e-CliniC
type: channel
description: e-CliniC (eCl) is published by the Indonesian Association of Anatomists in collaboration with the Faculty of Medicine, Sam Ratulangi University, Manado. This journal is published three times a year (March, July, and November). Since 2016, e-CliniC has been published twice a year (June and December). Since 2023, e-CliniC has been published three times a year (March, July, and November).
publisher: Universitas Sam Ratulangi
language: en-US
publication name: e-CliniC
issn: 2337-5949
copyright: COPYRIGHT Authors who publish with this journal agree to the following terms: Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal. Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal. Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
items: Hubungan antara Kadar Vitamin D dengan Kejadian Kanker Kolorektal: Studi Kasus dengan Pendekatan Berbasis Bukti
items: Successful Visual Rehabilitation After Penetrating Ocular Trauma via Yamane Scleral Fixation: A Case Report
items: Analisis Faktor Risiko dengan Kejadian Berat Badan Lahir Rendah di RSUP Prof. Dr. R. D. Kandou Manado Periode 2023-2024
items: Otitis Media Supuratif Kronik Tipe Aman dan Tipe Bahaya di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022-2024
items: Eight-year-delayed Diaphragmatic Hernia due to a Blunt Trauma: A Case Report
items: Korelasi Ketebalan Tunika Intima-Media Arteri Karotis dengan Kadar Kolesterol Total pada Mahasiswa Pendidikan Dokter
items: Evaluasi Luaran Klinis Pasien dan Karakteristik Pasien Frozen Shoulder yang Menjalani Prosedur Shoulder Arthroscopy
items: Karakteristik Pasien Laki-laki dengan Striktur Uretra di RSUP Prof. Dr. R. D. Kandou Manado
items: Karakteristik Mortalitas Pasien Geriatri Pascaoperasi di ICU RSUP Prof. Dr. R. D. Kandou Manado Periode Juli 2024-Juli 2025
items: Profil Pasien dengan Delirium yang Dirawat di Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado Periode Juli 2024 – Juli 2025
items: Perbedaan Luaran Maternal dan Perinatal pada Preeklamsia Onset Dini dan Onset Lambat di RSUP Prof. Dr. R. D. Kandou Manado
items: Karakteristik Pasien dengan Benda Asing Esofagus di RSUP Prof. Dr. R. D. Kandou Manado
items: Korelasi antara Tingkat Distres dengan Early-Onset Dementia pada Narapidana LPP Kelas IIB Manado
items: Pengaruh Pemberian Kafein terhadap Luaran Klinis Penyakit Parkinson Skor UPDRS
items: Hubungan Faktor Risiko Penyakit Jantung Koroner dengan Jumlah Lesi Arteri Koroner Berdasarkan Sullivan Vessel Score pada Pasien STEMI
items: Evaluasi Luaran Labioplasti Menggunakan Indeks Asher-McDade
items: Luaran Klinis dan Tantangan Teknis Total Hip Replacement pada Pasien Muda dengan Dislokasi Panggul yang Terabaikan
items: Analisis Pengaruh Budaya Kerja, Kepemimpinan, serta Komunikasi Terhadap Kinerja Perawat Kontrak di Rumah Sakit Bhayangkara Tk. III Manado
items: Kasus Tonsilitis Akut dan Tonsilitis Kronik di RSUP Prof. Dr. R. D. Kandou Manado Periode 2022-2024
items: Stenosis Trakea Distal Jinak Berat Pasca Trakeostomi dengan Gagal Napas Hiperkapnik: Dilatasi Bougie Terpandu Bronkoskopi dan Trakeostomi Distal Terarah
items: Gambaran Pasien Sumbing Bibir dan Langit-langit di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022-2025
items: Profil Pasien Dewasa dengan Gangguan Pendengaran di Poliklinik THT-KL RSUP Prof. Dr. R. D. Kandou
items: Penetrating Neck Trauma Involving Zone I: Surgical Intervention and Outcomes
items: Analisis Pengaruh Motivasi Keluarga dan Kepatuhan Rehabilitasi Terhadap Kemandirian Pasien Pasca Stroke di Rumah Sakit Bhayangkara Tk. III Manado
items: Gambaran Karakteristik Pasien Anak dengan Epilepsi di RSUP Prof. Dr. R. D. Kandou Manado
items: Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang Pelayanan Obstetri Neonatal Emergensi Komprehensif dan Kamar Bersalin RSIA Kirana Manado
items: Perbandingan Luaran Fungsional Pasien Pasca Rekonstruksi ACL dengan Autograft Hamstring dan Autograft Peroneus Longus
items: Karakteristik Pasien Serumen Obturans di Poliklinik THT-BKL Rumah Sakit R. D. Kandou Manado Periode 2023-2024

Hubungan antara Kadar Vitamin D dengan Kejadian Kanker Kolorektal: Studi Kasus dengan Pendekatan Berbasis Bukti
type: item
description: Abstract: Colorectal cancer is the third most common malignancy worldwide and the second leading cause of cancer-related death in developing countries. Vitamin D is known to play a role in inhibiting the progression of cancer cells. Vitamin D deficiency is prevalent in both developed and developing countries. Several studies have suggested an association between vitamin D levels and the incidence of colorectal cancer. This study aimed to determine the association between vitamin D levels and the incidence of colorectal cancer. A comprehensive literature search was conducted across PubMed, Cochrane Library, EBSCOhost, and ProQuest databases. Article selection followed predefined eligibility criteria through title and abstract screening, full-text review, and assessment of inclusion and exclusion criteria. Critical assessment tools and levels of evidence of the final articles are based on the Oxford Center for Evidence-Based Medicine. Four studies met the inclusion criteria, consisting of one meta-analysis and three cohort studies. The results showed that all studies reported an association between vitamin D levels and colorectal cancer. All studies indicated that vitamin D deficiency is associated with an increased risk of colorectal cancer. In conclusion, there is an association between vitamin D deficiency and the incidence of colorectal cancer. Keywords: adults; vitamin D; colorectal cancer Abstrak: Kanker kolorektal merupakan kanker ketiga terbanyak didunia dan penyebab kematian kedua terbanyak yang menyebabkan kematian di negara berkembang. Vitamin D memiliki peran dalam menghambat perkembangan dari sel kanker. Defisiensi vitamin D cukup tinggi di negara maju dan berkembang. Beberapa penelitian menunjukkan hubungan vitamin D dengan kejadian kanker kolorektal. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar vitamin D dengan kejadian kanker kolorektal. Pencarian literatur dilakukan pada Pubmed, Cochrane Library, EBSCOhost, dan ProQuest dengan krite…
creator: Timothy S. Kairupan
creator: Inka A. T. Sukarno
creator: Yohannessa Wulandari
creator: Nurul R. M. Manikam
rights: Copyright (c) 2026 Timothy S. Kairupan, Inka A. T. Sukarno, Yohannessa Wulandari, Nurul R. M. Manikam https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-09
publication date: 2026-02-09
volume: 14
number: 2
starting page: 157
ending page: 165
doi: 10.35790/ecl.v14i2.63120

Successful Visual Rehabilitation After Penetrating Ocular Trauma via Yamane Scleral Fixation: A Case Report
type: item
description: Abstract: Penetrating ocular trauma frequently leads to traumatic cataract with capsular and zonular disruption, complicating standard in-the-bag intraocular lens (IOL) implantation. Sutureless intrascleral fixation (Yamane technique) offers a minimally invasive posterior chamber IOL option that avoids long-term suture-related complications. We reported a 68-year-old woman presented one day after penetrating needle injury to the right eye with uncorrected visual acuity (UCVA) 1/300, full-thickness corneal laceration (positive Seidel), anterior capsule tear, and zonular dialysis from 7 to 1 o’clock with lens fragments in the anterior chamber. Under retrobulbar anesthesia, corneal wound closure was performed with interrupted 10-0 nylon, followed by cataract extraction and anterior vitrectomy. In the same operation, two transconjunctival sclerotomies were created 2.0 mm posterior to the limbus (superonasal and superotemporal) using 27-gauge thin-walled needles at ~20°. A three-piece foldable IOL was implanted by the Yamane flanged-haptic technique; haptics were externalized, cauterized to 0.3–0.5 mm flanges, and tucked into scleral tunnels. The IOL centered well without tilt; no conjunctival peritomy was required. Postoperatively, UCVA improved to 1/60 on day 1, 6/60 at 2 weeks (after suture removal), and 6/15 at 1 month (6/6 with pinhole). In three-month follow-up, the retina remained attached, intraocular pressure was stable, no cystoid macular edema, and the IOL remained well positioned. In conclusion, in complex open-globe injury with inadequate capsular support, single-session repair with immediate Yamane sutureless scleral fixation of a three-piece IOL can achieve rapid, stable visual recovery and anatomic stability in geriatric eyes. Careful wound closure, symmetric needle entry, and precise flange creation are key to IOL centration and complication avoidance; continued follow-up is advised to monitor long-term flange stability. Keywords: penetrating ocular trau…
creator: Ade J. Nursalim
creator: Ardelia Emily
rights: Copyright (c) 2026 Ade J. Nursalim, Ardelia Emily https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-09
publication date: 2026-02-09
volume: 14
number: 2
starting page: 166
ending page: 172
doi: 10.35790/ecl.v14i2.65520

Analisis Faktor Risiko dengan Kejadian Berat Badan Lahir Rendah di RSUP Prof. Dr. R. D. Kandou Manado Periode 2023-2024
type: item
description: Abstract: Low birth weight (LBW) remains a significant health issue both globally and nationally, including in Manado, which has shown an increase in cases in recent years. This study aimed to analyze the relationship between maternal age, parity, placenta previa, preeclampsia, anemia, premature rupture of membranes (PROM), and urinary tract infection (UTI) with the incidence of LBW at Prof. Dr. R. D. Kandou General Hospital Manado from 2023-2024. This was a quantitative retrospective study with a cross-sectional approach. Samples were taken using total sampling from medical records at the Obstetrics and Gynecology Department, Prof. Dr. R. D. Kandou General Hospital that met the inclusion and exclusion criteria. Data were analyzed with the chi-square test with a significance level of p<0.05. The results obtained 1747 deliveries, with 284 cases of LBW. The analysis showed that only parity had a significant relationship with LBW (p=0.033), while maternal age (p=0.655), placenta previa (p=0.293), preeclampsia (p=0.637), anemia (p=0.657), PROM (p=0.589), and UTI (p=0.963) showed no statistically significant relationships (p>0.05). In conclusion, there is a significant relationship between parity and the incidence of LBW, while other risk factors do not show significant relationships with the incidence of LBW at RSUP Prof. Dr. R.D. Kandou Manado in the year 2023-2024. Keywords: low birth weight; risk factors; parity Abstrak: Masalah berat badan lahir rendah (BBLR) terus menjadi isu kesehatan baik secara global maupun nasional, termasuk di Kota Manado yang menunjukkan peningkatan dalam beberapa tahun belakangan. Penelitian ini bertujuan untuk menganalisis hubungan usia ibu, paritas, palsenta previa, preeklamsia, anemia, ketuban pecah dini (KPD), dan infeksi saluran kencing (ISK) dengan kejadian BBLR di RSUP Prof. Dr. R. D. Kandou Manado periode 2023-2024. Jenis penelitian ialah kuantitatif retrospektif dengan desain potong lintang. Sampel diambil secara total sampling dar…
creator: Angeline Meylani
creator: Hermie M. M. Tendean
creator: Gilbert W. Setiawan
rights: Copyright (c) 2026 Angeline Meylani, Hermie M. M. Tendean, Gilbert W. Setiawan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-15
publication date: 2026-02-15
volume: 14
number: 2
starting page: 173
ending page: 179
doi: 10.35790/ecl.v14i2.66056

Otitis Media Supuratif Kronik Tipe Aman dan Tipe Bahaya di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022-2024
type: item
description: Abstract: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity marked by tympanic membrane perforation and persistent or recurrent otorrhea for more than two months. This study aimed to determine the characteristics of the safe and unsafe types of CSOM at Prof. Dr. R. D. Kandou General Hospital in years 2022-2024. This was a retrospective and descriptive study using the total sampling technique. The results obtained 103 patients of safe type (64.4%) and 57 patients of unsafe type (35.6%). The most frequent age group for both types was 20-59 years, with a predominance of females (53.4%) in safe type and males in unsafe type (54.4%). Most of the patients had a middle level of education. The most common symptom in both types was otorrhea (100%) with central perforation was frequently found in safe type of CSOM (45.6%) and attic perforation was most common in unsafe type of CSOM (22.5%). The most frequent treatment was conservative in safe type (51.5%), while conservative and surgery were more frequent in unsafe type (54.4%). In conclusion, the safe type of CSOM was more commonly found. The majority of patients were adults with a middle level of education. Female predominated in safe type, whereas male predominated in unsafe type. The most frequent symptom was otorrhea. Central perforation was most commonly found in safe type and attic perforation in unsafe type. The safe type was treated conservatively, whereas the unsafe type was commonly treated with a combination of conservative and surgery. Keywords: chronic suppurative otitis media; safe type; unsafe type Abstrak: Otitis media supuratif kronik (OMSK) adalah inflamasi kronik telinga tengah dan rongga mastoid yang ditandai dengan temuan perforasi membran timpani dan otore secara menetap atau berulang selama lebih dari dua bulan. Penelitian ini bertujuan untuk mengetahui karakteristik OMSK tipe aman dan tipe bahaya di RSUP Prof. Dr. R. D. Kandou tahun 2022-2024. Jenis…
creator: Natelly E. Rustam
creator: Valentini M. Pontoh
creator: Moudi M. Mona
rights: Copyright (c) 2026 Natelly E. Rustam, Valentini M. Pontoh, Moudi M. Mona https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-15
publication date: 2026-02-15
volume: 14
number: 2
starting page: 180
ending page: 186
doi: 10.35790/ecl.v14i2.65849

Eight-year-delayed Diaphragmatic Hernia due to a Blunt Trauma: A Case Report
type: item
description: Abstract: Traumatic diaphragmatic rupture is an uncommon but potentially life-threatening injury, typically caused by blunt or penetrating thoraco-abdominal trauma. While most cases are identified in the acute phase, delayed presentations may occur years after the initial injury, often with nonspecific symptoms. Recognition requires a high index of suspicion to avoid morbidity associated with late diagnosis. We reported a 33-year-old male with a history of blunt chest trauma sustained eight years prior, who presented with incidental findings of a left diaphragmatic hernia. The patient was asymptomatic aside from decreased breath sounds on auscultation. Chest computed tomography revealed herniation of abdominal viscera, including the stomach, colon, omentum, and spleen, into the left thoracic cavity. Surgical management consisted of left posterolateral thoracotomy with reduction of herniated contents, adhesiolysis via laparotomy, and primary repair of a 10 × 5 cm diaphragmatic defect using interrupted non-absorbable sutures. Postoperatively, the patient recovered well with resolution of lung expansion and no evidence of recurrence on follow-up imaging. In conclusion, delayed diaphragmatic hernia following blunt trauma is a rare clinical entity that may remain silent for years before diagnosis. Thorough history-taking, clinical suspicion, and advanced imaging are critical in identifying such cases. Early surgical intervention remains the cornerstone of management, aiming to restore diaphragmatic integrity, prevent visceral complications, and optimize respiratory function. Keywords: delayed diaphragmatic hernia; blunt trauma; thoracotomy; diaphragmatic rupture
creator: Christha Z. Tamburian
creator: Wega Sukanto
creator: Pramijaya E. Pontoh
rights: Copyright (c) 2026 Pramijaya E. Pontoh, Christha Z. Tamburian, Wega Sukanto https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-19
publication date: 2026-02-19
volume: 14
number: 2
starting page: 187
ending page: 192
doi: 10.35790/ecl.v14i2.65952

Korelasi Ketebalan Tunika Intima-Media Arteri Karotis dengan Kadar Kolesterol Total pada Mahasiswa Pendidikan Dokter
type: item
description: Abstract: High total cholesterol is one of the major risk factors for atherosclerosis, which can cause thickening of the carotid arterial intima-media layer. Non-invasive carotid intima-media thickness/CIMT measurement serves as an early indicator for detecting vascular structural changes. This study aimed to determine the correlation between total cholesterol levels and CIMT among medical students at Universitas Sam Ratulangi, Manado. This was a quantitative and analytical observational study with a cross-sectional design. Total cholesterol levels were measured using the Autocheck device, while CIMT was assessed using the B-Mode Ultrasonography. The correlation between variables was analyzed using the Spearman test. The results obtained 79 students as subjects selected through purposive sampling. The results showed no significant correlation between total cholesterol level and CIMT (p=0.157; r=–0.161). In conclusion, there was no significant relationship between total cholesterol and carotid intima-media thickness among medical students at Universitas Sam Ratulangi. Future studies are recommended to include subjects with a wider age range and to analyze specific lipid fractions such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides for a more comprehensive understanding. Keywords: total cholesterol; carotid intima-media thickness; atherosclerosis Abstrak: Kadar kolesterol total yang tinggi merupakan salah satu faktor risiko utama terjadinya aterosklerosis yang dapat menyebabkan penebalan tunika intima-media arteri karotis (carotid intima-media thickness/CIMT). Pemeriksaan CIMT secara non-invasif dapat digunakan untuk mendeteksi dini perubahan struktur pembuluh darah. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar kolesterol total dengan CIMT pada mahasiswa Pendidikan Dokter Universitas Sam Ratulangi Manado. Jenis penelitian ialah kuantitatif dengan metode observasional analitik menggunakan desain potong lintang. Ka…
creator: Sharen C. J. Paat
creator: Erwin A. Pangkahila
creator: Herlina I. S. Wungouw
rights: Copyright (c) 2026 Sharen C. J. Paat, Erwin A. Pangkahila, Herlina I. S. Wungouw https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-19
publication date: 2026-02-19
volume: 14
number: 2
starting page: 193
ending page: 198
doi: 10.35790/ecl.v14i2.65850

Evaluasi Luaran Klinis Pasien dan Karakteristik Pasien Frozen Shoulder yang Menjalani Prosedur Shoulder Arthroscopy
type: item
description: Abstract: Frozen shoulder is characterized by a gradual increase in pain with spontaneous onset and limited range of motion in the glenohumeral joint. Arthroscopic capsular release is a most well-known technique with favorable outcomes for frozen shoulder. This was a single-center retrospective study examining the clinical outcomes of frozen shoulder cases undergoing arthroscopy at Prof. Dr. R. D. Kandou General Hospital in Manado from February 2025 to October 2025. The results showed that a total of 26 patients were included in this study. At preoperative assessment, pain levels averaged 4.96 ± 0.96 (median 5.00 [5.00–5.75]; range 3–6). Initial range of motion (ROM) showed significant limitations. At follow-up, an improvement in ROM was clearly observed. In conclusion, shoulder arthroscopy in patients with frozen shoulder results in a significant improvement in ROM from the first month and persisted until the third month after surgery indicating that arthroscopic capsular release is an effective surgical treatment option. Keywords: frozen shoulder; shoulder arthroscopy; range of motion Abstrak: Frozen shoulder ditandai dengan peningkatan nyeri secara bertahap dengan onset spontan dan keterbatasan dalam range of motion (ROM) sendi glenohumeral. Pelepasan kapsul artroskopi merupakan teknik yang paling terkenal dengan hasil yang baik untuk frozen shoulder. Penelitian ini bertujuan untuk melihat luaran klinis dari kasus frozen shoulder yang menjalani prosedur shoulder arthroscopy di RSUP Prof Dr. R. D. Kandou Manado pada periode Februari 2025 – Oktober 2025. Jenis penelitian ialah retrospektif single center studi. Hasil penelitian mendapatkan sebanyak 26 pasien dilibatkan dalam penelitian ini. Pada penilaian pra operasi, kadar nyeri berada pada rerata 4,96±0,96 (median 5,00 [5,00–5,75]; rentang 3–6). Nilai ROM awal menunjukkan keterbatasan bermakna. Pada tindak lanjut, peningkatan nilai ROM terlihat jelas. Simpulan penelitian ini ialah prosedur shoulder arthroscopy pad…
creator: Rangga B. V. Rawung
creator: Harsali Lampus
creator: Stefan Kambey
creator: Raynald Bagy
creator: Antony Sundah
creator: Christorei D. Tooy
rights: Copyright (c) 2026 Rangga B. V. Rawung, Harsali Lampus, Stefan Kambey, Raynald Bagy, Antony Sundah, Christorei D. Tooy https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-19
publication date: 2026-02-19
volume: 14
number: 2
starting page: 199
ending page: 204
doi: 10.35790/ecl.v14i2.65853

Karakteristik Pasien Laki-laki dengan Striktur Uretra di RSUP Prof. Dr. R. D. Kandou Manado
type: item
description: Abstract: Urethral stricture is a narrowing of the urethral lumen due to fibrosis, causing urinary dysfunction and requiring appropriate management according to patient characteristics. This study aimed to describe the characteristics of male patients with urethral stricture based on age, stricture location, stricture grade, etiology, surgical technique, and success rate at Prof. Dr. R. D. Kandou General Hospital in Manado. This was a descriptive retrospective study with total sampling of medical records of male patients with urethral stricture from June 2023 to June 2025. The results obtained 80 patients that met the inclusion criteria, with a median age of 63 years, and most of them were in the elderly age range. The most common location of the stricture was the anterior part of urethra, particularly the bulbous part (82.5%). The most common degree of stricture was partial stricture (67.5%), and the most common etiology was trauma (57.5%). The most frequently used surgical techniques were direct vision internal urethrotomy/DVIU (55.0%) and excision and primary anastomosis/EPA (37.5%). The procedure success rate was very high, with 76 patients (95.8%) experiencing no recurrence. In conclusion, urethral strictures in males most commonly occur in the elderly, with the dominant location in the anterior urethra, the primary etiology being trauma, and a good surgical success rate, especially for short strictures treated with EPA and DVIU. Keywords: urethral stricture; direct vision internal urethrotomy; excision and primary anastomosis; augmented urethroplasty Abstrak: Striktur uretra merupakan penyempitan lumen uretra akibat fibrosis yang menyebabkan gangguan berkemih dan membutuhkan penatalaksanaan yang tepat sesuai karakteristik pasien. Penelitian ini bertujuan menggambarkan karakteristik pasien laki-laki dengan striktur uretra berdasarkan usia, lokasi striktur, derajat striktur, etiologi, teknik operasi, dan tingkat keberhasilan di RSUP Prof. Dr. R. D. Kandou Manado…
creator: Rafli A. Loleh
creator: Eko Arianto
creator: Stefan G. Kambey
rights: Copyright (c) 2026 Rafli A. Loleh, Eko Arianto, Stefan G. Kambey https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-20
publication date: 2026-02-20
volume: 14
number: 2
starting page: 205
ending page: 210
doi: 10.35790/ecl.v14i2.65854

Karakteristik Mortalitas Pasien Geriatri Pascaoperasi di ICU RSUP Prof. Dr. R. D. Kandou Manado Periode Juli 2024-Juli 2025
type: item
description: Abstract: Increased number of elderly population is accompanied by a decline in physiological function and multiple comorbidities, therefore, increases their vulnerability to postoperative complications and mortality. This study aimed to describe the clinical characteristics of postoperative mortality in geriatric patients in the Intensive Care Unit (ICU) at Prof. Dr. R. D. Kandou General Hospital in Manado from July 2024 to July 2025. This was a descriptive and retrospective study using medical records of 119 geriatric patients who met the inclusion criteria. The variables examined included age, gender, comorbidities, type of surgery, and length of hospital stay. The results showed that the pre-elderly group (60-69 years) was the largest group (50.42%). The gender proportion was relatively balanced, with 50.42% female and 49.58% male. Hypertension (60.50%) was the most common comorbidity, while digestive surgery was the most common type of surgery (36.13%). In addition, the majority of patients had a length of stay ≥7 days (57.98%). In conclusion, pre-elderly patients with multiple comorbidities, especially hypertension, as well as those who underwent digestive surgery and had a longer length of stay, were the most common group found in the mortality population of this study. Keywords: geriatric patients; Intensive Care Unit; characteristics; retrospective; mortality Abstrak: Pertambahan populasi lanjut usia, disertai penurunan fungsi fisiologis dan komobiditas multipel, meningkatkan kerentanan mereka terhadap komplikasi pascaoperasi dan mortalitas. Penelitian ini bertujuan menggambarkan karakteristik klinis mortalitas pasien geriatri pascaoperasi di Intensive Care Unit (ICU) RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2024-Juli 2025. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medis 119 pasien geriatri yang memenuhi kriteria inklusi. Variabel yang dikaji meliputi usia, jenis kelamin, komorbiditas, jenis operasi, dan lama rawat inap. …
creator: Sintikhe C. Y. Laritmas
creator: Barry I. Kambey
creator: Diana Ch. Lalenoh
rights: Copyright (c) 2026 Sintikhe C. Y. Laritmas, Barry I. Kambey, Diana Ch. Lalenoh https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-21
publication date: 2026-02-21
volume: 14
number: 2
starting page: 211
ending page: 216
doi: 10.35790/ecl.v14i2.65857

Profil Pasien dengan Delirium yang Dirawat di Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado Periode Juli 2024 – Juli 2025
type: item
description: Abstract: Delirium is a disorder of attention and consciousness. It is a common complication in critically ill patients. Delirium is associated with poor clinical outcomes. Data on the characteristics of delirium patients in Indonesia, particularly in North Sulawesi, are still limited. This study aimed to determine the profile of patients with delirium treated in the Intensive Care Unit (ICU) of Prof. Dr. R. D. Kandou General Hospital, Manado, from July 2024 – July 2025. This was a descriptive observational study with a retrospective design. The results showed that out of the 1,029 ICU patients during the study period, there were 45 patients (4.37%) were included as samples. The majority of patients were aged 18–59 years (66.67%) and male (68.89%). The most common RASS score was -2 (20%), indicating a predominance of low-activity delirium. The most common diagnoses were postoperative (35.56%) and sepsis (22.22%). The ICU mortality rate was 33.33%. The average length of stay was 10.73 days with a median of 9 days. In conclusion, the incidence of delirium in the Intensive Care Unit of Prof. Dr. R. D. Kandou General Hospital was 4.37%. The majority occurred in adults, males, with a tendency toward hypoactive delirium. Post-operative conditions and sepsis were the most common diagnoses. Mortality and length of stay were relatively high. Keywords: delirium; Intensive Care Unit; RASS score Abstrak: Delirium merupakan gangguan pada perhatian dan kesadaran yang sering menjadi komplikasi pada pasien kritis. Delirium berkaitan dengan luaran klinis yang buruk. Data mengenai karakteristik pasien delirium di Indonesia, khususnya di Sulawesi Utara, masih terbatas. Penelitian ini bertujuan untuk menentukan profil pasien dengan delirium yang dirawat di Intensive Care Unit (ICU) RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2024–Juli 2025. Jenis penelitian ialah deskriptif observasional dengan desain retrospektif. Hasil penelitian mendapatkan bahwa dari 1.029 pasien ICU dalam peri…
creator: Ruth D. Yana
creator: Mordekhai L. Laihad
creator: Barry I. Kambey
rights: Copyright (c) 2026 Ruth D. Yana, Mordekhai L. Laihad, Barry I. Kambey https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-23
publication date: 2026-02-23
volume: 14
number: 2
starting page: 217
ending page: 222
doi: 10.35790/ecl.v14i2.65892

Perbedaan Luaran Maternal dan Perinatal pada Preeklamsia Onset Dini dan Onset Lambat di RSUP Prof. Dr. R. D. Kandou Manado
type: item
description: Abstract: Timing of preeclampsia onset, early-onset (<34 weeks) and late-onset (≥34 weeks), is known to be associated with varying degrees of severity and pregnancy outcomes. This study aimed to determine the differences in maternal and perinatal outcomes between early-onset and late-onset preeclampsia at Prof. Dr. R. D. Kandou General Hospital Manado during years 2022–2024. This was an analytical and observational study with a cross-sectional approach. Data were collected retrospectively from medical records using a total sampling technique. Data were analyzed using the chi-square test or Fisher’s exact test. The results obtained 488 patients that met the inclusion criteria, consisting of 159 patients with early-onset preeclampsia and 329 patients with late-onset preeclampsia. Maternal outcomes such as eclampsia (13.2% vs 1.8%; p<0,001), HELLP syndrome (33.3% vs 4.9%; p<0.001), and maternal mortality (5.0% vs 0.9%; p=0.007) were significantly higher in the early-onset group. Meanwhile, pulmonary edema and placental abruption showed no significant difference. For perinatal outcomes, early-onset preeclampsia demonstrated a markedly higher rate of complications, including prematurity (91.8%), low birth weight (92.5%), neonatal asphyxia (58.5%), IUGR (34.0%), and perinatal mortality (54.7%), all with p<0.001 compared to the late-onset group. In conclusion, there are significant differences in maternal and perinatal outcomes between early-onset and late-onset preeclampsia at Prof. Dr. R. D. Kandou General Hospital Manado, with early-onset preeclampsia being associated with poorer maternal and perinatal outcomes. Keywords: preeclampsia; early-onset; late-onset; maternal outcomes; perinatal outcomes Abstrak: Waktu munculnya preeklamsia, yaitu onset dini (<34 minggu) dan onset lambat (≥34 minggu), diketahui berkaitan dengan variasi tingkat keparahan dan luaran kehamilan. Penelitian ini bertujuan untuk mengetahui perbedaan luaran maternal dan perinatal pada preeklamsia onse…
creator: Natan Arikalang
creator: Erna Suparman
creator: John J. E. Wantania
rights: Copyright (c) 2026 Natan Arikalang, Erna Suparman, John J. E. Wantania https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-28
publication date: 2026-02-28
volume: 14
number: 2
starting page: 223
ending page: 228
doi: 10.35790/ecl.v14i2.65895

Karakteristik Pasien dengan Benda Asing Esofagus di RSUP Prof. Dr. R. D. Kandou Manado
type: item
description: Abstract: Esophageal foreign bodies represent a medical emergency that may lead to serious complications in adults and children. Esophagoscopy serves as the main modality for identifying the location and removing the foreign body, either using rigid or flexible instruments. This study aimed to determine the characteristics of patients with esophageal foreign bodies at Prof. Dr. R. D. Kandou General Hospital Manado. This was a descriptive and retrospective study using medical record data of patients diagnosed with esophageal foreign bodies at Prof. Dr. R. D. Kandou General Hospital Manado for the years 2020–2024. The results showed that out of 56 samples, 55.35% were male patients. The highest percentages were found in childhood age group (48.21%), odynophagia (32.14%), and dysphagia (30.36%) as the primary symptoms, inorganic foreign bodies (85.71%), and cervical esophagus (80.36%) as the site of impaction. Rigid esophagoscopy was the most commonly used extraction method (96.42%). In conclusion, esophageal foreign bodies are more commonly found in males, predominantly in children. Odynophagia was the most frequently reported symptom. Most foreign bodies causing impaction were inorganic in nature, and the cervical esophagus was the most common site of lodgment. Rigid esophagoscopy remains the primary modality used in management. Keywords: esophageal foreign body; esophagoscopy management; rigid esophagoscopy Abstrak: Benda asing esofagus merupakan salah satu kegawatdaruratan medis yang berpotensi menimbulkan komplikasi serius baik pada anak maupun dewasa. Esofagoskopi menjadi modalitas utama dalam menentukan lokasi dan sekaligus mengekstraksi benda asing, baik dengan esofagoskopi kaku maupun fleksibel. Penelitian ini bertujuan untuk mengetahui karakteristik pasien dengan benda asing esofagus di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medis pasien dengan diagnosis benda asing esofagus di RSUP Prof. Dr.…
creator: Yose L. F. H. Karokaro
creator: Steward K. Mengko
creator: Rizki R. Najoan
rights: Copyright (c) 2026 Yose L. F. H. Karokaro, Steward K. Mengko, Rizki R. Najoan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-03
publication date: 2026-03-03
volume: 14
number: 2
starting page: 229
ending page: 234
doi: 10.35790/ecl.v14i2.65856

Korelasi antara Tingkat Distres dengan Early-Onset Dementia pada Narapidana LPP Kelas IIB Manado
type: item
description: Abstract: Female inmates in correctional institutions are vulnerable to psychological distress, including depression, anxiety, and stress. High levels of distress are associated with an increased incidence of early-onset dementia (EOD), which refers to dementia occurring before the age of 65. This study aimed to determine the correlation between distress levels and EOD among female inmates. This was an analytical observational study with a cross-sectional design, conducted at the Manado Class IIB Women’s Correctional Institution from August to November 2025. Sampling was carried out using the stratified random sampling technique, with DASS-21 and MoCA-Ina questionnaires as research instruments. The results obtained a total of 59 female inmates participated in this study. Most inmates had normal distress levels, including normal depression (59,3%), anxiety (49,2%), and stress (59,3%). Based on EOD assessment, the majority (62.7%) showed cognitive impairment. The Spearman’s correlation test indicated a significant relationship between distress levels and early-onset dementia (p=0.000). In conclusion, there is a significant correlation between distress levels and early-onset dementia among female inmates at the Manado Class IIB Women’s Correctional Institution. Keywords: distress levels; early-onset dementia Abstrak: Narapidana perempuan di lembaga pemasyarakatan rentan mengalami distres, seperti depresi, kecemasan, maupun stres. Tingginya tingkat distres berdampak pada angka kejadian early-onset dementia (EOD), yang merujuk pada demensia di rentang usia <65 tahun. Penelitian ini bertujuan untuk mengetahui korelasi antara tingkat distres dengan EOD pada narapidana LPP Kelas IIB Manado. Jenis penelitian ialah observasional analitik dengan desain potong lintang. Penelitian ini dilakukan di LPP Kelas IIB Manado selama bulan Agustus-November 2025, dengan teknik pengambilan sampel menggunakan stratified random sampling. Instrumen penelitian menggunakan lembar kuesioner DASS…
creator: Yohanes A. Pua
creator: Junita M. Pertiwi
creator: Finny Warouw
rights: Copyright (c) 2026 Yohanes A. Pua, Junita M. Pertiwi, Finny Warouw https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-03
publication date: 2026-03-03
volume: 14
number: 2
starting page: 235
ending page: 239
doi: 10.35790/ecl.v14i2.65855

Pengaruh Pemberian Kafein terhadap Luaran Klinis Penyakit Parkinson Skor UPDRS
type: item
description: Abstract: Parkinson’s disease is the second most common neurodegenerative disorder worldwide and still lacks of a disease-modifying therapy. Caffeine, an A2AR antagonist, may provide neuroprotection and modulate the dopaminergic system, potentially improving both motor and non-motor symptoms of this disease. This study aimed to evaluate the association of caffeine administration with Unified Parkinson’s Disease Rating Scale (UPDRS) score changes in patients with Parkinson’s disease through a meta-analysis of clinical trials. This meta-analysis showed that caffeine was associated with a statistically significant reduction in UPDRS III scores at enam weeks with moderate certainty, statistically insignificant reductions on UPDRS I, II, III (beyond six weeks), and IVFluctuations with moderate certainty, and statistically insignificant increases in UPDRS IVDyskinesia with low certainty. All UPDRS subscale changes might not be clinically meaningful. In conclusion, caffeine likely reduces UPDRS I, II, III, and IVFluctuation scores and may increase UPDRS IVDyskinesia, but may not be clinically meaningful. Nonetheless, caffeine remains a potential adjuvant candidate warranting further trials incorporating drug holidays to prevent tolerance Keywords: Parkinson’s disease; caffeine; Unified Parkinson’s Disease Rating Scale Abstrak: Penyakit Parkinson merupakan penyakit neurodegeneratif kedua tersering di dunia dan masih belum memiliki terapi yang dapat memodifikasi progresifitasnya. Kafein, antagonis A2AR, diduga memiliki efek neuroprotektif dan modulasi sistem dopaminergik yang berpotensi memperbaiki gejala motorik maupun non-motorik penyakit ini. Penelitian ini bertujuan untuk menilai hubungan pemberian kafein terhadap perubahan skor Unified Parkinson’s Disease Rating Scale (UPDRS) pada pasien penyakit Parkinson melalui meta-analisis uji klinis. Hasil meta-analisis menunjukkan bahwa pemberian kafein secara statistik bermakna menurunkan skor UPDRS III durasi intervensi enam mi…
creator: Daniel N. Adinata
creator: Sekplin A. S. Sekeon
creator: Finny Warouw
rights: Copyright (c) 2026 Daniel N. Adinata, Sekplin A. S. Sekeon, Finny Warouw https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-10
publication date: 2026-03-10
volume: 14
number: 2
starting page: 240
ending page: 246
doi: 10.35790/ecl.v14i2.66057

Hubungan Faktor Risiko Penyakit Jantung Koroner dengan Jumlah Lesi Arteri Koroner Berdasarkan Sullivan Vessel Score pada Pasien STEMI
type: item
description: Abstract: ST-elevation myocardial infarction (STEMI) is a clinical manifestation of coronary heart disease (CHD) with a high mortality rate. The anatomical severity of coronary artery disease (CAD) varies and is influenced by the burden of cardiovascular risk factors. This study aimed to analyze the relationship between CHD risk factors and the number of coronary artery lesions based on the Sullivan Vessel Score in STEMI patients at Prof. Dr. R. D. Kandou General Hospital in Manado. This was an analytical and retrospective study with a cross-sectional design using electronic medical records with total sampling technique. The results showed that among 204 included patients, there were statistically significant relationships (p<0.05) between gender, smoking (38.2%), hypertension (77.5%), dyslipidemia (66.7%), diabetes mellitus (37.3%), and obesity (46.1%) with the number of coronary artery lesions. No statistically significant relationship (p >0.05) was found for the variables of age and family history (2.9%). In conclusion, there is a relationship between gender, smoking, hypertension, dyslipidemia, diabetes mellitus, and obesity with the number of coronary artery lesions, however, there is no relationship with age and family history. Keywords: coronary heart disease; risk factors; coronary artery lesion Abstrak: Infark miokard dengan elevasi segmen ST (STEMI) ialah manifestasi klinis penyakit jantung koroner (PJK) dengan tingkat mortalitas yang tinggi. Derajat keparahan anatomi penyakit arteri koroner bervariasi dan dipengaruhi oleh beban faktor risiko kardiovaskular. Penelitian ini bertujuan untuk menganalisis hubungan antara faktor risiko PJK dan jumlah lesi arteri koroner berdasarkan Sullivan Vessel Score pada pasien STEMI di RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah analitik retrospektif dengan desain potong lintang, menggunakan rekam medis elektronik dengan teknik total sampling. Hasil penelitian mendapatkan bahwa di antara 204 pasien, terdapa…
creator: Bezalel T. Sarjono
creator: Starry H. Rampengan
creator: Edmond L. Jim
rights: Copyright (c) 2026 Bezalel T. Sarjono, Starry H. Rampengan, Edmond L. Jim https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-14
publication date: 2026-03-14
volume: 14
number: 2
starting page: 247
ending page: 252
doi: 10.35790/ecl.v14i2.66604

Evaluasi Luaran Labioplasti Menggunakan Indeks Asher-McDade
type: item
description: Abstract: The Asher-McDade Index is one of the most widely used international methods for evaluating postoperative aesthetic outcomes in cleft lip patients. However, local studies assessing labioplasty outcomes using this index remain limited. This study aimed to evaluate the aesthetic results of labioplasty at Prof. Dr. R. D. Kandou General Hospital using the Asher-McDade Index in years 2022-2025. Aesthetic evaluation was performed on postoperative photographs by a single assessor. The analysis was conducted descriptively. The results obtained a total of six samples. The overall mean scores ranged from 1 to 2.75, with median values per patient between 1 and 2.5. The components that most frequently demonstrated higher scores were nasal profile and vermilion border, while nasal form and deviation consistently scored 1. In conclusion, the aesthetic outcomes of labioplasty in these samples were generally classified as good, although variations were observed particularly in the vermilion and nasal profile components. Keywords: cleft lip; cleft lip and palate; Asher-McDade Index Abstrak: Indeks Asher-McDade merupakan metode yang paling banyak digunakan secara internasional untuk mengevaluasi hasil estetika pascaoperasi bibir sumbing, namun, penelitian lokal yang menilai luaran labioplasti menggunakan indeks ini masih sangat terbatas. Peneltian ini bertujuan untuk menilai luaran estetika labioplasti di RSUP Prof. Dr. R. D. Kandou Manado menggunakan indeks Asher-McDade tahun 2022-2025. Analisis dilakukan secara deskriptif. Evaluasi estetika dilakukan pada foto pascaoperasi oleh satu penilai. Hasil penelitian mendapatkan total enam sampel. Skor rerata keseluruhan berkisar antara 1-2,75, dengan nilai median per pasien berada pada rentang 1-2,5. Komponen yang paling sering menunjukkan skor lebih tinggi ialah profil hidung dan batas vermilion, sementara bentuk dan deviasi hidung konsisten berada pada skor 1. Simpulan penelitian ini ialah luaran estetika labioplasti pada sampel…
creator: Prayvie S. F. Tulandi
creator: Mendy J. Hatibie
creator: Harsali F. Lampus
rights: Copyright (c) 2026 Prayvie S. F. Tulandi, Mendy J. Hatibie, Harsali F. Lampus https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-20
publication date: 2026-03-20
volume: 14
number: 2
starting page: 253
ending page: 257
doi: 10.35790/ecl.v14i2.65953

Luaran Klinis dan Tantangan Teknis Total Hip Replacement pada Pasien Muda dengan Dislokasi Panggul yang Terabaikan
type: item
description: Abstract: Neglected hip dislocation in young patients often leads to severe deformity, soft-tissue contractures, avascular necrosis, and secondary osteoarthritis. Total hip replacement (THR) has become a viable reconstructive option, although the available evidence remains limited and is primarily derived from small case series. This study aimed to evaluate the clinical and functional outcomes of THR in young patients with neglected hip dislocation. A structured search was conducted across six predetermined databases for studies published between 2015 and 2025, following PRISMA and PICOS guidelines. 18 studies met the inclusion criteria and were appraised using the OCEBM 2011 and JBI 2020 tools. Most studies reported substantial postoperative improvement, including marked pain reduction and significant increases in functional scores—particularly the Harris Hip Score, with average gains of 40–50 points. Major complications were uncommon, and uncemented THR was more frequently employed to preserve bone stock. The main surgical challenges included acetabular deformity, soft-tissue fibrosis, limb-length discrepancy, and risk of recurrent dislocation. In conclusion, THR appears effective in restoring function and improving quality of life in young patients with neglected hip dislocation, although larger prospective studies are required to strengthen the long-term evidence base. Keywords: total hip replacement; neglected hip dislocation; young patients Abstrak: Dislokasi panggul terabaikan pada pasien muda sering menyebabkan deformitas berat, kontraktur jaringan lunak, avaskular nekrosis, dan osteoartritis sekunder. Total hip replacement (THR) telah menjadi pilihan rekonstruksi yang layak, meskipun bukti yang ada masih terbatas dan terutama berasal dari seri kasus kecil. Penelitian ini bertujuan untuk menilai luaran klinis dan fungsional dari THR pada pasien muda dengan dislokasi panggul terabaikan. Pencarian terstruktur dilakukan pada enam basis data yang telah ditentuka…
creator: Fadilla N. R. Sadi
creator: Stefan A. G. P. Kambey
creator: Angelica M. J. Wagiu
rights: Copyright (c) 2026 Fadilla N. R. Sadi, Stefan A. G. P. Kambey, Angelica M. J. Wagiu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-20
publication date: 2026-03-20
volume: 14
number: 2
starting page: 258
ending page: 263
doi: 10.35790/ecl.v14i2.66621

Analisis Pengaruh Budaya Kerja, Kepemimpinan, serta Komunikasi Terhadap Kinerja Perawat Kontrak di Rumah Sakit Bhayangkara Tk. III Manado
type: item
description: Abstract: Nursing is a very vital part of the healthcare service system in hospitals and directly affects the quality of the service itself. This study aimed to analyze the influence of work culture, leadership, and communication on the performance of contract nurses in the Inpatient Installation of Rumah Sakit Bhayangkara Tk. III Manado. This was an explanatory study using a quantitative approach. The research population includes 110 contract nurses, and samples were randomly selected with a total of 86 respondents. Data were collected through structured questionnaires. Data analysis was conducted using multiple linear regression to test the influence of independent variables on the dependent variable. The results showed that work culture, leadership, and communication had significant influence on the performance of contract nurses, both individually and collectively. A strong work culture enhances work efficiency, effective leadership motivates nurses to achieve higher standards, and good communication improves team coordination. In conclusion, improving the performance of contract nurses can be achieved through strengthening a positive work culture, implementing supportive leadership styles, and fostering effective communication. This study recommends that hospital management strengthen leadership training programs, build a work culture that supports innovation, and improve communication channels to support nurse performance. Keywords: work culture; leadership; communication; nurse performance Abstrak: Keperawatan merupakan bagian yang sangat vital dalam sistem pelayanan kesehatan di rumah sakit serta secara langsung berdampak pada kualitas layanan itu sendiri. Penelitian ini bertujuan menganalisis pengaruh budaya kerja, kepemimpinan, serta komunikasi terhadap kinerja perawat kontrak di Instalasi Rawat Inap Rumah Sakit Bhayangkara Tk. III Manado. Metode penelitian ialah eksplanatori melalui pendekatan kuantitatif. Populasi penelitian mencakup 110 perawat kontrak,…
creator: William S. Wangko
creator: Yanuar Jak
creator: Grace Rumengan
rights: Copyright (c) 2026 William S. Wangko, Yanuar Jak, Grace Rumengan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-03-27
publication date: 2026-03-27
volume: 14
number: 2
starting page: 264
ending page: 275
doi: 10.35790/ecl.v14i2.64242

Kasus Tonsilitis Akut dan Tonsilitis Kronik di RSUP Prof. Dr. R. D. Kandou Manado Periode 2022-2024
type: item
description: Abstract: Tonsillitis is an inflammation of the palatine tonsils that is commonly found in healthcare services and can be acute or chronic. Acute tonsillitis is generally self-limiting, while chronic tonsillitis is often associated with recurrent infections and impaired quality of life. This study aimed to determine the distribution of tonsillitis cases at Prof. Dr. R. D. Kandou General Hospital in Manado. This was a retrospective and descriptive study using total sampling method. The results showed 30 patients with acute tonsillitis (18.2%) and 135 patients with chronic tonsillitis (81.8%) at Prof. Dr. R. D. Kandou General Hospital Manado during the years 2022–2024. Males were the majority in both diseases (60% acute, 53.3% chronic tonsillitis). The adult age group dominated in both diseases (36.7% acute, 52.6% chronic tonsillitis). Fever was the most common symptom found in acute tonsillitis (73.3%), and painful swallowing (71.1%) in chronic tonsillitis. The most common tonsil size in acute tonsillitis was T2-T2 (53.3%) and T3-T3 (35.6%) in chronic tonsillitis. Medical management in the form of antibiotics was the most common treatment for both diseases (90% acute, 91.1% chronic tonsillitis), and tonsillectomy was the most common surgical procedure performed on patients with chronic tonsillitis (53.3%). In conclusion, chronic tonsillitis is more common than acute tonsillitis. There are differences in clinical and demographic characteristics between the two groups, which emphasize the importance of describing epidemiological profiles in optimizing the management of tonsillitis. Keywords: acute tonsillitis; chronic tonsillitis; clinical profile Abstrak: Tonsilitis merupakan inflamasi tonsil palatina yang sering ditemukan pada layanan kesehatan dan dapat bersifat akut maupun kronik. Tonsilitis akut umumnya bersifat self-limiting, sedangkan tonsilitis kronik sering berhubungan dengan infeksi berulang dan gangguan kualitas hidup. Penelitian ini bertujuan untuk mengetah…
creator: Sabastian L. P. Gultom
creator: Olivia C. P. Pelealu
creator: Valentini M. Pontoh
rights: Copyright (c) 2026 Sabastian L. P. Gultom, Olivia C. P. Pelealu, Valentini M. Pontoh https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-04-07
publication date: 2026-04-07
volume: 14
number: 2
starting page: 276
ending page: 282
doi: 10.35790/ecl.v14i2.65894

Stenosis Trakea Distal Jinak Berat Pasca Trakeostomi dengan Gagal Napas Hiperkapnik: Dilatasi Bougie Terpandu Bronkoskopi dan Trakeostomi Distal Terarah
type: item
description: Abstract: Tracheal stenosis is a progressive upper-airway obstruction, most commonly occurring after intubation or tracheostomy in adults. We reported a 24-year-old man with a history of tracheostomy and prior bronchoscopy presented with acute worsening dyspnea and inspiratory stridor. Pre-intubation arterial blood gas demonstrated compensated hypercapnia (pH 7.347; pCO₂ 80 mmHg) despite oxygen saturation of 100%. Chest X-ray showed no significant parenchymal abnormality, and neck CT excluded external compression, while bronchoscopy revealed benign granulation tissue occluding >90% of the distal tracheal lumen, consistent with severe distal tracheal stenosis (Cotton–Myer grade 3–4) complicated by hypercapnic respiratory failure. Management consisted of emergency airway stabilization with orotracheal intubation and ICU care, followed by bronchoscopic bougie dilatation and targeted tracheostomy distal to the stenosis. This case highlights the need for high clinical suspicion and a multidisciplinary, stepwise approach to secure ventilation and bridge to definitive therapy. Keywords: tracheal stenosis; bronchoscopy; tracheostomy; hypercapnic respiratory failure Abstrak: Stenosis trakea merupakan obstruksi jalan napas atas yang dapat progresif dan pada pasien dewasa paling sering terjadi pasca-intubasi atau pasca-trakeostomi. Kami melaporkan seorang laki-laki 24 tahun dengan riwayat trakeostomi dan bronkoskopi sebelumnya, datang dengan sesak mendadak memberat disertai stridor inspirasi dan rasa tercekik. AGD pra-intubasi menunjukkan hiperkapnia terkompensasi (pH 7,347; pCO₂ 80 mmHg) dengan saturasi oksigen 100%. Foto toraks tidak menunjukkan kelainan parenkim bermakna dan CT colli tidak menemukan kompresi eksternal, sedangkan bronkoskopi memperlihatkan jaringan granulasi jinak yang menutup >90% lumen trakea distal. Pasien didiagnosis stenosis trakea distal jinak derajat berat setara Cotton–Myer 3–4 dengan gagal napas hiperkapnik. Tata laksana dilakukan secara bertahap me…
creator: Ronald D. Tampubolon
creator: Barry I. Kambey
creator: Mordekhai L. Laihad
creator: Efata B. I. Polii
rights: Copyright (c) 2026 Ronald D. Tampubolon, Barry I. Kambey, Mordekhai L. Laihad, Efata B. I. Polii https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-04-12
publication date: 2026-04-12
volume: 14
number: 2
starting page: 283
ending page: 289
doi: 10.35790/ecl.v14i2.65878

Gambaran Pasien Sumbing Bibir dan Langit-langit di RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022-2025
type: item
description: Abstract: Cleft lip and palate are the most common congenital abnormalities of the face resulting from incomplete fusion of the upper lip or roof of the mouth during fetal development. This study aimed to determine the general characteristics of cleft lip and palate, such as gender, age, type of disorder, type of cleft, location of defect, etiology, clinical type, management, and complications. This was a retrospective and descriptive study using medical records of patients with cleft lip and palate. The results showed that most patients were male (51.47%), and age group undergoing surgery being 0-4 years (61.76%). The most common type of abnormality was cleft lip and palate (58.82%), with complete cleft type (48.53%), and most defects occurred on the left side (38.24%). The most common cause was family history (25%), most patients were non-syndromic (79.10%), surgery had been performed (89.71%), and most had no complications (90.16%). In conclusion, patients with cleft lip and palate were predominantly male, underwent surgery at the age of 0-4 years, had a combination of cleft lip and palate, had a complete cleft, occurred on the left side, had a family history, non-syndromic, underwent surgical treatment, and had no complications. Keywords: cleft lip; cleft palate; congenital abnormality Abstrak: Sumbing bibir dan langit-langit merupakan kelainan bawaan paling umum pada wajah akibat tidak sempurnanya penyatuan jaringan bibir atas atau langit-langit mulut selama perkembangan janin. Penelitian ini bertujuan untuk mengetahui gambaran umum terkait sumbing bibir dan langit-langit seperti jenis kelamin, usia, jenis kelainan, tipe celah, lokasi defek, etiologi, tipe klinis, penatalaksanaan, dan komplikasi. Jenis penelitian ini ialah deskriptif retrospektif dengan menggunakan data rekam medis pasien sumbing bibir dan langit-langit. Hasil penelitian memperlihatkan bahwa sebagian besar pasien ialah laki-laki (51,47%), dengan kelompok usia 0-4 tahun (61,76%). Jenis kelainan …
creator: Ricardo F. Langingi
creator: Mendy J. Hatibie
creator: Rangga B. V. Rawung
rights: Copyright (c) 2026 Ricardo F. Langingi, Mendy J. Hatibie, Rangga B. V. Rawung https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-04-13
publication date: 2026-04-13
volume: 14
number: 2
starting page: 290
ending page: 295
doi: 10.35790/ecl.v14i2.66296

Profil Pasien Dewasa dengan Gangguan Pendengaran di Poliklinik THT-KL RSUP Prof. Dr. R. D. Kandou
type: item
description: Abstract: Hearing loss can affect individuals of all ages and has significant impacts on communication, social functioning, and overall quality of life. Its prevalence continues to rise with advancing age and exposure to various risks factors. This study aimed to obtain the profile of patients with hearing loss at the ENT clinic of Prof. Dr. R. D. Kandou General Hospital during the 2023 to 2024 period. This was a descriptive retrospective study using electronic medical record data that met the inclusion criteria. The analyzed variables included age, sex, residence, occupation, diagnosis, type of hearing loss, severity of hearing loss, and management. Data were presented as frequency and percentage distributions. The results obtained a total of 134 patients that met the inclusion criteria. The highest percentages of distribution were adult age group (50.75%), male patients (52.24%), from outside of Manado City (67.16%), occupation as housewife (29.10%), diagnosed as hearing loss (38.81%), followed by chronic suppurative otitis media (21.64%) and impacted cerumen (11.19%). Mixed hearing loss was the predominant type (48.51%), and severe level of hearing loss (34.32%). The most frequent management provided was hearing aids (59.70%). In conclusion, the majority of hearing loss cases were mixed hearing loss with severe level. The majority of patients were male in the adult age group and recieved hearing aids. Keywords: types of hearing loss; mixed hearing loss Abstrak: Gangguan pendengaran dapat dialami semua kelompok usia dan berdampak pada komunikasi, fungsi sosial, serta kualitas hidup. Prevalensi kondisi ini terus meningkat dengan bertambahnya usia dan paparan faktor risiko. Penelitian ini bertujuan untuk mendeskripsikan profil pasien gangguan pendengaran pada orang dewasa di Poliklinik THT-KL RSUP Prof. Dr. R. D. Kandou Manado periode 2023-2024. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medis elektronik pasien yang memenuhi kriteria inklu…
creator: Yves Villeneuve
creator: Moudi M. Mona
creator: Steward K. Mengko
rights: Copyright (c) 2026 Yves Villeneuve, Moudi M. Mona, Steward K. Mengko https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-04-19
publication date: 2026-04-19
volume: 14
number: 2
starting page: 296
ending page: 301
doi: 10.35790/ecl.v14i2.65954

Penetrating Neck Trauma Involving Zone I: Surgical Intervention and Outcomes
type: item
description: Abstract: Penetrating neck injuries (PNI) are injuries that penetrate the platysma and represent a major cause of morbidity and mortality due to the vital structures confined in the neck area. They account for approximately 5–10 % of all trauma cases presenting to the emergency department. Depending on the depth of penetration and anatomy of trachea, the deeper the penetration, the bigger chance that tissues surrounding the trachea to be injured, causing complications including the lungs. We reported a male patient presented with respiratory distress approximately eight hours after sustaining a penetrating neck wound. Initially, he was fully conscious but had difficulty in breathing. Physical examination revealed low oxygen saturation, lagging movement of the right chest wall, dull right lungs percussion, absence of right vesicular breath sound, mild anemia, subcutaneous emphysema, and an anterior neck wound (3x2 cm) with no active bleeding. C-spine control, intubation and chest tube were performed. Chest auscultation identified persistent ronchi in the right lung. Imaging confirmed subcutaneous emphysema (C2-C7), right hemothorax, and tracheal rupture. Surgical intervention included wound explorationand tracheostomy. A vertical rupture involving the anterior tracheal rings (4–6) was identified and managed with a tracheal cannula. No posterior tracheal injury was found. Postoperatively, the patient showed improved airway patency with subsiding emphysema, though right lung expansion remained limited. In conclusion, this case highlights the proximity of vital structures poses challenges in surgical access, underscoring the need for meticulous airway management and postoperative monitoring. Keywords: pentrating neck trauma; tracheal rupture; subcutaneous emphysema; hemothorax
creator: Nico Lumintang
creator: Rigel K. Paat
creator: Marturia I. Aruperes
rights: Copyright (c) 2026 Nico Lumintang, Rigel K. Paat, Marturia I. Aruperes https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-01
publication date: 2026-05-01
volume: 14
number: 2
starting page: 302
ending page: 307
doi: 10.35790/ecl.v14i2.66771

Analisis Pengaruh Motivasi Keluarga dan Kepatuhan Rehabilitasi Terhadap Kemandirian Pasien Pasca Stroke di Rumah Sakit Bhayangkara Tk. III Manado
type: item
description: Abstract: This study aimed to evaluate whether patients' levels of family motivation and rehabilitation compliance affect their ability to live independently after stroke at Rumah Sakit Bhayangkara Tingkat III Manado. This was a quantitative study using a cross-sectional and an analytical survey design. By using quota sampling, 63 hospitalised stroke patients receiving rehabilitation were chosen as the respondents. For this study, we relied on validated and reliable questionnaires to gather data. A multiple linear regression analysis was run on the data in order to determine the impact of each independent variable on the dependent variable. The results showed that patients' levels of independence after stroke were significantly impacted by both family motivation and rehabilitation compliance. The combined effect of family motivation and rehabilitation also significantly contributed to improvement of patient independence. In conclusion, optimal family support and strong rehabilitation adherence are crucial factors in enhancing post-stroke patient independence. Recommendations for the hospital include enhancing family education programs and support to encourage rehabilitation adherence and integrating family-centered approaches in rehabilitation services. Future research is encouraged to explore other variables that may influence post-stroke patient independence. Keywords: family motivation; rehabilitation adherence; patient independence Abstrak: Studi ini bertujuan untuk mengetahui tingkat motivasi keluarga dan kepatuhan rehabilitasi pasien terhadap kemampuan hidup mandiri pasca stroke di Rumah Sakit Bhayangkara Tingkat III Manado. Penelitian ini menggunakan metodologi kuantitatif dengan desain potong lintang dan survei analitik. Dengan menggunakan quota sampling, dipilih 63 pasien stroke rawat inap yang menerima rehabilitasi sebagai responden penelitian ini. Pada penelitian ini, digunakan kuesioner yang telah divalidasi dan dapat diandalkan untuk mengumpulkan data. …
creator: Chandra Tanoeisan
creator: Yanuar Jak
creator: Grace Rumengan
rights: Copyright (c) 2026 Chandra Tanoeisan, Yanuar Jak, Grace Rumengan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-06
publication date: 2026-05-06
volume: 14
number: 2
starting page: 308
ending page: 316
doi: 10.35790/ecl.v14i2.67067

Gambaran Karakteristik Pasien Anak dengan Epilepsi di RSUP Prof. Dr. R. D. Kandou Manado
type: item
description: Abstract: Epilepsy is a neurological disorder with a high incidence rate in children, characterized by recurrent seizures due to abnormal electric activity in the brain, which disrupts brain function and affects children's mental health, thinking abilities, and social interactions. This study aimed to determine the characteristics of pediatric patients with epilepsy in the Department of Pediatrics, Prof. Dr. R. D. Kandou General Hospital, Manado. This was a retrospective and descriptive study with a cross-sectional approach based on the medical records of pediatric patients aged 1–17 years during the periods of 2023–2024. The variables studied included age, gender, seizure type, EEG results, and the administered antiepileptic therapy. The results showed that out of 60 pediatric patients with epilepsy, there was an increase in cases from 24 patients (2023) to 36 patients (2024), with the largest age group being 1–4 years (48.3%) and the majority being male (58.3%). The most common type of seizure was focal seizures (73.3%), and abnormal EEG results were found in 93.3% of patients. Most patients received monotherapy (78.3%), mainly valproic acid (58.3%), while the most common combination in polytherapy was valproic acid and levetiracetam (8.3%). In conclusion, epilepsy in children at Prof. Dr. R. D. Kandou General Hospital in Manado was most commonly found in males aged 1–4 years with focal seizures, abnormal EEG results, and the most common therapy being valproic acid. Keywords: epilepsy; children; therapies for epilepsy Abstrak: Epilepsi merupakan gangguan neurologis dengan angka kejadian yang tinggi pada anak, ditandai dengan kejang berulang akibat aktivitas listrik di otak yang abnormal, sehingga mengganggu fungsi otak dan berdampak pada kesehatan mental, kemampuan berpikir, serta interaksi sosial anak. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik pasien anak dengan epilepsi di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Manado. Pene…
creator: Astrid Zafira
creator: Praevilia M. Salendu
creator: Suryadi N. N. Tatura
rights: Copyright (c) 2026 Astrid Zafira, Praevilia M. Salendu, Suryadi N. N. Tatura https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-27
publication date: 2026-05-27
volume: 14
number: 2
starting page: 317
ending page: 321
doi: 10.35790/ecl.v14i2.66622

Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang Pelayanan Obstetri Neonatal Emergensi Komprehensif dan Kamar Bersalin RSIA Kirana Manado
type: item
description: Abstract: Healthcare-Associated Infections (HAIs) and antibiotic resistance are serious threats in healthcare facilities. Mapping bacterial patterns and antibiotic susceptibility profiles in the hospital environment is crucial for infection prevention and control. This study aimed to identify the pattern of aerobic bacteria and antibiotic sensitivity of the bacteria found in the Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) unit and delivery rooms of RSIA Kirana Manado. This was a descriptive observational study with a cross-sectional design. A total of 25 samples were taken from surfaces (walls, floors, equipment) and air in the two rooms. Bacterial identification used Gram staining and biochemical tests, followed by antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method against 11 antibiotics. All samples showed the growth of Gram-positive aerobic bacteria. The identified bacteria were Bacillus sp. (44%), Staphylococcus sp. (40%), Streptococcus sp. (8%), and Lactobacillus sp. (8%). The susceptibility test showed high sensitivity to gentamicin, meropenem, and ciprofloxacin. Conversely, high resistance was found against various β-lactam antibiotics such as ampicillin, amoxicillin/clavulanate, cephalothin, cefepime, and aztreonam. In conclusion, dominant aerobic bacterial patterns, Bacillus sp. and Staphylococcus sp., and their antibiotic susceptibility profiles were identified in the CEmONC unit and delivery room environment of RSIA Kirana Manado. Keywords: aerobic bacteria; antibiotic susceptibility test; CEmONC unit; delivery room Abstrak: Healthcare-Associated Infections (HAIs) dan resistensi antibiotik merupakan ancaman serius di fasilitas Kesehatan. Pemetaan pola bakteri dan kepekaan antibiotik di lingkungan rumah sakit sangat penting untuk pencegahan dan pengendalian infeksi. Penelitian ini bertujuan mengidentifikasi pola bakteri aerob dan uji sensitivitas antibiotik pada bakteri yang ditemukan di ruang PONEK dan kamar ber…
creator: Misael N. Suhanto
creator: Heriyannis Homenta
creator: Fredine E. S. Rares
rights: Copyright (c) 2026 Misael N. Suhanto, Heriyannis Homenta, Fredine E. S. Rares https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-28
publication date: 2026-05-28
volume: 14
number: 2
starting page: 322
ending page: 326
doi: 10.35790/ecl.v14i2.67144

Perbandingan Luaran Fungsional Pasien Pasca Rekonstruksi ACL dengan Autograft Hamstring dan Autograft Peroneus Longus
type: item
description: Abstract: Anterior cruciate ligament (ACL) reconstruction aims to restore knee stability and function after injury. The choice of autograft is an important factor in influencing postoperative functional outcomes. Hamstring autografts are commonly used, but the peroneus longus is now often used as a promising alternative because of its similar tendon strength and lower donor site morbidity. This study aimed to compare the functional outcomes of patients with post ACL reconstruction using hamstring autograft and those using peroneus longus autograft. This was a comparative analytical study involving 51 patients who underwent ACL reconstruction at Prof. Dr. R. D. Kandou General Hospital with a follow-up period of ≥6 months. Functional outcomes were assessed using the IKDC, Lysholm, and ACL-RSI questionnaires and analyzed using the independent sample t-test (p<0.0167). Most patients were males aged 19–44 years with sports-related injuries (72.5%). Peroneus longus autograft (51%) showed lower donor site complications and morbidity without significant differences in IKDC (p=0.685), Lysholm (p=0.356), and ACL-RSI (p=0.653) scores. In conclusion, the peroneus longus autograft is a viable and effective alternative in ACL reconstruction procedures, as it provides functional outcomes comparable to hamstring autografts. Keywords: functional outcome; hamstring autograft; peroneus longus autograft Abstrak: Rekonstruksi Anterior Cruciate Ligament (ACL) bertujuan memulihkan stabilitas dan fungsi lutut pasca cedera. Pemilihan autograft menjadi faktor penting dalam memengaruhi luaran fungsional pascaoperasi. Autograft hamstring umum digunakan, namun autograft peroneus longus kini sering digunakan sebagai alternatif menjanjikan karena kekuatan tendon serupa dan morbiditas donor site lebih rendah. Penelitian ini bertujuan untuk membandingkan luaran fungsional pasien pasca rekonstruksi ACL menggunakan autograft hamstring dengan autograft peroneus longus. Metode penelitian analitik kompa…
creator: Marselinda M. Mulalinda
creator: Rangga B. V. Rawung
creator: Harsali F. Lampus
rights: Copyright (c) 2026 Marselinda M. Mulalinda, Rangga B. V. Rawung, Harsali F. Lampus https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-05-28
publication date: 2026-05-28
volume: 14
number: 2
starting page: 327
ending page: 332
doi: 10.35790/ecl.v14i2.67068

Karakteristik Pasien Serumen Obturans di Poliklinik THT-BKL Rumah Sakit R. D. Kandou Manado Periode 2023-2024
type: item
description: Abstract: Cerumen plays an important role in protecting the ears and maintaining ear hygiene and health. In some cases, cerumen can accumulate and form a mass that can cause ear canal blockage, known as impacted cerumen. This study aimed to obtain the characteristics of patients with impacted cerumen. This was a descriptive retrospective study that using medical record data of patients with impacted cerumen at the ear nose throat, head and neck surgery polyclinic at Prof. Dr. R. D. Kandou General Hospital in Manado from 2023 to 2024. The results showed that of the total 474 research samples, the majority were male patients (60.34%) and the rest were female patients (39.66%), with the largest age group being children aged 0-9 years (50%), who had no history of ear infection (93.04%) and no anatomical factors affecting the formation of impacted cerumen (97.89%). The most commonly used treatment, either alone or in combination, was irrigation (72.78%). In conclusion, the majority of samples were male patients, mostly children (aged 0-9 years), with no history of ear infections and no anatomical factors that could affect impacted cerumen. The most common treatment was irrigation. Keywords: impacted cerumen; history of ear infections; anatomical factors, cerumenolytic, irrigation, suction, extraction Abstrak: Serumen berperan penting dalam melindungi telinga serta menjaga kebersihan dan kesehatan telinga. Pada beberapa kasus, serumen dapat menumpuk dan membentuk massa yang dapat menyebabkan penyumbatan liang telinga atau disebut dengan serumen obturans. Penelitian ini bertujuan untuk mengetahui karakteristik pasien serumen obturans. Metode penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik pasien serumen obturans di poliklinik THT-BKL RSUP Prof. Dr. R. D. Kandou Manado periode 2023-2024. Hasil penelitian mendapatkan dari total 474 sampel penelitian, mayoritas merupakan pasien laki-laki (60,34%) dan sisanya merupakan pasien perempuan (39,66%), de…
creator: Erlan S. Dama
creator: Olivia C. P. Pelealu
creator: Rizki R. Najoan
rights: Copyright (c) 2026 Erlan S. Dama, Olivia C. P. Pelealu, Rizki R. Najoan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-06-12
publication date: 2026-06-12
volume: 14
number: 2
starting page: 333
ending page: 338
doi: 10.35790/ecl.v14i2.66298