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Level of Community Compliance About Health Protocols and Influencing Factors in Panceran Hamlet, Ngancar Village Kediri Regency Dian Fery Handrianti; Anggraeni, Novita
Indonesian Journal of Nutritional Epidemiology and Reproductive Vol. 5 No. 3 (2022): September
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/ijner.v5i3.189

The spread of the Covid-19 virus has been increasing lately. The high rate of transmission has made every country appeal to the public to reduce activities outside the home. We hope that by implementing health protocols during the Covid-19 pandemic according to the government's recommendations, we can help stop the spread of various kinds of bacteria or viruses, including the Covid-19 Virus. However, until now there are still many people who still do not comply with health protocols properly. The factors that influence compliance include knowledge, attitudes, support and self-motivation. The purpose of this study was to analyze the factors that influence community compliance with health protocols in Panceran Hamlet, Ngancar District, Kediri Regency. The research method used in this study is a quantitative method. This study used a cross-sectional design. The population in this study was the community of Panceran hamlet, Ngancar village with a sample of 50 respondents. The statistical test used for data analysis in this study was a simple linear regression test with a degree of confidence = 0.05. The results showed that there was an influence of the knowledge factor with the level of community compliance with health protocols of 60% with a t-count value of 8.483. The influence of self-motivation factors with the level of community compliance with health protocols is 89.5% with a t-count value of 20.249. The influence of family support factors on the level of community compliance with health protocols is 68.9% with a t-count value of 10.306. The influence of the attitude factor with the level of community compliance with health protocols is 92.5% with a t-count value of 24,268. Thus it can be concluded that knowledge, self-motivation, family support and character are factors that have an influence on a person's level of compliance.

Adverse Event : Myocardial Injury after Non-Cardiac Surgery (MINS) Post Craniectomy in Critical Care Fajri, Doni; Anggraeni, Novita; Hidayat, Nopian; Ananda, Pratama
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.664

Intracerebral hemorrhage (ICH) describes the non-traumatic parenchymal hemorrhage caused by the rupture of cerebral vessels, accounting for 2030% of all strokes. ICH will cause compression on the surrounding brain tissues, eventually giving rise to increased intracranial pressure. Decompressive craniectomy (DC) effectively reduce intracranial pressure. Myocardial injury is defined as an elevation of cardiac troponin levels with or without associated ischemic symptoms. Case a male, 66 years old patient was admitted to the ICU after undergoing Emergency Craniectomy Hematoma Evacuation due to Spontaneous ICH. After 52 hours of treatment, the patient was found to have ventricular tachycardia (VT) on the monitor and restlessness. The patient was also found to have comorbid hypertension. On a 12-Lead ECG we found NSTEMI, and Troponin I level was measured at 453.0 ng/L (positive). This patient was treated with anticoagulants, antiplatelet and statin, with monitoring of the ECG daily. On The 6th day patient was moved to High Care Unit (HCU). Myocardial Injury after Noncardiac Surgery is defined by elevated postoperative cardiac troponin concentrations, with or without accompanying symptoms or signs. It typically occurs within 30 days after surgery. The management of MINS involves the use of anticoagulants and antiplatelet therapy. Anticoagulant therapy should be considered between benefit and risk of re-bleeding post operative. MINS is a rare condition but is associated with an increased risk of 30-day mortality. A multidisciplinary treatment approach and a coordinated team effort are essential for improving the outcomes of patients with this condition.

Management of Patient with Neuroleptic Malignant Syndrome Ginarsyah, Riando; Anggraeni, Novita
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 2 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Neuroleptic Malignant Syndrome (NMS) is a rare, life-threatening condition often induced by the use of antipsychotic drugs, characterized by hyperthermia, muscle rigidity, altered mental status, and autonomic dysfunction. This syndrome can be precipitated by antipsychotic medications, including haloperidol and fluphenazine, or by abrupt withdrawal of dopaminergic medications. This case report presents the management of a 56-year-old male patient admitted with decreased consciousness, muscle rigidity, and high fever, diagnosed with NMS. The patient was treated with supportive care, electrolyte correction, and medications including ceftriaxone, resfar, omeprazole, and others. The patient’s condition gradually improved with proper monitoring, and after intensive care, the patient was transferred to the ward. This report highlights the importance of early detection, discontinuation of causative drugs, and appropriate therapeutic interventions to reduce the mortality rate, which remains high at 20-30% if untreated. The treatment approach emphasizes symptom management, including fluid resuscitation and the use of medications like bromocriptine or dantrolene for severe cases.

Myasthenia Gravis with Thymoma Complication: Dilemmas and Prospective Anesthesiology Approach Jaya, Pelinggo; Ananda, Pratama; Anggraeni, Novita
Jurnal Ilmu Kedokteran Vol 19, No 1 (2025): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26891/JIK.v19i1.2025.96-99

Myasthenia gravis (MG) is an autoimmune disease affecting the postsynaptic neuromuscular junction. Myasthenia Gravis occurs in 1:7500 individuals, mostly female and or Asian. Myasthenia gravis can later be complicated with thymoma, and by several indications might need an operative approach. The need for thymectomy while there is a preexisting neuromuscular anomaly in Myasthenia gravis becomes a dilemma when choosing the right anesthetic regimens. This case report aims to discuss findings and offer a possible anesthetic approach that can be considered for cases of Myasthenia gravis with thymoma complications. We received a referred female patient with main complaints of dyspnoea, which was suspected as lung cancer. After further investigation, we found that the patient has previously been diagnosed with Myasthenia gravis, but did not follow through with her treatment plan. We performed a CT scan and confirmed a suspected thymoma as a complication of her Myasthenia gravis. Tymectomy was performed afterwards under general anesthesia. Post-operative extubation was successful, and maintenance of Myasthenia gravis treatment was followed by a neurologist. MG with thymoma is a rare finding in our hospital. Myasthenia gravis causes neurologic anomalies in which patients require special consideration on choosing a proper anesthesia regimen, as general anesthesia and muscle relaxants can worsen respiratory depression. Developing A proper scoring and suitable management plan will enhance the outcome and quality of life. Currently, there are several known anesthetic and supportive medicine approaches to thymectomy in Myasthenia gravis patients, including alternative regimens with similar efficacy.

Effect of warming gown use on shivering and body temperature in chronic kidney disease patients undergoing hemodialysis via catheter Anggraeni, Novita; Saryono, Saryono; Upoyo, Arif Setyo
Jurnal Keperawatan Padjadjaran Vol. 13 No. 1 (2025): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v13i1.2701

Background: Haemodialysis is often accompanied by shivering, especially in patients with catheter access, which can reduce comfort, impair treatment efficacy, increase the risk of complications and contribute to inadequate dialysis. Addressing this issue through non-pharmacological means, such as a warming gown, offers a potentially effective, safe, and economical solution to improve patient outcomes. Purpose: To develop a warming gown as an innovation to reduce the incidence of shivering in chronic kidney disease patients undergoing haemodialysis with a haemodialysis catheter. Methods: This study employed a two-stage Research and Development design. In the first stage, a reusable, adaptive warming gown for HD catheter patients was developed and validated (S-CVI/Ave = 0.99). Second, a quasi-experiment was conducted with 60 patients recruited through total sampling. Subsequently, patients were randomly allocated to either the intervention group (warming gown) or the control group (blanket) using computer-generated randomisation based on their identification numbers. Shivering (Crossley and Mahajan scale) and body temperature (digital thermometer) were measured at 0, 15, 30, 60, and 120 minutes. Data were analysed using Wilcoxon, Friedman, and Bonferroni-corrected repeated Mann–Whitney tests. Results: The intervention group showed a significant reduction in shivering levels from 2.63 ± 1.27 to 0.37 ± 0.49 (p < 0.001) and an increase in body temperature from 36.36 ± 0.52 to 36.84 ± 0.29 (p < 0.001). In contrast, the control group showed no significant changes (p > 0.05). Conclusions: The warming gown was proven effective in reducing shivering and increasing body temperature in haemodialysis patients, offering advantages in comfort, safety, and cost efficiency.

Efficacy of Opioid-Free Anesthesia vs Opioid Anesthesia in Postoperative Outcome of Patients Underwent General Anesthesia Ananda, Pratama; Anggraeni, Novita; Sari, Valencia Ayu
Journal of Anaesthesia and Pain Vol. 6 No. 1 (2025): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Background: Opioids are widely used narcotic analgesics in perioperative settings. However, it has a series of postoperative side effects. Opioid-free anesthesia (OFA) is an anesthetic technique that avoids the use of opioids intraoperatively to minimize their side effects. This study aimed to compare the postoperative outcome and side effects between OFA and opioid anesthesia. Methods: This is a randomized comparative experimental study in adults undergoing elective surgery under general anesthesia. We enrolled 30 patients and divided them into Group A (treatment) (n = 15), who were given ketamine at 0.25-0.5 mg/kg repeated every 30 minutes and 2% lidocaine at 1-1.5 mg/kg followed by maintenance doses. Group B (control) (n = 15) received fentanyl at 1-5 µg/kg/hour. Postoperative outcome (pain intensity) using the Wong-Baker FACES® Pain Rating Scale and side effects of opioids, including postoperative hypoxia, ileus, delirium, and postoperative nausea and vomiting (PONV), were observed. The data between groups were analyzed using the Wilcoxon, chi-square, unpaired t-test, Fisher’s exact, and Mann-Whitney test with α = 0.05. Result: Moderate to severe postoperative pain was observed to be higher in the control group than in the treatment group (88.9% vs 11.1%) (p = 0.020). Incidence of hypoxia, ileus, delirium, nausea, and vomiting in group A (p = 0.003; p = 0.030; p = 0.042; p = 0.001, respectively) was higher compared to group B. Conclusion: The use of OFA results in better postoperative pain control and a lower incidence of postoperative opioid-related side effects, i.e., postoperative hypoxia, ileus, delirium, and PONV.

Management of Patient with Neuroleptic Malignant Syndrome Ginarsyah, Riando; Anggraeni, Novita
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 2 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/.v7i2.290

Neuroleptic Malignant Syndrome (NMS) is a rare, life-threatening condition often induced by the use of antipsychotic drugs, characterized by hyperthermia, muscle rigidity, altered mental status, and autonomic dysfunction. This syndrome can be precipitated by antipsychotic medications, including haloperidol and fluphenazine, or by abrupt withdrawal of dopaminergic medications. This case report presents the management of a 56-year-old male patient admitted with decreased consciousness, muscle rigidity, and high fever, diagnosed with NMS. The patient was treated with supportive care, electrolyte correction, and medications including ceftriaxone, resfar, omeprazole, and others. The patient’s condition gradually improved with proper monitoring, and after intensive care, the patient was transferred to the ward. This report highlights the importance of early detection, discontinuation of causative drugs, and appropriate therapeutic interventions to reduce the mortality rate, which remains high at 20-30% if untreated. The treatment approach emphasizes symptom management, including fluid resuscitation and the use of medications like bromocriptine or dantrolene for severe cases.

Myocardial Injury after Noncardiac Surgery: A Case Report of Acute Chest Pain and Elevated Troponin Levels, Challenges and Management Strategies Ton, Yori Yarson; Anggraeni, Novita; Irawan, Dino; Hidayat, Nopian
JAI (Jurnal Anestesiologi Indonesia) Vol 17, No 3 (2025): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.68386

Background: Perioperative myocardial injury is a common complication following noncardiac surgery, linked to significant morbidity and mortality. With over 300 million surgeries performed worldwide annually, this number has increased by more than 100 million in the past two decades.Case: A 42-year-old woman underwent elective craniotomy for a right cerebellar hemangioblastoma and was admitted to the intensive care unit (ICU) postoperatively. On day three, she developed typical chest pain, inferior ST-elevation myocardial infarction (STEMI), and cardiogenic shock. Her medical history included the use of euthyrox following a total thyroidectomy 15 years prior, with no prior cardiac issues. Upon examination, she was conscious but had low blood pressure (58/41 mmHg), an elevated heart rate (103 bpm), and cold extremities. Her troponin I level was elevated at 9383.0 ng/mL. The diagnosis was major postoperative myocardial infarction.Therapy: The patient received aspirin, atorvastatin, heparin, norepinephrine, and dobutamine for shock management, with close hemodynamic monitoring. By day six, her condition improved, and her electrocardiogram (ECG) was normal. By day nine, she was transferred to the high care unit.Discussion: Myocardial injury after noncardiac surgery (MINS) includes both myocardial infarction and ischemic myocardial injury, which may not meet the Universal Definition of Myocardial Infarction. MINS usually occurs within 30 days of surgery, especially within the first 72 hours. Its causes are multifactorial, including plaque rupture, oxygen supply-demand imbalance, arrhythmias, and pulmonary embolism. Studies suggest that cardiovascular therapy, including aspirin and statins, is effective. Aspirin reduces 30-day mortality, while statins offer long-term benefits through anti-inflammatory effects. Low-dose aspirin, statins, and Renin-Angiotensin System inhibitors are recommended.Conclusion: MINS is a serious postoperative complication, even in patients without a history of cardiovascular disease, as demonstrated in this case. Prompt recognition and appropriate therapy with aspirin, heparin, and statins, along with close monitoring, can lead to significant clinical improvement.

Perioperative Anesthetic Management in Repair Diaphragmatic Hernia with Atrial Septal Defect and Pulmonary Hypertension Noorrahman, M Irvan; Ananda, Pratama; Anggraeni, Novita
Indonesian Journal of Anesthesiology and Reanimation Vol. 6 No. 2 (2024): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V6I22024.106-115

Introduction: Patients who had suffered disease of atrial septal defect (ASD) coming by pulmonary hypertension (PH) often present a clinical dilemma. Both of these disorders are congenital anomalies that often appear in pediatrics. Anaesthetic management in diaphragmatic hernia repair with this comorbidity requires precision and accuracy to avoid morbidity and mortality during surgery. The right management and care of anesthetic procedures is needed for patients who will be operated on with these two disorders. Objective: To describe the anesthetic management of a diaphragmatic hernia repair patient with comorbid ASD and pulmonary hypertension. Case report: The patient, a 1.5-month-old female baby born, has presented with shortness of breath complaints since the birth. Those were born spontaneously at the midwife's office and did not cry immediately, and a history of blueing and decreased consciousness was admitted for 20 days. Based on the examination, the diagnosis of diaphragmatic hernia from echocardiography found ASD and PH with a left ventricular ejection fraction of 64%. The patient was planned for diaphragmatic hernia repair under general anesthesia. Induction of anesthesia was performed with 5 mcg of fentanyl and inhalation anesthetic 3.5 vol% sevoflurane. After the endotracheal tube (ETT) was attached, the patient was desaturated to 50%, then the hyperventilated oxygenation was performed and positioned with knee chest position, and then milrinone at a dose of 1 mcg/min was given, saturation rose to 100%. During intraoperative ventilation control with manual bagging and maintenance anesthesia with inhalation ansethetic sevoflurane of 3.2 vol%. After surgery, the patient was admitted and observed in the pediatric intensive care unit for 2 days before extubation. Conclusion: Appropriate perioperative management in ASD patients with PH can reduce perioperative morbidity and mortality.

EDUKASI MANAJEMEN DAN PENCEGAHAN BULLYING DI SDN KAUM PANDAK 04 KARADENAN CIBINONG KABUPATEN BOGOR Anwar, Syaiful; Hamzah, Zeze Zakaria; Muhlis, Muhlis; Hamdan, Muchammad; Herlina, Erna; Catur, Andri; Rukmini, Mimin; Anggraeni, Novita
Devote: Jurnal Pengabdian Masyarakat Global Vol. 4 No. 4 (2025): Devote: Jurnal Pengabdian Masyarakat Global, 2025 (In Press)
Publisher : LPPM Institut Pendidikan Nusantara Global

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55681/devote.v4i4.4365

This Community Service Program aims to strengthen the roles of teachers and parents in preventing and handling bullying among elementary school children. Using a participatory and reflective approach, the activity was carried out in the form of workshops and focus group discussions (FGDs) involving teachers and parents at SDN Kaum Pandak 04, Karadenan, Bogor Regency. The materials presented included understanding the forms and impacts of bullying, early detection techniques, intervention strategies, and empathetic communication between parents, teachers, and students. The results showed a significant improvement in participants' knowledge and skills in addressing bullying issues wisely and effectively. This activity also fostered collective awareness of the importance of school-family collaboration in creating a safe and child-friendly learning environment. The program is expected to serve as a replicable model for educational community empowerment in other schools.

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