Nahwa Arkhaesi
Staf pengajar Bagian IKA FK UNDIP, Jl. Dr. Sutomo No.18 Semarang

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HUBUNGAN ANTARA JENIS ANTIPIRETIKA YANG DIGUNAKAN DENGAN MANIFESTASI PERDARAHAN PADA ANAK YANG MENDERITA DEMAM BERDARAH DENGUE Rachmawati, Elfian; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Latar Belakang: Demam Berdarah Dengue (DBD) merupakan suatu penyakit infeksi akut yang sering menimbulkan wabah terutama pada golongan anak – anak. Gejala klinis demam yang muncul pada fase awal hampir sama denganpenyakit infeksi lain, sehingga beberapa ibu rumah tangga memberikan obat penurun panas (antipiretika) kepada anak mereka sebagai penanganan pertama tanpa dilatar belakangi oleh pengetahuan yang cukup tentang penggunaan jenis antipireika secara tepat dan diduga mampu memperburuk manifestasi perdarahan.Tujuan: Membuktikan hubungan antara jenis antipiretika yang digunakan dengan manifestasi perdarahan pada anak DBD.Metode : Penelitian yang dilakukan merupakan penelitian observasional dengan pendekatan studi cross sectional. Pengambilan sampel dilakukan melalui metode consecutive sampling di Departemen Ilmu Kesehatan Anak RSUP Dr. Kariadipada bulan Maret 2012 sampai dengan Juni 2012. Data tentang penggunaan jenis antipiretika diperoleh melalui wawancara kuesioner kepada ibu atau pendamping pasien anak DBD yang bersedia menjadi responden, dan manifestasi perdarahan dikonfirmasi melalui data rekam medis. Uji hipotesis dilakukan menggunakan uji Chi-square atau uji alternatif Fisher exact.Hasil : Didapatkan 32 pasien anak DBD di RSUP Dr.Kariadi selama periode penelitian. Berdasarkan hasil analisis data didapatkan terdapat hubungan yang bermakna antara jenis antipiretika yang digunakan dengan manifestasi perdarahan pada anak yang menderita DBD (p= 0,04). Anak yang mendapatkan antipiretika jenis non parasetamol sebelum dirawat di rumah sakit memiliki risiko 2,3 kali lebih besar untuk mengalami perdarahan dibandingkan dengan anak yangmendapatkan parasetamol.Simpulan : Didapatkan hubungan yang bermakna antara jenis antipiretika yang digunakan dengan manifestasi perdarahan pada anak DBD.Kata kunci : DBD, manifestasi perdarahan, jenis antipiretika
PERBEDAAN TINGKAT PENGETAHUAN IBU DAN TINDAKAN PENCEGAHAN DEMAM BERDARAH DENGUE DI WILAYAH ENDEMIS DAN NON ENDEMIS Rahadian, Dimas Aditya; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Background: Dengue hemorrhagic fever is still an issue in Indonesia. DHF incidence rate in children shows a significant increase both in number of patients and epidemic area. Problems that still exist nowadays are people ignorance and inconsistent prevention effort. People in endemic and non-endemic area may have different knowledge and precaution towards DHF due to the environment and ease in gaining information about DHF.Aim: To prove the difference of knowledge and precaution towards DHF in mothers between endemic and non-endemic area.Method: This was an analytic-observational study with cross sectional design, which held from March- June 2012. The samples were mothers who had children less than 14 years old in age and lived in Gajahmungkur (endemic) and Sekayu (non-endemic). Sampling done by using questionnaire. Data were being tested statistically with X2.Result: There was no significant differences between age of the respondents, occupations, income, age of the children and DHF history in a family in both groups, while the education level showed significant difference (p<0,001). 46.2% of the respondents in endemic area had good knowledge level, while other respondents in non-endemic area had poor knowledge level (92.3%). Six respondents in endemic area had good precaution towards DHF (23,1%), but all of the respondents in non endemic area (100%) had poor precaution towards DHF. A chi-square test showed that there were significant different level of knowledge (p=0,002) and precaution towards DHF (p=0,01) in both groups.Conclusion: Knowledge level and precaution towards DHF of respondents in endemic area is higher than the respondents in non endemic area.Keywords: Endemicity, knowledge, precaution, DHF.
HUBUNGAN ANTARA TINGKAT PENGETAHUAN IBU TENTANG DEMAM TIFOID TERHADAP KEBIASAAN JAJAN ANAK SEKOLAH DASAR Putra, Ade; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Background Infectious disease abdominal typhus or typhoid fever is transmitted through food and drink that contaminated with S.typhi. In Indonesia, typhoid is endemic are often found in big cities. Typhoid fever is more commonly is closely associated with the snacking behavior.Aim to prove the association between the level of maternal knowledge about typhoid fever with snacking behavior of elementary school pupils.Methods This was an analytic-observational study with cross sectional study design. Samples of this study were mothers who had elementary school pupils children lived in Kedungmundu (endemic area). Sampling done by using questionnaire. Data were being tested statistically with Chi-square/ Fischer test.Result this study showed 13 mothers (72,2%) with moderate-high knowledge level about typhoid fever having elementary school pupil with rare snacking behavior and 5 mother (27,8%) having elementary school pupil with often snacking behavior. This study also showed 1 mother (16,7%) with poor knowledge level about typhoid fever having elementary school pupil with rare snacking behavior and 5 mothers (83,3%) having elementary school pupil with often snacking behavior. There was a significant association between mother’s knowledge level about typhoid fever and elementary school pupil snacking behavior(p=0,017, PR=3,0). there was no significant association between elementary school pupil snacking behavior and friends invitation (p=0,4), amount of pocket money(p=0,2), and the number of snack places.Conclusion Levels of maternal knowledge about typhoid fever had a significant association with snacking behavior of elementary school pupils.Keyword : Knowledge, typhoid fever, snacking behavior of elementary school pupils
PENGARUH PENYULUHAN KESEHATAN TERHADAP TINGKAT PENGETAHUAN, SIKAP DAN PRAKTIK IBU DALAM PENCEGAHAN DEMAM BERDARAH DENGUE PADA ANAK Kusumawardani, Erika; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Latar Belakang: Penyuluhan kesehatan tentang DBD merupakan salah satu cara yang digunakan untuk menambah pengetahuan seseorang tentang DBD dengan tujuan mengubah atau mempengaruhi perilaku manusia dalam pencegahan DBD. Tujuan penyuluhan kesehatan tentang DBD adalah menginformasikan kepada masyarakat tentang penyakit tersebut.Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh penyuluhan kesehatan terhadap tingkat pengetahuan, sikap dan praktik ibu dalam pencegahan DBD pada anak.Metode: Penelitian ini adalah penelitian intervensional dengan rancangan quasi experimental non equivalent control group design pada periode Maret s/d Juni 2012. Penelitian dilakukan di wilayah Kelurahan Gajahmungkur (kelompok perlakuan) dan Kelurahan Tembalang (kelompok kontrol). Pada kelompok perlakuan diberikan penyuluhan kesehatan tentang DBD. Kelompok kontrol tidak mendapat penyuluhan apapun. Instrumen penyuluhan adalah penyuluhan langsung dan leaflet. Uji hipotesis yang dilakukan menggunakan Mann-Whitney dan Friedman.Hasil: Skor KAP kelompok perlakuan pada pretest adalah 106,07 (kategori buruk), posttest hari ke-15 adalah 131,59 (kategori sedang) dan posttest hari ke-30 adalah 135,07 (kategori sedang). Sedangkan pada kelompok kontrol pada pretest adalah 113,63 (kategori sedang), posttest hari ke-15 adalah 114,04 (kategori sedang) dan posttest hari ke-30 adalah 113,78 (kategori sedang). Pada kelompok perlakuan dijumpai peningkatan yang bermakna pada skor KAP sampai dengan hari ke-30 pengamatan (p<0,001), sedangkan pada kelompok kontrol perbedaan skor KAP tidak bermakna (p=0,9).Simpulan: penyuluhan kesehatan berpengaruh terhadap tingkat pengetahuan, sikap dan praktik ibu dalam pencegahan DBD pada anak.
HUBUNGAN TINGKAT PENGETAHUAN IBU MENGENAI PENYAKIT DBD TERHADAP KEJADIAN PENYAKIT DBD PADA ANAK SIDIEK, ABOESINA; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Background: Dengue hemorrhagic fever (DHF) was still becomes a health issue in Indonesia. DHF incidence rate in children showed a significant increase both in number of patients and epidemic area. Problems that still exist nowadays were shortage of people’s knowledge towards DHF that leaves unawareness to prevention effort. Adequate knowledge was suspected to be a factor that could decrease the risk of being transmitted with DHF.Aim: To prove the relationship of mother’s level of knowledge of DHF towards DHF incidents at child.Method: This was an analytic-observational study with case control design. Research subjects of this study in case group were mothers who had child whom aged less than 14 years old and experiencing DHF. Research Subjects of control group were mothers who had child whom aged less than 14 years old and had not experiencing DHF and lived in Sekayu, Semarang. The data had been retrieved from samples by interviewing subjects using questionnaire. Data were being tested statistically with 2 test and Fisher exact test.Result: There were no significant differences between ages, occupations, level of education on respondent of both groups. The amount of poor leveled knowledge of case group’s respondent were 3 (8,8%) people, while the control group had 7 (8,8%) people. The amount of fair-good leveled knowledge of case group’s respondent were 31(91,2%), while the control group had 27(79,4%) people. There was not significant relationship between levels of knowledge towards DHF incidents at child (p=0,2).Conclusion: There was not significant relationship between levels of knowledge towards DHF incidents at child.Keywords: Knowledge, DHF.
HUBUNGAN ANTARA TINGKAT PENGETAHUAN IBU TENTANG DEMAM DENGAN PENGELOLAN DEMAM PADA ANAK Riandita, Amariila; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Background: Fever is a common condition that occurs primarily in children. Treatment of fever in children is highly dependent on the role of parents, especially mothers. Different knowledge of mothers will result in the different wayof mothers to manage the fever in children.Objective: To find out the relationship between the level of maternal knowledge about the fever with the management of fever in their children.Methods: Analytical observational research with cross sectional approach. Subjects were mothers of children whom suffered ill that accompanied with fever whose underwent outpatient or had been treated in the ward infections department of Dr. Kariadi hospital. Data was collected from March-June 2012 using a structured questionnaire that has been tested. Data was analyzed with Chi Square test using SPSS ver 17 for Window.Results: The total of respondents in this study were 44 mothers. Most of the respondents were less educated and have family income above minimum wage. There were 52% of respondents who have low knowledge about the fever. Theresult shows that 50% of the total respondents have a good management of fever in tehir children. Based on the results using Chi square test, there was a significant association between mothers level of knowledge about the fever withthe management of fever in children.Conclusion: Mothers with high level knowledge about fever in children have a better management of fever in their children.Keywords: maternal knowledge, fever management, children.
UJI DIAGNOSTIK TES SEROLOGI WIDAL DIBANDINGKAN DENGAN KULTUR DARAH SEBAGAI BAKU EMAS UNTUK DIAGNOSIS DEMAM TIFOID PADA ANAK DI RSUP Dr. KARIADI SEMARANG Rachman, A. Fatmawati; Arkhaesi, Nahwa; Hardian, Hardian
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
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Background: Typhoid fever is a health problem in developing countries. Diagnosis by blood culture as the gold standard of Salmonella enterica. A more rapid, simple, and cheaper diagnostic method are needed.Widal serological test is a test that meets these criteria and still widely used.. This study was aim to determain the accuration of Widal serological test.Methods: Data used in this study is patients suspected of suffering from typhoid fever in the Paediatric ward RSUP Dr .Kariadi Semarang in March to June 2011. Study subjects totaled 49 children aged 24-178 months. Blood cultures compared with the Widal serological test, determine the cut- off point and then assess the diagnostic Widal.Results: At 1:80 titer obtained sensitivity values, specificity, positive expected value, negative expected value, and accuracy of Salmonella thypi sequentially Salmonela thypi O (97.737%, 10.00%, 40.00%, 75.00% and 36.734 %). Salmonella thyipi H (89.474%,16.667%, 40.476%, 71.429% and 44.898%). Salmonella parathypi AO (94.737%, 13.333%, 40.909%, 80.00% and 44.898%). Salmonella parathypi (100.00%, 3.33%, 39.583%, 100.00% and 40.816%). Salmonella parathypi BO (100%, 10.00%, 41.304%, 100.00%, and 44.898). Salmonella parathypi BH (73.684%, 10.667%, 35.897%, 50.00% and 38.776%).Conclusion: The accuration of Widal serological test for diagnosing typhoid fever in children was low.Keyword:Typhoid fever, Salmonella thypi, widal serological test, blood culture
PERBANDINGAN ANTARA RASIONALITAS PENGGUNAAN ANTIBIOTIK PASIEN ANAK RAWAT INAP DENGAN RAWAT JALAN DI PUSKESMAS HALMAHERA SEMARANG Saputra, Wibowo Bagus; Arkhaesi, Nahwa; Anam, Mohammad Syarofil
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background: The increasing prevalence of antibiotic use over time which is not rational in many fields of medicine including pediatrics is one of the causes of antibiotic resistance. Puskesmas has an important role as a first-line health services to improve the national health in Indonesian. Both inpatient and outpatient in Puskesmas provide antibiotic treatment to patients in pharmacy service. Thus, evaluation of the rationality of the use of antibiotics both inpatients and outpatients in the clinic is necessary to be done.Objective: This study was conducted to compare between the rationality of antibiotic use for inpatient and outpatient pediatric patients in Puskesmas Halmahera Semarang.Methods: This study is an analytic observational study with cross sectional design using retrospective approach. The subjects were 200 medical records of in inpatient and outpatient pediatric patients that meet the criteria for inclusion and exclusion in Puskesmas Halmahera Semarang at 2013-2014. The rationality of the use of antibiotics was assessed using criteria Gyssens and reviewed by 3 experts. Chi-square test was used Comparison between the rationality of antibiotic use for inpatient and outpatient pediatric.Results: The irrationality of antibiotic use for inpatient pediatric patients is 78% and for outpatient is 75%. The use of antibiotics which is no indication is 43% in inpatient and 66% in outpatient subject. 74% of inpatients diagnosed with typhoid and 68% of outpatient diagnosed upper respiratory tract infection. Amoxicillin is the most used antibiotics in both inpatient(41%) and outpatient (80%). No statistically significant difference (p = 0.62) between the rationality of antibiotic use for pediatric patients hospitalized with outpatient. However, based on each criterion Gyssen significantly different (p = 0.00) in the category of rationality class V (without indication), IV D (there are more specific antibiotics) and IIA (not appropriate dose).Conclusions: There was no significant difference (p = 0.62) between the rationality of antibiotic use for inpatient and outpatient pediatric patients in Puskesmas Halmahera Semarang.
PENGARUH PENDEKATAN BLENDED LEARNING TERHADAP PENGETAHUAN DAN SIKAP SISWA KELAS 5 SEKOLAH DASAR TENTANG DEMAM BERDARAH DENGUE Ratih K., I Gusti Agung; Arkhaesi, Nahwa; Anam, Mohammad Syarofil
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background The program to prevent and get rid of DHF in Indonesia has been applied for approximately 43 years, but still haven’t succeeded in reducing the number of casualties. Providing health education through socialization, especially lecturing-like-socialization, is often chosen by most people, but there are tons of flaws in this method. A novel method known as blended learning is potential to improve students’ learning quality.Aim To prove the effect of blended-learning-approach towards the knowledge and attitude of elementary 5th graders’ regarding prevention of DHF.Method This research is a quasi-experiment with none-quivalent and pretest-posttest control group design. The subject of this research is 227 students who were divided into 6 classes; 3 classes as the controlled group and 3 classes as the experimental group.Results Experimental and controlled group shows improving knowledge and attitude (pretest and posttest) after being given blended-learning-approach and lectures seen from p=0,000. In the posttest of knowledge, there is a significant difference between blended learning approach and lecturing-method, seen from p=0,014 but the median of the controlled group is higher than the experimental group (76.67>75.00). In the posttest of attitude, there is a significant difference between blended learning approach and lecturing-method seen from p=0,006, with the median of the controlled group is smaller than the experimental group (90.20<92.80).Conclusion There are some effects of blended learning approach towards the knowledge and attitude of elementary fifth graders regarding DHF.
HUBUNGAN ANTARA TINGKAT PENGETAHUAN IBU DENGAN PENGELOLAAN AWAL INFEKSI SALURAN PERNAPASAN AKUT PADA ANAK Gagarani, Yumeina; Anam, Mohammad Syarofil; Arkhaesi, Nahwa
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background Acute respiratory tract infection (ARTI) is one of the main causes of death in children in developing country. In Indonesia, prevalence period of ARTI in 2013 was 25%. This infection is also one of the main causes of patient go to the health service. Mother’s extensive knowledge has an important role in detecting and preventing ARTI earlier and also in early management independently at home. Objective To determine the association between the mother’s knowledge level and the early management of ARTI in children. Methods This was an analytic observational study with cross sectional design. Subject was the mother of children who suffered from ARTI that came to Puskesmas Rowosari Semarang on May-June 2015 and met the inclusion criteria. Sampling used consecutive sampling and gained 108 respondents. Mother’s knowledge and early management of ARTI were assessed by questionnaire that had been reviewed by three experts. The association between mother’s knowledge level and early management of ARTI in children was tested by chi square test. Results Mother with low knowledge of ARTI is 85,2%. Mother has done early management of ARTI in children according to the guideline 56,5%. There is no significant association between mother’s knowledge level and early management of ARTI in children (p=0.097). Conclusion There is no significant association between mother’s knowledge level and early management of ARTI in children.