Latar belakang: Luka terbuka mempunyai resiko untuk terjadinya infeksi yang serius dan dapat menyebabkan kematian. Penanganan luka yang sesuai sangat penting untuk mengurangi terjadinya infeksi pada luka. Metode: Penelitian ini merupakan penelitian deskritif prospektif dengan metode cross-sectional tentang profil penangan luka pada pasien trauma di IGD RSUP NTB. Subjek penelitian ini adalah pasien yang mengalami luka akibat trauma dan ditangani di IGD RSUP NTB. Penelitian ini menggunakan total sampling. Pengambilan data dilakukan dari bulan Juli sampai September 2015. Hasil: Didapatkan 90 pasien luka akibat trauma yang terdiri dari 73% laki-laki dan 27% perempuan. Tindakan disinfeksi luka dilakukan pada 100% pasien, anestesi luka pada 65,6% pasien dan irigasi luka pada 97% pasien. Debridement luka dilakukan pada 13% pasien, penjahitan luka pada 61% pasien dan dressing luka pada 77% pasien. Antibiotik profilaksis diberikan pada 26% pasien dan antitetanus profilaksis diberikan pada 28% pasien. Kesimpulan: Tindakan disinfeksi luka terutama menggunakan povidon iodin. Tindakan anestesi luka menggunakan Lidocain dan irigasi luka menggunakan NaCl 0,9%. Tindakan penjahitan luka terutama menggunakan jahitan simple suture. Antibiotik profilaksis terutama menggunakan Amoxicilin dan antitetanus profilaksis terutama menggunakan ATS.

Background The free margin of distal resection is an attempt to prevent local recurrence of the tumor and prolong survival. The recommended length of distal resection margin are varied among the researchers. This study was done to know the correlation between extents of distal intramural spread (DIS) and histology grading, stage and CEA levels of colorectal cancer. Methods The design of the study was a cross sectional. Sample was patients diagnosed with colon or rectal adenocarcinoma in the period of September 2017–March 2018 and underwent resection at Dr.Kariadi Hospital. Resected fresh tissue tumors were directly measured for the distal resection margin and histopathologic examination done by anatomical pathologists. This study has been approved by the ethics committee of Dr.Kariadi Hospital/Faculty of Medicine Diponegoro University. The relationship between DIS length to histology grading, tumor stage and CEA level were analyzed using Spearman's correlation test. Results The subjects of this study were 26 patients with colorectal cancer consisted of 15 men and 11 women. The average age of the patients was 53,04 years. The locations of the tumor were 17 in the rectum and 9 in the colon. The length DIS were between 1,07 and 11,49 mm. The longer DIS were occurred when the grading histology worsens, the tumor stage increases and the higher CEA levels with correlation coefficient were r = 0,77 (p < 0,001); r = 0,66 (p < 0,001) and r = 0,44 (p = 0,024) respectively. For the rectal location, the DIS length range were 0,28–10,36 mm. The longer DIS when grading histology worsens r = 0,59 (p = 0,012) and an increased tumor stage r = 0,73 (p = 0,001). The DIS length of the rectum was not proven to correlate with elevated CEA levels r = 0,14 (p = 0,588). Conclusion Histological grading, tumor stage and CEA levels can be predictors of distal intramural spread (DIS) colorectal cancer. The strongest correlation were between DIS and histologic grading. Thus, in mid and lower third of the rectal cancer, the histologic grade examination is strongly recommended. Based on this study, it is recommended that in rectal cancer undergoing sphincter preserving surgery distal resection sould be more than 2 cm from the tumor margin.

Latar Belakang: Penanganan terhadap komplikasi trauma tulang seperti delayed union, nonunion, malunion dan keadaan hilangnya sebagian dari tulang (defek) masih menjadi masalah. Diperlukan donor tulang (bone graft) untuk mengisi defek atau kekosongan pada tulang yang hilang agar terjadi penyambungan.Tujuan: Penelitian ini bertujuan untuk mengetahui karakterisasi hydroxyapatite yang dibuat dari sumber alami yaitu dari tulang sapi dan cangkang telur sebagai bahan untuk cangkok tulang (bone graft) dalam tindakan kedokteran.Metode: Tulang panjang sapi Bali dan sapi Brahman dipotong 5x5x5 mm untuk selanjutnya dikalsinasi pada suhu 800oC dan 1000oC. Hydroxyapatite yang dihasilkan diukur kadar kalsium dan fosfornya dengan metode spektrofotometer, kemudian dibandingkan dengan kadar kalsium dan fosfor pada tulang manusia.Hasil Penelitian: Hydroxyapatite dihasilkan baik dari tulang sapi Bali atau sapi Brahman memiliki kadar kalsium rata-rata 28 – 35%, kadar fosfor rata-rata 12- 15%. Kadar kalsium dan fosfor lebih tinggi pada tulang kortikal dibandingkan trabekular. Dibandingkan dengan kadar kalsium dan fosfor pada tulang manusia tidak berbeda bermakna (p<0,005). Kadar kalsium paling tinggi didapatkan pada cangkang telur (64%).Pembahasan: Kadar kalsium dan fosfor baik pada tulang sapi Bali atau sapi Brahman mempunyai kadar yang hampir sama dengan manusia. Ini karena setiap tulang mamalia mempunyai komposisi mineral dan air yang sama.Kesimpulan: Hydroxyapatite (HA) dari tulang sapi Bali, sapi Brahman dan cangkang telur mempunyai karakteristik yang hampir sama dengan tulang manusia dan bisa digunakan sebagai bahan untuk donor tulang.

Mastery of students in medical skills is a very important aspect that will bridge the gap between clinical competence and procedural knowledge. Based on the 2012 Indonesian Doctor Competency Standards, urinary catheter installation skills have 4A competencies, which means that a primary care doctor graduate must be able to do it independently, by mastering theory, indications, contraindications, and complications that can arise. Students' perceptions of the learning system and learning environment will be the basis for maximizing and varying the learning system and environment. Basic knowledge of students related to a learning system will affect the perception and how the student learning process in the future. This research is a descriptive study with a research design cross sectional for students in the fifth and seventh semesters of the Medical Education Study Program, Faculty of Medicine, University of Mataram. The sampling technique used a total sampling technique and the sample was asked to fill out a questionnaire about perceptions of medical skills in inserting a urinary catheter. From 196 respondents consisting of men (34.7%) and women (65.3%) with an age range of 19-23 years. Good perception of medical skills in infusion is seen from the percentage of motivation factors (96.9 %), instructors (89.8%-100%), self-awareness (99%-100%), learning atmosphere (81.1%-96 .9%), facilities and infrastructure (43.4%-89.3%), self-confidence (57.7%-99.5%), and clinical learning environment (89.8%). The bad perception is only found in the difference between learning in the mannequin and the patient (56.6%). The majority of students have a good perception of the medical skills learning system of urinary catheter insertion.

Asthma is a chronic condition that is becoming more common around the world. Asthma has been demonstrated to affect pregnancy in several studies. Because the severity of asthma might fluctuate throughout pregnancy, it is important to know what kind of asthma medicine to take and how much to take. Increased perinatal mortality, stunted fetal growth, early birth, increased cesarean section, low birth weight, and postpartum hemorrhage are all concerns that uncontrolled asthma can cause in infants. The overall course of asthma has been observed to improve, deteriorate, or remain the same throughout pregnancy. Although previous research suggests that patients with more severe asthma are more likely to worsen their condition during pregnancy, other studies have found that asthma severity during pregnancy is comparable to asthma severity a year before pregnancy, as long as the patient takes their prescribed medications. Anxiety is a known asthma trigger; if necessary, it should be handled perioperatively. Spirometry and deep breathing should be encouraged to avoid atelectasis. Theophylline is generally contraindicated in asthmatic patients undergoing surgery, and it should be halted perioperatively if possible. Because the degree of anesthetic is reduced, tracheal extubation, while the patient is awake, reduces the risk of aspiration, but the tracheal tube can stimulate reflexes and cause bronchospasm. Bronchodilators may be used if bronchospasm occurs at the onset. Continued mechanical ventilation in the intensive care unit may be required for refractory bronchospasm.