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Pemberdayaan Kader Pos Kesehatan Pesantren (POSKESTREN) dalam Penanganan Kegawatdaruratan di Pondok Pesantren Jabal Nur Kandis Kabupaten Siak Riau Fajri Marindra Siregar; Riki Sukiandra
Engagement: Jurnal Pengabdian Kepada Masyarakat Vol 4 No 2 (2020): November 2020
Publisher : Asosiasi Dosen Pengembang Masyarajat (ADPEMAS) Forum Komunikasi Dosen Peneliti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52166/engagement.v4i2.421

Everyone including santri should have the ability to handle day-to-day emergencies. This community service activity aims to empower students who are cadres of Pesantren (Islamic Boarding House/Schools) health posts (Poskestren) in dealing with emergency cases. The community service was carried out by applying the Asset Based Community Development (ABCD) approach, by providing training to Poskestren cadres in the form of lectures and case simulations for handling situations and victims. Based on the results of the evaluation, it was found that there was an increase in the knowledge of the participants before and after participating in the activity, which means that the activity had a positive impact on the Pesantren students.

Overview of Ischemic Stroke Risk Factors in the Neurology Ward Patient of Arifin Achmad Hospital, Riau Province Yossi Maryanti; Enny Lestari; Riki Sukiandra; Nadia Salvira; Rahma Dani; Ahza Chairum Mulia
Nusantara Science and Technology Proceedings 4th Riau Medical Scientific and Expo 2022
Publisher : Future Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/nstp.2022.2829

Stroke is a disease that continues to be one of the leading health problems in Indonesia and throughout the world. Stroke is the second leading cause of death and the leading preventable cause of disability after heart disease. Risk factors have an essential role in the occurrence of stroke. Control of risk factors is an important factor in the treatment of stroke. This study aims to describe the risk factors of ischemic stroke patients treated in the neurology ward of Arifin Achmad Hospital, Riau Province. This research is descriptive by looking at data from medical records from July 2022 until October 2022. The inclusion criteria were all stroke patients who were treated at the Arifin Achmad Regional Hospital, Riau Province, the exclusion criteria were patients with incomplete data. The data were processed and then analyzed. This study obtained a sample of 60 people. In this study, the number of male samples was 34, and the female sample was 26. Based on the risk factors, 22 patients (36.7%) had a history of hypertension, one patient (1.7%) had a history of diabetes mellitus (1.7%), two patients (3.3%) had a history of heart disease, four patients (6.7) had a history of smoking, and 31 patients (51,7%) patients had a history of mixed risk factors (having more than one risk factor). From this study, it can be concluded that ischemic stroke patients treated in the neurological ward of Arifin Achmad Hospital, Riau Province, mostly have more than one risk factor for stroke occurrence.

Hubungan Disfagia Dengan Kejadian Gangguan Elektrolit Pada Pasien Stroke Iskemik Yang Dirawat Di Bangsal Saraf RSUD Arifin Achmad Provinsi Riau Tahun 2023 Sukiandra, Riki
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.518

Introduction: Ischemic stroke is the most common type of stroke according to the South East Asian Medical Information Center (SEAMIC). The prevalence of stroke in Riau is 8.3%, which has increased from 2013. One of the symptoms of ischemic stroke is dysphagia which is defined as difficulty swallowing, which means difficulty passing food from the mouth to the stomach. This symptom is of concern because it is a common cause of dehydration resulting in electrolyte imbalance, stroke associated pneumonia (SAP) which can increase mortality rates. The need for early detection of dysphagia can reduce the incidence of electrolyte disorders. Aim: To determine the relationship between dysphagia and the incidence of electrolyte imbalance in ischemic stroke patients treated in the neurology ward of Arifin Achmad Regional Hospital, Riau Province. Methods: This research is an analytical research with a cross sectional method. The research will be carried out in the neurological ward of Arifin Achmad Regional Hospital, Riau Province from August Ã¢â‚¬â€œ November 2023. Results: In this study, it was found that 42.5% of ischemic stroke patients experienced dysphagia with the characteristics of the majority being 51-60 years old (41.2%) male (58.8%) with a frequency of first stroke attacks (52.9%) and the majority had multiple risk factors (70.6%). The majority of electrolyte levels in dysphagia patients have low electrolyte levels. The most common lesion locations in dysphagia patients were subcortical and combined (35.3%). There was a significant relationship between dysphagia and the incidence of electrolyte disturbances (p=0.000). Discussion: Lack of fluid intake that does not reach optimal needs can be a risk of dehydration which can lead to electrolyte disorders. Dysphagia directly interferes with the ability to eat and drink so that intake is not strong. This can affect water and electrolyte balance Keywords: dysphagia, electrolyte imbalance, ischemic stroke

PROFIL KLINIS DAN LUARAN PASIEN STROKE-ASSOCIATED PNEUMONIA (SAP) DI RSUD ARIFIN ACHMAD PROVINSI RIAU Juananda, Desby; Sukiandra, Riki; Maryanti, Yossi; Sucipto, Sucipto; Rahmata Illahi, Annisa; Luo Putra Fau, Joyada; Muslimah Syahrianti, Ukhty
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

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

Introduction: Stroke-associated pneumonia (SAP) is a post-stroke complication that increases morbidity and mortality. Aim: This study aims to examine the clinical characteristics and outcomes to facilitate appropriate clinical decision-making for the treatment and prevention of post-stroke complications. Methods: This cohort retrospective study utilizes medical records of SAP patients at RSUD Arifin Achmad from July 2019 to June 2024. The populations were patients who have developed pneumonia within 48 hours to 7 days after stroke onset. Results: Out of 1,040 stroke patients, 108 (10.4%) developed SAP, with 66.7% classified as definite cases and 33.3% as probable cases. Patients in the Ã¢â€°Â¥60 age group accounted for the highest number of cases (54.6%), with a male-to-female predominance of 64.8%. SAP occurred more frequently in ischemic stroke (68.5%) compared to hemorrhagic stroke (31.5%). Most SAP patients required mechanical ventilation (52.8%). SAP patients required hospitalization, with 45.4% staying for Ã¢â€°Â¤14 days and 53.7% for >14 days. Regarding comorbidities, SAP patients also suffered from hypertension (54.1%), followed by other comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease (COPD), and atrial fibrillation (AF). The blood glucose levels upon hospital admission indicated that SAP patients had a glucose distribution range of 80-144 mg/dl (53.7%), 145-179 mg/dl (14.8%), and Ã¢â€°Â¥180 mg/dl (31.5%). The mortality rate was 57.4%, resulting in 62 deaths. Discussion: This study reveals a significant incidence of SAP in older male stroke patients, especially those with ischemic strokes. The strong association to ventilator use and mortality rates emphasizes the need for early identification and management strategies.

The Eye as a Window to Systemic Hemodynamics: A Novel Approach to Estimating Central Venous Pressure via Tonometry in Sepsis M. Irvan Noorrahman; Nopian Hidayat; Riki Sukiandra; Pratama Ananda
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1473

Background: Effective hemodynamic management in sepsis is critical, yet current practices are constrained by the risks and interpretive challenges of invasive central venous pressure (CVP) monitoring. The clinical utility of CVP is debated, fueling the search for safer alternatives. This study investigates a novel approach, exploring intraocular pressure (IOP) as a non-invasive surrogate for CVP, predicated on the direct anatomical link between the ocular venous drainage system and the central circulation. Methods: We conducted a prospective, single-center observational study in a tertiary intensive care unit, enrolling 20 adult patients with sepsis and indwelling central venous catheters. High-fidelity measurements of CVP via a pressure transducer and IOP via Perkins applanation tonometry were performed simultaneously. Data were collected at a baseline steady-state and again 15 minutes after a standardized fluid challenge (median volume 300 mL) to assess the dynamic relationship. The association was quantified using Pearson correlation and modeled with simple linear regression. Results: A strong, statistically significant positive correlation was observed between CVP and IOP at baseline (r=0.756, p=0.001). This physiological coherence was profoundly amplified following the fluid challenge, strengthening to a very strong correlation (r=0.947, p<0.001). The post-challenge data yielded a robust, preliminary predictive model, defined by the equation: CVP (mmHg) = -0.619 + (0.522 x IOP (mmHg)). The slope of this relationship was precisely estimated (95% CI: 0.435 to 0.609). The model demonstrated high predictive power, with post-challenge IOP accounting for 89% of the variance in CVP (R²=0.89). Conclusion: This pilot investigation provides compelling evidence for a strong and dynamic correlation between IOP and CVP in critically ill patients with sepsis. The findings suggest that ocular tonometry shows significant promise as a non-invasive method for assessing right-sided filling pressures and, more importantly, for tracking the dynamic response to fluid therapy, thereby offering a potential window into venous congestion. While intriguing, these results are from a small cohort. The derived formula is strictly hypothesis-generating and requires extensive validation in larger, more diverse clinical trials before any potential for clinical application can be considered.

Pembentukan Dan Pelatihan Kader Pos Kesehatan Pesantren Imam Adz-Dzahabi Kabupaten Kampar Firdaus; Winarto, Winarto; Sukiandra, Riki; Sofian, Amru
Jurnal Pengabdian UntukMu NegeRI Vol. 7 No. 1 (2023): Pengabdian Untuk Mu negeRI
Publisher : LPPM UMRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37859/jpumri.v7i1.4875

Islamic Boarding School Health Post (POSKESTREN) is one form of community-based health efforts in the Islamic boarding school environment. The Imam Adz-Dzahabi Islamic Boarding School, which is located in Tambang District, Kampar Regency, Riau Province, already has a health post, but its management has not been implemented. The purpose of this service activity is to increase the knowledge of Poskestren managers and Santri Husada about the steps for establishing Poskestren, provide training in self-reflection surveys, and also provide training in the formulation of work programs. The socialization of Poskestren management and self-reflection survey training was well carried out in the presence of 33 participants, consisting of 3 Poskestren managers and 30 Santri Husada. There was an increase in participants' knowledge about the steps for establishing Poskestren. Participants can also practice self-reflection surveys and develop a program of Poskestren activities.

The Eye as a Window to Systemic Hemodynamics: A Novel Approach to Estimating Central Venous Pressure via Tonometry in Sepsis M. Irvan Noorrahman; Nopian Hidayat; Riki Sukiandra; Pratama Ananda
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1473

Background: Effective hemodynamic management in sepsis is critical, yet current practices are constrained by the risks and interpretive challenges of invasive central venous pressure (CVP) monitoring. The clinical utility of CVP is debated, fueling the search for safer alternatives. This study investigates a novel approach, exploring intraocular pressure (IOP) as a non-invasive surrogate for CVP, predicated on the direct anatomical link between the ocular venous drainage system and the central circulation. Methods: We conducted a prospective, single-center observational study in a tertiary intensive care unit, enrolling 20 adult patients with sepsis and indwelling central venous catheters. High-fidelity measurements of CVP via a pressure transducer and IOP via Perkins applanation tonometry were performed simultaneously. Data were collected at a baseline steady-state and again 15 minutes after a standardized fluid challenge (median volume 300 mL) to assess the dynamic relationship. The association was quantified using Pearson correlation and modeled with simple linear regression. Results: A strong, statistically significant positive correlation was observed between CVP and IOP at baseline (r=0.756, p=0.001). This physiological coherence was profoundly amplified following the fluid challenge, strengthening to a very strong correlation (r=0.947, p<0.001). The post-challenge data yielded a robust, preliminary predictive model, defined by the equation: CVP (mmHg) = -0.619 + (0.522 x IOP (mmHg)). The slope of this relationship was precisely estimated (95% CI: 0.435 to 0.609). The model demonstrated high predictive power, with post-challenge IOP accounting for 89% of the variance in CVP (R²=0.89). Conclusion: This pilot investigation provides compelling evidence for a strong and dynamic correlation between IOP and CVP in critically ill patients with sepsis. The findings suggest that ocular tonometry shows significant promise as a non-invasive method for assessing right-sided filling pressures and, more importantly, for tracking the dynamic response to fluid therapy, thereby offering a potential window into venous congestion. While intriguing, these results are from a small cohort. The derived formula is strictly hypothesis-generating and requires extensive validation in larger, more diverse clinical trials before any potential for clinical application can be considered.

Nerve Conduction Study (NCS) in Patients with Cervical Radiculopathy at Arifin Achmad General Hospital, Riau Province Sukiandra, Riki; Putri, Azzahra Nur Aulya; Juananda, Desby; Maryanti, Yossi
Frontiers on Healthcare Research Vol. 2 No. 1 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n1.p9-14.2025

Background: Radiculopathy is one of the most common causes of neck pain in everyday clinical practice. Radiculopathy can occur in the cervical segment. The prevalence of cervical radiculopathy is lower than lumbar radiculopathy. NCS is an attempt to confirm the diagnosis of radiculopathy. This study aims to describe the NCS findings in cervical radiculopathy patients at RSUD Arifin Achmad, Riau Province. Methods: This descriptive quantitative study was conducted from January to September 2024 at RSUD Arifin Achmad, Riau Province, using total sampling. Data from NCS tests, including latency, amplitude, nerve conduction velocity (NCV), and F-wave parameters for motor and sensory nerves, were analyzed using descriptive statistics. Result: The majority of the results were ≥40 years old (69.2%), female (61.5%), and predominance of one extremity testing in cervical radiculopathy (60%). NCS of cervical radiculopathy motor, n.medianus latency was elongated (5.13 ± 2.22 ms), amplitude was normal (4.42 ± 3.03 mV), and KHS was decreased (46.50 ± 11.79 m/s). The n.ulnaris latency lengthened (4.49 ± 5.53 ms), amplitude shortened (5.02 ± 2.70 mV), and KHS decreased (46.44 ± 16.51 m/s). The n.radialis latency (2.34 ± 0.98 ms), amplitude (3.25 ± 0.98 mV), and KHS (78.91 ± 27.47 m/s) were normal. Cervical radiculopathy sensory NCS, n.medianus latency was normal (2.86 ± 0.51 ms), amplitude shortened (19.37 ± 19.38 µV), and KHS decreased (43.82 ± 20.27 m/s). In n.ulnaris, latency lengthened (3.30 ± 1.78 ms), amplitude was normal (17.13 ± 13.98 µV), and KHS decreased (42.62 ± 16.63 m/s). The n.medianus (26.47 ± 2.74 ms) and ulnar (24.83 ± 1.63 ms) F-waves were normal. Conclusion: NCS findings in cervical radiculopathy patients at RSUD Arifin Achmad reveal prolonged distal latency, decreased nerve conduction velocity, and reduced amplitude, suggesting demyelination and axonal loss. These results reinforce the role of NCS as a key diagnostic tool for cervical radiculopathy. Further research is needed to evaluate its correlation with clinical severity.

Incidence and Risk Factors of Stroke-Associated Pneumonia in Ischemic Stroke with Dysphagia: A Cross-Sectional Study Sukiandra, Riki; Maryanti, Yossi; Sucipto; Juananda, Desby; Trihardi, Rizfan; Risman, Salsa Wiratama; Qadriyyah, Lu’lu’ul; Ashiddiqi, Hafil
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p51-57.2025

Background: Stroke-associated pneumonia (SAP) is a common and debilitating complication following stroke, typically occurring within the first 7 days of onset in about one-third of patients with acute ischemic stroke. SAP significantly contributes to increased morbidity, mortality, and healthcare costs due to prolonged hospitalizations. In Riau, the reported prevalence of stroke is 8.3%, which has been rising since 2013, alongside an increase in SAP cases. Dysphagia, defined as difficulty swallowing, is a major risk factor for SAP as it predisposes patients to aspiration, a leading cause of pneumonia. If left untreated, dysphagia can lead to dehydration and electrolyte imbalance. Despite the clinical importance of SAP, local data regarding its incidence and associated risk factors at Arifin Achmad General Hospital in Riau Province is lacking. This study aims to investigate the incidence and risk factors associated with SAP in ischemic stroke patients with dysphagia. The findings are expected to provide evidence-based references to improve neurointensive care and preventive strategies for SAP in this patient population. Methods: This cross-sectional study was conducted at Arifin Achmad General Hospital, Riau Province, from August to November 2023. Ischemic stroke patients who underwent the Water Swallow Test (WST) were included. Dysphagia, electrolyte imbalance, and SAP were the key variables. Data were collected from medical records and observation sheets. Statistical analysis was performed using the Chi-square test (p < 0.05) with SPSS version 25. Results: The study found that 37.5% (15 patients) of ischemic stroke patients developed stroke-associated pneumonia, while 42.5% experienced dysphagia. The majority of these patients were aged 51-60 years (41.2%), male (58.8%), had their first stroke attack (60%), and had multiple risk factors (73.3%). A significant number of dysphagia patients had low electrolyte levels. The most common lesion locations in dysphagia patients were bilateral (66.7%). There was a significant correlation between dysphagia and the incidence of SAP (p=0.000). Patients with dysphagia had 78.75 times higher odds of developing SAP (95% CI: 9.95-622.6) compared to those without dysphagia. Conclusion: SAP is a frequent complication in ischemic stroke patients. Future prospective studies should adopt a unified definition, strict inclusion criteria, and long-term follow-up to better identify the incidence, prognosis, and related factors of SAP.

Comparing Postoperative Fentanyl Use: Ibuprofen VS Ibuprofen-Dexamethasone as Preemptive Analgesia Herman, Awanda; Hidayat, Nopian; Sukiandra, Riki; Johannas
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p45-50.2025

Background: Fentanyl is the most frequently used opioid analgesic for managing postoperative pain. While effective, it is associated with various side effects. Postoperative pain is mainly due to acute tissue damage. Several studies have shown that administering preemptive analgesia before anesthesia can help reduce postoperative pain, thus decreasing the need for fentanyl and its side effects. Methods: This research employed a randomized controlled trial (RCT) with a double-blind design. Postoperative pain was measured using the Numeric Rating Scale (NRS). Patients with an NRS score above 6 received fentanyl. Statistical analysis was conducted to compare the impact of preemptive analgesia with Ibuprofen 800 mg alone versus Ibuprofen 800 mg combined with Dexamethasone 10 mg in patients undergoing postoperative gynecological abdominal surgery. Results: The findings revealed a significant difference in NRS pain scores between the groups. The group receiving the combination of Ibuprofen 800 mg and Dexamethasone 10 mg had a 69% reduction in the need for postoperative fentanyl compared to the group that received only Ibuprofen. Conclusion: Patients who received preemptive analgesia with Ibuprofen and Dexamethasone had lower pain scores and a reduced need for fentanyl in the postoperative period compared to those receiving Ibuprofen alone.

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