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All Journal Jurnal Kedokteran Brawijaya Medula JUSTICIA SAINS: Jurnal Ilmu Hukum Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Khadafi Indrawan
Program Pendidikan Dokter Fakultas Kedokteran Universitas Brawijaya
Education Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health

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EFEK KOMBINASI ARTEMISININ DAN N-acetylcysteineTERHADAP KADAR Malondialdehyde(MDA) OTAK DAN PARU MENCIT GALUR Balb/c YANG DIINFEKSI Plasmodium berghei Fitri, Loeki Enggar; Iskandar, Agustin; Permatasari, Nur; Gunawan, Joko Agus; Indrawan, Khadafi
Jurnal Kedokteran Brawijaya Vol 24, No 2 (2008)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.577 KB) | DOI: 10.21776/ub.jkb.2008.024.02.4

Abstract

Cerebral and lung damage during malaria infection is believed to be caused by free radicals activitiesthat are produced during immunology process. The free radicals react with lipid component of cellular membrane which generates malondialdehyde (MDA) as its end-product. The aim of the research was to determine whether combination of artemisinin and NAC was moreeffective in decreasing cerebral and lung MDA level compared to artemisinin mono-therapy . The researchwas post-test-control-only design using 5 groups consisted of group A (negative control group), group B mice which infected with P.berghei without therapy (positive control group), group C mice which infected with P.berghei and received artemisinin mono-therapy (0.04 mg/g BW for 7 days), group D mice which infected with P.berghei and received artemisinin in combination with NAC (1 mg/g BW for 7 days) and group E mice which infected with P.berghei and received artemisinin in combination with NAC (1 mg/g BW for 3 days and tapered into ½ mg/g BW for 4 days). On the 3rd, 5th,and 7thday, 3 mice from each group were scarified and assayed for MDA level. On the 3rd day, a decreasing trend of cerebral and lung MDA level wasobserved on all treatment groups. On the 5thday, a decreasing trend of cerebral and lung MDA level wasobserved in group that received artemisinin and NAC whereas group’s that received artemisinin mono-therapy increased. Cerebral and lung MDA level of groupthat received artemisinin mono-therapy was significantly different with group that received combination of artemisinin and NAC in constant dose (p = 0.014) and with group that received combination artemisinin  and NAC in tapering dose (p = 0.004).
Peran Majelis Kehormatan Disiplin Kedokteran Indonesia Dalam Kasus Pelanggaran Standar Profesional Dokter Indrawan, Khadafi; Fakih, M.; Budiyono, Budiyono
JUSTICIA SAINS - Jurnal Ilmu Hukum Vol 9, No 2 (2024): JUSTICIA SAINS: Jurnal Ilmu Hukum
Publisher : Universitas Sang Bumi Ruwa Jurai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24967/jcs.v9i2.3288

Abstract

In Indonesia, the increase in the number of medical disputes reflects dissatisfaction with health services. This study aims to analyze the role of MKDKI as a law enforcement tool in cases of violation of doctors' professional standards, as well as supporting and inhibiting factors for the implementation of this role. The research method used is the empirical normative method. The data collected was analyzed to identify how MKDKI carried out its role in handling violation cases. The results of the study show that the Government has established laws and established KKI, MKDKI, and MKEK to protect the doctor-patient relationship. This panel assesses disciplinary violations based on operational and professional standards. The effectiveness of the Assembly is influenced by regulations, member commitment, institutional support, and resources. Obstacles such as inadequate regulation and external intervention need to be overcome through regulatory revision strategies, increased resources, and transparency. The suggestion in this study is to increase transparency and consistency in handling cases of violations of doctors' professional standards, the Indonesia Medical Honorary Council (MKDKI) needs to be supported by strong regulations and the support of related institutions. It is also important to establish MKDKI in each province and conduct socialization about their roles, as well as ensure that their decisions are in line with the Indonesia Medical Council (KKI)
Plasmapheresis and Multidisciplinary Intensive Care Management for Guillain-Barré Syndrome with Prolonged Mechanical Ventilation: A Case Report Indrawan, Khadafi; Manggala, Sidharta Kusuma
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.249

Abstract

Guillain-Barré syndrome (GBS) is a rare, acute autoimmune peripheral neuropathy often triggered by infections. It leads to rapid-onset muscle weakness and, in severe cases, respiratory failure requiring mechanical ventilation. Plasmapheresis is recommended to reduce circulating autoantibodies that damage peripheral nerves. Guidelines suggest that early initiation of plasmapheresis may improve clinical outcomes, especially in patients with significant motor weakness. A 41-year-old female was referred to the emergency room with progressive ascending bilateral limb weakness, sensory deficits, and urinary incontinence. Symptoms emerged 26 days prior and treatments from previous hospitals were ineffective. Physical examination revealed cranial nerve involvement, proprioceptive disturbance, and reduced deep tendon reflexes. Laboratory tests showed leukocytosis, thrombocytosis, hypoalbuminemia, electrolyte imbalance, and elevated D-dimer. Cerebrospinal fluid analysis was normal. The patient was diagnosed with GBS, intubated by day six post-admission due to respiratory failure and tracheotomized by day eight. The patient was admitted to the intensive care unit. Plasmapheresis, initiated on day 17, improved motor strength after three sessions spaced over 10 days. However, delayed intervals between sessions and limited access potentially impeded the recovery process. Despite improvements, the patient remained ventilator-dependent and require multidisciplinary interventions. Inhalation therapy, enteral feeding, physical rehabilitation, and psychiatric interventions were administered. The family was informed of potential long-term ventilator dependency and home care preparation. This case underscores the importance of timely plasmapheresis and coordinated, multidisciplinary ICU management in severe GBS, encompassing neurological treatment, respiratory care, nutrition management, physical rehabilitation, and psychological support for the patient and their caregivers.
Komplikasi Spinal Anastesi Pada Pasien Operasi: Literature Review Sujadi, Didi; Suharmanto, Suharmanto; Indrawan, Khadafi
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1646

Abstract

Abstract Spinal anesthesia is a commonly used anesthetic technique in various surgical procedures. Most operations are performed using spinal anesthesia rather than general anesthesia or local anesthesia. Spinal anesthesia is a regional anesthetic technique that involves injecting a local anesthetic into the subarachnoid space. Spinal anesthesia can avoid the risks of failed endotracheal intubation and the possibility of aspiration of gastric contents during general anesthesia, and can provide patient satisfaction. This article was written using a literature review method conducted through a literature search of various national and international journals. Journal articles from 2015 to 2025 served as the basis for the article used. References used were searched through the Pubmed, NCBI, and Google Scholar databases. The reading sources used were then analyzed using a systematic literature review method, which includes the activities of collecting, evaluating, and developing research with a specific focus. Spinal anesthesia, while having advantages, can also cause several complications. Complications of spinal anesthesia can include hypothermia, shivering, post-operative nausea and vomiting (PONV), post-dural puncture headache (PDPH), high or total spinal block, and urinary retention.
MANAJEMEN ANESTESI PADA PASIEN TUMOR TIROID DEXTRA SUSPEK KEGANASAN: SEBUAH LAPORAN KASUS Salsabila, Indah; Indrawan, Khadafi
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1683

Abstract

Thyroid nodules are excessive growth and structural changes with or without functional changes in one or more parts of the thyroid tissue. The prevalence of thyroid cancer is 4-6% of thyroid nodules ( both of single or multiple nodules). Thyroid cancer is the most common endocrine malignancy with an incidence of 3.1% worldwide. One of the treatments for thyroid cancer is thyroidectomy. Indications for thyroidectomy are thyroid malignancy, obstructive symptoms, retrosternal goiter and Graves' disease unresponsive to medical treatment, recurrent hyperthyroidism, Hashimoto's disease and for cosmetic reasons. Thyroid malignancy poses several difficulties in anesthesia. Airway management in patients who have cancer in the head and neck may experience abnormal changes in the airway anatomy. Therefore, it is necessary to prepare an anesthesia plan as well as appropriate pre-operative, intra- operative and post-operative management so that the operation runs smoothly and safely and reduces morbidity and mortality in patients.
Pencegahan Hipotensi Pasca Anestesi Spinal pada Operasi Sectio Caesarea: Literature Review Indahsari, Verra Rachma; Indrawan, Khadafi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1766

Abstract

Spinal anesthesia is widely used for cesarean section, but it often causes hypotension due to sympathetic blockade, making vasopressor prophylaxis necessary. Ephedrine has long been the traditional choice, although several studies have linked it to a higher risk of neonatal acidosis. Phenylephrine is now more commonly recommended because of its effectiveness in maintaining blood pressure, while recent evidence suggests that norepinephrine may provide comparable hemodynamic stability with a lower incidence of maternal bradycardia. Literature searching was performed through PubMed, Google Scholar, and ScienceDirect using keywords related to ephedrine, phenylephrine, norepinephrine, hypotension, and spinal anesthesia for cesarean delivery. Articles discussing vasopressor use for the prevention or management of hypotension were reviewed and summarized narratively. The findings indicate that phenylephrine effectively maintains blood pressure but may cause bradycardia; norepinephrine at doses of 0.05 µg/kg/min offers hemodynamic stability similar to phenylephrine 0.625 µg/kg/min, with no significant differences in neonatal outcomes across several studies; and ephedrine remains useful, especially when maternal bradycardia occurs, although some research reports a higher risk of neonatal acidosis. Overall, the evidence is mixed and does not show clear superiority of one vasopressor over another. Both phenylephrine and norepinephrine can be used for prophylaxis of spinal-induced hypotension in cesarean section, each with its own advantages and limitations, while ephedrine remains relevant in specific situations. Further studies are needed to establish more definitive recommendations regarding the optimal vasopressor choice.
Manajemen Jalan Napas Sulit pada Pasien Dewasa: Literature Review Sianturi, Aditya Gloria Monalisa; Indrawan, Khadafi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1767

Abstract

Difficult airway is a clinical situation in which a healthcare provider who is skilled at airway management encounters difficulty with one or more standard methods of airway management. Difficult airway may obstruct mask ventilation or increase the risk of failed intubation attempts. The purpose of this literature review is to understand the management of difficult airway on adult patient. The method used in this literature review involved searching for literature published between 2018 into 2023 on NCBI, PubMed, and Google Scholar databases, focusing on management of difficult airway on adult patient. Then, literature was analyzed using systematic literature review method, which included data collection and evaluation activities in accordance with the objective of the literature review. There are several indicators of difficult airway, which are face mask ventilation, laryngoscopy, supraglottic airway ventilation, tracheal intubation and extubation, and invasive airway. In addition, there are several predictors as a reference in identifying difficult airway, which are LEMON mnemonic  and MOANS mnemonic. After a difficult airway has been identified, there are several interventions that can be apply, which are awake tracheal intubation, anesthetized tracheal intubation, and mixed intubation.
Pertimbangan Anestesi Preoperatif, Intraoperatif dan Pascaoperatif pada Pasien Geriatri: Literature Review Devi, Putri Puspa; Indrawan, Khadafi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1768

Abstract

Geriatric patients commonly experience multiple anatomical and physiological changes related to the aging process, involving the cardiovascular, respiratory, metabolic, endocrine, digestive, nervous, and musculoskeletal systems. These changes increase perioperative risks associated with anesthesia and contribute to higher morbidity and mortality rates. This literature review aims to minimize undesirable events and complications that may occur during the preoperative, intraoperative, and postoperative phases in geriatric patients. The method used involved a literature search of studies published between 2015 and 2025 using the NCBI, PubMed, and Google Scholar databases, focusing on anesthetic considerations in geriatric patients across perioperative phases. Selected articles were analyzed using a systematic literature review approach, including data collection, evaluation, and synthesis in accordance with the review objectives. The findings indicate that preoperative preparation in elderly patients should include comprehensive functional assessment to identify cognitive impairment, reduced cardiopulmonary reserve, depression, frailty, nutritional status, polypharmacy, and anticoagulation issues. Intraoperative management involves appropriate selection of anesthetic techniques and pharmacological agents, close monitoring, careful fluid or intravenous transfusion management, adequate pulmonary ventilation, and prevention of hypothermia. Postoperative considerations include effective perioperative analgesia, prevention and early detection of postoperative delirium and cognitive dysfunction, as well as monitoring for other potential complications. A comprehensive and integrated anesthetic approach is essential to improve patient safety and optimize clinical outcomes in the geriatric population undergoing surgical procedures.
Co-Authors Agustin Iskandar Budiyono Budiyono Devi, Putri Puspa Indahsari, Verra Rachma Joko Agus Gunawan Loeki Enggar Fitri M. Fakih Manggala, Sidharta Kusuma Nur Permatasari Salsabila, Indah Sianturi, Aditya Gloria Monalisa Suharmanto Sujadi, Didi