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All Journal E-Jurnal Medika Udayana Indonesian Journal of Medicine Community Medicine and Education Journal The Hip and Knee Journal
Dharmayuda, Cokorda Gde Oka
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Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health

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Gambaran Karakteristik Pasien Fraktur Klavikula di Rumah Sakit Umum Pusat (RSUP) Sanglah Periode Januari-Desember 2019 Devinta, Made Ratih Santi; Asmara, Anak Agung Gde Yuda; Dharmayuda, Cokorda Gde Oka
E-Jurnal Medika Udayana Vol 11 No 2 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i02.P17

Abstract

Clavicle fracture is a common cause of injuries in adult, with over 2.6?4% of cases have been found with an incidence rate of 30 over 100.000 population. Although having a high incidence rate, availability of studies on the characteristics of clavicle fractures in Indonesia remains limited. Based on the high incidence of cases, variability of concomitant injuries and the evolution of science and technologies in health, this study was conducted to discover the characteristics of clavicle fractures patients in Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar. This study used a cross sectional approach with descriptive retrospective as the study design and using secondary data of clavicle fracture patients in RSUP Sanglah in January?December 2019. Secondary data used in this study were obtained from the Morning Reports of Orthopaedic and Traumatology Department in RSUP Sanglah. Variables in this study including age, gender, type of fracture, type of concomitant injuries and type of treatment. The data was obtained using total sampling technique. Among 91 cases of clavicle fracture, they were mainly found in a group of young productive men (17?25 years old) and mostly classifed as closed fractures (97.8%). Most of the patients came with head injuries (45.1%) and thorax injuries (45.1%) and mainly went through surgical procedures (ORIF) 74.7%.
Comparison of Mortality Rate Between Bipolar Hemiarthroplasty and Proximal Femoral Nail Anti-rotation for Intertrochanteric Fractures in Sanglah Hospital, Bali Dusak, I Wayan Suryanto; Aryana, I Gusti Ngurah Wien; Dharmayuda, Cokorda Gde Oka; Subawa, I Wayan; Nugraha, Hans Kristian; Susila, Made Arya; Mahadhana, Sri
The Hip and Knee Journal Vol 1, No 1 (2020): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (844.577 KB) | DOI: 10.46355/hipknee.v1i1.25

Abstract

Introduction: Intertrochanteric fractures occur in about 50% of all hip fracture events, with a mortality rate within 1 year after fracture reaching 15 to 20%. The most common treatment nowadays is either the bipolar hemiarthroplasty procedure or proximal femoral nail anti-rotation (PFNA), although there is still no consensus regarding which is better from the two, especially on patient mortality.Method: This study was an observational study using a retrospective cohort design. A total of 102 study subjects who met the inclusion requirements were grouped into 2 groups, one with bipolar hemiarthroplasty fixation treatment and another with PFNA fixation treatment. Mortality rate was recorded by survey 2 years after surgery.Results: Chi-square test showed that 2-year mortality rate after intertrochanteric fracture treated with bipolar hemiarthroplasty (21.4%) was significantly higher than the PFNA group (10.3%) (p = 0.028). Bipolar hemiarthroplasty group also had longer length of stay (50%) than the PFNA group (32.4%), albeit statistically insignificant (p = 0.13). There was no significant difference between the 2-year mortality rate and length of stay (p = 0.976).Conclusion: Patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty have significantly higher 2- year mortality rate than similar patients underwent fixation with PFNA, while they did not experience higher length of stay than the PFNA group. Future prospective, multi center study with larger sample size will be likely to validate similar fixation choice needed to decrease the mortality rate in intertrochanteric fractures.
Enhancing Hospital Efficiency and Patient Outcomes Through Flexible Resident Scheduling: A Meta-Analysis Dharmayuda, Cokorda Gde Oka; Arlina Dewi
Community Medicine and Education Journal Vol. 5 No. 3 (2024): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v5i3.639

Abstract

The traditional, rigid work schedules of medical residents have been linked to fatigue, burnout, and potential adverse effects on patient safety. The implementation of flexible working hours has been proposed as a potential solution to mitigate these risks and improve patient outcomes. This meta-analysis aims to evaluate the impact of flexible resident scheduling on hospital efficiency, patient safety, and resident well-being. A systematic search of electronic databases (PubMed, Embase, Cochrane Library, Web of Science) was conducted to identify studies published between 2014 and 2024 that investigated the effects of flexible resident work hours on patient outcomes, medical errors, length of stay, and resident well-being. The quality of included studies was assessed, and data were extracted for meta-analysis using random-effects models. The meta-analysis included four studies. The results demonstrated that flexible resident scheduling was associated with a significant reduction in prolonged length of stay (pooled odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.06-1.14) and a decrease in medical errors (pooled OR = 0.93, 95% CI = 0.30-2.87). The results highlight the positive correlation between resident flexibility and enhanced patient care efficiency, indicating a decrease in medical errors. The findings of this meta-analysis suggest that implementing flexible resident scheduling can enhance hospital efficiency, improve patient outcomes, and promote resident well-being. Healthcare institutions should consider adopting flexible work-hour policies to optimize patient care and support the professional development of resident physicians.
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.
Clinical Demographics Characteristic of Total Knee Arthroplasty at Prof IGNG Ngoerah General Hospital, Bali, Indonesia Aryana, I Gusti Ngurah Wien; Dharmayuda, Cokorda Gde Oka; Febyan, Febyan; Dimitri, Dominicus; Limena, Shianita; Kuswara, Leonardus William
Indonesian Journal of Medicine Vol. 8 No. 2 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.2.616

Abstract

Background:  Total knee arthroplasty (TKA) is a widespread surgical procedure for severe arthritis. By 2030, primary TKA would reach over 1.2 million procedures annually in the United States. In Indonesia, the prevalence of joint disease is about 19.5 million cases. This study aims to evaluate the clinical demographics characteristics of TKA in Prof. Ngoerah General Hospital, Bali, Indonesia.Subjects and Method:  This is a descriptive study using a Cross-Sectional method with a total 57 adult patients undergoing TKA caused by Osteoarthritis grade III/IV in Prof IGNG Ngoerah Hospital from June 2020-June 2022. The dependent variable is the TKA procedure. Independent Variable is Age, gender, grade of knee osteoarthritis, comorbidities, and complications Data from the medical record was collected and stored in a Microsoft Office Excel 365 spreadsheet, the distributive table was analyzed and collected by using SPSS.Results:  Patient characteristic is dominated by an elderly female (84.2%), with age group 61-70 (38.6%). Comorbidities in this study include hypertension (28.1%), type II diabetes (10.5%), and rheumatoid disease (1.8%). The main complication recorded in this study includes joint stiffness (3.5%), and persistent pain (5.3%).Conclusion:  After Total Knee Arthroplasty was performed on 57 patients with a wide range of comorbidities, only a small number of complications occurred. This study implied that TKA could be performed even if the patient had some comorbidities as long as the patient pursued a complete pre and post-operative evaluation algorithm of the procedure.Keywords:  knee arthroplasty, osteoarthritis, human and medicine, rehabilitationCorrespondence:  IGN Wien Aryana, Consultant of Sports Medicine, Dept. Orthopaedic and Traumatology, Prof IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University. Jl. Diponegoro, Dauh Puri Klod. Denpasar City, Bali 80113 Email: wienaryanaortho@gmail.com. Mobile: +62811385263.Indonesian Journal of Medicine (2023), 08(02): 128-135https://doi.org/10.26911/theijmed.2023.08.02.01 
Co-Authors Arlina Dewi Aryana, I Gusti Ngurah Wien Asmara, Anak Agung Gde Yuda Devinta, Made Ratih Santi Dimitri, Dominicus Dusak, I Wayan Suryanto Febyan Febyan, Febyan Gunawan, Dary Hans Kristian Nugraha, Hans Kristian I Ketut Suyasa I Wayan Subawa Kuswara, Leonardus William Limena, Shianita Sri Mahadhana, Sri Susila, Made Arya