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All Journal Jurnal Kedokteran STM (Sains dan Teknologi Medik) Medistra Medical Journal (MMJ)
Sentoso, Andhika Budi
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Legal Study on Health Service Facilities for Company Employees During the COVID-19 Pandemic Sentoso, Andhika Budi
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/y9wj1p05

Abstract

The COVID-19 pandemic transformed patterns of employment, occupational safety, and access to health services for company employees. The high rate of SARS-CoV-2 transmission since early 2020 led to public health control measures such as social distancing, mandatory masking, and remote working arrangements (Work From Home/WFH). This situation raises a legal question: to what extent are employers obligated to ensure employee health and safety as part of the right to health, particularly when work must continue under a public health emergency. This study is a normative (doctrinal) legal research with a descriptive qualitative approach. Primary legal materials include Law No. 17 of 2023 on Health, national regulations on occupational safety and health, Ministry of Health guidance for COVID-19 prevention in the workplace, and World Health Organization recommendations on worker protection during infectious disease outbreaks. Secondary legal materials include health law scholarship, occupational health literature, and recent international publications addressing worker protection during the COVID-19 pandemic. Data were analyzed by interpreting applicable legal norms and assessing their practical relevance to the fulfillment of employees’ right to health in corporate settings. he findings indicate that the obligation to provide health service facilities for employees extends beyond curative access and includes preventive and promotive measures such as periodic health screening, staggered/shift-based work arrangements, reduced physical contact, virtual communication systems, provision of basic protective equipment, and guaranteed referral pathways to health services. These obligations are consistent with the principles of the right to health, occupational safety and health (OSH), and worker protection under Indonesian law. However, implementation faced barriers including fear and stigma, misinformation, and unequal company resources.
SPEKTRUM PLASENTA AKRETA DENGAN KOMPLIKASI APENDISITIS AKUT PADA KEHAMILAN ATERM DENGAN TIGA RIWAYAT SEKSIO SESAREA SEBELUMNYA: LAPORAN KASUS: PLACENTA ACCRETA SPECTRUM COMPLICATED BY ACUTE APPENDICITIS IN A TERM PREGNANCY WITH THREE PREVIOUS CESAREAN DELIVERIES: A CASE REPORT Sentoso, Andhika Budi; Tarigan, Ronny Ajartha; Rahma, Nazua Maulida
Jurnal Kedokteran STM (Sains dan Teknologi Medik) Vol. 9 No. 2 (2026): Issue in Progress
Publisher : Fakultas Kedokteran Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/stm.v9i2.1266

Abstract

Placenta Accreta Spectrum (PAS) is characterized by abnormal placental adherence or invasion into the myometrium and is associated with significant maternal morbidity. It is one of the leading causes of life threatening postpartum hemorrhage, particularly among women with a history of repeated cesarean deliveries. A 32-year-old woman (G4P3A0) with a history of three previous cesarean deliveries was referred with suspected PAS based on ultrasonographic findings of abnormal placental implantation. The patient presented with severe lower abdominal pain accompanied by nausea and vomiting. Physical examination revealed stable hemodynamic status with a temperature of 38°C. Laboratory investigations demonstrated moderate anemia and leukocytosis with neutrophilia, suggestive of an inflammatory process. The patient underwent cesarean section with simultaneous appendectomy. Intraoperative findings demonstrated abnormal placental adherence suggestive of PAS and inflammatory changes of the appendix suggestive of acute appendicitis. Estimated blood loss was approximately 1200 mL, requiring transfusion of 3 units of packed red blood cells. A healthy male infant weighing 3100 g was delivered with Apgar scores of 8 and 10 at 1 and 5 minutes, respectively. The postoperative course was uneventful, and the patient was discharged in good condition on postoperative day five. PAS is strongly associated with repeated cesarean deliveries due to abnormal trophoblastic attachment and invasion at scarred uterine sites. Concurrent acute appendicitis during pregnancy is uncommon and may complicate diagnosis because of altered anatomical presentation. Early recognition of PAS risk factors and concurrent intra-abdominal pathologies, together with adequate perioperative preparation and multidisciplinary management, are essential to improve maternal and neonatal outcomes. AbstrakPlacenta Accreta Spectrum (PAS) ditandai dengan perlekatan atau invasi abnormal plasenta ke dalam miometrium dan berhubungan dengan morbiditas maternal yang signifikan. Kondisi ini merupakan salah satu penyebab utama perdarahan postpartum yang mengancam jiwa, terutama pada wanita dengan riwayat operasi sesar berulang. Seorang wanita berusia 32 tahun (G4P3A0) dengan riwayat tiga kali persalinan melalui operasi sesar dirujuk dengan dugaan PAS berdasarkan temuan ultrasonografi berupa implantasi plasenta abnormal. Pasien datang dengan keluhan nyeri hebat di perut bagian bawah disertai mual dan muntah. Pemeriksaan fisik menunjukkan kondisi hemodinamik stabil dengan suhu tubuh 38°C. Pemeriksaan laboratorium menunjukkan anemia sedang dan leukositosis disertai neutrofilia yang mengarah pada proses inflamasi. Pasien menjalani operasi sesar disertai appendektomi simultan. Temuan intraoperatif menunjukkan perlekatan plasenta abnormal yang mengarah pada PAS serta perubahan inflamasi pada apendiks yang mengarah pada appendisitis akut. Estimasi perdarahan intraoperatif sekitar 1200 mL sehingga diperlukan transfusi 3 unit packed red blood cells (PRC). Seorang bayi laki-laki sehat dengan berat lahir 3100 gram dilahirkan dengan skor Apgar 8 dan 10 pada menit pertama dan kelima. Perjalanan pascaoperasi berlangsung tanpa komplikasi, dan pasien dipulangkan dalam kondisi baik pada hari kelima pascaoperasi. PAS berhubungan erat dengan riwayat operasi sesar berulang akibat perlekatan dan invasi trofoblas abnormal pada area jaringan parut uterus. Keberadaan appendisitis akut yang terjadi bersamaan selama kehamilan merupakan kondisi yang jarang dan dapat mempersulit diagnosis akibat perubahan anatomi selama kehamilan. Identifikasi dini faktor risiko PAS dan patologi intraabdomen yang menyertai, disertai persiapan perioperatif yang adekuat serta tata laksana multidisiplin, sangat penting untuk meningkatkan luaran maternal dan neonatal.
Co-Authors Rahma, Nazua Maulida Tarigan, Ronny Ajartha