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Published by RSUP Dr. Kariadi Semarang

ISSN : 23014369 EISSN : 26857898 DOI : https://doi.org/10.36408/mhjcm

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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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Hubungan Antara Mekanisme Koping Dengan Derajat Depresi Pada Caregiver Pasien Skizofrenia Studi di unit rawat jalan Rumah Sakit Jiwa Amino Gondo Hutomo Provinsi Jawa Tengah Supiyarti, Retti; Noerhidajati, Elly; Julianti, Hari Peni
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang: Memiliki anggota keluarga yang menderita skizofrenia merupakan suatu stressor yang mengakibatkan stres yang bersifat kronik. Stress kronik lebih banyak dihubungkan dengan tingkat derajat depresi. Derajat depresi dibedakan sesuai dengan banyak dan beratnya gejala terhadap fungsi kehidupan pasien. Caregiver pasien skizofrenia akan melakukan mekanisme koping dalam mengatasi stressor tersebut yang terbagi atas problem focused coping dan emotion focused coping. Mekanisme koping memiliki peranan penting dalam interaksi antara situasi yang menekan dan proses adaptasi. Tujuan: Mengetahui hubungan mekanisme koping dan derajat depresi pada caregiver pasien skizofrenia. Metode: Penelitian ini merupakan penelitian analitik kuantitatif dengan rancangan cross sectional. Sampel adalah caregiver pasien skizofrenia di unit rawat jalan Rumah Sakit Amino Gondohutomo Jawa Tengah dan memenuhi kriteria inklusi penelitian. Subyek penelitian sebanyak 58 responden di pilih dengan metode consecutive sampling. Instrumen penelitian yang digunakan adalah Beck Depression Inventory (BDI) II dan Kuesioner The Ways of Coping serta kuesioner karakteristik sosiodemografi. Analisis dengan program komputer SPSS. Hasil : 27 responden (46,6%) menggunakan emotional focused coping. 31 responden (53,4%) menggunakan problem focused coping. 43 responden (74,1%) tidak depresi, 12 responden (20,7%) depresi ringan, 2 responden (3,4%) depresi sedang dan 1 responden (1,7%) depresi berat. Hasil analisis hubungan mekanisme koping dengan derajat depresi caregiver pasien skizofrenia dengan menggunakan uji Chi-square didapatkan P value > 0,05 bahwa tidak ada hubungan yang signifikan antara mekanisme koping dengan derajat depresi caregiver pada pasien skizofrenia. Simpulan: Tidak terdapat hubungan antara mekanisme koping dengan derajat depresi pada caregiver pasien skizofrenia Kata kunci :Mekanisme koping, Depresi, Caregiver Background: Having family members who suffer from schizophrenia is a stressor that results in chronic stress. Long life events or chronic stress are more associated with depression. Derajat depresi dibedakan sesuai dengan banyak dan beratnya gejala terhadap fungsi kehidupan Caregiver schizophrenic patients will carry out coping mechanisms in dealing with these stressors which are divided into problem focused coping and emotion focused coping. Coping mechanisms have an important role in the interaction between situations that suppress and adaptation processes. Objective: To analyze the relationship between coping mechanisms and the degree of depression in caregiver schizophrenic. Method: This study is a quantitative analytic study with a cross sectional design. The sample was a schizophrenic caregiver in the outpatient unit of Amino GondoHutomo Hospital in Central Java and fulfilled the study inclusion criteria. Sampling using consecutive sampling method. The research instruments used were the Beck Depression Inventory (BDI) II and The Ways of Coping Questionnaire and the socio-demographic characteristic questionnaire. Analysis with computer programs. Results: 27 respondents (46.6%) used emotional focused coping. 31 respondents (53.4%) used problem focused coping. 43 respondents (74.1%) were not depressed, 12 respondents (20.7%) mild depression, 2 respondents (3.4%) moderate depression and 1 respondent (1.7%) had severe depression. The results of the analysis of the relationship between coping mechanism with the degree of caregiver depression in schizophrenic patients using the Chi-square test obtained P value> 0.05 that there was no significant relationship between coping mechanisms with caregiver depression degrees in schizophrenic patients. Conclusion: There is no relationship between coping mechanism and the degree of depression in the caregiver of schizophrenic patients Keywords: Coping mechanism, Depression, Caregiver

Kasus Dua Orang Wanita Umur 36 Tahun Dan 60 Tahun Dengan Akromegali Ismayanti, Fajri; Sukmaningtyas, Hermina
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Kasus Akromegali di RSUP dr. Kariadi sangat jarang terdeteksi pada fase awal karena minimnya gejala yang ditimbulkan. Pasien ditemukan tanpa sengaja biasanya datang dengan keluhan penyerta yang lain. Pemeriksaan Radiologi membantu menegakkan diagnosis Akromegali. Dilaporkan 2 kasus wanita usia 36 tahun dan 60 tahun dengan Akromegali. Kasus pertama Ny. D usia 36 tahun dengan keluhan benjolan di leher dan sulit menelan datang ke poliklinik Penyakit Dalam RSUP dr. Kariadi. Pada pemeriksaan USG colli didapatkan pembesaran kelenjar tiroid, penebalan isthmus, nodul solid dengan jaringan nekrotik (ukuran terbesar ± 3.64 x 2.16 cm). Kasus kedua, Ny. N usia 60 tahun dengan keluhan nyeri diseluruh sendi. Tulang membesar, mentruasi berhenti pada usia 35 tahun. Pada pemeriksaan radiologi X Foto vertebra lumbosacral tampak gambaran Ankylosing Spondilosis. Pada pemeriksan MRI kepala kedua pasien diatas ditemukan makroadenoma. Kedua pasien berperawakan pendek dengan pembesaran tangan, kaki dan tulang wajah (prognatism) Akromegali adalah suatu penyakit akibat dari peningkatan sekresi hormon pertumbuhan (somatotropin) oleh sel eosinofilik dari lobus anterior kelenjar pituitari, yang disebabkan oleh hiperplasia kelenjar atau tumor yang menyebabkan pertumbuhan tulang yang meningkat. Akromegali umum ditandai dengan pembesaran tangan, kaki dan tulang wajah. Akromegali menyebabkan perubahan bertahap pada bentuk wajah, seperti rahang bawah dan alis yang menonjol, hidung membesar, bibir menebal dan gigi jarang. Akromegali cenderung berkembang perlahan. Pemeriksaan foto cranium, tangan dan kaki menunjukkan kelainan pada tulang. Dilaporkan kasus diatas untuk membantu klinisi menegakkan diagnosa Akromegali dengan menggunakan multi modalitas radiografi, sehingga dapat ditegakkan lebih awal untuk membantu tatalaksana pasien. KATA KUNCI : Akromegali, Prognatism, Makroadenoma

Kematian Mendadak Akibat Kardiomiopati Hipertrofi Pada Dewasa Muda Iswara, Raja Al Fath Widya; Sadad, Arif Rahman; Rohmah, Intarniati Nur; Bhima, Sigid Kirana Lintang
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang : Kematian mendadak merupakan kasus yang paling sering terjadi dan dapat ditemukan dalam berbagai macam kondisi. Penyebab kematian mendadak terbanyak adalah sistem kardiovaskular dan salah satu kelainan yang jarang terjadi adalah kardiomiopati hipertrofi. Kardiomiopati hipertrofi merupakan kelainan jantung yang ditandai dengan hipertrofi miokardial akibat mutasi sarkomer dengan angka kejadian 1 dari 500 orang dewasa. Temuan utama pada kardiomiopati hipertrofi antara lain adanya hipertofi ventrikel dan atau septum interventrikel, kerusakan miosit dan peningkatan fibrosis miokardium. Terdapat variasi manifestasi klinis pada Kardiomiopati hipertrofi, dari asimptomatik hingga mengakibatkan kematian mendadak akibat gagal jantung. Tujuan laporan kasus ini adalah mengetahui diagnosis kematian akibat kardiomiopati hipertrofi pada dewasa muda. Kasus : Seorang laki-laki usia 18 tahun ditemukan meninggal di kamar kostannya dibawa ke kamar jenazah RSUP dr. Kariadi Semarang untuk diotopsi. Pemeriksaan luar tidak ditemukan tanda-tanda kekerasan. Pemeriksaan dalam didapatkan adanya jendalan darah dalam ventrikel, hipertrofi ventrikel kiri, penebalan pada katub jantung, pengerasan pada otot jantung dan penggantung katub serta tanda asfiksia. Pemeriksaan histopatologi menunjukkan kardiomiopati hipertrofi. Pembahasan : Patogenesis kardiomiopati hipertrofi dapat menyebabkan asfiksia yaitu terjadinya mutasi intrasarkomer yang meningkatkan peningkatan sensitivitas dan produksi Calsium yang mengakibatkan peningkatan kontraksi miokardium sehingga menyebabkan hipertrofi ventrikel kiri. Selain itu juga terjadi peningkatan sintesis kolagen yang mengakibatkan terjadinya fibrosis miokard yang menyebabkan hipertrofi ventrikel kiri. Terjadinya hipertrofi ventrikel kiri jangka panjang akan menyebabkan kondisi gagal jantung yang dapat mengakibatkan asfiksia. Simpulan : Kematian mendadak akibat kardiomiopati hipertrofi merupakan hal yang jarang. Oleh karena itu dibutuhkan otopsi yang teliti dan pemeriksaan histopatologi untuk mendiagnosis dengan pasti. Kata Kunci : Kematian mendadak, kardiomiopati hipertrofi, dewasa muda, sarkomer Background : Sudden death is the most common case and can be found in a variety of conditions. The most common cause of death is the cardiovascular system and a rare one disorders is hypertrophic cardiomyopathy. Hypertrophy cardiomyopathy is a heart disorder characterized by myocardial hypertrophy due to sarcomere mutations with an incidence of 1 in 500 adults. The main findings in hypertrophic cardiomyopathy include the presence of ventricular hypertrophy and / or interventricular septum, myocyte damage and increased myocardial fibrosis. There are variations in clinical manifestations in hypertrophic cardiomyopathy, from asymptomatic to sudden death due to heart failure. The purpose of this case report is to know the diagnosis of sudden death due to hypertrophic cardiomyopathy in young adults Case : A 18-year-old man was found dead in his boarding room. On the external examination there were no signs of violence. On the internal examination in the presence of blood in the ventricles, left ventricular hypertrophy, thickening of the entire heart valve, hardening of the heart muscle and hanging valves and signs of asphyxia. Histopathological examination showed hypertrophic cardiomyopathy. Discussion : The pathogenesis of hypertrophic cardiomyopathy can cause asphyxia is the occurrence of intrasarcomere mutations that increase the sensitivity and production of calcium which results in increased contraction of the myocardium causing left ventricular hypertrophy. In addition there is also an increase in collagen synthesis which results in the occurrence of myocardial fibrosis which causes left ventricular hypertrophy. The occurrence of long-term left ventricular hypertrophy will cause a condition of heart failure which can lead to asphyxia. Conclusion : Sudden death due to hypertrophic cardiomyopathy is rare one. Therefore a careful autopsy is needed and histopathological examination is needed to get definitive diagnose. Keywords : Sudden death, hypertrophic cardiomyopathy, young adults, sarcomere

Schneiderian Carcinoma Apriana, Ledisda; Sadhana, Udadi; Wijaya, Indra; Karlowee, Vega
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang: Squamous Cell Carcinoma (SCC) adalah keganasan paling umum dari kepala dan leher (sekitar 3%), tetapi hanya <1% dari seluruh jenis keganasan (insidensi jarang), yang dibagi menjadi jenis keratinizing dan non-keratinizing. Nonkeratinizing squamous cell carcinoma mempunyai berbagai nama lain, salah satunya Schneiderian carcinoma. Dahulu, Schneiderian carcinoma disebut sebagai Carcinoma Ex-Schneiderian Papilloma (malignant transformation). Atas kelangkaan dan keberagaman penamaan kasus ini, maka penulis tertarik untuk menyajikan kasus ini. Laporan Kasus: Seorang laki-laki 68 tahun datang dengan keluhan utama benjolan di leher kanan. Dilakukan tindakan wide eksisi dan rekontruksi, kemudian dikirimkan sampel untuk pemeriksaan histopatologi, didapatkan gambaran kelompok-kelompok sel epithelial ganas, dengan inti bulat oval, pleomorfik, hiperkromatik, berkromatin kasar, sitoplasma eosinofilik, mitosis dapat ditemukan, tumbuh papilifer, infiltratif diantara dalam stroma jaringan ikat fibrous. Dilakukan pemeriksaan lanjutan dengan pengecatan imunohistokimia yang memberikan hasil: CK5/6 positif, P63 positif, dan Ki67 positif > 80%. Diskusi: Ciri dan gejala pada pasien ini sesuai dengan kekhasan epidemiologi berdasarkan literatur. Berdasarkan pemeriksaan histopatologis dan pulasan imunohistokimia menyokong diagnosis Squamous cell carcinoma, transisional differenteated (Schneiderian carcinoma) regio colli sisi dekstra. Kesimpulan: Pemeriksaan histopatologi dan imunohistokimia pada kasus Schneiderian carcinoma ini menjadi penting serta harus dibedakan dengan jenis lainnya karena masing-masing manajemen dan prognosisnya pun berbeda. Kata Kunci: Schneiderian carcinoma, nonkeratinizing squamous cell carcinoma, transisional differenteated, Carcinoma Ex-Schneiderian Papilloma. Background: Squamous Cell Carcinoma (SCC) is rare, accounting for <1% of malignant tumours and only about 3% of malignancies of the head and neck, that includes a keratinizing and a non keratinizing type. Nonkeratinizing squamous cell carcinoma has various other names, which one is Schneiderian carcinoma. In the past, Schneiderian carcinoma was referred to as Carcinoma Ex Schneiderian Papilloma (Malignant Transformation). Based on the scarcity and diversity of naming these cases, the authors are interested to presenting this case. Case Description: A 68-year-old man comes with a complaint of a lump in the right neck. Wide excision and reconstruction were carried out, then samples were sent for histopathology, a description of malignant epithelial cell groups, with oval, pleomorphic, hyperchromatic, coarse chromatin nuclei, eosinophilic cytoplasm, mitosis can be found, papilliferous growth, infiltrative within the tissue fibrous stroma. Follow-up examination with immunohistochemical staining that gave results: CK5/6 positive, P63 positive, and Ki67 >80%. Discussion: Characteristics and symptoms in these patients are consistent with epidemiological characteristics based on literature. Based on histopathological and immunohistochemical examination support to diagnosis Squamous cell carcinoma, transitional differenteated (Schneiderian carcinoma) in colli region right side. Conclusion: Histopathology and immunohistochemistry examination in the case of Schneiderian carcinoma are important and must be distinguished from other types because each management and prognosis are different. Keywords: Schneiderian carcinoma, nonkeratinizing squamous cell carcinoma, transisional differenteated, Carcinoma Ex-Schneiderian Papilloma.

Guillain-Barré Syndrome In Pregnancy Fajar Sekti Reliyana; Retnaningsih Retnaningsih
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Guillain-Barré Syndrome (GBS) is an acute demyelinating polyadiculopathy that usually present as progressive and symmetrical muscle weakness accompanied by absence or loss of deep tendon reflexes. This has been associated with various infectious agents, such as Campylobacter jejuni and usually occurs after 2-4 weeks after respiratory or gastrointestinal diseases. Estimated general incidence in population was 0.75-2: 100,000. Pregnancy can increase risk of GBS. The diagnostic criteria of GBS consist of clinical, laboratory and electrophysiological tests. Developing treatments such as plasmapheresis and intravenous immunoglobulin (IVIG) are relatively safe in pregnancy. Time and methode of delivery are based on obstetric indications and depend on maternal and fetal status. Purpose: The condition is rare in pregnancy and only few cases have been reported in literature. Appropiate management of pregnant patients with GBS is needed. Case report: We presented the case of a 20-year-old woman, with a 20-week pregnancy. She had experienced various complications from her GBS such as syndrome of inapropriate antidiuretic hormone secretion (SIADH), dysphagia, type 2 respiratory failure, and infectious during hospital treatment. The termination of pregnancy was carried out at 34 weeks with consideration of maternal and fetal conditions. She delivered a healthy baby. Conclusion: GBS in pregnancy must be handled by a multidisciplinary team involving neurologists, obstetricians, internist, and anesthetists. Keywords: Gullain Barre syndrome, pregnancy, intensive care management, SIADH, Intraveva Immunoglobulin , plasmapharesis

Pengaruh Latihan Zumba Terhadap Resting Heart Rate dan Peak Expiratory Flow Rate Pada Wanita Usia Dewasa Muda Ruberto, Sandro; Supatmo, Yuswo; Setiawati, Erna; Ambarwati, Endang
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Introduction : Lack of physical activity is one of the risk factor for general mortality, therefore it is important to do regular physical activity. Zumba is one of the most popular physical activity methods and it has a lot of benefits especially for cardiorespiratory fitness. Objective : To determine the effect of Zumba exercise on Resting Heart Rate (RHR) and Peak Expiratory Flow Rate (PEFR) as an indicator of cardiorespiratory fitness. Methods : This is an experimental study using pre-test and post-test control group design. In this study, 26 females were divided in 2 groups (intervention and control group). Zumba exercise was given to intervention group 2 times a week (60 minutes per session) for 8-weeks exercise program. Zumba exercise was done virtually using videos provided by Zumba instructor. RHR measurement was carried out independently by research subjects in the morning when they woke up. PEFR measurement was done by using a peak-flow meter. Results : After 8-weeks Zumba exercise program, there was insignificant decreased of RHR from 71 ± 9 beat per minute to 70 ± 8 beats per minute (p>0,005). PEFR was significantly increased from 364 ± 36 liter/minute to 397 ± 42 liter/minute (p<0,005). But, there was no significant difference compared to control group. Conclusion : Zumba exercise can increase PEFR and decrease RHR, but it is not significantly different from the control group. It can be caused by the accuracy of the Zumba exercise is not supervised by the instructor. Keywords : peak expiratory flow rate, resting heart rate, zumba

Pengaruh Robotic Therapy dalam Meningkatkan ROM dan Memperbaiki Tonus Pasien Stroke Iskemik Pangesti, Adelia; Julianti, Hari Peni; Pudjonarko, Dwi; Rahmawati, Maria Belladonna; Ismail, Rifky
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: After stroke occurs, the patients generally have upper extremity hemiparesis. It makes movement restrictions due to decreased elbow active ROM and abnormal upper arm muscle tone, so they need to get rehabilitation therapy. Besides conventional therapy, robotic therapy has now been developed to restore their motor funtions. Objective: To prove that the effect of robotic therapy in increasing elbow active ROM and improving upper arm muscle tone in ischemic stroke patients is better than the effect of conventional rehabilitation exercises. Methods: A quasy-experimental study with two groups pre-test and post-test design was carried out among outpatient ischemic stroke patients in Diponegoro National Hospital and William Booth General Hospital Semarang which was chosen using consecutive sampling.The interventions were by doing exercises using an exoskeleton robotic hand in the robotic group and conventional rehabilitation exercises in the control group. Pre-test and post-test data of robotic group were analyzed using Wilcoxon test, while pre-test dan post-test data of control group were analyzed using Wilcoxon test and paired t-test. Pre-test an post-test data between two groups were analyzed using Mann-Whitney test and unpaired-t test. Results: The robotic group experienced an insignificant increase in ROM (p= 0,593) and significant improvement in muscle tone (p= 0,025). The control group experienced insignificant reduction in ROM (p= 0,980) and insignificant improvement in muscle tone (p= 0,081). Conclusion: There was a significant improvement of upper arm muscle tone in ischemic stroke patients after had exoskeleton robotic hand exercise. Keywords: Stroke, elbow active ROM, muscle tone, exoskeleton robotic

Full Text Volume 7 Nomor 2 November 2020 Kariadi General Hospital
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Full Text Volume 4 Nomor 3 November 2017 Kariadi General Hospital
Medica Hospitalia : Journal of Clinical Medicine Vol. 4 No. 3 (2017): Med Hosp
Publisher : RSUP Dr. Kariadi

Full Text Volume 4 Nomor 3 November 2017

Full Text Volume 5 Nomor 1 Mei 2018 admin medica
Medica Hospitalia : Journal of Clinical Medicine Vol. 5 No. 1 (2018): Med Hosp
Publisher : RSUP Dr. Kariadi

Full Text Volume 5 Nomor 1 Mei 2018

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