AbstrakAnalgesik dosis tinggi dapat menimbulkan berbagai efek samping. Penggunaan kombinasi analgesik bekerja melalui mekanisme yang berbeda dan memiliki efek sinergis. Penelitian ini bertujuan mengetahui perbedaan lama analgesik antara kombinasi ibuprofen 75 mg dan parasetamol 250 mg per oral dibanding dengan parasetamol 1 g per oral terhadap nyeri pascabedah odontektomi. Penelitian eksperimental dengan uji klinis acak tersamar buta ganda terhadap 26 subjek penelitian yang menjalani odontektomi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli-Oktober 2019. Subjek dibagi menjadi kelompok P (Parasetamol) dan kelompok K (Kombinasi). Data hasil penelitian diuji secara statistik menggunakan Uji Mann-Whitney. Hasil penelitian ini didapatkan perbandingan lama analgesik pascabedah kelompok K (74,23±15,79 menit) lebih lama dibanding dengan kelompok P (50,76±17,22 menit) dengan p<0,05. Hasil skor nyeri pascabedah odontektomi pada kelompok K (2,92±0,75) lebih rendah dibanding dengan kelompok P (3,92±0,86) dengan p<0,05. Simpulan penelitian ini adalah kombinasi preemptive analgesia ibuprofen dan parasetamol per oral memiliki efek analgesik yang lebih lama dibanding dengan parasetamol per oral pada pascabedah odontektomi.Kata kunci: Ibuprofen, kombinasi analgesik, manajemen nyeri, parasetamol, preemptive analgesia Abstract High dose analgesic can cause multiple side effects. Use of analgesics combination enable analgesics to work through different mechanisms and produce a synergistic effect. This study aimed to evaluate the analgesic effects of oral 75 mg ibuprofen and 250 mg paracetamol combination in comparison to oral 1 g paracetamol on post-odontectomy pain. This study was an experimental double blind randomized clinical trial conducted on 26 subjects who underwent odontectomy in Dr. Hasan Sadikin General Hospital Bandung during the period of July-October 2019. Subjects were divided into P (Paracetamol) group and K (combination) group. Data collected were statistically tested using the Mann-Whitney test. Results showed that the time when post-odontectomy pain started in K group (74.23±15.79 minutes) was significantly longer when compared to that of P group (50.76±17.22 minutes) with p<0.05. The post-odontectomy pain score in K group (2.92±0.75) was also lower than that of P group (3.92±0.86), with p<0.05. In conclusion, oral analgesic agent combinations have a longer analgesic effect than oral paracetamol only in post-odontectomy patients.

Penyakit jantung koroner (PJK) adalah salah satu penyakit pada sistem kardiovaskular yang sering terjadi dan merupakan problema kesehatan utama di negara maju. Bedah pintas koroner merupakan salah satu penanganan intervensi PJK. Beberapa faktor risiko berhubungan dengan peningkatan mortalitas pascabedah pintas koroner. Tujuan penelitian ini adalah mengetahui angka mortalitas pada pasien yang menjalani bedah pintas koroner berdasar atas usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time, dan penyakit penyerta di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2016. Metode yang digunakan pada penelitian ini adalah deskriptif observasional dengan pendekatan retrospektif berdasar atas data rekam medis yang dilakukan bulan April 2017. Dari penelitian diperoleh hasil angka mortalitas pascabedah pintas koroner sebesar 15,15%. Angka mortalitas pasien yang menjalani bedah pintas koroner dipengaruhi beberapa faktor diantaranya usia, jenis kelamin, left ventricular ejection fraction, cross clamp time, cardio pulmonary bypass time dan penyakit penyerta.

The rapidly increasing number of COVID-19 patients has posed a massive burden on many healthcare systems worldwide. Moreover, the limited availability of diagnostic and treatment equipment makes it difficult to treat patients in the hospital. To reduce the burden and maintain the quality of care, asymptomatic patients or patients with mild symptoms are advised to self-isolate at home. However, self-isolated patients need to be continuously monitored as their health can turn into critical condition within a short time. Therefore, a portable device that can remotely monitor the condition and progression of the health of these patients is urgently needed. Here we present a portable device, called Respinos, that can monitor multiparameter vital signs including respiratory rate, heart rate, body temperature, and SpO2. It can also operate as a spirometer that measures forced vital capacity (FVC), forced expiratory volume (FEV), FEV in the first second (FEV1), and peak expiratory flow Rate (PEFR) parameters which are useful for detecting pulmonary diseases. The spirometer is designed in the form of a tube that can be ergonomically inflated by the patient, and is equipped with an accurate and disposable turbine based air flow sensor to evaluate the patient's respiratory condition. Respinos

 This paper describes the process of a rapid development of the CPAP ventilator 'Vent-I' during the COVID-19 pandemic using appropriate technology and locally available components.  It was found that noble values and spirit are very important success factors, i.e. gotong royong, social entrepreneurship, pioneering and volunteerism.  Public trust was a very valuable social capital during the development and crowdfunding.  Collaboration between academic institutions, industry and the relevant authority from the very beginning will speed up the development and certification process.

Esophageal atresia is a disorder of the esophageal continuity with or without a connection with the trachea or the under-development esophagus. Most babies who suffer from esophageal atresia also have tracheoesophageal fistula (an abnormal connection between the esophagus and the trachea/windpipe). The possibility of these two conditions is accompanied by other anomalies such as congenital heart disease and anorectal malformations. Esophageal atresia can also be interpreted as malformations caused by the failure of the esophagus to develop a continual passage that may or may not establish a connection to the trachea (tracheoesophageal fistula) or it can be said that the esophageal atresia is the failure of the esophagus to form a channel from the pharynx to the stomach during embryonic development. Another understanding of esophageal atresia is an interruption in the growth of a segment of the esophagus and remains as thin sections without continual channels. Tracheal esophageal fistula is an abnormal connection between the trachea and esophagus. Miscellaneous types of esophageal atresia include: Type A. The incidence of Type A esophageal atresia was about 5% -8%. Type A esophageal atresia occurs at each end of the esophageal sac, and is apart without fistula to the trachea. Type B incident is rare. Type B esophageal atresia occurs at each end of the esophagus, and there is fistula from the trachea to the upper segment of esophagus. Incidence of Type C esophageal atresia occurs about 80% -95%. Type C esophageal atresia occurs at the proximal esophageal segment and ends at a dead-end sac, and distal segments are connected to the trachea or primary bronchus. Type D esophageal atresia is rare. In this type, upper and lower segment of the esophagus is connected to the trachea. Type E esophageal atresia is rare when compared with Types A and C esophageal atresia. In this type the esophagus and trachea are normal but they are connected with fistula.

Objective: To find out the pattern of antibiotic utilization in intensive care unit (ICU). The high use of antibiotics in intensive care may increase antibiotic resistance. Methods: This was a retrospective study with total sampling method from patients who were treated in ICU in the period of January to June 2016. Selected data is processed using the Anatomical Therapeutic Chemical (ATC) Classification/Defined Daily Dose (DDD) system as an international measurement standard for analyzing and comparing usage applied by the WHO. Results: The results showed that of the 57 medical records collected, the total antibiotic use was 295.72 DDD/100 bed-days. Levofloxacin, meropenem, ceftriaxone, ceftazidime, and metronidazole were the five maximally utilized antibiotics with 143.18, 49.88, 30.62, 19.74, dan 16.99 DDD/100 bed-days respectively. Conclusion: The most frequently used of antibiotics is ceftriaxone, used in 54.39% of patients. Whereas in number, the most widely used antibiotic is levofloxacin with a total of 143.18 DDD/100 bed-days.

Tuberculosis (TB) is a global health problem, in which the majority of cases occur in population-dense developing countries. Despite advances in various diagnostic TB modalities, extrapulmonary TB remains a challenge due to complexities related to its diagnostic approach. Hereby, we present a rare case of endocarditis and spondylodiscitis associated with Mycobacterium tuberculosis (MTB). This case report highlighted the challenges faced in diagnosing blood culture-negative infective endocarditis (BCNIE). We also emphasized the importance of considering MTB as etiology of BCNIE, particularly in endemic TB areas.

AbstrakPintas jantung paru (PJP) diperlukan untuk sebagian besar prosedur bedah pintas arteri koroner (BPAK). Fungsi paru dan oksigenasi menurun sekitar 2-90% pada pasien pascabedah jantung dengan PJP. Ketergantungan terhadap ventilator setelah BPAK secara signifikan berhubungan dengan morbiditas dan mortalitas. Tujuan penelitian ini adalah mengorelasikan waktu PJP dengan lama bantuan ventilasi mekanis pada pasien BPAK. Penelitian ini merupakan analisis kohort retorospektif pada 43 pasien yang menjalani BPAK dengan PJP yang dirawat di Unit Perawatan Intensif Jantung RSUP Dr. Hasan Sadikin Bandung pada bulan Januari 2014 sampai Juni 2015. Lama PJP dibagi menjadi ≤90 menit dan >90. Lama bantuan ventilasi mekanis terbagi menjadi ≤12 jam dan >12 jam. Parameter yang dicatat pada penelitian ini adalah usia, berat badan, tinggi badan, indeks massa tubuh, lama PJP, waktu klem aorta, dan lama bantuan ventilasi mekanis. Analisis stastistik menggunakan uji korelasi Lambda, signifikan jika nilai p<0,05. Penelitian ini menunjukkan korelasi yang cukup kuat antara waktu PJP dan lama bantuan ventilasi mekanis setelah BPAK dengan korelasi positif (0,545) dan signifikan (p<0,05). Simpulan penelitian ini adalah semakin lama waktu PJP berkorelasi dengan memanjangnya lama bantuan ventilasi mekanis. Lung functions and oxygenation are impaired in 20% to 90% of CPB cardiac surgery patients. Ventilator dependency following CABG is often associated with significant morbidity and mortality. This study aimed to correlate the CPB time and mechanical ventilation duration after coronary artery bypass graft. This was a retrospective analysis cohort study on 43 consecutive patients undergoing CABG on CPB admitted to cardiac intensive care unit between January 2014 and June 2015 in Dr. Hasan Sadikin General Hospital Bandung. The CPB time was divided into <90 minutes and ≥90 minutes. Duration of mechanical ventilation was defined as ≤12 hours and ≥12 hours of ventilation. Parameters recorded in this study were age, weight, height, body mass index, CPB time, aortic cross-clamp time, and mechanical ventilation duration. Statistical analysis was performed using Lambda correlation, which is significant if p value <0.05. This study showed moderate correlation between CPB time and mechanical ventilation duration after CABG surgery with a positive (0.545) and significant correlation (p<0.05). Conclusion of this research is longer CPB time correlates with prolonged mechanical ventilation