Wayan Widyantara - Academia.edu (original) (raw)

Papers by Wayan Widyantara

International Journal of Research and Review

Background: Subdural hemorrhage (SDH) occurs due to the accumulation of abnormal blood under the ... more Background: Subdural hemorrhage (SDH) occurs due to the accumulation of abnormal blood under the dura mater, a protective layer of brain tissue under the calvarium due to the rupture of the bridging veins. The importance of hematological factors as parameters related to intracranial bleeding, one of which is SDH. Mean Platelet Volume (MPV) is one of the main parameters that reflect the function and activity of platelets. The relationship between MPV values and the incidence and outcome of SDH is not fully known. This study aims to determine the relationship between MPV and SDH outcomes for monitoring and prognostic purposes for SDH. Methods: This research is cross-sectional. This research was conducted based on data from medical records from inpatient installations at Prof. I.G.N.G Ngoerah General Hospital Denpasar with a total sample of 96 cases. The data included in the inclusion criteria were medical record data which contained information about research variables, which are gend...

International Journal of Research and Review

Background: Hematologic parameter had been considered as simple prognostic markers for status epi... more Background: Hematologic parameter had been considered as simple prognostic markers for status epilepticus. Hematologic profile might be related to outcomes. This research was aimed to address status epilepticus cases in Sanglah General Hospital and to analyze the relationship between hematologic profiles and the outcomes of status epilepticus patient. Method: This research used cross sectional design. We resumed status epilepticus cases in Sanglah General Hospital, Bali, Indonesia, from 2019 to 2020. With consecutive sampling, we obtained data from medical records. Statistic tests were done with software. Results: One hundred and eight patients with status epilepticus, 58 males and 50 females aged 18 to 95 years old were involved. Fifty-five had focal and 53 general seizures. Fifty-one (47.2%) survived and 57 (52.8%) did not. Intensive care was given to 34 (31.5%) patients. Factors that had relationship with outcome were comorbidity (p<0.01), renal failure (p=0.05), pneumonia (p&...

Cermin Dunia Kedokteran, May 1, 2015

Romanian Journal of Neurology

Background and purpose. This study aimed to explain that Sepsis-Associated Encephalopathy (SAE) i... more Background and purpose. This study aimed to explain that Sepsis-Associated Encephalopathy (SAE) is a term that describes sepsis-associated brain dysfunction, which most often occurs in intensive care and is becoming an increasingly common disease in the Emergency Room with high rates of morbidity and mortality. In SAE, the clinical description that appears consists of a description of the underlying disease, namely sepsis, and encephalopathy. The source and aetiology of infection are essential factors in developing SAE. Methods. It was a descriptive and retrospective study that described the characteristics of SAE patients. The data involved age, gender, vital signs, level of consciousness, haematological parameters, culture results, source of infection, underlying disease, and patient’s external condition. The samples were taken based on the medical record data of patients who met the inclusion criteria, which were then processed descriptively through the number and percentage. Res...

International Journal of Medical Reviews and Case Reports, 2020

Background: Improvements in cardiac arrest cannot reduce mortality and disability. Neurological d... more Background: Improvements in cardiac arrest cannot reduce mortality and disability. Neurological disability or sequel that occurs can be in the form of cognitive and motor disorders. Report: A 66-year-old man with congested complaints diagnosed Acute Decompensated Heart Failure (ADHF) type C and intubated pneumonia due to respiratory failure. Two days of treatment, the patient experienced Atrial Fibrillation (AF) without a pulse, Ventricle Tachycardia (VT) / Ventricle Fibrillation (VF) asystole then Return of Spontaneous Circulation (ROSC). Post cardiac arrest of patients with Glasgow Coma Scale (GCS) 6 coma awareness accompanied by jerking movements several times, especially when touched in the distal extremity.Discussion: Patients with brief systemic circulation stops may experience cerebral ischemia-anoxia. Disorders that occur in the early phase after cardiac arrest is a decrease in a severe coma. Anoxic conditions can cause myoclonus. Myoclonus due to lesions in the brain stem includes exaggerated startle, reticular reflex myoclonus and palatal myoclonus or tremor. Conclusion: Reticular brainstem myoclonus as a neurological manifestation of post-cardiac arrest due to anoxia.

Romanian Journal of Neurology

Baclofen was previously known for its efficacy to treat spasticity but this agent has been studie... more Baclofen was previously known for its efficacy to treat spasticity but this agent has been studied and reported to have several other uses including its role in central hyperthermia. Central hyperthermia is associated with increased morbidity, mortality, and the impact of neuronal damage on the central nervous system. Until now there is no established guideline for the management of central hyperthermia which generally does not respond to standard antipyretic therapy. In this literature review, we will discuss the basic concepts of central hyperthermia and the role and mechanism of action of baclofen as an option for central hyperthermia therapy.

Callosum Neurology

Pendahuluan: Kesalahan dalam mengidentifikasi suatu sinkop sebagai bangkitan epileptik merupakan ... more Pendahuluan: Kesalahan dalam mengidentifikasi suatu sinkop sebagai bangkitan epileptik merupakan hal yang tidak jarang terjadi. Pasien mendapatkan manajemen epilepsi namun bangkitan tidak kunjung terkendali. Masalah kardiovaskular harus dipertimbangkan dalam keadaan ini karena keterlambatan identifikasi meningkatkan mortalitas. Kasus: Pasien laki-laki, 26 tahun, mengalami bangkitan onset general motorik tonik klonik yang terjadi lebih dari 20 kali dalam waktu 18 jam dengan durasi 3-5 menit. Diantara kejang pasien sadar baik tanpa adanya periode bingung. Pasien mendapatkan terapi diazepam 10 mg intravena sebanyak 3 kali pemberian namun kejang terus terjadi. Pemeriksaan fisik menunjukkan bradikardia, kardiomegali dengan bising sistolik mitral dan tidak didapatkan defisit neurologis lainnya. Gambaran EKG menunjukkan AV blok derajat 3 dengan gambaran echocardiography dilatasi ventrikel kiri dengan regurgitasi moderat katup mitral. Pemeriksaan CT-scan kepala dan EEG normal. Dilakukan pe...

ABSTRACTThe therapeutic aspect of epilepsy is growing from the beginning by giving bromide as the... more ABSTRACTThe therapeutic aspect of epilepsy is growing from the beginning by giving bromide as the first-line therapy to the latest generation of antiepileptic drugs. The principle management of epilepsy is to achieve a high therapeutic plasma concentrations with minimal toxicity. Magnesium is an endogenous NMDA (N-methyl D-aspartate) receptor antagonist, that is required to perform its normal function. The use of magnesium as anticonvulsants have long been used primarily to prevent seizures in patients with eclampsia which is mainly used the form of magnesium sulfate.

International Journal of Research and Review

Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanis... more Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanism to terminate the seizures or the onset of abnormal seizure activity resulting in prolonged seizure’s duration for more than five minutes. The available research data on status epilepticus in Indonesia is still limited. The purpose of this study was to determine the profile of patients with status epilepticus at Sanglah General Hospital from 2020 to 2021. Methods: This was a descriptive study with a retrospective approach. The study populations were patients with status epilepticus who were treated at Sanglah General Hospital in 2019-2020 who had no missing data in the medical records. Results: There were 117 patients with status epilepticus, 63 males (53.8%) and 54 females (46.2%). There are 41 patients>60 years (35%), general onset in 63 patients (53.8%), and focal onset in 54 patients (46.2%). Etiology from cerebral was 68 patients (58.1%), followed by metabolic in 28 patients (23...

Open Access Macedonian Journal of Medical Sciences, 2020

BACKGROUND: The incidence and survival rates of cerebral tumor patients are increasing, along wit... more BACKGROUND: The incidence and survival rates of cerebral tumor patients are increasing, along with advances in medical technology. Severe complications, such as multiorgan failure in patients, cause the need for intensive care to improve. The effectiveness of intensive care in tumor patients is still controversial, considering that patients included in low and vulnerable performance status. Patients with cerebral tumors also require intensive care either before or after effective action. The controversy of economic and ethical issues still places aggressive action in intensive care on oncology patients. It is necessary to identify and know the characteristics of tumor patients that are useful in intensive management. AIM: The purpose of this study was to determine the demographic characteristics, length of stay, complications, and mortality rates of cerebral tumor patients undergoing intensive care at Sanglah Hospital Denpasar, the period January–December 2017. METHODS: This study i...

Indonesia Journal of Biomedical Science

International Journal of Medical Reviews and Case Reports

Introduction: Pneumonia is a complication in stroke. Pneumonia is one of the most common nosocomi... more Introduction: Pneumonia is a complication in stroke. Pneumonia is one of the most common nosocomial infections, with an incidence of 1.5% to 13.0% in stroke patients. Specific factors that increase the risk of pneumonia in stroke patients are not fully known, especially patients who receive intensive care. Methods: Descriptive observational study using a cross-sectional descriptive study design of stroke patients with pneumonia who treated in intensive care Sanglah General Hospital, based on medical record data from 1 January 2017-31 October 2018. Data analysis using quantitative descriptive using SPSS processing software. Results: The incidence of pneumonia was 20% in 70 stroke patients treated in the Intensive Therapy Room. More pneumonia occurs in hemorrhagic stroke patients (78.6%, p = 0.09), first-time stroke (85.7%; p = 0.176), stroke onset ≤ 24 hours (57.1%; p = 0.001) , severe stroke (93.9%; p = 0.362), mechanical ventilator (85.7%; p = 0.497), length of stay more than 7 days (71.4%; p = 0.150), and intensive care living conditions (78.6%; p = 0.113). Conclusion: Stroke of more than 24 hours was associated with pneumonia and admitted to intensive care while stroke type, stroke degree, ventilator support, intensive care duration, and intense discharge conditions.

International Journal of Medical Reviews and Case Reports

Objective: To determine the characteristics of neurology cases in the ER Sanglah Hospital who und... more Objective: To determine the characteristics of neurology cases in the ER Sanglah Hospital who underwent an emergency call period from January 2016 to 2018. Material and Methods: This research is a descriptive cross-sectional study using secondary data. This study is total sampling method. The study used a questionnaire, data obtained from all cases of neurology who underwent an emergency call within the study period recorded in the emergency call register. Descriptive analysis using SPSS 21.00 for windows. Results: Samples obtained in 76 cases. The majority of cases in this study were men (n=40, 52.6%) and the mean age of all cases was 55.05 (± 15.23). The major cases are reported hemorrhagic stroke (n=40, 52.6%), intracranial infection (n=10, 13.2%), ischemic stroke (n=9, 11.8%), epilepsy (n=3, 3.9%), and malignancy (n=3, 3.9%). Most cases had a secondary diagnosis that accompanied the primary diagnosis (n=54, 71.1%). The mean duration of treatment in the emergency room before an emergency call (pre rhesus call) was 308 (± 629.99) minutes. The mean duration of treatment in the emergency department after an emergency call (post rhesus call) was 540 (± 766.1) minutes. The dominant case outcome was death (n = 68, 89.5%). Conclusion: The most common cases undergoing emergency calls are a hemorrhagic stroke, intracranial infection, ischemic stroke, epilepsy, and malignancy. The majority of clinical outcomes in each case were deaths. Analytical research needs to be done to find out which variables can influence clinical outcomes.

International Journal of Medical Reviews and Case Reports

Drowning is an event of submersion or immersion in liquid which results in respiratory impairment... more Drowning is an event of submersion or immersion in liquid which results in respiratory impairment. In 1970, drowning was the third leading cause of accidental death in the U.S., resulting in 7,860 deaths in the U.S. alone and roughly 15,000 mortality worldwide. When someone is in a drowning process, there is a limit in which he can't longer hold their airway clear. Eventually, water will pour into the mouth, which will be either spat out or swallowed. Initial resuscitation involves placing the victim in a supine position with trunk and head at the same level. If the victim still actively breathe in the absence of consciousness, they should place in a lateral decubitus position. The cardiopulmonary rescue should be initiation immediately. Clinical outcomes depend on the early onset of resuscitation.

International Journal of Research and Review

Background: Subdural hemorrhage (SDH) occurs due to the accumulation of abnormal blood under the ... more Background: Subdural hemorrhage (SDH) occurs due to the accumulation of abnormal blood under the dura mater, a protective layer of brain tissue under the calvarium due to the rupture of the bridging veins. The importance of hematological factors as parameters related to intracranial bleeding, one of which is SDH. Mean Platelet Volume (MPV) is one of the main parameters that reflect the function and activity of platelets. The relationship between MPV values and the incidence and outcome of SDH is not fully known. This study aims to determine the relationship between MPV and SDH outcomes for monitoring and prognostic purposes for SDH. Methods: This research is cross-sectional. This research was conducted based on data from medical records from inpatient installations at Prof. I.G.N.G Ngoerah General Hospital Denpasar with a total sample of 96 cases. The data included in the inclusion criteria were medical record data which contained information about research variables, which are gend...

International Journal of Research and Review

Background: Hematologic parameter had been considered as simple prognostic markers for status epi... more Background: Hematologic parameter had been considered as simple prognostic markers for status epilepticus. Hematologic profile might be related to outcomes. This research was aimed to address status epilepticus cases in Sanglah General Hospital and to analyze the relationship between hematologic profiles and the outcomes of status epilepticus patient. Method: This research used cross sectional design. We resumed status epilepticus cases in Sanglah General Hospital, Bali, Indonesia, from 2019 to 2020. With consecutive sampling, we obtained data from medical records. Statistic tests were done with software. Results: One hundred and eight patients with status epilepticus, 58 males and 50 females aged 18 to 95 years old were involved. Fifty-five had focal and 53 general seizures. Fifty-one (47.2%) survived and 57 (52.8%) did not. Intensive care was given to 34 (31.5%) patients. Factors that had relationship with outcome were comorbidity (p<0.01), renal failure (p=0.05), pneumonia (p&...

Cermin Dunia Kedokteran, May 1, 2015

Romanian Journal of Neurology

Background and purpose. This study aimed to explain that Sepsis-Associated Encephalopathy (SAE) i... more Background and purpose. This study aimed to explain that Sepsis-Associated Encephalopathy (SAE) is a term that describes sepsis-associated brain dysfunction, which most often occurs in intensive care and is becoming an increasingly common disease in the Emergency Room with high rates of morbidity and mortality. In SAE, the clinical description that appears consists of a description of the underlying disease, namely sepsis, and encephalopathy. The source and aetiology of infection are essential factors in developing SAE. Methods. It was a descriptive and retrospective study that described the characteristics of SAE patients. The data involved age, gender, vital signs, level of consciousness, haematological parameters, culture results, source of infection, underlying disease, and patient’s external condition. The samples were taken based on the medical record data of patients who met the inclusion criteria, which were then processed descriptively through the number and percentage. Res...

International Journal of Medical Reviews and Case Reports, 2020

Background: Improvements in cardiac arrest cannot reduce mortality and disability. Neurological d... more Background: Improvements in cardiac arrest cannot reduce mortality and disability. Neurological disability or sequel that occurs can be in the form of cognitive and motor disorders. Report: A 66-year-old man with congested complaints diagnosed Acute Decompensated Heart Failure (ADHF) type C and intubated pneumonia due to respiratory failure. Two days of treatment, the patient experienced Atrial Fibrillation (AF) without a pulse, Ventricle Tachycardia (VT) / Ventricle Fibrillation (VF) asystole then Return of Spontaneous Circulation (ROSC). Post cardiac arrest of patients with Glasgow Coma Scale (GCS) 6 coma awareness accompanied by jerking movements several times, especially when touched in the distal extremity.Discussion: Patients with brief systemic circulation stops may experience cerebral ischemia-anoxia. Disorders that occur in the early phase after cardiac arrest is a decrease in a severe coma. Anoxic conditions can cause myoclonus. Myoclonus due to lesions in the brain stem includes exaggerated startle, reticular reflex myoclonus and palatal myoclonus or tremor. Conclusion: Reticular brainstem myoclonus as a neurological manifestation of post-cardiac arrest due to anoxia.

Romanian Journal of Neurology

Baclofen was previously known for its efficacy to treat spasticity but this agent has been studie... more Baclofen was previously known for its efficacy to treat spasticity but this agent has been studied and reported to have several other uses including its role in central hyperthermia. Central hyperthermia is associated with increased morbidity, mortality, and the impact of neuronal damage on the central nervous system. Until now there is no established guideline for the management of central hyperthermia which generally does not respond to standard antipyretic therapy. In this literature review, we will discuss the basic concepts of central hyperthermia and the role and mechanism of action of baclofen as an option for central hyperthermia therapy.

Callosum Neurology

Pendahuluan: Kesalahan dalam mengidentifikasi suatu sinkop sebagai bangkitan epileptik merupakan ... more Pendahuluan: Kesalahan dalam mengidentifikasi suatu sinkop sebagai bangkitan epileptik merupakan hal yang tidak jarang terjadi. Pasien mendapatkan manajemen epilepsi namun bangkitan tidak kunjung terkendali. Masalah kardiovaskular harus dipertimbangkan dalam keadaan ini karena keterlambatan identifikasi meningkatkan mortalitas. Kasus: Pasien laki-laki, 26 tahun, mengalami bangkitan onset general motorik tonik klonik yang terjadi lebih dari 20 kali dalam waktu 18 jam dengan durasi 3-5 menit. Diantara kejang pasien sadar baik tanpa adanya periode bingung. Pasien mendapatkan terapi diazepam 10 mg intravena sebanyak 3 kali pemberian namun kejang terus terjadi. Pemeriksaan fisik menunjukkan bradikardia, kardiomegali dengan bising sistolik mitral dan tidak didapatkan defisit neurologis lainnya. Gambaran EKG menunjukkan AV blok derajat 3 dengan gambaran echocardiography dilatasi ventrikel kiri dengan regurgitasi moderat katup mitral. Pemeriksaan CT-scan kepala dan EEG normal. Dilakukan pe...

ABSTRACTThe therapeutic aspect of epilepsy is growing from the beginning by giving bromide as the... more ABSTRACTThe therapeutic aspect of epilepsy is growing from the beginning by giving bromide as the first-line therapy to the latest generation of antiepileptic drugs. The principle management of epilepsy is to achieve a high therapeutic plasma concentrations with minimal toxicity. Magnesium is an endogenous NMDA (N-methyl D-aspartate) receptor antagonist, that is required to perform its normal function. The use of magnesium as anticonvulsants have long been used primarily to prevent seizures in patients with eclampsia which is mainly used the form of magnesium sulfate.

International Journal of Research and Review

Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanis... more Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanism to terminate the seizures or the onset of abnormal seizure activity resulting in prolonged seizure’s duration for more than five minutes. The available research data on status epilepticus in Indonesia is still limited. The purpose of this study was to determine the profile of patients with status epilepticus at Sanglah General Hospital from 2020 to 2021. Methods: This was a descriptive study with a retrospective approach. The study populations were patients with status epilepticus who were treated at Sanglah General Hospital in 2019-2020 who had no missing data in the medical records. Results: There were 117 patients with status epilepticus, 63 males (53.8%) and 54 females (46.2%). There are 41 patients>60 years (35%), general onset in 63 patients (53.8%), and focal onset in 54 patients (46.2%). Etiology from cerebral was 68 patients (58.1%), followed by metabolic in 28 patients (23...

Open Access Macedonian Journal of Medical Sciences, 2020

BACKGROUND: The incidence and survival rates of cerebral tumor patients are increasing, along wit... more BACKGROUND: The incidence and survival rates of cerebral tumor patients are increasing, along with advances in medical technology. Severe complications, such as multiorgan failure in patients, cause the need for intensive care to improve. The effectiveness of intensive care in tumor patients is still controversial, considering that patients included in low and vulnerable performance status. Patients with cerebral tumors also require intensive care either before or after effective action. The controversy of economic and ethical issues still places aggressive action in intensive care on oncology patients. It is necessary to identify and know the characteristics of tumor patients that are useful in intensive management. AIM: The purpose of this study was to determine the demographic characteristics, length of stay, complications, and mortality rates of cerebral tumor patients undergoing intensive care at Sanglah Hospital Denpasar, the period January–December 2017. METHODS: This study i...

Indonesia Journal of Biomedical Science

International Journal of Medical Reviews and Case Reports

Introduction: Pneumonia is a complication in stroke. Pneumonia is one of the most common nosocomi... more Introduction: Pneumonia is a complication in stroke. Pneumonia is one of the most common nosocomial infections, with an incidence of 1.5% to 13.0% in stroke patients. Specific factors that increase the risk of pneumonia in stroke patients are not fully known, especially patients who receive intensive care. Methods: Descriptive observational study using a cross-sectional descriptive study design of stroke patients with pneumonia who treated in intensive care Sanglah General Hospital, based on medical record data from 1 January 2017-31 October 2018. Data analysis using quantitative descriptive using SPSS processing software. Results: The incidence of pneumonia was 20% in 70 stroke patients treated in the Intensive Therapy Room. More pneumonia occurs in hemorrhagic stroke patients (78.6%, p = 0.09), first-time stroke (85.7%; p = 0.176), stroke onset ≤ 24 hours (57.1%; p = 0.001) , severe stroke (93.9%; p = 0.362), mechanical ventilator (85.7%; p = 0.497), length of stay more than 7 days (71.4%; p = 0.150), and intensive care living conditions (78.6%; p = 0.113). Conclusion: Stroke of more than 24 hours was associated with pneumonia and admitted to intensive care while stroke type, stroke degree, ventilator support, intensive care duration, and intense discharge conditions.

International Journal of Medical Reviews and Case Reports

Objective: To determine the characteristics of neurology cases in the ER Sanglah Hospital who und... more Objective: To determine the characteristics of neurology cases in the ER Sanglah Hospital who underwent an emergency call period from January 2016 to 2018. Material and Methods: This research is a descriptive cross-sectional study using secondary data. This study is total sampling method. The study used a questionnaire, data obtained from all cases of neurology who underwent an emergency call within the study period recorded in the emergency call register. Descriptive analysis using SPSS 21.00 for windows. Results: Samples obtained in 76 cases. The majority of cases in this study were men (n=40, 52.6%) and the mean age of all cases was 55.05 (± 15.23). The major cases are reported hemorrhagic stroke (n=40, 52.6%), intracranial infection (n=10, 13.2%), ischemic stroke (n=9, 11.8%), epilepsy (n=3, 3.9%), and malignancy (n=3, 3.9%). Most cases had a secondary diagnosis that accompanied the primary diagnosis (n=54, 71.1%). The mean duration of treatment in the emergency room before an emergency call (pre rhesus call) was 308 (± 629.99) minutes. The mean duration of treatment in the emergency department after an emergency call (post rhesus call) was 540 (± 766.1) minutes. The dominant case outcome was death (n = 68, 89.5%). Conclusion: The most common cases undergoing emergency calls are a hemorrhagic stroke, intracranial infection, ischemic stroke, epilepsy, and malignancy. The majority of clinical outcomes in each case were deaths. Analytical research needs to be done to find out which variables can influence clinical outcomes.

International Journal of Medical Reviews and Case Reports

Drowning is an event of submersion or immersion in liquid which results in respiratory impairment... more Drowning is an event of submersion or immersion in liquid which results in respiratory impairment. In 1970, drowning was the third leading cause of accidental death in the U.S., resulting in 7,860 deaths in the U.S. alone and roughly 15,000 mortality worldwide. When someone is in a drowning process, there is a limit in which he can't longer hold their airway clear. Eventually, water will pour into the mouth, which will be either spat out or swallowed. Initial resuscitation involves placing the victim in a supine position with trunk and head at the same level. If the victim still actively breathe in the absence of consciousness, they should place in a lateral decubitus position. The cardiopulmonary rescue should be initiation immediately. Clinical outcomes depend on the early onset of resuscitation.