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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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Articles 529 Documents

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Etiologi Dan Patofisiologi Kasus Intractable Hiccups Pada Pasien Laki-Laki 57 Tahun Iriani, Desy; Antono, Dwi; Muyassaraoh, Muyassaroh
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang : Hiccup adalah hembusan napas yang mengacu dari suara yang dihasilkan kontraksi diafragma dan otot intercostal secara tidak sadar dan mendadak dilanjutkan dengan kontraksi mendadak dari glotis. Hiccup merupakan gejala yang biasa dikenal setiap orang namun tetap merupakan gejala patologis. Laporan kasus : Dilaporkan laki laki usia 57 tahun dengan cegukan sejak 1 tahun. Pemeriksaan laringoskopi fleksibel menunjukkan adanya LPR (RFS 15). Pasien didiagnosis LPR dan intractable hiccup ec susp gangguan sentral (CNS), diagnosis banding psikogenik. Pasien diberikan terapi metochlopramid dan chlorpromazine selama 5 hari. Hasil evaluasi pasien mengeluh cegukan tidak berkurang. Pasien lalu diberikan terapi omeprazole 20 mg per 12 jam. Pembahasan : Persistent dan intractable hiccup merupakan gejala yang sulit diobati, bila penyebab diketahui maka diobati sesuai penyebabnya, namun bila penyebab tidak diketahui terapi empiris dilakukan untuk menekan GERD sehingga gejala hiccup perbaikan. Apabila terapi ini gagal agen farmakologi ditujukan ke reseptor dopaminergik dan GABA-ergik. Kesimpulan : Penatalaksanaan hiccup perlu diketahui etiologi terutama gangguan LPR, GERD dan CNS hingga perlu penanganan multidisipliner dari bagian THT, interna, neurologi dan psikiatri.

Laporan Kasus Butterfly gliobasltoma pada Laki-Laki Usia 24 Tahun Kartika, Dewa; Nurdopo, Baskoro
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Pendahuluan Butterfly Glioma adalah high grade astrocytoma, biasanya glioblastoma (WHO grade IV), yang melintasi garis tengah melalui corpus callosum. Komissura white matter lainnya kadang juga terlibat. Istilah kupu-kupu mengacu pada ekstensi yang melewati garis tengah seperti sayap. Butterfly Glioma paling sering terjadi di lobus frontal, melintasi garis tengah melalui genu corpus callosum, namun butterfly glioma posterior kadang juga ditemui. Laporan kasus Seorang pasien laki-laki usia 24 tahun dengan keluhan utama 9 bulan, yang lalu. Penglihatan kabur, konsentrasi menurun. Kejang(-). Kemudian 3 bulan yang lalu mata tidak bisa melihat. Dan 1 bulan yang lalu tubuh lemas susah digerakkan Pemeriksaan patologi anatomi menunjukkan Pylocytic Astrocytoma. Pemeriksaan CT scan kepala menunjukkan Massa solid inhomogen intraxial ( ukuran ± AP 7,6 x 8,9 x CC 6,2 cm ) disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema à curiga gambaran glioblastoma multiformis. Pembahasan Hasil pemeriksaan anamnesis dan pemeriksaan fisik pasien ini menunjukkan kecurigaan adanya SOL. Pemeriksaan CT scan kepala menunjukkan Massa solid inhomogen intraxial disertai kalsifikasi di dalamnya pada corpus callosum yang tampak cross mid line ( sisi kiri lebih dominan ) membentuk gambaran butterfly sign dengan perifocal edema à curiga gambaran glioblastoma multiformis. Dari PA didapatkan hasil Pilocytic astrocytoma. Sedangkan gambaran radiologi Pilocytic astrocytoma berupa lesi kistik dengan nodul mural yang enhanced. Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan.. Modalitas imejing pilihan yang dapat dilakukan pada kasus Butterfly Glioblastoma adalah CT scan dan MRI. Kesimpulan Kasus ini secara radiologis lebih mengarah ke Butterfly Glioblastoma dengan adanya lesi yang melewati garis tengah, serta ada komponen nekrotik dan perdarahan. Dan pemeriksaan radiologis yang dapat digunakan pada Butterfly Glioblastoma adalah CT scan dan MRI.

A Toddler with Juvenile Ocular Myasthenia Gravis: Clinical Experience Putranti, Alifiani Hikmah; Septieningtyas, Rr.Kartika Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background:Myasthenia gravis is an extremely rare autoimmune disorder affecting the neuromuscular junction. The incidence rate is 0.9-2.0 cases per 1 million children per year.Ocular myasthenia gravispresents as ptosis with extraocular motility restriction and is prone to be misdiagnosed as third nerve palsy and is difficult to diagnose in very young children. Case: A girl aged 2 years 6 months with clinical features with bilateral ptosis and was diagnosed as juvenile ocular myastenia gravis based on history, physical examination and other diagnostic proceduressuch as chest X-raywithin normal limit and no thymoma, the ice test showed positive result, electromyography (EMG) showed decrement response >10%,progstigmin test showed positive result, andserum acetylcholine receptor antibody levels was 0.43 nmol/L (reference range : positive as >0.40 nmol/L). Conclusion:Juvenile ocular myastenia gravis diagnostics can be established using simple examinations such as ice tests,prostigmin test to sophisticated examinations as systemic acetylcholinesterase antibodies. Management begins with a first-line drug, pyridostigmine, that is safe and effective. Disease monitoring and looking for etiology are very important for successful treatment.

Full Text Volume 8 Nomor 3 November 2021 Hospital, Kariadi General
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Full Text Volume 8 Nomor 3 November 2021

CORRELATION BETWEEN VITAMIN D LEVELS AND PEDIATRIC ANTHROPOMETRY STATUS IN NEONATES Sari, Tri Elina; Muslimin, Muslimin; Radityo, Adhie Nur; Pratiwi, Rina
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Problems of vitamin D deficiency is now starting to become a concern in the world because 1 million people worldwide have vitamin D deficiency and nearly 50% have vitamin D insufficiency. Vitamin D deficiency is more common in neonates which can increase the risk of low birth weight and also effect on baby length, head circumference. Aim: Understanding the correlation between vitamin D levels and anthropometric status in neonates.Method: This study used an observational analytic study with a cross sectional approach. The research sample was neonates at term. The data from questionnaires and direct anthropometric measurements on neonates who came to delivery room and pediatric polyclinic of the Diponegoro National Hospital, Semarang and Dr. Kariadi General Hospital, Semarang. The data normality test used the Saphiro-Wilk test. Correlation test between vitamin D levels and anthropometric status using the Pearson test, and test levels of vitamin D with nutritional status (WHZ, WAZ, HAZ) using the Spearman test.Results: Median (min-max) neonatal vitamin D levels were 12.12 (6.09 - 19.52). There was no significant correlation between vitamin D levels and neonatal age, neonatal anthropometric status, maternal sun exposure and neonatal diet type. This is influenced by several other factors that are consistent with the theory such as neonatal nutrition, genetics, time and length of sun exposure, poor dietary intake.Conclusion: There was no significant correlation between vitamin D levels and weight, body length, height, nutritional status of WHZ, WAZ, HAZ in neonates.

Pengembangan Skor Risiko KARIADI Sebagai Metode Stratifikasi Risiko Kejadian Kardiovaskular Mayor Pasca Intervensi Koroner Perkutan Primer Asrial, An Aldia; Herry, Yan; Udin, Bahrudin; Anggriyani, Novi; Suhartono, Suhartono
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background Reduction of major cardiovascular events (MACE) in ST elevation acute coronary syndrome (STE-ACS) patients has been achieved by primary percutaneous coronary intervention (PCI) strategy and intensive care management. However, the intensive care unit bed availability and cost remain a problem for those patients, and thus risk stratification using an objective risk score instrument is required. Aim To develop a risk score of in-hospital MACE for patients with STE-ACS underwent primary PCI. Methods A cohort study of 208 patients with STE-ACS undergoing primary PCI at the Dr. Kariadi General Hospital Semarang. Predictor analysis was carried out using bivariate Chi-Square test and multivariate logistic regression. The obtained independent predictors were then used as risk score variables. The quality of the risk score was tested by the Hosmer and Lemeshow calibration test and AUC ROC analysis for discrimination test. Results Seven out of 13 independent predictors, i.e. Killip class (OR 20,04, p=0,0001), age (OR 3,02, p=0,04), renal insufficiency (OR 9,48, p=0,007), infark related artery final TIMI flow (OR 11,57, p=0,001), admission systolic blood pressure (OR 3,04, p=0,025), duration of total ischaemic time (OR 3,14,p=0,032) and increase of blood glucose levels (OR 3,04, p=0,029) were fulfilled the criteria for risk scores of in-hospital MACE. The risk scores had a good quality with the Hosmer and Lemeshow calibration test> 0,05 and ROC AUC 0,886 (95% CI, 0,827-0,944, p <0,005). Conclusions A risk scoring modele consisting of 7 independent predictor variables i.e. Killip class, age, renal insufficiency, infark related artery final TIMI flow, admission systolic blood pressure, duration of total ischaemic time, and increase of blood glucose levels (KARIADI) has a good calibration and discrimination in predicting the risk of in-hospital MACE in patients with STE-ACS underwent primary PCI. Keywords Predictors of in-hospital MACE, primary PCI, ST-segment elevation acute coronary syndromes, risk score.

Hepatotoksik terkait Obat Antituberkulosis pada Pasien Tuberkulosis dan Koinfeksi Tuberkulosis-HIV Azmi, Rizki Nur; Ardiani, Tiara; Siami, Sahra
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

BACKGROUND : The side effect of antituberculosis drugs that is toxic to liver cells, called hepatotoxic, needs to be a concern in the treatment of tuberculosis. The presence of these unwanted side effects poses a challenge in treatment because it can lead to discontinuation oh therapy or a change in regimen. Coinfection with HIV is also thought to increase the potential for hepatotoxicity of antituberculosis drugs. OBJECTIVE: This study aims to determine the incidence of hepatotoxicity of antituberculosis drugs in patients with tuberculosis and tuberculosis-HIV coinfection. METHOD : This study is an observational study with a cross sectional design, which was conducted in one of the hospitals in Samarinda City. Sources of research data came from patient medical record in 2018 – 2020. There was 53 tuberculosis patients and 53 tuberculosis-HIV coinfection patients. Differences in live enzyme values (AST and ALT) and severity in the two groups were analyzed by Mann-Whitney and Chi-Square tests. RESULT : The average value of AST and ALT in tuberculosis-HIV coinfection patients were higher than patients without HIV infection, which is AST 127,1 µ/L and ALT 100,7 µ/L. The highest degree of severity experienced by the patient was grade 3 (severe hepatotoxicity). Tuberculosis-HIV coinfection patients with grade 3 severity were 22,6% and tuberculosis patients were 9,4%. The values of liver enzymes and the severity of hepatotoxicity in the two groups of patients were statistically significant with p value < 0,05. CONCLUSION : Tuberculosis-HIV coinfection patients tend to have a higher incidence of hepatotoxicity related to antituberculosis drugs than those without HIV infection.

Hubungan derajat friedman tounge position dengan nilai apnea-hypopnea index dan nilai low oksigen saturation pada pasien obstructive sleep apnea Ahmad Effendi; Willy Yusmawan; Anna Mailasari Kusuma Dewi; Zulfikar Naftali; Muyassaroh Muyassaroh; Dwi Antono; Herlina Suryawati; Kanti Yunika
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT Background: Obstructive Sleep Apnea (OSA) is characterized by an airway obstruction that causes breathing to stop momentarily, either totally or partially. OSA can cause serious complications. The definitive diagnosis of OSA with polysomnography (PSG). PSG is not widely available in health facilities, Friedman tongue position (FTP) examination is expected to be an initial simple examination that can be done to diagnose patients with suspected OSA. Objective: To determine the relationship between the degree of FTP with the Apnea Hyponea index (AHI) andvalues Low saturation (LSAT)in OSA patients at Dr. Kariadi Semarang. Methods: Cross-sectional study design, samples were taken from patients diagnosed with OSA by polysomnography in May – July 2021. AHI and LSAT values ??were taken from polysomnography results. FTP is determined by physical examination of the throat. Data analysis with Spearman correlation test. Results: The highest number of samples was 44 male, 32 samples (72.7%). The highest age group was 46-65 years, 26 (59.1%), the youngest was 18 years and the oldest was 81 years, the mean age was 64 years +17-81 years. , the most FTP results are type 2, the most AHI values ??are severe degrees, the most LSAT values ??are moderate degrees. There is a very strong positive significant relationship between the degree of FTP and the AHI value, there is no significant relationship between the degree of FTP and the LSAT value. Conclusion: There is a relationship between FTP and the AHI value, there is no FTP relationship with the LSAT value Keywords: Obstructive sleep apnea, friedman tongue position, Apnea-Hyponea index, Low saturation.

The EFFECT OF APPLICATION MOBILE DISCHARGE PLANNING (MODSPLAN) TO INCREASING THE HOSPITAL READNESS IN ACUTE MYOCARDIAL INFARCTION Megasari, Anis Laela
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

BACKGROUND: Acute myocardial infarction is a disease that has a high recurrence rate. Discharge planning is an intervention that can be used to minimize the occurrence of repeated treatments. However, many reports state that the implementation of discharge planning is still not optimal. The use of inappropriate methods is the cause of the non-optimal implementation of discharge planning. This study proposes a new discharge planning method, namely the modisplan application OBJECTIVE: To increase the effect of the application of modisplan on optimizing discharge readiness in acute myocardial infarction patients. Not only that, this application is expected to improve the patient's ability to carry out continuity of care so that repeated treatments do not occur METHODS: The design used quasi-experimental with pretest-posttest nonequivalent control group design. Total respondent 30 were divided into the control group (15 respondents) and the intervention group. (15 respondents). The application of the Modis Plan application was carried out in a structured manner starting from assessment, management, monitoring and evaluation. Readiness to go home was measured using the Readiness of hospital discharge Scale questionnaire. The statistical test used the Wilcoxon test and the Independent T-Test. RESULTS: There is an effect of modisplan application to increasing the hospital readiness in acute myocardial infarction patien’s (p value 0.000). The final mean score in the control group was 114.73, while in the intervention group it was 134.80 CONCLUSION: The application of the modesplan application has been proven to optimize discharge readiness of acute myocardial infarction

Pengaruh Senam Qigong terhadap Kebugaran Kardiorespirasi Lansia Satriya, Reffi Yuwono; Widagda, I Made; Asmara Putri, Rahmi Isma
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRAK Pendahuluan : Menurunnya kapasitas fisik lansia dapat menjadi faktor yang menyebabkan kurangnya partisipasi lansia untuk latihan dalam meningkatkan kebugaran kardiorespirasi. Dibandingkan dengan senam lansia ataupun Tai chi, senam Qigong memiliki gerakan yang sederhana, lambat, dan intensitas rendah sehingga akan mudah dipelajari dan meningkatkan partisipasi lansia dalam latihan. Meskipun latihan ini merupakan latihan dengan intensitas ringan-sedang, senam Qigong memiliki efek aerobik yang cukup baik untuk meningkatkan kebugaran kardiorespirasi. Tujuan : Penelitian ini bertujuan mengetahui pengaruh senam Qigong terhadap kebugaran kardiorespirasi lansia. Metode : Penelitian ini merupakan quasi experimental. Sampel berjumlah 21 orang lansia di Panti Pelayanan Sosial Lanjut Usia, Pucang Gading, Semarang yang terbagi menjadi 2 kelompok yaitu kelompok Qigong (n=11) dan kelompok kontrol (n=10). Kelompok Qigong mendapatkan intervensi senam Qigong dan kelompok kontrol mendapatkan intervensi senam lansia. Intervensi pada kedua kelompok dilakukan 3 kali seminggu selama 8 minggu. Konsumsi oksigen maksimal (VO2max) yang merupakan indikator kebugaran kardiorespirasi diukur menggunakan 6 minute walk test(6MWT). Hasil : Pada akhir penelitian, rerata nilai VO2max adalah 12,39 ± 3,60 ml/kg/menit pada kelompok Qigong dan 13,03 ± 4,75 ml/kg/menit kelompok kontrol dengan tidak ada perbedaan signifikan diantara kedua kelompok. Perbaikan nilai VO2max sebelum dan sesudah intervensi didapatkan sebesar 2,23 ± 1,40 ml/kg/menit pada kelompok Qigong dan 2,69 ± 0,75 ml/kg/menit pada kelompok kontrol dengan tidak ada perbedaan signifikan diantara kedua kelompok. Simpulan : Senam Qigong dan senam lansia memberikan dampak perbaikan serupa terhadap kebugaran kardiorespirasi. Kata kunci : Latihan Qigong, Lansia, Kebugaran kardiorespirasi

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Maya Nuriya Widyasari

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