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All Journal Medicina E-Jurnal Medika Udayana Indonesian Journal of Cancer ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Global Health research Indonesian Journal of Cancer
Eka Wiratnaya
Departemen Orthopaedi Dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health

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The use of compression stockings produces lower Interleukin-6 (IL-6) levels, Higher American Orthopaedic Foot and Ankle Society Score (AOFAS), and does not produce higher alkaline phosphatase level in postoperative patients with fracture around the ankle Gede Agung Krisna Yudha; I Ketut Siki Kawiyana; Ketut Gede Mulyadi Ridia; I Ketut Suyasa; I Gede Eka Wiratnaya
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (237.333 KB) | DOI: 10.15562/ism.v12i1.895

Abstract

Background: Fractures around the ankles are common injuries. The use of compression stockings is one of the postoperative modalities that has been widely used in developing countries but is rarely used in Indonesia. This study aimed to determine the effect of using compression stockings on changes in inflammatory biomarkers level and functional outcomes in postoperative patients with fractures around the ankle.Methods: This study was a randomized clinical trial (post-operative-only design) in 26 patients with fractures around the ankle. The study subjects were divided into groups using postoperative compression stockings and groups without compression stockings. Its efficacy was assessed by measuring levels of Interleukin-6 (IL-6), Alkaline Phosphatase (ALP), and American Orthopedic Foot and Ankle Society (AOFAS) scores. Data were analyzed using SPSS version 20 for Windows.Results: Postoperative 24-hour IL-6 levels were not significantly different (p=0.200; -59.93–266.42), but they were significantly different postoperatively in 3 days (p = 0.001; 8.76-30.21), 14 days (p=0.015; 2.40-20.49), and 30 days (p=0.000; -15.49–[-5.03]). ALP was not different significantly, both at 24 hours (p=0.160; -16.0-2.80), 3 days (p=0.072; -0.65-14.19), 14 days (p=0.098; -1,310–12,54), and 30 days (p=0.419; -5.00–11.61) after surgery. The AOFAS scores was different significantly 30 days postoperatively (p=0.000; -3.915– [-1.469]).Conclusion: The use of compression stockings can be considered as postoperative therapy to lower the IL-6 levels but do not affect ALP levels in postoperative patients with fractures around the ankle. The use of compression stocking resulted in a higher AOFAS score than without wearing compression stockings in postoperative patients with fractures around the ankle.
Laminoplasty provides better functional outcomes than laminectomy in the management of cervical stenosis myelopathy: a systematic review Putu Kermawan; I Ketut Siki Kawiyana; I Gusti Ngurah Wien Aryana; I Gusti Lanang Ngurah Agung Artha Wiguna; I Gede Eka Wiratnaya; I Ketut Suyasa
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (297.207 KB) | DOI: 10.15562/ism.v12i1.896

Abstract

Background: Increasing the life expectancy of an individual will be accompanied by the emergence of various degenerative diseases such as cervical stenosis myelopathy (CSM). CSM is characterized by the presence of signs and symptoms of spinal cord compression associated with narrowing the spinal canal dimensions. Decompression can be achieved by conventional methods such as laminectomy or a lamina reshaping procedure known as a laminoplasty. This study reports recent evidence regarding laminectomy and laminoplasty procedures in managing CSM in terms of functional outcomes.Methods: A systematic search was conducted on the PUBMED database to identify and find studies comparing laminoplasty and laminectomy procedures. Inclusion criteria included patients older than 65 years diagnosed with cervical myelopathy, including CSM and/or ossified posterior longitudinal ligament (OPLL). Randomized controlled studies and prospective and retrospective cohorts were included in this study, while case series and case reports were excluded. The comparison of effectiveness is based on the results of measuring functional outcomes using the Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and the visual analogue scale (VAS) for pain assessment.Results: A thorough search through the PUBMED database yielded 156 citations. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 14 articles. All articles have a retrospective cohort design. In total, there were 187 patients in the laminoplasty group and 161 patients in the laminectomy group. There was no significant difference between laminoplasty and laminectomy when viewed from the JOA score in weighted mean difference (WMD) (WMD 0.28; 95% Confidence Interval [CI]:-0.34-0.91) and VAS score (WMD 0.06; 95% CI: -1.13-1.02). However, laminoplasty was shown to have a better NDI score (WMD 3.32; 95% CI: -6.50-0.14).Conclusion: Laminoplasty is superior to laminectomy for managing cervical myelopathic stenosis in terms of NDI score.
Bacterial growth from the surgical wound base smear at the end of the operation and superficial surgical site infection in the administration of cefazolin single dose, ceftriaxone single dose, and ceftriaxone 3 days as prophylactic antibiotics in cases of Mario Daniel Simatupang; I Wayan Suryanto Dusak; I Ketut Suyasa; I Gede Eka Wiratnaya
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.031 KB) | DOI: 10.15562/ism.v12i1.898

Abstract

Background: The use of prophylactic antibiotics in hospitals still often found to be not in accordance with the guidelines of prophylactic antibiotics used and therapy published by the hospital itself. This study aims to compare the effectiveness of prophylactic antibiotics between cefazolin and ceftriaxone in single-dose administration in patients with closed long bone fractures after implant surgery in Sanglah General Hospital on the incidence of Surgical Site Infection (SSI) and germ growth on the base of the surgical wound.Methods: This study used a randomized clinical trial design from a population of closed long bone fracture patients who underwent implant surgery at Sanglah General Hospital. The sample selection was carried out by consecutive sampling during the period July-August 2020. The statistical test was the Chi-Square Test or Fisher Exact Test using the SPSS version 20 for Windows.Results It was found that there was no growth of germs, or in other words, negative culture results were obtained in all study subjects (growth of N (%) 0 (0%), p = -) bacteria in all three groups on a single dose and 3-days dose. SSI did not occur in all study subjects in the three groups so that it could automatically be concluded that there was no difference in the proportion of SSI incidents in the three groups (SSI incidence N (%) 0 (0%), p = -) on single-dose and 3 days dose antibiotics administration, so that the proportional comparison test, either the Chi-Square test or the Fisher Exact test, cannot be performed.Conclusion The prophylactic antibiotics (which are the cephalosporins, namely single dose generic cefazolin and single-dose generic ceftriaxone and 3 days dose) have the same effectiveness in preventing the growth of germs on the surgical wound base smear and prevent the occurrence of superficial SSI on the 30th postoperative day.
Perbandingan angka kejadian low back pain pada buruh suun dan buruh angkat pasir Made Krisna Wibawa Paramartha; I Gede Eka Wiratnaya; Ketut Gede Mulyadi Ridia
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (365.412 KB) | DOI: 10.15562/ism.v12i1.917

Abstract

Background:  Low Back Pain (LBP) is a clinical syndrome that manifests in the form of pain in the 12th rib area and the gluteal folds. Globally, 60% of LBP sufferers are related to work that involves lifting heavy loads. Sandbag-lifters and lifting goods on the top of the head (suun) workers are at risk of suffering from LBP, therefore this connection needs to be investigated further. Aims : This study aims to examine the correlation between occupation, especially lifting sandbags and suun workers with the LBP event among manual laborers in Kumbasari Market, Karangasem, Bali.Method: This study is an observational analytical study using a cross sectional approach. Data were taken using a primary source through the Modified Oswestry Low Back Pain Disability’ questionnaire answers.Result : Totally, there are 50 manual laborers who voluntarily join the study which consist of  25 sandbag lifting workers and 25 suun workers. Respondents’ age ranged According to Body Mass Index (BMI) measurement, most of them (60%) are overweight. In general, 74% manual laborers experienced LBP with the sandbag lifting workers having a higher percentage compared to suun workers (92% vs 56%). Chi-square analysis shows that male gender (r=0.395; p=0.005)., age < 33.6 years old (r=0.296; p=0.037) and working as a sandbag lifter (r=0.633; p=0.000) are correlated with the LBP event.Conclusion : Working as a sandbag lifting workers is correlated with LBP. The other factors that are correlated as well are younger age and male gender. Further longitudinal study needs to be done to assess the risk of LBP.  Latar Belakang: Latar Belakang: Low Back Pain (LBP) merupakan sindrom klinis yang bermanifestasi berupa nyeri di daerah rusuk ke-12 dan lipatan gluteal. Secara global, 60% penderita LBP berhubungan dengan pekerjaan yang melibatkan mengangkat beban berat. Pekerja pengangkat karung pasir dan pengangkat barang di atas kepala (suun) pekerja berisiko menderita LBP, oleh karena itu keterkaitan ini perlu diteliti lebih lanjut.Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara pekerjaan khususnya pekerja angkat karung pasir dan pekerja suun dengan kejadian LBP pada tenaga kerja manual di Pasar Kumbasari, Karangasem, Bali.Metode: Penelitian ini merupakan penelitian analitik observasional dengan pendekatan cross sectional. Pengambilan data menggunakan sumber primer melalui jawaban kuesioner Modified Oswestry Low Back Pain Disability.Hasil: Total ada 50 pekerja manual yang secara sukarela mengikuti studi yang terdiri dari 25 pekerja pengangkut karung pasir dan 25 pekerja suun. Rentang umur responden berdasarkan pengukuran Body Mass Index (BMI), sebagian besar (60%) mengalami kegemukan. Secara umum 74% pekerja manual mengalami LBP dengan persentase pekerja pengangkat karung pasir lebih tinggi dibandingkan dengan pekerja suun (92% vs 56%). Analisis chi-square menunjukkan bahwa jenis kelamin laki-laki (r = 0,395; p = 0,005)., Usia <33,6 tahun (r = 0,296; p = 0,037) dan bekerja sebagai pengangkat karung pasir (r = 0,633; p = 0,000) berkorelasi dengan acara LBP.Kesimpulan: Bekerja sebagai pekerja pengangkut karung pasir berhubungan dengan LBP. Faktor lain yang berkorelasi juga adalah usia yang lebih muda dan jenis kelamin laki-laki. Studi longitudinal lebih lanjut perlu dilakukan untuk menilai risiko LBP.
PREVALENSI TUMOR TULANG GANAS RSUP SANGLAH DENPASAR PADA TAHUN 2013-2015 Indraharsana, Ida Bagus Yudharma; Wiratnaya, I Gede Eka
E-Jurnal Medika Udayana Vol 12 No 9 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i09.P09

Abstract

Tumor tulang ganas sering bermetastasis atau menyebar keseluruh tubuh. Di hampir semua kasus, pengobatan untuk tumor ganas melibatkan kombinasi kemoterapi, radiasi, dan pembedahan. Tujuan penelitian untuk mengetahui gambaran dan prevalensi tumor tulang ganas di RSUP Sanglah Denpasar. Penelitian ini menggunakan rancangan retrospektif deskriptif terhadap 28 orang pasien tumor tulang ganas di RSUP Sanglah tahun 2013-2015. Terdiri dari tiga jenis tumor tulang ganas yaitu Osteosarcoma, Ewing Sarcoma, dan Chondrosarcoma. Berdasarkan hasil penelitian yang dilakukan ditemukan bahwa penderita tumor tulang ganas ganas (Osteosarcoma, Ewing Sarcoma, dan Chondrosarcoma) dari 28 orang sampel lebih banyak ditemukan pada jenis kelamin perempuan yaitu sebanyak 15 orang (54%) dibandingkan penderita dengan jenis kelamin laki-laki yang berjumlah 13 sampel (46%). Hasil penelitian juga menunjukkan bahwa tumor tulang ganas utamanya Osteosarcoma, Ewing Sarcoma, dan Chondrosarcoma didominasi oleh penderita pada usia remaja (13-20 tahun) yaitu sebanyak 17 orang (60,7%), usia dewasa awal (21-35 tahun) sebanyak 5 orang (17,9%), dewasa madya (36-60 tahun) sebanyak 4 orang (14,3%), dan masing-masing satu kejadian (3,6%) pada individu dengan pada usia anak dan dewasa lanjut. Kata kunci : Tumor tulang ganas, umur, jenis kelamin, jenis tumor, lokasi
Perbedaan Kadar Tumor Marker CEA dan CA 125 Antara Karsinoma Paru dengan Metastase Tulang dan Karsinoma Paru Tanpa Metastase Tulang di RSUP Sanglah Denpasar Tamzil, Kezia Aurelia; Wiratnaya, I Gede Eka; Astawa, Putu; Suyasa, I Ketut
E-Jurnal Medika Udayana Vol 11 No 11 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i11.P07

Abstract

Lung carcinoma is one of the most common malignancies metastasized to bone, as much as 30-40% of lung malignancies metastasize to bone in the course of the disease. Carcinoembryonic Antigen (CEA) and Cancer Antigen 125 (CA 125) are tumor markers often used to assess lung malignancy. Eventhough the character of tumor markers are less sensitive and specific, some evidence address an increase in these tumor markers in the case of lung malignancies which metastasize to bone. The purpose of this study is to prove an increase in the levels of tumor markers CEA and CA 125 in lung carcinoma with bone metastases compare to lung carcinoma without bone metastases. A cross sectional study consecutively by reviewing lung carcinoma with bone metastases and without bone metastases in patient’s medical record between 2013-2021 at RSUP Sanglah Denpasar. Of 50 lung carcinoma patients (25 patients with bone metastases and 25 patients without bone metastases), levels CEA and CA 125 tumor markers were processed using SPSS. The results showed levels of CEA were significantly higher in lung carcinoma with bone metastases (p=0,028), but levels of CA 125 were not significantly higher in lung carcinoma with bone metastases (p=0,796). The results of the study concluded that levels of CEA could be used as a valuable marker to assess lung malignancy which metastasized to bone in clinical application. Keywords: Tumor Marker Levels, CEA, CA 125, Lung Carcinoma, Bone Metastases
Marginal Excision as a Surgical Treatment for The Schwannoma of Posterior Aspect of Femur: A Case Report Raditya, Risang Haryo; Wiratnaya, I Gede Eka
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1151

Abstract

Introduction: Schwannoma is a benign nerve sheath neoplasm attached to a peripheral nerve that often develops in the middle-aged population. It usually presents as an asymptomatic mass at first but can be transformed into a pain, swelling, neurologic, or mechanical symptom in several patients. In this study, we are reporting a case of a schwannoma of the posterior aspect of the thigh, in a young adult male. Case Presentation: We reported a 31-year-old male complained of sharp pain, tingling sensation, and mechanical block in the posterior aspect of the right thigh. Radiological imaging showed the tumor of the posterior aspect of the right thigh, with associated soft tissue edema, the cortex is not invaded. Surgical resection was performed on the patient and the tumor was excised with marginal excision surgery technique. Conclusions: The schwannomas of the femur can successfully be excised with no postoperative complications. There is no sign of a recurrent tumor in six months after the procedure.
Retrograde Insertion of An Antegrade Intramedullary Femoral Nail for Treatment of A Pathological Femoral Shaft Fracture in A Patient with Metastatic Bone Disease Kusuman, Kevin; Wiratnaya, I Gede Eka
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.4420

Abstract

Pathological fractures of the femur due to metastatic bone disease are challenging to treat, requiring stabilization to improve patient quality of life. Intramedullary nailing is a common treatment method, typically performed in an antegrade manner. However, in cases where antegrade insertion is difficult, retrograde techniques may be considered. We report a case of a 68-year-old female with metastatic breast cancer, presenting with a pathological fracture of the femoral shaft. Due to a large proximal femoral lesion and limited access for traditional antegrade femoral nail insertion, a retrograde approach was chosen. A standard antegrade intramedullary femoral nail was inserted retrograde through the distal femur. The procedure was successful, providing immediate stability and pain relief. Postoperatively, the patient was able to ambulate with assistance and was discharged for further oncological management. The retrograde insertion of an antegrade femoral nail offers an alternative in cases where antegrade insertion is not feasible due to proximal femoral involvement. While antegrade nailing is traditionally preferred, retrograde techniques offer comparable stability and functional outcomes, especially in metastatic bone disease where palliative treatment is a priority. This approach allows for reduced surgical trauma and faster recovery. Retrograde insertion of an antegrade femoral nail can be a viable option for stabilizing pathological femoral shaft fractures in patients with metastatic bone disease. It provides a feasible alternative when conventional approaches are not suitable, improving patient outcomes and quality of life.
Co-Authors Aakash Aakash Achmad Fauzi Kamal Agus Roy Rusly Hariantana Hamid Anak Agung Wiradewi Lestari Dewa Ayu Karunia Dewi Elysanti Dwi Martadiani Gede Agung Krisna Yudha Gede Ketut Alit Satria Nugraha Gusti Made Laksmana Aris Saputra Gusti Ngurah Putra Stanu Herryanto Agustriadi Simanjuntak I Gede Nata Desrianta I Gusti Lanang Ngurah Agung Artha Wiguna I Gusti Ngurah Pramartha Wijaya Putra I Gusti Ngurah Wien Aryana I Ketut Suyasa I Made Artha Wibawa I Wayan Juli Sumadi I Wayan Subawa I Wayan Suryanto Dusak Indraharsana, Ida Bagus Yudharma Ivander Purvance Ketut Gede Mulyadi Ridia Ketut Siki Kawiyana Khema Metta Wijaya Komang Septian Sandiwidayat Kusuman, Kevin Made Bramantya Karna Made Karina Duta Dwijayanti Made Wirabhawa Mario Daniel Simatupang Meiske Margaretha Ngakan Gde Agung Panji Khrisna Sudharma Ni Made Puspa Dewi Astawa Pande Putu Esa Cesarani Putu Astawa Putu Kermawan Raditya, Risang Haryo RINO PATTIATA Rino Pattiata Setiawan, I Gede Budhi Tamzil, Kezia Aurelia