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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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The Causes of Lack of Pharmaceutical Logistics Monitoring in Surgery Rooms: A Case Study in a Type C Hospital Iswari, Luh Putu Ayu Pradnya; Youandi, Abdi Agus; Indriani, Wiwin
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.2020.031.02.10

Abstract

The surgery rooms have an important role in the hospital, so it must be managed properly. The surgery rooms consume 9% of the annual hospital budget. High operational costs caused by the large cost of human resources, medical materials, and other supporting facilities. This study was conducted in a private hospital type C with 181 beds and has four surgery rooms. The number of patients which was operated in X Hospital was very high, and the highest number in July 2019 reached 515 patients. There were a large supply of drugs and medical devices in the surgery rooms.  The number of each drug reached hundreds ampoule, and medical devices reached tens and some in the hundreds. The management of pharmaceutical supplies in the surgery rooms was carried out by senior nurse head of surgery rooms. Monitoring logistic by pharmacy officer only done once a month. This made excessive of stock and become expired. The purpose of this study was to analyze the factors that cause the lack of pharmaceutical logistics monitoring in the surgery rooms. Determination the root of the problem was done by using a fishbone diagram through a Focus Group Discussion with the division heads and subdivision heads of X Hospital. Focus Group Discussion is done by asking the participants one by one to find the root of the problem based on five factors (man, material, method, machine, and environment). Obtained 8 root problems then analyzed with 5 why to get the main root problem. Furthermore, determine the biggest problem using the CARL (capability, accessibility, readiness, and leverage) method, with a weighting score between 1-5. The results found that the absence of pharmaceutical logistics monitoring SOP in the surgery rooms was the most contributing factor to the lack of pharmaceutical logistics monitoring in the surgery rooms.
The Nurses' Experience in Providing Health Care for Criminals in General Hospital Wirmando, Wirmando; Astari, Asti Melani; Yuliatun, Laily
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.2021.031.03.4

Abstract

Providing health care for criminals is very complex, stressful, and challenging for the general hospital nurses who are usually not habituated to treat them. The nurses are required to keep their caring and professional work. Providing health care for criminals puts the nurses into a risky working environment. They are susceptible to physical and psychological aggressions that can influence their practices and their applied nursing care quality. The objective of this research is to explore the general hospital nurses' experience in providing health care for the criminals. This is qualitative method research with a phenomenological approach. The data collection was done by a deep interview for 10 nurses. The applied data analysis is the Interpretative Analysis Phenomenology (IPA). The six themes found in the research are: 1) feeling discomfort in working, 2) experiencing emotional conflict, 3) working in an unsafe environment, 4) having difficulties in creating a therapeutic relationship, 5) unnatural caring emergence, and 6) not wanting the police officers to get involved in treating the patients. The security and emotional feeling factors of the nurses become the greatest challenges. They make the nurses difficult to create a therapeutic relationship and lead to unnatural caring committed by the nurses. Therefore, it is important for the nurses to internalize and reflect sincere caring as the essential principles in the nursing profession. Thus, it can reach the objectives of nursing, service equality, and patient recovery.
Re-engineering Prescription Services as an Alternative Solution Indriastutik, Nunung; Fitriasari, Nikma; Rusdiana, Dina
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Medication errors could occur at any stage, including prescribing, transcribing, dispensing, and administration stages. Errors in the prescribing stage accounted for the most significant percentage, ranging from 70% to 99%. The most mistake at the prescribing stage is the illegible prescription. This situation causes high morbidity and mortality in hospitals. This study aimed to analyze the root of the problems of the incidence of illegible prescriptions and find anticipating strategies. This research is a descriptive study initiated by finding the root of the problems, followed by identifying alternative solutions and preparing priority solutions. From the analysis of the root of the problems, the illegible prescription included incomplete identity, drug name and the preparation, unclear usage, the error in assuming the writing in the prescription, and ineffective design of the prescription. The solution chosen was the improvement of prescription service flow (re-engineering) that added an identity labeling procedure to correct the error on patient's identity due to the repetition of manual writing and the addition of an authorization procedure by double-checking. The second solution was creating patient identity labels, creating appropriate prescription designs, and developing prescription service guidelines to support the implementation of prescription services re-engineering. This research concludes that the root of the problems on the illegible prescription is the absence of prescription service procedures that aim to anticipate medication errors. Hence, a re-engineering of prescription service needs to be prepared as an alternative solution
Optimation of Combination of N-Hexane Solution and Ethyle Acetate on Secondary Metabolite Compounds Profile of Streptomyces hygroscopicus Ariel, Dio Giovanni; Winarsih, Sri; Putri, Fitria Febriliani; Erwan, Nabila Erina; Putri, Ajeng Maharani; Cahyono, Alfian Wika; Mardhiyyah, Kana; Fitri, Loeki Enggar; Nugraha, Rivo Yudhinata Brian
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.2021.031.03.11

Abstract

Streptomyces hygroscopicus (S.hygroscopicus) is a Gram-positive soil bacterium that can produce secondary metabolites from fermentation that have a therapeutic effect. The fermented S. hygrocospicus metabolites that are still in the form of crude extracts are difficult to develop as drug preparations because the active compounds are not yet known, so it will be challenging to determine the dosage of drugs that have a therapeutic effect. Therefore, it is necessary to carry out exploratory research to narrow down the secondary metabolite profile from the fermentation of S. hygroscopicus, using extraction and fractionation methods, which are then identified by Thin-Layer Chromatography (TLC) using a combination of solvents. This study used the extraction method with a separating funnel. The fractionation was carried out using the BUCHI (Sepacore®) Flash Chromatography and Reveleris® PREP Purification System column chromatography gradually using ethyl acetate and n-hexana.  47 and 60 of the fractionation results were taken as samples, that further were profiled using TLC and given the appearance of 10% KOH stains and p-Anisaldehyde - sulfuric acid, so that various classes of compounds with different Rf values were obtained, namely Monoterpenes, Triterpenes, Steroids, Saponins, Coumarin, Scopoletin, and Alkaloids.
Three Characterisctics of Atopy to Diagnose Allergy in Children with Respiratory Symptomps Far-Far, Imanuel; Endaryanto, Anang; Setyoningrum, Retno Asih; Soegiarto, Gatot
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.2020.031.02.9

Abstract

The prevalence of allergic diseases has increased in the last decade. Therefore, precise and reliable in predicting allergy in children were needed. However, in daily practice, most misdiagnosis occurs because it is only based on a family history of allergy. This study aims to evaluate the chronicity, recurrence of symptoms with similar exposure, and family history of allergy to be used as a predictor of allergy in children with respiratory symptoms. Cross sectional study was conducted in children who referred to the Pediatric Allergy and Immunology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya from January 1st - July 31st 2019. Children with a suspected allergy who developed respiratory symptoms was included. The data was taken from standardized medical record. The sensitivity and specificity of the 3 characteristics of atopic with positive SPT were calculated. A total of 115 children were admitted and 109 children fulfill the inclusion criteria. Gender 60% male and 40% female. The most common group of age founded was age 5-<10 years 39.4%, followed by 1-<3 years (25.8%), 3-<5 years (22.9%), 10 years 8.3%, and <1 year (3.6%). Fifty-four patients (49.5%) fulfilled 3 characteristics of atopy and there were 64 patients (58.7%) with positive SPT results. The sensitivity, specificity, positive predictive value and negative predictive value were 81.3%, 95.6%, 96.3%, and 78.2%, respectively. The 3 characteristics of atopy have good sensitivity and specificity to predict allergy in children.
Gender Differences in Denial-Acceptance Duration Based on Kübler-Ross Cycle After HIV Diagnosis Burhan, Niniek Budiarti; Febriliant, Muhammad Reza
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.2021.031.03.7

Abstract

Patients who have been diagnosed with HIV often suffer from sadness and grief that, in turn, affect the adherence to HIV treatment. This study aimed to examine gender differences in the denial-acceptance duration based on the Kübler-Ross cycle in patients after diagnosed with HIV. A cross-sectional survey was conducted on 63 adult HIV patients aged 19-60 years who received routine treatment at the HIV/VCT outpatient department of Saiful Anwar General Hospital Malang. Subjects were interviewed using the Acceptance of Disease and Impairments Questionnaire (ADIQ). Gender differences in denial-acceptance duration after diagnosed with HIV were analyzed using the unpaired T-test. Results were statistically significant if p value <0.05. The median duration of denial-acceptance in male subjects was 16 weeks with the shortest duration of 1 week and the longest duration of 144 weeks, while the median duration of female subjects was 12 weeks with the shortest duration of 1 week and the longest duration of 240 weeks. There are no gender differences in the denial-acceptance duration (p value = 0.629). In conclusion, there are no gender differences in denial-acceptance duration based on the Kübler-Ross cycle after diagnosed with HIV.
Physical Activity Correlates to Body Mass Index among Medical Students Vikawati, Nura Eky; Sarosa, Hadi; Makarim, Fadli Rizal; Fasitasari, Minidian
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.2020.031.02.8

Abstract

Physical activity (PA) has a positive effect on preventing risk on cardiovascular and metabolic syndrome, including obesity. Learning behavior that tends to be sedentary causes medical students to tend to be physically inactive. This present study aimed to associate the physical activity (PA) level with blood pressure, body mass index, and non-fasting blood glucose level (NFBG) among medical students. This cross-sectional study was conducted from February to March in 2019 on the first-year medical students at Sultan Agung Islamic University (UNISSULA). A total of 167 medical students (64.7% female and 35.3% male) were enrolled in this study. The international physical activity questionnaire (IPAQ)-short form was used to measure the PA level. The activity level was classified into low, moderate, and high. Blood pressure and glucose level were measured using a digital sphygmomanometer and NFBG dipstick. The association between PA level and Body Mass Index (BMI), Blood Pressure (BP), and NFBG level were analyzed using Spearman's correlation test. Chi square test was done to analyse the difference of PA level between male and female groups. The majority of the respondents had a low PA level (64.7%). A positive association was shown between PA level and BMI (p<0.05, r=0.192). Female medical students tend to be physically inactive than males (OR 2.004, 95% CI (1.038-3.8690)). Female students need to be encouraged to do more physical activity. The university's policies that promote physical outdoor activity need to be suggested.  
Frontliner: Does it play a role in reducing the waiting time of outpatient registration? Hapsari, Riva Redianita; Fitriasari, Nikma; Pratama, Bramantya Surya
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

Outpatient services often become the first gateway for patient access to hospital services. One of the minimum service standards for improving the quality of hospital services is collecting the medical record files in less than 10 minutes. This study aimed to prove whether the frontliners can help cut the process in the outpatient registration by revising the SOP and describing the outline of the outpatient service flow involving the frontliners at Ananda Srengat Hospital. The study applied quantitative analysis methods with a descriptive analysis technique to patients, medical records unit employees, outpatients, and related units. A total population of 10 people was taken within one week. The methods of collecting data were using a questionnaire instrument and a stopwatch. The results of this study are the changes in the SOP and the description of frontliner tasks in assisting the process of sorting files that can reduce the process of registration waiting time.
Comparison of Snail-1 and Estrogen Receptor Immunoexpression between Fibroadenomas and Phyllodes Tumors Quzwain, Fairuz
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.2020.031.02.6

Abstract

Fibroadenomas (FA) and phyllodes tumors (PT) are fibroepithelial lesions in the breast, which until now the relationship between the pathogenesis of both have not been ascertained yet. Epithelial cells are thought to be involved in the regulation of changes in the stromal cells in the PT, so it can be estimated that this process is involved in epithelial-mesenchymal transition (EMT). This study aims to compare of snail family transcriptional repressor 1 (Snail-1) and estrogen receptor (ER) impression as EMT factors among tumor type  (FA, benign PT, boderline PT and malignant PT). This study was an observational analysis with the cross-sectional method. After the histologic grade of the samples was reviewed, immunohistochemistry examination for ER and Snail-1 was performed. Statistical analysis for categorical data was tested by chi-square test. There were 66 samples, consists of 20 FA, 17 benign PT, 16 borderlines PT, and 13 malignant PT. A significant difference in the loss of ER expression in borderline and malignant PT was found compared to FA and benign PT. This is inversely proportional to the snail-1 expression, where the expression was high in borderline PT and malignant PT stromal cells. This could support the consideration of the pathomechanism regulation of epithelial-mesenchymal cell transition changes in FA with PT, where Snail-1 is one of the proteins in the regulation of the EMT and RE processes acting as an inhibiting factor in transcription factors in the mechanism of EMT occurrence.
Re-Layout of Service Room to Overcome Waiting Time of Finished Drug Services in Outpatient Pharmacy of dr. Iskak General Hospital Tulungagung Yulianto, Wahyu; Sujianto, Sujianto; Hariyanti, Tita
Jurnal Kedokteran Brawijaya Article in Press
Publisher : Fakultas Kedokteran Universitas Brawijaya

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Abstract

ABSTRACT Background: The minimum standard waiting time for finished drug services in an outpatient pharmacy depot is less than 30 minutes. However, the implementation of standard waiting time for finished drug services at dr. Iskak General Hospital Tulungagung is still above the standard that is 69.83 minutes. This study aimed to analyze the factors causing the long waiting time for finished drug services in outpatient pharmacy and to find solutions to overcome the long waiting time.Methods:  This research used a qualitative method, and the data collection was carried out by observation, interviews, and focus group discussions (FGD).Results:  The observation results show that the actual time required to complete one prescription was 11 minutes and 50 seconds. The roots of the problem identified were the accumulation of prescriptions in the administration of the outpatient pharmacy depot, inefficient service layout, and low utilization of information technology. The results of the FGD illustrated the alternative solutions to the regulation of prescription arrival by setting the doctor schedule, the application of electronic prescriptions, and spatial arrangements for outpatient pharmacy depots.Conclution: This study concluded that ineffective service layout is a very influential factor in the waiting time for finished drug services in the pharmacy. Arrangement of the outpatient pharmacy service layout can reduce the waiting time for drug services into less than 30 minutes.Keywords: waiting time, focus group discussion, re-layout, pharmacy

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