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Antikolinesterase untuk Gigitan Ular dengan Bisa Neurotoksik Farica Sutantoyo, Felisitas; Jaya Gunawan, Erik
Cermin Dunia Kedokteran Vol 43, No 1 (2016): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Kasus gigitan ular merupakan salah satu penyakit yang termasuk dalam daftar neglected tropical disease WHO. Jenis ular yang patut diwaspadai di Indonesia adalah Famili Elapidae dan Viperidae. Neurotoksisitas adalah fitur kunci beberapa kasus gigitan ular famili Elapidae. Kelemahan neuromuskuler akut dengan keterlibatan otot pernapasan adalah efek klinis bisa neurotoksik yang paling penting. Gejala, pola kelemahan, keterlibatan pernapasan, dan respons terhadap antibisa ular dan antikolinesterase, bervariasi tergantung spesies ular, neurotoksisitas, dan geografi. Artikel ini membahas patofisiologi neurotoksisitas bisa ular pada neuromuscular junction dan tatalaksana kasus gigitan ular terutama peran antikolinesterase pada gigitan ular dengan manifestasi neurotoksik.

Antikolinesterase untuk Gigitan Ular dengan Bisa Neurotoksik Felisitas Farica Sutantoyo; Erik Jaya Gunawan
Cermin Dunia Kedokteran Vol 43, No 1 (2016): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i1.39

Kasus gigitan ular merupakan salah satu penyakit yang termasuk dalam daftar neglected tropical disease WHO. Jenis ular yang patut diwaspadai di Indonesia adalah Famili Elapidae dan Viperidae. Neurotoksisitas adalah fitur kunci beberapa kasus gigitan ular famili Elapidae. Kelemahan neuromuskuler akut dengan keterlibatan otot pernapasan adalah efek klinis bisa neurotoksik yang paling penting. Gejala, pola kelemahan, keterlibatan pernapasan, dan respons terhadap antibisa ular dan antikolinesterase, bervariasi tergantung spesies ular, neurotoksisitas, dan geografi. Artikel ini membahas patofisiologi neurotoksisitas bisa ular pada neuromuscular junction dan tatalaksana kasus gigitan ular terutama peran antikolinesterase pada gigitan ular dengan manifestasi neurotoksik.

PROGRAM PENINGKATAN KESEHATAN REPRODUKSI ANAK DAN REMAJA LAKI-LAKI DI KECAMATAN SAMBIKEREP SURABAYA Erik Jaya Gunawan; Salmon Charles P.T. Siahaan; Etha Rambung; Stefani Nurhadi; David Ferdinandus; Fransisca Suyanto Pangemanan; Aura Dhiya Ulhaq; Stephanie Laurensia Budi; Wilhelmus Alvin Kaka; Samantha Debora Ang; Vincent Aurelius
Jurnal Pengabdian Masyarakat Bumi Raflesia Vol. 5 No. 2 (2022): Jurnal Pengabdian Kepada Masyarakat Bumi Raflesia
Publisher : Universitas Muhammadiyah Bengkulu

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

Indonesia memiliki demografi penduduk usia 10-19 tahun mencapai 16,47% dari total populasi. Berdasarakan data nasional, angka kekerasan seksual terhadap anak usia sekolah dan remaja masih tinggi. Selain itu, pandemi COVID-19 menyebabkan akses masyarakat terhadap pelayanan kesehatan juga terganggu. Tujuan dari kegiatan ini adalah meningkatkan pengetahuan dan akses layanan kesehatan terkait kesehatan reproduksi pada anak dan remaja laki-laki di kecamatan Sambikerep Surabaya. Metode yang kami gunakan untuk meningkatkan pengetahuan adalah memberikan penyuluhan materi, pemberian brosur, dan tanya jawab terkait masalah kesehatan reproduksi anak laki-laki. Sedangkan untuk meningkatkan akses pelayanan kesehatan reproduksi, kami mengadakan khitan gratis (oleh tim dokter yang kompeten) dan evaluasi luka operasi. Kegiatan diikuti oleh 75 orang (25 anak dan kedua orang tuanya) dan dilaksanakan di Universitas Ciputra Surabaya. Antusiasme peserta dan orang tua saat pemaparan materi dan sesi tanya jawab sangat baik. Orang tua semakin memahami pentingnya Pendidikan kesehatan reproduksi untuk anak. Kegiatan khitan gratis berjalan dengan lancer. Tidak didapatkan komplikasi selama Tindakan khitan ataupun saat evaluasi luka operasi (4 hari setelahnya). Kegiatan ini selain bermanfaat dalam memudahkan akses pelayanan kesehatan serta meningkatkan pengetahuan mengenai kesehatan reproduksi anak dan remaja. Peningkatan pengetahuan akan kesehatan reproduksi juga menjadi bekal dalam menghindari kekerasan seksual dan membangun sumber daya manusia yang sehat secara fisik dan mental yang merupakan modal utama bagi pembangunan bangsa dan negara di masa yang akan datang. Kata Kunci: kesehatan reproduksi, anak, remaja, laki-laki, khitan

Modification of qSOFA Increases Mortality Prediction Accuracy in Sepsis Patients Gunawan, Erik Jaya; Siahaan, Salmon Charles Pardoman Tua; Idarto, Areta; Pribadi, Florence; Handayani, Lidya
Jurnal Kedokteran Brawijaya Vol. 33 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.01.3

The Quick Sequential Organ Failure Assessment (qSOFA) is a simple parameter, however, its sensitivity as a mortality predictor is low. This study aimed to improve the predictor performance of qSOFA for in-hospital mortality. This study was a retrospective single-centered cohort using medical record data. This study included 150 patients aged 18-80 years old, who experienced sepsis and received ICU care between September 2021 and August 2022. qSOFA and modified ROX index (mROX) were calculated based on the most severe condition recorded in the emergency department (ED). Each variable's area under the receiver operating characteristic (AUROC) curve, sensitivity, and specificity were compared to predict in-hospital mortality. qSOFA scores ≥2 and mROX values ≤3.20 were independent factors that increased the risk of in-hospital mortality (OR 3.69 and 21.50; p 0.004 and 0.005, respectively). The combination of qSOFA scores ≥2 and mROX value ≤3.20 as in-hospital mortality predictors resulted in AUROC 0.791 with a sensitivity of 71.7% and specificity of 75.7%. The AUROC, sensitivity, and specificity of the combination of qSOFA and mROX were higher than qSOFA (0.766, 70.8%, 70.3%) or mROX (0.760, 68.1%, 67.6%) alone. In conclusion, the combination of qSOFA scores ≥2 and mROX values ≤3.20 increase the sensitivity and specificity for predicting in-hospital mortality in sepsis patients.

Comparison Between Hypnoanesthesia and Local Anesthesia in Minor Surgery Amri, Ihyan; Siahaan, Charles; Gunawan, Erik Jaya; Ritunga, Imelda; Tjiptohardjo, Andianto Indrawan
Jurnal Ilmu Kesehatan dan Kesehatan Vol 8 No 01 (2024): FEBRUARY
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/mhsj.v8i01.5882

Background: Hypnoanesthesia is a state of anesthesia achieved through hypnosis techniques. Meanwhile, local anesthesia is anesthesia carried out by injecting local anesthetic drugs in or around the surgical site which causes temporary obstruction to the conduction of afferent impulses. Objective: This research was conducted to prove that there is no difference between hypnoanesthesia and local anesthesia in minor surgical procedures, with the indication of pain relief. Methods: The research subjects were patients with benign soft tissue tumors consisting of 40 people who were divided into 2 groups, namely treatment and control. Minor surgical procedures with hypnoanesthesia were performed in the treatment group, while in the control group, minor surgical procedures were performed with local anesthesia using 2% lidocaine. Pain is measured with FPS (Face Pain Scale) and monitored with a vital sign monitor. The intervention process was recorded with camcorder video. Changes in serum levels of excitatory neurotransmitters (Glutamic Acid and Substance P) and inhibitory (Beta Endorphin, Enkephalin, and Serotonin) before and after intervention were analyzed using ELISA (Enzym-Link Immunosorbent Assay) in both groups. Results: In the treatment group, it was discovered that patients did not feel pain after undergoing hypnoanesthesia intervention by providing suggestions for the relief of pain in the area where surgery would be performed. In the control group, patients also did not feel pain after local anesthetic intervention in the area to be operated on. However, the results of research and statistical tests showed that there was no significant difference in changes in Beta Endorphins, Enkephalin, and Serotonin as inhibitory neurotransmitters (p > 0.05) or Glutamic Acid and Substance P as excitatory neurotransmitters (p > 0.05) before and after the intervention in both groups of research subjects. Conclusion: the results of this study show that there is no significant difference between the treatment and control groups, they have equality in the final result, namely the relief of pain.

The Impact of Docosahexaenoic Acid (DHA) Supplementation on Calcium Levels in Third Trimester Pregnant Women with Chronic Energy Deficiency (CED): A Correlational Study Santosa, Rahajoe Imam; Siahaan, Salmon Charles; Gunawan, Erik Jaya; Pribadi, Florence; Bueya, Eirene Putri Febriani Pratama
Jurnal Ilmu Kesehatan dan Kesehatan Vol 8 No 02 (2024): AUGUST
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/mhsj.v8i02.6409

Background: Chronic Energy Deficiency (CED) during pregnancy represents a critical health challenge, especially in developing regions, where it significantly threatens maternal and fetal well-being. Docosahexaenoic Acid (DHA), an essential omega-3 fatty acid, plays a pivotal role in fetal neurodevelopment and maternal health. However, the impact of DHA supplementation on maternal calcium levels, particularly among pregnant women affected by CED, has not been extensively studied. This study evaluate the correlation between DHA supplementation and calcium levels in third-trimester pregnant women with CED, with the goal of improving outcomes for this vulnerable population. Method and Results: This research uses experimental cohort study design with a quantitative approach, using non-probability sampling techniques such as quota and purposive sampling, and involving a total of 24 participants. Statistical analysis revealed a significant increase in calcium levels following DHA supplementation, with a p-value of 0.007 (<0.05), indicating a notable impact of the intervention. The mean calcium levels post-treatment were higher than pre-treatment, demonstrating the efficacy of DHA supplementation in improving calcium levels. Further analysis showed no significant correlation between pre-supplementation calcium levels and Body Mass Index (BMI) (p = 0.622, > 0.05). However, a significant correlation was found between post-supplementation calcium levels and BMI (p = 0.002, < 0.05). These findings indicate a positive correlation between DHA supplementation and calcium levels in pregnant women with CED during the third trimester. However, further investigation is needed to fully understand the relationship between calcium levels and BMI. Conclusion: This study lays the groundwork for future research aimed at optimizing therapeutic interventions or supplementation strategies to improve the nutritional status of underweight pregnant women.

Improvements in Primary Emergency Care Understanding during Matches for Football Coaches and Referees in East Java Gunawan, Erik Jaya; Arisanti, RR Shinta; Yuwono, Natalia; Suisan, Yohan Christian; Sasono, Bimo
Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement) Vol 9, No 4 (2023): Desember
Publisher : Direktorat Pengabdian kepada Masyarakat Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpkm.85900

Improper initial management of emergency conditions during football matches causes long-term morbidity, affects the athlete’s future performance, and may be life-threatening. Football coaches and referees may come from non-medical backgrounds, but they should understand how to provide primary care in emergency situations during matches. This program aims to improve the primary emergency care understanding of the coaches and referees in East Java. The program was conducted in September 2022 – January 2023. All referees, assistant referees, and coaches of the Football Association of the Indonesia (FAI) region East Java (128 participants) were included. The primary emergency care training material consisted of video, PowerPoint media, and hands-on mannequins. Participants were given pre-and post-test to assess their level of knowledge, with a passing grade 75. Comparative tests (Wilcoxon signed rank, McNemar, and Chi-square test) were used to analyze the data. The median of the pre-and post-test scores were 62.5 and 87.5. There was a significant difference between pre-and post-test scores (p < 0.001). There was no significant difference between coaches and referee groups in pre-test scores (p = 0.743). This program improved the primary emergency care understanding during matches of coaches and referees.

Health Promotion to Increase Knowledge about Puberty in Boys Denys Putra Alim; Erik Jaya Gunawan; Yohan Christian Suisan; Raden Roro Shinta Arisanti; Ihyan Amri
Bubungan Tinggi: Jurnal Pengabdian Masyarakat Vol 6, No 4 (2024)
Publisher : Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/btjpm.v6i4.12428

Puberty is a normal developmental process in which a child develops into a biologically and/or sexually mature adult. Even though puberty is a natural event, it is not uncommon for children to be confused or worried about puberty. Therefore, using the Participatory Action Research Method, this community service aims to increase knowledge about puberty in boys in the Sambikerep sub-district, Surabaya. The activities include health promotion, education, and free circumcision for the children by surgeons and medical students from the School of Medicine, Universitas Ciputra Surabaya. Statistical analysis of knowledge before and after health promotion used the Wilcoxon test in SPSS version 26 with a significance limit of p < 0.05. The overall community service activities ran quite smoothly; there were 24 children who took part, with the number of children getting a pre-test score < 75 points as high as 29.2%. However, no children got a post-test score of < 75 points after the health promotion. The median score of knowledge about puberty before and after health promotion was 75 (12.5–100) and 100 (87.5–100) points, respectively (p-value <0.001). Through this community service, health promotion and education about puberty must be continuously provided to pre-pubertal boys so that they have a good understanding of puberty and make healthy decisions related to their sexual and emotional health.

Acute Kidney Injury (AKI) Pasca Primary Coronary Intervention (PCI) pada Pasien STEMI Gunawan, Erik Jaya; Isnaini, Isnaini; Siahaan, Salmon Charles P. T.; Setyawan, Yuswanto; Ritunga, Imelda
Nommensen Journal of Medicine Vol 10 No 1 (2024): Nommensen Journal of Medicine: Edisi Agustus
Publisher : Universitas HKBP Nommensen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36655/njm.v10i1.1376

Background: Treating STEMI with PCI not only has a positive impact on patients, but also the risk of complications. A complication that can occur is AKI. The aim of this case report is to increase clinician awareness by analyzing the risk of AKI after PCI in order to reduce patient morbidity and mortality rates. Case: A 58-years old-man, with a history of diabetes mellitus, dyslipidemia, and a previous heart attack, came to the emergency department because of chest pain. The patient experienced STEMI and received fibrinolytic therapy. After 3 days of treatment, the condition worsened and the patient experienced shortness of breath (pulmonary edema). The patient was referred to RSUD Dr. M. Soewandhie Surabaya to undergo PCI. Two days after PCI, there were clinical signs of AKI. The patient was prepared for Renal Replacement Therapy (RRT), but the patient experienced cardiac arrest and was declared dead. Discussion: AKI after PCI involves various complex mechanisms. Several factors that can increase the probability of AKI after PCI in this case are a history of diabetes mellitus, previous decline in kidney function, and pulmonary edema. Technique factors such as transfemoral PCI and the amount of contrast volume used also have an influence on the incidence of AKI after PCI and need to be studied further. Risk factors in patients can be used to determine clinical scores, such as the Mehran, ADVANCIS, or ACEF-MDRD scores to predict the probability of AKI after PCI. Conclusion: AKI after PCI is a frequent complication and calculations using clinical scores can be applied to predict this event.

IDENTIFIKASI POSSIBLE SARCOPENIA MELALUI TES CALF CIRCUMFERENCE PADA AKTIVITAS FISIK USIA REMAJA Roro Shinta Arisanti, Raden; Natalia Yuwono; Erik Jaya Gunawan
Jurnal Kesehatan dan Pembangunan Vol 15 No 2 (2025): Jurnal Kesehatan dan Pembangunan
Publisher : LPPM STIKes Mitra Adiguna

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52047/jkp.v15i2.396

Physical activity is a movement activity that involves the physical through elements of the limbs in the form of muscles, small muscles or large muscles. Sarcopenia is a progressive decrease in muscle mass and strength, which usually occurs during aging, is a syndrome that is directly influenced by physical activity. Measurement of muscle strength and measurement of physical performance as additional methods to diagnose sarcopenia. Calf circumference is a measurement test to see the circumference of the calf. This study is a quantitative study. The samples used were students from West Surabaya High School and students from the Ciputra Faculty of Medicine, with details of 40 students with an age range between 14-16 years and 67 students with an age range between 17-23 years. The results of the study that have been obtained were obtained from 67 students, 14 men with a percentage of 21% were categorized as normal, while 8 men with a percentage of 12% were categorized as possible sarcopenia. Of the 67 people, 27 women with a percentage of 40% were categorized as normal, while 18 women with a percentage of 27% were categorized as possible sarcopenia. While of the 40 students, 20 men with a percentage of 50% were categorized as normal, while 9 men with a percentage of 23% were categorized as possible sarcopenia. Of the 40 people, 6 women with a percentage of 15% were categorized as normal, while 5 women with a percentage of 13% were categorized as possible sarcopenia.

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