Obat anti-inflamasi nonsteroid (OAINS) merupakan analgetik yang sering digunakan pada pascaoperasi bedah ortopedi. Penelitian ini bertujuan melihat apakah terdapat perbedaan nilai agregasi trombosit akibat pengaruh penggunaan analgestik ketorolak dengan ibuprofen intravena setelah operasi. Penelitian ini merupakan penelitian uji klinis dengan uji acak tersamar buta ganda yang membandingkan perbedaan pengaruh ketorolak 30 mg intravena/6 jam dengan ibuprofen 800 mg intravena/6 jam. Populasi penelitian ini adalah pasien yang menjalani tindakan pembedahan elektif dengan anestesi umum di RSUP Haji Adam Malik Medan pada bulan Agustus 2016. Pasien dibagi menjadi 2 kelompok dengan tiap-tiap kelompok berjumlah 20 pasien. Ketorolak atau ibuprofen sebagai analgetik diberikan setelah 30 menit selesai operasi, kemudian dilanjutkan per 6 jam sampai dengan 2 hari selesai operasi. Uji statistik menggunakan tes Wilcoxon untuk sebelum perlakuan dan Uji Mann-Whitney untuk sesudah perlakuan pada kedua kelompok. Data karakteristik subjek homogen. Agregasi trombosit pada kelompok ketorolak dengan kelompok ibuprofen berbeda bermakna setelah 10 menit ekstubasi dengan 8 jam setelah pemberian obat terakhir. Tidak terdapat perbedaan bermakna antara kelompok ketorolak dan kelompok ibuprofen setelah 10 menit ekstubasi (p>0,05), namun terdapat perbedaan bermakna pada 8 jam setelah akhir pemberian obat. Simpulan, ketorolak menurunkan persentase agregasi trombosit lebih besar daripada ibuprofen setelah 8 jam pemberian obat terakhir.

AbstrakKreatinin serum memiliki banyak keterbatasan dalam mendiagnosis cedera ginjal akut (CGA) terutama dalam ruang lingkup unit perawatan intensif sehingga kurang sensitif untuk menggambarkan tingkat disfungsi ginjal pada pasien sakit kritis. Dari sekian banyak penanda biologis baru yang tersedia, terdapat 4 penanda biologis yang saat ini secara luas digunakan para klinisi di seluruh dunia untuk mendeteksi CGA, antara lain neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, dan interleukin-18. Tujuan penelitian ini adalah mengetahui sensitivitas dan spesifisitas cystatin C dan kreatinin serum dalam mendiagnosis cedera ginjal akut pada pasien sepsis yang dirawat di ruang rawat intensif. Jenis penelitian ini adalah uji diagnostik dengan jumlah sampel 24 pasien dan dikerjakan di ruang rawat intensif Rumah Sakit H. Adam Malik (RSHAM) periode Februari-Maret 2014. Populasi dalam penelitian ini adalah semua pasien dewasa dengan sepsis, sepsis berat, dan syok sepsis di ruang rawat intensif. Uji statistik dilakukan dengan metode receiving operator characteristics (ROC) melalui perangkat lunak SPSS 17. Hasil penelitian ini menunjukkan bahwa cystatin C serum lebih superior dibanding dengan kreatinin serum dalam mendeteksi CGA pada pasien sepsis di ruang rawat intensif. Cystatin C memiliki sensitivitas, nilai prediksi positif, nilai prediksi negatif, dan area under curve-receiving operator characteristics (AUC-ROC) yang lebih tinggi dibanding dengan kreatinin serum. Namun, dari nilai spesifisitas dijumpai nilai yang sama pada kedua penanda biologis. Simpulan, cystatin C dapat dijadikan penanda biologis alternatif untuk deteksi CGA pada pasien sepsis di RRI (Ruang Rawat Intensif) dengan nilai diagnostik yang lebih baik.Kata kunci: Cedera ginjal akut, cystatin C serum, kreatinin serum Sensitivity and Specificity of Serum Cystatin C and Creatinine for Diagnosing Acute Kidney Injury in Sepsis Patients Treated in Intensive Care Unit at H. Adam Malik Hospital Medan AbstractSerum creatinine has many limitations when being used to diagnose acute kidney injury (AKI), especially in the scope of intensive care unit due to its low sensitivity to depict the kidney dysfunctional level of criticallyill patients. Out of numerous new available biological markers, four biological markers are widely used all over the world to detect AKI, e.g. neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, KIM-1, and interleukin-18. The purpose of this study was to determine the sensitivity and specificity of serum cystatin C and creatinine in establishing the diagnosis of acute kidney injury in sepsis patients treated in intensive care room. This study was a diagnostic test to 24 patients and conducted in intensive care room of H. Adam Malik Hospital during the period of February-March 2014. Population in this study is all adult patients with sepsis, severe sepsis, and septic shock in the intensive care room. A statistical test was conducted using receiving operator characteristics (ROC) method using SPSS 17 software. The r...

Background Chest physiotherapy and suctioning are routine methods for airway clearance in mechanically-ventilated children. However, chest physiotherapy has not been confirmed to affect ventilation parameters, such as tidal volume (TV), peak inflation pressure (pIp), peak inspiratory flow (pIF), and peak expiratory flow (pEF), as well as blood gas analysis (BGA) values in pediatric intensive care unit (pICU) patients. Objective To determine the efficacy of chest physiotherapy and suctioning vs. suctioning alone for improving the mechanical ventilation and BGA parameters. Methods This randomized, single-blind, clinical trial was conducted from November 2012 to June 2013 in the pICU at Haji Adam Malik Hospital, Medan. A total of 40 mechanicallyventilated pediatric patients were enrolled and divided into either the chest physiotherapy and suctioning group (24 subjects) or the suctioning alone group (16 subjects). Subjects underwent treatment, followed by monitoring of their ventilation parameters and blood gas analyses. Data were analyzed by independent T-test and Mann-Whitney test. Results Subjects comprised of 23 boys and 17 girls, with an age range of 1-204 months. After the respective treatments (chest physiotherapy and suctioning vs. suctioning alone), the ventilation parameters were as follows: median TV (60.0 vs. 56.5 mL, respectively; p=0.838), median pEF (10.4 vs. 10.8 I/s, respectively; p=0.838), median pIF (7.4 vs. 8.2 I/s, respectively; p=0.469), and mean pIp (17.3 vs. 15.6 cmH2O, respectively; p=0.23). The BGA values were: median pH (7.4 vs. 7.3, respectively; p=0.838), median pCO2 (38.4 vs. 36.2 mmHg, respectively; p=1.000), mean pO2 (136.6 vs. 139.2 mmHg, respectively; p=0.834), median HCO3 (20.4 vs. 22.7 mmol/L, respectively; p=0.594), median TCO2 (22.0 vs. 23.7 mmol/L, respectively; p=0.672), mean BE (-4.3 vs. -3.1 mmol/L, respectively; p=0.629), and median O2 saturation (98.5 vs. 98.3 %, respectively; p=0.967). Conclusion In mechanically-ventilated children in the pICU, ventilation parameters and BGA values are not significantly

Introduction: One of the important COVID-19 management considerations was to prevent delayed intubation. There is a lack of objective criteria to decide the time of intubation. Previously, respiratory parameters were the only tools used to determine the success of high flow nasal cannula (HFNC) therapy, but several studies have reported on the role of respiratory rate oxygenation (ROX) index which combined respiratory rate (RR) and oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) in predicting intubation after receiving high flow nasal cannula (HFNC). The primary objective of this study was to evaluate the validity of the ROX index in predicting intubation in COVID-19 pneumonia receiving HFNC. Methods: This study is a systematic review that used online databases (PubMed, Science Direct, Google Scholar, and CENTRAL) in obtaining eligible journals. The sources of data were from published observational studies and preprints. The outcomes of this study were ROX index validity, intubation predictors, and factors associated with the ROX index. Results: Seven journals were yielded during the search. ROX index was significantly lower in the HFNC failure group at any time interval with high sensitivity and specificity in predicting intubation (p ≤  0.001). ROX index can be used to predict intubation starting at 4 hours after HFNC initiation and calculated repeatedly. Conclusion: ROX index was a good parameter in predicting intubation in COVID-19 pneumonia patients who receive HFNC. The higher value of the ROX index was associated with a higher chance of HFNC success and a lower risk of mortality.

Human beings were created by Allah with complex and complex structures and functions. The more we try to dig about the brain, it will never end. Therefore, everything that Allah made every part of us is a sign of Allah's greatness that should be our contemplation together. There is a term that states that understanding how the brain works is the main way to uncover the very essence of human beings. Character (morals or behavior) is the most important thing that must be owned by every human being and we must observe and analyze that the brain is the center of human character. The brain is part of the composition of the central nervous system that works as a center for controlling human activities in the form of thinking, moving, behaving, feeling something, remembering, and so on. Without the brain, humans will not live, like inanimate objects, without any use and potential. If we talk about interactions with the Qur'an that humans do such as reading, memorizing, listening, meditating or contemplating the meaning of the Qur'an, then this will affect the function directly or indirectly even the structure and function of the brain itself microscopically cellular can be affected. Many studies have been conducted to prove how the effects of the Qur'an from listening, reading, memorizing the Qur'an to brain function, especially in terms of brain waves, mental health, and so on.  Health effects can be obtained very much before we interact with the Qur'an. If we analyze simply the stages of a person's activity before interacting with the Qur'an also indirectly has a positive impact on the body.