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NI NYOMAN MESTRI AGUSTINI
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GANESHA MEDICINA
Published by Universitas Pendidikan Ganesha
ISSN : -     EISSN : 27978672     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Ganesha Medicina Journal is open access; double-blinded peer-reviewed journal aiming to communicate high-quality research articles, case report, reviews and general articles in the field. Ganesha Medicina Journal publish articles that encompass all aspects of basic research/clinical studies related to the field of medical sciences. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship, and to encourage a vigorous dialogue between medical scholars and practitioners.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 83 Documents
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Tingkat Kesiapan Interprofessional Education Mahasiswa Kedokteran Dalam Pembelajaran Field Lab Travel Medicine Ni Luh Putu Pranena Sastri; Made Kurnia Widiastuti Giri; Komang Hendra Setiawan; Made Bayu Permasutha
Ganesha Medicina Vol. 5 No. 1 (2025)
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v5i1.94526

Abstract

Interprofessional education (IPE) menjadi suatu hal yang penting dalam pembelajaran kedokteran dan kesehatan, dengan tujuan untuk meningkatkan kerjasama dalam tim dan pemahaman mahasiswa mengenai peran profesinya dalam perawatan pasien IPE sebagai persiapan dari mahasiswa profesi kesehatan untuk dapat berkolaborasi dan kerjasama tim dalam perawatan pasien sejak dini. Mahasiswa Kedokteran di FK Undiksha mempelajari materi IPE pada mahasiswa semester 7. Beberapa penugasan kuliah IPE terkait dengan pelaksanaan field lab travel medicine yang dilaksanakan di beberapa puskesmas di Kabupaten Buleleng. Field lab ini dilaksanakan pada semester 7 serta berkaitan dengan kesehatan masyarakat dan kedokteran pariwisata. Penelitian ini dilakukan untuk untuk mengetahui tingkat kesiapan pembelajaran IPE mahasiswa dalam pembelajaran field lab. Penelitian ini dilakukan kepada mahasiswa semester 7 Program Studi Kedokteran FK Undiksha yang dipilih secara secara total sampling. Instrumen yang digunakan adalah RIPLS yang telah diuji validitas dan reliabilitas. Hasil akan dianalisis secara deskriptif untuk mengetahui tingkat kesiapan pembelajaran IPE dari mahasiswa pada masing-masing item instrumen. Pada penelitian ini mahasiswa menunjukkan telah memiliki pemahaman yang baik mengenai kerjasama dan kolaborasi antar profesi, identitas professional positif dan identitas professional negative. Kata Kunci : interprofessional education (IPE), field lab travel medicine, kesiapan mahasiswa.   Abstract Interprofessional education (IPE) is important in medical and health education, to improving students’ teamwork and  understanding their profession role in patient care. IPE as a preparation for health profession students to be able to collaborate and teamwork in patient care. Medical students in FK Undiksha are learned IPE on 7th semester. Several IPE assignments are related to the implementation of the travel medicine field lab which is carried out in several health centers in Buleleng Regency. This field lab is carried out in 7th semester and is related to public health and travel medicine. This study was conducted to determine the level of readiness of students' IPE learning on field lab learning. This study was conducted on 7th semester Medical Student in FK Undiksha who were selected by total sampling. The instrument used was RIPLS which has been tested for validity and reliability. The results will be analyzed descriptively to determine the level of readiness of students' IPE learning on each instrument item. In this study, students showed that they had good understanding of cooperation and collaboration between professions, positive professional identity and negative professional identity. Keywords : interprofessional education (IPE), field lab travel medicine, student readiness
A Giant Auricular Soft Tissue Tumor Mimicking Keloid Treated with Surgical Excision and Local Advancement Flap: A Case Report: Laporan Kasus: Operasi Pengangkatan Tumor Jaringan Lunak Raksasa di Telinga yang Mirip Keloid, Diikuti dengan Teknik Tutup Kulit (Flap) Lokal Kadek Dwi Stiti Dharma; Nyoman Siska Ananda
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.102891

Abstract

Soft Tissue Tumor (STT) is a heterogeneous group of benign and malignant lesions originating from non-epithelial tissues and extraskeletal elements. These lesions may cause functional and aesthetic problems, especially when located in the head and neck area. The main treatment is surgical excision with adequate margins, followed by reconstruction if there is a large defect. Local flap is one reconstruction technique with advantages in color and texture match, while maintaining blood supply. This case report presents a 31-year-old male with a mass on the left auricle that had enlarged over two years after ear piercing. Clinical and supporting examinations, histopathological diagnosis, and tumor excision with local advancement flap were performed. A total excision of a 15 × 7 cm tumor down to the cartilage base was carried out, followed by defect reconstruction with a local advancement flap. Histopathology showed “Hyalinized Fibroma,” a benign fibrous tissue tumor with hyalinization. Postoperatively, the wound healed well without complications. Auricular soft tissue tumor excision with local flap reconstruction provided satisfactory functional and aesthetic results in cases with good local blood supply. This approach is effective in preserving auricular shape and function while minimizing postoperative complications.
The Relationship Between Physical Activity And Body Mass Index In Elementary School’s Students Made Kurnia Widiastuti Giri; Ketut Parining; Putu Ayu Aprilia Saraswati; Anak Agung Ayu Mutiara Parameswari; I Gede Kawihana; Ayu Komang Awidya Maha Dewi; Desak Putu Ramita Pratiwi
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.103487

Abstract

Physical activity is essential for maintaining energy balance and preventing obesity, while Body Mass Index (BMI) serves as a simple indicator of nutritional status in school-aged children. This study aimed to examine the relationship between physical activity and BMI among sixth-grade students. An observational analytic design with a cross-sectional approach was applied, involving 60 students in SDN 3 Seririt elementary school, who met the inclusion criteria. Physical activity was assessed using a questionnaire, and BMI was calculated from weight and height measurements. Data were analyzed with the Spearman Rank test. Results showed that 46.67% of students had moderate physical activity, while BMI distribution included 60% normal, 5% underweight, 13.33% overweight, 20% obese, and 1.67% severe obesity. Statistical analysis revealed a p-value of 0.0033 (p < 0.05) with a weak negative correlation (r = -0.276). These findings indicate a significant relationship between physical activity and BMI in the study population.
Composite Graft for Oblique Fingertip Amputation of the Ring Finger in an Adult: A Case Report and Literature Review Zagat Indrawana; Nyoman Siska Ananda
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.104487

Abstract

Fingertip amputations are common hand injuries that may significantly affect function and cosmetic appearance. Composite grafting is a relatively simple reconstructive technique that reattaches the amputated tissue without microvascular anastomosis and may provide satisfactory outcomes in selected adult patients. A 41-year-old male presented with a lateral oblique fingertip amputation of the right ring finger after a wood-cutting injury. Clinical examination revealed a 2.5 × 1.5 cm wound with exposed distal phalanx and non-viable tissue. The patient underwent debridement and composite grafting using the amputated fragment after trimming and thinning of excess subcutaneous tissue. Postoperative management included hand elevation, oral antibiotics, analgesics, and regular follow-up evaluations. Progressive graft maturation and satisfactory healing were observed, with satisfactory graft viability, preserved fingertip contour, and acceptable functional and cosmetic outcomes at one-month follow-up. Composite grafting remains a practical and cost-effective option for selected adult fingertip amputations, particularly when meticulous debridement, graft preparation, and postoperative care are performed. This case demonstrates favorable graft survival and satisfactory clinical outcomes following composite graft reconstruction in an adult patient.
Weekly Hippotherapy Improves Gross Motor Function in Cerebral Palsy: A Meta-Analysis: Evidence on Weekly Therapy Dosage in Children With Cerebral Palsy I Nyoman Windiana; Komang Alit Gita Andhira; Kadek Surya Candra Wijaya; I Gusti Agung Ayu Pramasinthya Aguseny Yudana
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.105995

Abstract

Current clinical practice guidelines have not specifically addressed the roles of physiotherapy and occupational therapy in enhancing physical function during activities in children with cerebral palsy. Nonetheless, hippotherapy, which utilizes equine movement as a therapeutic modality, has shown promise as an adjunctive intervention for improving gross motor function in this population. This meta-analysis aims to assess the therapeutic effects of weekly hippotherapy sessions on gross motor function in children diagnosed with cerebral palsy. A systematic review was conducted according to PRISMA guidelines. Searches were performed on Google Scholar, PubMed, and Scopus databases for randomized controlled trials (RCTs) evaluating the impact of weekly hippotherapy on children with cerebral palsy. The methodological quality of included studies was assessed using the Cochrane Risk of Bias 2 (ROB-2) tool. Five RCTs involving a total of 203 children with cerebral palsy met the inclusion criteria. Meta-analysis using random-effects models demonstrated significant improvements in gross motor function following weekly hippotherapy sessions (SMD, 0.44; 95% CI, 0.04-0.85; P = 0.03). Study heterogeneity was moderate (I2 = 57%). Weekly hippotherapy sessions significantly enhance gross motor function in children with cerebral palsy compared to controls. These findings support the inclusion of hippotherapy in comprehensive rehabilitation programs aimed at optimizing motor skill development. Further research is needed to establish standardized treatment protocols and examine long-term outcomes.
Diagnostic Challenges of Acute Limb Ischemia Rutherford IIa with Pancytopenia Nyoman Budhi Wirananda Setiawan; I Ketut Andriyasa; Putu Arya Nugraha; Made Widiastika; Dwiputra Yogi Pramarta; Ni Made Nova Andari Kluniari
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.111031

Abstract

Pancytopenia is a hematological condition associated with impaired blood cell production and an increased risk of bleeding, making arterial thrombosis an uncommon clinical finding. The coexistence of pancytopenia and acute limb ischemia presents significant diagnostic and therapeutic challenges. This case report aims to describe the complexity of diagnosing and managing acute limb ischemia in a patient with underlying pancytopenia. An 87-year-old woman with a known history of pancytopenia presented with pain and blackish discoloration of the right great toe. Laboratory evaluation revealed severe anemia, leukopenia, and thrombocytopenia. Doppler ultrasonography demonstrated atherosclerosis with multiple thrombi in the femoral and anterior tibial arteries. Peripheral blood smear showed abnormal erythrocyte and platelet morphology. A diagnosis of acute limb ischemia with pancytopenia was established. Management posed a clinical dilemma, as anticoagulation was required to prevent ischemic progression, while severe thrombocytopenia increased the risk of bleeding. After multidisciplinary discussion, conservative treatment with heparin was initiated. The patient’s family declined invasive diagnostic and therapeutic procedures, including bone marrow examination and thrombectomy. This case highlights the importance of considering a broad differential diagnosis in pancytopenia and emphasizes the need for individualized management strategies when acute limb ischemia occurs in patients with high bleeding risk.
An 18 Years Old Male with Leptospirosis: A Case Report Heri Pribadhi; Ni Made Dewi Arimas; Made Dinda Pratiwi
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.111223

Abstract

Leptospirosis is a zoonotic bacterial infection caused by pathogenic Leptospira species and remains a major public health concern in tropical and subtropical regions. Early clinical manifestations are often nonspecific and resemble other acute febrile illnesses, leading to delayed diagnosis and treatment. Severe leptospirosis may develop even in young and previously healthy individuals, resulting in significant morbidity and mortality. An 18-year-old male presented with acute-onset fever, severe arthralgia, nausea, and vomiting. He had a history of environmental exposure, including frequent flooding around his residence and the presence of rodents. Physical examination revealed fever, conjunctival injection, and jaundice. Laboratory findings showed thrombocytopenia, acute kidney injury, and marked hyperbilirubinemia with mildly elevated transaminases. Serological testing for Leptospira IgM was positive, confirming the diagnosis. Abdominal ultrasonography demonstrated no biliary obstruction or structural liver abnormalities. The patient was treated with intravenous ceftriaxone, adequate fluid resuscitation, and close monitoring of renal function. Clinical and laboratory improvements were observed, and the patient was discharged in stable condition after six days of hospitalization. This case highlights that severe leptospirosis can occur in adolescents and young adults without comorbidities. Recognition of environmental risk factors, early diagnosis, and prompt initiation of appropriate antimicrobial and supportive therapy are crucial to prevent severe complications. Increased clinical awareness is essential to improve outcomes in leptospirosis-endemic areas.  
Diagnosing and Managing Ischemic Stroke in Children in Limited Resources Facilities: A Case Report Made Suadnyani Pasek; Ni Nyoman Mestri Agustini; Made Dinda Pratiwi
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.111939

Abstract

Stroke is a significant cause of death and disability in children. Stroke is among the 10 leading causes of death in children aged 5 to 25 years. ischemic stroke is defined when a focal neurological deficit occurs that lasts more than 24 hour, with neuroimaging evidence of cerebral infarction. We report a 9-year-old boy presented to the emergency room complaining of weakness in the right half of his body. this complaint was sudden, improved for several hours, and then persisted. The patient also complained of slurred speech and a headache prior admission. Laboratory test revealed, head CT scan showed an acute cerebral infarction of the lentiform nucleus and left temporal bone. Treatment consisted of aspirin 3.5 mg/kg/day for its antiplatelet effects and intravenous citicoline 10 mg/kg every 12 hours, a neuroprotective agent that supports recovery following neurological conditions such as stroke or brain injury. The patient showed improvement on the third day of treatment, with improvement in right hemiparesis and slurred speech. Early recognition of stroke in children is crucial, along with the implementation of targeted and neuroprotective therapies.
A Qualitative Evaluation of Telemedicine Service Implementation in Morowali Regency, Indonesia Gilvandris Aimang; Rajindra; Abdul Kadri; Irna Olvaliani Aimang
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.112175

Abstract

Telemedicine has become an important strategy for improving healthcare delivery, especially in geographically challenged areas. In Morowali Regency, dispersed settlements and limited infrastructure hinder access to health services. This study evaluated telemedicine implementation based on clinical effectiveness, efficiency, accessibility, and user satisfaction. A descriptive qualitative study with purposive sampling was conducted at Morowali Regional General Hospital and five primary healthcare centers involving 15 informants, including managers, physicians, patients, and an IT operator. Data were collected through in-depth interviews, observation, and document review, then analyzed thematically using the Miles and Huberman interactive model supported by NVivo software. Four major themes emerged: clinical effectiveness, efficiency, accessibility, and user satisfaction. From the clinical effectiveness perspective, telemedicine facilitated clinical consultations, diagnostic support, and inter-facility coordination, although its use remained inconsistent and technically constrained. From the efficiency perspective, telemedicine reduced travel burden and improved access to specialist services for remote communities, but efficiency gains were limited by weak workflow integration. From the accessibility perspective, telemedicine expanded healthcare access despite infrastructure disparities and irregular service continuity. From the user satisfaction perspective, most healthcare providers and patients expressed positive experiences, although technical disruptions and the absence of structured evaluation mechanisms remained challenges. Overall, telemedicine showed benefits across all dimensions, highlighting the need for stronger infrastructure, routine utilization, and institutionalized evaluation to support sustainable and equitable healthcare delivery in geographically challenged regions.
Characteristics of Outpatients with Chronic Tonsillitis at the ENT Clinic of Sanjiwani Regional General Hospital, Gianyar, in 2023–2024 Mulyawan Made Bramastya Nugraha Teja Kusuma; Widhidewi Ni Wayan; Indraningrat Anak Agung Gede; Santosa Agus
Ganesha Medicina Vol. 6 No. 2 (2026):
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i2.112526

Abstract

Chronic tonsillitis is a recurrent and persistent inflammation of the palatine tonsils that commonly affects children to young adults and may impact quality of life. This study aimed to describe the characteristics of outpatients with chronic tonsillitis at the ENT Clinic of Sanjiwani Regional General Hospital, Gianyar, during the 2023–2024 period. This study employed a descriptive quantitative design with a retrospective cross-sectional approach using total sampling from 51 medical records. Univariate analysis was performed using Microsoft Excel to evaluate variables including age, sex, clinical symptoms, tonsillar hypertrophy grade (Brodsky classification), and management. The majority of patients were female (58.8%) and aged ≤16 years (45.1%). The most common symptom was halitosis (39.2%), followed by dysphagia and dilated tonsillar crypts (17.6% each). The most frequent tonsillar hypertrophy grade was T2 (25–50%) at 39.2%, which was more common in females and in patients aged ≤16 years. The most frequently administered treatment was medical therapy (60.8%), particularly for mild to moderate grades, whereas surgical referral was more common in cases with more severe tonsillar enlargement. In conclusion, chronic tonsillitis in this outpatient setting predominantly affected young female patients, with halitosis and T2 tonsillar hypertrophy as the main findings. Most cases were managed conservatively, highlighting the need to strengthen clinical guidelines and patient education.

Page 8 of 9 | Total Record : 83

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