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COVID-19 pada Kehamilan: Apakah berbahaya? Hanifa Salma Ramadhani; Nurul Islamy; Ade Yonata
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.74

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which spread rapidly throughout the world. These health emergencies, especially deadly in vulnerable populations and communities where health care providers are not adequately prepared to manage this infection. Pregnant women and fetuses represent high-risk populations in this pandemic. Study this article compiled using the literature review method, derived from journals and books resulting from literature searching from search engines (Google and Google Scholar) and electronic source of database (PubMed). There are 37 references reviewed in this article review. A challenge in treating pregnant patients affected by SARS-CoV-2. The explanation in the review of this article is to present a discussion of COVID-19 in pregnancy, intrauterine transmission, and fetal complications in the mother. Fetal health is something that must be taken into consideration during labor In addition, it needs to be focused on the safety of health workers in treating COVID-19 patients. COVID-19 in pregnancy is dangerous for mothers and infants, mothers with COVID-19 have clinical airway symptoms that will aggravate the state of pregnancy, for infants if intrauterine transmission occurs, COVID-19 in infants will cause ARDS (acute respiratory distress syndrome) so endangering lives. The clinical characteristics of pregnant women with COVID-19 are similar to non-pregnant adults. Fetal and neonatal outcomes appear to be good in some cases, but available data only cover pregnant women infected in the third trimester.
Hipertensi Kronis Superimposed Preeklampsia dengan Impending Eklampsia dan Partial HELLP Syndrome Dila Aulia; Nurul Islamy; Ade Yonata
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.79

Abstract

Hypertension in pregnancy is defined as systolic blood pressure of 140 mmHg or more or diastolic blood pressure of 90 mmHg or more. Preeclampsia is a new onset hypertension (blood pressure> 140 mmHg systolic and / or> 90 mmHg diastolic) after 20 weeks and proteinuria or in the absence of proteinuria. Chronic hypertension with superimposed preeclampsia is a chronic hypertension sufferer who has preeclampsia. Ten million women worldwide experience preeclampsia every year. Of these cases, 7,600 pregnant women die each year due to preeclampsia and related hypertension disorders. Preeclampsia accompanied by prodomal sign is called impending eclampsia. HELLP syndrome is a collection of symptoms that include hemolysis, elevated liver enzymes, and platelet counts that are less than the lower limit. The method used is a case report with analysis of primary data obtained from symptoms, physical examination and laboratory examination showing hemoglobin 11.2 g / dL, platelets 156,000 / µL, lactate dehydrogenase (LDH): 687 / µL and urine examination showed 500 mg results / dL. Ultrasonography (USG) on 26 October 2019 obtained a single live fetal head presentation, 26-27 weeks gestation, fetal weight 976 grams, congenital hydrocephalus abnormalities, sufficient amniotic fluid. Ultrasound on 04/10/2019 found a single fetus alive head presentation, 30 weeks gestation, congenital hydrocephalus abnormalities, normal membranes. There are risk factors associated with the onset of preeclampsia in these patients, namely a history of hypertension, old age, and BMI. In this case expectative management was chosen because in patients with preterm pregnancy <34 weeks.
G4P3A0 Hamil 30 Minggu Belum Inpartu dengan Partus Prematurus Imminens dan Ketuban Pecah Dini Putu A.L Amrita Kirana; Nurul Islamy; Ade Yonata
Medula Vol 10 No 3 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i3.94

Abstract

Imminent preterm is the presence of a threat in pregnancy with emergence signs in 20 weeks-37 weeks. Preterm premature rupture of membrane is rupture of chorioamniotic membrane before the onset of childbirth and occurs in gestational age less than 37 weeks.. This study is a case report. A 34 years old woman with preterm pregnancy come with complained of the release of amniotic fluid that is odorless and can not be held from seven hours before entering hospital and accompanied by two days before entering hospital. It is accompanied by pain that intermitently radiating to the waist but still rare. From physical examination found moderate sick in general condition, compos mentis, BP 120/70mmHg, pulse 100 x/min, respiratory rate 20 x/min, temperature 36,6oC. General examination within normal limits. In obstetric examination found that fundus uteri is 3 finger under proccesus xiphoideus (26 cm), his (+) 2x in 10 minutes duration 10-12 seconds, fetal heart rate 144 x/min. In inspekulo examination found that portio is livid, OUE closed, amniotic fluid (+) not active, erosion/laseration/polip (-), lakmus (+) red to blue. Vaginal toucher not performed in this patient. The diagnosis are G4P3A0 in 30 weeks pregnancy, not inpartu yet, with imminent preterm and premature rupture of membrane. Patient planned conservative therapy such as observation of his, fetal heart rate, and vital signs mother, IVFD RL gtt x x/min, dexamethasone 2x10 mg, nifedipine 4x10 mg, cefadroxil 2x500mg.
Tatalaksana Eklampsia dengan Gagal Ginjal Akut Nurul Islamy; Ade Yonata
Jurnal Kedokteran Universitas Lampung Vol 3, No 1 (2019): JK Unila
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v3i1.2226

Abstract

Eklampsia merupakan kelainan akut disebabkan hipertensi karena kehamilan atau hipertensi yang bertambah berat karena kehamilan. Eklampsia menyebabkan kegagalan multi organ dengan peningkatan tekanan darah yang mendadak dan tinggi mengakibatkan kegagalan autoregulasi aliran darah. Hampir seluruh organ penting tubuh dapat terganggu dengan berbagai derajat gangguan yang berbeda terutama glomerulus. Karakteristik histologis lesi renal pada preeklampsia/eklampsia adalah adanya endoteliasis glomerulus. Glomerulus mengalami pembesaran dengan sel-sel endotel bervakuola yang menyebabkan vasokonstriksi yang meluas, mengakibatkan terjadi gagal ginjal. Gagal ginjal akut didefinisikan sebagai suatu penurunan yang cepat dan mendadak dari fungsi ginjal. Pengelolaan komplikasi dilakukan secara konservatif sesuai dengan penyebab dan tahapan prarenal, renal atau pascarenal.Kata kunci: Eklampsia, gagal ginjal akut
Pengaruh Komorbid terhadap Terjadinya Bakterimia MDR Gram Negatif pada Pasien Rawat Inap Ade Yonata
Jurnal Kedokteran Universitas Lampung Vol 1, No 2 (2016): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v1i2.1613

Abstract

Bakterimia MDR Gram negatif dapat meningkatkan angka kematian, morbiditas pasien, lama perawatan dan biaya perawatan rumah sakit. Komorbid merupakan penyakit tambahan baik fisik maupun psikis selain dari kondisi utama pasien, yang meperburuk kondisi pasien. Penelitian ini bertujuan mengetahui pengaruh komorbid terhadap terjadinya bakterimiaMDR Gram negatif pada pasien rawat inap. Faktor risiko komorbid diidentifikasi menggunakan studi kasus kontrol. Data dikumpulkan dari catatan rekam medis pasien rawat inap yang memiliki kultur darah positif tumbuh bakteri patogen Gram negatif. Kelompok kasus adalah subjek dengan bakterimia MDR Gram negatif, kelompok kontrol adalah subjekdengan bakterimia non-MDR Gram negatif. Analisis bivariat dilakukan pada variabel bebas yaitu diabetes mellitus, AIDS, gagal jantung, stroke, gagal ginjal, dan keganasan. Berdasarkan hasil analisis bivariat tidak didapatkan variabel komorbid yang berbeda secara statistik antara kelompok MDR dan non MDR, dimana didapatkan variabel diabetes dengan p:0.837, AIDS dengan p:1.00, gagal jantung p:0.499, stroke p:0.172, gagal ginjal p:0.393, dan keganasan dengan p:0.979. Simpulan:faktor komorbid AIDS, diabetes, gagal jantung, gagal ginjal, stroke, dan keganasan tidak terbukti secara statistik sebagai faktor risiko terjadinya bakterimia MDR Gram negatif pada pasien rawat inap. [JK Unila. 2016; 1(2): 211-214] [JK Unila : 211-214]Kata kunci: bakterimia, gram negatif, komorbid, MDR
Faktor Risiko Anemia pada Penderita HIV/AIDS dengan Terapi Zidovudin di Rumah Sakit Umum Abdul Moeloek Periode November 2015 Ade Yonata; Yvonne Yolanda Fransiska
Jurnal Kedokteran Universitas Lampung Vol 2, No 1 (2018): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jk unila.v2i1.1898

Abstract

Anemia merupakan gangguan hematologi yang dapat meningkatkan morbiditas dan mortalitas penderita HIV/AIDS. Zidovudin dalam terapi infeksi HIV/AIDS telah diketahui kemampuannya dalam menimbulkan anemia. Tujuan dari penelitian ini adalah mencari hubungan antara berat badan, stadium klinik HIV/AIDS dan lama penggunaan Zidovudin terhadap anemia pada penderita HIV/AIDS dengan terapi Zidovudin di Rumah Sakit Umum Abdul Moeloek, serta mengetahui faktor yang paling berhubungan.Penelitian ini merupakan penelitian observasional analitik dengan pendekatan potong lintang. Pengambilan data dilakukan bulan November 2015. Data yang digunakan dalam penelitian merupakan data sekunder yang diambil dari rekam medik pasien HIV/AIDS di klinik Voluntary, Counselling and Testing, Rumah Sakit Umum Abdul Moeloek. Terdapat 42 rekam medik yang dijadikan sampel pada penelitian ini, dimana sampel diambil menggunakan teknik total sampling.Hasil penelitian menunjukan terdapat 26 pasien (61,9%) pengguna Zidovudin menderita anemia. Faktor yang berhubungan dengan anemia pada pengguna Zidovudin adalah berat badan (p= 0,010) dan stadium klinik HIV/AIDS (p= 0,010). Lama penggunaan Zidovudin tidak berhubungan dengan anemia (p= 0,421). Berat badan (≤50 kg) dan stadium klinik HIV/AIDS (3–4) merupakan faktor yang sama dominan dalam mempengaruhi anemia pada terapi Zidovudin. Kesimpulan dari penelitian ini adalah terdapat hubungan yang sama dominan antara berat badan dan stadium klinik HIV/AIDS dengan anemia pada penderita HIV/AIDS dengan terapi Zidovudin di Rumah Sakit Umum Abdul Moeloek. Lama penggunaan Zidovudin tidak menjadi faktor yang berhubungan dengan anemia pada penderita HIV/AIDS dengan terapi Zidovudin.Kata kunci: AIDS, anemia, HIV, zidovudin
Faktor Risiko Kejadian Stroke di Usia Produktif Rizky Agung Purnomo; Ade Yonata; Intanri Kurniati
Medula Vol 12 No 3 (2022): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v12i3.456

Abstract

Stroke is a disorder due to focal or global brain function disorders that occur triggered by cerebrovascular disorders. Stroke is characterized by paralysis of the face or limbs, difficulty speaking, decreased consciousness, and visual disturbances. Stroke is the number 2 cause of death in the world, which is about 6 million deaths every year. Recently, stroke does not only occur in the elderly population, but also in the productive age. This article is a literature compiled to analyze the risk factors associated with the incidence of stroke in productive age. The references used are articles published between 2016-2022. There are 4 main risk factors for stroke in productive age, namely hypertension, diabetes mellitus, dyslipidemia, and lifestyle. Each factor plays a role in increasing the risk of stroke with its own mechanism. There is no difference between stroke risk factors in the productive age and the general population.
Hipotensi Intradialitik pada Pasien Gagal Ginjal Kronik Ghina Nisrina Nurfatin; Ade Yonata; Ety Apriliana
Medula Vol 13 No 3 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i3.663

Abstract

Chronic renal failure is a disease defined as kidney damage or an estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m2 and persisting for 3 months or more. Chronic kidney disease is irreversible and often requires hemodialysis as a treatment. As many as 10% of people in the world have chronic kidney failure. More than 2 million people receive therapy with dialysis or hemodialysis and kidney transplants. Hemodialysis is a kidney replacement therapy that is carried out by flowing the patient's blood into a dialyser. This therapy is considered effective in reducing mortality due to chronic kidney failure. However, various complications can also be caused by the use of this hemodialysis device, one of which is intradialytic hypotension. Intradialysis hypotension will cause a decrease in tissue perfusion. This decrease in tissue perfusion will lead to reduced blood supply to the periphery, heart, kidneys, and even the brain. Preventive measures are the best method of avoiding intradialytic hypotension. This complication must be avoided and managed immediately because it can cause damage to vital organs which can be fatal to the body.
Hipertensi pada Diabetes Melitus: Patofisiologi dan Faktor Risiko Vania Widyadhari Damayanti; Ade Yonata; Evi Kurniawaty
Medula Vol 13 No 7 (2023): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v13i7.896

Abstract

Hypertension is a disease that commonly occurs in diabetes mellitus patients. There are 40 to 80 percent of DM patients who suffer from hypertension. Hypertension in diabetes mellitus increases the risk of cardiovascular complications. Even though there have been many studies that have proven that reducing blood pressure in diabetes mellitus patients has an effect on reducing the risk of cardiovascular complications, research shows that only 48 percent of the population can achieve a blood pressure target of less than 130/80 mmHg. The pathophysiology of hypertension in DM can be associated with a sedentary lifestyle, excess calorie intake, insulin resistance, dysregulation of the autonomic nervous system, premature vascular aging, increased intravascular volume, renal dysfunction, renin-angiotensin-aldosterone-system (RAAS), innate and acquired immunity, as well as environmental and socio-economic factors. Risk factors for hypertension in diabetes mellitus include age, gender, education, marital status, blood type, total cholesterol levels, HDL levels, LDL levels, triglyceride levels, smoking habits, employment, physical activity, body mass index, heredity of hypertension, DM heredity, and duration of suffering from DM, and blood glucose levels.
Korelasi antara Monocyte Lymphocyte Ratio dengan Stadium Pasien Chronic Kidney Disease Non Hemodialisis di RSUD Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2023-2024 Ade Yonata; Dafa Rafiqi Akbar; Maya Ganda Ratna
Jurnal Kesehatan Amanah Vol. 8 No. 2 (2024): Jurnal Kesehatan Amanah
Publisher : Universitas Muhammadiyah Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57214/jka.v8i2.666

Abstract

Chronic kidney disease (CKD) is a serious condition accompanied by various comorbidities, systemic inflammation, and kidney tissue damage, leading to a decline in the glomerular filtration rate (GFR), which determines CKD staging. The monocyte-lymphocyte ratio (MLR) can serve as a more practical alternative that does not increase laboratory examination costs and utilizes a complete blood count, a routine hospital test. Several studies have reported that MLR values are associated with clinical deterioration and inflammation in CKD patients. This study aims to determine the correlation between MLR and CKD stage in non-hemodialysis patients at Dr. H. Abdul Moeloek Regional General Hospital, Lampung. This study is an analytical observational study using a cross-sectional method involving all non-hemodialysis CKD patients who met the inclusion and exclusion criteria at Dr. H. Abdul Moeloek Regional General Hospital. The sampling technique used was total sampling, with a total of 346 non-hemodialysis CKD patients collected from medical records between July 2023 and June 2024. Data analysis was performed using the Spearman alternative test. Based on the study of 346 patients, bivariate analysis showed a significant correlation between MLR and CKD stage (p = 0.000; r = 0.444). There is a significant positive correlation of moderate strength between MLR and CKD stage in non-hemodialysis patients at Dr. H. Abdul Moeloek Regional General Hospital, Lampung.