DAISY SYAKHSIATUSY SYAHIQOH 22010110120011 BAB8KTI
DAFTAR PUSTAKA
1.
Vijayakumar S, Fareedullah M, Sudhakar Y, Venkateswarlu B, Kumar EA.
Current Review on Organophosphorus Poisoning. Arch. Appl. Sci. Res
2010;2:199-215.
2.
Sivagnanam S. Potential therapeutic agents in the management of
organophosphorus poisoning. Crit Care 2002;6:260-1.
3.
Schenker MB, Christiani D, Cormier Y, et al. Respiratory Health Hazards in
Agriculture. American Journal of Respiratory and Critical Care Medicine
1998;158:S1-S76.
4.
Mashali AA, Nounou HA, Sharara GM, Aziz MHA. Role Of Oxidative
Stress And Apoptosis In Acute Organophosphorus Intoxicated Patients. JMRI
2005;26:255-263.
5.
Bhat RV. Human health problems associated with current agricultural food
production. Asia Pac J Clin Nutr 2008;17 Suppl 1:91-4.
6.
Rahbar Taromsari M, Badsar A, Aghajankhah M, Akbar Poor M, Farhamand
Porkar N, Fallah Karkan M. The Study of Electrocardiographic Findings in
Patients with Organophosphate Poisoning. Iranian Jornal of Toxicology
2013;6:751-756.
7.
Lionte C, Bologa C, Sorodoc L. Advances in Electrocardiograms-Clinical
Applications. In: Toxic and Drug-Induced Changes of the Electrocardiogram.
Croatia: InTech, 2012.
8.
Abraham S, Oz N, Sahar R, Kadar T. QTc prolongation and cardiac lesions
following acute organophosphate poisoning in rats. Proc West Pharmacol Soc
2001;44:185-6.
9.
Anand S, Singh S, Nahar Saikia U, Bhalla A, Paul Sharma Y, Singh D.
Cardiac abnormalities in acute organophosphate poisoning. Clin Toxicol
(Phila) 2009;47:230-5.
10. Balouch GH, Yousfani AH, Jaffery MH, Devrajani BR, Shah SZA, Baloch
ZAQ. Electrocardiographical Manifestation of Acute Organophophate
Poisoning. World Appl. Sci. J 2012;16:1118-1122.
54
55
11. Karki
P,
Ansari
JA,
Bhandary
S,
Koirala
S.
Cardiac
and
electrocardiographical manifestations of acute organophosphate poisoning.
Singapore Med J 2004;45:385-9.
12. Mesude A, Ahmet S, Mehmet Oðuzhan A, et al. The relationship between
electrocardiographic changes, cholinesterase levels and mortality in acute
organophosphate poisoning. Cukurova Med J 2013;38:181-188.
13. Saadeh AM, Farsakh NA, al-Ali MK. Cardiac manifestations of acute
carbamate and organophosphate poisoning. Heart 1997;77:461-4.
14. Siu AYC, Tsoi LCH, Lo WCB, Chung CCH. QT Prolongation due to
Organophosphate Poisoning. Hong Kong j.emerg.med 2000;7:234-235.
15. Paul UK, Bhattacharyya AK. ECG manifestations in acute organophosphorus
poisoning. J Indian Med Assoc 2012;110:98, 107-8.
16. Yurumez Y, Yavuz Y, Saglam H, et al. Electrocardiographic findings of
acute organophosphate poisoning. J Emerg Med 2009;36:39-42.
17. Prasad DM. Correlation of Plasma Cholinesterase Levels with Mortality and
Morbidity
in
acute
Organophosphorus
Poisoning
Cases.
Belgaum
(Karnataka): KLE University, 2012.
18. Baydin A, Aygun D, Yazici M, Karatas A, Deniz T, Yardan T. Is there a
relationship between the blood cholinesterase and QTc interval in the patients
with acute organophosphate poisoning? Int J Clin Pract 2007;61:927-30.
19. Hurst JW, Fuster V, Walsh RA, Harrington RA. Hurst's the Heart, 13th ed.
New York: McGraw-Hill Medical, 2011.
20. de Luna AB. Clinical Electrocardiography: A Textbook. Oxford: Wiley, 2012.
21. Patel MM, Benowitz N. Cardiac conduction and rate disturbances, In:
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22. Dash PK. Electrocardiogram Monitoring. Indian J. Anaesth 2002;46:251-260.
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circulatory and neuropsychological
responses to acute hypoxia in
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26. Holstege C, Baer A, J. BW. The electrocardiographic toxidrome: the ECG
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27. Murphy NG, Benowitz NL, Goldschlager N. Cardiovascular toxicology, In:
Haddad and Winchester’s Clinical Management of Poisoning and Drug
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28. Chacko J, Elangovan A. Late onset, prolonged asystole following
organophosphate poisoning: a case report. J Med Toxicol 2010;6:311-4.
29. Lionte C, Sorodoc L, Petris O, Sorodoc V. Electrocardiographic changes in
acute organophosphate poisoning. Rev Med Chir Soc Med Nat Iasi
2007;111:906-11.
30. Vijayakumar S, Fareedullah M, Ashok Kumar E, Mohan Rao K. A
prospective study on electrocardiographic findings of patients with
organophosphorus poisoning. Cardiovasc Toxicol 2011;11:113-7.
31. Bacova I, Svorc P, Bracokova I. Chronophysiologyc aspects of ECG changes
during a systemic asphyxic episode and seubsequent reoxygenation in an
experimental rat model. Bratisl Lek Listy 2010;111:121-125.
32. Salman Shafi S, Syed Neyaz H, Tanu A, Deepankar S. A Comparison of 12
Lead ECG Status of Tobacco Smokers, Tobacco Chewers and Non Tobacco
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33. Devi MR, Arvind T, Kumar PS. ECG Changes in Smokers and Non
Smokers-A Comparative Study. J Clin Diagn Res 2013;7:824-6.
34. Khan IS, Rahman MA, Amin R. Study of ECG changes in Apperently
Healthy Adult Male Smokers. Dinajpur Med Col J 2011;4:7-14.
35. Sereny G. Effects of alcohol on the Electrocardiogram. Circulation
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36. Mahmoud S, Beauchesne LM, Davis DR, Glover C. Acute reversible left
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37. Gowda RM, Wilbur SL, Schweitzer P. Gender differencies in cardiac
electrophysiology and arrythmias. Part 1. Cardiol 2006;15:296-302.
38. John M, Oommen A, Zachariah A. Muscle injury in Organophosphorus
poisoning and its role ini the development of Intermediate Syndrome.
Neurotoxicology 2003;24:43-53.
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40. Roex EW, Keijzers R, VanGestel CA. Acetylcholinesterase inhibition and
increased food consumption rate in the Zebrafish, Danio rerio, after exposure
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41. Rohlman DS, Anger WK, Lein PJ. Correlating neurobehavioral performance
with biomarkers of organophosphorous pesticide exposure. Neurotoxicology
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42. Cherian M, Roshini C, Peter J, Cherian A. Oximes in organophosphorus
poisoning. Indian J Crit Care Med 2005;9:155-63.
43. Singh S, Sharma N. Neurological syndromes following organophosphate
poisoning. Neurol India 2000;48:308-13.
44. Cander B, Dur A, Yildiz M, et al. The prognostic value of the Glasgow coma
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serum
acetylcholinesterase
and
leukocyte
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exposure. Occupational Medicine 2004;54:69-75.
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51. Klaassen CD, Watkins JB. Casarett and Doull's Toxicology: The Basic
Science of Poisons, 5th ed. USA: McGraw-Hill Companies, 1999.
52. Yodenca AR. Faktor-Faktor yang Berhubungan dengan Keracunan Pestisida
Organofosfat, Karbamat dan Kejadian Anemia pada Petani Holtikultura di
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Universitas Diponegoro, 2008.
53. Kale B. ß-Glucuronidase as a new potent biomarker in the diagnosis and
prognosis of organophosphorus toxicity international Journal of Biological
Research 2013;1:5-9.
54. Zimmer KR, Lencina CL, Zimmer AR, Thiesen FV. Influence of physical
exercise and gender on acetylcholinesterase and butyrylcholinesterase
activity in human blood samples. Int J Environ Health Res 2012;22:279-86.
55. Temple WA, Smith NA. Cahpter 16. Organic Phospohorus Pesticides In:
Hayes W J & Laws (eds) Pesticides studied in man. Baltimore: Williams &
Wilkins, 1991:919-1123.
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57. Hadi A. Prinsip Pengelolaan Pengambilan Sampel Lingkungan. Jakarta:
Gramedia, 2005.
58. Cankaylali I, Demirage K, Ersoz B. The effect of N-acetylcysteine on
oxidative
stress
in
organophosphate
poisoning
model.
Adv
Ther
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59. Prasad DRMM, Jirli PS, Mahesh M, Mamatha S. Relevance of Plasma
Cholinesterase to Clinical Findings in Acute Organophosphorous Poisoning.
Asia Pacific Journal of Mediacal Toxicology 2013;2:23-27.
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60. Abdullat IM, Battah AH, Hadidi KA. The use of serial measurement of
plasma cholinesterase in the management of acute poisoning with
organophosphates
and
carbamates.
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2006;162:126-130.
61. Poojara L, Vasudevan D, Arun Kumar AS, Kamat V. Organophosphate
poisoning: Diagnosis of intermediate syndrome. Indian J Crit Care Med
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62. Paudyal BP. Organophosphorus poisoning. J Nepal Med Assoc 2008;47:2518.
63. Weissmann-Brenner A, David A, Vidan A, Hourvitz A. Organophosphate
Poisoning: A Multihospital Survey. IMAJ 2002;4:573-576.
64. Goel A, Aggarwal P. Pesticide Poisoning. Natl Med J India 2007;20:182-91.
65. Salvi RM, Lara DR, Ghisolfi ES, Portela LV, Dias RD, Souza DO.
Neuropsychiatric
Evaluation
in
Subjects
Chronically
Exposed
to
Organophosphate Pesticides. Toxicological Sciences 2003;72:267-271.
66. Liu SH, Lin JL, Weng CH, et al. Heart rate-corrected QT interval helps
predict mortality after intentional organophosphate poisoning. PLoS One
2012;7:e36576.
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Value of Serum Cholinesterase in Organophosphate Poisoning. Chest
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68. Kharoub MA, Elsharkawy SA. Cardiotoxicity of Acute Organophosphate
Poisoning. Benha M J 2008;25:9-10.
69. Deshpande A, Gaikwad N, Deshpande S. study of Glasgow coma scale score
and QTc Interval in prognosis of Organophosphate compound poisoning.
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70. Gul EE, Can I, Kusumoto FM. Case report: an unusual heart rhythm
associated
with
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organophosphate poisong by serial cholinesterase analyses. Arch. Intern. Med.
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LAMPIRAN
Lampiran 1. Ethical Clearance
62
63
Lampiran 2. Persetujuan Setelah Pemberitahuan
JUDUL PENELITIAN :
HUBUNGAN ANTARA KADAR
ASETILKOLINESTERASE DENGAN
GAMBARAN EKG PADA PETANI YANG
TERPAPAR KRONIK ORGANOFOSFAT
INSTANSI PELAKSANA:
BAGIAN FISIOLOGI FK UNDIP
Persetujuan Setelah Penjelasan
(INFORMED CONSENT)
Penelitian ini merupakan penelitian yang bertujuan mengetahui faktorfaktor yang berpengaruh terhadap terjadinya kelainan gambaran EKG pada petani
yang mengalami keracunan kronik organofosfat.
Pada penelitian ini akan dilakukan wawancara, pemeriksaan fisik,
elektrokardiografi dan pengambilan sampel darah. Kemungkinan terjadinya
komplikasi akibat penelitian ini sangat kecil karena dilakukan oleh tenaga terlatih.
Bapak/ Ibu/ Saudara bisa menolak apabila tidak setuju ikut serta dalam penelitian
ini. Apabila setuju untuk menjadi subjek penelitian, maka identitas Bapak/ Ibu/
Saudara akan kami rahasiakan. Seluruh biaya penelitian ditanggung oleh peneliti.
Peneliti juga akan memberikan imbalan sesuai dengan kemampuan peneliti.
Penanggung jawab penelitian adalah dr. Saekhol, dosen Bagian Ilmu
Kesehatan Masyarakat FK Undip. Alamat kantor: Jl. Prof. Dr. Soedarto,
Tembalang, Semarang.
Terima kasih atas kerjasama Bapak/ Ibu/ Saudara.
Setelah mendengar dan memahami penjelasan peneltian, dengan ini saya
menyatakan
SETUJU / TIDAK SETUJU
Untuk menjadi subjek penelitian
Semarang, 15 Maret 2014
Saksi
NamaTerang :
Alamat
: _________________
NamaTerang :
Alamat
: _________________
64
Lampiran 3. Kuesioner
No. :
Nama Pewawancara :
PENELITIAN HUBUNGAN ANTARA KADAR ASETILKOLINESTERASE DENGAN
GAMBARAN EKG PADA PETANI YANG TERPAPAR KRONIK ORGANOFOSFAT
(Isi atau lingkari nomor jawaban)
Sabtu, 15 Maret 2014
No Responden
Nama
Usia
Alamat
:
:
:
:
Lama tinggal di Kepakisan
Petani
:
:
Lama jadi petani
Menggunakan pestisida
semprot?
Alat pelindung diri yang dipakai
saat menyemprot (bisa lebih
dari 1 jawaban)
:
:
Bila pernah terkena tumpahan
pestisida, tindakan yang
dilakukan?
:
Adakah riwayat keracunan
pestisida
Bila ya, kapan?
:
:
:
Bila ada, apa pengobatan yang
didapatkan
:
Apakah saat terkena tumpahan,
terdapat gejala berikut (bisa
lebih dari 1 jawaban)
:
………………………. tahun
…………………………………………………………
……………...
…………………………………………………………
……………...
…………………………………………………………
……………...
………………………. tahun
1. Ya
2. Bukan
………………………. tahun
1. Ya
2. Tidak
1. Topi/ penutup kepala
2. Kacamata
3. Masker wajah
4. Sarung tangan plastik/ karet
5. Baju lengan panjang
6. Celana panjang
7. Sepatu boot
1. Mencuci dengan air
2. Mencuci dengan air dan sabun
3. Tidak melakukan apa-apa
4. lainnya: …………………………….
1. Ya, berapa kali …………………………….
2. Tidak
……………………………. hari/ bulan/ tahun yang
lalu
1. Dirawat di RS
2. Diobati di Puskesmas
3. Tidak berobat
4. Lainnya
1. Mengantuk
2. Sulit berkonsenstrasi
3. Bingung
4. Sulit bicara
5. Pusing berputar
6. Sakit kepala
65
7.
8.
9.
10.
11.
12.
13.
Badan lemah
Penglihatan kabur/ gelap
Sesak napas
Dada sakit/ sesak
Muntah
Diare
Lainnya…………………………….
Apakah saat ini terdapat gejala
berikut (bisa lebih dari 1
jawaban)
:
1. Mengantuk
2. Sulitber konsenstrasi
3. Bingung
4. Sulit bicara
5. Pusing berputar
6. Sakit kepala
7. Badan lemah
8. Penglihatan kabur/ gelap
9. Sesak napas
10. Dada sakit/ sesak
11. Muntah
12. Diare
13. Lainnya…………………………….
Penyakit yang pernah atau
sedang diderita
:
Adakah gejala berikut
:
Apakah minum alkohol
:
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
Apakah minum obat berikut (bisa
lebih dari 1 jawaban)
Apakah merokok
Sakit kuning/ sakit lever (hati)
Sakit ginjal
Sakit kencing manis
Tumor/ kanker
Lainnya…………………………….
Kulit, kuku, matakuning
Perut bengkak
Kaki bengkak
Badan lemas sering kesemutan
Lainnya…………………………….
Ya
Dulu ya, sekarang tidak
Terakhir minum…… bulan/ tahun yang lalu
3. Tidak pernah
1. Ciprofloxacin
2. Chloroquine
3. Diphenhidramin
4. Digoxin
5. Teofilin
6. Propanolol
7. Procainamide
8. Ephedrine
9. Pseudoephedrine
10. Lainnya………………………
1. Ya
2. Dulu ya, sekarang tidak.
Terakhir merokok …... bulan/tahun yang lalu
3. Tidak pernah
66
Lampiran 4. Data EKG
67
Lampiran 5. Hasil Analisis
68
69
70
71
Lampiran 6. Dokumentasi Penelitian
Gambar 10. Pencatatan biodata responden dan pengukuran
tekanan darah
Gambar 11. Pengukuran saturasi oksigen
72
Lampiran 7. Biodata Mahasiswa
Identitas
Nama
: Daisy Syakhsiatusy Syahiqoh
NIM
: 22010110120011
Tempat, tanggal lahir : Rembang, 26 Desember 1992
Jenis kelamin
: Perempuan
Alamat
: Bukit Cemara Residence 9L, Jl. Bulusan Selatan VII
No. HP
: 085229857060
e-mail
: leaf.leave.life@live.jp
Riwayat Pendidikan
SD
: MI An-Nashriyyah
Lulus tahun
2004
SMP : SMP N 1 Lasem
Lulus tahun
2007
SMA : SMA N 1 Rembang
Lulus tahun
2010
Fakultas Kedokteran Universitas Diponegoro
Masuk tahun 2010
1.
Vijayakumar S, Fareedullah M, Sudhakar Y, Venkateswarlu B, Kumar EA.
Current Review on Organophosphorus Poisoning. Arch. Appl. Sci. Res
2010;2:199-215.
2.
Sivagnanam S. Potential therapeutic agents in the management of
organophosphorus poisoning. Crit Care 2002;6:260-1.
3.
Schenker MB, Christiani D, Cormier Y, et al. Respiratory Health Hazards in
Agriculture. American Journal of Respiratory and Critical Care Medicine
1998;158:S1-S76.
4.
Mashali AA, Nounou HA, Sharara GM, Aziz MHA. Role Of Oxidative
Stress And Apoptosis In Acute Organophosphorus Intoxicated Patients. JMRI
2005;26:255-263.
5.
Bhat RV. Human health problems associated with current agricultural food
production. Asia Pac J Clin Nutr 2008;17 Suppl 1:91-4.
6.
Rahbar Taromsari M, Badsar A, Aghajankhah M, Akbar Poor M, Farhamand
Porkar N, Fallah Karkan M. The Study of Electrocardiographic Findings in
Patients with Organophosphate Poisoning. Iranian Jornal of Toxicology
2013;6:751-756.
7.
Lionte C, Bologa C, Sorodoc L. Advances in Electrocardiograms-Clinical
Applications. In: Toxic and Drug-Induced Changes of the Electrocardiogram.
Croatia: InTech, 2012.
8.
Abraham S, Oz N, Sahar R, Kadar T. QTc prolongation and cardiac lesions
following acute organophosphate poisoning in rats. Proc West Pharmacol Soc
2001;44:185-6.
9.
Anand S, Singh S, Nahar Saikia U, Bhalla A, Paul Sharma Y, Singh D.
Cardiac abnormalities in acute organophosphate poisoning. Clin Toxicol
(Phila) 2009;47:230-5.
10. Balouch GH, Yousfani AH, Jaffery MH, Devrajani BR, Shah SZA, Baloch
ZAQ. Electrocardiographical Manifestation of Acute Organophophate
Poisoning. World Appl. Sci. J 2012;16:1118-1122.
54
55
11. Karki
P,
Ansari
JA,
Bhandary
S,
Koirala
S.
Cardiac
and
electrocardiographical manifestations of acute organophosphate poisoning.
Singapore Med J 2004;45:385-9.
12. Mesude A, Ahmet S, Mehmet Oðuzhan A, et al. The relationship between
electrocardiographic changes, cholinesterase levels and mortality in acute
organophosphate poisoning. Cukurova Med J 2013;38:181-188.
13. Saadeh AM, Farsakh NA, al-Ali MK. Cardiac manifestations of acute
carbamate and organophosphate poisoning. Heart 1997;77:461-4.
14. Siu AYC, Tsoi LCH, Lo WCB, Chung CCH. QT Prolongation due to
Organophosphate Poisoning. Hong Kong j.emerg.med 2000;7:234-235.
15. Paul UK, Bhattacharyya AK. ECG manifestations in acute organophosphorus
poisoning. J Indian Med Assoc 2012;110:98, 107-8.
16. Yurumez Y, Yavuz Y, Saglam H, et al. Electrocardiographic findings of
acute organophosphate poisoning. J Emerg Med 2009;36:39-42.
17. Prasad DM. Correlation of Plasma Cholinesterase Levels with Mortality and
Morbidity
in
acute
Organophosphorus
Poisoning
Cases.
Belgaum
(Karnataka): KLE University, 2012.
18. Baydin A, Aygun D, Yazici M, Karatas A, Deniz T, Yardan T. Is there a
relationship between the blood cholinesterase and QTc interval in the patients
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LAMPIRAN
Lampiran 1. Ethical Clearance
62
63
Lampiran 2. Persetujuan Setelah Pemberitahuan
JUDUL PENELITIAN :
HUBUNGAN ANTARA KADAR
ASETILKOLINESTERASE DENGAN
GAMBARAN EKG PADA PETANI YANG
TERPAPAR KRONIK ORGANOFOSFAT
INSTANSI PELAKSANA:
BAGIAN FISIOLOGI FK UNDIP
Persetujuan Setelah Penjelasan
(INFORMED CONSENT)
Penelitian ini merupakan penelitian yang bertujuan mengetahui faktorfaktor yang berpengaruh terhadap terjadinya kelainan gambaran EKG pada petani
yang mengalami keracunan kronik organofosfat.
Pada penelitian ini akan dilakukan wawancara, pemeriksaan fisik,
elektrokardiografi dan pengambilan sampel darah. Kemungkinan terjadinya
komplikasi akibat penelitian ini sangat kecil karena dilakukan oleh tenaga terlatih.
Bapak/ Ibu/ Saudara bisa menolak apabila tidak setuju ikut serta dalam penelitian
ini. Apabila setuju untuk menjadi subjek penelitian, maka identitas Bapak/ Ibu/
Saudara akan kami rahasiakan. Seluruh biaya penelitian ditanggung oleh peneliti.
Peneliti juga akan memberikan imbalan sesuai dengan kemampuan peneliti.
Penanggung jawab penelitian adalah dr. Saekhol, dosen Bagian Ilmu
Kesehatan Masyarakat FK Undip. Alamat kantor: Jl. Prof. Dr. Soedarto,
Tembalang, Semarang.
Terima kasih atas kerjasama Bapak/ Ibu/ Saudara.
Setelah mendengar dan memahami penjelasan peneltian, dengan ini saya
menyatakan
SETUJU / TIDAK SETUJU
Untuk menjadi subjek penelitian
Semarang, 15 Maret 2014
Saksi
NamaTerang :
Alamat
: _________________
NamaTerang :
Alamat
: _________________
64
Lampiran 3. Kuesioner
No. :
Nama Pewawancara :
PENELITIAN HUBUNGAN ANTARA KADAR ASETILKOLINESTERASE DENGAN
GAMBARAN EKG PADA PETANI YANG TERPAPAR KRONIK ORGANOFOSFAT
(Isi atau lingkari nomor jawaban)
Sabtu, 15 Maret 2014
No Responden
Nama
Usia
Alamat
:
:
:
:
Lama tinggal di Kepakisan
Petani
:
:
Lama jadi petani
Menggunakan pestisida
semprot?
Alat pelindung diri yang dipakai
saat menyemprot (bisa lebih
dari 1 jawaban)
:
:
Bila pernah terkena tumpahan
pestisida, tindakan yang
dilakukan?
:
Adakah riwayat keracunan
pestisida
Bila ya, kapan?
:
:
:
Bila ada, apa pengobatan yang
didapatkan
:
Apakah saat terkena tumpahan,
terdapat gejala berikut (bisa
lebih dari 1 jawaban)
:
………………………. tahun
…………………………………………………………
……………...
…………………………………………………………
……………...
…………………………………………………………
……………...
………………………. tahun
1. Ya
2. Bukan
………………………. tahun
1. Ya
2. Tidak
1. Topi/ penutup kepala
2. Kacamata
3. Masker wajah
4. Sarung tangan plastik/ karet
5. Baju lengan panjang
6. Celana panjang
7. Sepatu boot
1. Mencuci dengan air
2. Mencuci dengan air dan sabun
3. Tidak melakukan apa-apa
4. lainnya: …………………………….
1. Ya, berapa kali …………………………….
2. Tidak
……………………………. hari/ bulan/ tahun yang
lalu
1. Dirawat di RS
2. Diobati di Puskesmas
3. Tidak berobat
4. Lainnya
1. Mengantuk
2. Sulit berkonsenstrasi
3. Bingung
4. Sulit bicara
5. Pusing berputar
6. Sakit kepala
65
7.
8.
9.
10.
11.
12.
13.
Badan lemah
Penglihatan kabur/ gelap
Sesak napas
Dada sakit/ sesak
Muntah
Diare
Lainnya…………………………….
Apakah saat ini terdapat gejala
berikut (bisa lebih dari 1
jawaban)
:
1. Mengantuk
2. Sulitber konsenstrasi
3. Bingung
4. Sulit bicara
5. Pusing berputar
6. Sakit kepala
7. Badan lemah
8. Penglihatan kabur/ gelap
9. Sesak napas
10. Dada sakit/ sesak
11. Muntah
12. Diare
13. Lainnya…………………………….
Penyakit yang pernah atau
sedang diderita
:
Adakah gejala berikut
:
Apakah minum alkohol
:
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
Apakah minum obat berikut (bisa
lebih dari 1 jawaban)
Apakah merokok
Sakit kuning/ sakit lever (hati)
Sakit ginjal
Sakit kencing manis
Tumor/ kanker
Lainnya…………………………….
Kulit, kuku, matakuning
Perut bengkak
Kaki bengkak
Badan lemas sering kesemutan
Lainnya…………………………….
Ya
Dulu ya, sekarang tidak
Terakhir minum…… bulan/ tahun yang lalu
3. Tidak pernah
1. Ciprofloxacin
2. Chloroquine
3. Diphenhidramin
4. Digoxin
5. Teofilin
6. Propanolol
7. Procainamide
8. Ephedrine
9. Pseudoephedrine
10. Lainnya………………………
1. Ya
2. Dulu ya, sekarang tidak.
Terakhir merokok …... bulan/tahun yang lalu
3. Tidak pernah
66
Lampiran 4. Data EKG
67
Lampiran 5. Hasil Analisis
68
69
70
71
Lampiran 6. Dokumentasi Penelitian
Gambar 10. Pencatatan biodata responden dan pengukuran
tekanan darah
Gambar 11. Pengukuran saturasi oksigen
72
Lampiran 7. Biodata Mahasiswa
Identitas
Nama
: Daisy Syakhsiatusy Syahiqoh
NIM
: 22010110120011
Tempat, tanggal lahir : Rembang, 26 Desember 1992
Jenis kelamin
: Perempuan
Alamat
: Bukit Cemara Residence 9L, Jl. Bulusan Selatan VII
No. HP
: 085229857060
: leaf.leave.life@live.jp
Riwayat Pendidikan
SD
: MI An-Nashriyyah
Lulus tahun
2004
SMP : SMP N 1 Lasem
Lulus tahun
2007
SMA : SMA N 1 Rembang
Lulus tahun
2010
Fakultas Kedokteran Universitas Diponegoro
Masuk tahun 2010