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Medica Hospitalia
Published by RSUP Dr. Kariadi Semarang
ISSN : 23014369     EISSN : 26857898     DOI : https://doi.org/10.36408/mhjcm
Core Subject : Health,
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health
Medica Hospitalia: Journal of Clinical Medicine adalah jurnal ilmiah yang diterbitkan RSUP Dr. Kariadi dan menerima artikel ilmiah dalam bahasa Indonesia dan bahasa Inggris yang diharapkan dapat menjadi media untuk menyampaikan temuan dan inovasi ilmiah dibidang kedokteran atau kesehatan kepada para praktisi dan akedemisi di bidang kesehatan dan kedokteran.
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Articles 21 Documents
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Search results for , issue "Vol. 12 No. 2 (2025): Med Hosp" : 21 Documents clear
Effect of R-CHOP Chemotherapy on Creatinine Clearance in Diffuse Large B-Cell Lymphoma Handhika Mustika; Willy Yusmawan; Rery Budiarti; Dwi Antono; Kanti Yunika
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1153

Abstract

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma (LNH). First-line therapy for DLBCL is a combination regimen of Rituximab, Cyclophosphamide, Hydroxydoxorubicin, Vincristine (Oncovin), and Prednisone (R-CHOP). The CHOP regimen causes acute kidney injury (AKI) directly or mediated by reactive oxygen species (ROS). AKI is associated with significant morbidity and mortality in cancer patients, including high mortality, increased hospitalization, and a lower cancer remission. AIM:  Analyzing the effect of R-CHOP chemotherapy on creatinine clearance values ​​in DLBCL lymphoma patients METHOD: Analytical observational study with a retrospective design involved 38 patients diagnosed with DLBCL who underwent R-CHOP chemotherapy at RSUP dr. Kariadi Semarang. The independent variable of the study was the frequency of chemotherapy. The dependent variables of the study were serum creatinine levels and creatinine clearance which were measured in 4 phases, namely before, post 3x-, post 4x- and post 5x- R-CHOP chemotherapy. Analysis used the Friedman, T-dependent, and Wilcoxon tests. RESULT:  The creatinine clearance value of DLBCL lymphoma patients before administering R-CHOP had a normal value with an average of 68.98 mL/min. The creatinine clearance value of DLBCL lymphoma patients after administering R-CHOP after 3x chemotherapy was found to be an average of 78.26 mL/min, after 4x chemotherapy the average was 75.50 mL/min and after 5x chemotherapy the average was 73.24 mL/min. There was a significant difference in creatinine clearance values ​​for DLBCL lymphoma patients before and after administration of R-CHOP (p=0.018). CONCLUSION: Administration of R-CHOP chemotherapy has a significant effect on the creatinine clearance value of DLBCL lymphoma patients.
The Role of Mammography in Early Detection of Breast Cancer: A Case Collection Report Lilik Lestari; Muhammad Harris Sis Sulthansyah
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1171

Abstract

Background: Breast cancer is still the main cause of death in women, both globally and nationally. Therefore, mammography screening needs to be carried at to detect breast cancer early. Cases Presentation: This paper presents the mammography findings of the 83 patients at dr. Ario Wirawan Pulmonary Hospital, Salatiga, Indonesia. Mammography examination used projection cuts, namely craniocaudal (CC) and mediolateral oblique (MLO). The classification used for this case series is BI-RADS. Discussion:  The results showed that of the 83 patients examined with mammography, 2 patients showed BI-RADS 4, indicating breast cancer, and 9 patients showed BI-RADS 2, indicating benign tumors. This case series report is consistent with previous studies explaining that mammography is important for making an accurate diagnosis of breast cancer between benign and malignant calcifications. Conclusion: Mammography has a role in the early detection of breast cancer. Mammography examination using CC and MLO projections is a standard procedure that aims to obtain high-quality breast images and provide accurate information for early diagnosis of breast cancer.
Integrating Neck Massage and Progressive Muscle Relaxation: A Comprehensive Approach for Reducing Migraine Disability and Enhancing Quality of Life Rina Budi Kristiani; Novita Fajriyah; Sosilo Yobel
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1205

Abstract

BACKGROUND: Migraine is a highly disruptive and common neurological disorder characterized by intense headache and transient somatosensory and motor disturbances that affects approximately 1 billion people worldwide with many common causative factors and often results in disability and reduced quality of life. This study aims to determine the effect of combined neck massage and progressive muscle relaxation therapy on disability and quality of life of migraine sufferers. METHOD: This quasi-experimental study used a pre-test-post-test control group design over eight weeks (May to July 2024), selecting 50 participants aged 18–60 years with migraines for over three months based on ICHD-3 criteria. The study utilized the Migraine Disability Assessment Questionnaire and the Migraine-Specific Quality of Life Questionnaire as instruments. RESULT: The combination therapy of neck massage and progressive muscle relaxation both has a significant effect on reducing the severity, frequency, and duration of migraine attacks, as well as improving migraine-related disability (p =0.000) and quality of life (p-value = 0.001). CONCLUSION: Combination therapy of neck massage and progressive muscle relaxation is effective in reducing migraine disability and improving the quality of life of migraine sufferers.
Association of Pre-treatment Serum Fibrinogen-Albumin Ratio Index (FARI) and Concurrent Chemoradiotherapy (CCRT) Therapeutic Response in Patients with Locally Advanced Cervical Cancer (LACC) Gezta Nasafir Hermawan; Bismarck Joel Laihad; Joice Margretha Mathilda Sondakh
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1207

Abstract

BACKGROUND: Cervical cancer is currently the second most prevalent women malignancy cases in Indonesia. High prevalence of cases diagnosed as locally advanced cervical cancer / LACC (FIGO Stage IIB-IVA), where concurrent chemoradiotherapy (CCRT) is the main treatment modality. Several therapeutic efficacy predictors in other malignancy cases including the pre-treatment serum fibrinogen-albumin ratio index (FARI) have been associated with therapeutic response to CCRT. However, there were no recent studies in cervical cancer cases. AIMS: To determine the association of pre-treatment FARI and CCRT therapeutic response in patients with LACC. METHOD: This is a prospective cohort study in patients with LACC from January – May 2024 whose clinical stage was determined. The pre-treatment FARI was calculated in patients who had met both inclusion and exclusion criteria, and undergone the CCRT regimen. Patients who completed the regimen were evaluated for therapeutic response. Data processing was carried out using SPSS 25 for Windows software. RESULT: In this study, it was found that the complete response (CR) group with the best outcome had the smallest pre-treatment FARI (9.79 ± 1.71), on the other hand the progressive disease (PD) group had largest pre-treatment FARI (33.72 ± 12.78). In addition, all CCRT therapeutic response groups had significantly different FARI values ​​(P value < 0.05) and the FARI cut point value of 12.44 had a sensitivity of 100% and a specificity of 78.1% for predicting complete response (CR) to CCRT. CONCLUSION: Low pre-treatment FARI is significantly associated with the likelihood of patients having a complete response (CR), which is the best outcome to CCRT.
Analysis of Category I Cesarean Section Response Time on Maternal-Neonatal Outcomes at Adam Malik Hospital Medan Mohammad Naufal; Sarma Nursani Lumbanraja; Iman Helmi Effendi; Edwin Martin Asroel; Hanudse Hartono; Sarah Dina
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1217

Abstract

BACKGROUND: Maternal and neonatal mortality remain significant global health concerns. Category I cesarean sections are performed in life-threatening obstetric emergencies, with a recommended decision-to-incision interval (DII) of ≤30 minutes. AIMS: To evaluate the proportion of category I emergency cesarean sections performed < 30-minute response time at Adam Malik Hospital, Medan, and to identify factors contributing to delays. METHODS: This retrospective cohort study included 44 consecutively selected cases of category I emergency cesarean sections performed at Adam Malik Hospital, Medan, between January 1 and December 31, 2023. Eligible cases involved immediate threats to maternal or fetal life and had complete documentation of surgical timings. Time data including decision-to-incision interval and its components were extracted from electronic medical records and cross-validated with operating room and delivery ward logs. The primary outcome was decision-to-incision interval (DII), dichotomized at 30 minutes. Variables associated with DII (p <0.25) were included in multivariate analysis using Firth’s penalized logistic regression to account for small sample size and data separation. RESULTS: Only 43.2% of cases achieved a DII of ≤30 minutes. Multivariable analysis identified patient transfer time (AOR = 16.91, 95% CI: 2.19–358.36) and anesthesia duration (AOR = 27.21, 95% CI: 2.29–889.18) as significant predictors of delay. No significant associations were found between DII and adverse maternal or neonatal outcomes. CONCLUSION: Delays in patient transfer and anesthesia were the main contributors to prolonged DII in emergency cesarean sections. While these delays did not significantly impact short-term clinical outcomes, targeted improvements in emergency obstetric workflows may help hospitals meet national response time standards and enhance quality of care.
The Association between Monocyte-derived Macrophages TNF-a Expression and Anthropometrics Measures in Polycystic Ovary Syndrome Naylah Muna; Oki Riayati; Heri Wibowo; Andon Hestiantoro
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1224

Abstract

BACKGROUND: Polycystic ovary syndrome (PCOS) is a female infertility disease that is often associated with low-grade chronic inflammation. This inflammation was suspected to correlate with certain body conditions, especially physical lipid composition that can be obtained under anthropometrics measurements. Monocytes and macrophages of PCOS patients were more susceptible to inflammation and contributed to this condition. Tumor Necrosis Factor-alpha (TNF-a), as one of the major inflammatory cytokines, holds an important role in the chronic inflammation of PCOS. AIMS:  This study aimed to evaluate the association of inflammatory cellular levels TNF-a in macrophage cells of women diagnosed with PCOS with physical anthropometrics. METHOD: Twenty PCOS women and ten healthy women as the control group were recruited in this study. Anthropometric data were measured. Peripheral blood was collected, mononuclear cells were isolated, and then cultured. Monocytes were selected and differentiated into macrophages. Macrophages were then exposed to oxidized Low-Density Lipoprotein (ox-LDL) and underwent flow cytometry to examine the level of TNF-a. Anthropometric data and TNF-a level were analyzed using Spearman-Rho Correlation test followed by a linear regression test. RESULT: TNF-a expression was found to be statistically correlated with Body Mass Index (BMI), waist circumference (WC), waist-to-height ratio, visceral fat level, and muscle mass of arm (MMA) (p<0.05). However, only WC and MMA gave significant impact to macrophage TNF-a expression based on linear regression association test with equation -96.971 + 0.601*waist circumference + 2.665*MMA. CONCLUSION: TNF-a was strongly associated with waist circumference and muscle mass percentage of arm in PCOS cases.
The Effect of Smoking Habits on Decreased Liver Function in Active Smokers Aged 20-50 Years old Mike Permata Sari; Afifa Radhina; Privia Muliamarshanti
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1229

Abstract

BACKGROUND: A study was conducted to determine the effect of smoking habits on decreased liver function in active smokers aged 20-50 years. This study was motivated by Indonesia’s high smoking prevalence and its associated liver-related health issues. The liver is an organ that plays a role in the body's metabolism. Smoking triggers the formation of free radicals, causing a decrease in liver function and inflammation. METHOD: In this study, mix method design was used with active smokers as the smoker group and the control group was respondents not active or passive smokers. Groups are categorized again based on age, ie 20-30, 31-40, and 41-50. The study population is the academic community of the Hermina Health Institute Jatinegara Campus and the community living on Kapitan III Road Tapos District, Depok City. Liver function is evaluated through enzymes SGPT, SGOT, ALP, and CRP as parameters for inflammation. To evaluate the influence of smoking habits and lifestyle factors on liver function risk, an analysis of variance (ANOVA) followed by post-hoc testing and linear regression analysis were performed. RESULT: Laboratory results showed that mean levels of ALT, AST, ALP, and CRP were higher in the smoker group compared to controls across all age categories, although most values remained within normal limits. ANOVA revealed statistically significant differences in all biomarkers (p<0.05), and post-hoc tests identified specific age-related group differences. Smokers’ habit data indicated that most smokers began smoking between the ages of 15–20 and had smoked for over five years. Lifestyle analysis showed a higher prevalence of insufficient physical activity, reduced sleep duration, and higher BMI among smokers. CLDQ scores for both groups generally reported minimal emotional disturbance and no signs of advanced liver disease. CONCLUSION: Smoking is associated with elevated liver enzymes (ALT, AST, ALP) and CRP levels, indicating subclinical hepatic and inflammatory alterations. These biochemical changes correlate with lifestyle risk factors and diminished quality of life. Early screening and lifestyle modification are recommended to prevent long-term hepatic damage among smokers.
The Association between Atopy, and Family History of Asthma Patient and Severity Asthma based on Spirometry Susanthy Djajalaksana; Aditya Sri Listyoko; M. Yusuf Musthafa; Didik Purbandiyono; Adrian Yusdianto; Adlan Pratama Binharyanto; Cindy Carrissa Primaputri; Ilham Revan Ananda; Marsha Nurandhini; Muli Yaman; Reza Aditya Mahendra; Zata Dini
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1231

Abstract

BACKGROUND: Asthma is a chronic inflammatory respiratory condition characterized by fluctuating symptoms, which often leads to diagnostic challenges. Accurate assessment and interpretation of clinical and functional parameters are essential to improve disease management and patient outcomes. AIMS: This study aims to analyze the demographic and clinical profiles of asthma patients, particularly investigating the relationships among the degree of airway obstruction, spirometric indices, smoking exposure, environmental risk factors, atopic history, and family history, to better understand the multifactorial nature of asthma. METHOD: A retrospective descriptive-analytic study was conducted using medical records of 107 asthma patients treated at the Outpatient Installation of the Lung Polyclinic, Wlingi General Hospital, Blitar Regency, from 2021 to 2022. Descriptive statistics were used to summarize demographic and clinical data, and Spearman correlation tests assessed associations between variables. RESULTS: A high proportion of patients had a history of smoking, with 22.4% being active and 52.3% passive smokers. However, no significant correlation was found between smoking status and asthma control. Common environmental risk factors included exposure to dust and cold air, though these did not consistently correlate with asthma exacerbations. Significant correlations were identified between the severity of airway obstruction and spirometric parameters such as FEV1, FVC, FEV1/FVC ratio, PEF, FEF 25, FEF 50, and FEF 75, confirming the impact of airflow limitation on lung function. No significant associations were found between asthma stability and atopic or family history. CONCLUSION: The findings underscore the complexity of asthma pathophysiology, where airflow obstruction is clearly linked to reduced spirometric function, but other factors such as smoking, environmental exposures, atopy, and family history do not show consistent predictive value for asthma control. These results highlight the need for a comprehensive and individualized approach in asthma diagnosis and management.
Optimization Axial T2WI Lumbar MRI in Spinal Stenosis: Effects of GRAPPA Acceleration Factor on Image Quality and Anatomy Diah Nisaa Harumsari; Dwi Rochmayanti; Nanang Sulaksono
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1235

Abstract

BACKGROUND: Patients with lumbar spinal stenosis (LSS) who struggle to lie down for long periods may encounter issues during lumbar MRI exams. GRAPPA, a parallel imaging method to speed up MRI scans, can reduce the Signal to Noise Ratio (SNR), affecting image quality and anatomical information. AIMS: This study aims to find the best GRAPPA acceleration factor by assessing its effect on image quality and anatomical information. METHOD: This study involved scans on 10 Lumbar MRI patients with LSS cases. The scans were performed using a Siemens Magnetom Aera 1.5 Tesla MRI machine with T2WI TSE axial cut. Each patient underwent 4 treatments with acceleration factors of 1 (without GRAPPA acceleration factor), 2, 3, and 4. Image quality was analysed using ROI to obtain SNR and CNR values. The radiologist assessed the anatomical information on the images. The analysis included a one-way ANOVA and the Kruskal-Wallis test was performed for image quality and anatomical information. RESULT: The research found that the GRAPPA acceleration factor significantly affects image quality and anatomical information in axial T2WI TSE Lumbar MRI scans for patients with LSS (p-value < 0.01). A factor of 3 reduces examination time by 65.35% without significant differences (p > 0.05) in image quality and anatomical information. CONCLUSION: The acceleration factor in axial T2WI TSE lumbar MRI significantly affects image quality and anatomical information for lumbar spinal stenosis cases. An acceleration factor of 3 is optimal for maintaining quality and anatomical information.
Effectiveness Of Mar'ke Bilar Drink Formulation On Pro- Anti-Free Radicals In The Blood Of Women Of Childbearing Age Operators In Gas Stations Ginta Siahaan; Fauzi Romeli; R.R. Sri Arini Winarti Rinawati; Suriani br Ginting; Kenya Putri Kasi Sembiring Pandia; Ifta Maulida Tanjung
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1242

Abstract

BACKGROUND: Women of childbearing age who wortk at gas stations are vulnerable to pollution exposure due to fuel emissions. The workers are susceptible to heavy metal (Pb) poisoning in the fuel content. This can cause health problems such as reproductive disorders, impaired kidney function and can even cause anemia in women. AIMS: To determine the effectiveness of Mar'ke Bilar formulation on Pb, MDA, and SOD in blood. METHOD: The study was Quasi Experimental with a pre and post test group design that allows researchers to see the comparison of the control group with the experimental group. The sample in the study was Women of childbearing age who worked as operators at gas stations with a total of 60 people and were determined based on purposive sampling with inclusion criteria then divided into 4 treatment groups. Data analysis used the T-dependent test to see the differences in each group then continued with the One Way ANOVA and Post Hoc-Tukey tests. RESULT: The results of the study showed that the three of  Mar’ke Bilar formulations were effective in reducing Pb and MDA levels, as well as increasing SOD levels, which are endogenous antioxidant enzymes that are important in the body's defense against oxidative stress. While formula 1 proved to be the most effective in increasing SOD levels. CONCLUSION: Mar'ke Bilar affects blood Pb, MDA, and SOD levels and formulation 1 is the most effective in increasing SOD levels. It is necessary to consume colored foods such as Marke'Bilar which are very good for avoiding diseases caused by free radicals  by air and water pollution, especially those caused by heavy metals.

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