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All Journal Medicina Jurnal Locus Penelitian dan Pengabdian The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Putra, I Komang Wisuda Dwija
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Aerospace Engineering Automotive Engineering Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Mathematics Medicine & Pharmacology

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Korelasihipotensiortostatik dan fungsi kognitif padapasien geriatri diRSUP Sanglah Putra, I Komang Wisuda Dwija; Kuswardhani, A Tuty
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (59.662 KB)

Abstract

Tujuanpenelitianiniadalahuntuk mengetahui hubungan tekanan darah dan fungsi kognitif pada pasienhipotensi ortostatik. Metode yang dipergunakanadalah analisis potong lintang, pada pasien rawat jalan dipoliklinik geriatri RSUP Sanglah. Hipotensiortostatikadalahpenurunan minimal 20 mmHg tekanandarahsistolikdanatau 10 mmHg padatekanandarahdiastolikdariperubahanposisi baring kedudukatauberdiridenganselangwaktu 3 menit. Fungsi kognitif menggunakan skormini mental state examination(MMSE)danmontreal cognitive assessment (MOCA). Padapenelitianini didapatkanperbedaan yang signifikanpada skor MMSE dan MOCA pada pasien hipotensi ortostatik berdasarkan tingkat pendidikan,skor MMSE(simpangbaku/SB) padakelompokpendidikan SMA dandi atasnyasebesar 21,31(2,983) berbanding16,79(4,526) padakelompokpendidikan SMP dandi bawahnya (nilai P=0,003 IK 95% 1,694sampai7,359) danuntukskor MOCA (SB) sebesar17,75(3,396)berbanding13,36(4,088) dengannilai P=0,003IK95% 1,594sampai 7,191. Terdapat korelasi positif yang signifikan antara tekanan darah diastolik saatberbaring dengan skor MMSE (r=0,481,nilaiP=0,007 dengan IK95% 22,836sampai41,132) dan terdapatkorelasi positif yang signifikan antara tekanan darah sistolik dan diastolik saat berbaring dengan skorMOCA (r=0,370 dan 0,447). Simpulanpenelitianini adalah tekanan darah memiliki korelasi denganpenurunan fungsi kognitif. Penelitianlanjutandenganjumlahsampel yang lebihbesar diperlukanuntukmengetahui hubungan tekanan darah dengan fungsi kognitif pada pasien hipotensi ortostatik.[MEDICINA.2016;50(3):7-11].The purpose of this study was to determine the relationship of blood pressure and cognitive function inorthostatic hypotension patients. The method used was a cross-sectional analysis on outpatient at geriatricclinic of Sanglah Hospital. Hypotension orthostatic was defined as a decrease at least 20 mmHg systolicblood pressure and or reduction of at least 10 mmHg diastolic blood pressure from lying position to sittingor standing position within 3 minutes. Cognitive function using themini mental state examination(MMSE)andmontreal cognitive assessment(MOCA) score. In this study, a significant difference in MMSE scoreand MOCA on patients with orthostatic hypotension based on their education level, MMSE score standarddeviation(SD) in high school education and above group is 21.31 (16.79), compare with number of juniorhigh and bellow group is 2.983 (4.526), (p value=0.003 95% CI 1.694 to 7.359) and for MOCA score(17.75 (3.396) and 13.36 (4.088)) with p value=0.003CI 95% 1.594 to 7.191. There wasa significantpositive correlation between diastolicblood pressure when lying down with MMSE score (r=0.481, pvalue=0.007 with CI 95% 22.836 to 41.132) and there is a significant positive correlation between systolicand diastolic blood pressure when lying down with MOCA score of (r=0.370 and 0.447). Theconclusion ofthis study was that the blood pressure has a correlation with declining of cognitive function. Larger studiesare necessary to determine the relationship between blood pressure and cognitive function on patients withorthostatic hypotension.[MEDICINA.2016;50(3):7-11].
Liver Abscess as a Rare Complication of Typhoid Fever in a Young Adult: A Case Report Pratama, Gede Made Cahya Trisna; Putra, I Komang Wisuda Dwija
Jurnal Locus Penelitian dan Pengabdian Vol. 5 No. 1 (2026): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v5i1.5391

Abstract

Typhoid fever, caused by Salmonella typhi, remains a significant endemic infection in developing countries. While its gastrointestinal and systemic symptoms are well known, liver abscess as a complication is exceedingly rare. This case report highlights the clinical significance of recognizing atypical presentations, particularly in resource-limited settings with common delayed diagnosis. The condition arises from hematogenous spread of Salmonella typhi in delayed or untreated cases, leading to localized hepatic infection and abscess formation. This descriptive case report documents this rare complication. A 19-year-old male presented with persistent high-grade fever, malaise, headache, and right upper quadrant abdominal pain, plus a history of hematochezia. Examination revealed fever, anemic conjunctivae, and hepatomegaly. Labs showed leukocytosis with neutrophilia, microcytic anemia, elevated liver enzymes, and positive fecal occult blood. The TUBEX TF test was reactive for IgM against Salmonella typhi. Abdominal ultrasonography and contrast-enhanced CT confirmed a solitary liver abscess. Initial ceftriaxone monotherapy yielded limited response; significant improvement followed added intravenous metronidazole. A 19-year-old male presented with persistent high-grade fever, malaise, headache, and right upper quadrant abdominal pain, plus a history of hematochezia. Examination revealed fever, anemic conjunctivae, and hepatomegaly. Labs showed leukocytosis with neutrophilia, microcytic anemia, elevated liver enzymes, and positive fecal occult blood. The TUBEX TF test was reactive for IgM against Salmonella typhi. Abdominal ultrasonography and contrast-enhanced CT confirmed a solitary liver abscess. Initial ceftriaxone monotherapy yielded limited response; significant improvement followed added intravenous metronidazole.
Immune Checkpoint Inhibitors (ICI) in the Functional Cure of Hepatitis B: A Narrative Review Putra, I Komang Wisuda Dwija; Mariadi, I Ketut; Somayana, Gde
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202660-69

Abstract

Chronic hepatitis B (CHB) remains a major global health burden, largely due to the persistence of covalently closed circular DNA (cccDNA) within infected hepatocytes, which hinders complete viral eradication despite long-term antiviral therapy. In recent years, immune checkpoint inhibitors (ICIs) have emerged as a potential therapeutic strategy by restoring exhausted antiviral immune responses. This review explores the mechanisms of action of ICIs, their current application in hepatitis B virus (HBV) infection, and their potential role in achieving a functional cure. Available evidence indicates that ICIs targeting programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), and cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) are capable of partially restoring HBV-specific T-cell function and reducing intrahepatic cccDNA transcriptional activity. Early-phase clinical studies have demonstrated encouraging outcomes, including declines in hepatitis B surface antigen (HBsAg) levels and occasional HBsAg loss; however, consistent achievement of a functional cure remains limited. Notably, combination strategies involving ICIs with therapeutic vaccines or nucleos(t) ide analogues appear to enhance antiviral efficacy compared with monotherapy. In conclusion, ICIs represent a promising adjunctive approach for CHB treatment and may contribute to the pursuit of a functional cure. Nevertheless, further well-designed clinical trials are required to establish their long-term safety, optimal treatment combinations, and effectiveness, particularly in HBV-endemic populations.
Co-Authors Gde Somayana I Ketut Mariadi Pratama, Gede Made Cahya Trisna R. A.T. Kuswardhani