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All Journal Jurnal Ilmu Kedokteran dan Kesehatan JOURNAL LA MEDIHEALTICO International Journal of Health Science & Medical Research Holistik Jurnal Kesehatan
Swarga, Tirta
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Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Initial Emergency Management of Trauma: A Literature Review Ahmad, St. Lutfiah; Swarga, Tirta; Irna, Ade
Journal La Medihealtico Vol. 6 No. 5 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i5.2614

Abstract

Trauma continues to be one of the leading causes of mortality and disability worldwide, including in Indonesia, with the most critical period occurring within the golden hour. Elevated mortality rates are often linked to delayed medical response, the absence of standardized treatment protocols, and limited healthcare resources. Objective: This review aims to assess the effectiveness of internationally recognized, protocol-driven interventions that have been adapted to the Indonesian context in enhancing trauma care outcomes. A systematic-narrative literature review was conducted in accordance with the PRISMA 2020 guidelines. Sources included SINTA, Scopus, ClinicalKey, as well as conference proceedings and dissertations published between 2023 and 2024. Each study was evaluated for methodological rigor, strength of evidence, and applicability to emergency care settings in Indonesia. Thematic analysis was applied to synthesize the findings. Adaptations of ATLS protocols, interdisciplinary simulation-based training, and the implementation of digital technologies for triage and prehospital communication demonstrated the potential to reduce trauma-related mortality by up to 30%. Furthermore, the early administration of tranexamic acid (TXA), application of tourniquets, and whole blood transfusion proved highly effective in managing severe trauma cases. The integration of international trauma care protocols with locally contextualized innovations and digital health technologies holds significant promise for improving the quality and effectiveness of trauma management in Indonesia.
Gambaran derajat stres pada pasien tumor payudara Musani, Melda Ayu Amanda; Jaya, Muhammad Alim; Swarga, Tirta; Gani, Aziz Beru; Karsa, Nevi Sulvita
Holistik Jurnal Kesehatan Vol. 19 No. 10 (2025): Volume 19 Nomor 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i10.1834

Abstract

 Background: The diagnosis and treatment of breast cancer pose significant psychological challenges, often leading to stress that can negatively impact patients' quality of life and recovery. Purpose: To determine the level of stress in breast cancer patients. Method: This study used a descriptive design with a cross-sectional approach and a sample of 70 respondents. Data collection used the Depression Anxiety Stress Scale-42 (DASS-42) stress measurement instrument. The collected data were processed and analyzed univariately using Microsoft Excel to display the frequency distribution and percentage of each stress category. Results: The majority of respondents (89%) experienced stress, with severe stress being the highest (36%), followed by moderate stress (24%). The largest proportion of respondents were in the 41–50 age group (23%), and the most common type of tumor was right breast cancer (31%). High levels of stress are related to the psychological impact of the diagnosis, changes in body image, and anxiety about treatment, which are often exacerbated by the multidimensional life burdens of middle adulthood. Conclusion: Breast tumor patients experience a high prevalence of stress, with severe stress being the most prevalent. Suggestion: Holistic patient management is needed, integrating psychosocial interventions and medical therapy to improve overall patient well-being.   Keywords: Breast Tumor;Right Breast Tumor; Stress Level.   Pendahuluan: Diagnosis dan pengobatan tumor payudara menimbulkan tantangan psikologis yang signifikan, seringkali menyebabkan stres yang dapat berdampak negatif terhadap kualitas hidup dan proses pemulihan pasien. Tujuan: Untuk mengetahui gambaran derajat stres pada pasien tumor payudara. Metode: Penelitian ini menggunakan desain deskriptif dengan pendekatan cross-sectional dan sampel yang digunakan sejumlah 70 responden. Pengumpulan data menggunakan instrumen pengukuran stres Depression Anxiety Stress Scale-42 (DASS-42). Data yang terkumpul diolah dan dianalisis secara univariat menggunakan microsoft excel untuk menampilkan distribusi frekuensi dan persentase setiap kategori stres. Hasil: Menunjukkan bahwa sebagian besar responden (89%) mengalami stres, dengan kategori stres berat sebagai yang tertinggi (36%), diikuti stres sedang (24%). Proporsi terbesar responden berada pada kelompok usia 41–50 tahun (23%), dan jenis tumor yang paling sering ditemukan adalah Tumor Mamma Dextra (31%). Tingginya tingkat stres berkaitan dengan dampak psikologis dari diagnosis, perubahan citra tubuh, serta kecemasan terhadap pengobatan yang sering diperburuk oleh beban kehidupan multidimensi pada masa dewasa madya. Simpulan: Pasien tumor payudara mengalami prevalensi stres yang tinggi dengan kategori stres berat sebagai yang paling dominan. Saran: Diperlukan manajemen pasien secara holistik dengan mengintegrasikan intervensi psikososial dan terapi medis untuk meningkatkan kesejahteraan pasien secara menyeluruh.   Kata Kunci: Derajat Stres; Tumor Mamma Dextra; Tumor Payudara.
Gambaran Derajat Stres Pada Pasien Tumor Ginekologi Yang Menjalani Kemoterapi Di Rumah Sakit Ibnu Sina Herlina, Besse; Jaya, Muhammad Alim; Swarga, Tirta; Dewi, Anna Sari; Ismail, Wirasto
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 2 (2026): Volume 13 Nomor 2
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i2.22174

Abstract

Pasien dengan tumor ginekologi yang menjalani kemoterapi berisiko mengalami stres psikologis akibat diagnosis penyakit yang mengancam jiwa, efek samping kemoterapi, serta perubahan fisik dan sosial. Stres yang tidak tertangani dapat berdampak negatif terhadap kualitas hidup dan kepatuhan terhadap pengobatan. Penelitian ini bertujuan untuk menggambarkan derajat stres pada pasien tumor ginekologi yang menjalani kemoterapi di Rumah Sakit Ibnu Sina Makassar. Penelitian ini merupakan penelitian deskriptif dengan desain cross-sectional. Sampel diambil menggunakan teknik purposive sampling pada pasien yang terdiagnosis tumor ginekologi dan sedang menjalani kemoterapi. Pengumpulan data dilakukan menggunakan kuesioner Depression Anxiety Stress Scale-42 (DASS-42) yang telah tervalidasi. Dari total 64 responden, sebagian besar pasien berada pada kategori stres sedang, yaitu sebanyak 39 responden (60,9%), diikuti oleh stres tinggi sebanyak 18 responden (28,1%), dan stres rendah sebanyak 7 responden (10,9%). Faktor yang berkontribusi terhadap stres antara lain lamanya menjalani kemoterapi, dukungan sosial, dan kondisi ekonomi. Kesimpulannya, mayoritas pasien tumor ginekologi yang menjalani kemoterapi mengalami tingkat stres sedang, sehingga diperlukan skrining dan intervensi psikologis sejak dini untuk meningkatkan kualitas hidup pasien. 
EFFECT OF EPIDURAL AND GENERAL ANESTHESIA ON PERIOPERATIVE NEUTROPHIL LYMPHOCYTE RATIO CHANGES IN MASTECTOMY PATIENTS Damayanti, Fina; Harahap, Muhammad Wirawan; Karim, Abdul Mubdi Ardiansar Arifuddin; Sommeng, Faisal; Swarga, Tirta
International Journal of Health Science & Medical Research Vol 5, No 1 (2026): February 2026
Publisher : UNG

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37905/ijhsmr.v5i1.36603

Abstract

Mastectomy induces a systemic inflammatory response that may be influenced by the anesthetic technique, as reflected by changes in the neutrophil–lymphocyte ratio (NLR). Unlike previous studies that assessed mixed breast surgeries, broadly evaluated regional anesthesia, or focused on combined general–epidural techniques and cytokine markers, this study uniquely compares perioperative pre–post changes in NLR (ΔNLR) between epidural anesthesia alone and general anesthesia alone in mastectomy patients using a routinely available biomarker. This quantitative experimental study was conducted at Ibnu Sina YW-UMI Hospital, Makassar, from August 2025, involving 30 mastectomy patients recruited consecutively and allocated into two independent groups (15 epidural, 15 general anesthesia). Venous blood samples were collected preoperatively and 24 hours postoperatively to calculate NLR, with ΔNLR as the primary outcome. Within-group analysis using the Wilcoxon test showed significant postoperative increases in NLR in both the epidural group (5.13 ± 5.42 to 7.65 ± 5.99; p0.001) and the general anesthesia group (4.12 ± 4.59 to 14.72 ± 8.43; p0.001). Between-group comparison using the Mann–Whitney test demonstrated that ΔNLR was significantly higher in the general anesthesia group (10.60 ± 7.23) than in the epidural group (2.52 ± 2.36; p0.001). These findings indicate that epidural anesthesia is associated with a smaller postoperative increase in NLR, suggesting better attenuation of the systemic inflammatory response after mastectomy. Further randomized studies with larger samples, additional inflammatory biomarkers, and clinical outcomes are recommended to enhance evidence strength and generalisability.
Co-Authors Ahmad, St. Lutfiah Damayanti, Fina Dewi, Anna Sari Gani, Aziz Beru Harahap, Muhammad Wirawan Herlina, Besse Irna, Ade Ismail, Wirasto Jaya, Muhammad Alim Karim, Abdul Mubdi Ardiansar Arifuddin Musani, Melda Ayu Amanda Nevi sulvita karsa Sommeng, Faisal