General Hospital Medan Research Articles

Effect Of Ramadhan Fasting On Apolipoprotein B And Small Dense Ldl In Type 2 Diabetes Mellitus Patients

This study's objective was to ascertain how type 2 Diabetes Mellitus patients' apolipoprotein B and small dense LDL were affected by Ramadan fasting. On 19 patients who had been diagnosed with type 2 DM at H. Adam Malik General Hospital Medan, a longitudinal prospective study from the fasting month of Ramadan until the end of the 2015 Ramadan fast was employed as the research methodology. The information was gathered by obtaining blood samples at the start and end of the Ramadan fast, after which the levels of apolipoprotein B and small dense LDL were determined. The T-Test and Wilcoxon tests were then used to assess the data. According to the study's findings, 13 respondents (68.4%) of the 19 patients with type 2 diabetes were men, and their average age was 57.26 years. Apoliprotein B (p=0.0001), small dense LDL (p=0.022), 2-hour PPG DGD (p=0.039), and mean body weight (p0.001) all indicated statistically significant changes. According to the study's findings, type 2 DM patients' apolipoprotein B and small dense LDL are significantly affected by Ramadan fasting.

Effectiveness of Propioceptive Neuromuscular Facilitation in Improving Walking Quality in Post-Stroke Patients at Haji General Hospital Medan

Nationally, the prevalence of stroke in Indonesia in 2018 was 10.9 per mile, an increase compared to 2013 which was 7 per mile. Stroke is the second leading cause of death and the third leading cause of disability in the world. Two-thirds of stroke events occur in developing countries. Weakness and decreased muscle strength in stroke sufferers occur on one side of the limb, however, in the trunk muscles, weakness occurs on both sides, resulting in limited trunk rotation and difficulty in maintaining balance and gait). Propioceptive Neuromuscular Facilitation (PNF) is a physiotherapy intervention method that can be used to improve the quality of walking in stroke patients. This method can improve proprioceptor function by stimulating it in muscles and tendons. PNF also improves muscle strength, flexibility, and balance). Description of respondent data was carried out using univariate analysis to determine the frequency of age, weight, height, gender, paralyzed side and Wisconsin values ??before and after the intervention for both groups. Bivariate test to compare the average WGS value after treatment with before treatment in both the PNF group and the conventional group and compare the average difference between the PNF group and the conventional group. The average value of the difference before and after the intervention in the PNF group was 1.75 with a standard deviation of ± 0.463, while in the conventional group the average value of the difference before and after the intervention was 0.63 with a standard deviation of ± 0.518. Statistical tests using the Wilcoxon rink test between the two groups obtained a p-value of 0.024, which is smaller than 0.05, which means there is a significant difference between the PNF intervention group and the Conventional intervention group.

Comparison of Changes in Cortisol Values Before and After Administration of a Combination of Continuous Fentanyl and Paracetamol Drip in Post-Craniotomy Patients in ICU of Haji Adam Malik General Hospital Medan

Introduction: Post-craniotomy surgical pain can trigger an inflammatory response and release various stress response mediators. Prolonged stress response to pain can increase cortisol secretion which will eventually be resulted in cortisol dysfunction and widespread inflammation. Opioids have been shown to provide pain management after craniotomy. Fentanyl is a commonly used opioid analgesic to manage postoperative pain. The addition of paracetamol is often used as multimodal analgesia which aims to reduce postoperative pain and to minimize the stress response that occurs. The aim of the study was to obtain a comparison of changes in cortisol values before and after the administration of a combination of continuous fentanyl and paracetamol in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan. Subject and Methods: This research design used a cross sectional test with pretest and posttest design, with primary data sources obtained directly from examinations on patients in the ICU. This study involved 15 post-craniotomy patients in the ICU with mechanical ventilation. The cortisol levels in the patient’s blood were checked before and after administration continuous fentanyl and paracetamol drip. Results: There was a decrease in cortisol levels after being given a combination of continuous fentanyl and paracetamol drip in post-craniotomy patients by 18% with a p-value of 0.001 (p <0.05). Conclusion: Combination of continuous fentanyl and paracetamol drip can provide analgesia effects that can reduce the stress response, namely cortisol.

Mortality of Guillain Barre Syndrome and Myasthenic Crisis in Haji Adam Malik Central General Hospital Medan January 2021- December 2022

Introduction: Neuromuscular disorders are disorders of the neuro system that impact the muscular system. Among them are Guillain-Barré Syndrome and Myasthenic Crisis. Guillain-Barré syndrome is an autoimmune disorder of the nervous system that is polyradiculoneuropathic, characterized by weakness that radiates from the legs to the arms, torso, and face. Myasthenic crisis is a state of acute respiratory failure due to the exacerbation of Myasthenia Gravis. These two diseases are the most common types of neurodiseases found in hospital ICU patients. Objective: Determining the mortality rate of Guillain-Barré Syndrome and Myasthenic Crisis at Haji Adam Malik Central General Hospital Medan January 2021-December 2022. Methods : This study was a descriptive study with data obtained from medical records. The subjects were inpatients and outpatients with Guillain Barré Syndrome and Myasthenia Crisis, with as many as 129 patients. The subjects were selected by purposive sampling and met the inclusion and exclusion criteria. Results: A total of 40 Guillain-Barré Syndrome patients were studied, and 6 of them died. The majority were patients aged 36-50 years, and the male and female sexes were equally significant. A total of 89 patients with Myasthenic Crisis were studied, and 1 of them died, namely patients with the age category of 36-50 years and female. Conclusion: Guillain-Barré Syndrome mortality was 15%, and Myasthenic Crisis was 1.12% at Haji Adam Malik Center General Hospital Medan January 2021-December 2022. Keyword : Guillain-Barré Syndrome, Mortality, Myasthenic Crisis

Impact of Environmental Laws Pertaining to Pollution Problems in Pharma and Chemical Sectors in India

Medical waste is regarded as a hazardous waste of a specific kind because of its high toxicity, presence of radioactive and toxic compounds, and propensity to cause sickness. The degree to which bacteria and viruses are present in medical waste, the dosage and type of exposure, and the degree to which the body is resistant to these pathogens Trash from isolation rooms for patients with infectious disorders, bacterial, infectious, and biological agent residues, waste from sterilization and disinfection, blood, serums, and plasma, and pharmaceutical residues are all considered to be medical waste. This manual offers suggestions for reducing trash creation through source reduction and recycling as well as an explanation of the processes that produce waste in hospitals. Hospitals will benefit by restricting the age of these materials at the source or reusing the wastes on or off site in light of the fact that doing so will limit removal expenses and liabilities connected with discarding hazardous waste. Compared to industrial facilities, general medical and surgical hospitals produce less hazardous wastes overall, although they do so in a number of different forms. Pharmaceuticals were formerly believed to enter the environment largely through usage or improper disposal. It was discovered that some production facilities were the sources of substantially higher ambient concentrations than those brought on by drug use. For both authorities and the pharmaceutical industry, the widespread discovery of waste medicines in environmental samples and the dangers posed by their introduction into wildlife habitats are key issues. Pharmaceutical firms should understand that reducing drug use and environmental damage is in their own best interests because doing so will prevent the emergence of drug resistance, which will prolong the shelf life of their medications. Changes in public and worldwide regulations, the reception of reasonable environmental principles inside current business standards, and requests from medical care suppliers and patients are likely impetuses for activity. Yet, clients can't pursue taught decisions because of the shortage of data about the wellspring of drugs and the impacts of creation on the climate. We suggest that one of several crucial strategies for lowering pollution from medicine manufacture would be improved transparency throughout the entire production chain.

Cesarean Scar Defect (Niche) Risk Factors: A Prospective Study on Indonesian Women

Introduction: Niche or cesarean scar defect is a complication of a cesarean section that has long-term implications for both obstetrics and gynecology. The rate of niche is believed to be increasing with the high number of cesarean sections. This study assesses the risk factors for niche development after cesarean section. Methods: A prospective cohort study was conducted on women who underwent cesarean section at the Haji Adam Malik General Hospital Medan between August 2020 and August 2022. Niche was assessed six weeks after cesarean section using transvaginal ultrasonography. The primary outcome was the presence of a niche. The antepartum, intrapartum and postpartum risk factors were analyzed for niche development. A logistic regression model was used to assess independent risk factors from the bivariate analysis. Results: There were 280 patients enrolled in this study. The prevalence of niche was 44.3% by using transvaginal ultrasound. There was no significant relationship between maternal age, gestational age, parity, nutritional status based on upper arm circumference, hypertension in pregnancy, anemia status, surgical indications, duration of surgery, volume blood loss, and puerperal infection to niche development (P > 0.05). The independent risk factors for niche development were Cervical dilatation > 4 cm (P = 0.035; RR = 1.75), locking suture technique (P = 0.015; RR = 13.81), non-closure vesicouterine folds (P = 0.04; RR = 0.14) and a retroflexed uterus (P = 0.001; RR = 0.039). Conclusion: Cervical dilatation > 4 cm, locking suture technique, non-closure vesicouterine folds, and a retroflexed uterus are risk factors for niche development after CS.

Comparison of Posterior Tibial Slope and Outcomes of Pre and Post Total Knee Arthroplasty in Osteoarthritis Genu Patients at H. Adam Malik General Hospital Medan

Comparison of Posterior Tibial Slope and Outcomes of Pre and Post Total Knee Arthroplasty in Osteoarthritis Genu Patients at H. Adam Malik General Hospital Medan

Analisis Faktor-Faktor Penunjang Kesiapan Pelaksanaan Rekam Medis Elektronik

This study aims to analyze the factors that support the readiness to implement electronic medical records at the Royal Prima Medan General Hospital. The research method uses cross-sectional. The results of this study indicate that there is an influence of the perception of benefits on the readiness of the implementation of electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.041, there is an influence of behavioral interest factors using the behavioral attention hospital management information system on the readiness for the implementation of electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.000, there is an influence of the use of the hospital management information system on the readiness of submitting electronic medical records at the Royal Prima Medan Hospital with a p-value = 0.016. The conclusion is that there is an influence of the perception of benefits, behavioral interest, and use of information systems on the implementation of electronic medical records is a behavioral variable. Keywords: Readiness for Implementation, Electronic Medical Records, Hospital

The Effect of Preoperative Oral Glucose Administration on Blood Glucose Levels in Diabetes Mellitus Patients in General Anesthesia Surgery

Background The administration of general anesthesia during surgery can trigger the body’s stress response causing changes in regular metabolic patterns that result in hyperglycemia and ketosis. The goal of this study is to investigate how preoperative oral glucose and non-glucose administration affect patients with diabetes mellitus with blood glucose levels during surgery under general anesthesia. Methods This is a single-blind, randomized controlled trial (RCT) being carried out by the Central Surgical Installation and postoperative recovery area at Haji Adam Malik General Hospital Medan. The study sample consists of 38 patients with diabetes mellitus who underwent electively scheduled laparotomies under general anesthesia and met inclusion/exclusion criteria. For treatment group participants, mineral water containing 50 grams of glucose was administered with 400 cc. Research hypotheses were assessed using the t-test, and significant findings had p-values equal to or less than 0.05 within a confidence interval of 95%. Results The study sample had a mean age of 50.1 ± 12.73 and showed a significant effect between glucose levels before (178.47) and after (163.78) administration of maltodextrin, with a P value (0.001). No side effects were observed during or after the post-operative evaluation process conducted in this study's participants. Conclusions Patients with diabetes mellitus experience a preoperative oral glucose-induced impact on blood glucose levels.

Proactive Psychiatry: Innovating the Delivery of Consultation-Liaison Services in a Pediatric Hospital

BackgroundThe benefits of a proactive consultation-liaison (C-L) psychiatry service have been well-documented in the adult population, including decreased length of stay, increased satisfaction among physicians, and enhanced collaborative care. However, there is no available research on the effectiveness of this model in pediatric hospitals. ObjectiveThis study compared patients ages 5-18 years on a general medical floor receiving a proactive psychiatry consult to concurrent controls receiving no consult and to historical controls receiving traditional reactive consults. MethodNew admissions to two pediatric general medical hospital teams were reviewed on weekday mornings to identify those with active psychiatric concerns. Adjusted negative binomial regression was used to compare the primary outcome of hospital length of stay between the proactive (n=65), concurrent control (n=63), and reactive historical control (n=45) groups. Patient satisfaction, hospitalist satisfaction, and recommendation concordance (degree to which psychiatry recommendations were implemented by the primary team) were also compared between groups as secondary outcome measures. ResultsAfter adjusting for age, sex, race, insurance type, reason for consult, and medical diagnosis, concurrent control patients had 14% (p = 0.295) longer mean length of stay than proactive consults and historical controls had twice (p < 0.001) the mean length of stay of those with proactive consults. Response rate for patient satisfaction scores was low, but responses were modestly more favorable among patients who received proactive C-L services. Based on nine paired pediatric hospitalist pre- and post- surveys, follow-up surveys were statistically significantly more favorable after a proactive psychiatry consult service was introduced. Concordance of recommendations was observed to be higher for proactive consults than concurrent controls for diagnoses and non-medication (other) recommendations. ConclusionThe positive impact of a proactive C-L psychiatry consultation model was observed in a pediatric hospital and was associated with a lower length of stay than concurrent controls and historical reactive consults, higher hospitalist satisfaction among paired responses, and greater concordance of diagnosis and other non-medication recommendations.

Analysis Of Factors Affecting Breast Cancer At Haji General Hospital Medan Using The Principal Component Analysis Method

Analysis Of Factors Affecting Breast Cancer At Haji General Hospital Medan Using The Principal Component Analysis Method

Comparison of Changes in Rso2 in Midazolam and Propofol Sedation Post Craniotomy in the Icu of H. Adam Malik Hospital

Introduction: Cerebral oxygen saturation reflects tissue perfusion in the cerebrum. Decreases in cerebral oxygen saturation are linked to longer hospital stays and cognitive impairment. Midazolam and propofol can decrease cerebral blood flow through decreasing the cerebral oxygen metabolic rate. The purpose of this research is to analyze the comparison of changes in cerebral oxygen saturation after midazolam and propofol administration in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan. Subject and Method: This is a randomized control trial study. Patients were divided into, Midazolam group, that given an initial dose of 0.05 mg/kg followed by a maintenance dose of 0.02-0.10 mg/kg/hour and Propofol group that given sedation with a dose of 0.3-3mg/kg/hour, with the target of the 2 groups being a Richmond Agitation-Sedation Scale (RASS) value of 0 to -2. Data analysis using unpaired T test. Results: The results for cerebral regional oxygen saturation and RASS between groups showed significant differences in right and left value (p &lt; 0.001), but there was no significant difference in RASS (p&gt;0.05) between each group at each measurement time. The results of the analysis of cerebral regional oxygen saturation and RASS between times, there was no significant difference in right and left value (p&gt;0.05), but there was a significant difference in RASS (p&lt;0.001) at each measurement time. Based on the results of the analysis carried out, it is known that there is no statistically significant difference in changes in cerebral regional oxygen saturation both right and left in changes in RASS because it is found that all data have p&gt;0.05. Conclusion: There is no change in right and left for cerebral regional oxygen saturation after administration of propofol and midazolam groups with RASS value 0 to -2 in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan

Pengaruh Karakteristik Individu Terhadap Minat Kunjungan Ulang Pemeriksaan Antenatal Care (ANC) Di Rumah Sakit Umum Ridos Medan Tahun 2024

Antenatal Care (ANC) examinations are an important strategy in reducing the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR), which are currently still high. Ridos Medan General Hospital is one of the hospitals that provides Antenatal Care (ANC) examinations with a low percentage of pregnant women who make repeat visits for Antenatal Care (ANC) examinations, namely 889 pregnant women who carry out Antenatal Care (ANC) examinations while those who do There will only be 498 pregnant women repeat visits for Antenatal Care (ANC) examinations in 2022. This type of research is a survey with an explanatory research type, which aims to explain the influence of individual characteristics (age, education, occupation, parity, health condition, pregnancy interval, income). , distance, attitude, knowledge, husband's support, and satisfaction with health workers) on interest in repeat visits for Antenatal Care (ANC) examinations at Ridos Medan General Hospital in 2023. The research was conducted at Ridos Medan General Hospital. The population in this study were pregnant women. The sampling technique was Accidental Sampling as many as 89 people. The data analysis used is multiple linear regression. The results of the study show that the variables that influence interest in repeat visits for Antenatal Care (ANC) examinations are education, knowledge, attitudes and satisfaction with health workers. The contribution of these four variables to interest in repeat visits for Antenatal Care (ANC) examinations was 57%. Of the four variables, the one with the strongest influence on interest in repeat visits for Antenatal Care (ANC) examinations is knowledge (B=0.475). Respondents' interest in repeat visits for Antenatal Care (ANC) examinations was generally in the low category, namely 40.4%, medium at 32.6%, and high interest in repeat visits for Antenatal Care (ANC) examinations at 27.0%. In an effort to increase interest in repeat visits for Antenatal Care (ANC) examinations, efforts must be made, namely advocacy and socialization about Antenatal Care (ANC) examinations, carrying out Antenatal Care (ANC) examinations according to standards, training related health workers and it is hoped that health workers will improve the quality of service by being friendlier, more alert, attentive and clear in conveying information.

The Correlation Between P Wave Dispersion and Left Ventricle Mass Index (LVMI) in Heart Failure Patients in H. Adam Malik Central General Hospital Medan

The Correlation Between P Wave Dispersion and Left Ventricle Mass Index (LVMI) in Heart Failure Patients in H. Adam Malik Central General Hospital Medan

The Accuracy of Monocyte Lymphocyte Ratio as a Predictor of Mortality in Patients Undergoing Regular Haemodialysis at H Adam Malik General Hospital Medan

The Accuracy of Monocyte Lymphocyte Ratio as a Predictor of Mortality in Patients Undergoing Regular Haemodialysis at H Adam Malik General Hospital Medan

Correlation between Peak Left Atrial Longitudinal Strain and The Severity of Mitral Valve Disease at Haji Adam Malik General Hospital Medan

Correlation between Peak Left Atrial Longitudinal Strain and The Severity of Mitral Valve Disease at Haji Adam Malik General Hospital Medan

PEACH Score Validation as a Predictor of Postoperative In-hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan

PEACH Score Validation as a Predictor of Postoperative In-hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan

Analysis of Family Support in Enhancing Life Quality among Breast Cancer Patients at Haji Adam Malik Central General Hospital Medan

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Cancer is the most common chronic disease worldwide, with cervical cancer, breast cancer, ovarian cancer, and skin cancer being the most prevalent. Breast cancer ranks second globally after lung cancer. Patients diagnosed with breast cancer undergo changes in their physical, sexual, social, and daily life activities, affecting their overall life quality. One crucial factor that can enhance the life quality for patients is the support from their families, which is a pivotal determinant for individual well-being. To determine the differences in the life quality among breast cancer patients with high and low family support and to analyze the correlation between family support and the breast cancer patients life quality. This study employed a quantitative analytic survey with a cross-sectional design. The research was conducted at Haji Adam Malik Central General Hospital from August to October 2023. The study population included all stage I and II breast cancer patients, totaling 205 outpatient individuals from March to April 2022, with a sample size of 66. Simple random sampling was utilized for participant selection. Data collection involved questionnaire interviews. Data analysis comprised two steps: first, univariate analysis using descriptive and frequency statistics, and second, bivariate analysis using Pearson's test and independent t-test with a significance level of 95% (p-value ≤ 0.05). Statistical results indicated a significant difference in the life quality between breast cancer patients with high and low family support (p=0.037). It was concluded that there is a significantive correlation between family support and the breast cancer patients life quality (p=0.001; r=-0.644). Family support is crucial for patients facing chronic diseases such as breast cancer. It is recommended that families strive to enhance their support to ensure patients' comfort during treatment and therapy programs, ultimately improving the breast cancer patients life quality.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keyword: Breast Cancer, Family, Life Quality&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Construction Management in the New Building Project for the Haji Medan General Hospital

Improving health services is one of the priorities in North Sumatra Province, a province that is currently carrying out a lot of development, one of which is the construction of hospitals which are used to meet the health needs of the people in North Sumatra. The development process carried out is a form of service improvement. This study was carried out to analyze the development management of RSU Haji Medan which was carried out by PT. KSO Adhi-Penta. Good construction management needs to be implemented to ensure that work can be completed according to the implementation schedule. The problem formulation in this research discusses three research focuses, namely: 1) Supervision of project management at RSU Haji Medan, 2) Arrangement of human and material resources, 3) Arrangement of scheduling of RSU Haji Medan project activities. The analytical method in this research was carried out using the and Build principle. The Design and Build method provides opportunities to increase time and cost efficiency. The results of this research are: 1) Construction supervision management ensures that all construction activities take place in accordance with the plans, specifications and standards that have been set. 2) Human resources (HR) and material factors cannot be separated because they will have an impact on the quality and running of the business activities carried out. Not only that, the quality of human resources and materials will provide maximum results. 3) PT. KSO Adhi-Penta's target for completion and implementation was successful in achieving the progress that had been determined step by step in accordance with the plan, this indicates that in the construction of RSU Haji Medan, the contractor or developer was successful in implementing management principles well.

Analysis Of Factors Influencing Patient Safety Incidents at Royal Prima Medan General Hospital in 2021

Incident safety patients must be minimized to avoid undesirable danger during maintenance in the hospital. Perception of health workers reporting patient safety incidents at the Royal Prima Medan General Hospital still needs to be higher. Low perception of health workers in writing incident Patient safety is related to individual and organizational factors. The study aims to identify the influence factor on patients' personal and corporate incident safety in the inpatient room of royal prima hospital medan. The type of research used is a method survey with a cross-sectional approach. The population in the study of health workers at the Royal Prima General Hospital in Medan was 259 people, and the sample was 119. Collection data with primary, secondary, and tertiary data was analyzed with multiple logistic regression statistical tests with a level of trust of 95%. Results study show bring individual factors (knowledge with p-value = 0.021 and experience with p-value=0.021) effect-on-patient safety incident reporting and organizational factors (organizational environment with p-value = 0.038 and power with p-value=0.014) effect on reporting incident safety patient, individual characteristics (motivation with p-value = 0.557) have no impact on writing incident safety patient And factor organization (organizational culture with p-value =0.535) has no effect to reporting incident patient safety and most influence reporting incident patient safety in Royal Prima General Hospital Medan is a knowledge variable (OR=155.6). They are recommended for a hospital for-develop system information integration related to writing incident patient safety and officer health to increase the perception of officer health through improvement, knowledge, and experience of officer health.