Universitas Prima Indonesia: Open Journal Systems
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Prevalence of ulcer disease among patients with diabetes mellitus at Royal Prima Hospital Medan
No full textBackground: Diabetes mellitus is a chronic metabolic disorder with a rapidly increasing prevalence, often leading to serious complications such as diabetic ulcers, which significantly affect quality of life and increase healthcare costs. This study aimed to determine the prevalence of ulcers in patients with diabetes mellitus treated at Royal Prima Medan Hospital and to analyze the associated factors.
Methods: This quantitative observational study employed a retrospective design and analyzed medical record data collected between 2021 and 2025. A total of 58 patients were selected using purposive sampling. Data analysis was conducted using the Chi-Square test and ANOVA with a 95% confidence level.
Results: The majority of the respondents were male (63.8%) and within the 56–65-year age group (34.5%). The most common skin condition was diabetic ulcers (82.8%), followed by diabetic bullae (12.1%) and viral infections (5.2%). The mean blood glucose level was 246.33 mg/dL, indicating hyperglycemia. Statistical analysis revealed no significant association between gender and skin disease type (p = 0.895) and no significant difference in blood glucose levels across types of skin disease (p = 0.135).
Conclusion: There was no significant correlation between skin disease type and blood glucose levels, suggesting that clinical management should also address other behavioral and metabolic factors
Gonial angle, antegonial angle, and bigonial breadth among Chinese and Batak ethnic groups: A panoramic radiographic analysis
No full textBackground: Mandibular morphology is a key aspect of antropometry and dentistry, reflecting anatomic variations influenced by genetic, ethnic, and environmental factors. Parameters such as bigonial width, gonial angle, and antegonial angle serve as primary indicators in mandibular morphometric analysis, with applications in orthodontics, maxillofacial surgery, and forensic identification. Population-based morphometric data for local Indonesian groups remain limited. This study addresses this gap by examining mandibular characteristics in Batak and Chinese ethnic groups. This study aimed to compare bigonial width, gonial angle, and antegonial angle between Batak and Chinese groups using panoramic radiographs.
Methods: This cross-sectional, observational, analytic study included 50 subjects (25 Batak and 25 Chinese) at RSGM Prima. Measurements were performed with ImageJ software and analyzed using Shapiro-Wilk normality test, Levene homogeneity test, and independent t-test.
Results: No statistically significant differences were found in gonial angle (p=0.665), antegonial angle (p=0.218), or bigonial width (p=0.328) between the groups.
Conclusion: No significant differences exist in gonial angle, antegonial angle, or bigonial width between Batak and Chinese groups. Mandibular morphometric variations are not determined solely by ethnicity. These parameters should be integrated with other anthropologic markers and primary identification methods for greater accuracy in clinical and forensic applications
Effects of rice husk nanosilica on color stability of metal-ceramic crowns
No full textBackground: Metal-ceramic crowns remain a primary choice for dental restoration due to their adequate mechanical strength and relatively low cost. However, their esthetic success depends on the color stability of the porcelain, particularly the opaque layer that masks the underlying metal. Nanosilica derived from rice husks is an environmentally friendly material with potential as a reinforcing agent, but data on its effect on color changes in metal-ceramic crowns remain limited. This study aimed to analyze the effect of adding 0.5% rice husk nanosilica to the opaque layer on color changes in metal-ceramic crowns.
Methods: An in vitro experimental study used Co-Cr metal samples coated with porcelain, with color evaluation based on the CIELAB system (L*, a*, b*) via colorimeter before and after nanosilica addition. Nanosilica was synthesized from rice husks and characterized using particle size analysis and scanning electron microscopy. Data were analyzed with Shapiro-Wilk test, Levene test, Welch t-test, and paired t-test.
Results: Characterization results showed nanosilica particles in the nanoscale range with two main distribution peaks and amorphous, spherical morphology with agglomeration tendency. L* values increased significantly, whereas changes in a* and b* values showed no significant differences.
Conclusion: These findings indicate that adding 0.5% rice husk nanosilica to the opaque layer increases brightness and total color change in metal-ceramic crowns, requiring esthetic control in its application
Pendampingan Penguatan Komitmen dan Kepuasan Kerja Perawat Pelaksana di RSUD Bengkalis Riau
No full textPerawat pelaksana memiliki peran strategis dalam penyelenggaraan pelayanan keperawatan yang berkualitas dan berorientasi pada keselamatan pasien. Tuntutan kompleksitas kondisi klinis pasien, beban kerja, serta tuntutan profesionalisme menempatkan perawat pelaksana sebagai garda terdepan dalam sistem pelayanan rumah sakit. Kinerja perawat pelaksana tidak hanya dipengaruhi oleh kompetensi klinis, tetapi juga oleh faktor organisasi seperti kepuasan kerja, kepemimpinan, supervisi, dan komitmen kerja. Kepuasan kerja mencerminkan penilaian subjektif perawat terhadap kondisi kerja yang diterimanya, sedangkan komitmen kerja menunjukkan loyalitas dan keterikatan perawat terhadap organisasi. Berbagai penelitian menunjukkan bahwa kepemimpinan yang efektif, supervisi yang suportif, serta komitmen kerja yang kuat berkontribusi terhadap peningkatan kinerja dan mutu asuhan keperawatan. Oleh karena itu, upaya peningkatan kinerja perawat pelaksana perlu mempertimbangkan aspek kepuasan kerja dan komitmen sebagai faktor penting dalam mendukung pencapaian mutu pelayanan dan keselamatan pasien di rumah sakit
The Effect of Progressive Muscle Relaxation Technique on Pain
No full textPain is a common clinical problem that can be managed through both pharmacological and non-pharmacological approaches, including progressive muscle relaxation. This study aimed to examine the effect of progressive muscle relaxation technique on pain among patients in the Fatmawati Ward of RSUD Sekarwangi. A pre-experimental study with a one-group pretest–posttest design was conducted involving 25 respondents selected through purposive sampling, consisting of patients experiencing mild to moderate pain. Progressive muscle relaxation was administered once daily for approximately 15–20 minutes over the intervention period. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention, and data were analyzed using the Wilcoxon Signed Rank Test. The results showed that prior to the intervention, most patients experienced moderate pain (84%), while after the intervention all patients (100%) reported mild pain. Statistical analysis revealed a significant difference in pain levels before and after the intervention (p = 0.001; < 0.05). These findings indicate that progressive muscle relaxation is effective in reducing pain among hospitalized patients. This technique can be considered a complementary nursing intervention in hospital pain management, and future studies are recommended to involve larger samples, control groups, and longer follow-up periods to evaluate its long-term effectiveness and broader clinical applications
Nursing Care for XDR-TB Complicated by Infected Bronchiectasis and Malnutrition: A Case Report
No full textExtensively drug-resistant tuberculosis (XDR-TB) presents a formidable challenge, often exacerbated by irreversible structural lung damage and severe malnutrition. Roy’s Adaptation Model (RAM) was employed as the theoretical framework to address the profound physiological and psychosocial disruptions in a high-complexity case. This report describes the integrated, nurse-led management of a patient with XDR-TB and destroyed lung syndrome during the acute stabilization phase. A 39-year-old woman with a decade-long history of TB treatment failure was admitted to a national referral hospital with XDR-TB, profound cachexia (BMI 13.96 kg/m2), and severe hypercapnia (pCO2 94.7 mmHg). During a 72-hour acute stabilization period, integrated nursing-led interventions including the Active Cycle of Breathing Technique (ACBT), therapeutic positioning, and a high-calorie, high-protein regimen resulted in marked clinical improvement. Respiratory stabilization allowed for oxygen weaning from 5 to 4 L/min with an SpO2 increase to 97%. Breaking the catabolic cycle was evidenced by weight stabilization (maintained at 35 kg) and a positive metabolic shift, alongside significantly improved oral intake (80–90% of requirements).. Functional status progressed from total bed rest to independent short-distance ambulation without desaturation. Comprehensive nursing interventions, focusing on airway clearance and acute metabolic stabilization, play a pivotal role in the rapid stabilization of complex XDR-TB cases. Highlighting outcomes within the first 72 hours demonstrates that structured nursing care acts as a catalyst for physiological adaptation, even in the presence of severe anatomical lung destruction
FROM SCROLL TO SKILL: ENHANCING GEN Z'S SPEAKING SKILLS THROUGH TIKTOK CONTENTS
No full textThis study explored the use of TikTok as an informal learning platform to support Generation Z English as a Foreign Language (EFL) learners in improving their English speaking skills. A qualitative descriptive method was applied, involving 20 Gen-Z EFL learners selected through purposive sampling. Data were collected over an eight-week period using semi-structured interviews, observations, and analysis of learner TikTok video testimonies. The findings indicated that learners perceived TikTok as an engaging, accessible, and motivating platform that contributed to improvements in pronunciation, vocabulary use, fluency, and speaking confidence. Learners frequently engaged with content such as pronunciation tutorials, daily conversation expressions, and short vocabulary lessons, which encouraged repeated exposure and self-directed speaking practice. Despite these advantages, the study also identified several challenges, including distractions, limited depth of explanations, and the presence of unreliable learning content. These issues suggest that learners require adequate digital literacy and strategic guidance to maximize the educational benefits of TikTok. Overall, TikTok was found to be a supportive tool for developing speaking skills when used intentionally, although it is best utilized as a supplementary resource alongside formal English instruction
A Case of Thyroglossal Duct Cyst in a 13-Year-Old Female Patient on Her First Visit to the Hospital
No full textThyroglossal duct cyst is the most common congenital neck abnormality, resulting from failure of the thyroglossal duct to obliterate during the embryogenesis of the thyroid gland. A 13-year-old female patient complaining of a lump under her chin for approximately 5 years prior to admission. Initially, the lump was painless, but two weeks before admission, it enlarged and was accompanied by throbbing pain and signs of local inflammation. Physical examination revealed a mass in the submental region with tenderness and erythema, without cervical lymph node enlargement. FNAB Examination result showed a thyroglossal duct cyst without signs of malignancy. Based on the anamnesis, physical examination, and supporting examination results, the patient was diagnosed with a thyroglossal duct cyst. The patient underwent a Sistrunk procedure under general anesthesia. The operation approximately 40 minutes and involved excision of the cyst and duct tract, resection of the middle part of hyoid bone, and placement of a handscoon drain. Postoperative wound care proceeded well, improvement in pain, stable condition, and no complications of bleeding or surgical wound infection. On the fourth postoperative day, the patient's condition was stable and she was allowed to go home with oral therapy
THE PROFILE OF PRESCRIPTION OF ANTITUBERCULOSIS DRUG IN PATIENTS OUTPATIENT CARE AT ADVENTIST HOSPITAL MEDAN
No full textTuberculosis, a highly infectious ailment, is triggered by the bacterium Mycobacterium tuberculosis, primarily affecting the lung's functional tissue. Transmission occurs when a person inhales airborne saliva droplets containing the bacteria expelled by a tuberculosis patient through coughing, thus spreading the disease. This investigation sought to determine the attributes of tuberculosis patients receiving outpatient care, along with the pattern of anti-tuberculosis drug prescriptions at X Hospital Medan between July and December 2023. Metode; The study utilized a non-experimental approach because of its design and structure, which involved collecting survey data from the hospital's historical records. Ninety-six tuberculosis drug prescriptions issued during July–December 2023 were selected through random sampling. The study's findings revealed that, among 96 patients, the 46–55 age group comprised 22 individuals (22.9%), with females accounting for 55 patients (57.3%), and 94 patients (95.8%) utilized BPJS as their payment guarantor. The research indicated that Category I anti-tuberculosis drugs were prescribed more frequently than Category II anti-tuberculosis drugs for 92 patients (95.8%), and 59 patients (61.5%) at X Hospital received OAT-FDC, a commonly employed tuberculosis treatment. This study proposed that future research should outline the anti-tuberculosis medication prescription profile, using patients’ health information
Application of Zinc Cream as an Adjunct Therapy to Enhance Wound Healing in Diabetic Foot Ulcers
No full textDiabetic foot ulcer is one of the most serious complications in individuals with diabetes mellitus, resulting from peripheral neuropathy, impaired vascularization, and chronic infection, which collectively delay the wound healing process. Proper wound management is essential to prevent severe outcomes such as amputation. Methods: This study employed a case study design to provide an in-depth clinical description of wound healing progression in patients with stage 4 diabetic foot ulcers. Purposive sampling was used to select three patients treated at Asri Wound Care Center Medan. Zinc cream was applied as an adjunct therapy for six weeks, with treatment administered twice weekly. Wound healing was evaluated using the Bates-Jensen Wound Assessment Tool (BWAT) and clinical observations. Results: All patients demonstrated observable improvements in BWAT scores, with reductions from 37 to 22, 40 to 26, and 39 to 24, respectively. Clinical observations indicated improved wound healing indicators, including increased granulation tissue, reduced exudate, and enhanced epithelialization. Conclusion: The application of zinc cream as an adjunct therapy may support the wound healing process in patients with stage 4 diabetic foot ulcers. However, due to the limited sample size and the absence of a control group, the findings should be interpreted cautiously, and further studies with larger samples and comparative designs are recommended