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Journal : Journal of Global Pharma Technology

The Effectiveness of Ranitidine Compared to Omeprazole in Maintaining Gastric Acidity in Head Injury Patients Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Gastric bleeding due to stress-related mucosal damage (SRMD) is a condition that is caused due to erosive gastritis that often occurs in critically ill patients in intensive care. One condition that is known as a risk factor for SRMD is traumatic brain injury. Two common agents used as gastric ulcer prophylaxis are proton pump inhibitor (PPI) and H2 antagonist receptor (H2AR). The goal of this study was to compare the effectiveness of PPI and H2AR administration as prophylaxis of SMRD in patients with TBIs who were treated in the ICU. Patients and Methods: This is a single-blind, randomized, controlled trial with pre and post-test measurements. All subjects were measured for baseline gastric pH before being given gastric ulcer prophylaxis. Gastric pH was measured using a pH-meter. The subjects were divided into two groups: omeprazole group (omeprazole 40 mg every 12 hours) and ranitidine group (received ranitidine 50 mg every 12 hours). The pH levels were measured regularly twice daily for five days.  Results: 56 subjects were involved in this study and divided equally into two groups. For each gastric pH measurement, the pH in both groups did not significantly differ. The optimal gastric pH was achieved in 24 hours after the first administration of gastric ulcer prophylaxis.  Conclusions: The administration of ranitidine or omeprazole is equally effective in maintaining the acidity of gastric acid in TBI patients in ICU. There was no significant difference in the incidence of gastric bleeding in ranitidine and omeprazole groups. Keywords: ICU, Gastric pH, PPI, H2-receptor antagonist.
Correlation between Central Vena Pressure Measurement with Collapsibility Index of Internal Jugular Veins in Critically ill Patients Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Central venous pressure (CVP) is popular for assessing fluid estimation, especially critically ill patients. Another method in assessing the CVP today is by using ultrasonic cardiac output monitors (USCOM) using transaortic or transpulmonary Doppler’s ultrasound. The objective of this study was to determine the correlation between CVP and IJV collapsibility index to monitor the adequacy of the intravascular volume status in critically ill patients in ICU. Patients and Method: This analytic, cross-sectional study involved 70 patients of 19 to 64 years. The internal jugular vein (IJV) collapsibility index was examined with ultrasound cardiac output monitoring (USCOM) to assess the patient's intravascular volume status, then the data was compared to CVP. The Spearman rank correlation was used to test the hypothesis. Results: The subjects consisted of 38 males and 32 females, with an age range of 19-64 years. The Spearman’s rank correlation test showed a statistically negative correlation between the CVP value and the internal jugular venous pressure index collapsibility value (R=-0.844, p <0.001). Conclusion: There is a strong negative correlation between IJV collapsibility index and CVP in patients treated in the ICU.Keywords: Hemodynamics, Volume status, CVP, USCOM, Collapsibility index.
Cefazolin as a Prophylactic Antibiotic in Laparoscopic Cholecystectomy: A Systematic Review Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 12 Issue 12 (2020) Dec. 2020
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Cefazolin is a first-generation cephalosporin prophylactic antibiotic which recommended for open cholecystectomy. Laparoscopic cholecystectomy is a clean contaminated surgery that does not require prophylactic antibiotics. Some surgeons still have the habit of giving prophylactic antibiotics for laparoscopic cholecystectomy. This systematic review aimed to examine evidence from randomized controlled trials comparing the incidence of surgical wound infection with cefazoline use. Methods: We collected randomized controlled trials (RCTs) throughout the years 2010-2020 from the Cochrane Library and PubMed in English language, which examined the incidence of surgical wound infection between the cefazolin prophylactic antibiotic groups versus placebo on laparoscopic cholecystectomy. Results: Six RCTs were included in the final analysis for a qualitative assessment using the Jadad scale, with four articles in the high category and the other two in the good category. The incidence of surgical wound infection in the cefazolin group was 1.09-4.8% (mean 2.63%) and did not differ significantly from the placebo group. Old age (> 60 years), obesity, timing of antibiotics, as well as tissue trauma and billiard spill during laparoscopic cholecystectomy were not significant factors. Conclusion: The prophylactic antibiotic cefazolin was not significant in reducing the incidence of surgical wound infection in lapaoscopic cholecystectomy. It is necessary to review the guidelines for prophylactic antibiotics in each health service place. Keywords: Cefazolin, Prophylactic antibiotics, Laparoscopic cholecystectomy, Surgical wound infection.
Scalp Nerve Block in Combination to General Anesthesia Lower the Increase of Inflammatory Markers Compared to General Anesthesia alone in Craniotomy Surgeries Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 12 Issue 02 (2020) Feb. 2020
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Regional anesthesia reduces the inflammatory response and surgery-related immunosuppressive response. The scalp nerve block technique is a relatively simple and safe technique. The goal of this study was to compare the inflammatory response between a combination of general anesthesia and scalp nerve block compared with general anesthesia in craniotomy surgery. Methods: This was a double-blind, randomized controlled trial with pre and post-test study in 50 subjects carried out at Sanglah General Hospital (Bali, Indonesia). Group A treated with scalp nerve block using 0.25% levobupivacaine solution, and group B treated with scalp nerve block using 0.9% NaCl solution. Blood tests were carried out before and after the surgery to measure platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) as inflammatory markers. Results: The mean difference of PLR, NLR, and CRP between the two groups were significantly different (p <0.001) at 72 hours after the surgery. The tests found no significant difference at before and right after the surgery (p >0.05). Conclusion: The application of scalp nerve block in combination to general anesthesia lower the increase of PLR, NLR, and CRP compared to general anesthesia alone in craniotomy surgeries.Keywords: PLR, NLR, CRP, Inflammation, Regional anesthesia.
The Effectivity of Clonidine Addition to Levobupivacaine 0.25% for Scalp Block in Patients Underwent Craniotomy Surgery Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

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Abstract

Background: The scalp nerve block technique is a relatively simple and safe technique. Clonidine is well-known as an agent that extends the analgesia effect of local anesthetic drugs. The goal of this study was to evaluate the effectiveness of clonidine addition as adjuvants in levobupivacaine 0.25% in scalp nerve block in craniotomy procedures. Patients and Methods: This was a clinical trial with a double-blind, randomized study using consecutive sampling technique. Inclusion criteria include patients underwent craniotomy surgery due to brain tumor using general anesthesia with endotracheal tube in 18-60 years of age. As an addition to general anesthesia, group a received levobupivacaine 0.25% and clonidine 2 µg/kg as a regiment for scalp block. Group B received levobupivacaine only for the same purpose. All other treatments were similar for both groups. Results: The intraoperative fentanyl requirement (100 (50-150) vs. 150 (75-200) mcg, p <0.001), the period to the postoperative first PCA dose (822.5±129.7 vs. 387.8±69.6 minutes, p <0.001), and the total need of postoperative morphine by PCA (2.0 (1.0-3.0) vs. 3.0 (2.0-7.0) mg, p <0.001) were lower in the clonidine-added levobupivacaine groups compared to levobupivacaine alone. 3 Conclusions: The addition of clonidine to levobupivacaine 0.25% on scalp block is effective in reducing the need for intraoperative and postoperative opioids, reducing postoperative pain, extending the duration of scalp nerve block, and delaying the first PCA dose.Keywords: Clonidine, Levobupivacaine, Fentanyl, Morphine, Pain, Requirements.
Effectiveness of Intravenous Subanesthetic Dose of Ketamine on the Subarachnoid Block to Attenuate Inflammation Response in Transurethral Resection of the Prostate Surgeries Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Perioperative anesthesia and surgery can induce a stress response in the body. Regional anesthesia with local anesthetic drugs in the transurethral Resection of the Prostate (TUR-P), has been proven to minimize inflammation. Patients and Methods: Forty-eight patients of ASA I-II, scheduled for TUR-P with spinal subarachnoid anesthesia were randomly divided into two groups, group A with ketamine and group B without ketamine. The blood level of interleukin (IL)-10, IL-8, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and IL-10/IL-8 ratio were measured in both groups at 1 hour before operation, also at 1 and 24 hours after operation. Results: Blood level of IL-10 (p<0.001) and IL-10/IL-8 Ratio (p<0.05) were significantly different with higher values on group A. Other parameters were not found to be different. Conclusion: Subanesthetic dose of ketamine on spinal subarachnoid anesthesia technique done for TUR-P operation was found able to control inflammation and prevent the deterioration of immune system perioperatively.Keywords: IL-10, IL-8, CRP, NLR, Benign prostatic hyperplasia.
Patients’ Characteristics and Initial Therapy at Diabetic Center of Sanglah General Hospital in 2018 Tjokorda Gde Agung Senapathi
Journal of Global Pharma Technology Volume 12 Issue 01
Publisher : Journal of Global Pharma Technology

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Abstract

Background: Diabetes mellitus (DM) is a chronic disease that requires medical treatment and education to prevent acute or chronic complications. Until today, there have been no published records in the incidence of DM in Bali. The goal of this study was to observe the characteristics of patients who visited Diabetic Center of Sanglah General Hospital in 2018. Methods: This was a cross-sectional, retrospective study. The subjects of this study were all patients newly-diagnosed with DM, aged 18 or older, who came to the Diabetic Center of Sanglah General Hospital. The sampling method was all-inclusive sampling. We recorded the age, sex, body height, body weight, body mass index (IMT), baseline fasting blood sugar, and baseline HbA1C. The data were analyzed descriptively.  Results: In 2018, 1,145 patients visited the Diabetic Center of Sanglah General Hospital. The majority of the subjects were men (66.11%), with the most frequent age-group was the 50-69 years age group (69.08%). As many as 117 patients received OADs as initial therapy, while 840 received insulin, and the remaining 665 received a combination of both OAD and insulin.  Conclusions: There were 1,145 patients visited the Diabetic Center of Sanglah Hospital in 2018, with the highest age-group was the 50-69 years age group. Only a small number of them received OADs as initial therapy, and most of received the combination of insulin and OADs.Keywords: Diabetes mellitus, Age, Sex, Bali, Indonesia.
Co-Authors A A Gde Putra Semara Jaya Adinda Putra Pradhana Adistaya, Anak Agung Gde Agung Albert Albert Anak Agung Gde Agung Adistaya Andi Irawan Andi Kusuma Wijaya, Andi Anggreni, Anak Agung Ayu Aprilnita, Aida Aryasa EM, Tjahya Aryawangsa, Anak Agung Ngurah Astawa N. M., Astawa N. Astawa P., Astawa Astuti, Mira Kusuma Astuti, Mira Kusuma Bayu Saputra, Ida Bagus Prema Satia Brillyan Jehosua Toar Budiadnyana, I Made Pasek Budiarta, Gede Cahyono, Ardy Wibowo Christopher Ryalino Christopher, Michael Cindryani Ra Ratumasa, Marilaeta Cung Flavyanto, Eugenius Silvester Cynthia Dewi Sinardja D.H., Asterina David Rendra Mahardika Dewa Ayu Mas Shintya Dewi Dewi, Dewa Ayu Mas Shintya Dewi, I Dewa Ayu Mas Shintya Doddy Setiawan Ekaputra Ekaputra, Ekaputra Elisma Nainggolan, Elisma EM, Tjahya Aryasa Emkel Perangin Angin, Emkel Eric Makmur, Eric Ery Oktadiputra Estrada, Ronald Eugenia, Michelle Ferry, Ferdinand Gede Semarawima, Gede Gede Wirya Kusuma Duarsa Giovanni, Malvin Hadiwijono, Vanessa Juventia Hartanto, Wijaya Hartawan , I.G.A.G. Utara Hartawan, IGAG Utara Hengky Hengky, Hengky Humianto, Michael I Dewa Made Sukrama I Gede Budiarta I Gede Prima Julianto I Gusti Agung Gede Utara Hartawan I Gusti Ayu Putri Purwanthi I Gusti Ngurah Mahaalit Aribawa I Ketut Sinardja I Ketut Wibawa Nada I Made Agus Kresna Sucandra I Made Bakta I Made Darma Junaedi, I Made I Made Gede Widnyana I Made Prema Putra I Made Subagiartha I Made Wiryana, I Made I Putu Agus Surya Panji I Putu Fajar Narakusuma I Wayan Aryabiantara, I Wayan I Wayan Suranadi Ida Bagus Krisna Jaya Sutawan IGNA Putra Arimbawa, IGNA Putra Jayantha Ananda, I Gusti Ngurah Bagus Jeanne, Bianca Jhoni Pardomuan Pasaribu Jimmy Wongkar Johanes, Kevin Paul Junaedi, I Made Darma Kadek Agus Heryana Putra Kadek Agus Heryana Putra, Kadek Agus Kamaswari, Ida Ayu Dwi Kenzi, Ignatio Armando Ketut Semara Jaya, Ketut Semara Ketut Wibawa Nada Ketut Yudi Arparitna, Ketut Yudi Komang Ady Widayana Komang Alit Artha Wiguna Komang Alit Artha Wiguna Kurnia, Prajnaariayi Prawira Kurniyanta, I P Kurniyanta, I Putu Kusuma, Oscar Indra Labobar, Otniel Adrians Leo, Joseph Nelson Lesmana, Pita Mora Leton, Yohanes PT Made Agus Kresna Sucandra Made Agus Kresna Sucandra, Made Agus Kresna Made Bagus Cahya Maha Putra Made Widnyana Made Wiryana Marilaeta Cindryani Marilaeta Cindryani Lolobali, Marilaeta Cindryani Marilaeta Cindryani, Marilaeta Marting, Millenia Mauritius Septa Murti, Dede Taruna Kreisnna Nada, I Ketut Wibawa Nandaswari, Ni Made Nilam Narakusuma, I Putu Fajar Ni Nyoman Sri Budayanti Ni Putu Novita Pradnyani, Ni Putu Novandi Kurniawan Pande Nyoman Kurniasari, Pande Panji, I PAS Patricia, Yoshie Pontisomaya Parami Pramana, Putu Bagus Gin Gin Pranoto, Theodorus Pascalis Yullie Pratana, Yolanda Jenny Putra, I Made Prema Putu Agus Surya Panji Putu Herdita Sudiantara, Putu Herdita Putu Kurniyanta Putu Pramana Suarjaya Ra Ratumasa, Marilaeta Cindryani Raka-Sudewi A. A. Ratumasa, Marilaeta Cindryani Ra Reynaldi Reiky Hadiwijaya Riko Riko Santo, Budi Saputra, Darmawan Jaya Satoto D., Satoto Satria Pinanditas S Sidabutar, Beny Pratama Sidemen, I Gusti Ayu Eka Para Santi Sidemen, I.G.P.Sukrana Sidemen, IGP Sukrana Sonni Soetjipto, Sonni Sri Maliawan Stefanus Taofik stefanus taofik, stefanus Suarjaya, I PP Suastika, I Gede Juli Sucandra, I Made Agus Kresna Sucandra, I MK Sumanti, Alan F. A. Sunanda Naibaho Suranadi , I Wayan Suryadi N. T., Suryadi N. Suryana, I Ketut Syamsuddin, Johanis Bosco Troy Tanuwijaya, Tommy M Tirta, Ian Tjahya Aryasa Tjahya Aryasa Tjahya Aryasa E M Tjokorda Gde Bagus Mahadewa Togi Stanislaus Patrick Virayanti, Luh Putu Diah W. A., W. Wardani, Dinar Kusuma Welly, Julian Widnyana, I MG Widyana, I Made Gede Wirananggala, Nyoman Bendhesa Wiryana M., Wiryana Yadikusumo, Andrian Yustisia, Putu Ngurah Krisna Denta