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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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EFEK PAPARAN RADIASI PENGION TERHADAP JUMLAH LEUKOSIT PEKERJA DI INSTALASI RADIOLOGI RUMAH SAKIT DI KUPANG, NTT Selly, Jannes Bastian; Roga, Anderias Umbu; Berek, Noorce Christiani
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

ABSTRACT BACKGROUND : Workers in hospital radiology installations are at risk of being exposed to ionizing radiation during work. Ionizing radiation has the potential to cause ionization in the body, so it can cause harm to workers. One of the efforts to minimize the risk of radiation exposure is to conduct regular health checks. OBJECTIVE: This study aims to identify the effects of radiation exposure, especially ionizing radiation received during work on the number of leukocytes of workers METHOD : The type of this research is observational analytic with cross sectional approach. Respondents in this study were 20 workers at radiology installations in 3 hospitals in Kupang who met the inclusion criteria specified. The independent variable (X) in this study is the dose of radiation exposure in units of milisieverts (mSv), while the dependent variable (Y) is the number of workers' blood leukocytes.. RESULT : The results showed that there was a significant effect of radiation exposure on the number of leukocytes of workers in radiology installations according to the equation Y = 3.959-3.989X with p-value 0.001 and R2 = 0.455 CONCLUSION : Exposure to ionizing radiation received by workers has an impact of 45.5% on a decrease in the number of leukocytes by 0.03 , every 1 unit dose increase Keywords: Radiation exposure doses, radiology installations, leukocytes, radiation workers, ionizing radiation

The Efek Penambahan Latihan Penguatan dengan Resistance Band terhadap Kekuatan Otot Quadriceps Femoris pada Lansia yang Mendapat Latihan Keseimbangan Kurniawan, Andriaz; Ambarwati, Endang; Setiawati, Erna
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Abstract Background : Decreased muscle strength and balance disorders that occur in elderly are risk factors for falls. The quadriceps femoris muscle is a predictor of falls and one of the determinants of functional ability in activities of daily living. Balance exercise is one of the exercises to improve the balance of the elderly. Strengthening exercises with resistance bands provide resistance using a stretched elastic band. The objectives of this study was to determine the effect of additional strengthening exercises using resistance bands on increasing the strength of the quadriceps femoris muscle in the elderly who received balance training. Methods: This study is a randomized experimental design with pre and post test design. The subjects were elderly, aged 60-70 years. Subjects were divided into two groups, control group (n=12) and intervention group (n=12). The intervention groups were given balance training 3 times per week for 5 weeks and added strengthening exercises using resistance bands 3 times per week for 5 weeks. The control group only did balance training. Before and after treatment, the strength of the quadriceps femoris muscle was measured in both groups. Results: Statistically significant differences were obtained for right quadriceps femoris muscle strength (p=0.001) and left quadriceps femoris muscle strength (p=0.001) pre and post treatment in the intervention group. In the comparison between groups, there were an increase in the mean muscle strength of the right and left quadriceps femoris, but there were no statistically significant differences in the right quadriceps femoris muscle strength (p=0.088) and left quadriceps femoris muscle strength (p = 0.093). Conclusion: The addition of a resistance band to balance training for 5 weeks had a clinical effect on the quadriceps femoris muscles strength in the elderly but had no statistically significant differences. Keywords: Resistance band, balance training, quadriceps femoris, elderly

HUBUNGAN GANGGUAN MENTAL EMOSIONAL DENGAN KECANDUAN MEDIA SOSIAL PADA MAHASISWA SEMESTER 1 TAHUN AJARAN 2019 DAN SEMESTER 3 TAHUN AJARAN 2018 DI UNIVERSITAS DIPONEGORO SEMARANG Mahardhika, Alain Stephano; Fitrikasari, Alifiati; Wardani, Natalia Dewi; Hadiati, Titis; Sutaty, Witrie; Julianti, Hari Peni
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Currently the level of addiction to social media tends to increase, especially among students. 75% of individuals who experience internet addiction are caused by problems in their relationships with other people. One of the related factors is emotional mental disorder. Objective: To determine the relationship between mental emotional disorders and social media addiction in students in the 1st semester of the 2019 academic year and the 3rd semester of the 2018 academic year at Diponegoro University, Semarang. Methods: Research with cross sectional design. The research sample is Diponegoro University Semarang students in 1st semester of the 2019 academic year and 3rd of the 2018 academic year. The independent variable is mental emotional disorder, while the dependent variable is social media addiction. The research instrument used a sociodemographic questionnaire, the Bergen Social Media Addiction Scale (BSMAS) and the Self Reporting Questionnaire 20 (SRQ20). Research variables were analyzed by chi square test. Results: The majority of research subjects had normal emotional mental disorders as many as 140 (82.8%) and 29 (17.2%) indicated experiencing emotional disorders. The majority of social media addiction levels were normal as many as 113 (66.9%), while alerts were 56 (33.1%), There was a relationship between emotional mental disorders and social media addiction (p=0.019, PR=2.587 95%CI=1.146 – 5,840). Conclusion: There is a significant relationship between mental emotional disorders and social media addiction. Diponegoro University Semarang students in 1st semester of the 2019 academic year and 3rd semester of the 2018 academic year.

- Perbandingan McKenzie dan Isometric Neck Exercise terhadap Keseimbangan pada Forward Head Posture: Studi pada Karyawan Pengguna Komputer Munawaroh, Naela; Sugiarto, Stephanie Indrawati; Wahyudati, Sri; Setiawati, Erna
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

BACKGROUND: The increasing use of computers in the current era is accompanied by an increase in the prevalence of poor posture due to the use of computers in fixed and inappropriate positions for a long time. This has the potential to cause changes in posture and body alignment such as forward head posture. McKenzie neck exercise and isometric neck exercise are considered to help maintain normal spinal alignment and improve body posture. OBJECTIVE: To compare the effect of McKenzie and Isometric Neck Exercise to balance in forward head posture METHOD: This study is an experimental study with a quasi-experimental pre and post-test design. Research subjects are computer users at RSUP dr Kariadi Semarang who suffer from forward head posture. A total of 24 research subjects were divided into group 1 (n=12) who received McKenzie neck exercise and group 2 (n=12) who received isometric neck exercise. Allocation was done by simple randomization. Each group did the exercise 12 times for 4 weeks with a frequency of 3 times per week. Balance assessment using the mCTSIB (Modified Clinical Test of Sensory Integration on Balance) questionnaire. Data analysis used Shapiro Wilk, Mann Whitney, independent t-test and paired t-test. RESULT: The demographic data of the sample in this study did not show any significant difference in either group 1 and 2. There was a significant improvement in condition 1 (balance on a flat bed with open eyes) in group 1 (p = 0.025). Significant results were also obtained in condition 2 (balance on a flat bed with closed eye) in group 2 (p = 0.041). There was no significant difference in the analysis of the two intervention groups. The McKenzie group did not provide a greater improvement in balance when compared to the isometric neck exercise group. CONCLUSION: McKenzie exercise is not superior to isometric neck exercise in improving balance

Hubungan Tympanogram dengan Lokasi dan Ukuran Tumor pada Pasien Karsinoma Nasofaring Dewi, Julita Melisa; Marliyawati, Dwi; Muyassaraoh, Muyassaroh
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Introduction : Hearing loss is the most frequent symptomps of patients with Nasopharyngeal Carcinoma (NPC), because there is a connection between the middle ear and the nasopharynx through the eustachian tube. Tympanometry is a hearing test in terms of evaluating the middle ear. Objective : This study aimed to evaluate the correlation between the tympanogram and the location and size of the nasopharyngeal carcinoma tumor at Dr. Kariadi General Hospital Semarang. Methods : This is a descriptive analytic study with cross-sectional study design of NPC patients at Dr. Kariadi Hospital Semarang, July 2020 to June 2021. Tympanometry was performed at the beginning of the diagnosis of NPC, the location and size of the tumor based on a head and neck physical examination, nasopharyngoscopy and CT scan results. Data analysis with spearmen rho . test. Result : From 52 subjects were diagnosed with NPC, most of them were in the 5th decade. The most common location of the tumor was in Rossenmuler fossa and extended to the wall and roof of the nasopharynx bilaterally (n=29; 55,7%). The most tumor size was T4 (n=26;50%). The results of statistical analysis showed that the tympanogram image had a strong correlation with the location of the tumor in NPC patients (r=0.853; p<0.001), but had no correlation with tumor size (r=0.061; p=0.668). Conclusion : The tympanogram in NPC is related to the location of the tumor, not to the size of the tumor.

Hubungan Anemia Defisiensi Besi dengan Pneumonia pada Anak Usia 6 Bulan – 5 Tahun Saputra, Novel Widya; Kusumawardani, Tri; Muryawan, Muhammad Heru
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background Iron deficiency anemia is a health problem in developing countries that causes an increase in the incidence of infection. One of the consequences of infection is pneumonia which is the cause of high morbidity and mortality in children under five around the world. Purpose To determine the relationship between iron deficiency anemia and the incidence of pneumonia infection in children 6 months – 5 years. Methods The study was conducted with a cross sectional design, 27 subjects aged 6 months – 5 years at Bendan Hospital Pekalongan. The characteristics of the subjects studied were age, gender, nutritional status, breast milk, ferritin, hemoglobin and pneumonia. The data obtained were analyzed by contingency test C and logistic regression with a significance level was set at p<0.05.Result Iron deficiency anemia is associated with the incidence of pneumonia, p value < 0.001, with a weak correlation value (0.437). From the results of logistic regression (multivariate) analysis, Hb and ferritin levels had no effect on iron deficiency anemia PR 1.281 (95% CI <0.05), p=1,000 and PR 2.364 (95% CI <0.05), p=0.995. Conclusion There is a weak relationship between iron deficiency anemia and the incidence of pneumonia infection in children under five.. Hemoglobin and ferritin levels are not the dominant variables that affect iron deficiency anemia.

HUBUNGAN ANTARA PENGGUNAAN SHOULDER BAG DENGAN KEJADIAN TRAPEZIUS MYALGIA Ramadhini, Amira Alya Cendekia; Adji, Raden Mas Soerjo; Kesoema, Tanti Ajoe; Wajdi, Muhammad
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background : The prevalence of Trapezius Myalgia is increasing, specifically in productive age (15-64 years old). In Indonesia, Trapezius Myalgia cases are less identified due to its minimal publication and frequently underdiagnosed. Trapezius Myalgia is generated by anaerobic metabolism in trapezius muscle triggered by lack of oxygenation. This process would release pain mediators and perceived as pain. Some factors were believed to cause trapezius myalgia, such as gender, heavy loads, repetitive movement, postures, and working with computer. The use of shoulder bag is considered as static loading and repetitively performed which is believed to cause trapezius myalgia. Aim : To determine the association between shoulder bag usage with Trapezius Myalgia in Toko Ananda Pojok Semarang workers. Method : This was an observational analytic study with cross-sectional design. Data assembled was primary data, consist of Nordic Musculoskeletal Questionnaire (NMQ) and confirmed by palpation using manual algometer. A total of 54 workers in Toko Ananda Pojok were selected as subjects. The group consists of 30 shoulder bag user and 24 non-shoulder bag user. Pearson Chi-Square was used for statistical analysis Results : Based on NMQ results, 30 subjects (55,6%) had neck pain, 35 subjects (64,8) had shoulder pain, 30 subjects (55,6%) had upper trapezius pain, and 20 subjects (37%) had lower trapezius pain. Pearson Chi-Square test of shoulder bag (p = 0,036) was statistically significant for trapezius myalgia risk (p<0,05). Conclusion : There was an association between shoulder bag usage with trapezius myalgia.

Primary Non-Hodgkin’s Lymphoma of the Female Urethra Presenting as Carunculous of Urethra: A Very Rare Case Report Tan Hengky; Nanda Daniswara; Ardy Santosa; Adi Soedarso; Eriawan Agung Nugroho; Sofyan Rais Addin
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Female urethral carcinoma occurred < 1% of all female malignancies. With a small prevalence of Malignant Urethral Lymphoma, there is lack of data about quality of the therapy. Case Report: A 41-year-old woman came to Division of Urology, Department of Surgery Dr. Kariadi Hospital Semarang with chief complaint a recurrence mass on her urethra. Her general condition was fine, and has a normal vital signs. On the physical examination of urogenital region, there was mass on the orifice of urethra external that can easily bleed. She is already performed excision of urethral caruncle with immunohistochemistry examination and found CD-20 positive which indicated a diffuse B-cell Lymphoma. Then she had 6 cycle chemotherapy procedures in Division of Hematooncology, Internal Medicine Department. Until now, she routinely check-up to urology and internal medicine departments to monitor her disease progression. Conclusion: Female urethral carcinoma is very rare, although surgery alone has been established as effective for treating low-stage urethral cancer, neither surgery nor radiation therapy alone provide good results. Delay in diagnose and treatment can decrease patient survival. Keyword: non-Hodgkin’s lymphoma, immunohistochemistry, Urethral carcinoma, urethral caruncle, chemotherapy

Hiperkalemia yang Disebabkan oleh Siklosporin pada Pasien Myelodysplastic Syndrome (MDS) Puspitasari, Winda Dwi; Felista, Ratih Ayu; Santosa, Damai
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang: Siklosporin merupakan calcineurin inhibitor yang dapat digunakan sebagai imunosupresan pada myelodysplastic syndrome (MDS). Hiperkalemia adalah salah satu efek samping siklosporin. Kejadian hiperkalemia dari penggunaan siklosporin belum banyak dilaporkan. Meskipun jarang disertai dengan gejala, hiperkalemia sedang dan berat dapat menjadi fatal dan mengancam jiwa. Tujuan: Menjelaskan secara rinci mengenai hiperkalemia yang disebabkan oleh siklosporin pada pasien MDS serta penatalaksanaannya. Kasus: Seorang laki-laki (74 tahun) datang dengan keluhan melena, lemas, batuk berdahak. Pasien memiliki riwayat MDS, hipertensi, Chronic Kidney Disease (CKD), dan diabetes mellitus dan rutin minum obat siklosporin, irbesartan, dan spironolakton. Pasien mengalami hiperkalemia sejak awal masuk rumah sakit (kalium 7,8 mmol/L). Selama rawat inap, spironolakton dihentikan, irbesartan dan siklosporin dilanjutkan. Untuk terapi hiperkalemia, pasien menerima infus insulin-dekstrose dan kalsium polistirena sulfonat namun kadar kalium masih tinggi. Kalium turun ke nilai normal (4,4 mmol/L) setelah siklosporin dihentikan pada hari ke-8. Diskusi: Beberapa faktor pemicu hiperkalemia (CKD, diabetes mellitus, penggunaan bersama obat siklosporin, spironolakton, dan irbesartan) menyebabkan penanganan hiperkalemia cukup sulit. Siklosporin menyebabkan hiperkalemia melalui beberapa mekanisme yang berbeda sehingga pengaruhnya cukup kuat. Strategi penatalaksanaan hiperkalemia pada pasien ini meliputi penghentian spironolakton, pemberian insulin-dekstrose dan kalsium polistirena sulfonat, diikuti penghentian obat siklosporin. Kesimpulan: Siklosporin dapat menyebabkan hiperkalemia, sehingga penting untuk melakukan pemantauan kadar kalium secara rutin terutama bila siklosporin diberikan bersama dengan obat lain atau pada kondisi yang dapat meningkatkan kadar kalium. Kata kunci: siklosporin, hiperkalemia, myelodysplastic syndrome

Seorang Anak Perempuan 1 Bulan Dengan Apert Syndrom (Acrocephalosyndactyly Syndrome Type 1) Nareswari, Tara; Ningrum, Farah Hendara
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 1 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang Sindrom apert merupakan salah satu jenis acrocephalosyndactyly yang paling dikenal dan disebabkan oleh mutasi gen fibroblast growth factor receptors2 (FGFR2) Acrocephalosyndactyly didefinisikan sebagai sindrom kongenital ditandai dengan penutupan yang terlalu dini dari sutura sutura tengkorak (craniosynostosis) Hal ini menghasilkan kepala dan wajah yang berbentuk tidak normal, serta fusi jari tangan dan kaki (sindactyly) 1. Tujuan studi kasus ini adalah untuk mengetahui penegakhan diagnosis sindrom apert Laporan kasus Pasien datang ke poli anak RS Kariadi Semarang tanggal 15 Oktober 2018 yang merupakan rujukan dari RS Keluarga Sehat Pati, dengan assesment suspek sindrom tertentu DD/ Craniosinostosis syndrom, Baller gerold syndrom. Orangtua pasien mengeluhkan bahwa saat bernafas anak berbunyi grok grok. Kesan dari pemeriksaan radiologi skeletal survey adalah Craniosynostosis yang membentuk gambaran Harlequin Eye, Syndactyly manus kiri, Polyndactyly pedis kiri, yang mana dari keseluruhan tanda klinis tersebut mendukung gambaran Apert Syndrome. Sedangkan kesan dari pemeriksaan MSCT kepala tanpa kontras adalah Sutura coronaria kanan kiri tampak sudah menutup, microcephali, brachicephalic, tak tampak gambaran hidrocephalus, tak tampak kalsifikasi patologis yang mencurigakan suatu infeksi kongenital, tak tampak tanda tanda peningkatan tekanan intracranial Pembahasan Apert syndrome (acrocephalosyndactyly) adalah kelainan perkembangan yang jarang terjadi, ditandai oleh craniosynostosis, hipoplasia midface, syndactili simetris tangan dan kaki. Karakteristik prodromal untuk penampilan wajah-cranio yang khas adalah craniosynostosis awal jahitan koronal, dasar kranial dan agenesis dari jahitan sagital. Apert Syndrome adalah sindrom craniosynostosis yang paling dikenal luas Apert syndrome merupakan acrocephalosyndactyly tipe I adalah malformasi kongenital yang langka dengan dikarakteristikan oleh kraniosinostosis, hipoplasia mid-face, syndactyly pada tangan dan kaki. Pada pasien ini tampak synostosis sutura coronaria kanan kiri yang membentuk gambaran harlequin eye. Syndactyly tangan dan kaki, dengan syndactyly pada tangan yaitu tipe 2 atau biasa disebut mitten hand yaitu tampak fusi jari ke 2- 4 tanpa keikutsertaan ibu jari. Dengan penampilan klinis pada mid face pasien menunjukan wajah dismorfik, flat facies, mata proptosis, hidung low nasal bridge, dan mulut palatum letak tinggi Kesimpulan Apert Syndrom merupakan salah satu tipe Acrocephalosyndactyly yaitu kelainan kongenital akibat mutasi heterozigot pada gen FGFR2 dengan sifat dominant autosomal, yang ditandai dengan craniosinostosis, hipoplasia midface, dan syndactyly pada tangan dan kaki. Pemeriksaan radiologi memiliki peranan penting dalam mendiagnosa kelainan ini

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