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All Journal Spektrum Hukum Nusantara Medical Science Journal Majalah Farmaseutik Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Unnes Journal of Public Health
Zaimatuddunia, Irma
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Dentistry Health Professions Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Potensi Medical Error Pada Pelaksanaan Tarif INA-CBG’s Zaimatuddunia, Irma
Jurnal Spektrum Hukum PMIH UNTAG Semarang Vol 21, No 1 (2024): Jurnal Spektrum
Publisher : PMIH Untag Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56444/sh.v21i1.5330

Abstract

Health planning and financing is one of the factors that influences the occurrence of medical errors. Currently, the National Health Insurance system uses the INA-CBGs tariff, which means a package tariff for all components in the hospital related to medical and non-medical services. Hospital treatment rates often exceed the INA_CBG's tariff package, this causes hospitals to have to implement efficiency across lines, this is very risky because it can affect the quality of service when this efficiency includes things related to patients. So, based on these problems, the author conducted research with the aim of discussing the potential for medical errors in the implementation of INA CBG's rates. From the research results, it was discovered that medical error was a very important factor. Not all of the problems were caused by medical personnel at the hospital but rather there was intervention from management. One of the potential medical errors in INA-CBGs rates is the problem of inaccurate diagnosis, efficiency of medicines, medical devices and payments to health workers.
Evaluasi Penggunaan Heparin dan Enoxaparin Sebagai Antikoagulan Profilaksis pada Pasien COVID-19 Rosnarita, Intan Adevia; Zaimatuddunia, Irma; Yasin, Nanang Munif; Ikawati, Zullies
Majalah Farmaseutik Vol 19, No 4 (2023)
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/farmaseutik.v19i4.89846

Abstract

Koagulopati merupakan kondisi yang kerap dialami oleh pasien positif COVID-19. Kondisi ini berhubungan dengan resiko terjadinya trombosis serta kematian pada pasien COVID-19. Data penggunaan kedua antikoagulan profilaksis yakni heparin dan enoxaparin didapatkan di RSUD dr. Loemnono Hadi Kudus, dengan melihat nilai laboratorium yakni kadar D-dimer pasien sebagai evaluasi terkait efektivitas penggunaan obat, dan episode kejadian perdarahan sebagai evaluasi terkait profil keamanan kedua obat tersebut. Penelusuran data dilakukan secara retrospektif yakni pasien COVID-19 yang mendapatkan perawatan di rumah sakit mulai tahun 2020 hingga 2022. Metode penelitian ini adalah kohort observasional menggunakan 127 sampel yang memenuhi kriteria eksklusi dan inklusi, dengan 55 data pada kelompok heparin dan 72 pada enoxaparin. Analisis efektivitas menggunakan uji Mann-Whitney menunjukkan terdapat penurunan kadar D-dimer yang signifikan pada pasien yang menggunakan antikoagulan enoxaparin  (p-value < 0.05) sedangkan pada pasien yang mendapatkan heparin tidak menunjukkan penurunan yang signifikan (p-value > 0.05). Berdasarkan evaluasi keamanan penggunaan kedua antikoagulan, enoxaparin juga memiliki insidensi kejadian perdarahan yang lebih kecil (33.3%) dibandingkan heparin (40.0%). Kondisi perdarahan yang paling sering dialami pasien COVID-19 yang menerima antikoagulan profilaksis adalah batuk darah atau hemoptisis (6.3%). Namun secara statistik tidak terdapat perbedaan yang signifikan pada kejadian perdarahan antar kedua kelompok obat (p-value > 0.05).
A Rare Case of Aplastic Anemia in Toxic Typhoid Fever NOVITA, MUTIARA PUTRI NOVITA; Zaimatuddunia, Irma
Nusantara Medical Science Journal Volume 9 Issue 1, January - June 2024
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.vi.32595

Abstract

Introduction and importance: Typhoid fever is one of the representative febrile diseases in the tropics, with unhygienic environmental conditions and poor public health systems. Pancytopenia from hemophagocytic lymphohistiocytosis is a rare complication of typhoid fever, which may be fatal if untreated. Presentation of case: A 20-year-old woman presented to our tertiary care center with high-grade fever, body pain, and slurring of speech. Investigations showed pancytopenia, TUBEX IgM Salmonella test positive, lymphadenopathy, and peripheral blood smear showed aplastic anemia after ruling out other possibilities and diagnostics. The patient responded to culture-sensitive antibiotics, steroids, and supportive care. Discussion: Pancytopenia in typhoid fever patients is linked to the mechanism of HLH (Hemophagocytic lymphohistiocytosis). Conclusion: It is essential to diagnose and treat toxic typhoid fever with an appropriate antibiotic to prevent complications.
A Rare Case of Aplastic Anemia in Toxic Typhoid Fever Novita, Mutiara Putri; Zaimatuddunia, Irma
Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Vol. 11 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/htj.v11i2.1623

Abstract

Background: Typhoid fever is a prevalent febrile illness in tropical regions where public health infrastructure and sanitation are limited. Pancytopenia resulting from hemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of typhoid fever that can be fatal without proper management. Objective: This case report aims to describe the clinical presentation, management, and outcome of a typhoid fever patient who developed pancytopenia, altered consciousness, and speech impairment. Methods: A comprehensive evaluation was conducted, including the patient’s medical history, physical examination, and various diagnostic tests. Laboratory workups revealed pancytopenia, positive TUBEX IgM for Salmonella, lymphadenopathy, and bone marrow aplasia. Differential diagnoses were considered and ruled out to confirm HLH as the underlying mechanism. Results: The patient responded positively to a regimen including ceftriaxone, steroids, and supportive care. The presence of pancytopenia in this typhoid fever case was linked to HLH. Conclusion: Early diagnosis and appropriate antibiotic therapy are critical for managing severe typhoid fever cases with complications such as HLH, helping prevent further complications and improving patient outcomes.
Factors of Diabetic Retinopathy among Type 2 Diabetes Mellitus Patients in Central Java Province, Indonesia Casmuti, Casmuti; Zainafree, Intan; Cahyati, Widya Hary; Ningrum, Dina Nur Anggraini; Saefurrohim, Muhamad Zakki; Hakam, Abdul; Zaimatuddunia, Irma; Prasetya, Henky Yoga; Jusran, Alek; Irsam, Muhamad
Unnes Journal of Public Health Vol. 14 No. 1 (2025)
Publisher : Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/ujph.v14i1.16126

Abstract

One of the microvascular complications of type 2 diabetes mellitus is diabetic retinopathy. The prevalence of diabetes mellitus in Central Java Province in 2022 by 10% increased to 12.52% in the third quarter of 2023. This prevalence rate has not reached the SDG's target, namely there is no increase in diabetes prevalence by 0%. The purpose of this study is to analyze factors associated the incidence of diabetic retinopathy in type 2 DM patients at Central Java Provincial Hospital in 2023. This research is quantitative research with a nested case control study design, using electronic medical record data from the Central Java Provincial Hospital in 2023. The variables in this study were gender, age, education level, employment status, marital status, health insurance status, BMI, DM diet, duration of DM, hypertension, other diseases, current blood glucose, and HbA1c. The analysis used was univariate, bivariate, and multivariate analysis (logistic regression). The results showed that there was association between age ≥70 years (p=0.006), DM diet (p<0.0001, OR=20.914), duration of DM (p=0.003, OR=3.010), hypertension (p=0.013, OR=2.619), other diseases including cataracts (p=0.040, OR=9.00), glaucoma (p=0.007), CHD (p=0.040, OR=9.00), and cardiomegaly (p=0.016), current blood glucose (p=0.045, OR=2.478), and HbA1c (p<0.0001, OR=6.152). DM diet is the most dominant factor associated with diabetic retinopathy in type 2 DM patients. 
Co-Authors Abdul Hakam Casmuti, Casmuti Dina Nur Anggraini Ningrum Intan Zainafree, Intan Irsam, Muhamad Jusran, Alek Nanang Munif Yasin Novita, Mutiara Putri NOVITA, MUTIARA PUTRI NOVITA Prasetya, Henky Yoga Rosnarita, Intan Adevia Saefurrohim, Muhamad Zakki Widya Hary Cahyati