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Seorang Wanita dengan Straight Back Syndrome

Christine, Ika

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Skeletal deformity may alter thoracic configuration, which leads to misdiagnosis of the cardiovascular system. An absence of normal thoracic kyphosis has been identified to be a cause of “pseudo-heart disease”. This deformity is characterized by a reduced antero-posterior diameter of chest that causing a compression of the heart and great vessel. It is well known as the Straight Back Syndrome. Although this abnormality is subtle, it may generate leftward displacement of the heart, resulting cardiac murmurs, chest pain, and tracheal compression. Straight back syndrome may closely mimicking several cardiac diseases, such as mitral valve prolapse, ventricle septal defect, and pericardial absence. Chest x-ray has been known to be the most convenient diagnostic tool for this syndrome. Careful clinical assessment of this syndrome may avoid patients from unnecessary medication. This literature presents a case of a 36 year-old woman who was misdiagnosed with ventricular septal defect from the physical examination, transthoracic echocardiography, and transesophageal echocardiography. However, the right and left diagnostic catheterization resulted normal findings. Consequently, the patient was suggested to discontinue completely her medication

EDITORIAL

Jurnal, Operator

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

EDITORIAL

Pemanjangan Interval QT Terkoreksi (QTc) pada Pasien Hipokalemia Berat dengan Penyulit Aritmia Ventrikel Fatal

Yofrido, Filipus Michael, Christine, Ika, Harjana, Lila Tri

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

QT prolongation (QTc > 440 ms) is risk factor for ventricular arrhythmias, especially Torsade de Pointes. It be caused by congenital, hypokalemia, hypocalcemia, hypomagnesemia, and drugs.Meticulous monitoring, immediate treatment of underlying, and avoiding drug-induceQT prolongation are useful to prevent lethal event.A 66-years-old man came to emergency department with nausea, postural imbalance, constipation, and history of periodic hypokalemia. 12-lead ECG revealed sinus rhythm with QT prolongation (QTc 650 ms). Laboratory showed hypokalemia, hyponatremia, hypocalcaemia, hypomagnesaemia, and hyperglycemia. He treated with omeprazole, ondansetron, sodium phosphate enema, and metoclopramide for his symptoms. Three hours later, he was suddenly collapse and ECG showed polymorphic Ventricular Tachycardia (VT) Torsade de Pointes. Magnesium sulfate and CPR were given. Fourthy-five minutes resuscitation didn’t return of spontaneous circulation and he was dead.

Distribution and Antibiogram of MRSA from Blood Specimens in Four Semesters Perspective in Dr. Soetomo General Hospital Surabaya

Sutandhio, Silvia, Widodo, Agung Dwi Wahyu, Wasito, Eddy Bagus

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

MRSA bloodstream infection is hospital-acquired problem that is difficult to treat. Bacteria spread to body organs, create multiple loci of infection, and survive in the presence of beta-lactam antibiotics. Study of distribution and antibiogram of MRSA from blood specimens was done in four semesters; i.e. July–December 2014, January–June 2015, July–December 2015, and January–June 2016. Blood of patients suspected for bloodstream infection was drawn aseptically, transferred into liquid medium, and sent to Clinical Microbiology Laboratory of Dr. Soetomo General Hospital. Medium with microbial growth was subcultured on solid medium, and incubated for 18-24 hours in aerobic condition. Identification and susceptibility test were done with BD Phoenix, and interpreted based on Clinical and Laboratory Standards Institute 2015. Of total 107 MRSA isolates; 23 isolates (22%) were collected on July–December 2014, 12 isolates (11%) on January–June 2015, 25 isolates (23%) on July–December 2015, and 47 isolates (44%) on January–June 2016. MRSA mostly isolated from internal disease wards (45%). Isolates are sensitive to linezolid (91%), quinupristin-dalfopristin (83%), fosfomycin (82%), and vancomycin (80%). Trend of MRSA bloodstream infection is increasing. Although antibacterial agents against MRSA are available, it is best to prevent MRSA transmissions and infections.

Peran Intervensi Dalam Meningkatkan Pemahaman Tentang Dinamika Menyusui

Watimena, Inge

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Introduction: WHO has not achieved its 50% exclusive breastfeeding target. To understand the causes, two different studies were conducted. Study 1: Performed a worldwide literature review of various breastfeeding reports, indexing: obtained through electronic media (International Breastfeeding Journals, Google Scholars) using guided keywords (breastfeeding, attitude, experience, intervention). Twenty articlesrepresenting countries with varying information were selected. Result: Breastfeeding was not properly understood.Study 2A: a one-shot case study design was performed on 110 pre-or several day post-natal women, who received verbal, written (reading a booklet), or verbal+written information. Subjects were contacted by mail approximately a year later to complete a quantitative and qualitative questionnaire, 45 responded. Result: 88.9% succeeded in breastfeeding longer than six months. No significant differences in knowledge attainment between the three methods of intervention were found. Qualitatively it was shown that the importance of breastfeeding was not sufficiently understood. Subjectshadbetter understanding after intervention, became more motivated, and experienced physical, psychological, and social wellbeing. Study also showed thatbreastfeeding was not actively promoted by the medical team and environment. Study 2B:a one-group pre-post-test design, performed on 30 pregnant and 30 post-natal women, each divided in three sub-groups. Each sub-group received either verbal, written, or verbal+written information. Result: all interventions had a larger influence on pregnant compared to post-natal women. Discussion and Conclusions: verbal and written intervention have positive effect on breastfeeding knowledge and attitude. Health Promotion should be actively performed or promoted, especially on pregnant women, ideally by a competent motivator for the welfare of family and nation as well.

Pemakaian Nitroglycerin Intravena Invivo Sebagai Antidotum Efek Heparin

Jiwangga, Dhihintia, Tahalele, Paul L., Basori, Achmad

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Introduction: intravenous nitroglycerin, if given simultaneously with heparin, can obstruct the heparins anticoagulant effect, but it still remains controversy. This statement underlies researcher to authenticate whether intravenous nitroglycerin can neutralize heparin Aim: to find out if intravenous nitroglycerin can neutralize heparin Method: this research is an in vivo experiment with a rabbit as the experimental subject at The Pharmacology Department of The Medical Faculty of The Airlangga University. The experimental subjects are divided into a control group and a treatment. The control group is only given a dose of heparin, while the treatment is given a dose of heparin and some doses of intravenous nitroglycerin. Each of this experimental subjects will be examined its activated clotting time (ACT) score with a hemochrone. The statistical test that will be used is the normality test with one sample kolmogorov smirnov test Result: the administration of 3 mg/kg dose of intravenous glyceryl trinitrate after the administration of 3 mg/kg heparin can reduce the ACT value or neutralize the heparins anticoagulant effect significantly with the value p= 0,001 (pc0,005). The group that receives 6 mg/kg glyceryl trinitrate, if compared to the prior ACT before the administration of 6 mg/kg glyceryl trinitrate, has a change with the value p= 0,001 (PO, 05). The group that receives 9 mg/kg glyceryl trinitrate, if compared to the prior ACT before the administration of 9 mg/kg glyceryl trinitrate, has a significant change with p=0,010 (P

Kuku Sebagai Petunjuk Penyakit Lain

Anggowarsito, Jose L.

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Changes in the color and texture of the surface of the nail can reflect a variety of medical conditions. We can notice subtle change as variations, and often these imperfections form will not mean much to some people, but for the trained eye, nail conditions can provide valuable clues about the health, though often not be the first hint of a serious illness. Healthy nails have a smooth texture with flat surface, without pits or grooves. They are uniform in color and consistency and free of spots or discoloration. Provided diligently observe this section, some of diseases can be identified from some of anomalies and unusual things. On the other hand, lack of proper treatment of the nail can also cause some health problems. Good habits of nail care can avoid the risk of health problems and the threat of some diseases

Terapi Oksigen Hiperbarik (TOHB) Pada Kasus Pasien Anak Tuli Mendadak Akibat Mumps

Suyono, Handi

JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Background One of rare mumps sequalaein pediatric is deafness. Many treatments have been applied to sudden deafness including HBOT. HBOT is still useful and give good result eventhough it was delayed. Subject and Method The boy, 13 years old, was suddenly deaf of right ear 2 months ago. He got oral steroids from ENT specialist. There was no improvement after 2 months medications and then stopped the steroids. He had mumps 1 month before sudden deafness. The audiometry test showed hearing decreased 30-60 dB on frequency 125-8000 Hz. He had allergic rhinitis and tonsillitis in the past medical history, and tonsillectomy 6 years ago. HBOT was given 2.4 ATA 1 hour per session per day for 56 sessions (8 weeks). There are no barotrauma during and after HBOT. Result He felt hearing improvement after 44 sessions. The audiometry test showed improvement 10-20 dB. Conclusion HBOT is usseful and can give clinical improvement eventhough it was delayed.

Gambaran Penanganan Ibu Hamil Dan Bersalin Pada Suku Boti Dalam Kecamatan Kie Kabupaten Timor Tengah Selatan

Ninu, Joy January A. S., Rihadi, Slamet, Tirtahusada, Kusuma

JURNAL WIDYA MEDIKA Vol 4, No 1 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

Maternal Mortality Rate (MMR) and Infant MortalityRate (IMR) in ASEAN are high, including Indonesia. An analysis by the Directorate of Maternal Health in 2010 indicates that maternal mortality is closely related to a helper and place or delivery facility. This research uses qualitative method with ethnography research type. The research was conducted at Boti Tribe of KiE Subdistrict of South Central Timor District (TTS) of East Nusa Tenggara Province (NTT) with research focus in Boti Dalam Tribe. The results showed that the main factor that makes the community of Tribe Boti Dalam tends to use the help of maternity dukun is the belief and adherence to following the adat. In the treatment of pregnant women and maternity, traditional birth attendants still use traditional methods ranging from massage andvarious traditional ingredients that are believed to improve maternal health conditions and overcome various complications that arise during pregnancy, childbirth, and childbirth and post partum.. The equipments are still traditional. The researcher suggested that regeneration and training of maternity dukun on the procedures for the handling of pregnant women and healthy and safe maternal mothers should be provided to the Boti Dalam tribecommunity with socio-cultural approach and local policy

Model Pembelajaran Moral dan Etika Kedokteran pada Mahasiswa, di F.K. Widya Mandala Surabaya

Tirtahusada, Kusuma, Maramis, Willy F.

JURNAL WIDYA MEDIKA Vol 4, No 1 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Abstract

The increasing conciousness on law and personal right among people, must be responded by medical doctors with increasing their attention on medical ethics when providing medical practice, to avoid malpractice. Ethics and medical law are closely related. Attention and learning medical ethics must begin early during medical study, and continue as long as the study. Widya Mandala medical faculty provide a programe called “Ethical Dilemma Discussion”. Begins from the first semester, designed for seven semesters. The programme consists of small group weekly discussions on moral dilemma cases, ten times for each semester, plus classes on morals, philosofy of man, bioethics, social ethics, behavioral sciences in medicine and medical law. Every student must be involved in each dilemma case discussion, express his/her opinion and the reasoning. The discussion attend to the six stages of L. Kohlberg’s moral development. Each dilemma case being analized according to the six principals of Beauchamp and Childress, those are personal autonomy, veracity, beneficence, nonmaleficence, confidentiality, justice. According to reports from students in internship, they feel at easy when discussing dilemma cases in hospital, because they are familiar with moral dilemma dialogues already