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Enhancing Emergency Fracture Diagnosis with Point-of-Care Ultrasound (Pocus) : A Rapid and Efficient Alternative: A Literature Review Agastya, Wayan Dhea; Rahmadinie, Amalia; Aulia, Khansa Tsabitah; Anrofi, Fakhirah Nailah; Al Habsyi, Alya Raguan; Firdausiyah, Shofie Ayu Nur; Winangest, Bisarda Kanira Permata Putri
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 5 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v2i5.177

Abstract Introduction: Fracture diagnosis is a crucial aspect of trauma and musculoskeletal injury management, traditionally relying on imaging modalities such as X-ray, CT scan, and MRI. However, these methods have limitations, including high costs, long waiting times, radiation exposure, and limited accessibility in remote areas. Point-of-Care Ultrasound (POCUS) has emerged as a diagnostic alternative that is more portable, cost-effective, radiation-free, and provides real-time results, making it a potential solution in emergency situations or resource-limited healthcare facilities. Methods: This study employs a literature search approach based on the PICO framework to evaluate the effectiveness of Point-of-Care Ultrasound (POCUS) in detecting fractures compared to X-ray, CT scan, and MRI. Literature sources were obtained from Scopus, ScienceDirect, Google Scholar, and PubMed using relevant keywords. Seven English-language journals were selected for further analysis. Results and Disscussion: POCUS is a rapid, non-invasive, and effective diagnostic tool for fracture and musculoskeletal injury. It allows fracture identification within an average of 3.9 minutes, with a sensitivity exceeding 85%, reaching up to 100% in children, while its specificity exceeds 90%. Although its accuracy is still lower than that of MRI, POCUS excels in terms of speed and patient convenience. Conclusion: POCUS serves as a safe and rapid alternative to conventional methods, particularly for children and patients with limited access to radiographic imaging. It provides a more patient-friendly diagnostic method, especially in medical settings requiring high safety and speed. While X-ray remains the gold standard, POCUS can be utilized in emergency situations. However, its effectiveness depends on operator skill and is less optimal for detecting complex fractures. Keywords: Point-of-Care-Ultrasound, POCUS, Fracture, Diagnosis, Medical Imaging

Efektivitas Blok Saraf Tepi Transversus Abdominis Plane (TAP) terhadap Nyeri Pascaoperasi Seksio Sesarea Darurat dalam Kondisi Bencana: Penelitian Kohort Retrospektif Agastya, Wayan Dhea; Rahmadinie, Amalia; Sepviyanti Sumardi, Fitri
Jurnal Anestesi Obstetri Indonesia Vol 8 No 2 (2025): Juli
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v8i2.226

Latar Belakang: Tsunami Palu 2018 menyebabkan peningkatan tajam tindakan seksio sesarea darurat di RSUD Undatta. Dalam kondisi keterbatasan, pendekatan analgesia regional seperti blok saraf tepi Transversus Abdominis Plane (TAP) block dapat menjadi strategi efektif untuk menekan kebutuhan opioid dan mempercepat pemulihan pasien. Tujuan: Menilai efektivitas Blok saraf tepi TAP dalam mengurangi nyeri pascaoperasi dan konsumsi opioid pada pasien seksio sesarea darurat dalam situasi bencana. Metode: Penelitian kohort retrospektif terhadap 100 pasien yang menjalani seksio sesarea darurat selama Oktober–November 2018. Dibandingkan dua kelompok: Blok saraf tepi TAP (n=50) vs analgesia sistemik konvensional (n=50). Parameter evaluasi: skor Visual Analog Scale (VAS) pada 1, 6, 12, 24 jam; konsumsi morfin ekuivalen; dan komplikasi. Hasil: Skor nyeri VAS kelompok TAP signifikan lebih rendah di semua titik waktu (p<0.01), dengan rata-rata skor VAS 24 jam: 2.0 ± 0.9 (vs 4.7 ± 1.3). Penggunaan morfin juga berkurang secara signifikan (1.5 mg vs 4.3 mg; p<0.01). Tidak ada komplikasi berat; 4% pasien TAP mengalami parestesia ringan. Simpulan: Blok TAP efektif dan aman sebagai analgesia pascaoperasi untuk seksio sesarea darurat dalam kondisi bencana. Teknik ini layak diintegrasikan ke dalam protokol anestesi kebencanaan

Optimizing Acute Pain Management After Trauma in the Emergency Department: the Role of Regional Nerve Blocks by Anesthesiologists: A Literature Review Agastya, Wayan Dhea; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 7 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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

Abstract Background: Acute pain management remains a critical challenge in emergency departments (EDs), particularly in trauma cases. Traditional systemic analgesics, especially opioids, pose risks of adverse effects and dependency. Regional nerve blocks (RNBs), administered by anesthesiologists, offer a promising alternative. This literature review explores the efficacy, safety, and practical considerations of RNBs in trauma-related acute pain within ED settings. Evidence suggests that RNBs significantly reduce pain scores and opioid consumption while maintaining a favorable safety profile. Collaborative implementation of RNBs in EDs can improve patient outcomes and reduce opioid-related risks. Method: This research employs a literature analysis approach by reviewing relevant theoretical and empirical sources, including Google Scholar, PubMed, and ScienceDirect. Discussion: The findings reveal that RNBs, particularly when guided by ultrasound and performed by anesthesiologists, significantly reduce pain scores, opioid use, and side effects compared to systemic analgesia. Despite logistical barriers in ED settings, collaborative approaches between emergency physicians and anesthesiologists enhance feasibility and patient outcomes. Conclusion: Regional nerve blocks by anesthesiologists offer fast, targeted, and safer pain relief in trauma care, reducing opioid dependence and improving outcomes. Integrating RNBs into emergency protocols enhances patient care and should be prioritized. Keywords: Regional Nerve Block, Trauma Pain, Emergency Department, Anesthesiologist

Implementasi Program Pendayagunaan Dokter Spesialis sebagai Salah Satu Bentuk Pengabdian Masyarakat di Daerah Rahmadinie, Amalia; Agastya, Wayan Dhea
Jurnal Peduli Masyarakat Vol 7 No 4 (2025): Jurnal Peduli Masyarakat: Juli 2025
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jpm.v7i4.6875

Kesenjangan akses pelayanan kesehatan antara daerah perkotaan dan pedesaan masih menjadi tantangan serius di Indonesia. Program pendayagunaan dokter spesialis atau disingkat PGDS dirancang untuk mengatasi kekurangan tenaga dokter spesialis di daerah. Artikel ini bertujuan untuk menggambarkan implementasi program PGDS, khususnya dokter spesialis anestesi, sebagai bentuk pengabdian masyarakat di daerah. Metode yang digunakan adalah studi deskriptif kuantitatif, data dikumpulkan secara retrospektif dari rekam medis pasien, dan meliputi seluruh pasien yang mendapatkan pelayanan anestesi oleh dokter PGDS selama masa penempatan dari Desember 2021 sampai dengan Nopember 2022. Literatur yang digunakan dibatasi pada publikasi dalam 10 tahun terakhir untuk menjaga keterkinian informasi dan relevansi konteks kebijakan. Dapat terlihat bahwa program ini telah memberikan kontribusi positif terhadap akses layanan kesehatan di daerah, walaupun menghadapi berbagai tantangan seperti keterbatasan infrastruktur dan fasilitas serta keberlanjutan penempatan dokter yang masih perlu dibenahi. Pelaksanaan PGDS di daerah adalah strategi efektif dalam pemerataan layanan kesehatan di Indonesia sekaligus sebagai salah satu bentuk pengabdian terhadap masyarakat.

Evaluating the Role of Atropine Sulphate in Preventing Motion-Related Postoperative Nausea and Vomiting in Patients Undergoing Cesarean Section using ERACS Protocol Rahmadinie, Amalia; Agastya, Wayan Dhea
Jurnal Kesehatan Islam : Islamic Health Journal Vol. 14 No. 1 (2025): Jurnal Kesehatan Islam : Islamic Health Journal
Publisher : Publikasi oleh Fakultas Kedokteran Universitas Islam Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33474/jki.v14i1.24123

ABSTRACT Background: PONV is common after cesarean section using ERACS protocol. Motion-related PONV during early mobilization can impair comfort and delay recovery. Anticholinergic agents such as atropine sulphate have antiemetic effects via muscarinic receptor antagonism, especially when vestibular pathways are involved, but their intravenous use for motion-related PONV prevention remains underexplored. Objective: To evaluate the effectiveness of intravenous atropine sulphate in reducing motion-related PONV within two hours postoperatively in patients undergoing cesarean section. Methods: A retrospective cross-sectional analysis was carried out involving 30 patients at a private hospital in Sidoarjo, Indonesia (May–June 2025). Patients were assigned to either control (no atropine) or treatment (0.5 mg atropine IV after cord clamping). The primary outcome was a combined PONV score: (1) vomiting episodes ≥ 1, (2) moderate-to-severe nausea/vomiting (VAS > 4), and (3) rescue antiemetic use. Secondary outcomes included atropine-related adverse effects. Results: The treatment group had significantly lower mean combined PONV scores (p < 0.001), fewer vomiting episodes (p = 0.035), less moderate-to-severe nausea (p = 0.002), and borderline reduced rescue antiemetic use (p = 0.05). No significant adverse effects were observed. Conclusion: IV atropine sulphate 0.5 mg after cord clamping effectively reduces motion-related PONV in ERACS cesarean patients without notable side effects. Keywords: atropine sulphate, cesarean section, ERACS, PONV vestibular pathway.

Disaster Medicine in Low-Resource Settings Recent Challenges and Innovations Agastya, Wayan Dhea
Journal of Diverse Medical Research: Medicosphere Vol. 1 No. 4 (2024): J Divers Med Res 2024
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i4.19

Background. Disaster medicine in low-resource settings faces many challenges. Most are aggravated by limited infrastructure, scarce medical supplies, and insufficiently trained health professionals. This calls for complexity in responding to these events due to enhanced logistic challenges and sociopolitical instability, according to which may hamper effective and timely medical interventions. Methods. Literature searching was conducted using databases such as PubMed, Google Scholar, and Web of Science using Search terms included "disaster medicine," "low-resource settings," "emergency response," and "innovations in disaster care.". Systematic reviews of peer-reviewed articles, reports, and case studies were chosen.

Impact of Technology on Disaster Medicine in Low-Resource Settings: A Literature Review Agastya, Wayan Dhea
Journal of Diverse Medical Research: Medicosphere Vol. 1 No. 5 (2024): J Diverse Med Res
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i2.25

AbstractBackground. Technology has become a key to face challenges in improving disaster medicine services in low resources settings. By using technology, some obstacles can be solved and increase the quality of the services. Methods. Literature searching was conducted using databases such as PubMed, Google Scholar, and Web of Science using Search terms included "disaster medicine," "low-resource settings," "emergency response," and "innovations in disaster care.". Systematic reviews of peer-reviewed articles, reports, and case studies were chosen.Discussion. Some key innovations which can be used include mobile health (mHealth) solutions, telemedicine, portable medical devices, drones, geographic information systems (GIS), and wearable health monitors. These tools have significantly improved disaster response by enhancing communication, enabling remote diagnostics, optimizing resource allocation, and ensuring continuous care. Telemedicine platforms have proven invaluable during crises like the COVID-19 pandemic, while portable devices and renewable energy solutions maintain medical operations amid power disruptions. Drones and GIS support timely delivery of medical supplies and effective disaster planning.Conclusion. Future strategies advocate for integrating artificial intelligence, robust governance, community engagement, and innovative research to enhance disaster resilience. This review underscores the critical need for sustainable, technology-driven approaches in disaster medicine to mitigate health disparities and improve outcomes in vulnerable populations. Keywords. disaster medicine, low resources, healthcare, technology

Advancements in Understanding and Managing Parkinson's Disease: A Review of Recent Literature: A Literature Review Arbani, Rafi Auliya Arbani; Agastya, Wayan Dhea
Journal of Diverse Medical Research: Medicosphere Vol. 1 No. 1 (2024): J Divers Med Res 2024
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i1.34

Background : Parkinson's Disease (PD) remains a complex and challenging condition, with ongoing research shedding light on its multifaceted nature. This review synthesizes recent findings on the genetic basis, autonomic dysfunction, lifestyle impacts, treatment advancements, and environmental considerations related to PD. By analyzing recent literature, this review aims to provide a comprehensive understanding of current trends and implications for future research and clinical practice. Methods : Literature searches were performed using databases including PubMed, Google Scholar, and SINTA with search terms such as "Parkinson’s" "Genetics" "lifestyle" and "environtment" Only systematic reviews of peer-reviewed articles, reports, and case studies were selected for inclusion. Discussion : The complexity of Parkinson's Disease (PD) and the necessity for a multidimensional approach to its understanding and management. Genetic research highlights opportunities for personalized medicine, while insights into autonomic dysfunction underscore the importance of comprehensive clinical evaluations. Lifestyle and environmental factors are increasingly recognized for their roles in PD prevention and management, advocating for a holistic approach. Advancements in treatment, including immunotherapy and neural grafting, provide hope for improved patient outcomes, though significant challenges remain in translating research into clinical practice. Conclusion : This review highlights the multifaceted nature of Parkinson's Disease, emphasizing the importance of integrating genetic, lifestyle, and environmental considerations into clinical practice. Recent advancements in understanding PD's underlying mechanisms and therapeutic innovations provide a foundation for improved management and prevention. A holistic and multidisciplinary approach is essential to enhance patient outcomes and address the challenges in diagnosing and treating this complex neurodegenerative disorder.

The Impact of Pneumococcal Conjugate Vaccines on Pneumonia in Children: A Review of Recent Studies Agustina, Putri Noviana; Agastya, Wayan Dhea
Journal of Diverse Medical Research: Medicosphere Vol. 1 No. 3 (2024): J Divers Med Res 2024
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i3.131

Background. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly reduced the burden of pneumonia in children worldwide, leading to decreased hospitalization rates, lower severity of disease, and a reduction in antibiotic resistance. However, regional disparities persist, particularly in low- and middle-income countries where healthcare infrastructure and access to vaccines are often limited. Methods. This review synthesizes findings from recent studies on the impact of PCVs on the incidence, severity, and management of pneumonia in children. It includes analyses of studies conducted in various regions, highlighting the global and regional effects of PCVs on pneumonia hospitalization rates, vaccine effectiveness against severe disease, and antibiotic resistance. Discussion. The review underscores the importance of PCVs in reducing pneumonia-related hospitalization rates, disease severity, and antibiotic resistance globally. Nevertheless, challenges persist in addressing regional disparities, particularly in underserved areas with limited healthcare infrastructure and vaccine accessibility. Conclusion. Continued surveillance and research are essential to evaluate the long-term effectiveness of newer PCV formulations. Developing strategies to improve vaccination coverage in underserved populations and monitoring the emergence of new serotypes are critical for adapting public health strategies. By addressing these challenges, the protective benefits of PCVs can be sustained, ultimately improving health outcomes for children Keywords:Pneumococcal conjugate vaccine, pneumonia, children, hospitalization, vaccine effectiveness, antibiotic resistance

Emerging Trends in Peripheral Artery Disease: A Review of Recent Studies: A Literature Review Zelda Rizkylia Meidinar Ardis; Agastya, Wayan Dhea
Journal of Diverse Medical Research : Medicosphere Vol. 1 No. 2 (2024): J Divers Med Res 2024
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v1i2.134

Abstract Background. Peripheral artery disease (PAD) is a chronic vascular condition characterized by the narrowing or blockage of peripheral arteries, primarily affecting the lower extremities. It is a major manifestation of atherosclerosis and a significant contributor to cardiovascular morbidity and mortality worldwide. The disease disproportionately affects older adults, smokers, individuals with diabetes, and those with a history of hypertension or hyperlipidemia. Methods. Existing scholarly work was explored through PubMed, Google Scholar, and Scopus, using relevant keywords, such as "peripheral artery disease," "diabetes," "atherosclerosis,” and “short-chain fatty acids.” Discussion. The global burden of PAD has risen, driven by aging populations and increasing prevalence of risk factors. Advances in diagnostic techniques, medical therapies, and interventional approaches have expanded treatment options, but challenges persist in ensuring early detection, equitable access, and effective long-term management. This review aims to synthesize the latest literature on PAD, emphasizing recent developments and identifying gaps that warrant further exploration. Conclusion. The objective of this review is to synthesize recent advancements in our understanding, diagnosis and management of peripheral artery disease (PAD). Peripheral Arterial Disease is a chronic, progressive vascular disorder with significant global health implications. The paper examines the complex relationship between PAD and type 2 diabetes mellitus (T2DM), a prevalent comorbidity linked to increased disease severity and unfavorable outcomes due to shared pathological mechanisms such as endothelial dysfunction, chronic inflammation, and atherosclerosis. Furthermore, it explores emerging treatment strategies, including novel pharmacological agents and innovative therapeutic technologies aimed at enhancing perfusion and mitigating disease progression. Keywords: Peripheral artery disease, diabetes, atherosclerosis, endovascular treatment, short-chain fatty acids, glucose control

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