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INDONESIA
Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 822 Documents
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Are Segmenting, Targeting, and Positioning Necessary for Strategic Marketing? Amira, Hisan; Fitriasari, Nikma
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Changes in the hospital environment have led to an increasingly competitive market. Marketing strategies are vital ingredients to offer more creative, innovative, and valuable products to customers to compete with other hospitals. Hyperbaric Oxygen Teraphy (HBOT) installation is one of the superrior service at  Paru Hospital Jember which have a low number of visit for the last three years. Segmenting, targeting, and positioning (STP) strategies will help to identify the most profitable market, which can be used to create the right connection to customers. This research aimed to arrange STP strategies as a base for the hospital strategic marketing plan at Hyperbaric Oxygen Therapy (HBOT) installation of Paru Hospital Jember. This research was a descriptive study. The root of the problems was identified using the urgency, seriousness and growth (USG) method and followed by identifying the problem solutions with the capability, accessible, readiness and leverage (CARL) method before finding the solutions. The results of this study show that the five geographic segmentation areas of the target market are Jember, Probolinggo, Lumajang, Bondowoso, and Banyuwangi. The targets are patients older than five years old, middle-high economic class people, patients with diabetic foot, Buerger's disease, and sudden deafness. The new tagline “Tabik” stands for “Instalasi Hiperbarik,” and the new motto “Jadikan hidup lebih baik bersama Tabik” is a positioning made for STP strategies. Ten-year projection showed a gap visit number as many as 1.958 patients with STP as a strategic marketing plan in HBOT Installation Paru Hospital Jember. The implementation of the marketing mix is one tool to reach the gap. Implementation of the promotion is the first element of the marketing mix to complete to reach number of visits gap. 
Anti-Methicillin-Resistant Staphylococcus aureus (MRSA) of Ethanol Extract of God's Crown (Phaleria macrocarpa) Leaves, Peel, and Fruit Flesh Hestiyani, Rani Afifah Nur; Handini, Tri Okmawati
Jurnal Kedokteran Brawijaya Vol 31, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2020.031.02.2

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that becomes the main concern since it is a multidrug-resistant organism and causes high morbidity and mortality. This study aimed to investigate the antibacterial activity of ethanolic extract of Phaleria macrocarpa leaves, peel, and fruit flesh on MRSA. This study was an experimental laboratory study with a post-test only control group design to assess the antibacterial activity of ethanolic extract from leaves, peel, and fruit flesh of Phaleria macrocarpa against MRSA ATCC 43300 and MRSA clinical isolates using a disk diffusion method. Extracts from the leaves, peel, and flesh of Phaleria macrocarpa had potential as an antibacterial agent against MRSA ATCC 43300 at a concentration of 40%, although not yet equivalent to antibiotic control. The ethanol extract of Phaleria macrocarpa peel at a concentration of 30-40% had potential as an antibacterial agent against MRSA clinical isolates, although not yet equivalent to antibiotic control. Further research needs to be performed so that Phaleria macrocarpa extract can be a potential source of subsequent antibacterial development against MRSA.
The Effect of Service Quality on the Number of Peristi Patients at Unisma Islamic Hospital Malang Sari, Dwi Ratna; Widyaningrum, Kurnia; Sarwiyata, Tri Wahyu; Rahmawati, Triwahyuning
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

ABSTRACTHospitals, as the spearhead of health services, are required to provide quality services that meet the expectations of the community. Decreasing number of Obstetrics and Gynecology (Peristi) patients at Unisma Islamic Hospital Malang into 119 patients in June 2019 and low BOR value of 15.1%-46.8% that is below the standard (60-85%) indicated that the number of patient visits to the Peristi unit is low. Low patient visits are associated with the satisfaction of quality services. This study aimed to determine the effect of service quality on the increasing number of patients. This study was carried out by using a survey with a cross-sectional study approach among patients in the obstetric unit and inpatients installation for three months. The sample in this study were 139 respondents from the obstetric unit and 18 respondents from Peristi obtained using the accidental sampling method. Data were collected using questionnaires based on the dimensions of service quality and semi-structured interviews. The results showed a number of respondent statements related to the quality of hospital services including dissatisfaction of outpatient flow which was not as promised, long patient waiting time, less responsive officers in responding to complaints or providing information to patients, and waiting room facilities that are not representative and lack complete equipment to support its services. The hospital is expected to provide high-quality services and excellent service to increase patient satisfaction so that it has an impact on increasing the number of patient visits to the Peristi Unit.
Reasons and Hindrances of the Community Leaders in Releasing Stocked Persons with Mental Problems in Southern East Sulawesi Patawari, Abdul; Wihastuti, Titin Andri; Muslihah, Nurul; Astari, Asti Melani; Utami, Yulian Wiji
Jurnal Kedokteran Brawijaya Vol 31, No 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.3

Abstract

Undertaking stock punishment is an action to immobilized individuals that suffer mental health disorders. It is mostly done by placing woods on individuals' ankles. They are designed to restrict the patients' movements and made from wooden bars. The patients are chained or locked in a special room. A community leader, as the leader of certain people, has important roles in undertaking the stocks. It is done by considering various reasons based on the constructed understanding and emerging assumptions in the middle of society. This research aims to explore the reasons and hindrances of the community leader in releasing the stocks undertaken on individuals with mental health disorders. The applied research method is qualitative research with an interpretative phenomenology. 7 participants were selected by using purposive sampling. Then, an analysis was carried out by the Interpretative Phenomenological Analysis (IPA). The findings dealing with the reasons for the community leader to undertake the stocks consisted of two themes. They dealt with the administered medication to recover individuals with mental health disorders and to protect them, their families, and society. Meanwhile, the hindrances of the community leader in discharging or releasing the punishment dealt with the difficulty to get psychiatric service. The conclusions are the stocks reasons deal with a lack of the community leader's understanding to care for the individuals with mental health disorders and the necessity of active participation of medical officers. Thus, the people could obtain maximum psychiatric service
H2O2-Scavenging Activity and Hyaluronidase Inhibition Scutellarin and Apigenin in Basil Leaf Extract Yusuf, Lydia; Girsang, Ermi; Nasution, Ali Napiah; Elvira, Cut; Wibowo, Satrio Haryo Benowo; Widowati, Wahyu
Jurnal Kedokteran Brawijaya Vol 31, No 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.1

Abstract

The potential utilization of flavonoid compounds, especially scutellarin, and apigenin, contained in basil (Ocimum basilicum L.) leaf extract to manage the aging effects on the skin, that occurs because of over-activated hyaluronidase enzyme and oxidative stress due to hydrogen peroxide (H2O2) radicals, is not well known. This study was conducted to assess the H2O2 scavenging activity and the inhibition of hyaluronidase from scutellarin and apigenin at various concentrations. The study was conducted by measuring H2O2 scavenging inhibition and hyaluronidase inhibition of scutellarin and apigenin in various concentrations using the spectrophotometry method. The various activity was tested using the One-Way ANOVA test followed by Tukey post hoc test. IC50 values were calculated based on linear regression equations of H2O2 scavenging inhibition and hyaluronidase inhibition. The analysis showed the highest H2O2 scavenging activity was found in scutellarin with IC50 158.76 μg/mL. Scutellarin has greater scavenging activity than apigenin. Hyaluronidase inhibition of scutellarin with IC50 35.25 µg/mL, while apigenin was 162.86 µg/mL. Scutellarin has higher hyaluronidase inhibition activity than apigenin. Antioxidant and antiaging effects of basil leaf extract caused by phytochemical compounds contained, especially scutellarin.
Intravesical Blood Clot Retention? How We Manage It, a Tertiary Hospital Preference Laksita, Tetuka Bagus; Rizaldi, Fikri
Jurnal Kedokteran Brawijaya Vol 31, No 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.8

Abstract

Intravesical blood clot retention is one of the Urological emergencies. Ongoing haematuria and blood clot formation in the bladder obstruct the urine outflow and lead to urinary retention, abdominal pain, anemia, urinary tract infection (UTI), and renal function deterioration. Most of the cases required cystoscopy blood clot evacuation and definitive surgery to stop the ongoing bleeding. This study aimed to discover the demography, characteristics, management, and complication of patients with intravesical blood clot retention in Dr. Soetomo General Acadenic Hospital, Surabaya from January 2017 until April 2020. This is an observational study, a retrospective-descriptive design. We conducted a review on the medical records of 97 patients, 76 males and 21 females with an average age of 54.9 years old. Of all patients initially treated conservatively using normal saline irrigation with a large three-way catheter (22-24 fr), four were successfully treated without surgery, and 89 patients underwent cystoscopy and definitive surgery. The mean operation time was 69,6 minutes, with an average blood clot volume of 167,7 ml (25-600 ml). Sources of bleeding were mostly originated from malignancy (58%), Benign Prostatic Hyperplasia (BPH) (10%), and hemorrhagic cystitis (7%).  The most common comorbidity found was hypertension (13) and chronic kidney disease (10). Based on our experience, managing intravesical blood clot retention with cystoscopy continued with definitive surgery in a one-step procedure is a good approach. Urological malignancy is the most frequent abnormality that causes intravesical blood clot retention.
The Effect of Unripe Dates (Phoenix dactylifera) on Rat Ovarian Follicle Maturation and Ovulation Herlambang, Herlambang; Rahman, Ave Olivia; Kusdiyah, Erny
Jurnal Kedokteran Brawijaya Vol 31, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2020.031.02.1

Abstract

Unripe dates are believed by Indonesian citizens to increase fertility. This study aimed to assess the effect of unripe dates in the ovary of rats. Fresh yellow-colored dates were dried in an oven and crushed into powder. Eighteen rats aged three months and had given birth once were randomly divided into three groups. The treatment groups were given unripe dates at doses of 160mg/kgBW and 320mg/kgBW through a feeding tube for 28 days, and the control group was only given distilled water. Histopathological examination was carried out by the pathology expert using Hematoxylin-Eosin staining to observe the number of ovarian follicles according to their maturation stage. The results showed that the administration of unripe dates powder 320mg/kgBW increased corpus luteum number (21.50±4.72) and was statistically significant compared to the control group (15.16±3.71). Similar differences were also found in other stages of the follicle although not statistically significant. Administration of unripe date powder can increase ovulation induction among fertile rats.
Increased Response Time and Triage Accuracy with Resetting of Systems and Spatial in a Hospital Emergency Room Hapsari, Riandiani Dwi
Jurnal Kedokteran Brawijaya Article in Press
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Abstract

The triage system in the emergency room is crucial for categorizing patients based on the level of emergency and finding out further medical services for the patients. An accurate triage system will accelerate the IGD response time and result in better ER quality. The purpose of this study was to determine the factors influencing the accuracy of the triage location in the Emergency Room of a type C hospital as well as the relationship between the activation of the triage area and the emergency response time. The sample consisted of 30 patients before and 30 patients after the activation of the triage area. According to the priority level, the sample was then divided into ten patients each. This research used field experimental design with a Participatory Action Research approach. The results showed that the accuracy of the triage implementation in the Emergency Room of this hospital was influenced by the facilities and infrastructure, human resources, and the flow of patients in the emergency room. Based on the Wilcoxon test, there is an increase in P1 and P3 patient response time before and after triage activation but not significant. The increase in response time in P2 patients before and after the activation of the triage area is significant with p-value <0.046. This study concludes that the right triage system can increase emergency response time.
Effect of Bortezomib on Total Cholesterol, Triglycerides and Histopathology Abdominal Aorta in Rats of Atherosclerosis Model Ismawati, Ismawati; Romus, Ilhami; Maryanti, Esy; Permatasari, Nopi; Luthfianty, Elfiah
Jurnal Kedokteran Brawijaya Vol 31, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2020.031.02.5

Abstract

The effects of using proteasome inhibitors on atherosclerosis could be beneficial or detrimental. This study aimed to analyze the effects of proteasome inhibitors in the progression stage. Experimental animals (18 rats) were divided into three groups, namely control (C) as a group of rats given standard feed, P1 as atherosclerosis-induced rat group, and P2 as atherosclerosis-induced rat group and given proteasome inhibitors. Proteasome inhibitor administered was bortezomib at a dose of 50µg/kgBW/day intraperitoneally on day 1 and 3. After four days of treatment, the termination and measurement of serum total cholesterol, serum triglycerides, and abdominal aorta histopathology with hematoxylin-eosin staining were carried out. Serum total cholesterol levels were measured using the CHOD-PAP (Cholesterol Oxidase-Peroxidase Aminoantypirin) method, whereas serum triglyceride levels were measured using the GPO-PAP (glycerol phosphatase oxidase−phenol4-amino antipyrene peroxidase) method. Histopathological assessment was carried out with a scoring system in 9 fields of view with a 400x magnification, which was then averaged. The ANOVA test showed significant differences in serum total cholesterol, serum triglycerides, and abdominal aortic histopathology between atherosclerosis and control groups, but there were no significant differences in the administration of bortezomib in atherosclerosis except in serum triglyceride levels. It can be concluded that the administration of 50µg/kg bortezomib for four days in the rats model of the progression stage of atherosclerosis can decrease serum triglyceride levels, although it can not inhibit the formation of atherosclerotic lesions and has no effect on serum total cholesterol. 
Professional Care Providers Instruction: Does It Reduce Postoperative Fever Rate? Pramudya, Indradi; Youandi, Abdi Agus; Indriani, Wiwin
Jurnal Kedokteran Brawijaya Article in Press
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Abstract

Postoperative fever is a fever that occurs after surgery and might develop among children, adults, and the elderly indirectly related to the type of surgery. Surgical site infection (SSI) is the most common cause of postoperative fever. However, it is common that the specific causes of fever are not found or without any signs of infection. This study aimed to determine the cause of postoperative fever and its intervention plan. This research was a case study at X Hospital in September to October 2019 initiated by identifying the root of the problem, identifying the priority of the root problem, and planning the intervention. The results of the identification of the root of the problems found that fever occurred less than 24 hours postoperatively. The results of the root problem identification revealed no SOP that regulates the Professional Care Providers (PCP) to give instructions to patients if there is a delay in the operating schedule. The proposed intervention plan is to make regulations regarding service delay instructions. Postoperative fever less that is than 24 hours causes patient discomfort due to the absence of instructions from the PCP if there is a delay in the operating schedule. The establishment of the regulations is a solution to reduce the incidence of postoperative fever.Keywords: postoperative fever, operation delay, regulation

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