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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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Efektivitas Diversi Urin pada Pasien Kanker Serviks di Rumah Sakit Tersier Semarang Nugroho, Eriawan Agung; Setyasworo, Singgeh; Simangunsong, Ragam Pesona; Listiyanto, Yandhi Ari; Yudha, Fajar Gemilang Purna; Santosa, Ardy; Soedarso, Moh Adi; Wibisono, Dimas Sindhu; Daniswara, Nanda; Addin, Sofyan Rais
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.v10i1.847

Abstract

BACKGROUND: Obstructive uropathy and hydronephrosis are common complications of cervical cancer. In order to provide an alternative route due to ureteral obstruction, urinary diversion was performed. Urinary diversion procedures are a therapeutic option for obstructive uropathy but their effectiveness is remain unclear. There is limited data that support urinary diversion as a treatment of ureteral obstruction to improve overall survival and progression-free survival. AIM:  To determine the effectiveness of urinary diversion in the treatment of obstructive uropathy in cervical cancer patients. METHOD: This study is a cross sectional involved cervical cancer patients with symptoms of obstructive uropathy. Data were obtained from medical records and limited to patients admitted from May, 2020 to May, 2021. Primary outcome was urea level, creatinine level, stage of hydronephrosis and overall survival rate of patients. RESULT: A total of 100 patients were included in the study. In both groups, the mean age of study subjects was 52-53 years with stage IIIB being the most widely reported. There was an improvement in post creatinine in the urinary diversion group. There was a significant difference in post creatinine levels between the non-urine diversion and urinary diversion groups (p=0.039).The 12-month survival rate, in the non-urinary diversion group had a value of 86% while the urinary diversion group had a value of 94%. CONCLUSION: This study shows that urinary diversion procedure is effective in increasing the renal function and increasing the 12-month survival of cervical cancer patients with obstructive uropathy.
Pain Improvement Among Chronic Lumbar Disc Herniation Patients Underwent Epidural Triamcinolone With Or Without Hyaluronidase Injection Within 3 Months Of Follow-Up: A Prospective Study Budisulistyo, Trianggoro; Husni, Amin; Tugasworo, Dodik; Pudjonarko, Dwi
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.v10i1.850

Abstract

Background Chronic lumbar disc herniation (CLDH) will accompany by chronic inflammation, so the fibrosis tissues formed in the epidural space and adjacent nerve roots, and lead to mixed pain syndrome. Objectives To compare between triamcinolone only and hyaluronidase 1500 international unit (IU) administration epidural injection for treating bulged or protrusion CLDH.     Methods This prospective study involved CLDH patients visiting the outpatient department of Neurology at Dr. Kariadi Hospital Semarang Indonesia from November 2021 until August 2022. They divided: triamcinolone (Group 1) and hyaluronidase 1500 IU and triamcinolone epidural injection (Group 2) with 3 days of hospitalization. Neurotrophic was prescribed during 3 months of follow-up and ordered for personal physical treatment. They analyzed pain improvements (NRS and Pain DETECT), and the Oswestry Disability Index (ODI) scores. Results The 37 subjects were recruited but 1 female dropped out cause of re-injection, so 13 males and 23 females aged between 24 to 72 years old (mean 48+2) were followed. They significantly improved (Wilcoxon test p=.000), as the NRS score was 47.9% (Group 1) and 55.4% (Group 2). ODI scores without significance (Mann-Whitney p> .005), such at 2 weeks (group 1= 20.4%, group 2= 23.6%) and 3 months (group 1= 58.1%, group 2= 53.7%). They observed nociceptive and neuropathic improvement even though needed more time for the healing process. Conclussions This study proved hyaluronidase administration before triamcinolone epidural injection with better improvements for treating bulged or protrusion CLDH patients.
Kejadian Kardiovaskular Mayor di Rumah Sakit pada Pasien STEMI di Era Pandemi COVID-19 Mangkoesoebroto, Arjatya Pramadita; Herry, Yan; Sofia, Sefri Noventi; Bahrudin, Udin
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.v10i1.852

Abstract

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has become a global burden, changing healthcare system and affecting patients with ST segment elevation myocardial infarction (STEMI). Several countries reported a decrease in hospital admission, changing management, increase total ischemic time, and major cardiovascular events (MACE) in the pandemic era. However, there is limited data especially in Indonesia. OBJECTIVE: To know the differences in admissions, characteristics, management and in-hospital MACE in STEMI patients between pre and pandemic era. METHODS: Comparative observational analytical study was done on 169 patients in the pre-pandemic (12 March 2019-11 March 2020) compared to 163 patients in the pandemic era (12 March 2020-30 September 2021) with STEMI at dr. Kariadi Semarang Hospital. Assessment of monthly admission rates, total ischaemic time, reperfusion management, COVID-19 status and MACE were carried out. RESULTS: During the COVID-19 pandemic, there was a decrease in the average admission of 14.1 to 8.6 patients per month (p<0.001), increase total ischaemic time of 8.78 (3.22-19.68) hours to 10.22 (3 .20-20.43) hours (p<0.001), decreased use of primary PCI (97.0% vs. 83.4%, p<0.001), increased fibrinolytic (1.8% vs8.6%,p=0.010) and no reperfusion (1.2%vs8.0%, p=0.007). There was a significant increase in MACE in the era of the COVID-19 pandemic (10.7%vs22.1%,p=0.008), with mortality (4.7%vs11.7%,p=0.035), stroke (1.2%vs1.8%,p=0.680), cardiogenic shock (4.1%vs11.0%, p=0.030), and acute pulmonary edema (3.6%vs10.4%,p=0.024). CONCLUSION: There was a decrease in admissions and primary PCI procedure, increase use of fibrinolytics and without reperfusion, total ischemic time prolongation, and significant increase of in-hospital MACE in STEMI patients during the COVID-19 pandemic.
Korelasi Kadar Prokalsitonin (PCT) Dengan Rasio Neutrofil Limfosit (RNL) Pada Pasien COVID-19 Apriliani, Isnawati; Fajrunni’mah, Rizana; Djajaningrat, Husjain; Widiantari, Aninda Dinar; Murtiani, Farida
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.v10i1.855

Abstract

BACKGROUND: Covid-19 treatment should be done early before the disease progress. Inflammatory biomarker is needed to ascertain the severity of disease as soon as possible.  Neutrophil-to-lymphocyte ratio (NLR) and Procalcitonin (PCT) are two of biomarker that are clinically used around the world. NLR is simpler, can routinely be done and available in peripheral region while PCT is more effective to describe inflammation. PURPOSE: This study aims to determine the correlation of procalcitonin (PCT) levels with neutrophil lymphocyte ratio (NLR) in COVID-19 patients. METHOD: This study is an analytic observational with a cross sectional design. We extracted data from medical record. Samples were 415 COVID-19 patients undergoing inpatient care at the Budhi Asih Hospital, East Jakarta for January - December 2021. RESULTS: Prevalence of male patients more than ≥60 years were 78 patients (18,8%) while female patients were 68 patients (16,4%). Average of PCT level was 1,93 ng/mL (0,02-200 ng/mL). Average of NLR was 5,09 cells/mm3 (0,22-31 cells/mm3). Spearman test proved there was a significant correlation between PCT and NLR levels in COVID-19 patients (p value = 0,0001). CONCLUSION: The higher the PCT level, the higher the NLR value in COVID-19 patients.
KORELASI ANTARA DIMENSI VENA PORTA DENGAN KEKAKUAN HEPAR PADA PASIEN SIROSIS HEPATIS DI CHILD PUGH A Santoso, Antonius Gunawan; Mubarok, Nala Khodlil; Widyasari, Maya Nuriya; Purnomo, Hery Djagat
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.v10i1.899

Abstract

BACKGROUND: Liver cirrhosis is an end-stage liver disease characterized by pathologic fibrosis and regenerative nodules with resultant liver dysfunction. The diagnostic hallmark of portal hypertension is slow flow velocities in addition to the increased caliber of the mean portal vein. That is, the diagnosis of portal hypertension requires the measurement of mean portal velocity and portal diameter, and the correlation between cirrhosis and mean portal velocity and port diameter is the correlation between liver cirrhosis and its complications.OBJECTIVE: To analyze the correlation between portal vein dimensions and liver stiffness in patients of Child-Pugh A cirrhosis.METHOD: This study was a cross-sectional study on 30 subjects with Child-Pugh A liver cirrhosis. The subjects of this research are patients who come to the Radiology Department of the Dr. Kariadi Hospital in Semarang for point shear wave elastography and abdominal ultrasound examination from January to December 2022. Spearman test correlation was used for the analysis.RESULT: Spearman test showed no correlation between liver stiffness and portal vein diameter (p=0.250, r= -0.217), liver stiffness and mean portal vein velocity (p=0.883, r= -0.028), and portal vein diameter with mean venous velocity in Child-Pugh A liver cirrhosis (p = 0.979, r = 0.005)
Full Text Volume 10 Number 1 March 2023 Hospital , Kariadi General
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.v10i1.947

Abstract

Full Text Volume 10 Number 1 March 2023
Correlation Between Visceral Fat And Lipid Profile in Myocardial Infarction Patients Yuniari, Dwi; Puruhita, Niken; Probosari, Enny; Subagyo, Hertanto Wahyu; Nugrohowati, Annta Kern
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.797

Abstract

BACKGROUND : Previous studies reported that visceral fat plays an important role in cardiovascular disease, even in non-obese individuals. Bioelectrical impedance analysis (BIA) is a non-invasive and radiation-free method for assessing visceral fat. Not much is known whether visceral fat correlates with lipid profile in myocardial infarction (MI) patients in Indonesian population. PURPOSE : To analyze the correlation between visceral fat and serum lipid profile in MI patients. METHODE : This is a correlational study on 32 MI patients hospitalized at the ICCU of RSUP Dr. Kariadi Hospital recruited with consecutive sampling. Visceral fat was measured by BIA SECA mBCA 525 series, data regarding levels of total cholesterol, triglycerides, low density lipoprotein (LDL), and high density lipoprotein (HDL) were gathered from medical record. The data were normally distributed, then the hypothesis was tested with the Pearson. RESULT : The mean age of the subjects was 55 ± 9.88 years, with 87.5% being male. As many as 81.3% of subjects experienced ST-elevation myocardial infarction (STEMI). The average body mass index (BMI) was 26.2 ± 3.68 kg/m², in which 40.6% of subjects were classified as grade 1 obesity. The majority of subjects (93.8%) had high visceral fat. As many as 68.8% of subjects had high LDL levels with an average of 120.5 ± 38.84 mg/dL. HDL average was 35±13.55 mg/dL with 62.5% of subjects having low HDL levels. More than half of the subjects (56.3%) experienced hypertriglyceridemia with an average of 157.4 ± 55.84 mg/dL. Visceral fat was significantly related to total cholesterol and triglycerides (r=0.40; p=0.02 and r=0.36; p=0.04). CONCLUSION : There is a significant correlation between visceral fat and total cholesterol and triglycerides in MI patients.
Analgesic Potency Of Ibuprofen, Paracetamol, And Mephenamic Acid: A Randomized Controlled Trial Nayoan, Christin Rony; Syamsi, Nur
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.842

Abstract

BACKGROUND: Analgesics are a group of drugs to relieve pain. The use of analgesics is quite high, around 22.8% is used per year. Selection of analgesic drugs having adequate potency and minimal side effects is needed. Common analgesics publicly known involve paracetamol 500 mg, mefenamic acid 500 mg, and ibuprofen 400 mg. This study aims to compare the analgesic potency of paracetamol 600 mg, ibuprofen 600 mg and mefenamic acid 500 mg. METHODS: This study used a double blind randomized control trial. The study population was healthy subjects. The study sample consisted of 30 subjects with the inclusion criteria involve normal vital signs, while the exclusion criteria involve history of allergy to NSAID class drugs. This study consisted of three  groups namely group 1 (K1)= paracetamol 600 mg, group 2 (K2)= mefenamic acid 500 mg, group 3 (K3)= ibuprofen 600 mg. Each subject was given medication according to the group and their pain latency (the time of onset of constant and unbearable pain) was measured every 30 minutes RESULTS: The repeated ANOVA test shows P= 0.1507 meaning that no significantly different analgesic potency  was found between groups. CONCLUSION: Paracetamol 600 mg, mefenamic acid 500 mg and ibuprofen 600 mg have equal analgesic potency.
The Effect of 1% Povidone Iodine Mouthwash on The Incidence of Oral Mucositis and Odynophagia in Patients with Head and Neck Malignancy Handayani, Peny; Budiarti, Rery; Yusmawan, Willy; Antono, Dwi; Dewi, Anna Mailasari Kusuma; Widodo , Pujo
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.854

Abstract

BACKGROUND: Oral mucositis is an injury of normal mucosal tissue with an acute inflammation of the oral, tongue, and pharyngeal mucosa after exposure to chemo-radiotherapy. Post chemoradiotherapy oral mucositis is commonly accompanied by painful swallowing or odynophagia. Povidone iodine 1% is an antiseptic mouthwash that widely used to prevent infections in the oral cavity. OBJECTIVE: The aim of this study was to determine the effect of 1% povidone iodine mouthwash on the incidence of oral mucositis in patients with head and neck malignancy at Dr. Kariadi General Hospital Semarang.    METHOD: This study was single random blinded experimental study, with total samples of 44 patients with head and neck malignancy after chemoradiotherapy. The samples divided into treatment group of 22 samples with 1% povidone iodine mouthwash and control group of 22 samples with NaCl 0.9% recruited using single random sampling at Dr. Kariadi Semarang General Central Hospital in 2022. The effect of 1% povidone iodine mouthwash on the incidence of oral mucositis and odynophagia was analyzed using the Fischer Exact and Mann Whitney test. RESULT: In the 1% povidone iodine mouthwash group day 15th, 21 patients (95.5%) were found without mucositis and 1 patient (4.5%) with mucositis oral grade I. In the 1% povidone iodine mouthwash group, 21 people (4.5%) were found without odynophagia and 1 people (4.5%) had odynophagia. There was an association between oral mucositis and odynophagia on povidone iodine 1% group (p < 0.05).        CONCLUSION: Povidone iodine 1% mouthwash can affect the incidence of oral mucositis in patients with head and neck carcinoma. Povidone iodine 1% mouthwash can reduce the incidence of oral mucositis and odynophagia compared to placebo in patients with head and neck carcinoma.
Effect of Fixed‐Dose Combinations Antituberculosis and Separate Formulations on Clinical Symptoms, Weight Gain, Adverse Effect and Plasma Concentration in Tuberculosis and HIV Coinfection Cases Sundari, Titi; Mariana, Nina; Permatasari, Debby Intan; Rusli, Adria; Sitompul, Pompini Agustina; Rosamarlina, Rosamarlina; Widiantari, Aninda Dinar; Maemun, Siti; Lisdawati, Vivi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.867

Abstract

BACKGROUND: Fixed Dose Combination (FDC) was aimed to simplify TB therapy and facilitate physician and patient compliance. OBJECTIVE: We aimed to evaluate the effect of FDC antituberculosis and separate formulations (SF) on clinical symptoms, weight gain, adverse effect and plasma concentration in TB/HIV cases during the intensive phase. METHOD: Prospective cohort study was conducted in public hospital, Jakarta. We recruited TB-HIV patients in May 2018-May 2019. Patients (over than 18 years old) diagnosed with TB-HIV who consumed either FDC or SF and had not received antiretroviral. A total of 36 subjects were included in this study, 20 subjects in FDC group and 16 subjects in SF group. RESULT:  There was not significant different between FDC and SF groups with an improvement of clinical symptoms (P = 0.70) and weight gain (P = 1.00). Gastrointestinal syndrome was 75% in FDC group; 62.5 % in SF group. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration after 2 weeks therapy in FDC group were 5.49 mg/L (±3.40 mg/L), 1.35 mg/L (±1.20 mg/L), 19.87 mg/L (±17.00 mg/L), respectively. Mean (±SD) of rifampicin, isoniazid, pyrazinamide plasma concentration in SF group were 6.42 mg/L (±4.80mg/L), 0.87 mg/L (±0.70 mg/L), 5.03 mg/L (±7.60 mg/L), respectively. CONCLUSION: There was not significant different between FDC and SF groups on improvement of clinical symptoms and weight gain in intensive phase of therapy, the highest of adverse effects was gastrointestinal syndrome, and all subjects had normal reference ranges of rifampicin concentrations, and isoniazid and pyrazinamide below the normal range.

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