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All Journal E-Jurnal Medika Udayana Universa Medicina Indonesian Journal of Kidney and Hypertension Indonesian Journal of Global Health research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Dewi, Ni Nyoman Gita Kharisma
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Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health

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HUBUNGAN OVERWEIGHT-OBESITAS DENGAN NILAI AKADEMIS SISWA SEKOLAH MENENGAH ATAS (SMA) NEGERI 1 TABANAN, BALI Dewi, Ni Nyoman Gita Kharisma; Arimbawa, I Made; Putra, I Gusti Ngurah Sanjaya; Windiani, I Gusti Ayu Trisna
E-Jurnal Medika Udayana Vol 11 No 8 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i8.P05

Abstract

Overweight-obesity is a condition that results from the accumulation of excess body fat and can affect cognitive function in adolescents, thus having an impact on academic achievement. The aim of this study was to see the relationship between overweight-obesity and academic achievement of student at SMA N 1 Tabanan. The research design of this study was analytic observational cross-sectional. The data were taken by consecutive sampling method through distributing questionnaires in the form of google form. The subject of this study were students of class XI of SMA N 1 Tabanan. Bivariate and multivariate tests were used to analyze the data in this study. The results of the bivariate analysis, the relationship between academic achievement with nutritional status (p = 0.018), gender (p = < 0.001), socioeconomic status (p = 0.005), screen time (p = 0.001), breakfast habits (p = 0.133), and physical activity (p = 0.516). The results of the multivariate analysis, the relationship between academic achievement with nutritional status (OR 4.343; CI 95% 1.050-17.964), socioeconomic status (OR 4.614; CI95% 1.775-11.993), breakfast habits (OR 2.605; CI95% 1.003-6.767), screen time (OR 0.245; CI95% 0.092-0.651), and gender (OR 2.567; CI95% 0.979–6.733).The conclusion is that the overweight-obesity nutritional status has a significant relationship with academic achievement that is less than the average. The habit of not frequent/never having breakfast and less socioeconomic status were also shown to have a significant relationship with academic achievement that is less than the average. Key word : overweight-obesity, academic achievement, school age students.
Correlation of Simple Laboratory Result Parameters to CTP and MELD Scores, and the Diagnostic Role of Simple Laboratory Indexes to Cirrhosis Decompensation Dewi, Ni Nyoman Gita Kharisma; Dewi, Ni Luh Putu Yunia; Dewi, Putu Itta Sandi Lesmana; Pamungkas, Kadek Mercu Narapati; Sindhughosa, Dwijo Anargha; Mariadi, I Ketut
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202427-33

Abstract

BackgroundCirrhosis of the liver is a final condition of all chronic liver diseases. Liver cirrhosis is the leading cause of increasing morbidity and mortality in adults worldwide. Systemic inflammation has been suggested to play an important role in causing progressive liver damage and is one of the leading causes of compensated and decompensated liver cirrhosis.Aim of StudyEvaluate the correlation of neutrophil-lymphocyte ratio (NLR), albumin-bilirubin ratio (ABR), albumin-bilirubin score (ALBI), aspartate aminotransferase to platelet ratio (APRI), albumin-creatinine ratio (ACR), lymphocyte-monocyte ratio (LMR), de ritis ratio to the severity of liver cirrhosis as assessed by CTP score and MELD score. In addition, this study also evaluated the diagnostic ability of NLR, ABR, ALBI, APRI, ACR, LMR, de ritis ratio, and CTP and MELD scores in predicting decompensated liver cirrhosis.MethodWe conducted a cross-sectional study involving patients diagnosed with liver cirrhosis at Prof DR IGNG Ngoerah General Hospital. All patients were diagnosed based on clinical history, physical examination, and investigations. This study enrolled 96 cirrhotic patients regardless of etiology. Laboratory examination results recorded platelets, neutrophils, lymphocytes, monocytes, AST, ALT, albumin, and creatinine. Then NLR, ACR, APRI, LMR, de raitis, ALBI, and ABR are calculated. CTP and MELD scores were calculated by taking data from the patient's medical recordResultOf the 96 patients tested in our study, the majority were male (66). The study found a significant moderate to very strong relationship to the MELD score between ACR, APRI, ALBI, ABR, LMR, WBC, sodium, and albumin. Neutrophil to lymphocyte ratio, ACR, De ritis, APRI, LMR, ALBI, ABR, sodium levels, and albumin have a moderate to very strong significant relationship to CTP score. ACR, De ritis, APRI, LMR, ALBI, ABR, WBC, sodium, and albumin levels with respective cut-offs £ 3.6; ≥ 1.5; ≥ 0.3; £ 2.8; ≥ 0.7; £1.6; ≥ 6.7, £ 136.50, and £ 3.0 can be used to help predict decompensated cirrhosisConclusionIn addition to using the CTP score and MELD score as a tool to predict the severity of liver cirrhosis, data from laboratory examination results in the form of albumin and ABR levels can help establish the diagnosis of decompensated cirrhosis. The sensitivity and specificity of ABR were 96.8% and 75.4% with a cut-off of £  1.6, while albumin levels were 93.5% and 81.5% with an amount off of £  3.0.
Low albumin-to-creatinine ratio: a novel predictor of 90-day mortality in hepatocellular carcinoma with liver cirrhosis Pamungkas, Kadek Mercu Narapati; Dewi, Putu Itta Sandi Lesmana; Dewi, Ni Luh Putu Yunia; Dewi, Ni Nyoman Gita Kharisma; Sindhughosa, Dwijo Anargha; Mariadi, I Ketut
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.313-320

Abstract

BackgroundDespite recent advances in the treatments of hepatocellular carcinoma (HCC), the prognosis of HCC patients remains controversial. Lowered serum albumin in hepatocellular carcinoma, an advanced stage of liver cirrhosis, indicates a worsening condition. Hepatorenal syndrome, marked by increased serum creatinine, is a key mortality indicator. The aim of this study was to determine the serum albumin-to-creatinine ratio (sACR) as a predictor of mortality in patients with HCC and liver cirrhosis. MethodsThis retrospective cohort study included 37 patients with HCC and liver cirrhosis. Patient characteristics, sACR, model of end-stage liver disease (MELD) score, and Child-Turcotte-Pugh (CTP) score were obtained from medical records. The optimal cut-off point for the sACR was determined using receiver operating characteristic (ROC) analysis to evaluate its predictive ability for 90-day mortality. Survival analysis was conducted using the Kaplan-Meier method with a log-rank test, and Cox regression was employed to obtain hazard ratios (HR) to estimate the patient’s prognosis. ResultsA low sACR cut-off of 2.32 was identified. Kaplan-Meier analysis confirmed that sACR met the proportional hazard assumption. sACR <2.32 was a significant predictor of 90-day mortality (HR 6.52; 95% CI 1.80-23.63; p=0.004), comparable to MELD 40 (HR 41.3; 95% CI 1.98-862.90; p=0.016) and CTP category (HR =2.19;95%CI: 0.79-6.06;p=0.131). Conclusion The sACR is a novel predictor of 90-day mortality in HCC patients with liver cirrhosis. Lower sACR is associated with overall survival and may help to design strategies to personalize management approaches among patients with HCC and liver cirrhosis.
Thyroid Storm in A Patient with Graves’ Disease and Tubo-Ovarian Abscess: A Clinical Case Report Dewi, Ni Nyoman Gita Kharisma; Wulandari, Dewi Catur
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6623

Abstract

Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, involving multi-organ dysfunction. This study aims to identify risk factors for thyroid storm and evaluate effective management strategies to reduce mortality. This study is a descriptive case report. Data were collected through patient interviews, physical examinations, and supporting tests at Wangaya Hospital. The data were analyzed qualitatively and presented in a narrative format based on case report guidelines. This paper reports the case of a 24-year-old female with a history of hyperthyroidism on methimazole and an intrauterine device (IUD) presented with abdominal pain that started in the epigastric region and migrated to the lower quadrants. She developed ocular prominence, vomiting, palpitations, generalized weakness, and non-bloody diarrhea. She also experienced persistent lower abdominal pain (pain score: 6/10), dysuria, and fever. A Burch-Wartofsky Point Scale (BWPS) score > 45 confirmed thyroid storm. She was admitted to the ICU and treated with propylthiouracil (PTU), hydrocortisone, digoxin, propranolol, and antibiotics for suspected infection. Her condition improved, and she was discharged after seven days. Thyroid storm is commonly triggered by Graves' disease. The diagnosis is clinical, based on BWPS or the Japanese Thyroid Association criteria, especially in patients with a history of hyperthyroidism and a precipitating factor. PTU is preferred due to its rapid onset and ability to inhibit the conversion of T4-to-T3. Successful management of thyroid storm requires prompt, comprehensive therapy to suppress thyroid hormone levels and treat triggering factors such as infection.
Validation Study of the Cirrhosis Acute Gastrointestinal Bleeding Score as Predictor Mortality in Patients with Liver Cirrhosis and Upper Gastrointestinal Bleeding Mariadi, I Ketut; Hardian, Harris; Alamsyah, Ajib Zaim; Dewi, Ni Luh Putu Yunia; Dewi, Putu Itta Sandi Lesmana; Dewi, Ni Nyoman Gita Kharisma; Pamungkas, Kadek Mercu Narapati; Somayana, Gde; Wira Nugraha, Komang Agus; Sindhughosa, Dwijo Anargha; bin Abd Rahman, Mohamad Fadli
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: 10.24871/271202619-26

Abstract

Background: The Cirrhosis Acute Gastrointestinal Bleeding (CAGIB) score was developed as a mortality predictor by integrating a range of clinical and laboratory parameters. This research seeks to validate the efficacy of the CAGIB score in predicting in-hospital mortality among cirrhotic patients experiencing upper gastrointestinal bleeding (UGIB) at Ngoerah Hospital.Methods: This study is a prospective observational study employing a validation test approach. A total of 161 patients diagnosed with liver cirrhosis and upper gastrointestinal bleeding (UGIB) at Ngoerah Hospital were enrolled. Receiver Operating Characteristic (ROC) analysis was utilized to evaluate the prognostic capability of the CAGIB score in predicting mortality and to identify the optimal cutoff point. Validation was conducted by assessing the CAGIB score's sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV).Results: The analysis of the CAGIB score as a predictor of mortality yielded an area under the curve (AUC) value of 0.83, with the optimal cutoff point determined at ≥ -4.66, based on the point farthest from the diagonal line on the ROC curve. The 95% Confidence Interval (CI) ranged from 0.777 to 0.897. Validation testing of the CAGIB score as a predictor of in-hospital mortality demonstrated a sensitivity of 80.8%, specificity of 70.5%, PPV of 69.4%, and NPV of 81.6%.Conclusion: The CAGIB score has been demonstrated to serve as a valid predictor of mortality, exhibiting commendable sensitivity and specificity, along with satisfactory positive and negative predictive values. The optimal cutoff points appropriately reflect the demographic and clinical characteristics of the cirrhosis patient population with UGIB at Ngoerah Hospital
Understanding Readmission Risks in End-Stage Kidney Disease: A Study from Wangaya Hospital Dewi, Ni Nyoman Gita Kharisma; Pratiwi, Made Sindy Astri; Agustini, Made Priska Arya; Dewi, Putu Itta Sandi Lesmana; Fahira, Cindy; Sunaka, I Wayan
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.206

Abstract

Background: End-stage kidney disease (ESKD) is a growing health burden. Poor patient knowledge and treatment adherence contribute to increased morbidity, as reflected in readmission rates. Objective: This study aimed to identify factors associated with readmission among ESKD patients in Bali. Methods: A retrospective cohort study was conducted at Wangaya Hospital. Adult patients (≥18 years) diagnosed with ESKD, with or without dialysis, between 2022 and 2024 were included. Patients with incomplete records or a solitary kidney were excluded. Bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression) were used to assess associations, with significance set at p <0.05. Results: A total of 199 patients met the inclusion criteria; 61.8% were male, with a median age of 57 years (range: 22–88 years). Readmission rates within and beyond one month were 18.6% and 15.1%, respectively. Reduced eGFR was significantly associated with 30-day readmission (p = 0.041). For readmission beyond 30 days, significant predictors included diabetes mellitus (p = 0.014), neurologic disorders (p < 0.001), and adherence (p = 0.019). Conclusion: eGFR predicts early readmission, while diabetes mellitus, neurological disorders, and treatment adherence influence later readmissions. Identifying these factors is vital for improving patient education and reducing healthcare burdens.
Co-Authors Agustini, Made Priska Arya Alamsyah, Ajib Zaim bin Abd Rahman, Mohamad Fadli Dewi Catur Wulandari Dewi, Ni Luh Putu Yunia Dewi, Putu Itta Sandi Lesmana Dwijo Anargha Sindhughosa, Dwijo Anargha Fahira, Cindy Gde Somayana Hardian, Harris I Gusti Agung Trisna Windiani I Gusti Ngurah Sanjaya Putra I Ketut Mariadi I Made Arimbawa Pamungkas, Kadek Mercu Narapati Pratiwi, Made Sindy Astri Sunaka, I Wayan Wira Nugraha, Komang Agus