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All Journal Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Health Sains
Theng, Luther
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Analysis and Improvement of Time Frames Management for Ischemic Stroke Services in the Emergency Room at Budi Medika Hospital, Bandar Lampung Theng, Luther; Jak, Yanuar
Jurnal Health Sains Vol. 5 No. 8 (2024): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v5i8.1347

Abstract

Stroke is a catastrophic disease and a major health problem both in Indonesia and in the world. Stroke causes a high number of morbidities and mortalities. The philosophy of stroke"Time Is Brain", it requires good time frames management according to the world guidelines related to ischemic stroke services in emergency departments (ED). The design of the study is a quantitative descriptive with retrospective method within the period from January to December 2023, continued qualitatively a mix methodf explanatory sequential sequential. The number of samples is 150 which meets the inclusion criteria. Quantitative analysis with SPSS V29 for mac and quantitative with NVIVO 14. The Median of door to triage time at study point was 1(1-5) minutes, door to physician 2 (0-10) minutes, Door to CT scan 19.5 (2 -50) minutes, Door To CT interpretation wa 20.5 (2-200) minutes and Door To Drug was 63 (12-267) minutes. Logistics regression analysis of time frames showed that the most significant result was door to CT scan (OR:14.5,95%CI5.3-39.4,p<0.001). Moderated Regression Analysis (MRA) showed significant time frame influences p<0.001 and R2 96% with ischemic stroke service in IGD. To provide the good performance of Door to drug time£60 minutes requires good time frames management, role of five (5) M management (man, method, material, machine and money) and good stroke code implementation.
Analysis and Improvement of Time Frames Management for Ischemic Stroke Services in the Emergency Room at Budi Medika Hospital, Bandar Lampung Theng, Luther; Jak, Yanuar
Jurnal Health Sains Vol. 5 No. 8 (2024): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v5i8.1347

Abstract

Stroke is a catastrophic disease and a major health problem both in Indonesia and in the world. Stroke causes a high number of morbidities and mortalities. The philosophy of stroke"Time Is Brain", it requires good time frames management according to the world guidelines related to ischemic stroke services in emergency departments (ED). The design of the study is a quantitative descriptive with retrospective method within the period from January to December 2023, continued qualitatively a mix methodf explanatory sequential sequential. The number of samples is 150 which meets the inclusion criteria. Quantitative analysis with SPSS V29 for mac and quantitative with NVIVO 14. The Median of door to triage time at study point was 1(1-5) minutes, door to physician 2 (0-10) minutes, Door to CT scan 19.5 (2 -50) minutes, Door To CT interpretation wa 20.5 (2-200) minutes and Door To Drug was 63 (12-267) minutes. Logistics regression analysis of time frames showed that the most significant result was door to CT scan (OR:14.5,95%CI5.3-39.4,p<0.001). Moderated Regression Analysis (MRA) showed significant time frame influences p<0.001 and R2 96% with ischemic stroke service in IGD. To provide the good performance of Door to drug time£60 minutes requires good time frames management, role of five (5) M management (man, method, material, machine and money) and good stroke code implementation.
Meningitis Tuberkulosis Pada Pasien Dewasa : Kajian Pustaka Rusmini, Hetti; Dilangga, Pad; Theng, Luther; Lyanda, Apri; Hendarto, Gatot Sudiro
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 11 (2025): Volume 12 Nomor 11
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i11.20467

Abstract

Meningitis tuberkulosis (MTB) pada dewasa memiliki mortalitas tinggi akibat inflamasi kompleks, gejala awal yang tidak spesifik, dan keterbatasan diagnostik. Tantangan semakin besar di Indonesia karena keterbatasan fasilitas molekuler dan neuroimaging. Merangkum bukti terbaru mengenai imunopatogenesis, diagnosis modern, dan tantangan klinis MTB pada dewasa, serta implikasinya bagi praktik di Indonesia. Tinjauan literatur naratif melalui PubMed, Scopus, dan Google Scholar menggunakan rentang tahun 2010–2024. Kata kunci meliputi “tuberculous meningitis,” “adult TBM,” “immunopathogenesis TBM,” “CSF biomarkers TB,” dan “Xpert Ultra.” Artikel yang memuat data patofisiologi, diagnosis, atau tatalaksana dewasa disertakan; laporan yang tidak relevan disingkirkan. MTB ditandai aktivasi mikroglia, respons sitokin, dan peningkatan MMP yang menyebabkan kerusakan BBB dan komplikasi neurologis. Analisis CSF dan kultur memiliki sensitivitas rendah, sedangkan GeneXpert/Xpert Ultra dan MRI meningkatkan akurasi diagnosis namun belum tersedia luas. Terapi tetap mengandalkan OAT jangka panjang dan kortikosteroid, sementara regimen lini kedua diperlukan pada resistensi obat. Pendekatan multimodal yang menggabungkan pemahaman patogenesis, pemeriksaan molekuler, dan neuroimaging diperlukan untuk deteksi dini. Peningkatan akses diagnostik dan pengembangan biomarker CSF serta strategi rifampisin dosis tinggi menjadi arah penelitian penting untuk memperbaiki luaran MTB dewasa.
Co-Authors Apri Lyanda Dilangga, Pad Gatot Sudiro Hendarto, Gatot Sudiro Jak, Yanuar Rusmini, Hetti