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Medica Hospitalia

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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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Perbandingan Nilai Corrected Count Increment pasca transfusi Thrombocyte Concentratedengan Thrombocyte Apheresispada penderita Keganasan Hematologi Like Rahayu Nindhita; Dian Widyaningrum
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Introduction : Transfusion thrombocyte concentrate (TC) and thrombocyteapheresis (TA) is a form of use of blood components as supportive measures to increase the number of platelets of patients with hematological malignancies thrombocytopenia, platelet transfusion success rated the corrected count increment (CCI).1 Platelet transfusion refractoriness (PTR) or failure increase in platelet post platelet transfusion, defined as more than two times the transfusion episode or successively obtained the value CCI <7.5 at 1 hour post first transfusion or <4.5 at 18-24 hours post transfusion.31 Materials and methods : Research samples from hematologic malignancies patients with platelet counts <50,000 / mm3, enforced through inspection Bone Marrow punction (BMP), got 2 or more episodes of platelet transfusions in the form Thrombocyte Concentrate (TC) and Thrombocyte Apheresis (TA), aged 1-70 years, do a complete blood count, is hospitalized at Dr. Kariadi’s hospital Semarang during the study period, from the number of pre- and post platelet transfusion CCI value is then determined between the recipient TA and TC. CCI value between TA to TC compared to perform statistical analysis computer using Mann Whitney test Research result : A study of 82 patients with both men and women diagnosed with Hematologic Malignancies obtained Platelet refractoriness cases as much as 5 of the 41 patients who received a transfusion history of using TA (12.19%), and 30 of 41 patients who received a transfusion history using TC (73.17 %). Mann Whitney test showed the value of CCI in case the recipient PTR between TA and TC got significant differences (p <0.05). Conclusion : There is significant difference between the value CCI of TA resipients and TC resipients. The value CCI of TA recipient was significantly higher than the value CCIof TC recipients. Keywords : thrombocyte apheresis, thrombocyte concentrate, CCI, PTR Pendahuluan: Transfusi thrombocyte concentrate (TC) dan thrombocyteapheresis (TA)merupakan bentuk penggunaankomponen darah sebagai tindakan suportif untuk meningkatkan jumlah trombositpasien keganasan hematologi dengan trombositopenia, Keberhasilan transfusi trombositdinilai dengan corrected count increment(CCI).1Platelet transfusion refractoriness (PTR) atau kegagalan kenaikan trombosit post transfusi trombosit, didefinisikan sebagai lebih dari dua kali episode transfusi atau berturut-turut didapatkan nilai CCI < 7,5 pada 1 jam pertama post transfusi atau < 4,5 pada 18-24 jam post transfusi.31 Bahan dan metode: Sampel penelitian adalah penderita keganasan hematologidengan jumlah trombosit <50.000 /mm3, ditegakkan melalui pemeriksaan Bone Marrow Punction (BMP), mendapat 2 atau lebih episode transfusi trombosit berupa Thrombocyte Concentrate (TC) maupunThrombocyte Apheresis (TA), usia 1-70 tahun, dilakukan pemeriksaan darah lengkap, menjalani rawat inap di RSUP Dr. Kariadi Semarang selama periode penelitian, Dari jumlah trombosit pre dan post transfusi kemudian ditentukan nilai CCI antara resipien TA dan TC. Nilai CCI antara TA dengan TC dibandingkan dengan melakukan analisis statistik komputer menggunakan uji Mann Whitney Hasil penelitian: Penelitian terhadap 82 pasien laki-laki maupun perempuan dengan diagnosis Keganasan Hematologi didapatkan kasus Platelet refractoriness sebanyak 5 dari 41 pasien yang mendapatkan riwayat transfusi menggunakan TA (12,19%), dan 30 dari 41 pasien yang mendapatkan riwayat transfusi menggunakan TC (73,17%).Uji Mann Whitney menunjukkan nilai CCI pada kasus PTR antara resipien TA dan TC didapatkan perbedaan secara signifikan (p<0,05). Simpulan: Didapatkan perbedaan secara signifikan nilai CCI antara yang mendapatkan TA dan yang mendapatkan TC. Nilai CCI resipien TA secara bermakna lebih tinggi daripada nilai CCI resipien TC Kata kunci :thrombocyte apheresis, thrombocyte concentrate, CCI, PTR

Analisis Faktor-Faktor Yang Mempengaruhi Kejadian Ekstravasasi Di Ruang Anak RSUP Dr. Kariadi Semarang Yuswinda Kusumawardhani
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Chemotherapy is one way to treat cancer by using drugs. Complications that can occur from chemotherapy is the occurrence of extravasation that occurs when chemotherapy drugs accidentally enter the tissue around intravenous access can cause persistent, painful and progressive ulceration if given incorrectly. Aim : to analyze the relationship between risk factor (canul size, vena location access, vena condition, kind of drug, long of explanation drug, and volume drug that used) to the incidence of extravasation in the pediatric ward RSUP Dr. Kariadi Semarang. Method: this research using observational analytic design according to cross sectional. The sample were taken by minimal sampling with criteria child 1-17 years old, child with chemotherapy cycle 1-6, and not using central vena access get 30 sample. The result of test using correlation regression. Result: showed that not connection between six risk factor with ekstravatation incident. Conclusion: the gold standard protocol must be carried out during the administration of chemotherapy Latar belakang. Kemoterapi merupakan salah satu cara penanganan kanker dengan menggunakan obat. Komplikasi dari pemberian kemoterapi yang dapat terjadi adalah kejadian ekstravasasi yang mana obat kemoterapi secara tidak sengaja masuk ke dalam jaringan di sekitar akses intravena yang dapat menyebabkan ulserasi yang menetap, nyeri dan progresif jika diberikan dengan tidak benar. Tujuan penelitian untuk menganalisis hubungan antara faktor resiko (ukuran kanula, lokasi akses vena, kondisi vena, jenis obat, lama paparan obat, dan volume obat kemoterapi) terhadap kejadian ekstravasasi di ruang anak RSUP Dr. Kariadi Semarang. Metodologi. Jenis penelitian ini menggunakan desain observasional analitik secara cross sectional. Pemilihan sampel menggunakan minimal sampling dengan kriteria anak usai 1-17 tahun, anak dalam siklus kemoterapi 1-6 dan tidak menggunakan akses vena sentral didapatkan 30 sampel. Analisa data menggunakan korelasi regresi. Hasil penelitian: tidak ada hubungan antara keenam faktor resiko dengan kejadian ekstravasasi. Kesimpulan: gold standard protocol harus dijalankan selama pemberian kemoterapi. Kata Kunci : Faktor Resiko, Kejadian Ekstraksasi, Kemoterapi Anak

Efektivitas Slow Stroke Back Massage Dengan Minyak Aromaterapi Lavender Terhadap Penurunan Nyeri Penderita Kanker Serviks Sri Setyowati; Anik Rakhmawati; Sumarsih Sumarsih; Maria Indri Wigatiningsih
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Pain is one of the main complaints of patients with Cervical cancer patients caused due to tumor growth, infiltrats, the effects of repeated diagnostics and treatment procedures. The types of treatment which are often given to the patients are pharmacological therapies or drugs, which can provide many side effects when used in the long term. This study aimed to know the effects of slow stroke back massage technique combined with lavender aromaterapy oil to reduce pain in patients with Cervical cancer in Dr. Kariadi Hospital. This study was a quantitative quasi experiment with randomized control group pretest-posttest design. The sampling was purposive sampling. The study involved 15 participants in the intervention group and 15 participants in the control group. The data were analyzed by univariate and bivariate analysis using wilcoxon test. The results showed that there were reduction of pain in the intervention groups with p = 0.000. This study revealed that slow stroke back massage technique combined with lavender aromaterapy oil techniques as a non-pharmacological therapy provided an effect on the decrease of pain in cervical cancer patients. Based on the study, it is suggested that nurses apply slow stroke back massage technique combined with lavender aromaterapy oil techniques as a non-pharmacological therapy to reduce pain in cervical cancer patients. Keywords: Pain, cervical cancer, slow stroke back massage, lavender aromaterapy oil Nyeri adalah salah satu keluhan utama pada pasien kanker serviks disebabkan karena pertumbuhan tumor, infiltrat di tempat lain, efek dari prosedur diagnostik dan perawatan yang berulang. Penanganan nyeri yang sering kali diberikan adalah pemberian terapi farmakologi atau obat-obatan yang memberikan banyak efek samping apabila digunakan dalam jangka waktu lama. Penelitian ini bertujuan untuk mengetahui pengaruh teknik slow stroke back massage dengan minyak aromaterapi lavender terhadap penurunan nyeri pada pasien kanker serviks di RSUP Dr Kariadi Semarang. Penelitian ini merupakan penelitian kuantitatif quasy eksperimental dengan metode randomized control group pre test posttest design. Pengambilan sampel dilakukan dengan teknik purposive sampling yaitu 15 responden sebagai kelompok intervensi dan 15 responden sebagai kelompok kontrol. Analisa data dilakukan secara bivariat dan univariat dengan menggunakan uji wilcoxon. Hasil penelitian menunjukkan terdapat perbedaan penurunan nyeri pada kelompok intervensi yang diberikan terapi slow stroke back massage dengan aromaterapi lavender dengan nilai p=0.000. Kesimpulan penelitian ini membuktikan bahwa teknik slow stroke back massage dengan minyak aromaterapi lavender sebagai terapi non farmakologis berpengaruh terhadap penurunan nyeri pada pasien kanker serviks. Saran: perawat diharapkan mengaplikasikan teknik slow stroke back massage dengan minyak aromaterapi lavender sebagai terapi non farmakologis untuk menurunan nyeri pada pasien kanker serviks. Kata kunci: Nyeri, Kanker Serviks, slow stroke back massage, minyak aromaterapi lavender

Gambaran Tatalaksana Nyeri Skala 1-3 Pada Pasien Kanker Di Ruang Perawatan Onkologi RSUP Dr. Kariadi Semarang Mufid Mufid
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background of the Study: Cancer is a disease or abnormalities of cells that grow new abnormally, excessively, uncontrollably, and finally can attack and spread to other organs around it. The pain always impairs cancer patients, it will differentially impair cancer patients', from mild, moderate, and severe. The pains can be overcome according to their standard: mild pain with nonpharmacology as an independent area of nursing, moderate pain with non-pharmacological and pharmacological combinations, they are collaborative areas, and severe pain with pharmacology, it is commonly given with medication. Objective of the Study: Find the description of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang Research Methodology: The design used was descriptive quantitative with cross-sectional approach, the sample size was 124 people. The sampling technique was Cluster-random sampling. The research instrument used was questionnaire sheet, while the analysis used was descriptive statistics to be displayed in the form of frequency distribution. Results of the Study: Description of the implementation of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang quantitatively on medical records shows that the average achievement of 95.16% (Good), quantitatively in the patients shows that the average achievement of 75.8% (Poor). Conclusion: Description of the implementation of pain management scales 1-3 by nurses towards cancer patients in oncology treatment room Dr. Kariadi General Hospital Medical Center or RSUP. Dr. Kariadi Semarang generally shows fair category. Keywords: Cancer, Pain Management, Semarang Latar Belakang : Kanker adalah penyakit atau kelainan sel-sel yang tumbuh baru secara abnormal, berlebihan, tidak terkendali, serta kemudian dapat menyerang dan menyebar ke organ lain di sekitarnya. Nyeri selalu menyertai penderita kanker, dengan tingkat nyeri yang dirasakan oleh penderita bervariasi, dari ringan, sedang, dan berat.Nyeri dapat ditanggulangi sesuai standartnya: yang ringan dengan non farmakologi sebagai area independen keperawatan, sedang dengan kombinasi non farmakologi dan farmakologi yaitu area kolaboratif, dan berat dengan farmakologi biasanya dengan pemberian medikasi. Tujuan penelitian: Mengetahui gambaran tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang Metode Penelitian : Desain yang digunakan deskriptif kuantitatif dengan pendekatan cross-sectional, besar sampel 124 orang. Tehnik sampling Clusterrandom sampling. Instrumen penelitian menggunakan lembar kuesioner sedangkan analisis yang digunakan statistik diskriptif yang akan ditampilkan dalam bentuk distribusi frekuensi. Hasil Penelitian : Gambaran implementasi tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang secara kuantitatif pada rekam medis menunjukkan bahwa rata – rata capaian 95,16 % (baik), secara kuantitatif pada pasien menunjukkan bahwa rata – rata capaian 75,8 %(kurang baik). Kesimpulan : Gambaran implementasi tatalaksana nyeri skala 1-3 oleh perawat pada pasien kanker diruang perawatan onkologi RSUP Dr. Kariadi Semarang secara umum menunjukkan cukup baik. Kata kunci : Kanker , Tatalaksana nyeri, Semarang

Gambaran Tingkat Kecemasan Pada Pasien Yang Akan Menjalani Operasi Bedah Jantung Di RSUP Dr. Kariadi Semarang Heru Noor Ramadhan; Tri Gunarti; Agung Purwanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Anxiety happens as the normal reaction of stressor and last for a moment. Anxiety may be experienced by patients who will undergo cardiac surgery. Objective: This study aimed to describe the anxiety that experienced by patients who will undergo cardiac surgery at Dr. Kariadi Hospital, Semarang. Methods: This descriptive study used Hamilton Anxiety Rating Scale (HARS) to measure the respondents’ anxiety rating scale and their responses during cardiac surgery. Thirty respondents were included in this study in Dr. Kariadi Hospital, Semarang. Results: All of the respondents that have been interviewed experienced various levels of anxiety; 8 respondents (26,7%) experienced mild anxiety, 18 respondents (60%) experienced moderate anxiety and 4 respondents (13,3%) experienced severe anxiety. Conclusion: This study concluded that all of the respondents who will undergo cardiac surgery in Dr. Kariadi Hospital Semarang experienced anxiety. Keywords: Anxiety, cardiac surgery, Dr. Kariadi Hospital Latar Belakang: Kecemasan muncul sebagai reaksi normal terhadap situasi yang sangat menekan dan berlangsung sebentar. Perasaan cemas mungkin akan dirasakan oleh sebagian besar pasien yang akan menjalani bedah jantung. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran kecemasan pasien yang akan menjalani operasi bedah jantung di RSUP Dr. Kariadi Semarang. Metode: Penelitian deskriptif ini menggunakan kuesioner HARS (Hamilton Anxiety Rating Scale) kepada responden untuk mengukur respon dan menilai tingkat kecemasan menjalani operasi bedah jantung. Sampel yang digunakan pada penelitian ini adalah 30 responden di RSUP dr. Kariadi Semarang. Hasil: 30 responden telah diwawancarai semua mengalami kecemasan dengan berbagai tingkatan sebagai berikut; 8 responden (26,7%) memiliki tingkat kecemasan ringan, 18 responden (60%) memiliki tingkat kecemasan sedang dan 4 responden (13,3%) memiliki tingkat kecemasan berat. Kesimpulan: Seluruh responden yang akan menjalani operasi bedah jantung di RSUP Dr. Kariadi Semarang mengalami kecemasan. Kata Kunci: Kecemasan, operasi bedah jantung, RSUP Dr. Kariadi

Pengaruh Latihan Sirkuit Terhadap Biomarker Inflamasi,Kapasitas Fungsional, Fungsi Paru, dan Kualitas Hidup Pasien Gagal Jantung Kronik Fauzan Muttaqien; Yulvina Yulvina; Riana Novita Sari; Fahmi Syarif; Sri Wahyudati; Sefri Noventi Sofia; Sodiqur Rifqi
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Physical exercise in patients with heart failure maydecrease the level of proinflammatory biomarkers,increase maximal oxygen consumption, improve pulmonary function and quality of life. Circuit training is one of the most advantageous exercise models because it improves cardiorespiratory fitness and muscle strength. Objective: This study was aimed to investigate the effect of circuit training on proinflammatory biomarkers, functional capacity, pulmonary function, and quality of life in patients with chronic heart failure in RSUP Dr. Kariadi Methods: Twenty-six stable chronic heart failure with reduced ejection fraction patients were randomized into exercise group that received circuit training in the rehabilitation center of Kariadi Hospital for a month and control group. TNF- ? levels, maximum oxygen consumption, pulmonary function, and quality of life were taken before and after the exercise period. Data between two groups was analyzed with the Mann-Whitney test. Pre and post data was analyzed with the Wilcoxon test. Results: Nine-teensubjects completed the study without any significant side effects.There was no significant difference in TNF-? levels before and after treatment between treatment groups and control groups (p=0,513). The treatment group with circuit training showed a greater increase in maximum oxygen consumption (p=0,034), greater increase in Forced Vital Capacity value(p=0,010) and a greater increase in quality of life score(p=0,047)than the control group. Conclusion: Circuit training in patients with chronic heart failure can increase maximal oxygen consumption, lung function, and quality of life, but no changes in inflammatory biomarkers. Keywords: Circuit training, TNF-a, maximal oxygen consumption, FVC, quality of life Latar belakang: Latihan fisik pada pasien gagal jantung dapat menurunkan kadar biomarker proinflamasi, meningkatkan konsumsi oksigen maksimal, memperbaiki fungsi paru dan meningkatkan kualitas hidup. Latihan sirkuit merupakan salah satu model latihan fisik yang lebih menguntungkan karena mampu memperbaiki kebugaran kardiorespirasi dan kekuatan otot sekaligus. Tujuan:Menganalisispengaruh latihan sirkuit terhadap biomarker inflamasi, kapasitas fungsional, fungsi parudan kualitas hiduppasien gagal jantung kronik di RSUP Dr.Kariadi. Metode:Dua puluh enam pasien gagal jantung kronik stabil dengan penurunan fraksi ejeksi ventrikel kiri dirandomisasi menjadi kelompok yang mendapatkan latihan sirkuit di bagian rehabilitasi RSUP Kariadi selama 1 bulan dan kelompok kontrol. Kadar TNF-a, nilai konsumsi oksigen maksimal, fungsi paru, dan kualitas hidupdiambil sebelum dan sesudah periode latihan. Analisis data antara dua kelompok menggunakan uji Mann-Whitney.Analisis data pre dan post, menggunakan uji Wilcoxon Hasil: Sembilan belas subjek menyelesaikan studi tanpa ada efek samping.Tidak didapati perubahan kadar TNF-a sesudah latihan sirkuit (p=0,513);Kelompok perlakuan dengan latihan sirkuit menunjukkan peningkatan konsumsi oksigen maksimal yang lebih besar (p=0,034), rerata peningkatan nilai FVC (Forced Vital Capacity) setelah latihan yang lebih besar (p=0,010), sertarerata peningkatan kualitas hidup yang lebih besar (p=0,047) dibandingkan kelompok kontrol. Simpulan: Latihan sirkuit pada pasien gagal jantung kronik dapat meningkatkan konsumsi oksigen maksimal, fungsi paru, dan kualitas hidup, namun tidak menyebabkan perubahan padabiomarker inflamasi. Kata Kunci: Latihan sirkuit, TNF-a, konsumsi oksigen maksimal, FVC, kualitas hidup

Rasio Netrofil Limfosit dan Limfositopenia Sebagai Penanda Sepsis Puja Laksana Maqbul; Ery Leksana; Muhammad Sofyan Harahap
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: The state of sepsis will initially lead to an increase in the number of neutrophils followed by an increase in lymphocytes, a state of sepsis that last longer will cause apoptosis of lymphocytes, so that the neutrophil lymphocyte ratio will increase, and absolute limfositopenia will occur which can be used as an indicator of sepsis. Aim: Knowing the value of RNL and lymphocyte count in patients suspected of sepsis in the ICU Dr. Kariadi Hospital Semarang Methods: This study is a non-experimental diagnostic and cross sectional design with a sample of 30 patients. Blood samples were taken from ICU patients with two or more signs of SIRS and suspected infection for leukocyte count and blood culture examination, then the data were analyzed using ROC curves. Result: The source of infection occurred in the digestive tract (43.3%), obstetrics gynecology (23.3%), respiratory tract (16.7%), cerebrovascular (10%) and urinary tract (6.7%). Neutrophils Lymphocytes count ratio has AUC 0,425 (sensitivity 60% and specificity 20%), absolute Limfositopenia has AUC 0,425 (sensitivity 40% and specificity 40%), while the RNL and Limfositopenia has AUC 0.575 (sensitivity 70% and specificity 45%). Conclusion: Neutrophils Lymphocytes count ratio and absolute Lymphocytopenia can not be used as an indicator of sepsis in ICU’s patients despite having a sensitivity of 70% and specifity 45%. Keywords: Sepsis, Ratio Neutrophils Lymphocytes, Limfositopenia absolute. Latar Belakang: Keadaan sepsis pada awalnya akan menyebabkan peningkatan jumlah netrofil diikuti oleh peningkatan limfosit, keadaan sepsis yang bertahan akan menyebabkan apoptosis dari limfosit, sehingga rasio netrofil limfosit akan meningkat, dan terjadi limfositopenia yang dapat dijadikan indikator sepsis. Tujuan: Mengetahui nilai RNL dan hitung limfosit pada pasien dicurigai sepsis di RSUP Dr. Kariadi Semarang Metode: Penelitian ini merupakan penelitian diagnostik non eksperimental dengan desain cross sectional dengan jumlah sampel 30 pasien. Pasien ICU dengan dua atau lebih tanda SIRS dan dicurigai infeksi diambil sampel darah untuk dilakukan pemeriksaan hitung jenis leukosit dan pemeriksaan kultur darah, kemudian data dianalisis menggunakan kurva ROC. Hasil: Sumber infeksi terbanyak terjadi pada traktus digestivus (43,3%), obstetri ginekologi (23,3%), traktus respiratorius (16,7%), cerebrovaskular (10%) dan traktus urinarius (6,7%). Rasio Netrofil Limfosit memiliki AUC 0,425 (sensitivitas 60% dan spesifitas 20%), Limfositopenia absolut memiliki AUC 0,425 (sensitivitas 40% dan spesifitas 40%), sedangkan RNL dan Limfositopenia memiliki AUC 0,575 (sensitivitas 70% dan spesifitas 45%). Kesimpulan: Rasio Netrofil Limfosit dan Limfositopenia absolut tidak bisa dijadikan indikator sepsis pada pasien-pasien di ICU walaupun memiliki sensitivitas 70% dan spesisifitas 45%. Kata kunci: Sepsis, Rasio Netrofil Limfosit, Limfositopenia absolut

Kidney Transplantation in Semarang: Outcomes and Prognosis Eriawan Agung Nugroho; Tommy Supit; Ardy Santosa; Nanda Daniswara; Sofyan Rais Addin; Anggun Ari Mukti
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Introduction & objective:Kidney transplantationis increasingly performed acrossIndonesia, including in Semarang. However there are limited publications onrenal transplantationfrom Indonesia, especially from centers outside Jakarta. The objective of this case series is to give a brief overview on the transplantation performed in Semarang, discusscurrent issues and ongoing efforts to address them. Case series:Twenty-seven renal transplants in Dr. Kariadi General Hospital from January2012 until July 2018wereretrospectively analyzed. On average recipients were younger (32.5 years old) compared to the donors (46.8 years old). All kidneys were acquired from living donors with the majority of them to be blood-related(74.1%). The 3 leading etiologies of end-stage renal disease were hypertension (36.0%), diabetes mellitus (26.9%), and autoimmune disease (11.2%). The average total ischemic time was 36.9 minutes andthe average length of stay was 11 days. We report 5 cases of mortality, 3 cases of allograft rejection and no re-transplantation. Discussion: The demographics of kidney transplant patients in Semarang were similar compared to the National data. The limited number of transplant in Semarang contributes to the low number of survival rate and highlights the need of further training and expertise. Better survival rate can be achieved with more transplants number as well as reaching the plateau of learning curve within the coming years. Conclusion: The development of kidney transplant in Semarang follows the National milestones. In order to maximize the potentialthe institution, further improvements should concentrate on the development of integrated organ transplant infrastructure. The main goal of this institution is to establish a solid transplant center capable of covering Central Java, aiding the decentralization of kidney transplant in the Nation Keywords: Kidney transplantation, End-stage Renal Disease, Chronic Kidney Disease, Indonesia, Semarang, Epidemiology, Update

Acute kidney injury due to multiple bee stings in a 3 years old girl Omega Mellyana; Dessy Adelina; Jati Kusuma
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 1 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Bee stings can lead to mild to severe allergic reaction . Serious complications of bee stings include hypersensitivity to the venom, which can develop after a single sting, and acute renal failure which has been reported mostly secondary of intravascular hemolysis developing after multiple bee stings. We report here a child who developed multiorgan system involvement. Case presentation: A-3 years-old-girl was admitted to Kariadi Hospital with multiple bee stings and referred due to acute kidney injury stage failure by local hospital. Clinical finding were anasarca edema, gastrointestinal bleeding, oliguria (0.8ml/kgBW/hours), stage II hypertension (124/99mmHg), flaccid paraparesis inferior. Laboratory finding were hypoalbuminemia (2.4g/dL), anemia (6g/dl), leukocytosis (35.800/mm3), electrolyte imbalance (hypocalsemia:1.66mg/dL) and estimated glomerular filtration rate (eGFR) 8.09 ml/min/1.73m2. Chest-X ray showed pulmonary edema and duplex pleural effusion. The renal function recovered with supportive management including four sessions of haemodialysis. Patient discharged from the hospital on the nineteenth day. Conclusions: Multiple bee stings can lead multiorgan system involvement Keyword: Bee sting, acute kidney injury, hemodialisys

Epilepsy surgery in Indonesia: Achieving better result with limited resources Muttaqin, Zainal
Medica Hospitalia : Journal of Clinical Medicine Vol. 1 No. 1 (2012): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Even with modern medication, 30 to 40% of epilepsy patients will be intractable and this condition leads to cognitive and psychosocial decline, resulting in worse quality of life and higher mortality. With 0.5–0.6% prevalence, there will be about 1.5 million epileptic in Indonesia, about 440.000 will be intractable, and 220.000 of them are potential candidates for epilepsy surgery (ES). A decade has passed since the first ES performed on July 1999, and the number increases every year reaching 35–47 ES per year in 2007–2009. Despite the excellent result shown, all of these ES were still performed in Semarang (Diponegoro University) while the patients were from all part of Indonesia. The major reason behind the unavailability of ES in most part of the country should be discussed for the sake of future development of ES in Indonesia. Material: Epilepsy surgery was started in July 1999 with anterior temporal lobectomy for a 34 Y-old female with left mesial temporal sclerosis (MTS) causing a long standing intractable seizures. The number of cases increases every year. Until the end of 2009, there were 238 cases of epilepsy surgery, including 212 anterior temporal lobectomies. Among these, 106 cases had been follow up more than 36 months, and evaluated for surgical results. Methods: To evaluate the patient's selection and the presurgical evaluation, we divide the ES cases into the first 5 years (56 cases) and the recent 5 years (182 cases). But for the purpose of evaluating surgical results, only those with at least 36 months postoperative follow-up were included (106 cases) and grouped into those operated before or after the age of 25 Y-old (group A and group B), and into those operated before or after the length of epilepsy of 10 years (group I and group II). Results: For the first five years-period, decision to operate were based on MRI and routine interictal EEG in 54 out of 56 TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, since MRI in both patients showed visually normal MRI. For the last five years, decision to operate were based on MRI and routine EEG in 91 out of 156 TLE cases. Long term ictal EEG were performed in 46 patients, subdural grid EEG in 10 patients, PET study in 7 patients, and EcoG in 2 patients. The overall seizure free (SF) rate were 70.75%, but if grouped according to patient's age at surgery (less than or over 25 Y-old), the SF rates were 75.4% vs 66.04% respectively. So did if grouped according to length of disease (less than or more than 10 years), the SF rates were 78.72% vs 64.40% respectively. Conclusion: MRI plays very important role to decide the side of the epileptic temporal side, but this role is decreasing as it was 96.4% during the beginning five years to become 58.34% for the last five years. This means that we are working on more difficult epilepsy cases recently. SF rate was significantly higher for those who was operated at younger age and for those with shorter duration of epilepsy. This means that surgery should be offered earlier for those intractable TLE patients with obvious focus on MRI.

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Home Page

OAI Link

Editorial Team

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Reviewer

Google Scholar

Contact Name Aziz Alfarisy

Contact Email medicahospitalia@rskariadi.co.id

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Journal Mail Official medicahospitalia@rskariadi.co.id

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Location Kota semarang, Jawa tengah INDONESIA

Abstract

Abstract

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Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Aziz Alfarisy

Contact Email
medicahospitalia@rskariadi.co.id

Phone
-

Journal Mail Official
medicahospitalia@rskariadi.co.id

Editorial Address
-

Location
Kota semarang,

Jawa tengah

INDONESIA