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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Medical Journal of Indonesia MNJ (Malang Neurology Journal) Bali Journal of Anesthesiology The Indonesian Journal of Infectious Diseases Callosum Neurology Journal : Jurnal Berkala Neurologi Bali ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Kedokteran Neurosains Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Archives of Biomedical Research (InABR) Cermin Dunia Kedokteran Magna Neurologica Neurona

Raka-Sudewi A. A.

Udayana University, Bali-Indonesia

Author-ID : 217340

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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HIGH PLASMA TNF-? LEVELS AND MONONUCLEAR CELLS iNOS AND TNF-? EXPRESSION AS RISK FACTORS FOR PAINFUL DIABETIC NEUROPATHY Eko Purwata, Thomas; Suastika, Ketut; Raka Sudewi, A. A.; Widjaja, Djoenaidi
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 2 Juli 2010
Publisher : Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (239.818 KB)

Painful Diabetic Neuropathy (PDN) is one of the most common and annoyingcomplications of diabetes mellitus. The pathogenesis of PDN is complex and still unclear.Recently it has become clear that nitric oxide (NO) and proinflammatory cytokines playan important role in the pathogenesis and maintenance of pain in PDN. Based on thisphenomenon, this study was conducted to investigate whether the cytokine tumornecrosis factor-alpha (TNF-?) and NO, in this case inducible Nitric Oxide Synthase(iNOS), play a role in PDN pathogenesis.The study was carried in two steps. The first step was a cross sectional and thesecond step was a case-control study. The study was performed in 110 type-2 diabeticpatients. The plasma TNF-? levels were determined by ELISA while the expression ofTNF-? and iNOS in mononuclear cells were analyzed immunohistochemically.Of 110 subjects, 59 patients suffered from Painful DN (case) and the remaining51 patients were Painless DN (control). Cross sectionally, plasma TNF-? levels andimmunoreactivity for iNOS and TNF-? were higher in patients with more severe pain inthe Visual Analog Scale (VAS). There were statistically significant differences (p <0.05) between mild and severe pain in regard to TNF-? level (15.24 pg/ml ± 5.42 vs.20.44 pg/ml ± 10.34 ); to iNOS immunoreactivity (9.72 % ± 8.61 vs. 15.6% ± 11.84); andto TNF-? immunoreactivity (13.0 % ± 9. 48 vs. 20.44% ± 11.75).The case control study showed that TNF-? had an odd ratio of 5.053 [CI 95%(2.241-11.392); p < 0.001]. TNF-? immunoreactivity of 4.125 [CI 95% (1.805-9.425); p< 0.001]; and iNOS immunoreactivity of 3.546 [CI 95% (1.613-7.795); p = 0.002]. There were correlations between TNF-? level, TNF-? and iNOS immunoreactivity andVAS with coefficient correlation: 0.330; 0.285 and 0.275 (p < 0.05) respectively.It is concluded that Diabetic Neuropathy patients with high TNF-? levels, iNOSand TNF-? immunoreactivity of mononuclear cells have higher risk for painful DN thanpainless DN. The higher TNF-? level, iNOS and TNF-? immunoreactivity the moresevere was the pain. This supports the hypothesis that TNF-? and iNOS have role inPDN pathogenesis. The results of this research could be applied as a basic for furtherresearch in pursuit of better management of PDN.

POTENTIAL OF ANTHOCYANIN BASED POLY (METHYL METHACRYLATE) NANOPARTICLES SPECIFIC ACTIVATED MICROGLIA IN MANAGEMENT INFLAMMATORY PAIN ON HERNIATED NUCLEUS PULPOSUS: A LITERATURE REVIEW Widyadharma, I Putu Eka; Satyarsa, Agung Bagus Sista; Sanjaya, Feliani; Gitari, Ni Made; Niryana, I Wayan; Purwata, Thomas Eko; Jawi, I Made; Suprapta, Dewa Ngurah; Sudewi, AA Raka
MNJ (Malang Neurology Journal) Vol. 7 No. 1 (2021): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.9

Pain is an unpleasant sensory and emotional experience that can affect the quality of life and leads to decreased productivity in patients. Low back pain (LBP) is one of the significant causes of disability worldwide with lifelong incidence. The purpose of this literature review describes the potential of anthocyanin-based Poly (Methyl Methacrylate) (PMMA)Â Â nanoparticles as the management of inflammatory pain in the Hernia Nucleus Pulposus (HNP ). The method used is a literature study by entering the keyword. Of the 77 journals reviewed, 47 journals were found by the topic and used as a reference for this work. The anthocyanin-based PMMA nanoparticles act as anti-nociceptors by inhibiting microglia that produce inflammatory mediators in HNP. Poly (Methyl Methacrylate) nanoparticles have specific targets in microglia. Anthocyanins have the effect of inhibiting inflammatory pain through many destinations. Anthocyanin inhibits the synthesis of nitric oxide (NO ) and prostaglandin E2 (PGE 2) and inhibits the activation of p38 MAPK and NF-kB pathways that express TNF-Î± and IL-1Î² genes as anti-nociceptive. The anthocyanin-based PMMA nanoparticles have potential as a novel therapy for inflammatory pain in HNP. There has been no research between these modalities. Therefore, further research is needed to find out the exact potential of anthocyanin-based PMMA nanoparticles.

Patogenesis Rabies - Aspek Neurotransmiter Imelda, Yuliana Monika; Sudewi, A.A. Raka
Cermin Dunia Kedokteran Vol 42, No 2 (2015): Bedah
Publisher : PT. Kalbe Farma Tbk.

Rabies merupakan penyakit virus yang menyebabkan peradangan otak akut pada manusia dan hewan berdarah panas lain. Penyebaran penyakit rabies biasanya melalui gigitan atau goresan yang mengandung air liur hewan terinfeksi virus rabies. Virus rabies akan menuju ke susunan saraf pusat (SSP) dan akan menyebar secara sentrifugal dari SSP ke berbagai organ, termasuk kelenjar ludah. Ada tiga reseptor virus rabies, yaitu reseptor nikotinat asetilkolin (NAChR), reseptor molekul adhesi sel neural, dan reseptor neurotropin P75 low-affinity. Asetilkolin, serotonin dan gamma amino butyric acid (GABA) merupakan neurotransmiter yang mempengaruhi terjadinya disfungsi saraf pada penyakit rabies.Rabies is a viral disease that causes acute inflammation of the brain in human and warm-blooded animal. The spread of rabies is through bites or scratches containing saliva of an infected animal. Rabies virus will go to the central nervous system (CNS) and will spread centrifugally from CNS to various organs, including salivary glands. Three rabies virus receptors are nicotinic acethylcholine receptor, neural cell adhesion molecule receptors and low-affinity receptor neurotropin P75. Acetylcholine, serotonin and GABA are neurotransmitters that play a role in neuronal dysfunction in rabies.

Karakteristik Penderita Rabies Paralitik di RSUP Sanglah, Denpasar Ginting, Ernesta; NM, Susilawathi; AA, Raka Sudewi
Cermin Dunia Kedokteran Vol 41, No 11 (2014): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Latar belakang: Ada dua tipe manifestasi klinis rabies pada manusia, yaitu tipe galak dan tipe paralitik. Rabies tipe galak biasanya dapat dengan mudah didiagnosis berdasarkan tanda dan gejalanya yang khas, tetapi diagnosis rabies tipe paralitik sering merupakan dilema bagi klinisi, karena gejalan yang tidak khas dan mirip dengan sindrom Guillain-Barre. Tujuan: Mengetahui karakteristik pasien rabies paralitik di RSUP Sanglah. Metode: Penelitian deskriptif observasional dengan metoda pengumpulan data sekunder dari catatan medis penderita rabies di bangsal perawatan Neurologi RSUP Sanglah dari Januari 2009 â€“ Desember 2010. Hasil: Pada penelitian ini ditemukan 13 (19,69%) kasus rabies paralitik. Gejala prodromal berupa: kesemutan daerah gigitan (69%), demam (46%), mual dan muntah (15%), insomnia dalam 2-5 hari sebelum masuk RS (7%). Gambaran klinis tipe paralitik berupa: paraparesis flaksid simetris (62%), paraparesis flaksid asimetris (15%), monoparesis (15%), fasikulasi (15%), inkontinensia urin (38%), retensi urin (15%), gejala gastrointestinal (distensi abdomen dan ileus paralitik) (53%). Pada stadium akhir (terminal) beberapa gejala klinis khas tipe galak juga muncul, yaitu: gangguan kesadaran berupa fase delirium dan agitasi yang berfluktuasi pada semua penderita (100%), hidrofobia (100%), hipersalivasi (84%), hiperhidrosis (38%), aerofobia (69%), dan fotofobia (7%). Pemeriksaan LCS mendapatkan jumlah sel normal pada 5 pasien dan sel meningkat pada 7(58%) pasien dengan rata-rata jumlah sel 32/mm3. Protein LCS normal pada 4 pasien dan meningkat pada 8(66%) pasien dengan rata-rata 184 mg/dl. Simpulan: Rabies tipe paralitik dan sindrom Guillain-Barre memiliki gejala klinis yang mirip yaitu adanya paralisis flaksid akut yang sering bersifat ascendens. Pada rabies tipe paralitik sering didapatkan beberapa gambaran klinis lain berupa demam, kesemutan di daerah luka gigitan, fasikulasi, inkontinensia urin, progresivitas gejala sangat cepat dan perubahan status kesadaran.Background: Human rabies can present in two clinical forms, furious and paralytic. Diagnosis of furious (encephalitic) form can be made based on typical symptoms and signs. In contrast, paralytic form poses a diagnostic dilemma to distinguish it from Guillain-Barre syndrome. Objective: To describe characteristics of paralytic rabies patients at Sanglah Hospital. Method: This is an observational descriptive study. All data was collected from secondary data from medical records of rabies patients in Neurology ward, Sanglah Hospital from January 2009 â€“ December 2010. Result: There were a total of 13 (19,69%) cases of paralytic rabies. Prodromal symptoms consisted of: paresthesias at the site of healed bite wound (69%), fever (46%), nausea and vomiting (15%), insomnia in about 2-5 days prior to admissions (7%). The clinical features of the paralytic form were: symmetrical flaccid paraparesis (62%), asymmetrical flaccid paraparesis (15%), monoparesis (15%), fasciculation (15%), urinary incontinence (38%), urinary retention (15%), gastrointestinal symptoms (abdominal distention and paralytic ileus) (53%). Particularly all patients showed features of furious rabies in terminal stage: fluctuating consciousness between lucid calm and agitation (100%), hypersalivation (84%), hyperhydrosis (38%), hydrophobia (100%), aerophobia (69%), photophobia (7%). CSF cell counts were normal in 5 patients and increased in 7 (58%) patients with mean cell count of 32 cells/mm3. CSF protein was normal in 4 patients and increased in 8 (66%) patients with mean protein 184 mg/dl. Conclusion: Despite similarities between paralytic rabies and Guillain-Barre syndrome, some clinical features i.e., fever, distal paresthesia, fasciculation, urinary incontinence, rapid progression of symptoms and alteration in sensorium may help clinicians to differentiate rabies from Guillain-Barre syndrome. All paralytic rabies cases showed features of furious rabies in terminal stage.

Gejala Otonom Tidak Spesifik pada Penderita Rabies di RSUP Sanglah, Denpasar Widanta IGN, Putra Martin; NM, Susilawathi; AA, Raka Sudewi
Cermin Dunia Kedokteran Vol 41, No 10 (2014): Hematologi
Publisher : PT. Kalbe Farma Tbk.

Latar belakang: Manifestasi klinis rabies sangat bervariasi. Gejala otonom tidak spesifik ditemukan pada 2/3 kasus terutama pada stadium prodromal menyebabkan misdiagnosis yang memperlambat penanganan rabies. Tujuan: Mengetahui manifestasi gejala sistem saraf otonom tidak spesifik pada penderita rabies di RSUP Sanglah. Metodologi: Penelitian retrospektif dari bulan Januari 2009 â€“ Desember 2010 di RSUP Sanglah Denpasar. Data diperoleh dari catatan medis penderita rabies. Hasil: Ditemukan 13 kasus rabies dengan manifestasi gejala otonom tidak spesifik, terdiri dari 8 kasus tipe galak (61,5%) dan 5 kasus tipe paralitik (38,5%). Pada stadium prodromal gejalanya adalah mual-muntah (38,5%), gangguan miksi (30,8 %), perut kembung (30,8%), nyeri uluhati/perut (15,4%), nyeri dada (15,4%), sesak nafas (53,8) dan diare (7,7%). Gejala sistem otonom pada stadium neurologi akut berupa gangguan miksi (inkontinensia dan retensio urine) (38,5%) dan distensi abdomen (30,8%). Pasien dirawat oleh bagian Ilmu Penyakit Dalam (69,2%), Ilmu Penyakit Anak (15,4%), Ilmu Penyakit Jantung (15,4%) antara 24 jam sampai 48 jam sebelum dikonsulkan ke bagian Ilmu Penyakit Saraf. Simpulan: Manifestasi gejala sistem otonom tidak spesifik sangat bervariasi, dapat ditemukan pada stadium prodromal dan neurologis akut.Background: Clinical manifestations of rabies may be preceded by nonspecific prodromal symptoms in 2/3 cases. This often leads to misdiagnosis resulting in delays in the management of rabies. Objective: To determine the non-specific autonomic nervous system symptoms in rabies patients in Sanglah Hospital. Method: This is descriptive retrospective study from January 2009 - December 2010 in Sanglah Hospital, Denpasar. Data obtained from medical records of rabies patients. Results: During the period, there were 13 cases of rabies with non-specific autonomic nervous system symptoms, 8 cases were furious type (61.5%) and 5 cases paralytic rabies (38.5%). Symptoms at prodromal stage are nausea/vomiting (38.5%), urinary symptoms (30.8%), abdominal distention (30.8%), abdominal/epigastric pain (15.4%), chest pain (15.4 %), shortness of breath (53.8%) and diarrhea (7.7%). The autonomic symptoms at acute neurologic stage were urinary disorders (urinary incontinence and retention) (38.5%) and abdominal distension (30.8%). All patients were treated by other departments between 24 to 48 hours prior to neurological consultation. Those departments were Internal Medicine (69.2%), Pediatrics (15.4%), Cardiology (15.4%). Summary: non-specific autonomic nervous system symptoms of rabies are diverse and complicate the diagnosis. It can occur in a prodromal and acute neurological stage.

Obesitas sentral meningkatkan risiko nyeri punggung bawah pada mahasiswa Program Studi Pendidikan Dokter Universitas Udayana Angelia Carolin; Eka Widyadharma; Raka Sudewi
E-Jurnal Medika Udayana Vol 7 No 5 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.085 KB)

Low back pain (LBP) is a common problem in the community. 70% to 80% of adults have experienced LBP at least once in their lives. LBP is a symptom that causes limitations, ranging from limiting physical activity, decreasing quality of life, to causing psychological distress. There are several things that can cause LBP, one of which is obesity, especially central obesity. Study design using case-control method, this study used 42 respondents who have met the inclusion criteria. Subject respondents are21 students were a group with high risk of LBP and 21 others were low risk group of LBP determined with the Keele START Back Questionnaire. After that, all respondents’ waist circumference were measured. It was found that in the group of people with high risk LBP compared with the high risk LBP group it tended to have central obesity state with proportion (66.7%). In this study a significant relationship between the central obesity with LBP was found (OR: 40, p = 0.02). It can be concluded that central obesity increases the risk of LBP among medical students in Udayana University. The results of this study is expected to be used as the basis for further research and with the existence of these studies the quality of life of medical students will get better. Keywords:Central obesity, low back pain, medical students

INFEKSI VIRUS RABIES DI ANAK-ANAK A.A.N. Subawa; DGD. Dharma Santhi; A.A Raka Sudewi; IWP. Sutirta Yasa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 3 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Rabies has been known in ancient Egypt and China since the fifth century. The disease is caused by the Rhabdovirus of the genusLyssavirus spread from animals or bats to humans by saliva. A five-year-old kid was admitted to Sanglah General Hospital on February19. 2010 with fever complaints, before admitted to the hospital, since the morning he always stuck out his tongue, bit his lips, drinkinga little of water and hard to swallow. From the anamnesis, it is known that the patient has a history of bitten by a dog on February 4.2010 at the lower eyelid and had received wound treatment and VAR, after a while having the treatment the patient eventually died onFebruary 21. 2010. According to the post-mortem sample of the LCS it is showed a positive PCR result of rabies virus infection.

A case report of disseminated cysticercosis in Bali, Indonesia A.A Raka Sudewi; Toni Wandra; Oka Adnyana; NFN Moestikaningsih; A A.B.N. Nuartha; Yasuhito Sako; Kazuhiro Nakaya; Akira Ito
The Indonesian Journal of Infectious Diseases Vol 1, No 2 (2013): The Indonesian Journal of Infectious Diseases
Publisher : Rumah Sakit Penyakit Infeksi Prof Dr. Sulianti Saroso

Abstract. We reported the case of a 36-year-old Balinese man who disseminated cysticercosis, presented neuro-, subcutaneous- and oral-cysticercosis. Diagnosis of it was based on anamnesis, clinical examination including CT Scan, histopathological and serological examinations. The patient visited outpatient clinic of Sanglah Denpasar Hospital in Bali, in June 2003 with two subcutaneous nodules in the body. Serological examinations (ELISA and immnunoblot) used both purified glycoproteins and chimeric recombinant antigen were positive. The two subcutaneous nodules disappeared after treatment with albendazole. In January 2004, the patient presented neuro-, and oral-cysticercosis. CT Scan showed multiple active lesions in the brain. During the treatment with 800 mg albendazole daily during for one month. The side effects of it such as nausea and vomit were found in that patient. Antibody responses in ELISA and immnunoblot were still positive and follow up CT scan in May 2004, it showed that very similar figures as previously. Repeated treatment with 400mg albendazole daily for one and half month was applied. Antibody responses became low, and CT scan in March 2006 did not show any active cysts but only calcified lesions.

A Case Report of Neurocysticercosis at Sanglah Hospital, Denpasar, Bali A.A Raka Sudewi; Ge Aris Geson; Ivan Elisabeth Purba; Toni Wandra
The Indonesian Journal of Infectious Diseases Vol 1, No 3 (2013): The Indonesian Journal of Infectious Diseases
Publisher : Rumah Sakit Penyakit Infeksi Prof Dr. Sulianti Saroso

We reported one neurocysticercosis (NCC) case who visited neurological outpatient clinic of Sanglah hospital, Denpasar, Bali. The patient is a 46-year-old man from Sumba, East Nusa Tenggara Province, and eastern part of Indonesia. The main symptoms of patient was headache and history of epileptic seizures, and spastic monoparesis on left lower limb. Diagnosis and follow up patient was performed clinically including CT scan and serologically. Detection of specific antibodies to Taenia solium in serum was performed by ELISA and immunoblot using native and recombinant antigens.

Biofilm forming potential of Streptococcus suis: focusing on luxs/ai-2-mediated quorum sensing system Tjokorda Istri Pramitasuri; Ni Made Adi Tarini; Ni Made Susilawathi; Anak Agung Raka Sudewi
Indonesian Archives and Biomedical Sciences Vol 1 No 1 (2021): Indonesian Archives and Biomedical Sciences Vol 1(1): 2021
Publisher : Konsorsium Ilmu Biomedik Indonesia (KIBI)

Because of its virulence and ability to survive, the incidence of infection caused by Streptococcus suis (S. suis), an emerging zoonotic pathogen, is expected to increase significantly. A biofilm-forming process, which is a cornerstone of chronic infection, influences the survival rate of S. suis. The mechanism helps bacteria to live longer in host tissues, form colonies, escape immune clearance, and share genetic information. At this moment, the most studied regulatory mechanism of S. suis biofilm formation is Quorum Sensing (QS), mainly on LuxS/AI-2-mediated QS system, in which AI-2 is the most closely related molecule to biofilm formation. In this system, LuxS acts as the key player in the process. The understanding of biofilm formation in S. suis, especially the LuxS/AI-2-mediated QS system, is a valuable contribution to future therapeutic research frameworks.

Co-Authors Adinda Putra Pradhana Agung Bagus S. Satyarsa Agus Eka Darwinata Akira Ito Anak Agung Bagus Ngurah Nuartha Anak Agung Ngurah Subawa Angelia Carolin Bagiada I N. A. Christine Ekawati, Christine Christopher Ryalino Cokorda Istri Dyah Sintarani Sintarani Dedi Silakarma Desak Gde Diah Dharma Santhi Dewa Ngurah Suprapta Djoenaidi Widjaja Ernesta Ginting F. S. Wignall Ge Aris Geson Ginting, Ernesta Gitari, Ni Made I Dewa Made Sukrama I Gde Raka Widiana I Gede Ketut Sajinadiyasa I Gusti Kamasan Nyoman Arijana I Gusti Ngurah Kade Mahardika I Ketut Suastika I Made Jawi I Nyoman Adi Putra I Putu Eka Widyadharma I Wayan Niryana I Wayan Putu Sutirta Yasa I. B. P. Dwija Ida Ayu Jasminarti Dwi Kusumawardani Ida Ayu Sri Wijayanti Ida Bagus Ngurah Rai Imelda, Yuliana Monika Ivan Elisabeth Purba K. Subrata K. Wirasandhi Kade Agus Sudha Naryana Kazuhiro Nakaya M Wiryana Made Nyandra Made Wiryana N ADIPUTRA, N N. K. Susilarini NFN Moestikaningsih Ni Luh Putu Eka Arisanti Ni Made Adi Tarini Ni Made Susilawathi Ni Nengah Dwi Fatmawati Ni Nyoman Sri Budayanti Ni Putu Sriwidyani Ni Wayan Candrawati Oka Adnyana Pangkahila W Paramita, Dyah Pradnya Pramitasuri, Tjokorda Istri Pusaka, Semerdanta Putra Martin Widanta IGN Putu Yogi Pramana Sanjaya, Feliani Senja Decy Ningrum Sri Maliawan Sukmawati, Ni Made Dewi Dian Suryapraba, Anak Agung Ayu Susilawathi, Ni Made Thomas Eko Purwata Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Tjokorda Istri Pramitasuri Toni Wandra Vania, Aurelia Widanta IGN, Putra Martin Yasuhito Sako Yuliana Monika Imelda

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