Evaluasi Sepuluh Tahun Tes Iculit Intradermal Untuk Diagnosis Rhinitis Allergica

ABSTRACT During a-10 year period (1984-1993) an intradermal test on 1,461 cases suspected suffering from allergic rhinitis, based on family history and symptoms of nasal obstruction, runny nose and sneezing, has been carried out. Standard methods of Community of Northern (Scandinavian) Society of Allergy, and laprin solution (Jakarta) were used in this study. Positive (++++ and +++) results showed different percentage of allergens, house dust (76.2%), human dender (72.8%), mites (44.5%), moulds (38.8%), animal dender (18.1%) and pollens (3.3%). Positive result on only one out of 6 allergens used in this study was 1.6%, the rest of 98.4% was allergy to more than one allergen. Negative (-) result to allergens showed for pollens 60.5%, animal dender 32.1%, mites 13.8%, moulds 12.8%, house dust 5.0% and human dender 5.1%. There was no risk of anaphylactic shock reaction during the study, but local itching as general symptom occurred in almost all cases. It could be concluded that intradermal test strengthening the diagnosis of allergic rhinitis in finding the specific allergen, and useful in follow-up prevention and immunotherapy. This test could be done safely, but the possibility of anaphylactic reaction should always be considered. Key words allergic rhinitis, intradermal test, allergens, therap

Aspek Kualitas Penelitian Interdisipliner

Kata kunci: Penelitia

Markov Model In Estimating The Transition Probabilities Of Rhinitis In Children, Purworejo Longitudinal Surveillance Study

ABSTRACT Penelitian ini mencoba menerapkan model proses Markov untuk kejadian rhinitis pada anak bawah lima tahun (Balita). Data penelitian terdiri atas catatan 3 bulanan kejadian rhinitis pada 5.080 Balite selama survailan longitudinal di Kabupaten Purworejo dari bulan Oktober 1994 sampai September 1995. Hanya dua status kesehatan yang diperhatikan, yaitu sehat (H) dan sakit (R untuk rhinitis). Model Markov sederhana merupakan status kesehatan yang lalu, yang berhubungan dengan status terbaru dan diikuti dengan status terdekat berikutnya, dengan interval tiga bulanan. Titik awai penelitian menentukan proporsi transisi status anak H â > R, H â > H, R > H, R > R dari satu observasi ke observasi selanjutnya. Keadaan ini digunakan untuk mengukur kemungkinan transisi rhinitis pada anak. Hasil penelitian menunjukkan bahwa transisi H > R, H > H, R â > H, dan R > R tergantung pada kelompok umur dan pada musim. Analisis terhadap kelompok umur (0-5), (6-11), (12-23), (24-35), dan (36-59) bulan, untuk H â>R, dan R > R menunjukkan penurunan probabilitas transisi pada kelompok umur (6-11) bulan. Kemungkinan transisi tetap menurun sejak kelompok umur tersebut kearah kelompok lebih tue. Disimpulkan bahwa transisi antara sehat clan rhinitis pada anak Balita dari satu observasi ke observasi yang lain, dapat dianalisis dengan menggunakan model Markov. Secara keseluruhan kemungkinan transisi tergantung musim dan umur. Disarankan penelitian untuk observasi yang lebih lama tidak hanya satu tahun, misainya 3 atau 5 tahun. Key words: Model Markov - rhinitis - anak Balite - survai rumah tangga longitudina

Kebijakan Nasional Pengembangan Pendidikan Kedokteran di Indonesia KPKI, 2005

In responding the global era of competition and collaboration, development of science and technology, various world agreements (e.g. WTO, GATS, and TRIPS), and WFME International Standards in Medical Education, each of Medical School in Indonesia should base their program development on the principles of national policy in medical education development. Institutional self-evaluation, external peer-review and consultation for future development have to be carried-out based on needs and demands of local, national, and regional level, and the international standards in medical education. Globalization should be responded appropriately through change the thread to be opportunity by developing some regulations in medical and health care, education and research. The direction of medical education development (basic, postgraduate, and continuing) as a continuum process is the integration between academic and professional training, to be BSc in Medicine (S.Ked) and Primary Medical Doctor (Dokter), MSc and General Specialist, and PhD and subspecialist. Curriculum of various program could be developed continuously on highest scientific and ethical basis, initiation a new methods and instructional tools innovative management, and sensitive to the development of medical health care and budgeting systems. The integration of new biomedical sciences (Biomollecular technology, cloning technology, stem cell studies) with clinical sciences and practice and public health issues could be used as a basic foundation for student-competence development of behavior and ethics, knowledge, skills including humanities and legal aspects. Competitive and collaborative networking among schools of medicine in country and overseas for quality improvement should be carried out. Independent bodies for accreditation, quality assurance, and regulation should be promptly developed by Indonesian Medical Counci

Uji Validitas dan Reliabilitas Kwesioner Etiologi dan Faktor Risiko Kanker Nasofaring

Validity and reliability tests on questionnaires designed for etiology and risk factors of nasopharynx cancerBackground: The etiology and risk factors of NPC is a combination of multi-risk factors of genetic history, lifestyle, environmental exposure, and EBV infection. Currently, there is no publication about NPC's questionnaire. This study analyzed the reliability and validity of the questionnaire of NPC's etiology and risk factors.Methods: The cross-sectional study of the questionnaires of NPC's etiology and risk factors were filled by the used-tryout samples i.e NPC sufferers and their family members, in April to August 2012. The study were done at Anatomical Pathology Laboratory of Kariadi & St. Elisabeth Hospitals Semarang. There are three main constructs, namely; genetic, lifestyle, and environmental exposure. The 74 filled-questionnaires were tested by correlation analysis of product moment for the validity, and the reliability tests conducted with Cronbach's Alpha. The data were analyzed with SPSS for Windows version 17.0.Results: A test for risk family history constructs were valid (p>0.932) and reliabel (Cronbach's Alpha=0.864). A test for lifestyle with a Pearson Correlation were p>0.785 for smoking habit, eating salted fish p>0.793, eating grilled-fish p>0.862, eating pickled p>0.831, drinking alcohol p>0.760, instant noodle p>0.497, food preservation p>0.495, food contains MSG p>0.627, with Cronbach's Alpha>0.751. A test for environmental exposure risk were valid for the exposure to passive cigarette smoke (p>0.486) Cronbach's Alpha=0.789,the exposure of the home environment p>0.658 Cronbach's Alpha=0.832, exposure-related jobs p>0.373 Cronbach's Alpha=0.697, and chronic nasopharingitis are all valid (p>0.900) with Cronbach's Alpha=0851.Conclusions: The questionnaires designed as a tool of NPC's etiology and risk factors are valid and reliable

The difference in biofilms formations on duration less than 90 d and more than 90 d of tracheotomy cannula usage

Currently, prevention of local and systemic infections caused by implantable devices is increasingly improved. Tracheostomy is a surgical action followed by an implantable device called tracheotomy cannula into a trachea to maintain upper airway patenting. The incidence of biofilm-related complications and infections is associated with the length of duration of the attached tracheostomy. The formation and spread of biofilms from distal cannula increase the infection incidence in stoma, tracheitis, and even peripheral pneumonia. However, until now there has been no consensus on when the tracheostomy replacement supposedly conducted. Some manufacturers recommend that cannula replacement supposedly conducted within 30 d, but the data are not yet in agreement and need further study. This study aimed to determine the difference in biofilms formations in a duration of less than 90 d and more than 90 d of tracheotomy cannula usage. It was a cross-sectional study involving patients who underwent a tracheostomy at the Department of Otorhinolaryngology of Dr. Sardjito General Hospital, Yogyakarta. Fisher exact test was applied to analyze the biofilms formations of the two different duration of tracheostomy cannula usage. A total of 20 patients were involved in this study.  Durations of more than 90 d had more biofilms formations compared to less than 90 d, although it was not significantly different (p>0.05). However, the PR value of 6 indicated that subjects who have attached cannula more than 90 d clinically have 6 times higher risk for developing biofilms formations than those less than 90. In conclusion, there is no significant differences in biofilms formations between the less than 90 d and more than 90 d of tracheostomy cannula usage. However, clinically subjects with longer duration of tracheostomy cannula usage have higher risk for developing biofilms formations

Pengambilan Keputusan Dokter dan Pasien terhadap Tindakan Sectio Caesarea Atas Permintaan Sendiri Berdasarkan Kaidah Autonomi

Tindakan sectio caesarea saat ini semakin meningkat, baik atas indikasi medis maupun tanpa indikasi medis yang lebih dikenal dengan istilah sectio caesarea atas permintaan. Sectio caesarea atas permintaan sendiri banyak menimulkan dilema baik dari sisi dokter terkait beneficence dan non-maleficence secara profesional, dan menghargai hak pasien (autonomy). Kebebasan untuk menentukan keputusan sendiri (autonomy) yang kemudian pada sisi dokter menjadi sangat dilematis. Menganalisis pengambilan keputusan pasien dan dokter terhadap tindakan sectio caesarea atas permintaan yang dapat dipertanggungjawabkan secara etik berdasarkan kaidah autonomy. Metode penelitian kuantitatif dan kualitatif (multi methods) dengan pendekatan explanatory sequential design. Pengambilan data melalui wawancara mendalam terhadap 10 orang informan dokter dan pasien. Tindakan operasi sectio caesarea atas permintaan dari aspek persepsi pasien dianggap sebagai otonomi mendasar sebagai hak sehinga kecenderungan dan keinginan untuk meminta tindakan operasi sectio caesarea dari sisi pasien dapat dibenarkan. Pengambilan keputusan dokter tentang tindakan operasi sectio caesarea atas permintaan berada pada sisi dilematis dimana pada satu sisi secara professional dokter tetap pada prinsip bahwa sectio caesarea dilakukan atas indikasi medis yang jelas dan disisi lain dokter juga dituntut untuk secara etis menghargai hak autonomi atau patient preference saat seksio atas permintaan pasien dilakukan. Kemampuan dokter dalam merubah presepsi pasien terhadap tindakan seksio atas permintaan sebagai bagian dari autonomi pasien melalui informed consentdan informed choice kelihatannya masih sangat sulit karena dokter masih dilematis dalam aspek medis dan aspek etis ketika pasien tetap memilih untuk seksio atas permintaan tanpa indikasi medis

Nilai Ambang C4VOE (Camphora, Cadinum, Capsaicin, Carbon disulphide, Vanilla, Oleum menthae piperitae, Ether) sebagai Sarana Uji Penghidu

Olfactory threshold values of C4VOE as test agents for measuring the olfactory capability The preliminary clinical study on seven volatile agents and their olfactory threshold values of cadinum, camphora, capsaicin, carbon disulphide, vanilla, oleum menthae piperitae and ether has been performed. Their concentrations in solution and as a vapour could be measured by regression calculation. The olfactory detection threshold of these evaporated agents constituted the following concentrations: cadinum 0.12325/0.007968, camphora 0.01993/0.0045364, capsaicin 0.0118/0.0007573, carbon disulphide 0.02703/0.0066363, vanilla 0.01884/0.004255, oleum menthae piperitae 0.01228/0.002064, and ether 0.014801/0.0003613. These agents could be normally recognized by healthy volunteers. The concentration of the agents can be drawn and displayed in linear graphic by arithmetic logarithm with 30% different vapour concentration for each agent. These volatile agents as test materials, based on these findings were called "C4VOE-GAMA Olfactometer". A clinical study to fmd out the normal standards of the olfactory threshold and the use of this test material in measuring the olfactory capability in cases of nasal pathology is suggested. Key words : C4VOE-LAMA olfactometer-volatile agent-olfactory threshold value-gas chromatograp

Studi Epidemiologi Otitis Media Chronica (OMC) Anak-Anak Sekolah Dasar di Bantul: Prevalensi, Faktor Risiko dan Prestasi Belajar

ABSTRACT Soenarto Sastrowijoto, Siswantoro, Hapsari & Moh. Khavid - Epidemiological study on chronic odds media in school children in Bantul regency An epidemiological study on Chronic Otitis Media (COM) in children in Bantui regency, especiallyits prevalence in relation to socioeconomic status and index ofachievement has been done. The study used two-step cluster random sampling. The subject of the study was 16 primary schools with 2896 children, taken out from 17 districts consisting of 514 primary schools with a total number of 90 000 children. The study was carried out for six months from May 1990, and the result showed that the prevalence of COM was 5.28%, consisting.of 2.10% serous COM and 3.18% suppurative COM, and middle ear cholesteatoma was found in three of them. A number of risk factors, the educational level and job of the father, the mother\u27s educational level, the economic status based on the value of their property, nutrition and tidiness, the status of children, and the size of the family were also studied. The result of the study showed that the economic status (

Faktor-Faktor Yang Mempengaruhi Peresepan Obat Generik Di Instalasi Rawat Jalan Rsup Dr. Sardjito = Factors Influencing Generic Drug Prescriptions In The Outpatients Department At Dr. Sardjito General Hospital

Background: The attempt of Dr. Sardjito General Hospital to maximized generic drug pre¬scriptions faced the reality that the residents as its main source of drug prescription are con¬tinuously changed. Although the hospital always socialized the compulsory of generic drug prescriptions to the new residents, nevertheless, 12 years after the ministerial decree, generic drug prescriptions at Dr. Sardjito General Hospital is still unsatisfactory. To maximized generic drug prescriptions, it needs to identify factors that influence drug prescriptions. Methods: Residents in the Pediatrics, Surgery, Internal Medicine, and Obgyn Policlinics are grouped based on the degree of: (a) knowledge, (b) reliability, (c) patients, (d) seniors, and (e) drug representatives\u27 influence. Grading was based on the score collected from the structured questions using Liken scale and true or false answers. All prescribed drugs given to non¬Askes patients was recorded and calculated. Results: There was a very significant difference of generic drug prescriptions between policlinics. The percentage of antibiotic generic prescriptions was higher among group of moderate pa¬tients\u27 Influence than low patients\u27 influence. Although reliability was not proven statistically, there was an indication that it has some influence on generic drug prescriptions. Keywords: generic drugs, resident, factors influencing drug prescriptions