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All Journal Jurnal Anestesiologi Indonesia MEDIA MEDIKA INDONESIANA International Journal of Science and Engineering (IJSE) JURNAL GIZI INDONESIA Nurse Media Journal of Nursing Jurnal Kedokteran Diponegoro Jurnal Keperawatan Soedirman (The Soedirman Journal of Nursing) Interest : Jurnal Ilmu Kesehatan Jurnal Keperawatan dan Kesehatan Masyarakat CENDEKIA UTAMA Jurnal Epidemiologi Kesehatan Komunitas Medica Hospitalia Journal of Telenursing (JOTING) Jurnal Aisyah : Jurnal Ilmu Kesehatan Diponegoro International Medical Journal (DIMJ) Narra J JHeS (Journal of Health Studies) Neurona Jurnal Bidan Cerdas

Dwi Pudjonarko

Fakultas Kedokteran Universitas Diponegoro

Author-ID : 348185

Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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The effect of additional protein, phosphatidylcholine, phosphatidylserine, and inulin on S100β levels of acute ischemic stroke patients at Dr. Kariadi Central Hospital, Semarang Stephani Nesya Renamastika; Endang Mahati; Martha Kartasurya; Dodik Pramukarso; Dwi Pudjonarko; Retnaningsih Retnaningsih
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 9, No 2 (2021): Juni
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jgi.9.2.172-183

Background: The brain releases biochemical substrates, such as S100β protein, into circulation in response to ischemic conditions as a sign of damage in nerve cells and disruption of the blood-brain barrier’s integrity. Thrombolytic therapy has led to the development of many neuroprotective therapies such as protein, phosphatidylcholine, phosphatidylserine, and inulin, which can be added to food products. Protein, phospholipids, and inulin, have a neuroprotective impact on nerve cells in the brain and blood-brain barrier.Objective: To prove the effect of protein, phosphatidylcholine, phosphatidylserine, and inulin on S100β levels and clinical outcomes in patients with acute ischemic stroke.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into nine subjects for the intervention group and nine subjects for the control group. The Control group received 250 ml conventional formula milk (11.8 g protein) 3 times/day. The intervention group received 250 mL commercial milk 3 rimes/day which contained 15 g protein with 128 mg phosphatidylcholine, 32 mg phosphatidylserine, and 3 g inulin. All of the groups were given hospital-standard therapy for ischemic stroke. S100β levels were measured at pre and post-intervention.Results: Pre and post S100β levels in intervention and the control group did not show any statistically difference (p = 0.777 and p = 0.096), but there was a trend of decreasing levels of S100β in the intervention group (-24.6 + 252.0 pg/mL) versus control group (135.8 + 216.2 pg/mL).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin did not have a significant effect on S100β levels.

Characteristics of stroke patients: An analytical description of outpatient at the hospital in Semarang Indonesia Lestari, Lis Mukti; Pudjonarko, Dwi; Handayani, Fitria Handayani
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 5, No 1: June 2020
Publisher : Universitas Aisyah Pringsewu

A country's population characteristic is influenced by differences in lifestyle due to changes in demographics, epidemiology and culture of each region so, the behavior risk is detrimental to health. The purpose of this study is to determine the characteristics of stroke patients in Semarang Districts. The method used was descriptive-analytic and samples were taken using a total sampling technique of 92 patients diagnosed with a stroke. Data obtained from patient medical records and interviews with patients or their families. The patients interviewed had an MMSE score of 24-30. The results of this study showed the characteristics of stroke patients in Semarang 57.6 percent aged 40-59 years, male patients by 50 percent, the population who had never been at school 30.4 percent, non-hemorrhagic stroke 83.7 percent, patients with left hemiparesis 51.1 percent, patients with risk factors for hypertension 85.9 percent, and 79.6 percent of patients had never been exposed to information about stroke. History of diabetes mellitus and smoking habits significantly influences the occurrence of non-hemorrhagic stroke. Patients with diabetes mellitus have a risk of 9.6 times and patients with smoking have a risk of 3.9 times to experience a non-hemorrhagic stroke.Karakteristik pasien stroke: Deskripsi analitis pada pasien rawat jalan di rumah sakit di Semarang IndonesiaAbstrakKarakteristik penduduk suatu negara dipengaruhi oleh perbedaan gaya hidup akibat adanya perubahan demografi, epidemiologi dan juga budaya masing-masing daerah sehingga berisiko terjadinya perilaku yang merugikan kesehatan. Tujuan penelitian ini adalah untuk mengetahui karakteristik pasien stroke di Kabupaten Semarang. Metode yang digunakan adalah deskriptif analitik dan sample diambil dengan menggunakan tehnik total sampling terhadap 92 orang pasien yang di diagnosa stroke. Data diperoleh dari rekam medis pasien dan wawancara kepada pasien atau keluarganya. Pasien yang diwawancara memiliki nilai MMSE 24-30. Hasil penelitian ini menunjukkan karakteristik pasien stroke di Kabupaten Semarang 57,6 persen berusia 40-59 tahun, pasien jenis kelamin laki-laki sebesar 50 persen, penduduk yang tidak pernah sekolah 30,4 persen, stroke non hemorhagik 83,7 persen, pasien dengan hemipharesis kiri 51,1 persen, pasien dengan faktor resiko hipertensi 85,9 persen, dan 79,6 persen pasien belum pernah terpapar informasi tentang stroke. Riwayat diabetes melitus dan kebiasaan merokok berpengaruh secara signifikan untuk terjadinya stroke non hemorhagik. Pasien dengan diabetes melitus memiliki risiko 9,6 kali dan pasien dengan kebiasaan merokok memiliki risiko 3,9 kali untuk mengalami stroke non hemorhagik.

Efektivitas Aromaterapi terhadap Kualitas Tidur dan Kecemasan Vania Pangestika Purwaningrum; Fitria Handayani Handayani; Dwi Pudjonarko
Journal of Telenursing (JOTING) Vol 5 No 2 (2023): Journal of Telenursing (JOTING)
Publisher : Institut Penelitian Matematika, Komputer, Keperawatan, Pendidikan dan Ekonomi (IPM2KPE)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31539/joting.v5i2.6050

This study aims to determine the effectiveness of aromatherapy on sleep quality and anxiety in elderly adult population patients. The method used is a systematic review related to the management of sleep disorders and anxiety with aromatherapy. The results showed that aromatherapy given by inhalation and massage methods with lavender, rosa damascene, chamomile and neroli essential oils for at least three nights and a maximum of thirty days was considered to have an effect on sleep quality and anxiety. Conclusion, aromatherapy is effective in improving sleep quality and reducing anxiety. Keywords: Anxiety, Aromatherapy, Sleep Quality

Pengaruh Robotic Therapy dalam Meningkatkan ROM dan Memperbaiki Tonus Pasien Stroke Iskemik Pangesti, Adelia; Julianti, Hari Peni; Pudjonarko, Dwi; Rahmawati, Maria Belladonna; Ismail, Rifky
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: After stroke occurs, the patients generally have upper extremity hemiparesis. It makes movement restrictions due to decreased elbow active ROM and abnormal upper arm muscle tone, so they need to get rehabilitation therapy. Besides conventional therapy, robotic therapy has now been developed to restore their motor funtions. Objective: To prove that the effect of robotic therapy in increasing elbow active ROM and improving upper arm muscle tone in ischemic stroke patients is better than the effect of conventional rehabilitation exercises. Methods: A quasy-experimental study with two groups pre-test and post-test design was carried out among outpatient ischemic stroke patients in Diponegoro National Hospital and William Booth General Hospital Semarang which was chosen using consecutive sampling.The interventions were by doing exercises using an exoskeleton robotic hand in the robotic group and conventional rehabilitation exercises in the control group. Pre-test and post-test data of robotic group were analyzed using Wilcoxon test, while pre-test dan post-test data of control group were analyzed using Wilcoxon test and paired t-test. Pre-test an post-test data between two groups were analyzed using Mann-Whitney test and unpaired-t test. Results: The robotic group experienced an insignificant increase in ROM (p= 0,593) and significant improvement in muscle tone (p= 0,025). The control group experienced insignificant reduction in ROM (p= 0,980) and insignificant improvement in muscle tone (p= 0,081). Conclusion: There was a significant improvement of upper arm muscle tone in ischemic stroke patients after had exoskeleton robotic hand exercise. Keywords: Stroke, elbow active ROM, muscle tone, exoskeleton robotic

Hubungan Hipertensi dengan Klasifikasi Hernia Nukleus Pulposus Lumbal berdasarkan Magnetic Resonance Imaging Sunjata, Winda Putri; Meutia, Yurida Binta; Sukmaningtyas, Hermina; Pudjonarko, Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT BACKGROUND : Hypertension is a disease that is known to affect other diseases. Recent research finds that HT is associated with disc degeneration disease. Herniated nucleus pulposus (HNP) lumbar as a result from disc degeneration disease need to be known to be affected by hypertension or not. OBJECTIVE: To know the relationship between hypertension and the classification of disc degeneration based on Pfirrmann’s criteria and herniated nucleus pulposus lumbar classification based on magnetic resonance imaging. METHOD : This research use descriptive observational with cross sectional design. Subjects were 62 lumbar HNP patients diagnosed at RSUP Dr. Kariadi Semarang from January 2019 - March 2020. The subject data were analyzed using non-parametric Chi Square test and Mantel Haenszel test. RESULT : Based on the analysis, it was found that p>0.05 was found in the relationship between age and sex with the classification of disc degeneration and lumbar HNP. The result of correlation test between hypertension and disc degeneration classification is p<0,05 with odds ratio 14,700 and lumbar HNP classification is p >0.05. In relation to the classification of disc degeneration with lumbar HNP classification, the value of p >0.05 was also obtained. CONCLUSION : There was no association between age, sex, the classification of disc degeneration and lumbar HNP classification. There was a significant association between hypertension and the classification of disc degeneration with the individual risk of hypertension increasing 14,7 times but no association was found with lumbar HNP classification. Keywords: Disc degeneration; Hypertension; Lumbar herniated nucleus pulposus

Pain Improvement Among Chronic Lumbar Disc Herniation Patients Underwent Epidural Triamcinolone With Or Without Hyaluronidase Injection Within 3 Months Of Follow-Up: A Prospective Study Budisulistyo, Trianggoro; Husni, Amin; Tugasworo, Dodik; Pudjonarko, Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.850

Background Chronic lumbar disc herniation (CLDH) will accompany by chronic inflammation, so the fibrosis tissues formed in the epidural space and adjacent nerve roots, and lead to mixed pain syndrome. Objectives To compare between triamcinolone only and hyaluronidase 1500 international unit (IU) administration epidural injection for treating bulged or protrusion CLDH. Methods This prospective study involved CLDH patients visiting the outpatient department of Neurology at Dr. Kariadi Hospital Semarang Indonesia from November 2021 until August 2022. They divided: triamcinolone (Group 1) and hyaluronidase 1500 IU and triamcinolone epidural injection (Group 2) with 3 days of hospitalization. Neurotrophic was prescribed during 3 months of follow-up and ordered for personal physical treatment. They analyzed pain improvements (NRS and Pain DETECT), and the Oswestry Disability Index (ODI) scores. Results The 37 subjects were recruited but 1 female dropped out cause of re-injection, so 13 males and 23 females aged between 24 to 72 years old (mean 48+2) were followed. They significantly improved (Wilcoxon test p=.000), as the NRS score was 47.9% (Group 1) and 55.4% (Group 2). ODI scores without significance (Mann-Whitney p> .005), such at 2 weeks (group 1= 20.4%, group 2= 23.6%) and 3 months (group 1= 58.1%, group 2= 53.7%). They observed nociceptive and neuropathic improvement even though needed more time for the healing process. Conclussions This study proved hyaluronidase administration before triamcinolone epidural injection with better improvements for treating bulged or protrusion CLDH patients.

Association Of Neuropathic Pain Improvement And hs-CRP Changes Among Trigeminal Neuralgia Patients Experienced Radiofrequency Ablation 60o and 65o Celcius: 6 months follow up Arlina, Yani; Budisulistyo, Trianggoro; Pudjonarko, Dwi; Tugasworo, Dodik; Suryawati, Herlina; Diah Pasmanasari, Elta
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.876

INTRODUCTION: Trigeminal neuralgia (NT) is a neuropathic pain that involves the trigeminal nerve in the face. The first-line medical management of patients with NT is Carbamazepine (CBZ). Radiofrequency ablation (RFA) procedure is a minimally invasive procedure using a high-frequency current-generating device that produced heat ablate of C-fibers with effectiveness around 76% for 10 yeas follow-up. Inflammed trigeminal nerve (TG) or the branch(es) might be one of the underlying mechanisms unless vascular compression is a common etiology. The heat effects might be according to the temperature set up varies recently from 60°C to 95°C. METHOD: This observational study enrolled 75 severe NT subjects without satisfactory improvement of treatments, divided into 3 groups: analgesics prescription (Control), RFA 60, and RFA 65 Groups. The LANSS scores and hs-CRP levels were followed-up before (baseline), 2 weeks, 3, and 6 months experienced the treatments. Subjects ages in the range of 48.32 + 12.73 to 50.88 + 14.59 years old, and the duration of illness from 4.48 to 10.32 months. RESULT: The LANSS score >12 before treatments showed significance improvements (p<0.001), as in the Control (64% with neuropathic pain), RFA 60 (100% with neuropathic pain), and RFA 65 group (92% with nociceptive pain) at 2 weeks followed-up. At 3 and 6 months observed 100% subjects with nociceptive pain but without significancies. Even though the hs-CRP levels observed reduced for all groups, especially RFA 60 and RFA 65, but have no significances. CONCLUSION: The LANSS scores changes observed significant improvement in all groups, which mentioned if the neuropathic pain syndromes might be better under each treatment. The Hs-CRP levels improvement is better in the neuro ablation groups than analgesic drugs treatment. Even though the Hs-CRP are following of systemic nonspecific inflammation, NT is a focal inflammation.

Fetal Growth Cut-Off Point To Predict Neonatal Outcome In Pregnancy With Normal And Deficient Vitamin D Levels: Intergrowth-21, World Health Organization Fetal Growth Curve, And Hadlock’s Estimated Fetal Weight Dewantiningrum, Julian; Kristanto, Herman; Pudjonarko, Dwi; Mexitalia, Maria; Ediati, Annastasia; Soejoenoes, Ariawan; Hadisaputro, Suharyo
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.877

Purpose : Analyze the cut-off point of fetal growth based on the Intergrowth-21, World Health Organization (WHO), and Hadlock’s estimated fetal weight (EFW) in pregnant women with normal or deficient vitamin D levels to predict neonatal outcomes. Method: This cross sectional study to develop a diagnostic test, included 120 of pregnant women who completed follow up until children aged 2 years, divided into normal and deficient vitamin D group. Ultrasound and maternal vitamin D level examined during the second trimester of pregnancy. EFW was calculated using Hadlock’s formula and plotted on the Intergrowth-21 and WHO curves. The reference standards were the neonatal outcome, LBW, stunting, and neurocognitive impairment. Significant odds ratio (OR) value and area under the curve (AUC) of 0.6 are used to determine the cut-off point to be used. Result: Fetal growth curve was based on the WHO at the 5th percentile to predict LBW to have an AUC of 0.6 and OR of 6, 95% confidence interval (CI) of 1.36–26.45. The AUC for predicting LBW based on Intergrowth and Hadlock were 0.45 and OR not significant. As well as the AUC estimated stunting based on Hadlock, the Intergrowth-21 and the WHO fetal growth curves is <0.6 with OR not statistically significant. The AUC predicted neurocognitive impairment based on WHO’s chart was 0.6 but OR not statistically significant. Conclusion: The WHO fetal growth curve can be used to predict LBW. The cut-off point of the fetal growth curve and which percentile is determined by the neonatal outcome.

Relationship Between Serum Malondialdehyde (MDA) Levels With Seizure Frequency In Epilepsy Patients With Combination Of Phenytoin And Valproic Acid Noegroho, Aji; Bintoro, Aris Catur; Pudjonarko, Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.987

Background: Oxidative stress is believed to be one of the factors involved in the pathogenesis of epileptogenic where lipid peroxidation occurs which produces Malondialdehyde (MDA). Epilepsy and some Antiepileptic Drugs (AEDs) can improve or worsen seizure frequency thereby significantly changing blood MDA levels. Objective: To determine the relationship between serum MDA levels and seizure frequency in epileptic patients treated with AEDs, a combination of phenytoin and valproic acid. Methods: A cross-sectional study with consecutive sampling of 46 subjects (with epilepsy receiving combination therapy with phenytoin and valproic acid. The research was conducted at the Neurology Policlinic at RSUP Dr. Kariadi in December 2022 – February 2023. MDA levels were measured using the Enzyme Linked Immunosorbent Assay (ELISA) method. The relationship between serum MDA levels and seizure frequency was analyzed using Spearman's test since both of the variables are ordinal scale, the results were significant if p<0.05. Results: There was no relationship between MDA levels and seizure frequency in epileptic patients with the combination of phenytoin and valproic acid. (p=0.516) There is a significant relationship between the frequency of seizures and the length of treatment (p=0.026) with a weak negative correlation (rho=0.328). There is a significant relationship between the frequency of seizures and the age of onset of epilepsy (p=0.037) with a weak negative correlation (rho=0.309). Conclusion: There is a significant relationship between the frequency of seizures with the length of treatment and the age of onset of epilepsy.

The Influence Of Spiritual Emotional Freedom Technique On Cortisol Levels in Ischaemic Stroke Patients Nurahman Hendra Kusuma, Aria; Pudjonarko, Dwi; Sujianto, Untung
Interest : Jurnal Ilmu Kesehatan INTEREST: Jurnal Ilmu Kesehatan Volume 13 Number 2 November 2024
Publisher : Poltekkes Kemenkes Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37341/interest.v13i2.688

Background: Ischaemic stroke patients experience an increase in cortisol of 38% over 90 days. The spiritual emotional freedom technique (SEFT) provides manual stimulation of acupuncture points, which makes the muscles feel relaxed so that they can control cortisol. This study set out to assess how SEFT affected the cortisol levels in patients who had suffered an ischaemic stroke. Methods: A control group and pre- and post-test measures were part of the quasi-experimental research design. There were seventy-one patients in the research population of the study. The sample was measured using the Slovin formula, and the sampling strategy used was purposeful sampling. Over the course of three months, the intervention group had 12 sessions of SEFT once a week, whereas the control group received regular spiritual treatment from RSUD Dr. Moewardi Surakarta, an outpatient nurse. The ELISA method was used to measure cortisol levels. The Kolmogorov-Smirnov test was used to assess normality, and the Levene test was used to test for homogeneity in bivariate data. The Mann-Whitney method was used to analyze the data. Results: The mean cortisol before intervention was 119.63, and the mean cortisol after intervention was 99.23. SEFT affects cortisol levels in patients who have had an ischaemic stroke, according to a statistically significant (p<0.05) p-value of zero. Conclusion: Patients with ischaemic stroke experienced a significant drop in cortisol levels after using the SEFT. Furthermore, it is necessary to study the dominant factors that influence the cortisol hormone and the need for a multi-religious approach in an effort to develop spiritual-based interventions.

Co-Authors Amin Husni Ani Margawati Annastasia Ediati Aria Nurahman Hendra Kusuma Arif Iskandar Arinta Puspita Wati, Arinta Puspita Aris Catur Bintoro Arlina, Yani Armatussolikha, Herna Rizkia Bagaskoro, Yoseph Cahyo Budisulistyo, Trianggoro Darmawati Ayu Indraswari Dewi Siyamti Diah Pasmanasari, Elta Dian Ratna Sawitri Dodik Pramukarso Dodik Tugasworo Dodik Tugasworo Dodik Tugasworo Pramukarso Edi Dharmana Endang Mahati Fauzi, Muhammad Iqbal Fitria Handayani Fitria Handayani Handayani Fitria Handayani Handayani Handayani, Fitria Hardhono Susanto Hari Peni Julianti Hartono, Jimmy Eko Budi Hassa, Nazwan Hastaning Sakti Herinawati, Herinawati Herman Kristanto Hermawan Istiadi Hermina Sukmaningtyas Ignatius Riwanto, Ignatius Julian Dewantiningrum Koestoer, Clara Krishanti Kusman Ibrahim Latifah Latifah Lestari, Lis Mukti Lis Mukti Lestari M Naharuddin Jenie Mardiyono, Mardiyono Maria Mexitalia Martha Irene Kartasurya Mateus Sakundarno Adi, Mateus Sakundarno Meidiana Dwidiyanti Meutia, Yurida Binta Muis, Siti F. Murbawani, Etisa A. Noegroho, Aji Nugraha, Laksmana AK. Nurahman Hendra Kusuma, Aria OS Hartanto Pangesti, Adelia Pradesta, Rizki Rudwi Pramukarso, Dodik T. Pranoto, Stephano Rahmawati, Maria Belladonna Ramadhany, Ghifarie A. Respati, Danendra RP. Retnaningsih Retnaningsih Rifky Ismail Satrio Adi Wicaksono Setyowati Setyowati Soejoenoes, Ariawan Sri Achadi Nugraheni Stephani Nesya Renamastika Subagio, Hertanto W. Suhartono, Suhartono Suharyo Hadisaputro Suharyo Hadisaputro Sunjata, Winda Putri Suparyatmo, J.B Suryawati, Herlina Tjandra, Kevin C. Udadi Sadhana, Udadi Untung Sujianto Vania Pangestika Purwaningrum

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