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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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Cytokine Storm score (CSs) in COVID-19 Patients Smokers at Dr. Saiful Anwar Malang Resti Fitriani Yuliawati; Tri Wahju Astuti; Yani Jane Sugiri
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.v10i2.902

Abstract

Background: After 3 years of the COVID-19 pandemic, its escalation is still causing a critical global health problem. Cytokine storm is a severe complication of COVID-19, and smoking is a risk factor for death. The prevalence of smoking in Indonesia is very high, but there is still little research on the effect of smoking on the occurrence of cytokine storms. The Cytokines Storm Score (CSs) is a quick and simple method for detecting cytokine storms early by utilizing D-dimer, lactate dehydrogenase (LDH), ferritin, and C-reactive protein (CRP) parameters. Objective: To evaluate CSs in COVID-19 patients smokers Methods: Retrospective analysis of 120 confirmed COVID-19 patients in November 2020–2021, divided into 2 groups (60 smokers and nonsmokers), male, without comorbidities. analysis using Chi-square and Mann-Whitney. Prior to the CSs examination, lymphopenia is required. CSs were positive if at least two of the D-dimer, LDH, or ferritin levels were elevated. The CRP level is measured if there is an increase in only one of these values. Elevated CRP, lymphopenia, and impaired D-Dimer, LDH, or ferritin will result in positive CSs. Results: CSs were significantly higher in smokers than non-smokers (54.5% vs. 45.5%, p = 0.024). D-dimer and CRP levels were significantly higher in smokers than non-smokers (1620 ng/mL vs. 1002.5 ng/mL, p = 0.001; and 13.8 mg/dL vs. 7.75 mg/dL, p = 0.001). Lower LDH and higher ferritin levels were not significant in smokers compared to nonsmokers (405.5 IU/L vs. 418 IU/L, p = 0.160; and 886.65 ng/mL vs. 790.5 ng/mL, p = 0.203). Conclusion: Cytokines Storm scores (CSs) increased significantly in COVID-19 patients who smoked, D-dimer and CRP levels were significantly higher in smoking COVID-19 patients compared to non-smokers
Nephrotoxicity and Kidney Fibrosis Due to Gentamicin in Wistar Rats Lusiana, Evi; Saleh, Irsan; Sinaga, Ernawati; Hafy, Zen
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.v10i2.909

Abstract

Background : Gentamicin is an aminoglycoside used as a treatment for various infections. One of the side effects reported on the use of gentamicin is nephrotoxic. However, there are still many uses of gentamicin that have not been precisely indicated. Objective : To analyze the nephrotoxic effects leading to renal fibrosis due to gentamicin induction in Wistar rats. Methods : This research is an in vivo experimental study, pre- and post-test control group design, conducted in September and October 2022 at the Animal House Laboratory of the Faculty of Medicine, Sriwijaya University, and the Palembang Health Laboratory Center. There were 4 treatment groups: Group I, placebo; Group II, gentamicin-induced (GIG I) at 80 mg/kgBW; Group III, gentamicin-induced (GIG II) at 120 mg/kgBW; and Group IV, gentamicin-induced (GIG III) at 240 mg/kgBW. Gentamicin was administered intraperitoneally for 7 days, to 8 Wistar rats per group. Blood was taken from all Wistar rats in each group on days 0, 3, 7, and 14. The results of the study were tested for normality with the Shapiro-Wilk test and homogeneity with the Levene's test. The ANOVA test and the Post-Hoc test were used to conduct the analysis. Results :  Induction of gentamicin in the GIG I and GIG II groups was significant in increasing the mean creatinine and urea levels on day 0 and day 14 of treatment (p<0.05). In the GIG III group there was a 50% mortality in experimental animals showing a Lethal dose of 50 (LD50) at that dose. Conclusion : GIG I and GIG II have significant nephrotoxic effects in increasing creatinine and urea levels which lead to renal fibrosi.
Comparison of ROX Index and Surfactant Protein-D with HFNC Outcome in COVID-19 Patients Rozi, Achmad Syamsufandi; Parsama Putra , Ngakan Putu; Setyawan, Ungky Agus; Listyoko, Aditya 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.v10i2.924

Abstract

Background: In COVID-19, severe clinical deterioration can lead to respiratory distress. High Flow Nasal Cannula (HFNC) is an oxygenation treatment recommended in severe COVID-19 patients, with various studies showing decreased recovery time and intensive care needed. However, instruments to predict HNFC outcomes, specifically in COVID-19, are not yet widely studied. ROX index is a practical instrument proven effective in predicting HFNC outcome in pneumonia while showing high variabilities of optimum time of assessments and cut-off values in COVID-19. Surfactant Protein-D (SP-D) is an alveolar protein showing potential as a biomarker in acute lung injury and respiratory distress. In this study, we analyzed ROX index and SP-D potential as HFNC outcome predictors in COVID-19 patients. Methods: This prospective study recruited severe and critical COVID-19 patients treated with HFNC. Patient characteristics, laboratory values including initial serum SP-D values, and ROX index were recorded. Significant differences were analyzed using Chi-Square and Mann-Whitney tests. Receiver operating characteristic (ROC) analysis was used to determine HFNC outcome predictive abilities of ROX index and serum SP-D. Result: 31 subjects with successful HFNC outcomes in 19 subjects and failed HFNC outcomes in 12 subjects were included in this study. ROX index and SP-D value were significantly higher in subjects with successful HFNC compared to failed HFNC (p < 0.05). ROX index at 6, 12, and 24 hours showed good HFNC outcome predictive ability (AUC > 0.7, p < 0.05). Conclusion: Successful HFNC outcome in COVID-19 was significantly related to higher ROX index and serum SP-D values. ROX index also showed good potential as an HFNC outcome predictor in COVID-19 patients.
CT Scan Imaging in Tuberculosis and Lung Cancer: A Case Report in Lung Hospital Lestari, Lilik; Sultansyah, Muhammad Harris Sis
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.v10i2.938

Abstract

Background: Tuberculosis is a contagious infectious disease that attacks various organs, especially the lungs. Chest CT scan modalities have a role in helping the diagnosis of tuberculosis and lung cancer. This case report presents a rare case of two women diagnosed with tuberculosis and lung cancer. Cases Presentation: Two women aged 43 and 42 years came to the radiology department with a history of chest pain, loss of appetite, and cough, and underwent tuberculosis therapy by taking medication for two months. The patient underwent chest x photo thorax, abdominal ultrasound, thoracic CT scan, and a biopsy was performed with CT scan guiding. Discussion:  The findings of this case are consistent with previous studies which explained that radiological CT scans found tuberculosis with lung cancer. In the lung window, CT scan chest contrast found cystic bronchiectasis. Other results showed an encapsulated pleural effusion in the right hemithorax, compression atelectasis, and multiple lymphadenopathies. Conclusion: CT scan imaging simultaneously can show the occurrence of tuberculosis and lung cancer. Lung cancer that worsens can cause adenocarcinoma with metastasis spreading to other organs.
Relationship Of Serum Hemoglobin And Vitamin D Levels With Posutral Balance Ngestiningsih, Dwi; Wicaksono, Maulana Akbar; Wicaksono, Muhammad Agung Wibowo; Probosuseno, Probosuseno; Supatmo, Yuswo; Rachmawati, Banundari
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.v10i2.948

Abstract

Background: The population of the elderly in Indonesia has increased significantly in recent years. The incidence of falls is influenced by postural balance. Vitamin D and hemoglobin deficiency are associated with decreased muscle function and postural balance. This study is to investigate the relationship between vitamin D and hemoglobin levels with postural balance in the elderly. Methods: The study used a cross-sectional design with the participation of 33 patients (aged 64.94±5.42 years). The study sample was elderly individuals who fulfilled the inclusion criteria at Semarang Elderly Posyandu. Patients performed postural balance test, with Sharpened romberg and tandem gait test. The examination of vitamin D and hemoglobin was taken from the patient's venous blood. Vitamin D was measured using ELISA. Results: The results of the independent sample t-test analytic test revealed a P value of vitamin D (0.007) and a P value of hemoglobin of (0.021) (p<0.05). There is a meaningful relationship between vitamin D and hemoglobin levels with postural balance in the elderly.. Conclusion: Decreasing Haemoglobine and Vitamin D impair the postural balance.
A 71-year Old Male Patient with 20 Hour Onset of Infarct Stroke that was Performed with Intra-Arterial Thrombolysis, Mechanical Thrombectomy, Balloon Angioplasty, and Carotid Stenting: A Case Report Kurnianto, Aditya; Andhitara, Yovita; Yudistira; Setiadi, Jeffri; Budiman, Jethro
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.v10i2.961

Abstract

Introduction: For above 2 decades, the definitive management for acute ischemic stroke is intravenous or intra-arterial thrombolysis (IAT), using recombinant tissue-type plasminogen activator. Recently mechanical thrombectomy (MT) was developed to overcome the problem that intravenous thrombolysis is only effective in removing large artery occlusions in the range of 10-30%. Early treatment with intra-arterial thrombolysis, permanent stent insertion and clot extraction devices evolved into the stent-retriever device used in most of the important trials and, recently, emerged aspiration tool. This case report presented 71-year-old male patient with infarct stroke who performed with MT. Case presentation: This case report presented 71-year-old male patient with the main complaint of right limbs weakness. A non-contrast head CT scan found infarction in the cortical-subcortical left parietal lobe, posterior pericornu of the right lateral ventricle and right temporal cornu periventricular; lacunar infarction in the right and left paramedian pons; old lacunar infarction in the left and right centrum semiovale, left corona radiata, right internal capsule, right parietal lobe white matter, left lentiform nucleus, left posterior crus of the internal capsule-thalamus, right thalamus, right lateral ventricular pericornu and left paramedian pons. The patient underwent cerebral digital substraction angiography (DSA), as well as IAT, MT, balloon angioplasty, and carotid stenting with good clinical outcome. Conclusion: With the overwhelming positive results of studies evaluating the safety, efficiency, and efficacy of mechanical thrombectomy; the standard of care for the treatment of patients with anterior circulation vessel occlusion is becoming clear.
Full Text Volume 10 Number 2 July 2023 Hospital , Kariadi General
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.v10i2.1010

Abstract

Full Text Volume 10 Number 2 July 2023
Case Series Report: Subarachnoid Hemorrhage and ICU Management Retnaningsih; Tugasworo, Dodik; Andhitara, Yovita; Ardhini, Rahmi; Kurnianto, Aditya; Daynuri; Harianto, Erlangga Pradipta
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.745

Abstract

Background: Subarachnoid hemorrhage is a neurological syndrome with complex systemic complications. Rupture of an intracranial aneurysm causes acute extravasation of arterial blood under high pressure into the subarachnoid space and often into the brain parenchyma and ventricles. Bleeding triggers a complex series of events, which can ultimately lead to early brain injury, delayed cerebral ischemia, and systemic complications. Cases: There were six cases of subarachnoid hemorrhage. Some patients come clinically with severe headache and loss of consciousness. The patient has been treated quickly and aggressively and even put on a ventilator for complications of respiratory failure, support for shock and management of aneurysm clipping and EVD. Rapid and precise diagnosis in the management of patients with SAH is of paramount importance, within the first few hours after the onset of SAH. The risk for early neurologic damage and high rates of severe long-term complications necessitated aggressive early management. Conclusion: Rapid diagnosis and attentive management of patients with SAH are essential, as early deterioration is possible within the first few hours after the onset of SAH. The risk for early neurologic damage and high rates of severe long-term complications necessitated aggressive early management. Prevention and Management of Complications. The most common complications were pneumonia, aspiration, respiratory failure/distress, sepsis and imbalance electrolyte (hyponatremia). Approximately 50% of deaths after SAH are due to medical complications.
Effectiveness of Sucralphate and Platelet-Rich Plasma Combinations For Vascular Endothelial Growth Factor (VEGF) Expression In Diabetic Ulcer Healing Syaropi Simanjuntak, Victor Jeremia; Yuniati, Renni; Prajoko, Yan Wisnu; Hario Seno, Heri Nugroho; Kristina, Tri Nur
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.862

Abstract

Background: Diabetic ulcer is one of the most feared chronic infections due to Diabetes Mellitus because it can lead to amputation and death. Aim: To prove the effectiveness of sucralfate and platelet-rich plasma (PRP) combination for Vascular Endothelial Growth Factor (VEGF) expression in diabetic ulcer healing. Methods: This research is an experimental study of Phase I Clinical Trial with post-test only group design. There were 20 patients with diabetic ulcers divided into two groups, namely the treated group that was given sucralfate and PRP therapy and the control group was given standard therapy of normal saline drainage and gauze covered. Parameters were VEGF expression levels, wound area after being given therapy, and side effect from the treatment. Data on VEGF expression levels were obtained by means of examination with the Quantikine Human VEGF-ELISA Quantikine, R&D System, Inc, Minneapolis. The measurement of the wound area was assessed based on several criteria, namely grade 0 (no change), grade 1 (wound size reduced to less than of the previous wound), grade 2 (wound size was reduced to less than of the previous wound, but granulation was visible), and grade 3 (wound has closed completely). Result: In unpaired t-test, the mean VEGF expression was 98.18+10.96 in the treatment group and 66.69+23.79 in the control group which showed significant difference in VEGF expression levels (p = 0.003). In Mann-Whitney test, the mean wound area was 0.68+0.40 in the treatment group and 0.77+0.67 in the control group which showed that there was not any significant difference in wound area (p = 0.152). There were no side effects in both study group. Conclusions: The combination of sucralfate and PRP can increase VEGF levels significantly in diabetic ulcer patients but does not show a different effect in reducing wound area compared to standard treatment. The combination did not cause any side effects in the study subjects, as well as those using standard treatment.
Body Composition and Its Related with Hypertension in Elderly in Surakarta Sudaryanto, Wahyu Tri; Wahyuni, Wahyuni; Herawati, Isnaini; Ayuningrum, Ika Yuli; Murti, Bhisma; Setiawan, Rizki; Putri, Nuristiqomah Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.873

Abstract

BACKGROUND: Several studies reported that obesity was linked to abnormal blood pressure. Obesity increases cardiovascular disease risk in adults and elderly. Body composition has been commonly measured using basic anthropometry, i.e body mass index (BMI). However, waist circumference (WC) is assumed to be more capable of capturing long-term visceral fat accumulation than BMI. Studies comparing BMI and WC to the risk of hypertension in the elderly are needed. OBJECTIVE: The aim of this study was to compare the risk of body composition using body mass index and waist circumference as risk factors for hypertension in the elderly. METHOD: A cross-sectional study was carried out in Surakarta, Central Java. A sample of 91 elderly was selected by convenience sampling. The dependent variable was hypertension. The independent variables included age, gender, body mass index (BMI), and central obesity (assessed by waist circum­ference). BMI and central obesity were used to measure body compo­sition. Blood pressure was measured by a sphygmomano­meter, body weight was measured by digital scale (kg), and body height was measured by stature meter (cm). Central obesity was categorized by waist circumference (WC in centimeter) measurement. The other variables were obtained from questionnaire. Comparison of body composition on hyper­tension were examined using simple logistic regression run on Stata 13. RESULTS: Elderly with central obesity (waist circumference ≥94 cm for males or ≥80 cm for females) had higher risk hypertension and it was statistically significant (OR= 3.07; 95% CI= 1.10 to 8.53; p= 0.032). CONCLUSION: Central obesity is significantly increase the risk hypertension in elderly.

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