Introduction: Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection. Sepsis and septic shock are major health problems, affecting millions of people worldwide each year and killing one in six people affected. Early identification and appropriate management in the early hours after the development of sepsis improves the patient's prognosis. Surviving Sepsis Campaign (SSC) 2021 recommends a fluid dose of 30mL/kgBW, but there are many studies stating that there is no difference in patient outcomes when we resuscitate patients with 10 or 20 mL/kgBW fluids. Norepinephrine is considered as the safest and most potent vasopressor agents than others. Methods: This study used a double-blind randomized clinical trial (RCT) design to assess MAP in sepsis patients in intensive care unit (ICU) of Haji Adam Malik General Hospital ,Medan. Results: There were more male (56.5%), than female (43.5%). In our study, administration of 10mL/kg and 20mL/kg fluid bolus with vasopressor resulted in increased MAP, and the differences were statistically significant (p < 0.05). Administration of 10 mL/kg fluid gave higher MAP values than the other groups, could be a consideration in choosing fluid in order to avoid fluid overload. Conclusion: There is a significant comparison in the ratio of norepinephrine pre-loading fluid toward MAP in sepsis patients. Comparison of the mean MAP value at 15, 20, 25 minutes was the highest in the 10 mL/KgBW group. Meanwhile, the lowest MAP was found in 30mL/KgBW the group.
败血症是由宿主对感染反应失调引起的危及生命的器官功能障碍。败血症和感染性休克是主要的健康问题，每年影响全世界数百万人，并导致六分之一的患者死亡。在脓毒症发生后的早期识别和适当的治疗可以改善患者的预后。存活脓毒症运动(SSC) 2021推荐30mL/kgBW的液体剂量，但有许多研究表明，当我们用10或20 mL/kgBW的液体对患者进行复苏时，患者的结果没有差异。去甲肾上腺素被认为是最安全、最有效的血管加压药物。方法:本研究采用双盲随机临床试验(RCT)设计，评估棉兰Haji Adam Malik综合医院重症监护病房(ICU)脓毒症患者的MAP。结果:男性占56.5%，女性占43.5%;在我们的研究中，给药10mL/kg和20mL/kg的液体加血管加压剂导致MAP升高，差异有统计学意义(p < 0.05)。给药10 mL/kg时，MAP值高于其他各组，这可能是选择液体时考虑的因素，以避免液体过载。结论:在脓毒症患者中，去甲肾上腺素预载液与MAP的比例有显著性差异。10 mL/KgBW组在15、20、25分钟时MAP平均值最高。同时，MAP在30mL/KgBW组最低。
{"title":"Comparison of Pre-Loading Fluid With Norepinephrine Toward Mean Arterial Pressure (MAP) In Sepsis Patients In Intensive Care Unit (ICU) of Haji Adam Malik General Hospital, Medan","authors":"Rendi Sidiq, B. Lubis, Yutu Solihat","doi":"10.47353/jsocmed.v1i2.7","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i2.7","url":null,"abstract":"Introduction: Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection. Sepsis and septic shock are major health problems, affecting millions of people worldwide each year and killing one in six people affected. Early identification and appropriate management in the early hours after the development of sepsis improves the patient's prognosis. Surviving Sepsis Campaign (SSC) 2021 recommends a fluid dose of 30mL/kgBW, but there are many studies stating that there is no difference in patient outcomes when we resuscitate patients with 10 or 20 mL/kgBW fluids. Norepinephrine is considered as the safest and most potent vasopressor agents than others. \u0000Methods: This study used a double-blind randomized clinical trial (RCT) design to assess MAP in sepsis patients in intensive care unit (ICU) of Haji Adam Malik General Hospital ,Medan. \u0000Results: There were more male (56.5%), than female (43.5%). In our study, administration of 10mL/kg and 20mL/kg fluid bolus with vasopressor resulted in increased MAP, and the differences were statistically significant (p < 0.05). Administration of 10 mL/kg fluid gave higher MAP values than the other groups, could be a consideration in choosing fluid in order to avoid fluid overload. \u0000Conclusion: There is a significant comparison in the ratio of norepinephrine pre-loading fluid toward MAP in sepsis patients. Comparison of the mean MAP value at 15, 20, 25 minutes was the highest in the 10 mL/KgBW group. Meanwhile, the lowest MAP was found in 30mL/KgBW the group.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129769449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Early prediction and avoidance of aggravation of AKI will be useful in identifying patients at risk of developing a higher degree of AKI. Many studies have been conducted to prevent AKI and find biomarkers to predict AKI. Many studies have identified biomarkers of AKI, such as neutrophil-associated lipocalin (NGAL), cystatin C, interleukin-18, and tissue inhibitors of metalloproteinase-2 (TIMP-2). Yet few have investigated the role of PCT as a predictor of AKI. The pathophysiological mechanisms that explain the association between serum PCT and AKI remain unclear. Various inflammatory responses are thought to play a role in the AKI development. PCT acts as a chemoattractant in the inflammation area and causes more monocytes to invade the inflammation. PCT is initially produced in adherent monocytes and then contributes to an increase in circulating PCT by attracting parenchymal cells as they attach directly to activated monocytes. High PCT levels ultimately act as a direct chemoattractant to monocyte counts.
{"title":"Serum Procalcitonin (PCT) Level In Acute Kidney Injury (AKI) In Critical Patients","authors":"Azwar Iwan Tona, M. Syukri","doi":"10.47353/jsocmed.v1i2.8","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i2.8","url":null,"abstract":"Early prediction and avoidance of aggravation of AKI will be useful in identifying patients at risk of developing a higher degree of AKI. Many studies have been conducted to prevent AKI and find biomarkers to predict AKI. Many studies have identified biomarkers of AKI, such as neutrophil-associated lipocalin (NGAL), cystatin C, interleukin-18, and tissue inhibitors of metalloproteinase-2 (TIMP-2). Yet few have investigated the role of PCT as a predictor of AKI. The pathophysiological mechanisms that explain the association between serum PCT and AKI remain unclear. Various inflammatory responses are thought to play a role in the AKI development. PCT acts as a chemoattractant in the inflammation area and causes more monocytes to invade the inflammation. PCT is initially produced in adherent monocytes and then contributes to an increase in circulating PCT by attracting parenchymal cells as they attach directly to activated monocytes. High PCT levels ultimately act as a direct chemoattractant to monocyte counts.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128657955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: As of March 11, 2020, the number of confirmed cases in China had reached 80,955 with the death toll reaching 3,162. So far, Covid-19 tends to infect people who have comorbid diseases such as heart disease, diabetes mellitus, cancer and chronic respiratory diseases as well as people over 60 years of age. Several cases of Covid-19 have also been reported in pregnant women. Method: Radiographic technologies and tools including chest X-Ray and Computed Tomography (CT) are applied for initial screening and the follow-up because they provide detailed diagnoses with specific pathological features for staging and treatment settings. Not infrequently cases of Covid-19 are found in pregnant women because during pregnancy women’s condition becomes very vulnerable to infection with pneumonia pathogens due to physiological changes during pregnancy that result in a decrease in the immune system. Although the clinical symptoms are the same as for non-pregnant women and there are no aggravating factors, pregnant women are prone to hypoxia. Results: Chest x-ray (CXR) is a radiographic projection tool that can help diagnose conditions or abnormalities in the thoracic cavity. Due to the spread of Covid-19, it is important to recognize the common Covid-19 imaging findings and the abnormal pneumonia that occurs over time on CXR results. CXR can be used to diagnose patients with acute respiratory distress as the first line of evaluation for Covid-19 patients 19. Conclusion: CXR can be a screening modality in Covid-19 patients including pregnant women. However, it is necessary to keep in mind that the CXR examination can have an impact on the fetus. Even though the risk is small, pregnant women who will undergo a Covid-19 examination or evaluation need special attention. In addition, it is necessary to consider other examinations that can be carried out especially on pregnant women, which do not have the effect of radiation
{"title":"Use of Chest X-Ray (CXR) in Covid-19 Screening as A Modalities","authors":"Adityo Prabowo","doi":"10.47353/jsocmed.v1i2.9","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i2.9","url":null,"abstract":"Background: As of March 11, 2020, the number of confirmed cases in China had reached 80,955 with the death toll reaching 3,162. So far, Covid-19 tends to infect people who have comorbid diseases such as heart disease, diabetes mellitus, cancer and chronic respiratory diseases as well as people over 60 years of age. Several cases of Covid-19 have also been reported in pregnant women. \u0000Method: Radiographic technologies and tools including chest X-Ray and Computed Tomography (CT) are applied for initial screening and the follow-up because they provide detailed diagnoses with specific pathological features for staging and treatment settings. Not infrequently cases of Covid-19 are found in pregnant women because during pregnancy women’s condition becomes very vulnerable to infection with pneumonia pathogens due to physiological changes during pregnancy that result in a decrease in the immune system. Although the clinical symptoms are the same as for non-pregnant women and there are no aggravating factors, pregnant women are prone to hypoxia. \u0000Results: Chest x-ray (CXR) is a radiographic projection tool that can help diagnose conditions or abnormalities in the thoracic cavity. Due to the spread of Covid-19, it is important to recognize the common Covid-19 imaging findings and the abnormal pneumonia that occurs over time on CXR results. CXR can be used to diagnose patients with acute respiratory distress as the first line of evaluation for Covid-19 patients 19. \u0000Conclusion: CXR can be a screening modality in Covid-19 patients including pregnant women. However, it is necessary to keep in mind that the CXR examination can have an impact on the fetus. Even though the risk is small, pregnant women who will undergo a Covid-19 examination or evaluation need special attention. In addition, it is necessary to consider other examinations that can be carried out especially on pregnant women, which do not have the effect of radiation","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125457751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This therapy is a method of cleaning the blood and wind by sucking. remove residual toxins in the body through the skin surface by sucking. Cupping is divided into two types, that’s wet cupping and dry cupping. Dry cupping includes slide cupping, fire cupping, and pull cupping. The difference between wet cupping and dry cupping is the presence or absence of blood. Cupping is an alternative method that involves placing a cup on the skin using heat or suction for a few minutes. This will pull the tissue under the skin and form a blood pool so that a localized healing process occurs. Cupping is very beneficial for these patients although the benefits may not be felt in the short term. The side effects caused by cupping are not severe, only cause discomfort due to cupped and incision on the skin. Cupping plays a role in reducing inflammatory mediators formed due to cell inflammation. This substance serves to send pain signals to the brain. Cupping can be used for diseases that are local or systemic. Cupping can be used to reduce pain such as headaches, carpal tunnel syndrome and some other local disease.
{"title":"The Medical Perspective of Dry Cupping and Wet Cupping: Effects and mechanisms of action","authors":"Qadri Fauzi Tanjung, Hendi Ishadi","doi":"10.47353/jsocmed.v1i1.6","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i1.6","url":null,"abstract":"This therapy is a method of cleaning the blood and wind by sucking. remove residual toxins in the body through the skin surface by sucking. Cupping is divided into two types, that’s wet cupping and dry cupping. Dry cupping includes slide cupping, fire cupping, and pull cupping. The difference between wet cupping and dry cupping is the presence or absence of blood. Cupping is an alternative method that involves placing a cup on the skin using heat or suction for a few minutes. This will pull the tissue under the skin and form a blood pool so that a localized healing process occurs. Cupping is very beneficial for these patients although the benefits may not be felt in the short term. The side effects caused by cupping are not severe, only cause discomfort due to cupped and incision on the skin. Cupping plays a role in reducing inflammatory mediators formed due to cell inflammation. This substance serves to send pain signals to the brain. Cupping can be used for diseases that are local or systemic. Cupping can be used to reduce pain such as headaches, carpal tunnel syndrome and some other local disease.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124096330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Incidence of perioperative anxiety is very high, many preoperative patient experience anxiety . Thiamine acts as an essential nutrition funtionate as cofactor enzyme in most of mitochondria in brain. Brain is very susceptible to thiamine deficiency because its dependency on mitochondrial ATP production. Decreased ATP production result in inhibition of COMT activity. Low COMT levels indicated tendency for anxiety. The aim of this study is to determine the effect of thiamine in increasing COMT enzyme levels in patient with preoperative anxiety Methods : A true experiment with pretest-posttest control group and double-blind design conducted at the Department of Anesthesia and Intensive Care of University of North Sumatra in August 2019. The 60 patients were analyzed which were planned for and done an elective surgery under general anesthesia. Preoperative anxiety was measured with Amsterdam Preoperative Anxiety and Information Scale (APAIS) and COMT enzyme level measured by ELISA assays. Results : The results showed that from 64 patients had incidence of preoperative anxiety in this study was 48.3%. We found that there is significant differences in COMT enzyme levels in thiamine group compared to control (p value = 0.001). In addition, it was seen that in thiamine group had an increased COMT levels from 0.96 ng/dL to 1.78 ng/dL, while in control group there also slight increasing from 0.44 ng/dL to 0.78 ng/dL. This show that increase in COMT levels is greater in thiamine group than control group. Conclusion : Thiamine can cause increasing COMT enzyme levels in patients scheduled for elective surgery with preoperative anxiety under general anesthesia
{"title":"Catechol-O-Methyltransferase (COMT) Enzyme Level In Preoperative Anxiety Patients","authors":"Akhyar Hamonangan Nasution, A. Lelo","doi":"10.47353/jsocmed.v1i1.5","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i1.5","url":null,"abstract":"Background: Incidence of perioperative anxiety is very high, many preoperative patient experience anxiety . Thiamine acts as an essential nutrition funtionate as cofactor enzyme in most of mitochondria in brain. Brain is very susceptible to thiamine deficiency because its dependency on mitochondrial ATP production. Decreased ATP production result in inhibition of COMT activity. Low COMT levels indicated tendency for anxiety. The aim of this study is to determine the effect of thiamine in increasing COMT enzyme levels in patient with preoperative anxiety \u0000Methods : A true experiment with pretest-posttest control group and double-blind design conducted at the Department of Anesthesia and Intensive Care of University of North Sumatra in August 2019. The 60 patients were analyzed which were planned for and done an elective surgery under general anesthesia. Preoperative anxiety was measured with Amsterdam Preoperative Anxiety and Information Scale (APAIS) and COMT enzyme level measured by ELISA assays. \u0000Results : The results showed that from 64 patients had incidence of preoperative anxiety in this study was 48.3%. We found that there is significant differences in COMT enzyme levels in thiamine group compared to control (p value = 0.001). In addition, it was seen that in thiamine group had an increased COMT levels from 0.96 ng/dL to 1.78 ng/dL, while in control group there also slight increasing from 0.44 ng/dL to 0.78 ng/dL. This show that increase in COMT levels is greater in thiamine group than control group. \u0000Conclusion : Thiamine can cause increasing COMT enzyme levels in patients scheduled for elective surgery with preoperative anxiety under general anesthesia","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128102963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Increasing levels of endogenous catecholamines occur acutely to provide short-time adaptation to stressful conditions, known as the fight-or-fly response. Catecholamine toxicity requires multidisciplinary management. In this case, the patient is diagnosed with a brain abscess since birth. According of the history, physical examination and investigations, it was concluded that the diagnosis of epidural abscess with abscess evacuation craniotomy and PS ASA 2 (leukocytosis) with GA-ETT anesthesia. The operation is carried out with a duration of 4 hours. Vital sign monitoring obtained blood pressure sp108 – 125 62 - 90 mmHg, heart frequency 90 - 120 times per minute, 99% oxygen saturation. When in the recovery room, the patient experiences cardiac arrest, this is thought to result from catecholamine toxicity. Patients are treated as resuscitation in accordance with the algorithm of cardiac arrest in children. Patients experienced a response of spontaneous circulation (ROSC) and performed vital sign monitoring.
{"title":"Catecholamine Toxicity After Craniotomy Evacuation Craniotomy and Evacuation of The Abscess","authors":"Ongta Gibson Sirait, Wulan Fadinie","doi":"10.47353/jsocmed.v1i2.3","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i2.3","url":null,"abstract":"Increasing levels of endogenous catecholamines occur acutely to provide short-time adaptation to stressful conditions, known as the fight-or-fly response. Catecholamine toxicity requires multidisciplinary management. In this case, the patient is diagnosed with a brain abscess since birth. According of the history, physical examination and investigations, it was concluded that the diagnosis of epidural abscess with abscess evacuation craniotomy and PS ASA 2 (leukocytosis) with GA-ETT anesthesia. The operation is carried out with a duration of 4 hours. Vital sign monitoring obtained blood pressure sp108 – 125 62 - 90 mmHg, heart frequency 90 - 120 times per minute, 99% oxygen saturation. When in the recovery room, the patient experiences cardiac arrest, this is thought to result from catecholamine toxicity. Patients are treated as resuscitation in accordance with the algorithm of cardiac arrest in children. Patients experienced a response of spontaneous circulation (ROSC) and performed vital sign monitoring.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129926332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are four situations in the use of Hospital Information Technology applications or better known as SIMRS in Indonesian hospitals, first, the hospital has not had SIMRS yet, second, the hospital already has SIMRS but it has not been integrated, third, the hospital has an integrated SIMRS based on non-web service but has not bridged with E-claim application, and fourth, the hospital already has SIMRS based on Web Services and bridged with INA-CBG's E-Claim Application. The purpose of this study was to discuss the effectiveness of the National Health Insurance ( JKN ) Inpatient Claim using an integrated SIMRS web-based (Bridging System) with the INA-CBG'S E-Claim application Version 5.2 at Indonesia. Electronic Claims (E-Claims) or the INA-CBG's application is one of the patient data entry tools used to group rates based on data derived from medical resumes. The INA-CBG's E-Claim application has been installed in hospitals that serve JKN participants.
{"title":"E-Claim System For Health Insurance And Social Security (BPJS) Types In Indonesia: Innovation And Effectiveness Of Services","authors":"Wachyoe Hadi Saputra, Agus Prima","doi":"10.47353/jsocmed.v1i1.4","DOIUrl":"https://doi.org/10.47353/jsocmed.v1i1.4","url":null,"abstract":"There are four situations in the use of Hospital Information Technology applications or better known as SIMRS in Indonesian hospitals, first, the hospital has not had SIMRS yet, second, the hospital already has SIMRS but it has not been integrated, third, the hospital has an integrated SIMRS based on non-web service but has not bridged with E-claim application, and fourth, the hospital already has SIMRS based on Web Services and bridged with INA-CBG's E-Claim Application. The purpose of this study was to discuss the effectiveness of the National Health Insurance ( JKN ) Inpatient Claim using an integrated SIMRS web-based (Bridging System) with the INA-CBG'S E-Claim application Version 5.2 at Indonesia. Electronic Claims (E-Claims) or the INA-CBG's application is one of the patient data entry tools used to group rates based on data derived from medical resumes. The INA-CBG's E-Claim application has been installed in hospitals that serve JKN participants.","PeriodicalId":370087,"journal":{"name":"Journal of Society Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133291648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：