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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi E-Jurnal Medika Udayana The Indonesian Biomedical Journal JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Indonesian Archives of Biomedical Research (InABR) Cermin Dunia Kedokteran
Sri Maliawan
Department Of Neurosurgery, Faculty Of Medicine Udayana University/Sanglah General Hospital, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : ISM (Intisari Sains Medis) : Jurnal Kedokteran

 1 
Gangguan pola bangun-tidur setelah cedera kepala Moses Kharisma Setyawan; Sri Maliawan; Tjokorda Gde Bagus Mahadewa; I Wayan Niryana; Dewa Putu Wisnu Wardhana
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (340.088 KB) | DOI: 10.15562/ism.v12i2.1013

Abstract

Traumatic brain injury is a common trauma. Traumatic brain injury is commonly followed by sleep disorder such as insomnia, hypersomnia and circadian rhythm disturbance. Sleep disorder can cause many complications, including the worsening of the brain injury prognosis. Insomnia occurs in 29% traumatic brain injury patient. Insomnia suspected due injury in inferior frontal, anterior temporal including basal forebrain, also sympathetic nerve hyperactivity. Insomnia increase the risk of stroke, disability and mood disturbance. Hypersomnia occurs in 28% traumatic brain injury patients. Hypersomnia suspected due orexin decrease and injury in sleep promoting area. Hypersomnia suspected related to recovery, less activity time and accident due sleepiness. There are no prevalence data of circadian rhythm disturbance after traumatic brain injury. This disturbance is caused by injury in supra-chiasmatic nucleus and related to global worsening on the patient. Insomnia and circadian rhythm disturbance are highly linked with injury area, but hypersomnia is not particularly linked to any area and only related to orexin decrease. Insomnia and circadian rhythm disturbance are highly related to the worsening condition on the patient, but hypersomnia is associated with recovery and not particularly related to any disturbances. It is hoped that understanding the sleep disorder after traumatic brain injury can rise the alertness of this matter and encourage clinicians to increase the quality of sleep disorder due to traumatic brain injury management.   Cedera kepala merupakan salah satu cedera yang umum terjadi. Cedera ini sering diikuti dengan gangguan tidur seperti insomnia, hipersomnia dan gangguan ritme sirkadian. Gangguan ini sering dapat menyebabkan berbagai komplikasi termasuk memperparah penyembuhan cedera kepala. Insomnia setelah cedera kepala terjadi sebanyak 29%. Insomnia diduga disebabkan oleh cedera pada daerah inferior frontal, anterior temporal termasuk basal otak depan, juga peningkatan kerja saraf simpatis. Insomnia meningkatkan resiko stroke, disabilitas dan gangguan suasana hati. Hipersomnia setelah cedera kepala terjadi sebanyak 28%. Hipersomnia diduga akibat penurunan orexin dan akibat kerusakan pada area yang mempertahankan bangun. Hipersomnia diduga berhubungan dengan penyembuhan, waktu tersita akibat tidur dan kecelakaan akibat mengantuk. Belum ada data prevalensi gangguan ritme sirkadian setelah cedera kepala. Gangguan ini disebabkan oleh cedera pada nukleus suprakiasmatik dan sering dikaitkan dengan perburukan kondisi pasien. Insomnia dan gangguan ritme sirkadian sering dihubungkan dengan lokasi tertentu dari cedera, namun hipersomnia berhubungan dengan kadar orexin dan tidak terlalu dikaitkan terhadap area tertentu. Insomnia dan gangguan ritme sirkadian berhubungan dengan perburukan, namun hipersomnia bisa menandakan perbaikan dan tidak berhubungan signifikan dengan gangguan lainnya. Diharapkan dengan memahami gangguan tidur ini dapat meningkatkan kewaspadaan bagi para klinisi dan mendorong untuk penelitian berikutnya sehingga penanganan pasien gangguan tidur akibat cedera kepala dapat menjadi lebih baik. 
Faktor risiko yang mempengaruhi outcome pada pasien cedera kepala di RSUP Sanglah, Bali, Indonesia pada tahun 2018-2019 I Gede Sutawan; Sri Maliawan; I Wayan Niryana
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (372.686 KB) | DOI: 10.15562/ism.v12i2.1047

Abstract

Background: Head injury or capitis trauma is a blunt/sharp force to the head or face resulting in temporary or persistent cerebral dysfunction. From a socio-economic point of view, the prognostic model by looking at baseline data on admission is an important factor in supporting cost-effective clinical decisions. This study aims to evaluate the risk factors that influence outcomes in head injury patients at Sanglah Hospital, Bali, Indonesia, in 2018-2019.Method: Prospective cohort study to see the effect of risk factors for head injury patients (exposure) with the outcome in the form of unfavorable conditions within 7 days. This research was conducted at the Surgery Department and Emergency Room Sanglah Hospital Denpasar- Bali for 6 months from September 2018-February 2019. Data were analyzed using SPSS version 16 for Windows.Results: Some of the factors significantly associated with and risk factors for the unfavorable outcome within 7 days in head injury patients who were treated at Sanglah General Hospital in 2018-2019 were hypotension, initial GCS 3-8, anisocoria pupil reflex, hypoxia, focal lesions, midline shift, and length of time operation ? 6 hours (p<0.05). Hypotensive blood pressure is the most dominant risk factor for the unfavorable outcome within 7 days of head injury patients admitted to Sanglah General Hospital (Adjusted OR: 5.4; 95% CI: 2.47-12.07; p=0.000).Conclusion: Hypotensive blood pressure is the most dominant risk factor for the unfavorable outcome within 7 days of head injury patients treated at Sanglah General Hospital in 2018-2019. Latar belakang: Cedera kepala atau trauma kapitis merupakan kekerasan tumpul/tajam pada kepala atau wajah yang berakibat disfungsi serebral sementara atau menetap. Dari sudut pandang sosioekonomi, model prognostik dengan melihat data awal saat masuk rumah sakit merupakan faktor penting dalam mendukung keputusan klinis yang cost-effective. Penelitian ini bertujuan untuk mengevaluasi faktor risiko yang mempengaruhi outcome pada pasien cedera kepala di RSUP Sanglah, Bali, Indonesia pada tahun 2018-2019Metode: Studi kohort prospektif untuk melihat pengaruh faktor resiko yang dimiliki pasien cedera kepala (exposure) dengan hasil luaran (outcome) berupa kondisi unfavourable dalam 7 hari. Penelitian ini dilakukan di Bagian Bedah FK UNUD/SMF Bedah Saraf RSUP Sanglah, Denpasar-Bali dan Instalasi Rawat Darurat RS Sanglah Denpasar-Bali selama 6 bulan dari bulan September 2018-Februari 2019. Data dianalisis menggunakan SPSS versi 16 untuk Windows.Hasil: Beberapa faktor yang berhubungan secara bermakna dan menjadi faktor risiko terjadinya outcome unfavorable dalam 7 hari pada pasien cedera kepala yang dirawat di RSUP Sanglah tahun 2018-2019 adalah hipotensi, GCS awal 3-8, reflek pupil anisokor, hipoksia, fokal lesi, midline shift, dan lama waktu tindakan operasi ? 6 jam (p<0,05). Tekanan darah hipotensi merupakan faktor risiko yang paling dominan terhadap outcome unfavorable dalam 7 hari pasien cedera kepala yang dirawat di RSUP Sanglah (Adjusted OR: 5,4; 95% IK: 2,47-12,07; p=0,000)Kesimpulan: Tekanan darah hipotensi merupakan faktor risiko yang paling dominan terhadap outcome unfavorable dalam 7 hari pasien cedera kepala yang dirawat di RSUP Sanglah tahun 2018-2019.
Description of hydrocephalus knowledge in pregnant woman at Puskesmas 1 Denpasar Utara Made Indra Erlangga Prathiwindya; I Wayan Niryana; Tjokorda Gde Bagus Mahadewa; Sri Maliawan
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (263.656 KB) | DOI: 10.15562/ism.v13i1.1256

Abstract

Background: Hydrocephalus is a pathological brain disorder resulting from increased cerebrospinal fluid without or with elevated intracranial pressure resulting in widening of the space where cerebrospinal fluid flows. Maternal environment such as experiencing infection during pregnancy, consuming alcohol and drugs, lifestyle such as obesity, diabetes, or hypertension, and lack of examinations in preparing for prenatal care and low socioeconomic status affect the risk factors for congenital hydrocephalus. The purpose of this study is to to determine awareness and knowledge level among pregnant women towards hydrocephalus. Methods: This descriptive research was conducted with a cross-sectional method using consecutive sampling as a sampling technique. 106 Pregnant Women at Puskesmas I Denpasar Utara was involved in completing the survey regarding Hydrocephalus during this research. For the collecting data using a questionnaire filled directly by each respondent containing 9 questions and then analyzed using the software Statistical Package for the Social Sciences (SPSS). Results: This study was participated by 106 respondents and figured that approximately 84,9% among the total number of respondents have a good knowledge of hydrocephalus while the rest, 15,1% are still at a low level with common characteristics of the respondents, including the age of 24 years old (age group 19-25), multipara (59.4%), with a college education background (45.3%), and working as a housewife (59.4%). Conclusion: This study conveys good knowledge about hydrocephalus in pregnant women, especially those who have a good level of education.
The role of Bone Morphogenetic Protein-2 in craniofacial osteogenesis: A literature review I Gusti Putu Hendra Sanjaya; Sri Maliawan
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.491 KB) | DOI: 10.15562/ism.v13i2.1290

Abstract

Bone Morphogenetic Protein (BMP) is a type of growth factor that belongs to the Transforming Growth Factor Beta (TGF-B) group. Bone Morphogenetic Protein-2 (BMP-2) is recognized as one of the first commercially available osteoblast inductors. When new bone is needed, mesenchymal stem cells can develop into osteoblasts, which then implant as osteocytes in the bone, providing additional structure and support. The principal agent that differentiates stem cells into osteoblasts is BMP-2. BMP-2 will be released into the bone matrix or serum in performing their job. BMP-2 activates the SMAD1/5/8 signal via mediating the physiological action of type I and II serine/threoninekine receptors. The active SMAD protein will form a complex with the SMAD4 protein, translocate DNA to the nucleus, and bind to particular genes like Dlx-2/5, Osx, and transcription. According to a recent study, BMP-2 boosts osteogenic growth. BMPs are effective in the treatment of craniofacial defects in current research. The subjects of this paper are the molecular mechanism of BMPs and their involvement in the clinical application of craniofacial deformity patients.
Co-Authors A.A. Gde Oka A.A. Ngr. Agung Wistara Widya AA GN Asmara Jaya AAGN Asmarajaya Andi Asadul Islam Astawa N. M., Astawa N. Astawa P., Astawa B. Sinaga D.P.W. Wardhana Dewa Putu Wisnu Wardhana Dian Megasafitri Eka J. Wahjoepramono Ekaputra Ekaputra, Ekaputra G. I. B Bomba Gatot S. Lowrence, Gatot S. Gde Rastu Adi Mahartha Gede Febby Pratama Kusuma Gede Wirya Kusuma Duarsa Hamsu Kadriyan I Dewa Made Sukrama I Gede Budhi Setiawan I Gede Sutawan I Gusti Agung Bagus Krisna Wibawa I Gusti Ayu Agung Laksemi I Gusti Kamasan Arijana I Gusti Putu Hendra Sanjaya I Ketut Suyasa I Ketut Wiargitha I Made Arya Winangun I Made Bakta I Made Gotra I Made Jawi I Nyoman Semadi I W. Sudarsa I Wayan Gede Artawan Eka Putra I Wayan Niryana I Wayan Putu Sutirta Yasa I. B. Tjakra Wibawa Manuaba Ida Bagus Adi Kayana Ilhamjaya Patellongi Iwan Antara Suryadi K.K. Putra Kadek Dede Frisky Wiyanjana Kadek Dede Frisky Wiyanjana Ketut Putu Yasa Ketut Siki Kawiyana Kevin Kristian Putra Koerniawan, Heru Sutanto Komang Ayu Vitriana Gamayanti L. K. Widnyani Wulan Laksmi L. R. M. Lengkong M Wiryana Made Agus Mahendra Inggas, Made Agus Mahendra Made Favian Budi Gunawan Made Indra Erlangga Prathiwindya Made Putri Hendaria Moses Kharisma Setyawan Mumtazah Mardliyah Ni Ketut Susilawati Ni Luh Putu Julita Yanti Ni Putu Enny Pratiwi Suardi Ni Wayan Ariani Vitriasari Nyoman Golden Putu Anda Tusta Adiputra Putu Indah Budi Apsari Putu Primeriana Nugiaswari Raka-Sudewi A. A. Reni Widyastuti Romdhoni, Achmad Chusnu S. Awyono Satoto D., Satoto Stanley-Ketting Oliver Suryadi N. T., Suryadi N. Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa W. A., W. Wayan Suardana Willy Adhimarta, Willy Wiryana M., Wiryana Yutina Himawan