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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
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Articles 181 Documents
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Beberapa Faktor Resiko pada Pasien dengan Infeksi oleh E. coli dan K. pneumoniae Penghasil ESBL di RSUP H. Adam Malik Medan Agnes, Selastri; L, Ricke; Muzahar, Muzahar
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 4 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Identification of risk factors for ESBL-producing bacteria infection are very important to avoidspread of ESBL and to decreased mortality. The aim of this study is to identify risk factors for infection ESBL-producing E. coli or K. pneumoniae.Method : An analytical study with cross sectional approach was conducted at H. Adam Malik hospital Medan from January-March 2014. Samples were divided into 2 groups of pairs: ESBL (n = 27) and nonESBL (n = 27). The length of hospital stay, utilization of invasive medical devices, comorbid disease, and surgery procedure are the risk factors that being analyzed. Antibiotic sensitivity tests in both groups also evaluated.Results: Based on the statistical analysis we found that the risk factors that have a significant relationship with ESBL infection was duration of hospital stay > 1 week OR 8.594 (1.680-43.953) p value 0.004, the use of peripheral venous catheters OR 0.156 (0,045-0,539) p value 0.002, urinary catheters OR 0.116 (0.023-0.595) p value 0.004, mechanical ventilator OR 0.091 (0.011-0.793) p value 0.002, nasogastric tube OR 0.160 (0.31-0.831) p value 0.018 and comorbid disease OR 15.625 (3.067-79.594). There was no significant correlation in utilization of CVC and surgery procedure. The ESBL-producing Escherichia coli or Klebsiella pneumoniae showed very good susceptibility to meropenem, imipenem (92.6%) and amikacin(85.2%).Conclusions: Risk factors associated with ESBL infections are duration of hospital stay > 1 week, the use of of invasive medical devices (peripheral venous catheters, urinary catheters, nasogastric tube and mechanical ventilator) and comorbid disease. Carbapenem is still an option for ESBL infectionKeywords : extended spectrum β-lactamase; risk factor; E. coli; K. pneumoniae
Hubungan antara Asthma Control Test (ACT) dengan spirometri sebagai alat pengukur tingkat kontrol asma Efzah Efzah; Zuhrial Zubir
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 1 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction :Asthma is a chronic respiratory disease that still a serious health problem worldwide. IIis nown that there is no cure for asthma, but tile disease can be c:ontrolled in some pati1:m.k;l111rn:1 t;u11lrulis fucuses on the adequacy therapy. GINA guideline for theassessment of asthma control using gauges lung ruriction, but this evaluation is difficult because of lack of facilities spir:imetry as a measure of lung function in primary care.Asthma control tool that is simple,efficient, easy and necessary for asthma patients. Asthma Control Test (ACT)is a screening test In the form :if a questionnaire :in a clinical assessment of patients withasthma. Method : This study wa cross se·::tionalstudy,in 61 patients with asthma were taken by consecutive samplin£. The whole subject of study conduct ACT questionnaire and splrometry followed by examination. The analysis data using the ROC curve for diagnostic value and Pearson correlation test. Result :61 subjects,39 ternale and 22 male subjects with a mean age of 54.44 yea•s. Based on thevalue of the subject ACT consists of 31.1% is well controllec, partly controlled 21.3% and 47.5"/, is not controlled. AC r cutoff values •'3f•'3fbased on ttiose receiver operating characteristic (ROC) to distinguishbetween normaland FEV1 <80% was 21.5 with 71.4% sensitivity and 96.3% specificity. By using the Pearson correlation test founo a significant ccrrelation between the ACT with FEV1 (p <0.001), showed modera:e positive correlatic•n (r= 0.5li3). Conclusion : There is a significart relationship between asthma controltest (ACT) with spirometry with moderate positive correlation. So that ACT can be used to assess asthma control in health facilities were spirometry not availab'e. Keyword: asthma bronchial, level of asthma i:ontrol, asthma confrol test (ACT), spirometry
Hubungan jumlah trombosit dengan fungsi trombosit pada pasien penyakit ginjal kronis tahap akhir pre-hemodialisis Ahsan Tanio Daulay; Savita Handayani; Dairion Gatot
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 1 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Renal failure is condition where kidney cannot fitter blood waste and toxins adequately. One of complication is bleeding diathesis causes insufficiency of platelet function, coagulation cascade or fibrinolysis system activation. Method :Analytic observaiional research from September-Dece mber 2014 to 31 pre-dialyzed subject.Conclusion :Nocorrelation among high serum creatinine and urea with platelet count. bleeding lime,and platelet aggregation. Nocorrelation between platelet count and function (bleeding time and platelet aggregation).Result : Of 31 subject, mean of c;ge 50.71(S0=10.91) years old; Platelet 250,548 (SD=98,268)fmm3 with thrombocytopenia 19.4% case; bleeding time 4.77 (SD=3.03) minutes;with prolong bleeding time 19.4% case and 3.2% of it is thrombocytooe nia; hypoaggregation, 19.4%case. No significant correlation between platelet count and platelet function;among serum creatinine with platelet count and function;and urea with platelet count and functions. Key Words :chronicrenaldisease; platelet; platelet aggregation
Analisa kasus kista ovarium di Rumah Sakit Umum Pusat (RSUP) Haji Adam Malik Medan periode I Januari 2010 - 31 Desember 2012 Dona Wirniaty; M. Fidel G Siregar; Rushakim Lubis; Henry Salim Siregar; Iman Helmi Effendi; Johny Marpaung
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Ovarían cysts are cystic neoplasms derived from ovarian tissue, can be benign or malignant. Characteristics ofovarian cysts is importantto be known, such as body mass index and risk ofmaligriancy index. Not only to be able to assess risk factors but also early detection prompt treatment to prevent progression to ovarian cancer.Methods : This is a descriptive study, conducted in Department of Obstetrics and Gynecology Hospital, Adam Malik Medan Medical records from all patients who will undergo elective surgery for ovarian cysts from January Pt 2010 to December 31th 2012 was collected. Data was analyzed descriptively and analytically with chi square by level of significance in this study was p<O.05.Results : There were 327 patients with ovarian cyst undergoing elective surgery in H. Adam Malik Hospital from January 2010  to December 201 2 but only I 99 were included in the study. Majority of patients with malignant ovarian cysts aged 51 years old (38.9%), number of pañty 2-5 (41 .7%), menarche at 1 3-16 years old (72.2%), BMI normoweight (44, 4%), levels of CA 125> 35 U/ml (95.8%), and the RMI > 250 (88.9%). Majority of patients with benign ovarian cysts aged 31-40 year olds (28.3%), parity 2-5 (46.5%), menarche at 13-16 years old (85.4%), BMI obese (44.9%), CA 125 levels similar, and RML 250 (63.8%).  The most common ovarian cyst is malignant adenocarcinoma (72 patients, 36.2%). This study showed that BMI (p=O.OO8) and RMI (jsO.OO1 ) are associated with ovarian cyst. Conclusion: This study showed that there is association of body mass index and risk of malignancy index with ovarian cysts.  Need further research with larger population samples. Keywords : Ovarían cysts; Body Mass Index; Risk of Malignancy index
Ekspresigen Homeobox Protein A (HOXA) 10 pada Jaringan Endometrium Penderita Endometriosis yang Infertil Johan Ricardo; Henry Salim; Muhammad Rusda; Letta Lintang; Edi Ardiansyah; Hanudse Hartono
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction :Endometriosis is associated with the abnormality of estrogen and progesterone.Both estrogen and progesterone had a role as strong mitogene in endometrialfocus.One of the mitogene is HOXA10 which was expressed in the nucleus of glandular and stromalcells. Method :This is an analytic study with cross sectionalapproach.40 subjects who fulfilled the inclusion criteria were obtained. lmmunohistochemistry was then performed to evaluate HOXA10 expression.This study was performed from March to April 2015.The obtained data was then analyzed statistically.This study objective is to determine HOXA1O gene expression in endometrialtissue of infertile women with endometriosis Result :Majority of subjects from endometriosis group were fromthe age group of 31-40 years old with 13 subjects (65o/o) and nulliparous with 19 subjects (95%).While from non endometriosis group, majority of subjects were from the age group 41-50 years old with 15 subjects (75%) and parity of 1-3 with 11 subjects (55%). Based on HOXA10 expression intensity, 14 subjects (70%) showed no expression, expression of +1 with 6 subjects (30°/o).While from non endometriosis group, expression of +3 were found in 13 subjects (65o/o), and expression of +2 were found in 7 subjects (35°/o), p<0.05.Conclusion : There is a significant difference of HOXA10 gene expression in endometrialtissue of subject with endometriosis and without endometriosis. Keywords :HOXA10, endometriosis, infertility
Kadar Kortisol Saliva Sebagai Penanda Gangguan Gejala Menopause pada Paramedis Poli Rawat Jalan Usia Perimenopause di Rumah Sakit Umum Pusat Haji Adam Malik Medan Yufi Permana; M. Fidel Ganis Siregar; Syamsul A. Nasution; Sanusi Piliang; Muldjadi Affendy; Yostoto B. Kaban
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction :The premenopausal period is characterized as a decline in estrogen levels that consequently result in disturbing symptoms. One noted significant factor in this period is the psychological state, a condition that is closely related to cortisol levels. Stress is known to be a product of the neuroendocrine system. As a product of tbis mechanism, cortisol is frequently used as a biomarker to study stress. Currently, menopausal symptoms are diagnosed based on present complaints, which tends to be subjective, consequently, a biomarker is required to diagnose menopausal disturbances. Method :This analytic, diagnostic, cross sectional study was conducted in the General Hiospital of Haji Adam Malik Medan, and enrolled paramedics working at the out patient clinic from March until April 2015. All subjects were asked to fill a Menopause Rating Scale (MRS), the results of which were then associated with obtained salivary cortisol levels. Results :Salivary cortisol levels was significantly associated with menopausal disturbances with p< 0.01. Salivary cortisol also significantly differed based on each MRS scores with p=0.008. A cut-off value of 9.52 ng/ml was obtained, with specificity and sensitivity values of 85 and 77%, respectively. Conclusion :Salivary cortisol testing as a marker for menopausal disturbances obtained a marker of 9.52 ng/mL with specificity and sensitivity values of 85 and 77%, respectively. Key words :Salivary cortisol, menopausal disturbances, Menopause Rating Scale
Eosinopenia Sebagai Penanda Dini Diagnosis Sepsis Bakterialis Elisabet Sipayung; Endang Sembiring; Armon Rahimi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction :The early diagnosis of sepsis bacterialis plays an integral role in the morbidity and mortality of patients admitted to the hospitals and the intensive care unit (ICU) because it ensures the early administration of antibiotics. Thus the good markers of sepsis bacterialis which had good accuracy, easy to use and also cheap. Previously procalcitonin (PCT) was used to diagnose sepsis, unfortunetely it is expensive and this coupled with the fact that it takes a long time for the results to be attained and not always exist in developing countries, it is not an ideal marker for the early diagnosis of sepsis. In sepsis bacterialis, eosinophil absolut count decreased thus eosinopenia could be an early marker. The aim ofthis study was to know the accuracy of eosinopenia compared wih PCT to early diagnose of sepsis bacterialis. Methods : This cross-secional study was held from March 2014 until August 2014 in Internal medicine ward and ICU of H. Adam Malik Hospital Medan. Results : In this study the mean eosinophil count of the sepsis bacterialis patients was 27 sel/mm3• The cut-off of eosinopenia compared with PCT was 37 cells/mm3, then from statistical analysis the sensitivity of eosinophil was 94.9%, specificity was 92.3%, positive predictive value (PPV) was 92.5%, and negative predictive value (NPV) was 94.7%. Positive likelihood ratio was 12.3 and negative likelihood ratio was 0.06. From analysis of ROC curve area under the curve (AUC) was 92.4% (95% Cl:84.8% - 100%; p = 0.0001). Conclusion :Eosinopenia could be used to an early diagnosis of sepsis bacterialis. Keywords :sepsis bacteria/is, early diagnosis, proca/citonin,  eosinopenia
Kadar lipoprotein (A) dan kadar sensitivitas tinggi C-reaktif protein pada penderita penyakit jantung koroner yang dilakukan angiografi Dian Effrida Lubis; Zulfikar Lubis; lsfanuddin Nya Kaoy
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : CAD marked by coronary artery blockage by fatty deposits that gather within the cell, either partially or totally from one or more of the coronary arteries. CAD is defined as the presence of stenosis > 70% with angiography examination. Understanding of atherosclerosis began after the hypothesis of response to injury and hypothesis of lipid disorder (lipid theory). Merge both this hypothesis can explain better the occurrence of atherosclerosis.This research aims to find out if there are differences in the levels of hs-CRP and Lp (a) in CAD patients compared with the control group. And determine whether the concentrations of hs-CRP and Lp(a) correlate with the CAD. Methods :This cross sectional study was conducted in 30 people with CADwhen angiography showed coronary artery stenosis>70% and coronary artery stenosis > 70% as a controlfrom Juli up to September 2014. Blood samples were taken after angiography to checked hs-CRP and Lp(a) levels Results : In this study,we found significant differences in hs-CRP level betwen CAD patients (35.29±42.79) and control group (2.96±1 .88) and also we found significant differences in Lp{a) level between CAD patient (79.09±40.18) and control group 17.21±9,74) with <0.05. The study also found a strong correlation between hs-CRP and Lp (a) with CAD patient (r-0.835 and p < 0.05), (r =Q.713, p < 0.05), respectively Conclusion :There were a significant difference in the levels of hs-CRP and Lp (a) in CAD group compared to the control groupThere is a strong correlation between hs-CRP and Lp (a) with the CAD. Key words : CAD, angiography, hs-CRP, Lp(a)
Kejadian keloid menurut golongan darah pada pasien pasca Iuka di Rumah Sakit Umum Pusat H. Adam Malik Medan Said Fuadi; Frank Bietra Buchari; Utama A.Tarigan
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 48, No 1 (2015): The Journal of Medical School
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Introduction :Keloid is a manifestation of wound healing with imbalance syntesize and collagen degradation. Abnormal scar will grow through to the edge of wound then feeling itchy and needle-like pain. The common cause of keloid is continously overproduced of collagen, remodelling defect in cells and extracelluler matrix, overform of infiltration cells, and deficit of elastic tissue due to increase of fibroblast metabolic activity. Keloid has component which contain collagen, fibronectin and glycosaminoglycan. Of all lession, N-acetylgalactosamine is the most common glycosaminoglycan. Antigen A contain a N­ acetylgalactosaminyttransferase which form of blood type A and AB. Objective :The aim of the study to determine blood types which have keloid risk post wound at RSUP H.Adam Malik Medan. Method :This study was a descripnve study which descripted the phenomenon included risk factor , effect, or result. This study used 33 people as sample, that represented post-wound keloid patients at Plastic Surgery Clinic H.Adam Malik Hospital. Data was collected by blood type from anamnesis or finger prick method. Result : In this study blood type B was the most common keloid post-wound with 54.5% and blood type A 24.2%, blood type 0 12.1% and blood type AB 9.1%. Conclusion : In this study blood type B was the most common keloid post-wound with 54.5%. Keywords : keloid, Finger Prick Method, blood type
Hubungan interleukin 10 (IL - 10) dengan gastritis helicobacter pylori dan non helicobacter pylori Fiblia Fiblia
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 1 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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  Abstrak Pendahuluan : Prevalensi gastritis di Indonesia jumlahnya semakin meningkat dan merupakan masalah yang sering dijumpai pada praktek klinis. Penyebab tersering dari gastritis adalah Helicobacter Pylori (H. Pylon). Perjalanan gastritis H.Pylori dapat menjadi kronik dan menyebabkkan munculnya suatu kanker lambung. Pada gastritis H.Pylori biasannya terjadi proses inflamasi yang menyebabkan munculnya faktor proinflamasi dan anti inflamasi yaitu IL-10. lL -10 disebutkan dapat menyebabkan persistensi patogen dan dapat menstabilisasi inflamasi kronik. Metode: Penelitian analitik dengan metode cross sectional terhadap 80 pasien gastritis yang telah dilakukan pemeriksaan skor Porto Alegre Dyspeptic Symtoms Questionnare (PADYQ) '3d 6 dan telah dilakukan endoskopi dengan hasil gastritis. Pasien dibagi ke dalam kelompok gastritis H.Pylori dan non H.Pylori berdasarkan Campylobacter Like Organism (CLO). Lalu diperiksa kadar IL-10 serum pasien. Hasil: Dari 80 subyek, diperoleh gastritis H.Pylori sebanyak 33 subyek (41.2%}, mayoritas laki-laki 21 subyek (63.6%) dengan usia rerata 49.33 tahun dan mayoritas suku batak yaitu 20 subyek (60.6%) . peningkatan kadar l -10 serum pada pasien gastritis H.Pylori (1.47 pg/ml) dibandingkan gastritis non H.Pylori (1.29 pg ml) secara bermakna (p<0.031) dan skor PADYQ memiliki hubungan terbalik dengan kadar IL-1O serum {r = -0.266) secara bermakna (p<0.017). Simpulan: Terdapat hubungan yang signifikan antara kadar IL-10 serum dengan gastritis H.Pylori dan non H.Pylori, dimana kacar l -10 serum pada gastritis H.Pylori lebih tinggi dibandingkan non H.Pylori Kata kunci: gastritis; H.Pyfor; non H.Pylori; skor PADYQ; IL-10 Abstract Introduction :The prevalence of gastritis in Indonesia are increasing and becC1me a problem lhat is orten encountered in clinical practice. The most common cause of gastritis is H.Pylori gastritis can involved became a gastric cancer. In H.Pylori gastritis usually occurs inflammatory process that released the proinflammatory and antinflammatory factors, such as IL-10 influenced the persistence of pathogens in chronic inflammation and able to stabilize the  chronic  inflammation. Methods : It was cross-sectional study with 80 patients who suffered gastritis already inspected by Porto Alegre Dyspeptic Symtoms Questionnare (PADYQ) score '3d 6 and has perfomed endoscopic with gastritis reults. Patients were divided into groups of H.Pylori gastritis and non H.Pylori based on Campylobacter Like Organism (CLOj. Then exemined serum levels of IL-10. Results : Following of 80 subjects show H.Pylorigastritis about 33 subjects (41.2%), the majority are men 21 subjects (63.6%) with a mean age of 49.15years and the majority ethnic is Batak about 20 subjects (60.6%).The increasing in serum levels of l -1G in patients with H.Pylori gastritis (1.47pg/mlicompared to non H.Pylori gastritis (1.20 pg/ml) were significantly (p<0.0031) and scores PADYO has an inverse relationship with IL-1O serum levels (r=-0.266) were significantly (p<O.O 17). Conclusion :There is a significant correlation between serum levels of IL-10 with H.Pylori gastritis and non H.pylori,in which IL-1O serum levels in H.Pylori gastritis is higher than non H.Pylori Keywords :gastritis, H.Pylori, non H.Pylori, PADYQ score, IL-10

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