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All Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan Majalah Anestesia & Critical Care (MACC) Journal Markcount Finance
Pratama, Muhamad Rizal Hadi
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Dentistry Economics, Econometrics & Finance Health Professions Medicine & Pharmacology Veterinary

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A Meta-Analysis of Dextrose Infusion as Perioperative Strategy on Preventing Postoperative Nausea and Vomiting Nabiel Erisadana, Rifaldy; Pratama, Muhamad Rizal Hadi; Muhammad, Faliqul Bahar; Gemawan, Taufiq; Fatmarita, Lia; Ekawaty, Uli Artha; Danar Sumantri, Syahrul Mubarak
Majalah Anestesia & Critical Care Vol 42 No 2 (2024): Juni
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v42i2.384

Abstract

Introduction: Dextrose infusion was introduced as a non-pharmacological perioperative strategy to decrease the PONV incidence. However, current published studies reported remain inconsistent and debatable results regarding the efficacy. This research was conducted to improve the evidence-based perioperative strategies of administering dextrose infusion to prevent PONV. Method: A literature search was conducted for randomized controlled trial studies (RCTs) in patients who administered dextrose infusion compared to other infusion fluid perioperatively. A quantitative analysis using Review Manager 5.4 was performed with a 95% confidence interval that was visualized in the forest plot graph using the fixed-effects or random-effects model based on the heterogeneity. Results: A total of 18 RCTs studies analyzed demonstrated there were significant differences in composite PONV (RR, 0.66, 95% CI 0.60, 0.74; P < 0.00001; I2=46%), patients with postoperative antiemetic rescue requirements (RR, 0.67, 95% CI 0.53, 0.86; P < 0.001; I2=68%), and postoperative blood glucose levels (SMD, 2.63, 95% CI 1.76, 3.50; P < 00001; I2=97%). However, there were insignificant results in PONV severity (SMD, -0.94, 95% CI -2.20, 0.31; P = 0.14; I2=97%), patients with analgesic requirements (RR, 0.84, 95% CI 0.60, 1.19; P = 0.33; I2=81%), dose of analgesic requirements (SMD, -2.31, 95% CI -5.76, 1.14; P = 0.19; I2=99%), and PACU stay (MD, -24.73, 95% CI -66.07, 16.61; P < 0.24; I2=99%). Conclusion: This meta-analysis demonstrated that administering dextrose infusion perioperatively prevents both the PONV incidence and postoperative rescue antiemetic requirements, and also increase postoperative blood glucose levels. However, dextrose infusion is not associated with reducing the PONV severity, postoperative analgesic requirements, a dose of postoperative analgesic use, and PACU stay. .
Analysis of Business Strategy of Clinic X in Denpasar City Veranita, Mira; Magaline, Monica Beatrice; Pratama, Muhamad Rizal Hadi; Wulandari, Ni Nyoman Feby; Haryadi, Pande Made Doddy
Journal Markcount Finance Vol. 2 No. 1 (2024)
Publisher : Yayasan Pendidikan Islam Daarut Thufulah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70177/jmf.v2i1.534

Abstract

Clinic X in Denpasar City, Bali Province is the first level health facility in Bali that provides primary health services and a training center for health workers, requiring effective and efficient strategic tactics for the advancement and development of clinics so they can compete in this increasingly modern era. This research was conducted with the aim of conducting an analysis of the strategic plan for Clinic X in the city of Denpasar, Bali Province in dealing with competition in health services. The research method used is descriptive qualitative on primary data and secondary data. Research results are processed by SWOT analysis. The results showed that Clinic X had greater strengths than Weaknesses when viewed from the internal side. From the external side, Clinic X has a greater threat than opportunity. After analysis, X strong clinic has the opportunity to continue to progress and develop. Therefore it can be concluded that Clinic X can focus more on expanding cooperation with BPJS by increasing promotions to compete in the BPJS market and maintaining service quality by proposing monitoring and evaluation activities to be carried out regularly in accordance with indicators determined using a market penetration strategy. This strategy is translated into a more concrete strategy to be monitored and evaluated in assessing the achievement of the strategy.  
PROFIL HEMODINAMIK PASIEN PRE OPERATIF, INTRA OPERATIF, DAN PASCA OPERATIF DENGAN HIPOALBUMIN Gemawan, Taufiq; Handoko, Adelia; Rachmania, Sheilla; Hasya, Aghnia; Aisy, Rihadatul; Pratama, Muhamad Rizal Hadi
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 4 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Albumin serum (SA) dibutuhkan dalam tubuh sebagai protein yang multifungsi. Peran penting albumin adalah untuk menekan respons inflamasi dalam tubuh dan menjaga permeabilitas vaskuler terutama saat proses inflamasi. Hal ini menjadi perhatian penting bagi pasien yang akan melakukan tindakan operatif untuk menjaga hemodinamik vaskuler. Berikut ini adalah serial kasus mengenai dua pasien dengan diagnosis canal stenosis lumbal dan hernia sikatrikalis. Hasil laboratorium albumin kedua pasien tersebut adalah <3,5 g/dL. Kedua pasien tersebut dipantau kondisi hemodinamik praoperatif, intraoperatif, dan pascaoperatif di Rumah Sakit Daerah dr. Soebandi, Jember, Indonesia. Semua pasien dengan hipoalbuminemia pada penelitian ini mengalami kondisi komorbid hipertensi. Kondisi hemodinamik praoperatif dan pascaoperatif relatif sama, sedangkan saat intraoperatif tekanan darah pasien mengalami penurunan. Albumin memiliki peran dalam mempertahankan permeabilitas vaskuler. Pemeriksaan albumin pada pasien praoperatif penting dilakukan untuk menimbang apakah hemodinamik intraoperatif dan pascaoperatif pasien dapat stabil. Kata Kunci: heart rate, hipoalbumin, mean arterial pressure (MAP), tekanan darah DOI : 10.35990/mk.v7n4.p432-441
Co-Authors Aisy, Rihadatul Danar Sumantri, Syahrul Mubarak Ekawaty, Uli Artha Fatmarita, Lia Handoko, Adelia Haryadi, Pande Made Doddy Hasya, Aghnia Magaline, Monica Beatrice Muhammad, Faliqul Bahar Nabiel Erisadana, Rifaldy Sheilla Rachmania, Sheilla Taufiq Gemawan Veranita, Mira Wulandari, Ni Nyoman Feby