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Patient Satisfaction and Characteristics of Maternity Room from April to June 2022 at Unggul Karsa Medika Hospital Theresia Monica Rahardjo; Yoctaf Octora Kadam; Jeffrey Christian Mahardhika
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Maternal Mortality Rate (MMR) is an indicator that reflects various aspects including the quality of healthcare from clinical standpoint, the quality of healthcare system, the quality of health insurance, the quality of referral systems and non-health aspects that related to healthcare such as economic, social, cultural, and education aspects. In order to reduce MMR, healthcare quality of maternity services should be increased. Patient satisfaction is one of indicators for healthcare quality. In this study, we aim to describe patient satisfaction in maternity room of Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia. Methods This is a quantitative descriptive study conducted in Maternity Room, Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia. The design of the study was cross-sectional. The research was conducted from April to June 2022. Minimal total sample of 97. Total sample that obtained in this study was 150 subjects. Sampling method used in this study was consecutive sampling. Results Percentage of total patient satisfaction of maternity room were slightly increasing from April to June 2022, with highest value was in June 2022 of 94,2%. Four out of six elements of patient satisfaction were increasing, which were speed of services, friendliness and responsiveness, clarity of information and instructions, and completeness of infrastructure and facilities. Conclusion Unggul Karsa Medika Hospital through its excellence service of maternity room has played a significant role to reduce maternal mortality rate in Indonesia, since good and increasing results in patient satisfaction of maternity room service from April to June 2022.

Pediatric Dengue Encephalopathy: A Review Ilham Setiorizaldi; Amandianti Arimbi Tedjaningrum; Cindy Grace Panggabean; Enjelina Nangin; Jeffrey Christian Mahardhika; Chandni P. Daryanani
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Dengue encephalopathy is a very common neurological complication of dengue fever. Dengue encephalopathy or dengue hemorrhagic fever (DHF) with Central Nervous System (CNS) involvement used to be considered a relatively rare condition. However, the number of cases reported in human studies were increasing every year. Many factors caused the encephalopathy dengue. Possible mechanisms are hepatic failure (hepatic encephalopathy), cerebral hypoperfusion (shock), cerebral edema (vascular leakage) electrolyte disturbances, and intracranial hemorrhage due to thrombocytopenia or coagulopathy, which are secondary mechanisms of hepatic failure. Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) of brain can be done to make certain of the diagnosis. The results can suggest the presence of extensive involvement of the bilateral cerebellar region, brain stem, and thalamus along with peculiar rim enhancement. Treatment in Intensive Care Unit (ICU) with a multidisciplinary team is required due to the patients’ decreased level of consciousness, underlying problems of airway, breathing, and circulation, comorbidities, and considerations of specific etiology.

What Should We Know About Twin to Twin Transfusion Syndrome: A Case Report Novinka Iriane; Andrieta Berliana Marzani; Angelica Rosa Septiana Hartono; Chris Monalisa; Cindy Thalia Putri; Jessica Natasya; Kevin Axel; Zarahnaya Putri; Sheila Meriyani; Rizna Tyrani Rumanti; Theresia Monica Rahardjo; Aloysius Suryawan
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Twin-to-twin transfusion syndrome (TTTS) is a condition that can occur as a complication of a monochorionic twin pregnancy that may develop at any stage of pregnancy and most cases are diagnosed in the second trimester of pregnancy. The syndrome is a placental vascular anomaly that can affect the two fetoplacental circulations which can result in hypotony, hypovolemia, anemia, and oliguria being developed in the donor, whereas the recipient fetus is at risk of hypertrophy, hypertension, hypervolemia, polycythemia, and polyhydramnios. Case presentation A 32-year-old multigravida woman (Gravida 5 Para 4 Abortion 0) with a gestational age of 26 weeks came to the Obstetrics and Gynecology Clinic of Unggul Karsa Medika Hospital with the results of the first ultrasound at 24 weeks of gestation which revealed monochorionic diamniotic intrauterine twins and anterior placenta with grade I maturity. Twin A Maturity of 23 weeks 2 days with a fetal weight of 578 grams, oligohydramnios, fetal kidney, and bladder are not visible, whereas Twin B Maturity of 26 weeks 6 days with a fetal weight of 1205 grams, polyhydramnios with a single 12 cm deepest pocket and normal fetal kidney with bladder distention. The diagnosis of twin-to-twin transfusion syndrome was made with twin A as donor twins and twin B as recipient twins. Conclusion TTTS can be diagnosed with routine prenatal ultrasound and can be deferred into 4 stages based on ultrasound and doppler results. There are multiple options for management including expectant management, amnioreduction, intentional septostomy, fetoscopic laser photocoagulation, selective reduction, and voluntary pregnancy termination.

The Undescended Testis in Adult Life: A Case Report Fabianus Ferdian Damario; Alicka Octorevia Witjaksono; Angela Mulyana Sugiaman; Kellen Clementine; Yeppy Arief Nurzaman
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Cryptorchidism or Undescended testis (UDT) is a common birth defect in male genitalia, in which at least one testicle is absent from the scrotum. The missing testicle can be found along the inguinal canal or in the ectopic case could go as far as the pre-pubic area or perineum. Case report A 35-year-old man came to the Unggul Karsa Medika Hospital with a complaint of a lump in the right groin. He said that his lump has been felt since the patient was a child, comes and goes, and has become more clearly visible in the last 2 weeks. On physical examination, a lump was found in the right inguinal area without discoloration and pain, with a negative Valsalva test, and no right testicle was found. Conclusion It is possible that abnormality in intrauterine hormonal function has a role in the etiology of UDT. Adult UDT usually happens due to late diagnosis by physician and lack of insight of the parents about surgery necessity and its complications. Reduced fertility, risk of cancer, testicular torsion, as well as psychological issues are factors that supports the need for surgery. Orchiectomy remains the treatment of choice for adult UDT, including in our case, due to the risk of testicular cancer.

Sudden Sensorineural Hearing Loss (SSNHL): Case Report Fikrilah Abdul Azis; Afiya Shafa Kamilah; Arifiana Larasati Restyani; Athaya Miraghassani; Henny Widyastuti
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Sudden sensorineural hearing loss (SSNHL) commonly known as sudden deafness, is an unexplained, rapid loss of hearing either all at once or over a few days in which patients experience a sudden drop in hearing. It is commonly linked to infections, head trauma, autoimmune diseases, iatrogenic, severe infections, blood circulation problems, neurological disorders, such as multiple sclerosis, disorders of the inner ear, such as Ménière’s disease, and even metabolic disorders such as diabetes mellitus. We presented a case of sudden sensorineural hearing loss in a secondary hospital in Indonesia to add more knowledge on this topic. Case presentation A 76-year-old male, had chief complain of a sudden right sided hearing loss. There were no other symptoms and he had no history of trauma to the ear. The patient had hypertension and consumed amlodipine and clonidine regularly. Patient had normal otoscopic and rhinoscopy examination results. Audiometry shown a hearing threshold of 37 dB in the left ear and 117 dB in the right ear, both in air and bone conducted pure-tone stimuli and tympanogram showed type As in both ears. A diagnosis of right ear sudden sensorineural hearing loss was made, and medical treatment consisted of methylprednisolone, acyclovir, mecobalamin, vitamin B6, ranitidine and omeprazole were given to the patient. Conclusion Pathophysiology of this disease are labyrinthine viral infection, labyrinthine vascular compromise, intracochlear membrane ruptures, and immune-mediated inner ear disease. In our case, we suspect that both ischemic vascular disease and viral infection as the cause of ISHHL. If there is no definitive or treatable etiology found, treatment regimen should be dictated by the most likely factors involved, which were systemic steroids and acyclovir in our case.

Precocious Puberty: A Case Report Anna Felita; Ivanna Sarahfebi; Anastasia Nadya; Parbati Anjali; Chandni P. Daryanani
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Puberty is a transitional period in children with acceleration of growth and development of secondary sexual characteristics. When this period appears before the age of 8 to 9 years in children, it is called precocious puberty. Depending on the primary source of the hormonal production, precocious puberty may be classified as central (gonadotropin dependent or true) or peripheral (gonadotropin independent or precocious pseudo-puberty). Case presentation We herein report a case of precocious puberty in a 7,5-year-old girl who has shown early sign of secondary sexual development. Patients complained pain on her nipple, her breasts began to grow in size, and changes in her body odour, but had no complaints about her pubic hair growth and any vaginal discharge. Laboratory findings shown high level in fertility hormones and level of bone age is equal to 10-year-old girl. Patient then had begun to receive monthly therapy of Leuprolide. Conclusion Detailed history taking on chronological order of thelarche, pubarche, menarche, and adrenarche, followed by assessment on family history, nutritional history, child developmental history, medication history, and neurological complaints should be done in order to diagnose precocious puberty. Physical examination and other examination of bone age determination, Luteinizing Hormone and Follicle-Stimulating Hormone level, and pelvic ultrasound are essentials in defining the diagnosis and treatment. Leuprolide is indicated for Central Precocious Puberty patient who have advanced bone age at the time of initial evaluation. As a clinician, it is necessary to diagnose precocious puberty as soon as possible to have good prognosis for the patient.

Psoriasis: A Case Report Liyenka Belusi Tantra; Nathalia Gabriella; Stephanie Astrid Gunawan; Nabilla Aisya Zhavira; Theresia Monica Rahardjo; Epi Panjaitan; Peter Nugraha Soekmadji
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. Psoriasis vulgaris is also called plaque-type psoriasis, and is the most prevalent type. Psoriasis vulgaris is chronic inflammatory disease and characterized by periods of attack and remission. The chronicity of psoriasis vulgaris can affect patient’s quality of life. Case presentation A 33-year-old male came to Unggul Karsa Medika Hospital’s outpatient department with itchy, scaly, red plaques all over his body except his palms, soles, and face. The patient went to the dermatologist because his symptoms were getting worse and worse. Dermatologic examination concludes the lesions as multiple, generalized, discrete, circumscriptive, elevated, dry, regular-discoid erythematous plaques with psoriasiform scales located at the patient’s head, ears, nape, back, chest, belly, both arms and legs. Conclusion The diagnosis of psoriasis vulgaris was made based on history and clinical symptoms, supported by histopathological results. Treatment optimization and transitioning for moderate-to-severe plaque psoriasis include methotrexate or cyclosporine, along with topical therapy and supportive therapy.

Paralysis Due to Hypokalemia and Hypocalcemia: A Case Report Ivanna Sarahfebi; Anastasia Nadya; Anisya Lisna; Parbati Anjali; Theresia Monica Rahardjo; Valentine Natasya Moenardi
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Hypokalemia is the most frequent electrolyte disorder encountered in clinical practice. It caused by inadequate potassium intake or excessive renal or gastrointestinal potassium loss. Hypokalemia may associate with muscle weakness. Hypocalcemia can result from disorders of vitamin D metabolism and action, hypoparathyroidism, resistance to parathyroid hormone (PTH), or other conditions such as nutritional deficiency. Numbness and tingling sensation may occur on hypocalcemia. Case presentation A 36-year-old woman came with complaints of weakness of upper and lower limbs three days before admission. At first, the weakness felt suddenly on the left arm and left foot after waking up in the morning, making her not being able to walk. Patient felt tingling sensation on her face, upper limbs, and lower limbs. Her hands felt stiff as well as her mouth. Patient had a decreasing serum level (3 mEq/l) and decreasing total calcium level (4,8 mg/dL). Conclusion In young adult patients with limbs weakness, it is necessary to consider electrolyte imbalance, such as hypokalemia and hypocalcemia. Hypokalemia can be caused by decreased potassium intake, excessive vomiting, drug consumption, kidney disease, and endocrine disease. To diagnose hypokalemia, it is necessary to carry out further examinations such as basic biochemical laboratories (magnesium, calcium, phosphorus), blood gas analysis, TSHs, urine analysis (urine calcium, potassium excretion in 24-hour urine collection), drug screening.

Placental Abruption as a Complication of Preeclampsia that Causes Fetal Distress Indra Hapdijaya; Ecclesia Tessalina; Elisabeth Mariska Natasha Herdiana; Janice Natalia; Gede Anggara Setya Dewa Brata; Hendrik Andrianto; Catharine Welanai Jemarut; Livia Devina; Aloysius Suryawan
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Placental abruption is a common complication of preeclampsia. It is an obstetric emergency which occurs when the placenta partially or completely separates from the uterine wall. The diagnosis is usually made clinically or objectively. It is relatively rare but put a serious risk for both the fetus and the mother. Case presentation We reported a case of a 32-year-old multigravida patient at 35-36 weeks gestation presented with moderate vaginal bleeding and lower abdominal pain. Her obstetric history included one premature vaginal delivery. Her blood pressure started to rise in the second trimester of pregnancy. The examination revealed that her blood pressure was 190/120 mmHg, she had pitting edema on her extremities and tender uterine fundus. The fetal heart rate was bradycardia at 100 beats per minute. Placental abruption and fetal distress were diagnosed. An emergency cesarean section was performed. Intraoperatively, the uterus showed intramural bleeding and was livid, with the beginning of Couvelaire-uterus. The uterus was left in situ. Conclusion As a conclusion, placental abruption interrupts the vital function of the placentae which leads to fetal hypoxia and even fetal death. It is an obstetric emergency that requires immediate intervention to save the fetus and reduce the risk of complications in the mother.

Hyperglycemic Crisis in Uncontrolled Diabetes Mellitus Type 2 Presenting as Breathlessness Putu Intan Kusuma Wardani; Christina Pretaliana; Henry Theo Prawira Sugitto; Eqen Desmonta; Kevin Hersan; Vannesa Shelly; Varda Natasya Hutapea; Fadhilla Liefya Zahraisha; Jeffrey Christian Mahardhika; Nafthalena; Theresia Monica Rahardjo
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Background Hyperglycemic crisis is emergency caused by metabolic problems due to uncontrolled diabetes mellitus. Hyperglycemic crisis consists of Hyperosmolar Hyperglycemic State (HHS) and Diabetic Ketoacidosis. Both are caused by relative or absolute deficiency of insulin; deficiency of insulin could be caused by type 1 and type 2 diabetes. Case presentation A 46-year-old woman came to the emergency room of Unggul Karsa Medika Hospital presenting with breathlessness which had occurred for a week. Her breathlessness was more severe on the day she presented to the emergency room. One week before, she went to a clinic nearby because of epigastric pain, but after returning home she felt breathless. After a few days, her breathlessness started to worsen, so she decided to go to emergency room. The patient had severe acidosis and high blood glucose. Hyperglycemia protocol of rehydration and insulin drip intravenously, accompanied by sodium bicarbonate and potassium chloride were given. Mechanical ventilation was used. The patient was healed and discharged safely after 9 days of hospitalization. Conclusion Hyperglycemic crisis is one of true emergency that can lead to mortality, thus prompt diagnosis and treatment should be done. It is important for clinicians to differ between HHS and DKA. HHS is caused by the relative or absolute deficiency of insulin while DKA is characterized by absolute insulin deficiency which prevents the body from metabolizing carbohydrates and results in severe hyperglycemia. In DKA and HHS the main goal of therapy is to rehydrate, correct hyperglycemia, and to correct electrolyte imbalances.

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Aloysius Suryawan

Contact Email
thealoysius888@gmail.com

Phone
+6281572017195

Journal Mail Official
mcujournalrsukm@gmail.com

Editorial Address
Taman Kopo Indah III Blok H-1, 40218, Mekar Rahayu, Kec. Margaasih, Kabupaten Bandung, Jawa Barat 40218

Location
Kab. bandung,

Jawa barat

INDONESIA

Abstract

Abstract

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Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Aloysius Suryawan

Contact Email thealoysius888@gmail.com

Phone +6281572017195

Journal Mail Official mcujournalrsukm@gmail.com

Editorial Address Taman Kopo Indah III Blok H-1, 40218, Mekar Rahayu, Kec. Margaasih, Kabupaten Bandung, Jawa Barat 40218

Location Kab. bandung, Jawa barat INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Aloysius Suryawan

Contact Email
thealoysius888@gmail.com

Phone
+6281572017195

Journal Mail Official
mcujournalrsukm@gmail.com

Editorial Address
Taman Kopo Indah III Blok H-1, 40218, Mekar Rahayu, Kec. Margaasih, Kabupaten Bandung, Jawa Barat 40218

Location
Kab. bandung,

Jawa barat

INDONESIA