92,6%). There was an increase in the respondents' knowledge where initially, the respondents' knowledge before counselling had a percentage of 96,6% to 98% after counselling. In the attitude and behaviour aspects of the respondents, there was also an increase after counselling was carried out. There was a significant difference in knowledge between before and after counselling

Nilai Diagnostik Leprosy Rapid Test untuk Menegakkan Diagnosis Morbus Hansen

Morbus Hansen (MH) masih merupakan masalah kesehatan serius. Gambaran klinis MH yang luas menyebabkan diagnosis MH sulit dibangun. Penegakan diagnosis MH secara akurat penting dalam memutuskan rantai transmisi dan keterlambatan pengobatan. Leprosy rapid test (LRT) merupakan sarana diagnostik yang cepat dan sederhana untuk mendiagnosis MH secara akurat. Tujuan penelitian ini untuk menentukan nilai diagnostik LRT dalam mendiagnosis MH dibandingkan dengan slit skin smear (SSS) pada pasien presumtif MH di RSUP Dr. Mohammad Hoesin (RSUPMH) Palembang. Uji diagnostik dengan rancangan potong lintang dilakukan dari  November 2014 hingga Februari 2015. Total 110 pasien presumtif MH yang berobat ke poliklinik Divisi Dermatologi Infeksi RSUPMH Palembang dan memenuhi kriteria inklusi diikutsertakan dengan metoda consecutive. Seluruh partisipan dilakukan pemeriksaan LRT, SSS dan histopatologi. Sensitivitas, spesifisitas, akurasi dan  area under curve of LRT secara signifikan lebih tinggi daripada SSS (98,1% vs 85,71%; 80% vs 60%; 97% vs 85% dan 0,890 vs 0,72; secara berurutan). Leprosy rapid test memberikan nilai diagnostik lebih tinggi secara signifikan dibandingkan SSS di RSUPMH Palembang. Leprosy rapid test dapat digunakan sebagai pengganti SSS sebagai pemeriksaan penunjang MH