BACKGROUND: Post-operative non-articular tibia fracture several problems that can occur include; pain, muscles atrophy, muscles weakness, joint stiffness, delayed union, and non-union that makes patients limited in their daily activities. Several factors that play a role in the process of fracture healing include osteoblast activity and exercise. Isometric exercises plantar flexor might effectively prevent the problem. Markers of osteoblast activity are bone-specific alkaline phosphatase (BSAP) levels and Hummer scale callus formation. Not yet known the effect isometric exercise of plantar flexor on osteoblast activity in the post open reduction internal fixation of non-articular tibia fractures, due to the lack of studies in this field. AIM: This research was conducted to investigate the effect of isometric plantar flexor on osteoblast activity and callus formation in patients post open reduction internal fixation nonarticular tibial fractures. HYPOTHESIS: There are differences in osteoblast activity and callus formation between groups that do isometric exercises of plantar flexor muscles with those that without isometric exercises plantar flexor. ANALYSIS: Hypothesis test used a paired t-test with a value of α 0.05 and a confidence level of 95%. METHODS: This clinical trial was true experimental with pre-post test control group design divided into two groups, group I obtained treatment of isometric exercises of the plantar flexor muscle, range of motion knee joint, and ankle while group II obtained the range of motion knee joints and ankle. Osteoblast activity measured with bone-specific alkaline phosphatase level and callus formation. RESULTS: The result of the study found to increase mean bone-specific alkaline phosphatase group I; 15.6 and group II; 5.2. A paired t-test of independent samples with α of 0.05 and confidence interval 95% was obtained p-value = 0.000, there is a significant difference in increased levels of bone-specific alkaline phosphatase group I obtained isometric exercises plantar flexor with group II without isometric exercises plantar flexor in patients post open reduction internal fixation of a non-articular tibia fracture. Radiographic examination of Hummer scale callus in group I who carried out isometric exercises plantar flexor had an average value of 2.63, whereas group II without isometric exercises plantar flexor average of 3.06. Wilcoxon test with a 0.05 and 95% confidence interval obtained p-value = 0.000, there is a significant difference in callus image in both groups of patients post open reduction internal fixation non-articular tibia fracture. The linear regression calculated of callus assessment with bone-specific alkaline phosphatase obtained the value of R quadrat = 0.793, which showed that the formation of callus Hummer classification could predict the change in bone-specific alkaline phosphatase value by 79%. CONCLUSION: The research found isometric exercise plantar flexor in patients post open reduction internal fixation non-articular tibia fracture enhances osteoblast activity and callus formation that will likely short the healing process time and prevent delayed union or non-union.
Olahraga berpengaruh terhadap sistem kardiovaskuler dan berdampak terhadap regulasi tekanandarah. Pemeriksaan tekanan darah dan denyut nadi pada atlet merupakan salah satu cara untukscreening adanya gangguan jantung dan risiko hipertensi pada atlet. Kegiatan pengabdian inibertujuan untuk melakukan pemeriksaan tekanan darah dan denyut nadi pada atlet dari berbagaicabang olahraga sebagai upaya untuk deteksi risiko hipertensi pada atlet. Hasil pengabdian didapatkanbahwa dari sebanyak 57 atlet, sebanyak 20 orang tekanan darahnya diatas normal (tinggi), namunkondisi ini belum dapat dipastikan atlet mengalami tekanan darah tinggi (hipertensi). Oleh karena ituperlu follow up dan pemeriksaan lanjutan seperti pemeriksaan elektrokardiogram (EKG) untukmengetahui ada tidaknya gangguan tekanan darah atau kelainan jantung pada atlet. Perlu pemeriksaansecara teratur dan berkala pada atlet untuk dapat mendeteksi dini hipertensi atau ada tidaknyagangguan pada jantung dan pembuluh darah.
Background: Post-operative non-articular tibia fracture some problems that often occur include pain, muscles atrophy, muscles weakness, and joint stiffness that makes patients limited in their daily activities. Several factors that play a role in muscles atrophy and weakness prolonged immobilisation and lack of exercise. Plantar flexor isometric exercise might effectively prevent the problem. Not yet known the effect isometric exercise of plantar flexor on calf circumference in patients post open reduction internal fixation of tibia fractures, due to the lack of studies in this field. The aim of investigating the effect of isometric exercise plantar flexor on calf circumference in patients post open reduction internal fixation non-articular tibia fracture.Methods: Study design using an experimental model with pre-test and post-test control group design divided into two groups, group A obtained treatment of isometric exercises of the plantar flexor muscles, range of motion knee and ankle joint while group B obtained a range of motion knee and ankle joint. Results: Descriptive analysis in group A there were 13 (81.3%) samples which increased calf circumference and 3 (18.7%) samples did not change while group B there were 4 (25%) samples increased calf circumference, 1 (6%) sample did not change and 11 (69%) samples were reduced calf circumference. The study was found increase mean calf circumference in group A was 0.76 cm and reduction mean calf circumference group B was 0.44 cm. Independent samples differences with α of 0.05 and confidence interval 95% was obtained p-value = 0.003, which has shown there is a significant difference in increased calf circumference group A obtained isometric exercises plantar flexor compared to group B without isometric exercises plantar flexor in patients post open reduction internal fixation of a non-articular tibia fracture. Conclusion: The study found plantar flexor isometric exercise in patients post open reduction internal fixation non- articular tibia fracture enhances calf circumference that will prevent muscle calf atrophy and weakness.
Kualitas pelayanan rumah sakit sangat tergantung pada tersedianya tenaga professional seperti dokter spesialis dan perawat. Keberhasilan rawatan dapat dinilai dari seberapa banyak pasien yang sembuh dan meninggal yang terekam dalam rekam medik. Rekam Medis dapat digunakan untuk berbagai kepentingan, seperti pengambilan keputusan pengobatan kepada pasien, bukti legal pelayanan yang telah diberikan, dan dapat juga sebagai bukti tentang kinerja sumber daya manusia di fasilitas pelayanan kesehatan. Penelitian ini dilakukan untuk mengetahui rasio tenaga dokter dan perawat terhadap angka kematian baik gross death rate (GDR) dan net death rate (NDR) di RSUD dr. Zainoel Abidin (RSUDZA) Banda Aceh tahun 2013–2016. Jenis penelitian ini adalah deskriptif yang dilakukan pada periode 15 Mei sampai 15 September 2017. Populasi dan sampelnya adalah hasil buku register rekam medik rawat inap di RSUDZA tahun 2013–2016, dan jumlah dokter dan perawat diambil dari Bagian Kepegawaian. Tercatat 245 dokter spesialis dan perawat pada saat penelitian yang dimasukkan dalam data penelitian, dengan proporsi 112 dokter dan 133 perawat. Berdasarkan hasil perhitungan menunjukkan bahwa GDR terendah adalah pada tahun 2014 dengan nilai 56.5‰, sedangkan tertinggi adalah pada tahun 2016 dengan nilai 62.3‰, dengan GDR rata-rata 60.8‰ per-tahun. Berdasarkan NDR pada tahun 2013–2016 dapat dideskripsikan bahwa NDR terendah pada tahun 2014 dengan nilai 42.9 ‰, sedangkan NDR tertinggi adalah pada tahun 2016 dengan nilai 50.5‰, dengan rata-rata NDR 47.4 ‰ per-tahun. Hasil tersebut di atas standar nasional yatu <45‰ untuk GDR dan <25‰ untuk NDR. Hasil perhitungan GDR dan NDR tahun 2013– 2016 didapatkan GDR RSUDZA Banda Aceh tiap-tiap tahunnya rata-rata >45‰ dan NDR >25‰, menunjukkan bahwa mutu pelayanan belum sesuai dengan standar nasional. Rasio jumlah dokter dan perawat dilihat dari GDR dan NDR menunjukkan masih kurangnya tenaga professional sehingga diperlukan penambahan jumlah tenaga dokter dan perawat walaupun kebutuhannya tidak sama untuk setiap kategori dokter di masing masing spesialisasi maupun perawat di masing-masing ruangan.
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