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Covid-19 Infection in Elderly with Comorbids Yudistira, Edo; Roza Mulyana
Biomedical Journal of Indonesia Vol. 7 No. 2 (2021): Biomedical Journal of Indonesia
Publisher : Fakultas Kedokteran Universitas Sriwijaya (Faculty of Medicine, Universitas Sriwijaya) Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v7i2.376

The senior population has a higher risk of contracting Covid-19 and is at risk ofdeveloping more severe disease. This is due to physiological changes in old age,which causes a decrease in immune function accompanied by an increase incomorbid disorders such as diabetes, hypertension, heart disease, lung disease,and dementia. WHO reports that the mortality rate for Covid-19 patients in theelderly above 80 years in China is around 21.9%, Italy is about 89% at the ageabove 70 years, and the United States is 85% at the age of 65 years and over.Delirium syndrome often appears as the primary complaint or infrequently; itoccurs on the first day the patient is treated and shows fluctuating symptoms.Symptoms of delirium, such as disorientation, difficulty concentrating, andinattention, often occur in the elderly and are associated with a poor prognosis.Management of geriatric patients with covid 19 must be carried out thoroughlyand completely, especially in geriatric patients with comorbidities. Managementincludes primary diseases, namely Covid-19 infection, delirium, nutritionaltherapy, blood sugar, family education for patient assistance, maintaining thepatient's body and environment cleanliness, oral hygiene, and, last but not least,moral support from the family for the patient. With complete management, elderlypatients with various comorbid can survive the Covid-19 infection.

Terapi Antibiotika pada Pneumonia Usia Lanjut Roza Mulyana
Jurnal Kesehatan Andalas Vol 8, No 1 (2019): Online Maret 2019
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v8i1.987

Pneumonia merupakan infeksi yang sering ditemukan pada usia lanjut. Berbagai faktor dapat meningkatkan risiko usia lanjut mengalami pneumonia, diantaranya perubahan sistem imun, multipatologi, dan penurunan status fungsional. Dalam memilih antibiotika bagi pasien usia lanjut dengan pneumonia, diperlukan berbagai pertimbangan diantaranya jenis pneumonia apakah di komunitas atau nosokomial, beratnya pneumonia yang dideritanya, dan status frailty pasien usia lanjut. Pilihan antibiotika awal yang diberikan tergantung jenis dan berat pneumonia, status frailty, dan faktor risiko yang mendasari penderita mengalami infeksi organisme tertentu. Dosis antibiotika yang diberikan disesuaikan dengan laju filtrasi glomerulus.

Understanding Anorexia and Eating Capability of Older Adults in Attempt to Prevent Malnutrition Afifah Amatullah; Roza Mulyana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 1 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i1.439

Because of the rise of life expectancy, the older adults are now a big part of world’s population. In United States, prevalence of adults aged more than 65 years old increased from 36.6 million in 2005 to 47.8 million in 2015. In Indonesia, percentage of older adults increased two-fold from 1971 – 2019 as much as 9,6% or more than 25 million people. Along with this aging population, eating problems and malnutrition are getting more frequent. Aging causes several changes and degradation of body function which physiologically lead to anorexia and eating difficulty in older adults. Moreover, the other age-related factors such as social factor, economic factor, psychological factor, diseases and polypharmacy also have significant impact on food intake in older adults. Prevalence of inadequate energy intake and malnutrition in older adults are increasing, which lead them to become susceptible to acute and chronic diseases or worsening of their disease, increase hospitalization, and increase mortality rate. Even so, the signs of malnutrition of older adults are often late to be recognized, whereas the recovery of malnutrition in older adults is much more complicating than in younger adults. This review discusses about problems encountered by older adults that decrease their intake and cause malnutrition, to help clinicians recognize the cause of malnutrition in older adults earlier.

Understanding Anorexia and Eating Capability of Older Adults in Attempt to Prevent Malnutrition Afifah Amatullah; Roza Mulyana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 1 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i1.439

Because of the rise of life expectancy, the older adults are now a big part of world’s population. In United States, prevalence of adults aged more than 65 years old increased from 36.6 million in 2005 to 47.8 million in 2015. In Indonesia, percentage of older adults increased two-fold from 1971 – 2019 as much as 9,6% or more than 25 million people. Along with this aging population, eating problems and malnutrition are getting more frequent. Aging causes several changes and degradation of body function which physiologically lead to anorexia and eating difficulty in older adults. Moreover, the other age-related factors such as social factor, economic factor, psychological factor, diseases and polypharmacy also have significant impact on food intake in older adults. Prevalence of inadequate energy intake and malnutrition in older adults are increasing, which lead them to become susceptible to acute and chronic diseases or worsening of their disease, increase hospitalization, and increase mortality rate. Even so, the signs of malnutrition of older adults are often late to be recognized, whereas the recovery of malnutrition in older adults is much more complicating than in younger adults. This review discusses about problems encountered by older adults that decrease their intake and cause malnutrition, to help clinicians recognize the cause of malnutrition in older adults earlier.

INFEKSI JAMUR PADA GERIATRI yossa tamia marisa; Roza Mulyana
HUMAN CARE JOURNAL Vol 5, No 1 (2020): Human Care Journal
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i1.615

Elderly patients need special and thorough attention, because in elderly patients often occur more than one disease multipatologi. One of them is an infectious disease that is prone to occur in elderly patients due to decreased functional body reserve, decreased immunity, repeated hospital stays, diagnosis and therapy that is often late, decreased response to antibiotic therapy, and increased potential for side effects and interactions between drug. Fungal infections are an increasing problem in the elderly population including opportunistic fungal infections in elderly patients with immunocompromised conditions with multipatolgi disease and coincidence, post chemotherapy in malignancies, post-transplantation, or receive immunosuppressant therapy due to dermatological and rheumatological diseases.

POLIFARMASI PADA PASIEN GERIATRI Husna Fauziah; Roza Mulyana; Rose Dinda Martini
HUMAN CARE JOURNAL Vol 5, No 3 (2020): Human Care Journal
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i3.796

Latar belakang: Polifarmasi banyak ditemukan pada populasi geriatri dan berhubungan dengan efek samping dan lama perawatan di rumah sakit. Polifarmasi adalah penggunaan bersamaan enam obat atau lebih oleh seorang pasien. Mengidentifikasi dan menghindari polifarmasi dapat memberikan hasil yang lebih baik pada pasien usia lanjut dan membantu meningkatkan kualitas hidup. Tujuan: Meningkatkan pemahaman dalam mengidentifikasi dan menatalaksana polifarmasi pada pasien geriatri. Tinjauan Pustaka: Polifarmasi banyak ditemukan pada pasien geriatri dan berkaitan dengan kondisi penyakit dan pertambahan usia. Peningkatan penggunaan obat pada geriatri meningkatkan risiko negatif seperti peningkatan biaya perawatan, kejadian efek samping obat, interaksi obat, ketidakpatuhan pengobatan, penurunan status fungsional, dan sindrom geriatri. Beberapa strategi untuk mengurangi polifarmasi di kalangan pasien usia lanjut membutuhkan kerjasama multidisiplin. Penerapan kriteria AGS Beers dan kriteria STOPP / START meningkatkan kesesuaian obat pada pasien usia lanjut dan mengurangi polifarmasi. Kesimpulan: Diperlukan pemahaman yang lebih baik tentang polifarmasi dan konsekuensinya pada pasien geriatri. Diperlukan implementasi instrumen dan metode untuk mengatasi polifarmasi pada praktek klinis sehari-hari pada pasien geriatri.

SINDROM DELIRIUM AKUT Nidya Angryni; Roza Mulyana
HUMAN CARE JOURNAL Vol 5, No 3 (2020): Human Care Journal
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i3.810

Sindrom delirium akut merupakan sebuah sindrom neuropskiatrik yang kompleks dengan onset akut dan besifat fluktuatif. Sindrom ini melibatkan suatu hendaya fungsi kognitif yang akut dan menyeluruh yang mempengaruhi kesadaran, perhatian, memori, kemampuan perencanaan, dan organisasi. Telah dilaporkan kasus sindrom delirium akut pada pasien laki-laki usia 75 tahun. Pasien datang dengan perubahan kesadaran yang terjadi 2 hari terakhir. Sindrom delirium akut yang terjadi pada pasien didasari atas infeksi paru. Pada pemeriksaan fisik paru didapatkan ronkhi basah halus nyaring di kedua lapangan paru. Pada pasien juga ditemukan adanya sindrom geriatri yang meliputi imobilisasi dengan ketergantungan total, instabilitas dengan risiko jatuh, malnutrisi, frailty, dan gangguan penglihatan. Pada pasien dilakukan penanganan secara komprehensif dalam tim medis interdisipliner dengan partisipasi keluarga yang merupakan salah satu pendekatan pelayanan geriatri paripurna

Diagnosis and Management of Refeeding Syndrome Auliangi Tamayo; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 9 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i9.567

Refeeding syndrome (RFS) is described as a syndrome of electrolyte abnormalities and changes in body fluids with metabolic abnormalities in malnourished patients who receive refeeding either orally, enteral, or parenterally. Patients at risk for RFS are patients who have lost 10% of their previous body weight in the last 3-6 months, cancer patients who are on chemotherapy, geriatric patients with malnutrition, and patients with anorexia. Clinical manifestations are caused by electrolyte changes that affect neurons, heart and muscle disorders with various symptoms, and even death. The specific characteristics of RFS are the presence of hypophosphatemia and accompanied by other symptoms of electrolyte imbalance such as changes in sodium levels, changes in glucose, protein, fat metabolism, vitamin B1 deficiency, hypokalemia, and hypomagnesemia. The principle of management of RFS is to correct biochemical abnormalities and electrolyte and fluid imbalances. Preventive steps that can be taken are identifying individuals at risk for RFS, monitoring refeeding and administering an appropriate diet regimen.

Karakteristik Pasien Lansia Sebelum Kemoterapi Pertama di RSUP Dr. M. Djamil Padang Yunia Habsari; Roza Mulyana; Elmatris Elmatris
Jurnal Ilmu Kesehatan Indonesia Vol 1 No 3 (2020): November 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Abstrak Latar Belakang. Penurunan fungsi tubuh dan gangguan organ akan memengaruhi karakteristik pasien lansia dengan kanker. Beberapa karakteristik pasien memengaruhi pemberian kemoterapi pada pasien lansia. Objektif. Penelitian ini bertujuan untuk mengetahui karakteristik pasien lanjut usia yang akan menjalani kemoterapi pertama di RSUP M Djamil, Padang. Metode. Penelitian ini merupakan penelitian deskriptif observasional dengan desain cross sectional. Data penelitian didapatkan dari rekam medik. Sampel penelitian sebanyak 110 pasien lansia yang akan menjalani kemoterapi pertama di RSUP dr. M. Djamil Padang periode Januari 2017 – Juli 2018. Hasil. Sebagian besar pasien berada di kelompok usia 60 - 69 tahun (78,2%) serta memiliki kadar haemoglobin dan hematokrit dibawah batas normal (73,6% dan 70% secara berurutan). Kesimpulan. Sebagian besar pasien berada di kelompok usia lansia muda dan memiliki nilai hemoglobin dan kadar hematokrit dibawah batas normal, sedangkan karakteristik lainnya cenderung normal. Kata kunci: Lansia, Kanker, Kemoterapi Abstract Background. Decreased body function and organ dysfunction will affect the characteristic of elderly patients with cancer. Some characteristics will affect the chemotherapy given in elderly patients. Objective. This study discussed the characteristics of elderly patients who received the first chemotherapy in RSUP dr. M. Djamil Padang. This research is an observational descriptive study with a cross sectional design. Methods.The research data was obtained from the patient's medical record. The research sample consisted of one hundred and ten elderly patients who received first chemotherapy at RSUP dr. M. Djamil Padang period January 2017 - July 2018. Result. Most of the patients were in the age group 60 - 69 years (78.2%) and had hemoglobin levels and hematocrit below the normal limit (73.6% and 70% respectively). Conclusion. Most of patients were in the young elderly age group and had hemoglobin values and hematocrit levels below the normal range, while other characteristics tend to be normal. Keywords: Elderly, Cancer, Chemotherapy

Profil Pasien Geriatri dengan Ulkus Dekubitus di RSUP Dr. M. Djamil Sasqia Trizolla; Roza Mulyana; Nurhayati Nurhayati
Jurnal Ilmu Kesehatan Indonesia Vol 1 No 2 (2020): Juli 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Latar Belakang. Ulkus dekubitus atau luka tekan merupakan kerusakan kulit dan jaringan lunak akibat tekanan terus-menerus pada area tonjolan tulang. Kejadian ulkus dekubitus banyak ditemukan pada usia lanjut dengan kondisi imobilisasi. Pasien usia lanjut dengan beberapa penyakit disebut dengan pasien geriatri. Objektif. Tujuan penelitian ini adalah mengetahui profil pasien geriatri dengan ulkus dekubitus yang dirawat di RSUP Dr. M. Djamil Padang tahun 2016 – 2019. Metode. Penelitian ini menggunakan metode deskriptif observasional dengan pengambilan data sekunder dari rekam medis. Jenis sampel yang digunakan adalah pasien dengan usia lanjut yang memiliki data rekam medis yang lengkap yaitu: stadium klinis ulkus, penyebab imobilisasi, lama imobilisasi, dan penyakit penyerta. Data diolah dan disajikan dalam bentuk tabel distribusi frekuensi. Hasil. Hasil penelitian ini menunjukkan 38,8% pasien berada pada kelompok umur 60 – 69 tahun dan 74,6% berjenis kelamin perempuan. Variasi stadium klinis terbanyak adalah stadium 2 (43,3%). Penyakit neurologis merupakan penyebab imobilisasi terbanyak berdasarkan faktor intrinsik (38,8%) dan trauma berdasarkan faktor ekstrinsik. Lama imobilisasi pasien tersingkat 7 hari dan terlama 10 tahun. Penyakit paru menjadi penyakit penyerta terbanyak pada pasien geriatri dengan ulkus dekubitus. Kesimpulan. Sebagian besar pasien berada pada kelompok usia lanjut muda dan berjenis kelamin perempuan. Stadium terbanyak adalah stadium 2 yang disebabkan oleh penyakit neurologi dan trauma. Lama imobilisasi tersingkat ditemukan 7 hari dan terlama 10 tahun. Penyakit penyerta terbanyak adalah penyakit paru. Kata kunci: Ulkus dekubitus, pasien geriatri, imobilisasi Background. Pressure ulcer is damage on the skin and soft tissue due to continuous pressure on the area of the bone prominent. The incidence of pressure ulcer is found in elderly with immobilization. Elderly patients with several diseases are called geriatric patients. Objective. This study was aimed to determine the profile of geriatric patients with pressure ulcer that are hospitalized at RSUP Dr. M. Djamil Padang year 2016 – 2019. Methods. The method used descriptive observational by collecting of the secondary data from medical records. The samples are taken from elderly patients who had intact data on medical records: clinical stage, causes of immobilization, immobilization duration, and comorbid disease. The data is shown in frequency distribution table. Results. The results showed that 38.8% patients were mostly in the group of age 60 – 69 years and 74.6% are female. The most variation of clinical stage was stage 2 (43.4%). Neurological disease was the most common causes of immobilization (38.8%). The shortest periods of immobilization of patients 7 days and the longest 10 years. Lung disease was the most common comorbidities found in geriatric patients with pressure ulcer. Conclusion. Most of patients were in the young elderly age group and are female. Most common stage was stage 2 caused by neurological disease and trauma. The shortest immobilization time was found 7 days and the longest 10 years. Most comorbidities are lung disease. Keyword: Pressure ulcer, geriatric patients, immobilization

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