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Hubungan rasio P(v-a)CO2/C(a-v)O2 terhadap lactate clearance sebagai penanda keberhasilan One Hour Bundle pada pasien sepsis: Pendekatan metode statistik regresi Taufik, Maulana; Nadeak, Rommy Fransiscus; Irina, Rr. Sinta; Wahyuni, Arlinda Sari
Jurnal SAGO Gizi dan Kesehatan Vol 6, No 2 (2025): Agustus
Publisher : Poltekkes Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/gikes.v6i2.2440

Abstract

Background: A prognostic predictive value in patients with sepsis and septic shock is needed to determine the aggressiveness of the therapy we will choose. Various methods are used to predict patient mortality. Based on this, a marker is needed to assess tissue perfusion disorders.Objectives: To determine the relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance as a marker of the success of the one-hour bundle in sepsis patients.Methods: This study is a descriptive analytic study of 40 patients who assessed the description of lactate, ScvO2, and PvaCO2 gap values in septic patients. The study was conducted at the Emergency Department (IGD) and Intensive Care Unit (ICU) of H. Adam Malik Hospital Medan, during the period of April to May 2023. The collected data were then analyzed using descriptive statistical methods to calculate the mean, standard deviation, and range of the variables studied. The differences between groups were analyzed using the t-test to compare the mean values of the parameters studied. Correlation analysis was conducted using Pearson’s correlation test to assess the relationship between lactate, ScvO2, and PvaCO2 gap.Results: At T0, the mean lactate level was 22,06 mmol/L (median 16,85 mmol/L), the mean P(v-a)CO2 was 9,28 mmHg (median 8,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,66 (median 3,56). At T1, the mean lactate level decreased to 12,52 mmol/L (median 9,00 mmol/L), the mean P(v-a)CO2 was 8,50 mmHg (median 7,50 mmHg), and the mean P(v-a)CO2/C(a-v)O2 ratio was 3,45 (median 2,57). The average lactate clearance was 48,29%. Bivariate analysis revealed a significant relationship between lactate clearance and the P(v-a)CO2/C(a-v)O2 ratio, with a P-value of 0,009 and a Spearman correlation of -0,521, indicating a strong negative correlation between the two variables.Conclusion: There is a significant relationship between the P(v-a)CO2/C(a-v)O2 ratio and lactate clearance in the success of the one-hour bundle for sepsis patients.
Pengaruh pelatihan Early Warning Score (EWS) terhadap tingkat pengetahuan dokter dan perawat dalam penerapan EWS di Rumah Sakit Laras PT. Prima Medika Nusantara Simalungun Lubis, Andriamuri Primaputra; Rusda, Muhammad; Wahyuni, Arlinda Sari; Effendy, Elmeida; Amin, Mustafa Mahmud
Jurnal PADE: Pengabdian & Edukasi Vol 7, No 2 (2025): Oktober
Publisher : Politeknik Kesehatan Kemenkes Aceh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/pade.v7i2.2739

Abstract

Background: The Early Warning Score (EWS) is a clinical monitoring system based on vital signs, designed to support early detection of patient deterioration. However, its implementation in hospitals is often hindered by limited knowledge and skills among healthcare professionals. Objective: To evaluate the impact of EWS training on improving doctors' and nurses' knowledge regarding the application of the system at Laras Hospital, PT. Prima Medika Nusantara. Methods: A quasi-experimental pre-post study without a control group was conducted involving 155 participants. The EWS training, delivered through lectures and simulations, was followed by pre- and post-intervention knowledge assessments using a structured questionnaire. Statistical analysis was performed using the Wilcoxon test. Results: The findings demonstrated a significant improvement in knowledge after training (p = 0.00), indicating the effectiveness of the intervention in enhancing clinical readiness among medical staff. Conclusion: EWS training plays a vital role in strengthening the clinical competencies of doctors and nurses. Its routine implementation can serve as a practical strategy to enhance early detection systems and improve patient safety and care quality in hospital settings.
Infection Markers as Prediction of Neonatal Sepsis Sirait, Cindy Clarissa; Lubis, Bugis Mardina; Tanjung, Ika Citra Dewi; Wijaya, Hendri; Wahyuni, Arlinda Sari; Pasaribu, Ayodhia Pitaloka
Indonesian Journal of Global Health Research Vol 7 No 3 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i3.6066

Abstract

Neonatal sepsis is one of the most common causes of neonatal death in the first month of life. Neonatal sepsis often shows atypical clinical features include temperature instability, lethargy, skin changes, feeding problems, and many others. Isolation of bacteria from the culture is the gold standard for diagnosing sepsis, but this approach is frequently time-consuming and even in cases of negative blood cultures, sepsis cannot be conclusively ruled out, posing a major challenge in its diagnosis and management. Early diagnosis and timely intervention are essential to improve the prognosis of neonatal sepsis. Aim: The aim of this study is to discuss how infection markers can aid in the early identification of neonatal sepsis and what are the best infection markers to predict neonatal sepsis mortality. Method: This study assessed the diagnostic accuracies of infection marker used in the diagnosis of neonatal sepsis. Included studies were retrieved by searching three major databases (Google Scholar, Pubmed, and Science Direct) using MeSH words and relevant references, and reviewed based on the inclusion/exclusion criteria. The article discusses potential advancements and future prospects for biomarkers. An excellent marker can guide antibiotic administration and duration if sepsis is confirmed, reducing unnecessary use. The marker should have high sensitivity, specificity, positive predictive value, negative predictive value and accuracy.
Antibiotic Resistance in the Pediatric Intensive Care Unit: Literature Review Ginting, Nina Melina; Wijaya, Hendri; Wahyuni, Arlinda Sari; Trisnawati, Yunnie; Evalina, Rita; Pasaribu, Ayodhia Pitaloka
Indonesian Journal of Global Health Research Vol 7 No 3 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i3.6087

Abstract

Antibiotics have been overused, the unwise use of antibiotics has become a special concern and has led to resistance. Almost 50% of antibiotic therapy is initiated inappropriately and without correct identification of the etiological agent. The high number of inappropriate antibiotic prescriptions contributes to the occurrence of antibiotic resistance and increased risk of death. MDR pathogens result in a 40% increase in mortality in hospital-acquired infections. The purpose of this study was to discuss the pattern of the resistance of antibiotic therapy in pediatric patients admitted to the PICU. Method: The search strategy was conducted through three databases (Google Scholar, Pubmed, Science Direct) which published during 2015-2025, using MeSH words “Antibiotic Resistance” AND “Pediatric intensive care unit”. There were thousand studies found, then by using the PRISMA flowchart, which total ten studies were included. PICU has a higher ratio of pathogen composition and bacterial resistance. Many factors can lead to antibiotic resistance, it might be caused by unnecessary or suboptimal prescribed antibiotic therapy from community before, previous health care and the hospital itself. The high number of inappropriate antibiotic prescriptions contributes to the occurrence of antibiotic resistance. Antibiotic resistance can lead to longer hospital stays and increased risk of mortality.
Relationship between Age and the Occurrence of Depression Symptoms in Children with Acute Lymphoblastic Leukemia Riano, Dwika Intania; Tanjung, Ika Citra Dewi; Malisie, Ririe Fachrina; Wahyuni, Arlinda Sari; Siregar, Olga Rasiyanti; Daulay, Rini Savitri
Indonesian Journal of Global Health Research Vol 7 No 3 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i3.6230

Abstract

In children and adolescents, depressive symptoms often presenting as irritability, anhedonia, or behavioral changes. Despite significant advancements in survival rates due to improved therapeutic protocols, the psychological burden experienced by children with ALL.Objective: To evaluate the relationship between age and the presence of depressive symptoms in children diagnosed with ALL.Methods: A cross-sectional study was done using consecutive sampling with 40 children aged from 7 to 18 years old acquired, conducted from August to October 2024 at the outpatient unit of Adam Malik Hospital, Medan. Forty children aged 7–18 years with a confirmed diagnosis of ALL were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Categorical variables were analyzed using the chi-square test, followed by bivariate to identify significant predictors of depression.Results: Among the 40 participants, the most age group were children ≤ 10 years old (65%). A statistically significant association was found between age group and the presence of depressive symptoms (p = 0.001, OR= 33,3). Conclusions: Age is significantly associated with the severity and presence of depressive symptoms in pediatric patients with ALL. Older children were more likely to report higher levels of depression. Psychological evaluation and targeted mental health support may be especially important in older age groups.
Education and Socialization of Mosquito Nest Erradication with 3M Plus Movement to Students and Teachers at SMA Negeri 1 Binjai District, Langkat District, North Sumatera, Indonesia Amelia, Rina; Wijaya, Hendri; Eyanoer, Putri Chairani; Yunanda, Yuki; Wahyuni, Arlinda Sari; Fujiati, Isti Ilmiati; Harahap, Juliandi; Alona, Ivana
ABDIMAS TALENTA: Jurnal Pengabdian Kepada Masyarakat Vol. 9 No. 1 (2024): ABDIMAS TALENTA: Jurnal Pengabdian Kepada Masyarakat
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/abdimastalenta.v9i1.17177

Abstract

Until now, there has been a tendency for dengue fever patients to increase, and its transmission has become one of Indonesia's most common public health problems. Getting rid of mosquito nest eradication (MNE) with the 3M Plus Movement regularly, which includes draining water reservoirs, burying used items, and closing water reservoirs, which make it harder for mosquitoes to breed, can stop the spread of dengue. Even though this disease can attack all groups, several studies have shown that children and teenagers are more susceptible to dengue fever, so it is essential to make efforts to increase understanding and education for school-aged children, including high school students and teachers, who must work together to prevent dengue fever. As a result, the community service team from the Medical Faculty of Universitas Sumatera Utara carried out this activity using an outreach strategy that included questions and answers with students about MNE, Clean and Healthy Living Behavior, and other topics as well as the actual implementation of 3M Plus. A good understanding of MNE among students and teachers allows for the formation of awareness of MNE's significance in the school environment, which is the outcome of this activity.
Empowering Kelompok Perempuan Pesisir Indonesia (Kppi) To Modify Moringa Leaf Fish Balls To Overcome Stunting In Bagan Deli Village Syarifah; Wahyuni, Arlinda Sari; Pujiati; Lubis, Zulhaida; Chairunny, Cici; Nabila, Salsa; Pohan, Indah Zakia
Journal of Community Research and Service Vol. 9 No. 1: January 2025
Publisher : Universitas Negeri Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24114/jcrs.v9i1.68377

Abstract

Stunting is a condition in which children experience impaired growth, so that their height is notappropriate for their age due to chronic nutritional problems. In Bagan Deli urban village, Medan Belawan subdistrict, stunting in children under five is a public health problem. The proportion of stunted children in BaganDeli Village is 10.37%, and children with poor nutrition (below the red line) is 2.9%. The service activity wascarried out on Friday, July 26, 2024 in Bagan Deli Village with participants as many as 10 members of theIndonesian Coastal Women's Group (KPPI) partners and 10 pregnant women and mothers who have toddlers. Thepurpose of the service activity is to increase participants' understanding and knowledge, especially related tostunting and skills in processing moringa leaf meatballs made from fish. The service method was carried out byconducting socialization / training on stunting and cooking demonstrations as well as pre-test and post-test tomeasure participants' understanding and knowledge before and after the material was delivered. The resultsshowed an increase in knowledge before and after the training. Of the 20 training participants, the average increasein respondents' knowledge was 1.7, which showed that this increase was statistically significant.
Penyuluhan Perawatan Kulit Bayi dan Anak pada Masyarakat Desa Buluh Cina, Kecamatan Hamparan Perak, Deli Serdang Paramita, Deryne Anggia; Effendy, Elmeida; Rahmawaty, Rodiah; Wahyuni, Arlinda Sari; Amin, Mustafa Mahmud; Hamdi, Ibnati Amira; Afia, Nadira
Jurnal Pengabdian Masyarakat Kedokteran Vol 5, No 1 (2026): January
Publisher : Fakultas Kedokteran, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/abdimasku.5.1.30-37

Abstract

Salah satu isu penting yang diangkat dalam pembangunan kesehatan di Provinsi Sumatera Utara adalah kesehatan kulit bayi dan anak, mengingat kelompok usia ini memiliki karakteristik kulit yang berbeda dibandingkan orang dewasa, yakni lebih tipis, sensitif, dan rentan terhadap berbagai gangguan seperti iritasi, ruam popok, biang keringat, dan infeksi kulit. Kurangnya pemahaman orang tua dan pengasuh mengenai perawatan kulit yang benar sering menjadi faktor utama munculnya permasalahan tersebut. Berdasarkan data global dan nasional, prevalensi penyakit kulit pada anak cukup tinggi, di antaranya dermatitis atopik (10–20%) dan ruam popok (sekitar 25%), dengan faktor lingkungan dan kebersihan sebagai penyebab dominan. Kegiatan pengabdian ini bertujuan untuk meningkatkan pengetahuan masyarakat mengenai perawatan kulit bayi dan anak melalui penyuluhan kesehatan dan konsultasi langsung. Metode yang digunakan meliputi edukasi interaktif, sesi tanya jawab, serta pelaksanaan pra-uji dan pasca-uji untuk menilai peningkatan pemahaman peserta. Hasil kegiatan diharapkan menunjukkan peningkatan signifikan dalam pengetahuan masyarakat tentang pentingnya menjaga kesehatan kulit, faktor risiko yang memengaruhi, serta praktik perawatan yang tepat. Implikasi dari kegiatan ini adalah meningkatnya kesadaran dan kemampuan masyarakat dalam melakukan perawatan kulit bayi dan anak secara mandiri di rumah sehingga dapat menurunkan kejadian penyakit kulit serta meningkatkan derajat kesehatan anak di lingkungan setempat.
Effectiveness of 0.25% vs 0.375% Ropivacaine for Incisional Infiltration in Cesarean Delivery with Spinal Anesthesia Siregar, Ahmad Habibi; Hamdi, Tasrif; Nadeak, Rommy F.; Wahyuni, Arlinda Sari
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.67832

Abstract

Background: Postoperative discomfort subsequent to a caesarean delivery significantly influences the recuperation process and necessitates efficacious therapeutic intervention. Ropivacaine is a local anesthetic used to manage this pain, but there is limited comparison between its 0.25% and 0.375% concentrations.Objective: To evaluate the comparative efficacy of varying dosages of ropivacaine, specifically 0.25% and 0.375% concentrations, as local anesthetic infiltrates during the surgical procedure of Cesarean section incision.Methods: This randomized controlled trial (RCT) encompassed a cohort of 60 patients who underwent cesarean sections utilizing spinal anesthesia at Adam Malik Hospital, Medan, Haji Hospital Medan, Prof. Chairuddin P. Lubis USU Hospital Medan, and Putri Hijau Hospital Medan. The participants were stratified into three distinct groups: ropivacaine 0.25% (n=20), ropivacaine 0.375% (n=20), and a control group (n=20). Pain intensity was quantitatively assessed employing the numerical rating scale (NRS) at intervals of 2, 6, 12, and 24 hours postoperatively. Furthermore, the utilization of supplementary analgesics and the occurrence of adverse effects were meticulously documented. Statistical analysis of the data was conducted utilizing the Kruskal-Wallis test (p<0.05).Results: Both ropivacaine 0.25% and 0.375% groups demonstrated significantly lower NRS pain scores at 2, 6, 12, and 24 hours postoperatively compared to the control group (p<0.05). Patients receiving ropivacaine infiltration also showed a significantly reduced need for additional analgesics compared to those who did not receive ropivacaine. However, no statistically significant differences in postoperative pain scores or supplemental analgesic requirements were observed between the 0.25% and 0.375% ropivacaine groups (p>0.05).Conclusions: Both 0.25% and 0.375% ropivacaine effectively reduce postoperative pain and the need for additional analgesics compared to the control group. However, there was no significant difference between the two ropivacaine concentrations.
The Effectiveness Comparison of Salmeterol/Fluticasone Propionate and Formoterol Fumarate/Budesonide on Level of Asthma Control in Moderate Persistent Asthma Resti, Riska; Tarigan, Amira Permatasari; Pradana, Andika; Wahyuni, Arlinda Sari
Jurnal Respirologi Indonesia Vol 46 No 1 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i1.851

Abstract

Background: Asthma is a prevalent chronic respiratory disease, affecting approximately 1–18% of the population worldwide. Despite its high prevalence, a substantial proportion of patients have partially controlled asthma, and limited data on the level of asthma control remain a significant concern. This study aimed to compare the effectiveness of salmeterol/fluticasone propionate and formoterol fumarate/budesonide in achieving asthma control levels according to the ACQ-GINA criteria. Methods: A retrospective cohort study was conducted using 61 medical records from January 2017 to December 2019. Patients with moderate persistent asthma received either salmeterol/fluticasone propionate or formoterol fumarate/budesonide for at least three months. Statistical analysis was performed using Fisher’s exact test. Results: A total of 61 patients were included. Most patients had partially controlled asthma (70.5%), followed by well-controlled (19.7%) and uncontrolled asthma (9.8%). No statistically significant difference in asthma control was observed between the two treatment groups (P=0.057). Conclusion: Within the limitations of this retrospective cohort study, no statistically significant difference in asthma control was observed between salmeterol/fluticasone propionate and formoterol fumarate/budesonide.
Co-Authors Adawiyah, Varihatul Afia, Nadira alfira, alfira Alona, Ivana Andika Pradana Bugis Mardina Lubis, Bugis Mardina Chairunny, Cici Danau Arta, Grace Effendi, Kevin Elisabeth Elisabeth Elmeida Effendy Fachrezi, Muhammad Alfian Faradila, Devita Fauriski Febrian Prapiska, Fauriski Febrian Fujiati, Isti Ilmiati Ginting, Nina Melina Hamdi, Ibnati Amira Hamdi, Tasrif Harahap, Armansyah Maulana Harahap, Juliandi Hasaroh, Yunita Hendri Wijaya, Hendri Hia, Sukmawati Indri Adriztina Irina, Rr. Sinta Irma Sepala Sari Siregar Keumalasari, Dina Kiking Ritarwan Lubis, Andriamuri Primaputra Malisie, Ririe Fachrina Muhammad Ihsan Mustafa Mahmud Amin Nababan, Windika Nabila, Salsa Nadeak, Rommy F. Nadeak, Rommy Fransiscus Nuraiza Meutia OLGA RASIYANTI SIREGAR, OLGA RASIYANTI Oslida Martony Panjaitan, Alfred Johnatan Paramita, Deryne Anggia Pasaribu, Ayodhia Pitaloka Pohan, Indah Zakia Pujiati Putri Chairani Eyanoer, Putri Chairani Rahmawaty, Rodiah Resti, Riska Riano, Dwika Intania Ribawanto, Muhammad Rafif Ricardo, Dion Rina Amelia Rini Savitri Daulay, Rini Savitri Risqin, Muhammad Anas Fatah Rita Evalina Rusda, Muhammad Salsabila, Anisa Satria, Fauzi Budi Sekali, Oktaviani Karo Sinaga, Bintang Yinke Magdalena Sirait, Asima Rodiarta Sirait, Cindy Clarissa Siregar, Ahmad Habibi Siregar, Rosmayanti Syafriani Siti Zahara Nasution, Siti Zahara Sormin, Delores Elisabeth Sundari, Rina Syarifah Tanjung, Ika Citra Dewi Tarigan, Amira Permatasari Taufik, Maulana Wijaya, Dadik Wahyu Yunanda, Yuki Yunnie Trisnawati, Yunnie Zulhaida Lubis