Penelitian ini bertujuan untuk menilai kesesuaian antara dacryoscintigraphy dibandingkan dacryocystography sebagai pemeriksaan penunjang pada pasien obstruksi duktus nasolakrimal primer didapat (PANDO). Penelitian ini merupakan suatu studi diagnostik pada pasien tersangka PANDO dengan epiphora yang datang ke poliklinik Plastik dan Rekonstruksi RSCM Kirana. Pasien tersebut selanjutnya dikirim ke Departemen Radiologi untuk pemeriksaan dacryoscintigraphy dan dacryocystography. Selanjutnya dengan observasi dan kuesioner dinilai efek samping dan kenyamanan terhadap kedua pemeriksaan.
Penelitian ini merekrut 31 subjek (62 mata). Melalui tes irigasi dan sondase didapatkan 47 mata tersangka PANDO. Sebanyak 87.1% subjek berjenis kelamin perempuan, dengan kelompok umur terbanyak (74.2%) yaitu >40 tahun. Pada pemeriksaan dacryoscintigraphy, waktu yang dibutuhkan untuk mencapai sakus yaitu 0 menit, duktus (5 menit), dan kavum nasi (12.5 menit). Nilai kesesuaian antara kedua pemeriksaan dalam menentukan ada atau tidaknya obstruksi sebesar 83.8% (strong agreement), sedangkan dalam menentukan letak obstruksi sebesar 70.9% (agreement).
Pada pemeriksaan dacryoscintigraphy tidak ditemukan adanya efek samping, sedangkan pada dacryocystography, terdapat 2 pasien yang menunjukan hiperemis konjungtiva. Terdapat 22 subjek mengeluhkan nyeri saat pemeriksaan dacryocystography, sedangkan tidak ada subjek yang mengeluhkan nyeri saat pemeriksaan dacryoscintigraphy (p<0.005). Sebanyak 16 subjek menyatakan dacryoscintigraphy lebih nyaman, 11 subjek menyatakan dacryocystography lebih nyaman, sedangkan 4 subjek menyatakan kedua pemeriksaan sama nyamannya. Dacryoscintigraphy memiliki nilai kesesuaian yang baik dengan dacryocystography dalam menentukan ada atau tidak obstruksi dan menentukan letak obstruksi pada pasien PANDO. Kedua pemeriksaan tersebut mempunyai tingkat kenyamanan yang sama, namun pemeriksaan dacryocystography dirasakan lebih nyeri sewaktu atau durante tindakan dibandingkan dengan dacryoscintigraphy.
This study aims to assess conformity of dacryoscintigraphy compared to dacryocystography as supporting assessment in patient with primary acquired nasolacrimal duct obstruction (PANDO). This diagnostic study performed in PANDO with epiphora complaint whose visiting RSCM Kirana Plastic and Reconstruction Division. Subsequently, subjects were sent to Radiology Department for dacryoscintigraphy and dacryocystography examinations. After the examination, observation and questionnaire assessed the side effects and comfort of both examinations.
This study recruited 31 subjects (62 eyes). Through irrigation and probing, there were 47 eyes found with PANDO. As much as 87.1% subjects were female, with mostly (74.2%) aged >40 years old. With dacryoscintigraph, time needed to reach sac was 0 minutes, duct was 5 minutes, and nasal cavum was 12.5 minutes. Conformity value between the two examinations in detecting obstruction was 83.8%, meanwhile in detecting the location of obstruction was 70.9%.
With dacryoscintigraph, there were no side effects found. Meanwhile with dacryocystograph, there were 2 patients found with conjunctival hyperemia. There were 22 subjects complaining with pain at dacryocystograph examination, while there were none at dacryoscintigraph examination (p<0.005). Sixteen subjects feel dacryoscintigraph examination was more convenient, eleven subjects feel dacryocystohraph examination was more convenient, while 4 subjects feel the two examinations just as convenient.
Dacryoscintigraph has good conformity value with dacryocystograph examination in detecting obstruction and defining the location in PANDO patients. Both examinations have high convenience level, even though dacryocystograph was more painful at the examination than dacryoscintigraph.
"Cholelithiasis is one of the major health problems of gastrointestinal system at the global level. This is due to changes in peoples lifestyles including decreased physical activity and inappropriate dietary patterns. One of the surgical treatments performed on cholelithiasis patients is laparoscopic cholecystectomy. The aims of this study is to analyse the nursing care of pre-laparoscopic cholecystectomy patients by applying deep breathing relaxation intervention to overcome the preoperative anxiety problem. Besides that, another intervention that is recommended based on evidence-based practice studies is the use of intervention of music therapy to reduce anxiety in pre-laparoscopic cholecystectomy patients. Combining the application of deep breathing relaxation and music therapy is expected to be applied by nurses, especially for patients who will undergo laparoscopic cholecystectomy to overcome the problem of preoperative anxiety."