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&nbsp; &nbsp;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> en-US <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> mayanuriyawidyasari@yahoo.com (Maya Nuriya Widyasari) medica.hospitalia@yahoo.com (Aziz Alfarisy) Wed, 15 May 2019 00:00:00 +0700 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 Komponen Glasgow Coma Scale (GCS) Dan Saturasi Oksigen Sebagai Prediktor Kematian Pada Pasien Cedera Kepala Di RSUP Dr. Kariadi Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/370 <p><strong>Abstrak</strong></p> <p><strong>Latar belakang :</strong> Angka kejadian dan kematian pasien cedera kepala cukup tinggi, sehingga menuntut pelayanan yang lebih baik, disisi lain fasilitas perawatan, terutama perawatan intensif (ICU) terbatas. Hal ini mengakibatkan rumah sakit harus melakukan seleksi terhadap pasien yang akan masuk ke ruang perawatan intensif. Prediktor kematian dapat digunakan sebagai salah satu alat untuk melakukan seleksi tersebut. Penelitian ini bertujuan untuk mendapatkan sebuah model prediksi kematian pada pasien murni cedera kepala dengan menggunakan pemeriksaan standar yang ada di Instalasi Gawat Darurat, terutama pada saat sebagian komponen GCS tidak dapat dinilai.</p> <p><strong>Metode :</strong> Penelitian ini menggunakan desain observasional dengan pendekatan prospektif. Responden ditentukan berjumlah 49 pasien. Analisis data dengan uji <em>spearman</em>, uji <em>lambda</em>, multivariat regresi logistik.</p> <p><strong>Hasil :</strong> Didapatkan korelasi yang bermakna antara semua variabel bebas dengan kematian pasien, GCS-E (p=0,011, r=0,647); GCS-V (p=0,002, r=0,647); GCS-M (p=0,008, r=0,529); SaO2 (p=0,022, r=0,429). Semua komponen GCS dapat digunakan untuk memprediksi probabilitas kematian pasien cedera kepala bersama dengan SaO2.</p> <p><strong>Simpulan :</strong> Semua komponen GCS dan saturasi oksigen dapat digunakan sebagai prediktor kematian pasien cedera kepala.</p> <p>&nbsp;</p> <p><strong>Kata Kunci</strong>: cedera kepala, prediktor kematian, komponen GCS.</p> <p><strong>&nbsp;</strong></p> <p><strong>Background</strong> <strong>:</strong> The number of incidence and mortality of patients with traumatic brain injury (TBI) is high, so it is called for better service, on the other hand healthcare care facilities, particularly bed of intensive care unit (ICU) limited. So often the hospital should perform a selection against patients. Mortality predictors can be used as tool for selection. The aims of this research is to gain a predictive model of mortality in isolative TBI patients using a standardized examination in Emergency Department, especially when part of&nbsp; GCS can’t be assesed. <strong>Methods :</strong> Design of this study is a observational study with prospective approach. Respondents totaled 49 person. Data analysis being performed with <em>spearman test</em>, <em>lambda test</em>, <em>Multivariate logistic regression</em>. <strong>Results :</strong> Correlation between all the independence variables with mortality of the patient, GCS-E (p=0,011, r=0,647); GCS-V (p=0,002, r=0,647); GCS-M (p=0,008, r=0,529); SaO2 (p=0,022, r=0,429). The all components of the GCS, SaO2 can be used to predict the probability of death of the patient injury head. <strong>Conclusion :</strong> GCS components and oxygen saturation can be used as mortality predictor on patients with traumatic brain injury.&nbsp;</p> <p><strong>Keywords</strong> : Traumatic brain injury, mortality predictor, components of GCS</p> <p>&nbsp;</p> <p>&nbsp;</p> Sumarno Sumarno, Moch Hidajat, Ika Setyo Rini ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/370 Fri, 20 Sep 2019 04:21:59 +0700 Pengaruh Suplementasi Ekstrak Ikan Gabus (Channa Striata ) Terhadap Kadar Albumin, Kolesterol, Waktu Remisi Dan Kejadian Relaps Pada Anak Sindrom Nefrotik http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/371 <p><strong>Background : </strong>Nephrotic syndrome (NS) is common in children with massive proteinuria causing severe hypoalbuminemia and hypercholesterolemia. Various attempts are required to increase albunin serum, accelerate remission time, and prevent relapse in order to reduce kidney damage. The <em>Channa striata</em> extract is known for its benefits in increasing albumin levels.</p> <p><strong>Objective : </strong>To prove <em>channa striata</em> extract supplementation effect in increasing albumin serum, reducing cholesterol serum, remission and relapse time in children with NS.</p> <p><strong>Methods :</strong>This is a double blind randomized controlled trial pre and post test design, 60 children with NS aged 1-15 years were included. A total of 500 mg / day <em>channa striata</em> extract capsule supplementation were administrated 2x1 to the treatment group for 21 days, meanwhile control group received placebo. Children with other chronic disease and with steroid resistance NS were excluded. The outcomes were serum albumin, cholesterol levels, remission and relapse time. Analysis data of albumin and cholesterol was performed by using unpaired t test and Mann-Whitney test. Remission and relapse times were analyzed by chi-square test.</p> <p><strong>Results:</strong> There are 60 children met the inclusion criteria (32 children received Channa extract and 28 children were given placebo). Increased albumin level after supplementation was 3,6<u>+</u>0.8 g/dL(<em>p</em>&lt;0.05) higher compared to placebo group 3,2<u>+</u>0.8 g/dL( <em>p</em>&lt;0.05). Decreased levels of total cholesterol between the two groups were not significant (<em>p</em>&gt;0.05). The treatment group remission time was 8.4<u>+</u>2.9 days, 11.0<u>+</u>3.7 day faster compared to placebo group (p &lt;0.05). Relapse in the treatment group (21.4%) were similar to the placebo group (21.9%) (<em>p</em>&gt; 0.05).</p> <p><strong>Conclusions</strong>: <em>Channa striata</em> extract supplementation 3x500 mg/day for 21 days is effective to increase albumin levels and accelerate remission time significantly. Decreased cholesterol serum and relapse were not significant.</p> <p><strong>Keywords</strong>: nephrotic syndrome, channa striata extract, albumin, cholesterol, remission time, relapse</p> <p>&nbsp;</p> <p><strong>Latar Belakang: </strong>Sindrom nefrotik (SN) banyak dijumpai pada anak dengan proteinuria masif yang menyebabkan hipoalbuminemia berat dan hiperkolesterolemia. Diperlukan upaya meningkatkan kadar albumin, mempercepat waktu remisi dan mencegah relaps guna mengurangi kerusakan ginjal. Ekstrak ikan gabus (EIG)/<em>Channa striata</em>) diketahui dapat meningkatkan kadar albumin.</p> <p><strong>Tujuan: </strong>Membuktikan pengaruh suplementasi EIG terhadap peningkatan kadar albumin, penurunan kolesterol,waktu remisi dan kejadian relaps pada anak SN.</p> <p><strong>Metode: </strong>Penelitian <em>r</em><em>andomized </em><em>co</em><em>ntrolled </em><em>t</em><em>rial pre and post test design</em>, tersamar ganda, dilakukan mulai Maret-November 2017 terhadap 70 anak SN usia 1-15 tahun, terbagi menjadi 35 anak kelompok suplementasi EIG 2x500 mg/hari selama 21 hari; 35 anak kelompok kontrol. Anak dengan penyakit kronis lain, anak dengan resisten steroid di eksklusi. Luaran yang diteliti adalah kadar albumin, kolesterol, waktu remisi dan kejadian relaps. Analisis data kadar albumin dan kolesterol dengan uji t tidak berpasangan dan uji <em>Mann-Whitney</em>, waktu remisi dan kejadian relaps dengan uji <em>Chi-Square</em>.</p> <p><strong>Hasil:</strong> Enam puluh subyek masuk kriteria penelitian (32 di kelompok EIG dan 28 di kelompok plasebo). Peningkatan kadar albumin setelah pemberian EIG 3,6<u>+</u>0,8 g/dL lebih tinggi dibanding kontrol 3,2<u>+</u>0,8 g/dL (<em>p</em>&lt;0,05). Penurunan kadar kolesterol total diantara dua kelompok didapatkan nilai <em>p</em>&gt;0,05. Waktu remisi kelompok EIG 8,4<u>+</u>2,9 hari, lebih cepat dibanding kontrol 11,0<u>+</u>3,7 hari (<em>p</em>&lt;0,05). Kejadian relaps kelompok EIG (21,4%) sama dengan kontrol (21,9%) (<em>p</em>&gt;0,05).</p> <p><strong>Kes</strong><strong>impulan: </strong>Suplementasi EIG 2x500 mg/hari selama 21 hari, efektif meningkatkan kadar albumin dan mempercepat waktu remisi secara bermakna. Penurunan kadar kolesterol dan kejadian relaps tidak bermakna.</p> <p><strong>Kata kunci: </strong>sindrom nefrotik, ekstrak ikan gabus, albumin, kolesterol, waktu remisi, relaps</p> Muhammad Heru Muryawan, Ag Soemantri, Hertanto Wahyu Subagio, Nanan Sekarwana ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/371 Fri, 20 Sep 2019 04:40:49 +0700 Pengaruh Posisi Tidur Semi Fowler 450 Terhadap Kenaikan Nilai Saturasi Oksigen Pada Pasien Gagal Jantung Kongestif Di RSUD Loekmono Hadi Kudus http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/372 <p><strong><em>&nbsp;Background : </em></strong><em>Congestive Heart Failure (CHF) is a physiological condition where the heart is unable to pump enough blood to fullfill the metabolic needs of the body that cause some clinical symptoms felt by clients such as dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) shortness of breath at night day. The most effective position for clients with congestive heart failure disease is 45<sup>0</sup> degree slope semi Fowler position, using gravity to aid lung compliance and reduce the pressure of the abdominal diaphragm. </em></p> <p><em>&nbsp;</em><strong><em>Aim:</em></strong><em>&nbsp;This study is to determine the effect of 45<sup>0</sup> semi Fowler bed position to increase the value of oxygen saturation in patients with congestive heart failure in dr. Loekmono Hadi Kudus General Hospital. The type of this research is to draft Experimental Pre-Pre and Post Test One Group Design. Conducted on 16 respondents with total sampling technique that met the inclusion criteria. </em></p> <p><strong><em>Methods:</em></strong><em> The research data were analyzed using dependent t-test. </em></p> <p><em>&nbsp;</em></p> <p><strong><em>Result :</em></strong><em> The result showed the difference in median 2 L / s average 2%, which use oxygen 3 L / s average 1%, and that does not use oxygen to experience average increase of 1%. 45<sup>0</sup> semi Fowler bed position has an effect&nbsp; to increase the value of oxygen saturation in patients with congestive heart failure. </em></p> <p><strong><em>Conclution :</em></strong><em> The study recommends to give 45<sup>0</sup> semi Fowler bed position to patients with congestive heart failure with decreased oxygen saturation.</em></p> <p><strong><em>Keywords:</em></strong><em> 45<sup>0</sup> semi Fowler bed position; CHF; SpO<sub>2&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</sub></em></p> <p><em><sub>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</sub></em></p> <p><strong><em>Latar Belakang</em></strong><em> : Congestive Heart Failure (CHF) </em>merupakan suatu kondisi fisiologis ketika jantung tidak mampu memompa darah yang cukup untuk memenuhi kebutuhan metabolik tubuh yang menimbulkan beberapa gejala klinis yang dirasakan klien beberapa diantaranya <em>dispnea, ortopnea, paroxysmal nocturnal dispnea (PND) </em>sesak nafas pada malam hari. Posisi yang paling efektif bagi klien dengan penyakit gagal jantung kongestif adalah posisi semi Fowler dengan derajat kemiringan 45<sup>0</sup>, yaitu dengan menggunakan gaya gravitasi untuk membantu pengembangan paru dan mengurangi tekanan dari <em>abdomen </em>pada <em>diafragma.</em></p> <p><strong>Tujuan</strong> : Penelitian ini untuk mengetahui pengaruh posisi tidur semi Fowler 45<sup>0 </sup>terhadap kenaikan nilai saturasi oksigen pada pasien gagal jantung kongestif di RSUD dr. Loekmono Hadi Kudus</p> <p><strong>Metode</strong> : Jenis penelitian ini adalah <em>Pra – Experimental </em>dengan rancangan <em>Pre&nbsp; and Post Test One Group Design. </em>Dilakukan pada 16 responden dengan tehnik total sampling yang memenuhi kriteria inklusi. Data penelitian di analisa menggunakan uji <em>dependent t – test. </em></p> <p><strong><em>Hasil</em></strong><em> : </em>Hasil penelitian didapatkan selisih median2 L/m rata – rata mengalami kenaikan 2%, yang menggunakan oksigen 3 L/m rata – rata mengalami kenaikan 1% dan yang tidak menggunakan oksigen mengalami rata – rata kenaikan 1%.</p> <p><strong>Kesimpulan</strong> : Ada pengaruh posisi tidur semi Fowler 45<sup>0 </sup>terhadap kenaikan nilai saturasi oksigen pada pasien gagal jantung kongestif. Penelitian ini merekomendasikan agar pasien gagal jantung kongestif dengan penurunan saturasi oksigen diberikan posisi tidur semi Fowler 45<sup>0</sup>.</p> <p><strong>Kata kunci : </strong>CHF; posisi semi Fowler 45<sup>0</sup>; SpO<sub>2</sub></p> <p><sub>&nbsp;</sub></p> Sugih Wijayati, Dian Hardiyanti Ningrum, Putrono Putrono ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/372 Fri, 20 Sep 2019 04:49:01 +0700 Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2 http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/373 <p><strong><em>BACKGROUND </em></strong><strong>:</strong><em>Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process.</em></p> <p><strong><em>OBJECTIVE : </em></strong><em>To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus.</em></p> <p><strong><em>METHOD : </em></strong><em>This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1<sup>st</sup> week and 24<sup>th</sup> week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test.</em></p> <p><strong><em>RESULT :</em></strong><em> There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus </em><em>(p=0,008).</em></p> <p><strong><em>CONCLUSION</em></strong><em> : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. </em></p> <p><strong><em>Keyword </em></strong><em>:</em><em> simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus</em></p> <p>&nbsp;</p> <p><strong>LATAR BELAKANG :</strong>Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis.</p> <p><strong>TUJUAN :</strong>Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2.</p> <p><strong>METODE :</strong>Penelitian ini adalah dengan <em>Randomized Pretest-Posttest Design</em> dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan&nbsp; diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan <em>Saphiro wilk</em>, lalu di analisis menggunakan uji beda <em>paired t test</em>dan <em>independent t test</em>.</p> <p><strong>HASIL </strong><strong>:</strong>&nbsp; Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 <u>+</u> 0,46; p=0,514),</p> <p><strong>KESIMPULAN : </strong>Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2.</p> <p><strong><em>Kata Kunci&nbsp;&nbsp;&nbsp;&nbsp; :</em></strong><em>simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2</em></p> <p>&nbsp;</p> <p>&nbsp;</p> <p><em>&nbsp;</em></p> Aditya Kurnianto, Dodik Tugaswowo Pramukarso ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/373 Fri, 20 Sep 2019 04:56:44 +0700 Perbandingan Nilai Corrected Count Increment pasca transfusi Thrombocyte Concentratedengan Thrombocyte Apheresispada penderita Keganasan Hematologi http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/374 <p><strong>Introduction :</strong></p> <p>Transfusion thrombocyte concentrate (TC) and thrombocyteapheresis (TA) is a form of use of blood components as supportive measures to increase the number of platelets of patients with hematological malignancies thrombocytopenia, platelet transfusion success rated the corrected count increment (CCI).<sup>1</sup> Platelet transfusion refractoriness (PTR) or failure increase in platelet post platelet transfusion, defined as more than two times the transfusion episode or successively obtained the value CCI &lt;7.5 at 1 hour post first transfusion or &lt;4.5 at 18-24 hours post transfusion.<sup>31</sup></p> <p><strong>Materials and methods :</strong></p> <p>Research samples from hematologic malignancies patients with platelet counts &lt;50,000 / mm3, enforced through inspection Bone Marrow punction (BMP), got 2 or more episodes of platelet transfusions in the form Thrombocyte Concentrate (TC) and Thrombocyte Apheresis (TA), aged 1-70 years, do a complete blood count, is hospitalized at Dr. Kariadi’s hospital Semarang during the study period, from the number of pre- and post platelet transfusion CCI value is then determined between the recipient TA and TC. CCI value between TA to TC compared to perform statistical analysis computer using Mann Whitney test</p> <p><strong>Research result :</strong></p> <p>A study of 82 patients with both men and women diagnosed with Hematologic Malignancies obtained Platelet refractoriness cases as much as 5 of the 41 patients who received a transfusion history of using TA (12.19%), and 30 of 41 patients who received a transfusion history using TC (73.17 %). Mann Whitney test showed the value of CCI in case the recipient PTR between TA and TC got significant differences (p &lt;0.05).</p> <p><strong>Conclusion :</strong></p> <p>There is significant difference between the value CCI of TA resipients and TC resipients. The value CCI of TA recipient was significantly higher than the value &nbsp;CCIof TC recipients.</p> <p><strong>Keywords :</strong> thrombocyte apheresis, thrombocyte concentrate, CCI, PTR</p> <p>&nbsp;</p> <p><strong>Pendahuluan: </strong>Transfusi <em>thrombocyte concentrate</em> (TC) dan <em>thrombocyteapheresis</em> (TA)merupakan bentuk penggunaankomponen darah sebagai tindakan suportif untuk meningkatkan jumlah trombositpasien keganasan hematologi dengan trombositopenia, Keberhasilan transfusi trombositdinilai dengan <em>corrected count increment</em>(CCI).<sup>1</sup><em>Platelet transfusion refractoriness</em> (PTR) atau kegagalan kenaikan trombosit <em>post</em> transfusi trombosit, didefinisikan sebagai lebih dari&nbsp; dua kali episode transfusi atau berturut-turut didapatkan nilai CCI &lt; 7,5&nbsp; pada 1 jam pertama <em>post</em> transfusi atau &lt; 4,5 pada 18-24 jam <em>post</em> transfusi.<sup>31</sup></p> <p><strong>Bahan dan metode: </strong>Sampel penelitian adalah penderita keganasan hematologidengan jumlah trombosit &lt;50.000 /mm3, ditegakkan melalui pemeriksaan<em> Bone Marrow Punction</em> (BMP), mendapat 2 atau lebih episode transfusi trombosit berupa <em>Thrombocyte Concentrate</em> (TC) maupun<em>Thrombocyte Apheresis</em> (TA), usia 1-70 tahun, dilakukan pemeriksaan darah lengkap, menjalani rawat inap di RSUP Dr. Kariadi Semarang selama periode penelitian, Dari jumlah trombosit <em>pre</em> dan <em>post </em>transfusi kemudian ditentukan nilai CCI antara resipien TA dan TC. Nilai CCI antara TA dengan TC dibandingkan dengan melakukan analisis statistik komputer menggunakan uji <em>Mann Whitney</em></p> <p><strong>Hasil penelitian: </strong>Penelitian terhadap 82 pasien laki-laki maupun perempuan dengan diagnosis Keganasan Hematologi didapatkan kasus <em>Platelet refractoriness</em> sebanyak 5 dari 41 pasien yang mendapatkan riwayat transfusi menggunakan TA (12,19%), dan 30 dari 41 pasien yang mendapatkan riwayat transfusi menggunakan TC (73,17%).Uji <em>Mann Whitney </em>menunjukkan nilai CCI pada kasus PTR antara resipien TA dan TC didapatkan perbedaan&nbsp; secara signifikan (p&lt;0,05).</p> <p><strong>Simpulan: </strong>Didapatkan perbedaan secara signifikan nilai CCI antara yang mendapatkan TA dan yang mendapatkan TC. Nilai CCI resipien TA secara bermakna lebih tinggi daripada nilai CCI resipien TC</p> <p><strong>Kata kunci</strong> :<em>thrombocyte apheresis</em>, <em>thrombocyte concentrate</em>, CCI, PTR</p> Like Rahayu Nindhita, Dian Widyaningrum ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/374 Fri, 20 Sep 2019 05:18:59 +0700 Analisis Faktor-Faktor Yang Mempengaruhi Kejadian Ekstravasasi Di Ruang Anak RSUP Dr. Kariadi Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/375 <p><strong>Background</strong>: Chemotherapy is one way to treat cancer by using drugs. Complications that can occur from chemotherapy is the occurrence of extravasation that occurs when chemotherapy drugs accidentally enter the tissue around intravenous access can cause persistent, painful and progressive ulceration if given incorrectly.</p> <p><strong>Aim</strong> : to analyze the relationship between risk factor (canul size, vena location access, vena condition, kind of drug, long of explanation drug, and volume drug that used) to the incidence of extravasation in the pediatric ward RSUP Dr. Kariadi Semarang.</p> <p><strong>Method:</strong> this research using observational analytic design according to cross sectional. The sample were taken by minimal sampling with criteria child 1-17 years old, child with chemotherapy cycle 1-6, and not using central vena access get 30 sample. The result of test using correlation regression.</p> <p><strong>Result:</strong> showed that not connection between six risk factor with ekstravatation incident. Conclusion: the gold standard protocol must be carried out during the administration of chemotherapy</p> <p>&nbsp;</p> <p><strong>Latar belakang</strong>. Kemoterapi merupakan salah satu cara penanganan kanker dengan menggunakan obat. Komplikasi dari pemberian kemoterapi yang dapat terjadi adalah kejadian ekstravasasi yang mana obat kemoterapi secara tidak sengaja masuk ke dalam jaringan di sekitar akses intravena yang dapat menyebabkan ulserasi yang menetap, nyeri dan progresif jika diberikan dengan tidak benar.</p> <p><strong>Tujuan</strong> penelitian untuk menganalisis hubungan antara faktor resiko (ukuran kanula, lokasi akses vena, kondisi vena, jenis obat, lama paparan obat, dan volume obat kemoterapi) terhadap kejadian ekstravasasi di ruang anak RSUP Dr. Kariadi Semarang.</p> <p><strong>Metodologi.</strong> Jenis penelitian ini menggunakan desain observasional analitik secara <em>cross sectional. </em>Pemilihan sampel menggunakan minimal sampling dengan kriteria anak usai 1-17 tahun, anak dalam siklus kemoterapi 1-6 dan tidak menggunakan akses vena sentral didapatkan 30 sampel. Analisa data menggunakan korelasi regresi.</p> <p><strong>Hasil penelitian</strong>: tidak ada hubungan antara keenam faktor resiko dengan kejadian ekstravasasi. Kesimpulan: <em>gold standard protocol </em>harus dijalankan selama pemberian kemoterapi.</p> <p><strong>Kata Kunci</strong>&nbsp;: Faktor Resiko, Kejadian Ekstraksasi, Kemoterapi Anak</p> <p>&nbsp;</p> Yuswinda Kusumawardhani ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/375 Fri, 20 Sep 2019 05:31:09 +0700 Efektivitas Slow Stroke Back Massage Dengan Minyak Aromaterapi Lavender Terhadap Penurunan Nyeri Penderita Kanker Serviks http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/376 <p>Pain is one of the main complaints of patients with Cervical cancer patients caused due to tumor growth, infiltrats, the effects of repeated diagnostics and treatment procedures. The types of treatment which are often given to the patients are pharmacological therapies or drugs, which can provide many side effects when used in the long term. This study aimed to know the effects of slow stroke back massage technique combined with &nbsp;lavender aromaterapy oil to reduce pain in patients with Cervical cancer in Dr. Kariadi Hospital. This study was a quantitative quasi experiment with randomized control group pretest-posttest design. The sampling was purposive sampling. The study involved 15 participants in the intervention group and 15 participants in the control group. The data were analyzed by univariate and bivariate analysis using wilcoxon test. The results showed that there were reduction of pain in the intervention groups with p = 0.000. This study revealed that slow stroke back massage technique combined with&nbsp; lavender aromaterapy oil techniques as a non-pharmacological therapy provided an effect on the decrease of pain in cervical cancer patients. Based on the study, it is suggested that nurses apply slow stroke back massage technique combined with lavender aromaterapy oil techniques as a non-pharmacological therapy to reduce pain in cervical cancer patients.</p> <p>Keywords: Pain, cervical cancer, slow stroke back massage, lavender aromaterapy oil</p> <p>&nbsp;</p> <p>Nyeri adalah salah satu keluhan utama pada pasien kanker serviks disebabkan karena pertumbuhan tumor, infiltrat di tempat lain, efek dari prosedur diagnostik dan perawatan yang berulang. Penanganan nyeri yang sering kali diberikan adalah pemberian terapi farmakologi atau obat-obatan yang memberikan banyak efek samping apabila digunakan dalam jangka waktu lama. Penelitian ini bertujuan untuk mengetahui pengaruh teknik <em>slow stroke back massage </em>dengan minyak aromaterapi lavender terhadap penurunan nyeri pada pasien kanker serviks di RSUP Dr Kariadi Semarang.</p> <p>Penelitian ini merupakan penelitian kuantitatif <em>quasy eksperimental</em> dengan metode<em> randomized&nbsp; control group pre test posttest design</em>. Pengambilan sampel dilakukan dengan teknik <em>purposive sampling</em> yaitu 15 responden sebagai kelompok intervensi dan 15 responden sebagai kelompok kontrol. Analisa data dilakukan secara bivariat dan univariat dengan menggunakan <em>uji wilcoxon</em>.</p> <p>Hasil penelitian menunjukkan terdapat perbedaan penurunan nyeri pada kelompok intervensi yang diberikan terapi <em>slow stroke back massage</em> dengan aromaterapi lavender dengan nilai p=0.000. Kesimpulan penelitian ini membuktikan bahwa teknik <em>slow stroke back massage </em>dengan minyak aromaterapi lavender sebagai terapi non farmakologis berpengaruh terhadap penurunan nyeri pada pasien kanker serviks. Saran: perawat diharapkan mengaplikasikan teknik <em>slow stroke back massage </em>dengan minyak aromaterapi lavender sebagai terapi non farmakologis untuk menurunan nyeri pada pasien kanker serviks.</p> <p>Kata kunci: Nyeri, Kanker Serviks, <em>slow stroke back massage</em><em>,</em> minyak aromaterapi lavender</p> <p>&nbsp;</p> Sri Setyowati, Anik Rakhmawati, Sumarsih Sumarsih, Maria Indri Wigatiningsih ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/376 Fri, 20 Sep 2019 05:42:54 +0700 Gambaran Tatalaksana Nyeri Skala 1-3 Pada Pasien Kanker Di Ruang Perawatan Onkologi RSUP Dr. Kariadi Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/377 <p><strong>Background of the Study</strong>: Cancer is a disease or abnormalities of cells that grow new abnormally, excessively, uncontrollably, and finally can attack and spread to other organs around it. The pain always impairs cancer patients, it will differentially impair cancer patients', from mild, moderate, and severe. The pains can be overcome according to their standard: mild pain with nonpharmacology as an independent area of nursing, moderate pain with non-pharmacological and pharmacological combinations, they are collaborative areas, and severe pain with pharmacology, it is commonly given with medication.</p> <p><strong>Objective of the Study</strong>: Find the description of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang</p> <p><strong>Research Methodology</strong>: The design used was descriptive quantitative with cross-sectional approach, the sample size was 124 people. The sampling technique was Cluster-random sampling. The research instrument used was questionnaire sheet, while the analysis used was descriptive statistics to be displayed in the form of frequency distribution.</p> <p><strong>Results of the Study</strong>: Description of the implementation of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang quantitatively on medical records shows that the average achievement of 95.16% (Good), quantitatively in the patients shows that the average achievement of 75.8% (Poor).</p> <p><strong>Conclusion</strong>: Description of the implementation of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room&nbsp; Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang generally shows fair category.</p> <p><strong><em>Keywords: Cancer, Pain Management, Semarang</em></strong></p> <p>&nbsp;</p> <p><strong>Latar Belakang</strong> : Kanker adalah penyakit atau kelainan sel-sel yang tumbuh&nbsp; baru secara abnormal, berlebihan, tidak terkendali, serta kemudian dapat menyerang dan&nbsp; menyebar ke organ lain di sekitarnya. Nyeri selalu menyertai penderita kanker, dengan tingkat nyeri yang dirasakan oleh penderita bervariasi, dari ringan, sedang, dan berat.Nyeri dapat ditanggulangi sesuai&nbsp; standartnya: yang ringan dengan non farmakologi sebagai area independen keperawatan, sedang dengan kombinasi non farmakologi dan farmakologi yaitu area kolaboratif, dan berat dengan farmakologi biasanya dengan pemberian medikasi.&nbsp;</p> <p><strong>Tujuan penelitian</strong>: Mengetahui&nbsp; gambaran tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang</p> <p><strong>Metode Penelitian</strong> : Desain yang digunakan deskriptif kuantitatif dengan pendekatan <em>cross-sectional</em>, besar sampel 124 orang. Tehnik sampling <em>Cluster</em><em>random sampling</em>. Instrumen penelitian menggunakan lembar kuesioner sedangkan analisis yang digunakan statistik diskriptif yang akan ditampilkan dalam bentuk distribusi frekuensi.</p> <p><strong>Hasil Penelitian</strong> : Gambaran implementasi tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang secara kuantitatif pada rekam medis menunjukkan bahwa rata – rata capaian 95,16 % (baik), secara kuantitatif pada pasien&nbsp; menunjukkan bahwa rata – rata capaian 75,8 %(kurang baik).</p> <p><strong>Kesimpulan</strong> : Gambaran implementasi tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang secara umum menunjukkan cukup baik.</p> <p><strong>Kata kunci&nbsp;&nbsp;&nbsp;&nbsp; : </strong><strong>Kanker </strong><strong>, </strong><strong>Tatalaksana nyeri, Semarang</strong></p> Mufid Mufid ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/377 Fri, 20 Sep 2019 05:49:06 +0700 Gambaran Tingkat Kecemasan Pada Pasien Yang Akan Menjalani Operasi Bedah Jantung Di RSUP Dr. Kariadi Semarang http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/378 <p><strong>Background:</strong> Anxiety happens as the normal reaction of stressor and last for a moment. Anxiety may be experienced by patients who will undergo cardiac surgery.</p> <p><strong>Objective: </strong>This study aimed to describe the anxiety that experienced by patients who will undergo cardiac surgery at Dr. Kariadi Hospital, Semarang.</p> <p><strong>Methods: </strong>This descriptive study used Hamilton Anxiety Rating Scale (HARS) to measure the respondents’ anxiety rating scale and their responses during cardiac surgery. Thirty respondents were included in this study in Dr. Kariadi Hospital, Semarang.</p> <p><strong>Results: </strong>All of the respondents that have been interviewed experienced various levels of anxiety; 8 respondents (26,7%) experienced mild anxiety, 18 respondents (60%) experienced moderate anxiety and 4 respondents (13,3%) experienced severe anxiety.</p> <p><strong>Conclusion: </strong>This study concluded that all of the respondents who will undergo cardiac surgery in Dr. Kariadi Hospital Semarang experienced anxiety.</p> <p>Keywords: Anxiety, cardiac surgery, Dr. Kariadi Hospital</p> <p>&nbsp;</p> <p><strong>Latar Belakang:</strong> Kecemasan muncul sebagai reaksi normal terhadap situasi yang sangat menekan dan berlangsung sebentar<strong>. </strong>Perasaan cemas mungkin akan dirasakan oleh sebagian besar pasien yang akan menjalani bedah jantung.</p> <p><strong>Tujuan:</strong> Penelitian ini bertujuan untuk mengetahui gambaran kecemasan pasien yang akan menjalani operasi bedah jantung di RSUP Dr. Kariadi Semarang.</p> <p><strong>Metode: </strong>Penelitian deskriptif ini menggunakan kuesioner HARS (<em>Hamilton Anxiety Rating Scale</em>) kepada responden untuk mengukur respon dan menilai tingkat kecemasan menjalani operasi bedah jantung. Sampel yang digunakan pada penelitian ini adalah 30 responden di RSUP dr. Kariadi Semarang.</p> <p><strong>Hasil: </strong>30 responden telah diwawancarai semua mengalami kecemasan dengan berbagai tingkatan sebagai berikut; 8 responden (26,7%) memiliki tingkat kecemasan ringan, 18 responden (60%) memiliki tingkat kecemasan sedang dan 4 responden (13,3%) memiliki tingkat kecemasan berat.</p> <p><strong>Kesimpulan: </strong>Seluruh responden yang akan menjalani operasi bedah jantung di RSUP Dr. Kariadi Semarang mengalami kecemasan.</p> <p><strong>Kata Kunci</strong>: Kecemasan, operasi bedah jantung, RSUP Dr. Kariadi</p> Heru Noor Ramadhan, Tri Gunarti, Agung Purwanto ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/378 Fri, 20 Sep 2019 05:55:37 +0700 Pengaruh Latihan Sirkuit Terhadap Biomarker Inflamasi,Kapasitas Fungsional, Fungsi Paru, dan Kualitas Hidup Pasien Gagal Jantung Kronik http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/379 <p><strong>Background: </strong>Physical exercise in patients with heart failure maydecrease the level of proinflammatory biomarkers,increase maximal oxygen consumption, improve pulmonary function and quality of life. Circuit training is one of the most advantageous exercise models because it improves cardiorespiratory fitness and muscle strength.</p> <p><strong>Objective: </strong>This study was aimed to investigate the effect of circuit training on proinflammatory biomarkers, functional capacity, pulmonary function, and quality of life in patients with chronic heart failure in RSUP Dr. Kariadi</p> <p><strong>Methods: </strong>Twenty-six stable chronic heart failure with reduced ejection fraction patients were randomized into exercise group that received circuit training in the rehabilitation center of Kariadi Hospital for a month and control group. TNF- ? levels, maximum oxygen consumption, pulmonary function, and quality of life were taken before and after the exercise period. Data between two groups was analyzed with the Mann-Whitney test. Pre and post data was analyzed with the Wilcoxon test.&nbsp;</p> <p><strong>Results: </strong>Nine-teensubjects completed the study without any significant side effects.There was no significant difference in TNF-? levels before and after treatment between treatment groups and control groups (p=0,513). The treatment group with circuit training showed a greater increase in maximum oxygen consumption (p=0,034), greater increase in Forced Vital Capacity value(p=0,010) and a greater increase in quality of life score(p=0,047)than the control group.</p> <p><strong>Conclusion: </strong>Circuit training in patients with chronic heart failure can increase maximal oxygen consumption, lung function, and quality of life, but no changes in inflammatory biomarkers.</p> <p><strong>Keywords: </strong>Circuit training, TNF-a, maximal oxygen consumption, FVC, quality of life</p> <p>&nbsp;</p> <p><strong>Latar belakang: </strong>Latihan fisik pada pasien gagal jantung dapat menurunkan kadar biomarker proinflamasi, meningkatkan konsumsi oksigen maksimal, memperbaiki fungsi paru dan meningkatkan kualitas hidup. Latihan sirkuit merupakan salah satu model latihan fisik yang lebih menguntungkan karena mampu memperbaiki kebugaran kardiorespirasi dan kekuatan otot sekaligus.</p> <p><strong>Tujuan:</strong>Menganalisispengaruh latihan sirkuit terhadap biomarker inflamasi, kapasitas fungsional, fungsi parudan kualitas hiduppasien gagal jantung kronik di RSUP Dr.Kariadi.</p> <p><strong>Metode:</strong>Dua puluh enam pasien gagal jantung kronik stabil dengan penurunan fraksi ejeksi ventrikel kiri dirandomisasi menjadi kelompok yang&nbsp; mendapatkan latihan sirkuit di bagian rehabilitasi RSUP Kariadi selama 1 bulan dan kelompok kontrol. Kadar TNF-a, nilai konsumsi oksigen maksimal, fungsi paru, dan kualitas hidupdiambil sebelum dan sesudah periode latihan. Analisis data antara dua kelompok menggunakan uji <em>Mann-Whitney.</em>Analisis data pre dan post, menggunakan uji <em>Wilcoxon</em></p> <p><strong>Hasil: </strong>Sembilan belas subjek menyelesaikan studi tanpa ada efek samping.Tidak didapati perubahan kadar TNF-a sesudah latihan sirkuit (p=0,513);Kelompok perlakuan dengan latihan sirkuit menunjukkan peningkatan konsumsi oksigen maksimal yang lebih besar (p=0,034), rerata peningkatan nilai FVC <em>(Forced Vital Capacity)</em> setelah latihan yang lebih besar (p=0,010), sertarerata peningkatan kualitas hidup yang lebih besar (p=0,047) dibandingkan kelompok kontrol.</p> <p><strong>Simpulan: </strong>Latihan sirkuit pada pasien gagal jantung kronik dapat meningkatkan konsumsi oksigen maksimal, fungsi paru, dan kualitas hidup, namun tidak menyebabkan perubahan padabiomarker inflamasi.</p> <p><strong>Kata Kunci: </strong>Latihan sirkuit, TNF-a, konsumsi oksigen maksimal, FVC, kualitas hidup</p> Fauzan Muttaqien, Yulvina Yulvina, Riana Novita Sari, Fahmi Syarif, Sri Wahyudati, Sefri Noventi Sofia, Sodiqur Rifqi ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/379 Fri, 20 Sep 2019 06:08:36 +0700 Rasio Netrofil Limfosit dan Limfositopenia Sebagai Penanda Sepsis http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/380 <p><strong><em>Background:</em></strong><em> The state of sepsis will initially lead to an increase in the number of neutrophils followed by an increase in lymphocytes, a state of sepsis that last longer will cause apoptosis of lymphocytes, so that the neutrophil lymphocyte ratio will increase, and absolute limfositopenia will occur which can be used as an indicator of sepsis.</em></p> <p><strong><em>Aim: </em></strong><em>Knowing the value of RNL and lymphocyte count in patients suspected of sepsis in the ICU Dr. Kariadi</em><em> Hospital</em><em> Semarang</em><strong><em>&nbsp;</em></strong></p> <p><strong><em>Methods:</em></strong><em> This study is a non-experimental diagnostic and cross sectional design with a sample of 30 patients. Blood samples were taken from ICU patients with two or more signs of SIRS and suspected infection &nbsp;for leukocyte count and blood culture examination, then the data were analyzed using ROC curves.</em></p> <p><strong><em>Result:</em></strong><em> The source of infection occurred in the digestive tract (43.3%), obstetrics gynecology (23.3%), respiratory tract (16.7%), cerebrovascular (10%) and urinary tract (6.7%). Neutrophils Lymphocytes count ratio has AUC 0,425 (sensitivity 60% and specificity 20%), absolute Limfositopenia has AUC 0,425 (sensitivity 40% and specificity 40%), while the RNL and Limfositopenia has AUC 0.575 (sensitivity 70% and specificity 45%).</em></p> <p><strong><em>Conclusion:</em></strong><em> Neutrophils Lymphocytes count ratio and absolute Lymphocytopenia can not be used as an indicator of sepsis in ICU’s patients despite having a sensitivity of 70% and specifity 45%.</em></p> <p><strong><em>Keywords:</em></strong><em> Sepsis, Ratio Neutrophils Lymphocytes, Limfositopenia absolute.</em></p> <p>&nbsp;</p> <p><strong>Latar Belakang: </strong>Keadaan sepsis pada awalnya akan menyebabkan peningkatan jumlah netrofil diikuti oleh peningkatan limfosit, keadaan sepsis yang bertahan akan menyebabkan apoptosis dari limfosit, sehingga rasio netrofil limfosit akan meningkat, dan terjadi limfositopenia yang dapat dijadikan indikator sepsis.</p> <p><strong>Tujuan: </strong>Mengetahui nilai RNL dan hitung limfosit pada pasien dicurigai sepsis di RSUP Dr. Kariadi Semarang</p> <p><strong>Metode: </strong>Penelitian ini merupakan penelitian diagnostik non eksperimental dengan desain <em>cross sectional </em>dengan jumlah sampel 30 pasien. Pasien ICU dengan dua atau lebih tanda SIRS dan dicurigai infeksi diambil sampel darah untuk dilakukan pemeriksaan hitung jenis leukosit dan pemeriksaan kultur darah, kemudian data dianalisis menggunakan kurva ROC.</p> <p><strong>Hasil: </strong>Sumber infeksi terbanyak terjadi pada traktus digestivus (43,3%), obstetri ginekologi (23,3%), traktus respiratorius (16,7%), cerebrovaskular (10%) dan traktus urinarius (6,7%). Rasio Netrofil Limfosit memiliki AUC 0,425 (sensitivitas 60% dan spesifitas 20%), Limfositopenia absolut memiliki AUC 0,425 (sensitivitas 40% dan spesifitas 40%), sedangkan RNL dan Limfositopenia memiliki AUC 0,575 (sensitivitas 70% dan spesifitas 45%).</p> <p><strong>Kesimpulan: </strong>Rasio Netrofil Limfosit dan Limfositopenia absolut tidak bisa dijadikan indikator sepsis pada pasien-pasien di ICU walaupun memiliki sensitivitas 70% dan spesisifitas 45%.</p> <p><em><strong>Kata kunci: </strong>Sepsis, Rasio Netrofil Limfosit, Limfositopenia absolut</em></p> Puja Laksana Maqbul, Ery Leksana, Muhammad Sofyan Harahap ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/380 Fri, 20 Sep 2019 07:59:12 +0700 Kidney Transplantation in Semarang: Outcomes and Prognosis http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/381 <p><strong>Introduction &amp; objective:</strong>Kidney transplantationis increasingly performed acrossIndonesia, including in Semarang. However there are limited publications onrenal transplantationfrom Indonesia, especially from centers outside Jakarta. The objective of this case series is to give a brief overview on the transplantation performed in Semarang, discusscurrent issues and ongoing efforts to address them.</p> <p><strong>Case series:</strong>Twenty-seven renal transplants in Dr. Kariadi General Hospital from January2012 until July 2018wereretrospectively analyzed. On average recipients were younger (32.5 years old) compared to the donors (46.8 years old). All kidneys were acquired from living donors with the majority of them to be blood-related(74.1%). The 3 leading etiologies of end-stage renal disease were hypertension (36.0%), diabetes mellitus (26.9%), and autoimmune disease (11.2%). The average total ischemic time was 36.9 minutes andthe average length of stay was 11 days. We report 5 cases of mortality, 3 cases of allograft rejection and no re-transplantation.</p> <p><strong>Discussion: </strong>The demographics of kidney transplant patients in Semarang were similar compared to the National data. The limited number of transplant in Semarang contributes to the low number of survival rate and highlights the need of further training and expertise. Better survival rate can be achieved with more transplants number as well as reaching the plateau of learning curve within the coming years.</p> <p><strong>Conclusion: </strong>The development of kidney transplant in Semarang follows the National milestones. In order to maximize the potentialthe institution, further improvements should concentrate on the development of integrated organ transplant infrastructure. The main goal of this institution is to establish a solid transplant center capable of covering Central Java, aiding the decentralization of kidney transplant in the Nation</p> <p><strong>Keywords:</strong> Kidney transplantation, End-stage Renal Disease, Chronic Kidney Disease, Indonesia, Semarang, Epidemiology, Update</p> Eriawan Agung Nugroho, Tommy Supit, Ardy Santosa, Nanda Daniswara, Sofyan Rais Addin, Anggun Ari Mukti ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/381 Fri, 20 Sep 2019 08:11:31 +0700 Acute kidney injury due to multiple bee stings in a 3 years old girl http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/382 <p><strong>Background:</strong></p> <p>Bee stings can lead to mild to severe allergic reaction . Serious complications of bee stings include hypersensitivity to the venom, which can develop after a single sting, and acute renal failure which has been reported mostly secondary of intravascular hemolysis developing after multiple bee stings. We report here a child who developed multiorgan system involvement.</p> <p><strong>Case presentation:</strong> A-3 years-old-girl was admitted to Kariadi Hospital with multiple bee stings and referred due to acute kidney injury stage failure by local hospital. Clinical finding were anasarca edema, gastrointestinal bleeding, oliguria (0.8ml/kgBW/hours), stage II hypertension (124/99mmHg), flaccid paraparesis inferior. Laboratory finding were &nbsp;&nbsp;hypoalbuminemia (2.4g/dL), anemia (6g/dl), leukocytosis (35.800/mm3), electrolyte imbalance (hypocalsemia:1.66mg/dL) and estimated glomerular filtration rate (eGFR) 8.09 ml/min/1.73m2. Chest-X ray showed pulmonary edema and duplex pleural effusion. The renal function recovered with supportive management including four sessions of haemodialysis. Patient discharged from the hospital on the nineteenth day.</p> <p><strong>Conclusions:</strong> Multiple bee stings can lead multiorgan system involvement</p> <p><strong>Keyword: </strong>Bee sting, acute kidney injury, hemodialisys</p> Omega Mellyana, Dessy Adelina, Jati Kusuma ##submission.copyrightStatement## http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/382 Fri, 20 Sep 2019 08:16:37 +0700