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All Journal Jurnal Penelitian Pendidikan IPA (JPPIPA) The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Narra J Jurnal Locus Penelitian dan Pengabdian Jurnal Sehat Indonesia (JUSINDO) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Muradi, Akhmadu
Divisi Vaskular Dan Endovaskular, Kelompok Staf Medis Ilmu Bedah, Fakultas Kedokteran Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta
Aerospace Engineering Agriculture, Biological Sciences & Forestry Automotive Engineering Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Decision Sciences, Operations Research & Management Dentistry Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Nursing Physics Public Health Veterinary

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Long–Term Patency Post–Endovascular Salvage Procedure and the Influencing Factors Darwis, Patrianef; Sitorus, Londung B.; Muradi, Akhmadu
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. The limited durability of vascular access referred to the great challenges in hemodialysis. An immature arteriovenous fistula (AVF) that inadequately develops to support dialysis noted as the leading cause to immature AVF if stenosis found after creation. The endovascular fistula salvage (EFS) addressed for the preemptive repair of immature AVF despite surgicalrevision. However, no study on EFS proceeded in Indonesia with its specific characteristics. Thus, this study aimed to evaluate the efficacy of EFS and its influencing factors. Method. A retrospective cohort study carried out on those with immature AFV who underwent EFS procedures during the period ofJanuary 2016 to December 2016. The primary patency after EFSwas assessed in correlation to subjects’ characteristics, anatomical variations, diabetes mellitus, and the length and diameter of balloon to post EFS patency Results. There was 125 stenosis noted, a total of 66 stenoses noted in juxta anastomosis. The average length of stenosis was 33.18 mm. Age, diabetes mellitus, length of stenosis and multiple stenoses were found as the influencing factors to the primary patency. The length of stenosis was the most influencing variable in 6 months primary patency (p
Correlation between Internal Jugular Vein Tunnel Cuffed Catheter Tip Position as Hemodialysis Access with Suspected Catheter Related Bacteremia and Related Risk Factors at RSCM 2018–2019 Pratomo, Susatyo J; Muradi, Akhmadu
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Infection is the main complication of prolonged–term catheter uses as hemodialysis access. The KDOQI recommends the insertion of tunnel venous hemodialysis catheter in the right internal jugular vein (IJV) where the tip placed in the right atrium and the arterial opening enfacing the mediastinum. The previous study showed that the incidence of catheter–related bacteremia (CRB) is 35% at three months' use and 54% at six months' use. The TCC tip position as hemodialysis access in left IJV is correlated more to dysfunction and infection compared to the right IJV. Method. A cross–sectional study was conducted with 62 subjects of hemodialysis patients using IJV TCC access. Data of TCC site of insertion, TCC tip position, suspected CRB, and subject’s characteristics including age, sex, and diabetes mellitus from January 2018 to January 2019 collected from medical records. The correlation between these variables analyzed using Chi–Square test with a p–value of Results. Out of 62 subjects enrolled in this study, 45 (72.6%) were 60 yr. or less, forty (66.1%) males, fifteen with diabetes mellitus as the comorbid (24.2%). Thirty–nine subjects (62.9%) TCC tip positioned in SVC, two subjects (3.2%) in CAJ, and 21 subjects (33.9%) in RA. Twenty–two of these 62 with suspected CRB (35.48%). There is no significant correlation between the TCC tip position with suspected CRB incidence (p = 0.92, OR 1.05, 95% CI = 0.35 – 3.08). Age, gender, and diabetes mellitus were not statistically proven as risk factors of suspected CRB. Conclusion. There is no significant correlation between the TCC tip position and studied risk factors with suspected CRB.
Penelitian dan Publikasi dalam Ilmu Bedah Muradi, Akhmadu
Jurnal llmu Bedah Indonesia Vol 45 No 1 (2017): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v45i1.37

Abstract

Pada era modern saat ini, Evidence Based Medicine (EBM) atau kedokteran berbasis bukti baik dalam diagnosis maupun tatalaksana merupakan suatu keharusan. Khususnya dalam lingkup ilmu bedah, penelitian dan publikasi untuk mendukung terwujudnya EBM yang baik masih kurang.1 Hanya 3.4% artikel yang dipublikasi di 5 besar jurnal jurnal ilmu bedah dalam rentang 1996-2000 yang berbentuk RCTs.2 Untuk menjawab tantangan ini, muncul banyak grant penelitian dan jurnal bedah yang membawa nama research sebagai bagian dari penyadaran, dorongan dan penyediaan sarana. Lebih lanjut lagi, hasil penelitian dan rekomendasi tatalaksana yang berasal dari populasi negara maju belum tentu langsung bisa diterapkan di Indonesia karena perbedaan karakteristik dalam banyak aspek.3 Oleh karena itu masih terbentang lebar lahan yang bisa diteliti baik dalam hal ilmu dasar maupun teknik operasi dan teknologi yang diaplikasikan dalam penatalaksanaan kasus-kasus bedah. Permasalahan yang muncul saat ini adalah jargon bahwa penelitian dan publikasi itu susah, kompleks dan menyita banyak waktu harus dapat kita ubah sedikit demi sedikit. Budaya membaca dan menulis merupakan hal dasar yang harus ditekankan. Pertanyaan atau ide penelitian sering muncul setelah banyak membaca jurnal, selain tentunya dari praktek keseharian yang dihadapi. Ilmu dan skill meneliti dapat dipelajari dan ditingkatkan dengan mengikuti kursus atau diintegrasikan selama pendidikan. Implementasi surgical research methodology program dalam kurikulum terbukti mampu meningkatkan produktivitas penelitian dan performa residen bedah.4 Program tersebut merupakan program terstruktur dengan topik orientasi, penelusuran literatur sistematik, etika, statistik, dan berbagai bentuk penelitian.4 Hal lain yang sangat mendukung suatu penelitian adalah sistem rekam medik yang ditulis dengan baik, lengkap dan mudah diakses. Permasalahan yang berikutnya adalah penghargaan terhadap suatu penelitian masih minim apalagi bila memiliki tingkat evidence yang rendah seperti laporan kasus dan serial kasus. Perlu digaris bawahi bahwa laporan kasus hingga saat ini masih dapat ditemukan pada jurnal-jurnal internasional dengan impact factor yang tinggi. Hal ini menunjukkan bentuk penghargaan dan penerimaan terhadap sekecil apa pun bentuk penelitian, terlebih bila merupakan kasus yang sangat jarang ditemukan atau menggunakan inovasi baru dalam penatalaksanaannya. Kumpulan dari laporan kasus yang sama dapat menghasilkan bentuk penelitian yang memiliki tingkat evidence yang lebih tinggi. Hal lain yang harus kita ingat adalah meskipun RCTs merupakan bentuk penelitian dengan tingkat evidence yang paling baik, terkadang sulit diterapkan dalam ilmu bedah dibanding penelitian medis lainnya apalagi bila menggunakan placebo sebagai kelompok kontrol.3 Mari kita bersama memajukan penelitian dan publikasi dalam ilmu bedah untuk mendukung praktek kedokteran berbasis bukti. Publikasikan hasil karya kita agar dapat bermanfaat untuk ahli bedah lainnya dan kami siap menerima semua jenis karya ilmiah: laporan kasus, serial kasus, evidence base case report, literature review, systematic review, dan original article. Terakhir, kami mengajak kepada semua ahli bedah untuk mensukseskan dan membawakan hasil kerjanya dalam acara pertemuan ilmiah tahunan ke-22 IKABI pada akhir Juli 2017 di Jakarta.
Management of Uncomplicated Stanford Type B Aortic Dissection : A Literature Review: Shalih, Zamzania A; Muradi, Akhmadu
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Outcomes of Percutaneous Transluminal Angioplasty for Central Vein Stenosis in Hemodialysis: A Literature Review Ibrahim, Hilman; Muradi, Akhmadu; Limianto, Eka A
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Percutaneous transluminal angioplasty (PTA) is the mainstay treatment for central vein stenosis. However, the recurrent rate of the stenotic lesion after PTA remains high. Thus, we ran a review found on some databases. Out of thirteen articles, five articles were eligible and reviewed. Drug-coated balloon angioplasty, plain old balloon angioplasty, percutaneous transluminal angioplasty, and stenting angioplasty were discussed regarding the outcomes with a focus on interest to prevent the stenosis.
Management of Pararenal Aortic Aneurysms : A Literature Review Ibrahim, Hilman; muradi, akhmadu; Fachriza, Ihza
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Abdominal aortic aneurysms (AAA) are the most common group of aortic aneurysms. Pararenal aortic aneurysm (PAA) is a classification of AAA where there is no normal aortic segment between the renal artery and the proximal border of the aneurysm. This group has a prevalence of around 20% of all AAA cases. In open repair (open surgery), PAA requires suprarenal clamps or even supraceliac which causes high morbidity. In endovascular procedures, PAA presents difficulties due to the absence of a landing zone to place the graft and the possibility of reintervention after action. A literature review is needed to discuss the strengths and weaknesses of each treatment. A review enrolling 7 focused on endovascular procedures for PAA and outcomes including mortality and morbidity with long-term follow-up
After A Year of Follow Up Non-Cirrhotic Portal Hypertension Patient with Partial Spleen Embolization (PSE) Management Akhmadu Muradi; Chyntia Olivia Maurine Jasirwan; Raden Suhartono; Patrianef Darwis; Dedy Pratama; Teguh Dwi Nugroho; Karina Zulkarnain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2019.322 KB) | DOI: 10.24871/2232021249-253

Abstract

Non-cirrhotic portal hypertension (NCPH) is a heterogeneous group of liver disorders leading to portal hypertension. There are multiple approaches to managing portal hypertension' clinical complications to treat/prevent spontaneous hemorrhage by mitigating thrombocytopenia. Portal hypertension complications have been traditionally managed with serial endoscopic variceal ligation (EVL) or with invasive open surgical procedures such as orthotopic liver transplantation (OLT) or portosystemic shunting, splenectomy.6–9 There are several risks associated with splenectomies, such as hemorrhagic complications or intraoperative blood loss.5,6,14 Partial Spleen Embolization (PSE) ‎may overcome the limitations of splenectomy and provide patients with an alternative treatment. An eighteen-year-old male has a splenomegaly history since he was 12 years old and has recurring hematemesis and melena. After performing abdominal computed tomography, laboratory studies, and several endoscopies, the results indicated secondary hypersplenism due to non-cirrhotic portal hypertension. The patient had 13 endoscopies and 2 EVL in 5 years. Despite adequate treatment, the patients developed recurrent variceal bleeding and no improvement in blood function. The patient underwent PSE at Integrated Cardiovascular Center in Dr. Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia. It was performed through the femoral access with a PVA (polyvinyl alcohol) embolus. The procedure went successful, and there was no major complication with the patient. Twenty days after the patient had an abdominal CT scan, it showed no abscess, and the spleen volume was reduced by 20%. Long-term results over a  year after the procedure are presented. PSE is a safe, effective, semi-invasive alternative to splenectomy in non-cirrhotic portal hypertension because it preserves functional spleen mass and avoids postprocedure accelerated liver disease or encephalopathy.
Uji Diagnostik Venous Clinical Severity Score dengan Klasifikasi Clinical-Etiology-Anatomy-Pathophysiology pada Varises Vena Tungkai Bawah Perawat Ruang Operasi Dimas Putra Asmoro; Akhmadu Muradi
Jurnal llmu Bedah Indonesia Vol. 50 No. 1 (2022): Desember 2022
Publisher : Ikatan Ahli Bedah Indonesia

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Pendahuluan: Venous clinical severity score (VCSS) merupakan alat bantu diagnosis varises vena tungkai bawah (VVTB) yang praktis dan dapat dikerjakan oleh tenaga kesehatan termasuk perawat. Saat ini belum ada peneliti yang melakukan validasi eksterna penilaian VCSS yang dikerjakan oleh perawat di Indonesia. Tujuan: Mengetahui tingkat ketepatan metode skor VCSS oleh perawat dibandingkan dengan komponen klinis (C) klasifikasi clinical-etiology-anatomy-pathophysiology (CEAP) oleh dokter spesialis bedah vaskular. Metode: Studi cross-sectional dengan 63 perawat instalasi bedah pusat RS Dr. Cipto Mangunkusumo tanpa varises sebelum menjadi perawat sebagai sampel yang diambil secara consecutive. Komponen klinis klasifikasi CEAP digunakan sebagai pembanding. Variabel dianalisis dengan uji Chi-square dan uji nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), likelihood ratio dan akurasi skor diagnostik, dan analisis dengan indeks Youden. Hasil: Prevalensi VVTB pada studi ini berdasarkan skor VCSS adalah 9,5%. Korelasi antara klasifikasi CEAP dan VCSS ditemukan bermakna (p <0,05). Derajat VVTB antara klasifikasi CEAP dan VCSS berhubungan secara signifikan (p <0,05). Pada cut-off VCSS 2 didapatkan nilai sensitivitas 66,67%, spesifisitas 66,67 %, NDP 32,0%, NDN 89,47%, likelihood ratio (+) sebesar 2,00, likelihood ratio (-) sebesar 0,50, dan akurasi 66,67%. Kesimpulan: Skor VCSS memiliki akurasi lemah terhadap komponen klinis (C) klasifikasi CEAP untuk menegakkan diagnosis VVTB.
Mutation and Variant of Coronavirus Disease 2019 (COVID-19): Review of Current Literatures Susilo, Adityo; Jasirwan, Chyntia Olivia Maurine; Wafa, Syahidatul; Maria, Suzy; Rajabto, Wulyo; Muradi, Akhmadu; Fachriza, Ihza; Putri, Myranda Zahrah; Gabriella, Stacy
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Since March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic has engulfed the world, including Indonesia, for nearly two years. SARS-CoV-2 has undergone several mutations during its evolution as a pathogen, resulting in various variants of global concern. Variants of this virus are suspected to impede the outbreak resolution and possibly causing the outbreak to spiral out of control. There is still considerable debate and research underway regarding the new SARS-CoV-2 variants. Rapid transmission mechanisms and widespread vaccination coverage have accelerated the virus’s mutation rate and resulted in numerous new variants. To date, this has resulted in the discovery of a new variant Omicron (B.1.1.529) in November 2021 in South Africa, which has since spread to 103 countries. Omicron is designated a Variant of Concern (VoC) due to its more powerful transmission than the previous variant. Although some information indicates that the symptoms associated with this variant are typically mild, the rapid transmission of Omicron can increase the next wave of COVID-19 cases. Additional research is required to determine transmissibility, pathogenesis, diagnosis, and proper management. As a result, we conducted an adjunct to studies on various COVID-19 mutations and variants until January 2022.
Association of Vitamin D Deficiency and Diabetic Foot Ulcer Patients in Dr Mohammad Hoesin General Hospital Palembang Dahlan, Kemas; Yususf, Fahmi Jaka; Irfannuddin, Irfannuddin; Murti, Krisna; Muradi, Akhmadu; Liberty, Iche Andriyani
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 1 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jsi.v7i01.149

Abstract

Vitamin D plays a role in the healing process of diabetic foot ulcers (DFU); it can improve the immune system, regulate inflammation function, and regulate growth factors in diabetes mellitus (DM). The immunomodulatory effects of vitamin D include reduced production of IL-2, IL-6, and TNF-alpha and increased production of IL-10. It also increases the activity of antimicrobial peptides (AMP) such as cathelicidin, and it promotes the differentiation of monocytes into macrophages, phagocytosis, and the production of lysosomal enzymes. Furthermore, vitamin D stimulates growth factors including vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-β). In this study, the incidence of DM and DFU in DM patients at RSUP Dr. Mohammad Hoesin Palembang will be compared to serum vitamin D levels. This research uses quantitative methods with an analytical observational design. The Mean vitamin D serum level was 11,727 ng/mL, and there was a significant association between serum vitamin D deficiency and DFU (p-value; 0.036 < 0.05). There was a significant association between serum vitamin D deficiency and DFU occurrence (p-value; 0.036 < 0.05) in Mohammad Hoesin General Hospital Palembang. Based on the results of this study, we proposed that patients with diabetic foot ulcers should have their serum vitamin D levels checked, and that vitamin D should be given to them as part of their therapy.
Co-Authors Adityo Susilo, Adityo Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Dahlan, Kemas Darwis, Patrianef Dedy Pratama Dimas Putra Asmoro Fachriza, Ihza Gabriella, Stacy Harunarashid, Hanafiah Herwirastri, Novinda Ibrahim, Hilman Iche Andriyani Liberty, Iche Andriyani Ihza Fachriza Irfannuddin Irfannuddin Irfanuddin Karina Zulkarnain Krisna Murti Limianto, Eka A Maria, Suzy Myranda Zahrah Putri Patrianef Darwis Pratomo, Susatyo J Putri, Myranda Zahrah Shalih, Zamzania A Sitorus, Londung B. Stacy Gabriella Suhartono, Raden Suzy Maria Syahidatul Wafa Syahidatul Wafa, Syahidatul Teguh Dwi Nugroho Wulyo Rajabto Yususf, Fahmi Jaka