Ditemukan 3 dokumen yang sesuai dengan query :: Simpan CSV
Yuli Kristianingsih; Pembimbing: Umar Fahmi Achmadi, Budi Hartono; Penguji: Ema Hermawati, Miko Hananto, Didi Purnama
Abstrak:
Penambangan emas di Desa Lebaksitu Kabupaten Lebak adalah Pertambangan Emas Skala Kecil (PESK). Merkuri merupakan logam berat yang memiliki tingkat toksisitas tinggi di dalam tubuh. Hati sebagai bagian utama metabolisme dan akumulasi merkuri dalam tubuh manusia sehingga merkuri dapat menyebabkan kerusakan hati. Serum Glutamic Pyruvic Transaminase (SGPT) merupakan penanda yang sensitif pada kerusakan hati karena enzim ini sumber utamanya di hati. Adanya peningkatan SGPT dapat digunakan sebagai biomarker enzim potensial untuk merkuri yang memicu terjadinya induced hepatotoxicosis yang pada akhirnya mempengaruhi kesehatan umum dengan mengubah fungsi dan struktur integritas hati. Penelitian ini bertujuan untuk mengetahui pengaruh pajanan merkuri dalam darah terhadap fungsi hati dengan mengukur kadar SGPT pada masyarakat. Penelitian ini menggunakan desain studi cross sectional. Penelitian dilakukan pada bulan Mei 2017 dengan populasi adalah warga yang bertempat tinggal di Desa Lebaksitu setelah menggunakan kriteria inklusi, dengan jumlah sampel 68 orang. Data penelitian diambil melalui wawancara menggunakan kuesioner dan pemeriksaan sampel darah untuk mengetahui kadar merkuri dalam darah dan kadar SGPT. Hasil penelitian ini didapatkan 77,9% responden adalah bukan pengolah emas, yang sudah tinggal di desa Lebaksitu lebih dari 10 tahun. 77,9% responden memiliki merkuri darah diatas normal (WHO : 10 μg/l). Peningkatan kadar SGPT dialami oleh 25% responden. Tidak terdapat hubungan yang signifikan antara merkuri darah terhadap kadar SGPT, namun variabel umur dan lama tinggal sebagai variabel confounding mempengaruhi kadar merkuri darah.
Mercury is a heavy metal that has high levels of toxicity in the body. The liver as a major part of metabolism and the accumulation of mercury in the human body so that mercury can cause liver damage. Serum Glutamic Pyruvic Transaminase (SGPT) is a sensitive marker of liver damage because this enzyme is the primary source in the liver. The increased SGPT can be used as a potential enzyme biomarker for mercury that induces the induced hepatotoxicosis that ultimately affects general health by altering the function and structure of liver integrity. This study aims to determine the effect of mercury exposure in the blood on liver function by measuring the levels of SGPT in the community. This study used cross sectional study design. The study was conducted in May 2017 with the population being residents residing in Lebaksitu after using inclusion criteria, with total sample of 68 people. The data were collected through interviews using questionnaires and blood samples to determine the levels of mercury in blood and SGPT levels. The results of this study found that 77.9% of respondents are not gold processors, who have lived in Lebaksitu more than 10 years. 77.9% of respondents had above- normal blood mercury (WHO: 10 μg / l). Increased levels of SGPT experienced by 25% of respondents. There was no significant relationship between mercury blood and SGPT levels, but the variable age and length of stay as confounding variables affect blood mercury levels.
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Mercury is a heavy metal that has high levels of toxicity in the body. The liver as a major part of metabolism and the accumulation of mercury in the human body so that mercury can cause liver damage. Serum Glutamic Pyruvic Transaminase (SGPT) is a sensitive marker of liver damage because this enzyme is the primary source in the liver. The increased SGPT can be used as a potential enzyme biomarker for mercury that induces the induced hepatotoxicosis that ultimately affects general health by altering the function and structure of liver integrity. This study aims to determine the effect of mercury exposure in the blood on liver function by measuring the levels of SGPT in the community. This study used cross sectional study design. The study was conducted in May 2017 with the population being residents residing in Lebaksitu after using inclusion criteria, with total sample of 68 people. The data were collected through interviews using questionnaires and blood samples to determine the levels of mercury in blood and SGPT levels. The results of this study found that 77.9% of respondents are not gold processors, who have lived in Lebaksitu more than 10 years. 77.9% of respondents had above- normal blood mercury (WHO: 10 μg / l). Increased levels of SGPT experienced by 25% of respondents. There was no significant relationship between mercury blood and SGPT levels, but the variable age and length of stay as confounding variables affect blood mercury levels.
T-4938
Depok : FKM UI, 2017
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Abdelrahman M S Alnweiri; Pembimbing: Nurhayati Adnan; Penguji: Helda, Hadianti Adlani
Abstrak:
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Demam berdarah dengue (DBD) tetap menjadi masalah kesehatan masyarakat yang signifikan di Indonesia, dengan komplikasi pada fungsi hati yang sering dijumpai. Penelitian ini bertujuan menganalisis hubungan antara peningkatan enzim transaminase hati hati (SGOT/SGPT) dan lama hari rawat inap (LOS) pada pasien dewasa DBD di RS Ummi Bogor selama periode Januari 2021–Desember 2023. Penelitian ini menggunakan desain retrospektif analitik kasus-kontrol berdasarkan data rekam medis. Variabel utama meliputi status peningkatan kadar SGOT/SGPT, lama rawat inap, komorbiditas, dan penggunaan obat hepatoprotektor. Analisis statistik mencakup uji Chi-square bivariat dan regresi logistik multivariat. Dari 786 pasien DBD, 329 (41,9%) mengalami peningkatan enzim transaminase hati hati. Rata-rata lama rawat inap pada pasien dengan peningkatan enzim transaminase hati hati adalah sekitar 5 hari, sedangkan kelompok tanpa peningkatan sekitar 4 hari (p < 0,05). Analisis multivariat menunjukkan bahwa peningkatan enzim transaminase hati hati secara mandiri berhubungan signifikan dengan lama rawat inap lebih lama (adjusted odds ratio 1,42; 95% CI 1,05–1,94). Komorbiditas dan tidak menerima terapi hepatoprotektor juga terbukti berhubungan signifikan dengan perpanjangan lama rawat inap. Temuan ini mengindikasikan bahwa gangguan fungsi hati pada pasien DBD berkaitan dengan masa rawat inap yang lebih panjang. Diharapkan deteksi dini dan penatalaksanaan gangguan hati sejak awal dapat meningkatkan hasil perawatan pasien.
Dengue fever remains a significant public health problem in Indonesia, and hepatic complications are frequently observed. This study aimed to analyze the relationship between elevated liver enzymes (SGOT/SGPT) and length of hospital stay (LOS) in adult dengue patients at UMMI Bogor Hospital from January 2021 to December 2023. We conducted a retrospective case-control study using medical records. The main variables included elevated SGOT/SGPT levels, length of stay, comorbidities, and hepatoprotective therapy. Statistical analysis involved bivariate Chi-square tests and multivariate logistic regression. Of the 786 dengue patients, 329 (41.9%) had elevated liver enzymes. The mean LOS was about 5 days for patients with elevated enzymes, compared to about 4 days for those without elevation (p < 0.05). Multivariate analysis showed that elevated liver enzymes remained independently associated with longer hospital stays (adjusted OR 1.42; 95% CI 1.05–1.94). In addition, comorbidities and lack of hepatoprotective therapy were also significantly associated with longer LOS. These findings suggest that liver involvement in dengue is linked to extended hospital stays. Early detection and management of hepatic dysfunction upon admission may improve patient outcomes.
T-7462
Depok : FKM-UI, 2025
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Ikhwan Rinaldi; Promotor: Mondastri Korib Sudaryo; Kopromotor: Besral, Suhendro; Penguji: Syahrizal, Aru Wisaksono Sudoyo, Abdul Muthalib, Soewarta Kosen; C Suharti
Abstrak:
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Latar Belakang: Trombositopenia merupakan penentu keparahan demam berdarah dengue terutama pada pasien dewasa. Beberapa literatur secara terpisah menunjukkan adanya hubungan antara beberapa faktor terhadap trombositopenia. Hingga saat ini belum ada penelitian yang mempelajari faktor-faktor tersebut secara bersamaan dalam satu penelitian yang sama. Penelitian ini bertujuan untuk membuat model prediksi berdasarkan pada faktor-faktor tersebut terhadap jumlah trombosit nadir ≤20.000 μL selama perawatan. Metode: Penelitian ini merupakan penelitian kohort retrospektif terhadap subjek Demam Dengue (DD)/ Demam Berdarah Dengue (DBD) dewasa yang masuk rawat pada fase akut (awitan demam ≤4 hari). Variabel bebas status koagulasi (ekspresi CD62P, ekspresi CD154, kadar trombomodulin, kadar PAI-1, dan kadar PF4) merupakan data primer yang didapatkan dengan teknik pemeriksaan nanoparticle flowcytometry plasma darah simpan EDTA. Variabel bebas lain yang merupakan data sekunder adalah karakteristik pasien (jenis kelamin, usia, IMT, dan komorbid), status hematologi (kadar hematokrit, kadar MCH, jumlah leukosit, jumlah neutrofil, jumlah limfosit, jumlah monosit, rasio neutrofil limfosit, dan jumlah trombosit saat masuk rawat), status fungsi hati (kadar SGOT, SGPT, dan albumin), dan koinfeksi multivirus dengue yang didapatkan dari rekam medis. Analisis statistik menggunakan regresi Cox. Hasil: Proporsi subjek demam dengue yang mengalami jumlah trombosit nadir ≤20.000 μL adalah 18 dari 121 subjek (14,9%). Variabel bebas yang berhubungan dengan jumlah trombosit nadir ≤20.000/μL adalah jumlah monosit <465,61/μL dengan HR 6,24; jumlah trombosit saat masuk rawat <161.000/μL dengan HR 2,98; kadar SGOT ³39,50 U/L dengan HR 5,51; kadar trombomodulin tinggi ³773,3550 sel/μL dengan HR 4,01; NLR ≥6,49 dengan HR 0,003; dan NLR x t dengan HR 4,95 (HR untuk hari keempat dan kelima adalah 1,64 dan 8,13). Model skoring yang menggunakan variabel tersebut dapat memprediksi jumlah trombosit nadir ≤20.000/μL pada titik potong skor 14 dengan sensitivitas 77,78%; spesifisitas 82,52%; PPV 43,74%; dan NPV 95,51%. Tanpa status koagulasi variabel bebas yang berperan terhadap trombosit nadir ≤20.000/μL adalah jumlah monosit <465,61/μL dengan HR 5,83; jumlah trombosit saat masuk rawat <161.000/μL dengan HR 4,09; kadar SGOT ≥39,50 U/L dengan HR 5,64; NLR ≥6,49 dengan HR 0,004; dan NLR x t dengan HR 5,31 (HR pada hari keempat dan kelima dengan adalah 3,27 dan 17,34). Model skoring tanpa faktor koagulasi memiliki titik potong skor 11 dengan sensitivitas 83,33%; spesifisitas 68%; PPV 31,25%; dan NPV 95,9%. Model skoring prediksi jumlah trombosit nadir ≤20.000/μL pada subjek demam dengue dalam perawatan dengan faktor koagulasi dan tanpa faktor koagulasi berdasarkan uji regresi Cox extended menunjukkan nilai diskriminasi yang baik (AUC 0,866 dan 0,833). Perbedaan nilai AUC ini secara statistik tidak berbeda bermakna (nilai p = 0,1278). Simpulan: Faktor yang berhubungan dengan trombosit nadir ≤20.000/μL adalah jumlah monosit absolut saat masuk rawat rendah, kadar SGOT tinggi, kadar trombomodulin tinggi, jumlah trombosit saat masuk rawat rendah, dan NLR x t. Model skoring yang paling aplikatif adalah model skoring berdasarkan analisis regresi Cox model extended tanpa faktor koagulasi.
Background: Thrombocytopenia is the determinant of the severity of dengue hemorrhagic fever, especially in adult patients. Several separate studies have shown association between various factors contributing to thrombocytopenia. Up to this day, no research has investigated these factors in a single study. This study aims to develop a predictive model for thrombocytopenia levels particularly nadir platelet count ≤20,000 μL, using these factors in one single study, during the treatment period. Method: This study is a retrospective cohort study of adult subjects with Dengue Fever (DF)/Dengue Hemorrhagic Fever (DHF) admitted during the acute phase (fever onset ≤4 days). The independent variables related to coagulation status (CD62P expression, CD154 expression, thrombomodulin levels, PAI-1 levels, and PF4 levels) as the primary data were obtained through nanoparticle flow cytometry technique on stored EDTA blood samples. Other independent variables as the secondary data, included patients’ characteristics (gender, age, BMI, and comorbidities), hematological status (hematocrit levels, MCH levels, leukocyte count, neutrophil count, lymphocyte count, monocyte count, neutrophil-lymphocyte ratio, and admission platelet count), liver function status (level of AST, ALT, and albumin), and dengue multivirus coinfection were obtained from medical records. Statistical analysis was performed using Cox regression. Results: The proportion of dengue fever subjects with nadir platelet count ≤20,000 μL was 18 out of 121 subjects (14.9%). Independent variables associated with nadir platelet count ≤20,000/μL were monocyte count <465.61/μL with HR 6.24; admission platelet count <161,000/μL with HR 2.98; AST levels ≥39.50 U/L with HR 5.51; high thrombomodulin ≥773.3550 cells/μL with HR 4.01; NLR ≥ 6.49 with HR 0.003; and NLR x t with HR 4.95 (HR on the fourth and fifth day were 1.64 and 8.13). A scoring model with these variables predicted nadir platelet count ≤20,000/μL with cut-off score of 14, sensitivity of 77.78%, specificity of 82.52%, PPV of 43.74%, and NPV of 95.51%. Without coagulation status, the independent variables contributing to nadir platelet count ≤20,000/μL were monocyte count <465.61/μL with HR 5.83; admission platelet count <161,000/μL with HR 4.09; AST levels ≥39.50 U/L with HR 5.64; NLR ≥ 6.49 with HR 0.004; and NLR x t with HR 5.31 (HR on the fourth and fifth day were 3.27 and 17.34). The scoring model without coagulation factors with cut-off score of 11, sensitivity of 83.33%, specificity of 68%, PPV of 31.25%, and NPV of 95.9%. The scoring model predicting nadir platelet count ≤20,000/μL in dengue fever subjects during treatment, with and without coagulation factors based on Cox regression analysis, showed good discrimination values (AUC 0.866 and 0.833). The difference in AUC values was not statistically significant (p = 0.1278). Conclusion: Factors associated with nadir platelet count ≤20,000/μL were low admission absolute monocyte count, high AST level, high thrombomodulin, low admission platelet count, and NLR x t. The most applicable scoring model was based on Cox regression analysis extended model without coagulation factors.
D-479
Depok : FKM-UI, 2023
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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