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"Background: Tire methods of ERCP have been used for diagnostic and therapeutic purposes to pass bile fluid and extract stones from the bite duct in patients with obstructive extrahepatic jaundice.

Method: A retrospective study was performed on patients with obstructive extrahepatic jaundice patients who underwent ERCP dttring a two-years time period from January 1999 to December 2000. ERCP was performed with a premedication of I0 mg midazolam, followed by a chollangiography contrast containing 1 mg/dl of Garamicin and 25 mg of Pethidine if sphincterotomy was performed.

Results: From 126 patients with obstructive extrahepatic jaundice treated with ERCR the male to female ratio was 1.86:1. The majority of the (group) of patients were between 51-60 years of age (33.3 % ). The youngest patient (group) was 24 years and the oldest 97 years. The diagnostic study found the following cases: normal 3 cases (28%), bile duct stone 46 cases (43.4%) carcinoma of ampula voter 20 cases (18.9%), CBD tumor 7 crises (6.6%), carcinoma of head of pancreas 2 cases (1.9%), diverticle 4 cases (38%), duodenal tumor I case (0.9%), carcinoma of ampula vater and bite duct stone 1 case (0.9%), SOD 5 cases (4.7%), CBD stricture 1 case (0.9%) and failure I6 cases (15.1%). The patients received the following treatment: sphyncterotomy 36 cases (51 .4%), stent application 11 cases (15.7%), sphincterotomy with stent 18 cases (25.7%) and basket method 5 cases ( 7. 1%)."

"Obstructive jaundice can be caused by malignant or benign origi. The treatment for these situations includes drainage by biliary stenting.The main of this study was to evaluate the success rate of endoscopic retrograde cholangiopancreatography (ERCP) in evaluating malignant obstructive jaundice and the success rate of plastic stent placement...."

"Tujuan: mendapatkan kesintasan dan faktor-faktor yang berhubungan dengan mortalitas pada pasien ikterus obstruktif dengan etiologi maligna. Metode: penelitian kohort retrospektif dan prospektif dilakukan dengan data sekunder pasien ikterus obstruktif yang dirawat di RS. Cipto Mangunkusumo, Jakarta antara Januari 2010-Desember 2013. Faktor-faktor yang dinilai meliputi umur, jenis kelamin, sepsis, hipoalbumin, tingkat bilirubin serum, tingkat CA 19-9 serum, drainase bilier, keganasan non ca ampula Vater, dan komorbid dengan hasil keluaran berupa mortalitas pasien.Hasil: sebanyak 181 dari 402 pasien ikterus obstruktif dengan etiologi maligna memenuhi kriteria penelitian dengan proporsi laki-laki sebesar 58,6 % dengan pasien berumur ≥50 tahun sebesar 57,5%. Analisis multivariat menunjukkan bahwa sepsis, riwayat drainase bilier sebelumnya dan skor komorbid Charlson ≥4 merupakan prediktor independen terhadap mortalitas. Median kesintasan pasien dengan faktor prognosis bermakna adalah 14 hari sedangkan median kesintasan keseluruhan 26 hari. Ambang skor prognostik terbaik didapatkan pada skor ≥2 dengan sensitivitas 68% dan spesifisitas 75%. AUC pada kurva ROC 0.769.Kesimpulan: kesintasan pasien dengan faktor prognosis sepsis, drainase bilier tidak berhasil/tidak ada, dan skor indeks komorbid Charlson ≥4 lebih pendek dibandingkan kesintasan keseluruhan pasien. Skor prognostik ≥2 termasuk dalam risiko tinggi kematian dan kemampuan prediksi mortalitas dari faktor prognosis bermakna adalah 76.9%.

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Aim: to obtain survival rate and mortality-related factors of malignant obstructive jaundice patients.Methods: all medical records of obstructive jaundice inpatient at Cipto Mangunkusumo Hospital, Jakarta from January 2010 to December 2013 were reviewed retrospectively. The following factors were analyzed in terms of mortality: age, gender, sepsis, hypoalbumin, serum bilirubin level, serum CA 19-9 level, billiary drainage, non-ampulla Vateri carcinoma, and comorbid factors.Results: total 181 out of 402 patients were enrolled in this study with male proportion was 58.6%, and patients aged 50 years or above was 57.5%. Multivariate analysis showed that only sepsis, unsuccessful or no prior biliary drainage and Charlson comorbid score ≥4 were independent predictors of mortality. Patients with significant prognostic factors had median survival 14 days compared with overall median survival 26 days. Score ≥2 identified as the highest prognostic score threshold with sensitivity 68%, specificity 75%, and AUC on ROC curve 0.769.Conclusion: sepsis, unsuccessful or no prior bilirary drainage, and Charlson comorbid score ≥4 are factors significantly associated with shortened survival in malignant obstructive jaundice patients. Prognostic score ≥2 was determined to classify patients into high risk mortality group. Mortality of patients with those significant prognostic factors can be predicted in 76.9%."

"Ambulasi dini merupakan suatu prosedur untuk mempercepat kemampuan pasien berjalan atau bergerak secara normal. Tujuan penelitian ini adalah untuk menilai pengaruh ambulasi dini 2 jam dan 8 jam terhadap kejadian perdarahan pada pasien pascaangiografi koroner diagnostik di bangsal kardiologi, ruangan RB3 dan VIP RSUP Haji Adam Malik, Medan. Penelitian ini menggunakan desain penelitian Quasi experimental dengan consecutive sampling, terdiri dari 18 responden diberikan ambulasi dini 2 jam sebagai kelompok intervensi dan 17 responden diberikan ambulasi 8 jam sebagai kelompok kontrol. Data dianalisis secara univariat dan analisis bivariat menggunakan uji Wilcoxon dan Kolmogorov- Smirnov. Hasil penelitian ini menunjukkan semua responden tidak mengalami perdarahan pada kedua kelompok baik sebelum maupun sesudah ambulasi (p=1; 𝛂=0,05). Kesimpulan tidak ada perbedaan ambulasi dini 2 jam dan 8 jam terhadap kejadian perdarahan pada pasien pascaangiografi koroner diagnostic. Hasil penelitian ini dapat dilaksanakan sebagai intervensi keperawatan pada pasien pascaangiografi koroner diagnostic untuk mengurangi rasa tidak nyaman seperti sakit punggung, masalah eliminas.

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Early ambulation is a procedure to expedite the patient's ability to walk or move normally. The purpose of this study was to assess the effect of early ambulation 2 hours and 8 hours on the incidence of bleeding in patients with coronary pascaangiografi diagnostics in cardiology ward, and a VIP room, RB3 room In general hospital center Medan Haji Adam Malik. This study uses Quasiexperimental research design with a consecutive sampling, consisted of 18 respondents provided an early ambulation two hours as the intervention group and 17 respondents provided ambulate 8 hours as a control group. Data were analyzed by univariate and bivariate analysis using Wilcoxon test and Kolmogorov-Smirnov.

The results of this study showed all of the respondents did not experience bleeding in both groups both before and after ambulation (p = 1; α = 0.05). The conclusion there was no difference in early ambulation 2 hours and 8 hours on the incidence of bleeding in patients with coronary diagnostic pascaangiografi. The results of this study can be implemented as a nursing intervention in patients with coronary diagnostic pascaangiografi to reduce discomfort such as back pain, the problem of elimination."

"Skripsi ini mengkaji pengaturan mengenai hak dan kewajiban pasien non-covid dalam pelayanan kesehatan di masa pandemi Covid-19, perlindungan hukum terhadap pasien non-covid dalam pelayanan kesehatan selama masa pandemi Covid-19, serta analisis penerapannya di RSUP H. Adam Malik Medan. Penelitian ini menggunakan metode yuridis-normatif dengan tipe penelitian deskriptif, data penelitian dikumpulkan melalui data sekunder yang terdiri dari bahan hukum, serta data primer melalui wawancara dengan Koordinator Pelayanan Medis dan Keperawatan RSUP H. Adam Malik Medan. Simpulan dari penelitian ini adalah pengaturan mengenai hak dan kewajiban pasien non-covid dalam pelayanan kesehatan di masa pandemi secara umum diatur dalam UUD NRI 1945, UU No. 36 Tahun 2009 tentang Kesehatan, UU No. 44 Tahun 2009 tentang Rumah Sakit, UU No. 29 Tahun 2004 tentang Praktik Kedokteran, serta Permenkes No. 4 Tahun 2018 tentang Kewajiban Rumah Sakit dan Kewajiban Pasien. Perlindungan hukum bagi pasien non-covid dalam pelayanan kesehatan bertujuan untuk menjamin kepastian hukum bagi pasien non-covid dalam penggunaan pelayanan kesehatan di masa pandemi Covid-19, yakni dengan memastikan terpenuhinya hak-hak pasien non-covid yang diatur secara umum dalam peraturan perundang-undangan. Dalam penelitian, ditemukan bahwa RSUP H. Adam Malik Medan dalam memberikan pelayanan kesehatan telah memenuhi hak-hak pasien non-covid yang secara umum diatur dalam peraturan perundang-undangan. Penelitian ini menyarankan kepada pemerintah untuk tetap melakukan pengawasan terhadap pelaksanaan pelayanan kesehatan terhadap pasien non-covid oleh rumah sakit, kepada rumah sakit agar tetap mengupayakan pelayanan kesehatan yang aman, serta bagi pasien non-covid agar tidak takut memeriksakan dirinya ke rumah sakit.

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This thesis examines the regulation of the rights and obligations of non-covid patients in health services during the Covid-19 pandemic, legal protection for non-covid patients in health services during the Covid-19 pandemic, and analyzes its application at H. Adam Malik Hospital Medan. This study uses a juridical-normative research method with descriptive research type, research data was collected through secondary data consisting of legal materials, and primary data through interview with the Coordinator of Medical and Nursing Services at H. Adam Malik Hospital Medan. The conclusion of this study is that the regulation regarding the rights and obligations of non-covid patients in health services during a pandemic is contained in 1945 Constitution of the Republic of Indonesia, Law No. 36 of 2009 concerning Health, Law No. 44 of 2009 concerning Hospitals, Law No. 29 of 2004 concerning Medical Practice, and Minister of Health Regulation No. 4 of 2018 concerning Hospital Obligations and Patient Obligations. Legal protection for non-covid patients in health services aims to ensure legal certainty for non-covid patients in the use of health services during the Covid-19 pandemic, namely by ensuring the fulfillment of the rights of non-covid patients which have been generally regulated in laws and regulations. In the study, it was found that H. Adam Malik Hospital Medan in providing health services has fulfilled the rights of non-covid patients which are generally regulated in laws and regulations. This research suggests the government to continue to supervise the implementation of health services for non-covid patients by hospitals, for hospitals to continue to strive for safe health services, and for non-covid patients not to be afraid to check themselves in a hospital."

"ABSTRAKTerapi Androgen Deprivation Therapy (ADT) adalah salah satu tatalaksana untuk pasien dengan kanker prostat stadium lanjut yang berhubungan dengan adanya perubahan dari komposisi masa tubuh dan mencetuskan adanya resistensi dari insulin perifer. Penelitian ini dilaksanakan di RSUP H. Adam Malik, Medan sejak Juni 2014 hingga Juni 2015. Terapi ADT menyebabkan peningkatan secara signifikan sebelum dan 6 bulan sesudah pemberian kadar gula darah post prandial 121.12 21 mg/mL vs 134.64 33.35 mg/mL, p-value=0.011 dan Glycosylated hemoglobin HbA1C 5 0.5 vs 5.5 0.79 , p-value = 0.000 . Pemberian ADT selama 3 sampai 6 bulan juga secara signifikan meningkatkan kadar Trigliserida TG 104.4 38.67 vs 131.2 32.27 vs 127 33.43, p-value = 0.005 .

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ABSTRACTTherapy ADT is one of the treatments in patients with advanced prostate cancer in which has been linked to the changes in body mass composition and induction of insulin peripheral resistance in many studies. This research was conducted at Dr H. Adam Malik, Medan from June 2014 to June 2015. ADT administration is found to cause a significant elevation of 2 hour postprandial blood glucose 121.12 21 mg mL vs 134.64 33.35 mg mL, p value 0.011 and Glycosylated hemoglobin 5 0.5 vs 5.5 0.79 , p value 0.000 HbA1c after 6 months of therapy. Additionally, ADT administration within 3 and 6 months of duration had also significantly increased triglyceride TG level when compared to before treatment 104.4 38.67 vs 131.2 32.27 vs 127 33.43 respectively, P value 0.005 ."

"Peningkatan jumlah kasus COVID-19 dan penyebarannya di berbagai negara terjadi berlangsung cukup cepat dan dalam waktu singkat. Hingga 4 Mei 2021, COVID-19 telah menginfeksi lebih dari 152 juta orang dan lebih dari 3 juta kematian di seluruh dunia. Indonesia telah melaporkan 1.682.004 kasus konfirmasi, tertinggi di Asia Tenggara, dan sebanyak 45.949 kematian terkait COVID-19 yang dilaporkan tertinggi ke-2 di Asia dan ke-17 di dunia. Masih terbatasnya data mengenai karakteristik dan faktor risiko yang terkait kematian akibat COVID-19 di Indonesia dan belum ada penelitian mengenai hal ini di kota Medan. Studi kasus-kontrol terhadap 222 pasien COVID-19 yang dirawat inap di RSUP H. Adam Malik Medan periode Maret 2020-Desember 2020 dilakukan menggunakan data rekam medis pasien. Penelitian ini mendeskripsikan karakteristik pasien COVID-19 berdasarkan usia, jenis kelamin, gejala klinis, komorbiditas dan tempat tinggal serta untuk mengidentifikasi faktor-faktor yang berhubungan dengan kematian pada pasien COVID-19. Hasil penelitian melalui analisis multivariat logistik regresi menunjukkan bahwa, adanya peningkatan risiko terhadap kematian pada usia ≥ 60 tahun (OR=5.495, 95% CI: 2.398-12.591), demam (OR=4.441, 95% CI: 1.401- 14.077), sesak napas (OR=8.310, 95% CI: 3.415-20.220), riwayat hipertensi (OR=2.454, 95% CI: 1.159-5.196), riwayat penyakit ginjal kronik (OR=10.460 kali, 95% CI: 3.282-33.331), riwayat penyakit kanker (OR=16.137, 95% CI: 2.798- 96.147) pada pasien COVID-19 yang dirawat inap di RSUP H. Adam Malik Medan Tahun 2020.

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The increase in cases of COVID-19 and its spread in various countries took place very quickly and in a short time. As of May 4, 2021, COVID-19 has infected more than 152 million people and more than 3 million deaths worldwide. Indonesia has reported 1,682,004 confirmed cases, the highest in Southeast Asia, and 45,949 COVID-19-related deaths, the 2nd highest reported in Asia and 17th in the world. Data on characteristics and risk factors related to death from COVID-19 in Indonesia are still limited and there has been no research on this in the city of Medan. A case control study of 222 COVID-19 patients who were treated at H. Adam Malik Hospital in Medan for the period March 2020-December 2020 was carried out using patient medical record data. This study describes the characteristics of COVID-19 patients based on age, gender, clinical symptoms, comorbidities, place of residence and to determines the factors associated with death in COVID-19 patients. The results of the study through multivariate regression analysis showed an increased risk of death at the age of 60 years (OR = 5,495, 95% CI: 2,398-12,591), fever (OR = 4,441, 95% CI: 1,401 -14,077), shortness of breath (OR = 8,310) . , 95% CI: 3,415-20,220, history of hypertension (OR=2,454, 95% CI: 1,159-5,196), history of chronic disease (OR=10,460 times, 95% CI: 3,282-33,331), history of cancer (OR=16,137, 95% CI: 2,798-96,147) in COVID-19 patients treated at H. Adam Malik Hospital Medan in 2020.

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"Obstructive: jaundice represents the most common complication of biliary tract Malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure"

"Latar Belakang:Tuberkulosis resisten obat (TB-RO) merupakan ancaman bagi seluruh dunia termasuk Indonesia, karena memerlukan waktu lama dan biaya yang besar dalam mengobati penyakit tersebut meskipun telah ditangani dengan baik. Data penelitian di luar negeri menunjukkan bahwa terdapat kekambuhan TB-RO, tapi datanya sangat terbatas. Di Indonesia belum ada data tentang angka kekambuhan TB-RO.Tujuan: Mengevaluasi pasien TB resisten obat (TB-RO) pasca pengobatan yang datang kontrol pada bulan ke 6, 12, 18, dan 24 di RSUP Persabatan Jakarta.Metode: Penelitian menggunakan desain penelitian potong lintang terhadap pasien TB-RO yang telah dinyatakan sembuh dan pengobatan lengkap yang datang kontrol di poli MDR RSUP Persahatan Jakarta mulai bulan April 2017 sampai Desember 2017. Dilakukan anamnesis, pemeriksaan fisis, pemeriksaan foto toraks dan biakan sputum. Mencatat data pengobatan dan hasil-hasil pemeriksaan terkait data yang diperlukan dalam dalam rekam medis pasien.Hasil: Didapatkan 60 subjek penelitian dengan rerata usia 42,3 + 12,5 tahun, berjenis kelamin laki-laki 31 (51,7%) dan perempuan 29 (48,3%), dengan rerata IMT 21,75+ 4,34. Dari hasil foto toraks didapatkan gambaran dominan lesi luas dan hasil kultur sputum semua pasien yang diteliti tidak ditemukan pertumbuhan Mycobacterium tuberculosis.Kesimpulan: Tidak ditemukan kekambuhan pada pasien TB resisten obat yang yang telah dinyatakan sembuh dan pengobatan lengkap yang datang kontrol pasca pengobatan di RSUP Persahabatan Jakarta.

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Objective: This study aimed to evaluate DR-TB patients which was biannually performed for two-years (e.g. at the 6th, 12th, 18th, and 24th mos) after treatment completion.

Methods: This cross-sectional study involved DR-TB patients completing their treatment at Persahabatan General Hospital Jakarta, Indonesia, between April and December 2017. The post-treatment evaluation during the 6th, 12th, 18th, and 24th mos included clinical, chest x-ray (CXR) and sputum culture examination.

Results: Sixty patients were observed in this study, 31 (51.7%) were males and 29 (48.3%) were females. The mean age was 42.3+12.5 yo and the mean body mass index was 21.75+4.34. Fourty nine (81.7%) patients showed extensive lesions per CXR and none of the patient showed Mycobacterium tuberculosis growth per sputum culture.

Conclusion: There was no recurrence of DR-TB from patients completing their treatment at Persahabatan General Hospital Jakarta, Indonesia during two-years post-treatment evaluation."