e-CliniC
type: channel
description: 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).
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: Scrotalis Fibrolipoma: A Case Report
items: Radical Parotidectomy and Neck Dissection on Carcinoma Parotid Dextra with Lymph Node Bilateral Metastasis: A Case Report
items: Profil Kasus Abses Leher Dalam dengan Diabetes Melitus
items: Efektivitas Suplementasi Vitamin C Terhadap Penurunan Kadar Il-6 Serum dan Aktivitas Penyakit Pasien Lupus Eritematosus Sistemik
items: Faktor Risiko Diare Akut pada Bayi Usia 0-12 Bulan di RSUP Prof. Dr. R. D. Kandou
items: Congenital Chylous Ascites Associated with Polycystic Kidney Disease: A Case Report
items: Cranioplasty after 25 Years of Implant Rejection
items: Correlation between Arterial Feeding Embolization and Pleural Effusion Dynamics in Breast Cancer Patients
items: Prediksi Apendisitis dengan Komplikasi Menggunakan Systemic Inflammation Response Index dan Systemic Immune-Inflamation Index
items: In Vitro Antibacterial Effectiveness of Stingless Bee Propolis against Infected Breast Cancer Ulcer
items: Faktor-faktor yang Memengaruhi Fungsi Anus setelah Prosedur PSARP pada Pasien Malformasi Anorektal
items: Implementasi Critical Care Outreach Team (CCOT) di Rumah Sakit Sentra Medika Minahasa Utara
items: Partial Intestinal Obstruction Caused by Left Diaphragmatic Hernia: A Case Report
items: Dampak Perundungan terhadap Kesehatan Mental Mahasiswa Fakultas Kedokteran
items: Clinical Characteristics and Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in the Last Five Years at Prof. Dr. R. D. Kandou Hospital
items: Profil Kasus Kematian Mendadak di RSUP Prof. Dr. R. D. Kandou Manado pada Tahun 2022-2024
items: Perbandingan Luaran Open Surgical Repair dan Endovascular Aneurysm Repair pada Pasien Aneurisma Aorta Abdominalis di Asia
items: Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang UGD dan Kamar Operasi RSIA Kirana Manado
items: Perubahan Kadar Asam Urat dan Estimasi Laju Filtrasi Glomerulus pada Pasien Penyakit Ginjal Kronis yang Menggunakan Terapi Alopurinol
items: Faktor-Faktor yang Berhubungan dengan Tingkat Stres Mahasiswa Profesi Dokter (Co-Assistant) di RSUP Prof. Dr. R. D. Kandou Manado
items: Profil Kasus Luka Bakar di Rumah Sakit Bhayangkara Tingkat III Manado Tahun 2023 – 2024
items: Gambaran Enuresis pada Anak Sekolah Dasar
items: Profil Kasus Benda Asing Saluran Cerna di Bagian Bedah Anak RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2021 – Juli 2025
items: Gambaran Kejadian Bullying dan Aspek Mental Siswa Sekolah Dasar Kelas 5 dan 6

Scrotalis Fibrolipoma: A Case Report
type: item
description: Abstract: Fibrolipoma is a rare histological subtype of scrotal lipoma and is often a benign mesenchymal neoplasm. Management of this tumor such as surgical excision provides histopathological diagnosis and resolution of symptoms. We reported a case of 44-year-old male who complained of slow growing and painless mass in the right hemiscrotum. The clinical appearance was a mass with firm boundary, smooth surface, dense and tending to be hard with a size of 20 cm x 20 cm x 8 cm. In this case we performed a simple orchiectomy, and histopathological examination of a fibrolipoma had been carried resulting in no malignant cells were found. Although fibrolipomas are histologically benign, regarding their natural history postoperative follow-up is suggested. During postoperative observation, the wound was well maintained and the patient's mobilization was also good. No signs of infection were found, and the pain was still within normal threshold. In conclusion, simple orchiectomy provides histopathological diagnosis and resolution of symptoms. Keywords: fibrolipoma; scrotum; benign tumor, orchiectomy
creator: Brian Sugito
creator: Priscilia Kalitouw
creator: Ferry Kalitouw
rights: Copyright (c) 2025 Brian Sugito, Priscilia Kalitouw, Ferry Kalitouw https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-04
publication date: 2025-09-04
volume: 14
number: 1
starting page: 1
ending page: 4
doi: 10.35790/ecl.v14i1.63139

Radical Parotidectomy and Neck Dissection on Carcinoma Parotid Dextra with Lymph Node Bilateral Metastasis: A Case Report
type: item
description: Abstract: Malignant salivary gland is a rare gland tumor, with parotid gland as the most common site. Parotidectomy for parotid gland malignancy includes management of primary salivary cancer, metastatic lymph nodes, and direct extension from surrounding structures or cutaneous malignancies. We reported a 66-year-old male referred to the hospital because of a lump at the bottom of the right ear three months ago. The lump got more significant day by day and suddenly it felt progressively enlarged. The patient complained of pain in the lump. The tumor size was 10x4 cm, immobile, fixed to underlying tissue, and had the same color as the surrounding skin. Ultrasonography showed lymphadenopathy at the right side of neck with multiple malignant node metastasis. Therefore, a radical parotidectomy was performed on this patient. The histopathological examination obtained squamous cell carcinoma identified as keratinized. After the surgery, the patient complained of right facial weakness. The patient then underwent medical rehabilitation for further treatment of his facial weakness. In conclusion, the malignancy of the parotid gland was uncommon, hosting the majority of all salivary gland tumors are benign. Successful management depends on prompt diagnosis, accurate histopathological evaluation, and a comprehensive multidisciplinary approach to develop optimal treatment plans. Keywords: malignancy of parotid gland; radical parotidectomy; neck dissection
creator: Nico Lumintang
creator: Sherly Tandililing
creator: Elisse S. Susilo
rights: Copyright (c) 2025 Nico Lumintang, Sherly Tandililing, Elisse S. Susilo https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-07
publication date: 2025-09-07
volume: 14
number: 1
starting page: 5
ending page: 9
doi: 10.35790/ecl.v14i1.63721

Profil Kasus Abses Leher Dalam dengan Diabetes Melitus
type: item
description: Abstract: Deep neck abscess (DNA) is a collection of pus in the deep neck space due to deep neck infection, this disease has rapid disease progression. In patients with diabetes mellitus (DM), there is a decrease in immune response, therefore, they are susceptible to infection. This study aimed to obtain the profile of DNA in patients with DM. This was a systematic literature review using the PICOS framework selection criteria. The results showed that based on the 10 literatures, the majoruty of patients were male, and the most frequent age groups were 44-60 years and 60-75 years. Tonsil infections, poor oral-hygiene, and odontogenic infection could increase the risk of having DNA. The most common pathogen to be found was Klebsiella pneumoniae. Patients with DM tended to have a longer length of stay compared to the patients who did not suffer from DM. In conclusion, deep neck abscess patients with DM tend to be found in males with older ages. The most commmon etiology and pathogen is odontogenic infection and Klebsiella pneumoniae. Diabetic patients with deep neck abscess tend to have longer length of stay compared to those without diabetes mellitus. Keywords: deep neck abscess; diabetes mellitus; Klebsiella pneumoniae Abstrak: Abses leher dalam (deep neck abscess/DNA) merupakan penumpukan pus di ruang leher dalam akibat infeksi leher dalam, yang memiliki progresivitas penyakit yang cepat. Pada pasien diabetes melitus (DM) terjadi penurunan respon imun sehingga pasien DM rentan terhadap infeksi. Penelitian ini bertujuan untuk memaparkan profil kasus DNA dengan DM. Jenis penelitian ialah systematic literature review dengan kriteria seleksi PICOS framework. Hasil penelitian mendapatkan 10 literatur. Mayoritas pasien DNA ialah ialah laki-laki, dan rentang usia 44-60 dan 60-75 tahun. Infeksi tonsil, kebersihan oral yang buruk, dan infeksi odontogenik dapat meningkatkan risiko DNA. Patogen yang sering menjadi penyebab infeksi ialah Klebsiella pneumoniae. Pasien DNA denga…
creator: Sontiar P. Mawar
creator: Rizki R. Najoan
creator: Steward K. Mengko
rights: Copyright (c) 2025 Sontiar P. Mawar, Rizki R. Najoan, Steward K. Mengko https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-09-10
publication date: 2025-09-10
volume: 14
number: 1
starting page: 10
ending page: 15
doi: 10.35790/ecl.v14i1.63725

Efektivitas Suplementasi Vitamin C Terhadap Penurunan Kadar Il-6 Serum dan Aktivitas Penyakit Pasien Lupus Eritematosus Sistemik
type: item
description: Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and its activity is related to interleukin-6 (IL-6) level. Lowering IL-6 levels can help to achieve remission. Vitamin C has antioxidant and immunomodulatory properties that have the potential to lower IL-6 level. However, research on vitamin C in SLE patients, especially in Indonesia, is still very limited. This study aimed to determine the effectiveness of vitamin C supplementation in reducing serum IL-6 levels and disease activity in SLE patients. This was a double-blind randomized controlled trial conducted on 34 patients with mild–moderate SLE at Dr. Mohammad Hoesin General Hospital. Subjects were divided into two groups namely intervention (vitamin C 2 x 500 mg/day) and control (placebo) groups, for eight weeks. Serum IL-6 levels and disease activity scores (Mex-SLEDAI) were measured before and after the intervention. The results showed that the vitamin C group had a significant decrease in serum IL-6 levels compared to placebo group, from a median of 6.46 (3.5–14.4) to 3.5 (3.5–8.36) pg/mL (p=0.001), while in the placebo group decreased from 3.7 (3.5–6.45) to 3.9 (3.5–14) pg/mL (p=0.136). The decrease in Mex-SLEDAI scores was statistically more significant in the vitamin C group compared to the placebo group (p=0.048). In conclusion, vitamin C 2x500 mg/day supplementation for eight weeks effectively reduces serum IL-6 levels and disease activity in mild–moderate SLE patients. Keywords: systemic lupus erythematosus; MEX-SLEDAI; vitamin C supplementation; interleukin 6 Abstrak: Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronik yang derajat aktivitasnya berkaitan dengan kadar interleukin-6 (IL-6). Penurunan kadar IL-6 dapat membantu dalam mencapai remisi. Vitamin C memiliki sifat antioksidan dan imunomodulator yang berpotensi menurunkan kadar IL-6, namun, penelitian mengenai vitamin C pada pasien LES khususnya di Indonesia masih sangat terbatas. Penelitian ini bertuju…
creator: Ady F. Saragih
creator: Nova Kurniati
creator: Theodorus Theodorus
creator: Eddy M. Salim
creator: Yuniza Yuniza
rights: Copyright (c) 2025 Ady F. Saragih, Nova Kurniati, Theodorus Theodorus, Eddy M. Salim, Yuniza Yuniza https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-10
publication date: 2025-10-10
volume: 14
number: 1
starting page: 16
ending page: 21
doi: 10.35790/ecl.v14i1.63617

Faktor Risiko Diare Akut pada Bayi Usia 0-12 Bulan di RSUP Prof. Dr. R. D. Kandou
type: item
description: Abstract: Acute diarrhea is a condition of defecation with stool consistency decreasing from loose to liquid three or more times a day, without mucus and blood, with a duration of less than seven days and not more than 14 days. Risk factors for acute diarrhea include low birth weight (LBW), maternal age at delivery, nutritional status, breastfeeding history, and previous antibiotic use. This study aimed to determine risk factors associated with the occurrence of acute diarrhea in infants at Prof. Dr. R. D. Kandou Hospital. This was an observational and analytic study with a cross sectional design. Data were obtained using the medical record data. Total sampling was used for acute diarrhea cases and exclusive sampling for acute diarrhea controls. Data were analyzed with chi-square test and binary logistic regression test with computerized assistance. The results showed that there was a significant relationship between previous antibiotic use and the incidence of acute diarrhea (p=0.034), meanwhile there was no significant relationship between LBW (p=0.440), maternal age at delivery (p=0.801), nutritional status (p=0.799), and breastfeeding history (p=0.404) to the incidence of acute diarrhea. In conclusion, previous antibiotic use can increase the risk of acute diarrhea in infants aged 0-12 months at Prof. Dr. R. D. Kandou Hospital. Keywords: acute diarrhea; low birth weight; maternal age at delivery; nutritional status; breastfeeding history; previous antibiotic use Abstrak: Diare akut adalah kondisi buang air besar dengan konsistensi tinja menurun dari melembek sampai menjadi cair sebanyak tiga kali atau lebih dalam sehari, tanpa disertai lendir dan darah, dengan durasi kurang dari 7 hari dan tidak lebih dari 14 hari. Faktor risiko dari diare akut termasuk berat badan lahir rendah (BBLR), usia ibu saat melahirkan, status gizi, riwayat pemberian air susu ibu (ASI), dan penggunaan antibiotik sebelumnya. Penelitian ini bertujuan untuk mengetahui faktor risiko yang ber…
creator: Felix Natanael
creator: Jeanette I. C. Manoppo
creator: Rocky Wilar
rights: Copyright (c) 2025 Felix Natanael, Jeanette I. C. Manoppo, Rocky Wilar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-10-23
publication date: 2025-10-23
volume: 14
number: 1
starting page: 22
ending page: 27
doi: 10.35790/ecl.v14i1.63138

Congenital Chylous Ascites Associated with Polycystic Kidney Disease: A Case Report
type: item
description: Abstract: Congenital chylous ascites is a rare condition caused by abnormalities in the lymphatic system, leading to the leakage of triglyceride-rich lymphatic fluid into the peritoneal cavity. The etiologies include congenital lymphatic malformations, lymphatic obstruction, or increased intra-abdominal pressure. Polycystic kidney disease (PKD) is suspected to impair lymphatic drainage due to elevated intra-abdominal pressure, causing chylous fluid accumulation.. We reported a 16-day-old female neonate born via cesarean section at 38 weeks of gestation due to hydrops fetalis. The infant presented with progressive abdominal distension. Abdominal ultrasound revealed massive ascites, a cystic mass in the left adnexa, and bilateral polycystic kidneys, suggesting secondary lymphatic obstruction. Babygram imaging confirmed significant abdominal distension without intestinal obstruction or skeletal anomalies. Ascitic fluid analysis confirmed its chylous nature, with no signs of malignancy or active infection. Laboratory tests revealed mild anemia, hypoalbuminemia, and elevated inflammatory markers.The underlying pathophysiology in this case suggests that PKD led to secondary lymphatic obstruction due to increased intra-abdominal pressure. The patient underwent ascites drainage using a pigtail catheter, fluid and electrolyte management, analgesics, and antibiotics. After 10 days post-intervention, the infant's condition showed gradual improvement, with reduced abdominal distention, stable respiratory function, and no signs of infection or further complications. In conclusion, congenital chylous ascites in neonates may be secondary to conditions like PKD, which cause lymphatic drainage impairment. Early diagnosis and comprehensive management are essential to prevent long-term complications and optimize outcomes in affected neonates. Keywords: congenital chylous ascites; polycystic kidney disease; neonate; lymphatic obstruction; ascitic fluid analysis
creator: Candy Candy
creator: Harsali F. Lampus
creator: Odwin B. Saumur
rights: Copyright (c) 2025 Candy Candy, Harsali F. Lampus, Odwin B. Saumur https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-10
publication date: 2025-12-10
volume: 14
number: 1
starting page: 28
ending page: 33
doi: 10.35790/ecl.v14i1.63866

Cranioplasty after 25 Years of Implant Rejection
type: item
description: Abstract: Cranioplasty is a common neurosurgical procedure performed to reconstruct cranial defects. Failure of cranioplasty may be early or delayed and further can be attributed to the surgical procedure itself or to the reconstruction material used for the procedure. We reported a 54-year-old man came to the clinic with wound and defect in his scalp. He had previous craniectomy 25 years ago due to an accident that caused a head injury. The size of the wound was 10 x 10 cm with granulation tissue at the base of the wound. There was no discharge at the site of the wound. In physical examination, vital sign was normal, laboratory examination showed slight leukocytosis. Cranioplasty surgery was performed to reconstruct the scalp defect. Implant failure was found characterized by pain at the implant site, erythema, and fever. Therefore, cranioplasty implant rejection was diagnosed. Reconstructive cranioplasty with titanium mesh was done a week later. Thirty years ago, PMMA maybe the most available biomaterial, however, disadvantages may occur such as infections, extrusion, decomposition, fracture of implant in larger defect, and lack of integration to the bone. Spontaneous implementation of the biomaterials leads to CIR, and without proper resolution under two weeks it leads to a foreign body response (FBR) and chronic inflammation. Hence in this study, the use of titanium mesh can overcome those disadvantages, with lower risk of infection, non-corrosive, non-inflammatory, good cosmetic results and great potential of osseointegration. In conclusion, materials in cranioplasty should be considered and follow up regularly and well. Cranioplasty implant rejection was a known complication risk that can leads to chronic inflammation. Associated symptoms including pain, erythema and fever. Using synthetic implants with non-inflammatory and great osseointegration characteristics can lead to great results as shown in this case. Keywords: cranioplasty; implant; rejection
creator: Dennis M. Frederik
creator: Mendy J. Hatibie
creator: Stevy C. Suoth
creator: Eko Prasetyo
creator: Maximillian C. Oley
creator: Ferdinan Tjungkagi
creator: Yovanka N. Manuhutu
rights: Copyright (c) 2025 Dennis M. Frederik, Mendy J. Hatibie, Stevy C. Suoth, Eko Prasetyo, Maximillian C. Oley , Ferdinan Tjungkagi, Yovanka N. Manuhutu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-10
publication date: 2025-12-10
volume: 14
number: 1
starting page: 34
ending page: 40
doi: 10.35790/ecl.v14i1.63865

Correlation between Arterial Feeding Embolization and Pleural Effusion Dynamics in Breast Cancer Patients
type: item
description: Abstract: Breast cancer is the most common malignancy in women and a leading cause of malignant pleural effusion (MPE). Arterial feeding embolization, as performed in transarterial chemo-embolization (TACE), has the potential to reduce effusion production by obstructing tumor blood supply. This study aimed to evaluate the correlation between arterial embolization and pleural effusion dynamics in patients with breast cancer. This was a prospective cohort study conducted at Prof. Dr. R. D. Kandou Hospital, Manado, from 2022 to 2024. Patients diagnosed with breast cancer were randomly assigned to the TACE or control group. Superselective embolization was performed using a microcatheter and a selected embolic agent to occlude the blood supply to the target lesion. Data were analyzed using SPSS v26 with Shapiro-Wilk normality test, t-test or Mann-Whitney U test, and linear regression. Study phases included subject selection, randomization, and data analysis. The results showed that a total of 21 female patients with breast cancer (mean age 52.19±9.17 years) were enrolled. Eleven patients (52.4%) underwent TACE, while ten (47.6%) did not. Pleural effusion was observed in four patients (19%), more frequently in the non-TACE group (30%) compared to the TACE group (9.1%), though the difference was not statistically significant (p=0.439). Multivariate analysis also revealed no significant association between arterial embolization and pleural effusion (p=0.244; R²=0.071), indicating a low predictive value. Arterial feeding embolization via TACE demonstrated clinical potential in reducing pleural effusion among breast cancer patients, although the results were not statistically significant. The limited efficacy may be attributed to the complex tumor vascularization and heterogeneous biological responses. A multimodal therapeutic approach remains necessary for optimal MPE management. In conclusion, although arterial embolization may clinically reduce tumor perfusion and subseque…
creator: Edward Iskandar
creator: Adrian Tangkilisan
creator: Wega Sukanto
rights: Copyright (c) 2025 Edward Iskandar, Adrian Tangkilisan, Wega Sukanto https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-11
publication date: 2025-12-11
volume: 14
number: 1
starting page: 41
ending page: 45
doi: 10.35790/ecl.v14i1.63867

Prediksi Apendisitis dengan Komplikasi Menggunakan Systemic Inflammation Response Index dan Systemic Immune-Inflamation Index
type: item
description: Abstract: This study aimed to predict complications in appendicitis using the Systemic Inflammation Response Index (SIRI) and Systemic Immune-Inflammation Index (SII) values. This was a hospital-based retrospective study. Patients in this study were those who entered the Emergency Room of Daha Sejahtera Hospital, Hulu Sungai Selatan Regency, South Kalimantan, with a diagnosis of appendicitis, and underwent appendectomy by a general surgeon between September 2024 - April 2025. Data were presented in groups of appendicitis with and without complications based on intraoperative characteristics. The results showed that 14 patients met the inclusion criteria. Mean SIRI level in appendicitis with complications was significantly higher than without complications [6.15 (4.96, 7.17) vs 1.44 (0.78, 1.88), p=0.000]. Similiarly, SII level in complicated appendicitis was also significantly higher than in uncomplicated appendicitis [3269.04 (1894.05, 5550.38) vs 649.30 (408.63, 1004.67), p=0.011]. The ability of SIRI in predicting complications was higher than SII, leukocytes, and neutrophils (area under the curve 0.855). In conclusion, SIRI and SII can be used in predicting the presence of complicated appendicitis. Keywords: appendicitis; diagnosis; SII; SIRI Abstrak: Penelitian ini bertujuan untuk memrediksi adanya komplikasi pada apendisitis dengan menggunakan nilai Systemic Inflammation Response Index (SIRI) dan Systemic Immune-Inflammation Index (SII). Penelitian ini menggunakan metode retrospektif berbasis rumah sakit. Pasien dalam penelitian ini yakni yang masuk ke IGD RSUD Daha Sejahtera, Kabupaten Hulu Sungai Selatan, Kalimantan Selatan, dengan diagnosis apendisitis, dan menjalani operasi apendektomi oleh dokter bedah umum antara September 2024 – April 2025. Data disajikan dalam kelompok appendisitis dengan dan tanpa komplikasi berdasarkan temuan intra operasi. Hasil penelitian mendapatkan 14 pasien yang memenuhi kriteria inklusi. Nilai rerata SIRI pada apendisitis denga…
creator: Enika N. C. Tilaar
rights: Copyright (c) 2025 Enika N. C. Tilaar https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-21
publication date: 2025-12-21
volume: 14
number: 1
starting page: 46
ending page: 51
doi: 10.35790/ecl.v14i1.64424

In Vitro Antibacterial Effectiveness of Stingless Bee Propolis against Infected Breast Cancer Ulcer
type: item
description: Abstract: Breast cancer is the most common cancer in women and often presents with malignant ulcers prone to infection. These wounds are difficult to manage, especially during chemotherapy, due to polymicrobial colonization and rising antibiotic resistance. Stingless bee propolis, rich in bioactive flavonoids, has shown promising antibacterial properties. This study aimed to evaluate in vitro antibacterial effectiveness of stingless bee propolis against bacteria from breast cancer ulcers. This was an in vitro study conducted at the Poltekkes Kemenkes Manado Medical Laboratory (July 2024–January 2025). Methanol-extracted stingless bee propolis was tested against MRSA and P. aeruginosa using disc diffusion, MIC, and MBC methods. Antibacterial activity was evaluated through inhibition zones and bacterial growth in serial dilutions. The outcomes were analyzed based on inhibition zone diameters and bacterial growth in serial dilutions. The results showed that propolis extract demonstrated antibacterial activity against MRSA and P. aeruginosa, with inhibition zones observed in both disc diffusion and dilution methods. Strong inhibition was noted at concentrations ≥80%, while minimal or no effect occurred below 30%. MIC and MBC were estimated at around 20%. Statistical analysis confirmed a significant dose-response relationship (ANOVA, p 0.0003), with stronger correlation in MRSA (R=0.84; p<0.001) than P. aeruginosa (R=–0.09; p 0.046). The minimum effective concentration was estimated at 32% for MRSA and 37% for P. aeruginosa. In conclusion, stingless bee propolis demonstrated concentration-dependent antibacterial activity against both Gram-positive (MRSA) and Gram-negative (P. aeruginosa) bacteria in vitro, with increased activity observed at higher concentrations. Minimum effective concentrations were 32% for MRSA and 37% for P. aeruginosa, supporting its potential use in treating infected breast cancer ulcers. These findings highlight propolis as a potential natural alt…
creator: Christian Manginstar
creator: Marselus Merung
creator: Albert Albert
rights: Copyright (c) 2025 Christian Manginstar, Marselus Merung, Albert Albert https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-22
publication date: 2025-12-22
volume: 14
number: 1
starting page: 52
ending page: 57
doi: 10.35790/ecl.v14i1.65682

Faktor-faktor yang Memengaruhi Fungsi Anus setelah Prosedur PSARP pada Pasien Malformasi Anorektal
type: item
description: Abstract: In anorectal malformations (ARM), posterior sagittal anorectoplasty (PSARP) procedure is the standard management, however, the anorectal functional outcomes vary. This study aimed to assess the factors affecting anorectal function after the PSARP procedure using the Rintala score. This was a retrospective cohort study of 29 ARM patients who underwent PSARP at Prof. Dr. R. D. Kandou Hospital Manado during the 2019–2022 period. Medical records and patient follow-up data were analyzed using the chi-square test and linear regression. The results showed that of the 29 patients (13 males, 16 females), 86.2% underwent staged repair, while the rest had one-stage repair. The mean Rintala score was 14.59±4.17; 24.1% had normal function, 62.1% good, 6.9% fair, and 6.9% poor. Adequate bowel management was performed in all patients. Surgical wound infection was found in one patient (3.4%). Re-do PSARP was performed in four patients (13.8%). There were no cases of malnutrition or musculoskeletal abnormalities. Syndromic diseases were found in three patients (10.3%). Multivariate analysis showed that no variables were significantly associated with the Rintala score (p>0.05). In conclusion, the majority of patients have good–normal anal function after PSARP. There is no significant relationship between bowel management, surgical wound infection, redo PSARP, malnutrition, musculoskeletal abnormalities, or syndromic diseases and anal function. Continuous bowel management education remains important for long-term outcomes. Keywords: anorectal malformation; PSARP; anal function; Rintala score Abstrak: Pada malformasi anorektal (MAR), prosedur posterior sagittal anorectoplasty (PSARP) merupakan standar tatalaksana, namun luaran fungsi anus bervariasi. Penelitian ini bertujuan untuk menilai faktor-faktor yang memengaruhi fungsi anus setelah prosedur PSARP menggunakan skor Rintala. Jenis penelitian ialah kohort retrospektif terhadap 29 pasien MAR yang menjalani PSARP di RSUP Pro…
creator: Vincent Suryoprabowo
creator: Harsali F. Lampus
creator: Leo Rendy
rights: Copyright (c) 2025 Vincent Suryoprabowo, Harsali F. Lampus, Leo Rendy https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-31
publication date: 2025-12-31
volume: 14
number: 1
starting page: 58
ending page: 62
doi: 10.35790/ecl.v14i1.65307

Implementasi Critical Care Outreach Team (CCOT) di Rumah Sakit Sentra Medika Minahasa Utara
type: item
description: Abstract: Clinical deterioration among hospitalized patients often occurs suddenly and can be prevented through early identification and timely intervention. The Critical Care Outreach Team (CCOT), as part of the Rapid Response System (RRS), is designed to detect and manage clinical deterioration before patients require admission to the Intensive Care Unit (ICU). This study aimed to describe the implementation of CCOT at Sentra Medika Hospital, North Minahasa, during the period from August 2024 to August 2025. A descriptive observational design was employed, with the researcher acting as a non-participant observer. Data collected included patient demographics, Early Warning Score (EWS) at admission and discharge, and the effectiveness of CCOT interventions based on patient stability, ICU readmission, code blue events, and mortality. Among 136 monitored patients, the highest proportion (30.8%) were aged 56–65 years and presented with moderate to high EWS upon admission. Following CCOT intervention, the average EWS decreased from 5.9 to 4.5. A total of 94.1% of patients remained stable in the ward, 3.7% were readmitted to the ICU, 1.5% experienced code blue events, and 0.7% died. In conclusion, the implementation of CCOT at this hospital has proven effective in the early detection of clinical deterioration and timely intervention, contributing to improved patient safety and service efficiency. Keywords: Early Warning Score (EWS); Rapid Response System (RRS); Critical Care Outreach Team (CCOT); clinical deterioration; early intervention Abstrak: Kemunduran kondisi pasien rawat inap sering kali terjadi secara tiba-tiba dan dapat dicegah melalui identifikasi dini serta intervensi cepat. Critical Care Outreach Team (CCOT) merupakan bagian dari sistem Rapid Response System (RRS) yang bertujuan mendeteksi dan menangani kemunduran kondisi sebelum pasien membutuhkan perawatan di Intensive Care Unit (ICU). Penelitian ini bertujuan untuk memberikan gambaran implementasi CCOT di…
creator: Monica C. Watuna
creator: Eka Y. Lantang
rights: Copyright (c) 2025 Monica C. Watuna, Eka Y. Lantang https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2025-12-31
publication date: 2025-12-31
volume: 14
number: 1
starting page: 63
ending page: 68
doi: 10.35790/ecl.v14i1.64939

Partial Intestinal Obstruction Caused by Left Diaphragmatic Hernia: A Case Report
type: item
description: Abstract: Diaphragmatic hernia in adults is a rare but potentially serious condition that often presents with non-specific gastrointestinal and respiratory symptoms. This case highlights a left-sided diaphragmatic hernia complicated by partial intestinal obstruction. We reported a 54-year-old male presented with a one-week history of progressive abdominal bloating and intermittent abdominal pain, accompanied by nausea but no vomiting or fever. Bowel movements and flatus were present. In examination, he was hemodynamically stable with abdominal distension and positive bowel sounds. Nasogastric tube drainage produced greenish fluid. Digital rectal examination showed normal stool without blood or mucus. Chest X-ray suggested a left diaphragmatic hernia, and abdominal X-ray revealed partial bowel obstruction without signs of pneumoperitoneum. Laboratory findings were within normal limits, except for mild hypokalemia (K⁺ 3.3 mmol/L). A diagnosis of partial mechanical intestinal obstruction due to a left diaphragmatic hernia was made. The patient underwent an urgent non-contrast abdominal CT followed by combined laparotomy and thoracotomy. Intraoperatively, a diaphragmatic defect (3×3 cm and 10×10 cm) with adhesions between the left lung and diaphragm was identified. Adhesiolysis was performed, and the defect was repaired using non-absorbable sutures, followed by diaphragmatic plication and chest tube insertion. In conclusion, this case underscores the importance of including diaphragmatic hernia in the differential diagnosis of adult patients with persistent abdominal symptoms. Timely imaging and a multidisciplinary surgical approach enabled resolution of obstruction and definitive repair, preventing serious complications. In conclusion, early recognition and appropriate surgical management are key to optimizing outcomes in adult diaphragmatic hernia with bowel involvement. Keywords: diaphragmatic hernia; intestinal obstruction
creator: Audi Pirade
creator: Rigel K. Paat
creator: Adrian Tangkilisan
rights: Copyright (c) 2026 Audi Pirade, Rigel K. Paat, Adrian Tangkilisan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-02
publication date: 2026-01-02
volume: 14
number: 1
starting page: 69
ending page: 72
doi: 10.35790/ecl.v14i1.65769

Dampak Perundungan terhadap Kesehatan Mental Mahasiswa Fakultas Kedokteran
type: item
description: Abstract: Bullying behavior often occurs in learning environments, including medical education with seniors as executor in most cases. Not everyone has the psychological defense to deal with bullying. Therefore, bullying can cause impacts that not only affect the victims’ psychology but also their performance in the future. This study aimed to obtain bullying behavior among medical students and its impacts on the medical students. This was a systematic review study using databases of Google Scholar, Pubmed, and Clincal Key. The literatures used to be in Indonesian or English, published in last five years. The results obtained nine articles from several countries. Bullying still occurred in medical environments. Moreover, bullying could cause depression, anxiety, and other mental disorders to their victims. The lack of reported cases supported the large number of cases of bullying in the medical environment. In conclusion, bullying is still common in medical environment, and causes decreased academic prestation and many mental disorders. Keywords: bullying; mental impacts; medical students Abstrak: Perilaku perundungan sering terjadi di lingkungan pembelajaran, termasuk pembelajaran kedokteran dengan para senior sebagai pelaku di kebanyakan kasus. Tidak semua individu memiliki pertahanan psikologis untuk menghadapi perundungan. Perundungan menyebabkan dampak yang tidak hanya berdampak bagi psikologis korban tetapi juga bagi kinerja korban di masa depan. Penelitian ini bertujuan untuk mengevaluasi perundungan di kalangan mahasiswa kedokteran serta dampaknya bagi korban perundungan. Jenis penelitian ialah systematic literature review dengan menggunakan database Google Scholar, Pubmed, dan Clinical Key. Literatur yang digunakan menggunakan bahasa Indonesia dan bahasa Inggris, yang diterbitkan dalam lima tahun terakhir. Hasil penelitian mendapatkan sembilan artikel dari berbagai negara. Perundungan masih sering terjadi di lingkungan kedokteran. Perundungan menyebabkan de…
creator: Brainly M. H. Tatambihe
creator: Anita E. Dundu
creator: Bernabas H. R. Kairupan
rights: Copyright (c) 2026 Brainly M. H. Tatambihe, Anita E. Dundu, Bernabas H. R. Kairupan https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-02
publication date: 2026-01-02
volume: 14
number: 1
starting page: 73
ending page: 78
doi: 10.35790/ecl.v14i1.65770

Clinical Characteristics and Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in the Last Five Years at Prof. Dr. R. D. Kandou Hospital
type: item
description: Abstract: Pancreatoduodenectomy (Whipple) is the standard procedure for resectable pancreatic and periampullary neoplasms. Although techniques and postoperative care continue to evolve, this procedure is still associated with high morbidity and significant complications, such as pancreatic fistula and delayed gastric emptying. It is most commonly performed on elderly patients with pancreatic adenocarcinoma and requires ongoing evaluation to improve outcomes. A five-year review is necessary to assess trends, complications, and postoperative outcomes as a basis for improving the quality of surgical management. This was a retrospective descriptive analysis of adult patients who underwent pancreatoduodenectomy at Prof. Dr. R. D. Kandou Hospital between 2020 and 2025. The inclusion criteria were patients with complete medical records, including demographic data, surgical indications, surgical outcomes, and postoperative complications. Cases with incomplete data, surgeries performed outside the study period, or patients who died before postoperative evaluation were excluded. Univariate analysis was performed using SPSS version 30 to describe clinical characteristics and patient outcomes. Of the 35 patients, the distribution of gender and diagnosis (icteric vs. non-icteric obstruction) was relatively balanced. Most underwent a single Whipple procedure (65.7%) using the duct-to-mucosa anastomosis technique (80%). Postoperative complications occurred in 57.1% of patients, and 30-day mortality was 34.3%. The mean age of patients was 55.6 years, the duration of surgery was 370 minutes, the blood loss was 568 cc, and the length of hospital stay was 9.8 days. In conclusion, the Whipple procedure demonstrates variable outcomes with high morbidity and a 30-day mortality rate of 34.3%. End-to-side anastomosis is the most commonly used technique. Age, case complexity, and operative variability influence patient recovery and prognosis. Keywords: pancreatoduodenectomy; pancreatic neop…
creator: Michael Tendean
creator: Ferdinand Tjandra
creator: Toar Mambu
creator: Marven Ayawaila
creator: Eric Sihaloho
rights: Copyright (c) 2026 Michael Tendean, Ferdinand Tjandra, Toar Mambu, Marven Ayawaila, Eric Sihaloho https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-17
publication date: 2026-01-17
volume: 14
number: 1
starting page: 79
ending page: 85
doi: 10.35790/ecl.v14i1.65822

Profil Kasus Kematian Mendadak di RSUP Prof. Dr. R. D. Kandou Manado pada Tahun 2022-2024
type: item
description: Abstract: Although sudden natural unexpected death is still common in Indonesia, data on sudden natural unexpected death are very limited. This study aimed to determine the profile of sudden natural unexpected death cases at Prof. Dr. R. D. Kandou Manado General Hospital in 2022-2024. This was a retrospective and descriptive study with a cross-sectional design, using secondary data from the medical records of Prof. Dr. R. D. Kandou Manado General Hospital. The results showed that between 2022 and 2024, there were 878 cases of sudden natural unexpected death at Prof. Dr. R. D. Kandou General Hospital in Manado that met the inclusion criteria. Year 2023 had the highest number of cases (331 cases). The highest number of cases was male, with 516 cases. Adults were the largest age group, with 420 cases, and most sudden natural unexpected deaths were caused by respiratory disorders or abnormalities, with 411 cases. In conclusion, the majority of sudden natural unexpected death cases at Prof. Dr. R. D. Kandou Manado General Hospital during 2022-2024 were males, within the adult age group, and had respiratory system disorders as the most common cause. Keywords: death; sudden natural unexpected death; cause of death Abstrak: Kematian mendadak masih banyak terjadi di Indonesia akan tetapi data mengenai kematian mendadak masih sangat terbatas. Penelitian ini bertujuan untuk mengetahui profil kasus kematian mendadak di RSUP Prof. Dr. R.D. Kandou Manado pada tahun 2022-2024. Metode penelitian yang digunakan ialah deskriptif retrospektif dengan desain potong lintang dan menggunakan data sekunder yang berasal dari rekam medis RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 878 kasus kematian mendadak di RSUP Prof. Dr. R. D. Kandou Manado pada tahun 2022 sampai tahun 2024 yang memenuhi kriteria inklusi. Tahun 2023 merupakan tahun terbanyak dengan jumlah 331 kasus. Jenis kelamin terbanyak merupakan jenis kelamin laki-laki dengan jumlah 516 kasus. Kelompok usia dewas…
creator: Yohana D. E. Tindaon
creator: Erwin G. Kristanto
creator: James F. Siwu
rights: Copyright (c) 2026 Yohana D. E. Tindaon, Erwin G. Kristanto, James F. Siwu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-18
publication date: 2026-01-18
volume: 14
number: 1
starting page: 86
ending page: 91
doi: 10.35790/ecl.v14i1.65530

Perbandingan Luaran Open Surgical Repair dan Endovascular Aneurysm Repair pada Pasien Aneurisma Aorta Abdominalis di Asia
type: item
description: Abstract: Abdominal aortic aneurysm (AAA) is a pathological dilation of the aorta that carries a risk of rupture and high mortality. Two methods of AAA management are Open Surgical Repair (OSR) and Endovascular Aneurysm Repair (EVAR). However, comparative data on the outcomes of these two methods in Asia is still limited. This study aimed to analyze the comparison of OSR and EVAR outcomes in AAA patients in Asia, including length of hospital stay, mortality, complications, and reintervention. This was a systematic review study using articles searched in the Epistemonikos, PubMed, Sage Journals, and ScienceDirect databases. The results obtained a total of 18 articles that met the inclusion and exclusion criteria based on the PICOS framework were obtained. The analysis was performed descriptively on postoperative outcome data. EVAR showed a significantly shorter length of hospital stay compared to OSR, but was accompanied by higher rates of reintervention and long-term complications, such as endoleak. Conversely, OSR was superior in terms of long-term durability and stability. The 30-day mortality rates showed inconsistent and statistically insignificant results. In conclusion, EVAR provides better short-term outcomes, while OSR is more reliable for the long term. The choice of method should consider the patient's condition. Keywords: abdominal aortic aneurysm; Open Surgical Repair; Endovascular Aneurysm Repair Abstrak: Aneurisma aorta abdominalis (AAA) merupakan dilatasi patologis aorta yang berisiko ruptur dan menimbulkan mortalitas tinggi. Terdapat dua metode dalam penatalaksanaan AAA yaitu Open Surgical Repair (OSR) dan Endovascular Aneurysm Repair (EVAR), namun, data perbandingan luaran keduanya di Asia masih terbatas. Penelitian ini bertujuan untuk menganalisis perbandingan luaran OSR dan EVAR pada pasien AAA di Asia yang meliputi lama rawat inap, mortalitas, komplikasi, dan reintervensi. Jenis penelitian ialah systematic review dari artikel-artikel yang ditelus…
creator: Ochta C. Aritonang
creator: Stephanus J. C. Tangel
creator: Andriessanto C. Lengkong
rights: Copyright (c) 2026 Ochta C. Aritonang, Stephanus J. C. Tangel, Andriessanto C. Lengkong https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-20
publication date: 2026-01-20
volume: 14
number: 1
starting page: 92
ending page: 99
doi: 10.35790/ecl.v14i1.65774

Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang UGD dan Kamar Operasi RSIA Kirana Manado
type: item
description: Abstract: Healthcare-Associated Infections (HAIs) are infections acquired during healthcare delivery, primarily caused by aerobic bacteria. Emergency rooms and operating rooms pose high HAI risks due to vulnerable patients and invasive procedures. This study aimed to determine aerobic bacterial patterns and antibiotic sensitivity in the emergency room and operating room of RSIA Kirana Manado. This was an observational and cross-sectional. There were 24 samples collected from walls, floors, air, medical equipment and non-medical equipment (14 from emergency room, 10 from operating room). Bacterial identification utilized nutrient agar and MacConkey agar culture, Gram staining, catalase test, coagulase test, and biochemical tests. Antibiotic sensitivity testing employed disc diffusion method on Mueller-Hinton agar against 11 antibiotics. The results showed that emergency room samples yielded 14 colonies on nutrient agar with no MacConkey growth. All were Gram-positive: Bacillus sp. (78.6%), Staphylococcus sp. (14.3%), and Streptococcus sp. (7.1%). Operating room samples produced nine colonies: Bacillus sp. (55.6%) and Staphylococcus sp. (44.4%). High sensitivity was observed for sulphamethoxazole/trimethoprim (90.9-100%), ciprofloxacin (90.9-100%), and meropenem (80-90.9%), while high resistance occurred with aztreonam (100%) and cefepime (54.5-60%). In conclusion, three bacterial genera were identified: Bacillus sp., Staphylococcus sp., and Streptococcus sp., showing high sensitivity to sulphamethoxazole/trimethoprim, ciprofloxacin, and meropenem, but resistance to aztreonam and cefepime. Keywords: aerobic bacterial pattern identification; antibiotic sensitivity test; emergency room; operating room Abstrak: Healthcare-Associated Infections (HAIs) merupakan infeksi yang didapat pasien selama perawatan di rumah sakit, terutama disebabkan bakteri aerob. Ruang UGD dan kamar operasi memiliki risiko tinggi HAIs karena pasien rentan dan prosedur invasif. Penelitian inin ber…
creator: Sania G. H. Hompas
creator: Heriyannis Homenta
creator: Olivia A. Waworuntu
rights: Copyright (c) 2026 Sania G. H. Hompas, Heriyannis Homenta, Olivia A. Waworuntu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-25
publication date: 2026-01-25
volume: 14
number: 1
starting page: 100
ending page: 104
doi: 10.35790/ecl.v14i1.65796

Perubahan Kadar Asam Urat dan Estimasi Laju Filtrasi Glomerulus pada Pasien Penyakit Ginjal Kronis yang Menggunakan Terapi Alopurinol
type: item
description: Abstract: Chronic kidney disease (CKD) is closely associated with hyperuricemia. Allopurinol is recommended for patients with CKD stages 2–5 to reduce serum uric acid levels, although its renoprotective effects may vary depending on patient characteristics. This study aimed to obtain changes in serum uric acid and estimated glomerular filtration rate (eGFR) in CKD patients receiving allopurinol therapy at Prof. Dr. R. D. Kandou Hospital Manado during 2021–2024. A retrospective longitudinal descriptive design was employed. As an exploratory purpose, pre–post therapeutic analyses and subgroup comparisons were conducted. The results showed that the greatest reduction in serum uric acid was observed among patients aged 30–65 years, males, those with type 1 diabetes mellitus, and individuals with stage G5 CKD. Increases in eGFR were noted in patients aged <30 years, females, and those with rheumatic heart disease as a comorbidity. Conversely, decreases in eGFR were found in patients aged ≥30 years, males, those with liver cirrhosis, and individuals in CKD stages G2–G3. In conclusion, changes in serum uric acid and eGFR among CKD patients receiving allopurinol vary according to age, sex, comorbidities, and stage of CKD. Keywords: chronic kidney disease; hyperuricemia; allopurinol Abstrak: Penyakit ginjal kronis (PGK) berhubungan erat dengan hiperurisemia. Alopurinol direkomendasikan pada pasien PGK stadium 2-5 untuk menurunkan kadar asam urat, meskipun efek renoprotektifnya dapat bervariasi menurut karakteristik pasien. Penelitian ini bertujuan mendeskripsikan perubahan kadar asam urat dan estimasi laju filtrasi glomerulus (eLFG) pada pasien PGK pengguna alopurinol di RSUP Prof. Dr. R. D. Kandou Manado periode 2021–2024. Jenis penelitian ialah deskriptif longitudinal retrospektif. Sebagai tujuan eksploratif, dilakukan analisis pre–post terapi serta komparatif antar-subkelompok. Hasil penelitian mendapatkan penurunan kadar asam urat terbesar pada kelompok usia 30–65 tahun,…
creator: Christina Angelica
creator: Octavianus R. H. Umboh
creator: Frans E. N. Wantania
rights: Copyright (c) 2026 Christina Angelica, Octavianus R. H. Umboh, Frans E. N. Wantania https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-25
publication date: 2026-01-25
volume: 14
number: 1
starting page: 105
ending page: 112
doi: 10.35790/ecl.v14i1.65797

Faktor-Faktor yang Berhubungan dengan Tingkat Stres Mahasiswa Profesi Dokter (Co-Assistant) di RSUP Prof. Dr. R. D. Kandou Manado
type: item
description: Abstract: Mental health remains an important issue among medical students, particularly clinical clerkship students (co-assistants) who must simultaneously manage academic and clinical demands. This study aimed to examine factors associated with stress levels among clinical clerkship students (co-assistants) at Prof. Dr. R. D. Kandou Hospital Manado. This was an observational quantitative study with a cross-sectional design. Respondents were selected using the Slovin formula through purposive sampling. Data were collected online using the PSS-10 to measure stress levels and the NASA-TLX to assess workload. Data analysis was performed using the Spearman Rank test and the Mann–Whitney U test. The results obtained 108 students as respondents with a mean age of 23 years (SD=0.85); majority of them were females. Most respondents experienced moderate stress (78.7%), followed by high and low stress levels (19.4% and 1.9%). The mean total workload score was 68.16%, with the highest dimension being effort at 21.29%. Bivariate analysis revealed a significant positive relationship between age and workload with stress levels, while gender and clinical rotation stage were not significantly associated. In conclusion, age and workload are factors associated with stress levels among clinical clerkship students (co-assistants). Therefore, psychosocial support programs, routine counseling, and evaluation of clinical workload are required to help students manage stress adaptively. Keywords: workload; stress level; clinical clerkship students (co-assistants) Abstrak: Kesehatan mental masih menjadi isu penting di kalangan mahasiswa kedokteran, terutama pada mahasiswa profesi dokter (co-assistant) yang menjalani beban akademik dan klinik secara bersamaan. Penelitian ini bertujuan untuk mengkaji faktor-faktor yang berhubungan dengan tingkat stres pada mahasiswa profesi dokter (co-assistant) di RS R.D Kandou Manado. Jenis penelitian ialah observasional kuantitatif dengan desain potong lint…
creator: Alida P. Talumedun
creator: Diana V. D. Doda
creator: Herlina I. S. Wungouw
rights: Copyright (c) 2026 Alida P. Talumedun, Diana V. D. Doda, Herlina I. S. Wungouw https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-25
publication date: 2026-01-25
volume: 14
number: 1
starting page: 113
ending page: 118
doi: 10.35790/ecl.v14i1.65798

Profil Kasus Luka Bakar di Rumah Sakit Bhayangkara Tingkat III Manado Tahun 2023 – 2024
type: item
description: Abstract: Burn injury represents a major health problem with both clinical and medicolegal implications, particularly when related to accidents or criminal incidents. This study aimed to describe the profile of burn injury cases at Rumah Sakit Bhayangkara Tingkat III Manado in 2023–2024. This was a descriptive and retrospective study based on secondary data obtained from medical records of burn cases treated during the study period. The results showed a total of 16 burn cases, with 12 patients (75%) survived and four patients (25%) died. The highest number of cases occurred in 2024 (62.5%). The most common cause of burns was fire (62.5%), followed by electricity and hot liquids (12.5% each), and explosion (6.3%). Based on total body surface area, the most frequent category was 10–29% (31.3%), and the most common burn degree was second-degree burns (31.3%). Most patients were adults aged 18–59 years (62.5%), and males constituted the majority (75%). All patients were Indonesian citizens residing in Manado. In conclusion, burn injuries in Manado most commonly affect adult males and are primarily caused by fire. These findings highlight the need for enhanced safety education in both workplace and domestic settings, as well as improved medicolegal documentation to support forensic analysis and inform public health policies. Keywords: burn injury; case profile; forensic aspect Abstrak: Luka bakar menjadi masalah kesehatan yang memiliki implikasi klinis maupun medikolegal, terutama ketika berkaitan dengan kecelakaan atau tindak pidana. Penelitian ini bertujuan untuk mengetahui profil kasus luka bakar di Rumah Sakit Bhayangkara Tingkat III Manado pada tahun 2023–2024. Jenis penelitian ialah deskriptif retrospektif dengan memanfaatkan data sekunder dari rekam medis pasien luka bakar yang dirawat selama periode penelitian. Hasil penelitian menunjukkan bahwa terdapat 16 kasus luka bakar yang tercatat, dengan 12 pasien (75%) hidup dan empat pasien (25%) meninggal dunia. Kasus …
creator: Evan Y. Rusly
creator: Djemi Tomuka
creator: Nola T. S. Mallo
rights: Copyright (c) 2026 Evan Y. Rusly, Djemi Tomuka, Nola T. S. Mallo https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-01-25
publication date: 2026-01-25
volume: 14
number: 1
starting page: 119
ending page: 123
doi: 10.35790/ecl.v14i1.65823

Gambaran Enuresis pada Anak Sekolah Dasar
type: item
description: Abstract: Enuresis is defined as involuntary voiding in children aged ≥5 years, occurring at least twice per week for three consecutive months, and not attributable to underlying medical conditions. Enuresis is influenced by biological, psychological, and environmental factors and remains commonly observed among primary school children. This study aimed to describe the occurrence of enuresis and its associated risk factors among elementary school children at Paal Dua District. A quantitative descriptive design with a cross-sectional approach was used. Samples were obtained through proportionate stratified random sampling from 250 respondents enrolled in SD Advent 3 Paal Dua, SD GMIM 22 Manado, and SD Advent 6 Kairagi Weru. Data were collected using the Clinical Management Tools (CMT) questionnaire from the Indonesian Urological Association and a previously validated and reliable research instrument. The findings showed that among the 15 children with enuresis, most were six years old (66.7%) and male (60%). The highest percentages were found in enuresis occurred predominantly at night (93.3%), the onset began since birth (66.7%), and voided 4–7 times per day (93.3%). The most frequently identified risk factors included toilet training at 3–4 years of age (73.3%), difficulty being awakened from sleep (53.3%), urinary tract infection complaints (33.3%), psychological stress (20%), and a history of constipation (26.7%). A family history of enuresis was present in 60% of cases, and the most common household composition was four family members (33.3%). In conclusion, enuresis remains present among primary school children in Paal Dua District, indicating the need for early detection and continuous parental education. Keywords: enuresis; elementary school children; nocturnal enuresis; risk factors Abstract: Enuresis merupakan pengeluaran urin secara involunter pada anak usia ≥5 tahun dengan frekuensi minimal dua kali per minggu selama tiga bulan berturut-turut tanpa diseba…
creator: Anastasya G. Tumbal
creator: Adrian Umboh
creator: Johnny L. Rompis
rights: Copyright (c) 2026 Anastasya G. Tumbal, Adrian Umboh, Johnny L. Rompis https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 14
number: 1
starting page: 124
ending page: 129
doi: 10.35790/ecl.v14i1.65843

Profil Kasus Benda Asing Saluran Cerna di Bagian Bedah Anak RSUP Prof. Dr. R. D. Kandou Manado Periode Januari 2021 – Juli 2025
type: item
description: Abstract: Pediatric foreign body ingestion is not an uncommon case, approximately 10%–20% require endoscopy, and 1% require surgery. This study aimed to describe the profile of gastrointestinal foreign body cases in the Pediatric Surgery Department of Prof. Dr. R. D. Kandou General Hospital, Manado. This was a descriptive cross-sectional retrospective study using electronic medical records of pediatric gastrointestinal foreign bodies. The results showed that among 42 included data, most cases were found in the school-age group (57.2%) and among males (54.8%). Most cases were symptomatic (64.3%) and had no comorbidities or complicating diseases (81.0%). All patients received X-ray examinations (100.0%). Most foreign bodies had a duration of ≤1 day (73.8%) in the gastrointestinal tract, blunt characteristic (42.9%), and 2-5 cm in size (78.6%). Foreign bodies were initially identified most often in the colon (35.7%). The majority of cases had no complications (76.2%). The most common management was endoscopy (61.9%), with the majority of foreign bodies found and successfully extracted (69.2%). Keywords: foreign body; location in gastrointestinal tract; pediatric surgery Abstrak: Tertelannya benda asing pada anak merupakan kasus yang tidak jarang dijumpai, yaitu sekitar 10%–20% kasus memerlukan tindakan endoskopi, dan 1% memerlukan operasi. Penelitian ini bertujuan untuk mengetahui profil kasus benda asing saluran cerna di Bagian Bedah Anak RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang menggunakan data rekam medis pasien anak dengan diagnosis benda asing saluran cerna. Hasil penelitian menunjukkan dari 42 pasien yang memenuhi kriteria inklusi berdasarkan total sampling, mayoritas berusia sekolah (57,2%) dan berjenis kelamin laki-laki (54,8%). Sebagian besar pasien simtomatik (64,3%) dan seluruhnya menjalani pemeriksaan X-ray (100%). Tidak ditemukan penyakit penyerta pada 81% kasus. Benda asing umumnya ber…
creator: Avanti H. Anggraeni
creator: Harsali F. Lampus
creator: Stephanus J. C. Tangel
rights: Copyright (c) 2026 Avanti H. Anggraeni, Harsali F. Lampus, Stephanus J. C. Tangel https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 14
number: 1
starting page: 130
ending page: 136
doi: 10.35790/ecl.v14i1.65844

Gambaran Kejadian Bullying dan Aspek Mental Siswa Sekolah Dasar Kelas 5 dan 6
type: item
description: Abstract: Bullying among elementary school students is a frequent issue and has a significant impact on children’s emotional condition, behavior, and mental health. This phenomenon needs to be examined comprehensively to understand its types and implications among fifth- and sixth-grade students. This study employed a mixed-methods approach, specifically an explanatory sequential design. Quantitative samples were obtained through stratified random sampling using the Olweus Bully/Victim Questionnaire-Revised (OBVQ-R), and interviews were conducted with selected victims and perpetrators to explore their mental aspects and subjective experiences. The results obtained 437 students of fifth- and sixth- grade at Malalayang as respondents. Bullying occurred quite frequently, predominantly in the form of verbal bullying, followed by emotional and physical bullying, with students involved as perpetrators, victims, or both. The mental impacts identified included anxiety, fear of attending school, decreased concentration, low self-esteem, and emotional distress, with several cases showing more severe symptoms. In conclusion, bullying among fifth- and sixth-grade students at Malalayang area still occurs and has a significant impact on students’ mental well-being. Keywords: bullying; mental aspect; elementary school students Abstrak: Bullying pada siswa sekolah dasar merupakan masalah yang sering terjadi dan berdampak signifikan terhadap kondisi emosional, perilaku, dan kesehatan mental anak. Fenomena ini perlu ditinjau secara komprehensif untuk memahami bentuk kejadian serta implikasinya pada siswa kelas 5 dan 6 di wilayah Malalayang. Penelitian ini menggunakan metode penelitian campuran, khususnya desain sekuensial eksplanatori. Sampel kuantitatif diperoleh melalui stratified random sampling dengan menggunakan kuesioner Olweus Bully/Victim Questionnaire-Revised (OBVQ-R), serta dilakukan wawancara pada korban dan pelaku terpilih untuk menggali aspek mental dan pengalaman subjek…
creator: Omega K. M. George
creator: Theresia M. D. Kaunang
creator: Anita E. Dundu
rights: Copyright (c) 2026 Omega K. M. George, Theresia M. D. Kaunang, Anita E. Dundu https://creativecommons.org/licenses/by-nc/4.0
license: https://creativecommons.org/licenses/by-nc/4.0
date: 2026-02-03
publication date: 2026-02-03
volume: 14
number: 1
starting page: 137
ending page: 142
doi: 10.35790/ecl.v14i1.65847