Diagnostic Overview and Management of Adult Pulmonary Tuberculosis Patients Inpatient at RSU Royal Prima Medan in 2020

Tuberculosis is an inflammatory disease of the lung parenchyma caused by infection with Mycobacterium tuberculosis. This research aims to find out the description of the diagnosis and management of adult pulmonary TB patients hospitalized at RSU Royal Prima Medan in 2020. This study is a descriptive study. This study is based on medical record data on inpatients with a diagnosis of pulmonary TB at the Royal Prima General Hospital Medan in 2020. The youngest patient was 18 years old and the oldest was 82 years old. The main complaint was shortness of breath (53%), additional complaints were cough (48%), symmetrical physical examination of the thorax (91%), positive sputum smear examination (72%), combined medical management of pulmicort + fumadryl + paracetamol + levofloxacin + OAT category I (72%), the longest length of stay was 7-8 days (38%), the shortest was 11-12 days (1%). In conclusion, pulmonary TB occurs more in men in the 37- 45 year age group (22%), the most complaints are shortness of breath (53%), and the most widely used combination treatment is pulmicort + fumadryl + paracetamol + levofloxacin + drugs anti tuberculosis category I (72%).

Hormonal Contraceptive Use Related to Menopausal Age

The change in the pattern and timing of menopause is an exciting and exploratory phenomenon that requires more detailed research to be carried out using hormonal contraception. This study was aimed to explore the relationship between hormonal contraceptive use and menopausal age. This study used a cross-sectional design. The study was conducted at Royal Prima General Hospital Medan from May to August 2021. A total of 68 research subjects participated in this study with the following inclusion criteria: menopausal women, aged 50-60 years, using hormonal contraceptives (pills, injections, implants), able to remember history previous contraceptive use. This study uses primary data obtained directly from guided interviews with respondents. Participants were dominated by ≥ 55 years old women with 57 people (83.81%), 62 Muslims (91.2%), menarche age >13 years as many as 28 people (41.2%). The number of children 2-4 were 32 people (47.1%) with an average menopause age of 51.93 and the smallest for 1 was 8 people (11.8%) with an average menopause age of 50.37. There were 49 users of hormonal contraception (72.1%) and 48 people (70.6%). In conclusion, we found that the use of hormonal contraceptives is significantly related to menopausal age.

Overview and Management of Chronic Kidney Disease Inpatients at Royal Prima General Hospital Medan in 2020

Chronic kidney disease (CKD) is a condition in which there is a gradual decline in kidney function. This disease is progressive and usually irreversible. Indications for hospitalized CKD patients with severe complications and do not allow inpatient therapy. This study was aimed to describe the overview and management of chronic kidney disease inpatient in Royal Prima General Hospital Medan. The type of research used is research with a descriptive and retrospective case study design. This study is based on medical record data related to inpatient CKD patients' diagnostic and management features at the Royal Prima General Hospital Medan in 2020. The research subjects were all inpatients diagnosed with CKD, whereas 100 research subjects with complete medical records were included in this study. It was found that the highest age group was 57-65 years, as much as 37.0%, and men as much as 27%. The chief complaint was shortness of breath at 43% and additional complaints, the most of which were fever + low back pain + edema at 38%. On physical examination, most of the inspections were weak, 55%. Most palpation was sociable 57%. There was auscultation of four abdominal regions and normal positive bowel sounds (93%). Complete blood count + blood sugar level + electrolytes + urea + creatinine 70%, the most combination medication is NaCl 0.9% + Furosemide injection 31%. Based on the length of stay, the longest was 13-14 days (20%).

Overview of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients at Royal Prima Hospital Medan Indonesia

Diabetes Mellitus (DM) is a chronic disease characterized by blood glucose (blood sugar) levels exceeding normal. Diabetic nephropathy is a chronic microvascular complication that often occurs in diabetics. This study presents a picture of diabetic nephropathy in type 2 DM patients at the Royal Prima Hospital in Medan. This research is a type of descriptive research. The sample from this study was the total data of patients suffering from diabetic nephropathy who met the inclusion and exclusion criteria at Royal Prima Hospital from January 1, 2020 – to December 31, 2020. The inclusion criteria for the subjects of this study were complete patient medical records, type 2 diabetes patients, urinalysis tests. (proteinuria ≥ +2), renal function examination exceeds normal values, blood urea, and creatinine. The mean age of diabetic nephropathy patients was 57.52 years and the majority were 62 men (50.8%). The average picture of urea levels in diabetic nephropathy patients is 51.8 and the average creatinine level is 1.48. The majority of patients with diabetic nephropathy do not have proteinuria. And the average blood sugar level is 267 mg/dL. In conclusion, the incidence of diabetic nephropathy is highest in patients aged 57 years. The mean value of urea level is 51.80 mg/dl, creatinine value is 1.48 mg/dl, and the average blood sugar level is 267 mg/dl. Most proteinuria was in the negative category of as many as 107 people (87%).

Diagnostic Overview of COVID-19 Patients with Comorbid Type 2 Diabetes Mellitus at Royal Prima General Hospital Medan in 2020

COVID-19 is a disease caused by infection with a coronavirus known as SARS-CoV-2. COVID-19 patients with diabetes have a poor prognosis and thus have a shorter life expectancy than those without diabetes. This is because COVID-19 causes severe lung dysfunction and inflammation. The purpose of the study is to find out the description of diagnostic of COVID-19 patients with comorbid diabetes mellitus type 2 at Royal Prima general hospital Medan in 2020. The case study design method is descriptive with a retrospective approach, the sample size of 63 patient medical records is taken by purposive sampling, a complete medical record and analyzed with descriptive statistics. Most patients were aged more than 50 years old (66.7%) and female (50.8%). With symptoms of fever (84.1%), cough (87.3%), shortness of breath (87.3%), headache (28.6%), diarrhea (9.5%), nausea (42.9%), abdominal pain (31.7%), loss of smell (20.6%). The longest hospitalization time (11-20 days) (46%). It can be concluded that the most age is > 50 years, the most gender is female and the most clinical symptoms are cough and shortness of breath.

Acute Toxicity Testing of White Turmeric Extract (Curcuma zedoaria) on Histopathological Imaging of the Lungs

White turmeric (Curcuma zedoaria) is a type of plant whose extract contains compounds that can inhibit carcinogenesis. Acute toxicity test was conducted to determine the safe dose and lethal dose (LD) 50 from the use of a drug substance. This research aimed to determine the effect of the acute toxicity test of white turmeric extract on the histopathological imaging of the lungs. This study is an experimental study with a post test only control group design. A total of 30 Wistar rats was divided into six groups. Data analysis was using one-way ANOVA statistical test, while for lung histopathology using ordinal data which were analyzed descriptively. In conclusion, the acute toxicity test of white turmeric extract on Wistar rats was not toxic and there was no death and no toxic symptoms and no necrosis, congestion and inflammation were found on the histopathological picture of the lungs.

The Relationship of Body Mass Index and Diabetic Foot Risk in Type 2 Diabetes Mellitus at Royal Prima Hospital on Period 2018 to 2020

Body mass index (BMI) is a simple method that is commonly used to determine whether a person is obese or not. Diabetes mellitus is a disorder of the metabolic system because the pancreas cannot produce enough insulin or the body's cells cannot use insulin effectively. Diabetic foot is one of the chronic complications of diabetes mellitus (DM). Diabetic foot begins with hyperglycemia which causes abnormalities in neuropathy and blood vessels, causing infection. To determine the proportion of body mass index in patients with diabetes mellitus, to determine the prevalence of diabetic feet and non-foots. The research design used in this study is observational analytic. There is a relationship between body mass index and the risk of diabetic foot in type 2 DM patients at Royal Prima Hospital. Prevalence of body mass index 23. 0 in DM Type 2 at Royal Prima Hospital Medan in 2018-2020 reached 70%. The prevalence of diabetic foot in Type 2 DM at the Royal Prima Hospital Medan in 2018-2020 reached 54%.

The Effect of Online Education on the Level of Knowledge of Methodist-2 Kisaran Junior High School Children in Maintaining Oral Hygiene During the Covid-19 Pandemic

The Covid-19 pandemic has changed people's habits to always maintain cleanliness. Good knowledge of the Covid-19 pandemic and oral hygiene as an effort to prevent the transmission of Covid-19 is important to apply during this pandemic, one of which is through online education. This study aims to determine the effect of online education on the level of knowledge of Methodist-2 Kisaran junior high school children in maintaining oral hygiene during the covid-19 pandemic. This type of research is pre-experimental with one group pretest post-test design. The research sample was 50 students of Methodist-2 Private SMP students. Data was collected by dividing the questionnaire twice (pretest and post test) via smartphone. Data were analyzed using paired t test. Based on the results of the study, the average score for knowledge of Methodist-2 Private SMP children in maintaining oral hygiene during the Covid-19 pandemic before being given online education was 34.96±1.795 and after increasing to 37.38±1.383. The conclusion of this study is that there is an effect of online education on the level of knowledge of Methodist-2 Kisaran junior high school children in maintaining oral hygiene during the Covid-19 pandemic.

Zenker Diverticulum

Zenker Diverticulum is a multifactorial disorder of the Killian’s triangle in thehypopharynx characterized by the main symptoms of dysphagia affecting theseventh and eighth decades of age and rarely under 40 years of age. The existenceof factors that cause an increase in the intraluminal pressure of the pharynx willlead to the formation of a pocket located in the Killian’s triangle, an area with weakertone of the hypopharyngeal wall and a decrease in relative pressure in theretropharyngeal space. Zenker Diverticulum was first described by Ludlow in 1769,who reported abnormal dilatation of the posterior pharyngeal wall on postmortemexamination of a patient who complained a lifelong dysphagia. Zenker Diverticulumis thought to be associated with increasing age in relation to motor musclecoordination for swallowing functions and GERD (gastroesophageal reflux disease).Symptoms include dysphagia, regurgitation, malnutrition, and recurrent aspirationpneumonia. Management includes invasive surgery and non-invasive endoscopy.

Eosinophilic Esophagitis: Atopy Conditions of the Esophagus

Eosinophilic esophagitis is an immune-allergic pathology of multifactorial etiology(genetic and environmental) characterized by major symptoms of esophagealdysphagia and eosinophil-predominant inflammation of the esophageal mucosathat affects both pediatric and adult patients. EoE is an immune-mediated diseaseby which environmental and food antigens stimulate the Th2 inflammatorycascade. It is correlated with food allergy and atopy condition such as asthma, atopydermatitis, rhinitis allergic and often in conjunction with Gastroesophageal RefluxDisease (GERD). Eosinophilic esophagitis (EoE) was first described in the 1990s,showing an increasing incidence and prevalence since then, in the United States isestimated to be approximately 57 per 100,000 persons being the leading cause offood impaction and the major cause of dysphagia. Its symptoms, which includeheartburn, regurgitation, and esophageal stenosis. This symptomps similar to thoseof gastroesophageal reflux disease, causing delays in diagnosis and treatment. Theendoscopic findings such as furrows, esophageal mucosa trachealization, andwhitish exudates, this diagnosis should be confirmed histologically confirmed bybiopsy on the presence of more than 15 eosinophils per high-power field and theexclusion of other causes of eosinophilia. Management includes medications, diet,and surgical dilatation.