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All Journal Medical Journal of Indonesia The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Narra J Jurnal Locus Penelitian dan Pengabdian The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Journal of Global Pharma Technology Journal of English Education
Dedy Pratama
Division Of Vascular And Endovascular Surgery‎, Departement Of Surgery, Faculty Of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Public Health

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Incidence of venous thromboembolism among patients who underwent major surgery in a public hospital in Singapore Susanto, Anindya P.; Krisnanda, Charles; Tan, Doreen S-Y.; Ong, Hean-Ye; Pratama, Dedy; Soeparwata, Rasjid
Medical Journal of Indonesia Vol 23, No 1 (2014): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (491.522 KB) | DOI: 10.13181/mji.v23i1.687

Abstract

Background: Venous thromboembolism (VTE) is a fatal yet potentially preventable complication of surgery. Routine thromboprophylaxis is still unequivocal prescription is problematic due to perception of low VTE incidence among Asian population. This study aims to investigate the incidence of VTE and thromboprophylaxis prescription among patients undergoing major surgery in a Singapore hospital.Methods: This was a cross-sectional study. Data were obtained from medical record of 1,103 patients who had underwent major orthopaedic or abdominal surgery in 2011-2012 at Khoo Teck Puat Hospital, Singapore. Incidence of VTE events either in the same admission or re-admission in less than one month time were noted as study parameters.Results: Incidence of VTE was 2.1% (95% CI: 1.67 - 2.53) of which 1.3% and 0.8% were DVT and PE cases respectively. Age, gender, history of VTE, ischemic heart disease, and mechanical prophylaxis were associated with VTE incidence based on bivariate analysis. The prescription of pharmacological thromboprophylaxis was associated with prior anticoagulant medication, type of surgery, and incidence of new bleeding. Conclusion: Subsequent to major surgeries, VTE is as common in Asian patients as published data in other populations. Pharmacologic thromboprophylaxis should be considered as recommended in non-Asian guidelines.Keywords: thromboprophylaxis, venous thromboembolism
Comparison of Wells Score, D–Dimer and Combination of Wells Score and D–Dimer with Venous Duplex Ultrasonography in Diagnosis of Acute Deep Vein Thrombosis in Lower Extremity Lesmana, Andy; Pratama, Dedy; Wangge, Grace
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Diagnosis of acute deep vein thrombosis (DVT) of lower extremity using available diagnostic tools such as venous duplex ultrasonography (VDUS) encountered problems including cost, time consuming and the operator. A simple and practical tool is required. Thus, we run a study aimed to evaluate the efficacy of Wells score, D–Dimer, or combination of both, compared to VDUS in early detection of acute DVT of lower extremity. Method. A diagnostic study was run using cross–sectional design in Department of Surgery enrolling all adult subjects of which suspected to acute DVT of lower extremity managed in period of January 2014 –December 2015 who met the criteria. The diagnosis was confirmed by VDUS. Those data of medical record were analyzed statistically with diagnostic study to find out the sensitivity and specificity. Results. The study enrolled of 85 subjects. The prevalence of acute DVT of lower extremity was 65.88%. Sensitivity and the highest negative predictive value of 100.00% were found in score combination of II and IV. While as the highest specificity of 89.66% and the highest positive predictive value of 92.68% were found in score combination of III. The score with balanced diagnostic value (sensitivity of 87.50% and specificity of 72.41%) was found in Wells score 3 level I. Conclusion. Wells score and VDUS showed comparable efficacy in detection of acute DVT of lower extremity. Thus, a score could be used as a diagnostic tool.
Risk Factors Associated with Limb Amputation in Necrotizing Fasciitis at dr. Cipto Mangunkusumo General Hospital Jakarta Pratama, Dedy; Harisandi, Sandra
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Early diagnosis and management of necrotizing fasciitis of the extremities has an impact on mortality and morbidity. Studies have shown a correlation of risk factors (e.g. gender, gangrene, and comorbid) with increased risk of amputations in necrotizing fasciitis. Method. A cross sectional study conducted on subjects diagnosed as necrotizing fasciitis managed at dr.Cipto Mangunkusumo General Hospital during January 2012 to December 2015. The subject characteristics i.e. gender, age, comorbid, wound presentation, pulse, respiratory rate, temperature, serum creatinine level, hemoglobin content, sodium, and leukocytes level were the variables subjected to statistical analysis. Results. There were 70 subjects enrolled; fifty percent were males. and 60% were less than 60 years old. The most comorbid found were hypertension (34.3%), diabetes mellitus (28.6%). and kidney disease (22.9%). Amputation occurred in 24.28% subjects. Female was shown to have a greater risk of amputation than male (p = 0.012). Diabetes mellitus, skin necrosis, gangrene and serum creatinine level ≥1.6 mg/dL were significantly associated as an amputation risk factor (p <0.005). Based on modified LRINEC scoring, 45 subjects were of high risk and 25 were of medium risk. Multivariate analysis showed three strong predictors for amputation were diabetes mellitus (risk ratio 7.685; 95% CI 1.898– 31.122; p = 0.004), gangrene (risk ratio 6.151; 95% CI 1.539–24.584; p = 0.010), and serum creatinine level >1.6 mg/dL (risk ratio 4.098; 95% CI; 0.937–17.255; p = 0.054). Conclusion. Diabetes mellitus, gangrene, and serum creatinine level >1.6 mg/dL referred as risk factors associated with limb amputation in necrotizing fasciitis .
Intraoperative Blood flow Rate as a Predictor for Maturity of Radiocephalic Arteriovenous Fistula Pratama, Dedy; Darwis, Patrianef; Yang, Andrew Jackson
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Arteriovenous fistula (AVF) is the best access for hemodialysis. The failure of arteriovenous fistula maturation is currently a major problem faced today. This study aims to assess whether an intraoperative blood flow rate measured with Doppler ultrasound can be a predictor of the maturity ofradiocephalic AVF. Method. Subjects were patients to be made radiocephalic AVFwith USG mapping according to the standard. Shortly after, the anastomosis blood flow rate was measured with a linear probe Doppler ultrasound. This study used a cross-sectional analytic design to obtain radiocephalic AVF maturation relationship with intraoperative blood flow rate. Results. Radiocephalic AVF (n = 71) in 71 patients were made and evaluated in 6 weeks. The mean intraoperative blood flow rate in mature fistulas was significantly higher than those which did not mature (201.85 and 141.96 mL/min; p 165.5 mL/min has a good predictor value for radiocephalic AVF maturation. Thus, it can be used as a reference to determine whether the surgeon needs for further assessment and revision intraoperatively, which in turn is expected to decrease the maturation failure rate of arteriovenous fistula.
Recanalization After Radio-frequency Ablation (RFA) in Limb Varices at Dr. Cipto Mangunkusumo and Fatmawati General Hospitals from 2015- 2017 Hermansyah, Rudi; Pratama, Dedy; Irfan, Witra
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Ligation in upper location and stripping of the varicose veins, enfacing high incidence of failure, recanalization. Endovascular surgery is a modality used to treat limb varicose. However, the recanalization following the procedure was never evaluated. Method. We ran a cohort study on subjects with reflux of the great saphenous vein treated by RFA. Following the RFA procedure, the evaluation proceeded using ultrasound within the first three weeks. Results. A total of 77 subjects were analysed for recanalization post-RFA. Recanalization was found in one subject (1.3%), partial recanalization in 6 subjects (7.79%), and no recanalization in 70 subjects (90.9%). No significant difference between the diameter of the great saphenous vein with the procedure (p <0.001). Conclusion. We concluded that RFA is effective in treating limb varicose. In addition, we found there is no association between recanalization and age, sex, and body mass index statistically.
Analisis Hubungan Polimorfisme Gen Matrix Metalloproteinase-9 (MMP-9) dengan Penyakit Ulkus Diabetik pada Penderita Diabetes Mellitus Tipe 2 di RSCM Pratama, Dedy; Wibawa, IGAB Krisna; Patrianef, Patrianef
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.20

Abstract

Latar Belakang: Ulkus kaki diabetik (UKD) adalah salah satu komplikasi dari diabetes melitus (DM) yang insidennya cenderung meningkat. Beberapa penelitian mengindikasikan polimorfisme gen matrix metalloproteinase-9 (MMP-9) pada titik -1562C/T dan +632A/G memiliki peranan penting dalam perkembangan dan patofisiologi ulkus kaki diabetik, yakni sebagai penanda inflamasi. Penelitian ini bertujuan untuk mengetahui hubungan polimorfisme gen MMP-9 dengan penyakit ulkus diabetik pada penderita DM tipe 2. Metode: Evaluasi menggunakan case control study, subjek penelitian adalah semua penderita DM tipe 2 dengan atau tanpa UKD yang memenuhi kriteria inklusi di RSUPN Dr. Cipto Mangunkusumo pada bulan Juli 2016 hingga Desember 2016. Hasil: Terdapat 197 pasien DM tipe 2 (laki-laki 49,2% dan perempuan 50,8%). Faktor yang berpengaruh dan bermakna secara statistik yakni penyakit arteri perifer (p=0,001), nyeri istirahat (p=0,001), neuropati (p=0,001), merokok (p=0,001), hipertensi (p=0,001), klaudikasio (p=0,001), anemia (p=0,001), dan leukositosis (p=0,001). Distribusi polimorfisme alel dari gen -1562C/T pada seluruh populasi, pada alel C = 74,6%, alel T = 25,4%. Distribusi polimorfisme alel dari gen +836A/G, pada alel A = 41,4%, dan alel G = 58,6% pada seluruh populasi. Simpulan: Pada MMP-9 -1562 C&gt;T, genotipe TC secara statistik memiliki perbedaan secara signifikan terhadap insiden dan merupakan faktor pencegah dalam terjadinya UKD (p=0,001).
Blood flow Rate Intraoperatif Sebagai Prediktor Maturitas Arteriovenous Fistula Brakiosefalika Pada Penderita Nefropati Diabetik Harisandi, Sandra; Pratama, Dedy
Jurnal llmu Bedah Indonesia Vol 46 No 1 (2018): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v46i1.30

Abstract

Latar Belakang: Penelitian ini merupakan penelitian lanjutan untuk melakukan pengkajian nilai batasan blood flow rate (BFR) intraoperatif menggunakan ultrasonografi Doppler dalam memprediksi maturitas fistula brakiosefalika dengan sampel yang lebih besar dan lebih spesifik untuk mendapatkan nilai dengan tingkat error dan bias lebih rendah, sehingga dapat dijadikan referensi di divisi Bedah Vaskular RSCM. Metode: Dilakukan studi potong lintang analitik di Divisi Vaskular Departemen Ilmu Bedah FKUI-RSCM, Jakarta yang melibatkan semua penderita gagal ginjal stadium 4-5 akibat nefropati diabetik yang akan dihemodialisis dengan akses vaskular fistula brakiosefalika. Hasil: Terdapat 71 subjek dengan rerata BFR 249,15 + 86,86 mL/menit, rerata diameter arteri 3,3 mm (2,0–7,4 mm) dan rerata diameter vena 3 mm (2,1–5,6 mm). Analisis statistik menunjukkan bahwa hanya BFR yang berhubungan bermakna dengan maturitas AVF (p&lt;0,001). Sensitivitas dan spesifisitas tertinggi BFR intraoperatif di 211,3 mL/menit. Nilai ini yang selanjutnya ditentukan sebagai cut-off value untuk batasan prediksi maturitas (95,45%, 92,59%) dengan positive predictive value sebesar 95,5% dan negative predictive value sebesar 92,6%. Simpulan: BFR intraoperatif menggunakan ultrasonografi Doppler sesaat setelah kreasi AVF brakiosefalika memprediksi maturasi jangka pendek dengan sensitivitas dan spesifisitas &gt;80%.
CO2 Contrast as Alternative Media Contrast for Renal Insufficiency Patient in Angiography: An Evidence Based Case Report Bermana, Frengky; Pratama, Dedy
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

The use of iodine contrast, which is more commonly used, is associated with systemic effects in nephrogenic systemic fibrosis, contrast-induced nephropathy (CIN) in patients with kidney function disorders, geriatric, hypertension, and patients with comorbid diabetes mellitus and hypersensitivity reactions. An evidence-based case report was carried out in the Medical Department of Surgery, FKUI-RSCM. The study indicated that the safety of CO2 angiography did not cause CIN to manifest and showing CO2 contrast proved to be safe for patients who have impaired renal function
After A Year of Follow Up Non-Cirrhotic Portal Hypertension Patient with Partial Spleen Embolization (PSE) Management Akhmadu Muradi; Chyntia Olivia Maurine Jasirwan; Raden Suhartono; Patrianef Darwis; Dedy Pratama; Teguh Dwi Nugroho; Karina Zulkarnain
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 3 (2021): VOLUME 22, NUMBER 3, December 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2019.322 KB) | DOI: 10.24871/2232021249-253

Abstract

Non-cirrhotic portal hypertension (NCPH) is a heterogeneous group of liver disorders leading to portal hypertension. There are multiple approaches to managing portal hypertension' clinical complications to treat/prevent spontaneous hemorrhage by mitigating thrombocytopenia. Portal hypertension complications have been traditionally managed with serial endoscopic variceal ligation (EVL) or with invasive open surgical procedures such as orthotopic liver transplantation (OLT) or portosystemic shunting, splenectomy.6–9 There are several risks associated with splenectomies, such as hemorrhagic complications or intraoperative blood loss.5,6,14 Partial Spleen Embolization (PSE) ‎may overcome the limitations of splenectomy and provide patients with an alternative treatment. An eighteen-year-old male has a splenomegaly history since he was 12 years old and has recurring hematemesis and melena. After performing abdominal computed tomography, laboratory studies, and several endoscopies, the results indicated secondary hypersplenism due to non-cirrhotic portal hypertension. The patient had 13 endoscopies and 2 EVL in 5 years. Despite adequate treatment, the patients developed recurrent variceal bleeding and no improvement in blood function. The patient underwent PSE at Integrated Cardiovascular Center in Dr. Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia. It was performed through the femoral access with a PVA (polyvinyl alcohol) embolus. The procedure went successful, and there was no major complication with the patient. Twenty days after the patient had an abdominal CT scan, it showed no abscess, and the spleen volume was reduced by 20%. Long-term results over a  year after the procedure are presented. PSE is a safe, effective, semi-invasive alternative to splenectomy in non-cirrhotic portal hypertension because it preserves functional spleen mass and avoids postprocedure accelerated liver disease or encephalopathy.
Single Nuclear Polymorphisms of VEGF, TGF-β1, MMP9 Genes in Type 2 Diabetic Foot Ulcer Patients in Indonesian Population: A Case Control Study Dedy Pratama
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

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Abstract

Objective: Vascular endothelial growth factor (VEGF), transforming growth factor beta 1 (TGF-β1) and matrix metalloprotein-9 (MMP9) are known to have roles in the process of diabetic foot ulcer (DFU) formation. VEGF rs2010963C>G rs1271283232T>C, TGF-β1 rs1982073C>T rs1800469C>T, and MMP9 rs3918242C>T rs367601348A>G genes polymorphism may result in differences in the quantity and quality of the proteins which influence the risk of DFU formation. This study aims to assess the difference in frequency distribution of certain VEGF, TGF-β1, and MMP9 genes polymorphism between diabetic patients with and without DFU.Methods: A case-control study was conducted among patients with type-2 DM with DFU (case) and without DFU (control) in Cipto Mangunkusumo Hospital Jakarta, with DNA analysis using Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) technique. The confounding factors are also analyzed.Results: A total of 197 patients was assessed, 96 with DFU and 101 control. The genotype analysis by logistic regression found significant association of CT genotype in TGF-β1 rs1982073C>T  (OR:0.28;95%CI:0.13-0.60;p=0.001 compared with CC); TT genotype in TGF-β1 rs1800469C>T, (OR:2.37;95%CI:1.11-0.60;p=0.001 compared with CC); TC genotype in MMP9 rs3918242C>T (OR:0.19;95%CI:0.19-0.64;p=0.001 compared with CC). There are no significant association in any mutation in VEGF rs2010963C>G, rs1271283232T>C, and MMP9 rs367601348A>G.Conclusion: VEGF rs2010963C>G rs1271283232T>C, and MMP9 rs367601348A>G polymorphisms did not have significant association with DFU formation. CT in TGF-β1 rs1982073C>T and TC in MMP9 rs3918242C>T found as protective factor for DFU, and TT in TGF-β1 rs1800469C>T as risk factor for DFU.Keywords: diabetic foot ulcer, genetic polymorphism, VEGF, MMP9, TGF-β1, rs2010963C>G, rs1271283232T>C, rs1982073C>T, rs1800469C>T, rs3918242C>T rs367601348A>G
Co-Authors Alfa Firdaus Almidawati Anindya P. Susanto Bermana, Frengky Candra Irawan Charles Krisnanda Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Darwis, Patrianef Dhanasari Vidiawati Doreen S-Y. Tan Fachriza, Ihza Grace Wangge, Grace Harisandi, Sandra Harunarashid, Hanafiah Hean-Ye Ong Hudaya, Miradz I Gusti Agung Bagus Krisna Wibawa Irfan, Witra Karina Zulkarnain Lesmana, Andy Muradi, Akhmadu Patrianef Darwis Purnomo, Hari Agus Rasjid Soeparwata Rudi Hermansyah, Rudi Sinaga, Bunga Riama Suhartono, Raden Teguh Dwi Nugroho Yang, Andrew Jackson