Latar Belakang: Populasi lanjut usia (lansia) dunia meningkat sangat cepat. Di Indonesia, Badan Pusat Statistik (2013) memproyeksikan jumlahnya mencapai 24.754.500 jiwa pada tahun 2018. Lansia merupakan tahap fisiologis lanjut dari suatu proses kehidupan yang ditandai dengan penurunan kemampuan tubuh beradaptasi terhadap stres lingkungan. Penurunan fungsi yang nyata pada lansia adalah penurunan masa otot atau atropi yang dapat mengakibatkan kesulitan dalam melakukan aktivitas sehari-hari. Hal ini dapat memengaruhi kualitas hidup lansia. Tujuan: Penelitian ini dilakukan untuk mengetahui hubungan kekuatan otot dengan kualitas hidup pasien lanjut usia. Metode: Penelitian ini merupakan observasional dengan pendekatan cross-sectional yang berlangsung pada bulan November-Desember 2019. Terdapat 40 responden lansia di Panti Wredha Natar Kabupaten Lampung Selatan yang tergabung dalam penelitian ini. Responden dilakukan pemeriksaan kekuatan otot menggunakan pemeriksaan hand grip strength dan penilaian kualitas hidup secara bersamaan. Hasil: Subyek dengan kekuatan otot baik sebanyak 15 responden (65,22%) berkualitas hidup baik, sedangkan subyek dengan kekuatan otot lemah sebanyak 7 responden (41,17%) memiliki kualitas hidup baik. Subyek dengan kekuatan otot baik 1,5 kali memiliki kualitas hidup baik dibandingkan dengan kekuatan otot yang lemah secara bermakna (p = 0,034; IK 95% 1,34–10,45). Simpulan: Kekuatan otot berhubungan dengan kualitas hidup lansia signifikan secara statistik.

Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus and identification of the causative bacteria is an essential step in selecting the appropriate antibiotic therapy. This study aimed to evaluate the bacterial pattern and antibiotic susceptibility of the bacteria causing DFI in Lampung Province in Indonesia. Methods: This study is a retrospective study reviewing the medical records of DFI patients admitted to the Dr Hi Abdul Moeloek Regional General Hospital in 2017–2019. DFI patients with complete medical record data were included in this study. Demographic, clinical, laboratory, wound culture and antibiotic susceptibility data were collected from the medical records using a short structural chart. The data obtained then reviewed. Results: In this study, 131 DFI patients met the study criteria and were included. Based on the wound culture results, Gram-negative bacteria were obtained in 112 (85.5%) subjects with Enterobacter spp. as the predominant bacteria. Gram-positive bacteria were found in 19 (14.5%) subjects with Staphylococcus spp. as the predominant bacteria. Gram-negative bacteria found in this study showed high susceptibility to amikacin, meropenem and sulbactam/cefoperazone. Meanwhile, the Gram-positive bacteria showed high susceptibility to meropenem, sulbactam/ cefoperazone and amikacin. Conclusion: The findings of the study revealed Enterobacter spp. as the most predominant bacteria causing DFI in the studied population. The highest antibiotic susceptibility was seen for amikacin, meropenem and sulbactam/cefoperazone.

Pendahuluan: Onychocryptosis merupakan penyakit kuku yang dikarakteristikkan oleh rasa nyeri, kemerahan hingga bengkak ataupun timbulnya nanah yang disebabkan oleh kuku yang tumbuh memotong paronikium. Penyakit ini merupakan penyakit yang sering dijumpai dalam praktik dokter sehari-hari dan seorang dokter umum harus dapat melakukan tindakan avulsi kuku sebagai salah satu pilihan tatalaksana operatifnya. Avulsi kuku merupakkan tatalaksana yang efektif, namun tidak mencegah rekurensi di kemudian hari. Untuk tujuan itu, setelah dilakukan prosedur avulsi kuku, dapat dilakukan tindakan matrikektomi. Meskipun efektif, prosedur tindakan ini tidak banyak dibahas. Pembahasan: Matrikektomi bertujuan untuk menghancurkan matriks kuku sehingga kuku tidak tumbuh memotong paronikium. Beberapa penelitian menunjukkan keunggulan avulsi kuku yang dilanjutkan dengan matrikektomi kimia dalam mencegah rekurensi onychocryptosis dibanding dengan prosedur avulsi kuku saja. Tindakan matrikektomi paling sering dilakukan dengan menggunakan agen kimia berupa fenol, tricloracetic acid (TCA) atau natrium hidroksida. Ketiga agen ini akan menyebabkan nekrosis pada matriks kuku sehingga tidak terjadi pertumbuhan kuku pada daerah yang diaplikasikan. Berbagai penelitian menunjukkan bahwa penggunaan ketiga agen kimia ini memiliki angka kesuksesan yang tinggi dalam mencegah rekurensi onychocryptosis. Kesimpulan: Matrikektomi kimia merupakan tindakan yang dapat dilakukan setelah tindakan avulsi kuku untuk mencegah rekurensi onychocryptosis. Agen kimia yang dapat digunakan adalah fenol, TCA atau natrium hidroksida. Ketiganya memiliki efektifitas yang setara. Kata kunci: Avulsi kuku, Matriektomi, Onychocryptosis

Introduction: The Achilles tendon endures continuous stress that increases the risk of rupture. The Achilles tendon rupture often happens to those participating in sports, either recreationally or professionally. It is often misdiagnosed on initial presentation even though delay in treatment can lead to a worse prognosis. Discussion: Patients with Achilles tendon rupture usually present with acute sharp in their lower limb accompanied by a popping sound. On physical examination, there may be a gap in the Achilles tendon either on inspection or palpation, hematoma, swelling, and weak plantarflexion of the ankle. To confirm the clinical diagnosis, several additional physical examination can be done such as Thompson test and Matles test. Diagnostic imaging in the form of ultrasonography or MRI is usually unnecessary if the clinical diagnosis is clear. The patient should be referred as soon as possible to an orthopaedic surgeon for further treatment. The treatment may be surgical or non-surgical, depending on comorbidities, goals, and preferences of the patient. Conclusion: The initial diagnosis of Achilles tendon rupture should be done correctly and the patients should be referred to an orthopaedic surgeon immediately to get the appropriate treatment for better prognosis.

Around 25% of people with diabetes experience diabetic foot ulcers in their lives, accompanied by infections due to various types of bacteria. Infection due to Gram-negative and Gram-positive bacteria are reported to have different inflammation patterns, where the latter being reported to have a higher mortality rate. This study was an analytic observational study with a cross-sectional design to determine the relationship between bacterial characteristics and mortality in diabetic foot ulcers. Data were obtained from medical records of diabetic ulcer patients admitted to Dr. H. Abdul Moeloek General Hospital, Lampung, in 2017–2020. There were 131 diabetic foot ulcers patients identified, with the median age of the subjects was 53 years, 43.5% of the subject were male, and 56.5% were female. The mean hemoglobin was 9.3 g/dl, WBCs were 19.0 ×103/ml, and platelets were 422.1 ×103/ml. The mean length of stay in the hospital was 10.7 days. Eighteen subjects died during the hospital stay, with 15 of them were from the Gram-negative monomicrobial group. The results of the Fischer Exact test on mortality and bacterial characteristics among monomicrobial infections (p=0.688) indicate no relationship between the characteristics of the infectious pathogen and mortality in diabetic foot ulcers. Keywords: bacteria, diabetes, diabetic foot ulcers, mortalityCorrespondence: iswandi.darwis@gmail.com