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ANALISIS KESIAPAN PENERAPAN REKAM MEDIS ELEKTRONIK (RME)DI RSUP DR. M. DJAMIL PADANG Vesri Yoga; Bestari Jaka; Mendhel Yanti
B-Dent: Jurnal Kedokteran Gigi Universitas Baiturrahmah Volume 8, Nomor 1, Juni 2021
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/jbd.v8i1.598

Introduction: The use of Electronic Medical Records (EMR) can provide great benefits for health services such as basic service facilities and referrals (hospitals). Currently, RSUP dr. M. Djamil plans to implement services with electronic medical records for services efficiency and improve the quality of services provided for patients, and ensure patient safety. Therefore, it is necessary to conduct a readiness assessment before implementing EMR. This will help identify processes and priority scales, as well as help establish operational functions to support the optimization of EMR implementation. Research objectives to analyze the readiness of implementing electronic medical records at RSUP dr. M. Djamil Padang. Methods: The research design used in this research is a case study with a qualitative approach. The research was conducted at the RSUP dr. M. Djamil Padang. The research activity was started from August to October 2020. The informants in this study were selected based on the purposive sampling method. Results: This study shows that organizational culture readiness is quite ready. Knowledge related to the application of EMR has been disseminated to all medical staff and medical support and experience in implementing EMR in the Emergency Room, which was currently running, there were still obstacles, still use manual printouts at the end. Regarding the readiness of governance and leadership, RSUP dr. M. Djamil Padang has a clear vision in implementing EMR. The average informant is optimistic that the change in the manual to electronic medical record system (EMR) can be successfully implemented in RSUP dr. M. Djamil Padang because the EMR can provide benefits for the hospital. The readiness of human resources for medical support is still in a gradual process. For infrastructure readiness, hardware and software can be implemented at RSUP dr. M. Djamil Padang in implementing EMR, although there were still some obstacles, the hospital is optimistic that the implementation of this EMR will run well. Conclusion: EMR implementation readiness still needs to be improved, such as organizational culture readiness, governance and leadership readiness, Human Resources (HR) readiness, and infrastructure readiness.

Serum Cystatin C Level in Liver Cirrhosis Patients with MELD-Na > 22 Arnelis Arnelis; Vesri Yoga; Nasrul Zubir; Saptino Miro; Andry Kurniawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 2 (2022): VOLUME 23, NUMBER 2, August 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Hepatorenal syndrome is a part of the prerenal acute kidney injury (AKI) characterized by kidney dysfunction which is secondary to the decreased renal blood flow that occurs in liver cirrhosis with portal hypertension and is a fatal complication. Hepatorenal syndrome (HRS) occurs in about 20% of liver cirrhosis patients with refractory ascites.Method: This study was conducted on 24 liver cirrhosis patients with ascites who visited Gastroenterohepatology Outpatient Ward and Internal Medicine Inpatient Unit, Dr. M. Djamil Padang. Samples were collected and data analyses were conducted in December 2019 to March 2020.Results: In this study, the model for end-stage liver disease (MELD)-Na score was used to determine the risk of HRS in liver cirrhosis patients with ascites, in which patients with a MELD-Na score 22 belonged to the group at risk of developing HRS. From 24 patients, the mean MELD-Na score was 24.58 ± 3.5. The lowest MELD-Na score was 22 in 8 patients (33.3%), while 1 patient (4.2%) had the highest MELD-Na score of 35. In this study, serum CysC levels were measured in patients with normal creatinine, and the mean serum CysC level was 2.69 ± 0.46 mg/L. The minimum value of CysC was 2.03 mg/L, while the maximum value was 3.9 mg/L. Serum CysC levels in all 24 patients were increased compared to the normal values.Conclusion: Liver cirrhosis patients who were at risk to develop HRS based on the MELD-Na score have increased serum Cystatin C levels, although serum creatinine levels were still normal.

Risiko Perdarahan Saluran Cerna pada Pasien COVID-19 berdasarkan Jenis Obat Antivirus di Rumah Sakit Umum Pusat Dr. M. Djamil Padang Arnelis Arnelis; Saptino Miro; Nasrul Zubir; Vesri Yoga; Andry Kurniawan; Alexander Kam; Abdul Alim Rahimi; Jersivindo Ranazeri; R. Ifan Arief Fahrurozi
Jurnal Kesehatan Andalas Vol 11, No 2 (2022): Online July 2022
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v11i2.2042

Coronavirus disease 2019 (COVID-19) has become a global pandemic to date. Some studies reported gastrointestinal tract (GIT) bleeding occurs in several patients hospitalized with COVID-19. Medications known to be associated with an increased risk of GIT bleeding were not associated with GIT bleeding in COVID-19 patients. Objectives: To examined the risk of gastrointestinal tract (GIT) bleeding in COVID-19 patients based on antiviral drugs at Dr. M. Djamil General Hospital Padang. Methods: A nested cohort study was conducted in Dr. M. Djamil General Hospital Padang from May until October 2021. All COVID-19 patients who received antiviral drugs with GIT bleeding with onset days 0 - 7 were included. COVID-19 was confirmed by RT-PCR swab. Data entry and analysis were conducted by computerized. Results: 30 patients were involved in this study. 43,3% COVID-19 Moderate stage and 56,7% Severe stage. 63,3% were treated with remdesivir and 36,7% were treated with favipiravir. Onset on GIT tract bleeding at day 4 (23,3%), day 5 (26.7%), day 6 (30%), and day 7 (20%). The Chi-square test to determine the factors associated with GIT bleeding in COVID-19 patients including COVID-19 severity, type of antiviral drugs, anticoagulant, and corticosteroid revealed that none of all potential factors above related to GI bleeding. Conclusion: The type of antiviral drugs was not related to GIT bleeding in COVID-19 patients.Keywords: antiviral drugs, COVID-19, gastrointestinal tract bleeding

Relationship between Albumin Levels and the Incidence of Ascites in Patients with Liver Cirrhosis Vesri Yoga; Arnelis; Nasrul Zubir; Saptino Miro; Andry Kurniawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 18 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i18.739

Background: Patients with cirrhosis often develop hypoalbuminemia. In conditions of hepatic dysfunction, albumin synthesis is decreased due to hepatic dysfunction and abnormal distribution of portal blood flow. Ascites is a major complication and an important sign in the course of cirrhosis and is associated with 50% mortality after two years. 75% of patients' ascites etiology is liver cirrhosis, 10% malignancy, 3% heart failure, 2% tuberculosis, 1% pancreatitis, and others. Methods: This cross-sectional study was conducted from the medical records of patients with liver cirrhosis who were treated at the internal medicine section of Dr. M Djamil General Hospital, Padang, in 2015-2020. Patients with heart defects, malignancy, tuberculosis, pancreatitis, kidney failure, and incomplete medical record data were excluded from the study. Patients were grouped according to the presence or absence of ascites and albumin levels. Analysis using the chi-square test in 2020. Results: From 225 cases, 103 cases were analyzed. 77 were men (74.8%), and 26 were women (25.2%). The age of the patient was in the range of 40-60 years. No ascites were found in 30 people (29.1%), and 73 people (70.9%) had ascites. From normal albumin levels, five were without ascites, and four were with ascites. On mild hypoalbumin, 13 had no ascites, and 38 people had ascites. On severe hypoalbumin, 12 people were without ascites and 31 with ascites. A chi-square test was analyzed, and it was found that there was no relationship between the incidence of ascites and albumin levels (p 0.182). Conclusion: The incidence of ascites is not related to blood albumin levels.

Relationship between Albumin Levels and the Incidence of Ascites in Patients with Liver Cirrhosis Vesri Yoga; Arnelis; Nasrul Zubir; Saptino Miro; Andry Kurniawan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 18 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i18.739

Background: Patients with cirrhosis often develop hypoalbuminemia. In conditions of hepatic dysfunction, albumin synthesis is decreased due to hepatic dysfunction and abnormal distribution of portal blood flow. Ascites is a major complication and an important sign in the course of cirrhosis and is associated with 50% mortality after two years. 75% of patients' ascites etiology is liver cirrhosis, 10% malignancy, 3% heart failure, 2% tuberculosis, 1% pancreatitis, and others. Methods: This cross-sectional study was conducted from the medical records of patients with liver cirrhosis who were treated at the internal medicine section of Dr. M Djamil General Hospital, Padang, in 2015-2020. Patients with heart defects, malignancy, tuberculosis, pancreatitis, kidney failure, and incomplete medical record data were excluded from the study. Patients were grouped according to the presence or absence of ascites and albumin levels. Analysis using the chi-square test in 2020. Results: From 225 cases, 103 cases were analyzed. 77 were men (74.8%), and 26 were women (25.2%). The age of the patient was in the range of 40-60 years. No ascites were found in 30 people (29.1%), and 73 people (70.9%) had ascites. From normal albumin levels, five were without ascites, and four were with ascites. On mild hypoalbumin, 13 had no ascites, and 38 people had ascites. On severe hypoalbumin, 12 people were without ascites and 31 with ascites. A chi-square test was analyzed, and it was found that there was no relationship between the incidence of ascites and albumin levels (p 0.182). Conclusion: The incidence of ascites is not related to blood albumin levels.

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