Abstrak: Morbus Hansen Tipe Borderline Lepromatosa (Bl) Dengan MorbusHansen Tipe Lepromatosa (Ll) Dengan Eritema Nodosum Leprosum RinganDan Kecacatan Kusta Tingkat 2: Laporan Kasus. Penyakit kusta atau MorbusHansen merupakan penyakit infeksi kronik yang disebabkan Mycobacterium leprae(M. leprae). Penyakit ini menyerang kulit dan saraf tepi, serta otot, mata, tulang,testis, dan organ dalam lainnya. Penyakit kusta dapat mengakibatkan terjadinyakecacatan yang cenderung irrevesible. Seorang pasien wanita 64 tahun, datangdengan keluhan muncul benjolan dan nyeri pada kedua lengan yang berulang. pasienjuga mengeluhkan jari tangan dan kaki pasien yang memendek. Riwayat keluhanserupa sejak 3 bulan yang lalu. Status dermatologis pada ekstremitas superiordekstra et sinistra, didapatkan nodul eritema multipel bentuk bulat, ukuran diameterbervariasi 0,5cm-0,8cm, nyeri tekan positif. Makula hipopigmentasi multipel, batas tidak tegas, bentuk geografika, ukuran 1x2cm-2,5x3cm. Ekstremitas inferior dekstra et sinistra didapatkan Makula hiperpigmentasi multipel, batas tegas, bentuk geografika, ukuran 2x3cm-3x5cm, distribusi bilateral, simetris. Pemeriksaan penebalan saraf didapatkan penebalan pada nervus ulnaris dekstra dan sinistra, konsistensi keras. Pemeriksaan sensibilitas meliputi raba, suhu, nyeri didapatkan menurun pada lesi. Pemeriksaan VMT 1. Pemeriksaan monofilamen tangan biru dan pemeriksaan monofilament kaki ungu. Pemeriksaan basil tahan asam pada cuping kanan 10/lp (+3) fragmented, pada cuping kiri 4/100 lp (+1) fragmented, dengan indeks morfologi 0. Pasien didiagnosis dengan morbus hansen tipe borderline lepromatosa (BL) dengan Eritema Nodosum Leprosum ringan membaik dan kecacatan kusta tingkat 2.
Thin Layer Chromatography (TLC), used in forensic analysis, has many advantages: simple, cheap, and efficient. This study aimed to separate dihydroxybenzene isomers in whitening creams in the market and online shops using the BPOM label or not. Of the six eluent mixtures, this research used Toluene: Diethyl Ether: Acetic Acid with a ratio of 80:20:1 after optimization and validation test. In this case, the recovery percentages of resorcinol and hydroquinone were 51-66% and 80-87%. Of the 20 samples tested, 12 whitening creams were added with resorcinol, and 4 were added with hydroquinone. The addition of resorcinol and hydroquinone based on the regulation in Perka BPOM no 18 of 2015 was 5%. Furthermore, 2 out of 20 samples were added with hydroquinone within the regulated threshold, while the remaining 2% were accepted and the other six were undetected. In this case, adding hazardous substances has violated the rules of consumer protection laws and regulations.
Abstrak: Nekrolisis Epidermal Toksik Dengan Infeksi HIV Stadium IV:Laporan Kasus. Nekrolisis epidermal toksik (NET) adalah suatu reaksimukokutaneus yang disebabkan oleh obat. Reaksi ini bersifat akut dan dapatmengancam jiwa yang ditandai dengan adanya nekrosis berat dan pelepasanepidermis. Berikut dilaporkan satu kasus seorang laki-laki 31 tahun dengan luaspermukaan tubuh yang terlibat berupa purpura disertai adanya skin detachmentdengan luas permukaan tubuh yang terlibat sebesar 36% serta adanya keterlibatantiga lesi pada membran mukosa yaitu pada mukosa mata, bibir dan kelamin dengangejala prodromal berupa demam sebelum timbulnya lesi dan didapatkan tandaNikolsky (+), antibodi HIV dengan hasil reaktif sehingga diadaptkan diagnosisnekrolisis epidermal toksik dengan infeksi HIV stadium IV. Pada kasus, penderitamendapatkan terapi berupa eliminasi obat yang dicurigai, pemberian deksametason10 mg-10 mg-10 mg intravena yang diturunkan hingga menjadi metilprednisolonsediaan oral 16 mg tiap 12 jam dalam waktu 14 hari, dan dua hari kemudianditurunkan kembali dosisnya diberikan konseling informasi dan edukasi (KIE).
Deontological Aspects in The Implementation of P-Care at TheFirst Level of Health Facilities in Yogyakarta City. The 2015 SustainableDevelopment Goals (SDGs) opened a new focus on Universal Health Coverage (UHC).In Indonesia, the UHC concept has been proclaimed since 2000 which is thenorganized by Badan Penyelenggara Jaminan Sosial (BPJS) following the Law of theRepublic of Indonesia number 24 of 2011 Article 9 concerning the National SecurityAdministering Body. In implementing Indonesia’s national health insurance (JKN),BPJS kesehatan uses a cloud-based information system for Fasilitas KesehatanTingkat Pertama (FKTP) / The first level health facility, namely Primary Care (P-Care)which contains medical information for more than 222 million people. According tothe Health Insurance Portability and Accountability (HIPAA), data in P-Care includesProtected Health Information (PHI) which can lead to potential ethical violations. Thisstudy aims to determine ethical issues from the Deontology aspect related to theapplication of P-Care in FKTPs in Yogyakarta City. The Method of research is thesequential exploratory mix method. The deontology point of view was chosen becausethe principle of Deontology, namely personal intrinsic value cannot be separated fromethical issues. The results showed that there are ethical issues in the application ofP-Care in FKTPs in Yogyakarta City, namely privacy and confidentiality, security, andinformed consent with the important issue being the involvement of third parties inP-Care data input, P-Care which can be accessed anywhere, lack of personalvalidation, as well as a printed diagnosis that anyone can read. The most powerfulinfluencing factor is the intrinsic value of each agent in understanding these ethicalissues.
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