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PREVALENSI DAN FAKTOR YANG MEMPENGARUHI NEUROPATI DIABETIK PADA PASIEN DIABETES MELITUS TIPE 2 DI RSUD WALED Widianti, Widianti; Zamzam Zein, Ahmad Fariz Malvi; Kusnandang, Agus
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 3 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Neuropati diabetik merupakan salah satu komplikasi yang umum ditemukan pada praktik klinis sehari-hari. Faktor risiko neuropati diabetik bersifat multifaktorial. Penelitian ini bertujuan ntuk mengetahui prevalensi dan menganalisis faktor yang memengaruhi neuropati diabetik pada pasien diabetes melitus tipe 2 di RSUD Waled. Penelitian dengan desain potong lintang ini berlangsung selama Juli 2023 di RSUD Waled, Cirebon, Indonesia. Subjek pada penelitian ini adalah pasien dengan diabetes melitus tipe 2 yang berobat di Poli klinik Penyakit Dalam. Jumlah subjek sebanyak 100 orang dengan menggunakan teknik consecutive sampling. Neuropati diabetik ditentukan berdasarkan hasil pemeriksaan uji monofilamen. Data penelitian menggunakan data primer dan data sekunder. Uji Analisis bivariat menggunakan uji chi-square dan analisis multivariat menggunakan regresi logistik. Prevalensi neuropati diabetik sebanyak 74%. Analisis bivariat menunjukkan bahwa lama menderita DM memiliki hubungan yang signifikan dengan neuropati diabetik dengan nilai p value 0,009 (p<0,05), status kontrol memiliki hubungan yang signifikan dengan neuropati diabetik dengan nilai p value 0,001 (p<0,05), dan hipertensi memiliki hubungan yang signifikan dengan neuropati diabetik dengan nilai p value 0,022 (p<0,05). Analisis multivariat menunjukkan faktor risiko yang paling berpengaruh terhadap neuropati diabetik adalah lama DM (OR 4,00; IK95% 1,396-11,486), status kontrol (OR 3,85; IK95% 1,396-10,661), dan hipertensi (OR 3,57; IK95% 1,082-11,784) secara berturut-turut. Sebanyak 74% pasien DM di RSUD Waled mengalami neuropati diabetik. Terdapat hubungan yang signifikan antara lama DM, status kontrol, dan hipertensi terhadap neuropati diabetik. Faktor yang paling berpengaruh adalah lama DM, status kontrol gula darah, dan hipertensi. Kata kunci : diabetes melitus, hipertensi, lama DM, neuropati diabetik, status kontrol DOI : 10.35990/mk.v7n3.p273-284
Correlation between Types of Bleeding Brain Lesion with Glasgow Coma Scale in Head Injury Patients at Gunung Jati Regional Hospital, Cirebon, Indonesia Tantowijaya, Bibit; Debyanti, Merliana; Kusnandang, Agus
GHMJ (Global Health Management Journal) Vol. 8 No. 1s (2025): Special Issues
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-81s1166

Abstract

Background: Head injuries were a leading cause of morbidity and mortality worldwide, often resulting in bleeding brain lesions such as epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and intracerebral hematoma. The Glasgow Coma Scale (GCS) was a widely used tool to assess the level of consciousness in head injury patients. Understanding this relationship was essential for guiding clinical management and predicting patient outcomes, especially in regions with high incidences of traumatic brain injuries, such as Cirebon, Indonesia. Aims: To analyze the relationship between bleeding brain lesions and the Glasgow Coma Scale in head injuries at Gunung Jati Regional Hospital, Cirebon, Indonesia. Methods: This study used an analytical observational method with a cross-sectional approach. Data collection was conducted using total sampling with a sample size of 28. The inclusion criteria were patients with CT-confirmed brain hemorrhages (epidural, subdural, subarachnoid, or intracerebral hematomas).  Data were obtained from medical records in 2023 at Gunung Jati Regional Hospital. The analysis was performed using the Spearman rank correlation test to evaluate the relationship between the type of brain hemorrhage and GCS scores. Results: The total sample of 28 included 21 patients (75%) with Intracerebral Hematoma, 3 patients (10.7%) with Subdural Hematoma, 2 patients (7.1%) with Epidural Hematoma, and 2 patients (7.1%) with Subarachnoid Hematoma. The level of consciousness in these patients was as follows: 15 patients (53.6%) with mild injuries, 8 patients (28.6%) with moderate injuries, and 5 patients (17.9%) with severe injuries. Spearman correlation analysis showed no significant relationship between Bleeding Brain Lesions and Glasgow Coma Scale in head injuries (p =0.645). The absence of correlation might have been due to unaccounted factors in this study, such as hemorrhage volume, lesion location, midline shift, and injury mechanism. Conclusion: There is no significant relationship between types of bleeding brain lesions and Glasgow Coma Scale in head injury patients. The study's limitations included a small sample size and the exclusion of variables such as hemorrhage volume and location, which could affect the level of consciousness. Future research was recommended to involve larger sample sizes and additional clinical factors to better understand the dynamics between types of brain hemorrhages and patients' levels of consciousness, potentially improving clinical management strategies.
The Association between Family Knowledge and Response with Pre-hospital Delay among Stroke Patients: A Study from Rural Area of Cirebon, Indonesia Ivanka, Muhammad Nabil Prawira; Pratiwi, Witri; Kusnandang, Agus
GHMJ (Global Health Management Journal) Vol. 7 No. 3s (2024)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-741111

Abstract

Background: Stroke is a non-communicable disease whose prevalence continues to increase in both young and old age groups. Stroke patients require immediate treatment at the hospital to prevent disability and death. Delayed treatment may result in a worse prognosis. Aims: To analyze the relationship between family knowledge and response with pre-hospital delay in stroke patients in Cirebon Regency, Indonesia. Methods: This cross-sectional study was conducted at Waled General Hospital, Cirebon Regency, Indonesia. The sampling technique used was consecutive sampling of patients hospitalized with stroke diagnosis from May 2024 to July 2024. Patients with recurrent stroke were excluded. Data were collected from medical records and questionnaires administered to the patient's families. The Indonesian version of Stroke Recognition Questionnaire (SQR) was used to explore family knowledge, while family responses were explored using the Stroke Action Test (STAT). Results: There were 61 stroke patients recruited in this study. Majority of the sample were delivered to hospital late (78.7%). Most of the patients’ families had poor knowledge (47.5%) and inadequate attitudes (85.2%). In the bivariate analysis, there was a strong correlation between family knowledge of stroke symptoms and pre-hospital delay (p=<0.001; r=0.746). Inadequate family response was associated with pre-hospital delay [p= 0.002; PR 2.596 (95%CI 1.024-6.581)]. Conclusion: There is a positive correlation between family knowledge and response with pre-hospital delay in stroke patients in Cirebon Regency, Indonesia.   Received: 26 September 2024  |  Reviewed: 19 October 2024  |  Revised: 24 November 2024  |  Accepted: 30 November 2024.
KARAKTERISTIK GAMBARAN PATOLOGIS VERTEBRAE LUMBOSACRAL PADA PEKERJA TAMBANG USIA 20 – 45 TAHUN DENGAN KELUHAN LOW BACK PAIN Nugraha, Verrel Adventa; Emman, Irene Max; Dewangga, Taufan Herwindo; Royyani, Nunik; Kusnandang, Agus
Tunas Medika Jurnal Kedokteran & Kesehatan Vol 10 No 3 (2024): TUNAS MEDIKA JURNAL KEDOKTERAN & KESEHATAN
Publisher : Fakultas Kedokteran UGJ Cirebon

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33603/tumed.v10i3.9586

Abstract

ABSTRAKPekerja tambang saat ini banyak berusia muda tetapi mengeluhkan low back pain dan setelah dilakukan screeningdengan foto rontgen terdapat gambaran penyempitan diskus intervertebralis, sklerotik end plate, osteofit,spondylolithesis, dan stenosis foramen intervertebralis. Dampak yang dialami oleh pekerja tambang tersebut dapatdikarenakan beban kerja yang berat dan lama kerja, usia, obesitas, dan kurang berolahraga. Ilmu yang mempelajaritentang rontgen vertebrae dan pertulangan yang berkaitan dengan pekerjaan disebut radiologi dan orthopedi.Untuk mengetahui karakteristik gambaran patologis radiografi pada vertebrae lumbosacral terhadap usia,pekerjaan, jenis kelamin dengan keluhan low back pain (LBP) pada pekerja tambang usia 20 – 45 tahun. Penelitianobservasional ini menggunakan rancangan deskriptif retrospektif. Sampel diambil dari hasil foto rontgen sebanyak54 orang. Teknik pengambilan sampel menggunakan Total sampling. Analisis data untuk melihat karakteristikgambaran patologis radiografi vertebrae lumbosacral pada pasien dengan pekerjaan sebagai pekerja tambang.Berdasarkan uji univariat didapatkan usia dewasa awal 26 – 35 tahun sebanyak 32 (59,3%), remaja akhir 20 – 25tahun sebanyak 13 (24,1%), dewasa akhir 36 – 45 sebanyak 9 (16,7%), laki - laki sebanyak 49 (90,7%), perempuansebanyak 5 (9,3%), penyempitan diskus intervertebralis sebanyak 50 (87,7%), osteofit sebanyak 7 (12,3%),sklerotik end plate sebanyak 0 (0%), spondylolithesis sebanyak 0 (0%), stenosis foramen intervertebralis sebanyak0 (0%). Karakteristik gambaran patologis radiografi vertebrae lumbosacral pada pasien pekerja tambangberdasarkan usia paling banyak di dapat adalah pasien usia dewasa awal, untuk jenis kelamin paling banyak adalahlaki - laki, untuk hasil foto rontgen paling banyak di dapat adalah penyempitan diskus intervertebralis.Kata kunci : Temuan radiologis lumbal, rontgen lumbal pekerja tambang, rontgen pasien LBP, rontgen lumbalpasien usia mudaABSTRACTToday's mining workers are mostly young but complain of low back pain and after screening with X-rays thereare pictures of narrowing of the intervertebral discs, sclerotic end plates, osteophytes, spondylolithesis, andstenosis of the intervertebral foramen. The impact experienced by mining workers can be due to heavy workloadand length of work, age, obesity, and lack of exercise. The science that studies X-rays of the vertebrae and bonesrelated to work is called radiology and orthopedics. To find out the characteristics of radiographic pathology ofthe lumbosacral vertebrae on age, occupation, gender with complaints of low back pain (LBP) in miners aged 20-45 years. This observational study used a retrospective descriptive design. Samples were taken from the results ofX-rays as many as 54 people. The sampling technique used total sampling. Data analysis to see the characteristicsof the pathological picture of lumbosacral vertebrae radiography in patients with occupations as mining workers.Based on univariate tests, it was found that the age of early adulthood 26 - 35 years was 32 (59.3%), lateadolescence 20 - 25 years was 13 (24.1%), late adulthood 36 - 45 was 9 (16.7%), men were 49 (90.7%), femaleas many as 5 (9.3%), intervertebral disc narrowing as many as 50 (87.7%), osteophytes as many as 7 (12.3%),sclerotic end plate as many as 0 (0%), spondylolithesis as many as 0 (0%), intervertebral foramen stenosis asmany as 0 (0%). The characteristics of the radiographic pathological picture of lumbosacral vertebrae in mineworker patients based on age are mostly early adult patients, for the most gender is male, for the most X-rayresults are narrowing of the intervertebral disc.Keywords : lumbar radiologic findings, lumbar x-rays of mine workers, X-ray of LBP patient, lumbar x-ray of ayoung patient