https://ejournal.unsrat.ac.id/v3/index.php/eclinic/issue/feed e-CliniC 2025-04-04T10:31:26+08:00 Sunny Wangko sunnypatriciawangko@gmail.com Open Journal Systems <p>e-CliniC (eCl) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia bekerja sama dengan Fakultas Kedokteran Universitas Sam Ratulangi Manado. Jurnal ini diterbitkan 3 (tiga) kali setahun (Maret, Juli, dan November). Sejak tahun 2016 e-CliniC diterbitkan 2 (dua) kali setahun (Juni dan Desember). Sejak tahun 2023 e-CliniC telah diterbitkan kembali 3 (tiga) kali setahun (Maret, Juli, dan November).</p> https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60871 Hubungan Kadar Kalium dengan Tekanan Darah pada Pasien Hipertensi 2025-03-03T22:53:55+08:00 Jessica C. Watulingas jessicawatulingas@gmail.com Murniati Tiho tihomurni@gmail.com Diana S. Purwanto dianashintapurwanto@unsrat.ac.id <p><strong>Abstract</strong>: Potassium is an intracellular cation in the body that controls the function of nerve and muscle cells, especially heart muscle, maintains water balance in the body, and regulates blood pressure. Potassium also reduce tension in blood vessel walls, which in turn lowers blood pressure. This study aimed to evaluate the relationship between potassium level and blood pressure in patients with hypertension. This was an observational and analytical study with a cross sectional design using medical records of 154 hypertensive patients at ODSK Regional Hospital, North Sulawesi Province from April 2022 – September 2023. The results showed that 55-64 years (31.2%) was the most dominant age group. There were more female patients (52.6%) than male patients (47.4%). The majority of patients suffered from hypertension grade 2 (60.4%), and had normal potassium level (55.8%). The Spearman correlation test showed a positive significant correlation between potassium evel and systolic blood pressure (p=0.035; r=0.170), but not with diastolic blood pressure (p=0.099). In conclusion, there is a significant relationship between potassium level and systolic blood pressure, but not with diastolic blood pressure in patients with hypertension.</p> <p><strong>Keywords</strong>: potassium level; hypertension; systolic blood pressure; diastolic blood pressure</p> <p><strong> </strong></p> <p><strong> </strong><strong>Abstrak</strong>: Kalium merupakan kation intrasel dalam tubuh yang mengontrol fungsi sel saraf dan otot, terutama otot jantung, menjaga keseimbangan air dalam tubuh, dan mengatur tekanan darah. Kalium juga membantu mengurangi ketegangan di dinding pembuluh darah, yang selanjutnya menurunkan tekanan darah. Penelitian ini bertujuan untuk mengetahui hubungan kadar kalium dengan tekanan darah pada pasien hipertensi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Data penelitian diambil dari rekam medis 154 pasien hipertensi di RSUD ODSK Provinsi Sulawesi Utara periode April tahun 2022–September 2023. Hasil penelitian mendapatkan kelompok usia 55–64 tahun (31,2%) yang terbanyak dibandingkan kategori usia lainnya. Pasien berjenis kelamin perempuan (52,6%) lebih banyak daripada laki-laki (47,4%). Majoritas pasien berada pada hipertensi derajat 2 (60,4%) dan memiliki kadar kalium normal (55,8%). Hasil uji korelasi Spearman menunjukkan adanya korelasi positif yang bermakna antara kadar kalium dengan TDS (p=0,035; r=0,170), namun tidak terdapat hubungan bermakna antara kadar kalium dengan TDD (p=0,099). Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar kalium dengan tekanan darah sistolik, namun tidak dengan tekanan darah diastolik. Pada pasien dengan hipertensi</p> <p><strong>Kata kunci: </strong>kadar kalium; hipertensi; tekanan darah sistolik; tekanan darah diastolik</p> 2025-03-08T00:00:00+08:00 Copyright (c) 2025 Jessica C. Watulingas, Murniati Tiho, Diana S. Purwanto https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60738 Gambaran Kadar Profil Lipid pada Stroke Iskemik 2025-02-16T23:25:55+08:00 Andi F. D. Fariza firdaadhafa@gmail.com Glady I. Rambert gladyrambert@unsrat.ac.id Siemona L. E. Berhimpon siemonaberhimpon@unsrat.ac.id <p><strong>Abstract</strong><strong>:</strong> Stroke is one of the leading causes of death and disability worldwide. Dyslipidemia is one of the risk factors for stroke that can trigger atherosclerosis in blood vessels in the heart as well as in the brain. This study aimed to obtain the lipid profile in patients with ischemic stroke at Prof. Dr. R. D. Kandou Hospital. This was a descriptive and retrospective study using medical records of patients ischemic stroke patients at Prof. Dr. R. D. Kandou Hospital in 2022, using the total sampling method. The results obtained 78 patients that met the inclusion criteria. The highest percentages were found in male patients (56.4%), age group of 56–65 years (42.3%), optimal total cholesterol level (53.8%), low HDL cholesterol level (52.6%), LDL cholesterol level approaching optimal (32.1%), and optimal triglyceride level (62.0%). In conclusion, patients with ischemic stroke most commonly have optimal total cholesterol levels, low HDL cholesterol levels, LDL cholesterol levels approaching optimal, and optimal triglyceride levels.</p> <p><strong>Keywords:</strong> lipid profile; ischemic stroke</p> <p><strong> </strong></p> <p><strong>Abstrak</strong><strong>:</strong> Stroke merupakan salah satu penyebab kematian dan kecacatan di seluruh dunia. Dislipidemia ialah salah satu faktor risiko stroke yang dapat memicu terjadinya aterosklerosis pada pembuluh darah, baik yang berada di jantung maupun otak. Penelitian ini bertujuan untuk mendapatkan gambaran profil lipid pada pasien stroke iskemik di RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ini ialah deskriptif retrospektif menggunakan data rekam medis pasien stroke iskemik di RSUP Prof. Dr. R. D. Kandou tahun 2022 dengan metode <em>total sampling</em>. Hasil penelitian mendapatkan 78 pasien stroke iskemik yang memenuhi kriteria penelitian. Pada hasil analisis didapatkan dominasi pasien berjenis kelamin laki-laki (56,4%), usia 56–65 tahun (42,3%), kadar kolesterol total optimal (53,8%), kadar kolesterol HDL rendah (52,6%), kadar kolesterol LDL mendekati optimal (32,1%), dan kadar kolesterol trigliserida optimal (62,0%). Simpulan penelitian ini ialah pasien stroke iskemik paling banyak ditemukan dengan kadar kolesterol total optimal, kadar kolesterol HDL rendah, kadar kolesterol LDL mendekati optimal, serta kadar kolesterol trigliserida optimal.</p> <p><strong>Kata kunci:</strong> profil lipid; stroke iskemik</p> 2025-03-09T00:00:00+08:00 Copyright (c) 2025 Andi F. D. Fariza, Glady I. Rambert, Siemona L. E. Berhimpon https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60872 Hubungan Kadar Natrium Darah dengan Tekanan Darah pada Pasien Hipertensi 2025-03-03T23:01:25+08:00 Noah A. Rompas noahrompas011@student.unsrat.ac.id Youla A. Assa youlaassa888@gmail.com Murniati Tiho tihomurni@gmail.com <p><strong>Abstract:</strong> Hypertension has become a significant health problem globally, with serious consequences for cardiovascular diseases and high mortality rates. This disease ranks first in the number of cases of the most common types of diseases in Manado in 2020. Blood sodium level has become a focus of attention due to its role in blood pressure regulation. Excessive sodium can cause fluid retention and increased blood volume, affecting blood pressure. This study aimed to analyze the relationship between blood sodium level and blood pressure in patients with hypertension. This was an observational analytical study using a retrospective and cross-sectional approach. The data used were medical records of patients with hypertension at RSUD ODSK, North Sulawesi, with total sampling method. The results obtained 160 patients as samples, dominated by 55-64 years old (30.6%), female (53.1%), patients with normal sodium levels (60.6%), and hypertension grade 2 (60.6%). The Spearman correlation test analysis resulted in p-values of &gt;0.05 for the correlation between sodium level and systolic blood pressure (p=0.121) and diastolic blood pressure (p=0.425). In conclusion, there is no relationship between blood sodium level and blood pressure in patients with hypertension at RSUD ODSK, North Sulawesi Province.</p> <p><strong>Keywords:</strong> hypertension; blood sodium level; blood pressure</p> <p><strong> </strong></p> <p><strong>Abstrak:</strong> Hipertensi telah menjadi masalah kesehatan yang signifikan secara global, dengan konsekuensi serius terhadap penyakit kardiovaskular dan tingkat kematian yang tinggi. Penyakit ini menduduki urutan pertama pada jumlah kasus jenis penyakit terbanyak di Kota Manado pada tahun 2020. Kadar natrium darah telah menjadi fokus perhatian karena perannya dalam meregulasi tekanan darah. Natrium berlebihan dapat menyebabkan retensi cairan dan peningkatan volume darah, yang memengaruhi tekanan darah. Penelitian ini bertujuan untuk menganalisis hubungan kadar natrium darah dengan tekanan darah pada pasien dengan hipertensi di RSUD ODSK Provinsi Sulawesi Utara. Penelitian ini bersifat analitik observasional dengan pendekatan retrospektif dan desain potong lintang menggunakan data rekam medis pasien hipertensi di RSUD ODSK dengan metode <em>total sampling</em>. Hasil penelitian mendapatkan jumlah sampel penelitian sebesar 160 pasien, yang didominasi oleh kelompok usia 55−64 tahun (30,6%), jenis kelamin perempuan (53,1%), pasien dengan kadar natrium darah normal (60,6%), dan hipertensi grade 2 (60,6%). Hasil analisis uji korelasi Spearman mendapatkan nilai p&gt;0,05 untuk hubungan antara kadar natrium dengan tekanan darah sistolik (p=0,121) dan diastolik (p=0,425). Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara kadar natrium darah dengan tekanan darah pada pasien dengan hipertensi di RSUD ODSK Provinsi Sulawesi Utara.</p> <p><strong>Kata kunci: </strong>hipertensi; kadar natrium darah; tekanan darah</p> 2025-03-12T00:00:00+08:00 Copyright (c) 2025 Noah A. Rompas, Youla A. Assa , Murniati Tiho https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/59605 Long-Term Follow-up after Kidney Trauma at Prof. Dr. R. D. Kandou General Hospital Manado 2024-12-23T12:18:15+08:00 Eko Arianto ekoarianto90@gmail.com Bryan P. Panelewen bryanpanelewen@gmail.com Ari Astram Ari.astram@gmail.com Christof Toreh christoftoreh@gmail.com Frendy Wihono Fwihono@gmail.com <p>Abstract: Renal trauma, caused by blunt or penetrating injuries, is associated with severe complications such as hypertension, chronic kidney disease (CKD), and pyelonephritis, especially in high-grade renal trauma. The study aimed to evaluate the complications and management of renal trauma patients at Prof. Dr. R. D. Kandou Hospital Manado from January 2022 to October 2024. This was an observational study with a cross-sectional design involving 17 patients that met the inclusion criteria. Data included types of trauma, severity level, management approaches, and post-trauma complications. Trauma severity was classified using the American Association for Surgery of Trauma (AAST) grading system. The results showed that 58.8% of patients had penetrating trauma, while 41.2% experienced blunt trauma. The highest percentages were found in grade II severity (29.4%). Operative management was the most common approach (58.8%). Post-trauma complications included CKD (70.5%), hypertension (29.4%), and pyelonephritis (29.4%). In conclusion, renal trauma, whether blunt or penetrating, often leads to significant complications such as CKD and hypertension. Proper long-term management and monitoring of kidney function and blood pressure are crucial to minimize the complications. This study highlights the need for early and effective intervention in high-grade renal trauma cases.</p> <p><strong>Keywords:</strong> renal trauma; hypertension; acute kidney injury (AKI); chronic kidney disease (CKD); post-trauma complications</p> 2025-03-13T00:00:00+08:00 Copyright (c) 2025 Eko Arianto, Bryan P. Panelewen, Ari Astram, Christof Toreh, Frendy Wihono https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60873 Hubungan Kadar Kolesterol Total dengan Tekanan Darah pada Pasien Hipertensi 2025-03-03T23:09:36+08:00 Nathan A. Koessoy nathankoessoy42@gmail.com Diana S. Purwanto dianashintapurwanto@unsrat.ac.id Stefana H. M. Kaligis stefana.kaligis@unsrat.ac.id <p><strong>Abstract</strong>: One of the non-communicable diseases that has a major health problem in Indonesia is hypertension. This disease has a close relationship with blood cholesterol level because excess cholesterol can cause atherosclerosis which leads to hypertension. This study aimed to determine the correlation between total cholesterol level and blood pressure in patients with hypertension. This was an observational and analytical study with a cross-sectional research design. This retrospective study used secondary data (medical record data) from August to December 2023. Population were patients with hypertension at RSUD ODSK Manado. Out of the population of 350 hypertensive patients, 72 patients were taken as samples. The Spearman correlation test showed that there were no correlations between either total cholesterol and systolic blood pressure (p=0.298) or total cholesterol and diastolic blood pressure (p=0.875). In conclusion, there is no relationship between total cholesterol and blood pressure in patients with hypertension.</p> <p><strong>Keywords</strong>: health problem; hypertension; total cholesterol level</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak</strong>: Salah satu penyakit tidak menular yang memiliki masalah kesehatan tinggi di Indonesia ialah hipertensi. Hipertensi memiliki keterkaitan dengan kolesterol total karena kelebihan jumlah kolesterol akan menyebabkan terjadinya kondisi aterosklerosis yang dapat mengakibatkan hipertensi. Penelitian ini bertujuan untuk mengetahui hubungan kadar kolesterol total dengan tekanan darah pada pasien hipertensi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Penelitian ini merupakan penelitian retrospektif dengan menggunakan data sekunder (data rekam medis). pada bulan Agustus hingga Desember 2023. Populasi penelitian ini mencakup pasien hipertensi di RSUD ODSK pada bulan Agustus hingga Desember 2023. Dari populasi 350 pasien hipertensi, diambil 72 pasien sebagai sampel. Hasil analisis uji korelasi Spearman menunjukkan tidak terdapat korelasi antara kolesterol total dengan tekanan darah sistolik (p=0,298) maupun kolesterol total dengan tekanan darah diastolik (p=0,875). Simpulan penelitian ini ialah tidak terdapat hubungan antara kadar kolesterol total dengan tekanan darah pada penyandang hipertensi.</p> <p><strong>Kata kunci: </strong>masalah kesehatan; hipertensi; kadar kolesterol total</p> 2025-03-13T00:00:00+08:00 Copyright (c) 2025 Nathan A. Koessoy, Diana S. Purwanto, Stefana H. M. Kaligis https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61014 Perbandingan Rasio FEV1/FVC pada Mahasiswa Perokok Elektronik dan Perokok Tembakau 2025-03-12T13:00:36+08:00 Feren E. I. Korto fereninri@gmail.com Ivonny M. Sapulete ivonnesapulete@gmail.com Erwin A. Pangkahila pangkahilaerwin@gmail.com <p><strong>Abstract:</strong> Tobacco cigarettes and electronic cigarettes contain harmful and toxic chemicals for the body, leading to addiction and dependence on users. Long-term cigarette consumption causes health problems, especially in the respiratory system, marked by disturbances or decreases in lung function. One parameter for measuring lung function is the FEV<sub>1</sub>/FVC ratio. This study aimed to determine the difference in the FEV<sub>1</sub>/FVC ratio between electronic and tobacco smokers. This was an analytical and observational study with a cross-sectional design. Samples were students of the Faculty of Civil Engineering, Universitas Sam Ratulangi obtained by using purposive sampling. Data were analyzed using the Mann-Whitney non-parametric independent sample test. The results showed that out of 37 respondents who were electronic cigarette smokers, 33 respondents (89,2%) were in the normal category, and two respondents (5,4%) were in the mild to moderate category. Among tobacco cigarette smokers, out of 46 respondents, 45 respondents (97,8%) were in the normal category, and one respondent (2,2%) was in the moderate category. The Mann-Whitney test revealed a p-value of 0.107 (p&gt;0.05) between the two groups. In conclusion. there is no significant difference in the FEV<sub>1</sub>/FVC ratio between electronic and tobacco smokers among students at the Faculty of Civil Engineering, Universitas Sam Ratulangi.</p> <p><strong>Keywords:</strong> FEV<sub>1</sub>/FVC ratio; electronic cigarette smokers; tobacco smokers</p> <p><strong> </strong></p> <p><strong> </strong><strong>Abstrak:</strong> Rokok tembakau dan rokok elektronik mengandung bahan kimia berbahaya dan beracun bagi tubuh serta mengakibatkan adiksi dan dependensi pada penggunanya. Konsumsi rokok jangka panjang menyebabkan masalah kesehatan khususnya sistem pernapasan, ditandai gangguan atau penurunan fungsi paru. Salah satu parameter pengukuran kesehatan paru ialah rasio FEV<sub>1</sub>/FVC. Penelitian ini bertujuan untuk mengetahui perbedaan rasio FEV<sub>1</sub>/FVC pada perokok elektronik dan tembakau. Jenis penelitian ialah observasional analitik dengan desain potong lintang. Sampel penelitian ialah mahasiswa Fakultas Teknik Sipil Universitas Sam Ratulangi, diperoleh dengan teknik <em>purposive sampling</em>. Alat yang digunakan untuk mengukur rasio FEV<sub>1</sub>/FVC ialah spirometer. Analisis data menggunakan uji beda sampel bebas non parametrik Mann-Whitney. Hasil penelitian mendapatkan total 37 responden jenis perokok elektronik; 33 responden (89,2%) kategori normal, dua responden (5,4%) kategori ringan - sedang. Perokok tembakau sebanyak total 46 responden; 45 responden (97,8%) kategori normal dan satu responden (2,2%) kategori sedang. Hasil uji Mann-Whitney mendapatkan nilai p=0,107 (p&gt;0,05). Simpulan penelitian ini ialah tidak terdapat perbedaan bermakna antara rasio FEV<sub>1</sub>/FVC pada perokok elektronik dan perokok tembakau mahasiswa Fakultas Teknik Sipil Universitas Sam Ratulangi.</p> <p><strong>Kata kunci:</strong> rasio FEV<sub>1</sub>/FVC; perokok elektronik; perokok tembakau</p> 2025-03-17T00:00:00+08:00 Copyright (c) 2025 Feren E. I. Korto, Ivonny M. Sapulete, Erwin A. Pangkahila https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61015 Evaluasi Penggunaan Antibiotik pada Pasien Pneumonia di Bangsal Pediatri 2025-03-12T13:09:23+08:00 Nadine E. Manan manannadine0@gmail.com Weny I. Wiyono wenyindayany@unsrat.ac.id Deby A. Mpila deby.mpila@unsrat.ac.id <p><strong>Abstract</strong>: Infectious diseases such as pneumonia are becoming more difficult to treat as antibiotics become less effective. This study aimed to evaluate the use of antibiotics in pneumonia patients in the pediatric ward of Robert Wolter Monginsidi Hospital Manado. This was a non-experimental conducted retrospectively using total sampling method, and the data were analyzed descriptively. The results obtained 89 pediatric patients with pneumonia from January to December 2023 as samples. The use of antibiotics with the right indication was 100%, the right patient was 100%, the right drug was 100%, and the right dose was 34.83%. In conclusion, the administration of antibiotics in pneumonia patients in the pediatric ward of Wolter Monginsidi Hospital Manado is appropriate for indications, appropriate for patients, and appropriate for drugs</p> <p><strong>Keywords</strong>: evaluation of therapy; antibiotics; pneumonia; pediatric patients.</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak</strong>: Penyakit-penyakit infeksi antara lain pneumonia menjadi semakin lebih sulit diobati karena antibiotik menjadi kurang efektif. Penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik pada pasien pneumonia di bangsal pediatrik Rumah Sakit Robert Wolter Monginsidi Manado. Metode penelitian ini bersifat non-eksperimental yang dilakukan secara retrospektif dengan pengambilan sampel secara <em>total sampling</em>, dan dianalisis secara deskriptif. Hasil penelitian mendapatkan 89 pasien pediatri dengan pneumonia pada periode Januari–Desember 2023 sebagai sampel. Didapatkan penggunaan antibiotik yang tepat indikasi sebesar 100%, tepat pasien sebesar 100%, tepat obat sebesar 100%, dan tepat dosis sebesar 34,83%. Simpulan penelitian ini ialah pemberian antibiotik pada pasien pneumonia di Bangsal Pediatrik Rumah Sakit Wolter Monginsidi Manado sudah tepat indikasi, tepat pasien, dan tepat obat.</p> <p><strong>Kata kunci: </strong>evaluasi terapi; antibiotik; pneumonia; pasien pediatri</p> 2025-03-17T00:00:00+08:00 Copyright (c) 2025 Nadine E. Manan, Weny I. Wiyono, Deby A. Mpila https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61045 Cardiac Stab Wound in Remote Area: A Case Report 2025-03-15T13:21:26+08:00 Wega Sukanto wegasukanto@dosenlb.unsrat.ac.id Christha Z. Tamburian christha.tamburian@gmail.com Marturia I. Aruperes aruperesmarturia@gmail.com <p><strong>Abstract: </strong>Penetrating cardiac injuries are life-threatening emergencies requiring immediate surgical intervention. We presented a case of cardiac stab wound leading to cardiac tamponade and rupture of the pulmonary artery and right ventricle who survived long enough to undergo emergency procedure. A 25-year-old male was stabbed in the left chest approximately nine hours before admission. He experienced chest pain and dyspnea but remained conscious. After initially treated at a local hospital, he was later referred to a tertiary facility. On assessment, he was tachycardic, tachypneic, and had distant heart sounds. Laboratory findings revealed leukocytosis, thrombocytosis, hyperglycemia, metabolic acidosis, lactic acidosis, and anemia. Chest radiograph showed a bottle-shaped heart, passive atelectasis, and a rightward shift of the thoracic vertebrae. The initial suspicion was cardiac tamponade due to myocardial rupture. Sternotomy revealed a pericardial hematoma (150 mL), a right ventricular tear extending to the pulmonary artery, and pneumothorax. Surgical repair was performed with drainage placement. After intervention, echocardiograph examination showed no myocardial damage or infarction, a dysfunction in diastolic which showed an impaired in relaxation of the left ventricle which is a temporary consequence of trauma, pericardial effusion or surgical intervention. In conclusion, this case underscores necessity of early surgical intervention even if this patient succeeded surviving for long hours before surgery. While this patient showed promising recovery, close postoperative monitoring remains crucial to detect functional changes and prevent complications.</p> <p><strong>Keywords: </strong>emergency sternotomy; <em>vulnus ictum</em>; chest trauma; sharp cardiac injury; repair of artery pulmonary; rupture of right ventricle</p> 2025-03-21T00:00:00+08:00 Copyright (c) 2025 Marturia I. Aruperes, Wega Sukanto, Christha Z. Tamburian https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61019 Gambaran Penggunaan Obat Antihipertensi pada Pasien Hipertensi di Instalasi Rawat Inap Salah Satu Rumah Sakit Swasta di Sulawesi Utara 2025-03-12T13:44:11+08:00 Puella Rue puellarue10@gmail.com Christi D. Mambo Christis.mambo@unsrat.ac.id Edward Nangoy edward.nangoy@unsrat.ac.id Octavianus Umboh orhumboh@unsrat.ac.id Diana S. Purwanto dianashintapurwanto@unsrat.ac.id Angelina S. R. Masengi asrmasengi@unsrat.ac.id <p><strong>Abstract:</strong> Management of hypertension is conducted to control the blood pressure in patients with hypertension. There are a variety of antihypertensie agents that can be used in patients with hypertension. This study aimed to evaluate the pattern of antihypertensive drug use among patients with hypertension in the Inpatient Ward<strong>. </strong>This was a retrospective and descriptive study using a cross-sectional design. The results showed that the dominant characteristics were female gender (64.29%), age ≥60 years (71.43%), housewife (51.43%), and completed senior high school education (34.29%). The most commonly prescribed drugs were amlodipine (25.71%), and the combination of amlodipine and candesartan (22.86%). In conclusion, the majority of patients with hypertension are females, aged ≥60 years, working as housewives, and have high school education. The most frequently used single antihypertensive drug is calcium channel blocker group, specifically amlodipine, while the combination therapy involve both a calcium channel blocker and an ARB, namely amlodipine and candesartan.</p> <p><strong>Keywords:</strong> hypertension; antihypertensive drugs</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak: </strong>Tatalaksana hipertensi dilakukan dengan tujuan untuk mengontrol tekanan darah pada pasien hipertensi. Terdapat bermacam jenis obat antihipertensi yang dapat digunakan pada pasien hipertensi. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan obat antihipertensi pada pasien hipertensi di Instalasi Rawat Inap. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Hasil penelitian mendapatkan karakteristik yang dominan ialah jenis kelamin perempuan (64,29%), usia ³60 tahun (71,43%), pekerjaan sebagai ibu rumah tangga (IRT) (51,43%), dan pendidikan terakhir SMA (34,29%). Penggunaan obat terbanyak ialah amlodipin (25,71%), serta kombinasi amlodipin dan candesartan (22,86%) Simpulan penelitian ini ialah pasien hipertensi paling banyak terdapat pada jenis kelamin perempuan, kelompok usia ³60 tahun, pekerjaan IRT, dan tingkat pendidikan terakhir SMA. Penggunaan obat antihipertensi tunggal terbanyak dari golongan antagonis kalsium yaitu amlodipin, sedangkan kombinasi obat antihipertensi ialah antagonis kalsium dan ARB, yaitu amlodipin dan candesartan.</p> <p><strong>Kata </strong><strong>k</strong><strong>unci</strong>: hipertensi; obat antihipertensi</p> 2025-03-21T00:00:00+08:00 Copyright (c) 2025 Puella Rue, Christi D. Mambo, Edward Nangoy, Octavianus Umboh, Diana S. Purwanto, Angelina S. R. Masengi https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/56247 Right Ventricular Septal Pacing to Produce Narrow QRS Duration in Patient with High Degree 2:1 AV Block 2024-06-26T10:33:22+08:00 Michael Santoso michaelelias91@yahoo.com Benny Setiadi setiadi.benny81@gmail.com Starry H. Rampengan starry8888@gmail.com Edmond L. Jim edmondleonard@ymail.com <p>Prolonged right ventricular (RV) apical pacing has been recognized to be associated with progressive left ventricular (LV) dysfunction. This impairment of LV function resultant from RV apical pacing is a remodelling process consequent to abnormal ventricular activation and contraction. RV septal pacing theoretically is associated with a more physiological ventricular activation results in shorter electrical activation delay and consequently less mechanical dyssynchrony. We reported A-75-year-old woman presented to emergency department (ED) with dyspnea only on exertion in the last 3 weeks before admission, she also complaint near syncope episode while doing activities. Electrocardiogram (ECG) result was high degree AV block with 2:1 conduction with ventricular rate 40 beats per minute. PPM implantation was performed with VVIR mode, ventricle lead inserted into mid-septal RV. ECG post implantation showed pacing rhythm with narrow QRS duration. Pacemaker-related LBBB is associated with an adverse prognosis. RV septal pacing produces more synchronous contraction denoted by narrow QRS, preventing the deterioration of LV structure and function. RV septal pacing, although not as good as intrinsic conduction or His bundle pacing, may be more desirable for chronic RV pacing compared to the RV apex as a narrow QRS is associated with improved LV dynamics. RV septal pacing was safely done in this patient, but further study needed to evaluate its long-term effect.</p> <p><strong>Keywords</strong>: AV block; permanent pacemaker; septal; right ventricle</p> 2025-03-21T00:00:00+08:00 Copyright (c) 2025 Michael Santoso, Benny Setiadi, Starry H. Rampengan, Edmond L. Jim https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61018 Gambaran Pengetahuan dan Sikap Wanita Kaum Ibu GMIM Sion Tumaluntung tentang Kanker Serviks 2025-03-12T13:36:26+08:00 Brenda Wongkaren brendawongkaren011@student.unsrat.ac.id Frank M. M. Wagey frankwagey@gmail.com Erna Suparman ernasuparman@yahoo.com <p><strong>Abstract:</strong> Based on data from WHO, cervical cancer is ranked second among all types of cancer that occur among Indonesian women. Lack of knowledge and the right attitude in dealing with this matter is the basis for an increase in cases of cervical cancer. This study aimed to obtain an overview of the knowledge and attitude of women from the GMIM Sion Tumaluntung Congregation regarding cervical cancer. This was a quantitative and descriptive study with a cross-sectional design. Sample were obtained by using a random sampling technique of 100 samples who met the criteria. The results showed that 91 respondents (91%) had good level of knowledge about cervical cancer, and nine respondents (9%) had poor level of knowledge. Meanwhile, related to attitudes in this study, 86 respondents (86%) had positive attitude towards preventing cervical cancer, and 14 people (14%) had less positive attitude. In conclusion, the majority of women in the GMIM Sion Tumaluntung Congregation have good knowledge and attitude about cervical cancer. This level of knowledge and good attitude cannot be separated from the influence of several factors such as age, experience, education, work, and sources of information.</p> <p><strong>Keywords</strong>: cervical cancer; knowledge; attitude</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak:</strong> WHO menyatakan bahwa kanker serviks menduduki ranking kedua diantara semua jenis kanker yang terjadi pada perempuan Indonesia. Kurangnya pengetahuan dan sikap yang tepat dalam menghadapi hal ini menjadi dasar terjandinya peningkatan kasus kanker serviks. Penelitian ini bertujuan untuk memperoleh gambaran pengetahuan dan sikap wanita kaum ibu jemaat GMIM Sion Tumaluntung tentang kanker serviks. Jenis penelitian ini ialah deskriptif kuantitatif dengan desain potong lintang dan menggunakan teknik pengambilan sampel random sampling sebanyak 100 orang yang memenuhi kriteria di Jemaat GMIM Sion Tumaluntung. Hasil penelitian mendapatkan sebanyak 91 responden (91%) dengan tingkat pengetahuan tentang kanker serviks yang baik, dan sembilan orang (9%) lainya memiliki tingkat pengetahuan yang kurang baik. Untuk pengukuran sikap diperoleh respoden sebanyak 86 orang (86%) yang memiliki sikap positif terhadapt pencegahan kanker serviks, dan 14 orang (14%) lainya memiliki sikap yang tidak positif. Simpulan penelitian ini ialah sebagian besar wanita di Jemaat GMIM Sion Tumaluntung memiliki pengetahuan dan sikap yang baik tentang kanker serviks. Tingkat pengetahuan dan sikap yang baik ini tidak lepas dari pengaruh beberapa faktor seperti, usia, pengalaman, pendidikan, perkerjaan, dan sumber informasi.</p> <p><strong>Kata kunci:</strong> kanker serviks; pengetahuan; sikap</p> 2025-03-26T00:00:00+08:00 Copyright (c) 2025 Brenda Wongkaren, Frank M. M. Wagey, Erna Suparman https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61016 Perbandingan Rasio FEV1/FVC pada Perokok Elektronik dan Perokok Tembakau Mahasiswa Universitas Sam Ratulangi 2025-03-12T13:26:24+08:00 Trinita E. Marasi trinitamarasi011@student.unsrat.ac.id Ivonny M. Sapulete ivonnesapulete@gmail.com Joice N. A. Engka Nancy051@unsrat.ac.id <p><strong>Abstract:</strong> Smoking can accelerate decrease of lung function due to the abundant harmful substances in cigarettes. Decreased lung function is characterized by a decrease in the values of forced expiratory volume 1 (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. This study aimed to compare the FEV1/FVC ratio in electronic smokers and tobacco smokers among students of Universitas Sam Ratulangi. This was a quantitative study using analytical and observational method with a cross-sectional design. Samples were students of the Faculty of Engineering Class 2021, Department of Electrical Engineering, Universitas Sam Ratulangi, obtained by using the purposive sampling method. There were 51 male students as respondents. The Mann-Whitney test on the FEV1/FVC ratio obtained a p-value of 0.022 (2-tailed) (&lt;0.05). In conclusion, there is a significant difference in the FEV1/FVC ratio between electronic smokers and tobacco smokers.</p> <p><strong>Keywords:</strong> ratio of FEV1/FVC; electronic smoker; tobacco smoker;</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak: </strong>Merokok dapat mempercepat penurunan fungsi paru akibat mengandung banyak zat berbahaya. Penurunan fungsi paru ditandai dengan penurunan nilai <em>forced expiratory volume 1 </em>(FEV1), <em>forced vital capacity</em> (FVC), dan penurunan rasio FEV1/FVC. Penelitian ini bertujuan untuk mengetahui perbandingan rasio FEV1/FVC pada perokok elektronik dan perokok tembakau mahasiswa Universitas Sam Ratulangi. Jenis penelitian ini ialah kuantitatif yang menggunakan metode penelitian observasional analitik dengan desain potong lintang. Sampel penelitian ialah mahasiswa Fakultas Teknik Angkatan 2021 Jurusan Teknik Elektro Universitas Sam Ratulangi, diperoleh dengan metode <em>purposive sampling.</em> Hasil penelitian mendapatkan 51 mahasiswa laki-laki sebagai responden penelitian. Hasil uji Mann-Whitney terhadap FEV1/FVC pada perokok tembakau dan perokok elektronik mendapatkan nilai p=0,22 (<em>2-tailed</em>) (p&lt;0,05). Simpulan penelitian ini ialah terdapat perbedaan bermakna pada rasio FEV1/FVC antara perokok elektronik dan perokok tembakau.</p> <p><strong>Kata kunci: </strong>rasio FEV1/FVC; perokok elektronik; perokok tembakau</p> 2025-03-29T00:00:00+08:00 Copyright (c) 2025 Trinita E. Marasi, Ivonny M. Sapulete, Joice N. A. Engka https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60743 Identifikasi Drug Related Problems (DRPs) pada Pasien Penyakit Jantung Koroner di Instalasi Rawat Inap CVBC RSUP Prof. Dr. R. D. Kandou Manado 2025-03-12T13:57:43+08:00 Carmelita Laloan carmelitalaloan105@student.unsrat.ac.id Weny I. Wiyono wenyindayany@unsrat.ac.id Deby A. Mpila deby.mpila@unsrat.ac.id <p><strong>Abstract</strong>: Patients with coronary heart disease (CHD) are prone to Drug Related Problems (DRPs) due to the many therapies received by patients. This study aimed to identify the prevalence of DRPs in each category of CHD patients. This was a descriptive and retrospective study using medical records of CHD patients during the period September-November 2023 who fulfilled the inclusion criteria. The results obtained 64 CHD patients as samples. There were 27 patients (42.19%) who had the potential to experience DRPs with 31 cases of DRPs in the identified DRPs categories including indications without therapy (77.41%) and therapy without indications (22.59%). There were no DRPs in the categories of ineffective drugs, dose too high, and dose too low. In conclusion, the therapy obtained by coronary heart disease patients in the CVBC inpatient installation of Prof. Dr. R. D. Kandou Hospital Manado still experienced DRPs, especially in the categories of indication without therapy and therapy without indication.</p> <p><strong>Keywords</strong>: coronary heart disease; drug related problems</p> <p><strong> </strong></p> <p><strong> </strong><strong>Abstrak</strong>: Pasien dengan penyakit jantung koroner (PJK) rentan mengalami <em>Drug Related Problems</em> (DRPs) karena terapi yang diterima pasien cukup banyak. Penelitian ini bertujuan untuk mengidentifikasi prevalensi kejadian DRPs pada setiap kategori dari pasien PJK. Jenis penelitian ialah deskriptif retrospektif dengan pengambilan data rekam medik pasien PJK yang memenuhi kriteria inklusi selama periode September-November 2023. Hasil penelitian mendapatkan 64 pasien PJK sebagai sampel. Terdapat 27 pasien (42,19%) yang berpotensi mengalami DRPs dengan 31 kejadian DRPs pada kategori DRPs indikasi tanpa terapi (77,41%) dan terapi tanpa indikasi (22,59%); tidak terdapat kejadian DRPs pada kategori obat tidak efektif, dosis terlalu tinggi, dan dosis terlalu rendah. Simpulan penelitian ini ialah terapi yang diperoleh pasien penyakit jantung koroner di instalasi rawat inap CVBC RSUP Prof. Dr. R. D. Kandou Manado masih mengalami kejadian <em>Drug Related Problems</em>, terutama pada kategori indikasi tanpa terapi dan terapi tanpa indikasi.</p> <p><strong>Kata kunci: </strong>penyakit jantung koroner; <em>drug related problems</em></p> 2025-03-29T00:00:00+08:00 Copyright (c) 2025 Carmelita Laloan, Weny I. Wiyono, Deby A. Mpila https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60874 Hubungan Kadar High Density Lipoprotein (HDL) dengan Tekanan Darah pada Pasien Hipertensi 2025-03-03T23:17:47+08:00 Victoria V. J. Tangkau ictoriatgkau@gmail.com Youla A. Assa youlaassa888@gmail.com Murniati Tiho tihomurni@gmail.com <p><strong>Abstract:</strong> One of the indicators to identify a person's risk of hypertension is by measuring lipid profile. Measuring the high-density lipoprotein (HDL) cholesterol level in the lipid profile plays an important role in evaluating the risk of hypertension. This study aimed to determine the relationship between HDL level and blood pressure among patients with hypertension at ODSK Hospital in North Sulawesi Province. This was a retrospective and analytical study using a cross-sectional design. The data used in this study were medical records of all patients with hypertension at the ODSK Hospital in the North Sulawesi Province during the period of April 2022 to September 2023. Samples consisted of patients with hypertension at the ODSK Hospital who meet the inclusion and exclusion criteria. The results showed that the majority patients with hypertension patients with low HDL levels were female (64.9%). Additionally, based on blood pressure the highest percentage of patients with hypertension was in the grade 1 category (57.1%). However, there was no significant correlation between HDL level and blood pressure (both systolic and diastolic) with p-values&gt;0.05 (p=0.683 and p=0.121). In conclusion, there is no significant relationship between HDL level and blood pressure in patients with hypertension at ODSK Regional Hospital, North Sulawesi Province.</p> <p><strong>Keywords</strong>: hypertension; blood pressure; high density lipoprotein</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak: </strong>Salah satu indikator yang digunakan untuk mengidentifikasi potensi seseorang terkena penyakit hipertensi ialah dengan mengukur profil lipid. Pengukuran kadar kolesterol <em>high-density lipoprotein</em> (HDL) dalam profil lipid berperan penting dalam mengevaluasi risiko hipertensi. Penelitian ini bertujuan untuk mengevaluasi hubungan kadar HDL dengan tekanan darah pada pasien hipertensi di RSUD ODSK Provinsi Sulawesi Utara. Jenis penelitian ialah analitik retrospektif dengan desain potong lintang<em>.</em> Data yang digunakan ialah rekam medik seluruh pasien hipertensi di RSUD ODSK Provinsi Sulawesi Utara pada periode April 2022 – September 2023. Sampel meliputi kelompok kasus pasien hipertensi di RSUD ODSK Provinsi Sulawesi Utara yang memenuhi kriteria inklusi dan eksklusi. Hasil penelitian mendapatkan bahwa berdasarkan kadar HDL, yang terbanyak yaitu kategori kadar HDL pada perempuan &lt;50 mg/dL (64,9%), dan berdasarkan tekanan darah yang terbanyak yaitu kategori derajat 1 (57,1%). Tidak terdapat hubungan bermakna antara kadar HDL dengan tekanan darah sistol dan diastol) pada pasien hipertensi dengan nilai p&gt;0,05 (p=0,683 dan p=0,121). Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara kadar HDL dengan tekanan darah pada pasien Hipertensi di RSUD ODSK Provinsi Sulawesi Utara.</p> <p><strong>Kata kunci:</strong> hipertensi; tekanan darah; <em>high density lipoprotein</em></p> 2025-03-31T00:00:00+08:00 Copyright (c) 2025 Victoria V. J. Tangkau, Youla A. Assa, Murniati Tiho https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/58292 Hubungan Penggunaan Tas Punggung dengan Kejadian Nyeri Muskuloskeletal pada Pelajar SMA 2025-02-17T15:00:39+08:00 Godilia Solo godiliaprr@gmail.com Octavia D. Wahyuni octaviaw@fk.untar.ac.id <p><strong>Abstract: </strong>Backpack is still quite popular among high school students, albeit, inappropriate usage of backpacks can cause side effects in the form of pain complaints in the musculoskeletal system. This study aimed to determine the relationship between backpack usage and musculoskeletal disorders among high school students. This was an observational and analytical study with a cross-sectional design. Samples were high school students grades X-XI of SMA Regina Pacis Jakarta obtained by using concecutive non-random sampling method. Data of musculoskeletal pain using the Nordic body map (NBM) questionnaire were accompanied by measurements of backpack weight, body weight, and height. The results otained 94 students as samples. Students who used backpacks appropriately and did not experience musculoskeletal disorders were 12 people (92.3%), while students who used backpacks inappropriately and experienced musculoskeletal disorders were 20 people (24.7%). Analysis of the relationship between variables using the Fisher’s Exact test obtained a p-value of 0.285, and a PR-value of 3.21. In conclusion, there is no significant relationship between backpack usage and musculoskeletal disorder among high school students of SMA Regina Pacis Jakarta. However, students who use backpacks inappropriately can experience musculoskeletal disorders 3.21 times greater than students who use backpacks appropriately.</p> <p><strong>Keywords</strong>: backpack usage; musculoskeletal disorder; students</p> <p><strong> </strong><strong> </strong></p> <p><strong>Abstrak: </strong>Penggunaan tas punggung di kalangan siswa sekolah menengah atas (SMA) masih cukup diminati, namun penggunaan tas punggung yang tidak sesuai dapat menimbulkan efek samping berupa keluhan nyeri pada sistem muskuloskeletal. Penelitian ini bertujuan untuk mengetahui hubungan antara penggunaan tas punggung dengan gangguan muskuloskeletal pada pelajar SMA. Metode penelitian ialah analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu pelajar SMA Regina Pacis Jakarta kelas X- XI berjumlah 94 orang. Pengambilan sampel menggunakan metode <em>concecutive non random sampling</em>. Pengambilan data nyeri muskuloskeletal menggunakan kuesioner <em>Nordic body map</em> (NBM), disertai pengukuran berat tas punggung, berat badan, dan tinggi badan. Hasil penelitian mendapatkan pelajar yang menggunakan tas punggung dengan tepat dan tidak mengalami gangguan muskuloskeletal sebanyak 12 orang (92,3%) sedangkan pelajar yang menggunakan tas punggung tidak tepat dan mengalami gangguan muskuloskeletal sebesar 20 orang (24,7%). Uji analisis hubungan antar variabel menggunakan uji <em>Fisher’s Exact Test</em> mendapatkan p=0,285 dan nilai PR=3,21. Simpulan penelitian ini ialah tidak didapatkan hubungan bermakna antara penggunaan tas punggung dengan gangguan muskuloskeletal pada pelajar SMA Regina Pacis Jakarta, namun, pelajar yang menggunakan tas punggung tidak tepat dapat mengalami gangguan muskuloskeletal 3,21 kali lebih besar dibandingkan pelajar yang menggunakan tas punggung dengan tepat.</p> <p><strong>Kata kunci</strong>: penggunaan tas punggung; gangguan muskuloskeletal; pelajar</p> 2025-04-01T00:00:00+08:00 Copyright (c) 2025 Godilia Solo, Octavia D. Wahyuni https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/60875 Profil Penggunaan Antibiotik pada Pasien Sepsis dan Syok Septik di Ruang Perawatan Intensif Prof. Dr. R. D. Kandou Manado 2025-03-03T23:29:42+08:00 Feysira C. E. P. Kowel feysirakowel77@gmail.com Diana C. Lalenoh diana.lalenoh@yahoo.com Mordekhai L. Laihad mordekhailaihad@unsrat.ac.id <p><strong>Abstract: </strong>Gram-negative and gram-positive bacteria are common causes of sepsis and septic shock, therefore, treatment often uses broad spectrum antibiotics. This study aimed to determine the types of antibiotics used, the suitability of antibiotics with etiology, and the average length of antibiotic use in sepsis and septic shock patients at Prof. Dr. R. D. Kandou Hospital Manado from July 2022 to June 2023. This was a descriptive and retrospective study using patients’ medical records. The results showed that the use of antibiotics in sepsis and septic shock included monotherapy and combination therapy. The most common antibiotics for monotherapy was levofloxacine (14.3%) in sepsis, and meropenem (8.7%) in septic shock. The most common combination for sepsis was meropenem-levofloxacine (6.7%) and meropenem-metronidazole (6.7%), meanwhile for septic shock was meropenem-levofloxacine (16.5%). Of the 91 sepsis patients, only 15 had the causative germs; 10 (9.62%) antibiotics did not match the etiology, eight (7.84%) did. In septic shock, of 91 patients, five patients had the causative germs; four (4.44%) antibiotics were according to etiology, three (3.37%) were not appropriate. The average use of antibiotics was one day, with an average value of 3.06 for sepsis and 2.24 for septic shock. In conclusion, in patients with sepsis and septic shock, the monotherapy is levofloxacine and meropenem, while the combination therapies are meropenem-levofloxacine and meropenem-metronidazole. Antibiotics appropriate to the etiology in sepsis and septic shock sepsis have nearly the same number with those inappropriate to etiology. The average duration of antibiotic use for both sepsis and septic shock is one day.</p> <p><strong>Keywords</strong>: antibiotics; sepsis; septic shock; profile of antibiotics usage</p> <p> </p> <p><strong>Abstrak: </strong>Bakteri Gram-negatif dan Gram-positif merupakan penyebab umum sepsis dan syok septik, sehingga pengobatannya sering menggunakan antibiotik spektrum luas. Penelitian ini bertujuan untuk mengetahui jenis antibiotik yang digunakan, kesesuaian antibiotik dengan etiologi, rerata lama penggunaan antibiotik pada pasien sepsis dan syok septik di RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2022–Juni 2023. Jenis penelitian ialah deskriptik retrospektif menggunakan data rekam medis pasien sepsis dan syok septik. Hasil penelitian mendapatkan penggunaan antibiotik pada sepsis dan syok septik meliputi monoterapi dan kombinasi. Antibiotik yang umum digunakan untuk monoterapi ialah levofloxacine (14,3%) pada sepsis, dan meropenem (8,7%) pada syok septik; untuk kombinasi meropenem-levofloxacine (6,7%) dan meropenem-metronidazole (6,7%) pada sepsis dan meropenem-levofloxacine (16,5%) pada syok septik. Dari 91 pasien sepsis, hanya 15 yang memiliki kuman penyebab; 10 (9,62%) antibiotik tidak sesuai etiologi, dan delapan (7,84%) sesuai. Pada syok septik, dari 91 pasien, lima memiliki kuman penyebab; empat (4,44%) antibiotik sesuai etiologi, dan tiga (3,37%) tidak sesuai. Rerata penggunaan antibiotik terbanyak ialah satu hari, dengan nilai rerata 3,06 untuk sepsis dan 2,24 untuk syok septik. Simpulan penelitian ini ialah antibiotik yang banyak digunakan pada pasien sepsis dan syok septik sebagai monoterapi yaitu levofloxacine dan meropenem, sedangkan untuk kombinasi ialah meropenem-levofloxacine dan meropenem-metronidazole. Antibiotik yang sesuai etiologi baik pada sepsis maupun syok septik hampir sama banyak dengan yang tidak sesuai etiologi. Rerata lama penggunaan antibiotik baik sepsis maupun syok septik ialah satu hari.</p> <p><strong>Kata kunci</strong>: antibiotik; sepsis; syok septik; profil penggunaan antibiotik</p> 2025-04-01T00:00:00+08:00 Copyright (c) 2025 Feysira C. E. P. Kowel, Diana C. Lalenoh, Mordekhai L. Laihad https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61259 Ovarian Cyst Torsion: A Case Report 2025-03-31T14:40:57+08:00 Harsali Lampus harsali_lampus@unsrat.ac.id Leo Rendy rendy_mercury@yahoo.com Candy Candy candy_wijaya.1601@gmail.com Andy Rangan Andyrangan@gmail.com <p><strong>Abstract: </strong>Accidents involving ovarian cysts might include cyst rupture, hemorrhage, and torsion. Any girl who has abdominal pain or a pelvic or abdominal mass should be evaluated for ovarian torsion, a rare issue in the juvenile age group. We reported a 10-year-old girl presented with complaints of lower left abdominal pain that began three days prior to her hospital admission. Initially, the pain was intermittent but subsequently became persistent and intensified, with no pain-free intervals. CT-Scan of the abdomen – pelvis without contrast revealed cystic mass with fat components and intralesional calcification, in the suprapubic quadrant. The impression came from the ovary (difficult to determine the right/left ovary), which urged the bladder to the anteroinferior and urged the uterus to the posterior, suspected of mature cystic ovarian teratoma. The patient was managed with intravenous fluids (IVFD), antibiotics, and analgesics for pain control. Due to the high suspicion of ovarian torsion, emergency exploratory laparotomy was performed. Anatomical differences in the paediatric population and their effects on surgery were also be considered. Intraoperative findings confirming a left ovarian cyst measuring approximately 8 x 6 x 4 cm, which had undergone torsion twice. Detorsion was performed, and the ovary was found to be viable. Cystectomy was carried out, preserving healthy ovarian tissue. The right ovary appeared normal. In conclusion, this case underscores the importance of timely surgical intervention, even beyond the traditional "golden period" of 6–12 hours, as collateral blood supply may help maintain ovarian viability. The shift from oophorectomy to ovarian preservation in the management of ovarian torsion reflects evolving clinical practices, emphasizing better reproductive and long-term health outcomes. Early recognition, prompt imaging, and surgical intervention are crucial to preserving ovarian function and improving patient prognosis. This case also highlights the need for increased awareness of ovarian torsion in pediatric and adolescent populations, given its rarity and diagnostic complexity.</p> <p><strong>Keywords: </strong>torsion cyst; ovarian cyst; paediatric surgery</p> 2025-04-09T00:00:00+08:00 Copyright (c) 2025 Harsali Lampus, Leo Rendy, Candy Candy, Andy Rangan https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/59701 Delayed Staged Hepatectomy for Metastatic Colorectal Cancer: A Single Case Report 2025-01-05T19:53:04+08:00 Michael Tendean michaeltendean@yahoo.com Steven Paparang steven_paparang@yahoo.co.id Ferdinand Tjandra ferdinandtjandra@dosenlb.unsrat.ac.id Toar Mambu toarmambu@gmail.com Jimmy Panelewen jimmypanalewen@dosenlb.unsrat.ac.id Billy Salem billy.salem92@gmail.com <p><strong>Abstract</strong><strong>: </strong>Liver metastases are common in patients with colorectal cancer; almost 70% will develop liver metastases during the course. The recommended treatment for colorectal liver metastasis (CRLM) is multidisciplinary, including liver resection and chemotherapy. We reported a 52-year-old female with stage 3B distal third rectal adenocarcinoma which eight months earlier underwent Mile’s procedure plus total mesorectal excision (TME) followed by adjuvant radiotherapy (50gy). During surveillance, liver metastases was found at segments 4B-5. A delayed anatomical staged hepatectomy segments 4B-5 was performed. Intraoperative USG findings suggested liver metastases at segments 7, 8, and 3, and non-anatomical liver resection was performed in accordance with parenchymal liver sparing principles. No post-hepatectomy liver failure (PHLF) was detected, but billoma occured at 1-month post hepatectomy. USG guided percutaneous drainage was performed to resolve the billoma. Colorectal metastasis (CRLM) was detected at six months post-hepatectomy, and the patient underwent adjuvant chemotherapy with improvement in survival rate. In conclusion, delayed staged hepatectomy for CRLM is a safe and beneficial procedure, though there is still no guideline regarding the sequence of resection.</p> <p><strong>Keywords: </strong>hepatectomy; colorectal metastasis; billoma; colorectal cancer</p> 2025-04-12T00:00:00+08:00 Copyright (c) 2025 Michael Tendean, Steven Paparang, Ferdinand Tjandra, Toar Mambu, Jimmy Panelewen, Billy Salem https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61264 Gambaran Pola Luka pada Kasus Kematian Akibat Kekerasan Tajam di RS Bhayangkara Tingkat III Manado Tahun 2023 2025-04-02T13:01:13+08:00 Olivia Caise oliviacaise011@student.unsrat.ac.id James F. Siwu jamessiwu@unsrat.ac.id Nola T. S. Mallo nm.forensik@unsrat.ac.id <p><strong>Abstract: </strong>Sharp violence is caused by the use of objects with sharp or pointed sides, so that, it can cause injuries to parts of the body. Attacks with sharp weapons and deaths from stabbing occur all over the world, from countries with high rates of crime and violence to countries known to be the safest in the world. This study aimed to determine wound pattern in cases of death due to sharp violence in Rumah Sakit Bhayangkara Level III Manado in 2023. This was a descriptive and retrospective study using secondary data from Visum et Repertum from Rumah Sakit Bhayangkara. The results found 15 cases of death due to sharp violence throughout 2023. Most cases were found in May (26.7%) followed by December (20%) with the most requests for Visum et Repertum from Manado (53.3%). The most common age group was 21-69 years (40%); all of them were male (100%). The type of wound was dominated by stab wound (93.3%). The most common location was in the chest area (60%) which mostly hit the heart and lungs (33.3%). In conclusion, the cases of death due to sharp violence are all male, young adult age group (21-30 years), and the most common type of stab wound in the chest area that affects the lungs and heart organs.</p> <p><strong>Keywords</strong>: wound pattern; sharp violence</p> <p><em> </em></p> <p><strong>Abstrak: </strong>Kekerasan tajam diakibatkan oleh penggunaan benda bersisi tajam maupun runcing sehingga dapat menimbulkan luka pada bagian tubuh. Serangan dengan senjata tajam dan kasus kematian akibat penikaman terjadi di seluruh dunia, mulai dari negara dengan tingkat kejahatan dan kekerasan yang tinggi hingga negara-negara yang dikenal paling aman di dunia. Penelitian ini bertujuan untuk mengetahui gambaran pola luka kasus kematian akibat kekerasan tajam di RS Bhayangkara Tingkat III Manado tahun 2023. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data sekunder hasil <em>Visum et Repertum </em>dari RS Bhayangkara Tingkat III Manado Sulawesi Utara. Hasil penelitian mendapatkan 15 kasus kematian akibat kekerasan tajam di RS Bhayangkara Tingkat III Manado sepanjang tahun 2023, paling banyak kasus dijumpai pada bulan Mei (26,7%) diikuti bulan Desember (20%) dengan permintaan <em>Visum et Repertum </em>paling banyak dari Kota Manado (53,3%). Kelompok usia terbanyak pada golongan usia 21-69 tahun (40%), seluruhnya berjenis kelamin laki-laki (100%). Jenis luka didominasi oleh luka tusuk (93,3%). Lokasi terbanyak pada daerah dada (60%) yang paling banyak mengenai jantung dan paru (33,3%). Simpulan penelitian ini ialah kasus kematian akibat kekerasan tajam seluruhnya berjenis kelamin laki-laki, golongan usia dewasa muda (21-30 tahun), paling banyak dijumpai jenis luka tusuk pada daerah dada yang mengenai organ paru dan jantung.</p> <p><strong>Kata kunci</strong>: pola luka; kekerasan tajam</p> 2025-04-13T00:00:00+08:00 Copyright (c) 2025 Olivia Caise, James F. Siwu, Nola T. S. Mallo https://ejournal.unsrat.ac.id/v3/index.php/eclinic/article/view/61271 Hubungan Tipe Fistula, Waktu Operasi, dan Toilet Training pada Malformasi Anorektal dengan Pola Defekasi Pascaoperasi Berdasarkan Skor Rintala 2025-04-04T10:31:26+08:00 Sabrandi P. Saputra sabrandipratama@yahoo.com Harsali F. Lampus harsali_lampus@unsrat.ac.id Candy Candy candy.wijaya.1601@gmail.com <p><strong>Abstract</strong>: Anorectal malformation is a congenital abnormality in which the anus does not open normally into the perineum. In several studies, earlier surgery time has a better impact on patients. Toilet training performed postoperatively is assumed to help improve patient defecation patterns. This study is an observational analytical study with a retrospective cohort design. The population in this study were pediatric patients after surgery for Anorectal Malformation based on the Wingspread classification at Prof. R.D. Kandou General Hospital, Manado. The independent variables were fistula type, surgery time, and toilet training. In this study, the dependent variable was postoperative defecation pattern based on the Rintala Score. Bivariate analysis was used to analyze the relationship between independent variables and dependent variables. The Somers' D test was used to measure the relationship between categorical variables. The results showed that the variables namely fistula type, surgery time, and toilet training in anorectal malformation did not have statistically significant relationships with postoperative defecation pattern based on the Rintala score (p-value &gt;0.05). The Rintala score does not always describe the anatomical or functional conditions of the anus in detail. In conclusion, there is no significant relationship between fistula type, surgery time, and toilet training in anorectal malformation with postoperative defecation pattern based on the Rintala score. </p> <p><strong>Keywords</strong>: anorectal malformation; fistula type; surgery time; toilet training; Rintala score</p> <p> </p> <p><strong>Abstrak</strong>: Malformasi anorektal merupakan sebagai salah satu kelainan bawaan dengan kondisi anus tidak membuka secara normal ke perineum. <em>Toilet training</em> yang dilakukan pascaoperasi diasumsikan membantu memperbaiki pola defekasi pasien. Penelitian ini bertujuan untuk mengevaluasi hubungan antara tipe fistula, waktu operasi, dan <em>toilet training </em>pada malformasi anorektal dengan pola defekasi pascaoperasi berdasarkan skor Rintala. Jenis penelitian ialah analitik observasional dengan desain kohort retrospektif. Populasi penelitian ialah pasien anak pascaoperasi malformasi anorektal berdasarkan klasifikasi Wingspread di RSUP Prof. Dr. R. D. Kandou Manado. Variabel bebas ialah tipe fistula, waktu operasi, dan <em>toilet training</em> sedangkan variabel terikat ialah pola defekasi paska operasi berdasarkan Skor Rintala. Analisis bivariat digunakan untuk menganalisis hubungan kedua variabel, dan uji Somers’D untuk mengukur hubungan variabel kategori. Hasil penelitian ini yaitu variabel tipe fistula, waktu operasi, dan <em>toilet training</em> pada malformasi anorektal tidak berhubungan bermakna secara statistik dengan pola defekasi pascaoperasi berdasarkan skor Rintala (p&gt;0,05). Skor Rintala tidak selalu menggambarkan kondisi anatomis atau fungsional anus secara rinci. Simpulan penelitian ini ialah tidak terdapat hubungan bermakna antara tipe fistula, waktu operasi, dan <em>toilet training </em>pada malformasi anorektal dengan pola defekasi pascaoperasi berdasarkan skor Rintala.</p> <p><strong>Kata kunci</strong>: malformasi anorektal; tipe fistula; waktu operasi; <em>toilet training</em>; skor Rintala</p> 2025-04-13T00:00:00+08:00 Copyright (c) 2025 Sabrandi P. Saputra, Harsali F. Lampus, Candy Candy