Lila Tri Harjana
Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

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Social-Fairness Perception in Natural Disaster, Learn from Lombok: A Phenomenological Report Filipus Michael Yofrido; Lila Tri Harjana
Indonesian Journal of Anesthesiology and Reanimation Vol. 1 No. 1 (2019): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (296.301 KB) | DOI: 10.20473/ijar.V1I12019.1-7

Abstract

Introduction: Disasters occur in all areas of the world and cause harm to populations, property, infrastructure, economies, and the environment.1Harm to populations includes death, injury, disease, malnutrition, and psychological stress.1Social-friction often isn’t recognized during disaster response and recovery. Objective: This report explored the existence of social-friction in disaster situation which able to make recovery more complex. Method: This was qualitative study with phenomenology report approach. The data collection was done by indepth interviewing five inhabitants when doing emergency disaster response two weeks after massive earthquake in North Lombok. Result and discussion: Two out of five inhabitants were Lombok native-people, the rest were immigrant. An inhabitant reported their feeling treated unfair by aid agencies because they received less aid than others. In another chance, when distributing clean-water, we were intercepted, they argue that they got more lack of water than another group who live far distally. Both claimed treated unfair making a dispute friction.Ethnic or social origin, language, religion, gender, age, physical or mental disability, and sexual orientation are just some of the deep-rooted causes of social-friction that can have such a devastating impact on their lives.Social-friction in everyday life rarely endangers lives, but in an emergency situation, it can be life-threatening. It affects not only people’s ability to survive the crisis, also their capacity to recover and regain their livelihoods. Conclusion: Risk reduction and preparedness are just as important a part of the process as any aspect of a disaster.Dialogue is fundamental in good programme design, monitoring and evaluation, and systematic efforts to listen to all groups affected by disaster can help pre-empt and remedy unfair-perception.Perhaps,most importantly, understanding and respecting the complex cultural context in which aid agencies are working and using the strategies and mechanismsto detectand minimize social-friction, will result great improvement in the effectiveness and equity of perceived support in humanitarian assistance.2
Myasthenia Crisis Vs Cholinergic Crisis: Challenges in Crisis Management Without Plasmapheresis or Intravenous Immunoglobulin (IVIG) Lila Tri Harjana; Hardiono Hardiono
Indonesian Journal of Anesthesiology and Reanimation Vol. 2 No. 2 (2020): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (531.301 KB) | DOI: 10.20473/ijar.V2I22020.53-58

Abstract

Introduction: Myasthenia gravis (MG) is an acquired autoimmune disorder clinically characterized by skeletal muscle weakness & fatigability on exertion with prevalence as high as 2–7 in 10,000 and women are affected more frequently than men (~3:2). Over 12-16% of generalized MG patients experience crisis once in their lifetime. A serious complication of myasthenia gravis is respiratory failure. This may be secondary to an exacerbation of myasthenia (myasthenia crisis) or to treatment with excess doses of a cholinesterase inhibitor (cholinergic crisis). Case Report: Thirty-two years old woman refereed from a private hospital to ED for further treatment with myasthenia in crisis, after nine days of treatment in the previous ICU. Patient already in intubation with mechanical ventilation and history of the treatment of a high dose of multiple anticholinesterase drugs and steroids without plasmapheresis or immunoglobulin intravenous. During admission, diarrhea was present, with no sign of GI infection. On the third day of admission, the patient performed a Spontaneous Breathing Trial and was a success then extubated. Then two day after extubation, the patient falls to respiratory failure and need mechanical ventilation. Anticholinesterase test was performed, and it shows no improvement in clinical signs, and diagnose as Cholinergic Crisis. After re-adjustment of anticholinesterase drug with a lower dose, clinically, the respiratory condition improved, and on the 10th day of admission, the patient was succeed extubated. At 12nd days of ICU admission, patient discharge from ICU. Discussion: Myasthenia and Cholinergic Crisis is a severe and life-threatening condition characterized by generalized muscle weakness with a respiratory compromise that requires ventilatory support. Respiratory failure may be present in the cholinergic crisis without cholinergic symptoms (miosis, diarrhea, urinary incontinence, bradycardia, emesis, lacrimation, or salivation). The most important management aspect of Myasthenia patients in crisis is the recognition and treatment of myasthenia vs cholinergic crisis.