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All Journal Jurnal Kesehatan Andalas Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Kedokteran Mulawarman Jurnal Sains dan Kesehatan
Putra, Indra Sukmana
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Hubungan Usia dan Fraksi Ejeksi Ventrikel Kiri dengan Kadar Kreatinin Pada Penderita Penyakit Jantung Koroner Tumenggu, Auliya Rizky; Magdaleni, Agustina Rahayu; Furqon, Muhammad; Sawitri, Endang; Putra, Indra Sukmana
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 10 (2024): Volume 11 Nomor 10
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i10.15880

Abstract

Penyakit Jantung Koroner (PJK) merupakan penyakit akibat pembentukan plak yang menyebabkan oklusi arteri koroner. PJK masih menjadi salah satu penyebab utama kematian di seluruh dunia. Usia dan fraksi ejeksi ventrikel kiri sangat memengaruhi perjalanan dan perkembangan PJK. PJK sendiri tidak hanya memengaruhi jantung, tetapi juga dapat memengaruhi ginjal. Tujuan penelitian ini adalah untuk mengetahui hubungan usia dan fraksi ejeksi ventrikel kiri dengan kadar kreatinin pada penderita PJK di RSUD Abdoel Wahab Sjahranie. Penelitian ini menggunakan pendekatan cross-sectional dengan menggunakan 96 sampel. Analisis bivariat menggunakan uji Chi-square dan bermakna jika p<0,05. Hasil penelitian menunjukkan bahwa terdapat 62 penderita PJK dengan risiko tinggi (64,6%), 49 penderita PJK berjenis kelamin laki-laki (51%), 53 penderita PJK memiliki fraksi ejeksi ventrikel kiri yang menurun (55,2%), dan 60 penderita PJK memiliki kadar kreatinin yang normal (62,5%). Hubungan usia dengan kadar kreatinin menunjukkan p=0,021 (p<0,05) dengan PR 3,390 (95%CI= 1,286-8,937). Hubungan fraksi ejeksi ventrikel kiri dengan kadar kreatinin menunjukkan p=0,000 (p<0,05) dengan PR 6,214 (95%CI= 2,347-16,453). Disimpulkan bahwa terdapat hubungan usia dan fraksi ejeksi ventrikel kiri dengan kadar kreatinin pada penderita PJK.
MANAGEMENT OF SEPTIC SHOCK PATIENTS WITH INTRABDOMINAL TRAUMATICS IN THE INTENSIVE CARE UNIT Putra, Indra Sukmana; Palinrungi, Ari Santri
Jurnal Kedokteran Mulawarman Vol 11, No 1 (2024): Jurnal Kedokteran Mulawarman
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30872/jkm.v11i1.16602

Abstract

Management of patients with septic shock with intrabdominal trauma is a complex medical treatment in the intensive care unit because the patient must be closely monitored and given adequate therapy. This case report is a case from the intensive care unit at Wahidin Sudirohusodo Hospital, Makassar. The patient was treated for 30 days starting on 10/24/23. The patient is a 15 year old male with the main complaint of a stab wound from a wooden beam that was stuck in his buttocks after falling from an 8 meter high building. The patient suffered stab wounds from the rectal, intrabdominal, diaphragm, left hemithorax to the pericard. The patient was referred from Pelamonia Hospital, Makassar, which had undergone airway treatment, then referred to Wahidin Hospital, Makassar. This patient underwent resuscitation and surgery, then was transferred to the intensive care unit. During the operation, serous laceration of the transverse colon, rectal laceration, urethral rupture, diaphragm and pericardial laceration were found. Patients had an APACHE II score of 17, SOFA score of 6 predicted mortality of 33.3%. Management during in the intensive care unit is treating the source of infection, fluid resuscitation, administering vasopressors. Norepinephrine as a first-line vasopressor agent with an initial target mean arterial pressure (MAP) is > 65mm Hg. Vasopressin is the second choice for treating septic shock, targeting MAP ≥ 65mmHg. Complicated intrabdominal infections are often caused by polymicrobial infections and require a combination of parenteral antibiotics during treatment. Therefore, it is necessary to select an antimicrobial agent appropriate to the patient's individual dosage. In cases of suspected intrabdominal infection, an aminoglycoside in combination with a beta lactam is recommended once daily, as gram-negative multidrug resistance often occurs. The empirical antibiotic given was a combination of meropenem 1gr/8 hours/IV + Amikacin 1gr/24 hours/IV for 6 days, continuous renal replacement therapy on treatment days 2 to 3 for 24 hours with CVVDHF modality. The results of the procalcitonin examination showed a downward trend followed by improvement in hemodynamics, decreased need for vasopressors, improved consciousness, gradual removal of the ventilator and transition to usual care on day 20. Comprehensive sepsis management resulted in better patient outcomes.Key words: Septic shock, Intrabdominal infection, Resuscitation, Continuous renal replacement therapy.
Hubungan Aktivitas Fisik dengan Ketahanan Kardiorespirasi pada Mahasiswa Program Studi Kedokteran Universitas Mulawarman Qhuzairi, Muhammad Rezwan; Magdaleni, Agustina Rahayu; Sulistiawati, Sulistiawati; Sawitri, Endang; Putra, Indra Sukmana
Jurnal Kesehatan Andalas Vol. 12 No. 2 (2023): Online July 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v12i2.2169

Abstract

Cardiorespiratory endurance is the ability of the body's circulatory and respiratory system to meet the oxygen needs of the muscles as a source of energy production during sustained physical activity. One of the factors that influenced the level of cardiorespiratory endurance of a person was physical activity. Objective: To determined the relationship between physical activity and cardiorespiratory endurance. Methods: It was an analytic observational with a cross-sectional study. Data were taken from primary data that were measured directly on 97 students of the Medical Study Program at Mulawarman University who were selected using a purposive sampling technique. The data collected included physical activity using the Global Physical Activity Questionnaire (GPAQ) and cardiorespiratory endurance using Queen's College Step Test. The statistical analysis used was Spearman's correlation test with a significance value of p <0.05. Results: The statistical test showed that the relationship between physical activity and cardiorespiratory endurance was p = 0.003 and r = 0.295. Conclusion: There was a significant positive relationship between physical activity and cardiorespiratory endurance, and the relationship's strength was weak.Keywords:  cardiorespiratory endurance, global physical activity questionnaire, physical activity, queen’s college step test
Manajemen Pasien Kritis Dengan Ketoasidosis Diabetik Disertai Dengan Multiple Organ Disfunction Putra, Indra Sukmana
Jurnal Kedokteran Mulawarman Vol 12, No 2 (2025): Jurnal Kedokteran Mulawarman
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30872/jkm.v12i2.22069

Abstract

AbstrakKetoasidosis diabetik (KAD) merupakan komplikasi akut diabetes mellitus yang mengancam nyawa, ditandai dengan hiperglikemia, asidosis metabolik, dan ketonemia. Pada kondisi berat, KAD dapat berkembang menjadi multiple organ dysfunction syndrome (MODS). Dilaporkan pasien perempuan 26 tahun dengan diabetes mellitus tipe 1, datang dengan gagal napas yang memerlukan ventilasi mekanik, syok sepsis, pneumonia bilateral, hiperglikemia, hiperkloremia, dan KAD berat. Sebelum masuk ICU, pasien telah mendapat resusitasi 3.000 mL NaCl 0,9%. Pemeriksaan awal menunjukkan asidosis metabolik (pH 6,82; HCO₃ 4,2 mmol/L), hiperkloremia (Cl⁻ 129 mmol/L), hipokalemia (K⁺ 2,1 mmol/L), dan fluid non-responsiveness (PPV 10%, SVV 9%). Perawatan di ICU meliputi strategi ventilasi protektif paru, vasopressor norepinefrin, koreksi kalium, titrasi insulin intravena, penggunaan kristaloid seimbang untuk maintenance, serta antibiotik spektrum luas (meropenem). Terapi continuous renal replacement therapy (CRRT) modalitas CVVHDF dilakukan untuk mengatasi asidosis metabolik refrakter, hiperkloremia, acute kidney injury (AKI) stadium 2, dan fluid overload. Setelah 48 jam CRRT, kadar klorida turun dari 129 mmol/L menjadi 109 mmol/L, pH meningkat menjadi 7,30, bikarbonat naik menjadi 11,8 mmol/L, dan base excess membaik dari −21,8 menjadi −14,8. Produksi urin meningkat dari 19 mL/jam menjadi 45 mL/jam, disertai perbaikan hemodinamik dan penurunan kebutuhan vasopressor. Prokalsitonin menurun dari 0,89 ng/mL menjadi 0,39 ng/mL, leukosit menurun dari 45.260/mm³ menjadi 25.570/mm³. Pasien berhasil weaning ventilator pada hari ke-7 dan keluar dari ICU setelah 9 hari perawatan. Penatalaksanaan komprehensif di ICU—meliputi dukungan ventilasi, optimasi hemodinamik, kontrol infeksi, koreksi gangguan metabolik dan elektrolit, serta penggunaan CRRT tepat waktu—berperan penting dalam keberhasilan perawatan pasien KAD dengan MODS.
Karakteristik Penderita Degenerasi Makula Karena Usia di Klinik Mata SMEC Samarinda Periode 2018-2022: Characteristics of Patients Age Related Macular Degeneration at the Samarinda SMEC Eye Clinic for the Period 2018-2022 Rimayanti, A. Annisa Aulia; Fatmawati, Nur Khoma; Sawitri, Endang; Putra, Indra Sukmana
Jurnal Sains dan Kesehatan Vol. 6 No. 4 (2024): J. Sains Kes.
Publisher : Fakultas Farmasi, Universitas Mulawarman, Samarinda, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25026/jsk.v6i4.2318

Abstract

Age-related macular degeneration which is a neurological disease that progresses over time and affects the macula. The purpose of this research was to identify the characteristics of patients diagnosed with age-related macular degeneration who were treated at the SMEC Eye Clinic Samarinda between the years 2018 and 2022. The study was descriptive-observational in nature and applied a cross-sectional method. It made use of secondary data obtained from the medical records of 335 patients diagnosed with age-related macular degeneration who were treated at SMEC Eye Clinic Samarinda between 2018 and 2022. The study found that the majority of patients with age-related macular degeneration during the period 2018-2022 were males, totaling 187 patients (53%). The highest age group was the 60-69 age group, with 145 patients (43%). The involvement of the eyes was predominantly unilateral, with 211 patients (64%), and the most common visual acuity among patients was <6/18-?6/60 or moderate visual impairment, with 180 eyes (39%).   Keywords:          Age Related Macular Degeneration, Gender, Side Eye, Age, Vision   Abstrak Degenerasi makula karena usia atau age related macular degeneration adalah suatu penyakit neurodegeneratif yang bersifat progresif dan mengenai pada makula. Penelitian ini bertujuan untuk mengetahui karakteristik penderita degenerasi makula karena usia di Klinik Mata SMEC Samarinda periode 2018-2022. Penelitian bersifat deskriptif dengan pendekatan cross sectional menggunakan data sekunder berupa rekam medik populasi terjangkau, yaitu 335 penderita degenerasi makula karena usia di klinik Mata SMEC Samarinda dalam periode 2018-2022. Penelitian ini mendapatkan penderita degenerasi makula karena usia terbanyak ialah berjenis kelamin laki-laki sebanyak 187 penderita (53%). Kelompok usia tertinggi ialah usia 60-69 tahun sebanyak 145 penderita (43%). Sisi mata yang terkena ialah unilateral sebanyak 211 penderita (64%) dan visus terbanyak penderita ialah <6/18-?6/60 atau gangguan penglihatan sedang sebanyak 180 mata (39%). Kata Kunci:         Degenerasi Makula Karena Usia, Jenis Kelamin, Sisi Mata Yang Terkena, Usia, Visus
Co-Authors Endang Sawitri Magdaleni, Agustina Rahayu Nur Khoma Fatmawati Palinrungi, Ari Santri Qhuzairi, Muhammad Rezwan Rimayanti, A. Annisa Aulia Sembiring, Rinawati Sulistiawati Sulistiawati Tumenggu, Auliya Rizky