https://ejournal.unsrat.ac.id/v3/index.php/msj/issue/feed Medical Scope Journal 2023-01-20T12:41:19+08:00 Sonny J. R. Kalangi sonnykalangi05@gmail.com Open Journal Systems <p><strong>Medical Scope Journal (MSJ) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia (PAAI) Komisariat Manado bekerjasama dengan Fakultas Kedokteran Universitas Sam Ratulangi dua kali setahun pada bulan Juni dan Desember. Tulisan yang dimuat dapat berupa artikel telaah (review article), hasil penelitian, dan laporan kasus dalam bidang ilmu kedokteran baik dalam bahasa Indonesia maupun dalam bahasa Inggris.</strong></p> https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/41689 Perilaku Profesional Tenaga Medis terhadap Tanggung Jawab Etik dan Transaksi Terapeutik dalam Menjalankan Kewenangan Klinis 2022-09-27T12:18:32+08:00 Vini H. R. Gosal vini.gosal08@gmail.com Aaltje E. Manampiring srjph@unsrat.ac.id Caecilia Waha caeciliawaha@unsrat.ac.id <p><strong>Abstract</strong>: Professional medical personnel must have elements of professionalism, basic principles of medicine and professional ethics in carrying out their profession. Clinical privilege is a doctor's special right obtained through the credential process by the Medical Committee. This study aimed to analyze the medical personnel towards ehical responsibility and therapeutic transactions in doing their clinical privilege. This was a qualitative study using case study method. Subjects were eight people consisting of general practitioners, specialists, the chairman of the Medical Committee, and the sub-committee for credentials of Rumah Sakit Umum Manado Medical Center. Primary data were obtained through in-depth interviews and observation guidelines. Validity of the data was done using the triangulation method. The results showed that the behavior of doctors was in accordance with the element of professionalism, but not all of them applied the professional behavior ethics according to hospital standard operating procedure (SOP). Based on the implementation of therapeutic transactions, not all of them have carried out the doctor's obligation to explain the patient's diagnosis completely and in detail simplly to be understood. The results of implementation of the credential were suitable to the procedure, but for evaluation, it was not optimal due to the re-credential was not carried out. In conclusion, not all medical personnel applied the professional behavior ethics according to hospital (SOP). Monitoring and evaluation through re-credentialing of medical personnel had not been performed at Manado Medical Center.</p><p><strong>Keywords: </strong>professional behavior; ethics; therapeutic transactions; clinical privilege</p><p>Â </p><p><strong>Abstrak</strong>: Tenaga medis yang profesional harus memiliki unsur-unsur profesionalisme, prinsip dasar kedokteran dan etika profesi dalam menjalankan profesinya. Kewenangan klinis merupakan hak khusus dokter yang didapatkan melalui proses kredensial oleh Komite Medik. Penelitian ini bertujuan untuk menganalisis perilaku profesional tenaga medis terhadap tanggung jawab etik dan transaksi terapeutik dalam menjalankan kewenangan klinis. Jenis penelitian ialah kualitatif dengan metode studi kasus. Subjek penelitian berjumlah delapan orang terdiri dari dokter umum, dokter spesialis, ketua Komite Medik dan sub komite kredensial Rumah Sakit Umum Manado Medical Center. Data penelitian diperoleh melalui wawancara mendalam dan pedoman observasi. Validitas data menggunakan metode triangulasi. Hasil penelitian menunjukkan perilaku dokter sesuai dengan unsur profesionalisme, tetapi belum semua menerapkan etika perilaku profesional sesuai standar prosedur operasional (SPO) Rumah Sakit. Dalam pelaksanaan transaksi terapeutik, belum semua dokter melaksanakan kewajibannya yaitu menjelaskan diagnosa pasien secara lengkap dan rinci dengan bahasa yang mudah dipahami. Pelaksanaan kredensial sesuai dengan prosedur, tetapi untuk evaluasi belum optimal karena pelaksanaan re-kredensial tidak dilakukan. Simpulan penelitian ini ialah belum semua dokter menunjukkan sikap dan perilaku sesuai SPO Rumah Sakit dan belum dilakukan monitoring dan evaluasi kembali melalui proses re-kredensial dokter umum dan dokter spesialis di Manado Medical Center.</p><p><strong>Kata kunci: </strong>perilaku professional; etik; transaksi terapeutik; kewenangan klinis</p> 2022-09-27T00:00:00+08:00 Copyright (c) 2022 Medical Scope Journal https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44599 Antecedents of Outpatient Satisfaction in Internal Medicine Polyclinic during Covid-19 Pandemic Era (Empirical Study At Hospital X) 2022-12-20T14:01:43+08:00 Meidy C. Elim meidyciciliaelim@gmail.com Ferdi Antonio ferdi.antonio@gmail.com <p><strong>A</strong><strong>bstract</strong>: There is high competition among private hospitals in seeking the quality of health services provided that meets consumer needs. The largest service unit in the hospital is the outpatient unit; one of the polyclinics is Internal Medicine unit. Patients coming for treatment in this unit during the COVID-19 pandemic expect the best health services. A variety of factors can affect patient satisfaction but only a few studies are focused on outpatient satisfaction in the COVID-19 pandemic era so far. This research aimed to evaluate the effects of environment and facilities, professional competence, caring attitudes and emotional support, perceived compliance of COVID-19 protocol, communication and information, and waiting time on patient’s satisfaction. There were 164 samples obtained by purposive sampling from respondents that filled out the online questionnaires. Data were analyzed by using the PLS-SEM. The results showed that the independent and mediating variables had significant positive effects on general satisfaction. The strongest effect was from environment and facilities and professional competence, while the direct effect on general satisfaction was found to be the strongest from waiting time. In conclusion, the results confirmed the theory of patient satisfaction with health services. Therefore, this research model has strong predictive accuracy and large predictive relevance to be used and developed in further research.</p> <p><strong>Keywords:</strong> satisfaction; outpatient; COVID-19; private hospitals</p> 2022-12-20T00:00:00+08:00 Copyright (c) 2022 Meidy C. Elim, Ferdi Antonio https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44239 Penetrating Neck Injury due to Foreign Body at C5 Level with Plexus Brachialis Nerve Injury: A Case Report 2022-12-08T10:47:03+08:00 Maximillian C. Oley max_oley@unsrat.ac.id Eko Prasetyo eko_mdo@yahoo.co.id Ferdinan Tjungkagi ferdinan.tjungkagi@gmail.com Yovanka N. Manuhutu yovanka.manuhutu@gmail.com Diornald J. Mogi diornald@gmail.com <p><strong>Abstract: </strong>Penetrating neck injury caused by screwdriver is a very rare case. Rapid transport to a major trauma center is needed for such patients to prevent neurological dysfunction and post traumatic tissue damage. Early and complete assessment and exact surgical procedure are very important to overcome a good outcome and prognosis. We reported a case of a 28-year-old male transferred to the emergency room after being stabbed using a screwdriver. No history of nausea, vomiting, and loss of consciousness. A screwdriver got stucked on the neck at the level of C5-C6 associated with edema but no active bleeding. The upper extremity examination revealed that the muscle contraction was 5555/4444, thumb test +/, opposition test +/-, abductor adductor test +/-, and sensory within normal limit. Radiology examination showed a metallic density of the foreign body in the cervical region penetrating from soft tissue to the vertebral body of cervical C5. The patient was diagnosed with penetrating neck injury due to foreign body in the posterior neck region at C5 level with plexus brachialis nerve injury. Foreign body removal and laminectomy were done to decompression purpose. This case need early, complete and adequate management to prevent post traumatic tissue damage, other neurological dysfunction, and mortality. On the fourth post-surgical day, the patient was discharged with stable vital signs and no neurological deficit. The regular follow up at the neurosurgical clinic showed that neither motoric nor sensoric deficit was found. In conclusion, penetrating neck injury which can cause severe morbidity and permanent disability need an adequate management to prevent any spinal cord damage and minimize any neurological dysfunction.</p> <p><strong>Keywords: </strong>penetrating neck injury; spinal cord injury</p> 2022-12-24T00:00:00+08:00 Copyright (c) 2022 Maximillian C. Oley, Eko Prasetyo, Ferdinan Tjungkagi, Yovanka N. Manuhutu, Diornald J. Mogi https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44645 Penatalaksanaan Hepatitis B pada Populasi Khusus 2022-12-22T00:01:53+08:00 Filya A Hunou Filyaaulia8@gmail.com Bradley J. Waleleng walelengbj@yahoo.com Linda W. A. Rotty linda_rotty@yahoo.com <p><strong>Abstract: </strong>Hepatitis B virus infection is still a big problem in public health worldwide. Hepatitis B contributes 80% to the cause of primary hepatocellular carcinoma and is also the second most common cause of cancer after smoking. In special populations, the management given is different from the management of hepatitis B patients who are not included in special populations. This is because in special populations there have been changes in the natural history of the disease, the risk of complications related to the liver, recommendations for VHB drugs to be used, and the duration of therapy. This study aimed to obtain the managemeny of hepatitis B in special populations. This was a literature review study using 10 literatures searched by using three data bases namely ProQuest, Pubmed, and ClinicalKey. Journals were selected based on inclusion and exclusion criteria. The results showed that the management of hepatitis B in special populations adjusted to the conditions of each population. In conclusion, the management of hepatitis B in special populations has a variety of treatments that are made according to the condition of each population, including the treatment strategy, drug selection, duration of administration, and monitoring needed during the therapy.</p> <p><strong>Keywords: </strong>management of hepatitis B; special population</p> <p><strong> </strong></p> <p><strong>Abstrak: </strong>Infeksi virus hepatitis B merupakan masalah besar pada kesehatan masyarakat di dunia. Penyakit hepatitis B menjadi penyumbang sebesar 80% pada penyebab terjadinya karsinoma hepatoseluler primer dan juga menjadi penyebab kanker kedua terbanyak setelah rokok. Pada populasi khusus pentalakasanaan yang diberikan berbeda dari penatalaksanaan pada pasien hepatitis B yang tidak termasuk pada populasi khusus. Hal ini disebabkan pada populasi khusus telah terjadi perubahan riwayat alamiah penyakit, risiko komplikasi terkait hati, rekomendasi obat VHB yang akan digunakan, serta durasi terapi. Penelitian ini bertujuan untuk mengetahui penatalaksanaan hepatitis B pada populasi khusus. Jenis penelitian ialah suatu <em>literature review</em> dengan pencarian literatur menggunakan tiga data base yaitu ProQuest, Pubmed, dan ClinicalKey. Hasil penelitian mendapatkan bahwa kesepuluh literatur menjelaskan penatalaksanaan hepatitis B pada populasi khusus disesuaikan dengan kondisi masing-masing populasi. Simpulan penelitian ini ialah penatalaksanaan hepatitis B pada populasi khusus memiliki beragam penatalaksanaan yang dibuat menyesuaikan dengan kondisi masing-masing populasi, mulai dari strategi pengobatan yang diberikan, pemilihan obat, durasi pemberian, serta pemantauan yang perlu dilakukan dalam terapi.</p> <p><strong>Kata kunci: </strong>penatalaksanaan hepatitis B; populasi khusus</p> 2022-12-31T00:00:00+08:00 Copyright (c) 2022 Filya A Hunou, Bradley J. Waleleng, Linda W. A. Rotty https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44682 Pengaruh Inflamasi Mikro terhadap Penyakit Ginjal pada Pasien Diabetes Melitus Tipe-2 2022-12-22T23:46:31+08:00 Sarah Rumondang sarahrumondang011@student.unsrat.ac.id Bisuk P. Sedli bisukps@gmail.com Octavianus R. H. Umboh orhumboh@unsrat.ac.id <p><strong>Abstract</strong><strong>: </strong>Diabetic nephropathy is a microvascular damage as a complication of type 2 diabetes mellitus (T2DM) and becomes one of the most frequent causes of chronic renal failure worldwide. This study aimed to determine the effect of micro-inflammation on renal impairment in T2DM patients. This was a literature review study and data were searched using three database sources, namely ClinicalKey, Pubmed, and Google Scholar. The results obtained 10 articles to be reviewed. All reviewed articles stated various increases in inflammatory mediators namely NGAL, NLR, serum cystatin-C, urinary IgG, transferrin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, monocyte ratio CD14+CD16+, pro-inflammatory cytokines Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, and eotaxin, and decreased levels of uromodulin and TNFR1. This occurred due to some components of the body in a state of hyperglycemia wouldl be able to activate the infiltration of hematopoietic cells, especially macrophages in the kidneys, which would further secrete proinflammatory cytokines and reactive oxygen species (ROS). Inflammatory cells present in the kidney are a response to tissue damage, but can also increase cell injury and the progression of DN in its early stages. In conclusion, there is an influence of immune and inflammatory mechanisms on the development of diabetic nephropathy in patients with type 2 diabetes mellitus.</p> <p><strong>Keywords: </strong>type 2 diabetes mellitus; micro inflammation; diabetic kidney disease</p> <p><strong> </strong></p> <p><strong>Abstrak</strong>: Nefropati diabetik (ND) adalah kerusakan mikrovaskuler sebagai komplikasi DMT2 dan menjadi salah satu penyebab tersering gagal ginjal kronis di seluruh dunia. Penelitian ini bertujuan untuk mengetahui pengaruh inflamasi mikro terhadap penyakit ginjal pada pasien DMT2. Penelitian ini menggunakan metode <em>literature review </em>dengan pencarian data melallui tiga sumber database yaitu <em>ClinicalKey, Pubmed, </em>dan <em>Google Scholar.</em> Hasil penelitian mendapatkan 10 artikel yang di-<em>review </em>yang melaporkan berbagai peningkatan mediator inflamasi, yaitu NGAL, NLR, serum cystatin-C, IgG urin, transferin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, rasio monosit CD14+CD16+, sitokin proinflamasi Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, dan eotaksin, serta penurunan kadar uromodulin dan TNFR1. Hal ini terjadi karena beberapa komponen pada keadaan DMT2 dapat mengaktifkan infiltrasi sel hematopoietik, terutama makrofag pada ginjal, yang akan mengeluarkan sitokin proinflamasi dan <em>reactive oxygen species</em> (ROS). Masuknya sel inflamasi ke dalam ginjal pasien merupakan respon terhadap kerusakan jaringan, tetapi juga dapat meningkatkan cedera sel serta progresifitas ND pada tahap awal. Simpulan penelitian ini ialah terdapat pengaruh mekanisme kekebalan dan inflamasi dalam perkembangan nefropati diabetik pada pasien diabetes mellitus tipe 2. </p> <p><strong>Kata kunci: </strong>diabetes melitus tipe 2; inflamasi mikro; penyakit ginjal diabetes</p> 2022-12-31T00:00:00+08:00 Copyright (c) 2022 Sarah Rumondang, Bisuk P. Sedli, Octavianus R. H. Umboh https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44684 Gambaran Kadar C-Reactive Protein pada Penyakit Tidak Menular di Indonesia 2022-12-23T00:04:27+08:00 Fahrezi Isnul Muhammad fahrezieci21@gmail.com Siemona L. E Berhimpon siemonaberhimpon@unsrat.ac.id Glady I. Rambert gladyrambert@unsrat.ac.id <p><strong>Abstract</strong>: Non-communicable diseases (NCDs) are the main cause of death and disability worldwide. Therefore, it is necessary to detect and treat as early as possible for each case of NCDs. C-reactive protein (CRP) is one of the supporting tests that helps to detect and monitor the NCDs. This study aimed to analyze the literatures of C-reactive protein levels in several NCDs in Indonesia. This was a literature review study. The results obtained 15 articles with a total of nine discussed diseases, as follows: cardiovascular diseases, hypertension, type 2 diabetes mellitus (T2DM), colorectal cancer, injury, chronic kidney disease (CKD), obesity, rheumatological diseases, and epilepsy with depression. In several types of NCDs in Indonesia, there were increased CRP levels with a maximum value of 199.4 mg/L and a minimum of 0.02 mg/L in patients aged 18-60 years. In conclusion, CRP levels are increased in the reviewed NCD cases.</p> <p><strong>Keywords: </strong>C-reactive protein; non-communicable diseases</p> <p><strong> </strong></p> <p><strong>Abstrak</strong>: Penyakit tidak menular (PTM) merupakan penyebab utama kematian dan kecacatan di dunia. Dibutuhkan deteksi, <em>screening</em>, dan terapi sedini mungkin untuk setiap kasus PTM. <em>C-Reactive Protein</em> (CRP) merupakan salah satu pemeriksaan penunjang yang membantu mendeteksi dan memonitoring PTM. Penelitian ini bertujuan untuk mendapatkan gambaran kadar <em>C-Reactive Protein </em>pada beberapa penyakit tidak menular di Indonesia. Jenis penelitian ialah suatu <em>literatur</em><em>e review</em>. Hasil penelitian mendapatkan 15 artikel dengan total sembilan penyakit yang dibahas yaitu penyakit kardiovaskuler, hipertensi, diabetes melitus tipe 2 (DMT2), kanker kolorektal, cedera, penyakit ginkal kronis (PGK), obesitas, penyakit reumatologi, serta epilepsi dan depresi. Pada beberapa tipe PTM di Indonesia terjadi peningkatan kadar CRP dengan nilai maksimum 199,4 mg/L dan minimum 0,02 mg/L untuk pasien dengan kisaran usia 18-60 tahun. Simpulan penelitian ini ialah terdapat peningkatan kadar CRP pada kasus penyakit tidak menular yang dikaji.</p> <p><strong>Kata kunci: </strong><em>C-</em><em>r</em><em>eactive protein</em>; penyakit tidak menular</p> 2022-12-31T00:00:00+08:00 Copyright (c) 2022 Fahrezi Isnul Muhammad, Siemona L. E Berhimpon, Glady I. Rambert https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44683 Asosiasi Kadar Hemoglobin dan Indeks Massa Tubuh terhadap Kualitas Hidup Pasien Penyakit Ginjal Kronik Stadium 5 Hemodialisis 2023-01-20T12:41:19+08:00 Alwerino Sitompul alwerinositompul15@gmail.com Linda W. A. Rotty linda_rotty@yahoo.com Cerelia Sugeng cereliasugeng@yahoo.com <p><strong>Abstract</strong><strong>:</strong> The prevalence of chronic kidney disease (CKD) increases every year, and majority of patients suffer from its complications namely anemia. Chronic inflammation also affects nutritional status, therefore, the patients tend to have a low body mass index (BMI). Low hemoglobin and BMI will cause a decrease in quality of life. This study aimed to determine the association of hemoglobin and BMI to the quality of life of patients with CKD stage 5 hemodialysis (CKD 5 HD). This was a cross-sectional study with 42 subjects with CKD 5 HD more than three months. Retrieval of hemoglobin data obtained through medical records, assessment of nutritional status by BMI calculations, and assessment of quality of life by interviewing the Short Form 36 questionnaire (SF-36). The results found that the analysis of the association between hemoglobin and the SF-36 score, carried out with the Pearson test, obtained a r-value of 0.330 and a p-value of 0.033. Analysis of the association between BMI and the SF-36 score carried out using the Kruskal-Wallis test, obtained a p-value of 0.890. In conclusion, there is an association between hemoglobin and quality of life, albeit, there is no association between BMI and quality of life in CKD 5 HD patients.</p> <p><strong>Keywords:</strong> hemoglobin; body mass index; short form 36; chronic kidney disease; hemodialysis</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak</strong>: Prevalensi penyakit ginjal kronik (PGK) meningkat setiap tahunnya dan mayoritas pasien mengalami komplikasi PGK yaitu anemia. Inflamasi kronik juga berpengaruh terhadap status nutrisi sehingga pasien tersebut cenderung memiliki indeks massa tubuh (IMT) rendah. Rendahnya hemo-globin dan IMT akan menyebabkan penurunan kualitas hidup. Penelitian ini bertujuan untuk menge-tahui asosiasi hemoglobin dan IMT terhadap kualitas hidup pasien penyakit ginjal kronik stadium 5 hemodialisis (PGK 5 HD). Penelitian ini merupakan studi potong lintang dengan subjek sebanyak 42 pasien PGK 5 HD lebih dari tiga bulan. Pengambilan data hemoglobin diperoleh melalui rekam medik, penilaian status nutrisi dengan perhitungan IMT, dan penilaian kualitas hidup diperoleh dengan wawancara kuesioner <em>Short Form </em>36 (SF-36). Analisis asosiasi antara hemoglobin dengan skor SF-36. Hasil analisis dengan uji Pearson mendapatkan nilai r=0,330 dan p=0,033. Analisis asosiasi antara IMT dengan skor SF-36, yang dilakukan dengan uji Kruskal-Wallis mendapatkan nilai p=0,890. Simpulan penelitian ialah terdapat asosiasi antara hemoglobin dengan kualitas hidup namun tidak terdapat asosiasi antara IMT dengan kualitas hidup pada pasien PGK 5 HD.</p> <p><strong>Kata kunci: </strong>hemoglobin; indeks massa tubuh; <em>short form</em> 36; penyakit ginjal kronik; hemodialisis</p> 2023-01-25T00:00:00+08:00 Copyright (c) 2023 Alwerino Sitompul, Linda W. A. Rotty, Cerelia Sugeng https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44720 Gambaran Foto Toraks Pasien Tuberkulosis Paru dengan HIV di RSUP Prof. Dr. R. D. Kandou Periode Januari – Juni 2022 2022-12-23T21:43:22+08:00 Karel Y. Wijaya karelwijaya123@gmail.com Martin L. Simanjuntak martinsimanjuntak.fkusr@gmail.com Yovana P. M. Mamesah karelwijaya123@gmail.com <p><strong>Abstract</strong>: Pulmonary tuberculosis is a contagious and chronic infectious disease caused by <em>Mycobacterium tuberculosis</em> and can occur in individuals including those with human immunodeficiency virus (HIV). The combination of these diseases can aggravate an individual's health condition. Chest X-ray examination is important for the diagnosis of this disease. This study aimed to review the chest X-ray in patients with pulmonary TB and HIV at Prof. Dr. R. D. Kandou Hospital from January to June 2022. Thus was a retrospective and descriptive study with a cross-sectional design. The data used were medical records of pulmonary TB patients with HIV who underwent chest X-ray examination at the Radiology Department of Prof. Dr. R. D. Kandou Hospital from January to June 2022 using the total sampling method. The results obtained 18 patients with pulmonary tuberculosis and HIV, dominated by males (88.9%) aged 26–35 years (44.4%). The most common characteristic of chest X-ray examination was the presence of infiltrates (88.9%), with far advanced lesion severity (55.6%). In conclusion, the majority of pulmonary tuberculosis patients with HIV were males, aged 26–35 years, and the chest X-ray characteristic was the presence of infiltrates with far advanced degree of severity.</p> <p><strong>Keywords</strong>: chest X-ray; pulmonary tuberculosis; human immunodeficiency virus</p> <p><strong> </strong></p> <p><strong>Abstrak</strong>: Tuberkulosis (TB) paru merupakan penyakit infeksi kronik menular disebabkan oleh <em>Mycobacterium tuberculosiss</em>. Penyakit ini dapat terjadi pada individu dengan infeksi <em>Human Immunodeficiency Virus </em>(HIV) yang akan memperparah kondisi kesehatan individu. Pemeriksaan radiologis foto toraks penting dilakukan untuk diagnosis penyakit ini. Penelitian ini bertujuan untuk mengetahui gambaran foto toraks pasien TB paru dengan HIV di RSUP Prof. Dr. R. D. Kandou periode Januari–Juni 2022. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Data yang digunakan ialah rekam medik foto toraks pasien TB paru dengan HIV di Bagian Radiologi RSUP Prof. Dr. R. D. Kandou periode Januari – Juni 2022 dengan metode <em>total sampling</em>. Hasil penelitian mendapatkan pasien TB paru dengan HIV di RSUP Prof. Dr. R. D. Kandou sebanyak 18 sampel. Mayoritas pasien berjenis kelamin laki-laki sebesar 88,9%. Kelompok usia paling dominan ialah 26-35 tahun sebesar 44,4%. Karakteristik foto toraks yang paling banyak ditemukan ialah infiltrat sebesar 88,9%. Derajat keparahan paling banyak ditemukan pada derajat lesi luas yaitu sebesar 55,6%. Simpulan penelitian ini ialah mayoritas pengidap tuberkulosis paru dengan HIV terjadi pada laki-laki, kelompok usia 26-35 tahun serta karakteristik gambaran foto toraks ialah infiltrat dengan derajat keparahan lesi luas</p> <p><strong>Kata kunci</strong>: foto toraks; tuberkulosis paru; <em>human immunodeficiency virus</em></p> 2023-01-28T00:00:00+08:00 Copyright (c) 2023 Karel Y. Wijaya, Martin L. Simanjuntak , Yovana P. M. Mamesah https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44724 Gambaran Foto Toraks Pasien Tuberkulosis Paru dengan Diabetes Melitus di RSUP Prof. Dr. R. D. Kandou Periode Januari – Juni 2022 2022-12-23T21:59:00+08:00 Putra Y. Tampubolon putra7887@gmail.com Alfa G. E. Y. Rondo alfa.rondo@unsrat.ac.id Martin L. Simanjuntak martinsimanjuntak.fkusr@gmail.com <p><strong>Abstract: </strong>Pulmonary tuberculosis (pulmonary TB) is one of the ten leading causes of death world-wide. Diabetes mellitus is a group of metabolic diseases characterized by hyperglycaemia. Thus, this disease can exacerbate the symptoms and increase the reccurence rate of pulmonary TB. Chest X-ray examination is used to support the diagnosis of pulmonary tuberculosis. This study aimed to obtain the chest X-ray profile of pulmonary TB patients with diabetes mellitus at Prof. Dr. R. D. Kandou Hospital from January to June 2022. This was a retrospective and descriptive study with a cross sectional design. The results obtained 21 patients of pulmonary TB with diabetes mellitus dominated by females (61.9%) and age group of 46-55 years (33.3%). The most common chest X-ray characteristic was fibrosis (95.2%). The most dominant degree of severity was far advanced lesion (61.9%). In conclusion, in this study the majority of pulmonary tuberculosis patients with diabetes mellitus were females and age group of 46-55 years. The most common chest X-ray characteristic was fibrosis with far advanced lesion.</p> <p><strong>Keywords: </strong>chest X-ray; pulmonary tuberculosis; diabetes mellitus</p> <p><strong> </strong></p> <p><strong>Abstrak: </strong>Tuberkulosis paru (TB paru) merupakan salah satu dari sepuluh penyebab kematian terbesar di dunia. Diabetes melitus merupakan kelompok penyakit metabolik dengan karakteristik hiperglikemia. Penyakit ini dapat memperparah gejala TB paru dan meningkatkan angka kekam-buhan penyakit TB paru. Untuk menunjang diagnosis TB paru digunakan pemeriksaan foto toraks. Penelitian ini bertujuan untuk mengetahui gambaran foto toraks pada pasien TB paru dengan diabetes melitus di RSUP Prof. Dr. R. D. Kandou periode Januari–Juni 2022. Hasil penelitian mendapatkan 21 pasien TB paru dengan diabetes melitus di RSUP Prof. Dr. R. D. Kandou, didomi-nasi oleh jenis kelamin perempuan (61,9%). Berdasarkan kelompok usia, yang paling dominan ialah kelompok usia 46-55 tahun (33,3%). Gambaran foto toraks yang paling sering ditemukan ialah fibrosis (95,2%). Derajat keparahan yang paling mendominasi ialah dengan luas lesi <em>far advanced</em> (61,9%). Simpulan penelitian ini ialah mayoritas pasien tuberkulosis paru dengan diabetes melitus ditemukan pada perempuan dengan kelompok usia 46-55 tahun. Gambaran foto toraks yang paling sering ditemukan ialah fibrosis dengan lesi <em>far advanced</em>.</p> <p><strong>Kata kunci: </strong>foto toraks; tuberkulosis paru; diabetes melitus</p> 2023-01-28T00:00:00+08:00 Copyright (c) 2023 Putra Y. Tampubolon, Alfa G. E. Y. Rondo, Martin L. Simanjuntak https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44770 Analisis Faktor-faktor yang Berhubungan dengan Persepsi Tenaga Kesehatan terhadap Penerapan Budaya Keselamatan Pasien di RSUP Prof. Dr. R. D. Kandou Manado 2022-12-28T10:58:59+08:00 Neni Ekawardani neniekawardani1111@student.unsrat.ac.id Aaltje E. Manampiring aldamanmpiring@unsrat.ac.id Erwin G. Kristanto erwinkristanto@unsrat.ac.id <p><strong>Abstract: </strong>Patient safety is a joint commitment regarding patient safety from each individual or group to create a safe service environment. This study aimed to determine the factors related to the perception of health workers on the application of patient safety culture at Prof. Dr. R. D. Kandou Hospital, Manado. This was an analytical and descriptive study with a cross sectional design. Sampling used non-probability sampling technique in consecutive sampling. We used a questionnaire that had been tested for validity and reliability. Data were analyzed univariate, bivariate using the Spearman Rank test, and multivariate using the logistic regression test with the SPSS program. There were 323 respondents in this study. The statistical analysis showed that the teamwork in work units and management support for perceptions of patient safety culture implementation had a significant value with a very strong correlation (r=0,803; r=0,897). Commu-nication, collaboration between works units, and the frequency of reporting incidents on the perception of implementing safety culture in patients also has significant value with a strong correlation (r=0,706; r=0,671; r=0,624). Management support was the most dominant variable with odds ratio value of 125,244. In conclusion, there was a strong to very strong positive relationship in the factors of teamwork in work units, communication, cooperation between work units, incident reporting frequency, and management support related to the perception of health workers toward the application of a patient safety culture at Prof. Dr. R. D. Kandou Hospital, Manado.</p> <p><strong>Keywords:</strong> perceptions of health workers; patient safety culture</p> <p><strong> </strong></p> <p><strong>Abstrak: </strong>Budaya keselamatan pasien merupakan komitmen bersama terkait keselamatan pasien dari setiap individu atau kelompok untuk menciptakan lingkungan pelayanan yang aman. Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan persepsi tenaga kesehatan terhadap penerapan budaya keselamatan pasien di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian deskriptif analitik dengan desain potong lintang. Penentuan sampel dengan teknik <em>non probability sampling</em> secara <em>consecutive sampling</em>. Kami menggunakan kuesioner yang telah teruji validitas dan reliabilitasnya. Data dianalisis menggunakan program SPSS secara univariat, bivariat menggunakan uji <em>Spearman Rank</em>, dan multivariat menggunakan uji regresi logistik. Hasil penelitian mendapatkan 323 responden. Uji statistik menunjukkan hubungan kerjasama tim di unit kerja dan dukungan manajemen terhadap persepsi penerapan budaya keselamatan pasien yang bermakna dengan nilai korelasi sangat kuat (r=0,803; r=0,897). Hubungan komunikasi, kerjasama tim antar unit, dan frekuensi pelaporan insiden terhadap persepsi penerapan budaya keselamatan pasien yang bermakna dengan nilai korelasi yang kuat (r=0,706; r=0,671; r=0,624). Faktor dukungan manajemen yang paling dominan dengan nilai <em>odds ratio</em> 125,244. Simpulan penelitian ini ialah terdapat hubungan positif kuat hingga sangat kuat pada faktor kerjasama tim di unit kerja, komunikasi, kerjasama antar unit kerja, frekuensi pelaporan insiden, dan dukungan manajemen dengan persepsi tenaga kesehatan terhadap penerapan budaya keselamatan pasien di RSUP Prof. Dr. R. D. Kandou Manado.</p> <p><strong>Kata kunci:</strong> persepsi tenaga kesehatan; budaya keselamatan pasien.</p> 2023-01-29T00:00:00+08:00 Copyright (c) 2023 Neni Ekawardani, Aaltje E. Manampiring, Erwin G. Kristanto https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44732 Korelasi Lama Menyandang Diabetes Melitus dan HbA1c dengan Estimasi Laju Filtrasi Glomerulus pada Pasien Diabetes Melitus Tipe 2 2022-12-24T10:55:13+08:00 Afdriansyah L. Kombe afdriansyahkombe011@student.unsrat.ac.id Cerelia E. C. Sugeng cereliasugeng@yahoo.com Bisuk P. Sedli bisukps@gmail.com <p><strong>Abstract</strong>: Diabetes mellitus (DM) is a group of metabolic diseases characterized by high blood sugar levels (hyperglycemia) that occur due to abnormalities in insulin secretion, insulin action, or both. Poor blood sugar control in the long term can cause various diseases, one of which is chronic kidney disease. This study aimed to determine the correlation between duration of DM and HbA1c (glycated hemoglobin) with estimated glomerular filtration rate (eGFR) in type 2 DM patients. This was an analytical study with a retrospective approach and a cross-sectional design. were taken by using consecutive sampling technique. Data of HbA1c and eGFR were obtained from the patient's medical record. Duration of suffering from diabetes mellitus was carried out by interviewing the patients. Data were analyzed using the Pearson and Spearman correlation statistical tests. The results obtained 38 type 2 DM patients as respondents. The correlation test between duration of DM and eGFR showed a significant negative correlation (r=-0.411; p=0.01), and the correlation test between HbA1c correlation test and eLFG showed a non-significant negative correlation (r=-0.109; p=0.516). In conclusion, there is a significant negative correlation between duration of DM and eGFR and a non-significant negative correlation between HbA1c and eGFR.</p> <p><strong>Keywords: </strong>duration of diabetes mellitus; glycated hemoglobin; estimated glomerular filtration rate</p> <p><strong> </strong></p> <p><strong>Abstrak</strong>: Diabetes melitus merupakan kelompok penyakit metabolik yang memiliki karakteristik kadar gula tinggi (hiperglikemia) yang terjadi karena kelainan sekresi insluin, kerja insulin atau keduanya. Kontrol gula darah yang buruk secara jangka panjang dapat menimbulkan berbagai penyakit salah satunya penyakit ginjal kronik. Penelitian ini bertujuan untuk untuk mengetahui korelasi lama menyandang DM dan HbA1c (<em>glycated hemoglobin</em>) dengan eLFG (estimasi laju filtrasi glomerulus) pada pasien DM tipe 2. Jenis penelitian ialah analitik dengan pendekatan retrospektif serta menggunakan desain potong lintang. Responden penelitian diambil dengan teknik <em>consecutive sampling</em>. Data HbA1c dan eLFG diperoleh melalui rekam medik pasien. Pengambilan data lama menyandang DM dilakukan dengan wawancara pada pasien. Pada penelitian ini digunakan uji statistik korelasi Pearson dan Spearman. Hasil penelitian mendapatkan sebanyak 38 responden. Hasil uji korelasi antara lama menyandang DM dengan eLFG menunjukkan korelasi negatif bermakna (r=-0,411; p=0,01), dan hasil uji korelasi HbA1c dengan eLFG menunjukkan korelasi negatif tidak bermakna (r=-0,109; p=0,516). Simpulan penelitian ini ialah terdapat korelasi negatif yang bermakna antara lama menyandang diabetes melitus dengan eLFG dan korelasi negatif tidak bermakna antara HbA1c dengan eLFG.</p> <p><strong>Kata kunci: </strong>lama menyandang diabetes melitus; <em>glycated hemoglobin</em>; estimasi laju filtrasi glomerulus</p> 2023-01-29T00:00:00+08:00 Copyright (c) 2023 Afdriansyah L. Kombe, Cerelia E. C. Sugeng, Bisuk P. Sedli https://ejournal.unsrat.ac.id/v3/index.php/msj/article/view/44722 Gambaran Foto Toraks pada Pasien Tuberkulosis Paru dengan Penyakit Ginjal Kronik di RSUP Prof. Dr. R. D. Kandou Periode Januari-Juni 2022 2022-12-23T21:51:04+08:00 Dian A. Safitri dianayusafitri51@gmail.com Yovana P. M. Mamesah dianayusafitri51@gmail.com Joan F. J. Timban joanfebry3@gmail.com <p><strong>Abstract: </strong>Pulmonary tuberculosis (TB), a chronic disease caused by <em>Mycobacterium tuberculosis</em>, is still a world health problem. Chronic kidney disease (CKD) is also a significant global health problem. In CKD, the immune system dysfunction occurs in the form of cell-mediated immunity (CMI). This study aimed to find out the imaging of chest X-ray in tuberculosis patients with chronic kidney disease at Prof. Dr. R. D. Kandou Hospital, Manado, from January to June 2022. This was a retrospective and descriptive study with a cross sectional design. The results obtained 34 tuberculosis patients with CKD, dominated by males (76.5%) and patients aged 56-65 years (41.2%). Based on CKD status, the risk of tuberculosis increased in patients undergoing hemodialysis (52.9%). The most common characteristic of chest X-ray were infiltrates and fibrosis (79.4%) and the dominant combination lesions on chest X-ray were infiltrates, consolidation, and fibrosis (23.5%). The area of tuberculosis lesion was commonly found in the form of minimal lesion (47.1%). In conclusion, the most common chest X-ray profiles in tuberculosis patients with chronic kidney disease were infiltrates and fibrosis, and minimal lesion.</p> <p><strong>Keywords:</strong> chest X-ray; tuberculosis; chronic kidney disease</p> <p><em> </em></p> <p><strong>Absrtrak:</strong> Tuberkulosis (TB) paru disebabkan oleh <em>Mycobacterium tuberculosis</em> dan merupakan penyakit kronis yang masih menjadi masalah kesehatan dunia hingga saat ini. Penyakit ginjal kronis (PGK) juga merupakan masalah kesehatan global yang signifikan. Pada PGK terjadi disfungsi sistem imun berupa <em>depressed cell-mediated immunity</em> (CMI). Penelitian ini bertujuan untuk mendapatkan gambaran foto toraks pada pasien tuberkulosis dengan PGK di RSUP Prof. Dr. R. D. Kandou pada periode Januari–Juni 2022. Jenis penelitian ini ialah deskriptif retrospektif dengan desain potong lintang. Hasil penelitian mendapatkan 34 pasien tuberkulosis, didominasi oleh jenis kelamin laki-laki (76,5%) dan usia 56-65 tahun (41,2%). Berdasarkan status PGK, risiko terkena tuberkulosis lebih meningkat pada pasien yang dilakukan hemodialis (52,9%). Karakteristik pada gambaran foto toraks yang paling banyak ditemukan yaitu infiltrat dan fibrosis (79,4%), dan lesi kombinasi yang dominan pada gambaran foto toraks ialah infiltrat, konsolidasi, dan fibrosis (23,5%). Luas lesi pada tuberkulosis ditemukan lebih banyak pada lesi minimal (47,1%). Simpulan penelitian ini ialah gambaran foto toraks yang paling sering ditemukan pada pasien tuberkulosis dengan PGK ialah infiltrat dan fibrosis, serta lesi minimal.</p> <p><strong>Kata kunci: </strong>foto toraks; tuberkulosis; penyakit ginjal kronik</p> 2023-01-29T00:00:00+08:00 Copyright (c) 2023 Dian A. Safitri, Yovana P. M. Mamesah, Joan F. J. Timban