Medica Hospitalia : Journal of Clinical Medicine http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh <p style="background-color: transparent; box-sizing: border-box; color: rgba(0, 0, 0, 0.87); font-family: &amp;quot; noto sans&amp;quot;,-apple-system,blinkmacsystemfont,&amp;quot;segoe ui&amp;quot;,&amp;quot;roboto&amp;quot;,&amp;quot;oxygen-sans&amp;quot;,&amp;quot;ubuntu&amp;quot;,&amp;quot;cantarell&amp;quot;,&amp;quot;helvetica neue&amp;quot;,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; line-height: 25px; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px; margin: 0px 0px 20px 0px;">Medica Hospitalia: <em style="box-sizing: border-box;">Journal of Clinical Medicine</em>&nbsp;(P-ISSN: <a style="background-color: transparent; box-sizing: border-box; color: #007ab2;" title="p-ISSN" href="http://u.lipi.go.id/1436428853" target="_blank" rel="noopener">2301-4369</a>; e-ISSN: <a style="background-color: transparent; box-sizing: border-box; color: #007ab2;" href="http://u.lipi.go.id/1562578179" target="_blank" rel="noopener">2685-7898</a> ) adalah jurnal ilmiah yang diterbitkan RSUP Dr Kariadi dan menerima artikel ilmiah dalam bahasa Indonesia dan bahasa Inggris yang diharapkan dapat menjadi media untuk menyampaikan temuan dan inovasi ilmiah dibidang kedokteran atau kesehatan kepada para praktisi dan akedemisi di bidang kesehatan dan kedokteran.</p> <p style="background-color: transparent; box-sizing: border-box; color: rgba(0, 0, 0, 0.87); font-family: &amp;quot; noto sans&amp;quot;,-apple-system,blinkmacsystemfont,&amp;quot;segoe ui&amp;quot;,&amp;quot;roboto&amp;quot;,&amp;quot;oxygen-sans&amp;quot;,&amp;quot;ubuntu&amp;quot;,&amp;quot;cantarell&amp;quot;,&amp;quot;helvetica neue&amp;quot;,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; line-height: 25px; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px; margin: 20px 0px 20px 0px;">Medica Hospitalia: <em style="box-sizing: border-box;">Journal of Clinical Medicine</em>&nbsp; merupakan jurnal kesehatan mengenai berbagai aspek yang berkaitan dengan bidang kedokteran/ kesehatan yang berbasis klinis khususnya Rumah Sakit.</p> <p style="background-color: transparent; box-sizing: border-box; color: rgba(0, 0, 0, 0.87); font-family: &amp;quot; noto sans&amp;quot;,-apple-system,blinkmacsystemfont,&amp;quot;segoe ui&amp;quot;,&amp;quot;roboto&amp;quot;,&amp;quot;oxygen-sans&amp;quot;,&amp;quot;ubuntu&amp;quot;,&amp;quot;cantarell&amp;quot;,&amp;quot;helvetica neue&amp;quot;,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; line-height: 25px; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px; margin: 20px 0px 0px 0px;"><span style="background-color: transparent; box-sizing: border-box; color: #000000; cursor: text; display: inline; float: none; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">Medica Hospitalia: </span><em style="background-color: transparent; box-sizing: border-box; color: #000000; cursor: text; font-size: 14px; font-style: italic; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; outline-color: transparent; outline-style: none; outline-width: 0px; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">Journal of Clinical Medicine</em><span style="background-color: transparent; box-sizing: border-box; color: #000000; cursor: text; display: inline; float: none; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;"> sudah terindeks </span><a style="background-color: transparent; box-sizing: border-box; color: #007ab2; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" title="Google Scholar" href="https://scholar.google.co.id/citations?hl=id&amp;user=r_-HSA0AAAAJ" target="_blank" rel="noopener">Google Scholar</a></p> <p>&nbsp;DOI&nbsp;Medica Hospitalia: <em>Journal of Clinical Medicine : <a href="doi.org/10.36408/mhjcm" target="_blank" rel="noopener">http://doi.org/10.36408/mhjcm&nbsp; </a>&nbsp;</em></p> RSUP Dr. Kariadi en-US Medica Hospitalia : Journal of Clinical Medicine 2301-4369 <p><strong>PEMBERITAHUAN HAK CIPTA</strong></p> <ul> <li><strong>Hak Cipta</strong>:</li> </ul> <p>Penulis yang mempublikasikan naskahnya pada Medica Hospitalia: <em>Journal of Clinical Medicine</em> menyetujui ketentuan berikut:</p> <ol> <li>Hak cipta pada setiap artikel adalah milik penulis, begitu juga dengan hak untuk mempatenkan. 2. Penulis mengakui bahwa Medica Hospitalia: <em>Journal of Clinical Medicine</em> berhak sebagai yang mempublikasikan pertama kali.</li> <li>Penulis dapat memasukan tulisan secara terpisah, mengatur distribusi non-ekskulif dari naskah yang telah terbit di jurnal ini kedalam versi yang lain (misal: dikirim ke respository institusi penulis, publikasi kedalam buku, dll), dengan mengakui bahwa naskah telah terbit pertama kali pada Medica Hospitalia: <em>Journal of Clinical Medicine</em></li> </ol> <ul> <li><strong>Lisensi</strong> :</li> </ul> <p>Medica Hospitalia: <em>Journal of Clinical Medicine</em> didiseminasikan berdasarkan ketentuan lisensi Creative Commons Atribusi-NonKomersial 4.0 Internasional. Lisensi ini mengizinkan setiap orang untuk menyalin dan menyebarluaskan kembali materi ini dalam bentuk atau format apapun, menggubah, mengubah, dan membuat turunan dari materi ini untuk kepentingan apapun. Anda tidak dapat menggunakan materi ini untuk kepentingan komersial. Anda harus mencantumkan nama yang sesuai, mencantumkan tautan terhadap lisensi, dan menyatakan bahwa telah ada perubahan yang dilakukan. Anda dapat melakukan hal ini dengan cara yang sesuai, namun tidak mengisyaratkan bahwa pemberi lisensi mendukung Anda atau penggunaan Anda.</p> Risk Factors of Diabetic Retinopathy with Type 2 Diabetes Mellitus http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/596 <p><strong>BACKGROUND:</strong> More than 75% of people with type 2 DM will anguish diabetic retinopathy 20 years after being diagnosed. However, the current changing of people’s lifestyle contributes to the tendency in type 2 DM that diagnosed at a younger age. This causes diabetic retinopathy can be occurred earlier and blindness will occur more quickly. It is important to prevent diabetic retinopathy by controlling some associated factors.</p> <p><strong>OBJECTIVE:</strong> To investigate associated factors of diabetic retinopathy in people with type 2 DM.</p> <p><strong>METHOD: </strong>Analytic observational study with cross-sectional design. Subjects were determined by purposive sampling. The subjects were interviewed using a questionnaire meanwhile, funduscopic examination is aimed to assess diabetic retinopathy and followed by deep interview. This study also used the subject’s medical record to complete the required data. The results were analyzed by using statistic software.</p> <p><strong>RESULT:</strong> From 43 subjects, there wes no significant relation among age (p=0.965), gender (p=0.437), level of knowledge (p=0.640), accessibility (p=1.000), economic level (p=0.680), duration of DM (p=0.477), history of hypertension (p=0.708), and history of dyslipidemia (p=0.244) with diabetic retinopathy in people with type 2 DM. However, there was significant relation among controlling blood glucose (p=0.014) with diabetic retinopathy in people with type 2 DM. Uncontrolled blood glucose was 13 times more affected in diabetic retinopathy than controlled blood glucose (OR 13.417, 95% CI:1.474-122.117).</p> <p><strong>CONCLUSION:</strong> There was a significant relation between controlling blood glucose and diabetic retinopathy in people with type 2 DM. Controlling blood glucose is the most dominant risk factor among the other factors in this study.</p> <p><strong>Keywords</strong>: diabetic retinopathy; risk factor; type 2 diabetes mellitus</p> Nisa Khoirun Nafia Trilaksana Nugroho Arief Wildan Hari Peni Julianti Hery Djagat Purnomo ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 265 272 10.36408/mhjcm.v8i3.596 THE EFFECTIVENESS OF HYDROLYZED VCO CREAM ON VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) EXPRESSION AND COLLAGEN THICKNESS FOR HEALING 2ND DEGREE BURNS INJURY IN WISTAR RATS http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/561 <p><strong>ABSTRACT</strong></p> <p>&nbsp;&nbsp; Burn wounds remain a serious problem in several countries. The presence of burn wounds might trigger local or in severe cases also triggers systemic response. Immediate treatment is required to prevent further tissue damage. Silver sulfadiazine cream is commonly used as a burn therapy. However, long-time usage might cause negative side effects. Several effective alternatives with better safety are opted, including virgin coconut oil (VCO). Originating from <em>Cocos nucifera</em>, commonly known as the coconut plant, VCO is a product that contains a lot of beneficial substances, such as lauric acid, polyphenol, and alpha-tocopherol. Hydrolyzed VCO can be an alternative to topical drugs in second-degree burns as it increases Vascular Endothelial Growth Factor (VEGF) expression and collagen thickness in the burn wound healing phase.</p> <p>&nbsp;&nbsp; This randomized post-test only with parallel-group experiment was done using Wistar rats induced to a second-degree burn. The effect of 70% and 100% on second-degree burn healing, measured by hydrolyzed VCO on VEGF expression and collagen thickness was observed between 6 and 12 days of therapy. VEGF expression and collagen expression increased higher in groups treated with 70% and 100% hydrolyzed VCO compared with the control group treated with base cream.</p> Fahmi Syarif Neni Susilaningsih Yuriz Bakhtiar ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 273 280 10.36408/mhjcm.v8i3.561 GAMBARAN HISTOPATOLOGI KULIT TIKUS WISTAR PADA PERIODE DEKOMPOSISI TERHADAP SUHU UDARA YANG BERBEDA http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/595 <p><strong>LATAR BELAKANG :</strong> Salah satu tujuan pemeriksaan forensik pada jenazah adalah menentukan perkiraan waktu kematian. Perubahan pada tubuh manusia setelah mati dapat berkontribusi dalam penentuan waktu kematian, namun hal ini cukup sulit bila kondisi jenazah sudah memasuki tahap pembusukan. Banyak metode telah dikembangkan untuk penentuan waktu kematian secara kuantitatif. Jaringan kulit merupakan bagian paling luar dari tubuh manusia yang juga mengalami perubahan setelah kematian sehingga dapat digunakan sebagai petunjuk waktu kematian tanpa melakukan insisi yang luas pada tubuh.</p> <p><strong>TUJUAN :</strong> Penelitian ini bertujuan untuk mengetahui pengaruh suhu udara yang berbeda pada periode dekomposisi terhadap gambaran histopatologi kulit tikus wistar.&nbsp; Periode dekomposisi yang dipakai adalah 24, 48 dan 72 jam. Suhu yang dipakai adalah suhu rata-rata di kota Semarang tahun 2019 yaitu pada suhu 18<sup>0</sup>C, 28<sup>0</sup>C dan 39<sup>0</sup>C.</p> <p><strong>METODE :</strong> Penelitian analitik deskriptif dengan pendekatan ekperimental menggunakan kulit tikus wistar sebagai sampel. Sampel kemudian di analisa secara Patologi Anatomi dengan pewarnaan HE, dilihat epidermis, dermis, folikel rambut dan kelenjar sebasea dalam 5 lapang pandang besar untuk melihat derajat kerusakan menurut Carsana (0-5), kemudian dikategorikan menjadi kategori ringan, sedang dan berat. Data kemudian diolah dengan SPSS for windows versi 15.</p> <p><strong>HASIL : </strong>Perbadingan derajat kerusakan histopatologi kulit pada periode dekomposisi 24, 48 dan 72 jam terhadap suhu udara memberikan hasil yang signifikan dengan nilai p&lt;0,05. Demikian juga dengan hasil uji kelompok suhu dibandingkan dengan periode dekomposisi memberikan hasil yang signifikan pada suhu 28<sup>0</sup>C dan 39<sup>0</sup>C.</p> <p><strong>KESIMPULAN : </strong>Penelitian ini menunjukan peningkatan suhu udara dan periode dekomposisi berbanding lurus dengan gambaran kerusakan histopatologi kulit.</p> Marlion Anthonius Elim Intarniati Nur Rohma Julia Ike Haryanto Hermawan Istiadi ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 281 291 10.36408/mhjcm.v8i3.595 Effectivity of Exoskeleton Robot-Assisted Therapy on Improving Muscle Strength in Post-Stroke Patient http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/588 <p><strong>Background: </strong>Upper limb weakness is the most disability caused by stroke. The availability of physiotherapists is still limited in Indonesia. The exoskeleton robot is a developing technology that involve in stroke rehabilitation therapy.</p> <p><strong>Objective:</strong> To evaluate the effectiveness of exoskeleton robot-assisted therapy on improving muscle strength of patients after stroke.</p> <p><strong>Methods:</strong> An experimental study with two groups pre-test and post-test design carried out using consecutive sampling among outpatient stroke patients in Diponegoro National Hospital (RSND) and William Booth Hospital (RSWB), Semarang. Patients in the robotic group (RG) (n=8) received 16 training sessions. Each session consists of 30 passive and ten active-weighted elbow flexion-extension with the exoskeleton robot. Meanwhile, the control group (CG) (n=8) received equivalent training of conventional therapy. The primary outcome of muscle strength was measured by Manual Muscle Testing (MMT) and handheld dynamometer. Pre and post-test MMT score data in each group were analyzed by Wilcoxon test, while handheld dynamometer score data were analyzed by paired t-test. Data between the two groups were analyzed by Mann-Whitney test and unpaired t-test.</p> <p><strong>Results:</strong> Significant improvements were shown for the MMT score (RG: p=0.014, CG: p=0.034). There were significant handheld dynamometer score improvements on muscle strength for elbow flexor and extensor in RG (p = 0.008 and p = 0.005 respectively) and in CG (p=0.036 and p=0.008 respectively). No significant differences for MMT and handheld dynamometer score between the two groups.</p> <p><strong>Conclusion:</strong> The exoskeleton robot-assisted therapy was as effective as conventional therapy for improving muscle strength in stroke patients.</p> Aulia Salwa Alfaina Rahmi Isma Asmara Putri Hari Peni Julianti Trianggoro Budisulistyo Rifky Ismail ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 292 296 10.36408/mhjcm.v8i3.588 The Association Between Variants of Angiotensin Converting Enzyme (ACE) Gene With Risk Factors in Patients with Ischemic Stroke at Dr. Kariadi Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/565 <p><strong>BACKGROUND : </strong>Stroke is the leading cause of death and disability in the world. The occurrence of ischemic stroke is indicated by genetic factors, environmental factors and the interaction between it. Angiotensin Converting Enzyme (ACE) genetic variant is associated with various characteristics of risk factors for ischemic stroke.</p> <p><strong>OBJECTIVE </strong>: Identifying genetic variants of Angiotensin Converting Enzyme (ACE) with the Polymerase Chain Reaction (PCR) method and to find it’s correlation beetwen risk factor in patients with Ischemic Stroke at Dr. Kariadi Semarang</p> <p><strong>METHOD : </strong>The subjects of the study were 72 patients with ishcemic stroke who were treated at the polyclinic of the Neurology Department Dr. Kariadi Semarang in January - December 2013. DNA extraction of research subjects was carried out at the Laboratory of the Center of Biomedical Research (CEBIOR), Faculty of Medicine, Diponegoro University from January to March 2020. Amplification using the Polymerase Chain Reaction (PCR) method was carried out using an Eppendorf thermocycler. Data were analyzed with SPSS for Windows Version 25</p> <p><strong>RESULT : </strong>72 samples analyzed obtained genetic variants of ACE II 39 (54.2%) samples, genetic variants of ACE DI 30 samples (41.7%), and genetic variants of ACE DD 3 (4.2%) samples. Meanwhile, there was no significant relationship ( p&gt;0,05 ) between genetic variants of ACE and the characteristics of risk factors for ischemic stroke, namely age, gender, Body Mass Index, smoking history, triglyceride levels, HDL levels, LDL levels, obesity and hypertension.</p> <p><strong>CONCLUSION :</strong> There are three types of ACE genetic variants, including the ACE II genetic variant, the ACE DI genetic variant, and the ACE DD genetic variant. Among the three genetic variants, ACE II genetic variant is the most common variant and there is no significant relationship to the various risk factor characteristics found in ischemic stroke patients at Dr. Kariadi Gneeral Hospital Semarang.</p> Dodik Tugasworo Pramukarso Herlina Suryawati Soetedjo Soetedjo Jimmy Eko Budi Hartono Trianggoro Budisulistyo Arinta Puspita Wati Aditya Kurnianto Patria Adri Wibhawa ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 297 303 10.36408/mhjcm.v8i3.565 Aspirasi Trombus Selektif Memperbaiki Aliran Koroner dan Mengurangi Tingkat Badai Trombus pada Pasien Sindroma Koroner Akut Dengan Elevasi Segmen ST yang dilakukan Intervensi Koroner Perkutan Primer http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/583 <p><strong>Latar belakang:</strong> Embolisasi distal koroner berkontribusi terhadap tingginya kejadian kardiovaskular mayor (KKVM) pasca intervensi koroner perkutan primer (IKPP). Aspirasi trombus (AT) manual berpotensi mengurangi embolisasi distal dan memperbaiki perfusi mikrovaskular pada pasien sindroma koroner akut dengan elevasi segmen ST (SKA-EST), terutama pasien dengan badai trombus tinggi.</p> <p><strong>Tujuan:</strong> Mengetahui pengaruh aspirasi trombus selektif terhadap skor TIMI trombus dan luaran klinis pasca IKPP.</p> <p><strong>Metode:</strong> Penelitian retrospektif pada pasien SKA-EST dengan onset ?12 jam dan skor trombus TIMI awal ?3 yang menjalani IKPP dengan aspirasi trombus selektif di RSUP Dr. Kariadi periode Januari 2018 sampai Desember 2019. Luaran klinis yang diobservasi adalah KKVM selama rawat inap yang terdiri dari mortalitas, syok kardiogenik, edema paru akut, aritmia, revaskularisasi ulang, dan stroke.</p> <p><strong>Hasil: </strong>Sejumlah 100 pasien memenuhi kriteria, terdiri dari 50 pasien kelompok AT dan 50 pasien kelompok non-AT. Rerata skor trombus TIMI awal kelompok AT dan non-AT, masing-masing 4,76 dan 3,8 (<em>p</em>&lt;0,001). Kelompok AT mengalami penurunan skor trombus TIMI lebih baik dibanding non-AT (4,72 vs. 3,8, p&lt;0,001). Terdapat 8 (16%) pasien kelompok AT dan 11 (22%) pasien non-AT yang mengalami KKVM pasca IKPP (RR 1,08, IK 95% 0,89-1.30, p=0,44).</p> <p><strong>Kesimpulan: </strong>Aspirasi trombus selektif mungkin mengurangi tingkat badai thrombus. Aspirasi trombus mungkin menurunkan kejadian kardiovaskular mayor selama rawat inap pasca IKPP pada pasien dengan skor trombus TIMI di atas 4 setara dengan yang memiliki skor trombus TIMI kurang dari 4 tanpa aspirasi trombus.</p> Liborius Bramantyo Udin Bahrudin Pipin Ardhianto Ilham Uddin Sodiqur Rifqi ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 304 310 10.36408/mhjcm.v8i3.583 Relationship between Hypertension and Classification of Lumbar Herniated Nucleus Pulposus Based on Magnetic Resonance Imaging http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/598 <p><strong><em>ABSTRACT</em></strong></p> <p><strong><em>BACKGROUND </em>:</strong> <em>Hypertension is a disease that is known to affect other diseases. Recent research finds that HT is associated with disc degeneration disease. Herniated nucleus pulposus (HNP) lumbar as a result from disc degeneration disease need to be known to be affected by hypertension or not.</em></p> <p><strong><em>OBJECTIVE: </em></strong>&nbsp;<em>To know the relationship between hypertension and the classification of disc degeneration based on Pfirrmann’s criteria and herniated nucleus pulposus lumbar classification based on magnetic resonance imaging.</em></p> <p><strong><em>METHOD : </em></strong><em>This research use descriptive observational with cross sectional design. Subjects were 62 lumbar HNP patients diagnosed at RSUP Dr. Kariadi Semarang from January 2019 - March 2020. The subject data were analyzed using non-parametric Chi Square test and Mantel Haenszel test.</em></p> <p><strong>RESULT :</strong> Based on the analysis, it was found that p&gt;0.05 was found in the relationship between age and sex with the classification of disc degeneration and lumbar HNP. The result of correlation test between hypertension and disc degeneration classification is p&lt;0,05 with odds ratio 14,700 and lumbar HNP classification is p &gt;0.05. In relation to the classification of disc degeneration with lumbar HNP classification, the value of p &gt;0.05 was also obtained.</p> <p><strong><em>CONCLUSION</em></strong> <em>: </em><em>There was no association between age, sex, the classification of disc degeneration and lumbar HNP classification. There was a significant association between hypertension and the classification of disc degeneration with the individual risk of hypertension increasing 14,7 times but no association was found with lumbar HNP classification.</em></p> <p><strong><em>Keywords</em></strong><em>:</em><em> Disc degeneration; Hypertension; Lumbar herniated nucleus pulposus</em></p> Winda Putri Sunjata Yurida Binta Meutia Hermina Sukmaningtyas Dwi Pudjonarko ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 311 316 10.36408/mhjcm.v8i3.598 AUTOLOGOUS FULL THICKNESS SKIN GRAFT WOUND HEALING ON SPRAGUE DAWLEY RATS Reviewed From TGF-? Expression And Neutrophil Number http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/489 <p><strong>Abstract</strong></p> <p><strong>Introduction :</strong> Skin grafts are now one of treatment option in wound healing process that is always developing. TGF-bexpression and the number of neutrophils have an important role in healing skin graft wounds. Ozone (O<sub>3</sub>) has disinfecting properties that are effective in wound healing.</p> <p><strong>Objective :</strong> Proving the effectiveness of Ozonated VCO for Full Thickness Skin Graft wound healing using parameter of TGF-b expression and neutrophil number.</p> <p><strong>Method :</strong> This study is an experimental study with a post-test only design group of 40 Sprague Dawley rats performed autologous skin graft at the same time. Samples were divided randomly into 8 groups (K1 = without Ozonated VCO), (A1 = Ozonated VCO 50 mg / ml), (B1 = Ozonated VCO 100 mg / ml), (C1 = Ozonated VCO 200 mg / ml), ( K2 = without Ozonated VCO) (A2 = Ozonated VCO 50 mg / ml), (B2 = Ozonated VCO 100 mg / ml), (C2 = Ozonated VCO 200 mg / ml). Assessment of TGF-b expression and neutrophil number of tissue was performed by staining hematoxylin &amp; eosin and immunohistochemistry on days 6 and 12 after skin graft.</p> <p><strong>Results :</strong> There were significant differences (p &lt;0.05) TGF-b expression and neutrophils number of tissue between the control group and the administration of Ozonated VCO doses of 50 mg / ml, 100 mg / ml and 200 mg / ml on days 6 and 12 post skin graft.</p> <p><strong>Conclusion :</strong> The administration of Ozonated VCO effectively improve Full Thickness Skin Graft wound healing seen from macroscopic wounds, increase TGF-b expression and decrease the number of neutrophils.</p> Nauval Marta Kusuma Hardian Hardian Najatullah Najatullah Renni Yuniati Neni Susilaningsih ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 317 325 10.36408/mhjcm.v8i3.489 Dry Eyes Syndrome in Patients with Type 2 Diabetes Mellitus http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/592 <p><strong><em>BACKGROUND </em>:</strong> <em>Type 2 diabetes mellitus patients have risk to suffer from dry eyes syndrome (DES), caused by peripheral and autonomic neuropathy, oxidative stress, and metabolic dysfunction. DES can reduce the patient’s quality of life then it could induce blindness if the patient didn’t get any therapy for DES. It is important to prevent DES by controlling its risk factors.</em></p> <p><strong><em>OBJECTIVE : </em></strong>&nbsp;<em>To investigate risk factors of DES in patients with type 2 diabetes mellitus.</em></p> <p><strong><em>METHOD : </em></strong><em>. </em><em>This study was an analytical observational study with cross-sectional design and purposive sampling. Subjects were examined by using questionnaire and slit lamp, then followed by deep interview in some subjects. This study was also using subject’s medical record to complete the required data. Subjects were diagnosed to suffer DES if OSDI score &gt;12 and schirmer score &lt;10mm. Data was analyzed by using statistic software.</em></p> <p><strong>RESULT :</strong> . From 42 subjects, 19 subjects (45,2%) suffered from DES whereas another 23 subjects (54,8%) didn’t. There was significant relation between diabetic retinopathy (p=0.009) and DES in patients with type 2 diabetes mellitus showed by p value under 0,05 (OR 5.700, 95% CI:1.364-23.821). However, age (p=0.516), gender (p=1.000), level of knowledge (p=0.555), accessibility to health provider (p=1.000), occupation (p=0.644), economic level (p=0.105), smoke exposure (p=0.432), duration of diabetic (p=0.707), diabetic controlling (p=0.305), and history of dyslipidemia (p=0.155) had no significant relations with DES in patients with type 2 diabetes mellitus.</p> <p><strong><em>CONCLUSION</em></strong><em> : There is a significant relation between diabetic retinopathy and DES in patients with type 2 diabetes mellitus. Diabetic retinopathy is the most dominant risk factor among the other factors in this study.</em></p> Desti Putri Setyorini Arief Wildan Trilaksana Nugroho Hari Peni Julianti Heri-Nugroho HS ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 326 334 10.36408/mhjcm.v8i3.592 The Effect Radial Shock Wave Therapy on Median Nerve Gliding Exercise to Pain Degree and Hand Function in Patient with Carpal Tunnel Syndrome http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/616 <p><strong><em><u>Background</u></em></strong><em>: Carpal tunnel syndrome (CTS), which was resulted from local compression of the median nerve, was a common entrapment neuropathy. Median nerve gliding exercise required a combination of other conservative therapies to provide optimal clinical improvement in CTS. Radial shock wave therapy (RSWT) was a safe, effective, practical, and non-invasive therapeutic method, can be used as a additional therapy for relieving pain and disability in CTS patients.</em></p> <p><em>&nbsp;</em></p> <p><strong><em><u>Objective</u></em></strong><em>: This study was aimed to examine the effect of RSWT on median nerve gliding exercise on improving the degree of pain and hand functional scores in patients with CTS.</em></p> <p><em>&nbsp;</em></p> <p><strong><em><u>Method</u></em></strong><em>: This study was a randomized controlled trial. The subjects were 22 patients from the Physical Medicine and Rehabilitation Polyclinic of RSUD KRMT Wongsonegoro, Semarang. They were divided into 2 groups randomly. The intervention group (n=11) was received RSWT 4 times in median nerve gliding exercise 3 times a day, every day for 4 weeks. The control group (n=11) was received only median nerve gliding exercise. The degrees of pain were measured with a manual algometer and hand functional scores were assessed by BCTQ.</em></p> <p><em>&nbsp;</em></p> <p><strong><em><u>Results</u></em></strong><em>: The mean of improving pain degree were 2,53 <u>+</u> 0,74 kg/cm<sup>2</sup> and 2,38 <u>+</u> 1,25 kg/cm<sup>2 </sup>in intervention and control group, respectively. An independent t-test showed that there were significant differences in improving pain degree between intervention and control group (p=0,016). The mean of improving BCTQ scores were -11,36 <u>+</u> 4,59 and -6,18 <u>+</u> 3,76 in intervention and control group, respectively. An independent t-test showed that there were significant differences in improving BCTQ scores between intervention and control group (p=0,009). </em></p> <p><em>&nbsp;</em></p> <p><strong><em><u>Conclusion</u></em></strong><em>: RSWT was improved the degree of pain and increased the hand functional scores of CTS patients who received median nerve gliding exercises.</em></p> <p><em>&nbsp;</em></p> <p><strong><em><u>Keywords</u></em></strong><em>: radial shock wave therapy, carpal tunnel syndrome, gliding exercise</em></p> Nurika Amalina Lanny Indriastuti Hari Peni Julianti Hindun Zuhdiana Noviolita Dwi Kusumawati ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 335 343 10.36408/mhjcm.v8i3.616 Hubungan Kelelahan Terhadap Kualitas Hidup Anak Dengan Kanker Yang Menjalani Pengobatan http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/624 <p><strong><em>BACKGROUND </em></strong><strong>:</strong> <em>Cancer is a disease that can affect all age groups, including children. Children who suffer from cancer, must undergo various treatments to be able to kill the cancer cells in their bodies. One of the side effects of treatment is fatigue which can disrupt the quality of life in children with cancer. </em></p> <p><strong><em>OBJECTIVE: </em></strong>&nbsp;<em>The aim of this study was to identify whether fatigue can affect the quality of life in children with cancer</em><em>.</em></p> <p><strong><em>METHOD : </em></strong><em>This type of research is descriptive correlation with cross sectional design. The sample in this study were 45 people aged 2-18 years at the Indonesian Cancer Child Love Foundation (YKAKI) Riau. The sampling technique used was accidental sampling. Fatigue and quality of life in children with cancer were measured using the PedsQoL Multidimensional Fatigue Scale and the PedsQoL Generic 4.0. Data analysis used the Spearman rank test.</em></p> <p><strong>RESULT :</strong> The results showed that there was a relationship between fatigue and quality of life in children with cancer (p value = 0.031), and showed that the average fatigue score experienced by children with cancer who underwent treatment was 46.80 (the higher the fatigue score the less fatigue was felt), while the quality As many as 34 people (75.6%) of children with cancer have a disrupted quality of life. The results of this study are expected to be able to help improve the quality of life in children with cancer to reduce fatigue due to the treatment they are undergoing which can affect the quality of life in children</p> <p><strong><em>CONCLUSION </em></strong><em>: There is a significant relationship between fatigue and quality of life in children with cancer on treatment</em></p> Feny Julia Ambrella Agnita Utami Eka Wisanti ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 344 350 10.36408/mhjcm.v8i3.624 AUDIOGRAM PROFILE OF MDR-TB PATIENTS IN HASAN SADIKIN GENERAL HOSPITAL BANDUNG http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/613 <p><strong>BACKGROUND</strong>: Multidrug-resistant tuberculosis (MDR TB) is a disease condition of TB that resistant to isoniazid and rifampin, with or without resistance to other anti-tuberculosis drugs. An important problem arising from MDR TB therapy is the ototoxicity associated with use of aminoglycosides. Monitoring of hearing function is important to evaluate ototoxic effects.</p> <p><strong>OBJECTIVE</strong>: This study was conducted to determine the audiogram profile in MDR-TB patients who received kanamycin therapy in Dr. Hasan Sadikin General Hospital Bandung</p> <p><strong>METHODS</strong>: A retrospective descriptive study with a cross sectional design was conducted on MDR TB patients at Dr. Hasan Sadikin General Hospital Bandung (RSHS) Bandung. The inclusion criteria of this study is all medical records of MDR TB patients at the MDR TB polyclinic RSHS Bandung in the period January 1 - December 31 2018. Exclusions criteria were a history of tympanic membrane perforation, congenital ear abnormalities, hearing loss before therapy, and incomplete medical record data.</p> <p><strong>RESULTS</strong>: There were 97 patients in the study sample. MDR TB mostly affects the 18–34 year age group. At the end of the first month of therapy, audiogram changes were found in 9.3% of patients and in the fourth month, 22.7% of patients have sensorineural hearing loss with varying degrees.</p> <p><strong>CONCLUSION</strong>: Changes in the audiogram profile have occurred at the end of the first month of MDR TB therapy which is characterized by sensorineural hearing loss.</p> Anton Hilman Wijana wijana Ratna Anggraeni ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 351 355 10.36408/mhjcm.v8i3.613 Comorbid Factors Affecting the Outcome of Covid 19 in the Intensive Care Unit of Dr. Kariadi Hospital, Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/606 <p><strong><em>BACKGROUND :</em></strong><em> Sars-Cov2 has become a pandemic and caused health problems. Several factors that worsen the condition of Covid-19 include age, previous comorbid diseases, secondary infections, and increased inflammatory indicators. There are many studies on the factors that influence the outcome of Covid-19, but the results are inconsistent. Thus, specific research in certain areas is needed so that it can be used in local management.</em></p> <p><strong><em>OBJECTIVE: </em></strong><em>This study aims to determine the factors that influence the outcome of Covid-19 in the intensive care unit of the Dr. Kariadi Hospital </em></p> <p><strong><em>METHOD : </em></strong><em>This study analyzed covid 19 patients in the ICU of Dr Kariadi Hospital for the period March-September 2020 with a retrospective method and purposive sampling. The hypothesis test used is adjusted to the measurement scale of each variable. The initial analysis was univariate using chi-square, fisher, t-test, and mann-whitney. </em></p> <p><strong><em>RESULT :</em></strong><em> From this study, it was found that the factors that influence the covid-19 outcome in a bivariate include a history of heart disease (p = 0.037), temperature (p = 0.012), respiratory rate (p = 0.030), oxygen saturation (p = 0.021), platelets ( p = 0.015), ureum (p = 0.034), PO2 (p = 0.002), oxygen fraction (FiO2) (p = 0.034), AaDO2 (p = 0.004), and PFR (p = 0.001). </em></p> <p><strong>CONCLUSION</strong> : History of heart disease, temperature, respiratory rate, oxygen saturation, platelets, urea, PO2, required oxygen fraction (FiO2), AaDO2, and PFR were predictors of Covid-19 mortality which were both theoretically and statistically significant.,independent or simultaneously</p> Sofyan Harahap Harry Mulyono Danu Soesilowati ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 356 362 10.36408/mhjcm.v8i3.606 Keberhasilan Kehamilan Spontan Paska Tindakan Laparoskopi Kistektomi Pada berbagai Stadium Endometrioma http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/621 <p><strong>PENDAHULUAN : </strong>Penelitian ini bertujuan mengetahui tingkat keberhasilan spontan tanpa induksi ovulasi pada pasien yang telah mengalami operasi laparoskopi kistetomi dan adhesiolosis.</p> <p><strong>METODE</strong> : Penelitian dilakukan secara retrospektif selama 5 tahun (2015-2019) di RSIA Anugerah Semarang, didapatkan total 70 pasien yang sesuai dengan kriteria inklusi, dimana seluruh pasien dilakukan operasi secara laparoskopi oleh sistem operasi dan tim operasi yang sama.</p> <p>Teknik stripping untuk kistektomi dilakukan secara hati-hati melalui operasi laparoskopi dilanjutkan dengan rekonstruksi ovarium secara menjahit setelah dilakukan penghentian perdarahan mengunakan bipolar yang dikombinasikan dengan sistem irigasi. Dan tingkat keberhasilan kehamilan diikuti 6 bulan setelah operasi dan dicatat dalam catatan medis secara detail hingga cara persalinan.</p> <p><strong>HASIL :</strong> Dari total 70 pasien yang sesuai kriteria inklusi didapatkan rerata stadium endometrioma stadium adalah 2,87. Angka keberhasilan kehamilan spontan dari 70 pasien adalah 51,4 % dan hanya 17,1 % yang belum dapat hamil 6 bulan paska operasi sedangkan hanya 42,9 % yang harus ditolong dengan seksio sesaria.</p> <p><strong>KESIMPULAN : </strong>Dengan 68,6% terjadinya kehamilan spontan paska tindakan operasi laparoskopi, maka teknik operasi laparoskopi kistektomi disertai dengan rekontruksi ovarium dengan penjahitan merupakan tindakan yang aman meskipun dilakukan pada berbagai tingkat stadium endometrioma.</p> Indra Adi Susianto Barkah Fajar Riyadi Fajar Widhi Atmojo ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 356 362 10.36408/mhjcm.v8i3.621 Relation Between Pain Intensity and Functional Status of Low Back Pain Patients http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/649 <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">LATAR BELAKANG </span></span></strong><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">:</span></span></strong>&nbsp;<span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> Selama pandemi, pemerintah menetapkan Skala Besar Pembatasan Sosial (PSBB) peraturan untuk mengurangi kasus infeksi COVID-19, sehingga intensitas kejadian LBP meningkat lebih dari sebelumnya karantina, mencerminkan </span></span><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">ed</span></span>&nbsp;the negative effect of the regulation. This is due to significant lifestyle changes such as increased time spent sitting, reduced exercise time, and the percentage of individuals reporting more stress during quarantine than before the PSBB was established. The current study reports the impact of low back pain which results in disruption of the patient's functional status due to the need for annual medical expenses and the limited visits of patients to health services, so this indicates that low back pain sufferers need to evaluate how much functional disability occurs and the factors that influence it.</p> <p><strong>OBJECTIVE</strong><strong>&nbsp;</strong><strong>: </strong>To determine the relationship between pain intensity and functional status of LBP patients at the Neurology Polyclinic, RSUP Dr. Wahidin Sudirohosudo.</p> <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">METODE :</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> Observasi analitik dengan pendekatan cross sectional dan teknik pengambilan sampel adalah simple random sampling. </span><span style="vertical-align: inherit;">Data yang digunakan adalah kuesioner Numerical Rating Scale dan Barthel Index. </span><span style="vertical-align: inherit;">Penelitian ini dilaksanakan di </span></span><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">RSUP </span></span><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Dr. Wahidin Sudirohusodo selama dua bulan dimulai dari bulan Maret 2021 sampai dengan April 2021.</span></span></p> <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">HASIL :</span></span></strong>&nbsp;<span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> Pada hasil analisis data sampel menggunakan uji korelasi tau-b Kendall, nilai korelasi (-0,644) dengan nilai signifikansi hubungan (p.sig 0,000) menunjukkan adanya hubungan yang signifikan antara intensitas nyeri dengan status fungsional.</span></span></p> <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">KESIMPULAN</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> &nbsp;: </span></span><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Intensitas nyeri berhubungan bermakna dengan status fungsional pasien Low Back Pain (LBP) di RSUP Dr. </span><span style="vertical-align: inherit;">Wahidin Sudirohusodo</span></span></p> <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Kata kunci</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> : </span></span>&nbsp;<span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Low Back Pain, NRS, Barthel Index</span></span></p> Muhammad Naufal Zuhair Jumraini Tammasse Susi Aulina Muhammad Yunus Amran ##submission.copyrightStatement## 2021-11-05 2021-11-05 8 3 369 373 10.36408/mhjcm.v8i3.649 FAKTOR DETERMINAN PELAKSANAAN INISIASI MENYUSU DINI (IMD) OLEH BIDAN DI KABUPATEN BREBES http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/654 <p><strong><em>Background: </em></strong><em>One of the roles and functions of being a midwife is as an implementer, in which of being a health worker assisting in delivery assistance and has an important role to facilitate the mother in the successful implementation of Early Breastfeeding Initiation (Inisiasi Menyusui Dini or IMD).&nbsp; Delivery aids are performed by health personnel who possess midwifery competencies in Brebes Regency for about 98.30%.&nbsp; The percentage of early breastfeeding initiation in Brebes was 40.39%.</em></p> <p><strong><em>Purpose:</em></strong> <em>The purpose of this research is to know and analyze the </em><em>determinant </em><em>factors early breastfeeding initiation (IMD) implemented by midwives working for Public Health Center (Pusat Kesehatan Masyarakat or Puskesmas) in the working area of ??Brebes Regency Health Office.</em></p> <p><strong><em>Methods:</em></strong> <em>This type of research is observational research with survey method and cross sectional approach.&nbsp; The research instrument uses a structured questionnaire that has been tested for its validity and reliability.&nbsp; The research also uses bivariate analysis with chi-square test and multivariate analysis with logistic regression test.&nbsp; The sample is 213 respondents of village midwives in Brebes Regency.</em></p> <p><strong><em>Results:</em></strong><em> The results of logistic regression test showed that the variables affecting the implementation of early breastfeeding initiation were midwife age (OR 0.026 CI 95% 0,0050-0,14), training (OR 2.77 CI 95% 1,29-5,97 ) and duration of work (OR 9.63 CI 95% 3.85-24.1). While the factors that are not related to the implementation of IMD is the attitude, refreshing training, support, and policy superiors.</em></p> <p><strong><em>Conclusion:</em></strong><em> It can be concluded that the most influential variable on initiation of early breastfeeding is length of work (OR 9.63 CI 95% 3,85-24,1).</em></p> <p>&nbsp;</p> Ziyadatul Chusna Almabruroh Yuni Alfi Kun Aristiati Susiloretni Ngadiyono Ngadiyono Mardiyono Mardiyono ##submission.copyrightStatement## 2021-11-10 2021-11-10 8 3 374 383 10.36408/mhjcm.v8i3.654 Polip Fibroepithelial di Leher Kandung Kemih Pada Anak : Laporan kasus http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/675 <p><strong>Latar Belakang</strong> : <em>Fibroepithelial polyps</em> (FEP) adalah tumor jinak non-epitel yang sangat jarang yang berasal dari mesodermal di sistem perkemihan. Insidensi FEP tersering pada Dewasa muda (40%). Sebagian besar FEP ditemui di ureter distal, 15% terletak di pelvis renalis; FEP lebih jarang ditemukan di uretra, kandung kemih, dan ureter proksimal. &nbsp;Polip dengan fitur ini jarang ditemukan pada anak-anak. Kasus ini diharapkan dapat menjadi gambaran untuk menangani kasus FEP terutama bila predileksi di vesika urinaria.</p> <p><strong>Laporan Kasus</strong> : seorang anak umur dua tahun dengan keluhan sulit buang air kecil disertai nyeri. Pasien pernah mengeluh&nbsp; buang air kecil disertai darah. Dilakukan pemeriksaan&nbsp; <em>ultrasonography</em> pada <em>lower abdomen </em>didapatkan massa dan hidronefrosis bilateral. Pasien dilakukan <em>cystoscopy </em>dengan pengambilan sampel biopsi. Hasil patologi anatomi menunjukan gambaran FEP.</p> <p><strong>Diskusi</strong> :. Kasus tumor vesica urinaria primer jinak jarang ditemukan dan di antara tumor jinak vesica urinaria, polip fibroepitel dianggap sebagai lesi yang paling umum. <em>Guideline</em> konsensus dalam tatalaksana manajemen optimal tumor FEP masih jarang, saat ini eksisi melalui <em>cystoscopy </em>paling sering digunakan. Modalitas baru dengan menggunakan Laser baik Thalium maupun Holmium.</p> <p><strong>Kesimpulan</strong> : FEP merupakan penyakit yang jarang prevalensinya tetapi tetap menjadi diferensial diagnosis pada pasien anak dengan nyeri pinggang dan hematuria.prosedur endoskopik sebagai modalitas penatalaksaan pilihan utama pada pasien FEB.</p> Sofyan Rais Addin Eriawan Agung Nugroho M. Adi Sudarso Ardy Santosa Nanda Daniswara Krisna Muhammad Jonathan Sugiharto ##submission.copyrightStatement## 2021-11-17 2021-11-17 8 3 384 387 10.36408/mhjcm.v8i3.675 Etiologi Dan Patofisiologi Kasus Intractable Hiccups Pada Pasien Laki-Laki 57 Tahun http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/676 <p><strong>Latar belakang</strong> <strong>&nbsp;</strong>: <em>Hiccup</em> adalah hembusan napas yang mengacu dari suara yang dihasilkan kontraksi diafragma dan otot intercostal secara tidak sadar dan mendadak dilanjutkan dengan kontraksi mendadak dari glotis. <em>Hiccup</em> merupakan gejala yang biasa dikenal setiap orang namun tetap merupakan gejala patologis.</p> <p><strong>Laporan kasus</strong> : Dilaporkan laki laki usia 57 tahun dengan cegukan sejak 1 tahun. Pemeriksaan laringoskopi fleksibel menunjukkan adanya LPR (RFS 15). Pasien didiagnosis LPR dan<em> intractable</em> <em>hiccup</em> ec susp gangguan sentral (CNS), diagnosis banding psikogenik. Pasien diberikan terapi metochlopramid dan chlorpromazine selama 5 hari. Hasil evaluasi pasien mengeluh cegukan tidak berkurang. Pasien lalu diberikan terapi omeprazole 20 mg per 12 jam.</p> <p><strong>Pembahasan</strong> : <em>Persistent</em> dan <em>intractable</em> <em>hiccup</em> merupakan gejala yang sulit diobati, bila penyebab diketahui maka diobati sesuai penyebabnya, namun bila penyebab tidak diketahui terapi empiris dilakukan untuk menekan GERD sehingga gejala <em>hiccup</em> perbaikan. Apabila terapi ini gagal agen farmakologi ditujukan ke reseptor dopaminergik dan GABA-ergik.</p> <p><strong>Kesimpulan : </strong>Penatalaksanaan <em>hiccup</em> perlu diketahui etiologi terutama gangguan LPR, GERD dan CNS hingga perlu penanganan multidisipliner dari bagian THT, interna, neurologi dan psikiatri.</p> Desy Iriani Dwi Antono Muyassaroh Muyassaraoh ##submission.copyrightStatement## 2021-11-17 2021-11-17 8 3 388 394 10.36408/mhjcm.v8i3.676 Laporan Kasus Butterfly gliobasltoma pada Laki-Laki Usia 24 Tahun http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/678 <p><strong>Pendahuluan</strong></p> <p>Butterfly Glioma adalah high grade astrocytoma, biasanya glioblastoma (WHO grade IV), yang melintasi garis tengah melalui corpus callosum. Komissura white matter lainnya kadang juga terlibat. Istilah kupu-kupu mengacu pada ekstensi yang melewati garis tengah seperti sayap. Butterfly Glioma paling sering terjadi di lobus frontal, melintasi garis tengah melalui genu corpus callosum, namun butterfly glioma posterior kadang juga ditemui.</p> <p><strong>Laporan kasus</strong></p> <p>Seorang pasien laki-laki usia 24 tahun dengan keluhan utama 9 bulan, yang lalu. Penglihatan kabur, konsentrasi menurun. Kejang(-). Kemudian 3 bulan yang lalu mata tidak bisa melihat. Dan 1 bulan yang lalu tubuh lemas susah digerakkan</p> <p>Pemeriksaan patologi anatomi menunjukkan Pylocytic Astrocytoma. Pemeriksaan CT scan kepala menunjukkan &nbsp;Massa solid inhomogen intraxial</p> <p>( ukuran ± AP 7,6 x 8,9 x CC 6,2 cm ) disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema curiga gambaran glioblastoma multiformis. &nbsp;</p> <p><strong>Pembahasan</strong></p> <p>Hasil pemeriksaan anamnesis dan pemeriksaan fisik pasien ini menunjukkan kecurigaan adanya SOL. Pemeriksaan CT scan kepala menunjukkan &nbsp;Massa solid inhomogen intraxial disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema curiga gambaran glioblastoma multiformis. Dari PA didapatkan hasil Pilocytic astrocytoma. Sedangkan gambaran radiologi Pilocytic astrocytoma berupa lesi kistik dengan nodul mural yang enhanced. Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan.. Modalitas imejing pilihan yang dapat dilakukan pada kasus Butterfly Glioblastoma adalah CT scan dan MRI.</p> <p><strong>Kesimpulan </strong></p> <p>Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan. Dan pemeriksaan radiologis yang dapat digunakan pada Butterfly Glioblastoma adalah CT scan dan MRI.</p> Dewa Kartika Baskoro Nurdopo ##submission.copyrightStatement## 2021-11-17 2021-11-17 8 3 395 411 10.36408/mhjcm.v8i3.678 A Toddler with Juvenile Ocular Myasthenia Gravis: Clinical Experience http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/679 <p><strong>Background</strong>:Myasthenia gravis&nbsp;is an extremely rare&nbsp; autoimmune disorder affecting the neuromuscular junction. The incidence rate is 0.9-2.0 cases per 1 million children per year.Ocular myasthenia gravispresents as ptosis with extraocular motility restriction and is prone to be misdiagnosed as third nerve palsy and is difficult to diagnose in very young children.</p> <p><strong>Case: </strong>A girl aged 2 years 6 months with clinical features with bilateral ptosis and was diagnosed as juvenile ocular myastenia gravis &nbsp;based on history, physical examination and other diagnostic proceduressuch as chest X-raywithin normal limit and no thymoma, the ice test showed positive result, electromyography (EMG) showed decrement response &gt;10%,progstigmin test showed positive result,&nbsp; andserum acetylcholine receptor antibody levels was 0.43 nmol/L (reference range : positive as &gt;0.40 nmol/L).</p> <p><strong>Conclusion:</strong>Juvenile ocular myastenia gravis diagnostics can be established using simple examinations such as ice tests,prostigmin test to sophisticated examinations as systemic acetylcholinesterase antibodies. Management begins with a first-line drug, pyridostigmine, that is safe and effective. Disease monitoring and looking for etiology are very important for successful treatment.</p> Alifiani Hikmah Putranti Rr.Kartika Dwi Septieningtyas ##submission.copyrightStatement## 2021-11-17 2021-11-17 8 3 412 415 10.36408/mhjcm.v8i3.679 Full Text Volume 8 Nomor 3 November 2021 http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/683 <p>Full Text Volume 8 Nomor 3 November 2021</p> Kariadi General Hospital ##submission.copyrightStatement## 2021-11-30 2021-11-30 8 3 10.36408/mhjcm.v8i3.683