Indonesia still ranks as the third country in the world to have the most cases of tuberculosis (TB). For this reason, there is a needed treatment for TB, called the Anti-Tuberculosis Drugs (ATD) which comprises of isoniazid, ethambutol, pyrazinamide, rifampicin and streptomycin and this should be taken for 6-8 months. However, ATD has side effects mainly in disturbing the liver function that can be assessed by the serum levels checkup of SGOT, SGPT and bilirubin. This study aimed to determine the level of bilirubin pulmonary TB of patients during the treatment in RSUP Prof. DR. R.D. Kandou Manado for the period of January 2012 to December 2014. This was an observational descriptive study with a cross sectional design by using the medical records of patients of pulmonary TB hospitalization for the period of January 2012 to December 2014. There were 32 patients as samples. There has been an increase in total bilirubin levels during the ATD treatment. It has been discovered that as big as (47%) had an increase level of total bilirubin. The total of bilirubin levels had increased more in male patients. The increase in the total bilirubin occurred in the age of >35 and the more it increases with age. Meanwhile, the increase in direct bilirubin levels had been found in as many as (56%). The indirect bilirubin levels had been found to be normal in (91%). A total of (31%), with hyperbilirubinemia, had not had comorbidities and most had often occurred in the first month of ATD treatment.Keywords: pulmonary tuberculosis, bilirubin, antituberculosis drug, hepatotoxicityAbstrak: Indonesia masih menempati urutan ketiga negara penderita tuberkulosis (TB) terbanyak didunia. Untuk itulah, dibutuhkan pengobatan TB, yang dinamakan Obat Anti Tuberkulosis (OAT) yang terdiri isoniazid, etambutol, pirazinamid, rifampicin dan streptomisin yang harus dikonsumsi selama 6-8 bulan. Akan tetapi, OAT memiliki efek samping terutama menggangu fungsi hati yang dapat dinilai melalui pemeriksaan kadar serum SGOT, SGPT dan bilirubin. Untuk mengetahui kadar bilirubin pasien TB Paru selama pengobatan di RSUP Prof DR. R.D. Kandou Manado periode Januari 2012-Desember 2014. Desain penelitian yang digunakan adalah penelitian observasional deskriptif dengan pendekatan potong lintang (cross sectional) dengan memanfaatkan rekam medik pasien TB Paru rawat inap periode Januari 2012-Desember 2014. Jumlah sampel yang terpakai sebanyak 32 orang. Terjadi peningkatan kadar bilirubin total selama pengobatan OAT. Ditemukan sebesar (47%) terjadi peningkatan kadar bilirubin total. Kadar bilirubin total meningkat lebih banyak pada pasien laki-laki. Peningkatan bilirubin total terjadi pada usia >35 tahun dan semakin meningkat seiring bertambahnya usia. Sedangkan, kadar bilirubin direk ditemukan sebanyak (56%) terjadi peningkatan kadar bilirubin direk. Kadar bilirubin indirek ditemukan normal pada (91%). Sebanyak (31%) yang menderita hiperbilirubinemia tidak memiliki penyakit penyerta dan paling sering terjadi pada satu bulan pertama pengobatan OAT.Kata kunci: tuberkulosis paru, bilirubin, obat antituberkulosis, hepatotoksitas
Iron deficiency anemia (IDA) is caused by deficiency of iron needed for hemoglobin synthesis. Based on WHO data 2011, of 100% cases of patients with severe anemia, there were 50% of pregnant women, 49% of non-pregnant women, and 42% of children suffered from iron deficiency. Other literatures mentioned about 2-5% of adult men and post menopause women were diagnosed as iron deficiency anemia in developed countries. This study was aimed to determine the relationship between iron therapy in patients and iron deficiency anemia. This was a literature review study, summarizing the results of studies that included iron therapy to iron deficiency anemia patients. The results showed a positive result of iron therapy among iron deficiency anemia patients. In conclusion, there is an increase in hemoglobin among iron deficiency anemia patients after being given iron therapy.Keywords: iron deficiency anemia, iron therapy Abstrak: Anemia defisiensi besi (ADB) disebabkan oleh kekurangan zat besi yang dibutuhkan untuk sintesis hemoglobin. Berdasarkan data dari WHO (World Health Organization) tahun 2011, dari 100% kasus penderita anemia berat yang dilaporkan, diperkirakan 50% wanita hamil, 49% wanita tidak hamil, dan 42% kasus anak penderita anemia didapatkan berkaitan dengan kekurangan zat besi. Data lain menyebutkan sekitar 2-5% pria dewasa dan wanita pasca menopause mengalami ADB di negara maju. Penelitian ini bertujuan untuk mengetahui hubungan pemberian besi pada pasien anemia defisiensi besi. Jenis penelitian ialah literature review. Hasil penelitian ini menunjukkan hasil positif pemberian terapi besi pada pasien anemia defisiensi besi. Simpulan penelitian ini ialah terdapat peningkatan hemoglobin pada pasien anemia defisiensi besi setelah diberikan terapi besi.Kata kunci: anemia defisiensi besi, terapi besi
Latar Belakang: Tuberkulosis merupakan masalah kesehatan global dan penyebab kematian tersering oleh infeksi setelah HIV. Penurunan kadar Hb dibawah nilai normal didefinisikan sebagai anemia, anemia sendiri adalah fitur utama pada pasien dengan infeksi bakteri. Trombositosis reaktif dapat ditemukan dalam sejumlah situasi klinis termasuk penyakit menular.Tujuan: Untuk mengetahui kadar hemoglobin dan jumlah trombosit pada pasien tuberculosis paru di RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2014 – Desember 2014Metode: Penelitian ini menggunakan metode penelitian deskriptif retrospektif.Hasil: Dari 67 pasien, jumlah pasien dengan kadar hemoglobin dibawah nilai normal atau anemia sebanyak 44 pasien (65,67%) dansebanyak 23 pasien (34,33%) tidak mengalami anemia. Jumlah pasien yang mengalami trombositopenia sebanyak 4 pasien (5,97%), pasien dengan kadar trombosit normal sebanyak 50 pasien (74,62%), dan yang mengalami trombositosis sebanyak 13 pasien (19,40%).Kesimpulan: Kadar hemoglobin pada penderita TB paru ditemukan terbanyak dengan kadar Hb yang rendah atau anemia, sedangkan jumlah trombosit pada penderita TB paru ditemukan terbanyak dengan jumlah trombosit normal.Kata kunci: Tuberkulosis paru, Hemoglobin, TrombositBackground: Tuberculosis remain a major health problem and second most common cause of death by infection after HIV. The decrease of Hb levels below normal value is defined as anemia, anemia itself is a major feature in patients with bacterial infection. Reactive thrombocytosis can be found in a number of clinical situations including infectious diseases.Objective: To determine hemoglobin levels and platelet counts in patients with pulmonary tuberculosis at Prof. Dr. R. D. Kandou Manado general hospital periods January 2014 – December 2014.Method: This research uses descriptive retrospective study design.Results: Among 67 patients, number of patients with hemoglobin levels below the normal value or anemia are 45 patients (65,67%) and 23 patients (34,33%) are not anemic. Number of patients with thrombocytopenia are 4 patients (5,97%), patients with normal number of platelets are 50 patients (74,62%) and number of patients with thrombocytosis are 13 patients (19,40%).Conclusion: Hemoglobin levels in patients with pulmonary TB are found most below the normal value or anemia while the number of platelets in patients with pulmonary TB are found most normal platelet counts.Keyword: Pulmonary tuberculosis, Hemoglobin, Platelets
Smoking has become a daily habit in Indonesia. Manado has a percentage of smokers as many as 23.6%. Many efforts have been done to find alternative tobacco cigarette. Electric cigarette is one of the new models to replace tobacco cigarette. This study was aimed to determine the ratio of hemoglobin levels in adult male electric cigarette users in Manado. This was an observational analytical study using a cross sectional design. Samples were obtained by using decisive sampling technique. There were 20 electric cigarette users and 20 conventional cigarette users in this study. The results showed that the mean hemoglobin level of conventional cigarette users was higher (17.080 g / dl) than of electric cigarette users (14.335 g/dl). The bivariate analysis using the T test (α=0.05) of the comparison of hemoglobin levels in electric cigarette users and conventional cigarette users resulted in a P value of 0.000. Conclusion: There was a significant comparison of hemoglobin levels in users of electric cigarettes and of conventional cigarettes among adult males in Manado.Keywords: electric cigarettes, conventional cigarettes, hemoglobin Abstrak: Merokok sudah menjadi kebiasaan sehari-hari bagi masyarakat Indonesia. Kota Manado memiliki persentase perokok sebanyak 23,6%. Banyak upaya yang telah dilakukan untuk mencari alternatif rokok tembakau. Rokok jenis elektrik merupakan salah satu fenomena baru yang diupayakan untuk mengganti rokok tembakau. Penelitian ini bertujuan untuk mengetahui perbandingan kadar hemoglobin pada pengguna rokok elektrik pria dewasa di kota Manado. Jernis penelitian ialah analitik observasional dengan desain potong lintang. Teknik pengambilan sampel menggunakan decisive sampling dengan jumlah sampel sebanyak 20 orang pengguna rokok elektrik dan 20 orang pengguna rokok konvensional. Hasil penelitian menunjukkan perbandingan kadar hemoglobin pada pengguna rokok elektrik dan rokok konvensional dimana rerata kadar hemoglobin pengguna rokok konvensional lebih tinggi (17,080 g/dl) dibandingkan pada pengguna rokok elektrik (14,335 g/dl). Hasil uji analisis bivariat menggunakan uji T terhadap perbandingan kadar hemoglobin pengguna rokok elektrik dan rokok konvensional pada pria dewasa dengan derajat kepercayaan α=0,05 mendapatkan P=0,000. Simpulan: Terdapat perbandingan bermakna dari kadar hemoglobin pengguna rokok elektrik dan rokok konvensional pada pria dewasa di Manado.Kata kunci: rokok elektrik, rokok konvensional, hemoglobin
Patients of post therapy lung tuberculosis (TB) that still have permanent or worsened clinical signs might be caused by chronic pulmonary aspergillosis (CPA). Diagnosis of CPA is difficult to confirmed without complete supporting tests. This study was aimed to establish whether Saint George’s Respiratory Questionnaire (SGRQ) could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients. This was an analytical observational study with a cross sectional design. There were 72 patients who had negative Gene Xpert sputum; 34.7% with positive Aspergillus-specific IgG. Their clinical signs were evaluated with SGRQ. The results showed that there was a very significant relationship between clinical score and CPA (p<0.0001). The lower the clinical score the less the probability of CPA. In this analysis we determined the diagnosis value of clinical score with a probability cut-off point = 0.5 which led to clinical score cut-off point of 45.6 with further results, as follows: sensitivity 68.0%; specificity 95.7%; positive predictive value 89.5%; negative predictive value 84.9%; OR 47.8, and CI 95% (9,2-248,2). In conclusion, SGRQ could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients.Keywords: post therapy lung TB; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ) Abstrak: Pasien TB paru pasca terapi yang masih memperlihatkan gejala klinis menetap atau bahkan memberat dapat disebabkkan oleh adanya chronic pulmonary aspergillosis (CPA). Diagnosis CPA sulit ditegakkan tanpa adanya pemeriksaan penunjang yang lengkap. Penelitian ini bertujuan untuk menentukan apakah Saint George’s Respiratory Questionnaire (SGRQ) dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan sputum Gene Xpert negatif (34,7% dengan positif IgG Aspergillus) dilakukan penilaian skor klinis menggunakan SGRQ. Hasil uji menunjukkan terdapat hubungan sangat bermakna antara skor klinis dengan terjadinya CPA (p<0,0001). Makin rendah skor klinis makin kecil peluang terjadinya CPA. Melalui analisis ini dapat ditentukan nilai diagnosis skor klinis SGRQ dengan mengambil titik potong peluang = 0,5. Nilai peluang = 0,5 memberikan titik potong skor klinis = 45,6. Dengan titik potong skor klinis SGRQ = 45,6 diperoleh nilai-nilai diagnosis sebagai berikut: Sensitivitas = 68,0%; Spesifisitas = 95,7%; Nilai Prediksi Positif = 89,5%; Nilai Prediksi Negatif = 84,9%; OR = 47,8 dengan CI 95% (9,2-248,2). Simpulan penelitian ini ialah SGRQ dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi.Kata kunci: tuberkulosis paru pasca terapi; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)
Smoking is a major health problem in Indonesia especially in adult males. The age of a person to initially start smoking becomes younger, therefore, the prevalence of smoking in Indonesia has increased in 2013 (36.3%) compared to that in 2007 (34.2%). Smoking is a risk factor for a number of chronic diseases such as cancer, lung diseases, and cardiovascular diseases. Several previous studies had suggested a relationship between hematocrit levels, blood viscosity and blood pressure. This study was aimed to determine the correlation between hematocrit level and blood pressure in young adult male smokers as subjects. This was an analytical study with a cross-sectional design. Blood pressure and hematocrit level were performed on a total of 40 male students of the Faculty of Engineering Sam Ratulangi University Manado. Data were analyzed statistically by using the Spearman correlation test. The correlation test on the relationship between blood hematocrit level and systolic blood pressure showed an r value of 0.236 and a P value of 0.143 while the correlation test on the relationship between blood hematocrit level and diastolic blood pressure resulted in an r value of 0.352 and a P value of 0.026. Conclusion: There was a positive correlation between hematocrit level and diastolic blood pressure in young adult smokers but not for systolic blood pressure.Keywords: smokers, hematocrit, blood pressure Abstrak: Merokok menjadi masalah kesehatan utama di Indonesia khususnya pada kaum lelaki dewasa. Usia seseorang mulai merokok semakin muda dan prevalensi merokok di Indonesia mengalami peningkatan pada tahun 2013 (36,3%) dibandingkan tahun 2007 (34,2%). Merokok sebagai faktor risiko sejumlah penyakit kronis seperti kanker, penyakit paru-paru, dan penyakit kardiovaskuler. Beberapa penelitian sebelumnya menyatakan adanya hubungan antara kadar hematokrit, viskositas darah, dan tekanan darah. Penelitian ini bertujuan untuk mengetahui hubungan kadar hematokrit dan tekanan darah pada subjek laki-laki perokok usia dewasa muda. Jenis penelitian ialah analitik dengan desain potong lintang. Subyek penelitian ialah 40 orang mahasiswa laki-laki Fakultas Teknik Universitas Sam Ratulangi Manado. Pemeriksaan tekanan darah dan hematokrit darah dilakukan terhadap seluruh subyek. Analisis statistik menggunakan uji korelasi Spearman. Hasil uji korelasi pada hubungan kadar hematokrit dengan tekanan darah sistolik (TDS) mendapatkan nilai r=0,236 dan nilai P =0,143 sedangkan pada hubungan kadar hematokrit dengan tekanan darah diastolik (TDD) didapatkan nilai r=0,352 dan nilai P=0,026. Simpulan: Terdapat hubungan positif antara kadar hematokrit dan tekanan darah diastolik pada perokok laki-laki usia dewasa muda tetapi tidak berlaku untuk tekanan darah sistolik.Kata kunci: perokok, hematokrit, tekanan darah
Pulmonary tuberculosis (pulmonary TB) is caused by Mycobacterium tuberculosis, an acid-fast bacillus (AFB). This disease is characterized by pulmonary infiltrates and caseous granuloma formation, fibrosis, as well as cavities. To date, this disease is still a global health problem. The highest incidence of pulmonary TB is usually in productive age between 15 and 44 years. This study was aimed to obtain the profile of pulmonary tuberculosis patients in productive age at RSUP Prof. Dr. R. D. Kandou Manado during years 2014 to 2015. This was a descriptive observational study using data of medical records. The result showed that there were 178 pulmonary TB patients in the age group of 15-44 years. Based on sex, there were 94 males (52.8%) and 84 females (47.2%). TB patients with positive acid-fast bacilli (AFB) in sputum were found in 117 patients (65.7%) and those with negative AFB in 61 patients (34.3%). In conclusion, pulmonary TB patients at productive age (15-44 years) were predominant in males with positive sputum of Mycobacterium tuberculosis.Keyword: pulmonary tuberculosis, productive age Abstrak: Tuberkulosis (TB) paru adalah infeksi paru yang disebabkan oleh Mycobacterium tuberculosis, yaitu sejenis basil tahan asam (BTA). Penyakit ini ditandai oleh adanya infiltrat paru dan pembentukan granuloma kaseosa, fibrosis, dan kavitas. Penyakit TB paru masih merupakan masalah global dengan insidensi tertinggi biasanya mengenai usia produktif, antara 15–44 tahun. Penelitian ini bertujuan untuk mengetahui gambaran pasien tuberkulosis paru usia produktif di RSUP Prof. Dr. R. D. Kandou Manado periode tahun 2014-2015. Jenis penelitian ialah deskriptif observasional menggunakan data rekam medis. Hasil penelitian mendapatkan 178 pasien TB paru pada golongan usia 15-44 tahun. Berdasarkan jenis kelamin didapatkan 94 orang laki-laki (52,8%) dan 84 orang perempuan (47,2%). Pasien TB dengan hasil pemeriksaan sputum BTA (+) sebanyak 117 orang (65,7%) dan pasien dengan hasil pemeriksaan sputum BTA (-) sebanyak 61 orang (34,3%). Simpulan penelitian ini ialah penderita TB paru pada usia produktif (15-44 tahun) lebih sering didapatkan pada jenis kelamin laki-laki dan dengan hasil pemeriksaan sputum BTA (+).Kata kunci: tuberkulosis paru, usia produktif
Along with the development of medical technology, endoscopy is mostly used in determination of the diagnosis and examination of gastrointestinal diseases. This study was aimed to determine the indications of gastrointestinal endoscopy, diagnoses of pre and post endoscopy, sex and age of patients undergoing endoscopy, and the prevalence of endoscopic patients from January 2018 to August 2019 at Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive and retrospective study using data of Medical Record Installation at Prof. Dr. R. D. Kandou Hospital. The results obtained 495 patients who were endoscopy performed on them. Males were predominant (59.8%) as well as age group of 50-59 years old (22.8%). The most frequent indication of endoscopy was dyspepsia/epigastric pain (68.5%). Moreover, EGD plus colonoscopy was the most common endoscopy performed. GERD (20.45%) had the highest percentage of pre endoscopy diagnosis meanwhile esophagitis Los Angeles Classification Grade A (28.8%) had the highest percentage of post endoscopy diagnosis. In conclusion, gastrointestinal endoscopy was performed more common on males, age group of 50-59 years, with indication of dyspepsia (epigastric pain), and in EGD plus colonoscopy. The most common diagnosis of pre endoscopy was GERD and of post endoscopy was esophagitis Los Angeles Classification Grade A.Keywords: gastrointestinal endoscopy Abstrak: Seiring dengan berkembangnya teknologi dibidang kesehatan, endoskopi yang merupakan salah satu cara penetapan diagnosis dan pemeriksaan gastrointestinal yang banyak digunakan. Penelitian ini bertujuan untuk mengetahui indikasi endoskopi gastrointestinal, diagnosis yang banyak ditemukan sebelum dan sesudah endoskopi, jenis kelamin, usia pasien yang dilakukan endoskopi, dan prevalensi jumlah pasien endoskopi periode Januari 2018 - Agustus 2019 di RSUP Prof. Dr. R. D Kandou. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data sekunder pasien di Instalasi Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 495 pasien yang dilakukan pemeriksaan endoskopi selama periode tersebut, dengan 296 pasien (59,8%) yang berjenis kelamin laki-laki. usia terbanyak ialah 50-59 tahun (22,8%), indikasi endoskopi terbanyak ialah dispepsia (nyeri epigastrium) (68,5%), tindakan endoskopi terbanyak dilakukan ialah EGD + kolonoskopi (48,7%). Diagnosis sebelum tindakan terbanyak ialah GERD (20,45%), dan setelah dilakukan endoskopi ialah esofagitis klasifikasi Los Angeles Grade A (28,8%). Simpulan penelitian ini ialah pasien yang melakukan pemeriksaan endoskopi terbanyak berjenis kelamin laki-laki, kelompok usia 50-59 tahun, dengan indikasi dispepsia (nyeri epigastrium). EGD + kolonoskopi merupakan tindakan tersering diterima oleh pasien, diagnosis sebelum tindakan endoskopi ialah GERD, dan setelah dilakukan endoskopi ialah esofagitis klasifikasi Los Angeles Grade A.Kata kunci: endoskopi gastrointestinal
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