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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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Niemann-Pick disease type A: a case report Mirani, Erna; Pratiwi, Rina; Widyastiti, Nyoman Suci; Ekowati, Liana; Mexitalia, Maria
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

BACKGROUND Niemann-Pick disease (NPD) types A result from the deficient activity of sphingomyelinase. NPD type A is characterized by early-onset, progressive neurodegenerative course; systemic disease manifestations, including massive hepatosplenomegaly, interstitial lung disease, and cherry-red macula; and death in early childhood. The objective: to enhance the recognition of health care providers about the potential undiagnosed NPD because nonspecific clinical manifestation CASE PRESENTATION A 18-months-old boy was admitted to Dr. Kariadi Hospital with enlarged abdomen since seventh month old with failure to thrive. He also showed progressive loss of neurologic function, microcephaly with open major fontanelle, recurrent pulmonary and systemic infection. Physical examination revealed facial dysmorphic, milestone regression, under-nutrition, crackles in both lungs, hepatosplenomegaly with petechial in extremities and floppy infants. Laboratory investigations showed anemia (9.4 g/dL) and thrombocytopenia (73.000/mm3). The lactate dehydrogenase (482 U/L) and alkaline phosphatase (159, 03 IU/L) were higher than normal. Abdominal ultrasound revealed hepatomegaly with normal parenchyma and splenomegaly without nodule. Skeletal survey revealed Erlenmeyer flask deformity. Foam cell are detected in bone marrow puncture. Retcam examination showed cherry red spot at the macula. Bera revealed auditory neuropathy. The enzyme activity showed normal ?–Glucosidase (5.55 uM/hr) and chitotriosidase (105,8 nmol/ml) but low sphingomyelinases activity (0.30 uM/hr) which confirmed the diagnosis of NPD. DISCUSSION Niemann-Pick disease (NPD) types A result from the deficient activity of sphingomyelinase. NPD type A is characterized by early-onset, progressive neurodegenerative course; systemic disease manifestations, including massive hepatosplenomegaly, interstitial lung disease, and cherry-red macula; and death in early childhood. Type A is very rare and a severe infantile form with neurologic degeneration resulting in death usually by 3 years of age. No treatment available for type A and It’s a rare disease in Indonesia. CONCLUSION These investigations were able to diagnose this child as a NPD-Type A. Patient was closely monitored and symptomatic treatment was provided.

Full Text Volume 8 Nomor 1 Maret 2021 Kariadi General Hospital
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Full Text Volume 8 Nomor 1 Maret 2021

Efektivitas Ozonated VCO Terhadap Penyembuhan Luka Full Thickness Skin Graft Ditinjau dari Proliferasi Endotel Progenitor Cell dan Angiogenesis pada Tikus Sprague Dawley Sidauruk, Rollin Hansen; Yuniati, Renni; Handojo, Djoko
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Abstract Background : Full thickness Skin graft is one technique to accelerate wound healing. EPC proliferation and new blood vessel formation have an important role in the success of Ful thickness Skin graft. Ozone content in Ozonated VCO has the ability to increase growth factors so that it can accelerate wound healing Aims : This study was aimed to prove the effects of ozonated vco in various doses in increasing EPC proliferation and angiogenesis in full thickness skin graft wounds. Methods : This research is an experimental study with randomized post test only with parallel group design. 40 Sprague Dawley rats performed autologous Skin grafts at the same time. Samples were randomly divided into 8 groups, two control groups (X1 and X5), and 6 other groups were given a multi-dose ozonated oil 50.6 mg / ml (X2, X6), 101.3 mg / ml (X3, X7) , 202.6 mg / ml (X4, X8). Conduct termination on day 6 and day 12. Examination of the number of EPC proliferation and the number of angiogenesis in each group. Data were analyzed by Saphiro Wijk, ANOVA, post hoc benferonni and pearsons Results : The number of EPC proliferation in groups X1, X2, X3, X4, X5, X6, X7, X8 has a mean of 6.2 + 0.837, 10 + 1.581, 13.80 + 2.049, 14.80+ 2,280, 9.40 + 2,074 , 13.20 + 1,483, 19,0 + 2,055 and 19.20 + 1,095.The number of Angiogenesis in groups X5, X6, X7, X8 has a mean of 9.20 + 1,095,14,60 + 2,881,17,40+ 3,286, 18,80 + 2,168,17,40 + 3,286,18.80+ 2,168. The administration of ozonated VCO dose of 202.6 mg / ml gave the best results in the amount of angiogenesis (p = 0.001) and the amount of angiogenesis (p=0,001).Correlation analysis between EPC proliferation and angiogenesis showed a significant correlation (p = 0.001 and r = 0.738). Conclusion : Ozonated oil can increase the number of EPC proliferation and angiogenesis in the wound healng process of Full thickness Skin graft. The ozone dose of 202,6 mg / ml showed the best effect on increase wound healing process. Keyword : Full thickness skin graft, Ozonated oil , EPC, Angiogenesis

EFEKTIVITAS OZONATED VIRGIN COCONUT OIL TERHADAP PENYEMBUHAN LUKA FULL- THICKNESS SKIN DEFECT PADA TIKUS SPRAGUE DAWLEY Surbakti, Herry Maha Putra; Yuniati, Renni; Handojo, Djoko
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

AbstractIntroduction: Wounds are a breakdown of tissue integrity / continuity that can lead to infection. Virgin Coconut Oil is a processed coconut product made by processing fresh coconut flesh at low temperature and has a high nutritional content. Ozone therapy is an alternative therapy that has disinfectant properties and can induce strong oxidative stress. Methods: This study was conducted on 50 Sprague-Dawley rats that had injuries. We performed full thickness wounds and administered ozonated doses of VCO to mice. We looked at shrinkage of wounds and TGF Beta levels in mice. Assessment was carried out on day 7 and day 14 to assess the wound and TGF-beta immunohistochemically. Results: There was a significant difference in the wound shrinkage variable between the negative control group and the group that received VCO offerings both on day 7 and day 14. We also found a significant difference in the TGF-beta variable between the negative control group and the group that received VCO offerings both on day 7 and day 14. Conclusion: The administration of ozonated virgin coconut oil was effective in increasing the expression of TGF-? in the full thickness defect of Sprague Dawley rats and was effective in increasing the reduction in wound size in the full thickness defect of Sprague Dawley rats.

Pengaruh Ekstrak Daun Wungu Terhadap Kadar Malondialdehid Darah Pada Tikus Diabetes Militus Elnitiarta, Jasmine; Istiadi, Hermawan; Hendrianingtyas, Meita; Retnoningrum, Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang: Diabetes melitus (DM) merupakan penyakit kronik dengan gejala glukosa darah yang tinggi (hyperglycaemia) dimana terjadi peningkatan biomarker stress oksidatif yaitu MDA. Daun wungu (Graptophyllum pictum (L.) Griff) memiliki alkaloid dan flavonoid yang bersifat antioksidan untuk mengurangi radikal bebas.Tujuan: Mengetahui pengaruh ekstrak daun wungu (Graptophyllum pictum (L.) Griff) terhadap kadar malondialdehid darah pada tikus Wistar yang diinduksi aloksan.Metode: Desain percobaan menggunakan post-test only control group design. Penelitian ini menggunakan tikus wistar jantan sebanyak 24 ekor yang dibagi menjadi 6 tikus setiap kelompok. Kelompok kontrol negatif diberikan aloksan, kelompok perlakuan 1, kelompok perlakuan 2, dan kelompok perlakuan 3 diberikan ekstrak daun wungu dengan dosis 50, 100 dan 200 mg/kgBB peroral kemudian kadar glukosa darah diperiksa untuk memastikan bahwa tikus sudah diabetes melitus. Setelah tikus diabetes melitus, dilakukan tindakan tiap kelompok. Pada hari ke-14 tikus diambil data kadar malondialdehid darahnya. Data diuji dengan uji normalitas Saphiro-Wilk. Pada penelitian ini data terdistribusi normal (p>0.05) sehingga dilakukan uji ANOVA kemudian dilakukan uji post-hoc. Hasil: Didapatkan penurunan kadar MDA darah pada tikus yang diberikan daun wungu. Hasil signifikan didapatkan antara kelompok perlakuan 3 dengan kelompok kontrol negatif dan kelompok perlakuan lainnya. Kesimpulan: Daun wungu dengan berbagai dosis dapat menurunkan kadar malondialdehid darah pada tikus DM.

PERBEDAAN USIA, UKURAN MAKROSKOPIS TUMOR, DAN PROFIL HORMON ANTARA PASIEN KARSINOMA TIROID PAPILER KLASIK DAN VARIAN FOLIKULER DI RSUP DR KARIADI SEMARANG Nabila, Alin; Istiadi, Hermawan; Wikanta, Edmond Rukmana; Miranti, Ika Pawitra; Puspasari, Dik
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: New cases of Papillary Thyroid Carcinoma and Carcinoma patients at Dr. Kariadi Hospital, Semarang is quite high, where the most types are Classical Papillary Thyroid Carcinoma and Follicular Variant Papillary Thyroid Carcinoma. On the other hand, in diagnosing PTC, histopathological examination which is a gold standard sometimes has a subjective value. Therefore, it is necessary to have a correlation with the clinical characteristics of the patient in order to get a correct diagnosis. Aim: Understanding the differences in age characteristics, tumor macroscopic size and hormone profile between Classical Papillary Thyroid Carcinoma and Follicular Variant patients at Dr. Kariadi Hospital, Semarang. Method: Analytic observational research with cross sectional design. The number of samples was 38 medical records in which 18 cases of Classic Papillary Thyroid Carcinoma and 20 cases of Follicular Variant Papillary Thyroid Carcinoma. Data with a nominal scale, namely age were analyzed using the Fisher exact test, while the data with a numerical scale, namely the macroscopic size of the tumor and the hormone profile, were tested for normality of Saphiro Wilk then continued with the Mann-Whitney test. Result: Based on the Fisher exact test, there was significant difference (p = 0,009) between age characteristics and Classical Papillary Thyroid Carcinoma and Follicular Variant. In the Mann-Whitney test there was no significant difference (p = 0.3) between the macroscopic size of the classical papillary carcinoma and follicular variant and there was no significant difference TSHs (p = 0.501) and fT4 (p = 0.953) hormone profiles between Classic Papillary Thyroid Carcinoma and Follicular Variants. Conclusion: There was significant difference between the characteristics of age at diagnosis, and there was no significant difference between the macroscopic size of the tumor and the hormonal profile of Classical Papillary Carcinoma and Follicular Variants in Dr. Kariadi Hospital, Semarang.

The The Effects of Zumba Exercise on LDL Levels and Oxidative Stress of Young Adult Women Putri, Alda Aulia Rahma Ananto; Supatmo, Yuswo; Setiawati, Erna; Ambarwati, Endang
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT Background: Sedentary lifestyle which refers to physical inactivity is one of the risk factors for non-communicable diseases, one of which is dyslipidemia. Zumba, as a form of aerobic exercise, is in great demand by young adults recently. This exercise has effects on reducing LDL levels and oxidative stress measured by malondialdehyde (MDA) levels as the biomarker. Objectives: To examine the effect of Zumba exercise on LDL and MDA levels in young adult women. Methods: This experimental study used two groups pre and post test design. Research subjects were 36 women, divided into intervention group (n=18) and control group (n=18). Zumba exercise was done by intervention group 2 times a week (60 minutes per session) for 8 weeks virtually. LDL and MDA levels were measured using blood samples of research subjects. Result data was analysed using T-paired test, Wilcoxon test and Mann-Whitney test. Results: There is no decrease in LDL levels from intervention group after 8 weeks of Zumba exercise. However, there is significant decrease in MDA levels. LDL levels increased from 94,18±25,60 mg/dL to 105,82±27,64 mg/dL (p<0,05) and MDA levels decreased from ,71±0,28 µmol/L to 0,37±0,64 µmol/L (p<0,05). There is no meaningful difference in LDL levels between intervention and control group. Nonetheless, there is meaningful difference in MDA levels among both groups. Conclusion: Zumba exercise 2 times a week for 8 weeks virtually can not reduce LDL levels but can significantly reduce MDA levels. Keywords: low density lipoprotein, malondialdehyde, Zumba exercise

Hubungan Faktor Fisik, Penyakit Komorbid, dan Faktor Psikis Terhadap Kualitas Hidup Lansia dengan Osteoartritis Rasyidin, Nur Laelatul; Julianti, Hari Peni; Ngestiningsih, Dwi; Purwoko, Yosef
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT BACKGROUND: Osteoarthritis were the fourth cause of disability in the world in 2020. Limitation of physical activity that occurred in elderly with osteoarthritis can affect the socio-economic aspects of the elderly, causing a decrease in health-related quality of life (HRQoL). In addition to osteoarthritis, recent studies have shown an association between history of hypertension, diabetes, and family support on quality of life in the elderly. OBJECTIVE: To analyze the relationship between physical factors, comorbid diseases, and psychological factors on the quality of life of the elderly with knee osteoarthritis. METHOD: This study was an observational analytic study with a cross-sectional design. The samples were patients with knee OA who underwent therapy at the William Booth Hospital Semarang and the Diponegoro National Hospital that met the inclusion criteria. The research subjects were 61 respondents selected through consecutive sampling. The analysis test performed using the Chi-square method and logistic regression with p-value considered significant if p <0.05. The instrument used in this study was a demographic characteristic questionnaire, VAS, family APGAR, and OPQOL-35. RESULTS: There was a significant relationship in the assessment of the level of pain and family function on the quality of life of the elderly with knee OA (p = 0.003 and p = 0.042). Assessment of other physical factors consisting of gender (p = 0.637), duration of illness (p = 0.2), and degree of radiology (p = 0.532), as well as comorbid factors consisting of hypertension (p = 0.37) and diabetes (p = 0.663), showed an insignificant relationship to the quality of life of the elderly with knee OA. The dominant factor that affected the quality of life of the elderly with knee OA is the level of pain (p = 0.022) with OR value 14.1. CONCLUSION: Factors that affected the quality of life of the elderly with knee OA were the level of pain and family function. Key: knee OA, Quality of Life, Elderly

Perbedaan Skor OSDI Pre dan Post Senam "PERMATA-KU" pada Computer Vision Syndrome Uyun, Fuadah; Rahmi, Fifin Luthfia; Saubig, Arnila Novitasari; Julianti, Hari Peni
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT DIFFERENCE OF OSDI SCORE BEFORE AND AFTER ‘SENAM PERMATA-KU’ IN COMPUTER VISION SYNDROME Background: Computer Vision Syndrome (CVS) is a group of symptoms that affects the eye and vision due to prolonged use of computer, cellphone, tablet, and e-reader. Dry eye is one of the symptoms that appear in CVS. In this study we did ‘senam PERMATA-KU’ (Pelihara Mata–Kendorkan Bahu) as additional exercise to reduce dry eye in CVS. Aim: Observe there is any improvement of OSDI (Ocular Surface Disease Index) score before and after doing “senam PERMATA-KU” in CVS. Methods: This was a Pre-Post with Control Design quasi experimental study. The subjects were students of Faculty of Medicine of Diponegoro University who had CVS and met the inclusion and exclusion criteria that were divided randomly into control group and experimental group. The experimental group were given an education about using computer ergonomically and ‘senam PERMATA-KU’ for 14 days. The control group were given an education about using computer ergonomically. OSDI score were measured before and after intervention was given using Ocular Surface Disease Index questionnaire. Result: The subjects were 32 students with 16 students in the experimental group and 16 students in the control group. One student in the control group and one student in the experimental group dropped out because they could not complete the procedure so that only 30 subjects were analyzed. OSDI score after intervention in experimental group was decreased significantly (p<0.05). OSDI score after intervention in experimental group was better compared to control group (p<0.05). OSDI score improvement in experimental group was higher compared to control group but statistically is not significant (p=0.595). Conclusion: ‘senam PERMATA-KU’ that was done for 14 days can improve OSDI score in Computer Vision Syndrome. Keywords: Computer Vision Syndrome (CVS), Ocular Surface Disease Index (OSDI), dry eye, ‘senam PERMATA-KU’

The difference of physical fitness of short stature children with and without Channa striata extract (CSE) supplementation Faiza, Arif; Anam, Mohammad Syarofil; Soetadji, Anindita; Mexitalia, Maria
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Physical fitness affected by aortic elasticity which is increased appropriately with insuline growth factor-1 (IGF-1). Channa striata extract (CSE) supplementation increased arginine serum level and further lead to increase of IGF-1, endothelial dysfunction remodeling, and physical fitness. The current study aimed to explore the difference of physical fitness of short stature children with and without CSE supplementation. Method: This cross sectional study conducted to 100 short stature children (male 58; female 42; CSE 50; placebo 50) aged 8-12 years in Brebes, Central Java Indonesia. Short stature was defined as the height/age Z score between -2 and -3 based on WHO 2007 growth chart standard. Physical fitness was measured by modified Harvard step test as stated as VO2max, physical activity by physical activity record and stated as physical activity level (PAL). Data was analyzed by independent t-test and Pearson correlation. Results: VO2max level was higher in CSE 41.67 ± 6.967 ml/kg/minutes and placebo 41.16 ± 5.238 mL/kg/minutes, p=0.682. Hemoglobin level was higher in CSE than placebo (13.12 ± 0.932; 12.99 ± 0.878) g/dL; p=0.5020. All children revealed active category on PAL. The results showed a significant relationship between PAL and physical fitness, hemoglobin and PAL on CSE (p<0.05), however there was no correlation between hemoglobin level and physical fitness. Conclusion: Physical fitness in short stature children with CSE supplementation or placebo was good category. There was no differences between hemoglobin level and PAL in both of groups. There was no difference between physical fitness in short stature children with CSE supplementation or placebo. Keywords: physical fitness, short stature, physical activity, hemoglobin level

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