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Beny Irawan
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Medistra Medical Journal (MMJ)
Published by Institut Kesehatan Medistra Lubuk Pakam
ISSN : -     EISSN : 30263492     DOI : https://doi.org/10.35451/mmj.v2i1
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Aims and Scope Medistra Medical Journal (MMJ) Aims to disseminate conceptual thoughts or ideas, reviews and research findings obtained by academics, researchers and practitioners in the field of Medicine and Health Medistra Medical Journal (MMJ) Scope: Biomedical Science & Clinical Practice Preventive Medicine Family Medicine Occupational Medicine Bioethics Trauma and Medical Emergencies Public Health Epidemiology and Biostatistics Mental Health Clinical Nutrition Clinical Pathology Anatomical Pathology
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 56 Documents
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Integration of Health Information Systems to Improve Emergency Management in Primary Care at Sembiring General Hospital Deli Tua in 2023 Ridwanto Situmeang
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/tkyc5e36

Abstract

Catastrophic emergencies, such as natural disasters, mass accidents, and pandemics, demand preparedness and resilience. Primary care plays a crucial role as the frontline in handling medical emergencies. Speed, accuracy, and strong coordination are key to saving patients' lives. However, challenges often arise, including delays in data recording, difficulty accessing medical records, and suboptimal communication between units. Health information system integration presents an innovation to address these challenges through digital, real-time, and interconnected data management across service units. This study aims to analyze the role of health information system integration in improving emergency management at Sembiring Deli Tua General Hospital in 2023. The research method used a descriptive qualitative design using interviews, observations, and document review techniques. Research informants included Emergency Unit healthcare workers, medical records officers, and hospital information system managers. The results showed that the implementation of a health information system can accelerate the triage process, improve the accuracy of patient records, and strengthen coordination between healthcare workers in critical situations. Consequently, the response to emergency patients becomes more efficient and targeted. Obstacles still encountered include limited technological infrastructure, human resource skills, and suboptimal policy support. In conclusion, health information system integration has proven to contribute significantly to improving emergency management in primary care. Going forward, strengthening digital infrastructure, improving healthcare worker competency, and managerial commitment will be key factors.
Evaluation of Clinical Decision-Making Quality in Catastrophic Emergency Management at Primary Care Services in Pagar Jati Community Health Center, 2023 Elias Siahaan
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/xzrvqp85

Abstract

Background: The quality of clinical decision-making is a crucial factor in managing catastrophic emergencies, particularly in primary care facilities that serve as the frontline of disaster response. Pagar Jati Community Health Center, as a primary health service, needs to be evaluated for its capacity to make rapid, accurate, and well-coordinated clinical decisions during disaster situations. Objective: This study aims to evaluate the quality of clinical decision-making among healthcare workers in managing catastrophic emergencies at Pagar Jati Community Health Center in 2023. Methods: This research employed a descriptive-analytic design with a quantitative approach. The sample consisted of medical personnel (doctors, nurses, and midwives) involved in emergency management. Data were collected through structured questionnaires, simulation observations, and a review of standard operating procedures (SOPs). Descriptive analysis was performed to assess timeliness, clinical accuracy, and team coordination. Results: The study found that most clinical decisions were made within ≤10 minutes, consistent with the golden time standard, although 23% of cases experienced delays due to communication barriers. Clinical accuracy reached 78% in accordance with national guidelines, but errors were identified in prioritizing patients with multiple injuries. Internal team coordination among healthcare workers was relatively good, yet external coordination with referral hospitals faced challenges, particularly in communication and the timely evacuation of critical patients. Conclusion: The quality of clinical decision-making at Pagar Jati Community Health Center is considered adequate but requires improvement through regular disaster simulation training, strengthening of referral communication systems, and the development of integrated emergency information systems. These efforts are expected to enhance the effectiveness of catastrophic emergency management in primary care services.
Factors Associated with the Level of Knowledge about Dental and Oral Health of Students of SD 27 Kedai Durian Village Medan Nanda Novzi; Mayasari Ramadhani; Tezar Samekto Darungan; Mayangsari Ayu; Farah Diba
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/2kgdqf56

Abstract

The state of the mouth cavity is one sign of a person's general health. Finding the elements that affect SD 27 kids' development and maintenance of excellent oral health is the aim of this study. With a cross-sectional methodology and an analytical research strategy, the study included 67 participants who were chosen by primary data sampling. The findings showed that most of the respondents (n = 44, 65.7%) were between the ages of 5 and 11. Furthermore, the vast majority of participants (n = 41, 61.2%) reported that they had obtained information via electronic media. Moreover, a high degree of expertise was demonstrated by the majority of responders (n = 52, 77.6%). Most respondents (n = 38, 56.7%) who showed a high degree of understanding were between the ages of 5 and 12. Age and children's degree of oral health knowledge were shown to be significantly correlated (p = 0.017). Similarly, a significant correlation (p = 0.012) was found between the amount of oral health knowledge and the information source.
High-Degree AV Block in STEMI with Metabolic Disorders: Who is the Prime Suspect? Brigitta Olivia Sinulingga; Andika Sitepu
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/az5zac60

Abstract

Background: ST-elevation myocardial infarction (STEMI) is typically associated with a single culprit lesion. However, cases involving dynamic progression or multiple simultaneous infarct-related arteries are rare but carry significantly higher risks, particularly when accompanied by malignant arrhythmias and electrical instability. Case Illustration: A 33-year-old male, active smoker and casual drinker, presented with acute chest pain, dyspnea, and nausea. He was initially diagnosed with inferior STEMI and transient ventricular tachycardia at the referring hospital. Upon transfer, his ECG evolved to show inferior-anterior STEMI with complete atrioventricular block. Shortly after arrival, he experienced cardiac arrest and was successfully resuscitated. Coronary angiography revealed dual culprit lesions: total occlusion of both the right coronary artery (RCA) and the left anterior descending artery (LAD). PCI was performed with drug-eluting stent placement in the RCA, and balloon angioplasty with thrombus aspiration and intracoronary eptifibatide in the LAD. Revascularization achieved TIMI III flow.Discussion: Despite successful PCI, the patient suffered recurrent cardiac arrests in the catheterization lab and ICU, ultimately dying from cardiac arrest. This case illustrates the rare but catastrophic progression of STEMI into a dual-vessel event with severe electrical and hemodynamic complications in a young patient. Conclusion: Dual culprit lesions in STEMI can evolve rapidly and unpredictably, particularly in the presence of malignant arrhythmias. Early recognition, rapid intervention, and aggressive hemodynamic support are essential to improve survival in these high-risk cases.
Relationship Between Family Support And Active Participation Of The Elderly Attending Elderly Health Posts In Tanjung Raja Village Deli Serdang District, 2025 Nisa El Hasanah; Andhika Budi Sentoso; Lilla Sarissa Br Ginting
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/yk326a41

Abstract

The elderly are a group that is vulnerable to health problems, thus requiring extra attention to maintain their quality of life. One measure taken is to increase active participation in the Elderly Posyandu programs. This study aims to identify the relationship between family support and the level of participation og the elderly in Posyandu activities in Tanjung Raja Village, Deli Serdang Regency, in 2025. The study applied a quantitative approach with a cross-sectional design. The research subjects were 42 elderly  individuals selected using a total sampling technique. Data collection was conducted using questionnaires and attendance lists, and then analyzed using the Chi-square test. The study findings revealed that most respondents received family support (59,5%), but the majority of elderly were classified as less actively involved in Posyandu activities (69,0%). Statistical analysis resulted in a p-value of 0.060. Statistical analysis yielded a p-value of 0.060, indicating no significant relationship between family assistance and elderly participation. It is recommended that families continue to provide full support, while posyandu cadres reinforce education to families about the importance of elderly involvement in posyandu programs.
Human Monkeypox Virus infection junita br tarigan; Maulinda Putri; Sri Ulina Br. Purba; Franciscus Ginting
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/3jp6vr60

Abstract

Monkeypox is a zoonotic disease. First, this infection was found in animals but has been widespread in humans and become a pandemic all over the world including Indonesia with different case fatality rates caused by monkeypox infection among the countries. Some clinical features caused by monkeypox infection are similar to other infections caused by chicken pox and other viruses. Treating and preventing monkeypox infection need holistic management among medical personnel.
Legal Study on Health Service Facilities for Company Employees During the COVID-19 Pandemic Andhika Budi Sentoso
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/y9wj1p05

Abstract

The COVID-19 pandemic transformed patterns of employment, occupational safety, and access to health services for company employees. The high rate of SARS-CoV-2 transmission since early 2020 led to public health control measures such as social distancing, mandatory masking, and remote working arrangements (Work From Home/WFH). This situation raises a legal question: to what extent are employers obligated to ensure employee health and safety as part of the right to health, particularly when work must continue under a public health emergency. This study is a normative (doctrinal) legal research with a descriptive qualitative approach. Primary legal materials include Law No. 17 of 2023 on Health, national regulations on occupational safety and health, Ministry of Health guidance for COVID-19 prevention in the workplace, and World Health Organization recommendations on worker protection during infectious disease outbreaks. Secondary legal materials include health law scholarship, occupational health literature, and recent international publications addressing worker protection during the COVID-19 pandemic. Data were analyzed by interpreting applicable legal norms and assessing their practical relevance to the fulfillment of employees’ right to health in corporate settings. he findings indicate that the obligation to provide health service facilities for employees extends beyond curative access and includes preventive and promotive measures such as periodic health screening, staggered/shift-based work arrangements, reduced physical contact, virtual communication systems, provision of basic protective equipment, and guaranteed referral pathways to health services. These obligations are consistent with the principles of the right to health, occupational safety and health (OSH), and worker protection under Indonesian law. However, implementation faced barriers including fear and stigma, misinformation, and unequal company resources.
Multimodal Radiological Imaging Findings in Premature Infant with Cytomegalovirus and Toxoplasma Coinfection Johannes Tanaka; Anandhika Dwijaya; Fitri Arianty Lubis
Medistra Medical Journal (MMJ) Vol 3 No 2 (2026): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/drnrmk57

Abstract

Background: Congenital co-infection with Cytomegalovirus (CMV) and Toxoplasma gondii is an extremely rare condition, particularly in premature infants, with overlapping clinical and radiological manifestations involving the central nervous system and respiratory tract. Premature infants are at high risk for intraventricular hemorrhage (IVH), which may be exacerbated by inflammation and impaired vascular maturation related to TORCH infections. Case illustration: A 35-week premature neonate weighing 2100 grams was admitted to the Neonatal Intensive Care Unit (NICU) due to respiratory distress and decreased activity. Serological testing confirmed congenital CMV and Toxoplasma gondii co-infection. Initial postnatal cranial ultrasonography revealed grade II IVH that had not been detected on prenatal ultrasound. Serial radiological follow-up demonstrated progression of IVH to post-hemorrhagic hydrocephalus. Non-contrast cranial computed tomography showed bilateral ventriculomegaly with periventricular calcifications consistent with congenital CMV infection. During hospitalization, serial chest radiographs demonstrated pneumonia with progressive atelectasis. Discussion: This case highlights the importance of a multimodal radiological approach in mapping disease progression in premature infants with TORCH co-infection. Cranial ultrasonography serves as the primary and serial modality for IVH detection, while cranial CT provides confirmation of structural complications, and chest radiography allows monitoring of respiratory involvement. Conclusion: Congenital CMV and Toxoplasma gondii co-infection in premature infants requires heightened vigilance for neurological and respiratory complications. Longitudinal multimodal radiological evaluation plays a pivotal role in disease assessment, clinical decision-making, and early multidisciplinary management.
The Effect of Ultrafiltration Rate Level in Blood Pressure Status Changes in Patients with Chronic Kidney Disease Undergoing Hemodialysis Elpiani Br Depari; Mona Herni Cristina Ritonga; Dewi Cahaya Br Hutabarat; Indria Sisilia Agata; Yoga Wijaya
Medistra Medical Journal (MMJ) Vol 3 No 2 (2026): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/m6pdbv92

Abstract

Background: Intradialytic blood pressure changes are common complications in patients undergoing hemodialysis and are suspected to be influenced by the ultrafiltration rate (UFR). These blood pressure fluctuations may affect patient morbidity and mortality through cardiovascular events. Objective: This study aimed to analyze the effect of ultrafiltration rate levels on intradialytic blood pressure status changes based on systolic blood pressure and mean arterial pressure (MAP) parameters. Methods: This study was a prospective observational analytic study conducted among patients with chronic kidney disease (CKD) undergoing hemodialysis at Grandmed Hospital Lubuk Pakam. The UFR was categorized into <10, 10–13, and >13 mL/kg/hour. Blood pressure status changes were classified as stable, hypotensive, and hypertensive. Data were analyzed using the chi-square test with a significance level of p<0.05. Results: A significant association was found between UFR levels and blood pressure status changes based on systolic blood pressure (χ²=12.691; p=0.013), but not on MAP (χ²=7.233; p=0.124). The highest proportion of blood pressure changes was observed in the >13 mL/kg/hour UFR group. Conclusion: Ultrafiltration rate levels significantly influence intradialytic systolic blood pressure changes, higher UFR associated with increased hemodynamic instability.
Erythrocyte Index–Based Morphological Distribution of Anemia in Patients with Chronic Kidney Disease Undergoing Hemodialysis Clarissa Anastasya; Elpiani Br Depari; Bagas Prasetyo; Tabita Syahara
Medistra Medical Journal (MMJ) Vol 3 No 2 (2026): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/bnedas20

Abstract

Background: Anemia is a common complication of chronic kidney disease (CKD), mainly caused by erythropoietin deficiency, although factors such as iron deficiency, chronic inflammation, blood loss, and nutritional disorders may also contribute. Erythrocyte indices, including mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC), are useful for evaluating erythrocyte morphology and identifying potential causes of anemia. Objective: To describe the distribution of anemia morphology based on erythrocyte indices in CKD patients undergoing hemodialysis. Methods: This analytical observational study with a cross-sectional design was conducted at the Hemodialysis Unit of Grandmed Hospital, Lubuk Pakam, from January to March 2026. Data were obtained from complete blood count results in patients’ medical records. Hemoglobin, MCV, and MCHC were analyzed, and anemia morphology was classified based on erythrocyte index

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