Sindrom Koroner Akut (SKA) merupakan puncak manifestasi klinis aterosklerosis di arteri koroner. Inflamasi terjadi dari tahapawal pembentukan ateroma sampai ruptur plak dan trombosis. Trombosis memainkan peran penting dalam perjalanan penyakit SKA.Trombositosis dan limfopenia berhubungan dengan derajat inflamasi sistemik dan Rasio Platelet Limfosit (PLR) menjadi petanda baruyang melibatkan kedua tolok ukur hematologi tersebut. Penelitian ini merupakan penelitian retrospektif di Rumah sakit Dr. WahidinSudirohusodo Makassar dengan mengambil data pasien SKA UAP, STEMI, NSTEMI dan menilai PLR dari pemeriksaan darah rutin saatmasuk Rumah sakit. Data PLR dibandingkan berdasarkan jenis SKA, kemudian dibandingkan dengan kontrol sehat. Hasil penelitiandidapatkan 223 data pasien SKA UAP, STEMI dan NSTEMI masing-masing 89, 68, 66 data dan kontrol normal 198 data. Hasil ujistatistik Kruskal wallis menunjukkan perbedaan bermakna PLR antara pasien UAP, NSTEMI dan STEMI (p=0,011). Hasil uji post hocmenunjukkan perbedaan bermakna antara UAP dan NSTEMI (p=0,023), UAP dan STEMI (p=0,006), tetapi tidak berbeda bermaknaantara NSTEMI dan STEMI (p=0,827). Nilai PLR pasien SKA lebih tinggi dibandingkan dengan pembanding (p=0,037). Berdasarkanhasil penelitian didapatkan nilai PLR meningkat di SKA dibandingkan dengan kontrol normal. Nilai PLR di STEMI dan NSTEMI lebihtinggi dibandingkan UAP, kemungkinan berhubungan dengan pembentukan trombus dan infark miokard.

Ischemic stroke is the cause of most cases which occur due to obstruction, this pathogenesis can be caused by the formation of thrombus in the cerebrum blood vessels. Platelet aggregation plays a role in the pathogenesis of thromboembolic cerebrovascular disease. Platelets size, measured as Mean Platelet Volume (MPV) is a marker of platelet function and is associated with the indicator of platelet activity. Several studies have found that there was an increased of MPV in acute ischemic stroke while the correlation with the severity and outcome of stroke was still controversial. The aim of study is to determine the MPV and their association with outcomes in acute ischemic stroke patients. A cohort study during May up to July 2010 was carried out, the researchers measured MPV and analyze their correlation with its outcome using modified Rankin scale score 10 days after the onset in 33 acute ischemic stroke patients. The mean of MPV for the first three days of the onset was 8.9 fl, on the 5th day was increased up to 9.4 but at the 10th day of onset the MPV remains the same value as the 5th day. The MPV of first three days and 5th day have a positive correlation, but insignificant with their outcome, with p values 0.158 and 0.06, respectively. From this study can be concluded that the increased of MPV on the fifth day onset did not have any significant correlation with the outcome of acute ischemic stroke illness.

ABSTRAK Infark Miokard merupakan salah satu penyakit terminal yang memerlukan perawatan intensif. Perawataan intensif yang diperlukan harus holistik, mencakup bio psiko sosial dan spiritual. Psikologis infark miokard harus selalu diperhatikan, karena salah satu penyebab infark miokard adalah dari psikologis atau dikenal dengan stress. Tujuan dari penelitian ini untuk mengetahui pengalaman pasien infark miokard akut yang menjalani perawatan di ruang intensif. Jenis penelitian adalah deskriptif kualitatif dengan pendekatan phenomenology yang dilakukan di salah satu rumah sakit di Bandung periode Juni-Juli 2013. Jumlah informan 10 orang pasien infrak miokard akut yang pada saat dilakukan wawancara sudah dalam perbaikan killip I dan II yang diambil secara purposive sampling, dirawat di ruang intensif dan kondisinya telah stabil. Pengumpulan data dilakukan dengan wawancara mendalam kemudian dianalisa menggunakan content analysis dari Hancoch. Hasil penelitian didapatkan 3 tema penelitan yaitu seluruh responden merasa tidak berdaya, 9 responden mengalami ketidakpastian menghadapi masa depan dan 10 responden menyatakan ketakutannya akan kematian. Seluruh pasien infrak miokard mengalami masalah psikologis, oleh karena itu hasil penelitian ini dapat menjadi rekomendasi dalam memberikan layanan kesehatan bagi pasien kondisi terminal; infark miokard akut yang sedang menjalani perawatan intensif. Penting kiranya untuk dapat mengelola dan mengintegrasikan pelayanan perawatan pada pasien infark miokard akut yang sedang dirawat di unit intensif secara holistik meliputi fisik psikologis sosial dan spiritual. Kata kunci: infark miokard akut, pengalaman psikologis, ruang intensif ABSTRACT Communication is a very important process in human relationship. In providing nursing care, nurses should have a good knowledge and communication skill as the beginning of a good relationship between nurses, patients, and their families. Nurses with good communication skill had an easier opportunity to make a good relationship with the patient and their families. This study aimed to identify effective communication barriers among nurses in developing communication with patients' family according to nurses' perspective in Intensive Care Unit Rumah Sakit Umum Al Islam Bandung. This descriptive explorative study involved 10 nurses were taken with accidental sampling. Data were gathered using interview and observation. Data analyzed with the content analysis. Result showed that there were at least five topic of effective communication barriers among nurses in developing communication with patients' family according to nurses' perspective in Intensive Care Unit Rumah Sakit Umum Al Islam Bandung; role conflict, family demographic factors, misunderstanding, environment and situation in the ICU, and family psychological condition. So, training related to communication between nurses and patients' family were necessary to undertake in order to improve the ability of nurses such as foreign language skills and patience in dealing with the situation in the ...

<p>Latar belakang: Patogenesis infark miokard akut melibatkan proses inflamasi sistemik, intraplak, ataupun miokardium. Neutrofil menginfiltrasi plak koroner dan miokardium yang mengalami infark serta memediasi terjadinya kerusakan jaringan melalui pelepasan enzim pendegradasi matriks dan spesies oksigen reaktif. Leukosit yang berperan dalam patogenesis infark miokard diduga berkaitan dengan mortalitas pasien infark miokard akut. Tujuan: Mengetahui kaitan jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit terhadap mortalitas pasien selama perawatan di rumah sakit. Metode: Studi retrospektif dengan menggunakan data sekunder dari rekam medik 64 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo, Makassar, periode Juli 2010 hingga Juni 2011. Dilakukan analisis pada jumlah leukosit, neutrofil, limfosit, dan rasio neutrofil limfosit yang diperoleh dari data hasil tes laboratorium saat pasien masuk rumah sakit. Uji statistik dilakukan dengan uji T, Mann Whitney, dan chi square. Hasil: Rerata jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit pada penderita infark miokard akut yang survive dan meninggal selama perawatan berturut-turut adalah 11.920+3.610/µL vs 14.410+3.090/µL (p=0,009), 73,98+11,16 vs 76,04+9,74 (p=0,647), 17,29+9,03 vs 15,00+7,00 (p=0,379), dan 5,97+3,90 vs 6,80+4,72 (p=0,403). Pasien dengan leukositosis memiliki risiko mortalitas 10,71 kali dibandingkan dengan jumlah leukosit normal (p=0,009; 95% interval kepercayaan (IK) 1,307 s/d 87,846). Simpulan: Rerata jumlah leukosit pada pasien infark miokard akut yang meninggal selama perawatan lebih tinggi dibandingkan dengan pasien yang survive. Pasien dengan leukositosis memiliki risiko mortalitas selama perawatan lebih tinggi dibandingkan pasien dengan jumlah leukosit normal.</p><p><br />Background: Pathogenesis of acute myocardial infarction involves systemic, intraplaque, and myocardial inflammatory processes. Neutrophils infiltrated coronary plaque and infarcted myocardium, also mediate tissue damage through release of matrix degradation enzymes and reactive oxygen species. Leukocyte is suspected to be related to mortality in acute myocardial infarction patients. Objective: To investigate the relationship of leukocyte count, neutrophils and lymphocyte percentages, also neutrophils and lymphocyte ratio with in-hospital mortality of acute myocardial infarction patients. Method: A retrospective study with using secondary data from medical record of 64 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of Dr. Wahidin Sudirohusodo Hospital, Makassar, from June 2010 to July 2011. Admission leukocyte count, percentages of neutrophils and lymphocyte, and neutrophils lymphocyte ratio were analyzed statistically using T, Mann Whitney, and chi square tests. Results: The mean of leukocyte count at-admission, percentages of neutrophils and lymphocyte, and neutrophil : lymphocyte ratio in survived and non survived acute myocardial infarction patients were 11920+3610/µL vs 14410+3090/µL (p=0.009), 73.98+11.16 vs 76.04+9.74 (p=0.647), 17.29+9.03 vs 15.00+7.00 (p=0.379), and 5.97+3.90 vs 6.80+4.72 (p=0.403) respectively. Patients with leukocytosis had 10.71 times mortality rate compared to patients with normal counts (p=0.009; 95% CI =1.307-87.846). Conclusion: Leukocyte count in non-survivors was significantly higher than in survivors. Patients with leukocytosis had higher mortality risk compared with normal count patients.</p>

Ovarian cancer is a female reproductive organ malignancy and the second most common gynaecological type cancers. World Health Organisation classifies ovarian cancer based on their origin: superficial stroma-epithelium tumour, cord-stroma sex tumour, and germ cell tumour originated from germinal cells (yolk sac). Epithelium type of ovarian cancer is common, while the germinal type is rare and can be found in teenagers and young women aged 16-20 years old. A case of suspected dysgerminomas ovarian cancer grade IIIA was reported in a 12 years old girl. The diagnosis was established by tumour markers, USG/CT Scan of abdomen, surgery, and frozen section evaluations. The reviewer expected better survival prognosis after surgery and three cycles of chemotherapy combinations were executed. The evaluations of when serial tumour markers CA-125 were suggested during chemotherapy to detect any recurrences factors possibility of the related cancer.