I Nyoman Semadi
Department Of Surgery, Thoracic And Cardiovascular Division, Medical Faculty, Universitas Udayana, Sanglah General Hospital, Denpasar, Indonesia

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Hyaluronic Acid Caused of Wider Epithelialization Compare to Normal Saline in Severe Diabetic Ulcer Sudarsa, I W; Semadi, I N; Riasa, N P
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objectives: Diabetic ulcer, one of chronic complications of diabetes mellitus (DM), showed a high morbidity and mortality rate. The main treatment modality for diabetic ulcer was debridement, followed by wound treatment as local control to promote wound healing. This study aims to compare efficacy of hyaluronic acid (HA) and 0.9% sodium chloride (NaCl) in severe diabetic ulcus two after debridement. Method: This study was a randomized clinical study to compare the efficacy of HA and NaCl 0.9% in severe diabetic ulcer two weeks post debridement. Thirty six severe diabetic ulcer (Wagner ?3) samples were collected using consecutive sampling method and divided into 2 treatment groups: standard wound treatment using NaCl 0.9% and using hyaluronic acid. T-independent test was applied for statistical analysis data and  p<0.05 was consider a statisticalle significant. Results: The two treatment groups showed insignificant difference in characteristics and laboratory findings. The mean tissue epithelialization width after two weeks of wound treatment using NaCl 0.9% was 17,22 ± 3,25 and using HA was 27,33 ± 2,43. Statistical analysis using t-independent test showed t = 10.59, p = 0.001 for both treatment groups. Conclusions: HA improves wound healing rate in severe diabetic ulcer 2 weeks post debridement compared to 0.9% NaCl.
PERBANDINGAN VOLUME ALIRAN DARAH FISTULA RADIOCEPHALICA SIDE TO END DANEND TO END Saraswati, Putu Ayu; Semadi, I Nyoman; Widiana, Gde Raka
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Hemodialisis merupakan terapi dominan sebagai pengganti fungsi ginjal pada pasien penyakit ginjalkronis. Hemodialisis memerlukan akses vaskular yang baik, dapat bertahan lama dengan komplikasiyang minimal. Fistula radiocephalica merupakan salah satu akses vaskular permanen. Ada empatteknik operasi fistula radiocephalica yaitu side to side, side to end, end to side dan end to end. Teknikterbanyak yang dipakai saat ini adalah side to end dan end to end. Saat ini belum ada data yangmembandingkan volume aliran darah pada kedua teknik tersebut. Penelitian ini adalah uji klinikacak terkontrol buta tunggal. Subjek penelitian adalah pasien penyakit ginjal kronis yang dilakukanoperasi fistula radiocephalica yang dibagi dalam dua kelompok. Kelompok pertama menggunakanteknik side to end dan kelompok kedua menggunakan teknik end to end. Volume aliran darah diukurmenggunakan CDU 4 minggu pasca-operasi. Sampel penelitian ini adalah 60 sampel yang terdiri dari36 (60 %) lelaki dan 24 (40 %) perempuan.Volume aliran darah kelompok side to end adalah 757 ( 389sampai 1125) ml/menit dan kelompok end to end  adalah 854 (534 sampai 1174) ml/menit dan bedavolume aliran darah adalah 97 ml/menit dengan nilai P = 0,074. Komplikasi terjadi pada kelompokside to end sebanyak dua pasien. Beda volume aliran darah pada kedua kelompok tidak bermaknasecara statistik. [MEDICINA 2015;46:141-4].Hemodialysis is the dominant therapy as a replacement for kidney function in chronic kidneydisease patients. Hemodialysis requires good vascular access, can last a long time and minimalcomplications. Radiocephalica fistula is one of the permanent vascular access. There are fourtype of radiocephalica fistula technique: side to side, side to end, end to side, and end to end.Most techniques used today is the side to end and end to end. Currently there is no data thatcompare blood flow volume in both these techniques.This study is single blind randomizedcontrolled trial. Subjects were patients with chronic kidney disease performed radiocephalicafistula surgery divided into two groups. The first group used a technique side to end and thesecond group used a technique end to end. Blood flow volume was measured using Dopplerultrasound 4 weeks postoperatively.The sample was 60 samples consisted from 36 (60%) menand 24 (40%) of women. Blood flow volume group side to end was 757 (389 to 1125) ml / min anda group of end to end was 854 (534 to 1174) ml / min and different volume rate was 97 ml / minwith a value of P = 0.074. Complications occurred in the group side to end by two patients.Bloodflow volume difference in the two groups statistically was not significant. [MEDICINA2015;46:141-4].
Kajian Atmosfir Terkendali untuk Memperlambat Penurunan Mutu Buah Mangga Arumanis selama Penyimpanan I Made Suphartha Utama; Yohanes Setiyo; Ida Ayu Rina Puja; Nyoman Semadi
Jurnal Hortikultura Indonesia Vol. 2 No. 1 (2011): Jurnal Hortikultura Indonesia
Publisher : Indonesian Society for Horticulture / Department of Agronomy and Horticulture

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (300.729 KB) | DOI: 10.29244/jhi.2.1.27-33

Abstract

Arumanis Mango (Mangifera indica L. cv Arumanis) which is one of Indonesia’s tropical fruits having a high potency to be developed as an export commodity. Limited volumes of the fruit have been exported using air cargo and attempts in using sea freights with reefer containers for long distance market had not given convincing result. Therefore, efforts in optimizing the use of a reefer container are essential. Investigations, were performed in order to decelerate the deterioration fruits which involved different combined concentrations of O2 and CO2 gases during storage of Arumanis mango at cold (12+1.5oC) and room (28+2oC) temperatures. Four different combined gases of O2 and CO2, namely 5% O2 and 5 % CO2; 5% O2 and 10% CO2; 10% O2 and 5% CO2; and 10% O2 and 10% CO2 were surged surrounding the fruits stored at the cold and room temperatures. Fruits without treatments with the combined gases were prepared as kontrols. The investigation indicated that the cold temperature of storage was still the best way to slowing down the deterioration of the fruit. There were no significant different effects on the rate of deterioration among the fruits treated with the different combined concentrations of O2 and CO2. The controlled atmospheres, however, were better for storing the fruits compared to those stored without controlled atmosphere.Key words: controlled atmosphere, Arumanis, mango
PROPORSI HASIL BASIL TAHAN ASAM NEGATIF PADA PASIEN TUBERKULOSIS PARU DI RSUP SANGLAH, BALI Brigitta Marcia Budihardja; I Nyoman Semadi
E-Jurnal Medika Udayana Vol 9 No 12 (2020): Vol 9 No 12(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i12.P02

Abstract

ABSTRAK Tuberkulosis (TB) masih tetap menjadi masalah besar di Indonesia. Diagnosis tuberkulosis menggunakan tes basil tahan asam (BTA) masih kurang dapat diandalkan, sehingga jumlah pasien tuberkulosis paru dengan hasil BTA negatif pun masih banyak. Penelitian ini dilakukan untuk mengetahui proporsi pasien dengan hasil BTA negatif pada pasien TB paru di RSUP Sanglah. Selain itu, penelitian ini juga dilakukan untuk mengetahui karakteristik pasien TB paru, baik pasien dengan hasil BTA negatif maupun positif. Penelitian ini menggunakan metode deskriptif dengan desain potong lintang menggunakan data sekunder dari rekam medis pasien di RSUP Sanglah, Bali. Sampel pada penelitian ini adalah pasien dengan diagnosis TB paru yang menjalani pemeriksaan di RSUP Sanglah, Bali pada periode Mei 2015 – Oktober 2016. Berdasarkan data dari 75 sampel, didapatkan 29 sampel (38,7%) dengan hasil BTA negatif dan 46 sampel (61,3%) dengan hasil BTA positif. Selanjutnya, hasil penelitian ini menunjukkan bahwa dari 29 sampel dengan hasil BTA negatif: (1) Dua puluh tiga sampel berjenis kelamin laki-laki; (2) Sembilan sampel memiliki usia di antara 21-30 tahun; (3) Sembilan belas sampel memiliki BMI di antara 18,5 – 25 kg/m2; (4) Dua puluh tujuh sampel memiliki gejala batuk; (5) Dua puluh tiga sampel tidak memiliki riwayat TB sebelumnya, dan; (6) Delapan sampel memiliki komorbiditas efusi pleura. Dari penelitian ini dapat disimpulkan bahwa proporsi pasien dengan hasil BTA negatif pada pasien TB paru di RSUP Sanglah periode Mei 2015 – Oktober 2016 adalah 38,7%. Karakteristik pasien yang paling sering ditemui pada pasien dengan hasil BTA negatif adalah: jenis kelamin laki–laki, kelompok umur 21-30 tahun, BMI normal (18,5 – 25 kg/m2), gejala batuk, demam, dan sesak nafas, tidak adanya riwayat TB sebelumnya, serta komorbiditas efusi pleura. Kata kunci: tuberkulosis paru, BTA negatif
PREVALENSI VARISES TUNGKAI PADA IBU HAMIL DI PUSKESMAS WILAYAH DENPASAR SELATAN Edwind Rakatama Fahlevie; I Nyoman Semadi
E-Jurnal Medika Udayana Vol 8 No 8 (2019): Vol 8 No 8 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Varises tungkai (vena varikosa) adalah manifestasi klinis dari aliran darah vena yang secara fisiologis tidak terjadi pada tungkai bawah. Kehamilan merupakan salah satu penyebab tersering varises tungkai. Saat kehamilan, faktor hormon dalam sirkulasi meningkatkan distensibilitas dinding vena. Varises pada kehamilan dapat menyebabkan komplikasi yang berbahaya bagi Ibu dan janin apabila tidak ditangani. Penelitian dilaksanakan di Puskesmas wilayah Denpasar. Peneliti menggunakan kuisioner yang berisi pertanyaan seputar varises pada kaki guna mendapatkan data primer dari sampel. Data yang didapat akan diolah secara manual, dianalisa secara deskriptif, dan disajikan dengan analisis univariat untuk memaparkan data demografis dan karakteristik sampel penelitian. Sebanyak 81 sampel diberikan kuisioner mengenai penyakit varises pada kaki. Sebanyak 14 Ibu hamil (17,3%) menderita varises dan 67 Ibu hamil (82,7%) tidak menderita varises. Pada pasien yang menderita varises, 10 orang (71,4%) sedang dalam trimester ke-3 kehamilan, 3 orang (21,45%) dalam trimester ke-2 kehamilan dan 1 orang (7,1%) dalam trimester pertama kehamilan. Kategori usia pasien sebanyak 8 pasien (57,1%) masuk dalam kategori umur 31-40 tahun, 5 pasien (35,7%) kategori 21-30 tahun dan 1 pasien (7,1%) kategori umur kurang dari 20 tahun. Ibu hamil yang menderita varises mempunyai pekerjaan sebagai Ibu rumah tangga 12 orang (85,7%). sebanyak 2 orang (14,28%) mempunyai riwayat varises sebelumnya. Sebanyak 9 orang (64,2%) dari penderita varises mempunyai riwayat varises kaki pada anggota keluarganya. sebanyak 8 varises (57,1%) terletak pada ekstrimitas bawah dekstra dan 6 varises (42,8%) pada sinistra. Sebanyak 94% varises terletak pada betis dan berwarna biru. Mayoritas penderita tidak merasakan rasa nyeri. Berdasarkan hasil dan pembahasan dapat diambil kesimpulan bahwa riwayat keluarga, usia subjek, usia kehamilan menggambarkan semakin tinggi variable, semakin tinggi angka kejadian varises. Penyedia kesehatan di Puskesmas harus lebih meningkatkan kewaspadaan terhadap varises kaki Ibu hamil karena semua varises yang ditemukan belum mendapatkan penanganan. Kata kunci: Varises tungkai, Ibu hamil
Hernia Bochdalek IGN Sanjaya Putra; Abdul Hamid; IN Semadi
Sari Pediatri Vol 7, No 4 (2006)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (364.131 KB) | DOI: 10.14238/sp7.4.2006.232-6

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Hernia diafragmatika adalah masuknya organ-organ abdomen melalui defek (lubang) padadiafragma ke dalam rongga toraks. Secara umum terdapat tiga tipe dasar herniadiafragmatika yaitu hernia Bochdalek (melalui defek posterolateral), hernia Morgagni(melalui defek anterio retrosternal) dan hiatus hernia. Diagnosis ditegakkan berdasarkananamnesis, gejala klinik, pemeriksaan radiologik, dan laboratorium. Insiden pasti herniadiafragma sulit diperkirakan karena separuhnya meninggal dalam kandungan ataumeninggal saat neonatus belum dibawa ke pusat rujukan atau sebelum diagnosis ditegakkan.Insiden hernia Bochdalek dilaporkan 1 : 2000-4000 kelahiran hidup dengan perbandinganjenis kelamin laki-laki : perempuan adalah 1,5 : 1. Hernia Bochdalek memberikan gejalakardiopulmonal yang berat, seperti sesak nafas segera setelah lahir dengan mortalitas yangtinggi, 40-50% sebelum pemakaian dan 30 %, setelah pemakaian Extracorporeal MembraneOxygenation (ECMO). Pembedahan dilaksanakan setelah kondisi bayi stabil.
Comparison of Mortality and Glasgow Outcome Scale Extended (GOSE) between Craniotomy and Decompressive Craniectomy in Patients with Traumatic Acute Subdural Hematoma at Sanglah General Hospital, Bali Ni Luh Putu Julita Yanti; I Wayan Niryana; Sri Maliawan; I Nyoman Semadi; Tjokorda G. B. Mahadewa; I G. A. B. Krisna Wibawa
JBN (Jurnal Bedah Nasional) Vol 6 No 1 (2022): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2022.v06.i01.p03

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Background: Craniotomy and decompressive craniectomy and are surgical modalities for the evacuation of acute subdural hematoma (SDH). These two techniques show different outcomes in various existing studies. The superiority between either techniques remains controversial. Objective: To determine the outcome comparison of mortality and Glasgow Outcome Scale Extended (GOSE) craniotomy with decompressive craniectomy in patients with traumatic acute SDH. Methods: This is a historical cohort study. Samples of the study were collected from January 2018 to March 2020 at Sanglah General Hospital. All patients with acute traumatic SDH who underwent SDH evacuation with craniotomy and decompressive craniectomy were assessed for mortality status at discharge and GOSE 3 months after surgery. Independent T-test will be carried out if the numerical variable were all normally distributed, while Mann-Whitney U test will be performed if otherwise. A Chi-square test will be performed on all unpaired categorical variables. Statistical analysis was performed with SPSS 25 with 95% confidence intervals. Results: As many as 40 subjects with traumatic acute SDH who underwent craniotomy and 40 subjects with traumatic acute SDH who underwent decompressive craniectomy were included in this study. There was no significant difference in mortality (RR: 1; 95% CI 0.67-1.87; p=0.651) and GOSE score (p=0.718) in traumatic acute SDH who underwent craniotomy or decompressive craniectomy. Conclusion: There was no difference in mortality and GOSE outcomes between a craniotomy and decompressive craniectomy for management of traumatic acute SDH.
Diagnostic validity of Thoracic trauma severity score in patient with blunt thoracic trauma for predicting mortality rate Ngakan Gede Dwija Hermawan; I Nyoman Semadi; I Gede Raka Widiana; Desy Permatasari; Christopher Ryalino
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

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Abstract

Introduction: The high incidence of blunt thoracic trauma is still a serious concern in emergency services. Mild to severe cases of blunt thoracic trauma that come to the emergency department are not those that can be considered simple but need to be reviewed for the possibility that can lead to the occurrence of advanced complications. This study aims to predict mortality in patient with blunt thoracic trauma with TTS (Thoracic trauma severity) score. Patients and Methods: This is a retrospective study with 52 subjects of blunt thoracic trauma patients treated at our University Hospital from January 2016 to May 2017. Eligible data were collected from medical record analyzed by receiver operating characteristics curve and cross tabulation. Results: The age of the subjects are 48.03±15.62, with male 42 subjects (80.8%) and female ten subjects (19.2%). The mean point of Thoracic trauma severity score (TTSS) was 8.32 ± SD: 2.69. The outcome was three patients dead (5.8%) and 49 patients discharged (94,2%). The sensitivity of TTSS 100 %, specificity 89.7%, positive predictive value (PPV) 37.5%, negative predictive value (NPV) 100%, and accuracy rate 90.3%. Highly sensitivity and specificity results for Thoracic Trauma Severity Score is valid for the screening of Blunt Thoracic Trauma. Conclusion: At 11.5 cut-off point, the TTSS was an excellent tool to predict the mortality rate of patients with blunt thoracic trauma. It has a 100% sensitivity and 89.7% specificity, as well as 37.5% PPV and 100% NPV.
Interval waktu iskemia, derajat iskemia, dan sindrom kompartemen merupakan faktor risiko amputasi pada pasien acute limb ischemia yang dilakukan tindakan trombektomi terbuka di RSUP Sanglah Denpasar Dea Emmanuel; Ketut Putu Yasa; Ida Bagus Putra Manuaba; I Nyoman Semadi; Ketut Widiana; Gede Wirya Kusuma Duarsa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (309.598 KB) | DOI: 10.15562/ism.v11i2.753

Abstract

Introduction: Acute Limb Ischemia (ALI) is a sudden decrease in perfusion in the extremities that causes the threat of tissue viability and is still one of the causes of disability. The purpose of this study was to determine the factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy.Methods: This was a retrospective observational study with case-control studies. As many as 40 patients with acute limb ischemia who underwent thrombectomy were seen as an outcome of amputation. Matching was done based on age and sex in the case (amputation) and control (without amputation) groups. Data collection is based on medical records from 2014 to 2019. Bivariate analysis uses Chi-Square or Fisher's Test while multivariate analysis uses logistic regression.Results: In this study we found that the time interval of ischemia and the degree of ischemia is a risk factor of amputation in person with ALI (p<0.05) but compartment syndrome was not significantly related to amputation in ALI. Multivariate analysis shows degree of Rutherford IIB / III ischemia to be a the most dominant factor for amputation (OR = 6.84; 95% CI = 1.19-39.35; p = 0.03).Conclusion: The time interval of ischemia and the degree of ischemia are factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy. The degree of ischemia is the most dominant risk factor affecting amputation. Latar Belakang: Acute Limb Ischemia (ALI) adalah penurunan secara tiba-tiba perfusi di ekstremitas sehingga menyebabkan ancaman viabilitas jaringan dan masih menjadi salah satu penyebab disabilitas Tujuan dari penelitian ini adalah untuk mengetahui faktor faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi.Metode: Penelitian ini merupakan penelitian observasional retrospektif dengan studi kasus kontrol. Sebanyak 40 pasien acute limb ischemia yang dilakukan trombektomi dilihat outcomenya dari amputasi. Dilakukan matching berdasarkan usia dan jenis kelamin pada kelompok kasus (amputasi) dan kontrol (tanpa amputasi). Pengambilan data berdasarkan catatan medis dari tahun 2014 hingga 2019. Analisa bivariat menggunakan Chi-Square atau Uji Fisher sedangkan analisa multivariat menggunakan regresi logistik.Hasil: Berdasarkan analisa statistik didapatkan didapatkan interval waktu iskemia dan derajat iskemia mempengaruhi amputasi (p<0,05) namun sindrom kompartemen tidak berhubungan secara signifikan. Hasil multivariat dengan regresi logistik ditemukan derajat iskemia Rutherford IIB/III menjadi faktor dominan terjadinya amputasi (OR = 6.84; IK 95% = 1,19-39,35; p = 0,03).Simpulan: Interval waktu iskemia dan derajat iskemia merupakan faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi. Derajat iskemia merupakan faktor risiko yang paling dominan mempengaruhi amputasi.
Neutrophil-Lymphocyte Ratio (NLR) as an output-outcome predictor in moderate-severe head injury at Sanglah General Hospital, Denpasar, Indonesia Melissa Krisanty; Tjokorda Gde Bagus Mahadewa; I Wayan Niryana; I Nyoman Semadi; I Gede Suwedagatha; I Gusti Agung Bagus Krisna Wibawa
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 (381.777 KB) | DOI: 10.15562/ism.v12i2.1060

Abstract

Background: This prospective cohort study aims to determine the best cut point value and the ability to predict Neutrophil Lymphocyte Ratio (NLR), analyze the most dominant factors, and the direct influence of the NLR to output and outcome in moderate and severe trauma to the head injury at Sanglah General Hospital, Denpasar, Indonesia.Methods: This study was an observational analytic with a prospective cohort design. The subjects of this study were head injury patients over 16 years old with Glasgow Coma Scale (GCS) ? 12 who visited and were treated at Sanglah General Hospital, Denpasar, Indonesia. Patients less than 16 years old, history of alcohol intoxication, stroke, metabolic disease, and multiple traumas were not included as research subjects. Data were analyzed using SPSS version 20 for Windows.Results: The research conducted on 49 respondents found that the best cut-off point of NLR was 6.05 has the most significant predictor (OR=7.6; p=0.001) and dominant (OR=64.97; p=0.002) factors to the output-outcome predictor in moderate-severe head injury. In addition, this cut-off value (6.05) also has a direct influence (x-value=0.523) in the occurrence of output and outcome unfavorable in moderate-severe head injury.Conclusion: the cut-off NLR values of 6.05 became the dominant predictor that directly affected the output and outcome unfavorable in moderate-severe head injury.