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All Journal Indonesian Journal of Medicine Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Journal Orthopaedi and Traumatology Surabaya (JOINTS)
Febyan, Febyan
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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The Potential Applications of Stem Cell Conditioned Medium Secretome in Knee Cartilage Regeneration: A Systematic Review Aryana, I Gusti Ngurah Wien; Febyan, Febyan; Ustriyana, Nyoman Gede Grenata Nanda
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 2 (2024): October 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i2.2024.84-99

Abstract

Background: Articular cartilage injuries often result from trauma, genetic predisposition, and degeneration. These injuries lack inherent regeneration mechanisms due to the absence of blood vessels and limited progenitor cell entry. Osteoarthritis is characterized by gradual cartilage deterioration. Mesenchymal stem cells (MSCs), particularly their secretome including exosomes, hold promise as a regenerative therapy. This review explores the application of MSCs and their secretome to address cartilage defects.Methods: This review was conducted based on PRISMA guidelines. Animal model studies focusing on the use of stem cell secretomes for cartilage regeneration were explored. The search, encompassing PubMed, MEDLINE, the Cochrane Library, Scopus, Web of Science, and Science Direct from January 10, 2023, to July 27, 2023, was conducted utilizing Google Chrome as the search engine. Studies with outcomes based on OARSI or ICRS scores, as well as any additional outcomes related to MSC secretome utilization, cartilage regeneration, and proliferation, were included.Results: Our systematic review identified six studies using MSCs in vivo and in vitro. Synovial membrane-derived MSCs significantly enhanced cartilage regeneration by elevating chondrogenic capabilities. Hydrogel-based systems techniques and 3D-printed scaffolds have emerged for innovative delivery. Specific microRNAs, such as miR-92a-3p, have been recognized for enhancing cartilage regeneration. Strategies for the effective targeting of MSC exosomes to the precise cartilage damage site have been explored.Conclusions: The studies demonstrate the potential of MSC-derived secretomes and exosomes for knee cartilage regeneration in animal models. Further research and clinical trials are needed to refine these approaches for practical application.
Proximal Tibial Osteosarcoma in Pediatric Patient: A Case Report Sandiwidayat, Komang Septian; Febyan, Febyan
Indonesian Journal of Medicine Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The most frequent primary malignant bone tumor in children is osteosarcoma. Patients with osteosarcoma are currently treated with a combination of neoadjuvant and adjuvant chemotherapy as well as surgery, either limb-sparing surgery or limb-ablation surgery. How to manage the remaining bone growth during the limb-sparing procedure in youngsters is one of the challenges. Unfortunately, amputation is still many perform for OS patients. The purpose of this study was to inform and educate doctors about the value of early OS diagnosis and treatment in pediatric patients.Case Presentation: We presented case from a male 16 years old Balinese complaint of pain on her left knee 12 months ago. The pain was continuous and got worse at night. The patient went to a traditional masseuse and was given topical herbal ointment. Three months later, a lump appeared on her knee at the size of a small ball and getting bigger. We did a review slide of the previous biopsy sample by the pathology of anatomy in our hospital. The result came out as osteosarcoma with osteoblastic cells. We performed to amputated the limb-affected tumor following wound care routinely controlled.Results: Intraoperatively, we performed wide excision, without patellar tendon, medial collateral ligament, and cruciate ligament preserve. We amputated the limb-affected tumor. The patient routinely controlled to our outpatient clinic every week. Unfortunately, the patient was died after 3 weeks of admission.Conclusion: To reduce the risk of misdiagnosis or delayed diagnosis of osteosarcoma, every source of knee pain with a mass in pediatric age groups should be thoroughly explored with a high index of suspicion for malignant lesions. Therefore, amputation is a cutting-edge osteosarcoma treatment that can be avoided if the patient can be identified early and treated quickly in pediatric oncology malignant instances.Keywords: osteosarcoma, long bone, diagnosis, tibia, pediatricCorrespondence: Komang Septian Sandiwidayat. Oncology Division, Department of Orthopaedic & Traumatology, Sanglah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. Email: drseptianortho@gmail.com. Mobile: 62-821-4725-2042.Indonesian Journal of Medicine (2022), 07(03): 298-305https://doi.org/10.26911/theijmed.2022.07.03.06  
Clinical Demographics Characteristic of Total Knee Arthroplasty at Prof IGNG Ngoerah General Hospital, Bali, Indonesia Aryana, I Gusti Ngurah Wien; Dharmayuda, Cokorda Gde Oka; Febyan, Febyan; Dimitri, Dominicus; Limena, Shianita; Kuswara, Leonardus William
Indonesian Journal of Medicine Vol. 8 No. 2 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.2.616

Abstract

Background:  Total knee arthroplasty (TKA) is a widespread surgical procedure for severe arthritis. By 2030, primary TKA would reach over 1.2 million procedures annually in the United States. In Indonesia, the prevalence of joint disease is about 19.5 million cases. This study aims to evaluate the clinical demographics characteristics of TKA in Prof. Ngoerah General Hospital, Bali, Indonesia.Subjects and Method:  This is a descriptive study using a Cross-Sectional method with a total 57 adult patients undergoing TKA caused by Osteoarthritis grade III/IV in Prof IGNG Ngoerah Hospital from June 2020-June 2022. The dependent variable is the TKA procedure. Independent Variable is Age, gender, grade of knee osteoarthritis, comorbidities, and complications Data from the medical record was collected and stored in a Microsoft Office Excel 365 spreadsheet, the distributive table was analyzed and collected by using SPSS.Results:  Patient characteristic is dominated by an elderly female (84.2%), with age group 61-70 (38.6%). Comorbidities in this study include hypertension (28.1%), type II diabetes (10.5%), and rheumatoid disease (1.8%). The main complication recorded in this study includes joint stiffness (3.5%), and persistent pain (5.3%).Conclusion:  After Total Knee Arthroplasty was performed on 57 patients with a wide range of comorbidities, only a small number of complications occurred. This study implied that TKA could be performed even if the patient had some comorbidities as long as the patient pursued a complete pre and post-operative evaluation algorithm of the procedure.Keywords:  knee arthroplasty, osteoarthritis, human and medicine, rehabilitationCorrespondence:  IGN Wien Aryana, Consultant of Sports Medicine, Dept. Orthopaedic and Traumatology, Prof IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University. Jl. Diponegoro, Dauh Puri Klod. Denpasar City, Bali 80113 Email: wienaryanaortho@gmail.com. Mobile: +62811385263.Indonesian Journal of Medicine (2023), 08(02): 128-135https://doi.org/10.26911/theijmed.2023.08.02.01 
Anterior Cruciate Ligament Ruptured Concomitant Meniscus Discoid in Young Patient: A Rare Case Report Aryana, I Gusti Ngurah Wien; Trisaputra, I Ketut Wahyu; Febyan, Febyan
Indonesian Journal of Medicine Vol. 8 No. 3 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.3.654

Abstract

Background:  Abnormalities of the human meniscus, including discoid meniscus, double-layered meniscus, and ring-shaped meniscus, have been reported. The prevalence of discoid meniscus is extremely rare, with an incidence of 0.9%－2.4% in the Asian population. Traditionally, discoid meniscus concomitant anterior cruciate ligament (ACL) ruptures are extremely rare cases. The aim of this study is to discuss a rare case to provide diagnosis and management properly by using arthroscopy.Case Presentation:  A 21-year-old male Balinese, complained of pain in his right knee after fast walking for two months and an unstable knee in the past 1 year ago. On physical examination, the range of motion was limited due to the pain for flexion of more than 90°. Special tests such as Lachman test positive, and Anterior drawer test positive. The patient had medial joint line tenderness, and a McMurray test elicited pain on the medial joint line. Meanwhile, an MRI examination of the right knee showed a discoid medial meniscus with a horizontal cleavage tear and a discoid lateral meniscus with an incomplete tear. We performed a partial meniscectomy of the incomplete discoid medial meniscus and resection of the pathologic medial patellar plica. We performed surgical reconstruction of the ACL ruptured after the meniscus was repaired.Results:  We presented a 21-year-old male with discoid meniscus concomitant ACL rupture to his right knee. After the patient was performed with partial meniscectomy of the incomplete discoid medial meniscus and resection of pathologic medial patellar plica following surgical reconstruction of the ACL ruptured. The patient had no limitation of motion or pain 1 year after the operation and he had no complaints and was satisfied with the result by radiograph.Conclusion:  We concluded that This rare case of medial discoid meniscus concomitant with the ACL rupture must be reconstructed. The treatment of discoid meniscus should consider its tear pattern and whether it is symptomatic. With the development of arthroscopic techniques, the treatment of discoid meniscus has gradually changed from total meniscectomy or partial meniscectomy.Keywords:  anterior cruciate ligament, meniscus, discoid, knee, arthroscopy.Correspondence:  I Gusti Ngurah Wien Aryana. Department of Orthopaedic & Traumatology, General Central Hospital of I.G.N.G Ngoerah Central Hospital/ Faculty of Medicine, Udayana University, Bali, Indonesia. Email: wienaryanaortho@gmail.com. Mobile: +62811-385-263.Indonesian Journal of Medicine (2023), 08(03): 317-324https://doi.org/10.26911/theijmed.2023.08.03.09
Paraspinal Abscess Secondary to Spondylodiscitis: A Rare Presentation with Progressive Neurological Deficits and Systemic Infection Putra, I Gusti Ngurah Paramartha Wijaya; Wijaya, I Gusti Ngurah Paramartha; Febyan, Febyan; Yulian, Kenny
Indonesian Journal of Medicine Vol. 10 No. 2 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2025.10.2.842

Abstract

Background: Spondylodiscitis is a rare but serious spinal infection that may result in neuro-logical and systemic complications, especially when associated with paraspinal abscess formation. This case highlights its clinical severity and the importance of early intervention. This study aims to highlight the clinical importance and potential severity of spondylodiscitis, particularly when complicated by paraspinal abscess formation. Case Presentation: A patient presented with progressive lower back pain, bilateral lower limb weakness, and systemic symptoms including fever and night sweats. Laboratory tests revealed hypoalbuminemia, leukocytosis, and anemia. MRI imaging identified a paraspinal abscess at the L3–L5 levels, resulting in lumbar canal stenosis and worsening neurological deficits. Emergency surgical intervention was undertaken, consisting of abscess drainage, laminectomy for neural decompression, and posterior spinal stabilization. Intraoperative findings included a substantial purulent collection, necessitating extensive debridement. Postoperatively, the patient demonstra¬ted clinical improvement with ongoing antibiotic therapy, nutritional support, and rehabilitation. Discussion: Spondylodiscitis with paraspinal abscess is a diagnostic challenge due to its insidious onset and non-specific presentation. Delayed recognition increases the risk of severe neurological impairment and systemic sepsis. MRI is the gold standard for early detection, while micro¬biological confirmation is crucial for targeted treatment. A multidisciplinary approach is essential. Surgical intervention is indicated for progressive neurological deficits, extensive abscess formation, or spinal instability, with timely antibiotic therapy playing a critical role in infection control. Conclusion: This case illustrates the importance of early diagnosis and timely surgical manage-ment in spondylodiscitis with paraspinal abscess. Multimodal treatment improves outcomes and helps prevent long-term disability.
Konsep Patogenesis Sepsis pada Ventilator Associated Pneumonia di Intensive Care Unit Febyan, Febyan; Lardo, Soroy
Majalah Kedokteran Indonesia Vol 68 No 12 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.12-2018-209

Abstract

Severe sepsis is sepsis with one or more organ dysfunction. One of the causes of sepsis in Intensive Care Unit (ICU) is Hospital-Acquired Pneumonia (HAP). HAP occurs 5-10 cases per 1000 patients on mechanical ventilation. Ventilator Associated Pneumonia (VAP) is predominantly caused by Pseudomonas aeruginosa. Several important factors in the pathogenesis of VAP are barrier to Na+-K+-Cl– transporter-1 (NKCC1), endotracheal tube device without antibiofilm. VAP can be prevented by oral hygiene, endotracheal tube device made from antibiofilm, head up 30 degrees, evaluation of cough ability, swallowing function
Co-Authors Aryana, I Gusti Ngurah Wien Dharmayuda, Cokorda Gde Oka Dimitri, Dominicus Kuswara, Leonardus William Limena, Shianita Putra, I Gusti Ngurah Paramartha Wijaya Sandiwidayat, Komang Septian Soroy Lardo Trisaputra, I Ketut Wahyu Ustriyana, Nyoman Gede Grenata Nanda Wijaya, I Gusti Ngurah Paramartha Yulian, Kenny