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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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Pregnancy Associated Plasma Protein-A (PAPP-A) as a Marker to Distinguish Normotensive with Early 2nd Trimester and Late 3rd Trimester Onset of Preeclampsia Ragam Pesona Simangunsong; Herman Kristanto; Mirza Iskandar; Syarief Thaufik; Besari Adi Pramono; Arufiadi Anityo Mochtar
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.979

Abstract

Introduction: Preeclampsia is a hypertensive condition that occurs after 20 weeks of gestation accompanied by target organ damage. Complications of preeclampsia can cause intrauterine fetal growth retardation, and placental hypoperfusion, even in the most serious situations, namely termination of pregnancy and death of the fetus and/or mother. Pregnancy-associated plasma protein-A (PAPP-A) is a high molecular weight glycoprotein that is produced in the placenta and secreted into the maternal bloodstream. However, based on several studies that have been conducted, there is uncertainty in the results of assessing PAPP-A levels obtained in pregnant women in the second and third trimesters. Aim: Proving differences in PAPP-A levels in the second and third trimesters in the incidence of early-onset preeclampsia and normotensive pregnancy. Methods: An analytic observational study with a cross-sectional approach was carried out in the delivery room of RSUP Dr. Kariadi Semarang, Halmahera Health Center, Ngesrep Health Center, Bulu Health Center, and private midwife practice in Semarang City. The subjects of the study were six 2nd-trimester preeclampsia patients, fourteen 3rd-trimester preeclampsia patients, and twenty normotensive pregnancy patients who met the inclusion and exclusion criteria. Data were analyzed using Mann Whitney with a significance of p<0.05 Results: There was a significant difference in PAPP-A levels (p<0.001) between the preeclampsia and normotensive pregnancy groups, whereas PAPP-A levels were higher in the preeclampsia group. There were significant differences in PAPP-A levels (p<0.001) between the 2nd-trimester preeclampsia, 3rd-trimester preeclampsia, and normotensive pregnancies, where the highest PAPP-A levels were found in the 2nd-trimester preeclampsia group. Conclusion: There was a significant difference in PAPP-A levels between the second and third trimesters of early-onset preeclampsia compared to normotensive pregnancies, where PAPP-A levels were higher in the second and third trimesters of early-onset preeclampsia. Elevated PAPP-A levels in the second and third trimesters are associated with an increased risk of early-onset preeclampsia.
Comparison Between Placenta Accreta Index and Tovbin Score as A Predictor of Placenta Accreta Spectrum Disorders (PASD) Willy Angga Dinata; Alini Hafiz; Arufiadi Anityo Mochtar; Julian Dewantiningrum; Putri Sekar Wiyati; Ratnasari Dwi Cahyanti
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.980

Abstract

Background : The incidence of  Placenta Accreta Spectrum Disorders (PASD) in developed countries has reportedly increased 10-fold in the last 50 years. The significant increase was followed by an increase in the number of caesarean section from 12.5% to 23.5% in the last 10 years. Maternal morbidity related to PASD events reaches 7% in intraoperative and postoperative actions, while the morbidity reaches 60%. In cases of late diagnosis, maternal mortality with placenta accreta reaches 30%. Efforts to prevent maternal morbidity and mortality can be carried out by early detection at antenatal care visits. The Placenta Accreta Index (PAI) and Tovbin scoring systems based on the results of ultrasound examination can be used to screening for placenta accreta. Objective: To analyze the comparison of the accuracy of the PAI and Tovbin scoring systems in predicting the incidence of Placenta Accreta Spectrum Disorder (PASD). Method: The study used an analytic observational with a cross sectional design. Sampling was done by consecutive sampling method. There were 35 subjects who met the inclusion and exclusion criteria. PAI and Tovbin scoring were performed on each selected subject. The accuracy of the PAI and Tovbin scoring systems was confirmed by establishing a diagnosis based on PASD histopathology. Results: The PAI scoring system in predicting PASD has a sensitivity value of 79.31%, a specificity of 83.33%, a positive predictive value (NDP) of 95.83%, a negative predictive value (NDN) of 45.45%, an accuracy of 80.00%. While the Tovbin scoring system obtained a sensitivity value of 86.21%, specificity of 83.33%, NDP of 96.15%, NDN of 55.56%, accuracy of 85.71 %. Conclusion: In the comparison of scoring systems, it was found that the Tovbin scoring system has almost the same sensitivity and accuracy and the same specificity in predicting Placenta Accreta Spectrum Disorder (PASD).
Comparison Of The Effectiveness Of High Intensity Laser Therapy (HILT) And Low-Level Laser Therapy (LLLT) On Improving Balance In Knee Osteoarthritis Kukuh Wibisono; Rudy Handoyo; Erna Setiawati
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.984

Abstract

BACKGROUND : Osteoarthritis (OA) of the knee is a joint disease with a high prevalence among the elderly. OA can cause balance disorders, which are one of the main causes of falls in the elderly. Balance can be measured using several scoring systems, one of which is the Berg Balance Scale (BBS). One of the treatment modalities for OA is laser therapy which is non-invasive and easy to apply. Low level laser therapy (LLLT) has been widely used in patients with knee OA, but recently high intensity laser therapy (HILT) has begun to be used in physical therapy with advantages over a wider range and depth. AIMS :  to compare the effect of LLLT and HILT therapy on improving functional balance in the elderly with knee OA. METHOD : This research is a randomized controlled trial pre-test and post-test-controlled group design. The sampling method used in this study is the simple random sampling method. The sample size was 27 subjects and divided into two groups, the LLLT group (n=14) and the HILT group (n=13). Each subject received laser therapy sessions 2 times a week for 4 weeks. Balance was assessed using the BBS before and after the intervention. RESULT :  There was an increase in BBS scores before and after treatment in the HILT group (p<0.001) and in the LLLT group (p<0.001), with the increase in the HILT group (7.79 ± 2.16) significantly greater than in the LLLT group (3 .08 ± 0.76) (p<0.001). CONCLUSION : HILT improves balance score better than LLLT.
Relationship Between Serum Malondialdehyde (MDA) Levels With Seizure Frequency In Epilepsy Patients With Combination Of Phenytoin And Valproic Acid Aji Noegroho; Aris Catur Bintoro; Dwi Pudjonarko
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.987

Abstract

Background: Oxidative stress is believed to be one of the factors involved in the pathogenesis of epileptogenic where lipid peroxidation occurs which produces Malondialdehyde (MDA). Epilepsy and some Antiepileptic Drugs (AEDs) can improve or worsen seizure frequency thereby significantly changing blood MDA levels.   Objective: To determine the relationship between serum MDA levels and seizure frequency in epileptic patients treated with AEDs, a combination of phenytoin and valproic acid.   Methods: A cross-sectional study with consecutive sampling of 46 subjects (with epilepsy receiving combination therapy with phenytoin and valproic acid. The research was conducted at the Neurology Policlinic at RSUP Dr. Kariadi in December 2022 – February 2023. MDA levels were measured using the Enzyme Linked Immunosorbent Assay (ELISA) method. The relationship between serum MDA levels and seizure frequency was analyzed using Spearman's test since both of the variables are ordinal scale, the results were significant if p<0.05.   Results: There was no relationship between MDA levels and seizure frequency in epileptic patients with the combination of phenytoin and valproic acid. (p=0.516) There is a significant relationship between the frequency of seizures and the length of treatment (p=0.026) with a weak negative correlation (rho=0.328). There is a significant relationship between the frequency of seizures and the age of onset of epilepsy (p=0.037) with a weak negative correlation (rho=0.309). Conclusion: There is a significant relationship between the frequency of seizures with the length of treatment and the age of onset of epilepsy.
Characteristics and Risk Factor of Multidrug-Resistant-Organism Infection in the Pediatric Intensive Care Unit of Dr. Kariadi Hospital Semarang Nahwa Arkhaesi; Moh Supriatna; Yusrina Istanti; Desvita Sari; Safira Rizqi Azzahra
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.989

Abstract

BACKGROUND: The Pediatric Intensive Care Unit (PICU) that treats critical patients with various invasive procedures is a potential place for Multidrug Resistant Organism (MDRO) infections. This spesific unit, especially in tertiary care facilities may have higher prevalence of MDRO than non-PICU settings, causes serious disease and mortality. AIMS: To describe the characteristics and risk factor of MDRO infection in the PICU of dr. Kariadi Hospital Semarang, METHOD: Retrospective study in patients aged 1 month - 18 years with growth of germs on culture results during 2021-2022. Demographic data, use of central venous catheters and ventilator, length of stay, duration of antibiotic usage, and history of major surgery were investigated from medical records. The amount of risk expressed by the Odds Ratio (OR).RESULT: From 544 culture examinations, 199 (36.5%) germs grew, consisting of 79 MDRO isolates (39.7%) and 120 non-MDRO isolates (60.3%). Gram-negative bacteria were found in 140 samples (70.4%) with Klebsiella pneumoniae as the most common germ (15.1%) and respiratory tract infection (56.3%) being the most common infection diagnosis. As many as 24 of 30 (80%) isolates that grew Klebsiella pneumoniae were MDRO. Mechanical ventilator use (OR 2.15; 95% CI 1.07 – 4.3; p=0.043) and length of stay in the PICU (OR 2.44; 95% CI 1.21 – 4.96; p=0.018) are risk factors for MDRO infection.CONCLUSION: Klebsiella pneumoniae is the most common germ found from culture isolates and respiratory tract infection is the most common diagnosis. The use of mechanical ventilators and length of stay in the PICU are risk factors for MDRO infection. 
Correlation Between Brixia Score Imaging and Clinical Laboratory Results In Severe-Critical Covid-19 Patients Receiving Standard Therapy Compared To Tocilizumab Aulia Fitriani; Frederica Mardiana Wahyuni; Bambang Satoto; Thomas Handoyo; Antonius Gunawan Santoso; Christina Hari Nawangsih; Nurdopo Baskoro
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.991

Abstract

Background. Coronavirus infection disease 19 (COVID-19) is a global health issue. Brixia score and inflammatory markers can assess COVID-19 severity. Severe-critical phase becomes the main concern of clinicians in the management of COVID-19 to reduce mortality. Standard therapy for moderate to severe COVID-19 is convalescent plasma which functions as an antiviral and immunomodulator, while tocilizumab is an IL-6 antagonist which underlies the occurrence of cytokine storms in severe-critical COVID-19. Aims. To examine the correlation between the Brixia score and clinical laboratory results in patients with severe-critical degree of Covid-19 who received both standard therapy and tocilizumab Method. A retrospective cohort study of Brixia score, with clinical laboratory results of D-dimer, fibrinogen, ferritin, and CRP (C-reactive protein) COVID-19 patients with severe-critical phase who were administered standard therapy and tocilizumab who were treated at RSUP DR Kariadi Semarang, then a correlation was carried out between the Brixia score and clinical laboratory results using a correlation test Spearman. Results. The research data consisted of 72 subjects divided into groups that were adiminstered tocilizumab therapy (36 subjects) and standard therapy (36 subjects). There was a significant correlation between the Brixia score and the D-dimer result with p = 0.024 (p <0.05), correlation coefficient = 0.377 in the standard pre-therapy and post therapy. A p-value of less than 0.05 indicates no significant correlation between the Brixia score and clinical laboratory results before or after tocilizumab therapy. Conclusion. There is a significant correlation between the Brixia score results and the D-dimer results in COVID-19 patients who are adiministered standard therapy, but not significant correlation in tocilizumab
Significant Relationship Between Brixia Score And The Degree Of Acute Respiratory Distress Syndrome In Covid 19 Patients Irni Dwi Aprianty Ibrahim; Bambang Satoto; Thomas Handoyono; Antonius Gunawan Santoso; Hermina Sukmaningtyas; FARAH HENDARA NINGRUM
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.993

Abstract

BACKGROUND: Chest X-ray has an important role in detecting early features of COVID-19. To improve risk stratification, a scoring system in chest x-ray called Brixia Score was developed. The Brixia score is designed to measure the severity of lung abnormalities in COVID-19, with an 18-point severity scale. Deaths in COVID-19 occur mainly due to Acute Respiratory Distress Syndrome (ARDS). ARDS is classified into mild, moderate, and severe degrees. If the degree can be predicted earlier, patients can receive earlier therapy and death rate can be reduced. AIMS:  to analyze relationship between Brixia Score and degree of ARDS in COVID-19 patients. METHOD: the research used an observational analytic method with a cross-sectional approach to 95 subjects who are positive for COVID-19 and diagnosed with ARDS, in January to December 2021. Brixia Score data was collected based on chest X-ray expertise, ARDS degree was based on medical records and blood gas analysis. Analysis of relationship between Brixia score and degree of ARDS was carried out using the Kruskal-Wallis test. RESULT:  There was a significant difference in Brixia score based on degree of ARDS (p value <0.05). The highest Brixia score was obtained in severe ARDS, while the low Brixia score was obtained in mild ARDS. This proves that there is a relationship between Brixia score and degree of ARDS. CONCLUSION: Brixia score has a significant relationship to the degree of ARDS in COVID-19 patients.
Effect of Sodium Lauryl Sulfate on Orthodontic Elastic Latex’s & Non-Latex’s Tensile Strength Indryasari; Wibowo, Budi; Vidyahayati, Indah Lestari
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.v10i3.996

Abstract

Background : Orthodontic elastic is one of the tools used in orthodontic treatment. Based on the type of material, orthodontic elastics are divided into latex & non-latex. Clinically, orthodontic elastic has decreased tensile strength which can be influenced by various factors including salivary pH and the use of toothpaste. The content of SLS in toothpaste can increase the pH of saliva, causing a decrease in tensile strength. Objective: This study aims to analyze the effect of Sodium Lauryl Sulfate on the elastic tensile strength of latex and non-latex orthodontics. Method : This is an experimental laboratory research with post-test only control group design. The research samples consisted of 15 samples of orthodontics elastics latex and 15 samples of orthodontics elastics non-latex of AO brand with diameter ¼ inches. The samples were divided into 3 groups with latex and non-latex variations in each group, the samples was soaked for 24 hours. Tensile strength was measured using Imada Motorized Tensile Test MV 110 .The statistic used one way Anova test. Result : One way Anova test showed that there was no significant difference between the control group, detergent toothpaste group and non-detergent toothpaste group with p = 0,757 (p > 0,05) for latex and p = 0,382 (p > 0,05) for non-latex. Conclusion : Detergent and non-detergent toothpaste did not affect the tensile strength of orthodontic elastic latex and non-latex.  
Fenomena Lucio pada pasien Morbus Hansen tipe Lepromatosa: Suatu Laporan Kasus Langka Amalia, Irma; Widayati, Agnes Sri; Ametati, Holy; Rahmat Sugianto, Yosep Ferdinand; Windayati, Sri
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.v10i3.998

Abstract

BACKGROUND: Lucio’s phenomenon is a rare leprosy reaction, characterized by severe necrotic cutaneous lesions that generally occur in patients with untreated or inadequately treated lepromatous leprosy (LL). OBJECTIVE: to describe and comprehend the diagnosis and management of Lucio’s phenomenon in leprosy patients CASE: Male, 34 years old with extensive wounds on both arms and legs. About 3 years earlier, the patient felt burning heat in both hands and feet followed by loss of eyebrows and eyelashes, and a change in the shape of the nose. The patient had not received previous therapy. Physical examination showed that the patient appeared anaemic, leonine facies, megalobuli, madarosis, saddle nose, thickening of the ulnar and posterior tibial nerves, deformities of the fingers and toes, and amputations of several fingers. The dermatological status showed multiple ulcers of irregular shape and varying sizes with pus and necrotic tissue. Reitz serum test revealed a bacterial index of +3 with a morphological index of 90%, and routine blood showed hypochromic microcytic anaemia and leucocytosis. The patient received corticosteroid therapy, anti-leprosy combination therapy, antibiotics, iron tablets and wound care. DISCUSSION: Lucio’s phenomenon consists of skin lesions that range from painful red-black patches to flaky blisters and ulcerations. These lesions usually occur on the lower extremities, and may extend proximally and distally. The lesions improved after administration of corticosteroids and anti-leprosy. Delayed diagnosis leads to significant disability and community transmission of the disease. The later the diagnosis, the more serious the disease becomes and can lead to death due to sepsis. Early diagnosis and appropriate treatment are important. CONCLUSION: Early detection is crucial in order to deliver therapy earlier and prevent disease worsening.
Concomitant Colon Adenocarcinoma And Tuberculous Lymphadenitis Arya Abisatya, Albertus Magnus; Prameswari, Ajeng Andini; Fauzi, Agung Rahmat; Febrianto, Aji Pratama; Nugroho, Alexander Steven; Andisari, Hendrata Erry; Harijono, Pandu; Yudadi, Redemptus
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.v10i3.1007

Abstract

BACKGROUND : Colon involvement in tuberculosis infection is a rare event. The coexistence of colon carcinoma and tuberculous lesions of the colon is less frequently reported. Carcinoma and tuberculosis of the colon can occur at the same site or at different sites. The occurrence of two pathologies at the same site is much less common. CASE PRESENTATION : A 52 year old woman complained of difficulty defecating, an enlarged stomach, pain and decreased appetite and weight loss within one month. On clinical examination, the abdomen appeared convex, slightly distended, and tenderness in the left lower iliac quadrant. Radiological examination supported the diagnose of partial obstructive ileus. The patient was diagnosed with adenocarcinoma of the ascending colon until the hepatic flexura was confirmed through surgery and histopathological examination. On histopathological examination, adenocarcinoma of the colon was found to coexistence with tuberculous lymphadenitis of the colon. CONCLUSION : The etiological and pathophysiological relationship between tuberculous lymphadenitis and colon cancer is still under debate, but surgeons need to be aware of this occurrence, to choose treatment and avoid post-operative worsening.

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