E-Jurnal Medika Udayana is a peer-reviewed scientific journal dedicated to publish good quality of research work in all areas of medical sciences. Scope of the journal includes: medicine, dentistry, nursing and allied health sciences, pharmacy, pathology, anatomy, pharmacology, toxicology, surgery and physiology.
BRAIN RESUSCITATION IN SEVERE HEAD INJURY AT SANGLAH CENTRAL GENERAL
Head trauma is a serious problem worldwide and causes morbidity and mortality at a young age. The increase in the number of severe head injuries continues to occur along with the number of accidents. This study aimed to examine the characteristics of brain resuscitation in patients with a severe head injury. Descriptive research with cross-sectional research method and the data obtained as many as 35. Data processing using SPSS and displayed in a distribution table according to the variables. This study found that patients with severe head injuries were most often at the age of >45 years, namely 18 people (51.4%), and male sex was more common than women as many as 24 people (68.6%). The most common GCS was found with GCS 3-5 as many as 21 people (60%). The brain resuscitation regimen in patients with a severe head injury was given crystalloid solution (0.9% NaCl, Ringer's lactate) in 35 people (100%), mannitol 20% in 22 people (62.9%), and phenytoin in 33 people (94.3%). The GOS value of all patients with severe head injury with a GOS value of 1 or died (100%). Most deaths from severe head injury patients were in the first <48 hours as many as 27 people (77.1%)
brain resuscitation, traumatic brain injury, severe head injury.
HUBUNGAN STRES AKADEMIK DENGAN TENSION TYPE HEADACHE PADA MAHASISWA PROGRAM STUDI SARJANA KEDOKTERAN UNIVERSITAS UDAYANA
Tensionntypeeheadachee(TTH) merupakan bentuk nyeri kepala primer yang paling sering diderita semua kelompok usia di seluruh dunia. Literatur menunjukkan bahwa stres merupakan pemicu utama dari serangan nyeri kepala. Tercatat sekitar 80% mahasiswa di seluruh dunia mengalami stres, baik setelah ujian, pembuatan karya ilmiah, maupun pembuatan tugas lainnya. Penelitiannini merupakannpenelitian observasional analitikkdengan rancangannstudiccross-sectional yang bertujuan untuk menilai hubungan antara stres akademik dengan TTH. Populasi penelitianIni merupakan mahasiswa Program Studi Sarjana Kedokteran, Fakultass Kedokterann Universitass Udayana angkatan 2018, 2019, dan 2020. Data dikumpulkan secara online dengan mengisi kuesioner student-life stress inventory (SSI) untuk menilai tingkat stres akademik dan diagnosis TTH dinilai berdasarkan kriteria diagnosis menurut International Headache Society (2018). Data hasil penelitian dianalisis dengan ujicchi-square untuk mengetahui hubungan tingkat stressakademikkdengan TTH. Sampel penelitian berjumlah 181 responden dengan 131 diantaranya mengalami TTH. Kejadian TTH lebih banyak ditemukan pada responden dengan stres sedang-berat yakni 94 (71,8%), sementara pada stres ringan sebanyak 37 (60,7%). Hasil uji analisis hubungan antara tingkat stres akademik dengan TTH menggunakan uji chi-square didapatkan p-value sebesar 0,012. Berdasarkan hasil penelitian ini dapat disimpulkan bahwa terdapat hubungan yang signifikan antara tingkat stres akademik dengan TTH pada mahasiswaaProgrammStudi Sarjana KedokterannUniversitas Udayana. Kata kunci : TTH, stres akademik, nyeri kepala. ABSTRACT Tension typehheadachee(TTH) is the most commonnform of primary headacheeaffecting all age groups worldwide. Literature showed that stress was a significant trigger of headache attacks. It has been recorded that around 80% of students worldwide have experienced stress after exams, writing scientific papers, and making other assignments. Thissstudy was anaanalytic observationalsstudy with accross-sectional study designnto assess the relationshippbetween academicsstress and TTH in medical students of Udayana University. The population of this study were medical students of Udayana University, batch 2018, 2019, and 2020. Data collection was taken online by filling out a student-life stress inventory (SSI) questionnaire to assess academic stress levels. In contrast, TTH diagnosis was assessed based on the diagnostic criteria according to the International Headache Society (2018). Data analysisswas performed using thecchi-square test to determine the relationship between academic stress levels and TTH. There were 181 respondents, with 131 of them were experiencing TTH. The incidencesof TTH was more found in respondents with moderate-severe stress, namely 94 (71,8%), while in mild stress were 37 (60,7%). The chi-square analysis test about the relationship between academic stress levels and TTH obtained a p-value of 0.012. Therefore, this study concluded alssignificant relationshippbetween academic stress and TTH in medical students of Udayana University. Keywords : TTH, academic stress, headache.
USE OF ANTICOAGULANTS IN COVID-19 PATIENTS AS A PREVENTIVE EFFORT FOR HEART FAILURE MORTALITY
Background: Thrombosis and hypercoagulable states are complications that can arise in COVID-19 and heart failure patients. This occurs due to a cytokine reaction, leading to the activation and increase of coagulation factors. This condition can lead to complications such as DVT, VTE, and PE, which will increase the severity and mortality of the patient's disease. Anticoagulants are one of the effective therapies to prevent and treat various types of thromboembolic diseases. Heparin and enoxaparin are commonly used anticoagulants in hospitals. Objective: This study aimed to determine whether the use of anticoagulants was associated with the mortality rate in COVID-19 patients diagnosed with heart failure. Methods: This study was conducted using a cross-sectional analytic design. The sample consisted of 71 patients, including 51 who used enoxaparin, 15 who used heparin, and 5 who used a combination of both. After the data was obtained, it was then processed and presented in tabular form. Results: While initial findings suggested that enoxaparin use was associated with lower mortality rates compared to heparin or a combination of both, subsequent analysis revealed no statistically significant difference in mortality rates among patients receiving enoxaparin, heparin, or a combination (p-value = 0,191). Conclusion: There was no significant difference in mortality rates between patients given enoxaparin, heparin, or a combination.
anticoagulant, heparin, enoxaparin, COVID-19, heart failure, mortality
PHARMACOTHERAPY PROFILE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN ELDERLY PATIENTS AT RSUP PROF DR. I.G.N.G NGOERAH DURING THE PERIOD OF JANUARY 2023 – DECEMBER 2023
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a global health issue that is often undiagnosed, particularly among the elderly. Furthermore, elderly patients with comorbidities may receive multiple and varied therapies to address their conditions, which can lead to complex polypharmacy. Therefore, research is needed to describe pharmacotherapy profile of COPD in elderly patients. Objective: To describe the pharmacotherapy profile of COPD in elderly patients at Prof. dr. I.G.N.G Ngoerah Hospital. Methods: This study employs a descriptive quantitative method with a cross-sectional approach, with samples taken retrospectively from the medical records of elderly COPD patients at Prof. dr. I.G.N.G Ngoerah Hospital in 2023, according to inclusion and exclusion criteria. Data was collected via Google Forms and analyzed using Microsoft Excel. Results: The most used COPD therapy regimen is the LABA-ICS combination, specifically the combination of salmeterol and fluticasone propionate (54.2%) followed by the combination of budesonide and formoterol fumarate (26.5%). Supportive therapy commonly administered to patients, include mucolytic agents such as N-acetylcysteine (61.4%) and ambroxol (22.8%). The most common comorbidity diagnosed among COPD elderly patient was cardiovascular disease (54.3%), with most patients receiving beta-blocker medications that have the potential to cause drug interactions with β2-agonists. Conclusion: The use of dual LABA-ICS combinations with additional symptomatic therapy in the form of mucolytics such as N-acetylcysteine and ambroxol is the most common choice for controller therapy for outpatient elderly COPD patients at Prof. dr. I.G.N.G Ngoerah Hospital.
Chronic Obstructive Pulmonary Disease (COPD), Elderly, Polypharmacy.
DEMOGRAPHIC ANALYSIS OF ELBOW FRACTURE PATIENTS AT RSUP PROF. DR. I.G.N.G. NGOERAH
Fraktur sekitar siku adalah cedera muskuloskeletal yang umum ditemukan di instalasi gawat darurat, terutama akibat trauma langsung maupun tidak langsung pada ekstremitas atas. Kompleksitas anatomi sendi siku, yang melibatkan artikulasi humeroulnaris, humeroradialis, dan radioulnaris proksimal, membuat fraktur pada area ini rentan menyebabkan gangguan fungsi jika tidak ditangani dengan tepat. Penelitian deskriptif retrospektif ini menganalisis kasus fraktur siku di RSUP Prof. Dr. I.G.N.G. Ngoerah pada periode November 2024 hingga Oktober 2025. Penelitian ini berfokus pada demografi pasien, jenis fraktur (terbuka/tertutup), penyebab, dan strategi penanganan. Sebanyak 51 rekam medis pasien dimasukkan, dengan mayoritas pasien laki-laki (51%) dan dalam rentang usia 15-64 tahun (84,3%). Sebagian besar fraktur adalah fraktur tertutup (86,3%), sementara fraktur terbuka terjadi pada 13,7%. Penyebab fraktur sebagian besar tidak diketahui (88,2%), diikuti oleh kecelakaan lalu lintas (11,8%). Lokasi fraktur yang paling sering ditemukan adalah olekranon, interkondiler humerus, dan kepala radius. Sebagian besar pasien (80,4%) menjalani fiksasi terbuka dan internal (ORIF) menggunakan plate dan screw. Temuan ini menyoroti pentingnya penanganan trauma yang tepat waktu dan akurat, terutama untuk fraktur yang memerlukan intervensi bedah. Penelitian ini juga menekankan perlunya protokol standar di instalasi gawat darurat untuk meningkatkan hasil pasien dengan fraktur siku. Penelitian lanjutan disarankan untuk menilai hasil fungsional jangka panjang dan memperbaiki strategi pengobatan.
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QUALITY-OF-LIFE OF ELDERLY NATIONAL HEALTH INSURANCE PARTICIPANTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS IN DENPASAR
Elderly individuals are at a high risk of suffering from chronic diseases, especially hypertension and type 2 diabetes mellitus (DM type 2). Chronic diseases were often accompanied by multimorbidity and require long-term treatment. This led to a decline in the quality - of -l ife among the elderly. This research aimed to understand the quality-of-life among elderly individuals with hypertension and DM type 2 who are participants of BPJS Kesehatan and reside in the city of Denpasar. The study used a cross-sectional descriptive design, conducted from January to August 2023. A total of 49 elderly individuals (age ≥60 years) from 4 community health centers in Denpasar were selected as respondents using consecutive sampling. Data were collected through interviews using a questionnaire. The collected data include d respondent characteristics and the level of quality-of-life based on the SF-36 questionnaire. Based on the data analysis, the majority of respondents suffer red from hypertension (51.0%) for a duration of 2-5 years (44.9%), with one accompanying disease (48.9%), mainly heart disease (48.9%). In terms of physical and mental aspects, elderly individuals with hypertension and/or DM type 2 had good quality-of-life . Individuals with hypertension/DM had better physical functional abilities compared to mental functional abilities, with poor social functioning. Conversely, elderly individuals with more than one chronic disease generally had a lower quality-of-life , with better mental functional abilities compared to physical functional abilities. Therefore, policymakers were encouraged to maintain efforts to improve the quality-of-life , such as through exercise or health promotion programs (Prolanis), and develop health programs focused on mitigating the impact of multimorbidity at both individual and community levels. Keywords :
quality-of-life, hypertension, diabetes mellitus.
THE RELATIONSHIP BETWEEN COMPLIANCE OF IRON-FOLIC ACID SUPPLEMENT TABLET CONSUMPTION WITH ANEMIA STATUS AMONG PREGNANT WOMEN AT KINTAMANI VI PRIMARY HEALTH CARE CENTER
Background: Anemia in pregnancy remains a common health problem that contributes to increased maternal and fetal morbidity and mortality. Preventive efforts have been implemented through the supplementation program of iron–folic acid tablets (Tablet Tambah Darah or TTD) recommended throughout pregnancy; however, its effectiveness depends greatly on compliance. Objective: To determine the association between compliance to iron-folic acid tablets consumption and anemia status among pregnant women in the working area of Puskesmas Kintamani VI. Methods: This was an analytical observational study with a cross-sectional design involving 75 third-trimester pregnant women who met the inclusion criteria and sampled using consecutive sampling. Compliance data were collected through interviews using a simplified Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire. Hemoglobin levels were obtained using a POCT (Point of Care Testing) device and medical records. Bivariate analysis was performed using the Chi-square test. Results: The results showed that 52% of respondents were classified as non-compliant. The proportion of pregnant women with anemia was 33.3% in the non-compliant group and 11.1% in compliant group. Bivariate analysis indicated a significant relationship between TTD compliance and anemia status (p-value=0.022; PR=0.33; 95% CI: 0.12–0.93). Other variables, including maternal age, education level, nutritional status, parity, micronutrient intake, sleep quality, hyperemesis gravidarum, income, occupation, and other medical factors, showed no significant association (p-value>0.05). Summary: Compliance to iron-folic acid tablets consumption serves as a protective factor against anemia. It is recommended that healthcare providers strengthen education, follow-up, and support strategies to improve adherence and help reduce anemia prevalence in pregnancy.
The Correlation between Bilirubin Levels and Birth Weight in Neonates with Neonatal Jaundice
Neonatal jaundice is a clinical condition caused by elevated bilirubin levels. Birth weight is often associated with the risk of neonatal jaundice due to liver function immaturity in low birth weight infants. However, research findings regarding the relationship between these two variables remain varied. This study aims to determine the relationship between total serum bilirubin levels and birth weight in neonates with neonatal jaundice at Ngoerah Hospital. This research is an observational analytic study with a cross-sectional approach using medical record data of patients who met the inclusion criteria at Ngoerah Hospital. Descriptive analysis results showed that the mean birth weight of the sample was 2,859.38 grams and the mean total bilirubin level was 17.77 mg/dL. The Spearman bivariate test results showed no significant relationship between birth weight and total bilirubin levels (p=0.222; r=0.198). Multivariate analysis also confirmed that birth weight was not a significant predictor (p=0.318) after controlling for gestational age and gender variables. There is no significant relationship between birth weight and total bilirubin levels in neonates with neonatal jaundice at Ngoerah Hospital. This result is likely influenced by the dominance of term infants in the sample and the presence of other, more dominant pathological factors.
PREVALENCE AND RISK FACTORS FOR SLEEP QUALITY DISORDERS IN PENCAK SILAT ATHLETES BULELENG REGENCY
The quality of sleep-in athletes contributes to athletic performance, injury risk, recovery time, cardiovascular endurance and anaerobic strength. Pencak silat athletes also have a risk of having poor sleep quality, in connection with the intensity of training and academic stress in athletes who are students. However, specific data on the prevalence and risk factors for sleep quality disorders in athletes are still limited. This study is aimed at determining the quality of sleep and factors related to pencak silat athletes. A cross-sectional study conducted on pencak silat athletes in Buleleng Regency in June-August 2025. A total of 32 pencak silat athletes participated in this research, who were selected using the total sampling method. The criteria for sample inclusion set include being willing to be the subject of the research, and signing the informed consent, being present at the data collection, being able to fill out the questionnaire completely and participating in the data collection until the end. The exclusion criteria in this study are athletes in poor physical and mental health, who are diagnosed by a doctor, and have moved their domicile outside Buleleng. Sleep quality data were collected by the interview method using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. As many as 59.4% of pencak silat athletes have good sleep quality. Early wake-up time, the use of sleep medications, the presence of sleep disorders and sleep efficiency are factors related to the quality of athletes' sleep (p <0.05). Therefore, it can be concluded that the sleep quality of pencak silat athletes is quite good. So, it is recommended to increase adequate sleep time supervision between 8-10 hours per day, avoid the use of sleeping pills and overcome sleep disorders in athletes to maintain athlete performance.
Athletes, cross-sectional, pencak silat, Pittsburgh Sleep Quality Index, sleep quality.
FACTORS ASSOCIATED WITH OBESITY AMONG STUDENTS AT SMA NEGERI 1 PENEBEL, TABANAN
Background: Adolescent obesity has become an increasing public health challenge, with long-term impacts on quality of life and an elevated risk of degenerative diseases. The urgency to address this condition continues to grow due to its rising prevalence and the potential for adverse health outcomes in adulthood. This study aimed to determine the prevalence of obesity and analyze factors associated with obesity among students at SMA Negeri 1 Penebel, Tabanan. Methods: This study employed an analytical observational design with a cross-sectional approach involving 140 respondents. Data were collected through anthropometric measurements and self-administered questionnaires assessing genetic factors, sex, physical activity level, and sleep duration. Data analysis was conducted using the Chi-square test, Fisher’s Exact Test, and multivariate logistic regression analysis. Results: The prevalence of obesity among students at SMA Negeri 1 Penebel, Tabanan was 37.1%. Bivariate analysis demonstrated significant associations between genetic factors (p = 0.006) and sleep duration (p = 0.013) with obesity. In contrast, sex (p = 0.073) and physical activity level (p = 0.824) were not significantly associated with obesity status. Multivariate analysis indicated that genetic factors were the strongest independent predictor of obesity among students (p = 0.031). Conclusion: Genetic factors and sleep duration were significantly associated with obesity, with genetic factors identified as the most dominant predictor. The high prevalence of obesity underscores the importance of preventive health interventions focusing on modifiable risk factors, particularly among students with a genetic predisposition.
VARIATION IN RADIOLOGYANATOMY MORPHOMETRY OF THE ANKLE IN PATIENTS WITH ANKLE FRACTURE TREATMENT AT REGIO DENPASAR HOSPITAL, 2019-2023
An ankle fracture is a condition where the continuity of the bone in the ankle is partially or completely disrupted Radiological imaging can be used to determine changes in the morphometric variations of the ankle due to ankle fractures. These radiological-anatomical morphometric variations in patients can be assessed through various measurements. This study aims to understand the radiological-anatomical morphometric variations of ankle fractures in patients treated at Regio Denpasar Hospital from 2019 to 2023. The research was conducted using an observational cross-sectional study approach. The results indicate that based on the type of displacement, the average values of radiological-anatomical morphometry of the ankle in ankle fracture patients at Regio Denpasar Hospital from 2019 to 2023 consist of talocrural angle (91.6°), lateral malleolar length (18.2 mm), medial malleolar length (10.6 mm), tibiofibular overlap (6.4 mm), medial clear space (5.1 mm), Johnson angle (96.1°), anterior distal tibial angle (88.9°), and tibiofibular clear space (2.9 mm). For undisplaced fractures, the values are talocrural angle (78.6°), lateral malleolar length (23.3 mm), medial malleolar length (9.1 mm), tibiofibular overlap (5.9 mm), medial clear space (2.4 mm), johnson angle (87.5°), anterior distal tibial angle (82.1°), and tibiofibular clear space (3.1 mm). There is a significant difference between displaced and undisplaced fracture types in the variables talocrural angle, lateral malleolar length, medial malleolar length, medial clear space, and anterior distal tibial angle. However, no significant difference was found between the displaced and undisplaced fracture types for the variables tibiofibular overlap and tibiofibular clear space.
THE INCIDENCE OF INFECTIOUS DISEASES IN CHILDREN IN TRUNYAN TOURISM VILLAGE
Background: Infectious diseases are the leading cause of death and morbidity among children. Children with these illnesses are frequently seen in primary healthcare settings. Epidemiological surveillance is essential to monitor and review the incidence of infections. Such surveillance activities provide valuable information about infection rates and emerging patterns. This study aims to determine the incidence of infectious diseases among children in Trunyan Village. Methods: This study is an analytical observational study using a cross-sectional design. Data were collected from electronic medical records of children aged 0 to 18 years who visited the health center in Trunyan Village between January 2024 and October 2024. All data were processed and statistically analyzed using SPSS version 26. Descriptive statistics, including proportions (percentages), counts, averages (standard deviations), and ranges (minimum–maximum), were calculated. The relationship between dependent and independent variables was assessed using Chi-square analysis, with a significance threshold of p<0.05. Results: A total of 79 study subjects met the inclusion and exclusion criteria, and 10 infectious diseases were identified. The three most prevalent conditions were upper respiratory tract infections (URTI), pneumonia, and diarrhea. Most patients were male (54.4%). The youngest patient was 1 year old, and the oldest was 17.3 years, with children in the age category of 6–12 years comprising the largest group (38%). Based on anthropometric data, the average body mass index (BMI) was 17.3, with a minimum of 11.1 and a maximum of 29.0. Most children were fully immunized (81%) and had received exclusive breastfeeding (68.4%). Regarding hospitalization history, 27.8% of children had been hospitalized due to conditions such as pneumonia, typhoid, diarrhea, and dengue fever. Conclusion: Ten common infectious diseases lead children to seek treatment, with four requiring hospital admission (Pneumonia, typhoid fever, diarrhoea, and dengue fever). The incidence of infections is influenced by factors such as exclusive breastfeeding and immunization status.
infectious diseases, pediatric infections, risk factors, tourism village
FACTORS ASSOCIATED WITH THE OCCURRENCE OF ATOPIC DERMATITIS IN CHILDREN
Dermatitis atopik merupakan kondisi inflamasi kulit kronik yang sering ditemukan pada anak. Penelitian ini bertujuan untuk mendeskripsikan determinan yang berhubungan dengan dermatitis atopik pada anak di Balai Kesehatan Kulit, Kelamin, dan Kosmetika Makassar. Penelitian ini menggunakan metode deskriptif kuantitatif dengan desain potong lintang. Sampel terdiri atas 61 anak berusia 0–18 tahun yang telah didiagnosis dermatitis atopik dan memenuhi kriteria inklusi. Data diperoleh melalui rekam medis dan kuesioner yang mencakup faktor genetik, faktor pencetus, dan faktor lingkungan. Hasil penelitian menunjukkan bahwa sebagian besar responden adalah perempuan (50,82%) dan berada pada kelompok usia 2–12 tahun (59,02%). Faktor genetik ditemukan pada 62,30% responden, dengan riwayat keluarga dermatitis atopik sebagai indikator yang paling banyak dilaporkan (59,02%). Faktor pencetus terdapat pada 67,21% responden, dengan gejala yang umumnya muncul setelah mengonsumsi makanan tertentu. Faktor lingkungan ditemukan pada 52,46% responden, terutama ventilasi buruk dan paparan suhu ruangan ekstrem. Penelitian ini menyimpulkan bahwa faktor genetik, faktor pencetus, dan faktor lingkungan hadir pada anak-anak yang didiagnosis dermatitis atopik di lokasi penelitian.
dermatitis atopik, anak, faktor determinan
EFFECTIVENESS OF DENTAL AND ORAL HEALTH COUNSELING USING TRADITIONAL FOLKLORE VIDEO MEDIA ON ATTITUDE IN 8-9 YEARS OLD CHILDREN
Oral health problems among elementary school children are still very high. One of the contributing factors is behavioral in maintaining oral hygiene. Behavior begins to form from knowledge which will then stimulate changes in attitudes and practice. Efforts to change children's attitudes can be achieved through counselling. This study aims to determine the effectiveness of dental and oral health counselling traditional folklore video media on attitudes in children aged 8-9 years. This type of research is quasi-experimental with a two group pre-test and post-test design. Sampling using multistage cluster random sampling with a total sample of 112 children aged 8-9 years in elementary schools, the sample was divided into 2 groups, 56 children using traditional folklore video as the intervention group and 56 children using conventional video as the control group. Attitude variables were measured using a questionnaire. Data analysis using the Independent T-Test and the Mann-Whitney U Test. The results of the difference analysis with the Mann-Whitney U Test at pre-post 2 showed a significant change in attitude in both intervention groups. The median attitude score of the traditional folklore video group showed a greater change compared to the conventional video group by 7,5 (5-14,0) (p 0,007). The conclusion of this study is that oral health counseling using traditional folklore video is more effective in changing attitudes towards maintaining dental and oral health in children aged 8-9 years compared to conventional video media.
THE EFFECT OF ZINC OXIDE NANOPARTICLE CONCENTRATION AS A COATING FOR HEAT CURED ACRYLIC RESIN ON Candida Albicans GROWTH
The most commonly used polymer material as a denture base is heat cured acrylic resin because it has high strength, accuracy, and aesthetics. However, heat cured acrylic resin has a disadvantage in biological properties, namely it does not have antimicrobial properties. This study aims to test the effect of ZnO nanoparticle concentration as a heat-cured acrylic resin coating on the growth of C. albicans. 24 acrylic resin samples were required in this study, measuring 13mm x 13mm x 2mm. The acrylic resin was coated with 3-(trimethoxysilyl)propyl methacrylate) and then coated with ZnO nanoparticles with varying concentrations of 2.5%, 5%, and 7.5% in ethanol. The ZnO nanoparticle coating was applied using the dip coating method. Samples were made in groups I, II, III, and IV. The samples were then tested for C. albicans growth. The data obtained were analyzed using the Kruskal-Wallis test followed by the Mann-Whitney test. The results showed that the mean and standard deviation of C. albicans growth after contact with acrylic resin coated with ZnO nanoparticles in groups I to IV were 2.00±0.89; 0.83±0.75; 0.00±0.00; 0.00±0.00. The Kruskal-Wallis test results showed a significance value of 0.002, which means that the concentration of ZnO nanoparticles as a coating had a significant effect on the growth of C. albicans on heat cured acrylic resin (p<0.05). The conclusion of this study is that the addition of zinc oxide nanoparticles as a coating on acrylic resin can reduce the growth of C. albicans statistically significantly.
Correlation Between Urine Protein Creatinine Ratio and Glomerular Filtration Rate in Pre-dialysis Chronic Kidney Disease Patients at Ngoerah General Hospital Denpasar
Background: Chronic Kidney Disease (CKD) is a global health problem with increasing prevalence and high mortality. By definition, CKD is characterized by abnormalities in kidney structure or function lasting for more than three months. Presence of protein in the urine (proteinuria) is one of the key indicators for assessing intrinsic structural damage in CKD. On the other hand, index for evaluating kidney function is Glomerular Filtration Rate (GFR). The degree of proteinuria influences renal function, with higher levels leading to faster deterioration of renal function. Objective: To investigate correlation between UPCR and GFR in pre-dialysis CKD patients at Ngoerah General Hospital Denpasar Methods: Analytical observation study with a cross-sectional design involving 40 pre-dialysis CKD patients at Ngoerah General Hospital Denpasar during the period 2023–2024 who met the inclusion and exclusion criteria. The correlation between UPCR and GFR was assessed using Spearman’s correlation test. Results: The study population consisted predominantly of females (57.5%), with a mean age of 46.28 ± 14.49 years, most of whom were in stage 5 (32,5%). The median UPCR was 1.45 (0.05–13.15) mg/mg, while the median GFR was 30.00 (2.74–114.90) mL/min/1.73 m². Spearman’s correlation analysis demonstrated a strong negative correlation between UPCR and GFR (r = -0.615; p < 0.001). Conclusion: A strong and significant negative correlation was found between UPCR and GFR in pre-dialysis CKD patients. These findings suggest that higher levels of proteinuria are associated with lower renal function in pre-dialysis CKD patients.
MULTIDRUG-RESISTANT KLEBSIELLA PNEUMONIAE DAN ESCHERICHIA COLI DI RUMAH SAKIT TERSIER PASCA PANDEMI COVID-19: PREVALENSI, KARAKTERISTIK, DAN POLA KEPEKAAN
Klebsiella pneumoniae dan Escherichia coli adalah bakteri Gram negatif dari famili Enterobacteriaceae yang banyak terisolasi di rumah sakit sebagai penyebab infeksi, baik hospital-acquired infections (HAIs) maupun community-acquired infections. Prevalensi resistensi bakteri tersebut semakin meningkat, termasuk resistensi terhadap antibiotik golongan karbapenem dan sefalosporin spektrum luas. Penelitian ini bertujuan untuk mengetahui pola kepekaan K. pneumoniae dan E. coli penghasil extended spectrum β-lactamase (ESBL) dan resisten karbapenem terhadap antibiotik yang diisolasi dari pasien rawat inap serta distribusinya berdasarkan usia, jenis kelamin, diagnosis, ruang rawat, lama rawat, status rujukan, dan jenis spesimen. Penelitian ini adalah penelitian deskriptif observasional dengan desain cross-sectional menggunakan data laboratorium dan data rekam medis di Instalasi Laboratorium Sentral dan Instalasi Rekam Medis RSUP Dr. Mohammad Hoesin Palembang periode Juli 2022-Juni 2023. Terdapat 587 isolat K. pneumoniae dan 506 isolat E. coli penghasil ESBL atau resisten karbapenem. Distribusi K. pneumoniae dan E. coli berdasarkan profil resistensinya di RSUP Dr. Mohammad Hosein Palembang, antara lain ESBL-K. pneumoniae (53,6%), ESBL-E. coli (72,1%), CR-K. pneumoniae (8%), CR-E. coli (1,8%), ESBL-CR-K. pneumoniae (2%), dan ESBL-CR-E. coli (1%). Berdasarkan pola kepekaan, isolat penghasil ESBL sensitif terhadap antibiotik piperasilin/tazobaktam, golongan karbapenem, amikasin, nitrofurantoin, dan tigesiklin. Isolat CRE sensitif terhadap amikasin, nitrofurantoin, dan tigesiklin. Isolat Enterobacteriaceae multidrug-resistant (MDR) yang paling banyak di RSUP Dr. Mohammad Hoesin Palembang selama periode penelitian adalah ESBL-E. coli (72,1%), dengan sensitivitasnya yang masih cukup tinggi terhadap piperasilin/tazobaktam, karbapenem, amikasin, nitrofurantoin, dan tigesiklin. ABSTRACT Hospital-acquired infections (HAIs) and community-acquired infections are frequently caused by two Gram-negative bacteria from the Enterobacteriaceae family: Escherichia coli and Klebsiella pneumoniae. These bacteria are frequently identified in hospitals. Resistance in bacteria, especially resistance to broad-spectrum cephalosporins and carbapenems, is becoming more common. This study aims to determine the antibiotics sensitivity pattern of ESBL-producing and carbapenem-resistant K. pneumoniae and E. coli isolated from hospitalized patients and its distribution based on age, gender, diagnosis, ward, length of stay, referral status, and specimen type. This research is a descriptive observational study with a cross-sectional design using laboratory and medical record. In this investigation, 587 K. pneumoniae isolates and 506 E. coli isolates that produced ESBL, or carbapenem-resistant, were detected. At Dr. Mohammad Hosein General Academic Hospital Palembang, the distribution of K. pneumoniae and E. coli is determined by their resistance profiles, which include ESBL-K. pneumoniae (53.6%), ESBL-E. coli (72.1%), CR-K. pneumoniae (8%), CR-E. coli (1.8%), ESBL-CR-K. pneumoniae (2%), and ESBL-CR-E. coli (1%). The susceptibility pattern showed that ESBL-producing isolates were sensitive to piperacillin/tazobactam, carbapenems, amikacin, nitrofurantoin, and tigecycline. The CRE isolate was sensitive to tigecycline, nitrofurantoin, and amikacin. ESBL-E. coli was the most prevalent multidrug-resistant Enterobacteriaceae in this investigation, with a significant degree of sensitivity to tigecycline, amikacin, carbapenems, nitrofurantoin, and piperacillin/tazobactam.
Klebsiella pneumoniae, Escherichia coli, ESBL, CRE