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All Journal Indonesian Journal of Medicine Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Febyan
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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KONSEP PATOGENESIS SEPSIS PADA VENTILATOR ASSOCIATED PNEUMONIA DI INTENSIVE CARE UNIT Febyan; Soroy Lardo
Majalah Kedokteran Indonesia Vol 68 No 12 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i12.209

Abstract

Sepsis berat didefinisikan sebagai sepsis dengan disfungsi satu atau lebih organ. Salah satu penyebab sepsis di Intensive Care Unit (ICU) adalah Hospital-Acquired Pneumonia (HAP). HAP terjadi 5-10 kasus per 1000 pasien yang memakai alat bantu napas mekanis. Ventilator Associated Pneumonia (VAP) merupakan bagian dari hospital-acquired pneumonia (HAP), terutama disebabkan oleh Pseudomonas aeruginosa. Beberapa faktor penting pada patogenesis VAP, antara lain sistem barier Na+-K+-Cl? transporter-1 (NKCC1), ETT tanpa antibiofilm. Upaya pencegahan VAP berupa oral higiene, alat ETT berbahan antibiofilm, elevasi kepala 30 derajat, evaluasi kemampuan batuk, dan fungsi menelan.
Clinical Outcomes Comparison in Administration of Secretome vs Hyaluronic Acid in Patients with Knee Osteoarthritis Kellgren-Lawrence Grade I-III Aryana, I Gusti Ngurah Wien; Suyasa, I Ketut; Dharmayuda, Cokorda Gde Oka; Febyan; Gunawan, Dary
Indonesian Journal of Medicine Vol. 9 No. 4 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.4.798

Abstract

Background: The prevalence of OA in Indonesia is predicted to reach more than 20% of the population aged over 60 years in 2050, with a high risk of disability. So far, early treatment of osteoarthritis in the form of administering hyaluronic acid has not been completely satisfactory and tends to be progressive until ending in more invasive operative therapy. This study aimed to compare the clinical outcomes between secretome injection and hyaluronic acid in patients with Kellgren-Lawrence grade I-III knee osteoarthritis. Subjects and Method: This was a single-blind experimental study. This study was conducted in the orthopedic polyclinic at General Hospital Prof. Dr. I.G.N.G. Ngoerah Bali. A total sample of 36 knee osteoarthritis patients was selected using permuted block sampling with randomization. The sample was divided into two groups, (1) secretome (intervention group) and (2) hyaluronic acid (control group). The independent variables were secretome injection and hyaluronic acid injection. The dependent variable was pain. Pain was measured using Western Ontario and McMaster University (WOMAC), Knee Osteoarthritis Outcome Score (KOOS), Visual Analog Score (VAS), and Patient-Reported Outcome Measure (PROM). Results: Based on gender, there are more women than men and the right foot is more affected at 58.3%. Functional score parameters in each secretome and hyluronic acid group were compared between the 3rd and 6th months of follow-up. Pain in the hyaluronic acid group was lower than in the secretome group. Conclusion: Hyaluronic acid has better effect in pain reduction than secretome. Further studies could explore the underlying mechanisms and potential long-term effects to better understand these differences in pain outcomes.
Surgical Management of Posterior Cruciate Ligament Avulsion Fracture: A Case Report Sadiwidayat, Komang Septian; Febyan; Dimitri, Dominicus
Indonesian Journal of Medicine Vol. 9 No. 1 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.1.710

Abstract

Background: Posterior Cruciate Ligament (PCL) avulsion fractures are relatively rare but significant injuries to the knee. The diagnosis and management of these injuries can be complex and require a comprehensive approach Case Presentation: A 24-year-old female presented to the emergency department following a motorbike fall. She experienced significant pain in her knee and had a swollen popliteal fossa. Imaging studies, including X-ray and CT scan, revealed an avulsion fracture at the PCL insertion. The patient underwent successful surgical fixation of the avulsed fragment, following a positive posterior drawer, sag, and dial test suggesting an isolated PCL avulsion. Conclusion: This case underscores the importance of a comprehensive and individualized approach to the management of PCL avulsion fractures. It further emphasizes the need for future research to delineate the long-term outcomes of different treatment strategies and to develop evidence-based guidelines for this unique and challenging injury. Keywords: posterior cruciate ligament, avulsion fracture, knee injury, surgical fixation.
Surgical Precision in Lumbar Spinal Canal Stenosis: Optimizing Outcomes in a Young Adult with Suspected Infection through Decompression-Stabilization-Fusion Putra, I Gusti Ngurah Paramartha Wijaya; Febyan; Ustriyana, Nyoman Gede Grenata Nanda
Indonesian Journal of Medicine Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.2.747

Abstract

Background: This case report examines the uncommon occurrence of Lumbar Spinal Canal Stenosis (LSCS) in a 23-year-old male patient, highlighting the diagnostic challenges and unique aspects of managing this condition in young adults. Typically associated with aging and degenerative changes, LSCS poses a diagnostic dilemma when encountered in a young individual with nonspecific causation. Case Presentation: The patient reported persistent lower back pain since February 2023, primarily on the right side, escalating over the past three months. The pain intensified during prolonged sitting, standing, and walking, alleviated by lying down and analgesics. Radiating pain to both buttocks and legs, particularly on the right side, accompanied a four-month history of persistent right foot numbness. Referred from RS Siloam Kupang to RSAD Denpasar and subsequently to RSUP Prof IGNG Ngoerah, the patient received a diagnosis of Lumbar Spinal Canal Stenosis at L2-L3-L4, L5-S1, with suspected Spondylitis TB. Results: This case underscores the intricacies of diagnosing Lumbar Spinal Canal Stenosis in young adults, emphasizing the exploration of non-traditional causes. The patient underwent Debridement-Decompression-Stabilization-Fusion-Biopsy+Culture, experiencing postoperative improvement. Cultures showed no growth, and biopsy results were nonspecific. The final diagnosis was Lumbar Spinal Canal Stenosis at L2-L3-L4, L5-S1 due to Spondylitis TB dd/Pyogenic Infection, with bilateral Neural Foraminal Stenosis Grade III at L5. The discussion focuses on the rarity of this presentation in young individuals, challenges in diagnosis, and the efficacy of decompression-stabilization-fusion treatment for achieving positive outcomes in young adult patients. Conclusion: The case discussion emphasizes the complexity of managing Lumbar Spinal Canal Stenosis in a young adult, particularly when infection is suspected. The decision to pursue Decompression-Stabilization-Fusion was rooted in the patient's age, the need for structural stability, and the suspicion of infection.
Co-Authors Aryana, I Gusti Ngurah Wien Dharmayuda, Cokorda Gde Oka Dimitri, Dominicus Gunawan, Dary I Ketut Suyasa Putra, I Gusti Ngurah Paramartha Wijaya Sadiwidayat, Komang Septian Soroy Lardo Ustriyana, Nyoman Gede Grenata Nanda