Sembiring, Yan Efrata
Department Of Cardiothoracic And Vascular Surgery, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya

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Pneumomediastinum Paul L Tahalele; Merlinda Dwintasari; Y Motulo; Yan Efrata Sembiring; Dhihintia Jiwangga Suta
JURNAL WIDYA MEDIKA Vol. 5 No. 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i2.2201

Abstract

Mediastinum is defined as the area demarcated by the thoracic inlet superiorly, the diphragm inferiorly, and the pleural cavities laterally. The mediastinum is a division of the thoracic cavity that contains thymus gland, the heart, trachea and portions of the seophagus, and other structures. Mediastinum divided into 3 region, anterior, posterior, superior, and middle regions. Pneumomediastinum or emphysematous mediastinum is existence of free air in the mediastinum due to spontaneous or secondary reasons. That can be confirmed with thorax X-Ray or CT- Scan thorax. The symptomps are severe central chest pain, shortness of breath, subcutaneous emphysema, laboured breathing and voice distortion. In physical diagnosis, especially on auscultation, there is spesific sign called “Hamman’s Crunch” (crunching sound corresponding with the cardiac cycle (Hamman’s Crunch). Pneumomediastinum can leadto pneumopericardium, pneumotoraks, penumoretroperitonium or penumoperitonium. Air in the mediastinal cavity can be absorbed by itself slowly, so penumomediastinum can treated non-operatively.
Analysis of Risk Factors for Antimicrobial Resistance in Bacterial Infections among Diabetic Foot Ulcer Patients William, Andrew; Sembiring, Yan Efrata; Widodo, Agung Dwi Wahyu; Novida, Hermina
Current Internal Medicine Research and Practice Surabaya Journal Vol. 6 No. 2 (2025): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v6i2.64804

Abstract

Introduction: Diabetic foot ulcer (DFU) is a chronic and progressive complication of diabetes mellitus resulting from macroangiopathy and microangiopathy disorders. Acknowledging the relationship between the Wagner diabetic foot ulcer classification system and infection severity may offer a promising instrument for guiding empirical antibiotic selections in clinical settings. This study aimed to assess the relationship between Wagner grades and the pathogen profiles of patients with DFU, along with their susceptibility to antibiotic therapy.Methods: A cross-sectional study was conducted from January 2021 to August 2023, utilizing 33 secondary datasets obtained from electronic medical records. The data contained the patients' Wagner grades alongside the results of their complete microbiological analysis and antibiotic susceptibility test. The association between determinant factors and patients' pathogen profiles and antibiotic susceptibility patterns was examined using the Chi-square bivariate analysis (p<0.05).Results: Positive culture results were observed in 32 patients (97%), with 59% exhibiting resistance to first-line antibiotics. The most commonly isolated pathogen was Staphylococcus aureus. The antibiotic susceptibility patterns indicated that gentamicin-syn demonstrated the highest activity against Gram-positive bacteria (GPB) isolates, while erythromycin was the most effective against Gram-negative bacteria (GNB) isolates. With escalating Wagner grades, there was an increased proportion of mixed infections, GNB infections (n=8, X²=23.28, p=0.003), and antibiotic resistance (n=8, X²=39.97, p=0.000). GNB isolates showed higher resistance compared to GPB isolates (n=18, X²=42.15, p=0.001).Conclusion: Our findings suggest that DFU patients with varying Wagner grades exhibit different bacterial profiles, infection patterns, and antibiotic sensitivities.   Highlights:1. This is the first study conducted in Indonesia to analyze the relationship between the Wagner diabetic foot ulcer classification system and patients' pathogen profiles and antimicrobial susceptibility.2. This study incorporated an in-depth analysis of several infection patterns and the occurrence of antimicrobial resistance, hence offering valuable information on the application of the Wagner classification system not only as a tool for grading infection severity but also for guiding clinicians in selecting the appropriate antibiotics for patients with diabetic foot ulcers.
Clinical outcomes of splenorenal shunts in esophageal varices patients: a literature review Putra, I Gusti Agung Made Adnyana; Hakim, Arief Rakhman; Soebroto, Heroe; Sembiring, Yan Efrata; Limanto, Danang Himawan; Rizki, Mohamad; Puruhito
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.40

Abstract

The disease known as esophageal varices is usually caused by portal hypertension. Portal hypertension is most commonly caused by extrahepatic portal vein thrombosis and other conditions, such as cardiac problems or hepatic cirrhosis. Clinical manifestations of esophageal varices can include melena, haematemesis, and gastrointestinal bleeding. Effective venous pressure reduction is achieved via the distal splenorenal shunt. We acquired the literature for our review from PubMed and Google Scholar. The search was done in English using terms that indicated a connection between improvements in bone grafting methods and the restoration of alveolar clefts. To expand the search results, we also looked through the papers cited in the literature. Almost all of the five gathered articles demonstrated that the distal splenorenal shunt (DSRS) is a beneficial surgical treatment that effectively avoids postoperative PH issues. Finally, DSRS is presented as a surgical long-term treatment for variceal esophageal reflux disease and portal hypertension. Because DSRS selectively decompresses the venous collaterals around the stomach and lower esophagus, it is a safe and effective therapy choice for decreasing bleeding over nonselective shunting surgeries as a selective shunt.
Profil Penyakit Jantung Bawaan Sianotik di Rumah Sakit Umum Daerah Dr. Soetomo Surabaya Alverina, Clara; Utamayasa, I Ketut Alit; Sembiring, Yan Efrata
Majalah Kedokteran Indonesia Vol 72 No 1 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.1-2022-762

Abstract

Introduction. Cyanotic congenital heart disease (CHD) is an abnormality of the heart that causes blood with low oxygen content to circulate directly to the body.Objective. To evaluate the profile of cyanotic congenital heart disease at Dr. Soetomo General Hospital Surabaya.Methods. This is a descriptive study using medical records of cyanotic CHD patients aged ≤18 years old from June 2018 – May 2020. Gender, age, nutritional status, sign and symptom, type of cyanotic CHD, complication and treatment were taken as the variables.Result. Out of 116 patients in this study, the majority were male (58.62%). Most patients first diagnosed at the age of 0 – less than 1 year (76.72%) with normal nutritional status (51.72%). Tetralogy of Fallot (TOF) is the most common type (42.24%). Murmur was the most common sign and symptom (92.24%). Frequently observed complications were pneumonia (37.07%).Conclusion. Patients with cyanotic CHD are mostly male, diagnosed at the age of 0 – less than 1 year with normal nutritional status. TOF is the most common type. Most patients present with murmurs. Predominant complication is pneumonia.
Mortality Risk Factors in Tetralogy of Fallot Patients Undergoing Total Correction Juliana, Juliana; Sembiring, Yan Efrata; Rahman, Mahrus Abdur; Soebroto, Heroe
Folia Medica Indonesiana Vol. 57, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

A total correction is a preferred treatment for Tetralogy of Fallot patients in every part of the world. However, the mortality in developing countries was as high as 6.9% to 15.3%. This was a retrospective analytic study that analyzed pre and post-operative risk factors that affected mortality on TOF patients that were performed total correction in Indonesia. A total of 47 TOF patients that were performed total correction from January 2016 to September 2019 were enrolled in this study based on the inclusion criteria. Preoperative and post-operative data were obtained from medical records. In this research, the majority of mortality was found in male patients (39.3%), while the female's rate was lower (36.8%). Overall mortality was 38.3% and one operative death was found. The average age of patients was 84.12 months (12-210 months), whereas the average height (85.56 ± 36.17cm vs. 112.93 ± 21.73) and weight (17.22kg vs. 28.21kg) were lower for mortality patients. Some significant preoperative variables were identified as mortality risk factors such as: age below 60 months (p=0.047), smaller weight and height (p=0.008; p=0.002), abnormal hematocrit (p=0.002), and oxygen saturation below 75% (p=0.018). Significant post-operative risk factors included: temperature above 38.5⁰C (p=0.000), and ventilator time of more than 48 hours (p=0.033). In conclusion, the mortality of TOF patients undergoing a total correction in developing countries was quite high. It was associated with some risk factors, such as younger age, lower weight and height, low oxygen saturation, post-operative fever, and prolonged ventilator time.
Early outcome of adult cardial surgery in low volume community hospital experiences of young surgeon from developing country Sembiring, Yan Efrata
Folia Medica Indonesiana Vol. 52, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

After finishing training, every young cardiac surgeon wants to start a good carrier as fast as they can. We describe the early outcome of adult cardiac surgery that have been done by a young in low volume community hospital in Surabaya – Indonesia within periods December 2010 – December 2013. A retrospective study of 133 adult cardiac cases during December 2010 – December 2013 at Division of Thoracic, Cardiac and Vascular Surgery Dr. Soetomo Hospital Surabaya provides a comprehensive data concerning adult cardiac procedures which collected and analyzed. In last 3 years, the total number of adult cardiac disease which is undergone a surgery was 133 cases. The procedures were involved CABG (85 cases, 63.91%); valve procedures (7 cases, 5.26%); and others procedures (6 cases, 4.51%). All cases were done by a young surgeon. Thirty day early follow up, there were 3 patients suffered from wound infection, 7 patients undergone re-do procedures due to mediastinal bleeding and cardiac tamponade. Mortality rate was 1.5%. The conclusion, good mentoring from senior surgeon and good training give a good result of adult surgery done by a young surgeon in low volume community hospital.
Modified vac dressing in sternal wound infection management. Cheap and feasible technique in developing country Sembiring, Yan Efrata
Folia Medica Indonesiana Vol. 52, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Sternal wound infection is a rare but serious complication of cardiac surgery leading to prolonged hospital stay and higher mortality. In the last decades several treatment modalities have been described, of which vacuum-assisted closure (VAC) shows the most promising results. However, the VAC therapy system is expensive, requires extensive amounts of product and needs a power source at all times. Modified VAC dressing to treat sternal wound infection is cheap and feasible technique to use in develop country. This technique can be use as an alternative to the original vacuum-assisted closure and hadshown to serve its function in providing adequatevacuum pressure for wounds.
Efficacy, Safety, and Clinical Outcomes of Splenorenal Shunt Surgery as a Therapeutic Intervention for Portal Hypertension Patients Sembiring, Yan Efrata; Soebroto, Heroe; Puruhito, Ito; Winarno, Dhihintia Jiwangga Suta; Putra2, I Gusti Agung Made Adnyanya; Negoro, Sri Pramesthi Wisnu Bowo; Yasa, Ketut Putu; Dillon, Jeffrey Jeswant
Folia Medica Indonesiana Vol. 59, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. This study systematically reviewed the efficacy, clinical outcomes, and safety of the splenorenal shunt procedure with a comprehensive and meticulous approach. 2. The splenorenal shunt procedure is an innovative surgical intervention that offers a viable option for the management of portal hypertension. Abstract Portal hypertension is the second most common gastrointestinal bleeding in cirrhosis and non-cirrhosis patients. The splenorenal shunt surgery is a potential intervention that may be considered for portal hypertension patients with clinical symptoms such as upper gastrointestinal bleeding caused by the rupture of gastro-esophageal varices. In this study, the researchers aimed to analyze the efficacy, clinical outcomes, and safety of splenorenal shunt surgery in portal hypertension patients. The sources were obtained from electronic search databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords "Efficacy," "Safety," and "Clinical Outcomes." in relation to splenorenal shunt surgery in portal hypertension patients. The researchers set specific criteria for inclusion and exclusion to select the articles. This systematic review revealed the efficacy of the splenorenal shunt procedure with favorable outcomes. The success rate of splenorenal shunt surgery in reducing the clinical symptoms of portal hypertension varied between 66% and 100%. The prevailing complications observed in this study were shunt thrombosis, rebleeding, and thrombocytopenia. However, notable improvements could be achieved with general treatment. In terms of short- and long-term clinical outcomes, the splenorenal shunt procedure demonstrated favorable results. It can be concluded that splenorenal shunt surgery provides excellent clinical outcomes and should be considered a viable treatment option for patients with both cirrhotic and non-cirrhotic portal hypertension.