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Journal : Medula

Enterobactericeae Sebagai Bakteri Patogen Infeksi Nosokomial di Rumah Sakit Putri, Abrila Tamara; Soleha, Tri Umiana; Nareswari, Shinta; Ramadhian, M. Ricky
Medula Vol 14 No 1 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i1.942

Abstract

Enterobactericeae are gram-negative rod bacteria which are often pathogenic bacteria that cause nosocomial infections. Enterobactericeae bacteria have several characteristics including small size and rod shape, natural habitat in the digestive tract of humans or animals and some others originate from bodies or inanimate objects, are motile and non-motile, cannot form spores, and are aerobic to facultative anaerobic. Nosocomial infections are infections that are acquired during the health care process at the hospital, but are not present when the patient is admitted to the hospital. The source of transmission of nosocomial infections can result from direct or indirect contamination in the health care process in hospitals. Common nosocomial infections include Central Line Associated Blood Stream Infection (CLABSI), Catheter Associated Urinary Tract Infection (CAUTI), Surgical Site Infection (SSI), and nosocomial pneumonia consisting of Hospital Acquired Pneumoniae (HAP), Ventilator Associated Pneumoniae (VAP), and Health Care Associated Pneumoniae (HCAP). The Enterobactericeae bacteria that often cause nosocomial infections in hospitals include Escherichia coli, Klebsiella sp, Enterobacter sp, Pseudomonas sp, and so on. Nosocomial infections have a negative impact on the health recovery process of inpatients in hospital, so they need to be handled well and preventive efforts are made to avoid this undesirable event through health service efforts that comply with standard operational procedures and pay attention to aseptic principles.
Hubungan Usia, Paritas, Dan Kadar Hemoglobin Ibu Dengan Kejadian Bayi Berat Lahir Rendah (BBLR) Di RSUD Dr. H. Abdul Moeloek Provinsi Gabrile Madumey, Diora; Nareswari, Shinta
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1495

Abstract

Low Birth Weight (LBW) is defined as a birth weight of less than 2,500 grams. Infants born with low birth weight represent a significant and ongoing health issue, both locally and globally. The occurrence of LBW is multifactorial, and among the various risk factors, most are related to maternal conditions. Based on existing research, several maternal factors that may influence the incidence of LBW include maternal age, parity, and hemoglobin levels. This study employed an observational analytic method with a cross-sectional approach. The research sample consisted of postpartum mothers who delivered LBW infants and met the inclusion and exclusion criteria at Dr. H. Abdul Moeloek Regional General Hospital (RSAM) from January 2020 to November 2021, totaling 135 subjects. The independent variables in this study were maternal age, parity, and hemoglobin levels, while the dependent variable was the incidence of LBW, classified into small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA). The sampling technique used was total sampling. The results showed that maternal age was significantly associated with the incidence of LBW, with a p-value of 0.037 (<0.05), and maternal hemoglobin level was also significantly associated with LBW, with a p-value of 0.024 (<0.05). However, parity was not associated with the incidence of LBW, as indicated by a p-value of 0.111 (>0.05). In conclusion, maternal age and hemoglobin levels are associated with the incidence of LBW, whereas parity is not.
Kekuatan Genggaman Tangan pada Dewasa Muda Tiasti, Jania; Setiorini, Anggi; Nareswari, Shinta; Sangging, Putu Ristyaning Ayu
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1665

Abstract

Handgrip strength (HGS) is an important indicator that reflects both musculoskeletal health and overall well-being. Hand grip strength is widely applied in research and clinical practice because its measurement is simple, reliable, and able to represent overall muscle strength. The assessment of HGS is conducted using a handgrip dynamometer, which operates based on specific principles. However, the limited literature on normative data for young adult populations hinders the interpretation of handgrip performance in this age group. One normative study reported that in healthy young adults, the average HGS reached 36.32 kg in men and 22.96 kg in women. These values may vary depending on ethnicity, level of physical activity, and lifestyle habits. Factors influencing HGS include body composition, anthropometric characteristics, sex, age, nutritional status, and physical fitness. Physiologically, men tend to have higher HGS than women due to differences in muscle mass, hormonal levels, and muscle fiber distribution. The decline of HGS with increasing age is closely related to sarcopenia, a condition characterized by reduced muscle strength, mass, and function associated with aging. Therefore, maintaining handgrip strength from an early age is crucial to support daily activities, preserve independence in older age, and serve as an indicator of future health risks.
Hubungan antara Imunisasi Rotavirus dengan Kejadian Diare pada Balita Syahfira, Reisyah; Nareswari, Shinta; Berawi, Khairunnisa
Medula Vol 15 No 2 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i2.969

Abstract

Diarrhea is a condition of defecating more than 3 times a day accompanied by a change in the consistency of the stool to liquid with or without mucus and blood that lasts less than one week. Diarrhea results in a loss of fluids and electrolytes, especially sodium and potassium, in large amounts. Fluid loss that continues and is not balanced with adequate replacement will result in dehydration. The risk of dehydration in toddlers is greater due to the inability to meet their fluid needs while their body fluid composition is large. Dehydration that is allowed to continue will result in several complications and even death. Therefore, diarrhea is one of the diseases that is the main cause of morbidity and death in children under five. One prevention of diarrhea is rotavirus immunization. Rotavirus immunization is an effort to actively create/increase a person's immunity against a disease so that if one day they are exposed to the disease they will not get sick or will only experience mild illness. This research was conducted to determine the relationship between rotavirus immunization and the incidence of diarrhea in toddlers. This research uses a literature review method with data sources from the National Center for Biotechnology Information, Google Scholar, and Science. The research year range of articles is 2018 to 2021 and articles conducted in English and Indonesian literature. The results of this literature review from the 6 articles analyzed stated that there was a relationship between rotavirus immunization and the incidence of diarrhea in toddlers.
Meningitis TB Pada Anak 16 tahun: Laporan Kasus Alghani, Sulthan Rafi; Nareswari, Shinta
Medula Vol 14 No 12 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i12.1279

Abstract

Tuberculous meningitis is a form of Mycobacterium tuberculosis infection that affects the meninges of the brain. The case discussed involves a 16-year-old male adolescent who initially presented with symptoms of headache, fever, neck pain, and neck stiffness, which persisted for several weeks. The delay in diagnosis occurred due to the similarity of the initial symptoms to bacterial meningitis, often leading to postponed TB treatment. The diagnosis was established through anamnesis, physical examination, and supporting tests, including a molecular rapid test (TCM) on cerebrospinal fluid (CSF) and a head CT scan, which confirmed the presence of miliary TB in the lungs and meningitis accompanied by hydrocephalus. The patient also experienced a weight loss of four kilograms over the past two weeks, indicating systemic signs of chronic infection. Although the patient received Anti-Tuberculosis Treatment (ATT) such as rifampicin, isoniazid, pyrazinamide, and ethambutol, his condition deteriorated, and he ultimately passed away on the ninth day of hospitalization. Neurological examination revealed a progressive decline in consciousness to a GCS score of 8 and the presence of pathological reflexes, such as a positive Babinski sign, confirming central nervous system involvement. The mortality rate of TB meningitis remains high due to delayed ATT caused by the lack of early diagnosis, emphasizing the importance of early detection to improve patient prognosis. Preventive efforts through active screening of high-risk groups and education about the early symptoms of TB meningitis are crucial in reducing morbidity and mortality rates.
HUBUNGAN DIABETES MELITUS GESTASIONAL TERHADAP KEJADIAN BERAT BADAN LAHIR RENDAH DI RSUD DR H ABDUL MOELOEK TAHUN 2023 Suhaili, Gadis Bunga; Rukmono, Prambudi; Nareswari, Shinta; Sari, Ratna Dewi Puspita
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1304

Abstract

A low birth weight (LBW) infant is defined as an infant born weighing less than 2500 grams regardless of gestational age. The main factors causing LBW are maternal factors, fetal factors, and placental factors. Risk factors for LBW associated with maternal factors include a history of complications during pregnancy, one of which is gestational diabetes mellitus. This study used a cross-sectional design with Pearson Chi-Square statistical test conducted at Dr. H. Abdul Moeloek General Hospital, Lampung Province in October - November 2024. The study sample was infants born at Dr. H. Abdul Moeloek Hospital in the period January - December 2023. The results of this study indicate that 16% of infants born were extremely low birth weight (ELBW), 20% of infants born were very low birth weight (VLBW), and 64% of infants born were low birth weight (LBW). The results of the chi-square analysis showed that there was a relationship between gestational diabetes mellitus (p = 0.042) and low birth weight (LBW).  
Hubungan Prosedur Invasif dan Lama Rawat Inap Terhadap Kejadian Sepsis Neonatorum Awitan Lambat di RSUD Dr. H. Abdul Moeloek Tahun 2023 Putri Arafah, Aisyah; Rukmono, Prambudi; Nareswari, Shinta; Saputra, Oktadoni
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1310

Abstract

Infant Mortality Rate (IMR) in Indonesia is still dominated by neonatal deaths, accounting for 55% of all infant deaths. Neonatal sepsis is the third leading cause of neonatal deaths after low birth weight (LBW) and asphyxia. Late-onset neonatal sepsis (LONS) is a systemic response to infection when the neonate is more than 72 hours old, as evidenced by a positive blood culture. Currently, late-onset neonatal sepsis remains the third leading cause of neonatal deaths. Late-onset neonatal sepsis usually occurs through the transmission of pathogens from the environment (nosocomial). The difficulty of early diagnosis in late-onset neonatal sepsis necessitates a diagnosis based on nosocomial infection factors, such as the use of invasive procedures and prolonged hospital stays. This research employed a descriptive analytic method with a cross-sectional approach. The sample consisted of all neonates diagnosed with neonatal sepsis and recorded in medical records with positive blood culture results in the Perinatology ward of RSUD Dr. H. Abdul Moeloek Bandar Lampung in 2023. Data were analyzed univariately and bivariately using the Chi-square test with Fisher's exact test as an alternative. The data suggests a statistically significant correlation between invasive procedures (p= 0.043) and length of hospital stay (p= 0.012) with the development of late-onset neonatal sepsis (LONS).
Demensia Alzheimer pada Lansia Nadhifa, Farin; Ramadhian, Muhammad Ricky; Nareswari, Shinta
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1355

Abstract

Alzheimer’s dementia in the elderly is a health problem that affects the quality of life of patients and their families. This study aims to explore the risk factors, prevention, and management of Alzheimer's Dementia in the elderly, focusing on the use of information technology for early detection, and the impact of physical activity as a preventive strategy. This research utilizes a literature review method by analyzing previous studies related to Alzheimer's dementia in the elderly. The analysis includes risk factors for dementia, prevention through physical activity, and the role of information technology in early detection and disease management. The results of the literature review indicate that the risk factors for Alzheimer's dementia in the elderly include age, genetics, and lifestyle. The study also shows that physical activity has a positive effect in reducing the risk of dementia. Moreover, information technology has significant potential in aiding early detection and disease management, allowing for more timely and effective intervention. Alzheimer’s dementia in the elderly requires a comprehensive approach involving early detection, prevention, and disease management. Physical activity and the use of information technology play vital roles in preventive and therapeutic strategies for Alzheimer's dementia.
Anak dengan Tuberkulosis (TB) Paru Kasus Baru Terkonfirmasi Bakteriologis dengan Riwayat Human Immunodeficiency Virus (HIV) yang Menjalani Pengobatan Antiretroviral (ARV) Soemarwoto, Retno Ariza S; Afryan, I Made; Nareswari, Shinta; Sinaga, Fransisca; Saputra, Oktadoni; Herliyana, Lina; Hidayat, Hidayat
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1423

Abstract

Tuberculosis (TB) in children with Human Immunodeficiency Virus (HIV) is a complex clinical challenge due to the synergistic interaction between these two diseases, which mutually worsen the patient's clinical condition. HIV decreases immunity, thus increasing the risk of TB infection, while TB accelerates HIV progressivity. TB-HIV co-infection is a major cause of morbidity and mortality, especially in children with undetected M. Tuberculosis infection. By 2022, an estimated 710,000 HIV patients will develop TB, of which 187,000 will die. This article aims to provide an update on the management of pulmonary TB in children with HIV who are routinely on antiretroviral (ARV) treatment. The discussion covers the definition, epidemiology, etiology, disease progression, pathogenesis, diagnosis, supporting investigations, and management of TB-HIV. The diagnosis of TB in children with HIV is often difficult due to non-specific clinical manifestations and limitations of diagnostic tests. Therefore, early detection through comprehensive testing is essential. TB-HIV management requires a multidisciplinary approach, including appropriate TB treatment and integrated ARV administration. Intensive monitoring is also required to prevent complications, such as drug resistance or adverse effects of therapy. In conclusion, this article emphasizes the importance of a holistic approach in evaluating and managing pulmonary TB in children with HIV, including interprofessional collaboration, family education, and preventive efforts to improve patients' quality of life and reduce mortality.
Hubungan antara status kesehatan balita dengan kejadian pneumonia di indonesia (analisis data riskesdas 2018) Howay, Susan Yulia Laura; Sutarto, Sutarto; Larasati, TA; Nareswari, Shinta
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1719

Abstract

Pneumonia is a leading cause of under-five mortality in Indonesia. Several risk factors—such as low birth weight, incomplete immunization, lack of exclusive breastfeeding, and poor nutritional status—contribute to the high mortality rate. This study aims to determine the prevalence of pneumonia and the distribution of low birth weight, immunization status, nutritional status, and exclusive breastfeeding among Indonesian children under five, as well as to analyze their associations with pneumonia. This study used secondary data from the 2018 National Basic Health Research (Riskesdas) covering 34 provinces in Indonesia with a cross-sectional design. Samples were selected using probability proportional to size (PPS) with a two-stage sampling method. Data were analyzed using the chi-square test. The results of statistical tests in this study showed that there was a significant relationship between birth weight status and nutritional status with the incidence of pneumonia (p value = 0.000; 95% CI, 1.269-1.996; OR = 1.592) and (p value = 0.029; 95 % CI, 1.023-1.449; OR = 1.218), while the results of statistical tests also showed that there was no significant relationship between immunization status and exclusive breastfeeding status with the incidence of pneumonia (p value = 0.656; 95% CI, 0.808-1.137; OR = 0.958 ) and (p value = 0.803; 95% CI, 0.832-1.153; OR = 0.979). In the conclusion, a significant association was found between birth weight status and nutritional status with the occurrence of pneumonia.