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Majalah Kedokteran Nusantara The Journal Of Medical School
Published by Universitas Sumatera Utara
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Arjuna Subject : -
Articles 181 Documents
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Osteopenia prematuritas dan upaya pencegahannya Febriyanti Mobilina; Guslihan Dasa Tjipta; Emil Azlin; Pertin Sianturi; Bugis Mardina Lubis; Beby Syofiani Hasibuan
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 3 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Osteopenia of prematurity is a common problem encountered in preterm infants or infant with low birth weight. This is characterized by decreased bone mineral content due to inadequat nutritional intake and biochemical factors. This condition can make metabolic disorders in pathological bone fractures even in newborns. Incidence of osteopenia in low birth weight infants in 30%, whereas in infants less than 1000 g of about 55%, and infants less than 1500 g as much as 23%. For preterm infants, the features commonly associated with fracture are delivery at less than 28 weeks of gestation. Metabolic bone disease is often not detected at early stage and became known after appearing obvious abnormalities in the bone or in radiologic examination. Therefore, it is necessary to screening with serum biochemical examination of blood in serum levels of calcium, phosphate and alkaline phosphatase. In addition, it was important to intake of calcium and phosphorus are sufficient for bone mineralization. Key word : osteopenia of prematurity, preterm, calcium, calcium
Korelasi Kadar Hepsidin dan Reticulocyte Hemoglobin pada Penderita Gagal Ginjal Terminal dengan Hemodialisis Reguler Ginting, Almaycano; Ganie, Ratna Akbari; Nasution, Syafrizal
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction Anemia is a frequent complication in Chronic Kidney Disease (CKD), especially in End-State Renal Disease (ESRD) undergoing hemodialysis (HD). Reticulocyte Hemoglobin (Ret.He) represents the average value of Hemoglobin (Hb) distribution in reticulocytes and the availability of iron in the process of erythropoiesis. Hepcidin is a hormone that plays a role in the regulation and metabolism of iron. Hepcidin correlation and Ret.He levels in ESRD patients undergoing regular HD is not known clearly. The aim of study is to determine the correlation of hepcidin and Ret.He in ESRD patients undergoing regular HD.Methods This is a cross sectional study that were conducted at H.Adam Malik Hospital, December 2015-March 2016. Subjects were ESRD outpatients undergoing regular HD in Hemodialysis Unit of H. Adam Malik Hospital over 3 months with a frequency of two times per week and signed the informed consent. Spearman correlation test was used for statistical analysisResults The median levels of hepcidin (0.3 ng/ml) and Ret.He (33.6 pg), were found in 31 subjects. There is a weak correlation but insignificant of hepcidin and Ret.He (r = 0.135, p = 0.467).Conclusion There was no correlation of hepcidin and Ret.He in ESRD patients undergoing regular HD.Keywords : Anemia, Hepcidin in End-Stage Renal Disease, Reticulocyte Hemoglobin, ,Regular hemodialysis, iron status
Hubungan Modifikasi Kadar Natrium Dialisat dengan Kualitas Hidup yang Diukur dengan SF-36 pada Pasien Hemodialisis Reguler Siregar, Bangun Tua; Nasution, Syafrizal; Lubis, Abdurrahim R
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
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Introduction Regular hemodialysis patients frequently showed fluctuation of quality of life influence by several factors such as anaemia, age, body water volume regulation and nutritional status and others. Sodium dialysate concentration can be regulated by manually and automatically through hemodyalisis machine. The aim of this study was to determine correlation between sodium dialysate modification and Quality of life measured by Short form-36 (SF-36) in hemodialysis patients.Methods This is an experimental study with case-control design. We recruited 54 chronic hemodialysis patients in hemodialysis center at Adam Malik hospital. Blood sample for sodium serum were taken and quality of life measurement by SF -36 questionaire before and after sodium dialysate modification was performed to all subjects. Then to evaluate the difference and correlation.Results Positive significant correlation found in modification group between physical and mental dimension score and sodium dialysate modification with r = 0.864 and r = 0.339.Conclusion There was a significant correlation between Sodium dialysate modification and physical and mental health dimension from quality of life measured in by SF-36 in hemodialysis patients.Keywords :Sodium dialysate modification, Quality of life (SF-36),Hemodialysis
Analisis Kadar Glial Fibrillary Acidic Protein dengan Tingkat Keparahan Cedera Kepala di Rumah Sakit Umum Pusat (RSUP) Haji Adam Malik Sinulingga, R. Disfahan Yonanda; Japardi, Iskandar; Sastrodiningrat, Abdul Gofar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction This study was to determine the relationship of serum Glial Fibrillary Acidic Protein (GFAP) levels with severity of head injury patients.Methods This study was an analytical study using cross-sectional design. The study lasted from June 2013 until March 2014 at Adam Malik General Hospital. Severe head injury patients were included in the study if the onset is less than 48 hours. Selected patients were evaluated based on the findings of the Computed Tomography (CT) scan of the head. Consecutive sampling was done to select the subjects, then blood samples were taken for examination and imeasurement of cumulative GFAP serum level.Results The results showed that GFAP levels were associated significantly with GCS after resuscitation (r = -0.631, p = 0.0001). The correlation was a negative correlation (r = -0.631, p = 0.0001). If the higher Glasgow Coma Scale (GCS) after resuscitation, serum GFAP levels would be even lower.Conclusion Levels of GFAP severe head injury patients (11.9 ± 10.52) was significantly higher compared to patients with moderate head injury (1.82 ± 1.60, p = 0.0001). There is a significant correlation between serum GFAP levels with initial GCS after resuscitation (r = -0.631, p = 0.0001).Keywords : GFAP, head injury, biomarker
Efektifitas Kombinasi Ekstrak Sambiloto (Andrographis paniculata (burm.f.) nees) dan Daun Salam (Syzygium polyanthum (wight) walp) terhadap Kadar hs-CRP pada Pasien Dislipidemia Yulindaa, Wina; Lindarto, Dharma; Syafril, Santi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction Dyslipidemia is risk factor of cardiovascular disease and significantly correlated with increased hs-CRP concentration. Simvastatin, a sintetic antidyslipidemic drug, decreases hs- CRP concentration. But long term use of sintetic drug may cause side effects, so that phytopharmaca is preferably to be consumed. Combination sambiloto extract and salam could decrease proinflammatory cytokines, cholesterol, and triglyceride. Aim of this study was to compare the effect of combination sambiloto extract and salam with simvastatin on hs-CRP concentration in dyslipidemic patientsMethods This clinical trial use prospective design. Treated group (n = 15) and control group (n = 15) were selected by double blind random sampling. Before and after 30 days therapy, blood sample was taken. Data was analysed with SPSS, p < 0.05 was considered significant.Results There was significant decrease of hs-CRP before and after 30 days therapy in treated group ((3.02 ± 3.13 vs 1.67 + 1.37) mg/dL; p = 0.005); meanwhile insignificant decrease was there in control group ((2.78 ± 1.97 vs 2.25 ± 2.32) mg/dL; p = 0.285). hs-CRP decrease of treated group was bigger than in control group, but statistically insignificant ((1.35 ± 2.37 vs 0.53 ± 1.96) mg/dL; p = 0.089 mg/dL).Conclusion Combination sambiloto extract (Andrographis paniculata) and salam (Syzygium polyanthum) 2 x 150 mg for 30 days decreased hs-CRP concentration lower than simvastatin 1 x 20 mg, but statistically insignificant.Keywords : hs-CRP, Andrographis paniculata and Syzygium polyanthum, dyslipidemia
Hubungan Koloni Pseudomonas Aeruginosa dengan Persentase Split Take Thickness Skin Graft (STSG) Pada Pasien Luka Bakar Di RSUP H. Adam Malik Medan Nst, Roni Marzuki; Buchari, Frank Bietra; Tarigan, Utama; Lelo, Aznan
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Pendahuluan Luka bakar masih merupakan masalah global. Insiden luka bakar di seluruh dunia pada tahun 2004 diperkirakan 1,1 per 100.000 penduduk. Dan hampir separuh terjadi di wilayah Asia Tenggara. Skin graft digunakan dalam berbagai situasi klinis termasuk rekonstruksi luka bakar. ). Patogen yang paling umum yang menyebabkan kegagalan graft adalah coagulase positive staphylococcus, Pseudomonas dan beta-haemolytic Streptococcus. Oleh karena itu, peneliti perlu meneliti hubungan koloni Pseudomonas aeruginosa dengan tingkat keberhasilan skin graft pada pasien luka bakar di RSUP H. Adam Malik Medan.Metode Penelitian ini merupakan penelitian descriptive analitik dengan desain penelitian crossectional, dilakukan di Departemen Ilmu Bedah Plastik RSUP H. Adam Malik Medan selama periode Februari sampai Juni 2014. Populasi dalam penelitian ini adalah seluruh penderita luka bakaryang dirawat di RSUP H. Adam Malik Medan pada kurun waktu Februari sampai Juni 2014 yang dilakukan skin graft.Hasil Dari 22 kasus luka bakar dijumpai persentase take skin graft > 80% pada 16 pasien (72.7%), persentase take skin graft antara 50-80% pada 5 pasien (22.7%), dan persentase take skin graft < 50% dijumpai pada 1 pasien. take skin graft >80% pada luka bakar dengan Pseudomonas aeroginosa dijumpai pada 3/7 kasus (42,86%) yang lebih sedikit pada luka bakar non Pseudomonas aeroginosa yaitu pada 13/15 kasus (86,67%). Take <80% pada penderita luka bakar dengan Pseudomonas aeroginosa ( 4/7 = 57.14% ) lebih banyak dari pada luka bakar dengan non Pseudomonas aeroginosa ( 2/15 = 13,33% ). Namun perbedaan ini secara statistik hampir bermakna (p=0,073).Kesimpulan Tingkat keberhasilan skin graft sebesar >80% pada luka bakar dengan Pseudomonas aeroginosa dijumpai pada 3/7 kasus (42,86%) yang lebih sedikit pada luka bakar non Pseudomonas aeroginosa yaitu pada 13/15 kasus (86,67%). Berdasarkan uji chi square tidak dijumpai adanya hubungan koloni Pseudomonas aeruginosa dengan tingkat keberhasilan skin graft pada penderita luka bakar (p=0,073)Kata Kunci Pseudomonas Aeruginosa, Split Take Thickness Skin Graft (STSG), Luka Bakar
Karakteristik Penderita Infeksi Pasca Operasi Fiksasi Interna Ekstremitas Bawah di Instalasi Bedah Pusat RSUP Haji Adam Malik Medan Periode Januari 2012 - Juni 2014 Fahmi, Ichsan; Siregar, Chairiandi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
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Introduction The surgical site infection in Orthopaedic surgery is a serious problem for both the patient and surgeonMethods This study was conducted using retrospective descriptive method using medical record data of the patients that underwent internal fixation surgery of the lower extremities in RSUP H. Adam Malik Medan within the period of January 2012 – June 2014. The characteristics assessed in this study include stage, gender, site of the infection, history of internal fixation surgery (implants) and risk factors.Results There were 25 patients (5.9%) out of 420 sample that developed infection with characteristics, 23 were male (92%) and 2 were female (8%). There were 11 patients (42%) aged less than 30 years old, 11 patients (42%) aged 30-60 years old, and 3 patients (12%) aged above than 60 years old. According to the site of the infection it is found that there were 13 patients has infections originating from the femur (52%), tibial area 8 patients (32%), ankle area 1 patient (4%) and the combination of multiple sites are 3 patients all together. From the data of 25 patients that developed infection it is found that there were 4 smokers and 2 patients suffering from diabetes and 3 elderly patients (above 60 years old).Conclusion: Patients developing infection post internal fixation surgery of the lower extremities in RSUP H. Adam Malik are still considered high. In this study, the risk factor relating to the surgical site infection is unclear although it is known that the risk factors such as elderly age, duration of operation, smoker, diabetes mellitus, length of stay in the ward and mucosal damage around the fracture site causes one to develop infection.Keywords : : internal fixation purgery, post operation, infection, risk factor
Pemeriksaan Protein, Kolesterol dan Laktat Dehidrogenase Cairan Pleura sebagai Parameter dalam membedakan Efusi Pleura Transudat dan Eksudat Ginting, Guntur Mulia Jendry; Abidin, Alwinsyah; Keliat, Ermanta Ngirim
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction To evaluate the benefit of three pleural fluid parameters pLDH, pProt and pChol both in single or combination form for differentiating exudative and transudative pleural effusion.Methods Sixty six cases of pleural effusion at Adam Malik Hospital from January-Mei 2014 were divided into exudate (56) and transudate group (10) based on their definite clinical diagnosis. Comparations were made between all parameters in single and combination form to evaluate its strength.Results All parameters both in single or combination were significantly different between exudate and transudate. However, the combination of two or more from three parameters (pLDH+pProt / pLDH+pChol / pProt+pChol / pLDH+pProt+pChol) were found superior in accuracy (92.4%), sensitivity (94.6%), and NPV (75%).Conclusion This study found that combination of two or more from three parameters (pLDH, pProt and pChol) has superiority in differentiating exudate and transudate pleural fluid.Keywords : Pleural effusion; transudat; exudate
Deteksi Dini Ventilator Associated Pneumonia Pada Pasien Terpasang Ventilator di Instalasi Perawatan Intensif RSUD Provinsi NTB Atmaja, Hadi Kusuma; Kisid, Kristiani Murti
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
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Introduction The use of mechanical ventilator to the patients in intensive care unit (ICU) increases the risk of Ventilator Associated Pneumonia (VAP). The aim of this study was to detect the signs of nosocomial pneumomia by using Clinical Pulmonary Infection Score (CPIS) in the ICU patients with ventilators.Method A retrospective-descriptive study was conducted in Nusa Tenggara Barat Province’s general hospital with 15 patients and the data was analysed by univariate analysis.Hasil The majority of respondents (87 % or 13 patients) with mechanical ventilator were between 18-60 years old, 8 respondents (53%) were male and the indication of intensive care was due to brain injuries (66%). Among all respondents, 14 patients (93,3%) had CPIS value less than 6 (no VAP) and 1 patient (6,6%) had CPIS value above/equal to 6 (with VAP).Conclusion Based on this study, it is recommended to measure CPIS value to predict the risk of VAP.Key words : Mechanical Ventilation,CPIS, VAP
Residu Urine Pasca Total Vaginal Histerektomi setelah Pemberian Misoprostol di RSUP H. Adam Malik Medan Djaganata, Servin Pandu; Ardiansyah, Edy; Tala, M. Rhiza Z; Sihite, Herbert; Siregar, Henry Salim; Effendi, Iman Helmi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction One of the late complications of total vaginal hysterectomy (TVH) commonly involves urinary tract, i.e urinary retention (21-87%). Treatment with misoprostol can prevent the occurrence of urinary retention.Methods This study was a retrospective descriptive study using secondary data from 5-year-(January 2010-December 2014) medical records at Adam Malik Hospital in patients that underwent TVH. Samples were collected by total sampling. Data were analysed using univariate and ANOVA bivariate analysis. The p-value was considered significant if p<0.05 with a confidence interval of 95%.Results A total of 66 patients underwent TVH with mean post voiding urine volume 30.71 ± 6.78 mL. Based on the age, one person, 6, and 59 people were alloted into the following groups: 30- 39 (1.51%), 40- 49 (9.09%), and ≥50 years old (89.39%), respectively. Each group showed no significant difference in post voiding urine volume (20 ml; 27.8 ± 6.58 ml; 31.18 ± 6.69 ml, sequentially). The mean residual urine obtained increased along with parity, but showed no significant difference (p> 0.05).Conclusion: In this study, urinary retention was not present in patients going for TVH treated misoprostol. There is no significant difference in mean post voiding urine volume by age and parity group.Keywords : Total Vaginal Hysterectomy (TVH); residual urine; misoprostol

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