1,720,971 research outputs found
Hubungan antara Length of Stay dan Tingkat Rehospitalisasi 6 Bulan pada Pasien Heart Failure with Reduce Ejection Fraction (HFrEF) di RSUP HAM Tahun 2022
Full text linkBackground. Globally, heart disease has been the highest cause of death throughout the world for the last 20 years. Risk stratification regarding length of stay can help provide good opportunities for patient care by identifying patients who require special attention and specific interventions such as education and initiation of specific therapy. This study aims to determine the relationship between length of stay and 6 month rehospitalization rate in heart failure patients with reduced ejection fraction at RSUP HAM in 2022. This study uses analytical methods with a cross sectional design using the total sampling method. The number of samples in this study was 109 people. The results of this study show that the demographic characteristics in this study were mostly male, 67 patients (61.5%), and aged 56 - 65 years, 47 patients (43.1%). The length of stay for heart failure patients in this study was 8.58 ± 1.86. A total of 58 patients (53.2%) in this study experienced rehospitalization within a period of 6 months. There is a significant relationship between the length of patient stay and the incidence of rehospitalization in heart failure patients.82 PagesSkripsi Sarjan
Hubungan Konsumsi Pemanis Rendah Kalori dengan Penyakit Jantung Koroner dalam Suatu Systematic Review
No full textBackground. In theory, reducing the consumption of sugar is one of the ways to reduce the risk of cardiovascular disease as diabetes, obesity and unhealthy diet are the risk factors of cardiovascular disease. The usage of low-calorie sweetener considered as a healthier option due to several health beneficial findings. However, some research found the opposite outcomes. This systematic review is conducted to revise, summarise and analyse data regarding consumption of low-calorie sweeteners and cardiovascular disease. Aim. To study the relationship between consumption of low-calorie sweeteners and cardiovascular diseases. Method. Systematic reviews were conducted and articles were searched on PubMed and Scopus. The inclusion criteria are articles that were published from 2011 to 2021, available in English, and using case-control or cohort as methodology of research. The Newcastle Ottawa Scale (NOS) were used to measure the quality of a journal. Results. A total of 5877 literatures were found and checked systematically using PRISMA and only 4 were included in this review. Conclusions. Although these findings cannot establish firm causality due to possible reverse causation, we could see that consumption of low-calorie sweeteners increases the risk of coronary heart disease.Latar Belakang. Secara teoritis, mengurangkan konsumsi gula merupakan satu upaya untuk menurunkan risiko penyakit kardiovaskular kerana diabetes, obesitas dan diet yang tidak sihat merupakan faktor risiko penyakit kardiovaskular. Pendekatan penggunakan pemanis rendah kalori dianggap sebagai pilihan yang lebih sihat kerana beberapa penelitian melaporkan manfaat penggunaan gula alternatif. Namun ada penelitian yang melaporkan sebaliknya. Penelitian dengan metode systemic review dilaksanakan untuk menelaah, merangkum dan menganalisis data mengenai hubungan konsumsi pemanis rendah kalori dan penyakit jantung. Tujuan. Penelitian ini bertujuan untuk mengetahui hubungan konsumsi pemanis rendah kalori dan penyakit kardiovaskular. Metode. Penelitian ini menggunakan desain systematic review. Pencarian artikel dilakukan menggunakan situs PubMed dan Scopus. Kriteria inklusi terdiri dari penelitian yang telah dipublikasi dalam rentang waktu 2011 hingga 2021, tersedia dalam Bahasa Inggris dan menggunakan metodologi case-control atau cohort. The Newcastle Ottawa Scale (NOS) digunakan untuk menilai kualitas literatur. Hasil. Sebanyak 5877 literatur ditemukan dan diperiksa secara sistematis dengan tahapan PRISMA sehingga didapatkan 4 literatur yang ditelaah pada penelitian ini. Kesimpulan. Meskipun data ini tidak dapat menetapkan kausalitas yang tegas dengan adanya kebarangkalian pengaruh penyebab terbalik (reverse causation), konsumsi pemanis rendah kalori meningkatkan risiko kejadian penyakit jantung koroner.63 HalamanSkripsi Sarjan
Hubungan Hipertensi dengan Kejadian Sindroma Koroner Akut di RSUP H Adam Malik Medan Tahun 2016
No full textForeword. Acute coronary syndrome is a syndrome consists of several coronary disease such as unstable angina pectoris, non-ST-segment elevation myocardial infarction and ST-segment elevation myocardial infarction. ACS risk factors are divided into 2 categories, the conventional risk factors and recently known atherothrombosis-associated risk factors. Hypertension is one of ACS major risk factors. According to Survei Kesehatan Rumah Tangga data in Indonesia that most of the death (16,4%) caused by cardiovascular disesase such as hypertension, while the deaths caused by this disease found above 45 years old. Objective. To investigate the correlation between Hypertension and Acute Coronary Syndrome in RSUP H. Adam Malik Medan. Method. This was an analytic study with cross-sectional study design, using the secondary data of patient’s medical record. Sample of this study was 85 acute coronary síndrome patients. The sample was chosen with non-probability sampling method with purposive sampling technique. Results. The research on 85 subjects showed acute coronary syndrome was predominantly found in men (72,9%) than woman (27,1%), with 32 years old as the youngest, 80 years old as the oldest, and the average age was 57,8 years old, and ACS patients were more likely to have hypertension (76,5%) than patients with no hypertension (23,5%). Conclusion. There was a correlation between hypertension and acute coronary síndrome.Latar Belakang. Sindroma koroner akut merupakan satu sindrom yang terdiri dari beberapa penyakit koroner yaitu angina pektoris tidak stabil, infark miokard tanpa elevasi ST dan infark miokard dengan elevasi ST. Faktor risiko SKA dibagi menjadi dua kelompok besar yaitu faktor risiko konvensional dan faktor risiko yang baru diketahui berhubungan dengan proses aterotrombosis. Hipertensi merupakan salah satu faktor risiko major SKA. Menurut data Survei Kesehatan Rumah Tangga di Indonesia bahwa penyebab kematian terbanyak (16,4%) disebabkan karena penyakit jantung dan pembuluh darah yang diantaranya adalah Hipertensi, sedangkan kematian terbanyak akibat penyakit ini dijumpai pada usia 45 tahun keatas. Tujuan. Mengetahui hubungan Hipertensi dengan kejadian Sindroma Koroner Akut di RSUP H. Adam Malik Medan. Metode. Penelitian ini adalah penelitian analitik dengan pendekatan metode cross sectional study dengan menggunakan data sekunder yaitu melihat rekam medis pasien. Sampel pada penelitian ini adalah 85 orang penderita sindroma koroner akut. Sampel dipilih dengan metode nonprobabiity sampling dengan teknik purposive sampling. Hasil. Pada penelitian terhadap 85 subjek, ditemukan angka kejadian dari sindroma koroner akut lebih tinggi pada laki-laki (72,9%) daripada perempuan (27,1%), dengan usia terendah 32 tahun, usia tertinggi 80 tahun dan rerata usia penderita 57,8 tahun, serta penderita SKA yang disertai hipertensi (76,5%) lebih tinggi dibandingkan yang tidak disertai hipertensi (23,5%). Kesimpulan. Terdapat hubungan antara hipertensi dengan sindroma koroner akut.Skripsi Sarjan
Hubungan kadar Low Density Lipoprotein Cholestrol (LDL-C) dengan Kejadian Infark Miokard Akut ST Elevasi (IMASTE) di Rumah Sakit Umum Pusat Haji Adam Malik Periode Bulan Oktober - Desember Tahun 2017)
No full textLatar Belakang. IMASTE merupakan salah satu spektrum sindroma koroner akut yang paling berat. Pada pasien IMASTE, terjadi penurunan aliran darah koroner secara mendadak akibat oklusi trombus pada plak aterosklerotik yang sudah ada sebelumnya. Tingginya kadar LDL-C dianggap sebagai salah satu faktor risiko terjadinya IMA. Hubungan antara kadar LDL-C dan IMA masih menunjukkan hasil yang tidak konsisten pada berbagai literatur.Tujuan. Penelitian ini dilakukan untuk melihat hubungan antara kadar LDL-C dan kejadian IMA. Metode. Penelitian yang dilakukan bersifat deskriptif dengan desain cross sectional. Sampel penelitian adalah subjek dari data rekam medis di RSUP Haji Adam Malik periode bulan Oktober - Desember tahun 2017 yang telah memenuhi kriteria inklusi dan eksklusi (92 sampel untuk kasus). Untuk kasus, data yang digunakan adalah pasien IMA. Teknik pengambilan data adalah secara purposive sampling. Hasil. Dari 92 sampel, didapatkan 33 pasien IMASTE, 19 pasien IMANSTE dan 1 pasien UAP dengan kadar LDL-C meningkat pada tahun 2017. Berdasarkan angka kejadian sesuai rentang usia, kasus IMA dengan kadar LDL-C meningkat paling banyak pada kelompok 56-65 tahun yaitu 20 kasus (54,1%). Berdasarkan jenis kelamin, kasus IMA dengan kadar LDL-C meningkat paling banyak pada laki-laki yaitu 43 kasus (58,1%)). Kesimpulan. Pada penelitian ini kasus IMASTE dengan kadar LDL-C meningkat terbanyak terjadi pada laki-laki dan juga pada penderita dengan rentang usia 56-65 tahun.Background. ACS is one of the most severe spectrums of acute coronary syndrome. In ACS patients, there is a sudden decrease in coronary blood flow due to occlusion of thrombus in pre-existing atherosclerotic plaques. High levels of LDL-C are considered as one of the risk factors for ACS. The relationship between LDL-C and ACS levels still shows inconsistent results in various literature. Objectives. This study was conducted to examine the relationship between LDL-C and ACS incidence.Methods. The research conducted was descriptive with cross sectional design. The research sample was a subject from the medical record data at Haji Adam Malik Hospital in 2017 that had fulfilled the inclusion and exclusion criteria (92 samples for the case). For cases, the data used were IMA patients. The data collection technique is purposive sampling.Results. From 92 samples, 33 STEMI patients, 19 NSTEMI patients amd 1 patient UAP with LDL-C levels were increased in 2017. Based on the age-matched incidence, the ACS case with LDL-C levels increased the most in the 56-65 year group, 20 cases (54.1%) . Based on gender, the ACS case with LDL-C levels increased significantly in men, 43 cases (58,1%). Conclusion. In this study the IMASTE case with LDL-C levels increased the most in men and also in patients with an age range of 56-65 years.Skripsi Sarjan
Hubungan Rasio C - Reactive Protein/Albumin dengan Keparahan Lesi Koroner Menggunakan Skor SYNTAX pada Pasien Infark Miokard Akut Non Elevasi Segmen ST di RSUP Haji Adam Malik Medan
No full textIntroduction: Myocardial Infarction Acute with Non ST Segment Elevation
(IMA-NEST) is acute coronary syndromes that has a high mortality rate.
Inflammation plays a major role in the progression and destabilization of
atherosclerotic plaque in coronary heart disease. C-Reactive Protein/albumin
ratio is new prognostic marker and believed to be a more accurate indicator of
the inflammatory status than C-Reactive Protein or albumin alone. The severity
of myocardial ischemia or infarction is determined by the lesion of coronary
artery and can be measured based on the SYNTAX score. This study aimed to
determine the relationship between the C-Reactive Protein/albumin ratio and the
severity of coronary lesions using the SYNTAX score.
Method: This is a cross-sectional study of 50 NSTEMI patients who underwent
angiography at the RSUP HAM from March 2022 to July 2022. Measurements
of C-Reactive Protein/albumin ratio based on laboratory findings. The SYNTAX
score was calculated based on the results of the angiography. Bivariate analysis
was conducted to assess correlation between the two variables. Then, ROC
analysis was performed to assess the C-Reactive Protein/albumin ratio as a
predictor of coronary lesion severity.
Result: Total subjects were 50 NSTEMI patients consist of 15 (27%) patients
with non-severe coronary lesions (SYNTAX score < 23) and 35 (73%) patients
with severe coronary lesions (SYNTAX score ³ 23). There is a moderate positive
correlation between the C-Reactive Protein/albumin ratio and the SYNTAX
score (r = 0.401; p < 0.001). Based on ROC analysis, C-Reactive
Protein/albumin can predict the severity of coronary lesions with AUC = 88%.
Conclusion: C-Reactive Protein/albumin ratio has a correlation with the
SYNTAX score and can predict the severity of coronary lesions in NSTEMI
patients.82 HalamanTesis Magiste
Penurunan Nilai Interleukin-6 sebagai Prediktor Perbaikan Kapasitas Fungsional Pasca Program Rehabilitasi Jantung Fase II pada Pasien Bedah Pintas Arteri Koroner di RSUP H. Adam Malik Medan
Full text linkBackground : Improved functional capacity is a good prognostic value in patients
after CABG. Phase II cardiac rehabilitation provides beneficial effects on physical
function, cardiopulmonary function, inflammatory response, autonomic function,
and improves functional capacity, and there is a significant decrease in
Interleukin-6 values in patients after CABG. Several studies have selected
Interleukin 6 as an inflammatory cytokine that can be used to assess the beneficial
effects of cardiac rehabilitation in coronary heart disease conditions. The aim of
the study was to determine the relationship of Interleukin-6 value as a predictor of
functional capacity improvement after phase II cardiac rehabilitation in patients
undergoing CABG.
Methods : This study was analytic observational study conducted retrospectively
on 31 CABG patients who underwent phase II cardiac rehabilitation. Data
collection on functional capacity, Interleukin-6 examination before and after
phase II cardiac rehabilitation. Data were analyzed univariately and bivariately to
assess the relationship between Interleukin-6 and functional capacity. Multivariate
analysis will then be performed using linear regression. The relationship test will
be performed with Pearson correlation test. Statistical data analysis using SPSS
software, p value <0.05 is statistically significant.
Results : There were 29 samples. The results of the cardiac exercise test showed
an increase in distance at the end of phase II cardiac rehabilitation compared to
the initial examination (457,655 ± 24,346 vs 180,482 ± 13,941). At the end of the
examination there was a decrease in the average Interleukin-6 level from 24.412 ±
2.516 to 13.647 ± 1.413. There was a significant relationship between
improvement in functional capacity and Interleukin-6 (p=0.032, r=0.40). An
increase of 1 MET will decrease Interleukin-6 by 2.238 pg/mL. There was a
decrease in mean Interleukin-6 from 24,412±2,516 to 13,647±1,413 at the end of
phase II with p value <0.001.
Conclusion : Interleukin-6 can be a predictor of improved cardiac functional
capacity after phase II cardiac rehabilitation program in patients undergoing
BPAK.93 PagesTesis Magiste
Gambaran Tingkat Stres Mahasiswa Fakultas Kedokteran Universitas Sumatera Utara dalam Sistem Pembelajaran Daring pada Era Pandemi Covid-19
No full textBackground. On March 2020, WHO declared the Coronavirus Disease 2019 (COVID-19) outbreak
a global pandemic. The emergence of novel infectious diseases can increase stress levels. Research
shows that people who work and study in medical fields tend to have a greater risk of psychological
pressure, anxiety, and exhaustion compared with other populations. Besides, during the COVID-19
pandemic, most medical schools around the world have changed their learning process, from the
pre-clinical system to the online learning system. Objectives. This study was conducted to determine
the overview of the stress level among undergraduate medical students in Universitas Sumatera
Utara who undergo online learning during the COVID-19 pandemic. Methods. The population of
this study was the undergraduate medical students, starting from the 2nd year to the 4th year, in
Universitas Sumatera Utara. Using a descriptive cross-sectional design, the data were collected
with a stratified random sampling technique, utilizing a validated questionnaire, the Medical
Student Stressor Questionnaire (MSSQ). Data were then analyzed using the SPSS program. Results.
Prevalence of mild, moderate, high, and very high stress was 29,1%, 49,1%, 19,1%, and 2,7%.
Based on their age, 20 years old students had the highest stress level (37%). Female students were
also found to have a significantly higher prevalence of stress (61,1%) than males (38,9%). Based
on the year of study, 2nd-year students had a significantly higher stress prevalence (35,2%)
compared to another year of study. Conclusion. This study shows that the majority of undergraduate
medical students in Universitas Sumatera Utara, who undergo online learning during the COVID-
19 pandemic, had a moderate stress level, with 20 years old studenLatar Belakang. Pada bulan Maret 2020, WHO menetapkan Coronavirus Disease 2019 (COVID-
19) sebagai kasus pandemi dunia. Munculnya penyakit menular yang baru diketahui dapat
meningkatkan stres pada masyarakat. Penelitian menunjukkan bahwa pekerja dan pelajar di bidang
kesehatan memiliki risiko yang lebih tinggi dari segi tekanan psikologis, anxietas dan kelelahan
daripada populasi lain. Terlebih lagi, selama pandemi COVID-19, sebagian besar fakultas
kedokteran di dunia telah mengubah bentuk kurikulum pembelajaran pre-klinik menjadi
pembelajaran daring (dalam jaringan). Tujuan. Penelitian ini bertujuan untuk mengetahui
gambaran tingkat stres mahasiswa Fakultas Kedokteran USU dalam sistem pembelajaran daring
pada era pandemi COVID-19. Metode. Penelitian ini menggunakan metode deskriptif observasional
dengan pendekatan cross sectional. Data yang akan digunakan ialah data primer, yang diambil
dari kuesioner, dengan menggunakan teknik stratified random sampling. Populasi penelitian ini
adalah mahasiswa FK USU semester III-VII. Data akan dianalisis dengan menggunakan SPSS.
Hasil. Pada penelitian ini, didapatkan bahwa sebagian besar mahasiswa mengalami stres sedang
(49,1%), stres ringan (29,1%), stres berat (19,1%), dan stres sangat berat (2,7%). Berdasarkan
umur, tingkat stres paling tinggi terdapat pada mahasiswa yang berumur 20 tahun, yaitu 37%.
Berdasarkan jenis kelamin, tingkat stres didapatkan tinggi pada mahasiswa perempuan (61,1%),
dibandingkan laki-laki (38,9%). Berdasarkan angkatan, tingkat stres paling tinggi terdapat pada
mahasiswa angkatan 2019 (35,2%). Kesimpulan: Penelitian ini menunjukkan bahwa sebagian besar
mahasiswa Fakultas Kedokteran Universitas Sumatera Utara mengalami stres sedang dalam sistem
pembelajaran daring pada era pandemi COVID-19, dengan mahasiswa berumur 20 tahun, berjenis
kelamin perempuan, dan berada pada angkatan 2019 memiliki prevalensi tingkat stres yang lebih
tinggi dibandingkan karakteristik lainnya.95 HalamanSkripsi Sarjan
Gambaran Kadar Neutrophil Lymphocyte Ratio (NLR) pada Pasien Penyakit Jantung Koroner di Rumah Sakit Umum Pusat Haji Adam Malik Medan
No full textBackground. Cardiovascular disease is the largest cause of death in the world,
WHO explains that there are 17.9 million deaths from cardiovascular disease in
the world. Of all cases of death by cardiovascular disease, 7.4 million (42.3%)
were caused by coronary heart disease (CHD). Neutrophil Lymphocyte Ratio
(NLR) is one of the examination biomarkers that aims to assess the level of
inflammation that is currently occurring in a disease. NLR has a significant
relationship in increasing the Framingham risk score (FRS) in predicting CHD
mortality, NHANES-III states that NLR should be used as a biomarker in
assessing CHD inflammation. Objective. Knowing the description of the levels of
NLR in patients with CHD. Method. This study is a descriptive study with a crosssectional
approach that uses secondary data from patient medical records with
collected using total sampling . Data analysis was performed using Statistical
Program and Service Solution (SPSS). Results. The average NLR level of CHD
patients was 4,438, the NLR cut-off point in this study was categorized into <2.5
(decreasing) and > 2.5 (increasing). Based on the age group, it was found that the
NLR level increased more in the young adult age group (45-60 years) with a
sample of 41 patients (27%), based on gender, the NLR level increased in males
with a sample of 62 patients (41%). Conclusion. The NLR levels in RSUP. Haji
Adam Malik Medan in CHD patients is increasing, especially in the young adult
age group and patients with male gender.132 HalamanSkripsi Sarjan
Efektifitas Telemonitoring Perawatan Diri Berbasis Smartphone terhadap Readmisi dan Self Care Behavior pada Pasien Heart Failure di Pusat Jantung Terpadu RSUP Haji Adam Malik Medan
Full text linkHeart failure ( HF) is an issue that needs a complex treatment plan. Due to its high risk of recurrence, individuals with heart failure require more days of treatment and run the risk of staying longer in the hospital. rate in heart failure patients causes days of treatment and the possibility of patients being readmitted. The concept of independent self-care is increasingly developing, this is related to autonomy and personal responsibility for healthy behavior, developing activities needed to manage health. Good self-care plays an important role in the management of heart failure. Patients with good self-management have good self-care behavior, reducing readmissions thereby reducing hospital costs and reducing mortality rates. This study aims to identify the effectiveness of self-care telemonitoring on readmissions and self-care behavior in heart failure patients. The research design used was a quasi-experimental design with a non-equivalent pretest-posttest control group design. The sample in this study consisted of 102 respondents with intervention and control groups. The instrument used to measure self-care behavior is the European Heart Failure Self-care Behavior Scale (EHFScB ). The results of this study show that for readmission there is no significant relationship with a p-value = 0.558, while for self-care behavior it shows a significant relationship with a p-value = 0.000. The conclusion of this study shows that telemonitoring of self-care is very important in improving self-care of heart failure patients who have been discharged increasing independence and behavior to maintain health and prevent readmissions. Further research is needed _ carried out to look deeper into the influence of telemonitoring self-care for readmissions and self-care behavior.112 PagesTesis Magiste
Perbandingan Faktor Resiko Aorta Abdominal Dilatasi pada Penderita Penyakit Jantung Koroner dengan Menggunakan Ekokardiografi
No full textBackground : Patients with coronary artery disease share common risk factors as abdominal aortic aneurysm (AAA), in which screening for AA dilatation is recommended. Transthoracic echocardiography (TTE) may offer the opportunity to evaluate the cardiac function and to screen for AA dilatation during the same examination.
Aims : This study aimed to compare risk factors for abdominal aortic dilatation with abdominal aorta index in patients with coronary artery disease, and to evaluate the feasibility of AA dilatation screening at bedside using TTE in population with CAD.
Methods : This is a cross-sectional study of patients with CAD. The abdominal aortic was measured at the end of a regular TTE performed in consecutive patients admitted in coronary care unit of Haji Adam Malik Hospitel Medan using an echocardiography machine.
Results : We enrolled 75 patients (age 56 + 10 years). Dilatation of abdominal aortic was observed in 21 patients (28%). From the analysis obtained a significant relationship between history of acute myocardial infarction with dilatation abdominal aorta (p = 0.04).
Conclusion : Overall, the prevalence of dilatation of abdominal aortic increased with age and history of AMI. In regard to the simplicity, screening for AA dilatation during TTE may be of value for patients with CAD, especially in elder patients.Latar Belakang : Penderita dengan penyakit jantung koroner (PJK) berbagi faktor resiko umum yang sama dengan aneurisma aorta abdominal (AAA), sehingga penyaringan terhadap dilatasi aorta abdominal (AA) merupakan suatu hal yang direkomendasikan. Transtorakal ekokardiografi (TTE) dapat memberikan suatu kesempatan untuk mengevaluasi fungsi kardiak dan untuk melakukan penyaringan terhadap dilatasi AA pada saat pemeriksaan yang sama.
Tujuan : Penelitian ini bertujuan untuk membandingkan faktor-faktor resiko terhadap dilatasi AA dengan menggunakan diameter AA pada penderita PJK, dan untuk mengevaluasi manfaat kegunaan penyaringan dilatasi AA pada pemeriksaan bedside dengan menggunakan TTE pada populasi PJK.
Metode : Penelitian ini merupakan studi potong lintang pada penderita PJK. Diameter AA diukur pada akhir dari pemeriksaan reguler TTE yang dilakukan pada penderita yang dirawat di ruang rawat inap kardiovaskular Rumah Sakit Haji Adam Malik Medan, dengan diameter AA > 20 mm dianggap dilatasi.
Hasil : Terdapat 75 pasien (usia 56 + 10 tahun). Dilatasi dari aorta abdominal dijumpai pada 21 responden (28%), dengan rerata usia 58.2 + 7.3 tahun. Peneliti memperoleh hubungan yang signifikan antara riwayat infark miokard akut (IMA) dengan dilatasi AA (p = 0.04).
Kesimpulan : Secara keseluruhan, prevalensi dilatasi AA meningkat dengan usia, serta dijumpai hubungan yang signifikan antara riwayat IMA dengan dilatasi AA. Dengan memperhatikan kesederhanaannya, penyaringan dilatasi AA pada pemeriksaan TTE dapat bermanfaat pada penderita PJK, terutama pada penderita dengan usia lanjut.42 HalamanTesis Magiste
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