Medical Scope Journal

Correlation between Doctor-Patient Communication with Patient Satisfaction and Loyalty

Nancy S. Lampus — 2024-01-28

Abstract: Effective communication between doctors and patients has been recognized as a key factor in influencing the patient’s experience during treatment and will affect patient loyalty. This study aimed to investigate and analyze the correlation between doctor and patient communication with patient satisfaction and loyalty, in the context of health services. This was a cross-sectional study using a questionnaire as an instrument to collect data from several patients receiving outpatient treatment at the cardiovascular unit at XYZ Hospital. Data were analyzed multivariate using the PLS-SEM statistical method with SmartPLS^®4 software. The results were obtained from 182 respondents who met the inclusion criteria taken in 2023 by purposive sampling with a questionnaire from individuals who had received cardiovascular outpatient services at XYZ Hospital. The five aspects of doctor communication skills were proven to have significant and positive effects. The strongest influence was shown in the empathy factor of communication by a doctor (R² = 0.274; p-value 0.011; CI 0.086 – 0.479). This study proved the positive impact of patient satisfaction on patient loyalty at XYZ Hospital. From the findings of this study, managerial implications could be drawn for the development of doctors’ communication skills with patients, maintaining doctor quality, and strengthening the hospital image by providing the best services for patients. In conclusion, effective communication plays an important role in increasing patient satisfaction and loyalty toward health services in hospitals. It is necessary to maintain and improve skills in doctor-patient communication.

Keywords: effective communication; patient satisfaction; patient loyalty

Validity of Predictive Markers for Post ERCP Pancreatitis Patients: A Single Centre Study

Michael Tendean — 2024-01-28

Abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is a proprietary procedure, endoscopic modality, and specialized procedure used to diagnose and treat disorders of the pancreatic and biliary systems. The incidence of reported post-ERCP complications varied among several studies including post ERCP pancreatitis (PEP), duodenal perforation, and cholangitis. In this study, the author would like to show certain intra procedural factors related to PEP incidence. This was a retrospective study of secondary data of patients undergoing ERCP procedures from 2017-2022 at Prof. Dr. R. D. Kandou Hospital, Manado. Length of procedure, cannulation on pancreatic duct, pancreatogram, double wire technique, and the use of certain common bile duct (CBD) stone retrieval techniques such as endoscopic papillary balloon dilatation (EPBD) were recorded and analyzed. The results showed that based on the analyzed data, the percentage of pancreas cannulation was 8%, pancreatogram 5%, double-wire technique 3%, and EPBD procedure 10%, Incidence rate of PEP in all ERCP procedures was 19%. Increased amylase/lipase enzymes were found in 13 of 24 patients (54%) who underwent cannulation; 8 of 16 patients (50%) who underwent pancreatogram; 4 of 9 patients (44%) who underwent double wire procedure; and 10 of 30 patients (33%) who underwent EPBD. This PEP could be caused by several risk factors during ERCP including cannulation, pancreatogram, double wire, and EPBD. Number of cannulation attempt could result in trauma to the ampulla. Pancreatogram could result in hydrostatic, chemical, and allergic injury. Any manipulation of the pancreas that caused trauma could trigger the incidence of PEP. Assessment of the occurrence of PEP was based on increases in lipase and amylase enzyme values by four times the normal value and tested 6 hours after procedure. We could reduce the incidence of PEP by providing prophylactic therapy before ERCP. In conclusion, PEP is the most common complication in ERCP procedures and can be risky in patients with high risk factors. In this study, factors that affecting the incidence of PEP are cannulation, pancreatogram, double wire and EPBD.

Keywords: endoscopic retrograde cholangiopancreatography; pancreatitis; complications

Hubungan Jenis dan Siklus Kemoterapi dengan Derajat Neuropati pada Pasien Keganasan

Harlinda Haroen — 2024-01-28

Abstract: Antineoplastic chemotherapy agents in cancer treatment can cause peripheral neuropathy. Antineoplastic agents associated with chemotherapy-induced peripheral neuropathy include platinum-based drugs (carboplatin, cisplatin and oxaliplatin) and taxane (paclitaxel and docetaxel). This study aimed to evaluate the relationship between the type and cycle of chemotherapy with the level of neuropathy in malignant patients at Prof. Dr. R. D. Kandou Hospital, Manado, in 2022. The results obtained 43 cancer patients aged 18-65 who underwent chemotherapy, especially drugs from the platinum group (81.4%) such as oxaliplatin (62.8%). The majority of cases were colorectal adenocarcinoma (63%). Using the Toronto Score, the majority of subjects experienced mild neuropathy (55.8%), followed by without neuropathy (32.5%) and moderate neuropathy (11.6%). Although there was an indication of a relationship between the type of chemotherapy and the severity of neuropathy, the results were not statistically significant (p=0.069). In conclusion, there is no relationship between the type and cycle of chemotherapy with the level of neuropathy in cancer patients.

Keywords: neuropathy; chemotherapy cycles; types of chemotherapy

Abstrak: Agen kemoterapi antineoplastik dalam pengobatan kanker dapat menyebabkan neuropati perifer. Agen antineoplastik terkait neuropati perifer yang diinduksi kemoterapi termasuk obat berbasis platinum (carboplatin, cisplatin dan oxaliplatin) dan taxane (paclitaxel dan docetaxel). Penelitian ini bertujuan untuk mengetahui hubungan jenis dan siklus kemoterapi dengan keparahan neuropati pada pasien keganasan di RSUP Prof. Dr. R. D. Kandou Manado pada tahun 2022. Hasil penelitian mendapatkan 43 pasien kanker berusia 18-65 tahun yang telah menjalani kemoterapi, khususnya obat berbasis platinum (81,4%) seperti oxaliplatin (62,8%). Jenis keganasan yang terbanyak ialah adenokarsinoma kolorektal (63%). Dengan menggunakan Skor Toronto, didapatkan mayoritas subjek mengalami neuropati ringan (55,9%) diikuti tanpa neuropati (32,5%) dan neuropati sedang (11,6%). Meski ada indikasi hubungan antara jenis kemoterapi dengan tingkat neuropati, hasilnya tidak bermakna secara statistik (p=0,069). Simpulan penelitian ini ialah tidak terdapat hubungan antara jenis dan siklus kemoterapi dengan tingkat neuropati pada pasien keganasan.

Kata kunci: neuropati; siklus kemoterapi; jenis kemoterapi

The Importance of Preoperative Evaluation to Predict the Outcome of Percutaneous Nephrostomy

Ronald J. Datu — 2024-01-28

Abstract: Percutaneous nephrostomy (PCN) is an invasive procedure equal to a grade 4 penetrating kidney trauma. It should be carefully considered whether has a greater benefit or risk. There are currently no parameters or scores to predict the outcome of nephrostomy in our center. This study aimed to conduct a review to find out whether there were parameters or scores that could be used to predict the outcome of nephrostomy. This research used relevant studies obtained from Clinical Key, PubMed, Semantic Scholar, Dimensions, and Science Direct published in the last 10 years and written in English. Studies on children and transplant cases were excluded. Studies that met the PICO criteria were selected. The results showed that of the 141 articles collected, and filtered with inclusion criteria, exclusion criteria, and PICO criteria, finally the remaining were three studies selected. The studies discussed about classification, SFU grading system, and complication of nephrostomy; significant variables affecting recoverability of renal function; patients’ characteristics and outcomes of double J ureteral stenting (DJS) and PCN; and 12-month-post-operative creatinine level change. Most patients who failed DJS had increased creatinine level. However, one of the indications for a nephrostomy was stenting failure. In conclusion, predictor factors that can affect the renal recovery after nephrostomy include kidney shape and size, pre-nephrostomy creatinine levels, urine output, state of infection, and degree of hydronephrosis. However, the evidence is still not enough. Further research is needed on the predictor factors for renal recovery after nephrostomy.

Keywords: percutaneous nephrostomy; hydronephrosis; kidney function; predictors

Tiroidektomi Endoskopi Transoral dengan Pendekatan Vestibular Untuk Nodul Tiroid: Serial 12 Pasien Pertama di RSUP Prof. Dr. R. D. Kandou

Riston R. Sitompul — 2024-02-01

Abstract: Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to the conventional thyroidectomy, without any scar as the advantage. This study aimed to present the feasibility and safety of patients with solitary or multinodular goitre and or papillary thyroid carcinoma using TOETVA. This was a case series using 12 patients recorded undergoing TOETVA procedure. Eleven patients’ specimen obtained through FNAB resulted as benign nodule. In one patient, the nodule was malignant and unilateral, therefore, endoscopic isthmolobectomy was performed. Outcomes and measures included conversion to open conventional surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue scores, and postoperative complications. The results showed a total of 12 patients; all were women, aged 33-64 years. The size of thyroid nodules ranged from 2 cm to 7 cm. One patient got converted to open isthmus lobectomy. In this series, none of the patients were noted to have mental nerve injury but two patients developed anterior neck chin skin bruise. The mean postoperative VAS measurements were 2, 1, and no pain or 0, on the first, second, third, and seventh postoperative days, respectively. In conclusion, endoscopic thyroidectomy is feasible, safe, and comparable to open thyroidectomy and yields excellent aesthetic results.

Keywords: endoscopic thyroidectomy; minimally invasive surgical procedures; thyroid neoplasms

Abstrak: Tiroidektomi endoskopi transoral dengan pendekatan vestibular (TOETVA), menunjuk-kan hasil sebanding dengan tiroidektomi konvensional, tanpa adanya bekas luka sebagai keuntungan. Penelitian ini bertujuan untuk menyajikan kelayakan dan keamanan pasien dengan penyakit gondok soliter atau multinodular dan atau karsinoma tiroid papiler menggunakan TOETVA. Jenis penelitian ialah serial kasus yang menjalani TOETVA selama Januari 2018 hingga Desember 2019 di RSUP Prof. Dr. R. D. Kandou. Terdapat 12 pasien tercatat menjalani prosedur TOETVA; 11 spesimen pasien diambil melalui FNAB dan menghasilkan nodul jinak. Pada salah satu pasien didapatkan nodul ganas unilateral sehingga dilakukan istmolobektomi endoskopi. Hasil dan tindakan termasuk konversi ke operasi konvensional terbuka, waktu operasi, kehilangan darah intraoperatif, ukuran kelenjar tiroid, rawat inap pasca operasi, VAS, dan komplikasi pasca operasi. Hasil penelitian mendapatkan 12 pasien, semuanya berjenis kelamin perempuan, berusia 33-64 tahun. Ukuran nodul tiroid berkisar 2 - 7 cm. Satu pasien diubah menjadi lobektomi terbuka. Tidak ada pasien yang tercatat mengalami cedera saraf mental, namun dua pasien mengalami memar pada kulit dagu leher bagian depan. Rerata pengukuran VAS pasca operasi ialah 2, 1, dan tidak nyeri atau 0, masing-masing pada hari pertama, kedua, ketiga, dan ketujuh pasca operasi. Simpulan penelitian ini ialah tiroidektomi endoskopi layak dilakukan, aman dan sebanding dengan tiroidektomi terbuka serta memberikan hasil estetika yang sangat baik.

Kata kunci: tiroidektomi endoskopi transoral; minimal invasif; neoplasma tiroid

Efek Pemberian Suplementasi Kombinasi Vitamin C dan Albumin Terhadap Viabilitas Spermatozoa dalam Proses Sentrifugasi (Studi In Vitro)

Maria K. A. Klau — 2024-02-10

Abstract: Sperm centrifugation is an important process to obtain good spermatozoa for assisted reproductive techniques. However, the centrifugation process has additional impacts such as increased reactive oxygen species (ROS) and oxidative stress affecting sperm viability due to damage of spermatozoa membrane. The use of vitamin C (ascorbic acid) can reduce elevated ROS levels, thereby protecting DNA and spermatozoa from damage caused by oxidative stress, meanwhile albumin can reduce oxidative stress and maintain the integrity of spermatozoa membrane. This study aimed to obtain the effect of combination of vitamin C and albumin on spermatozoa viability in centrifugation process. This was a true experimental in vitro study using post-test-only control design. There were four groups in this study, as follows: the control group (K); the treatment group (P1), centrifugation without vitamin C and albumin; (P2), centrifugation with vitamin C; and (P3), centrifugation with a combination of vitamin C and albumin. The Mann-Whitney test for each group showed significantly differences in spermatozoa viability (p<0.05) among them. The treatment group receiving supplementation with a combination vitamin C and albumin produced the highest viability after the control group. In conclusion, supplementation of combination of vitamin C and albumin is capable in maintaining spermatozoa in centrifugation process.

Keywords: assisted reproduction technique; centrifugation; spermatozoa viability; supplementation

Abstrak: Sentrifugasi sperma merupakan proses penting untuk mendapatkan spermatozoa yang baik dalam keperluan teknik bantu reproduksi, namun proses sentrifugasi memberi dampak lain yaitu terjadinya peningkatan reactive oxygen spesies (ROS) dan stres oksidatif yang memengaruhi viabilitas spermatozoa akibat rusaknya membran spermatozoa. Pemberian vitamin C (asam askorbat) dapat menurunkan kadar ROS yang meningkat sehingga melindungi DNA dan spermatozoa dari kerusakan akibat stres oksidatif sedangkan albumin mampu mengurangi stres oksidatif dan mempertahankan integritas membran spermatozoa. Penelitian ini bertujuan untuk mengevaluasi pengaruh kombinasi vitamin C dan albumin terhadap viabilitas spermatozoa. Jenis penelitian ialah true experimental in vitro menggunakan post test only control design dengan pengamatan pada kelompok kontrol (K); kelompok perlakuan (P1) sentrifugasi tanpa vitamin C dan albumin; (P2) sentrifugasi dengan vitamin C; dan (P3) sentrifugasi dengan kombinasi vitamin C dan albumin. Hasil uji Mann-Whitney dari masing-masing kelompok menunjukkan viabilitas spermatozoa yang berbeda bermakna (p<0,05) antar satu sama lain. Kelompok perlakuan yang mendapat suplementasi kombinasi vitamin C dan albumin menghasilkan viabilitas tertinggi setelah kelompok kontrol. Simpulan penelitian ini ialah suplementasi kombinasi vitamin C dan albumin mampu mempertahankan viabilitas spermatozoa dalam proses sentrifugasi.

Kata kunci: teknik bantu reproduksi; sentrifugasi; viabilitas spermatozoa; suplementasi

Hubungan Kegiatan Ekstrakurikuler dengan Psychological Well-Being Mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi

Felicia A. Gunawan — 2024-02-12

Abstract: Pre-Clinical Students tend to experience a decline in quality of life and well-being due to different responsibilities in curriculum, tasks, and demands during their studies. Extracurricular activities involve aspects of perseverance, empathy, and mindfulness, where these elements can prevent, and even enhance, an individual's psychological well-being (PWB). This study aimed to evaluate the correlation between extracurricular activities and PWB in pre-clinical medical students of Universitas Sam Ratulangi, Manado. This was a quantitative approach study employing data collection through the administration of the PWB scale (PWBS) questionnaire with 84 items developed by Ryff. The results obtained a total of 155 respondents participated in this study. The analysis did not reveal any correlation between participation in extracurricular activities and the dimensions of PWB. Albeit, a correlation was identified between the duration of involvement in extracurricular activities and specific dimensions of PWB (p<0.05). In conclusion, there is no correlation between extracurricular activities and PWB. However, there is a correlation between the duration aspect of involvement in extracurricular activities and PWB dimensions, especially the dimensions of positive relations with others and personal growth.

Keywords: extracurricular activities; psychological well-being; duration aspect

Abstrak: Mahasiswa Program Studi Pendidikan Dokter cenderung mengalami penurunan kualitas hidup dan kesejahteraan karena adanya perbedaan dari segi kurikulum, tugas, dan tuntutan dalam menjalani studi. Kegiatan ekstrakurikuler merupakan suatu kegiatan yang melibatkan aspek ketekunan, empati, dan mindfulness, di mana aspek-aspek ini dapat mencegah penurunan, bahkan meningkatkan psychological well-being (PWB) seseorang. Penelitian ini bertujuan untuk mengevaluasi korelasi antara kegiatan ekstrakurikular dengan PWB pada mahasiswa pre-klinik Universitas Sam Ratulangi, Manado. Jenis penelitian ialah kuantitatif dengan metode pengambilan data menggunakan kueisioner PWB scale (PWBS) 84–items oleh Ryff. Hasil penelitian mendapatkan 155 responden yang terlibat dalam penelitian ini yang mengikuti kegiatan ekstrakurikuler. Tidak ditemukan adanya korelasi antara kegiatan ekstrakurikuler dengan dimensi PWB, tetapi terdapat korelasi antara aspek durasi keterlibatan ekstrakurikuler dengan dimensi-dimensi PWB tertentu (p<0,05). Simpulan penelitian ini ialah tidak terdapat hubungan antara ekstrakurikuler dengan PWB, tetapi terdapat hubungan antara aspek durasi keterlibatan ekstrakurikuler dengan dimensi PWB, terkhususnya dimensi positive relations with others dan personal growth.

Kata kunci: aktivitas ekstrakurikuler; psychological well-being; aspek durasi

Tingkat Depresi, Cemas, dan Stres pada Pasien Kanker yang Menjalani Kemoterapi

Johanes A. Mastan — 2024-02-16

Abstract: Chemotherapy in cancer patients has psychological impacts which are depression, anxiety and stress. This study aimed to evaluate the levels of depression, anxiety and stress in cancer patients undergoing chemotherapy. This was a descriptive study with a cross-sectional design. Samples were obtained by using non-probability sampling with purposive sampling technique. Subjects were cancer patients undergoing chemotherapy at Prof. Dr. R. D. Kandou Hospital aged over 18 years old, not pregnant, and not having an infectious disease. Assessment of levels of depression, anxiety and stress using DASS-42. The results obtained 62 patients undergoing chemotherapy; 47 were women (75.8%). The median and interquartile age range was 52 (14.75) years and body mass index (BMI) was 22 (5.17), 42 patients having an income <3.5 million rupiahs (67%), 36 patients with duration of illness >1 year (58%) and the majority of patients (79%) were in marital status. Among subjects, 23% experienced depression, 40% experienced generalized anxiety disorder, and 21% experienced stress. In conclusion, patients undergoing chemotherapy can experience depression, anxiety and stress disorders.

Keywords: depression; anxiety; stress; chemotherapy; cancer patients

Abstrak: Kemoterapi pada pasien kanker memiliki dampak psikis yaitu depresi, cemas, dan stres. Penelitian ini bertujuan mengetahui tingkat depresi, cemas, dan stres pada pasien kanker yang menjalani kemoterapi. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel diperoleh menggunakan non-probability sampling dengan teknik purposive sampling. Subjek penelitian ialah pasien kanker yang menjalani kemoterapi di RSUP Prof. Dr. R. D. Kandou dengan usia di atas 18 tahun, tidak hamil, dan tidak sedang dalam pengobatan penyakit infeksi. Penilaian tingkat depresi, cemas, dan stres menggunakan DASS-42. Hasil penelitian mendapatkan 62 pasien yang menjalani kemoterapi; 47 pasien ialah perempuan (75,8%). Median dan interquartil range usia ialah 52 (14,75) tahun dan IMT 22(5,17), dengan 42 pasien mempunyai pendapatan <3,5 juta rupiah (67%), 36 pasien dengan lama sakit >1 tahun (58%) dan sebagian besar pasien (79%) dalam status kawin. Sebanyak 23% pasien mengalami depresi, 40% gangguan cemas menyeluruh, dan 21% mengalami stres. Simpulan penelitian ini ialah pasien yang menjalani kemoterapi dapat mengalami gangguan depresi, cemas dan stres.

Kata kunci: depresi; cemas; stres; kemoterapi; pasien kanker

Effectiveness and Outcome of Electronic Medical Record in Patient Service: A Systematic Review

Turido Pratama — 2024-02-16

Abstract: Using electronic medical records is one endeavor to enhance healthcare services and patient outcomes. The electronic medical record (EMR) is employed in healthcare facilities to accomplish every objective. This studyaimed to evaluate the effectiveness and effect of medical record usage in hospitals. This was a systematic review study. Three databases—PubMed, ScienceDirect, and Cochrane—were searched for research publications in this study. Publications published during the last ten years were targeted for search. Three reviewers were involved in the screening of the title and abstract to establish eligibility. Information was acquired from the studies included in this systematic review using a data extraction form that had been pilot tested. The results obtained a total of 1341 articles selected through a search process by entering keywords in a predetermined database. Articles based on inclusion and exclusion criteria were selected, so that, seven articles were included in this study. Most of the studies indicated that EMR benefited health workers to give better clinical performances to the patients, improving quality-adjusted life year (QALY) of the patients, and reduce the mortality rates. In conclusion, implementing the EMR system may benefit health workers and increase their hospital performance.

Keywords: electronic medical record; outcome; hospital; health workers

Gambaran Alasan Penggunaan Lensa Kontak pada Mahasiswa Fakultas Kedokteran

Ryanaldi Bagy — 2024-02-23

Abstract: Despite being aware of the complications associated with contact lens and the practice of hygienic contact lens wear, many medical faculty students still wear contact lenses. This study aimed to obtain the reasons of contact lens wear among medical faculty students. This was a quantitative and descriptive study with a cross-sectional design conducted through total sampling. Respondents were students at Medical Faculty of Universitas Sam Ratulangi that wore contact lens. A total of 83 respondents participated in this study. Based on age groups, there was a tendency for differences in reasons related to ease of access. Based on gender, there was a tendency for differences in cosmetic reasons and the perception that wearing contact lenses were more comfortable than glasses. Overall, the reasons for the respondents to use contact lenses revolved around correction of refractive disorders, cosmetic purposes, and as a substitute for glasses. In conclusion, respondents' reasons for wearing contact lenses tend to be related to correcting refractive disorders, cosmetic purposes, and as a substitute for glasses.

Keywords: reasons; contact lens wearers; medical faculty students

Abstrak: Jumlah mahasiswa fakultas kedokteran yang menggunakan lensa kontak relatif banyak walaupun mahasiswa telah mengetahui komplikasi penggunaan lensa kontak dan praktik penggunaan lensa kontak yang higenis. Penelitian ini bertujuan untuk mendapatkan alasan penggunaan lensa kontak pada mahasiswa fakultas kedokteran. Jenis penelitian ialah kuantitatif yang bersifat deskriptif dengan desain potong lintang. Sampel penelitian diperoleh dengan total sampling. Responden penelitian ialah mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi (FK Unsrat) yang menggunakan lensa kontak. Hasil penelitian mendapatkan 83 mahasiswa FK Unsrat sebagai responden penelitian. Berdasarkan kelompok usia, terdapat kecenderungan perbedaan pada alasan kemudahan akses. Berdasarkan jenis kelamin, terdapat kecenderungan perbedaan pada alasan kosmetik dan alasan lensa kontak lebih nyaman daripada kacamata. Secara keseluruhan, alasan mahasiswa FK Unsrat untuk menggunakan lensa kontak cenderung pada alasan untuk mengoreksi gangguan refraksi, kosmetik, dan sebagai pengganti kacamata. Simpulan penelitian ini ialah alasan responden untuk menggunakan lensa kontak cenderung untuk mengoreksi gangguan refraksi, kosmetik, dan sebagai pengganti kacamata.

Kata kunci: alasan; pengguna lensa kontak; mahasiswa fakultas kedokteran

Gambaran Ultrasonografi Ginjal pada Penderita Penyakit Ginjal Kronis dengan Hiperurisemia di RSUP Prof. Dr. R. D. Kandou Periode Juli 2022 hingga Juli 2023

Yoel F. Silas — 2024-02-23

Abstract: Most studies identify hyperuricemia as an independent risk factor for chronic kidney disease (CKD). Radiologic examination, especially renal ultrasonography (USG), is an important examination to establish the diagnosis of this disease. This study aimed to investigate the overview of renal USG in CKD patients with hyperuricemia at Prof. Dr. R. D. Kandou Hospital from July 2022 to July 2023. This was a retrospective descriptive study with a cross sectional design using medical records of CKD patients with hyperuricemia who had renal USG performed on them at the Radiology Department of Prof. Dr. R. D. Kandou Hospital from July 2022 to July 2023 using proportional random sampling method. The results obtained 68 patients dominated by 56-65 years old (35.3%), male (57.4%), patients who did not undergo routine hemodialysis (69.1%), and 3th severity grade (41.9%). Renal USG characteristics were dominated by normal size (68.4%), increased parenchymal echogenicity (95.6%), normal cortex thickness (66.2%), blurred corticomedullary echogenicity differentiation (41.9%), and normal pelviocalyceal system (96.3%). In conclusion, CKD patients with hyperuricemia are mostly at the age of 56-65 years, male, at 3th severity grade, and do not undergo routine hemodialysis.

Keywords: chronic kidney disease; hyperuricemia; renal ultrasonography

Abstrak: Sebagian besar penelitian mengidentifikasi hiperurisemia sebagai faktor risiko independen terjadinya penyakit ginjal kronis (PGK). Pemeriksaan radiologis, terutama ultrasonografi (USG) ginjal, merupakan pemeriksaan penunjang yang penting untuk menegakkan diagnosis penyakit ini. Penelitian ini bertujuan untuk mengetahui gambaran USG ginjal pada penderita PGK dengan hiperurisemia di RSUP Prof. Dr. R. D. Kandou periode Juli 2022 hingga Juli 2023. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang menggunakan rekam medis pasien PGK dengan hiperurisemia yang dilakukan pemeriksaan USG ginjal di RSUP Prof. Dr. R. D. Kandou pada Juli 2022 hingga Juli 2023. Pengambilan sampel menggunakan metode proportional random sampling. Hasil penelitian mendapatkan 68 pasien sebagai sampel penelitian yang didominasi oleh kelompok usia 56−65 tahun (35,3%), jenis kelamin laki-laki (57,4%), pasien yang tidak menjalani hemodialisis rutin (69,1%), dan derajat keparahan 3 (41,9%). Gambaran USG ginjal didominasi oleh ukuran normal (68,4%), ekogenisitas parenkim meningkat (95,6%), ketebalan korteks normal (66,2%), batas ekogenisitas korteks dan medula mengabur (41,9%), dan sistem pelviokalises normal (96,3%). Simpulan penelitian ini ialah penderita PGK dengan hiperurisemia sebagian besar berada pada usia 56-65 tahun, berjenis kelamin laki-laki, berada pada derajat keparahan 3, dan tidak menjalani hemodialisis rutin.

Kata kunci: hiperurisemia; penyakit ginjal kronis; ultrasonografi ginjal

Prevalensi Skabies pada Warga Binaan di Lembaga Pemasyarakatan Kelas IIA Tuminting Manado

Raul C. Zachawerus — 2024-02-25

Abstract: Scabies is a contagious skin disease caused by the mite Sarcoptes scabiei var, hominis. The prevalence of scabies in Indonesia in 2016 is estimated at 4.6-12.9% of the 261.6 million population. Scabies ranks 3rd out of the 12 most common skin infections. This study aimed to determine the prevalence of scabies among inmates in Lembaga Pemasyarakatan kelas IIA Tuminting Manado (correctional insitution). This was a quantitative and descriptive study with a cross sectional design using The DeSkab (Deteksi Skabies) questionnaire. The results showed that 86 inmates out of a total of 190 inmates were detected of having scabies (45.3%) dominated by age 25-44 years (51.2%), middle education (76.7%), and unqualified occupancy density (100%). The most common distributions of lesions were between fingers (30.7%), followed by front part of wrist (20.2%), and elbow (13.5%). Cardinal signs of scabies were itching worse at night (98.8%), followed by lesions (86.1%), and itching complained by roommates (70.9%). In conclusion, the prevalence of scabies in Lembaga Pemasyarakatan kelas IIA Tuminting Manado is 45.3%. Inmates with detected scabies are dominated by age 25-44 years, middle education, unqualified occupancy density, distribution of lesion between fingers, and cardinal sign as itching worse at night.

Keywords: scabies; correctional institution; inmates

Abstrak: Skabies merupakan penyakit kulit menular yang diakibatkan oleh tungau Sarcoptes scabiei var, hominis. Skabies menempati peringkat 3 dari 12 penyakit infeksi kulit tersering. Penelitian ini bertujuan untuk mengetahui prevalensi skabies pada warga binaan di Lembaga Pemasyarakatan kelas IIA Tuminting Manado. Jenis penelitian ialah deskriptif kuantitatif dengan desain potong lintang dan menggunakan kuesioner DeSkab (Deteksi Skabies). Hasil penelitian mendapatkan 86 warga binaan dari total 190 warga binaan yang terdeteksi skabies (45,3%), didominasi oleh usia 25-44 tahun (51,2%), tingkat pendidikan menengah (76,7%), dan kepadatan hunian yang tidak memenuhi syarat (100%). Sebaran lokasi lesi yang terbanyak ialah sela jari tangan (30,7%), diikuti pergelangan tangan depan (20,2%), dan siku luar (13,5%). Tanda kardinal skabies yang tersering muncul ialah keluhan gatal pada malam hari (98,8%), diikuti adanya bintil/lecet/borok (86,1%), dan keluhan gatal pada orang lain (sekamar) (70,9%). Simpulan penelitian ini ialah prevalensi skabies pada warga binaan Lembaga Pemasyarakatan Kelas IIA Tuminting Manado sebesar 45,3%. Warga binaan terdeteksi skabies didominasi oleh usia 25-44 tahun, tingkat pendidikan menengah, kepadatan hunian yang tidak memenuhi syarat, sebaran lokasi lesi di sela jari tangan, dan tanda kardinal skabies keluhan gatal pada malam hari.

Kata kunci: skabies; lembaga pemasyarakatan; warga binaan

Pendekatan Diagnostik Disfagia Orofaring dengan Pemeriksaan Flexible Endoscopic Evaluation of Swallowing pada Anak dan Dewasa di RSUP Prof. Dr. R. D. Kandou Manado

Marsella P. Castendo — 2024-02-29

Abstract: Dysphagia is a swallowing disorder that requires effort and time to digest food. It can occur in all age groups, due to damage of organ structures or certain medical conditions. The most common method of examining oropharyngeal dysphagia is Flexible Endoscopic Evaluation of Swallowing (FEES). This study aimed to obtain the clinical diagnosis and further management in dysphagia cases. This was a retrospective descriptive study with a cross sectional design. Samples were medical records of dysphagia patients at Prof. Dr. R. D. Kandou Hospital from 2020 to 2023. The results obtained 32 cases out of 315 patients with dysphagia. Orophatyngeal dysphagia was more common in males (68.8%) and age 20-59 years (53.1%). Based on preswallowing and swallowing assessment, the characteristics that appear tend to be impaired in pharyngeal phase. The most common clinical diagnoses were aspiration pneumonia and laryngopharyngeal reflux (LPR) (each of 18.6%). Further management was diet modification and swallowing rehabilitation (78.7%). In conclusion, oropharyngeal dysphagia is common in male patients and occurs at the age of 20-59 years. The most common causes of oropharyngeal dysphagia are aspiration pneumonia and LPR. The FEES measures can determine further management, namely diet modification and swallowing rehabilitation.

Keywords: oropharyngeal dysphagia; swallowing disorders; swallowing rehabilitation

Abstrak: Disfagia adalah gangguan proses menelan sehingga butuh usaha dan waktu untuk mencerna makanan yang dapat terjadi pada semua kelompok usia, akibat kerusakan struktur organ atau kondisi medis tertentu. Metode pemeriksaan disfagia orofaring yang sering dilakukan ialah Flexible Endoscopic Evaluation of Swallowing (FEES). Penelitian ini bertujuan untuk mengetahui diagnosis klinis dan manajemen lanjutan pada kasus disfagia. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Sampel penelitian ialah rekam medik pasien disfagia di RSUP Prof. Dr. R. D. Kandou sejak 2020-2023. Hasil penelitian mendapatkan 32 pasien yang memenuhi kriteria dari 315 pasien disfagia. Disfagia orofaring lebih sering dialami oleh laki-laki (68,8%) dan usia 20-59 tahun (53,1%). Berdasarkan hasil preswallowing dan swallowing assessment karakteristik yang muncul cenderung mengalami gangguan fase faring. Diagnosis klinis terbanyak ialah pneumonia aspirasi dan RLF (masing-masing 18,6%). Manajemen lanjutan yang dilakukan ialah modifikasi diet dan rehabilitasi menelan (78,7%). Simpulan penelitian ini ialah disfagia orofaring sering dialami oleh laki-laki, usia 20-59 tahun, dengan penyebab tersering yaitu pneumonia aspirasi dan RLF. Dengan tindakan FEES dapat ditentukan manajemen lanjutan yaitu dengan modifikasi diet dan rehabilitasi menelan.

Kata kunci: disfagia orofaring; gangguan menelan; rehabilitasi menelan

Profil Pasien Peritonitis Primer, Peritonitis Sekunder, dan Peritonitis Tersier di RSUP Prof. Dr. R. D. Kandou Tahun 2022

Angelica M. J. Wagiu — 2024-03-01

Abstract: The complex structure of abdomen makes the diagnosis and treatment of intraperitoneal infections a challenge in the practice of medicine. This study aimed to obtain the profile of primary peritonitis, secondary peritonitis, and tertiary peritonit patients treated at Prof. Dr. R. D. Kandou Hospital, Manado. This was a retrospective and descriptive study using medical records of peritonitis patients during the period January–December 2022. The results showed that most peritonitis patients treated at Prof. Dr. R. D. Kandou were males in the age group of 19-59 years. The most common peritonitis was secondary peritonitis (52 patients), followed by tertiary peritonitis (11 patients) and primary peritonitis (9 patients). Based on the etiology, hepatic cirrhosis (45%) was the most common etiology of primary peritonitis; gastric perforation (38%) was the most common etiology of secondary peritonitis; and post appendectomy (18%), post nephrostomy (18%) and leakage of sigmoid anastomosis (18%) were the most common etiologies of tertiary peritonitis. Generally patients had radiological features of preperitoneal fat depletion (44%), and subdiaphragm free air (20%). Most patients received operative treatment, and admitted to the hospital with sepsis. In conclusion, the majority of peritonitis patients suffer from secondary peritonitis, males of age group 19-59 years, with varied etiologies for each type of peritonitis.

Keywords: patient profile; primary peritonitis; secondary peritonitis; tertiary peritonitis.

Abstrak: Struktur abdomen yang kompleks membuat diagnosis dan pengobatan infeksi intraperitoneal menjadi tantangan dalam praktik kedokteran. Penelitian ini bertujuan untuk mengetahui profil pasien peritonitis primer, peritonitis sekunder, dan peritonitis tersier yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medis pasien peritonitis selama periode Januari – Desember 2022. Hasil penelitian mendapatkan 72 pasien peritonitis dirawat di RSUP Prof. Dr. R. D. Kandou Manado sebagai subjek penelitian. Peritonitis paling sering terjadi pada laki-laki, kelompok usia 19-59 tahun. Peritonitis yang tersering ialah peritonitis sekunder (52 pasien), diikuti peritonitis tersier (11 pasien) dan peritonitis primer (9 pasien). Berdasarkan etiologi, sirosis hati (45%) merupakan etiologi tersering peritonitis primer; perforasi gaster (38%) merupakan etiologi tersering peritonitis sekunder; serta pasca apendektomi, pasca nefrostomi dan leakage anastomosis sigmoid merupakan etiologi tersering peritonitis tersier (masing-masing 18%). Umumnya pasien memiliki gambaran radiologi penipisan lemak preperitoneal (44%), dan udara bebas subdiafragma (20%). Pasien terbanyak menerima tatalaksana operatif, dan datang dengan sepsis. Simpulan penelitian ini ialah mayoritas pasien dengan peritonitis berjenis kelamin laki-laki, kelompok usia 19-59 tahun, kategori peritonitis sekunder, dengan etiologi bervariasi untuk setiap jenis peritonitis.

Kata kunci: profil pasien; peritonitis primer; peritonitis sekunder; peritonitis tersier

Exploring the Therapeutic Benefits of Silymarin Herbal Extract as a Supplement to Pulmonary Tuberculosis Treatment: A Comprehensive Review from Laboratory to Clinical Trials

Muhammad I. D. Rakasiwi — 2024-03-03

Abstract: Indonesia is ranked second in the number of tuberculosis (TB) cases with an incidence rate of 300 per 1000 population. A combination of antibiotics with a minimum six-month-administration regimen is an effective first line of TB treatment. Silymarin (Sm) is a plant extract which is known to have hepatoprotective and anti-microbial effects. This literature review aimed to discuss the potential of Sm in pulmonary TB treatment, starting from laboratory studies to clinical trials in humans. Studies on the use of Sm in tuberculosis literatures were obtained from a rapid systematic search in Pubmed and ScienceDirect databases. Supporting articles were searched based on specific keywords with inclusion criteria. The in vitro test showed immunomodulatory and bactericidal capacities of Sm against Mycobacterium tuberculosis. The in vivo test of Sm administration showed that Sm was able to increase the percentage of macrophage cells expressing the cytokines NF-κB and IFN-β. Sm had a bactericidal effect at levels >50 μM. The hepatoprotective character of Sm could prevent the increase in liver enzymes in mice receiving anti-TB drugs. Clinical trials showed that administration of Sm could prevent anti-tuberculosis drug hepatoxicity. In conclusion, silymarin has the potential to be an adjuvant therapy for the treatment of anti-TB drug-sensitive or resistant tuberculosis, as well as protection against the hepatotoxic properties of anti-TB drugs.

Keywords: tuberculosis; silymarin; supplementation therapy; antituberculosis therapy

Eutanasia Ditinjau dari Etika Kedokteran di Indonesia

Octaviane K. Rarung — 2024-03-04

Abstract: Legal perspective euthanasia is a form of taking one's life. There are differences in the legality of euthanasia in Indonesia and several other countries that require doctors to understand the medical ethics related to euthanasia. This study aimed to explore the medical ethics related to euthanasia. This was a systematic literature review study using three database sources, namely ClinicalKey, Pubmed, and Sage Journal based on inclusion criteria and exclusion criteria. The results showed that euthanasia was not an appropriate and ethical matter for doctors to do. Doctors had to fulfill the autonomy of patients meanwhile doctors had also to consider the decisions given by patients since not all decisions of the patients had to be fulfilled, let alone decisions asking for euthanasia. Medical ethics viewed euthanasia as an unethical act to be performed by a doctor. Legal and religious views viewed euthanasia as something that should not be done. Moreover, medical ethics' view on euthanasia was different from bioethics' view on euthanasia. Bioethics viewed euthanasia from various perspectives, broader than medical ethics did. In conclusion, medical ethics respects the autonomy of the patient, albeit, the patient does not have the right to assert the obligation of others to fulfill that right.

Keywords: euthanasia; medical ethics; doctors; patient’s autonomy

Abstrak: Dalam perspektif hukum eutanasia merupakan suatu bentuk tindakan menghilangkan nyawa seseorang. Terdapat perbedaan legalitas eutanasia di Indonesia dengan beberapa negara lain yang mewajibkan dokter untuk mengetahui etika kedokteran terkait eutanasia. Penelitian ini bertujuan untuk memahami etika kedokteran terkait eutanasia. Jenis penelitian yang dilakukan ialah systematic literature review dengan tiga sumber database yang digunakan yakni ClinicalKey, Pubmed, dan Sage Journal berdasarkan kriteria inklusi serta kriteria eksklusi. Hasil penelitian mendapatkan bahwa eutanasia bukan hal yang pantas dan bukan hal yang etis untuk dilakukan oleh seorang dokter. Dokter memang harus memenuhi otonomi pasien namun dokter juga harus mempertimbangkan keputusan yang diberikan pasien karena tidak semua keputusan yang diambil pasien harus dipenuhi oleh dokter, apalagi keputusan meminta untuk eutanasia. Etika kedokteran memandang eutanasia sebagai tindakan yang tidak etis untuk dilakukan oleh seorang dokter. Pandangan hukum dan pandangan agama memandang eutanasia sebagai hal yang tidak patut untuk dilakukan. Pandangan etika kedokteran terhadap eutanasia berbeda dengan pandangan bioetika terhadap eutanasia. Bioetika memandang eutanasia dari berbagai sudut pandang, yang lebih luas dari pandangan etika kedokteran. Simpulan penelitian ini ialah etika kedokteran menghargai otonomi pasien namun pasien tidak mempunyai hak untuk menuntut kewajiban orang lain untuk memenuhi hak tersebut.

Kata kunci: eutanasia; etika kedokteran; dokter; otonomi pasien

Tingkat Pengetahuan Penggunaan Kosmetik pada Akne Vulgaris serta Sikap dan Perilaku Penggunaan Kosmetik pada Mahasiswa Fakultas Kedokteran

Sabrinna R. N. Hanumningtyas — 2024-03-11

Abstract: Some cosmetics contain risky ingredients for the skin, especially for those with sensitive skin or acne. This study aimed to obtain the level of knowledge, attitude, and behavior towards cosmetics use in acne vulgaris (AV) among medical students. This was a descriptive categorial with a cross sectional design using primary data in the form of questionnaires. Respondents were students of Medical Faculty, Universitas Sam Ratulangi, Manado. The results showed that the level of knowledge of the cosmetics use in AV was in the moderate category (53.6%). The attitude of cosmetic use in the poor category was 100%. The behaviors of cosmetic use were, as follows: face cleaning twice a day (71.5%), using one type of facial cleanser (43.6%), using one facial cleansing device (71.5%), always using facial cream (36.9%), always using sunscreen (46.9%), and female respondents who used solid powder (41.8%). In conclusion, the level of knowledge of medical students at Universitas Sam Ratulangi was in moderate category, meanwhile the attitude was in poor category. Furthermore, the majority of students exhibited the behavior of cleansing their faces twice daily, using a singular type of facial cleanser and cleansing device. Additionally, most students consistently applied facial cream and sunscreen, while a significant portion of female respondents using compact powder.

Keywords: level of knowledge; attitude; behavior; cosmetics; medical students

Abstrak: Beberapa jenis kosmetik mengandung bahan berisiko bagi kulit, terutama untuk yang berkulit sensitif atau berjerawat. Penelitian ini bertujuan untuk mengetahui tingkat pengetahuan penggunaan kosmetik pada acne vulgaris (AV) serta sikap dan perilaku penggunaan kosmetik pada mahasiswa Fakultas Kedokteran (FK). Jenis penelitian ialah deskriptif kategorik dengan desain potong lintang menggunakan kuesioner. Responden penelitian ialah mahasiswa FK Universitas Sam Ratulangi (Unsrat). Hasil penelitian memperlihatkan tingkat pengetahuan penggunaan kosmetik pada AV berada dalam kategori cukup sebesar 53,6%. Sikap penggunaan kosmetik responden berada dalam kategori kurang sebesar 100%. Perilaku penggunaan kosmetik responden dalam membersihkan wajah 2x/hari (71,5%), menggunakan satu jenis pembersih wajah (43,6%), menggunakan satu perangkat pembersih wajah (71,5%), selalu menggunakan krim wajah (36,9%), selalu menggunakan tabir surya (46,9%), dan responden perempuan yang menggunakan bedak padat (41,8%). Simpulan penelitian ini ialah tingkat pengetahuan mahasiswa FK Unsrat ialah cukup, sikap mahasiswa dalam penggunaan kosmetik ialah kurang, dan perilaku mahasiswa mayoritas membersihkan wajah dua kali sehari, menggunakan satu jenis pembersih dan perangkat pembersih wajah. Sebagian besar mahasiswa selalu menggunakan krim wajah dan tabir surya, serta sebagian besar responden perempuan menggunakan bedak padat.

Kata kunci: tingkat pengetahuan; sikap; perilaku; kosmetik; mahasiswa fakultas kedokteran

Faktor-faktor yang Berperan terhadap Kecemasan pada Mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi

Sthevanus N. Moe — 2024-03-14

Abstract: Anxiety is a prevalent issue among medical students due to the demanding schedule, frequent module exams, OSCE, and tutorial activities. This study aimed to determine the relationships between factors contributing to anxiety among students at the medical faculty. This was an analytical observational study with a cross-sectional design, using primary data from questionnaires administered to the students. Respondents were students of third semester Faculty of Medicine of Universitas Sam Ratulangi. The results showed that majority of respondents experienced expected parenting model, first-born, come from outside the region, with severe academic stress, moderate stress in the learning process, moderate interpersonal stress, moderate social stressors, mild pressure from lacking motivation, and moderate stress in group activities. Respondents without anxiety were 41.8% of students, followed by mild anxiety in 28.2%, moderate anxiety in 17.3%, severe anxiety in 9.1%, and very severe anxiety in 3.6%. Factors related to anxiety were academic stressors (p=0.001), learning process stressors (p=0.001), interpersonal stressors (p=0.000), and group activity stressors (p=0.000). In conclusion, academic stressors, learning process stressors, interpersonal stressors, and group activity stressors are related to anxiety among the third-semester medical education students at Unioversitas Sam Ratulangi.

Keywords: anxiety; stressor; medical students; academic demands

Abstrak: Kecemasan merupakan permasalahan pada mahasiswa fakultas kedokteran akibat jadwal pembelajaran yang padat, ujian modul yang sering, OSCE serta kegiatan tutorial. Penelitian ini bertujuan untuk mengetahui hubungan faktor-faktor yang berperan terhadap kecemasan pada mahasiswa fakultas kedokteran. Jenis penelitian ialah analitik observasional dengan desain potong lintang menggunakan data primer dari kuesioner kepada mahasiswa. Responden penelitian ialah mahasiswa semester III Fakultas Kedokteran Universitas Sam Ratulangi (FK Unsrat). Hasil penelitian mendapatkan mayoritas responden mendapatkan model pengasuhan yang diharapkan, anak non sulung, perantau, dengan stres akademik berat, stres proses pembelajaran sedang, stres interpersonal sedang, stresor sosial sedang, tekanan dari motivasi yang kurang secara ringan, dan stres aktivitas kelompok sedang. Responden tidak mengalami kecemasan sebanyak 41,8%, disusul oleh kecemasan ringan sebanyak 28,2%, kecemasan sedang 17,3%, kecemasan berat 9,1%, dan kecemasan sangat berat 3,6%. Faktor-faktor yang memiliki hubungan korelasi dengan kecemasan ialah stresor akademik (p=0,001), stresor pembelajaran (p=0,001), stresor interpersonal ((p=0,000), dan stresor aktivitas berkelompok (p=0,000). Simpulan penelitian ini ialah terdapat hubungan bermakna stresor akademik, stresor pembelajaran, stresor interpersonal, dan stresor aktivitas berkelompok dengan ansietas pada mahasiswa Semester III Fakultas Kedokteran Universitas Sam Ratulangi.

Kata kunci: kecemasan; stresor; mahasiswa kedokteran; tuntutan akademik

Hubungan Preeklamsia Berat dengan Kejadian Persalinan Preterm di RSUP Prof. Dr. R. D. Kandou Manado Periode 2021–2022

Cresensia R. N. Widjaja — 2024-03-18

Abstract: Preeclampsia/eclampsia may lead to additional pregnancy complications, including the occurrence of preterm labor either spontaneously or be induced. Severe preeclampsia is a frequent reason for iatrogenic preterm labor. This study aimed to determine the relationship between severe preeclampsia and the incidence of preterm labor at Prof. Dr. R. D. Kandou Hospital, Manado, period 2021–2022. This was a case-control study design. The population in this study were mothers who gave birth at Prof. Dr. R. D. Kandou Hospital, Manado, from January 1st, 2021– December 31st, 2022. The case samples were mothers with preterm labor, meanwhile the control samples were mothers with term labor. Data were obtained from medical records of mothers who gave birth at the Obstetrics and Gynaecologist Department of Prof. Dr. R. D. Kandou Hospital. The chi square test showed that the most common preterm birth in severe preeclampsia was iatrogenic preterm labor (73.7%) and the most frequent indication was severe preeclampsia without impending eclampsia (43.9%). The chi-square test obtained a significant relationship between severe preeclampsia and the incidence of preterm labor (p=0.000, OR=2.359, 95% CI 1.709–3.773). In conclusion, there is a significant relationship between severe preeclampsia and the incidence of preterm labor at Prof. Dr. R. D. Kandou Hospital, Manado, period 2021–2022.

Keywords: severe preeclampsia; preterm labor; term labor

Abstrak: Preeklamsia/eklamsia dapat mengakibatkan masalah kehamilan lainnya, seperti persalinan preterm yang dapat terjadi secara spontan atau melalui tindakan iatrogenik (terminasi). Preeklamsia berat merupakan salah satu indikasi paling sering pada persalinan preterm yang dilakukan secara iatrogenik. Penelitian ini bertujuan untuk mengetahui hubungan preeklamsia berat dengan kejadian persalinan preterm di RSUP Prof. Dr. R. D. Kandou Manado periode 2021–2022. Jenis penelitian ialah deskriptif analitik dengan desain studi kasus-kontrol. Sampel kasus ialah ibu dengan persalinan preterm dan sampel kontrol ialah ibu dengan persalinan aterm yang didapatkan dari data rekam medik ibu bersalin di Bagian Obstetri Ginekologi RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan bahwa persalinan preterm terbanyak pada preeklamsia berat ialah persalinan preterm iatrogenik (terminasi) (73,7%) dan indikasi terbanyak ialah preeklamsia berat tanpa impending eklamsia (43,9%). Hasil uji chi square mendapatkan hubungan bermakna antara preeklamsia berat dan persalinan preterm (p=0,000; OR=2,539, 95% CI 1,709-3,773). Simpulan penelitian ini ialah terdapat hubungan bermakna antara preeklamsia berat dengan kejadian persalinan preterm di RSUP Prof Dr. R. D. Kandou Manado periode 2021–2022.

Kata kunci: preeklamsia berat; persalinan preterm; persalinan aterm

Korelasi antara Rasio Limfosit Neutrofil dan Nilai Ambang Batas Siklus RT-PCR pada Bayi Terinfeksi Covid-19

Suryadi N. N. Tatura — 2024-03-28

Abstract: Covid-19 pandemic has been a new illness since the start of 2019 which was caused by SARS-CoV-2 coronavirus. In children, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been linked to a multisystem inflammatory syndrome and coronavirus disease 2019 (Covid-19). This study aimed to obtain the correlation between the neutrophil-lymphocyte ratio (NLR) and the cycling threshold (CT) value (viral load) of RT-PCR for Covid-19 in infant patients. This was a descriptive and analytical study with a cross-sectional design. Secondary data were obtained from medical records of March 2020 to February 2022 at Prof. Dr. R. D. Kandou Hospital, Manado. Subjects were all infants admitted or born during the recording period, with suspected or confirmed Covid 19, including infants with mothers whose Covid-19 antigen tests were reactive. Data of age, gender, diagnosis, outcome CT value of RT-PCR test, and NLR were retrieved, and analyzed with Pearson correlation, meanwhile comparison based on gender and outcome of care using the independent T-test. All analyses were conducted with IBM SPSS 26.0. The results showed that the correlation between CT value and NLR was -0.361 with a p-value of 0.067. In conclusion, there is no significant correlation between CT value and NLR level with weak correlation. However, CT and NLR values appeared to be inversely associated; the higher the NLR value, the lower the CT value.

Keywords: infants; Covid-19; cycle threshold of RT-PCR; neutrophil-lymphocyte ratio

Abstrak: Pandemi Covid-19 menjadi penyakit baru sejak awal tahun 2019 sebagai akibat dari virus corona SARS-CoV-2. Pada anak, infeksi sindrom pernapasan akut parah coronavirus-2 (SARS-CoV-2) telah dikaitkan dengan sindrom inflamasi multisistem dan penyakit virus corona 2019 (Covid-19). Penelitian ini bertujuan untuk mengetahui hubungan antara rasio neutrofil-limfosit (NLR) dan nilai ambang batas siklus (CT) RT-PCR Covid-19 pada bayi. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Data sekunder diperoleh dari rekam medis sejak Maret 2020 hingga Februari 2022 di RSUP Prof. Dr. R. D. Kandou Manado. Semua bayi yang dirawat atau lahir selama periode pencatatan, dengan suspek atau konfirmasi Covid-19, termasuk bayi dengan ibu yang tes antigen Covid-19-nya reaktif. Data yang dianalisis pada penelitian ini antara lain usia, jenis kelamin, diagnosis, nilai CT hasil tes RT-PCR, dan NLR. Analisis data yang dilakukan yaitu analisis deskriptif, korelasi Pearson, dan perbandingan berdasarkan jenis kelamin dan hasil perawatan dengan analisis uji t independen. Semua analisis dilakukan dengan software IBM SPSS 26.0. Hasil analisis menunjukkan nilai korelasi antara nilai CT dan NLR sebesar -0,361 (p=0,067). Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara nilai CT dan nilai NLR dengan korelasi yang lemah. Nilai CT dan NLR tampaknya berkorelasi terbalik dengan NLR yang lebih tinggi dikaitkan dengan nilai CT yang lebih rendah.

Kata kunci: bayi; Covid-19; nilai ambang batas siklus RT-PCR; rasio neutrofil-limfosit

Gambaran Kadar Glukosa Darah Puasa pada Pasien Stroke Iskemik di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022

Teofaniblesstin Mangontan — 2024-04-09

Abstract: Ischemic stroke is the most common type of strokes, especially in patients with history of diabetes—a non-modifiable risk factor. Hyperglycemia is common in acute ischemic stroke patients, whether with or without history of diabetes. This study aimed to obtain the overview of fasting blood glucose (FBG) levels in ischemic stroke patients at Prof. Dr. R. D. Kandou Hospital in 2022. This was a retrospective and descriptive study using secondary data from medical records of ischemic stroke patients at Prof. Dr. R. D. Kandou in 2022 using total sampling method. The results showed that of 40 samples, the predominance were female patients (55.0%) with FBG levels of ≥126 mg/dL (27.5%), aged 56–65 years (35.0%) with FBG levels of ≥126 mg/dL (12.5%), without history of diabetes (70.0%) with FBG levels of 70–99 mg/dL (30.0%), and stroke in the acute phase (90.0%) with FBG levels of 70–99 mg/dL (32.5%). In conclusion, ischemic stroke patients were predominantly female and aged 56–65 years with hyperglycemic FBG levels. Additionally, most patients had no history of diabetes and were in the acute phase with normal FBG levels.

Keywords: fasting blood glucose; ischemic stroke; diabetes mellitus

Abstrak: Stroke iskemik merupakan jenis stroke yang paling sering ditemukan, terutama pada pasien dengan riwayat diabetes. Diabetes merupakan faktor risiko stroke yang tidak dapat diubah. Keadaan hiperglikemia umum ditemukan pada pasien stroke iskemik akut, baik dengan atau tanpa riwayat diabetes. Penelitian ini bertujuan untuk mengetahui gambaran kadar glukosa darah puasa (GDP) pada pasien stroke iskemik di RSUP Prof. Dr. R. D. Kandou Manado tahun 2022. Penelitian ini bersifat deskriptif retrospektif menggunakan data sekunder rekam medis pasien stroke iskemik di RSUP Prof. Dr. R. D. Kandou tahun 2022 diperoleh dengan metode total sampling. Hasil penelitian mendapatkan 40 sampel pasien dengan stroke iskemik yang didominasi oleh jenis kelamin perempuan (55,0%) dengan kadar GDP ≥126 mg/dL (27,5%), usia 56–65 tahun (35,0%) dengan kadar GDP ≥126 mg/dL (12,5%), tanpa riwayat diabetes melitus (70,0%) dengan kadar GDP 70–99 mg/dL (30,0%), dan stroke fase akut (90,0%) dengan kadar GDP 70–99 mg/dL (32,5%). Simpulan penelitian ini ialah pasien stroke iskemik di RSUP Prof. Dr. R. D. Kandou Manado tahun 2022 didominasi oleh perempuan dan kelompok usia 56–65 tahun dengan kadar GDP hiperglikemia, serta tanpa riwayat diabetes melitus dan fase akut dengan kadar GDP normal.

Kata kunci: glukosa darah puasa; stroke iskemik; diabetes melitus

Gambaran Fungsi Ginjal pada Anak Penderita Diare dengan Dehidrasi di RSUP Prof. Dr. R. D. Kandou Manado

Putri F. Ibrahim — 2024-04-12

Abstract: Diarrhea associated with dehydration can cause decreased tissue perfusion and circulating volume, thus inhibiting kidney function characterized by a decrease in glomerular filtration rate (GFR) and an increase in metabolic waste. This study aimed to determine the description of kidney function in children with diarrhea and dehydration at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective and descriptive study with a cross-sectional design. Samples were children with diarrhea and dehydration hospitalized at Prof. Dr. R. D. Kandou Hospital from July 1, 2020 to June 30, 2023. The results obtained 120 patients predominantly between the ages of 1 month -<1 year (50.0%), male (59.2%), and had mild to moderate dehydration (78.3%). Kidney function features showed normal serum ureum and serum creatinine in most samples by 89% and 91%, respectively, while GFR decreased in less than half of the samples by 49.2%. Increased serum ureum, serum creatinine, and decreased GFR were most common in severely dehydrated children by 69.2%, 73.1%, and 84.6%, respectively. In conclusion, diarrheal children with dehydration had normal serum ureum and serum creatinine levels, and decreased GFR. Increased serum ureum, serum creatinine, and decreased GFR were most common in diarrheal children with severe dehydration.

Keywords: diarrhea; dehydration; children; serum ureum; serum creatinine; glomerular filtration rate

Abstrak: Diare yang disertai dehidrasi dapat menyebabkan penurunan perfusi jaringan dan volume sirkulasi sehingga menghambat fungsi ginjal yang ditandai dengan penurunan laju filtrasi glomerulus (LFG) dan peningkatan limbah metabolisme di dalam tubuh. Penelitian ini bertujuan untuk mengetahui gambaran fungsi ginjal pada pasien anak penderita diare dengan dehidrasi di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Sampel penelitian yaitu pasien anak diare dengan dehidrasi yang dirawat inap di RSUP Prof. Dr. R. D. Kandou Manado selama periode 1 Juli 2020–30 Juni 2023. Hasil penelitian mendapatkan 120 pasien anak diare dehidrasi didominasi usia 1 bulan -<1 tahun (50,0%), jenis kelamin laki-laki (59,2%), dan dehidrasi ringan-sedang (78,3%). Gambaran fungsi ginjal pada anak diare dengan dehidrasi memperlihatkan ureum serum dan kreatinin serum normal pada sebagian besar sampel (89% dan 91%), sedangkan LFG menurun pada kurang dari setengah sampel (49,2%). Peningkatan ureum serum, kreatinin serum, serta penurunan LFG paling sering pada anak dengan dehidrasi berat (69,2%, 73,1%, dan 84,6%). Simpulan penelitian ini ialah pada anak diare dengan dehidrasi, kadar ureum serum dan kreatinin serum didapatkan normal, sedangkan LFG menurun. Peningkatan ureum serum, kreatinin serum, dan penurunan LFG pada anak diare dengan dehidrasi paling sering pada derajat dehidrasi berat.

Kata kunci: diare; dehidrasi; anak; ureum serum; kreatinin serum; laju filtrasi glomerulus

Identifikasi Pola Bakteri dan Uji Sensitivitas Antibiotik di Kamar Bedah RSU GMIM Pancaran Kasih Manado

Alexander A. Waleleng — 2024-04-12

Abstract: Healthcare associated infections/Hospital acquired infections (HAIs) or nosocomial infections can cause mild to severe complications to patients. Types of nosocomial infections that often occur are primary bloodstream infections (BSI), catheter-associated urinary tract infections (UTI), surgical site infections (SSI), ventilator-associated pneumonia, etc. This study aimed to determine the bacterial pattern and antibiotic sensitivity in the surgical room of GMIM Pancaran Kasih Hospital Manado. This was an observational and descriptive study with a cross-sectional design. This study aimed to identify the bacterial pattern and sensitivity test in surgical room of GMIM Pancaran Kasih Hospital. The results obtained three types of Gram-positive bacteria in the surgical room, namely Staphylococcus sp. (62.5%), Bacillus sp. (25%), and Streptococcus sp. (12.5%); all bacteria had high sensitivity to meropenem (100%) and not sensitive (resistant) to erythromycin (0%). In conclusion, since there are bacteria found in the surgical room, personal sterility and sanitation must be improved by medical personnel.

Keywords: bacterial pattern; antibiotic sensitivity test; surgical room

Abstrak: Healthcare-associated infections/hospital-acquired infections (HAIs) atau infeksi nosokomial dapat menyebabkan komplikasi ringan hingga berat pada pasien. Jenis infeksi nosokomial yang sering terjadi ialah infeksi aliran darah primer (IADP), infeksi saluran kemih (ISK) terkait kateter, infeksi daerah operasi (IDO), pneumonia terkait ventilator, dll. Penelitian ini bertujuan untuk mengidentifikasi pola bakteri dan sensitivitas antibiotik di kamar bedah RSU GMIM Pancaran Kasih Manado. Jenis penelitian ialah deskriptif observational dengan desain potonng lintang. Penelitian ini bertujuan untuk mengidentifikasi pola bakteri dan uji sensitivitas terhadap bakteri di kamar bedah RSU GMIM Pancaran Kasih Manado. Hasil penelitian mendapatkan tiga jenis bakteri Gram positif di kamar bedah, yaitu Staphylococcus sp. (62,5%), Bacillus sp. (25%), dan Streptococcus sp. (12,5%). Ketiga jenis bakteri memiliki sensitivitas tinggi terhadap antibiotik meropenem (100%) dan tidak sensitif (resisten) terhadap antibiotik erythromycin (0%). Simpulan penelitian ini ialah dengan didapatkannya bakteri di kamar bedah maka sterilitas ruangan dan sanitasi pribadi tenaga medis perlu ditingkatkan.

Kata kunci: identifikasi pola bakteri; uji sensitivitas antibiotik; kamar bedah