Decreasing Energy and Nutrient Intake During Hospitalization In Muhammadiyah Lamongan Hospital

Inpatient Malnutrition rates are quite high and distributed in almost all hospitals for all types of diseases and socio-economic sufferers. This study aims to examine the nutritional status, total patient intake, and factors that influence the total intake of newly hospitalized patients at Muhammadiyah Lamongan Hospital. The study was conducted from November to December 2019 in the internal, surgical, and Obgyn departments of the Muhammadiyah Lamongan Hospital. A total of 80 patients were selected as samples using the accidental sampling technique. The results showed that 87.5% of patients were hospitalized due to non-communicable diseases such as diabetes mellitus, acute and chronic kidney failure, cirrhosis, acute myocardial infark, and others. Only 12.5% ​​are treated for infectious diseases such as tuberculosis, meningitis, diarrhea, and others. Calculation of BMI in patients shows that 10% of patients are obese, 30% are overweight, 50% are normal and 10% are malnourished. 24-hour recall results showed that 100% of patients could not meet energy and nutrient requirements (<80% of energy and nutrient demand figures). The average patient is only able to meet 24% of energy, 17% protein, 24% carbohydrates, and 18% fat. As many as 35% of patients complained of nausea and 22.5% of them were accompanied by vomiting. The number of patients said that decreased appetite because abdominal pain (35%), 25% patients experienced shortness of breath. Many patients complained that their bodies were weak / without strength (95%). Appetite also decreased due to difficulty chewing (17.5%) and difficulty swallowing (22.5%). Physical conditions like weakness accompanied by other eating disorders can be the cause of the patient's decreased food intake. This has led to a decrease in nutritional status in patients due to inadequate energy and nutrient need (especially those who have to go through a long period of hospitalization).

HUBUNGAN KEPATUHAN PEMBATASAN CAIRAN TERHADAP TERJADINYA EDEMA POST HEMODIALISA PADA PASIEN GAGAL GINJAL KRONIK DI RUMAH SAKIT AMINAH KOTA TANGERANG

Adherence is defined as the degree to which the patient carries out the treatment and behavior recommended by the doctor or others, in achieving the goals. IDWG is an increase in fluid volume with an increase in body weight as a basis for knowing the amount of fluid that enters during the interdialytic period, Edema is an excessive accumulation of fluid between body cells or in various body cavities. This study aims to identify the relationship between adherence to fluid restriction and the occurrence of post HD edema in CKD patients at Aminah Hospital Tangerang City in 2021, there were 68 people and post HD patients participated in this study using the Random Sampling technique. Researchers collected data using instruments. The post HD fluid restriction compliance instrument used in this study was a standardized questionnaire based on the Morisky compliance questionnaire (MMAS), while for the edema instrument in patients with chronic kidney failure the researcher used observational techniques, namely body weight measurement using a weight scale measuring instrument and using data patient medical record. Statistical test using Spearman Rank statistical test. Based on the results of the study obtained with a p value = 0.000 or <0.05, it can be concluded that there is a significant relationship between fluid restriction adherence to the occurrence of Post Hemodialysis Edema with a value of r = 935. Abstrak Kepatuhan didefinisikan sebagai tingkat penderita melaksanakan cara pengobatan dan perilaku yang disarankan oleh dokter atau yang lain, dalam mencapai tujuan. IDWG adalah peningkatan volume cairan dengan peningkatan berat badan sebagai dasar mengetahui jumlah cairan yang masuk selama periode interdialitik, Edema adalah penimbunan cairan secara berlebihan di antara sel-sel tubuh atau di dalam berbagai rongga tubuh. Penelitian ini bertujuan mengidentifikasi Hubungan Kepatuhan Pembatasan Cairan Terhadap Terjadinya Edema Post HD Pasien GGK di Rumah Sakit Aminah Kota Tangerang Tahun 2021, terdapat 68 orang dan pasien post HD berpartisipasi dalam penelitian ini dengan menggunakan teknik Random Sampling. Peneliti melakukan pengumpulan data menggunakan Instrumen. Untuk Instrumen kepatuhan pembatasan cairan post HD yang digunakan dalam penelitian ini adalah kuisioner baku berdasarkan kuisioner kepatuhan morisky (MMAS), sedangkan untuk instrument edema pada pasien gagal ginjal kronik peneliti menggunakan tehnik observasi, yaitu pengukuran berat badan menggunakan alat ukur timbangan berat badan serta menggunakan data rekam medis pasien. Uji statistik menggunakan uji statistik Spearman Rank. Berdasarkan hasil penelitian didapatkan dengan nilai p= 0,000 atau <0,05 maka dapat disimpulkan terdapat hubungan yang signifikan antara kepatuhan pembatasan cairan terhadap terjadinya Edema Post Hemodialisa dengan nilai r = 935.

Evaluation of Oxidative Stress potential of some Nsaıds against Hydrogen Peroxide in experimental animal

Background: Oxidative stress is imbalance between aggressive and defensive system. Overproduction of oxidative stress contribute in pathogenesis of many diseasesincluding Parkinsonism, Alzheimer diseases, apoptosis, hepatic fibrosis ,chronic kidney failure and liver steatosis etc . There are several OTC drugs including NSAIDs that generate oxidative stress when administered. So there is a need to explore about these drugs. Therefore this study was designed to evaluate the oxidative stress potential of Acetaminophen, acetyl salicylic acid and Celecoxib NSAIDs. Objective: The present study is design to investigate the oxidative stress of NSAIDs of acetaminophen, aspirin and Celecoxib drug with reference to the hydrogen peroxide. Material and method: The Experimental protocol was designed for estimate the level of oxidative stress in NSAIDs treated animals against hydrogen peroxides. Animal of control group received only vehicle throughout experimental protocol. Rats of AAP group, ASA group ,CX group were exposed to acetaminophen (150mg/kg; orally) acetyl salicylic acid (300mg/kg ;orally) and Celecoxib (50mg/kg; orally) for forty two days . Rodent of HP group were challenged with Hydrogen peroxides (0.5%) with same schedule as above. At end of experimental protocols, all the animals were sacrificed and their organ were identified and collected for oxidative stress estimation and histological examination. Result: NSAIDs administration caused increase in oxidative stress measured in terms of SOD, CAT, MDA, GSH and GPx. HP administration produced maximum oxidative stress compare to all other groups. Oxidative parameter i.e. SOD, CAT, GSH and GPx were found to be decreased as compare to control rats. However MDA were found to be increased as compare to control rats. Additionally, CX produced less oxidative stress compare to other NDAIDs. Further, histological examinations support the biochemical results. Conclusion: From the above observations it can be concluded that NSAIDs have oxidative stress potential and generate oxidative stress and damage the organs when administrated chronically. Thus, these drugs should be used judiciously.

Constrictive Myelopathy in An Old Giant Dog

In pugs, West Highland white terriers and other small breeds, congenital or acquired malformations/deviations of the spine are commonly reported, resulting, amongst other complications, in chronic meningeal compression and fibrosis, and interference with cerebrospinal fluid flow into the sub-arachnoid space. This leads to constrictive myelopathy (CM) which involves the constriction and consequent reduced diameter of the spinal cord accompanied by parenchymal damage (mostly gliosis). A11-year-old giant mixed breed male dog presented with ataxia in the hindlimbs, paresis, reduced proprioception, and normal reflexes. Neurolocalization was to the thoracolumbar spinal cord (T3-L3). Myelographic computed tomography and magnetic resonance imaging (MRI) of this tract showed spondylosis, multiple disc protrusions with mild cord compression, and reduced spinal cord diameter. Genetic test for SOD1 mutations performed to evaluate predisposition to degenerative myelopathy negative results; although poorly compressive, the symptoms were attributed to multiple disc protrusions, leading to spinal cord atrophy. The dog underwent physiotherapy and 23 months later, was more ataxic and paretic however still ambulatory; repeated MRI confirmed the previous findings, however, the onset of concomitant megacolon and a chronic kidney failure, induced the owner to euthanasia. Histopathological assessment indicated diffused remodeling of the meninges with progressive constriction of the spinal cord of concomitant megacolon and a chronic kidney failure, induced the owner to euthanasia. Histopathological assessment indicated diffused remodeling of the meninges with progressive constriction of the spinal cord. Altered distribution of the mechanical forces among the meningeal layers with stiffening of the ventral pachymeninges, probably caused by the disc protrusions, was considered the most likely trigger. To our knowledge, this is the first case reporting clinical, MRI and histological findings resembling an acquired constrictive myelopathy in a large-breed dog.

THE EFFECT OF VIRTUAL EDUCATION TO IMPROVE COMPLIANCE OF HEMODIALISYS PATIENTS WITH HEALTH PROTOCOLS DURING PANDEMIC

Background: The spread of COVID-19 has continued to increase since March 2020. Patients with chronic kidney failure who undergo Hemodialysis are one of the groups vulnerable to COVID-19 because they routinely undergo Hemodialysis. One of the ways to prevent transmission of COVID-19 to hemodialysis patients is by providing education to comply with the COVID-19 prevention Health protocol. Objective: The purpose of this study was to determine the effect of virtual education on Hemodialysis patient compliance in preventing covid-19 transmission at the Muhammadiyah Hospital in Lamongan. Methods: This study used the Pre-Experiment approach one group pre-test post-test design on all CKD patients who were routine Hemodialysis at Muhammadiyah Lamongan Hospital from October - December 2020 who were taken using the purposive sampling technique. The intervention given was playing educational videos for 2 months. Data were collected using a questionnaire before and after the intervention, which was tested by the Wilcoxon test with α <0.05. Results: There were 69 patients who took part in the entire processes until it was completed. The results revealed that there were differences in the level of compliance of hemodialysis patients before and after treatment (p = 0.000). Further research with larger sample and RCT design is needed for stronger generalization in population. Conclusion: Providing educational videos can increase the level of compliance of hemodialysis patients in implementing Health protocols to prevent transmission of COVID-19.

Pengaruh Foot Reflexology Terhadap Penurunan Kelelahan Pada Pasien Gagal Ginjal Kronik yang Menjalani Terapi Hemodialisa : Literature Review

Fatigue is an unpleasant and terrible experience in life. Fatigue often occurs in hemodialysis patients, the cause of fatigue in hemodialysis patients occurs due to several factors, namely physiological and psychological factors of the patient. Foot Reflexology is a non-pharmacological therapy. Foot Reflexology is a massage that is carried out in the foot by applying pressure and massaging movements of the feet that are connected to other organs through the nervous system, foot reflexology creates relaxation, increases blood flow to the feet, brain, kidneys, and intestines. Therefore it is useful for overcoming fatigue. The purpose of this literature review was to determine the effect of foot reflexology on reducing fatigue in chronic kidney failure patients undergoing hemodialysis therapy. The method used in this study was a literature review, by looking for articles related to the theme taken from Pubmed, Science Direct and Google Scholar. The articles were selected according to the research inclusion criteria, then analyzed using the Hawker Checklist critical review instrument. The results of the literature review of the five articles, showed that the average score of fatigue in the intervention group after receiving footreflexology was decreased. The results of the analysis of the five articles proved that there was a significant reduction in fatigue in the intervention group, as evidenced by the bivariate value (p – value) was less than 0.05. Foot Reflexology can reduce fatigue in hemodialysis patients and can be used as an alternative treatment method in nursing because it is safe and non-invasive.Key words : Fatigue, Foot Reflexology,Hemodialysis Patients AbstrakKelelahanmerupakan pengalaman tidak menyenangkan dan menyulitkan dalam kehidupan. Kelelahan sering terjadi pada pasien hemodialisa, penyebab kelelahan pada pasien hemodialisa terjadi karena beberapa faktor, yaitu faktor fisiologi maupun psikologis pasien. Foot Reflexology merupakan terapi non farmakologi. Foot Reflexology merupakan pemijatan yang dilakukan di area kaki, dengan penerapan tekanan dan gerakan memijat kaki yang terhubung dengan organ lain melalui sistem saraf, foot reflexology menciptakan relaksasi, meningkatkan aliran darah ke kaki, otak, ginjal, dan usus sehingga bermanfaat untuk mengatasi kelelahan. Tujuan dari literatur review ini adalah untuk mengetahui pengaruh foot reflexology terhadap penurunan kelelahan pada pasien gagal ginjal kronik yang menjalani terapi hemodialisa. Metode yang digunakan dalam penelitian ini adalah literatur review, dengan mencari artikel yang berkaitan dengan tema yang diambil dari beberapa search engine yaitu Pubmed, Science Direct dan Google Scholar. Artikel dipilih sesuai dengan kriteria inklusi penelitian, kemudian dianalisa menggunakan instrument telaah kritis Hawker Cheklist. Hasil literatur review dari kelima artikel, skor rata – rata kelelahan pada kelompok intervensi setelah mendapat footreflexology mengalami penurunan. Hasil dari analisa dari kelima artikel membuktikan bahwa terdapat penurunan kelelahan yang signifikan pada kelompok intervensi, dibuktikan dengan nilai bivariate ( p – value) p > 0,05. Foot Reflexology dapat menurunkan kelelahan pada pasien hemodialisa dan dapat dijadikan sebagai metode pengobatan alternatif dalam keperawatan karena aman dan non invasif.Kata Kunci : Kelelahan , Pasien Hemodialisa, Pijat Refleksi Kaki

Gambaran Tingkat Kecemasan Pada Pasien Yang Menjalani Hemodialisa : Literature Review

Patients with chronic renal failure undergo hemodialysis for survival. Commonly, the hemodialysis process causes anxiety, which is related to machines and equipment, blood-flowing tubes and the process that takes 2 to 3 hours. This study aimed to describe the level of anxiety in patients undergoing hemodialysis. This study applied literature review. Articles were searched from PubMed, Garba Referral Digital (GARUDA), and ResearchGate according to inclusion and exclusion criteria. There are 5 articles met the criteria. More than half (65,8%) was male, 281 respondents (40,9%) have secondary education level, and majority (78%) of the respondents were not working 489. Around 58,7% of the respondents experienced of hemodialysis for 1 year. 358 respondents (52,1%) were categorized in mild anxiety. The majority of patients undergoing hemodialysis experienced mild anxiety. Accordingly, hospitals or health facilities can improve nursing care to treat anxiety in chronic kidney failure patients undergoing hemodialysis.Keywords: Anxiety, Chronic Kidney Failure, Hemodialysis. AbstrakPasien gagal ginjal kronik menjalani hemodialisa demi kelangsungan hidupnya. Proses hemodialisa seringkali menimbulkan perasaan cemas dikarenakan mesin dan peralatan yang serba asing, selang-selang yang dialiri darah serta prosesnya yang membutuhkan waktu 2 sampai 3 jam. Penelitian ini bertujuan untuk mengetahui gambaran tingkat kecemasan pada pasien yang menjalani hemodialisa berdasarkan literature review. Penelitian ini merupakan penelitian deskriptif, metode yang digunakan dalam penelitian ini adalah literatur review dengan penelusuran online dari PubMed, Garba Rujukan Digital (GARUDA) dan ResearchGate sesuai kriteria inklusi yaitu artikel tahun 2011 sampai 2021 serta artikel yang ditulis dalam bahasa Indonesia dan bahasa Inggris. Hasil penelusuran didapatkan 5 artikel tahun 2014 sampai 2020. Karakteristik jenis kelamin pada literature review ini laki – laki 432 responden (65,8%) dari 657 responden, tingkat pendidikan menengah 281 responden (40,9%) dari 687 responden, jenis pekerjaan tidak bekerja 489 responden (78%) dari 627 responden, dan lama hemodialisa ≤1Tahun 88 responden (58,7%) dari 150 responden. Tingkat kecemasan terbanyak adalah kecemasan ringan dengan jumlah 358 responden (52,1%) dari 687 responden. Pasien yang menjalani hemodialisa mayoritas mengalami kecemasan ringan, jadi bagi rumah sakit atau sarana kesehatan agar dapat melakukan penatalaksanaan untuk menurunkan tingkat kecemasan dengan teknik distraksi maupun relaksasi.Kata Kunci: Gagal Ginjal Kronik, Hemodialisa, Kecemasan.

Literature Review : Gambaran Kualitas Hidup Pasien Yang Menjalani Hemodialisa

In patients with chronic renal failure, hemodialysis therapy is needed to replace kidney function by removing nitrogenous substances and toxins in the blood and excessive water. Appropriate management of patients with chronic kidney failure in addition to preventing complications is expected to increase the client's life expectancy. In patients with chronic kidney failure, quality of life also reflects the quality of treatment because it involves physical, psychological, and social processes to be achieved. A good quality of life is needed by hemodialysis patients to prevent the disease from getting worse. This literature review aims to describe the quality of life hemodialysis patients. This study accesses an online database with electronic searches on Pubmed, Portal garuda and Proquest. The search was conducted by combining the keywords “quality of life, chronic kidney disease, hemodialysis” and articles published in the period 2012-2021. Instrumen for the literature review using Strobe instrument. The results of the literature review show that the quality of life score on the physical health dimension is low while on the psychological and environmental dimensions the quality of life score is high. . It is hoped that this study can be a reference for nurses in providing holistic nursing care to patients undergoing hemodialysis so that their quality of lifecan improve. This research is then needed as a data base for the development of other researchers.Keywords: Chronic renal failure; hemodialysis; quality of life AbstrakGagal ginjal kronik disebabkan karena disfungsi ginjal yang bersifat menahun, progresif, irreversible yang memerlukan terapi hemodialisa, pengaturan pola makan dan akses cairan yang masuk. Pada pasien gagal ginjal kronik terapi hemodialisa diperlukan untuk mengganti fungsi ginjal mengeluarkan zat-zat nitrogen dan racun dalam darah dan air yang berlebihan. Pasien hemodialisa dihadapkan pada sejumlah permasalahan fisik dan psikososial yang bisa menurunkan kualitas hidup. Kualitas hidup juga mencerminkan kualitas pengobatan karena melibatkan proses fisik, psikologis, dan sosial yang ingin dicapai. Kualitas hidup yang baik sangat dibutuhkan pasien hemodialisa untuk mencegah penyakit bertambah buruk. Literature review ini bertujuan untuk mengetahui gambaran kualitas hidup pasien hemodialisa. Metode penelitian yang digunakan yaitu studi literature review. Data yang dikumpulkan dengan mengakses database online dengan penelusuran elektronik pada Pubmed, Portal garuda dan Proquest. Pencarian dilakukan dengan mengkombinasikan kata kunci bahasa Inggris “quality of life, chronic kidney disease, hemodialysis dan kata kunci dalam bahasa Indonesiagagal ginjal kronik, hemodialisa dan kualitas hidup”. Instrumen untuk literature review menggunakan instrumen Strobe. Hasil literature review menunjukan skor kualitas hidup pada dimensi kesehatan fisik rendah sedangkan pada dimensi psikologis dan lingkungan skor kualitas hidup tinggi. Penilaian kualitas hidup merupakan indikator penting untuk menilai keefektifan tindakan hemodialisis yang diberikan dan menjadi tujuan penting dalam pengobatan penyakit gagal ginjal tahap akhir. Kata kunci: Gagal Ginjal Kronik; hemodialisa; kualitas hidup.