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Tantangan Perioperatif pada Pasien Penyakit Jantung Rematik yang menjalani Prosedur Seksio Sesarea – Laporan Kasus Hotabilardus, Nusi A; Masjkur, Diana; Anggraeni, Novita
Journal of Medicine and Health Vol 7 No 1 (2025)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v7i1.9982

Abstract

Rheumatic heart disease (RHD) is a major contributor to maternal morbidity and mortality in developing countries, including Indonesia. Severe preeclampsia further complicates management by exacerbating cardiovascular strain and increasing the risk of adverse outcomes for both mother and fetus. This case report highlights the importance of multidisciplinary collaboration and careful perioperative planning for pregnant women with RHD, particularly in resource-limited settings. We report the case of a 31-year-old woman (G3P2A0) at 40–41 weeks of gestation, diagnosed with severe preeclampsia, severe mitral stenosis, moderate mitral regurgitation, and severe tricuspid regurgitation due to RHD. An elective cesarean section was performed under epidural anesthesia with 0.75% ropivacaine, ensuring hemodynamic stability throughout the procedure and during a 24-hour ICU observation. Despite limited access to cardiovascular specialists and surgical options, a team-based approach and tailored anesthetic management ensured a favorable outcome. In conclusion, this case demonstrates that even in settings with constrained resources, proper planning, close monitoring, and multidisciplinary coordination can mitigate the risks associated with multivalvular heart disease and severe preeclampsia in pregnancy. Interdisciplinary collaboration and individualized anesthetic strategies are crucial for optimizing maternal and fetal outcomes in such complex scenarios.
Implementasi Kebijakan Pelindungan dan Pemenuhan Hak Kesehatan Penyandang Disabilitas di Kabupaten Jember Anggraeni, Novita; Sandra, Christyana; Khoiri, Abu
Jurnal Kebijakan Kesehatan Indonesia Vol 11, No 1 (2022): March
Publisher : Center for Health Policy and Management

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkki.69719

Abstract

Penyandang disabilitas kerap mendapatkan perlakuan diskrimitatif seperti masih terbatasnya akses untuk memperoleh pelayanan kesehatan. Berdasarkan studi pendahuluan yang dilakukan peneliti, Ketua Dewan Pembina PERPENCA (Persatuan Penyandang Cacat) Kabupaten Jember menyebutkan bahwa infrastruktur dan sumber daya manusia fasilitas pelayanan kesehatan belum terdistribusi secara merata. Penelitian ini bertujuan untuk mengkaji bagaimana implementasi pemenuhan hak kesehatan berdasarkan variabel isi kebijakan, konteks implementasi dan dampak kebijakan. Penelitian ini merupakan penelitian studi kasus dengan pendekatan kualitatif. Implementasi kebijakan pemenuhan hak kesehatan berupa upaya pelayanan kesehatan preventif dan promotif serta penyediaan fasilitas pelayanan kesehatan tingkat pertama bagi penyandang disabilitas di Kabupaten Jember telah disesuaikan dengan isi kebijakan dalam Peraturan Daerah Nomor 7 Tahun 2016. Berdasarkan konteks implementasi kekuasaan kebijakan mencakup pada wilayah Kabupaten Jember. Karakteristik lembaga pelaksana sebagai yang menyediakan fasilitas dan merancang penganggaran dana, dirasa belum seluruhnya pelaksana mengetahui adanya peraturan daerah terkait. Meskipun, secara garis besar kepatuhan dan daya tanggap lembaga legislatif maupun eksekutif dalam implementasi dinilai baik oleh masyarakat. Implementasi kebijakan ini juga memberikan dampak positif maupun negatif yang dirasakan mulai dari kalangan pemerintah maupun masyarakat. Kebijakan pelindungan dan pemenuhan hak kesehatan penyandang disabilitas di Kabupaten Jember telah diimplementasikan, namun perlu dilakukan evaluasi kebijakan untuk selanjutnya dapat dilakukan perbaikan serta pengembangan kebijakan.
Determinan Discretionary Loan Loss Provision pada Perbankan Syariah di Indonesia Anggraeni, Novita; Putra, Rosyid Nur Anggara
Sunan Kalijaga: Islamic Economics Journal Vol. 1 No. 1 (2022)
Publisher : Department of Islamic Economics, Faculty of Islamic Economics and Business, Universitas Islam Negeri Sunan Kalijaga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/skiej.2022.1.1.1523

Abstract

This study is a quantitative study that aims to examine the effect of pre-managed earnings, capital management, leverage, sharia supervisory board, concentration ownership, and institutional ownership variables on earnings management proxied through discretionary loan loss provision. The research object used in this study were 12 Islamic banks registered with the Financial Services Authority (OJK) for the 2015-2019 period which were selected through purposive sampling technique. The data analysis technique used is panel data regression analysis using the help of the e-views software version 11. The results of this study indicate that pre-managed earnings, concentration ownership, and institutional ownership have no effect on discretionary loan loss provision. The leverage variable has a significant negative effect on the discretionary loan loss provision and the sharia supervisory board has a significant positive effect on the discretionary loan loss provision. While the capital management variable has an effect on the discretionary loan loss provision but has the opposite direction to the hypothesis in this studyKeywords: Discretionary Loan Loss Provision, Pre-managed Earnings, capital management, Leverage,  sharia supervisory board, Ownership
PENINGKATAN MOTIVASI SISWA DALAM MENGGAPAI CITA-CITA DI SMP MATHUSA DWI ELANG CIBUNGBULANG KABUPATEN BOGOR Muhlis, Muhlis; Anggraeni, Novita; Mujito, Mujito
Jurnal Pengabdian Indonesia (JPI) Vol. 1 No. 2 (2025): Vol. 1 No. 2 Edisi Juli 2025
Publisher : PT. Jurnal Center Indonesia Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62567/jpi.v1i2.619

Abstract

Pengabdian masyarakat "Mengapai Cita" bertujuan untuk membantu siswa dalam mengidentifikasi dan mengatasi berbagai hambatan yang mungkin mereka hadapi dalam melanjutkan pendidikan, seperti masalah keuangan, kekhawatiran tentang beban akademik, tekanan sosial, serta strategi untuk mengatasi tantangan tersebut. Melalui program ini, siswa diharapkan dapat mengembangkan motivasi untuk merencanakan langkah-langkah konkret dalam mencapai cita-cita mereka, termasuk memahami pendidikan yang perlu dijalani dan keterampilan yang perlu dikembangkan. Manfaat yang diharapkan dari kegiatan ini antara lain adalah membantu siswa membangun rasa percaya diri dengan mendengarkan kisah inspiratif dari para pembicara yang telah berhasil mencapai tujuan hidup mereka. Selain itu, program ini juga bertujuan untuk memberikan arah yang jelas, meningkatkan motivasi, serta membekali siswa dengan pengetahuan dan kepercayaan diri yang diperlukan untuk meraih cita-cita mereka di masa depan.
Anesthetic Management of a Giant Ovarian Cyst: A Case Report Indriani, Andi Riza Mirda; Saputra, T. Addi; Anggraeni, Novita
Journal of Health and Nutrition Research Vol. 4 No. 3 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i3.507

Abstract

Ovarian cysts are highly prevalent among women, particularly those of reproductive age. However, giant ovarian cysts are rare, as most cases are detected early during routine gynecological or ultrasound examinations. A giant ovarian cyst is defined as an ovarian cyst that is more than 10 cm in diameter. Cases with giant size pose significant clinical challenges. We report a case of an 18-year-old female patient with symptoms of an enlarged abdomen for six months causing shortness of breath, difficulty in activities and supine position. Initial examination revealed an abdominal circumference of 120 cm and a large cystic mass that required laparotomy. Challenges in anesthetic management are related to increased abdominal pressure by the mass, including aspiration risk, hemodynamic disorders, supine hypotensive syndrome, and re-expansion pulmonary edema. Consideration of anesthetic agent selection and perioperative monitoring strategies is key to minimizing complications and ensuring patient safety. In this case, anesthetic agents were carefully selected due to the presence of a giant ovarian cyst that significantly increased intra-abdominal pressure. A balanced general anesthesia approach was employed, prioritizing agents with minimal cardiovascular effects to maintain hemodynamic stability. Propofol was chosen for induction because of its rapid onset and ease of titration, while sevoflurane was used for maintenance due to its favorable cardiovascular profile and rapid recovery characteristics. Rocuronium was administered to facilitate muscle relaxation, and fentanyl was selected for analgesia owing to its potency and minimal impact on hemodynamics. To mitigate the risk of aspiration, rapid sequence induction was performed with endotracheal intubation in a semi-recumbent position. This anesthetic strategy was specifically tailored to address the risks associated with large intra-abdominal masses, such as aspiration, cardiovascular instability, and respiratory compromise.