Latar Belakang: Cedera otak merupakan kejadian trauma yang mengenai otak dan menyebabkan kerusakan baik secara struktur maupun fungsi. Tingginya angka kejadian cedera otak baik di dunia maupun di Indonesia mayoritas diakibatkan oleh kecelakaan lalu lintas kendaraan bermotor. Adanya kerusakan tersebut menyebabkan munculnya sekuele psikiatri dan salah satunya adalah delirium. Metode: Penelitian ini merupakan observasional deskriptif dengan pendekatan cross-sectional. Pengambilan data dilakukan di RSUDP NTB dengan metode nonprobability sampling yaitu consecutive sampling. Cara pengambilan data yaitu secara langsung pada 39 orang pasien cedera otak rawat inap di RSUDP NTB. Peneliti melakukan observasi langsung kepada pasien dan mengkaji rekam medis pasien. Hasil: Dari 39 sampel pasien cedera otak, didapatkan 32 orang (82,05%) mengalami delirium, dengan dominasi pria sebanyak 24 orang (61,54%) mengalami delirium. Berdasarkan derajat keparahannya, didapatkan cedera otak sedang (COS) terbanyak diantara derajat lainnya. Dari hasil CT Scan pasien dengan delirium, kebanyakan pasien memiliki lesi diffuse. Selain itu, hasil laboratorium terhadap kadar leukosit didapatkan meningkat pada pasien delirium, sedangkan kadar glukosa mayoritas pasien dalam batas normal. Kesimpulan: Pasien dengan delirium pada TBI didominasi oleh pria terutama kelompok usia 51-65 tahun. Selain itu, letak lesi yang diffuse, peningkatan kadar leukosit, dan kadar glukosa yang normal sering didapatkan pada pasien delirium pada TBI.   Kata kunci: cedera otak, TBI, delirium, jenis kelamin, usia, letak lesi, kadar leukosit, kadar glukosa

Latar belakang: Setiap operasi ulang pada pasien yang telah menjalani prosedur operasi jantung terbuka maka risiko operasi menjadi lebih berat. Hal ini paling disebabkan oleh proses adhesi yang terjadi di rongga mediastinum. Tujuan penelitian ini membuktikan asam hialuronat dapat mengurangi terjadinya adhesi eperikardium paska perikardiotomi. Metode: Penelitian ini merupakan studi eksperimental dengan pendekatan Posttest-Only Control Group Design. Sampel terbagi menjadi dua kelompok. Sebanyak 8 ekor kelinci mendapat perlakuan pemberian asam hialuronat pada jaringan epicardium setelah dilakukan sternotomi, sedangkan delapan ekor tidak mendapat perlakuan. Dilakukan pengamatan selama 8 minggu kemudian jaringan epicardium dari kelinci diperiksa secara makroskopis (skor adhesi) dan secara histopatologi pada setiap masing-masing kelompok. Hasil: Rerata Adhesion Tenacity Score pada kelompok kontrol (2,25±0,77) lebih besar dibanding dengan kelompok perlakuan (1,25±0,46) dan perbedaan secara statistik bermakna (p<0,05). Pada uji rerata Adhesion Tissue Thickness pada kelompok perlakuan lebih rendah dibandingkan dengan kelompok kontrol yaitu 88,98 ± 30,64 µm dibandingkan dengan 40,24 ± 17,5 µm dan perbedaan secara statistik bermakna (p<0,05). Kesimpulan: Pemberian anti adhesi berupa asam hialuronat dapat dipertimbangkan pada kasus operasi Pericardiotomy sebagai terapi utama akan memberikan efek anti adhesi sehingga dapat menurunkan morbiditas dan mortalitas pada saat dilakukan reoperasi. Katakunci pericardialadhesion,AdhesionTenacityScore,AdhesionTissueThickness,Pericardiotomy,Hyaluronic Acid, anti-adhesion substance

Introduction: Cardiovascular diseases have high morbidity and mortality rates. Skills in administering diagnosis and treatment of the diseases is part of general physician competencies according to the Indonesian Doctors Competency Standards. The teaching of cardiovascular lab skills at the Medical Faculty of the University of Mataram has not optimally prepared standardized simulation rooms and patients. As a result, this complicates students’ clinical understanding in handling cardiovasdcular events at the hospitals and clinics with different facilities. The effectiveness of the standardization is measured from results of skill lab exams and students’ satisfaction scores. Objectives: To identify the difference in the satisfaction and skills lab scores of cardiovascular physical exam and electrocardiography (ECG) installation among students of simulation room and patient standardization groups as compared to non-standardization groups. Method: This cross sectional study involved 20 students of 5th semester of the Faculty of Medicine, Mataram University. Samples were taken randomly based on prior stratified lab skills scores. They comprised 2 treatment groups and 2 control groups as follows: group 1, simulation room and patient standardization for cardiovascular physical exam; group 2, simulation room and patient standardization for ECG examination; group 3, simulation room and patient non-standardization for cardiovascular physical exam; group 4, simulation room and patient non-standardization for ECG examination. The students then attended a Master Course, lab skills demonstration, and independent practices for 2 weeks. Satisfaction scores are measured by means of a questionnaire whose contents were validly tested, while lab skills exam scores are measured using a standard checklist issued by the Medical Faculty. Unpaired t-test is used to identify the differences in the students’ satisfaction scores and skill lab scores among the 2 groups. Study Findings: There are significant differences in the mean of students’ satisfaction scores in terms of simulation patients, lab skills room, and instructors for cardiovascular physical exam and ECG exam between the standardization and non-standardization groups. There was no significant difference in the mean of scores on communicative and eticomedicolegal competence, clinical skills competence and clinical reasoning competence on cardiovascular physical exam and ECG exam between standardization and nonstandardization groups. Conclusion: Standardization of simulation patients and rooms for cardiovascular physical exam and ECG exam significantly increases students’ satisfaction scores but does not significantly increases students’ lab skills scores. Keywords: standardization, simulation patients, simulation room, satisfaction scores, lab skills scores.

Intoduction: Currently, the prevalence of chronic kidney disease (CKD) is an increasing public health problem. In Indonesia, CKD increased from 0.2% in 2013 to 0.38% in the year 2018. CKD requires very high maintenance and handling costs for hemodialysis. To be able to do hemodialysis, it is necessary to create vascular access as a pathway for blood circulation from the patient's body to the hemodialysis machine. This research is to determine the profile of vascular access and the association between vascular access with comorbid, age, and sex. Methods: This research is descriptive quantitative research, cross sectional. Data were taken from the registration data or medical record of CKD patient that undergo hemodialysis at West Nusa Tenggara Distric Hospital. Data collection was carried out from 10th January 2020 to 10th March 2020. By applying certain inclusion and exclusion criteria, there were 100 obtained data and subsequently were analyzed using SPSS software. Univariate and bivariate analysis using chi-square test were carried out to descrive the data distribution and the association between variables respectively. Result: Of the 100 respondents, it was found that most of them were female 57%. Most data were aged 48-58 years 43% people. The most comorbid is Diabetes Mellitus with 53% of people. The most used vascular access is AV Fistula Brachiocephalic 58.0%. Based on the Chi-Square statistical test, it shows that there is a significant association between vascular access with the comorbid disease (p <0.05) p = 0.003, and the present association between vascular access to sex was obtained p-value = 0.001 (p <0.05) and there is no significant association between the use of vascular access to age showed a value (p> 0.05) p = 0.08. Based on this study to determine vascular access, comorbid and sex are considered in decision making. Conclusion: The research shows that there is association between the vascular access type to comorbidities and gender.