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All Journal JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Firman Setya Wardhana
Department Of Ophthalmology, Faculty Of Medicine, Public Health, And Nursing, University Of Gadjah Mada, Yogyakarta, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Kadar Plasma 25-Hydroxyvitamin-D (25-OHD) pada Pasien Age-related Macular Degeneration (AMD) Stadium Akhir di Yogyakarta: Studi Korelasi Supanji Supanji; Dewi Fathin Romdhoniyyah; Ayudha Bahana Ilham Perdamaian; Anindita Dianratri; Muhammad Bayu Sasongko; Angela Nurini Agni; Tri Wahyu Widayanti; Firman Setya Wardhana; Dian Caturini Sulistyaningrum; Mohammad Eko Prayogo; Masashi Kawaichi; Chio Oka
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art3

Abstract

Background: Age-related Macular Degeneration (AMD) is a degenerative disease caused by multiple factors, including inflammation. This condition may lead to irreversible macular damage. Vitamin D has anti-inflammatory and immune-modulating qualities, therefore, is expected to protect against the development of AMD.Objective: This study aimed to evaluate the correlation between plasma 25-hydroxyvitamin D (plasma 25-OHD) levels and neovascular Age-Related Macular Degeneration (nAMD).Methods: This was a case-control study involving AMD and control subjects. All subjects underwent a standardized eye examination to check for eligibility by a retinal specialist. Blood samples were drawn for analysis using a DRG Elisa Kit to determine the plasma 25-OHD (Total). Plasma 25-OHD levels were categorized into deficiency (<12 ng/mL), insufficiency (12 - <20 ng/mL), adequate (20 – 50 ng/mL), and high (>50 ng/mL).Results: Total subjects were 39, which consisted of 20 AMD subjects and 19 controls. There were 17 male subjects (43.6%) and 22 female subjects (56.4%). The mean age for the case and control group was 69.35±7.04 and 68.26±6.83, respectively (p=0.612). Those in their 70s dominated the age distribution with a percentage of 56.41% of all participants. The mean plasma 25-OHD in the case group was 32.30±17.10 ng/mL, while the control group was 50.63±11.95 ng/mL (p=0.066). There was no significant association between AMD and plasma 25-OHD levels in all groups (p>0.05).Conclusion: Plasma 25-OHD levels did not correlate positively with nAMD in our study population.
PEMODELAN DAN SIMULASI ANTRIAN UNTUK MEMPERBAIKI WAKTU TUNGGU POLIKLINIK VITREORETINA RS MATA “DR.YAP” YOGYAKARTA Anggun Desi Wulandari; Irwan Endrayanto Aluicius; Firman Setya Wardhana
Journal of Health Service Management Vol 25 No 01 (2022)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpk.v25i01.4771

Abstract

Background: Queuing problems often occur in the health care industry, such as hospitals. The problem has arisen because many requests access the services, but it is in imbalance with the adequacy of providers. Increased outpatient visits at the vitreoretinal polyclinic at the “Dr. YAP” causes long queues and long waiting times. Meanwhile, waiting time is an essential indicator of service quality in hospitals and affects patient satisfaction. Queueing model and simulation can be one method to identify queuing process problems and find the most optimal queuing scenario. Objectives: Identify the queuing system model at the vitreoretinal polyclinic service at the “Dr. YAP”, analyze the vitreoretinal polyclinic queuing system’s performance measures, and identify the optimal queuing scenario through simulation to improve the total waiting time. Methods: This research was conducted in two stages. The first stage is a quantitative descriptive analysis where the queue performance parameters are calculated. Data collection techniques used in this research are observation to obtain primary data (patient arrival time, service time, and waiting time on each server) and interviews to get supporting data. The second stage is the study of model construction. At this stage, the simulation model is designed to predict changes in patient waiting time for several scenarios using Ms. Excel and JaamSim software. Results: The queuing system model in the vitreoretinal polyclinic is Multi-Channel Multi-Phase, consisting of 3 queue phases with more than 1 server. A total of 338 patients were served, and the patients’ largest distribution for total waiting time was patients who waited for > 2 hours (41.12%) and between 1-2 hours (37.57%). The longest waiting time is for a doctor’s check-up length of 1 hour and 47 minutes. Several queuing scenarios were made from several identified problems. The first scenario, simulating the doctor’s arrival on time, reduces 25% of the total waiting time to 1 hour and 20 minutes. In the second scenario, separating the laser procedure schedule reduces 4% of the waiting time to 1 hour and 43 minutes. By combining scenarios 1 and 2, the third scenario reduced the total waiting time by 29% to 1 hour and 16 minutes. The fourth scenario is carried out through modeling on the JaamSim software by adding one doctor and one nurse, and the result is that there is a decrease in waiting time and the number of patients waiting in queues. Conclusions: Hospitals can take several ways to improve the waiting time. The first is to improve the punctuality of doctor’s practice time. This effort can be made by evaluating the starting hours of a doctor’s practice following the doctor’s feasibility and using an information system that can send automatic messages to the patients regarding the doctor’s practice start time and the patient’s arrival time. The second is the separation of the queue for laser procedures from the polyclinic queue. Laser procedures for reserved patients can be scheduled before the start of practice, after the practice, or on another day. Third, the addition of a Retinal Subspecialist Doctor and nurses at certain hours when there is no retinal schedule. The doctor is a preferably permanent doctor who has first practice license at the “Dr. YAP” Eye Hospital.
Surgical Technique of Late Spontaneous IOL-Capsular Bag Complex Dislocation with Low Corneal Endothelial Cell Density: A Case Report Firman Setya Wardhana; Dhimas Hari Sakti; Supanji Supanji; Muhammad Bayu Sasongko; Tri Wahyu Widayanti; Angela Nurini Agni
International Journal of Retina Vol 2 No 1 (2019): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2019.vol002.iss001.54

Abstract

Introduction: IOL-capsular bag complex dislocation is a rare but serious complication of phacoemulsification surgery. Technique to repair this complication should be based on various clinical parameters including quality of corneal endothelial cells and the type of dislocated IOL. Case Presentation: We present a case of a 67-year-old male with left eye spontaneous one-piece foldable IOL-capsular bag complex dislocation to vitreous cavity 4 years after phacoemulsification surgery. Visual acuity of the left eye was 1/60, pupil was round with 3 mm diameter and IOP was 15 mmHg. Noncontact specular microscopy examination showed that the corneal endothelial cell density was 1100 cells/mm2. It was managed with 23-gauge posterior vitrectomy, IOL evacuation to anterior chamber, releasing the capsular bag and repositioning the IOL into posterior chamber by sutured scleral fixation. Result: Follow-up at 6thmonth, best corrected visual acuity of the left eye achieved 6/6, IOL at central position and the last corneal endothelial cell density was 1076 cells/mm2. Conclusions: Late spontaneous IOL-capsular bag complex dislocation with low corneal endothelial cell density can be safely managed with proper surgical technique. Vitrectomy and sutured scleral fixation of the previously dislocated IOL were effective in managing such case. Longer follow-up should be done to assure the stability of IOL position and the quality of corneal endothelial cells.
Vitreous Hemorrhage in Dr.Sardjito General Hospital Irene Titin Darajati; Firman Setya Wardhana; Mohammad Bayu Sasongko; Supanji Supanji; Tri Wahyu Widayanti; Angela Nurini Agni
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i3.106

Abstract

Background: Vitreous hemorrhage is the extravasation of blood in the vitreous cavity of the eye. It cause mild vision impaired to blindness. Moreover, vitreous hemorrhage obscures the posterior segment and if severe and non-traumatic, may lead to diagnostic dilemmas unless associated with classic systemic sign and symptoms. Objective : To provide data regarding causes and clinical aspects of vitreous hemorrhages to guide clinicians in better delineating the expected etiologic patterns of these hemorrhages. Methods: We collected medical records of patient who diagnosed vitreous hemorrhages in  Dr. Sardjito General Hospital Jogjakarta between March 2015-March 2016. Characteristics of patients to be explored: age, visual acuity and gender. The data were analyzed descriptive quantitative.Results: There were 189 patients (200 eyes) who diagnosed vitreous hemorrhage in first examination. Fifty three percent of them were male and 47 % were female, most of them  were over 50 years old (67.2%) and 32.8% were under 50 years old. The causes of vitreous hemorrhage were proliferative diabetic retinopathy in 131(69.3%), age-related macular degeneration (AMD) 17(9%), retinal vein occlusion 11(5.8%), retinal tear 8(4.2%), Posterior Vitreous Detachment 4(2.1%), vasculitis 3(1.6 %), Polypoidal Choroid Vasculopathy 2(1.1%), trauma 2(1.1%), Eales disease 1(0.5%), and unknown 10(5.3%) patients.  Vitreous hemorrhage caused by diabetic retinopathy had vast range of visual acuity (6/7,5- Light Perception) and the worst was among patients with AMD.Conclusion: Most of vitreous hemorrhages caused by proliferative diabetic retinopathy. AMD give the worst visual acuity.  Keywords: Vitreous hemorrhage, etiology, visual acuity
Patient's Perspective of Eye Service Quality in Yogyakarta's Teaching Hospital Dhimas Hari Sakti; Indra Tri Mahayana; Firman Setya Wardhana; Dwima Faiqa Nafisha; Dhimas Ali Firman; Novika Handayani; Tiara Putri Utami
Majalah Oftalmologi Indonesia Vol 44 No 2 (2018): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v44i2.165

Abstract

Introduction : The eye care service in The Dr. Sardjito Hospital has one of the highest number of patients amongst other health care services provided. Thus evaluation of the patients' satisfaction upon the service provision is needed to improve the quality of the eye care service. Methods : A cross-sectional study was performed in the ophthalmology outpatient clinic at the teaching hospital in Daerah Istimewa Yogyakarta, Indonesia. Interviews were conducted on 77 patients using Patient Satisfaction Questionnaire Short Form (PSQ-18) in 2017. Results : Overall, patients were mostly satisfied with the interpersonal manner of the doctors (mean : 4.12  0.42) and least satisfied with the time spent with doctors (mean : 3.310.95). There was a statistically significant difference among each subscale (p=0.000). Gender, income, occupation, and education had no significant statistical difference to the aspects of quality. However, significant differences were found in the financial aspects of marital status, education level, and co-diagnoses group with p-value of 0.009, 0.043, and 0.048 respectively. Conclusions : Patient satisfaction could be improved by increasing the time spent at each visit with the doctor. Meanwhile, financial aspect is mostly affected by the patients’ background. This study needs to be continued to get wider perspectives on the larger population sample of eye patients. Therefore, the quality of eye care services may be improved.
Co-Authors Angela Nurini Agni Angela Nurini Agni Angela Nurini Agni Anggun Desi Wulandari Anindita Dianratri Ayudha Bahana Ilham Perdamaian Chio Oka Dewi Fathin Romdhoniyyah Dhimas Ali Firman Dhimas Hari Sakti Dian Caturini Sulistyaningrum Dwima Faiqa Nafisha Indra Tri Mahayana Irene Titin Darajati Irwan Endrayanto Aluicius Masashi Kawaichi Mohammad Eko Prayogo Muhammad Bayu Sasongko Novika Handayani Supanji Supanji Supanji Supanji Supanji Supanji Tiara Putri Utami Tri Wahyu Widayanti Tri Wahyu Widayanti Tri Wahyu Widayanti