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Peran Brain Stimulation TMS Pada Prajurit Penderita Depresi Yang Penugasan di Kapal Perang I KETUT TIRKA NANDAKA
HANG TUAH MEDICAL JOURNAL Vol 19 No 1 (2021): Hang Tuah Medical Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/htmj.v19i1.80

Abstract Military personnel have a high risk of suffering from depression due to the nature of their work and training, separation from family, carrying out military missions, changing tasks, assignments in narrow places (warships) and being exposed to dangerous events and equipment. In a study by Al-Amri et al., in Saudi Arabia by taking 357 random samples, it was found that the prevalence of depression was 17.1% in an area of military operations in the Middle East. PDSKJI (2017) reports that 3.7% of the population in Indonesia suffers from depressive disorders. This study is a case report pre and post test design as many as 4 patients of naval soldiers who have been diagnosed with major depressive disorder who will receive standard therapy in the form of antidepressants and psychotherapy. First, an assessment of the level of depression was carried out using the BDI (Beck Depression Inventory) and HDRS (Hamilton Depression Rating Scale). Standard therapy for depression was given to both groups and one group plus TMS augmentation therapy, power adjusted to RMT (resting motor threshold), TMS therapy protocol with amplitude 100% high frequency 18 Hz, 2 sec with inter-train intervals of 20 sec, 55 and 59 train for 20 minutes 5 times a week. From the results of this study, clinically all patients who received TMS augmentation showed better clinical results starting from the first week of therapy with a decrease in BDI scores of 15 points and HDRS scores of 14 points. Scores decreased by a difference of 6-8 points on the BDI scale and a difference of 5-7 on the HDRS scale in patients receiving standard therapy compared to those receiving standard therapy and TMS augmentation. Keywords : Depression – BDI / HDRS - Soldier - TMS

Clinical insights: Anxiety levels and sleep quality among Hang Tuah Faculty of Medicine's class of 2017-2022 pre-clinical and clinical Students Ronald Pratama A.; Janette Alvina; Joel Timothy; Jihan Delima; Jocelyn Christabella; Kadek Aris Saputra Mulya; Hendra Widjajanto; Renata Prameswari; I Ketut Tirka Nandaka
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 8 No 01 (2024): Qanun Medika Vol 08 No 01 January 2024
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v8i01.20074

Anxiety is a global psychiatric phenomenon, while poor sleep quality remains a pressing public health issue. The arduous medical education journey exposes students to prolonged stress, potentially exacerbating anxiety and sleep disturbances. This study investigates the correlation between anxiety and sleep quality in Hang Tuah Faculty of Medicine students, bridging the pre-clinical and clinical phases. Employing an analytical observational approach with a cross-sectional design, this study enrolled students from pre-clinical (batches 2020, 2021, 2022) and clinical years (batches DM45, DM46, DM47). Among the 409 approached participants, 296 met the inclusion criteria after excluding 113 samples. Data collection utilized online questionnaires with acquired informed consent. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, generating scores from 0 to 21. This study showed significantly robust evidence of an association between anxiety and sleep quality (p-value: 0.0001; r: 0.342) across both pre-clinical and clinical students. This study underscores a direct relationship: elevated anxiety levels correspond to diminished sleep quality. Such findings resonate with the prevailing challenges in medical education and their impact on students' mental and physical well-being. Implementing targeted interventions is crucial to address these concerns. In conclusion, this study underscores the undeniable link between anxiety and sleep quality among Hang Tuah Faculty of Medicine students, encompassing the years 2017 to 2022. The implications are far-reaching, emphasizing the necessity of interventions that enhance both psychological well-being and sleep quality. By recognizing and addressing these challenges, medical institutions can foster healthier academic environments and better equip students for their medical careers.

PERAN TERAPI HBO TERHADAP PERBAIKAN KLINIS DAN KUALITAS HIDUP PASIEN DEPRESI devi, ismylatifa; Rahardjo, Indarwati Mulio; Ayu P, Intan Tiara; Azizah, Ismi; Mardinata P, Ivan; Nandaka, I Ketut Tirka; Poerwanto, Eka
E-Jurnal Medika Udayana Vol 13 No 07 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i07.P16

ABSTRAK Depresi adalah gangguan mood dengan gejala merasa kosong, kelelahan yang berlebihan, hilang motivasi untuk beraktivitas hingga menimbulkan keinginan untuk bunuh diri. Berdasarkan data WHO bunuh diri pada orang depresi merupakan salah satu penyebab utama kematian pada usia produktif. Terapi Oksigen Hiperbarik (HBOT) adalah terapi pemberian oksigen 100% dalam tekanan lebih dari 1 ATA. Beberapa studi menunjukkan manfaat signifikan dari HBOT pada tubuh, salah satunya meningkatkan produksi antioksidan tubuh. Studi ini akan mengkaji lebih lanjut mengenai peran HBOT terhadap perbaikan klinis dan kualitas hidup pasien depresi yang diukur melalui kuisioner HDRS dan BDI. Desain studi adalah kuasi eksperimen, sebanyak 7 pasien dilakukan pemeriksaan tingkat depresi dengan kuisioner HDRS dan BDI. Pasien dengan skor di atas 10 (menunjukkan depresi ringan-berat) selanjutnya mengisi kuisioner untuk kualitas hidup. Setelah penilaian dengan kuisioner, pasien mendapatkan terapi oksigen hiperbarik selama 5 hari. Setelah pemberian HBOT dilakukan pemeriksaan ulang perbaikan klinis dan kualitas hidup. Hasil penelitian menunjukkan pada sebelum dan sesudah terapi HBO terdapat perubahan pada perbaikan klinis melalui penilaian HDRS (p=0.001) dan BDI (p=0.012) dan kualitas hidup pasien dengan penilaian WHOQOL domain 1 (p=0.014), domain 2 (p=0.071), domain 3 (p=0.022), domain 4 (p=0.013). Perubahan signifikan (p<0.005) pada hasil pretest dan posttest menunjukkan perbaikan klinis dan kualitas hidup pasien meningkat sebelum dan sesudah terapi HBO. Kata kunci : Depresi, Terapi Oksigen Hiperbarik, Kualitas Hidup

Hubungan Tingkat Stres Dengan Durasi Bermain Game Online Pada Mahasiswa Angkatan 2020 Pendidikan Dokter Fakultas Kedokteran Universitas Hang Tuah Surabaya Rafly, Muhammad; Nandaka, I Ketut Tirka; Mutiadesi, Wahyu Prasasti; Pasaribu, Irma A.
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 5 No. 1 (2024): Juni
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar

Stres dapat dialami oleh siapa saja, termasuk mahasiswa, dan penyebabnya dapat berasal dari berbagai faktor seperti lingkungan, faktor internal diri, atau pikiran. Saat menghadapi situasi yang memicu terjadinya stres tubuh akan merespon dengan mengalami stres. Jika stres ini tidak ditanggulangi, dapat berkembang menjadi stres berat, dan tanpa penanganan yang tepat dapat mengalami gangguan mental serius seperti depresi, dan gangguan kecemasan. Ketika seseorang mengalami stres, ada upaya untuk mengatasinya, dan salah satu caranya adalah dengan bermain game. Penelitian ini bertujuan untuk mengetahui hubungan tingkat stres dengan durasi waktu bermain game online pada mahasiswa Angkatan 2020 pendidikan dokter Fakultas Kedokteran Universitas Hang Tuah Surabaya. penelitian ini bersifat observational analitik merupakan penelitian yang menjelaskan adanya hubungan antar variable. Desain penelitian yang digunakan adalah cross sectional dimana semua data yang menyangkut variable penelitian diukur pada waktu bersamaan (point time approach). Sampel diambil dengan teknik pengambilan simple random sampling sebanyak 64 orang. Alat dan bahan yang digunakan dalam penelitian ini adalah kuesioner. menggunakan analisis uji korelasi spearmen dengan tingkat kemaknaan α = 0,05 atau 95%. Hasil uji statistic didapatkan nilai p = 0,907 > α = 0,005. Didapatkan bahwa tidak adanya hubungan tingkat stres dengan durasi waktu bermain game online. Tidak ada hubungan tingkat stres dengan durasi bermain waktu bermain game online pada mahasiswa Angkatan 2020 Pendidikan Dokter Fakultas Kedokteran Universitas Hang Tuah Surabaya.

The Effect of Hyperbaric Oxygen in Reducing Blood Cortisol Levels in Patients with Sleep Disorders I Ketut Tirka Nandaka; Hisnindarsyah Hisnindarsyah; Saptono Putro
Jurnal Indonesia Sosial Sains Vol. 5 No. 12 (2024): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v5i12.1530

Sleep disorders disrupt normal sleep patterns, including timing, duration, and quality, often linked to elevated cortisol levels and high nerve metabolism requiring oxygen. Hyperbaric oxygen therapy (HBO), delivering pure oxygen in high-pressure settings (≥1.4 ATA), may alleviate hypoxia and reduce cortisol, offering potential treatment for sleep disorders. This research uses a quasi-experimental design with a randomized pre-post control group design. The population studied was male sleep disorder sufferers, aged 25-40 years at the psychiatric poly of Dr. Ramelan Surabaya Hospital, with a sample of 9 members of the Indonesian Navy who met the inclusion and exclusion criteria. This research is related to development research in the field of health and maritime, with a focus on diving and hyperbaric oxygen therapy, which is expected to be published in the International Journal indexed Shinta 2. This research has the potential to enrich the understanding of the effects of Oxygen Hyperbaric (OHB) therapy in overcoming sleep disorders, as well as contributing to the health and maritime sectors. The research concluded that OHB therapy in sleep disorder patients resulted in a slight reduction in mean cortisol levels (from 79.09 ng/ml to 76.38 ng/ml). Although the majority of patients (56%) experienced a decrease in cortisol levels after therapy, there was no statistically significant effect of OHB therapy on cortisol levels in sleep disorder patients.

Depression Among Cervical Cancer Patients: A Cross-Sectional Analysis of Clinical and Sociodemographic Factors sharond, zhaqirra; Nefertiti , Eva Pravitasari; Nandaka, I Ketut Tirka
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 6 No. 1 (2025): June
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/comphijournal.v6i1.281

Cervical carcinoma is a type of cancer that predominantly affects women and significantly impacts their quality of life, particularly psychological well-being. Depression is a common psychological complication experienced by cervical carcinoma patients. This study aims to analyze the characteristics of cervical carcinoma patients experiencing depression at RSPAL dr. Ramelan Surabaya in 2024. The research used a descriptive design with a retrospective approach, with data obtained from patient medical records and the Beck Depression Inventory (BDI) questionnaire. The analysis classified patients' depression levels into normal, mild mood disturbance, borderline depression, low depression, moderate depression, and extreme depression, while evaluating risk factors such as age, employment, and marital status. The results showed that the majority of patients were in the extreme depression category, with a percentage of 35.2%. Age-related risk factors revealed that 74.1% of patients were in the adult age group (19–59 years). Regarding employment, most patients were housewives or unemployed (68.5%). Furthermore, the majority of patients were married or previously married (85.2%). In conclusion, cervical carcinoma patients tend to experience extreme depression, particularly those in the adult age group, women who are unemployed, and those who are married. These findings are expected to serve as a reference for developing psychological intervention programs to improve the quality of life of cervical carcinoma patients

Clinical insights: Anxiety levels and sleep quality among Hang Tuah Faculty of Medicine's class of 2017-2022 pre-clinical and clinical Students Pratama A., Ronald; Alvina, Janette; Timothy, Joel; Delima, Jihan; Christabella, Jocelyn; Saputra Mulya, Kadek Aris; Widjajanto, Hendra; Prameswari, Renata; Nandaka, I Ketut Tirka
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 8 No 01 (2024): Qanun Medika Vol 08 No 01 January 2024
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v8i01.20074

Anxiety is a global psychiatric phenomenon, while poor sleep quality remains a pressing public health issue. The arduous medical education journey exposes students to prolonged stress, potentially exacerbating anxiety and sleep disturbances. This study investigates the correlation between anxiety and sleep quality in Hang Tuah Faculty of Medicine students, bridging the pre-clinical and clinical phases. Employing an analytical observational approach with a cross-sectional design, this study enrolled students from pre-clinical (batches 2020, 2021, 2022) and clinical years (batches DM45, DM46, DM47). Among the 409 approached participants, 296 met the inclusion criteria after excluding 113 samples. Data collection utilized online questionnaires with acquired informed consent. Sleep quality was evaluated via the Pittsburgh Sleep Quality Index, generating scores from 0 to 21. This study showed significantly robust evidence of an association between anxiety and sleep quality (p-value: 0.0001; r: 0.342) across both pre-clinical and clinical students. This study underscores a direct relationship: elevated anxiety levels correspond to diminished sleep quality. Such findings resonate with the prevailing challenges in medical education and their impact on students' mental and physical well-being. Implementing targeted interventions is crucial to address these concerns. In conclusion, this study underscores the undeniable link between anxiety and sleep quality among Hang Tuah Faculty of Medicine students, encompassing the years 2017 to 2022. The implications are far-reaching, emphasizing the necessity of interventions that enhance both psychological well-being and sleep quality. By recognizing and addressing these challenges, medical institutions can foster healthier academic environments and better equip students for their medical careers.

The Effect of Hyperbaric Oxygen Therapy on Reducing Blood Cortisol Levels in Individuals with Anxiety Disorders Hisnindarsyah, Hisnindarsyah; Nandaka, I Ketut Tirka
Asian Journal of Healthcare Analytics Vol. 2 No. 2 (2023): November 2023
Publisher : PT FORMOSA CENDEKIA GLOBAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55927/ajha.v2i2.7542

This research pertains to developmental advancements in the health and maritime sectors, specifically focusing on diving and hyperbaric oxygen therapy's (HBO) application. The study holds the potential to enhance comprehension regarding the Effects of Hyperbaric Oxygen Therapy (HBO) in addressing anxiety disorders, thus contributing significantly to the realms of health and maritime industries. Hyperbaric oxygen therapy involves subjecting patients to heightened pressure environments while administering pure oxygen at levels exceeding atmospheric pressure, with a minimum clinical threshold of 1.4 ATA. (HBO) interventions, utilized for countering hypoxia and cortisol reduction, exhibit promise in mitigating anxiety disorders. The research methodology commences with a systematic screening procedure employing an anxiety disorders questionnaire, ensuring the acquisition of a well-defined, credible, consistent, and unbiased participant pool. Employing a quasi-experimental design featuring a randomized pre-post control group arrangement, the study targets males aged 25-40 with anxiety disorders, drawn from Dr. Ramelan Surabaya's psychiatric clinic.

The Effect of Hyperbaric Oxygen in Reducing Blood Cortisol Levels in Patients with Sleep Disorders Nandaka, I Ketut Tirka; Hisnindarsyah, Hisnindarsyah; Putro, Saptono
Jurnal Indonesia Sosial Sains Vol. 5 No. 12 (2024): Jurnal Indonesia Sosial Sains
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jiss.v5i12.1530

Sleep disorders disrupt normal sleep patterns, including timing, duration, and quality, often linked to elevated cortisol levels and high nerve metabolism requiring oxygen. Hyperbaric oxygen therapy (HBO), delivering pure oxygen in high-pressure settings (≥1.4 ATA), may alleviate hypoxia and reduce cortisol, offering potential treatment for sleep disorders. This research uses a quasi-experimental design with a randomized pre-post control group design. The population studied was male sleep disorder sufferers, aged 25-40 years at the psychiatric poly of Dr. Ramelan Surabaya Hospital, with a sample of 9 members of the Indonesian Navy who met the inclusion and exclusion criteria. This research is related to development research in the field of health and maritime, with a focus on diving and hyperbaric oxygen therapy, which is expected to be published in the International Journal indexed Shinta 2. This research has the potential to enrich the understanding of the effects of Oxygen Hyperbaric (OHB) therapy in overcoming sleep disorders, as well as contributing to the health and maritime sectors. The research concluded that OHB therapy in sleep disorder patients resulted in a slight reduction in mean cortisol levels (from 79.09 ng/ml to 76.38 ng/ml). Although the majority of patients (56%) experienced a decrease in cortisol levels after therapy, there was no statistically significant effect of OHB therapy on cortisol levels in sleep disorder patients.

Metaplasia Myelofibrosis WIJAYANINGRUM, LENA; I DEWA MADE WIDI HERSANA; I KETUT TIRKA NANDAKA
Hang Tuah Medical Journal Vol 23 No 1 (2025): Hang Tuah Medical Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/htmj.v23i1.662

Background: Myelofibrosis with myeloid metaplasia is a rare myeloproliferative disorder. Epidemiological data on the incidence of Myelofibrosis with myeloid metaplasia are still lacking. In Goteborg, Sweden, from 1983 to 1992, the incidence of the disease was retrospectively calculated at 0.4 per 100,000 population. In population- based leukemia data in the UK, the incidence of Myelofibrosis with myeloid metaplasia is estimated to be 0.73 per 100,000 person-years in men and 0.40 per 100,000 person-years in women. It is estimated that there are 230 new cases each year in England and Wales, 330 in Italy, and 1,600 in the United States. No medical therapies have been shown to be effective against the overall survival of patients. The prognosis of myelofibrosis with myeloid metaplasia varies widely. For this reason, it is necessary to report cases of Myelofibrosis Myeloid Metaplasia Methode: Descriptive research, in the form of case reports of patients with myelofibrosis metaplasia, with data obtained from primary data anamnesa and direct physical examination of patients and secondary data from medical records, the results of examinations of doctors at RSPAL Dr Ramelan Surabaya 2022-2024. Results: Since 13 December 2022 until this date 3 May 2024 (17 months).Patient with a diagnosis of Primary Myelofibrosis and high Uric Acid after undergoing therapy with jakavi 15 mg 1x1. Allopurinol 300mg 1x1 and Nabic 3x1. Experienced improvement in complaints of increased appetite. Resting at night there are no complaints. Activity such as walking is not easily tired, mass in the abdomen that does not cause pain. On physical examination, there was an increase in body weight from 50 kg to 55 kg and still found S IV splenomegaly, from the haematological examination there was a decrease in platelets 136.00 (10^3µL) which was previously 203.00 (10^3µL). Uric acid improved from 10.8 mg/dl to 7.7 mg/dl. Conclusion: Jakavi is a drug containing ruxolitinib that can treat splenomegaly or disease-related symptoms in adult patients with myelofibrosis. Keywords: Myelofibrosis Metaplasia.Splenomegaly.Jakavi

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