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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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Antibacterial and Antioxidant Effect from Nanoparticle of Andrographis paniculata Extract on Wistar Rat Infected with Listeria monocytogenes Nawasyifa Atmaja; Neni Susilaningsih; Helmia Farida
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.v12i2.1301

Abstract

BACKGROUND: Listeria infection triggers the production of ROS (Reactive Oxygen Species) and radical-waste accumulation such as Malondialdehyde (MDA). Andrographis paniculata, triggers the production of Superoxide Dismutase (SOD) as antioxidant and suppresses the bacteria multiplication in host’s body. However, these active-phytochemical have poor destruction due to their large size and molecular weight. Nanoparticle technology may overcome this problem to increase bioavailability and benefit of herbal pharmacology. AIMS:  to evaluate the effectivity nanoparticle of A. paniculata extract to increase bacteria elimination, increase SOD level, and reduce MDA level in rat infected with L. monocytogenes METHOD: Experimental research with post-test only controlled trial design was conducted using white rats (Rattus novergicus strain Wistar) into Normal (N), Negative Control (K-), A. paniculata extract (EAP-200), and Nanoparticle of A. paniculata extract Group (nEAP-100, nEAP-200, and nEAP-400). Colony was measured using total plate count method. SOD & MDA level were measured using colorimetric method RESULT:  L. monocytogenes bacterial count from group with extract A. paniculata was significantly lower than those in negative control (p<0,05). SOD level from group with extract A. paniculata was very significantly higher than those in negative control (p<0,01), while MDA level from group with extract A. paniculata was very significantly lower than those in negative control (p<0,01). Dose of 200 mg/kgBW in nanoparticle form was the most optimum dose. CONCLUSION: Extract of A. paniculata at various doses and form, increase bacterial clearance, increase SOD level, and reduce MDA level in rat infected with L. monocytogenes.
Effects of 4G 2100 MHz Radiation on Lymphocyte Levels: An Experimental Study in Wistar Rats Nafiisah Nafiisah; Fatiha Sri Utami Tamad; Nur Signa Aini; Ika Murti Harini; Tendi Novara
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.v12i2.1305

Abstract

BACKGROUND: Electromagnetic radiation (EMR) from mobile phones has become a global concern due to its potential impact on the immune system. However, the effects of EMR on lymphocyte levels remain inconsistent across studies. AIMS: This study aimed to evaluate the effects of 4G 2100 MHz EMR exposure on lymphocyte levels in Wistar rats. METHOD: This research employed a true experimental design with a Post Test Only Controlled Group Design. Four groups of male Wistar rats were used: a control group (G1) and three exposure groups subjected to EMR for 15 (G2), 30 (G3), and 45 days (G4). The exposed groups were subjected to 2 hours per day of 4G 2100 MHz EMR using a Redmi A2 mobile phone in WhatsApp call mode. Lymphocyte levels were analyzed using ANOVA to determine differences among the groups. RESULT: The average lymphocyte levels in groups G1, G2, G3, and G4 were 68.92 ± 4.78%, 63.37 ± 6.29%, 67.00 ± 11.51%, and 64.35 ± 13.58%, respectively. Statistical analysis revealed no significant differences among the groups (p = 0.703). CONCLUSION: Exposure to 4G 2100 MHz EMR for 15–45 days did not significantly change lymphocyte levels in Wistar rats. These findings support the need for further studies to evaluate other immunological parameters and the long-term effects of EMR exposure.
Perbandingan Intensitas Latihan Berdasarkan Anaerobic Threshold pada Laki-Laki dengan Tingkat Aktivitas Rendah Terhadap Performa Fisik Rudy Handoyo; Wahyu Wiryawan; Hari Hendriarti Satoto; Sri Wahyudati; Tanti Ajoe Kesoema; I Made Widagda; Erna Setiawati; Rahmi Isma Asmara Putri; Robby Tjandra; Naela Munawaroh; Aditya Paramitha Andini; Ratih Dwiratna Hakim; Arvin Manuel Wulur; Nura Eky Vikawati; Ellena Rachma Kusuma; Mela Kurnia Widyarini; Novritasari Setyaningrum
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.v12i3.1306

Abstract

Background: Low level of physical activity can reduce physical fitness. Aerobic training can improve physical fitness. A precise aerobic training based on anaerobic threshold (AT) is recommended by American College of Sports Medicine (ACSM) whenever possible. Methods: This was a randomized-single blinded control trial including 24 male subjects with low level of physical activity in Kariadi hospital during December 2023 until February 2024. It was randomized with a sealed envelope. Subjects were allocated in 2 groups (above AT and below AT). Physical performance was measured using SPPB score and muscle endurance that was presented using total repetition of 1RM of knee flexor muscle. Results: There was no significant difference between two groups for total SPPB score (p=0.053). There was a significant difference of muscle endurance between two groups (p=0.010) with the above AT group resulting in higher improvements of muscle endurance (12.00 ± 5.71 vs. 6.67 ± 3.26). Conclusion: Aerobic exercise with intensity based on AT did not show significant differences in total SPPB score. However, aerobic exercise above AT showed a better improvement of muscle endurance in healthy adult men with low levels of physical activity.
Bahasa Inggris Garry Aditya Pranata; Nur Farhanah; Rudy Santoso; Budi Setiawan; Nurvita Nindita; Rahmad Rizal Budi Wicaksono
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.v12i3.1314

Abstract

Background: Indonesia is an endemic country for dengue virus infections, particularly in several regions. Dengue virus infection is a disease caused by the dengue virus and transmitted through the bite of the Aedes aegypti mosquito. In pregnancy, dengue virus infection increases the risk of dengue shock syndrome, pre-eclampsia, fetal distress, preterm delivery, cesarean section and maternal death. Despite the abundance of reports on dengue infection in pregnancy, data from Indonesia remain limited, particularly regarding clinical presentation, management decisions, and outcomes in resource-limited settings. This case series aims to contribute practical insights into clinical management, decision-making during the critical phase, and maternal-fetal outcomes in dengue-infected pregnancies. Cases: We report three cases of dengue virus infection during pregnancies. All three patients presented with acute fever and thrombocytopenia. Two of the three exhibited elevated in transaminase enzymes. One patient tested positive for NS1 antigen, while the other two tested positive for anti-dengue IgM and IgG. Blood component transfusions were administered to two patients during treatment. Two cases underwent termination of pregnancy via cesarean section due to indications of maternal and fetal distress. One neonate initially presented with an abnormal outcome but showed clinical improvement after intensive treatment. All three cases had normal maternal outcomes. Discussion: Pregnancy involves various physiological changes related to the cardiovascular, respiratory, and hematological systems. In these three cases, acute fever and thrombocytopenia (first and second cases) were observed, and there was no increase in hematocrit exceeding 20% of the baseline data, thus leading to a diagnosis of dengue fever. The WHO states that there is no difference in the amount and rate of intravenous fluid administration for pregnant and non-pregnant women, but recommends using pre-pregnancy body weight for fluid calculations. During the critical phase, termination of pregnancy should be performed only if the mother's life is threatened or if the patient experiences spontaneous labor. Timely multidisciplinary decision-making is crucial to optimize maternal and fetal outcomes, as fetal complications such as distress or preterm delivery may occur. In the first case, termination of pregnancy by cesarean section during the critical phase was performed due to induction failure and fetal distress. The neonate initially suffered moderate asphyxia but experienced clinical improvement after intensive care. Conclusion: Dengue virus infection in pregnancy increases the risk of morbidity and mortality for both mother and fetus. Therefore, strict monitoring and evaluation are needed, as well as management involving a multidisciplinary team that considers aspects of maternal and fetal safety.
Comparison of Effectiveness Cost Therapy and Increasing Level of Haemoglobin, Ferritin in Pregnant Women with Anemia Whom Are Given Iron Tablet Everyday and Every Two Days Agung Pramartha Irawan; M. Besari Adi Pramono; Asih Wijayanti
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.v13i1.1338

Abstract

BACKGROUND: Anemia is common in pregnancy, with a prevalence of 48.9% in Indonesia (Riskesdas 2018). It increases the risk of impaired fetal growth, stunting, and intellectual disorders. Iron supplementation, as recommended by Permenkes No. 88/2014, is a key preventive strategy. Evidence such as Moretti et al. (2015), suggests that alternate-day supplementation improves absorption due to reduced hepcidin activity. AIM: To evaluate the effectiveness of administering iron tablets every two days in terms of treatment cost, increases in hemoglobin (Hb) and ferritin levels, and incidence of gastrointestinal adverse effects. METHODS: This was a true experimental study using a randomized pre–post test control group design. The control group received iron tablets daily for two months, while the intervention group received iron tablets every two days. The study was conducted at the Obstetrics and Gynecology Polyclinic of Kariadi Central General Hospital and Halmahera Primary Health Care over eight months (December 2023 – July 2024). Each group included 23 subjects. Body weight, hemoglobin, and ferritin were measured at baseline and after two months. Adverse effects and neonatal outcomes were also documented. RESULTS: Baseline characteristics were normally distributed. The intervention group showed a significant increase in hemoglobin and ferritin levels, higher neonatal birth weight, and lower treatment cost and adverse effects compared to the control group (p < 0.05). Post-treatment differences between groups were 0.5 g/dL for hemoglobin and 17.2 ng/mL for ferritin. CONCLUSION: Administering iron tablets every two days is effective in improving hemoglobin and ferritin levels in pregnant women with anemia and is also cost-effective with fewer adverse effects.
Comparison of Line Dance And Senam Lansia to Improve Cardiorespiratory Endurance In Elderly
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.v12i2.1343

Abstract

Background: Physical activity in the elderly has a positive impact on promoting healthy aging. Senam lansia is used to be taught to healthy elderly in community however it is boring because of monotonous movement. Line dance is an alternative aerobic exercise that has been taught to elderly. However, there was not any research that compares the effectiveness of both exercises to cardiorespiratory endurance. Aims: This study come to verify that the increase of cardiorespiratory endurance in elderly after line dance was better than senam lansia. Methods: This study was a quasi-experimental pre-test and post-test- controlled group design on 2 groups which was line dance group (n = 20) and senam lansia group (n = 16). The exercise was given based on each group 3 times a week for 6 weeks and VO2max measurement were taken with 6-minute walking test before and after intervention in both groups. Results: The increase of the mean difference/delta VO2max between groups did not differ statistically between groups (line dance: 2,19 ± 3,54 vs senam lansia: 1,79 ± 1,68; p = 0,683). There was a statistically significant difference in the mean pre- and post- intervention VO2max values at line dance group (32,20 ± 3,99; p = 0,013) and senam lansia group (27,03 ± 3,77; p = 0,001). Conclusions: The increase of cardiorespiratory endurance in line dance group and senam lansia group did not differ statistically.
Bupivacaine-Fentanyl Induced Anaphylactic Reaction in Cesarean Delivery Undergoing Spinal Anesthesia: A Case Report Ulfa Filliana; Firda Ridhayani; Dwi Pura Bagas Towo; Amalia Nurul Ulum
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.v12i2.1349

Abstract

BACKGROUND: Incidences of anaphylaxis during pregnancy are unreported but high risks to both infant and mother due to pharmacokinetic profile changes of local anesthesia agents in pregnancy. CASE: A 36-year-old woman (G4P2A1) delivered an infant at 40 weeks of her gestation using a cesarean surgical procedure with spinal anesthesia technique. The spinal anesthetic was administrated bupivacaine 15 mg and adjuvant analgesic (fentanyl 25 mcg). The delivery proceeded seamlessly. The patient was experiencing itching, swelling, and erythema in almost every part of her body, including her face, neck, arm, thigh, and leg in 43 minutes after drugs administration. This anaphylaxis reaction resolved after 22 minutes using 2 ampoules of intravenous dexamethasone 5 mg/ml and 1 ampoule of intravenous methylprednisolone 125 mg/ml. No data on second phase allergy was reported from the patient and infant who are born healthy and have a good response, indicated by an Apgar score 8-9. CONCLUSION: The alterations pharmacokinetic profile of local anaesthesia in pregnancy can cause adverse effects such as anaphylaxis reactions. Anaphylaxis reactions require suitable therapeutic intervention (adrenaline and glucocorticoids) to ensure the safety of both the mother and infant during the delivery operation.
The Correlation of Vitamin D Levels and Ghrelin, Adiponectin, and Resistin Levels Among Post-Ischemic Stroke Patients Santoso Jaeri; Retnaningsih Retnaningsih; Amin Husni; Nani Maharani; Gemala Anjani
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.v12i2.1350

Abstract

BACKGROUND: Dyslipidemia is one of the modifiable risk factors for stroke. The pathogenesis of dyslipidemia is through several mechanisms including adipose tissue-mediated adiponectin, resistin, and leptin secretion. Vitamin D is correlated with lipid profiles, but there is no evidence of the role of vitamin D in ghrelin, adiponectin, and resistin secretion, which may contribute to the mechanisms of the impairment of lipid profile among post-ischemic stroke. AIMS: To determine the correlation between vitamin D and ghrelin, adiponectin, and resistin among post-ischemic stroke. METHODS: An observational analytic study with a cross-sectional approach was conducted among forty post-ischemic stroke patients which was obtained consecutively. The serum vitamin D, ghrelin, adiponectin, and resistin levels were measured using the venous blood obtained from the median cubital vein. Data analysis was performed using the Spearman correlation test to determine the correlation between the serum vitamin D levels, ghrelin, adiponectin, and resistin levels. RESULT: The age of our subjects is approximate 57 years old with the proportion of males being more than female subjects. There is a significant association between serum vitamin D levels and gender, total energy as well carbohydrate diet but no significant association between hormonal status and the characteristics of subjects was revealed. Furthermore, there is no significant correlation between serum vitamin D levels with the hormonal status of ghrelin, adiponectin, or resistin levels (p=0.994; 0.395; 0.858, respectively). CONCLUSION: There is no significant correlation between serum vitamin D levels and serum ghrelin, adiponectin, or resistin levels among post-ischemic stroke patients
Faktor Risiko Terjadinya Pneumonia Oleh Carbapenem-Resistant Organism (Cro) Pada Bayi Dan Anak di Ruang Perawatan Intensif : Sebuah studi di RSUP Dr. Kariadi
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.v13i1.1353

Abstract

BACKGROUND: Inappropriate antibiotic use has led to bacterial resistance, including carbapenem-resistant organisms (CROs), which cause severe infections in neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) patients. CRO infections are associated with high morbidity and mortality rates, with limited treatment options. Risk factors such as prolonged hospitalization, broad-spectrum antibiotic use, invasive procedures, and prior infections contribute to these cases. This study is the first in Indonesia to specifically examine CRO pneumonia risk factors in NICU and PICU children. OBJECTIVES: This study aimed to analyze the risk factors for pneumonia caused by carbapenem-resistant organisms (CROs) in children in the pediatric and neonatal intensive care unit. METHODS: This case-control study was conducted in neonatal intensive care unit (NICU) and Pediatric Intensive Care Unit (PICU) of Dr. Kariadi Hospital, Semarang, using medical records of patients admitted between November 2022 and October 2024. This study analyzed the relationship between various risk factors, including hospitalization duration, antibiotic use, mechanical ventilation, catheterization, prior surgery, and bacterial infection history, with CRO pneumonia in NICU and PICU patients. RESULTS: This case-control study in NICU and PICU on 87 pediatric pneumonia patients found that 55.2% had CRO pneumonia. Multivariate analysis revealed that carbapenem use for >7 days (p = 0.049), mechanical ventilation (p = 0.044), and urinary catheterization (p = 0.020) were independent risk factors for CRO pneumonia. CONCLUSION: CRO infections in NICU and PICU patients are highly prevalent, with prolonged carbapenem use, mechanical ventilation, and urinary catheterization as independent risk factors for CRO pneumonia.
Differences In The Severity Of Diabetic Neuropathy Based On Electromyography In Type 2 Diabetes Mellitus Patients With And Without Comorbidities Dessy Natalia; Maria Belladonna Rahmawati; Maria Immaculata Widiastuti Samekto; Endang Kustiowati; Herlina Suryawati; Elta Diah Pasmanasari
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.v12i3.1357

Abstract

Introduction: Diabetic neuropathy is one of the most common complications of type 2 Diabetes Mellitus. Hyperglycemia causes axonal abnormalities and impaired schwan cell metabolism. Hypertension and hyperlipidemia associated with atherosclerosis, lipid metabolism and arterial compliance. This study aims to determine the difference in the severity of diabetic neuropathy based on electromyography between type 2 DM patients with and without comorbidities. Methods: This study used a cross sectional design. A total of 78 diabetic neuropathy subjects from Outpatient Installation of Dr. Kariadi Hospital Semarang were divided into 3 groups, 26 subjects without comorbidities, 25 subjects with comorbid hypertension and 27 subjects with comorbid hypertension and hyperlipidemia. Inclusion criteria were aged 40-80 years, distal symmetrical polyneuropathy classification, without comorbid and with comorbid hypertension and hyperlipidemia. Exclusion criteria were patients with chemotherapy, HNP, CKD stage 5, incomplete medical records. Data were analyzed using Kruskal-Wallis comparative test. Results: There is a difference in the severity of diabetic neuropathy based on EMG between type 2 DM patients without comorbidities and with comorbidities (p<0.01). No difference in the severity between patients with type 2 DM without comorbidities and with comorbid hypertension (p 0.058). There is a difference in the severity between patients with type 2 DM without comorbidities and with comorbid hypertension and hyperlipidemia (p<0.01). Conclusion: There is a difference in the severity of diabetic neuropathy based on EMG between patients with type 2 DM without comorbidities, with comorbid hypertension and with comorbid hypertension and hyperlipidemia. The more comorbidities, the greater the severity of diabetic neuropathy.

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