Cermin Dunia Kedokteran

The Effect of Number of Visits, Length of Stay (LOS), and Emergency Room Density on Mortality in the Emergency Room of Malang City Tertiary Hospital

Willy Johan — 2024-11-07

Introduction: Emergency department (ED) mortality is a critical issue that has a major impact on individuals, society, and the entire health system and is one of the indicators of emergency department service performance. This research aims to provide input to hospital management regarding the impact of non-medical factors (number of visits, length of stay/LOS, and ED crowding) on patient mortality, related to improvement policy-making in ED patient services. Method: A retrospective study on 130 ED shifts from medical record data during 2022-2023. The independent variables were the number of visits, LOS, ED crowding measured by CEDOCS, and ED mortality as the dependent variable. Results: There were deaths in 38 out of 130 shifts in the ED, with a total mortality of 1.6%. Statistical tests showed a significant effect between crowding and ED mortality (p = 0.01), a non-significant effect between visits and ED mortality (p = 0.76), and a non-significant effect between LOS and ED mortality (p = 0.62). The results of the regression analysis were able to explain the data (p = 0.91; Hosmer-Lameshow test). The area under the curve (AUC) for prognosis in hospital treatment is 0.641 with a 95% confidence interval of 0.539-0.744 (medium category). Conclusion: The significant effect between crowding and patient mortality in the ED indicates that strategic management must be carried out to reduce ED crowding.

The Role of Brand Image in Bridging Service Quality to Patient Expectations

Stevany — 2024-11-07

Patient expectations in the context of modern health services are defined as patient expectations regarding the availability of information, participation in decision-making, and overall service quality. The research aim is to analyze the influence of tangibility, empathy, reliability, responsiveness, and assurance on patient expectations intervened by hospital brand image. The selection used the accidental sampling technique of 200 respondents at emergency room patients using accidental sampling technique. This study employed quantitative methodology, focusing on associative causality through a cross-sectional framework. Data were gathered via questionnaires and analyzed using structural equation modeling—partial least squares (SEM-PLS). The findings suggested that patient expectations were shaped by tangibility, empathy, and responsiveness yet were unaffected by reliability and assurance, with brand image served only to mediate the impact of responsiveness on patient expectations. These outcomes offer insights for hospital administration on the importance of enhancing systems for facility upgrades, technological advancements, and the improvement of human resources through targeted training.

Analysis of Differences in Outpatient Health Service Quality Based on Accreditation Status with Service Quality Method

Selvi Hartati — 2024-11-07

Background: To ensure the universal availability of high-quality health care services, the reform of health systems tried not only to improve the coverage of health care but also the overall quality of health care services. Strategies to improve the quality of health care services include the development of a national accreditation system. This study aims to find out the differences in the quality of outpatient health services based on accreditation status. Methods: The study used a cross-sectional design. The population were all outpatients visiting the GS and the KB community health center with inclusion and exclusion criteria. The sample was selected by accidental sampling. Bivariate analysis using the Mann Whitney U test. Results: A significant difference in empathy (p <0.05), but no significant difference in tangibles, reliability, responsiveness, or assurance (p > 0.05). Conclusion: A significant difference in the quality of outpatient health services in ‘paripurna’ (GS) and ‘utama’ (KB) accredited community health centers is only in the quality of empathy.

Diagnosis and Management of Anterior Cruciate Ligament Injuries

I Wayan Ryan Adhitya Prabawa — 2024-11-07

In the world of sports, the anterior cruciate ligament (ACL) plays a very important role in maintaining the stability and function of the knee joint. ACL injuries are most common in 20 to 40 years old and can be caused by unbalanced physical conditions, which can lead to problems such as loss of strength, stability, and mobility. If not treated properly, ACL injuries can lead to movement disorders.

Persistent Hypoglycemia in Premature, Small for Term, and Low Birth Weight Neonates from Mothers with a History of Severe Preeclampsia

Asterisa Retno Putri — 2024-11-07

Background: Neonatal hypoglycemia is a metabolic problem that is often found in the NICU and is one of the causes of permanent brain damage in infants. The diagnosis of persistent hypoglycemia and its causes are still controversial. Case: A male baby was born to a mother with severe preeclampsia at 36 weeks of gestation, with a birth weight of 1600 grams. At 1 hour of age, he experienced hypoglycemia that lasted more than 72 hours with the lowest blood sugar of 18 mg/dL, and experienced hyperkalemia (potassium level 6.1 mmol/L). The baby is diagnosed as persistent hypoglycemia. The clinical condition improved after being given dextrose and dexamethasone, and was discharged in stable condition. Conclusion: Management of persistent hypoglycemia depends on the cause. Diagnosis refers to risk factors before or after birth.

Diabetic Ketoacidosis in Children

Astrellatiffany Kuntjoro — 2024-11-07

The incidence of diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus reaches 1–12 per 100 patients each year. The case is a boy aged 13 years 10 months with chief complaints of weakness and drowsiness. Blood sugar levels 532 mg/dL, blood ketone levels 6.6, blood pH 7.13, HbA1c 19.2%. The principles of DKA management include fluid therapy, insulin, electrolyte balance, treat the underlying disease, and monitor complications.

Topical Pure Coconut Oil as an Alternative Therapy Atopic Dermatitis

Oktatika Agustinus — 2024-11-07

Atopic dermatitis, also known as atopic eczema, is a common chronic, recurrent inflammatory condition of the skin. This condition is most commonly experienced in childhood, especially aged 0 to 12 months. The most frequent symptom is itching. This disease greatly affects the patients’ quality of life, psychology and productivity, requiring long-term treatment. To this day, the management of atopic eczema refers to conventional treatment using generic medicines such as oral anti-allergies (antihistamines) and both topical and oral corticosteroids. This article examines potentials of virgin coconut oil as an alternative treatment for atopic dermatitis, various methods of virgin coconut oil production, as well as the composition of the active compounds of virgin coconut oil and their roles in the management of atopic dermatitis.

Review of the Benefits of the Mediterranean Diet

Loury Priskila — 2024-11-07

The rapid growth of nutrigenomics and nutrigenetics has greatly contributed to understanding the importance of genetic, nutrition, and environmental interaction in maintaining human health. Healthy lifestyles such as adequate physical activity and healthy diet patterns have been widely reported may reduce the risk of various diseases. One of the health diet patterns that has been widely studied is the Mediterranean diet (MedDiet). MedDiet is a plant-based diet pattern high in fiber, high in unsaturated fatty acids, and low in meat and dairy products. This literature study aims to summarize the health benefits of the MedDiet pattern and its biomechanisms.

Clinical Benefits of Insulin Glargine U300 - Second Generation Basal Insulin

Nanang Miftah — 2024-11-07

Untreated diabetes can lead to complications and increase the risk of death. Many patients with type 2 diabetes will require injectable medication within 5-10 years after diagnosis, following the failure of two or three oral antidiabetic therapies. Adding basal insulin can be well tolerated, more effective with lower risks of hypoglycemia and weight gain compared to other insulin regimens, but it carries a risk of hypoglycemia. Insulin glargine U300, with its special formulation, reduces the risk of hypoglycemia in diabetic patients.

Potential of Mesenchymal Stem Cell Secretome for Regenerative Therapy of Fibrosis Lung Disease

Ronald Kartika — 2024-11-07

Mesenchymal stem cells (MSC) associated with anti-inflammatory, immunomodulatory, regenerative, pro-angiogenic, and anti-fibrotic properties offers a novel therapeutic approach for fibrosis lung disease. Such therapeutic effects may be attributed to the MSC-secretome, made from free soluble proteins and extracellular vesicles (EVs). This review summarizes some literature findings related to the efficacy and safety of MSC-derived products in pre-clinical models of lung diseases, demonstrating the biologically active substances contained in the MSC-secretome and its mechanisms involved in tissue regeneration. A perspective view is given on the secretome as a high-quality, safe, and effective
medicinal product.