Kepuasan Pasien Pengguna Kartu Jakarta Sehat di Unit Rawat Jalan Rumah Sakit

Peluncuran Kartu Jakarta Sehat (KJS) pada bulan November 2012 mengakibatkan jumlah kunjungan pasien yang melonjak drastis di fasilitas kesehatan, khususnya rumah sakit, baik itu rumah sakit pemerintah pusat, rumah sakit pemerintahdaerah maupun rumah sakit swasta yang berkomitmen dengan Pemerintah Daerah Jakarta. KJS memberikan kemudahan akses layanan kesehatan agar pasien dapat berobat secara gratis. Namun persoalan yang muncul kemudian adalah pasien harus mengantre lama di loket pendaftaran, ruang pemeriksaan, maupun ruang pengambilan obat. Penelitian ini bertujuan untuk mengetahui hubungan faktor sosial budaya, pribadi, dan psikologis dengan kepuasan pasien pengguna KJS pada 110 responden di Unit Rawat Jalan RSU UKI, dan telah dilaksanakan pada bulan Maret 2013. Rancangan penelitian yang digunakan adalah deskriptif kuantitatif dengan pendekatan potong lintang. Hasil penelitian menunjukkan kepuasan pasien KJS sebesar 40,9%. Akses ke rumah sakit, motivasi, informasi baik dan informasi tidak baik berhubungan signifikan dengan kepuasan pasien KJS, tetapi motivasi adalah hal yang paling dominan berhubungan. Selain itu, kepuasan pasien KJS juga berhubungan bermakna dengan pemanfaatan kembali layanan dan minat merekomendasikan layanan pada orang lain.Jakarta Health Card (JHC) was launched on November 2012, followed by sudden increase number of patient in any hospital accordingly. Jakarta Health Card ease the patient to afford health care without payment. We conducted study on the relation among socio-culture, demographic characteristics, and psychology factors toward patient satisfaction in using JHC. The study subjects were 110 outpatient of UKI Hospital, with study design descriptive quantitative with cross sectional approach. The result showed 40,9% of the patients were satisfied with the hospital service. Factors such as hospital access, motivation, good information and bad information were associated with patient satisfaction significantly, and motivation was the dominant factor. Besides, patient satisfaction also has significant correlation with revisiting/ reusing and recommendation of the hospital to other patients

Retrobulber Neuritis Post Nephrectomy

Abstract A 52 years old lady was referred due to a sudden decrease of vision. She underwent nephrectomy two days before being admitted to the Department of Ophthalmology. The examination showed that the right eye visual acuity was 1/60, left eye 20/70, ascertained with Marcus Gunn pupil reflex. Electroretinography examination revealed a retrobulber optic nerve disorder, diagnosed as neuritis. She received medication of methylprednisolone injection, followed by oral. On the last examination right eye visual acuity was 4/60, left eye 20/30 with S +0,50, and no more inflammation.Keywords: retrobulbar neuritis, nephrectomy, complication Abstrak Seorang perempuan berusia 52 tahun datang dengan keluhan tajam penglihatan turun mendadak. Penderita mengalami nefrektomi dua hari sebelumnya, dan kemudian dirujuk ke Departemen Penyakit Mata. Pada pemeriksaan ditemukan visus mata kanan 1/60 dan visus mata kiri 20/70 yang disertai refleks pupil Marcus Gunn. Pemeriksaan elektroretinografi memperlihatkan hasil gangguan di nervus optikus retrobulber. Pasien dengan neuritis retrobulber diterapi dengan injeksi metilprednisolon, dilanjutkan pemberian oral. Pada pemeriksaan terakhir didapatkan visus mata kanan 4/60 dan mata kiri 20/30 dengan S +0,50, dan tidak ditemukan lagi tanda peradangan.Kata kunci: neuritis retrobulber, nefrektomi, komplikas

Quantum Nucleation in a Ferromagnetic Film Placed in a Magnetic Field at an Arbitrary Angle

We study the quantum nucleation in a thin ferromagnetic film placed in a magnetic field at an arbitrary angle. The dependence of the quantum nucleation and the temperature of the crossover from thermal to quantum regime on the direction and the strength of the applied field are presented. It is found that the maximal value of the rate and that of the crossover temperature are obtained at a some angle with the magnetic field, not in the direction of the applied field opposite to the initial easy axis.Comment: 15 pages, RevTex, 3 PostScript figures. To appear in Phys. Rev.

Magnetic Field Dependence of Macroscopic Quantum Tunneling and Coherence of Ferromagnetic Particle

We calculate the quantum tunneling rate of a ferromagnetic particle of $\sim 100 \AA$ diameter in a magnetic field of arbitrary angle. We consider the magnetocrystalline anisotropy with the biaxial symmetry and that with the tetragonal symmetry. Using the spin-coherent-state path integral, we obtain approximate analytic formulas of the tunneling rates in the small $\epsilon (=1- H/H_c)$-limit for the magnetic field normal to the easy axis ($\theta_H = \pi/2$), for the field opposite to the initial easy axis ($\theta_H = \pi$), and for the field at an angle between these two orientations ($\pi/2 << \theta_H << \pi$). In addition, we obtain numerically the tunneling rates for the biaxial symmetry in the full range of the angle $\theta_H$ of the magnetic field ($\pi/2 < \theta_H \leq \pi$), for the values of \epsilon =0.01 and 0.001.Comment: 25 pages of text (RevTex) and 4 figures (PostScript files), to be published in Phys. Rev.

Learning curve of sutureless transconjunctival 20-gauge vitrectomy

Background To report the learning curve of transition from 20-gauge (20 G) conventional vitrectomy to a 20 G sutureless vitrectomy technique. Materials and methods This is a retrospective descriptive case study of 32 eyes from 32 consecutive patients who underwent sutureless 20 G pars plana vitrectomy. A 20 G microvitreoretinal blade was introduced, beveled transconjunctivally, slowly, parallel with the limbus, creating a conjunctivoscleral tunnel incision. Study participants were divided into three groups, and surgical time, induced astigmatism, and complications were compared. Results Of 32 consecutive patients, there was no significant difference in induced astigmatism or maneuvering between the early learning curve and other groups. The true learning curve was the first three patients. There were three cases where suturing the sclerotomy was necessary: one port in each case, three of 32 cases (9.3%), or three of 96 ports (2.9%). Conclusion There were no significant difficulties in surgical maneuvers while performing 20 g sutureless vitrectomy. Keywords: sutureless, vitrectomy, 20 G, learning curv

Reimplantasi Lensa Setelah Komplikasi Operasi Katarak

Ada keterbatasan laporan implementasi lensa intraokuler sekunder di Indonesia. Penelitian ini bertujuan untuk melaporkan hasil implementasi lensa intraokuler sekunder di Rumah Sakit Communion of Churches in Indonesia (CCI) Cikini, Fakultas Kedokteran Universitas Kristen IndonesiaJakarta. Penelitian dengan sumber data sekunder rekam medis pasien dengan bedah inclusi eventful dengan atau tanpa implementasi lensa dan setiap komplikasi post operasi, termasuk penurunan penglihatan dan inflamasi katarak. Segmen anterior dan posterior diperiksa secara menyeluruh dan dicatat. Sinechiolisis dilakukan 360o dan viskoelastik disuntikkan untuk membuka ruangan antara iris dan kapsul rensi remain. Remain vitreous di depan chamber dipotong dan diangkat. Intraocular lens (IOL) ditanam di sulkus. Hasilnya yaitu ada 8 pasien yang memenuhi kriteria inklusi yang kemudian dievaluasi (50% adalah pria), 6 pasien underwent extracapsular catarac extraction (ECCE), dan 2 pasien underwent phacoemulsification before. Semua pasien mempunyai kornea sentral yang jernih. Ada 5 pasien denganuveitis dan opasitas vitreous. Ada 1 pasien dengan (AC IOL), 2 pasien dengan (PCIOL) terdislokasi sebagian pada rongga vitreous dan sisanya aphakic. Semua prosedur bedah dikerjakan dengan anastesi lokal retrobulbar dan diimplementasi IOL pada sulkus tanpa fiksasi. Rata-rata umuradalah 56,3 + 18,5 tahun. Rata-rata best corrected visual acuity (BCVA) sebelum operasi 0,33 + 0,26 dan setelah operasi 0,89 + 0,16 (p = 0,000). Rata-rata intraocular pressure (IOP) adalah 20,25 + 8,2 dan 15,25 + 3,5 mmHg sebelum dan sesudah operasi secara berurutan (p = 0,140). Pemantauan dilakukan 1 - 60 bulan. Implementasi IOL sekunder dapatmemperbaiki penglihatan dan mengurangi subjektif dan temuan klinik setelah operasi katarak sebelumnya.Kata kunci: Intraokuler, implementasi, katarakAbstractThere are limited reports of secondary intraocular lens implantation in Indonesia. The purpose of study is to report the result of secondary intraocular lens implantation in Cikini Communion of Churches in Indonesia (CCI) Hospital/Faculty of Medicine University Universitas Kristen Indonesia Jakarta. Retrospective study of medical records of patients with inclusioneventful cataract surgery with or without lens implantation with any complications postoperatively, including reduced vision and inflammation. Anterior and posterior segment findings were examine thoroughly and recorded. Synechiolysis done 360 degree and viscoelastic injected to open space between iris and remain lens capsule. Remain vitreous in anterior chambercut and removed. Intraocular lens (IOL) implanted in the sulcus. There are 8 patients that fulfills inclusion criteria which then evaluated (50% are men), 6 patients underwent extracapsular catarac extraction (ECCE), and 2 patientsunderwent phacoemulsification before. All patient have clear central cornea. There are 5 patients with uveitis and vitreous opacity. There are 1 patients with (AC IOL), 2 patients with (PC IOL) dislocated some part to vitreous cavity and the rest aphakic. All surgical procedures were done under local retrobulbar anesthesia and IOL implanted in the sulcus withoutfixation. Mean age were 56,3 + 18,5 years. Mean best corrected visual acuity (BCVA) preoperatively 0,33 + 0,26 and postoperatively 0,89 + 0,16 (p = 0,000). Mean intraocular pressure (IOP) were 20,25 + 8,2 and 15,25 + 3,5 mmHg pre and post operative respectively (p = 0,140). Follow up was 1 - 60 months. Secondary IOL implantation can improve vision and reduce subjective and clinical findings after remarkable cataract surgery.Key words: Intraocular, implementation, catarac