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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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The Effect Of Giving A Vibrator With A Cooler On Pain Level In Childhood With Venipuncture In Tidore Kepulauan Hospital Abdullah, Fadila; Anwar, Nursanti
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.v10i2.870

Abstract

BACKGROUND : Atraumatic care is therapeutic care that is carried out as part of an intervention to remove or suppress psychological or physical stress suffered by a child. The act of minimizing pain, stress and trauma to children when given at the time of blood collection is part of the principle of atraumatic care. One of the atraumatic actions that can be performed on children is the use of a vibrator with a cooler to minimize pain when stabbing a vein AIMS : to determine the effectiveness of giving a vibrator accompanied by a cold compress against pain in children when taking venous blood. METHODS : The design of this research is true experimental with a post-test only control group design. Researchers divided into 2 groups, namely the intervention and control groups were taken randomly. Then the researcher made a vibrator with a cooler that had been previously tested on 30 adults, then after being declared to have passed the ethical study it would be applied to children when taking venous blood, assessing children's pain using the FLACC instrument (face, legs, activity, cry and controllability). The study was conducted at the Tidore Islands Hospital. Data processing was carried out previously by testing the homogeneity and normality test, if normally distributed it will use the independent t-test to assess the difference in the average of the two groups, while if it is not normally distributed it will be tested with Mann-Whitney. RESULT : The results of this study indicate that the characteristics of respondents according to age are mostly 4 years old. In the control group the average age of children is 3.87 while in the intervention group the average age of children is 3.93. Most of the experience of having blood drawn in both groups had blood drawn before. Based on gender characteristics, most of the control and intervention groups were women. There are differences in pain scores in the control and intervention groups. The mean pain score in the intervention group was 3.13 and the mean pain score in the control group was 7.87. The results of statistical tests using Mann Whitney showed that there was a significant difference in pain during venipuncture in the intervention group and the control group (p=0.013). CONCLUSION : The results of the statistical test show that there was a significant difference in pain in the intervention group and the control group (p=0.013). The use of a cooling vibrator can be an alternative to reduce pain in children during venipuncture.
PERBANDINGAN PROGRAM LATIHAN OTAGO MODIFIKASI DAN LATIHAN BERJALAN TERHADAP PHYSICAL PERFORMANCE PADA LANSIA PRE-FRAIL Vikawati, Nura Eky; Julianti, Hari Peni; Dewi, Novita Sari; Mariani, Endang Sri
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.v10i2.874

Abstract

Background: Multicomponent training program like OTAGO is considered to improve the physical performance of pre-frail elderly, thereby reducing risk of fall. The Short Physical Performance Battery (SPPB) is a combination test that assesses physical performance and becomes a fall risk screening test for pre-frail elderly. This study aimed to compare the modified OTAGO to walking training on physical performance as measured by SPPB in the pre-frail elderly. Methods: This was an observational study with a cross-sectional design. The data were taken from the previous study including pre-frail subjects in Prolanis, Gunung Pati area, Semarang before and after giving intervention (modified OTAGO vs walking training) for 6 weeks. The SPPB score was measured from balance function test, chair stand test, and 4-meter walking test before and after the intervention. Data analysis was using SPSS ver 20.0. Paired sample T-test and Wilcoxon signed ranks test were used to analyze the SPPB score before and after interventions in the modified OTAGO and walking training group, respectively. Mann-Whitney U was used to analyze the difference in the average improvement of SPPB score. Results: There was a significant improvement in SPPB score before and after interventions either in modified OTAGO (p=0.013) or walking training (p=0.013). No significant difference was found in the average improvement of SPPB score in both groups (p=0.826). Conclusion: Both modified OTAGO and walking training intervention can improve the physical performance of pre-frail elderly. The modified OTAGO training is not superior in improving physical performance compared to walking training.
Strategi Koping dan Skor DASS pada Perawat yang Bertugas di Ruang Isolasi COVID-19: Sebuah studi cross-sectional Adinoto, Septo Pero; Fitrikasari, Alifiati; Wardani, Natalia Dewi; Noerhidajati, Elly
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.v10i2.875

Abstract

BACKGROUNDS: Nurses are at risk for mental health problems while caring for Corona Virus Disease 2019 (COVID-19) patients. The COVID-19 pandemic had impacted not only on emotions but also nurses' coping strategies. The difference between this study and previous research in this study adds up the total DASS 42 (Depression Anxiety Stress Scale) scores as parameter to assess mental health problems of the subjects. OBJECTIVE: To determine the association between coping strategies and the DASS score among nurses on duty in the COVID-19 isolation room of Dr Kariadi Hospital. METHODS: This cross-sectional study involved nurses who treated patients in the COVID-19 isolation ward, the COVID-19 intensive room, and the COVID-19 emergency room. All participants were involved by the consecutive sampling method. The research instrument used a sociodemographic questionnaire, the Brief COPE, and the DASS 42. Inclusion criteria included nurses who served in the COVID-19 isolation room and aged 22-60 years. Higher DASS score indicates that the subject is experiencing general psychological distress compared to subjects with a lower score. RESULTS: Most of the respondents in this study (n=112 subjects) had problem-focused coping strategies. The mean DASS score on the subjects is 14.29 ± 13.25. There was an association between coping strategies (p=0.048), sex (p < 0.001), place of work (p = 0.041), and DASS score. CONCLUSION: There was a relationship between coping strategies and the DASS score of nurses on duty in the COVID-19-19 isolation room. Further research needs to explore environmental factors and social support, also examine physical illnesses in more detail.
Association Of Neuropathic Pain Improvement And hs-CRP Changes Among Trigeminal Neuralgia Patients Experienced Radiofrequency Ablation 60o and 65o Celcius: 6 months follow up Arlina, Yani; Budisulistyo, Trianggoro; Pudjonarko, Dwi; Tugasworo, Dodik; Suryawati, Herlina; Diah Pasmanasari, Elta
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.v10i2.876

Abstract

INTRODUCTION: Trigeminal neuralgia (NT) is a neuropathic pain that involves the trigeminal nerve in the face. The first-line medical management of patients with NT is Carbamazepine (CBZ). Radiofrequency ablation (RFA) procedure is a minimally invasive procedure using a high-frequency current-generating device that produced heat ablate of C-fibers with effectiveness around 76% for 10 yeas follow-up. Inflammed trigeminal nerve (TG) or the branch(es) might be one of the underlying mechanisms unless vascular compression is a common etiology. The heat effects might be according to the temperature set up varies recently from 60°C to 95°C. METHOD: This observational study enrolled 75 severe NT subjects without satisfactory improvement of treatments, divided into 3 groups: analgesics prescription (Control), RFA 60, and RFA 65 Groups. The LANSS scores and hs-CRP levels were followed-up before (baseline), 2 weeks, 3, and 6 months experienced the treatments. Subjects ages in the range of 48.32 + 12.73 to 50.88 + 14.59 years old, and the duration of illness from 4.48 to 10.32 months. RESULT: The LANSS score >12 before treatments showed significance improvements (p<0.001), as in the Control (64% with neuropathic pain), RFA 60 (100% with neuropathic pain), and RFA 65 group (92% with nociceptive pain) at 2 weeks followed-up. At 3 and 6 months observed 100% subjects with nociceptive pain but without significancies. Even though the hs-CRP levels observed reduced for all groups, especially RFA 60 and RFA 65, but have no significances. CONCLUSION: The LANSS scores changes observed significant improvement in all groups, which mentioned if the neuropathic pain syndromes might be better under each treatment. The Hs-CRP levels improvement is better in the neuro ablation groups than analgesic drugs treatment. Even though the Hs-CRP are following of systemic nonspecific inflammation, NT is a focal inflammation.
Fetal Growth Cut-Off Point To Predict Neonatal Outcome In Pregnancy With Normal And Deficient Vitamin D Levels: Intergrowth-21, World Health Organization Fetal Growth Curve, And Hadlock’s Estimated Fetal Weight Dewantiningrum, Julian; Kristanto, Herman; Pudjonarko, Dwi; Mexitalia, Maria; Ediati, Annastasia; Soejoenoes, Ariawan; Hadisaputro, Suharyo
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.v10i2.877

Abstract

Purpose : Analyze the cut-off point of fetal growth based on the Intergrowth-21, World Health Organization (WHO), and Hadlock’s estimated fetal weight (EFW) in pregnant women with normal or deficient vitamin D levels to predict neonatal outcomes. Method: This cross sectional study to develop a diagnostic test, included 120 of pregnant women who completed follow up until children aged 2 years, divided into normal and deficient vitamin D group. Ultrasound and maternal vitamin D level examined during the second trimester of pregnancy. EFW was calculated using Hadlock’s formula and plotted on the Intergrowth-21 and WHO curves. The reference standards were the neonatal outcome, LBW, stunting, and neurocognitive impairment. Significant odds ratio (OR) value and area under the curve (AUC) of 0.6 are used to determine the cut-off point to be used. Result: Fetal growth curve was based on the WHO at the 5th percentile to predict LBW to have an AUC of 0.6 and OR of 6, 95% confidence interval (CI) of 1.36–26.45. The AUC for predicting LBW based on Intergrowth and Hadlock were 0.45 and OR not significant. As well as the AUC estimated stunting based on Hadlock, the Intergrowth-21 and the WHO fetal growth curves is <0.6 with OR not statistically significant. The AUC predicted neurocognitive impairment based on WHO’s chart was 0.6 but OR not statistically significant. Conclusion: The WHO fetal growth curve can be used to predict LBW. The cut-off point of the fetal growth curve and which percentile is determined by the neonatal outcome.
The Wistar Rat Parietal Lobe Cell And Pain Perception Changes After Frequent Of Mobile Phone Electromagnetic Wave Expose Tamad, Fatiha Sri Utami; Budisulistyo, Trianggoro; Husni, Amin; Retnaningsih, Retnaningsih; Suryawati, Herlina; Suryadi, Suryadi
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.v10i2.884

Abstract

Background: The increasing number of mobile phone users raises concerns about the effects. Mobile phone electromagnetic wave radiation harms pain perception due to granular cell changes in the cerebral parietal cortex. Objective: To determine the effect of exposure to electromagnetic waves mobile phone on pain perception due to changes in the granular cells of the cerebral parietal cortex Wistar rats. Methods: Experimental research using randomized posttest with control group design. Samples were 28 rats divided into 4 groups. The control group was not exposed, the treatment group was exposed to 2100 MHz electromagnetic waves for 2 hours/day with a distance of 3 cm for 15 days in treatment group 1, for 30 days in treatment group 2, and 45 days in treatment group 3. Measurement of pain onset using the hot method. Changes in pain threshold were taken from the difference in pain onset after exposure to before exposure. Granular cell changes in the cerebral parietal cortex were assessed from the total score with the provisions of normal cells (sumx0), hydropic degenerated cells (sumx1), and necrotic cells (sumx2). Results: The longer the exposure to mobile phones, the higher the pain threshold and the cerebral parietal cortex granular cell damage score. There was a significant difference in pain threshold and changes in cerebral parietal cortex granular cells between groups (p=0.000). There was a significant relationship between changes in the parietal cerebral cortex granular cells and pain threshold in Wistar rats exposed to electromagnetic waves (p=0.000). Conclusion: Exposure to mobile phone electromagnetic waves affects pain perception due to changes in the granular cells of the cerebral parietal cortex in wistar rats.
The Relationship Between Serum Folic Acid Levels With The Cognitive Function of The Elderly Hermanto, Hermanto; Muhartomo, Hexanto; Husni, Amin; Widiastuty, Maria Immaculata; Suryawati, Herlina; Wati, Arinta Puspita
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.v10i2.891

Abstract

Background: Cognitive decline is a common condition that occurs in the elderly. One of the early indicators of senility is a decrease in cognitive function. Folic acid is thought to protect the arteries from damage because of homocysteine by converting homocysteine into cysteine and then excreted in the urine. Increased levels of homocysteine can interfere with vascular function and cause toxic effects on neurons thereby increasing the risk of cognitive decline. Objective: To determine the relationship between serum folic acid levels and cognitive function of the elderly. Method: Analytical descriptive research with a cross-sectional approach. The research subjects were the elderly who met the inclusion criteria and did not have exclusion criteria. The research was conducted from May to July 2022 at the Pucang Gading Nursing Home, Semarang. Serum folic acid levels were examined using the ELISA (Enzyme-linked immunosorbent assay) method. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (MoCA) simultaneously on the subject. Cognitive function is normal if the MoCA-INA value is ≥ 26 and it is said to be cognitive dysfunction if the MoCA-INA value is < 26. Data were analyzed using the Spearman test. Results are considered significant if the value of p <0.05.  Result: There is a strong positive correlation between serum folic acid levels and cognitive function in the elderly (r=0.914, p<0.001). There is a relationship between educational level and cognitive function (r=0.922, p<0.001) where higher education correlates with increased cognitive function in the elderly. Conclusion: There is a significant positive correlation between serum folic acid levels and cognitive function in the elderly
Relationship Between Serum Albumin Levels And Pulmonary Edema In Glomerulonephritis Patients Fikria, Nabilla; Partingrum, Dwi Lestari; Kuntjoro, Lydia Purna Widyastuti Setjadiningrat; Meutia , Yurida Binta
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.v10i2.892

Abstract

Background: Glomerulonephritis is an inflammatory disease of the glomerulus that causes changes in permeability, changes in kidney’s structure, and function of the glomerulus. Hypoalbuminemia in glomerulonephritis can decrease oncotic pressure resulting in extravasation of fluid into the interstitium. In severe hypoalbuminemia, extravasation of fluid can result in pulmonary edema. The subjective of this study was to analyze the correlation between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis. Methods: The samples of this study were collected by purposive sampling using secondary data from the medical records of Dr. Kariadi Hospital in Semarang with a total of 46 subjects from January 2016-January 2021. The serum albumin was categorized as normal if serum albumin was >3,5 g/dL, mild hypoalbuminemia if serum albumin was 2.5-3.5 g/dL and severe hypoalbuminemia if serum albumin was <2.5 g/dL. Result: Mann Whitney test showed a significant relationship between between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis (p = 0.016). A higher mean rank was found in patients with pulmonary edema compared to patients without pulmonary edema. Conclusion:There is a significant relationship between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis. Patients with lower serum albumin have a greater tendency to develop pulmonary edema than patients with higher serum albumin.
The Effect of Effleurage along with Moisturizing Application on Skin Elasticity Afrianti Wahyu Widiarti; Dwi Kurniawati
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.v10i2.900

Abstract

Background: A decrease in skin elasticity is a problem often complained of, especially by women. Changes in some of the structure and elasticity of the skin occur with age as a result of reduced production of natural oils and skin collagen. There are several ways to increase skin elasticity, including by stimulating collagen. One of them is by using topical skin care such as using a moisturizer that suits skin type. Aim: This study intends to determine the effect of effleurage in the application of moisturizer on skin elasticity.   Method: The research design was a randomized controlled-trial with two groups pre and posttests conducted on 30 students of the Physiotherapy Department Surakarta randomly selected and divided into two groups. The treatment group applied moisturizer to the skin using the effleurage technique, while the control group applied only moisturizer. The groups were intervened for two weeks. Skin elasticity was measured using the EH-900U skin analysis system. Result: The Pre-Posttests of group one’s skin elasticity with the Paired Samples T-Test yielded a p value = 0.013, which means that there is an effect of effleurage in applying moisturizer on skin elasticity. The Pre-Posttests of group two's skin elasticity with the Wilcoxon Test yielded a p value = 0.551, which means that there is no effect of topical moisturizer on skin elasticity. There were significant differences in the treatment and control groups Conclusion: The application of moisturizer along with effleurage for skin elasticity is more robust than applying only topical moisturizer.
Palliative Care Case Report: A Man with End Stage Lung Cancer with Brain Metastases Yanuar Ardani; Hamzah Shatri; Rudi Putranto; Rendi Faris Anggono
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.v10i2.901

Abstract

INTRODUCTION : Lung cancer accounts for 13% of malignancies in the world and the most common type of cancer suffered by men in Indonesia. The 5-year survival rate for patients with lung cancer is only 18.1%. About 25-30% will develop brain metastases. Overall palliative care is needed including biologically targeted therapy, chemotherapy, stereotactic radiosurgery (SRS), surgery in selected cases, and whole brain radiotherapy treatment (WBRT). Rare studies that take into account surgical palliation in advanced NSCLC. It has been demonstrated that metastaticectomy generally improves survival and, in some patients, even long-term survival. CASE REPORT : A 65-year-old male patient with Non-Small Cell Carcinoma favor Lung Adenocarcinoma and cerebellum metastases. The patient underwent surgery to remove a brain tumor. The patient received 8 radiotherapies and Erlotinib chemotherapy for 4 cycles for 6 months. The dose of Erlotinib 150g/24 hours was used in the first month. The dose was reduced in the 2nd to 6th month to 100g/24 hours. Assessment of palliative care was carried out using the Karnopsky Questionnaire, Fatigue Severity Scale (FSS), and Palliative Performance Scale (PPS). CONCLUSION : . Despite major improvements in the way lung cancer patients are treated in recent years, morbidity and death rates are still high. Palliative care (PC) is an approach to treating patients with life-threatening diseases, one of which is lung cancer

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