1,720,979 research outputs found
Overview of Risk Factors Patients with Chronic Obstructive Pulmonary Disease (COPD) at RSUP H. Adam Malik Medan in 2022-2023
No full textIntroduction. Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by symptoms, such as shortness of breath, cough, sputum production, with or without exacerbations. COPD is one of the leading causes of death worldwide and a serious non-communicable disease in Indonesia, with a mortality prevalence of approximately 4.8 million people (5.6%). Major risk factors for COPD globally include smoking and exposure to polluting particles in the environment, workplace or indoors. Objective. This study aims to determine the description of the risk factors for patients with Chronic Obstructive Pulmonary Disease (COPD) at RSUP H. Adam Malik Medan in 2022-2023. Methods. This study used a descriptive survey design with a cross-sectional approach and total sampling technique. The sample consisted of 52 patients taken from medical record data based on inclusion and exclusion criteria. Data were presented in a frequency distribution table. Results. Most patients with COPD have a severe degree of severity as many as 37 people (71.2%). The largest age group was the elderly (60-79 years) as many as 34 people (65.4%), with the majority of male gender as many as 39 people (75.0%). The most common occupation was farmer as many as 26 people (50.0%). Most patients with COPD have a severe Brinkman Index (30 people, 57.7%), active smokers (22 people, 42.3%), and exposed to outdoor air pollution (46 people, 88.5%). Conclusion. The majority of patients with COPD have a severe degree of severity. The largest age group was the elderly (60-79 years), with more men than women. Most occupations are farmers, and most Brinkman Indexes are in the severe category. The highest smoking risk was found in active smokers, while the most exposure to air pollution came from outdoors.87 PagesSkripsi Sarjan
Dampak Pemberian Short-Acting Bronchodilator Terhadap Penanganan Penyakit Paru Obstruktif Kronik Eksaserbasi Akut: Meta Analisis
No full textBackground. COPD is a preventable and treatable chronic respiratory disease characterized by persistent respiratory symptoms and airflow limitation usually caused by significant exposure to particulate matter, noxious gases, or by other factors, such as abnormal lung development. In 2016, COPD was the cause of death for three million people worldwide. One of the problems with COPD is the tendency to exacerbations. Exacerbations can reduce lung function, which can lead to death. Mortality due to COPD in 1 year reaches 40%. Therefore, COPD exacerbations should be treated as soon as possible. Objective. This study aims to determine the impact of short-acting bronchodilators on the management of acute exacerbations of COPD. Methods. This meta-analysis research uses online literature sourced from Google Scholar, PubMed, Cochrane, ScienceDirect, and ClinicalKey. The journal used is a clinical research journal that discusses the impact of short-acting bronchodilators on the management of acute exacerbations of COPD. This research uses Review Manager 5.4. Results. Eight studies involving a total of 521 patients were analyzed. There were not any significant differences of reduction of dyspnoea (p=0.09), reduction of hospitalization time (p=0.13), enhancement of FEV1 (p=0.09), enhancement of FVC (p=0.77), and side effects (p=0.11) between experiment group and control group. Conclusions. Short-acting bronchodilators can be used in the treatment of acute exacerbations of COPD, although there is no significant difference in the effect of number of doses, the method of administration, and the type of short-acting bronchodilator used.Latar Belakang. PPOK merupakan penyakit respirasi kronis yang dapat dicegah dan diobati, ditandai dengan gejala pernapasan persisten dan keterbatasan aliran udara yang biasanya disebabkan oleh paparan yang signifikan dari partikel, gas berbahaya, ataupun oleh faktor lain, seperti perkembangan paru-paru yang abnormal. Pada tahun 2016, PPOK telah menjadi penyebab kematian bagi tiga juta orang di seluruh dunia. Salah satu permasalahan dari PPOK adalah kecenderungan mengalami kejadian eksaserbasi. Kejadian eksaserbasi dapat menurunkan fungsi faal paru, hingga dapat menyebabkan kematian. Mortalitas akibat PPOK dalam 1 tahun mencapai 40%. Oleh karena itu, PPOK eksaserbasi harus dapat ditangani sesegera mungkin. Tujuan. Penelitian ini bertujuan untuk mengetahui dampak pemberian short-acting bronchodilator terhadap penanganan PPOK eksaserbasi akut. Metode. Penelitian meta analisis ini menggunakan literatur online yang bersumber dari Google Scholar, PubMed, Cochrane, ScienceDirect, dan ClinicalKey. Jurnal yang digunakan adalah jurnal penelitian klinis yang membahas dampak pemberian short-acting bronchodilator terhadap penanganan PPOK eksaserbasi akut. Penelitian ini menggunakan aplikasi Review Manager 5.4. Hasil. Delapan studi diikutsertakan dalam meta analisis ini dengan total 521 pasien. Berdasarkan analisis data, tidak terdapat perbedaan yang signifikan pada pengurangan gejala sesak napas (p=0.09), pengurangan lama waktu perawatan (p=0.13), peningkatan nilai FEV1 (p=0.09), peningkatan nilai FVC (p=0.77), dan timbulnya efek yang tidak diinginkan (p=0.11) antara kelompok eksperimen dengan kelompok kontrol. Kesimpulan. Short-acting bronchodilator dapat digunakan dalam pengobatan PPOK eksaserbasi akut, walaupun tidak ada perbedaan dampak signifikan dalam jumlah dosis, metode pemberian, serta jenis short-acting bronchodilator yang digunakan68 HalamanSkripsi Sarjan
Gambaran Pasien Gagal Napas Dengan Kelainan Paru Pada Rawat Inap di Rumah Sakit Umum Haji Adam Malik Medan Bulan Januari Sampai Agustus Tahun 2017
No full textBackground. Respiratory failure is a syndrome in which the respiratory system fails to maintain O2 and CO2 gas. Acute respiratory failure is classified into two causes of acute respiratory failure (respiratory failure type I) and acute hypercapnia respiratory failure (respiratory failure type II). Thediagnostic techniques and therapies have developed rapidly, respiratory failure is still the cause of high morbidity and mortality rates in intensive care installations. Objective. This study aims to determine the description of the incidence of disease patients in the respiratory tract of RSUP. Haji Adam Malik Medan 2017. Method. This research is a retrospective descriptive research using medical record data. This research is in RSUP H. Adam Malik Medan. The study sample was inpatients with lung abnormalities who performed AGDA checks from January to August 2017. Samples were selected using the total sampling method and adjusted for the inclusion and exclusion criteria. Results. Patients with respiratory failure with lung disorder were more likely to be males (72%) and feeding age 51-60 years (44%) with employee private (47%). Lung disease underlying seizures in patients with pulmonary abnormalities is pulmonary (52%) with type 1 (92%). Conclusion. Characteristics of respiratory failure patients with men ages 51-60 with self-employed workers. The type of respiratory failure is type I with the cause of lung injury.Latar Belakang. Gagal napas merupakan sindrom di mana sistem pernapasan gagal untuk mempertahankan pertukaran gas O2 dan CO2.Gagal napas akut digolongkan menjadi dua yaitu gagal napas akut hipoksemia (gagal napas tipe I) dan gagal napas akut hiperkapnia (gagal napas tipe II). Kemajuan teknik diagnosis dan terapi intervensi telah berkembang pesat, tetapi gagal napas masih merupakan penyebab angka kesakitan dan kematian yang tinggi di instalasi perawatan intensif. Tujuan. Penelitian ini bertujuan untuk mengetahui gambaran kejadian gagal napas pasien dengan kelainan paru dan saluran pernapasan pada rawat inap di RSUP. Haji Adam Malik Medan 2017. Metode.Penelitian ini adalah penelitian deskriptif retrospektif dengan menggunakan data rekam medik.Penelitian ini berlokasi di RSUP H. Adam Malik Medan. Sampel penelitian adalah pasien rawat inap dengan kelainan paru yang melakukan pemeriksaan AGDA pada bulan Januari sampai Agustus 2017. Sampel dipilih dengan menggunakan metode total sampling dan disesuaikan dengan kriteria inklusi dan eksklusi. Hasil. Pasien-pasien gagal nafas dengan kelainan paru lebih banyak diderita oleh laki-laki(72%)dan usia terbanyak yaitu 51-60 tahun (44%) dengan pekerjan terbanyak yaitu pegawai swasta (47%). Penyakit paru yang mendasari terjadinya gagal napas pada pasien dengan kelainan paru terbanyak adalah tb paru (52%) dengan tipe terbanyak adalah tipe 1 (92%). Kesimpulan. Karakteristik penderita gagal napas terbanyak yaitu laki-laki dengan usia 51-60 dengan pekerjan wiraswasta. Tipe gagal napas terbanyak adalah tipe I dengan penyebab terbanyak tb paru.Skripsi Sarjan
Relationship Between Microbial Patterns and Resistance Testing with Mortality in Pneumonia Patients at The ICU of RSUP H. Adam Malik
No full textBackground and Objectives: The mortality rate in hospitals among intensive care patients is 20-30%, and ICU patients contribute to 20-50% of all hospital deaths. Mortality in the ICU is high, but the risk increases further when accompanied by nosocomial infections. Therefore, it is crucial to detect infections, especially in the lower respiratory tract, through examinations such as BAL, which is useful for mapping the microbial patterns in hospitals, thereby ensuring the precise use of antibiotics to reduce mortality. Based on the aforementioned background, there appears to be a relationship between microbial patterns and mortality. However, the association between microbial patterns and mortality based on BAL examinations is limited, prompting researchers to conduct a study on the "Relationship between microbial patterns and resistance testing with mortality based on BAL examinations in inpatient pneumonia cases in the ICU."
Method: This research uses a quantitative method with a cross-sectional study design to examine the relationship between microbial patterns and resistance testing with mortality.
Results: Based on the research findings, the mortality rate of pneumonia patients in the ICU at RSU H. Adam Malik is 17 cases (37%). The highest category of pneumonia patients is classified as CAP (Community Acquired Pneumonia), with 18 cases (39.1%), and the lowest category is VAP (Ventilator Associated Pneumonia), with 11 cases (23.9%). There is no relationship between drug resistance and mortality in pneumonia patients in the ICU in H. Adam Malik General Hospital. There is no relationship between microbial patterns and mortality in pneumonia patients in the ICU of H. Adam Malik General Hospital.76 PagesTesis Magiste
Correlation of Bronchoscopy Visualization with Cell Type in Lung Cancer Patients at Haji Adam Malik Hospital Medan 2023
No full textBackground: Lung carcinoma, or lung cancer, is a tumor that originates in the lung parenchyma or bronchi. Cigarette smoking, including secondhand smoke exposure, is the leading cause of lung cancer. Lung cancer is divided into two main types: Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC). Bronchoscopy is an important tool in the diagnosis and management of lung carcinoma, allowing tissue or mucus samples to be taken via biopsy. Timely bronchoscopy is essential for the rapid and accurate diagnosis of lung carcinoma.Objective: This study aimed to determine the relationship between bronchoscopic visualization images and carcinoma cell type characteristics from histopathology.Methods: An observational analytic cross-sectional study was conducted from October 2023 until the sample size was met. Data included bronchoscopic visualization images and lung carcinoma cell types from histopathology. Data were analyzed univariately and bivariately to assess the relationship between bronchoscopic visualization and lung carcinoma cell type in lung cancer patients.Results: Of the 62 patients, 50 were male (80%), with the majority aged 20-60 years (54%). Batak ethnicity dominated (73%), and 44% of patients worked outside the home. Most patients were married (87%). All patients had NSCLC (100%). Based on bronchoscopy, 62% of cases were in a central location, 65% had a partially closed orifices, 77.5% showed hyperemic mucosa, 83.8% had mucoid secretions, and 32.2% were in the right main bronchus.Conclusion: Lung carcinoma is most commonly found in the right main bronchus and is most prevalent in males, with NSCLC as the most common cancer cell type.111 PagesTesis Magiste
Gambaran Kelainan Paru secara Radiologi pada Penderita TB Paru dengan Penyakit Penyerta Diabetes Melitus di RS Prof Chairuddin P Lubis Medan Tahun 2022
Full text linkBackgrounds. Tuberculosis (TB) is an infectious disease that can affect various organs, especially the lungs. Individuals with diabetes mellitus are more susceptible to tuberculosis infection due to impairments in the function of immune cells. This condition can worsen the symptoms of pulmonary TB and increase the recurrence rate of pulmonary TB. Chest X-ray examination is used to support the diagnosis of pulmonary TB. Aims. This study aims to investigate the chest X-ray findings in patients with pulmonary TB and diabetes mellitus at Prof. Chairuddin P. Lubis Hospital in Medan during January to December 2022. Methods. This study is a retrospective descriptive research that uses a cross-sectional secondary data approach. Subjects are categorized based on age, gender, occupation, education, and radiological features of chest X-rays (appearance, extent of lesions, and lesion location). Results. A total of 85 samples were obtained with research results indicating that the most frequent age group was 56–65 years, comprising 32 individuals (37.6%). Based on gender, 58.8% were male and 41.2% were female. In terms of occupation and highest education level, the majority were self-employed (34.1%) and had completed high school (40.0%). The most commonly observed chest X-ray appearance was fibroinfiltrate (27.1%). The severity degree that predominated was far advanced lesion extent (80.0%), with the most common lesion location being atypical (35.3%). Conclusion. Patients with pulmonary TB and DM are most commonly found in the productive and elderly age group (36-70 years) and are predominantly male. On average, patients have occupations, with the most common highest education level being high school. The most frequently observed chest X-ray appearance is fibroinfiltrate, with a widespread extent of far-advanced lesions and the most common lesion location being atypical.54 PagesSkripsi Sarjan
Hubungan Tingkat Pengetahuan dan Sikap terhadap Perilaku Merokok pada Mahasiswa Fakultas Kedokteran Universitas Sumatera Utara Angkatan 2019 – 2021
No full textBackground. Smoking behavior is a problem related to public health because it can cause various diseases and even cause death for both smokers and those around them. Even though everyone knows that smoking is harmful to health, in reality smoking behavior is still rigorous to control. Aim. To find out the correlation between knowledge and behavior with level of dependence on smoking behavior in students of the Faculty of Medicine, University of North Sumatra class of 2019-2021. Methods. This research is analytical with a cross sectional study. Results. It was found that 16 of the active smokers, 4 of them were categorized as heavy smokers, this is erroneous considering that medical students are pioneers of healthy living and later will become someone who educates others to live a healthy life. The results using the Fisher exact test on knowledge with active smoking behavior showed that exact sig(2-sided) value of 0.569. The results using the Fisher exact test on behavior with active smoking behavior showed that exact sig(2-sided) value of 0.262. The results using the Fisher exact test on knowledge with inactive smoking behavior showed that exact sig(2-sided) value of 0.074. The results using the Fisher exact test on behavior with inactive smoking behavior showed that exact sig(2-sided) value of 0.421. Conclusions. There is no correlation between knowledge and behavior with level of dependency on smoking behavior in students of the Faculty of Medicine, University of North Sumatra class of 2019-2021.96 HalamanSkripsi Sarjan
Pengaruh Paparan Debu Terhadap Nilai Arus Puncak Ekspirasi pada Pedagang Kaki Lima
No full textLatar belakang. Salah satu penyebab masalah kesehatan adalah pencemaran udara. Akibat dari pencemaran udara dapat membahayakan sistem pernapasan karena partikel debu (polutan) langsung masuk ke paru – paru dan mengendap di alveoli. Salah satu cara untuk menilai fungsi faal paru adalah dengan memeriksa nilai arus puncak ekspirasi menggunakan peak flow meter untuk memberikan peringatan dini penurunan fungsi paru. Nilai normal APE pada laki – laki dewasa adalah 450-600 L/menit dan pada wanita dewasa adalah 300-500 L/menit. Setiap orang pada umumnya sekitar ± 8 jam/hari berada ditempat kerja dan menghirup ± 3.500 liter udara termasuk bahan pencemar dan patofisiologi penyakit karena terpapar debu terjadi setelah bekerja 2 tahun. Pedagang kaki lima adalah mereka yang melakukan kegiatan usaha dagang perorangan atau kelompok yang dalam menjalankan usaha nya menggunakan tempat – tempat fasilitas umum, seperti trotoar, pinggir – pinggir jalan umum, dan lain sebagainya Tujuan. Untuk mengetahui pengaruh paparan debu terhadap fungsi faal paru pada pedagang kaki lima. Metode. Penelitian ini menggunakan rancangan penelitian analitik dengan pendekatan studi potong lintang.Hasil. Dari 92 sampel didapatkan 62 orang perempuan dan 32 orang laki – laki. Kesimpulan. Berdasarkan karakteristik demografi didapati responden yang berjenis kelamin perempuan lebih banyak dari pada laki – laki. Dengan Nilai APE yang baik sebanyak 70 responden.Background. One of the causes of health problems is air pollution. Effects of air pollution could damage the respiratory system because the dust particles (pollutants) enter straight inside the lungs and deposit at the alveoli. One way to measure lung function is by measuring peak expiratory flow using the peak flow metri tool to give early warning about the decreasing of lung funcions. The normal value of peak expiratory flow rate is 400 – 600 l/min for and adult male and 300- 500 l/min for an adult female. Every person generally spends ±8 hours/day at the workplace and inhales ±3.500 liters of air including pollutants and pathophysiology of disease causes by dust exposure occurs after working for 2 years. Street vendors are people who carry out individual or groups bussiness using place of public facilities, such as sidewalk , roadside and etc. Objective. The Objective of this study is to find out the effects of dust esposeure on the lung function of street vendors. Method. This sudy uses an analytical research design with a cross-sectional study approach. Result. Out of 92 samples, there were 62 women and 30 men. Conclusion. Based on demographic characteristics, there were more female respondents than males with a good peak expiratory flow rate of 70 respondents.Skripsi Sarjan
Hubungan Derajat Keparahan Gejala, D-Dimer dan Rasio PaO2/FiO2 Pada Analisa Gas Darah terhadap Kejadian ARDS pada Pasien Covid-19 di Rumah Sakit Umum Pusat Haji Adam Malik Medan Sumatera Utara
No full textBackground : Global experience of managing patients with COVID-19-related
acute respiratory distress syndrome (ARDS) is growing rapidly, along with an
increasing number of reports on respiratory system mechanics and ventilator
management. Over the past two decades, ARDS heterogeneity has become
increasingly recognized, and efforts have been made to describe subgroups of
patients with different clinical and biological characteristics, clinical outcomes,
and treatment responses. Given the importance of mechanical ventilation of lung
protectors in ARDS. With the increase in COVID-19 cases, the purpose of this
study is how the relationship of the severity of symptoms, d-dimer and pao2/FiO2
ratio in blood gas analysis of ards incidence in COVID 19 patients at RSUP H
Adam Malik Medan, North Sumatra.
Method: The design of this study is analytical research with cross sectional
design using data on the medical records of patients diagnosed as COVID-19
patients with ARDS and non-ARDS who are treated in the isolation room of
Adam Malik Hajj Central General Hospital.
Results : In this study, in terms of the severity of symptoms, there was a
meaningful relationship (p=0.000). It was later found a significant association
between d-dimer levels in early admission patients with ARDS incidence in
COVID-19 patients and a 7.3 times higher risk of d-dimer being ARDS, according
to the Mert O et all study. In older age (>40 years) can not be meaningful relationships (p = 0.284), but older age is more experienced ARDS. Results :
There is no meaningful relationship between age, gender, cough, loss of smell,
loss of taste, fever, nausea, myalgia, colds, diarrhea, smoking habits, comorbid
factors, PaO2/FiO2 ratio of ARDS incidence. Then, there is a link between
shortness of breath, severity of symptoms and d-dimer values against ARDS
events. Thoracic photos cannot be assessed because all research subjects have
bilateral infiltrates. Then there was the meaningful relationship between the sexes
and the incidence of ARDS (p=0.005), men at 3.8 times higher risk of becoming
ARDS. In terms of complaints, shortness of breath and loss of smell are quite
significant (p=0.000, p=0.000), not by coughing, loss of taste, fever, nausea,
muscle aches, chest pain, colds, and diarrhea (p=0.312, p=1,000, p=0.750,
p=1,000, p=0.059, p=0.460, p=0.255, p=0.589, respectively). There was a
significant association between smoking habits and ARDS incidence and when
further analysis was conducted, patients with smoking habits 2.8 times developed
into ARDS compared to non-smoking patients. The thoracic photo relationship to
ards events cannot be assessed because all research subjects have bilateral
infiltrates. The relationship of comorbid factors to ARDS events, 29 of which
were found to be comorbid, but statistically, there is no meaningful relationship
between comorbid factors and ARDS events.
Conclusion: There is no meaningful relationship between age, cough, loss of
smell, loss of taste, fever, nausea, muscle pain, colds, diarrhea, smoking habits,
comorbid factors, PaO2/FiO2 ratio there is an incidence of ARDS. Then, there is a
meaningful relationship between the severity of symptoms, d-dimer values,
gender and shortness of breath to the incidence of ARDS. Thoracic photos cannot
be assessed because all research subjects have bilateral infiltrates.139 HalamanTesis Magiste
Characteristics of Inflammatory Markers with ARDS Events in Confirmed Case of COVID-19 Patients with Severe and Critical Degree at H Adam Malik Hospital Medan
No full textBackground: COVID-19 can cause a serious condition known as acute respiratory distress syndrome (ARDS). The clinical features of COVID-19 patients with acute respiratory distress syndrome (ARDS) were described, and further described the inflammatory markers on ARDS in COVID-19. There is a scarcity of information on the clinical features and inflammation markers of people with severe COVID-19 and ARDS.
Objectives : This study aimed to evaluate characteristics routines inflammatory markers with COVID-19-associated ARDS among patients hospitalized with COVID-19 cases in H Adam Malik Hospital Medan.
Methods : This is a retrospective analysis of 204 medical record on patients hospitalized with confirmed case COVID-19 with severe and critical degree in RSUP H Adam Malik Medan between February and July 2021. The laboratory values were analyzed to compare ARDS group and non-ARDS group.
Results : Among 204 patients, with mean age was 57 years, and 119 patients (58.3%) were male, and more than half, 116 patients (56.9%) developed ARDS. And in ARDS group, 58 patients (28.3%) were in elderly group (≥ 60 years old).
Nearly half of the patients in ARDS group (42.6%) had at least one chronic medical illness. Compared to non-ARDS group, ARDS patients more likely to have coexisting hypertension conditions (34.8% vs 22.1%), more elevated neutrophil count (11.07 vs 7.57 x 103/μL), neutrophilia (43.6% vs 13.2%), lymphocytopenia (47.1% vs 9.8%), higher NLR count (13.87 vs 10.31), increased NLR (42.2% vs 14.7%), higher procalcitonin value ( 5.43 vs 2.81 ng/mL), and an increased procalcitonin (43.1% vs 13.7%).
Conclusion : Older age was linked to a higher risk of ARDS and death, most likely due to a weakened immunological response. Measuring these parameters of inflammation can help physicians quickly identify severe COVID-19 patients and may facilitate an early start of effective treatment of ARDS in COVID-19 patients.120 PagesTesis Magiste
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