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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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Analysis of Category I Cesarean Section Response Time on Maternal-Neonatal Outcomes at Adam Malik Hospital Medan Mohammad Naufal; Sarma Nursani Lumbanraja; Iman Helmi Effendi; Edwin Martin Asroel; Hanudse Hartono; Sarah Dina
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1217

Abstract

BACKGROUND: Maternal and neonatal mortality remain significant global health concerns. Category I cesarean sections are performed in life-threatening obstetric emergencies, with a recommended decision-to-incision interval (DII) of ≤30 minutes. AIMS: To evaluate the proportion of category I emergency cesarean sections performed < 30-minute response time at Adam Malik Hospital, Medan, and to identify factors contributing to delays. METHODS: This retrospective cohort study included 44 consecutively selected cases of category I emergency cesarean sections performed at Adam Malik Hospital, Medan, between January 1 and December 31, 2023. Eligible cases involved immediate threats to maternal or fetal life and had complete documentation of surgical timings. Time data including decision-to-incision interval and its components were extracted from electronic medical records and cross-validated with operating room and delivery ward logs. The primary outcome was decision-to-incision interval (DII), dichotomized at 30 minutes. Variables associated with DII (p <0.25) were included in multivariate analysis using Firth’s penalized logistic regression to account for small sample size and data separation. RESULTS: Only 43.2% of cases achieved a DII of ≤30 minutes. Multivariable analysis identified patient transfer time (AOR = 16.91, 95% CI: 2.19–358.36) and anesthesia duration (AOR = 27.21, 95% CI: 2.29–889.18) as significant predictors of delay. No significant associations were found between DII and adverse maternal or neonatal outcomes. CONCLUSION: Delays in patient transfer and anesthesia were the main contributors to prolonged DII in emergency cesarean sections. While these delays did not significantly impact short-term clinical outcomes, targeted improvements in emergency obstetric workflows may help hospitals meet national response time standards and enhance quality of care.
Serum Protein D Surfactant Level Based on Length of Exposure in Workers at the Supit Urang Waste Disposal Site, Malang Zata Dini; Tri Wahju Astuti; Rezki Tantular
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 1 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i1.1218

Abstract

BACKGROUND: Waste collectors are at risk of developing lung disease due to exposure to bioaerosols from organic and inorganic materials. The function of surfactant protein D (SP-D) is as innate immunity that protects the lungs.  Exposure to bioaerosols in landfills causes inflammatory reactions which can increase the permeability of the blood-lung barrier. As a result, SP-D will leak into the plasma. AIMS: This study aims to analyze serum SP-D levels in relation to length of exposure in waste collectors. METHOD: This analytical, cross-sectional study was done in a Supit Urang waste disposal site, Malang, Indonesia. Samples for serum SP-D analysis were taken from peripheral blood samples and analyzed with ELISA technique. RESULT: There were 68 subjects, consisting of 24 subjects with exposure duration of 5 years, 14 subjects of 5-10 years, and 30 subjects with exposure of 10 years. The number of smokers and non-smokers were 36 and 32 subjects respectively. Significant differences in SP-D serum levels were found between different exposure durations, particularly with exposure of more than 5years. A significant positive correlation was obtained between serum SP-D levels and exposure duration (r = 0,585; p = 0,000). Meanwhile, there was no significant difference in serum Sp-D levels based on smoking status (p=0.112). CONCLUSION: Length of exposure significantly affected SP-D serum levels in waste workers, especially with exposure of more than 5 years.
Hubungan Antara Asupan Vitamin A dan Seng dengan Penanda Inflamasi pada Pasien Tuberkulosis Paru di Rumah Sakit Umum Pusat Persahabatan Surya Mitrasari; Fariz Nurwidya; Yohannessa Wulandari; Heidy Agustin
Medica Hospitalia : Journal of Clinical Medicine Vol. 13 No. 1 (2026): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v13i1.1222

Abstract

BACKGROUND: Indonesia has the second highest burden of tuberculosis (TB) worldwide, with an incidence of 354 per 100,000 population and approximately 969,000 cases reported in 2021. Micronutrients such as vitamin A and zinc play important roles in immune function and may influence inflammatory responses in TB. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are potential markers of systemic inflammation; however, evidence regarding their association with dietary micronutrient intake in pulmonary TB patients remains limited, particularly in Indonesia. AIMS: To examine the association between vitamin A and zinc intake and inflammatory markers in pulmonary TB patients. METHODS: A cross-sectional study was conducted among 133 pulmonary TB patients recruited consecutively from March to April 2024 at Persahabatan Hospital. Vitamin A and zinc intake were assessed using a semi-quantitative food frequency questionnaire (SQ-FFQ), while NLR and PLR values were obtained from medical records. Data normality was tested using the Kolmogorov–Smirnov test, and correlations were analyzed using Spearman’s test. The median vitamin A intake was 105.47 RE/day and zinc intake was 7.38 mg/day, with median NLR and PLR of 2.91 and 202.08, respectively. RESULTS: No significant correlations were found between vitamin A or zinc intake and NLR or PLR (p > 0.05). CONCLUSION: In conclusion, vitamin A and zinc intake were not associated with inflammatory markers in pulmonary TB patients, although host-related factors may contribute to the inflammatory response.
The Association between Monocyte-derived Macrophages TNF-a Expression and Anthropometrics Measures in Polycystic Ovary Syndrome Naylah Muna; Oki Riayati; Heri Wibowo; Andon Hestiantoro
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1224

Abstract

BACKGROUND: Polycystic ovary syndrome (PCOS) is a female infertility disease that is often associated with low-grade chronic inflammation. This inflammation was suspected to correlate with certain body conditions, especially physical lipid composition that can be obtained under anthropometrics measurements. Monocytes and macrophages of PCOS patients were more susceptible to inflammation and contributed to this condition. Tumor Necrosis Factor-alpha (TNF-a), as one of the major inflammatory cytokines, holds an important role in the chronic inflammation of PCOS. AIMS:  This study aimed to evaluate the association of inflammatory cellular levels TNF-a in macrophage cells of women diagnosed with PCOS with physical anthropometrics. METHOD: Twenty PCOS women and ten healthy women as the control group were recruited in this study. Anthropometric data were measured. Peripheral blood was collected, mononuclear cells were isolated, and then cultured. Monocytes were selected and differentiated into macrophages. Macrophages were then exposed to oxidized Low-Density Lipoprotein (ox-LDL) and underwent flow cytometry to examine the level of TNF-a. Anthropometric data and TNF-a level were analyzed using Spearman-Rho Correlation test followed by a linear regression test. RESULT: TNF-a expression was found to be statistically correlated with Body Mass Index (BMI), waist circumference (WC), waist-to-height ratio, visceral fat level, and muscle mass of arm (MMA) (p<0.05). However, only WC and MMA gave significant impact to macrophage TNF-a expression based on linear regression association test with equation -96.971 + 0.601*waist circumference + 2.665*MMA. CONCLUSION: TNF-a was strongly associated with waist circumference and muscle mass percentage of arm in PCOS cases.
In Vitro Testing of the Antibacterial Activity of Ethanol Extract of Lontar Leaves (Borassus flabellifer) Against Staphylococcus aureus Ami Febriza Achmad; Asdar Tajuddin; Rifqah Amaliah; Rolly Riksanto Bahtiar
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 3 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i3.1228

Abstract

BACKGROUND: Staphylococcus aureus is a bacterium that frequently causes infections and often develops resistance to antibiotics. Efforts to identify alternative treatments using herbal remedies are increasing. In Indonesia, a country rich in biodiversity, lontar leaves (Borassus flabellifer) have been traditionally used and show potential antibacterial activity. AIMS: To evaluate the antibacterial activity of ethanol extract of lontar leaves against Staphylococcus aureus in vitro. METHOD: This experimental study employed a post-test-only control group design. Antibacterial activity was tested using the well diffusion method. Extracts were obtained through maceration with 96% ethanol and tested at 75%, 50%, and 25% concentrations. Ciprofloxacin was used as the positive control, and 10% DMSO as the negative control. RESULTS: The inhibition zone diameters were 21.86 mm (75%), 19.64 mm (50%), and 18.37 mm (25%). The positive control (ciprofloxacin) measured 24.43 mm, while the negative control (DMSO) showed 0 mm. CONCLUSION: The 96% ethanol extract of lontar leaves demonstrated antibacterial activity against Staphylococcus aureus, with higher concentrations yielding stronger inhibition.
The Effect of Smoking Habits on Decreased Liver Function in Active Smokers Aged 20-50 Years old Mike Permata Sari; Afifa Radhina; Privia Muliamarshanti
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1229

Abstract

BACKGROUND: A study was conducted to determine the effect of smoking habits on decreased liver function in active smokers aged 20-50 years. This study was motivated by Indonesia’s high smoking prevalence and its associated liver-related health issues. The liver is an organ that plays a role in the body's metabolism. Smoking triggers the formation of free radicals, causing a decrease in liver function and inflammation. METHOD: In this study, mix method design was used with active smokers as the smoker group and the control group was respondents not active or passive smokers. Groups are categorized again based on age, ie 20-30, 31-40, and 41-50. The study population is the academic community of the Hermina Health Institute Jatinegara Campus and the community living on Kapitan III Road Tapos District, Depok City. Liver function is evaluated through enzymes SGPT, SGOT, ALP, and CRP as parameters for inflammation. To evaluate the influence of smoking habits and lifestyle factors on liver function risk, an analysis of variance (ANOVA) followed by post-hoc testing and linear regression analysis were performed. RESULT: Laboratory results showed that mean levels of ALT, AST, ALP, and CRP were higher in the smoker group compared to controls across all age categories, although most values remained within normal limits. ANOVA revealed statistically significant differences in all biomarkers (p<0.05), and post-hoc tests identified specific age-related group differences. Smokers’ habit data indicated that most smokers began smoking between the ages of 15–20 and had smoked for over five years. Lifestyle analysis showed a higher prevalence of insufficient physical activity, reduced sleep duration, and higher BMI among smokers. CLDQ scores for both groups generally reported minimal emotional disturbance and no signs of advanced liver disease. CONCLUSION: Smoking is associated with elevated liver enzymes (ALT, AST, ALP) and CRP levels, indicating subclinical hepatic and inflammatory alterations. These biochemical changes correlate with lifestyle risk factors and diminished quality of life. Early screening and lifestyle modification are recommended to prevent long-term hepatic damage among smokers.
The Association between Atopy, and Family History of Asthma Patient and Severity Asthma based on Spirometry Susanthy Djajalaksana; Aditya Sri Listyoko; M. Yusuf Musthafa; Didik Purbandiyono; Adrian Yusdianto; Adlan Pratama Binharyanto; Cindy Carrissa Primaputri; Ilham Revan Ananda; Marsha Nurandhini; Muli Yaman; Reza Aditya Mahendra; Zata Dini
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1231

Abstract

BACKGROUND: Asthma is a chronic inflammatory respiratory condition characterized by fluctuating symptoms, which often leads to diagnostic challenges. Accurate assessment and interpretation of clinical and functional parameters are essential to improve disease management and patient outcomes. AIMS: This study aims to analyze the demographic and clinical profiles of asthma patients, particularly investigating the relationships among the degree of airway obstruction, spirometric indices, smoking exposure, environmental risk factors, atopic history, and family history, to better understand the multifactorial nature of asthma. METHOD: A retrospective descriptive-analytic study was conducted using medical records of 107 asthma patients treated at the Outpatient Installation of the Lung Polyclinic, Wlingi General Hospital, Blitar Regency, from 2021 to 2022. Descriptive statistics were used to summarize demographic and clinical data, and Spearman correlation tests assessed associations between variables. RESULTS: A high proportion of patients had a history of smoking, with 22.4% being active and 52.3% passive smokers. However, no significant correlation was found between smoking status and asthma control. Common environmental risk factors included exposure to dust and cold air, though these did not consistently correlate with asthma exacerbations. Significant correlations were identified between the severity of airway obstruction and spirometric parameters such as FEV1, FVC, FEV1/FVC ratio, PEF, FEF 25, FEF 50, and FEF 75, confirming the impact of airflow limitation on lung function. No significant associations were found between asthma stability and atopic or family history. CONCLUSION: The findings underscore the complexity of asthma pathophysiology, where airflow obstruction is clearly linked to reduced spirometric function, but other factors such as smoking, environmental exposures, atopy, and family history do not show consistent predictive value for asthma control. These results highlight the need for a comprehensive and individualized approach in asthma diagnosis and management.
Correlation Between Bacterial Count and Duration of Tracheostomy Tubes Use Angga Kusuma; Bambang Hariwiyanto; Dian Paramita Wulandari; Andrew Johan
Medica Hospitalia : Journal of Clinical Medicine Vol. 13 No. 1 (2026): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v13i1.1232

Abstract

BACKGROUND: Tracheostomy tubes (TTs) are life-sustaining medical devices widely used for patients with upper airway obstruction or requiring prolonged mechanical ventilation. However, TTs serve as an indwelling substrate that promotes bacterial colonization and biofilm formation, particularly by resistant pathogens such as Pseudomonas aeruginosa and Staphylococcus aureus. Despite the well-recognized clinical risks, evidence correlating the duration of TT use with quantitative bacterial load in the Indonesian hospital setting remains limited, creating a gap in local clinical guidance for tube replacement scheduling. AIM: To analyze the correlation between TT duration of use and bacterial colony count (CFU/mL), and to identify the predominant colonizing pathogens in order to inform evidence-based infection prevention and tube replacement timing. METHOD: This cross-sectional observational study was conducted from July 2020 to January 2021 at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. A total of 20 polyvinyl chloride (PVC) Portex™ tracheostomy tubes were collected via consecutive sampling from patients undergoing decannulation procedures. Bacterial cultures were performed at the Department of Microbiology, Universitas Gadjah Mada, with bacterial load expressed as colony-forming units per milliliter (CFU/mL). Spearman’s rank correlation was used for statistical analysis. RESULTS: Mean bacterial counts (CFU × 10³/mL) were 48.5, 9,853.83, and 28,200.00 for TT use durations of <30 days, 30–90 days, and >90 days, respectively. Spearman’s rank correlation demonstrated a strong positive association between duration and bacterial count (r = 0.70, p = 0.01). Pseudomonas aeruginosa was the most prevalent organism, identified in 60% of tubes. CONCLUSION: Duration of TT use exceeding 30 days is significantly correlated with higher bacterial colonization burden. Pseudomonas aeruginosa was the predominant pathogen. These findings support the recommendation for scheduled TT replacement within 30 days as an infection control measure in tracheostomized patients.
Optimization Axial T2WI Lumbar MRI in Spinal Stenosis: Effects of GRAPPA Acceleration Factor on Image Quality and Anatomy Diah Nisaa Harumsari; Dwi Rochmayanti; Nanang Sulaksono
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 2 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i2.1235

Abstract

BACKGROUND: Patients with lumbar spinal stenosis (LSS) who struggle to lie down for long periods may encounter issues during lumbar MRI exams. GRAPPA, a parallel imaging method to speed up MRI scans, can reduce the Signal to Noise Ratio (SNR), affecting image quality and anatomical information. AIMS: This study aims to find the best GRAPPA acceleration factor by assessing its effect on image quality and anatomical information. METHOD: This study involved scans on 10 Lumbar MRI patients with LSS cases. The scans were performed using a Siemens Magnetom Aera 1.5 Tesla MRI machine with T2WI TSE axial cut. Each patient underwent 4 treatments with acceleration factors of 1 (without GRAPPA acceleration factor), 2, 3, and 4. Image quality was analysed using ROI to obtain SNR and CNR values. The radiologist assessed the anatomical information on the images. The analysis included a one-way ANOVA and the Kruskal-Wallis test was performed for image quality and anatomical information. RESULT: The research found that the GRAPPA acceleration factor significantly affects image quality and anatomical information in axial T2WI TSE Lumbar MRI scans for patients with LSS (p-value < 0.01). A factor of 3 reduces examination time by 65.35% without significant differences (p > 0.05) in image quality and anatomical information. CONCLUSION: The acceleration factor in axial T2WI TSE lumbar MRI significantly affects image quality and anatomical information for lumbar spinal stenosis cases. An acceleration factor of 3 is optimal for maintaining quality and anatomical information.
Validity of Leukocyte Esterase Dipstick Test Compared to Gold Standard Urine Culture in Hospitalized Children Suspected of Urinary Tract Infections Alya Rahmatika Sabtyastuti; Raja Iqbal Mulya Harahap; Rini Rossanti; Ahmedz Widiasta; Arif Tri Prasetyo
Medica Hospitalia : Journal of Clinical Medicine Vol. 12 No. 3 (2025): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v12i3.1236

Abstract

BACKGROUND : Urinary tract infection (UTI) is an illness that affects specifically the bladder and other structures in the urinary tract. The leukocyte esterase dipstick examination is recognized for its high sensitivity but limited specificity. Additional diseases, like glomerulonephritis, can yield positive outcomes in this test. This research was conducted to determine the validity of leukocyte esterase examination in urine culture in children suspected of urinary tract infection. AIMS :  To assess the accuracy of leukocyte esterase testing on urine culture in children suspected of having a . METHOD : This study employed a diagnostic test method with a cross-sectional design. Research data were obtained from medical record of pediatric patients admitted to RSUP dr. Hasan Sadikin from 2022 to 2023 with suspected urinary tract infection. RESULT :  The values for the diagnostic test results are follows true positive 80%, false positive 51%, true negative 25%, and false negative 40% respectively. The calculations reveal that the leukocyte esterase dip stick has a sensitivity of 67%, specificity of 33%, positive predictive value (PPV) of 61%, negative predictive value (NPV) of 38%, a positive likelihood ratio of 1.56, and a negative likelihood ratio of 0.625. CONCLUSION : This study indicates that the leukocyte esterase dipstick examination has a sensitivity rate of 67%, specificity rate of 33%, PPV of 61%, and NPV value of 38%. The leukocyte esterase dipstick has a high sensitivity level and a low specificity level.

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