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I Made Dwiki Arta Kusuma
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WMJ (Warmadewa Medical Journal)
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Published by Universitas Warmadewa
ISSN : 25274627     EISSN : 25799010     DOI : doi.org/10.22225/wmj
Core Subject : Health,
Health Professions Medicine & Pharmacology
WMJ (Warmadewa Medical Journal) is the Journal of Medicine & Health, contains scientific articles (Original/ Research Articles, Review Articles, Case Reports) by academic community of the Faculty of Medicine and Health Sciences Warmadewa University, other Faculties of Medicine and Health Sciences and other related Institutions. It is the medium for hardskill and softskills development as an integral part of the Tri Dharma Perguruan Tinggi (Education, Research, Public Service) and health services in the forms of media of communication, information, scientific education, as a subsystem of Medicine and Health holistic and comprehensive services.
Arjuna Subject : -
Articles 104 Documents
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Early Parenteral Nutrition (PN) As A Mortality Risk Factor in COVID-19 Patients at the Intensive Care Unit (ICU) of RSUP Dr. Kariadi Ratha, Putu Prayoga; Niken Puruhita; Aryu Candra; Siti Fatimah Muis; Enny Probosari
WMJ (Warmadewa Medical Journal) 56-69
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.10.2.12741.56-69

Abstract

Mortality in COVID-19 patients in the ICU is reported to be higher than non-ICU. Early parenteral nutrition is avoided considering the complications, but COVID-19 patients in the ICU require parenteral nutrition because enteral intake is inadequate or contraindicated. This study aims to identify early parenteral nutrition and other risk factors that cause mortality of COVID-19 patients in the ICU of Dr. Kariadi Hospital. Observational analytic study using a retrospective cohort approach using secondary data involving COVID-19 patients treated in the ICU of RSUP dr. Kariadi in March – September 2020. The sampling technique used total sampling with the following criteria: inclusion: confirmed COVID-19, age >18 years and given PN and EN therapy or a combination thereof. Statistical analysis using Chi Square test and Logistic Regression. Total of 188 subjects met the inclusion criteria. There was no difference in the mortality of patients who were given early or late PN p:0.92 RR 0.90 (95% CI 0.43-1.84). The risk factors for mortality were the presence of comorbidities p=0.023 RR 2.13 (95% CI 1.15-3.95), use of VM p=<0.0001 RR 43.68 (95% CI 18.52 – 102.99) , energy deficit p=0.002 RR 3.09 (95% CI 1.52-5.99) and protein deficit p=0.039 RR 1.93 (95% CI 1.07-3.49). In the multivariate analysis of controlled VM usage with ARDS status p=0.022 RR 6.20 (95% CI 1.29 – 29.72) and energy deficit p=0.045 RR 2.15 (1.01 – 4.57) together -the same as a risk factor for mortality in COVID-19 patients in the ICU of Dr. Kariadi Hospital. Early PN is not a risk factor for mortality in COVID-19 patients while the use of VM is controlled by ARDS status and energy deficit together are risk factors for mortality in COVID-19 patients in the ICU of RSUP dr. Kariadi.
Infark Miokard Non-Segmen Elevasi ST pada Kasus Fraktur Terbuka Multipel: Laporan Kasus Devinta, Made Ratih Santi; I Gusti Agung Bagus Krisna Jayantika
WMJ (Warmadewa Medical Journal) 75-79
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.10.2.13400.75-79

Abstract

Myocardial infarction (MI) generally occurs due to coronary atherosclerosis. However, under certain circumstances, trauma can act as a trigger for MI. This case report discusses the occurrence of NSTEMI in a patient with multiple open fractures and explores several hypotheses that may contribute to the development of myocardial infarction in the setting of non-thoracic trauma. A 53-year-old man presented to the emergency department following a motorcycle accident. He was treated for multiple open fractures and developed a myocardial infarction on the first day of hospitalization, approximately 40 hours after the trauma. Electrocardiography (ECG) revealed no significant ST-segment changes, while high-sensitivity troponin I levels were markedly elevated at 609.5 ng/mL, and the hemoglobin level was 8.3 g/dL. The patient was co-managed with the cardiology team and received dual antiplatelet therapy (DAPT) and anticoagulation. The orthopedic procedure was postponed until hemodynamic stability was achieved. Myocardial infarction following an open fracture may occur due to rupture of an atherosclerotic plaque, an imbalance between myocardial oxygen supply and demand, and/or increased pro-inflammatory mediators resulting from the bone remodeling process or post-traumatic stress. Myocardial infarction in the setting of open fractures may result from atherosclerotic plaque rupture, oxygen supply–demand imbalance, and/or elevated pro-inflammatory mediators associated with bone remodeling or post-traumatic stress. Increased awareness of potential cardiovascular complications is essential, particularly in trauma patients with pre-existing cardiovascular risk factors.
Bridging Knowledge and Readiness: The Relationship Between Menstrual Awareness and Menarche Preparedness Among Elementary School Girls in Badung, Bali Armynia Subratha, Hesteria Friska; Nabila Amelia Hanisyah Putri; Nis'atul Khoiroh; Made Suadnyani Pasek; Ida Ayu Diah Purnama Sari; Luh Ita Mahendrayani
WMJ (Warmadewa Medical Journal) 101-109
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.10.2.13646.101-109

Abstract

Menarche represents a key developmental transition in early adolescence, making it essential to understand how menstrual knowledge shapes girls’ preparedness for this event. This cross-sectional study examined the relationship between menstrual knowledge and menarche preparedness among elementary school girls in Badung, Bali. A total of 150 students in grades 4–6 from five public schools, purposively selected due to low literacy and numeracy indicators, participated in the study. Data were collected using validated, self-administered questionnaires assessing menstrual knowledge and preparedness. Chi-square analysis with Odds Ratio (OR) estimation was employed. Most participants demonstrated good menstrual knowledge (60.0%) and were categorized as prepared for menarche (63.3%). A significant association was observed between menstrual knowledge and preparedness (p < 0.001; OR = 5.50; 95% CI: 2.65–11.41), indicating that students with higher knowledge levels were substantially more likely to be well prepared. Parental support and exposure to information from schools or health professionals also appeared to contribute to improved preparedness. These findings underscore the importance of strengthening school-based reproductive health education, complemented by active family engagement and culturally appropriate learning materials, to enhance early menarche readiness among young girls.
Nutritional Status and Food Preference Differences Among Primary School Students in Karangasem, Bali Kowara, Mellysa; Suiraoka, I Putu; Octaria, Yessi Crosita; Sari, Eny Kurnia; Malipu, Agnes A
WMJ (Warmadewa Medical Journal) 88-100
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.10.2.13770.88-100

Abstract

Nutritional status during primary school age is essential for optimal physical growth and cognitive development. Dietary transitions driven by modernization—including increased consumption of fast foods and sweetened beverages—may reduce the intake of nutrient-dense foods. This study aimed to describe the nutritional status and food preferences of students at SDN 2 Besakih, Karangasem, Bali. A cross-sectional study was conducted. Anthropometric measurements were obtained from all students present (n = 211) and assessed using BMI-for-age and height-for-age indicators based on WHO AnthroPlus standards. Food preference data were collected from 72 students selected through stratified sampling using a pictorial Likert-scale questionnaire. Data were analysed using univariate, bivariate, and multifactorial tests. Most students exhibited normal nutritional status, although both undernutrition and overnutrition were present. The leftward shift in BMI-for-age and height-for-age z-score curves indicated vulnerability to undernutrition and stunting. Female students demonstrated significantly higher preference scores for chicken dishes (p = 0.003) and milk-based or sweetened beverages (p = 0.009). Grade level influenced preferences for chicken dishes and beverages, with no significant interaction between gender and grade. Vegetable preference was relatively low across all groups. Primary school children in rural Karangasem face a double burden of malnutrition accompanied by shifting dietary preferences toward less balanced food choices. Strengthening school-based nutrition interventions, including nutrition education, healthy canteen programs, and routine growth monitoring, is critical to fostering healthy dietary habits early in life.

Page 11 of 11 | Total Record : 104

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