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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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Chromosome Aberration on Growth and Developmental Disorder Eva Diah Setijowati; Herni Suprapti; Maria Widijanti Sugeng; Retno Dwi Wulandari
Jurnal Kedokteran Brawijaya Vol. 32 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.02.5

Abstract

Growth and development in humans begin at conception, which shows progress and interdependence. Normal children show the characteristic of growth and development. In children with growth and development disorder, chromosomal abnormality may be found. This study aimed to determine chromosomal abnormality in patients with growth and development disorder. The samples were taken from karyotype results of patients in the Medical Genetics Laboratory, Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, from 2010-2020. The inclusion criteria were infants to adolescents aged 24 years and unmarried who experienced impaired growth and development, including sexual development. Chromosomal abnormalities were obtained from cytogenetic analysis using the G-banding method. From 75 samples with growth and development disorders, there were abnormalities in the number of autosomal chromosomes and sex chromosomes found in patients with Down syndrome, Turner syndrome, Klinefelter syndrome, and Edwards syndrome. Chromosomal structural abnormalities found were deletion, translocation, inversion, duplication, marker chromosome, and heteromorphism. This study showed the importance of karyotyping in children and adolescents with growth and developmental disorders.
Comparative Assessment of the Safety between Pazopanib and Sunitinib for Metastatic Renal Cell Carcinoma Eka Yudha Rahman; Choirin Nur; Deddy Rasyidan Yulizar
Jurnal Kedokteran Brawijaya Vol. 32 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.02.4

Abstract

Renal cell carcinoma (RCC) is the most common kidney lesion with approximately 90% of all kidney malignancies and 30% of people with RCC have developed metastasis at the time of diagnosis. Based on European Association of Urology (EAU) guideline, therapy for metastatic RCC (mRCC) patient who cannot tolerate immune checkpoint inhibitor is pazopanib or sunitinib. However, these drugs cause several uncomfortable side effects for the patient. Therefore, this meta-analysis was made, based on the available evidence base, to compare the safety of pazopanib and sunitinib as the treatment of mRCC. Systematic reviews were made in accordance with the PRISMA guideline requirements, a literature review was conducted in January 2022 used PubMed, ScienceDirect, Cochrane Library, publishing year of at least 10 years with an adult population. And the data is analyzed using RevMan V.5.4. In total 1.665 participants, there were 431 patients taking pazopanib and 1.234 patients taking sunitinib from 8 studies. The result shows that sunitinib has more frequent result of side effects than pazopanib in several occasion like hand-foot syndrome, nausea/vomiting, skin rash, stomatitis & mucosal inflammation, leucopenia and thrombocytopenia. Meanwhile, there are no significant differences between pazopanib and sunitinib in causing other side effect such as fatigue, diarrhea, hypertension, anemia, and increased liver enzymes. The conclusion is that pazopanib is better and has less frequent side effects than sunitinib.
Perceived Family Functionality among Elderly Patient with Covid-19 Infection: A Perspective from Developing Country Sri Sunarti; Didi Candradikusuma; Dewi Indiastari; Siti Fatma Prehatiningsih; Bogi Pratomo Wibowo; Affa Kiysa Waafi
Jurnal Kedokteran Brawijaya Vol. 32 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.02.8

Abstract

Family is a basic social unit of senior citizen. Relationship among family members considered as source of emotional comfort. Meanwhile, economic, political, and social changes during pandemic has an impact on the family, the support provided can be manifested among vulnerable groups such as the elderly. Prolonged stress due to isolation care of Covid-19 infection increase psychological distress by reducing family support. This study aimed to explore perceived family function among elderly patients after Covid-19 infection. A cross sectional study was conducted among 33 elder patients with history of Covid-19 infection in Saiful Anwar General Hospital, Indonesia. Perceived family functionality was evaluated using APGAR family score. Data was analyzed using descriptive analyses, independent T test, correlation and regression. Mean total APGAR score was 9.610.70 with joint pain had significant association with APGAR score (p 0.021) indicating full family support in elder person with symptoms. Gender female was associated with 'Resolve' (p 0.038) which might correlate with bigger role of elder female in Indonesian family. Length of stay was significantly associated with 'Partnership' (p 0.012) and 'Growth' (0.043) with inverse correlation. It showed how prolonged hospital stay affected family relationship especially in terms of communication. Perceived family supports remained high in elderly during Covid-19 isolation in Indonesia. Specific symptoms such as joint pain, even strengthen the family support for elder member of family. Prolonged stay in the hospital during Covid-19 infection, might become a communication barrier between elder person and the family which affect decision sharing and emotional expression.
Initial Assessment Form of Medical Record Document: Is It Important to Complete? Zhafira Anisah Kesuma; Nuthea, Merry; Hariyanti, Tita
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.2022.032.01.4s

Abstract

Medical record document completeness is crucial because it serves as a means of communication, quality evaluation, payment, and legal protection. A preliminary study showed that none of the initial assessment forms in the outpatient unit of Puri Bunda Mother and Child Hospital were filled completely. This study aimed to explore the causes of incomplete initial assessment forms to avoid lawsuits against the hospital. The method used was qualitative research with a case study approach. Data were collected using triangulation, which included in-depth interviews with 15 participants, flow observations, and document studies on 150 medical record files. Data were analyzed using thematic analysis. The document study found none of the medical records with a complete initial assessment form (0%). A total of 141 documents (94%) were not filled at all, and only 9 (6%) of the initial assessment forms were filled in certain fields. The flow observation disclosed that file availability was one of the contributing problems to the completeness of filling. Seven reasons for incomplete initial medical assessment documents were categorized into individual internal and external factors. The internal factors include the lack of awareness of doctors and feeling a high workload, and the external factors include the absence of communication between management and doctors, unavailability of work procedures, the absence of a reward and punishment system, the format and availability of initial assessment forms, and individual culture.
Decreased Motivation as a Reason for Switching Normal Labor from Obstetricians to Midwives in Hospitals Kusuma Wardhana, Eka Chandra; Nuthea, Merry; Hariyanti, Tita
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.2022.032.01.9s

Abstract

Based on the regulations, normal delivery with complications referred to a mother and child hospital is not under the right and obligation of the midwife as a maternity leader but must be led by an obstetrician. However, 58% of the normal deliveries were referred to midwives at Puri Bunda Mother and Child Hospital. This study aimed to explore the cause of the transfer of leadership in normal deliveries from obstetricians to midwives as the basis for developing solutions to the problems. This research was qualitative with a case study approach. Data were collected through focus group discussions, unstructured observations, and in-depth interviews. The total number of participants involved in this study was 16 people. Focus group discussions were conducted with midwives in the delivery room. In-depth interviews were conducted with the hospital director, the head of the delivery room, and obstetricians who provide normal delivery services. The results showed no guidelines and policies regarding the transfer of normal deliveries.
Teleconsultation in Hospital Service: Implementation Challenge Ernawati, Cicilia Maria; Agustina, Else; Suryanto, Suryanto
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.2022.032.01.3s

Abstract

Teleconsultation is one of the telemedicine services provided by hospitals and is getting popular during the Covid-19 pandemic. As a new service model, developing a quality management system that can ensure the effectiveness and safety of this service to provide users' satisfaction is necessary. This research aimed to identify and analyze the process and problems of teleconsultation services. This research was qualitative with a descriptive case study approach to get a detailed picture of the teleconsultation process in a hospital and its issues. The study was conducted from September to October 2021 in a type C private hospital in Malang. Data were obtained from interviews with officers and patient feedback on teleconsultation services. Problems in teleconsultation services in the hospital were ineffective communication, limited-service coverage, lack of support for medical support facilities, technological constraints, lack of understanding of service flow, and cost affordability.
Stock Procurement and Documentation as Emergency Trolley Content Discrepancy Factors in Emergency Installation (Study on a Private General Hospital in Malang Regency) Yoga Sedana, I Ketut; Listuhayu, Kararawi; Setijowati, Nanik
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.2022.032.01.1s

Abstract

One of the common problems in managing emergency logistics is the emergency trolley that conflicts with the standard operating procedures. It causes a mismatch of the emergency trolley contents. In fact, the availability of unstandardized emergency trolleys will impact the quality of emergency services in the emergency department. The emergency medicine shortage and emergency trolley content discrepancy also occurred several times in the ER. This study was conducted to analyze the determinant factor of content discrepancy in the emergency trolley in the emergency room of a private hospital in Malang Regency. The research method used was descriptive quantitative. The methods of identifying the root of the problem were carried out through field observations, literature studies, brainstorming, and Focus Group Discussions (FGD). Statistical tests were done using Bartlett's test of sphericity and Kaiser-Mayer Olkin (KMO) with a value higher or equivalent to 0.5. The study results formed two determinants of content discrepancies in the emergency trolley in the ER. The stock procurement factor is able to explain the problem by 48.02%, and the process documentation factor is able to explain the problem by 17.63%.
Determinants of Suboptimal Use of Digital Marketing at X Hospital Pradana, Endy Wira; Hanggriyani, Kristiwi; Prawestiningtyas, Eriko
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.2022.032.01.17s

Abstract

During the Covid-19 pandemic era, digital-based hospital activities were chosen as an alternative solution to support the physical distancing policy. Digital marketing is a digital-based marketing activity to reach customers widely. This study aimed to determine the determinants of suboptimal digital marketing in X Hospital. This research was conducted using a qualitative descriptive method. Data were collected using observation, document review, and Focus Group Discussion (FGD). FGD respondents determined were six respondents consisting of the Head of General and Administrative Division, Head of Finance, two Public Relations and Marketing Staff, Hospital Management Information System (SIMRS) staff, and Patient Registration Coordinator. The root of the problem is presented in the fishbone diagram and followed by the 5-Whys method. The priority of the root of the problem found was that the PR and marketing unit staff of X Hospital had not optimally used the features on social media for marketing activities. The alternative solution was chosen using a scoring method on Capability, Accessibility, Readiness, and Leverage (CARL), which was optimizing the Instagram business feature as the main social media for X Hospital in the digital marketing activities.
Causes of Medication Errors in Inpatient Wards at Private Hospital in Malang Faruqi, Faris; Maiga Mahliafa Noor, Viva; Suryanto, Suryanto
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.2022.032.01.5s

Abstract

The absence of medication errors is a sign of successful implementation of patient safety management, particularly safe treatment. The quality indicator data report at the Pharmacy Installation of a private hospital in Malang in 2020 showed a number of drug administration errors in the inpatient unit. This study aimed to explore the incidence and causes of medication errors in the inpatient unit. The study was conducted at a private hospital in Malang in August-September 2021. The study design was descriptive with data collected through focus group discussions (FGD) with five inpatient pharmacy staff, four inpatient nurses, and the head of the medical support. The study results indicated no clear regulation, especially the Standard Operational Procedure (SOP) for administering drugs to inpatients, which becomes a latent cause of medication errors. Hospitals need to develop SOPs for administering drugs to inpatients according to the 7 Pillars, followed by socialization to nurses in inpatients and periodic monitoring.
Analysis of Factors for Incomplete Informed Consent at Medical Record Installation of Bangil Regional General Hospital in 2021 Mahbubah, Mahbubah; Roosalina, Arma; Holipah, Holipah
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.2022.032.01.7s

Abstract

All medical procedures on patients must be initiated by completing the informed consent. According to the hospital's minimum service standard, the completeness of informed consent filling is 100%, but the achievement of informed consent completeness at Bangil Regional General Hospital is still 37%. This study analyzed the causative factors of incomplete informed consent at Bangil General Hospital. The data analysis method used was descriptive. Data collection techniques were document studies and focus group discussions (FGD). Document studies were conducted on 100 informed consent documents, and FGD was done with 17 people consisting of 7 physicians-in-charge and 10 installation heads. The results of the FGD were analyzed using a fishbone diagram and revealed a list of problems that caused incomplete informed consent at Bangil General Hospital; then, scoring was carried out to determine the three main factors driving the problem of incomplete informed consent at the hospital. The three main factors for incomplete informed consent were the absence of a flow or policy guide for filling out, the unavailability of informed consent documents in outpatient installations, and the absence of a person in charge of the room for filling out informed consent.

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