Pendahuluan: Gangguan bicara dan bahasa telah lama menjadi perhatian para klinisi yang berkecimpung dalam kesehatan anak. Hal ini dikarenakan adanya berbagai kelainan yang dapat menyertai gangguan tersebut, juga adanya implikasi signi kan terhadap kehidupan anak- anak penyandangnya. Gangguan bicara dan bahasa dapat merupakan akibat dari berbagai kelainan seperti retardasi mental, gangguan pendengaran, gangguan persepsi, gangguan psikososial, autisme, mutisme elektif, afasia reseptif, dan cerebral palsy.

Tujuan: Untuk mengetahui gambaran hasil penapisan pendengaran pada penderita dengan keterlambatan bicara dan bahasa di poli THT- KL, RSUP Sanglah Denpasar.
Metode: Penelitian ini merupakan penelitian deskriptif dengan rancangan deskriptif retrospektif dengan mengambil data dari rekam medis pasien dengan gangguan bicara dan bahasa di poliklinik THT-KL RSUP Sanglah periode Januari 2017 hingga Desember 2017.

Hasil: Dari total 125 anak yang diteliti, dengan lelaki 77 anak dan perempuan 48 anak, didapatkan rentang usia terbanyak penderita keterlambatan bicara dan bahasa yaitu di atas 5 tahun (37 anak). Hasil pemeriksaan otoacoustic emission (OAE) didapatkan hasil pass pada telinga kanan sebanyak 42% (52 anak), telinga kiri 39% (49 anak) dan refer pada telinga kanan sebanyak 58% (73 anak), telinga kiri sebanyak 61% (76 anak). Pada pemeriksaan derajat pendengaran dengan brainstem evoked response audiometry (BERA) dan auditory steady state response (ASSR), didapatkan lebih banyak tuli derajat sangat berat, yaitu 66% pada telinga kanan dan 63% pada telinga kiri.

Kesimpulan: Penderita keterlambatan bicara dan bahasa lebih banyak pada lelaki dengan usia terbanyak di atas 5 tahun. Penderita sebagian besar mengalami gangguan pendengaran, dengan derajat terbanyak yaitu tuli sangat berat.

Objective: This research is to nd out the description of auditory screening results in patients with delayed speech and language at the ENT policlinic of Sanglah general hospital, Denpasar.
Methods: This study was a descriptive study with a retrospective descriptive design by taking data from medical records of patients with delayed speech and language in the ENT policlinic of Sanglah general hospital on January 2017 to December 2017.

Results: Out of a total of 125 children studied, with 77 male and 48 female children, the highest age range of speech and language delays was above 5 years (37 children). On otoacoustic emission (OAE) examination obtained 42% of the right ear pass (52 children), 39% (49 children) left ear pass and 58% refer on the right ear (73 children), 61% refer on the left ear (76 children). On examination of the degree of hearing with brainstem evoked response audiometry (BERA) and auditory steady state response (ASSR), more severe degrees of deafness were obtained, namely 66% in the right ear and 63% in the left ear.

Conclusion: Patients with delayed speech and language was more in men with the most age above 5 years. Most su erers experience hearing loss, with the highest degree of deafness being Profound.

Pendahuluan: Gangguan cemas merupakan gangguan mental yang paling sering ditemukan dan berhubungan dengan beban penyakit yang tinggi. Prevalensi terkait gangguan kecemasan di Indonesia menurut hasil Riset Kesehatan Dasar (Riskesdas) pada tahun 2013 menunjukkan bahwa sebanyak 6% populasi usia 15 tahun ke atas sekitar 14 juta penduduk di Indonesia mengalami gangguan mental emosional yang bermanifestasi sebagai gangguan kecemasan dan depresi. Salah satu penyakit yang diketahui dapat menyebabkan gangguan cemas adalah kanker. Gangguan cemas pada caregiver pasien kanker dapat menyebabkan gangguan kualitas hidup pada caregiver pasien kanker.

Tujuan: Penulisan penelitian ini bertujuan untuk mencari prevalensi kecemasan caregiver pasien kanker sehingga dapat memberikan psikoterapi khususnya mengenai terapi gangguan cemas pada caregiver pasien kanker.

Metode: Penelitian ini merupakan suatu studi dengan menggunakan rancangan penelitian deskriptif dengan rancangan yang digunakan potong lintang (cross-sectional) untuk mengetahui angka prevalensi gangguan cemas yang terjadi pada pasien dan caregiver yang melakukan pengobatan di rumah sakit sehingga dapat diketahui besarnya masalah yang terjadi sesuai tujuan penelitian ini. Pengambilan sampel secara purposive random sampling. Kuisioner HARS (Hamilton Anxiety Rating Scale) digunakan sebagai alat ukurnya. Hasil: Berdasarkan hasil penelitian tentang prevalensi kecemasan pada caregiver pasien kanker di RSUP Sanglah periode Januari 2019 yang dilakukan terhadap 30 orang caregiver didapatkan mayoritas usia dewasa akhir sekitar (50,0%) dengan rata-rata tingkat kecemasan ringan-sedang (36,7%).

Kesimpulan: Penelitian ini menunjukkan bahwa caregiver pasien kanker justru mengalami gangguan cemas lebih banyak dibandingkan pasien kanker itu sendiri.

 

Pendahuluan: Ketuban pecah dini merupakan pecahnya selaput ketuban sebelum adanya tanda-tanda persalinan. Ketuban pecah dini dapat meningkatkan angka mortalitas dan morbiditas bagi ibu dan bayi di dunia terutama di Indonesia. Hormon relaksin dipercaya kadarnya meningkat pada pasien dengan ketuban pecah dini. Diharapkan hormon relaksin dapat dijadikan suatu penanda dalam usaha mendeteksi secara dini serta mencegah terjadinya ketuban pecah dini.

Tujuan: Mengetahui hubungan antara hormon relaksin sistemik dengan terjadinya ketuban pecah dini.

Metode: Penelitian ini merupakan studi observasional analitik dengan rancangan Cross-Sectional di Bagian Obstetri dan Ginekologi RSUP Sanglah Denpasar dan Laboratorium Prodia dari September 2017 sampai Juni 2018. Sampel penelitian adalah ibu hamil preterm dan aterm yang mengalami ketuban pecah dini yang datang ke Poliklinik dan Kamar Bersalin Instalasi Gawat Darurat (IGD) RSUP Sanglah Denpasar, yang memenuhi kriteria dan bersedia ikut serta dalam penelitian. Total sejumlah 40 orang ibu hamil yang memenuhi kriteria inklusi yang bersedia diikutkan dalam penelitian. Pemeriksaan serum darah dilakukan untuk mengidenti kasi kadar serum relaksin sistemik. Dilakukan uji Chi-Square untuk mengetahui hubungan peningkatan kadar relaksin sistemik terhadap ketuban pecah dini. Data dianalisis dengan menggunakan Program SPSS.

Hasil: Hasil uji Chi-square kadar hormon relaksin terhadap kedua kelompok ketuban pecah dini preterm dengan ketuban pecah dini aterm didapatkan nilai p = 0,003 (p<0,05).

Kesimpulan: Terdapat hubungan antara hormon relaksin sistemik dengan terjadinya ketuban pecah dini, dimana kadar hormon relaksin yang tinggi lebih bermakna pada kejadian pecah dini preterm preterm

 

Introduction: Adolescent pregnancy is a pregnancy that occurs in women aged 15-19 years. Pregnancy in adolescents is a reproductive health problem that can affect health, social, psychological and other aspects of the mother and child and the family responsible for the growth and development of the child. The incidence of morbidity and mortality in adolescents and the fetus they contain increases.

Objective: This study aims to determine the profile of teenage pregnancy, in the form of teen pregnancy rates, distribution of teenage pregnancies based on education level, occupation, parity, marital status, antenatal care (ANC) frequency and provider, complications, actions, and perinatal and maternal deaths at Sanglah Hospital Denpasar during 2016-2017.

Methods: This research is a retrospective descriptive study using variables from secondary data sources. The population of study in this research is all pregnant women who come to the Obstetric and Gynaecology Department (polyclinic and outpatient clinic)of Sanglah Hospital Denpasar, aged 15 to 19 years during 2016- 2017.

Results: The results showed that there were 155 cases of teenage pregnancies out of a total of 5112 cases. Based on the level of education, the majority of patients have high school level education (51.6%), junior high school (40.7%) and elementary school (7.7%). Based on their occupation, 65.9% of the study sample are not working, and only 34.1% are working. Almost all the adolescent pregnancy patient is primigravida (92.2%), with only a small 7.8% are multigravida (7.8%). Based on marital status, 113 (72.9%) were married, and 42 (27.1%) were unmarried. Based on the ANC frequency, fourteen patients (9.1%) never had ANC ANC, fifty patients (32.2%) had ANC for less than three times, and ninety-one (58.7%) did ANC for more more than three times.

Conclusion: The study showed that 71.3% experienced complications and preterm labor was the most common complication. Around sixty percent of teen pregnancies do not require specific management other than spontaneous labor.

Pendahuluan: Perilaku bunuh diri adalah masalah kesehatan masyarakat yang signifikan. Gangguan psikologis bisa menyebabkan seseorang melakukan percobaan bunuh diri.

Tujuan: Untuk mendapatkan gambaran mengenai dinamika percobaan bunuh diri pada pasien periode tahun 2016-2018.

Metode: Desain penelitian yang digunakan yaitu deskriptif dengan metode studi kasus melalui pengumpulan data dari seluruh pasien dengan percobaan bunuh diri yang tercatat dalam register Instalasi Gawat Darurat (IGD) di RSUP Sanglah Denpasar yang ditangani oleh bidang Psikiatri.

Hasil: Data tiga tahun terakhir menunjukkan jumlah kasus dengan percobaan bunuh diri sebanyak 234 kasus, dimana jumlah pasien perempuan sebanyak 156 kasus (66,7%). Hasil penelitian didapatkanjumlahpasiendenganpercobaanbunuhdiridengan diagnosis depresi terbanyak pada perempuan dengan cara peracunan diri.

Kesimpulan: Kesimpulan penelitian ini yaitu pasien membutuhkan motivasi berupa dukungan sosial.

Introduction: Suicidal behavior is a significant public health problem. Psychological disorders such as depression can cause a person to commit suicide.

Objective: The aim of this study was to find the dynamics characteristic of the patients with suicide attempt in 2016-2018.

Methods: The research design applied is descriptive, the case study method through the data collection from all patientsattempting suicide that were registered in Intensive Care Unit of RSUP Sanglah Denpasar handled by the poly psychiatry.

Results: The datas from last three years show the number of cases of patients attempting sucide as many as 234 cases, in which the number of female patients was 156 cases (66.7%). The result of the study shows that the number of patients attempting suicide and diagnosed with depression is mostly experienced by women by self- poisoning.

Conclusion: The conclusion of the study is the patients need motivation which is social support.

Pendahuluan: Masih terdapat kontroversi mengenai pengaruh tandur lien paska splenektomi terhadap fungsi immunologi. Asplenia dapat menurunkan kemampuan respon imun adaptif dan humoral. Kejadian overwhelming post splenectomy infection (OPSI) yang terjadi paska splenektomi memiliki angka insiden 5% dengan angka mortalitas 38- 70%. Penelitian ini bertujuan untuk mengetahui pengaruh tandur lien terhadap kadar imunoglobulin G, A dan M serum tikus wistar.

Metode: Rancangan penelitian ini adalah randomized post-test only control group design. Sebanyak 36 ekor tikus wistar dewasa dengan berat 200-250 g ditempatkan dalam kandang terpisah dan dalam kondisi yang terkontrol dan diberikan makan minum bebas. Semua hewan coba diberikan anestesi ketamine secara intramuskuler dengan dosis 50 mg/kg. Tikus dibagi menjadi dua kelompok, yakni splenektomi (kontrol) dan tandur lien (perlakuan). Sembilan minggu setelah dilakukan tindakan, masing- masing tikus akan diambil sampel darahnya, dan dilakukan pemeriksaan imunoglobulin serum. Setelah diboservasi selama sembilan minggu, tikus diambil sampel darah untuk diperiksa kadar imunoglobulin serum.

Hasil: Dari hasil pemeriksaan, kadar imunoglobulin serum pada kelompok tandur lebih tinggi dibanding kelompok splenektomi, namun hanya IgM yang berbeda signifikan (0,428±0,092 vs 0,208±0,071, p <0,05).

Kesimpulan: Kami menyimpulkan bahwa tindakan tandur lien dapat dipilih sebagai salah satu cara untuk mempertahankan fungsi lien paska splenektomi. Tandur lien bisa menjadi salah satu pilihan terapi pencegahan OPSI disamping ada tindakan preservasi lien lainnya maupun keterlibatan protokol vaksinasi

Introduction: Aerodigestive foreign body is a substance normally does not exist in the tract. This study aimed to know the patient’s distribution of aerodigestive foreign body in ENT-HNS Faculty of Medicine Udayana University / Sanglah General Hospital Denpasar.

Method: This study use retrospective descriptive methods. Samples were all patients suspected of being inhaled or ingested by foreign bodies and were performing esophagoscopy or bronchoscopy at Sanglah General Hospital Denpasar during January 2012 until December 2016.

Result: One hundred and seven patients with a history of foreign bodies in the aerodigestive tract, 62 male and 45 female with a ratio 1,4:1. The most common age groups is 0-10 years old, where the youngest is 5 month dan oldest is 92 years old. The most tribes is Balinese 73.83%. The most chief complaints are history of ingested foreign bodies 57.94%. Chicken bone is the most organic foreign body 26.17% and coin is the most inorganic foreign body 21.49%. The most management were esophagoscopy 76.64%. As many as 78.50% foreign bodies in the esophageal tract and 21.50% in the tracheobronchial tract.

Conclusion: In this study, most patients with a history of inhaled or ingested foreign bodies in the aerodigestive tract were male with a ratio 1,4:1. The most common age groups is 0-10 years old. The most common management is esophagoscopy.

Introduction: Children with disability have a potential to have a complete life and contribute wholly in social, cultural, and economy aspects. They are faced a wide range of issues, not only do they have physical limitations, but also bound to mental and emotional problems.

Method: A descriptive study with cross-sectional design at Yayasan Pendidikan Anak Cacat Jimbaran Bali was done to know the characteristics of mental and emotional in children with disability based on Strength and Difficulties Questionairre.

Result: This study results found that male was more than female with 21 students (21/32). Five students were in the age group of childhood (6-9 years-old) and 27 were in the adolescent groups (6-11 years-old). Based on birth history, 26 (26/32) were term babies. Most fathers and mothers’ education were at the senior high school level. Based on the parents’ income, 19 children mostly were categorized as middle economic level (19/32). The value of the total difficulties indicated the number of abnormal categories as many as 16 children (16/32), while the value of strength (prosocial) most normal category as many as 22 children (22/32). Of the four subscales on the value of difficulties in total, 20 of 32 children were with emotional problems, 15 of 32 children were with conduct and peer problems. Only 8 out of 32 children had hyperactivity problems.

Conclusion: Based on these results, we can conclude that the majority of children with disability had difficulties score on the abnormal category, but score of strength were on the normal category.

Pendahuluan: Ketuban pecah dini pada kehamilan preterm merupakan suatu keadaan yang dapat menyebabkan peningkatan morbiditas dan mortalitas maternal maupun perinatal. Kondisi kehamilan preterm dengan ketuban pecah dini memerlukan penanganan untuk mencegah terjadinya persalinan preterm dan mengurangi komplikasi yang dapat terjadi seperti solusio plasenta, infeksi intrauterine, hingga kematian bayi. Penting sekali mempertahankan integritas selaput ketuban selama kehamilan namun pada ketuban pecah dini terjadi apoptosis sel amnion.

Tujuan: Mengetahui adanya hubungan antara indeks apoptosis sel amnion pada persalinan preterm dengan ketuban pecah dini. Penelitian ini merupakan studi cross sectional di Departemen Obstetrik dan Ginekologi RSUP Sanglah dan Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana Denpasar dari 5 Juli 2017 sampai 16 Februari 2018.

Metode: Sampel adalah 40 ibu hamil yang datang ke ruang bersalin IGD RSUP Sanglah Denpasar dengan usia kehamilan 20 minggu sampai 36 minggu 6 hari yang memenuhi kriteria inklusi dan bersedia ikut serta dalam penelitian. Total sejumlah 20 ibu hamil yang datang dengan ketuban pecah dini dan 20 ibu hamil tanpa ketuban pecah dini. Selaput ketuban lapisan amnion diambil dari plasenta setelah persalinan, dilakukan pemeriksaan indeks apoptosis dengan pemeriksaan Terminal deoxynucleotidyl transferase mediated deoxy Uridine triphospate biotin Nick End Labeling (TUNEL) di laboratorium. Data penelitian kemudian dilakukan uji Chi-Square dan dianalisis dengan menggunakan SPSS.

Hasil: Hasil uji Chi-square dan Prevalence Ratio diperoleh PR= 19,0 (IK 95% = 2,81 - 128,6, p = 0,001).

Kesimpulan: Penelitian ini menunjukkan terdapat hubungan yang kuat antara indeks apoptosis sel amnion sebagai faktor risiko terjadinya ketuban pecah dini pada kehamilan preterm.Indeks apoptosis sel amnion berhubungan dengan ketuban pecah dini pada persalinan preterm.

 

Background: Pelvic fractures are rare injuries which occur at frequency as aa percentage of all fractures lies between 0.3%-6% of all fractures. In polytrauma, pelvic ring injury is present in 20% of cases. Pelvic ring fractures can affect all ages; however, the predominant age group was in the 18 to 44 age group with an overall mean age of 45. The purpose of this study was to describe the incidence of pelvic fracture, gender characteristic, fracture type, mortality rate, and associated injuries in Sanglah Hospital.

Methods: We conducted a descriptive retrospective study, using patients’ medical record data obtained from Sanglah General Hospital between January 2017– December 2018, with a total of 47 patients with pelvic fractures. The variables obtained were sex, age, diagnosis, management, mode of injury, fracture type classification, treatment, mortality rate, and associated injury. Then these data were analyzed using SPSS 22.

Results: During the 24- month study period, 47 patients with pelvic fracture were documented. Among those patients, 27 patients were male (57.4%) and 20 patients were female (42.6%). Out of the 47 patients, 9 patients (19.1%) were younger than 20 years old, 19 patients (40.4%) belong to 20-39 years old age group, 11 patients (23.4%) were in 40-59 years old age group and 8 patients (17.1%) were older than 60 years old. The highest number of patients belonged to 20-39 years old age group. The prevalence of low energy injury was 6.4% and high energy injury was 93.6%. We classified the pelvic fracture based on Tile Classification, of which classified as stable in 46.8% patients (type A injury), rotationally unstable in 40.5%patients (type B injury), and rotationally vertically unstable in 12.7% patients (type C injury). The overall operative rate of all pelvic fractures is 46.8%. Mortality rate is 7.2% of all pelvic fractures.

Conclusion: This study showed that in Sanglah Hospital from January 2017 – December 2018, among patients with pelvic fracture, men with age ranging from 20-39 has the highest incidence rate, and the mode of injury mainly high energy injury from motor vehicle accident. Most of the patients have other associated injuries, concluding that in every case of pelvic fractures, other organs trauma should be suspected. A proper understanding and study on the epidemiology of pelvic fractures may lead to future strategies to curb the number of pelvic fractures experienced by Indonesian population.

Pendahuluan: Tingkat pengetahuan para praktisi olahraga di Kabupaten Buleleng dalam memberikan pertolongan pertama terhadap cedera olahraga masih perlu ditingkatkan. Banyak atlet yang mengalami cedera belum mendapat pertolongan pertama secara optimal. Data dari Kementerian Pemuda dan Olahraga mengenai kajian penatalaksanaan cedera olahraga pada olahragawan tahun 2010 ditemukan kejadian cedera olahraga sangat tinggi pada atlet, sementara keterlibatan para praktisi olahraga (pelatih, atlet, guru olahraga) dalam kegiatan penanganan cedera termasuk rendah (11%). Keterlibatan para praktisi olahraga dalam penanganan cedera olahraga sangat bermanfaat untuk memberikan pertolongan pertama secara tepat sehingga dapat mencegah cedera menjadi lebih parah dan bahkan dapat menyelamatkan nyawa atlet apabila terjadi kegawatdaruratan sebelum mendapat pertolongan medis.

Tujuan: Tujuan penelitian ini adalah: 1) untuk mengetahui jenis-jenis cedera olahraga yang sering terjadi pada cabang olahraga unggulan di Kabupaten Buleleng; 2) untuk mengetahui tingkat pengetahuan para praktisi olahraga di Kabupaten Buleleng dalam memberikan pertolongan pertama terhadap cedera olahraga dengan metode RICE. Metode: Penelitian ini adalah penelitian deskriptif kuantitatif, dimana teknik pengumpulan data dengan menggunakan kuesioner dan wawancara. Sampel penelitian adalah atlet, pelatih, dan guru olahraga di Kabupaten Buleleng yang ditentukan dengan teknik purposive sampling.

Hasil: Hasil penelitian menunjukkan bahwa jenis-jenis cedera olahraga yang sering terjadi pada cabang olahraga unggulan di Kabupaten Buleleng adalah: sprain, strain, kram otot, luka lecet, luka memar.

Kesimpulan: Tingkat pengetahuan para praktisi olahraga di Kabupaten Buleleng terhadap cedera olahraga masih sangat rendah. Dapat disarankan pelatihan penanganan cedera olahraga bagi praktisi olahraga di Kabupaten Buleleng masih sangat diperlukan, sarana dan prasarana olahraga perlu dilengkapi agar dapat memberikan pertolongan pertama saat terjadi cedera olahraga.

Internet addiction is described as a pathological state because too much internet use. Adolescents with internet using problem are in risk of physical problems and behavioral disorders such as oppositional de ant disorder. One case of male adolescent with atrial brillation and occasional extrasistole ventricles, complained of irritability and often opposed to his father's advice since got depended on playing the internet after his parents' divorce 3 years ago. On the Internet Addiction test (IAT) examination, IAT score 60 were categorized as moderate level of internet addiction and in accordance with the “Pedoman Penggolongan dan Diagnosis Gangguan Jiwa (PPDGJ) III and Diagnostic and Statistical Manual Of Mental Disorder (DSM)-5 ful lling the criteria for oppositional disrupted disorder. The pharmacotherapy modalities with amiodarone for heart problems and psychiatric management in the form of Cognitive Behavior Therapy for Internet addiction (CBT- IA) and family psychoeducation showed satisfactory results. After 3 months the patient has no physical complaints, starting to eliminate his dependence on the internet with an IAT score 24 (normal user), able to control his emotion and behavior and improve communication with the family. Management of heart problems and psychiatric disorders requires collaboration between medical personnel, parents and the environment in addition to providing pharmacotherapy and psychotherapy.

Alcohol and cannabis withdrawal may elicit a multitude of neuropsychiatric manifestations. However, concomitant withdrawal of both substances rarely reported. Herein we reported a patient who had demonstrated pyschosis and shaking movement as a result of alcohol and cannabis withdrawal. 24year-old male was admitted to the ER complaining of headache, pain on the whole body, nausea and vomiting 6 hours prior to admission. He had confusion, agitation, aggression, insomnia, delusion of persecution accompanied by auditory and visual hallucination, depression, and suicidal ideation 10 days prior. Patient also exhibited rhythmic shaking predominantly on the upper extremities and trunk which impaired his writing and drawing capabilities. These symptoms had appeared since he abruptly stopped alcohol and cannabis consumption 48 hours prior. He had a chronic history of alcohol consumption (i.e. 15 years and ongoing) with approximately 10-12 alcohol units per day and chronic cannabis use of 3-4 times per day, thrice a week, 6 years prior. Patient was treated with thiamine, benzodiazepines, psychotherapy, relaxation, and CBT. He was finally stabilized and discharged 10 days later. Concomitant alcohol and cannabis withdrawal may demonstrate different signs and symptoms than if it stands alone. In this case, he demonstrated psychiatric disturbances, in addition to postural and enhanced physiologic tremor. He also exhibited restlesness, insomnia, nausea and vomiting, traceable to the last onset of alcohol and cannabis consumption, respectively. The corresponding treatment should be tailored individually according to patient’s needs.