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Medica Hospitalia
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 584 Documents
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Perbandingan Kombinasi Senam Kaki dengan Hidroterapi dan Tanpa Hidroterapi terhadap Sensitivitas Kaki pada Lansia: Comparison of Combination of Foot Exercise with Hydrotherapy and Without Hydrotherapy on Foot Sensitivity in the Elderly Triyuliani, Liliana Evita; Marijo, Marijo; Mas Soerjo Adji, Raden; Supatmo, Yuswo
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.815

Abstract

LATAR BELAKANG: Penuaan memengaruhi berbagai aspek kehidupan, salah satunya yaitu kesehatan, dimana fungsi tubuh pada lansia mengalami penurunan, seperti sensitivitas kaki yang menurun. Salah satu aktifitas fisik yang mudah dilakukan bagi lansia adalah senam kaki dan hidroterapi, dimana aktivitas tersebut dapat meminimalisir gangguan sensitivitas kaki. Tujuan dari penelitian ini untuk mengetahui perbandingan kombinasi senam kaki dengan hidroterapi dan tanpa hidroterapi terhadap sensitivitas kaki pada lansia. METODE: Penelitian eksperimental dengan parallel 3 groups pre and post-test design pada 21 lansia di RW 04 Karang Wetan, Ungaran Barat yang dipilih dengan pendekatan purposive sampling dan dibagi menjadi tiga kelompok. Kelompok perlakuan melakukan intervensi selama 5 minggu dengan frekuensi tiga kali dalam satu minggu. Skor sensitivitas kaki diukur sebelum dan setelah intervensi menggunakan monofilament 10gr. Semakin baik sensitivitas kaki seseorang maka semakin tinggi jumlah skor sensitivitas kaki yang diperoleh dari hasil pengukuran menggunakan monofilament 10gr. HASIL: Hasil penelitian menunjukkan bahwa pada kelompok kombinasi senam kaki dan hidroterapi terjadi peningkatan skor sensitivitas kaki yang bermakna (p<0,05) maupun pada kelompok perlakuan senam kaki saja (p<0,05), sedangkan pada kelompok kontrol tidak didapatkan kenaikan skor sensitivitas kaki (p>0,05). Pada kelompok perlakuan kombinasi senam kaki dan hidroterapi dengan kelompok perlakuan senam kaki tidak ditemukan perbedaan yang bermakna.   KESIMPULAN: Kombinasi senam kaki dengan hidroterapi dan tanpa hidroterapi yang dilakukan sebanyak 3 kali dalam seminggu selama 5 minggu terbukti meningkatkan skor sensitivitas kaki pada lansia. Namun diantara keduanya tidak didapatkan perbedaan bermakna yang lebih efektif dalam meningkatkan skor sensitivitas kaki pada lansia. KATA KUNCI: Senam kaki,  hidroterapi, sensitivitas kaki, lansia.
Korelasi Indeks Massa Tubuh dan Tekanan Darah dengan Rasio TG/HDL pada Penderita Diabetes Mellitus Tipe 2 Etnis Jawa: Correlation of Body Mass Index and Blood Pressure with TG/HDL Ratio in Type 2 Diabetes Javanese Patients Tursinawati, Yanuarita; Setiowati, Lilis; Wahab, Zulfachmi; Kartikadewi, Arum
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.817

Abstract

LATAR BELAKANG: Salah satu komplikasi makrovaskuler penderita diabetes melitus tipe 2 (DMT2) yaitu penyakit jantung koroner (PJK). Kematian utama pada DMT2 disebabkan karena PJK. Rasio trigliserida (TG)/ high density lipoprotein (HDL) dapat memprediksi perkembangan PJK dan berkorelasi dengan indeks massa tubuh (IMT) dan tingkat tekanan darah. TUJUAN: Penelitian ini bertujuan membuktikan korelasi IMT dan tekanan darah dengan rasio TG/HDL penderita DMT2 Etnis Jawa. METODE : Sampel penelitian sejumlah 107 subjek DMT2 etnis Jawa. Data sekunder berupa rekam medis pasien DMT2 di Puskesmas, Semarang. Uji korelasi Spearman dipakai untuk menganalisis korelasi IMT dan tekanan darah dengan rasio TG/HDL dengan p<0,05. HASIL: Pada DMT2 etnis Jawa ditemukan rerata IMT adalah 24,3 + 3,3 kg/m2 dengan mayoritas IMT obesitas (42,1%), rerata tekanan darah sistolik (138,4+19 mmHg) dan tekanan darah diastolik (80,5+8,9 mmHg) dengan mayoritas mengalami prehipertensi (46,7%). Terdapat korelasi positif lemah yang signifikan antara IMT terhadap rasio TG/HDL pada penderita DMT2 etnis Jawa (r= 0,262, p= 0,006). Tekanan darah tidak terdapat korelasi signifikan terhadap rasio TG/HDL pada penderita DMT2 etnis Jawa (r= -0,114, p=0,243,). KESIMPULAN: Terdapat korelasi signifikan antara indeks massa tubuh (IMT) dengan rasio TG/HDL pada penderita DMT2 etnis Jawa. Sedangkan tingkat tekanan darah tidak berkontribusi terhadap rasio TG/HDL pada penderita DMT2 etnis Jawa. KATA KUNCI: Indeks massa tubuh, tekanan darah, rasio TG/HDL, DMT2
FAKTOR RISIKO OBSTRUCTIVE SLEEP APNEA PADA PASIEN DIABETES MELLITUS : FAKTOR RISIKO OBSTRUCTIVE SLEEP APNEA PADA PASIEN DIABETES MELLITUS Patria, Dimas Adi; Budiarti, Rery; Ayu Ruspita, Dian; Yunika, Kanti; Tedjo Minuljo, Tania; Farokah, Farokah
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.824

Abstract

LATAR BELAKANG : Sleep Disordered Breathing(SDB) memiliki hubungan dua arah dengan sindrom metabolik seperti Diabetes Mellitus (DM) dan hipertensi, komponen sindrom metabolik meningkatkan risiko terjadinya SDB. IMT >30 kg/m2, aktivitas fisik, lingkar leher >40 cm dan hipertensi berisiko tinggi terhadap kejadian SDB. SDB telah terbukti meningkatkan risiko dan keparahan DM, sehingga penanganan SDB dibutuhkan untuk tindakan preventif  DM. TUJUAN : Mengetahui bahwa obesitas, lingkar leher besar, hipertrofi konka inferior, deviasi septum hidung, hipertrofi tonsila palatina, makroglosia, obstruksi saluran nafas atas dan hipertensi merupakan faktor resiko yang mempengaruhi kejadian SDB pada penderita DM. METODE : Penelitian observasional analitik dengan desain cross sectional melibatkan subyek sebanyak 57 penderita DM rawat jalan di Poli Penyakit Dalam RSUP Kariadi Semarang yang memenuhi kriteria inklusi pada bulan Januari 2022 - Maret 2022. Data diperoleh dari rekam medik, kuesioner ESS, pemeriksaan fisik THT dan pemeriksaan Laryngoscopy Flexible. Analisis menggunakan uji chi-square dan uji regresi multivariat. HASIL : Rerata usia 51.87 tahun, dengan SD 9.094, termuda usia 27 tahun, tertua usia  63 tahun. Laki-laki sebanyak 28(49.1%) dan perempuan 29 (50.9%). Obesitas (p= 0,036), lingkar leher besar(p=0.017), hipertrofi konka inferior(p=0,020), makroglossia(p=0,012), hipertrofi tonsila palatina(p=0,017), hipertensi (p=0,001), dan obstruksi saluran nafas atas(p=0,020) merupakan faktor risiko SDB pada penderita DM. Analisis regresi multivariat didapatkan obesitas (p=0,043 RP=13,387.CI 95%:1,083-165,475)dan hipertropi tonsil palatina(p=0,019 RP=9,703.CI 95%=1,446-65,121) merupakan faktor risiko yang paling dominan. SIMPULAN : Obesitas, lingkar leher besar, hipertrofi konka inferior, makroglossia, hipertrofi tonsila palatina, hipertensi, dan obstruksi saluran nafas atas merupakan faktor resiko SDB pada penderita DM. Obesitas dan hipertropi tonsil palatina merupakan faktor risiko yang paling dominan KATA KUNCI: SDB, DM, faktor risiko, hipertrofi tonsil, makroglosia
OSA FAKTOR RISIKO KEJADIAN OBSTRUCTIVE SLEEP APNEA PADA PASIEN STROKE ISKEMIK: - Rosyidah, Nurul Uly; Mailasari Kusuma Dewi, Anna; Marliyawati, Dwi; Yunika, Kanti; Suryawati, Herlina; Budiarti, Rery
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.826

Abstract

LATAR BELAKANG: Sleep Disordered Breathing (SDB)  memiliki hubungan dua arah dengan stroke iskemik. SDB yang tidak diobati dapat menyebabkan stroke berulang. Penanganan SDB adalah kunci untuk preventif pada pasien stroke. TUJUAN: Menganalisis IMT, lingkar leher besar, deviasi septum, hipertrofi konka, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas sebagai faktor risiko SDB pasien stroke iskemik. METODE: Penelitian observasional dengan desain cross sectional, pada 86 pasien stroke iskemik di Poli Neurologi dan THT-KL RSUP Kariadi Semarang bulan Desember 2021-Juli 2022. Data diperoleh melalui kuesioner, pemeriksaan fisik dan pemeriksaan nasolaringoskopi fleksibel. Analisis menggunakan uji chi-square dan uji regresi multivariat. HASIL: Didapatkan 86 subjek terdiri dari 42 laki-laki(48,8%) dan perempuan 44 (51,2%), usia rerata 54 th, dan 61 subjek (70,9%) stroke iskemik pertama. Septum deviasi (p= 0,020), hipertrofi konka inferior (p= 0,021), makroglosia (p= 0,012), hipertrofi tonsila palatina (p= 0,013), dan obstruksi saluran nafas atas (p= 0,035) merupakan faktor risiko SDB pada pasien stroke iskemik. Septum deviasi berisiko 6,1x, konka inferior hipertrofi berisiko 4,1x, dan hipertrofi tonsila palatina  berisiko 8,8x terhadap SDB pada pasien stroke iskemik. SIMPULAN: Septum deviasi, konka inferior hipertrofi, makroglossia, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas merupakan faktor resiko terhadap SDB pasien stroke iskemik. Hipertrofi tonsila palatina merupakan faktor risiko yang paling dominan terhadap SDB pasien stroke iskemik. KATA KUNCI: SDB, faktor risiko, stroke iskemik, hipertrofi tonsila palatina, septum deviasi
Full Text Volume 9 Nomor 3 November 2022: Full Text Volume 9 Nomor 3 November 2022 General Hospital , Kariadi
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.868

Abstract

Full Text Volume 9 Nomor 3 November 2022
Management of Deep Neck Abscess Cases Accompanied by Comorbid Renal Failure Sari Ratunanda, Sinta; Alkatirie, Sania Taufik; Sudiro, Melati
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.741

Abstract

Background: Deep neck abscess is a life threatening disease as its complications. Some comorbidities affect the successful management of deep neck abscess. Kidney failure is one of comorbidities causing uremia which in turn affecting imbalance of pro and anti inflammatory mediators. Aims: To describe the proper management of deep neck abscess comorbids with kidney failure.Case Report: To report series of deep neck abscess comorbids with kidney failure being administered therapies with various outcomes.Method: Evidence based -literature review about deep neck abscess comorbids with kidney failure was conducted in Pubmed, Clinical Key, and Google Scholar. Retrieved articles were then critically appraised.Results: Three evidence based-articles meeting criteria were included. The management of neck abscess comorbids with renal failure starts from kidney management according to Kidney disease: Improving Global Outcome (KDIGO) year 2012, and followed by management of deep neck abscess except in emergency situation. Diagnose and management of kidney disease need series examination of serume creatinine and urine monitoring.Conclusion: The management of deep neck abscess comorbids with kidney failure commences with therapy for renal failure followed by management of deep neck abscess.
Serial Case: Infarct Stroke In Covid 19 Patients Retnaningsih, Retnaningsih; Tamad, Fatiha Sri Utami; Tugasworo, Dodik; Andhitara, Yovita; Ardhini, Rahmi; Kurnianto, Aditya
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.744

Abstract

Introduction: SARS-CoV-2 has been reported to cause various neurological symptoms including stroke. SARS-CoV-2 infection causes the release of cytokines, proinflammatory chemokines, immune system activation, coagulopathy, endothelium, vasculitis, hypoxia, renin-angiotensin system imbalance, and cardiovascular complications, all of which can contribute to stroke. Purpose: Describe the incidence of stroke with different conditions in COVID 19 Cases: There were two cases of stroke infarct in a COVID-19 patient who was admitted to our hospital. Both were treated with a diagnosis of stroke infarct with previous COVID-19 symptoms, the results of laboratory examinations revealed an increase in inflammatory markers in both patients and had been given appropriate treatment according to each patient's condition. But at the end of the treatment one patient died and the other patient went home with clinical improvement. Discussion: The incidence of stroke infarct in this case is thought to be due to several factors, namely the presence of comorbidities in the patient, microvascular thrombus due to the formation of neutrophil extracellular traps (NET), activation of complement which causes thrombogenesis and vasculopathy, formation of antiphospholipid antibodies so that protein c is reduced, the formation of microparticles causes platelet hyperactivation. and increased tissue factor (TF) resulting in hypercoagulation. Adequate therapy in controlling inflammation due to COVID 19 has shown clinical improvement in stroke infarct patients. Conclusion: There are 2 cases of stroke infarction in patients with covid 19 who have comorbidities. The first case with COVID advanced stages experienced a worsening of the condition despite being given appropriate therapy. The second case with COVID middle stages experienced an improvement in the condition after the viral inflammatory factors were controlled and the comorbidity was well controlled.
Difference Between BMI At Admission and Discharge and NIHSS at Admission and Discharge In Iscemic Stroke Patients at Dr.Kariadi Horpital Fauziah, Annisa; Subagio, Hertanto Wahyu; Nugrohowati, Annta Kern; SS, Darmono; Probosari, Enny
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.777

Abstract

BACKGROUND : Hospitalized patients are at risk for malnutrition. Decreased BMI (Body Mass Index) in stroke patients is negatively correlated with patient outcomes. Studies on differences in BMI and NIHSS (National Institutes of Health Stroke Scale) at admission and discharge in stroke patients have not been conducted in Indonesia. OBJECTIVE: To describe the difference between BMI and NIHSS at admission and discharge in ischemic stroke patients at Dr. Kariadi hospital METHOD : An observational study on 49 hospitalized ischemic stroke patients at the Stroke Unit of dr. Kariadi hospital. Outcomes were measured using the National Institutes of Stroke Scale (NIHSS). Data was collected from the patient's medical record and analyzed using Paired Sample t Test. RESULT : There was no significant difference between BMI at admission and discharge (p = 0.161). There was a significant difference between the NIHSS at the time of admission and at the time of discharge (p= 0.014). CONCLUSION : There is no significant difference between BMI at admission and discharge. There is functional improvement in ischemic stroke patients during treatment
Correlation between Preoperative Osteitis Degree with Postoperative Endoscopic Score in Chronic Rhinosinusitis Apriansyah, Apriansyah; Dewi, Anna Mailasari Kusuma; Ningrum, Farah Hendara
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.784

Abstract

BACKGROUND: In chronic rhinosinusitis patients, there is a subgroup of patients with persistent symptoms after treatment, who often shows bone thickening and remodeling in their paranasal sinuses and described as osteitis. Osteitis can be evaluated by several methods, one of which is the Global Osteitis Score (GOS) AIM: To analyse the correlation between preoperative osteitis degree with the postoperative endoscopic scores in chronic rhinosinusitis METHOD: It was an observational study with cross-sectional design. We use GOS from CT scan before surgery and Lund Mackay’s endoscopic score 4 weeks after Functional Endoscopy Sinus Surgery (FESS). The analysis performed with Spearman correlation test. RESULT:  There were 30 patients as subjects. There statistical analysis test between preoperative osteitis degree with post operative endoscopic score showed p = 0.296 with r = 0.197. The analysis result between risk factors for wound healing with the postoperative endoscopic score were allergic rhinitis (p = 1.000), polyps (p = 0.624), and smoking (p = 0.309) CONCLUSION: There is no significant correlation between preoperative osteitis degree with the postoperative endoscopic score, but there is a tendency for a positive correlation between preoperative osteitis degree with the postoperative endoscopic score. There was no significant correlation between allergic rhinitis, polyps, and smoking habits with postoperative endoscopic score
Thyroid Storm Post-Radioactive Iodine Therapy Hardina, Septi; Budiawan, Hendra
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.785

Abstract

Background Thyroid storm is an endocrine disorder emergency which has a high morbidity and mortality rates. The incidence of thyroid storm is seen in less than 10% of all hospitalized thyrotoxicosis patients. However, it has a high mortality rate, which accounts to 20-30% of the cases. It is important to diagnose early to facilitate appropriate immediate management, which can improve prognosis and clinical outcome in patients. Thyroid storm usually begins with precipitating factor. Thyroid storm precipitated by radioactive iodine therapy is rare. Case Report We report a rare case in a 28 year old female patient. Patient came with complaints of palpitations, nausea without vomiting, fever, >3x diarrhea, and shortness of breath after radioactive iodine therapy. The clinical presentation of thyroid storm is polymorphic that becomes a diagnostic problem as it can delay treatment and increase the risk of mortality. It is important to suspect a thyroid storm based on the patient's clinical presentation, because the diagnosis of thyroid storm is based more on the patient's clinical presentation. The existence of the Burch-Wartofsky scoring system facilitates the diagnosis of a thyroid storm. The total Burch-Wartofsky score in this patient based on the clinical presentation is 45, which is highly suggestive of thyroid storm. Conclusion Thyroid storm precipitated by radioactive iodine therapy is rare. The incidence of thyroid storm after administration of radioactive iodine therapy is 0.34 percent. Precipitating factors other than the administration of radioactive iodine therapy such as infection and discontinuation of antithyroid drug therapy can trigger a thyroid storm.

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