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e-CliniC
Published by Universitas Sam Ratulangi
ISSN : 23375949     EISSN : -     DOI : -
Core Subject : Health,
Health Professions
Jurnal e-CliniC (eCl) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia bekerja sama dengan Fakultas Kedokteran Universitas Sam Ratulangi Manado. Jurnal ini diterbitkan 3 (tiga) kali setahun (Maret, Juli, dan November). Sejak tahun 2016 Jurnal e-CliniC diterbitkan 2 (dua) kali setahun (Juni dan Desember). Jurnal e-CliniC memuat artikel penelitian, telaah ilmiah, dan laporan kasus di bidang ilmu kedokteran klinik.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,074 Documents
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Perubahan Kadar Asam Urat dan Estimasi Laju Filtrasi Glomerulus pada Pasien Penyakit Ginjal Kronis yang Menggunakan Terapi Alopurinol Angelica, Christina; Umboh, Octavianus R. H.; Wantania, Frans E. N.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65797

Abstract

Abstract: Chronic kidney disease (CKD) is closely associated with hyperuricemia. Allopurinol is recommended for patients with CKD stages 2–5 to reduce serum uric acid levels, although its renoprotective effects may vary depending on patient characteristics. This study aimed to obtain changes in serum uric acid and estimated glomerular filtration rate (eGFR) in CKD patients receiving allopurinol therapy at Prof. Dr. R. D. Kandou Hospital Manado during 2021–2024. A retrospective longitudinal descriptive design was employed. As an exploratory purpose, pre–post therapeutic analyses and subgroup comparisons were conducted. The results showed that the greatest reduction in serum uric acid was observed among patients aged 30–65 years, males, those with type 1 diabetes mellitus, and individuals with stage G5 CKD. Increases in eGFR were noted in patients aged <30 years, females, and those with rheumatic heart disease as a comorbidity. Conversely, decreases in eGFR were found in patients aged ≥30 years, males, those with liver cirrhosis, and individuals in CKD stages G2–G3. In conclusion, changes in serum uric acid and eGFR among CKD patients receiving allopurinol vary according to age, sex, comorbidities, and stage of CKD. Keywords: chronic kidney disease; hyperuricemia; allopurinol    Abstrak: Penyakit ginjal kronis (PGK) berhubungan erat dengan hiperurisemia. Alopurinol direkomendasikan pada pasien PGK stadium 2-5 untuk menurunkan kadar asam urat, meskipun efek renoprotektifnya dapat bervariasi menurut karakteristik pasien. Penelitian ini bertujuan mendeskripsikan perubahan kadar asam urat dan estimasi laju filtrasi glomerulus (eLFG) pada pasien PGK pengguna alopurinol di RSUP Prof. Dr. R. D. Kandou Manado periode 2021–2024. Jenis penelitian ialah deskriptif longitudinal retrospektif. Sebagai tujuan eksploratif, dilakukan analisis pre–post terapi serta komparatif antar-subkelompok. Hasil penelitian mendapatkan penurunan kadar asam urat terbesar pada kelompok usia 30–65 tahun, laki-laki, komorbid diabetes melitus tipe 1, dan stadium G5. Peningkatan eLFG terjadi pada kelompok usia <30 tahun, perempuan, dan komorbid penyakit jantung rematik. Sebaliknya, penurunan eLFG terlihat pada kelompok usia ≥30 tahun, laki-laki, kelompok komorbid sirosis, serta stadium G2–G3. Simpulan penelitian ini ialah perubahan kadar asam urat dan eLFG pada pasien PGK yang menggunakan alopurinol bervariasi menurut usia, jenis kelamin, komorbid, dan stadium PGK. Kata kunci: penyakit ginjal kronis; hiperurisemia; alopurinol
Faktor-Faktor yang Berhubungan dengan Tingkat Stres Mahasiswa Profesi Dokter (Co-Assistant) di RSUP Prof. Dr. R. D. Kandou Manado Talumedun, Alida P.; Doda, Diana V. D.; Wungouw, Herlina I. S.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65798

Abstract

Abstract: Mental health remains an important issue among medical students, particularly clinical clerkship students (co-assistants) who must simultaneously manage academic and clinical demands. This study aimed to examine factors associated with stress levels among clinical clerkship students (co-assistants) at Prof. Dr. R. D. Kandou Hospital Manado. This was an observational quantitative study with a cross-sectional design. Respondents were selected using the Slovin formula through purposive sampling. Data were collected online using the PSS-10 to measure stress levels and the NASA-TLX to assess workload. Data analysis was performed using the Spearman Rank test and the Mann–Whitney U test. The results obtained 108 students as respondents with a mean age of 23 years (SD=0.85);  majority of them were females. Most respondents experienced moderate stress (78.7%), followed by high and low stress levels (19.4% and 1.9%). The mean total workload score was 68.16%, with the highest dimension being effort at 21.29%. Bivariate analysis revealed a significant positive relationship between age and workload with stress levels, while gender and clinical rotation stage were not significantly associated. In conclusion, age and workload are factors associated with stress levels among clinical clerkship students (co-assistants). Therefore, psychosocial support programs, routine counseling, and evaluation of clinical workload are required to help students manage stress adaptively. Keywords: workload; stress level; clinical clerkship students (co-assistants)   Abstrak: Kesehatan mental masih menjadi isu penting di kalangan mahasiswa kedokteran, terutama pada mahasiswa profesi dokter (co-assistant) yang menjalani beban akademik dan klinik secara bersamaan. Penelitian ini bertujuan untuk mengkaji faktor-faktor yang berhubungan dengan tingkat stres pada mahasiswa profesi dokter (co-assistant) di RS R.D Kandou Manado. Jenis penelitian ialah observasional kuantitatif dengan desain potong lintang. Responden dipilih menggunakan rumus Slovin melalui teknik purposive sampling. Pengumpulan data dilakukan secara daring menggunakan kuesioner PSS-10 untuk mengukur tingkat stres dan NASA-TLX untuk menilai beban kerja. Analisis data dilakukan menggunakan uji Spearman Rank dan uji Mann-Whitney U. Hasil penelitian mendapatkan sebanyak 108 mahasiswa sebagai responden, mayoritas dengan rerata usia 23 tahun (SD=0,85), didominasi oleh perempuan. Responden terbanyak mengalami stres sedang (78,7%), diikuti stres tinggi (19,4%) dan stres rendah (1,9%). Rerata total skor beban kerja 68,16% dengan dimensi tertinggi yaitu tingkat usaha 21,29%. Analisis bivariat menunjukkan adanya hubungan positif bermakna antara usia dan beban kerja dengan tingkat stres, sedangkan jenis kelamin dan stase profesi pendidikan dokter tidak bermakna. Simpulan penelitian ini ialah usia dan beban kerja merupakan faktor-faktor yang berhubungan dengan tingkat stres pada mahasiswa profesi dokter (co-assistant). Oleh karena itu, diperlukan dukungan psikososial, konseling rutin, dan evaluasi beban kerja klinik untuk membantu mahasiswa mengelola stres secara adaptif. Kata kunci: beban kerja; tingkat stres; mahasiswa profesi dokter (co-assistant)
Clinical Characteristics and Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in the Last Five Years at Prof. Dr. R. D. Kandou Hospital Tendean, Michael; Tjandra, Ferdinand; Mambu, Toar; Ayawaila, Marven; Sihaloho, Eric
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65822

Abstract

Abstract: Pancreatoduodenectomy (Whipple) is the standard procedure for resectable pancreatic and periampullary neoplasms. Although techniques and postoperative care continue to evolve, this procedure is still associated with high morbidity and significant complications, such as pancreatic fistula and delayed gastric emptying. It is most commonly performed on elderly patients with pancreatic adenocarcinoma and requires ongoing evaluation to improve outcomes. A five-year review is necessary to assess trends, complications, and postoperative outcomes as a basis for improving the quality of surgical management. This was a retrospective descriptive analysis of adult patients who underwent pancreatoduodenectomy at Prof. Dr. R. D. Kandou Hospital between 2020 and 2025. The inclusion criteria were patients with complete medical records, including demographic data, surgical indications, surgical outcomes, and postoperative complications. Cases with incomplete data, surgeries performed outside the study period, or patients who died before postoperative evaluation were excluded. Univariate analysis was performed using SPSS version 30 to describe clinical characteristics and patient outcomes. Of the 35 patients, the distribution of gender and diagnosis (icteric vs. non-icteric obstruction) was relatively balanced. Most underwent a single Whipple procedure (65.7%) using the duct-to-mucosa anastomosis technique (80%). Postoperative complications occurred in 57.1% of patients, and 30-day mortality was 34.3%. The mean age of patients was 55.6 years, the duration of surgery was 370 minutes, the blood loss was 568 cc, and the length of hospital stay was 9.8 days. In conclusion, the Whipple procedure demonstrates variable outcomes with high morbidity and a 30-day mortality rate of 34.3%. End-to-side anastomosis is the most commonly used technique. Age, case complexity, and operative variability influence patient recovery and prognosis. Keywords: pancreatoduodenectomy; pancreatic neoplasm
Profil Kasus Luka Bakar di Rumah Sakit Bhayangkara Tingkat III Manado Tahun 2023 – 2024 Rusly, Evan Y.; Tomuka, Djemi; Mallo, Nola T. S.
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65823

Abstract

Abstract: Burn injury represents a major health problem with both clinical and medicolegal implications, particularly when related to accidents or criminal incidents. This study aimed to describe the profile of burn injury cases at Rumah Sakit Bhayangkara Tingkat III Manado in 2023–2024. This was a descriptive and retrospective study based on secondary data obtained from medical records of burn cases treated during the study period. The results showed a total of 16 burn cases, with 12 patients (75%) survived and four patients (25%) died. The highest number of cases occurred in 2024 (62.5%). The most common cause of burns was fire (62.5%), followed by electricity and hot liquids (12.5% each), and explosion (6.3%). Based on total body surface area, the most frequent category was 10–29% (31.3%), and the most common burn degree was second-degree burns (31.3%). Most patients were adults aged 18–59 years (62.5%), and males constituted the majority (75%). All patients were Indonesian citizens residing in Manado. In conclusion, burn injuries in Manado most commonly affect adult males and are primarily caused by fire. These findings highlight the need for enhanced safety education in both workplace and domestic settings, as well as improved medicolegal documentation to support forensic analysis and inform public health policies. Keywords: burn injury; case profile; forensic aspect    Abstrak: Luka bakar menjadi masalah kesehatan yang memiliki implikasi klinis maupun medikolegal, terutama ketika berkaitan dengan kecelakaan atau tindak pidana. Penelitian ini bertujuan untuk mengetahui profil kasus luka bakar di Rumah Sakit Bhayangkara Tingkat III Manado pada tahun 2023–2024. Jenis penelitian ialah deskriptif retrospektif dengan memanfaatkan data sekunder dari rekam medis pasien luka bakar yang dirawat selama periode penelitian. Hasil penelitian menunjukkan bahwa terdapat 16 kasus luka bakar yang tercatat, dengan 12 pasien (75%) hidup dan empat pasien (25%) meninggal dunia. Kasus terbanyak ditemukan pada tahun 2024 (62,5%). Penyebab luka bakar yang paling seringa ialah api (62,5%), diikuti oleh listrik dan cairan panas (masing-masing 12,5%), serta ledakan 6,3%. Berdasarkan luas luka, kategori 10–29% merupakan yang terbanyak (31,3%), sedangkan derajat luka yang paling sering ditemukan ialah derajat II (31,3%). Kelompok usia terbanyak ialah dewasa (18–59 tahun) (62,5%), dengan jenis kelamin terbanyak laki-laki (75%). Seluruh korban merupakan warga negara Indonesia yang berdomisili di Manado. Simpulan penelitian ini ialah luka bakar di wilayah Manado paling sering terjadi pada laki-laki usia produktif akibat paparan api, sehingga diperlukan upaya pencegahan melalui peningkatan edukasi keselamatan kerja, kewaspadaan domestik, serta penguatan dokumentasi medikolegal untuk mendukung analisis forensik dan perencanaan kebijakan kesehatan Kata kunci: luka bakar; profil kasus; aspek forensik

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