PERANCANGAN PEMUSNAHAN REKAM MEDIS RAWAT JALAN DI PUSKESMAS SERING MEDAN TAHUN 2018

Puskesmas adalah Fasilitas pelayanan kesehatan yang menyelenggarakan upaya kesehatan masyarakat dan upaya kesehatan perseorangan tingkat pertama dengan lebih mengutamakan upaya promotif dan preventive, untuk mencapai derajat kesehatan masyarakat yang setinggi-tingginya di wilayah kerjanya (RI NO.75 Tahun 2014). Rekam medis berdasarkan Permenkes RI No.269/Menkes/Per/III/2008 merupakan berkas yang berisikan catatan dan dokumen tentang identitas pasien, pemeriksaan, pengobatan, tindakan, dan pelayanan lain yang telah dberikan kepada pasien. Berkas rekam medis pada rak penyimpanan tidak selamanya akan disimpan. Hal ini dikarenakan jumlah rekam medis terus bertambah sehingga ruang penyimpanan akan penuh dan tidak mencukupi lagi untuk rekam medis rekam medis yang baru. Pemusnahan rekam medis merupakan salah satu upaya yang dilakukan oleh pihak puskesmas dengan tujuan mengurangi penumpukan berkas rekam medis diruang penyimpanan.Berkas rekam medis rawat jalan disimpan selama 2 tahun. Jenis penelitian ini menggunakan penelitian deskripsi kualitatif. Penelitian kualitatif merupakan penelitian yang digunakan untuk menyelidiki, menemukan, menggambarkan. Puskesmas sering sudah melakukan pemusnahan terhadap berkas rekam medis dari tahun 1990 sampai dengan tahun 2015 dengan cara dibakar tanpa mengikuti proses yang sesuai dengan permenkes. Pemusnahan seharusnya dilakukan sesuai dengan prosedur PerMenkes.  Perlu adanya petugas khusus tamatan  rekam medis untuk mengelola rekam medis yang ada di puskesmas.</jats:p

PERBANDINGAN EFEKTIVITAS EKSTRAK DAUN BINAHONG (ANREDERA CORDIFOLIA (TEN.) STEENIS) 25% DAN 50% DIBANDINGKAN OBAT TRIAMCINOLONE ACETONIDE TERHADAP PENYEMBUHAN RECURRENT APHTHOUS STOMATITIS (RAS) MINOR

Recurrent Aphthous Stomatitis (RAS) is an inflammation of the soft tissues of the mouth characterized by recurrent ulcers without symptoms of other diseases. Clinically, RAS is characterized by painful recurrent ulcerations of the oral mucosa that appear recurrently in single or multiple numbers and have a red halo appearance that usually appears on the lip, cheek, lateral, and ventral mucosa of the tongue in the oral cavity. Triamcinolone acetonide is a prednisolone derivative and is considered an intermediate glucocorticoid. It is effective in reducing the signs and symptoms of many conditions of inflammation of the mouth, including RAS. Binahong contains active compounds of flavonoids, alkaloids, terpenoids, and saponins which have an antibacterial effect in inhibiting the growth of Streptococcus mutans and Staphylococcus aureus bacteria. so Binahong leaf extract can be used as an alternative natural treatment for minor RAS. This research compared the effectivity of extracts leaves Binahong (Anredera cordifolia (Ten.) Steenis) concentrations of 25%, 50% with Triamcinolone Acetonide in healing Recurrent aphthous stomatitis (RAS) minor. The research was pretest-posttest control group design, 30 samples divided into 3 treatment groups, where the treatment group I used Triamcinolone acetonide, treatment group II used 25% binahong leaf extract, and treatment group III used 50% Binahong leaf extract. Data were analyzed with a parametric statistical test of paired sample T-test and showed that there was a significant decrease in RAS diameter in groups I, II, and III (p &lt;0.05). The mean difference of RAS diameter between-group in order 2.7mm for the first treatment group, in the second treatment group, was 1.3mm and 2.2mm for the third treatment group. Analysis with Oneway ANOVA showed that after the treatment was given to the three groups, there was a significant average difference of the minor RAS diameter decrease (p &lt;0.05). The results showed that Triamcinolone acetonide was more effective in accelerating the healing of minor RAS than 25% and 50% binahong leaf extract.</jats:p

Multiple neuroendocrine tumors of the small bowel: a case report

Neuroendocrine tumors of the small bowel are rare malignancies that often occur in the case of bowel obstruction or intestinal bleeding. The present case is a 46-year-old man who underwent emergency surgery for obstruction due to a rare presentation of multiple neuroendocrine lesions located in an intestinal loop. Pathology showed 15 NETs (grade 1) between 4 and 15 mm diameter with positive lymph nodes and liver metastases already detected by the preoperative CT scan.</jats:p

BIOASSAY-GUIDED FRACTINATION OF ANTIMITOTIC COMPOUND FROM ONGKEA CORTEX (MEZZETTIA PARVIFLORA BECC) TOWARDS SEA URCHIN EGGS

Ongkea cortex, the wood bark of Mezzettia Parviflora Becc, is a traditional medicine originated from Southeastern Sulawesi (Indonesia). It has been empirically known to have antitumor property. In this study, we examined the antiproliferative activity and obtained the antimitotic compound of ongkea cortex. Antimitotic activity was ultimately determined by the inhibition of cleavage-stage of newly fertilized sea urchin (Lytechinus variegatus) eggs. A bioassay-guided fractination was performed in order to find the bioactive substance of ongkea cortex. The IC50 values of methanolic extract, ethyl acetate-soluble part of metanolic extract and ethil acetat insoluble part of metanolic extract were      1221.68 µg/mL,  2.69 µg/mL, and 15.15 µg/mL, respectively. Ethyl acetate-soluble part of metanolic extract was further investigated. It was partitionated using vacuum liquid column chromatoghraphy with different solvent system by increasing their polarities. There were three different fractions obtained. Fraction III exerted the highest inhibition activity with IC50 value of 1.33 µg/mL.  It was separated subsequently to result four groups of compounds. III-C group presented the most potent inhibition activity with IC50 value of  0.7147 µg/mL. It was then subjected to preparative TLC and yieldedsix groups of subfractions. III-C-3 subfraction was indicated as the most potent compound with IC50 value of 0.3378 µg/mL. It was ten times weaker compared with antimitotic activity of Vincristine with IC50 of 0.0351 µg/mL. As a conclusian, ongkea cortex might have antimitotic property with the highest rate inhibition activity exhibited by III-C-3 compound. Keywords: ongkea cortex, Mezzettia Parviflora Becc, sea urchin eggs, antimitotic compound, antiproliverative activit

Tyrosinase Inhibitory and Antioxidant Activity of Paederia foetida L.

Paederia foetida L. is a tropical Asian plant containing bioactive compounds and often used as functional foods. The aim of this study was to determine the antioxidant capacity and inhibitory activity of P. foetida leaves extract on tyrosinase activity. In addition, the total phenolic content (TPC) and total flavonoid content (TFC) were determined. TPC and TFC was evaluated by the Folin-Ciocalteu and the aluminum chloride (AlCl3) colorimetric method, respectively. The antioxidant capacity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP), and cupric reducing antioxidant capacity (CUPRAC) method. The antioxidant capacity was expressed as trolox equivalent antioxidant capacity (TEAC) dan ascorbic acid equivalent capacity (AAEC). The tyrosinase inhibitory activity was conducted by enzyme-linked immunosorbent assay (ELISA) using L-tyrosine as a substrate and measured at 490 nm by ELISA reader. TPC in the crude extract, fraction A, and fraction B was 173.18 ± 3.99, 553.95 ± 5.70 and 405.37 ± 33.90, respectively. TFC in the crude extract, fraction A, and fraction B was 12.79 ± 0,25, 143.16 ± 9.27, 143.50 ± 6.90, respectively. The best antioxidant capacity of the extract was shown in the DPPH method (15.71 ± 1.6 mg TEAC/g and 100.77 ± 8.5 mg AAEC/g). Meanwhile, fraction B showed the best antioxidant capacity by the FRAP (11.48 ± 1.5 TEAC/g and 8.39 ± 1.2 mg AAEC/g ) and CUPRAC (116.34 ± 1.9 mg TEAC/g and  66.11 ± 1.3 mg AAEC/g) methods. Tyrosinase inhibitory activity exhibited that the IC50 of fraction A and B was 13.67 μg/mL and 13.37 μg/mL, respectively.</jats:p

Investigation of Antituberculosis from Medicinal Plant of Community Ethnic in South Sulawesi

Background: Tuberculosis is one of the transmitted diseases that has been claimed as one of the most serious health problems worldwide resulting in death, as reported in WHO in Global Tuberculosis Report 2014. It has been predicted that 9 million people suffer from tuberculosis disease and 1.5 - 2 million deaths occur by this disease. Objective: The aim of this research is to know the species of plant used as anti-hematemesis medicine that has the activity of antituberculosis and antituberculosis-MDR and then investigate the phytochemistry characteristics of the compound from every parts of the plant extract that show the activity of antituberculosis and antituberculosis-MDR which is indicated by the value of Minimum Inhibitory Concentration (MIC) of the extracts. Methods: The extraction method used in this research was the maceration method. The antituberculosis activity test was investigated using MODS and LJ media methods. The isolation of the active compound was carried out using Bioassay Guided Fractionation and then the compound characteristics were identified using spectroscopy data. Results: The results showed that extracts from Talas (Collocasia esculenta tuber) and Kariango (Acorus calamus rhizome) plants were active against M. tuberculosis. The FTIR spectroscopy data showed that three isolates obtained from Talas plants contained aliphatic OH and C-O and CH groups. The MIC values of kariango and Talas extracts using the MODS method were 45 mg/ml and 40 mg/ml, respectively. Conclusion: Talas (Collocasia esculenta) tuber and Kariango rhizome ethanolic extract have a potency for antituberculosis and anti-MDR tuberculosis drugs. </jats:sec