I Wayan Suranadi
Department Of Anesthesiology, Pain Management, And Intensive Care, Faculty Of Medicine, Udayana University, Sanglah General Hospital, Denpasar-Bali, Indonesia

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PROGRAM PENCEGAHAN ANEMIA BAGI WANITA MASA PRAKONSEPSI DI WILAYAH KERJA PUSKESMAS SIDEMEN KABUPATEN KARANGASEM L.S. Ani; I.W. Weta; N.W.A. Utami; W. Suranadi; K. Suwiyoga
Buletin Udayana Mengabdi Vol 17 No 3 (2018): Buletin Udayana Mengabdi
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (289.17 KB) | DOI: 10.24843/BUM.2018.v17.i03.p26

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Kecamatan Sidemen memiliki masalah anemia di mana kejadian anemia pada ibu hamil adalah 60,5%. Meskipun Puskesmas Sidemen telah melaksanakan program kesehatan ibu dan anak melalui pemberian tablet 90 Fe kepada ibu hamil, tetapi kejadian anemia dan masalah gizi lainnya masih tinggi. Ini mungkin karena anemia dan atau kekurangan gizi telah terjadi dalam periode prakonsepsi. Anemia dapat diatasi dengan pemberian tablet besi 200mg selama 90 hari. Hanya saja kepatuhan wanita dalam tablet besi masih sangat rendah yaitu sebesar 35%. Selain itu, variasi sistem pelayanan dari tenaga kesehatan spesialis dan bidan cukup besar dalam hal dosis dan waktu pemberian tablet besi. Ini tentu akan berdampak pada keberhasilan program pencegahan anemia untuk semua wanita hamil. Berdasarkan itu, program pencegahan anemia pada periode prakonsepsi perlu dilaksanakan sebagai alternatif dari program yang ada. Pengabdian ini dilakukan dengan memberikan informasi tentang pentingnya mengkonsumsi tablet besi selama kehamilan pada wanita yang berprasangka dan juga kepada petugas kesehatan tentang cara yang efektif dan dosis tablet zat besi. Hasil dari pengabdian menemukan bahwa kejadian anemia pada wanita selama periode prakonsepsi sangat tinggi, yaitu 40,2%. Ceramah tentang anemia meningkatkan pengetahuan wanita yang prasekognisi tentang anemia sebesar 60%. Dan hasil FGD pada bidan menemukan bahwa tidak ada program administrasi tablet besi pada kelompok wanita pra-konsepsi. Jadi disarankan untuk memberikan tablet besi pada wanita prasekognisi karena pencegahan lebih baik daripada pengobatan
Profil penurunan tekanan darah pasca induksi dengan anastesi umum di RSUP Sanglah periode Juli-Desember 2016 Gusti Ayu Amalindasari Prabayastita Masta; I Wayan Suranadi; Dewa Ayu Mas Shintya Dewi
E-Jurnal Medika Udayana Vol 7 No 5 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Induction of intravenous anesthesia is the process of lulling the patient through anesthetic drugs until the patient enters the anesthesia stage. One of the common anesthesia drugs used in the induction of anesthesia is propofol and the induction of fentanyl. The use of propofol at induced doses causes a significant change in hemodynamic stability in the form of decrease in hemodynamic. Decrease in that parameter can lead to tissue hypoxia, myocardial ischemia, shock to death. The design of cross-sectional descriptive research obtained through secondary data is medical records in the period from June 2016 to December 2016 Sanglah Hospital in patients with elective surgical upper arm fractures with general anesthesia induction. The subjects were 39 patients who met the inclusion and exclusion criteria and received treatment with general anesthesia. Then, recording parameters of hemodynamic changes in systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP) were assessed at the time of induction of anesthesia. In patients with upper arm bone surgery most were men in 39 cases in the 20-40 year age range with ASA I and received general anesthetic induction of propofol and fentanyl. Post induction in the hemodynamic parameters decreased at systolic blood pressure of 10.42%, then diastolic blood pressure decreased by 2.5%, mean arterial pressure (MAP) decreased by 5.9%. There is a decrease of hemodynamic parameters of both systolic, diastolic and MAP blood pressure in post-induced patients with propofol and fentanyl induction. Keywords: propofol, fentanyl, hypotension
KNOWLEDGE OF BASIC LIFE SUPPORT (BLS) in FIRST YEAR MEDICAL STUDENTS FACULTY of MEDICINE UDAYANA UNIVERSITY Kadek Dinda Pramadyanti; I Wayan Suranadi; I Made Agus Kresna Sucandra
E-Jurnal Medika Udayana Vol 8 No 4 (2019): Vol 8 No 4 (2019): Vol 8 No 4 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Basic life support is a skill in early relief measures to maintain the airway, support breathing and circulation to promote emergency oxygenation during resuscitation. These skills must be mastered to reduce the adverse effects of cardiac arrest. The purpose of this study is to determine the level of knowledge of students at the faculty of medicine Udayana University against BLS. This study is a cross sectional descriptive study conducted at the Faculty of Medicine Udayana University. The number of samples of this study is 170 from all first year course students. The study programs at Udayana University's medical faculty include medicine education programs, nursing, psychology, dentistry, physiotherapy, and public health sciences. Characteristics of data obtained by sex category dominated by male is 49 people (28.9%), by educational background dominated by medicine programs as 65 people (38.2%), and the result in each study program, the result of knowledge level on BLS is not good, while the level of knowledge is medicine education is a study program that has more knowledge from other study program that is 4 people (6,2%), nursing 2 person (8.7%) and psychology of 1 person (5.0%). Others have less knowledge. This indicates that the study program influences the level of knowledge about the BLS and from respondents who have never received and received material before have insufficient knowledge. Keywords: knowledge, BLS, BLS questionnaire, cardiac arrest
Antifungals patterns in critical patients with candidiasis in the intensive care units at Sanglah General Hospital 2019 Komang Ady Widayana; I Wayan Aryabiantara; Tjokorda Gde Agung Senapathi; I Wayan Suranadi; I Gusti Ngurah Mahaalit Aribawa
Neurologico Spinale Medico Chirurgico Vol 2 No 3 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (378.685 KB) | DOI: 10.36444/nsmc.v2i3.83

Abstract

Abstract Introduction: The prompt initiation of appropriate antifungal therapy is essential in controlling invasive candidiasis and improving the prognosis in critical patients undergoing treatment in the Intensive Care Unit. Candida Score can assess patients at risk of candidiasis and is expected to assist clinicians in starting antifungal therapy in patients suspected Candidiasis. The purpose of this study was to determine the pattern of antifungal administration in critically ill patients with candidiasis in the Intensive Care Unit at Sanglah General Hospital. Patients and Methods: The design of this study is a cross-sectional descriptive study involving critically ill patients who were under treatment in Intensive Care Unit of Sanglah General Hospital from Januari to June 2019. The patients included in this study were patients who were ≥ 18 years old and under treatment in ICU for at least 7 days. Results: There are 64 patients undergoing treatment in the Intensive Care Unit. From 64 patients, 6 pasien had CS = 0, 29 patients had CS = 1, 13 patients had CS = 2, 11 patients had CS = 3, 5 patients had CS = 4, and no patients had CS = 5. Eleven patients received empirical antifungal therapy. All empirical antifungal therapies use the Triazole group. Conclusion: In this study was found that 11 of 16 patients with a CS value of ≥ 2.5 were given empirical antifungal therapy, while 48 patients with a CS value of <2.5 were not given empirical antifungal therapy. Keywords: Invasive Candidiasis, Candida Score, Empirical Antifungal Therapy.
THE CORRELATION BETWEEN TYPE 2 DIABETES MELLITUS WITH BACTERIAL INFECTION IN COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT AT CENTRAL GENERAL HOSPITAL PROF. DR. I.G.N.G. NGOERAH DENPASAR IN 2021-2022 Bayu Saputra, Ida Bagus Prema Satia; Suranadi, I Wayan; Senapathi, Tjokorda Gde Agung
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.P10

Abstract

Type 2 Diabetes Mellitus (T2DM) has a detrimental impact on the immune system, resulting in a decrease in the body's immune response, making patients highly susceptible to bacterial infections. Patients with T2DM, especially those treated in the Intensive Care Unit (ICU) of a hospital, face an increased risk of infection. The emergence of COVID-19, which also infects T2DM patients, further diminishes the immune system's function in these patients. Consequently, individuals with both T2DM and COVID-19 are at a heightened risk of developing secondary infections, commonly referred to as Hospital-Acquired Infections.This research aims to explore the relationship between T2DM, assessed through blood sugar levels, and the occurrence of bacterial infections in COVID-19 patients treated in the ICU of Prof. Dr. I.G.N.G. Ngoerah Central Hospital from 2021 to 2022. The research design employed is quantitative analytical correlational study using a cross-sectional approach, with a sample size of 98 patients collected from the Medical Records and Hospital Management System of Prof. Dr. I.G.N.G. Ngoerah Central Hospital in Denpasar. This study found that there is a significant correlation between patient’s infection profile with random blood glucose levels with an Odds Ratio (OR) of 1.15 (95% CI: 1.04 – 1.27; p = 0.013). Additionally, a significant relationship was observed between the severity of COVID-19 and bacterial infections in patients, with an Odds Ratio of 1.12 (95% CI: 1.01 – 1.26; p = 0.04). Keywords : T2DM, ICU, Hospital-Acquired Infection
KUALITAS DAN DERAJAT NYERI PADA INJEKSI PROPOFOL INTRAVENA DENGAN PEMBERIAN LIDOKAIN INTRAVENA DI RSUP SANGLAH DENPASARr Pratiwi, Made Sindy Astri; Suranadi, I Wayan; Sinardja, I Ketut; Kurniyanta, I Putu
E-Jurnal Medika Udayana Vol 11 No 3 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i03.P01

Abstract

Induksi anestesi menggunakan propofol secara intravena menyebabkan nyeri yang dapat diatasi dengan premedikasi lidokain intravena. Hingga kini, belum ada penelitian terbaru mengenai derajat dan kualitas nyeri akibat induksi propofol dengan premedikasi lidokain intravena di RSUP Sanglah Denpasar. Penelitian ini bertujuan untuk mengukur kedua hal di atas. Desain penelitian ini adalah deskriptif observasi cross-sectional bertempat di RSUP Sanglah Denpasar. Subjek penelitian dipilih dengan consecutive sampling berjumlah 39 pasien berjenis kelamin laki-laki atau perempuan, berusia 18-64 tahun, BMI 18,5-22,9 kg/m2, status fisik ASA I atau II, menjalani operasi elektif dengan propofol intravena dan premedikasi lidokain intravena, serta menandatangani informed consent. Penilaian kualitas nyeri menggunakan SFMP-Q sementara derajat nyeri dinilai menggunakan kombinasi VAS dan NRS. Data yang terkumpul akan dianalisis secara univariat. Nyeri akibat propofol intravena dengan premedikasi lidokain penelitian ini ditemukan tidak nyeri 23,1%, nyeri ringan 74,4%, nyeri sedang 2,6%, dan tidak ada yang mengalami nyeri berat. Lidokain menyebabkan sensitisasi nyeri sensori yang rendah terhadap 80% pasien dan tidak mengalami gangguan afeksi pada 80% pasien. Pada penelitian ini, propofol intravena dengan premedikasi lidokain dapat mengurangi rasa nyeri dengan sensitisasi nyeri yang rendah tanpa gangguan afeksi.
INCIDENCE OF HYPOTENSION AND NAUSEA VOMITING IN SUBARACHNOID BLOCK ANESTHESIA TECHNIQUE IN CESAREAN SURGERY Nandaswari, Ni Made Nilam; Parami, Pontisomaya; Suranadi, I Wayan; Senapathi, Tjokorda Gde Agung
E-Jurnal Medika Udayana Vol 13 No 3 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i03.P03

Abstract

Hypotension and nausea vomiting are common side effects in patients undergoing cesarean surgery with subarachnoid block anesthesia techniques. Cases of hypotension and nausea vomiting in this case are often found but research data in Indonesia, especially in Bali, is still very limited. Therefore, this research is important to do with the aim of knowing the incidence of hypotension and nausea vomiting in cesarean surgery with the subarachnoid block anesthesia technique at Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. This study used a prospective cross-sectional observational descriptive method. The study data were taken from the presence or absence of hypotension and nausea vomiting during and after cesarean surgery from April 2022 – June 2022. The data were analyzed using Microsoft Excel 2013 software to obtain characteristics of patient demographic data in the form of maternal age and gestational age, patient distribution based on height of sensory blockade, type and dose of antiemetics, type and dose of opioids, bleeding, incidence of hypotension, and incidence of nausea vomiting. The results showed that the number of patients who experienced hypotension was 13 people (28.3%), and those who did not experience hypotension were 33 people (71.7%). A total of 30 people (65.2%) patients did not experience nausea vomiting, 8 people (17.4%) experienced nausea and 8 people (17.4%) experienced vomiting. By taking good precautions, it can reduce the side effects of hypotension and nausea vomiting.
PREVALENSI PASIEN SYOK SEPSIS DI RUANG TERAPI INTENSIF RSUP SANGLAH TAHUN 2016-2020 Farha, Nabilla; Pradhana, Adinda Putra; Ryalino, Christopher; Suranadi, I Wayan
E-Jurnal Medika Udayana Vol 12 No 1 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i01.P17

Abstract

Sepsis ialah keadaan disfungsi organ yang dapat menimbulkan kematian akibat tidak teraturnya respon tubuh terhadap infeksi yang dapat memburuk menjadi syok sepsis. Syok sepsis merupakan keadaan sepsis disertai hipotensi yang menetap, sehingga memerlukan vasopresor untuk mempertahankan tekanan arteri rerata ?65 mm Hg. Salah satu penyebab utama kematian di ruang terapi intensif adalah syok sepsis. Maka dari itu, dilakukan penelitian mengenai prevalensi pasien syok sepsis di ruang terapi intensif (RTI) RSUP Sanglah Denpasar pada tahun 2016-2020 agar dapat mengetahui gambaran permasalahan syok sepsis sehingga dapat membantu dalam perencanaan sistem kesehatan mengenai penatalaksanaan syok sepsis. Penelitian ini merupakan penelitian dengan desain deskriptif retrospektif dengan menggunakan data sekunder berupa rekam medis pasien yang dirawat di RTI RSUP Sanglah Denpasar periode 2016-2020 yang didapat dari instalasi rekam medik RSUP Sanglah Denpasar. Pada penelitian ini teknik sampling yang digunakan adalaj purposive sampling yang disesuaikan dengan kriteria penelitian. Berdasarkan penelitian ini didapatkan prevalensi pasien syok sepsis sebesar 3% dengan karakteristik 50% pasien berjenis kelamin laki-laki dan 50% berjenis kelamin perempuan, mayoritas berada pada rentang usia 18-65 tahun (64%), dan mengalami kematian (52%). Melalui hasil tersebut, dapat disimpulkan angka kematian pasien syok sepsis masih tinggi. Kata kunci: kematian, prevalensi, ruang terapi intensif, sepsis, syok sepsis
CARDIOPULMONARY RESUSCITATION SUCCESS RATE IN PATIENTS WHO HAVE CARDIAC ARREST IN SANGLAH HOSPITAL Cristy, Nadia Assecia; Ryalino, Christopher; Suranadi, I Wayan; Hartawan, I Gusti Agung Gede Utara
E-Jurnal Medika Udayana Vol 11 No 6 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i06.P10

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ABSTRAK Henti jantung adalah hilangnya fungsi jantung secara mendadak dan bisa terjadi pada seseorang yang memiliki penyakit jantung atau tidak. Penyebab kejadian henti jantung terbanyak adalah penyakit pada sistem kardiovaskular seperti bradikardia, takikardia, kardiomiopati. Resusitasi Jantung Paru merupakan tindakan pertolongan untuk mengembalikan fungsi pernapasan dan sirkulasi pada orang henti jantung. Peneliti tertarik memperluas informasi mengenai Angka Keberhasilan Resusitasi Jantung Paru Pada Pasien Yang Mengalami Henti Jantung di Rumah Sakit Umum Pusat Sanglah. Penelitian ini dilakukan dengan metode deskriptif potong lintang. Subjek penelitian dipilih menggunakan metode consecutive sampling berdasarkan kriteria inklusi terhitung sejak 1 Januari 2021 sampai 30 Juni 2021 di IGD dan ruang rawat inap RSUP Sanglah Denpasar. Variabel dalam penelitian ini meliputi: data demografi pasien berupa usia, jenis kelamin, luaran. Data dianalisis secara deskriptif. Sebanyak 294 pasien yang di RJP pada tahun 2019, dan 121 pasien yang di RJP pada tahun 2020. Subjek penelitian pada tahun 2019 terdiri dari 42,5% perempuan, dan 57,5% laki-laki. Pada tahun 2020 terdiri dari 41,3% perempuan dan 58,7% laki-laki. Usia subjek penelitian dibagi menjadi delapan kelompok, namun usia dengan persentase terbanyak pada tahun 2019 adalah >65 tahun sebanyak 29,9%. Pada tabel menunjukkan bahwa populasi laki-laki yaitu 57,8% dengan usia terbanyak >65 tahun sebanyak 29,4% mengalami henti jantung. Terdapat 68,0% yang meninggal selama dua tahun. Kejadian henti jantung diperoleh sebanyak 415 kasus di RSUP Sanglah. Diperoleh angka keberhasilan RJP pasien henti jantung sebesar 32%. Keberhasilan RJP ini dapat dipengaruhi oleh beberapa faktor seperti usia, jenis kelamin. Kata kunci : angka keberhasilan, henti jantung, resusitasi jantung paru.
Effect of Hypervirulent Strains, Antibiotic Resistance, and Host Characteristics on Mortality of Klebsiella pneumoniae Bacteremia Patients at a Tertiary Referral Hospital in Denpasar, Indonesia Adhy Candra, I Kadek Bayu; Suranadi, I Wayan; Darwinata, Agus Eka; Tarini, Ni Made Adi; Dharmika, Ida Ayu Gde Wahyudevi; Fatmawati, Ni Nengah Dwi
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3297

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Klebsiella pneumoniae bacteremia is one of the leading causes of sepsis that has a high mortality rate. The effect of multidrug resistance and different virulence of Klebsiella pneumoniae on mortality is still controversial. This study aimed to determine the impact of hypervirulent K. pneumoniae (hvKp), MDR, and clinical characteristics on mortality of K. pneumoniae bacteremia patients. A retrospective cross-sectional study was conducted on  K.  pneumoniae bacteremia cases of patients hospitalized at Professor dr. I.G.N.G Ngoerah General Hospital from December 1, 2020, to May 31, 2021. A positive PCR of rmpA, iucA genes, and/or a positive string test was identified as hvKp. The mortality rate of 51 K. pneumoniae bacteremia patients samples (aged 0-74 years) was 72.5%, in which 9.8% (5/51) of them were hvKp and 51% of the isolates (26/51) produced the Extended Spectrum Beta Lactamase (ESBL). Furthermore, 9.8% (5/51) of the cases were carbapenem-resistant. Thus, hvKp, MDR, gender characteristics, and comorbidities do not significantly affect the mortality of K. pneumoniae bacteremia patients. Multivariate logistic regression analysis showed that sepsis (odds ratio (OR) 4.29; p=0.038) and adult age group (mean 50 years) (OR 3.75; p=0.039) are independent predictors with a significant effect on mortality of  K. pneumoniae bacteremia patients. Careful and integrated management of K. pneumoniae bacteremia patients is essential for better outcomes, especially in sepsis and elderly patients. Although hvKp prevalence is low, emerging MDR-hvKp in health facilities is a severe concern for further actions and research.