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Tjandra, Djony E.
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Biochemistry, Genetics & Molecular Biology Health Professions

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Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS Sumarauw, Ekanova R. N.; Hatibie, Mendy J.; Tjandra, Djony E.; Langi, Fredrik G.
JURNAL BIOMEDIK : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23323

Abstract

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik
Korelasi Blood Flow Rate Intraoperasi dan Enam Minggu Pascaoperasi Arteriovenous Fistula Brakiosefalika Dihubungkan dengan Maturitas di RSUP Prof. Dr. R. D. Kandou Manado Palin, Aubrey W.; Tjandra, Djony E.; Sumangkut, Richard M.
Jurnal Biomedik : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23325

Abstract

Abstract: American National Kidney Foundation (2002) states that end-stage kidney disease is an indication for renal replacement therapy, one of which is hemodialysis. Vascular access comprises a fundamental component of hemodialysis therapy (HD), facilitating the patient’s blood flow to the dialyzer. However, there are some factors affecting the maturity of an arteriovenous fistula (AVF), inter alia the patient, comorbidities, and anatomical and functional conditions of the blood vessels involving the blood flow rate (BFR). This study was aimed to establish the differences between intra-operative BFR and BFR six weeks after surgery as well as any correlations between intraoperative BFR, venous diameter, and skin to vein distance with maturity of brachiocephalic AVF. This was prospective cohort study conducted at the Department of Surgery, Prof. Dr. R. D. Kandou General Hospital Manado. Subjects were 41 CKD patients who underwent brachiocephalic AVF surgery. The vein diameter, skin to vein distance, and BFR were measured immediately as intra-operative data using a Doppler USG and all were re-measured at six-week-follow-up examination as six-week-postoperative data. The results showed that there was a significant increase in BFR at six weeks postoperation compared to intraoperation (t=-19.215; P <0.0001). Bi-serial point correlation analysis revealed that there was a significant correlation between intraoperative venous diameter and maturity (rpb=0.276; P=0.04) as well as a significant correlation between intraoperative BFR and maturity (rpb=0.615; P=0.002). No significant correlation was observed between intra-operative skin to vein distance and maturity (rpb=0.093; P=0.281). Conclusion: There was a significant difference in BFR between intraoperation and 6 weeks postoperation in the mature AV fistula. There was a significant relationship between intraoperative BFR and maturity as well as between intraoperative venous diameter and maturity, while no significant relationship between skin-vein distance and maturity was found.Keywords: brachiocephalic AVF, BFR, maturityAbstrak: American National Kidney Foundation (2002) menyatakan bahwa penderita dengan penyakit ginjal tahap akhir diindikasikan untuk dilakukan terapi pengganti ginjal, salah satunya hemodialisis (HD). Akses vaskular merupakan komponen penting pada terapi HD karena melalui akses vaskular darah dari tubuh pasien dapat dialirkan menuju dialyzer. Terdapat banyak faktor yang memengaruhi maturitas suatu arteriovenous fistula (AVF), yaitu pasien itu sendiri, komorbid, serta keadaan anatomi dan fungsional pembuluh darah termasuk nilai blood flow rate (BFR). Penelitian ini bertujuan untuk mengetahui perbedaan BFR intraoperasi dan BFR enam minggu pascaoperasi serta adanya korelasi antara BFR intraoperasi, diameter vena, dan jarak kulit-vena dengan maturitas AVF brakiosefalika. Penelitian ini dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado dengan desain kohort prospektif. Subyek penelitian ialah 41 pasien PGK yang menjalani operasi pembuatan AVF brakiosefalika. Setelah selesai operasi dihitung diameter vena, jarak kulit-vena, dan BFR sebagai data intraoperasi menggunakan USG Doppler. Penghitungan dilakukan kembali 6 miggu pascaoperasi. Hasil penelitian mendapatkan peningkatan BFR yang sangat bermakna pada enam minggu pascaoperasi dibandingkan intraoperasi (t =-19,215, P<0,0001). Dengan analisis korelasi point biserial didapatkan hubungan bermakna antara diameter vena intraoperasi dengan maturitas (rpb=0,276; P=0,04), tidak terdapat hubungan bermakna antara jarak kulit-vena intraoperasi dengan maturitas (rpb=0,093; P=0,281), dan terdapat hubungan bermakna antara BFR intraoperasi dengan maturitas (rpb=0,615; P=0,002). Simpulan: Terdapat perbedaan bermakna antara BFR intraoperasi dan BFR 6 minggu pascaoperasi pada AVF matur. Terdapat hubungan bermakna antara BFR intraoperasi dan diameter vena intraoperasi dengan maturitas namun tidak terdapat hubungan bermakna antara jarak kulit-vena dengan maturitas.Kata kunci: AVF brakiosefalika, BFR, maturitas
Korelasi Posisi Tip Catheter Double Lumen dengan Nilai Quick of Blood pada Pemasangan CDL Tunneling Vena Jugularis Interna Kanan di RSUP Prof. Dr. R. D. Kandou Tubagus, Angga P.; Tjandra, Djony E.; Sumangkut, Richard
Jurnal Biomedik : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23322

Abstract

Abstract: Chronic kidney disease (CKD) is a global public health problem with increasing prevalence and incidence. Patients with CKD require kidney replacement therapy such as hemodialysis. The quick of blood (Qb) value is one of the most important determinants for adequate hemodialysis. Many factors can affect the Qb value, inter alia the catheter tip position. It is very complex and still controversial to determine the optimal position of the catheter itself. This study was aimed to determine the correlation between the double lumen catheter tip position and Qb value in insertion of the right internal jugular vein CDL tunneling at Prof. Dr. R. D. Kandou hospital. This was a correlation analytical study with a cross-sectional design. The position of the CDL tips were evaluated by using chest x-ray and the Qb values were determined by using hemodyalisis machine. Data were analyzed by using point-biserial correlation test. In total, 55 patients were included, mostly were males (56.4%) and late elderly (41.8%). The results showed that the average Qb value with CDL tip position in intraatrial (178.2 ml/minute) was slightly higher than the average Qb value with CDL tip position in CAJ (171.6 ml/minute). The bivariate analysis showed that the position of the double-lumen catheter tip had a weak positive correlation but not significant with the Qb value. Conclusion: There was a correlation but not statistically significant between the position of the CDL tip and the Qb value.Keywords: CKD, catheter tip position, catheter double-lumen, Quick of bloodAbstrak: Penyakit ginjal kronik (PGK) merupakan masalah kesehatan masyarakat global dengan prevalensi dan insidens yang terus meningkat. Pasien gagal ginjal memerlukan terapi pengganti ginjal seperti hemodialisis. Nilai quick of blood (Qb) merupakan salah satu penentu yang sangat penting bagi hemodialisis yang adekuat. Banyak faktor yang dapat memengaruhi nilai Qb, salah satunya ialah posisi tip kateter. Hal yang menentukan posisi optimal dari kateter sendiri sangat kompleks dan masih kontroversial. Penelitian ini bertujuan untuk mengetahui korelasi antara posisi tip kateter double lumen dengan nilai quick of blood pada pemasangan CDL vena jugularis interna kanan di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah analitik korelasi dengan desain potong lintang. Alat ukur yang digunakan ialah foto toraks untuk menentukan posisi tip CDL dan mesin hemodialisa untuk melihat nilai Qb. Data hasil penelitian dianalisis dengan uji korelasi point-biserial. Subyek penelitian ini sebanyak 55 pasien, lebih banyak yang berjenis kelamin laki-laki (56,4%) dan berada dalam kategori usia lansia akhir (41,8%). Hasil penelitian menunjukkan nilai rerata Qb posisi tip CDL di intraatrial (178,2 ml/menit) sedikit lebih tinggi daripada rerata nilai Qb posisi tip CDL di CAJ (171,6 ml/menit). Hasil analisis data mendapatkan korelasi positif lemah dan tidak bermakna (antara posisi tip catheter double-lumen dengan nilai Qb. Simpulan: Terdapat korelasi yang tidak bermakna secara statistik antara posisi tip CDL dengan nilai Qb.Kata kunci: PGK, posisi tip kateter, double-lumen catheter, quick of blood
Co-Authors Mendy Hatibie Palin, Aubrey W. Richard M. Sumangkut, Richard M. Sumangkut, Richard Sumarauw, Ekanova R. N. Tubagus, Angga P.