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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi E-Jurnal Medika Udayana The Indonesian Biomedical Journal JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Indonesian Archives of Biomedical Research (InABR) Cermin Dunia Kedokteran Jurnal Neuroanestesi Indonesia Physical Therapy Journal of Indonesia Cermin Dunia Kedokteran
Sri Maliawan
Department Of Neurosurgery, Faculty Of Medicine Udayana University/Sanglah General Hospital, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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PENYULUHAN KESEHATAN TENTANG PENTINGNYA MENGGUNAKAN HELM SAAT BERKENDARA DENGAN SEPEDA MOTOR S. Maliawan; N. Golden; T.G.B. Mahadewa; I.W. Niryana; D.P.W. Wardhana; S. Awyono; K.K. Putra
Buletin Udayana Mengabdi Vol 23 No 2 (2024): Buletin Udayana Mengabdi
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/BUM.2024.v23.i02.p10

Abstract

In the year of 2020, 100.028 cases of traffic accident were noted in Indonesia, according to data from the Traffic Corps of the Republic of Indonesia Police (Korlantas Polri). To reduce poor long-term outcome of head injury, a need of appropriate prevention is needed. One easy and effective way to do this is to drive safely according to the traffic guidelines to hinder accident and to wear a helmet. Usage of helmet could effectively protect agains severe and lethal head injury. The basis of university education is the tri dharma which includes education, research, and community service. Bedah Saraf Bersama Masyarakat held by Neurosurgery Residency Programme in FK UNUD / RSUP Sanglah created a health promotion as a form of community service. Health promotion on the importance of using helmet while riding a motorcycle was conducted at PRO 2 RRI FM. Our goal is to educate about the potential for head injuries while driving a motor vehicle and educate the public about the importance of using a helmet when riding a motorcycle. Keywords : Head injury, helmet, health promotion, motorcyc
RESUSITASI OTAK PADA PASIEN CEDERA KEPALA BERAT DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR TAHUN 2020 Dwikinta, Made Anindya; Mahadewa, Tjokorda Gde Bagus; Maliawan, Sri; Niryana, I Wayan
E-Jurnal Medika Udayana Vol 13 No 2 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i02.P15

Abstract

ABSTRACT Head injury is a serious problem worldwide and causes morbidity and mortality at a young age. The increase in the number of severe head injuries continues to occur along with the number of accidents. This study aimed to examine the characteristics of brain resuscitation in patients with a severe head injury. Descriptive research with cross-sectional research method and the data obtained as many as 35. Data processing using SPSS and displayed in a distribution table according to the variables. This study found that patients with severe head injuries were most often at the age of >45 years, namely 18 people (51.4%), and male sex was more common than women as many as 24 people (68.6%). The most common GCS was found with GCS 3-5 as many as 21 people (60%). The brain resuscitation regimen in patients with a severe head injury was given crystalloid solution (0.9% NaCl, Ringer's lactate) in 35 people (100%), mannitol 20% in 22 people (62.9%), and phenytoin in 33 people (94.3%). The GOS value of all patients with severe head injury with a GOS value of 1 or died (100%). Most deaths from severe head injury patients were in the first <48 hours as many as 27 people (77.1%) Keywords : brain resuscitation, traumatic brain injury, severe head injury.
KARAKTERISTIK HIDROSEFALUS PADA USIA DEWASA Arasy, Mohd Firdaus; Mahadewa, Tjokorda Gde Bagus; Niryana, , I Wayan; Maliawan, Sri
E-Jurnal Medika Udayana Vol 12 No 6 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i06.P09

Abstract

Istilah hidrosefalus berasal dari dua kata yaitu "hydro" dan "cephalous" yang masing-masing mewakili air dan otak. hidrosefalus adalah komplikasi ketika cairan dalam hal ini cairan serebrospinal (LCS) terbentuk di dalam rongga-rongga jauh di dalam otak, kelebihan cairan ini meningkatkan ukuran ventrikel sehingga meningkatkan tekanan keseluruhan pada otak. Cairan serebrospinal dalam keadaan normal akan mengalir melalui ventrikel dan serebral dan juga medula spinalis. Rangkuman menyeluruh dalam bentuk systematic review mengenai karakteristik pasien hidrosefalus pada usia dewasa. Protokol dalam studi ini menggunakan The Centre for Review and Dissemination and The Joanna Briggs Institute (JBI) Guideline sebagai panduan dalam asesmen kualitas dari studi yang akan dirangkum. Evaluasi dari systematic review akan menggunakan PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist untuk menentukaan penyelesaian studi yang telah ditemukan dan disesuaikan dengan tujuan dari systematic review. Berdasarkan 9 artikel studi, gejala klinis yang sering ditemukan pada pasien hidrosefalus berdasarkan data yang terdapat pada 3 artikel studi adalah gangguan gaya berjalan. Berdasarkan data pada 3 artikel studi, komorbid yang sering ditemukan adalah hipertensi (1.503 pasien) yang diikuti dengan diabetes mellitus dalam 4 studi artikel dengan jumlah pasien sebanyak 893 pasien. Dalam 4 artikel studi, didapatkan bahwa jenis intervensi yang diberikan kepada pasien berupa shunt treatment dengan mayoritas adalah Ventriculoperitoneal shunt (VP shunt) sebanyak 1.563 pasien. Berdasarkan hasil dan pembahasan dalam systematic review ini, dapat disimpulkan bahwa karakteristik hidrosefalus pada usia dewasa didominasi oleh jenis kelamin laki-laki, dengan gejala klinis yang sering ditemukan berupa gangguan gaya berjalan. Kebanyakan pasien memiliki komorbid hipertensi dan mendapatkan intervensi berupa ventriculoperitoneal shunt (VP shunt).
SKOR GLASGOW COMA SCALE (GCS) SEBAGAI FAKTOR RESIKO TERHADAP LAMANYA MASA RAWAT INAP PADA PASIEN EPIDURAL HEMATOMA (EDH) DI RSUP SANGLAH PERIODE 2018-2019 Mardliyah, Mumtazah; Niryana, I Wayan; Maliawan, Sri; Mahadewa, Tjokorda Gde Bagus
E-Jurnal Medika Udayana Vol 11 No 9 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i9.P11

Abstract

Cedera kepala merupakan salah satu masalah penting dalam dunia kesehatan yang harus dihadapi oleh petugas kesehatan. Epidural Hematoma (EDH) merupakan jenis yang paling banyak menjadi perhatian para klinisi dan peneliti karena frekuensi kejadiannya yang tinggi. Kondisi awal pasien pada saat datang ke rumah sakit akan mempengaruhi lamanya masa rawat inap pasien di rumah sakit, diantaranya tingkat kesadaran pasien yang dapat diukur dengan Glasgow Coma Scale (GCS). Penelitian ini bertujuan untuk mengetahui skor GCS sebagai faktor resiko terhadap lamanya masa rawat inap pada pasien Epidural Hematoma (EDH) di RSUP Sanglah periode 2018-2019. Penelitian ini merupakan penelitian observasional analitik dengan menggunakan metode kohort retrospektif dengan jumlah sampel sebanyak 81 orang yang diambil dari data sekunder pasien EDH yang dirawat di RSUP Sanglah periode 2018-2019. Berdasarkan hasil penelitian, ditemukan adanya hubungan bermakna antara Skor GCS dengan lama masa rawat inap (p = 0.000), dengan relative risk ( RR= 3.385), dan adanya hubungan yang bermakna antara ada tidaknya tindakan operasi dengan lama masa rawat inap (p = 0.000), dengan relative risk ( RR= 5.288). Pada penelitian ini menunjukkan skor GCS beresiko mempengaruhi lama masa rawat inap pada pasien EDH. Kata kunci: GCS, EDH, lama masa rawat inap .
KARAKTERISTIK KLINIS CEDERA KEPALA PADA PEDIATRI DI RSUP SANGLAH DENPASAR TAHUN 2020 Gunawan, Made Favian Budi; Maliawan, Sri; Mahadewa, Tjokorda Gde Bagus; Niryana, I Wayan
E-Jurnal Medika Udayana Vol 11 No 5 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i05.P16

Abstract

Head injury is one of many emergency cases in pediatric with high mortality cases. The incidence of pediatric head injury in the world, is in the range of 47-280 per 100,000 inhabitants and a total of more than 3 million cases of head injury in children occur each year. This study aims to find out more about the clinical characteristics of head injuries in children, especially patients treated at Sanglah Hospital Denpasar in 2020. This study was conducted using a cross-sectional descriptive method using secondary data in the form of patient medical records. From the results of the research conducted, it was obtained as many as 86 cases, with the conclusion that the most cases were in the group of adolescent patients, in the age range of 13-18 years (62.8%), with the most mechanism of injury due to traffic accidents without the use of helmets (47.7%), then the most frequent GCS values ??were in the range 14-15 which were classified as mild head injury (55.8%), the most common complaint was headache (79.1%), the most common skull fractures were linear fractures (41 ,9%) and intracranial lesions with the most frequency were epidural hematomas (46.5%). The findings of this study are expected to be used as a basis for further research in pediatric head injury and to increase community awareness about child safety.
Optic Nerve Pilocytic Astrocytoma in a Pediatric Patient: A Case Report Pramantara, I Made Stepanus Biondi; Niryana, I Wayan; Sista Satyarsa, Agung Bagus Sista; Golden, Nyoman; Mahadewa, Tjokorda Gede Bagus; Maliawan, Sri; Suarjaya, I Putu Pramana
Jurnal Neuroanestesi Indonesia Vol 13, No 3 (2024)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i3.594

Abstract

Pilocytic astrocytoma is a type of low-grade glioma that can develop in any part of the central nervous system. It primarily affects individuals in the pediatric and young adult age groups. Optic nerve pilocytic astrocytoma is an uncommon, gradually developing type of brain tumor known as a glioma. It is categorized as a grade I tumor by the World Health Organization (WHO). We aim to report rare optic nerve pilocytic astrocytomas and discuss their clinical findings and interconnection with the current literature. A 7-year-old male patient exhibited left-sided eye proptosis and complete loss of vision. A magnetic resonance imaging (MRI) performed before surgery showed the presence of a tumor in the left eye socket. The mass has a spherical shape and smooth boundaries, resulting in the compression of the left optic tract from behind. The left optic tract appears darker on T1-weighted images and brighter on T2-weighted images. On contrast administration, there is heterogenous contrast enhancement. A total resection of the mass was performed. Histopathology results show pilocytic astrocytoma (WHO Grade I). Optic nerve pilocytic astrocytoma is a tumor that can affect the optic nerve pathway. Early diagnosis and multidisciplinary team management are required. Treatment must be individualized, and the options include chemotherapy, radiotherapy, and surgical intervention. Surgery is only recommended in cases of painful or disfiguring proptosis and exposure keratopathy in eyes with severe vision impairment.
Dormant No More: The Neurogical Impact of Herpes Simplex Virus Reactivation Following Traumatic Brain Injury Johansyah, Theodorus Kevin Putra; Soetomo, Cindy Thiovany; Tiffany, Tiffany; Maliawan, Sri
Jurnal Neuroanestesi Indonesia Vol 14, No 1 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i1.659

Abstract

Herpes simplex viruses (HSV), including HSV-1 and HSV-2, are neurotropic viruses capable of establishing lifelong latency in sensory ganglia and reactivating under various triggers, including traumatic brain injury (TBI). TBI induces secondary injury cascades such as neuroinflammation, excitotoxicity, and blood-brain barrier disruption, which create a conducive environment for HSV reactivation. The reactivation of HSV after TBI, particularly HSV-1 and HSV-2, can lead to significant neurological consequences, including encephalitis, cognitive decline, and the development of neurodegenerative diseases like Alzheimers disease and Chronic Traumatic Encephalopathy. Current therapeutic approaches focus on antiviral agents like acyclovir and valacyclovir, which manage acute HSV infection but are less effective in preventing long-term neurological damage. Emerging research highlights the potential of anti-inflammatory and neuroprotective strategies to complement antiviral therapies, aiming to reduce the neuronal damage caused by viral reactivation and inflammation. However, gaps remain in understanding the precise mechanisms linking TBI-induced neuroinflammation to HSV reactivation and its long-term impact on neurological health. This review synthesizes the current literature on the pathophysiology of HSV reactivation following TBI, and their contributions to acute and chronic neurological outcomes
Kranioplasti untuk Kasus Cedera Kepala Wayan Niryana; Dewa Putu Wisnu Wardhana; Heru Sutanto Koerniawan; Sri Maliawan
Cermin Dunia Kedokteran Vol 45 No 8 (2018): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i8.744

Abstract

Seiring kemajuan teknik operasi bedah saraf, jumlah pasien cedera kepala yang mampu selamat pasca-kraniektomi dekompresi meningkat signifikan. Pasien-pasien tersebut selanjutnya akan menjalani kranioplasti untuk memperbaiki defek kranium. Keuntungan lain prosedur kranioplasti antara lain: menyediakan proteksi otak, pencegahan, atau eliminasi kolapsnya hemisfer otak atau herniasi serebri yang disebut sindrom pasca-trepanasi. Hingga saat ini belum ada material ideal untuk kranioplasti.   Advances in neurosurgery techniques will increase decompressive craniectomy survivors significantly. These patients will undergo cranioplasty to correct the cranium defects. Cranioplasty has other advantages: to provide brain protection, to prevent, or to eliminate brain hemisphere collapse or cerebral herniation called post trephine syndrome. There is no truly ideal material for cranioplasty until now.
Clinical efficacy of bone marrow mesenchymal stem cells in chronic spinal cord injury: A single-arm meta-analysis of clinical trials Wardhana, Dewa Putu Wisnu; Soetomo, Cindy Thiovany; Satyarsa, Agung Bagus Sista; Maliawan, Sri; Mahadewa, Tjokorda Gde Bagus
Physical Therapy Journal of Indonesia Vol. 6 No. 2 (2025): Inpress July-December 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i2.318

Abstract

Background: Chronic spinal cord injury (SCI) leads to irreversible neurological deficits with limited therapeutic options, making it a major challenge in neuroregenerative medicine. This study aimed to evaluate the clinical efficacy of bone marrow mesenchymal stem cells (BMMSC) therapy in patients with chronic SCI using a single-arm meta-analysis. Methods: This research was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, covering studies up to August 2024 in PubMed, CENTRAL, and ScienceDirect. Included trials applied BMMSC therapy in patients ≥1 year post-injury. A random-effects model was employed using R software. Outcomes included changes in the American Spinal Injury Association (ASIA) impairment scale, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), infralesional voluntary muscle contraction (IVMC), active muscle reinnervation (AMR), and urodynamic parameters. Heterogeneity was assessed with the I² statistic, and study quality was evaluated via ROBINS-I. This study has been registered on PROSPERO with registration number CRD42024577161. Results: Seven studies comprising 133 patients were included. AIS grade improvement was observed in 0.37 (95% CI: 0.24–0.52). Improvements were also seen in SSEP at 0.40 (95% CI: 0.18–0.67), MEP at 0.37 (95% CI: 0.25–0.51), IVMC at 0.47 (95% CI: 0.34–0.60), and AMR at 0.74 (95% CI: 0.39–0.92). Urodynamic outcomes demonstrated increased maximum cystometric capacity [0.48 (95% CI: 0.30–0.67)], improved bladder compliance [0.73 (95% CI: 0.55–0.85)], and reduced detrusor pressure [0.61 (95% CI: 0.43–0.76)]. Conclusion: BMMSC therapy was associated with clinically meaningful neurological and urodynamic improvements in chronic SCI. Standardized administration protocols and randomized controlled trials are necessary to validate efficacy and optimize treatment paradigms.
Co-Authors A.A. Gde Oka A.A. Ngr. Agung Wistara Widya AA GN Asmara Jaya AAGN Asmarajaya Agung Bagus S. Satyarsa Andi Asadul Islam Arasy, Mohd Firdaus Astawa N. M., Astawa N. Astawa P., Astawa B. Sinaga D.P.W. Wardhana Dewa Putu Wisnu Wardhana Dian Megasafitri Dwikinta, Made Anindya Eka J. Wahjoepramono Ekaputra Ekaputra, Ekaputra G. I. B Bomba Gatot S. Lowrence, Gatot S. Gde Rastu Adi Mahartha Gede Febby Pratama Kusuma Gede Wirya Kusuma Duarsa Gunawan, Made Favian Budi Hamsu Kadriyan I Dewa Made Sukrama I Gede Sutawan I Gusti Agung Bagus Krisna Wibawa I Gusti Ayu Agung Laksemi I Gusti Kamasan Arijana I Gusti Putu Hendra Sanjaya I Ketut Suyasa I Ketut Wiargitha I Made Arya Winangun I Made Bakta I Made Gotra I Made Jawi I Made Stepanus Biondi Pramantara I Nyoman Semadi I W. Sudarsa I Wayan Gede Artawan Eka Putra I Wayan Niryana I Wayan Putu Sutirta Yasa I. B. Tjakra Wibawa Manuaba Ida Bagus Adi Kayana Ilhamjaya Patellongi Iwan Antara Suryadi Johansyah, Theodorus Kevin Putra K.K. Putra Kadek Dede Frisky Wiyanjana Kadek Dede Frisky Wiyanjana Ketut Putu Yasa Ketut Siki Kawiyana Kevin Kristian Putra Koerniawan, Heru Sutanto Komang Ayu Vitriana Gamayanti L. K. Widnyani Wulan Laksmi L. R. M. Lengkong M Wiryana Made Agus Mahendra Inggas, Made Agus Mahendra Made Indra Erlangga Prathiwindya Made Putri Hendaria Mardliyah, Mumtazah Moses Kharisma Setyawan Ni Ketut Susilawati Ni Luh Putu Julita Yanti Ni Putu Enny Pratiwi Suardi Ni Wayan Ariani Vitriasari Niryana, , I Wayan Nyoman Golden Putu Anda Tusta Adiputra Putu Indah Budi Apsari Putu Pramana Suarjaya Putu Primeriana Nugiaswari Raka-Sudewi A. A. Reni Widyastuti Romdhoni, Achmad Chusnu S. Awyono Satoto D., Satoto Setiawan, I Gede Budhi Sista Satyarsa, Agung Bagus Sista Soetomo, Cindy Thiovany Stanley-Ketting Oliver Suryadi N. T., Suryadi N. Tiffany, Tiffany Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa W. A., W. Wayan Suardana Willy Adhimarta Wiryana M., Wiryana Yutina Himawan