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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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Predictive measure for Ischemic Heart Disease among Workers in Jakarta, Indonesia Leli Hesti Indriyati; Gea Pandhita S; Nurhayati Anis; Anna Suraya
Jurnal Kedokteran Brawijaya Vol. 31 No. 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.8

Abstract

Ischemic Heart Disease (IHD) is one of the leading causes of morbidity and mortality in many countries, including Indonesia. Therefore, cardiovascular risk-prediction models are required in clinical practice for early detection in high-risk populations, including the worker population. This study intends to develop a predictive risk measure for early detection of IHD incidences among employees in Jakarta, Indonesia. Source of data was the database of 4,100 medical check-up (MCU) results of employees and entrepreneurs in Jakarta and surrounding areas in January to October 2019. Multivariate analysis showed that being aged >40 years (p=0.000; OR=5.329 (95% CI 2.621-10.833)), having a history of dyspnea (p=0.000; OR=5.699 (95% CI 2.524-12.871)), smoking (p=0.048; OR=2.007 (95% CI 1.924-4.359)) and HDL<50 mg/dL (p=0.049; OR=1.811 (95% CI 1.099-3.281)) were all good predictors to detect IHD in the worker population. The combination of these predictors results with a cut-off point of 2.5, showed accuracy (79.2% sensitivity and 66.3% specificity). Workers who have a score >2.5 are at high risk of developing IHD in the future. This scoring system can be used by workers or companies to take early preventive measures.
Validation of TWIST (Testicular Workup for Ischemia and Suspected Torsion) Score System for Differential Diagnosis in Acute Scrotum in Tertiary Teaching Hospital Nyoman Gede Prayudi; Besut Daryanto; Taufiq Nur Budaya
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.4

Abstract

The acute scrotum is a common urological emergency and has a broad differential diagnosis. There is no clear consensus on a particular algorithm to follow in the diagnosis of testicular torsion. Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score, a risk scoring system based on signs and symptoms, can be invaluable in managing patients with the acute scrotum, specifically testicular torsion. This study aimed to evaluate the effectiveness of the TWIST scoring system for differential diagnosis of acute scrotal patients. The study was conducted using secondary data, medical records from 111 male patients diagnosed with acute scrotum in Saiful Anwar General Hospital Malang between January 2015 and December 2018. Data about the onset of pain, first contact, history, physical examination findings, any adjunct test performed, and intra-operative findings were collected. The effectiveness of the TWIST score in diagnosing testicular torsion was determined by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Of the 111 patients, 43 patients (38.7%) had testicular torsion. The mean age was 17.49 (6.69) years. A total of 39 patients were classified as high risk as per the TWIST Score with cut point 5 had 83.7% sensitivity, 95.6% specificity, 92.3% positive predictive value (PPV), and 90.3% negative predictive value (NPV). The area under the curve was 0.93. The use of the TWIST Score in clinical practice can accurately determine high-risk patients who can proceed straight to the operating theatre without the need for an ultrasound.
The Theory of Planned Behavior to Identify Out-of-Hospital Cardiac Arrest (OHCA) Bystanders' Intentions Zenita Habibatul Ilmiyah; Sri Andarini; Tony Suharsono
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.11

Abstract

The theory of planned behavior states that intention is the best predictor of behavior. The intention to perform a behavior is determined by a person's attitude, subjective norms, and perceived behavioral control. As volunteers in the health sector, volunteers of the Indonesian Red Cross (PMI) have been equipped with knowledge and skills regarding the role of an OHCA bystander. Besides, the intentions of PMI volunteers greatly affect a person's tendency to be willing or unwilling to become an OHCA bystander. This study aims to apply the theory of planned behavior in identifying the factors that influence the intentions of PMI volunteers in acting as OHCA bystanders and the dominant factors that affect intentions. This study used an observational research type with a cross-sectional approach. The respondents in this study were 105 PMI volunteer members in Tuban Regency, which were conducted using the purposive sampling technique. In determining the most dominant factor that influenced intention, ordinal logistic regression analysis was used in which it was shown that the variable used in the last modeling analysis stage was the subjective norm (OR= 6.19). Based on the results of the analysis, it can be concluded that subjective norms are the most predictor factor that influences intentions.
Baseline Stroke Severity as a Predictor of 30-Day Post-Ischemic Stroke Disability Outcome Diana Teresa; Rizaldy Taslim Pinzon; Sugianto Adisaputro
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.6

Abstract

More than 50% of patients who survived stroke have a chronic disability. The National Institute of Health Stroke Scale (NIHSS) is a scoring system to determine the neurologic deficit of a stroke patient. This study analyzed stroke severity based on baseline NIHSS score as a determinant for 30-day post-ischemic stroke disability. This study method uses a retrospective cohort design based on medical records and stroke registry of ischemic stroke patients in Bethesda Hospital Yogyakarta. During admission, the predictive factors for the disability of the study subjects were evaluated. The baseline NIHSS assessment score was measured at 1x24 hours after admission. Disability was measured using a simplified modified Rankin Scale questionnaire (smRSq) Indonesian version at 30-day post-ischemic stroke. Statistical analysis includes univariate, bivariate, and logistic regression multivariate data analysis. The subjects were 84 patients with ischemic stroke. Disability at 30-day post-ischemic stroke occurred in 22 patients (26.2%). Logistic regression multivariate analysis show that Neutrophil to Lymphocyte Ratio (NLR) (RR: 4.488, CI: 1.873–10.756, p: 0.001) and baseline NIHSS score (RR: 28.563, CI: 2.891–282.181, p: 0.004) together significantly affect the mRS of 30-day post-ischemic stroke. Patients admitted with a higher baseline NIHSS score have a 28.5 fold risk for a worse functional outcome than those with lower baseline NIHSS scores. Stroke severity based on baseline NIHSS score is a determinant factor for disability in patients at 30-day post-ischemic stroke.
Effectiveness of 0.1% Retinol Serum and Astaxanthin Gel on Skin Photoaging Boedhy Setyanto; Sinta Murlistyarini; Dea Florensia
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.12

Abstract

Skin photoaging is cumulative skin damage due to chronic environmental exposure, especially ultraviolet (UV) light, which interferes with the keratinocyte and fibroblast syntheses by matrix metalloproteinases (MMP). Retinol can improve wrinkles, pigmentation, elasticity, firmness, brightness, and various signs of photoaging on the skin. Astaxanthin is a powerful antioxidant that protects the skin from UV rays, inhibits MMP, and stimulates collagen production. This case report presents 2 cases of women complaining about deep skin wrinkles, dullness, and looseness. Physical examination in the facial region revealed wrinkles when resting in the first patient and wrinkles during motion in the second patient. The first patient was diagnosed Glogau III photoaging, while the second patient was diagnosed Glogau II photoaging. Both patients received astaxanthin gel therapy and SPF 33 sunscreen cream every morning, as well as 0.1% retinol serum every night. There was an improvement after six weeks. Astaxanthin and retinol 0.1% can be used as photoaging therapy. Adequate use of photoprotection is also necessary to prevent the worsening of photoaging.
Correlation between Nurse Practice and Pre-hospital Ambulance Service Satisfaction in Bali I Wayan Edi Sanjana; Titin Andri Wihastuti; Nurul Muslihah
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.8

Abstract

The pre-hospital emergency service was the first guard of nursing and treatment delivery. The pre-hospital ambulance service could be used to offer first aid to the patient or victim who experienced trauma or non-trauma with unpredictable condition. The improvement of service quality on emergency sector was required to assure that the health service was given and performed well. This research was aimed to analyze the correlation between nurse practice and pre-hospital ambulance service satisfaction in Bali. The correlative analytic research method and cross sectional approach were exerted to accomplish this research. The total sample was 271 respondents which were consisted of 144 patients and 127 nurses. The result of Spearman-rank referred p value 0.024; r 0.189 which it was indicated a significant relation between nurse practice and pre-hospital ambulance service satisfaction in Bali. The nurse practice was instituted through educational degree and training experience. The improvement of nurse practice value was in line with the pre-hospital ambulance service satisfaction value in Bali.
Risk Factors for Mortality Due to Covid-19: A Case Study at a Distric Hospital in March-September 2020 Luthfiana Husnaini Utami; Dyah Yulia Ariani; Oskar Renagalih Amarta
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.14

Abstract

The Covid-19 pandemic, which becomes a global health problem, has widely impacted not only health but also social, economic, and politics in Indonesia. Previous studies have indicated that the patient's prognosis is influenced by the degree of disease, age, gender, and comorbidities. District hospital in Bojonegoro is a Covid-19 referral hospital and 37,1 % of patients who died in march-september 2020. This study was conducted to identify risk factors for death in patients with Covid-19 in hospital so we can reduce casa fatality rate in district hospital in Bojonegoro. The independent variables in the study were age, gender, and comorbid status, while the dependent variable was the output status (recovered or deceased). The study was conducted at a private hospital in East Java in October 2020 on 104 patients as subjects. Data were analyzed using the chi-square test. The results show that all the factors studied, age p = 0.006, gender p = 0.050, and comorbid status p = 0.001, have a statistically significant relationship with mortality. In short, at this hospital, advanced age, male gender, and comorbidities are the risk factors for Covid-19 death.
Comparing Personal Protective Equipment Practice among Health Worker's Job Role and Hospital Unit Perdani, Fandaruzzahra Putri; Chalidyanto, Djazuly
Jurnal Kedokteran Brawijaya Vol. 32 Supplement 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.8s

Abstract

Health workers have the highest risk exposure that can increase the pathogen infection risk during the Covid-19 pandemic. The use of Personal Protective Equipment (PPE) is the most significant prevention, but mistakes while using PPE may occur in the donning (putting on) and doffing (taking off) process. This study compares the practice of using PPE among groups of health providers and hospital service units. The study design was a cross-sectional study conducted on non-infectious hospital employees in one specific hospital in Surabaya, totaling 102 employees. The Infection Prevention and Control Link Nurse (IPCLN) of the hospital conducted observations and analyses of health personnel in inpatient and triage units, treatment units, and support units. Based on the job roles, the employees were divided into health providers, healthcare support workers, and other health workers. Work units were categorized into inpatient units, outpatient and triage units, treatment units, and support units (cashier and registration areas). The results of the assessment were measured using One-Way ANOVA. Based on the job role, significant errors occurred when removing masks (p=0.048) made by health workers (38%). Meanwhile, in the hospital unit category, significant errors occurred in removing masks (p=0.000) and the use of gloves (p=0.002). Most mistakes were made in the outpatient and triage units, 92% and 42%, respectively. The complexity of wearing and removing PPE requires increased awareness and updated training on the correct use of PPE for all health workers who work in hospitals based on WHO recommendations during the Covid-19 pandemic.
Epidermoid Cyst of Sole Wuriandaru Kurniasih; Arif Widiatmoko
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.13

Abstract

An epidermoid cyst is benign cystic tumor coated with squamous epithelium and contains keratin. It generally appear on the body parts which have pilosebaceous follicles, such as head, neck, and body. The manifestation of the disease is a skin-colored, mobile, painless nodule with a punctum in the center. Epidermoid cyst of sole is often similar to clavus, callus, and verruca plantaris. However, epidermoid cyst of sole is rare because the area is without pilosebaceous follicles. The etiopathology is believed due to trauma that causes implantation of epidermal cells into the dermis layer, thus triggering the formation of epidermoid cysts. This case report a girl with an epidermoid cyst of sole that was initially thought as a verruca plantaris and clavus. A 14-year-old girl complained about a bump on her right foot that got bigger during nine months. The lesions surface was slippery, and the patient felt pain when walking. The patient denied any trauma or changing footwear with friends or relatives. Examination in the right lateral plantar pedis region, a nodule was found skin-colored, round, measuring 2x2 cm, and solitary. The patient was planned to undergo excochleation, but since a white cystic mass was found during the operation, it was continued with extirpation surgery. The histopathological examination results showed a stroma with keratin, which was concluded as an epidermoid cyst. In the case of epidermoid cysts with atypical clinical symptoms and unusual lesion locations, histopathological examination is required for a definite diagnosis.
The Use of PILA-Pack: Differences in Length of Stay of Hemorrhoidal Patients Fadli Robby Amsriza; Rizka Fakhriani
Jurnal Kedokteran Brawijaya Vol. 32 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.01.7

Abstract

Hemorrhoids are a common anorectal disease and can affect all ages. This research aims to specify the differences in Length of Stay (LOS) of hemorrhoidal patients who underwent a modified combined method of rubber ligation and sclerotic injection using Paran Injection Ligation for Ambeien pack (PILA pack) compared to a hemorrhoidectomy. This study consisted of 56 respondents who underwent hemorrhoidectomy, and the other 56 respondents experienced a modified combined method of rubber ligation and sclerotic injection using a PILA pack. Data showed the LOS's average of respondents who underwent hemorrhoidectomy was 47.33 hours or 1.97 days. Meanwhile, respondents' average length of stay who underwent a modified combined rubber ligation and sclerotic injection using a PILA pack was 20.44 hours or 0.85 days. Finally, the T-test results showed a p-value of 0.001 (p<0.05), indicating that there was a statistically significant difference in the average LOS between hemorrhoidal patients who underwent hemorrhoidectomy and hemorrhoidal patients who underwent a modified combined method of rubber ligation and sclerotic injection using PILA pack. Based on the result, it can be concluded that the mean LOS for hemorrhoidal patients receiving haemorrhoidectomy vs. hemorrhoidal patients undergoing a modified technique of rubber ligation and sclerotic injection utilizing the Paran Injection Ligation for Ambeien pack was significantly different.

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