Medical Scope Journal

Profil Pasien dengan Gangguan Elektrolit yang Dirawat di Ruang Perawatan Intensif

Vania S. P. Sumule, Mordekhai L. Laihad, Barry I. Kambey — Tue, 10 Dec 2024 00:00:00 +0800

Abstract: Electrolyte disturbance is a common health problem in critical patients in the Intensive Care Unit (ICU). These disorders can cause serious complications and contribute to increased morbidity and mortality. This study aimed to determine the description of electrolyte disturbances experienced by patients in the ICU of Prof. Dr. R. D. Kandou Hospital. This was an observational study with a retrospective design involving 252 patients admitted to the ICU with electrolyte disturbances from January to June 2023. Data were obtained from medical records and analyzed descriptively. The results showed that hyponatremia was the most common electrolyte disorder (65.1%), followed by hypokalemia (48%), hypochloremia (53.6%), hypocalcemia (61.5%), and hyperphosphatemia (40.5%). The highest incidence was in the age group >65 years (18.7% for hyponatremia and hypocalcemia). The majority of patients were male. The most common disease diagnosis was sepsis. In conclusion, hyponatremia and hypocalcemia are the main electrolyte disorders in critical patients in the ICU of Prof. Dr. R. D. Kandou Hospital. The high-risk group is elderly men with sepsis. Close monitoring of electrolytes needs to be done especially in patients with these conditions to prevent fatal complications.

Keywords: electrolyte disturbance; hyponatremia; hypocalcemia

Abstrak: Gangguan elektrolit merupakan masalah yang sering terjadi pada pasien kritis di Intensive Care Unit (ICU). Penelitian ini bertujuan mengetahui profil pasien dengan gangguan elektrolit di ICU RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah observasional retrospektif dan pendekatan kuantitatif. Sampel penelitian ialah 252 pasien dengan gangguan elektrolit yang dirawat di ICU RSUP Prof. Dr. R. D. Kandou periode Januari-Juni 2023. Pengambilan sampel dilakukan secara purposive sampling. Variabel yang diteliti meliputi jenis gangguan elektrolit, karakteristik pasien (usia, jenis kelamin), diagnosis penyakit, dan lama rawat inap. Data dikumpulkan dari rekam medis dan dianalisis secara deskriptif. Hasil penelitian mendapatkan gangguan elektrolit terbanyak ialah hiponatremia (65,1%) dan hipokalsemia (61,5%). Kelompok usia >65 tahun (18,7%) dan laki-laki lebih banyak mengalami gangguan elektrolit, dan diagnosis tersering ialah sepsis. Rerata lama rawat inap pasien 1-7 hari. Simpulan penelitian ini ialah hiponatremia dan hipokalsemia merupakan gangguan elektrolit yang paling umum terjadi pada pasien ICU RSUP Prof. Dr. R. D. Kandou. Pasien usia lanjut dan sepsis berisiko tinggi mengalami gangguan elektrolit.

Kata kunci: gangguan elektrolit; hiponatremia; hipokalsemia

Penetrating Head Injury by a Key: A Case Report

Tue, 07 Jan 2025 00:00:00 +0800

Abstract: Penetrating head injury is defined as head trauma caused by an object that penetrates the skull and the underlying duramater. We reported a 22-year-old man who came to the hospital with a motorcycle key stuck into the back of his head after a fight with his friend approximately one hour before admission. The patient was fully conscious. History of projectile vomiting, and seizures were denied, and there were no other neurological deficits. Blindly removing the key can damage the neural tissue and can cause secondary injury to the brain and surrounding blood vessels. The primary goal of treatment for patients with suspected traumatic brain injury is to prevent secondary brain injury and infection. The removal of the object safely, debridement of the damaged parenchyma, removal of the hematoma, and closure of the injured dura and skin are the main goals of surgical treatment for penetrating head injuries. In this case, motor key evacuation was performed followed by craniotomy and debridement. The prognosis was good, and there was no neurological deficit. In conclusion, complete and adequate care is essential for patients with penetrating brain injuries. The strategy for treating these injuries is primarily surgery with the aim of preventing secondary brain injury and infection. According to existing research, antibiotics should be given for an indefinite period after surgery.

Keywords: penetrating head injury; motorcycle key

Selective Embolization of Arteriovenous Malformation in Gross Hematuria Post-Renorrhaphy: A Case Report

Adrian Tangkilisan, Wega Sukanto, Rigel Paat, Edward Iskandar — Tue, 07 Jan 2025 00:00:00 +0800

Abstract: Management approaches for renal trauma vary from conservative methods for contusions to surgical interventions for severe injuries. Postoperative renal artery embolization (RAE) is crucial to control bleeding and preserve renal parenchymal tissue integrity. We reported a patient presented with hematuria 30 minutes after sustaining a stab wound to the right waist, accompanied by severe pain, dizziness, and cold sweats. Physical examination revealed a penetrating wound in the right flank, gross hematuria, and signs of hypovolemic shock. The patient was diagnosed with grade II hypovolemic shock due to a renal laceration and duodenal rupture, initial resuscitation and conservative management were followed by exploratory laparotomy and renorrhaphy. Persistent gross hematuria post-renorrhaphy necessitated embolization. Hypovolemic shock resulted from significant bleeding from duodenal and renal lacerations. Renorrhaphy effectively minimized renal parenchymal damage without urine extravasation. Subsequent angiography revealed gross hematuria, indicating renal arteriovenous malformation (AVM). Embolization using a vortex coil successfully managed bleeding from large vessels and improved perfusion in the lesion area. In conclusion, renal trauma poses serious risks, including hypotension and hemorrhagic shock. Prompt resuscitation followed by surgical repair and angiographic embolization are essential. Embolization remains a generally safe and effective method for achieving selective hemostasis in such cases.

Keywords: renal trauma; gross hematuria; renorrhaphy; renal-artery embolization

Evaluation of Clinical Outcomes in Sport Participants Undergoing Anterior Cruciate Ligament Reconstruction

Thu, 16 Jan 2025 00:00:00 +0800

Anterior cruciate ligament (ACL) injury is one of the most common musculoskeletal injuries. Evaluating the clinical outcomes of the ACL reconstruction (ACLR) procedure is essential to provide information regarding the benefits of this procedure. This study aimed to assess the clinical outcomes of patients who underwent ACLR at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective study. Secondary data were collected from all athlete patients who underwent ACLR. The ACLR procedure was performed by a single operator following the standard arthroscopic procedure. All grafts used Hamstring grafts (gracilis and semitendinosus). Suspense fixation was done using a button, while tibial fixation was done with interference fixation (bioabsorbable screw). Patients were evaluated over a short period, specifically at three months, six months, and nine months. Outcome parameters were assessed using the Visual Analog Scale (VAS), Range of Motion (ROM), Lachman test, Anterior Drawer test, and Knee Functional Score (KFS). Any complications that arose were documented. The results showed that among 21 patients at Prof. Dr. R. D. Kandou Hospital Manado, it was found that ACL injuries were more common in physically active men, especially in the age group of 26-30 years. Most patients who underwent ACLR had serious injuries that required immediate treatment. Hamstring graft was the most common choice (85.7%). Knee stiffness was the most common complication and required special attention during the rehabilitation program. Based on KFS, most patients successfully achieved good knee function recovery. There was a decrease in the VAS score reflecting the effectiveness of the procedure in reducing postoperative pain. There was an increase in the KSS reflecting the success of ACLR in restoring knee stability and function to almost normal levels. In conclusion, anterior cruciate ligament reconstruction in sport participants showed significant improvements in knee mobility and pain reduction, with low complications.

Keywords: anterior cruciate ligament injury; anterior cruciate ligament reconstruction; graft fixation

Cervical Approach for Retrosternal Struma: A Case Report

Sherly Tandililing, Edwin Z. Sipayung — Thu, 30 Jan 2025 00:00:00 +0800

Abstract: Retrosternal struma is the inclusion of the thyroid gland into the thoracic cavity. Combined access with a neck incision and chest incision or only a neck incision to free the tumor from the chest cavity and avoid damage to surrounding tissues, makes treatment of substernal struma a challenge both preoperatively and during surgery. Systematic technique minimizes the need for sternotomy, even in patients with significant intra thoracic components, and keeps severe complication rates at levels comparable to those of conventional thyroidectomy. We reported a 46-year-old woman complaining of lumps on the right and left neck for six years. The masses were found on the right side of the neck (10x6cm) and on the left side of the neck (4x3cm), which were hard consistency, well-defined, immobile, skin-colored, painless, and moving when swallowing. CT-scan showed a solid mass struma that had entered the superior thoracic aperture. Total thyroidectomy was performed through cervical approach with a good outcome. In conclusion, total thyroidectomy through a cervical approach is able to remove the entire thyroid gland tissue extending to the retrosternal region with a good outcome without performing a sternotomy.

Keywords: retrosternal struma; thyroidectomy; cervical approach

Manajemen Sindrom Koroner Kronik: Laporan Kasus

Starry H. Rampengan, Alvin E. Cahyono — Sat, 01 Feb 2025 00:00:00 +0800

Abstract: Over the last decades, the management of chronic coronary syndromes (CCS) has improved rapidly that contributes in the decreasing of cardiovascular mortality. After myocardial infarction, the patient’s condition can improve with the usage of reperfusion therapy with thrombolysis or primary angioplasty and preventive treatment with aspirin and antiplatelet agents, statin, beta-blockers, and renin-angiotensin antagonists. Moreover, percutaneous coronary intervention (PCI) can improve the survival of patients suffering from acute coronary syndrome (ACS). We reported a 49-year-old man, who complained of chest pain for the last one year, which worsened with activity. One day before hospitalization, the chest pain worsened. The patient was diagnosed with CCS CCS (Chronic Coronary Syndrome Canadian Cardiovascular Society) II-III, GERD, hyponatremia, dyslipidemia, hyperuricemia, and dyspepsia. After further examination, a RF-CL of 20% (moderate) was obtained. A Dobutamine Stress Echocardiography examination was carried out resulting a positive ischemic response, then DCA-PCI was performed. The patient went home without any complaints. The management of this patient from diagnosis to therapy is in accordance with the ESC CCS 2024 guidelines. In conclusion, regarding the importance of acute chest pain management, patients with chest pain should not be underestimated and there are many modalities that can be used to confirm the diagnosis of chronic coronary syndromes.

Keywords: chronic coronary syndrome; dobutamin stress echocardiography; percutaneous coronary intervention; risk factor-clinical likelihood

Abstrak: Selama beberapa dekade terakhir, manajemen sindrom koroner kronis telah meningkat pesat yang menyebabkan mortalitas kardiovaskular telah menurun secara stabil. Kondisi pasien setelah infark miokard dapat menjadi lebih optimal dengan adanya terapi reperfusi dengan trombolisis atau angioplasti primer dan terapi pencegahan seperti aspirin dan agen antiplatelet lainnya, statin, beta-blocker, dan antagonis renin-angiotensin. Intervensi koroner perkutan (IKP) dapat meningkatkan kelangsungan hidup pasien yang mengalami sindrom koroner akut (SKA). Kami melaporkan seorang laki-laki berusia 49 tahun, dengan keluhan nyeri dada sejak 1 tahun terakhir, diperberat dengan aktivitas. Sehari sebelum masuk rumah sakit, nyeri dada dirasakan memberat. Pasien didiagnosis dengan sindroma koroner kronik CCS CCS (Chronic Coronary Syndrome Canadian Cardiovascular Society) II-III, GERD, hiponatremia, dislipidemia, hiperurisemia, dan dispepsia. Pada pemeriksaan lanjut, didapatkan RF-CL 20% (moderate), kemudian dilakukan pemeriksaan dobutamin stress echocardiography dan didapatkan hasil iskemik respons positif, sehingga dilanjutkan dengan IKP. Penatalaksanaan pasien ini sejak konfirmasi diagnosis sampai terapi telah sesuai dengan Guidelines ESC CCS 2024. Pasien dipulangkan dengan tidak ada keluhan. Simpulan kasus ini ialah terkait tatalaksana nyeri dada akut, pasien dengan nyeri dada tidak boleh diremehkan, dan telah banyak modalitas yang dapat digunakan untuk mendiagnosis sindroma koroner kronik.

Kata kunci: sindrom koroner kronik; dobutamin stress echocardiography; intervensi koroner perkutan; risk factor-clinical likelihood

Scalp Defect of Cranioplasty with Titanium Mesh: A Case Report

Sun, 23 Feb 2025 00:00:00 +0800

Abstract: Several implant materials for cranioplasty have been studied, including autologous bone, titanium mesh, polyetheretherketone (PEEK), and polymethyl methacrylate (PMMA). Titanium mesh is believed to have excellent biocompatibility, low cost, and satisfactory cosmetic effects, especially in three-dimensional (3D) custom-made meshes. We reported a 54-year-old man complaining of open wound in his left temporoparietal region since a month. Blood tests showed leukocytosis. Patient was diagnosed as scalp infection with previous cranioplasty using bone cement on temporoparietal region. The patient underwent scalp reconstruction with skin flap, removing skin defect, and split thickness skin graft (STSG) from left thigh. Patient was provided with outpatient medication consisting of analgesics and broad-spectrum antibiotics. Follow-up assessment 14 days after surgery did not reveal any secondary infections on titanium mesh implant and skin flap. The main complications of cranioplasty, in addition to the studied aesthetic results, are represented by the risk of infection, postoperative hematoma, impaired wound healing, as well as prolonged failure due to transplant absorption or infection, as a result of which the prosthesis needs to be removed. In conclusion, titanium mesh is still a better choice of material for cranioplasty in many factors such as price, accessibility, infection rate, and biocompatibility

Keywords: scalp; cranioplasty; head injury; prosthesis

Kecemasan pada Remaja yang Hamil di Luar Nikah

Widya Rahayu, Farida Kartini, Askuri Askuri — Fri, 28 Feb 2025 00:00:00 +0800

Abstract: Teenagers with premarital pregnancy can experience more stress, feelings of helplessness, hopelessness, depression, suicidal willingness, feelings of failure, and loss of self-esteem. This study aimed to analyze the anxiety in teenagers who were pregnant before marriage in Manado. This was a mixed method study with quantitative sampling technique using total sampling (67 samples). The instrument used for quantitative research was the PASS questionnaire. Qualitative samples obtained from the results of quantitative research with purposive sampling technique, the type of research used phenomenology. Quantitative data were analyzed univariately and bivariately. The results showed that the highest percentages were found in age 15-18 years (71.6%), senior high school education (59.7%), gestational age of second trimester of pregnancy (46.3%) and third trimester of pregnancy (44.8%). The qualitative analysis obtained four major themes, namely: the anxiety of adolescents with premarital pregnancy, the impact of pregnancy, the experience of adolescents, the factors of premarital pregnancy. The chi-square test for the relationship between anxiety level and premarital pregnancy had a p-value of 0.040. In conclusion, there is a relationship between anxiety level and premarital pregnancy in adolescents in Manado. The contributing factors are inappropriate parents and couple support, and readiness for being pregnancy.

Keywords: anxiety; adolescents; pre-marital pregnancy

Abstrak: Remaja hamil di luar nikah lebih mengalami stres, perasaan tidak berdaya, putus asa, depresi, keinginan bunuh diri, merasa diri gagal, serta kehilangan harga diri. Penelitian ini bertujuan untuk menganalisis kecemasan pada remaja hamil di luar nikah di Kota Manado. Penelitian ini menggunakan mixed method dengan pendekatan explanatory sequential design. Populasi dan sampel yakni remaja usia 15-24 tahun yang hamil di luar nikah di Kota Manado. Desain kuantitatif yaitu deskriptif analitik. Pengambilan sampel kuantitatif menggunakan total sampling berjumlah 67 sampel. Instrumen penelitian yaitu kuesioner PASS. Sampel kualitatif berasal dari hasil penelitian kuantitatif dengan purposive sampling, dan jenis penelitian fenomenologi. Analisis data kuantitatif secara univariat dan bivariat. Hasil penelitian mendapatkan persentase tertinggi pada kategori usia remaja 15-18 tahun (71,6%), pendidikan SMA (59,7%), serta usia kehamilan trimester II (46,3%) dan trimester III (44,8%). Hasil analisis kualitatif mendapatkan empat tema besar, yaitu: kecemasan remaja yang hamil di luar nikah, dampak hamil, pengalaman remaja, dan faktor terjadinya kehamilan di luar nikah. Hasil uji chi-square terhadap hubungan antara tingkat kecemasan dengan hamil di luar nikah mendapatkan nilai p=0,040. Simpulan penelitian ini terdapat hubungan bermakna antara tingkat kecemasan dengan remaja hamil di luar nikah di Kota Manado. Faktor yang memengaruhi kecemasan pada remaja hamil yakni kurangnya dukungan keluarga dan pasangan, dan kesiapan menjalani kehamilan.

Kata kunci: kecemasan; remaja; hamil di luar nikah

Gambaran Pola Luka dan Prevalensi Kasus Kecelakaan Lalu Lintas di Bagian Ilmu Kedokteran Forensik dan Medikolegal RSUP Prof. Dr. R. D. Kandou Manado Tahun 2022-2023

Margaretha A. Tulung, Erwin G. Kristanto, Djemi Tomuka — Sun, 02 Mar 2025 00:00:00 +0800

Abstract: Traffic accidents have become one of the health problems causing various material and non-material losses. Victims of traffic accidents can suffer from minor injuries to potentially fatal ones. Patient data on traffic accident cases, including injury patterns, plays a significant role for medical institutions, law enforcement, and the community. These injury patterns may vary among different regions due to various factors. This study aimed to determine the pattern of wounds and the prevalence of traffic accident cases in the Department of Forensic Medicine and Medicolegal at Prof. Dr. R. D. Kandou Hospital Manado in the years 2022-2023. This was a descriptive and retrospective study, using secondary data from Visum et Repertum (VeR) reports of deceased victims due to traffic accident. The results showed that the total number of victims was 36 cases, with 28 victims meeting the inclusion-exclusion criteria. Throughout the years 2022-2023, the highest number of cases occurred in March, with a total of six fatalities. The majority of victims were male, and the most common age group was 17-25 years old (28.57%). The most frequently type of injury was abrasion (54.7%), primarily located on the head and face. The majority of victims were drivers (28.5%), with motorcycles being the most commonly involved vehicles. In conclusion, the majority of cases were male, age group 17-25 years, had abrasion primary located on the head and face, and roled as motorcycle drivers.

Keywords: traffic accident; pattern of wounds

Abstrak: Kecelakaan lalu lintas (KLL) menjadi salah satu penyebab masalah kesehatan yang menyebabkan berbagai kerugian material dan non material. Korban KLL dapat mengalami cedera ringan hingga berpotensi menyebabkan kematian. Keberadaan data pasien kasus kecelakaan lalu lintas berupa karakteristik dan gambaran pola luka, memiliki peran signifikan bagi instansi medis, aparat hukum, dan masyarakat. Gambaran pola luka dapat mengalami perbedaan antara korban kecelakaan lalu lintas di suatu daerah dengan daerah yang lain karena berbagai faktor. Penelitian ini bertujuan untuk mengetahui gambaran pola luka dan prevalensi kasus KLL di Bagian Ilmu Kedokteran Forensik dan Medikolegal RSUP Prof. Dr. R. D. Kandou Manado pada tahun 2022-2023. Jenis penelitian ialah deskriptif retrospektif, menggunakan data sekunder dari Visum et Repertum (VeR) korban meninggal dari kasus KLL. Hasil penelitian mendapatkan bahwa jumlah keseluruhan korban sebanyak 36 kasus dengan 28 korban memenuhi kriteria inklusi dan eksklusi. Sepanjang tahun 2022-2023 kasus terbanyak terjadi di bulan Maret dengan total enam korban meninggal. Korban terbanyak berjenis kelamin laki-laki, dan usia pada kelompok 17-25 tahun (28,57%). Jenis luka terbanyak berupa luka lecet (54,7%), dengan lokasi tersering pada bagian kepala dan wajah. Jenis peran korban terbanyak sebagai pengemudi (28,5%) dengan kendaraan paling banyak terlibat berupa sepeda motor (32,14%).

Kata kunci: kecelakaan lalu lintas; pola luka

Efficacy and Safety of Drug Elution Bead-Transarterial Chemoembolization in Advanced Soft Tissue Sarcoma

Albert Albert, Christian O. Manginstar, Denny Saleh, Marselus A. Merung — Fri, 07 Mar 2025 00:00:00 +0800

Abstract: Soft-tissue sarcomas (STS) are rare and heterogeneous tumors originating from mesenchymal tissues. While surgical resection remains the primary treatment, not all patients are eligible for surgery, particularly in advanced stages. Drug-eluting bead transarterial chemoemboli zation (DEB-TACE) is a promising therapeutic option for such cases. This retrospective study evaluated the efficacy and safety of DEB-TACE in 30 patients with advanced STS at Prof. Dr. R. D. Kandou Hospital, Manado, from 2020 to 2023. The overall response rate (ORR) was 76.7% (p<0.05), with five patients achieving complete response and 18 showing partial response. The main adverse reactions included post-embolization syndrome (fever, pain, nausea, vomiting) and grade II or higher bone marrow suppression. Despite a morbidity rate of 93.3%, no treatment-related mortality was observed. In conclusion, DEB-TACE is an effective and safe treatment for advanced STS, providing superior short-term efficacy compared to traditional systemic chemotherapy.

Keywords: soft tissue sarcoma; drug eluting bead; transarterial chemoembolization

Hubungan Metakognisi dengan Indeks Prestasi Kumulatif (IPK) Pada Mahasiswa Program Studi Pendidikan Dokter

Agnes M. Silalahi, Damajanty H. C. Pangemanan, Elvin C. Angmalisang — Fri, 28 Mar 2025 00:00:00 +0800

Abstract: Grade Point Average (GPA) is an evaluation parameter of student learning outcomes at university, and can be influenced by many factors, one of which is metacognition. Metacognition helps a person become lifelong learners who are independent in learning and able to adapt to the development of science. This study aimed to determine the relationship between metacognition and GPA of medical students of batch 2022 in Universitas Sam Ratulangi. This was a quantitative study with an observational and analytical approach, and designed with a cross-sectional model. Samples were medical students batch 2022 of Universitas Sam Ratulangi, as many as 211 students who met the inclusion criteria. Students' metacognition was measured using the Metacognitive Awareness Inventory (MAI) questionnaire, and GPA data obtained through the students’ transcripts. The results showed that respondents with very good metacognition (12.3%), good (34.1%), enough (52.6%), dan low (0,9%). Respondents’ GPA divided into praised (79,1%), very satisfactory (19,9%), satisfactory (0.5%), and unsatisfactory (0.5%). The Fisher’s Exact Test analysis obtained a p-value of 0.388 (p>0.05). In conclusion, there is not significant relationship between metacognition and GPA of medical students batch 2022 in Universitas Sam Ratulangi.

Keywords: metacognition; grade point average; metacognitive awareness inventory

Abstrak: Indeks Prestasi Kumulatif (IPK) merupakan suatu parameter evaluasi hasil belajar mahasiswa pada tingkat pendidikan tinggi, yang dapat dipengaruhi oleh banyak faktor, salah satunya ialah metakognisi. Metakognisi membantu seseorang menjadi lifelong learner yang mandiri dalam belajar dan mampu beradaptasi terhadap perkembangan ilmu pengetahuan. Penelitian ini bertujuan untuk mengetahui hubungan antara metakognisi dengan IPK pada mahasiswa angkatan 2022 Fakultas Kedokteran Universitas Sam Ratulangi. Jenis penelitian ialah kuantitatif dengan pendekatan observasional analitik, dan desain potong lintang. Sampel penelitian ialah mahasiswa angkatan 2022 Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi berjumlah 211 orang yang memenuhi kriteria inklusi. Metakognisi mahasiswa diukur dengan menggunakan kuesioner Metacognitive Awareness Inventory (MAI) dan data IPK didapatkan melalui transkrip nilai mahasiswa. Hasil penelitian mendapatkan responden memiliki metakognisi sangat baik (12,3%), baik (34,1%), cukup (52,6%), dan rendah (0,9%). IPK responden terbagi menjadi pujian (79,1%), sangat memuaskan (19,9%), memuaskan (0,5%), dan kurang memuaskan (0,5%). Hasil analisis Fisher’s Exact Test mendapatkan nilai p=0,388 (p> 0,05). Simpulan penelitian ini ialah idak terdapat hubungan antara metakognisi dengan IPK pada mahasiswa angkatan 2022 Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi.

Kata kunci: metakognisi; indeks prestasi kumulatif; metacognitive awareness inventory

Gambaran Kasus Nyeri Punggung Bawah di RSUP Prof. Dr. R. D. Kandou Manado Periode Tahun 2020– 2022

Reinaldi S. F. N. Baka, Joudy Gessal, Christopher Lampah — Fri, 28 Mar 2025 00:00:00 +0800

Abstract: Low back pain (LBP) is a common musculoskeletal complaint that often leads to impairment and disability, with a continuously increasing global incidence. This study aimed to obtain the overview of low back pain cases at the Installation of Medical Rehabilitation of Prof. Dr. R. D. Kandou Hospital in Manado during the period from 2020-2022. This was a descriptive and retrospective study with a cross-sectional design, using medical record data. The results obtained 379 medical records of patients with LBP. The majority of patients were ≥ 56 years (79.2%), female (63.1%), housewives (31.7%), body mass index above 25 kg/m2 (49.6%), non-smokers (88.4%), mechanical etiology (50.1%), and had radiating pain (50.1%). In conclusion, the majority of patients with low back pain were ≥56 years old, female, housewives, excess body mass index, non-smokers, and had mechanical etiology and radiating pain.

Keywords: low back pain; age; gender; occupation; body mass index; smoking; etiology; radiating pain

Abstrak: Nyeri punggung bawah (NPB) merupakan keluhan muskuloskeletal yang sering menyebabkan gangguan dan disabilitas, dengan insiden global yang terus meningkat. Penelitian ini bertujuan untuk mengetahui gambaran kasus NPB pada pasien di Instalasi Rehabilitasi Medik di RSUP Prof. Dr. R. D. Kandou periode tahun 2020-2022. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang menggunakan data rekam medis. Hasil penelitian mendapatkan 379 rekam medik pasien dengan NPB (n=379). Mayoritas pasien berusia 56 tahun ke atas (79,2%), didominasi oleh perempuan (63,1%), berlatar belakang sebagai ibu rumah tangga (31,7%), indeks massa tubuh di atas 25 kg/m² (49,6%), tidak merokok(88,4%), terdapat etiologi mekanik (50,1%), dengan nyeri menjalar (50,1%). Simpulan penelitian ini ialah pasien yang datang dengan nyeri punggung bawah mayoritas berusia 56 tahun ke atas, didominasi perempuan, pekerjaan sebagai ibu rumah tangga, memiliki indeks massa tubuh berlebih, tidak merokok, etiologi mekanik, dan nyeri menjalar.

Kata kunci: nyeri punggung bawah; usia; jenis kelamin; pekerjaan, indeks massa tubuh, merokok, etiologi, nyeri menjalar

Pengaruh Rehabilitasi Kardiovaskular terhadap Kapasitas Fisik pada Pasien Gagal Jantung

Richard L. Santoso, Victor F. F. Joseph, Agnes L. Panda — Sat, 29 Mar 2025 00:00:00 +0800

Abstract: Cardiovascular rehabilitation is one of the essential management strategies recommended to enhance functional capacity of patients with heart failure. This study aimed to determine the effect of cardiovascular rehabilitation on physical capacity in heart failure patients at Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive and analytical method with a retrospective and cross-sectional design. This study involved 145 heart failure patients undergoing cardiovascular rehabilitation, of whom 48 fulfilled the inclusion criteria, while 97 were excluded. The results showed that majority of participants were male, aged 45–59 years, and had a body mass index (BMI) in the obesity I category. Most patients had hypertension, dyslipidaemia, and were prescribed ACE-I/ARB and statin therapies. Most participants' ejection fractions were classified as reduced (<40%) or mildly reduced (40–49%). Statistical analysis using the paired t-test showed significant improvements in 6-minute walk test distance, VO2 Max, and METs after cardiovascular rehabilitation (p-value <0.05 for each variable). In conclusion, cardiovascular rehabilitation significantly improved physical capacity in heart failure patients, as evidenced by increased 6-minute walk test distance, VO2 Max, and METs. These findings indicate a positive effect of cardiovascular rehabilitation on the physical capacity of heart failure patients at Prof. Dr. R. D. Kandou Hospital Manado.

Keywords: cardiovascular rehabilitation; physical capacity; heart failure

Abstrak:Rehabilitasi kardiovaskular merupakan salah satu strategi penatalaksanaan penting yang direkomendasikan untuk meningkatkan kapasitas fungsional pasien gagal jantung. Penelitian ini bertujuan untuk menganalisis pengaruh rehabilitasi kardiovaskular terhadap kapasitas fisik pada pasien gagal jantung di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang retrospektif. Sampel penelitian ialah 145 pasien gagal jantung yang menjalani rehabilitasi kardiovaskular; 48 pasien memenuhi kriteria inklusi dan 97 pasien dieksklusi. Hasil penelitian mendapatkan mayoritas pasien ialah laki-laki, berusia 45–59 tahun, dengan indeks massa tubuh (IMT) kategori obesitas I. Sebagian besar pasien memiliki hipertensi, dislipidemia, dan mendapatkan terapi ACE-I/ARB serta statin. Sebagian besar fraksi ejeksi pasien dikategorikan sebagai reduced ejection fraction (<40%) atau mildly reduced ejection fraction (40–49%). Analisis statistik menggunakan uji paired t-test menunjukkan peningkatan bermakna pada jarak tempuh uji jalan 6 menit, VO2 Max, dan METs setelah rehabilitasi kardiovaskular (nilai p<0,05 untuk setiap variabel). Simpulan penelitian ini ialah rehabilitasi kardiovaskular secara bermakna meningkatkan kapasitas fisik pasien gagal jantung, yang ditunjukkan oleh peningkatan jarak tempuh uji jalan 6 menit, VO2 Max, dan METs. Temuan ini mengindikasikan adanya pengaruh positif rehabilitasi kardiovaskular terhadap kapasitas fisik pasien gagal jantung di RSUP Prof. Dr. R. D. Kandou Manado.

Kata kunci: rehabilitasi kardiovaskular; kapasitas fisik; gagal jantung

Validation of Guy’s Stone Score, RUSS, S-RESC SCORE, and S.T.O.N.E Score for Predicting Stone Free Rate in Percutaneous Nephrolithotomy in a Residency Teaching Hospital

Bryan P. Panelewen, Eko Arianto, Ari Astram, Christof Toreh, Frendy Wihono — Fri, 11 Apr 2025 00:00:00 +0800

Abstract: Kidney stones represent a significant health burden globally, with a high risk of recurrence. Percutaneous nephrolithotomy (PCNL) is the primary treatment option for kidney stones larger than 20 mm, offering superior outcomes compared to open surgery. Several scoring systems, including Guy’s Stone Score (GSS), S.T.O.N.E. Nephrolithometry Score, Resorlu Unsal Stone Score (RUSS), and Seoul Renal Stone Complexity (S-ReSC), have been developed to predict the Stone-Free Rate (SFR) following PCNL. However, the comparative effectiveness of these scoring systems remains unclear. This study aimed to evaluate and compare the predictive accuracy of GSS, S.T.O.N.E., RUSS, and S-ReSC scoring systems in determining SFR after PCNL. This was an analytical and retrospective study. Data were collected from 60 patients with kidney stones treated at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2023. Patients underwent PCNL, and preoperative non-contrast CT scans and postoperative plain abdominal X-rays were used for evaluation. Statistical analyses included univariate, bivariate, and multivariate tests, as well as ROC curve analysis. The results showed that all four scoring systems were statistically significant in predicting SFR (p<0.005). The RUSS score demonstrated the highest predictive value, with an odds ratio 20 times higher than without scoring. The ROC analysis showed AUC values of 0.792 for GSS, 0.913 for RUSS, 0.694 for S-ReSC, and 0.945 for S.T.O.N.E. These findings highlight significant relationships between stone complexity scores and SFR, emphasizing their utility in surgical planning. In conclusion, each scoring system has significant predictive value for SFR following PCNL. Among them, RUSS showed the highest reliability, followed by S.T.O.N.E. and GSS. Despite differences in focus, all scores contribute to treatment planning and patient management. Further research is needed to optimize these tools and integrate them with advanced imaging and minimally invasive techniques for personalized patient care.

Keywords: percutaneous nephrolithotomy; kidney stones; Stone-Free Rate; Guy’s Stone Score; S.T.O.N.E Nephrolithometry Score; Resorlu Unsal Stone Score; Seoul Renal Stone Complexity

Perbandingan Range of Movement pada Pasien Post Total Knee Replacement Teknik Cruciate Retaining dengan Teknik Posterior Stabilized

Patrick S. Arikalang, Albertus D. Noersasongko, Tommy Suharso — Sun, 13 Apr 2025 00:00:00 +0800

Abstract: Total knee replacement (TKR) is a common surgical procedure to treat pain and dysfunction in the knee joint due to osteoarthritis. Two techniques that are often used are cruciate retaining (CR) and posterior stabilized (PS). This study aimed to compare the range of movement (ROM) between the two techniques. This was a comparative study with prospective cohort design conducted at Prof. Dr. R. D. Kandou Manado Hospital. A total of 100 patients undergoing TKR were included, consisting of 12 patients with CR technique and 88 patients with knee PS. ROM technique was measured using goniometer. Statistical analysis used the Mann-Whitney test and linear regression. The results showed that the median age of patients was 66 years dominated by women (77%). There were no significant differences in ROM of knee flexion and extension between CR and PS techniques (p>0.05). Regression analysis showed that the PS technique tended to have a lower ROM than CR (6-7° for knee flexion), but statistically meaningless. The patient's age had a meaningful negative relationship with post-TKR ROM. In conclusion, the CR and PS techniques provide equivalent ROM results in post-TKR patients. The selection of techniques can be adjusted to the operator's expertise, the availability of implants, and hospital facilities. Follow-up research with longer duration and multi-flashlights is needed to evaluate long-term outcomes.

Abstrak: Total knee replacement (TKR) merupakan prosedur bedah yang umum dilakukan untuk mengatasi nyeri dan disfungsi pada sendi lutut akibat osteoartritis. Dua teknik yang sering digunakan yaitu cruciate retaining (CR) dan posterior stabilized (PS). Penelitian ini bertujuan membandingkan range of movement (ROM) antara kedua teknik tersebut. Penelitian ini merupakan studi komparatif dengan desain kohort prospektif yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Sebanyak 100 pasien yang menjalani TKR diikutsertakan, terdiri dari 12 pasien dengan teknik CR dan 88 pasien dengan teknik PS. ROM lutut diukur menggunakan goniometer. Analisis statistik menggunakan uji Mann-Whitney dan regresi linear. Hasil penelitian memperlihatkan median usia pasien ialah 66 tahun didominasi perempuan (77%). Tidak terdapat perbedaan bermakna pada ROM fleksi dan ekstensi lutut antara teknik CR dan PS (p>0,05). Analisis regresi menunjukkan teknik PS cenderung memiliki ROM lebih rendah dibandingkan CR (6-7° untuk fleksi lutut), namun secara statistik tidak bermakna. Usia pasien memiliki hubungan negatif yang bermakna dengan ROM pasca TKR. Simpulan penelitian ini ialah teknik CR dan PS memberikan hasil ROM yang ekuivalen pada pasien pasca TKR. Pemilihan teknik dapat disesuaikan dengan keahlian operator, ketersediaan implan, dan fasilitas rumah sakit. Penelitian lanjutan dengan durasi lebih panjang dan multi-senter diperlukan untuk mengevaluasi hasil jangka panjang.

Kata kunci: total knee replacement; cruciate retaining; posterior stabilized; range of movement

Korelasi Penggunaan Artificial Intelligence dengan Nilai Modul Keterampilan Belajar, Komunikasi, dan Informasi Teknologi Mahasiswa Kedokteran

Aveva V. Pontororing, Heriyannis Homenta, Firginia P. Manoppo — Mon, 14 Apr 2025 00:00:00 +0800

Abstract: Artificial intelligence (AI) utilization is considered to enhance the efficiency and effectiveness of student learning. However, the correlation between AI utilization and academic performance remains underexplored. This study aimed to analyze the correlation between AI utilization and module scores in Learning, Communication, and Information Technology Skills (KBKIT) among 2024 cohort students of the Faculty of Medicine, Universitas Sam Ratulangi. This was an observational and analytical study with a cross-sectional design. The total sample comprised 194 students selected using the total sampling method. Data were collected using Google form-based questionnaires and KBKIT module transcripts, then were analyzed using the Gamma test to determine the correlation between the two variables. The results showed that most students were in the moderate category for AI utilization, both in usefulness (67.5%) and ease of use dimensions (64.9%). KBKIT module scores were mostly in categories A (46.4%) and B+ (26.8%). The Gamma correlation test yielded a coefficient of -0.013 with p = 0.913, indicating no significant correlation between AI utilization and KBKIT module scores, with a very weak correlation strength and a negative direction. In conclusion, there is no significant correlation between AI utilization and KBKIT module scores among students of the Faculty of Medicine, Universitas Sam Ratulangi.

Keywords: artificial intelligence; KBKIT module scores

Abstrak: Penggunaan artificial intelligence (AI) dianggap dapat meningkatkan efisiensi dan efektivitas pembelajaran mahasiswa, namun hubungan antara penggunaan AI dengan kinerja akademik masih kurang dieksplorasi. Penelitian ini bertujuan untuk menganalisis korelasi antara penggunaan AI dengan nilai modul Keterampilan Belajar, Komunikasi, dan Informasi Teknologi (KBKIT) mahasiswa angkatan 2024 Fakultas Kedokteran Unsrat. Jenis penelitian ialah observasional analitik dengan desain potong lintang. Total sampel berjumlah 194 mahasiswa yang dipilih melalui metode total sampling. Data dikumpulkan menggunakan kuesioner berbasis google form dan transkrip nilai modul KBKIT, kemudian dianalisis menggunakan uji Gamma untuk melihat ada tidaknya korelasi antara kedua variabel. Hasil penelitian mendapatkan sebagian besar mahasiswa berada pada kategori sedang dalam penggunaan AI, baik dimensi kegunaan (67,5%) maupun kemudahan (64,9%). Nilai modul KBKIT menunjukkan mayoritas berada pada kategori A (46,4%) dan B+ (26,8%). Uji korelasi Gamma menghasilkan koefisien -0,013 dengan p=0,913, menunjukkan tidak terdapat korelasi bermakna antara pengguanaan AI dengan nilai modul KBKIT dengan kekuatan korelasi sangat lemah dan arah korelasi negatif. Simpulan penelitian ini ialah tidak terdapat korelasi bermakna antara penggunaan AI dengan nilai modul KBKIT mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi.

Kata kunci: artificial intelligence; nilai modul KBKIT