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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Medicina E-Jurnal Medika Udayana WMJ (Warmadewa Medical Journal) JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of Social Research JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Journal of Indonesia Vascular Access Jurnal Ilmu Kedokteran dan Kesehatan Indonesia

Ketut Putu Yasa

Divisi Bedah Thoraks Kardiovaskular, Fakultas Kedokteran Universitas Udayana, Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali, Indonesia

Author-ID : 352817

Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Social Sciences

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EVENTRATION OF DIAPHRAGM Eka Pratiwi, I G A P; Purniti, P Siadi; Subanada, IB; Putu Yasa, Ketut
Medicina Vol 39 No 1 (2008): Januari 2008
Publisher : Medicina

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Eventration of diaphragm (ED) refers to an abnormally high position of part or all of the diaphragm, but intact diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area with only the peripheral thoracic attachments showing normal muscle. Etiologically ED is congenital or acquired. Congenital diaphragmatic abnormalities occur in 1 per 2000 to 4000 birth, which 7% is diaphragmatic eventration. Most children with ED are asymptomatic when incidentally first seen, will not need theraphy. Those with symptoms develop acute respiratory distress, feeding difficulties, and recurrent pneumonitis. If the patient need assissted ventilation or cannot be weaned off the ventilator, she or he should be plicated. Failure to achieve extubation within a week of plication is an ominous prognostic sign. We reported a case of one month and four days old girl who was dispnea, feeding difficulty and bronchopneumonia caused by right ED with acquired etiology. Plication was done to repaired the symptom. But unfortunately this was not succeded because there was complication of postoperative treatment.

A 44-DAY OLD MALE INFANT WITH THORACOABDOMINAL ECTOPIA CORDIS OF PENTALOGY CANTRELL’S SYNDROME Yuliantini, Tri; Gunawijaya, Eka; Putu Yasa, Ketut
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Ectopia cordis is a rare and impressive congenital abnormality, occurring in 5.5 to 7.9 per 1 million live births. The defect is characterized by partial or complete displacement of the heart out of the thoracic cavity. This defect require a staged procedure to achieve a complete repair. We reported a 44-day-old male infant presented with symptoms of tachypnea and mild cyanosis since birth. On physical examination, the child looked lethargic with a weak cry. The midline defect extended from the lower margin of the neck to the umbilicus. The sternum was completely bifid, with an inter-ridge distance of 6 cm, through which the heart was protruded for 4-5 cm and the apex pointed anteriorly. The first and second heart sounds were normal with ejection holosystolic murmur. The diagnosis was ectopia cordis. A two dimensional echocardiography showed complete atrioventricular septal defect, which was known as a group of cyanotic congenital heart defect. The infant was referred subsequently to the neonatal intensive care unit with the ventilator support. Historically, the prognosis of this condition is poor. Our patient died before surgery being performed.

WOUND HEALING IN DIABETIC ULCER Putra Pramana, Ida Bagus; Yasa, Ketut Putu
Medicina Vol 43 No 1 (2012): Januari 2012
Publisher : Medicina

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The mechanism of wound healing is a complex mechanism and involves a variety of cells. Injury is defined as a disruption of normal structure and function. Various types of growth factors and cytokines such as platelet derived growth factor and transforming growth factor beta involved in the mechanism of wound healing. There are four phases of wound healing mechanisms : hemostasis, inflammatory, proliferative, and remodeling. Diabetic ulcers is one major complication, occurring in 15% of patients with diabetes mellitus (DM) and as much as 84% of patients with diabetic ulcers require amputation action. In DM patients there is a failure in normal wound healing mechanisms. Various histopathological studies showed elongation phase of inflammation in patients with diabetes mellitus, thus inhibiting the formation of granulation tissue. Increased blood sugar levels will lower the expressin of perlecan, increased advanced glycation endproducts, decreased the formation of nitric oxide (by ± 67%), changes in the structure and function of fibroblasts and increased activity of matrix metalolproteinases, it will cause distruption of the normal wound healing mechanisms. (MEDICINA 2012;43:49-53).

MITRAL VALVE REPLACEMENT AT 11 YEARS OLD GIRL WITH RHEUMATIC MITRAL STENOSIS Malik, Suryani; Gunawijaya, Eka; Yasa, Ketut Putu
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

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Rheumatic heart disease (RHD) is the permanent heart valve damage resulting from one or more attacks of acute rheumatic fever (ARF), representing the permanent lesions of the cardiac valve. Rheumatic heart disease’s patient with valvar involvement usually require long term follow-up. The ultimate decision of clinical management or invasive therapy is made on an individual basis. We reported a 11-year-old girl with RHD and severe mitral stenosis whom underwent mitral valve replacement with mechanical valve. Postoperative echocardiogram showed no mitral regurgitation and we gave anticoagulant to maintain INR of 3-4 by giving warfarin 2mg / kg each day for lifelong to prevent bleeding and thrombosis. [MEDICINA 2014;45:120-6]

CARDIAC MYXOMA Yutina Himawan; Ketut Putu Yasa; Sri Maliawan
E-Jurnal Medika Udayana vol 2 no3 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

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Myxoma is a benign primary tumor of the heart which is usually occurred in adult, which usually develop in the left atrium of the heart. In 1845, Cardiac Myxoma is first described by the expert. Myxoma, an endocrine neoplasm which usually begins from the endocardium of the heart it self. Generally, the shape of myxoma are round, oval with a smooth or lobulated surface. The clinical finding of myxoma is determined by it’s location, size, and mobility. Most of the patient comes with one or more from the triad of embolism, intracardiac obstruction, and associated symptoms. Until now, operation is the only treatment for cardiac myxoma.

Hubungan Lokasi Fistula Arteriovena dan Riwayat Penggunaan Kateter Double Lumen Ipsilateral Terhadap Kejadian Hipertensi Vena Perifer di RSUP Sanglah Denpasar Aslesa Wangpathi Pagehgiri; Ketut Putu Yasa; Gde Raka Widiana
JBN (Jurnal Bedah Nasional) Vol 3 No 1 (2019): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: untuk mengetahui faktor-faktor yang berhubungan dengan kejadian hipertensi vena perifer paska pembuatan akses fistula arteriovena untuk hemodialysis. Metode: penelitian ini menggunakan rancangan cross sectional. Subyek penelitian adalah pasien dengan Chronic Kidney Disease (CKD) Stadium V dengan akses fistula arteriovena yang menjalani hemodialisis di RSUP Sanglah selama periode Desember 2016-Desember 2017 sebanyak 141 sampel. Hasil: dilakukan uji multivariat dengan analisa regresi logistik untuk masing-masing faktor, dengan mengendalikan faktor perancu, yaitu usia, jenis kelamin, etiologi CKD, lama hemodialisis, dan status gizi pasien. Nilai rasio prevalens untuk lokasi fistula arteriovena brakiosefalika sebesar 15,2 dengan nilai p<0,001. Nilai rasio prevalens untuk riwayat pemakaian kateter double lumen ipsilateral sebesar 20,9 dengan nilai p<0,001. Simpulan: dari hasil analisis data secara statistika dapat disimpulkan lokasi fistula arteriovena brakiosefalika dan riwayat penggunaan kateter double lumen secara statistika bermakna terhadap kejadian hipertensi vena perifer pada pasien CKD stage V yang menjalani hemodialisis regular di RSUP Sanglah Periode Desember 2016-Desember 2017.

Percutaneous retrieval of intracardiac fragmented hemodialysis catheter using a snare-loop catheter: A case report Adhitya Ginting; Ketut Putu Yasa; Yan Efrata Sembiring
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 2, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss2.art14

We presented a 60-year-old woman with an history of end-stage renal disease on regular hemodialysis, twice a week, came with a tunneled dialysis catheter (TDC) that was attached to the right internal jugular vein. TDC has been dysfunction since one week ago that was suspected as a result of thrombosis in the lumen of TDC. TDC was cut in the insertion of the jugular vein. And then a wire was inserted into TDC that has been cut off. From Chest x-ray imaging, migration of fragmented TDC was found inside the heart chamber with wire inside the lumen. Fluoroscopy showed a picture of a fragmented TDC in the heart chamber with a wire inside the lumen. Retrieval of fragmented TDC used percutaneus snare loop method with wire guiding that was inserted through the left femoral vein. Fragmented TDC was removed successfully. Retrieval of the fragmented TDC through endovascular techniques is classified as a simple. Simple snare loop method is quite effective and very cheap compared to the commercial snare, open surgery or laparoscopic surgery that can be avoided.

Management of denture foreign body in esophagus with cervical esophagotomy: case report Kadek Yudi Fajar Mahendra; Ketut Putu Yasa
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Introduction: Impaction of dentures in the esophagus is a distressing experience for a patient and can lead to serious consequences, such as esophageal perforation. Patients with an impacted denture often present with a history of accidental swallowing, frequently during trauma, seizures, or sleep or in association with some degree of psychological dysfunction. The common signs and symptoms of an impacted denture are odynophagia, dysphagia, or simply pain and tenderness in the neck or chest.The preferred method of removal of esophageal foreign bodies is extraction with the flexible endoscope. Surgical removal is rarely indicated except in the event of perforation or other foreign body complications.In situations where this appears potentially hazardous, such as with impacted denture, open surgical extraction by cervical oesophagotomy is promptly performed is a safe option.Cases Report: The successful removal of impacted denture in the esophagus in a patient is reported, with a review of the literature. A women23-year-oldÂ complained of dysphagia after swallowing his denture. Following unsuccessful attempts at removal via a rigid esophagoscope, open surgery was performed. Without further delay, the impacted denture was removed by cervical oesophagotomy, and the patient recovered uneventfully.Conclusion: The successful removal of impacted denture by cervical oesophagotomy in the esophagus in a patient is reported. We conclude that cervical esophagotomy is a safe method for removing foreign bodies impacted in the cervical esophagus when they cannot be removed endoscopically.

Pengaruh kadar haemoglobin dan hematokrit dengan insiden kegagalan arteriovenous fistula pada pasien gagal ginjal kronik stadium V Satrio Ryandi; Ketut Putu Yasa; I Gede Raka Widiana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Chronic Kidney Disease (CKD) is a disease that requires important attention. Chronic kidney failure is mentioned as kidney damage that occurs more or equal to 3 months in the form of abnormal structural or functional damage from the kidney with or without a decrease in GFR. Management of chronic renal failure is hemodialysis. Hemodialysis performed on patients with chronic renal failure requires appropriate vascular access.Method: This study involved 76 respondents with a cross-sectional observation design in patients with stage V chronic kidney disease in Sanglah Hospital Denpasar from January 2018 to December 2018 conducted by arteriovenous fistula, with an age range of 17 years to 65 years, who have undergone regular hemodialysis for more than 3 month and with complete medical records.Result: From this study it was found, characteristics based on age ? 55 years were 40 respondents (52.6%) and age <55 were 36 respondents (47.4%). Characteristics based on gender obtained male data as many as 43 respondents (56.6%) and women as many as 33 respondents (43.4%). Characteristics based on BMI obtained a median value of 26. Characteristics based on BMI ? 26 Kg / m2 were 39 respondents (51.3%) and BMI <26 Kg / m2 were 37 respondents (48.7%). Characteristics based on INR ? 1.2 were 10 respondents (13.2%) and INR 0.9-1.1 were 66 respondents (86.8%). Characteristics based on DM disease obtained with DM disease data as many as 17 respondents (22.4%) and without DM disease as many as 59 respondents (77.6%). Patients with hemoglobin hemoglobin levels <9.9 gr / dl with non-patent AVF 47 (73.4%) and ? 9.9 gr / dl with non-patent AVF 17 (26.6%) while hemoglobin levels <9, 9 gr / dl with patent AVF of 3 (25%) and ? 9.9 gr / dl with patent AVF of 9 (75%) [PR=1,4; IK1,07-1,91; p=0,001].Conclusion: Hemoglobin <9.9 associated with failure of AVF. Low hemoglobin is the most important risk factor for the occurrence of AVF failure in CRF patients. Hematocrit <29.18 related to AVF failure. Gagal Ginjal Kronik (GGK) merupakan penyakit yang memerlukan perhatian penting. Gagal ginjal kronik disebutkan sebagai kerusakan ginjal yang terjadi lebih atau sama dengan 3 bulan baik berupa kerusakan struktur atau fungsi yang abnormal dari ginjal dengan atau tanpa penurunan GFR yang dilakukan kepada pasien GGK memerlukan akses vaskular yang tepat.Metode: Penelitian ini melibatkan 76 responden dengan rancangan observasi crossectional pada pasien gagal ginjal kronis stadium V di RSUP Sanglah Denpasar dari mulai bulan Januari 2018 sampai Desember 2018 yang dilakukan arteriovenous fistula, dengan rentang umur 17 tahun sampai 65 tahun, yang sudah menjalani hemodialisis regular lebih dari 3 bulan dan dengan catatan medis yang lengkap. Hasil: Karakteristik berdasarkan umur ? 55 tahun sebanyak 40 responden (52,6%) dan umur < 55 sebanyak 36 responden (47,4%). Karakteristik berdasarkan jenis kelamin didapatkan data laki-laki sebanyak 43 responden (56,6%) dan perempuan sebanyak 33 responden (43,4%). Karakteristik berdasarkan BMI didapatkan nilai median 26. Karakteristik berdasarkan BMI ? 26 Kg/m2 sebanyak 39 responden (51,3%) dan BMI < 26 Kg/m2 sebanyak 37 responden (48,7%). Karakteristik berdasarkan INR ? 1,2 sebanyak 10 responden (13,2%) dan INR 0,9-1,1 sebanyak 66 responden (86,8%). Karakteristik berdasarkan penyakit DM didapatkan data dengan penyakit DM sebanyak 17 responden (22,4%) dan tanpa penyakit DM sebanyak 59 responden (77,6%). Pasien dengan kadar haemoglobin Haemoglobin < 9,9 gr/dl dengan AVF tidak paten sebanyak 47(73,4%) dan ? 9,9 gr/dl dengan AVF tidak paten sebanyak 17(26,6%) sedangkan kadar haemoglobin < 9,9 gr/dl dengan AVF paten sebanyak 3 (25%) dan ? 9,9 gr/dl dengan AVF paten sebanyak 9 (75%) [PR=1,4; IK1,07-1,91; p=0,001].Simpulan: Hemoglobin < 9,9 berhubungan dengan kegagalan AVF. Haemoglobin yang rendah menjadi faktor risiko yang paling berperan terhadap terjadinya kegagalan AVF pada pasien GGK..Hematokrit < 29,18 berhubungan dengan kegagalan AVF.

Interval waktu iskemia, derajat iskemia, dan sindrom kompartemen merupakan faktor risiko amputasi pada pasien acute limb ischemia yang dilakukan tindakan trombektomi terbuka di RSUP Sanglah Denpasar Dea Emmanuel; Ketut Putu Yasa; Ida Bagus Putra Manuaba; I Nyoman Semadi; Ketut Widiana; Gede Wirya Kusuma Duarsa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Acute Limb Ischemia (ALI) is a sudden decrease in perfusion in the extremities that causes the threat of tissue viability and is still one of the causes of disability. The purpose of this study was to determine the factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy.Methods: This was a retrospective observational study with case-control studies. As many as 40 patients with acute limb ischemia who underwent thrombectomy were seen as an outcome of amputation. Matching was done based on age and sex in the case (amputation) and control (without amputation) groups. Data collection is based on medical records from 2014 to 2019. Bivariate analysis uses Chi-Square or Fisher's Test while multivariate analysis uses logistic regression.Results: In this study we found that the time interval of ischemia and the degree of ischemia is a risk factor of amputation in person with ALI (p<0.05) but compartment syndrome was not significantly related to amputation in ALI. Multivariate analysis shows degree of Rutherford IIB / III ischemia to be a the most dominant factor for amputation (OR = 6.84; 95% CI = 1.19-39.35; p = 0.03).Conclusion: The time interval of ischemia and the degree of ischemia are factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy. The degree of ischemia is the most dominant risk factor affecting amputation.Â Latar Belakang: Acute Limb Ischemia (ALI) adalah penurunan secara tiba-tiba perfusi di ekstremitas sehingga menyebabkan ancaman viabilitas jaringan dan masih menjadi salah satu penyebab disabilitas Tujuan dari penelitian ini adalah untuk mengetahui faktor faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi.Metode: Penelitian ini merupakan penelitian observasional retrospektif dengan studi kasus kontrol. Sebanyak 40 pasien acute limb ischemia yang dilakukan trombektomi dilihat outcomenya dari amputasi. Dilakukan matching berdasarkan usia dan jenis kelamin pada kelompok kasus (amputasi) dan kontrol (tanpa amputasi). Pengambilan data berdasarkan catatan medis dari tahun 2014 hingga 2019. Analisa bivariat menggunakan Chi-Square atau Uji Fisher sedangkan analisa multivariat menggunakan regresi logistik.Hasil: Berdasarkan analisa statistik didapatkan didapatkan interval waktu iskemia dan derajat iskemia mempengaruhi amputasi (p<0,05) namun sindrom kompartemen tidak berhubungan secara signifikan. Hasil multivariat dengan regresi logistik ditemukan derajat iskemia Rutherford IIB/III menjadi faktor dominan terjadinya amputasi (OR = 6.84; IK 95% = 1,19-39,35; p = 0,03).Simpulan: Interval waktu iskemia dan derajat iskemia merupakan faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi. Derajat iskemia merupakan faktor risiko yang paling dominan mempengaruhi amputasi.

Co-Authors Ade Sinyo Aristantrisna Adhitya Ginting Anak Agung Gede Agung Budhi Kesuma Aria, Anselmus Danus Aslesa Wangpathi Pagehgiri Dea Emmanuel Eka Gunawijaya Fernandi, Ryan Gede Budhitresna, Anak Agung Gede Wirya Kusuma Duarsa Golden, I Nyoman Harta, I Komang Adhi Parama I Gde Raka Widiana I Gusti Ayu Putu Eka Pratiwi I Ketut Widiana I Nyoman Semadi I Wayan Sudarma Ida Bagus Putra Manuaba Ida Bagus Putra Pramana Ida Bagus Subanada Ida Bagus Yudharma Indraharsanae Kadek Yudi Fajar Mahendra Katritama, Arinda Agung Mahayasa, I Made Maranatha, Maranatha Ni Putu Siadi Purniti Nyoman Maharmaya Pertiwi, Putu Febry Krisna Satrio Ryandi Sembiring, Yan Efrata Sri Maliawan Sudartana, I Ketut Sueta, Made Agus Dwianthara Suryani Malik, Suryani Tidja, Yonatan Esli Alexander Tri Yuliantini Wibawa, I Gusti Agung Bagus Krisna Yutina Himawan

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