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All Journal Medicina IPTEKMA journal of internal medicine Buletin Udayana Mengabdi E-Jurnal Medika Udayana Health Science Journal of Indonesia The Indonesian Biomedical Journal Universa Medicina Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Cancer Jurnal Penyakit Dalam Indonesia

I Gusti Putu Suka Aryana

Divisi Geriatri, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Udayana, Bali

Author-ID : 234375

Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation between albumin serum and frailty in geriatric inpatient and outpatient clinic at Sanglah Hospital Denpasar Putu Shely Prihastuti Rudy; RA Tuty Kuswardhani; I Gusti Putu Suka Aryana; Nyoman Astika; Ida Bagus Putu Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background. Frailty in the elderly has a bad impact on health, especially in the elderly with acute illness. Elderly with frailty has an increase susceptibility to falls, disability and death. Frailty is a common problem in elderly patients, and hypoalbuminemia suggested to increase the risk of death. This study aimed to determine the relationship between albumin and frailty.Method: A Cross-Sectional Study was conducted from February 2018 to January 2019 at Sanglah Hospital with total 60 patients. Patients were divided into two groups, patients with hypoalbuminemia (albumin < 3.5 g/dL) and patients with normal serum albumin levels (albumin ? 3.5 g/dL). The frailty status assessment was measured with Fried's Frailty Phenotype questionnaire. Chi-square test was used to find the relationship between serum albumin and frailty.Result: We evaluated 60 patients, 36 patients (60%) were male and 24 patients (40%) were female. The age of the study subjects ranged from 62 to 92 years. In this study 26 patients (43.3%) with hypoalbuminemia and 34 patients (56.7%) with normal serum albumin. There were 20 patients (76.9%) with frailty in the hypoalbuminemia group, compared to 11 patients (32.4%) in the group of patients with normal serum albumin. Hypoalbuminemia has a risk of 6.97 times greater frailty compared to normal albumin in elderly patients (p = 0.001).Conclusion: This study exhibited a significant relationship between serum albumin and frailty in elderly admitted to inpatient unit and outpatient clinic. The lower the serum albumin level, the higher the probability of the elderly to experience frailty.

Korelasi pemeriksaan darah lengkap dengan derajat keparahan COVID-19 pada pasien lansia di Rumah Sakit Umum Daerah (RSUD) Tabanan tahun 2021 Richard Samsudin; I Gede Agus Sastrawan; I Gede Risnawan Suastika Ardanayasa; I Gusti Putu Suka Aryana
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: COVID-19 infects all patients of all ages including the elderly. Several studies have shown that complete blood counts can be used as a marker of the severity of COVID-19. This study aims to examine complete blood counts with the severity of COVID-19 in elderly patients at the Tabanan Regional General Hospital (RSUD) in 2021. Methods: This research was conducted using an retrospective study method, using 277 samples taken from secondary data (patient medical records) at Tabanan General Hospital. The independent variables of study including haemoglobin, haematocrit, leukocytes, relative lymphocyte levels, relative neutrophil levels, neutrophil lymphocyte ratio (NLR), relative eosinophil levels, relative basophil levels, relative monocyte levels, platelets, and depending variable is the severity of the patient, divided to moderate, severe, critically ill. Data analysis using SPSS version 26 for Windows. Results: Complete blood counts were significantly correlated with Lymphocytes (r2 = 0,069; p < 0,001), Monocyte (r2 = 0,045; p < 0,001), Leukocyte (r2 = 0,037; p = 0,001), NLR (r2 = 0,03; p = 0,004), Eosinophil (r2 = 0,022; p = 0,013), and Haematocrit (r2 = 0,069; p = 0,022). Conclusion: In this study, complete blood count (leukocytes, NLR, haematocrit with a positive value correlation, and lymphocytes, eosinophils, monocytes with a negative value correlations) can be used as predictors to assess the severity of COVID-19 patients. However, neutrophils, basophils, haemoglobin, and platelets were not correlated significantly. Latar Belakang: COVID-19 menginfeksi semua pasien dari segala usia termasuk lansia. Beberapa studi menunjukkan bahwa pemeriksaan darah lengkap dapat dipergunakan sebagai penanda derajat keparahan COVID-19. Penelitian ini bertujuan untuk mengevaluasi pemeriksaan darah lengkap dengan derajat keparahan COVID-19 pada pasien lansia di Rumah Sakit Umum Daerah (RSUD) Tabanan tahun 2021. Metode: Penelitian ini dilakukan dengan metode studi retrospektif menggunakan 277 sampel yang diambil dari data sekunder rekam medis pasien di RSUD Tabanan. Variabel independen penelitian meliputi hemoglobin, hematokrit, leukosit, kadar limfosit relatif, kadar neutrofil relatif, neutrofil limfosit ratio (NLR), kadar eosinofil relatif, kadar basofil relatif, kadar monosit relatif, trombosit, dan dependent derajat keparahan pasien yaitu sedang, berat, kritis. Analisis data memakai SPPS versi 26 untuk Windows. Results: Pemeriksaan darah lengkap menunjukkan hasil yang bermakna pada Limfosit (r2 = 0,069; p < 0,001), Monosit (r2 = 0,045; p < 0,001), Leukosit (r2 = 0,037; p = 0,001), NLR (r2 = 0,03; p = 0,004), Eosinofil (r2 = 0,022; p = 0,013), dan Hematokrit (r2 = 0,069; p = 0,022). Conclusion: Pada penelitian ini pemeriksaan darah lengkap (leukosit, NLR, hematokrit dengan korelasi positif, dan limfosit, eosinofil, monosit dengan korelasi nilai negatif) dapat digunakan sebagai prediktor untuk menilai derajat keparahan pasien COVID-19. Akan tetapi neutrofil, basofil, hemoglobin, dan trombosit tidak berkorelasi secara bermakna.

Breast Cancer in the Balinese Elderly Population: Analysis of the Hospital-Based Cancer Registry I Gusti Putu Suka Aryana; Putu A.T Adiputra; Yulan Permatasari; Pande K. A. Prayudi; Hendra P. Setiawan
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.895

Background: The elderly population in Indonesia will continue to increase over the next few decades. Breast cancer is 22.9% of all female cancers, and aging is one of the biggest risk factors. The challenge in managing older cancer patients is the ability to accurately assess whether the expected benefits of treatment outweigh the risks. Epidemiological data is very important for research and the advancement of medical science in the future. Currently, the incidence of breast cancer in Indonesia is 26 per 100,000 population, but the incidence of breast cancer in the elderly is unknown.Methods: This is a descriptive study of all breast cancer cases recorded in the cancer registry of Sanglah General Hospital, the largest cancer registry in Bali. Statistical analyses were conducted using descriptive statistics with the Statistical Package for the Social Sciences version 16.0 (SPSS).Results: From 1997 until 2013, 1,020 cases of breast cancer among Balinese women of various ages were recorded, of which only 78 cases (7.6%) were attributed to the elderly (age ≥ 65 years). At the time of diagnosis, distant metastasis was recorded for 28.9% of the elderly, compared with 24.4% for the younger group of patients (age < 65 years). Locally advanced breast cancer (LABC) was also recorded higher in the elderly (49.4% vs. 47.5%). A lower proportion of primary surgical treatment was recorded for the elderly than for the younger group of patients (69.7% vs. 76.2%). A lower proportion of adjuvant therapy, either by chemotherapy or radiotherapy, was also recorded for the elderly (45.5% vs. 53.4% and 2.6% vs. 4.9%, respectively), but the proportion of adjuvant hormonal therapy was recorded higher in the elderly (1.3% vs. 0.7%). In contrast, palliative care was recorded higher in the elderly (7.7% vs. 5.7%). Unfortunately, no data about survival were available.Conclusions: There is a tendency for older women in Bali to have more advanced disease at the time of diagnosis and receive less surgical treatment as the primary therapy, but they are more likely to receive adjuvant hormonal therapy and palliative care than their younger counterparts. This information should be of major interest to clinicians.

COVID-19 and the ageing immune system in an elderly patient : a case report I Gusti Putu Suka Aryana; Ida Ayu Pradnya Paramita
Universa Medicina Vol. 42 No. 1 (2023)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2023.v42.101-107

BackgroundThe severity of COVID-19 infection has an increasing trend in the elderly, which contributes to the high morbidity and mortality rates in this population. Aging itself is a prominent risk factor for severe disease and death from COVID-19. Case DescriptionThis case report a 71-year-old woman who complained of shortness of breath for 3 days before being admitted to the hospital. Bilateral consolidation and increased bronchovascular pattern were found on chest radiograph, and a positive SARS-COV2 nasopharyngeal swab PCR test result was noted. This patient was diagnosed with confirmed severe manifestation of COVID-19, community-acquired pneumonia and type 1 respiratory failure, as well as type II diabetes mellitus and suspicion of acute gastritis. The results of the geriatric status assessment were moderate functional status, risk of malnutrition, and moderate risk of deep vein thrombosis (DVT). This patient underwent treatment in accordance with the COVID-19 protocol along with management for geriatric status improvement. The patient was given permission to return home after 14 days of treatment, during which time her health had improved and her functional status had changed to moderate dependency. During follow-up, the patient continued to receive therapy. She is still being observed and future evaluations will be conducted. ConclusionThe increased susceptibility of the elderly to COVID-19 infection is caused by various factors. A burden of death and long-term disability brought on by this pandemic may be lessened by new or modified therapies that target aging-associated mechanisms. Therefore, COVID-19 case management in this population should be done with a comprehensive approach.

Sarkopenia pada Lanjut Usia: Patogenesis, Diagnosis dan Tata Laksana Njoto, Edwin Nugroho; Suka Aryana, I Gusti Putu
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

‘Sarcopenia’ involves a progressive age-related loss of muscle mass and associated muscle weakness that renders frail elders susceptible to serious injury from sudden falls and fractures and losing their functional independence. This disease has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. In the previous definition by the European Working Group on Sarcopenia in Older People (EWGSOP) in 2010, the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function. Since the 2010 definition is difficult to be translated to clinical practice, the EWGSOP uses low muscle strength as the primary parameter of sarcopenia in the 2018 definition; sarcopenia is probable when low muscle strength is detected. A sarcopenia diagnosis is confirmed by the presence of low muscle quantity or quality. When low muscle strength, low muscle quantity/quality and low physical performance are all detected, sarcopenia is considered severe. According to the pathophysiological factors involved in the pathogenesis of sarcopenia, different treatment strategies against sarcopenia are resistance exercise training, increase essential amino acids intake, vitamin D supplementation for those with vitamin D deficiency, polyunsaturated fatty acids (PUFAs) supplementation, testosterone supplementation, angiotensin-converting enzyme inhibitor administration.

Co-Authors A Santoso AAG Budhiart Anak Agung Ayu Ratih Hapsari Anak Agung Mas Putrawati Triningrat Anak Agung Wiradewi Lestari Cilik Wiryani Dian Pritasari Jeger Hendra P. Setiawan I Gede Agus Sastrawan I Gede Risnawan Suastika Ardanayasa I Gusti Agung Wilaja Putra I Ketut Suastika I Made Jawi I Nyoman Astika I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I Wayan Losen Adnyana I. N. Astika I.D. G.A.E. Putra Ida Ayu Pradnya Paramita Ida Bagus Putu Putrawan IN Astika IW Yuna Ariawan Jovita Secunda Ludirdja Juniarta, Pande Made K Andriyasa K Widana Katrin Kurniawan Leonard Kencana MADE RATNA SARASWATI . Michelle Prinka Adyana N Astika N. K.S. Diniari Ngakan Ketut Wira Suastika, Ngakan Ketut Wira Ni Ketut Rai Purnami Ni Made Ayu Sintya D Ni Made Putri Suastari Njoto, Edwin Nugroho Nym Astika Pande K. A. Prayudi Pande Nyoman Bayu Tirtayasa Putu A.T Adiputra Putu Shely Prihastuti Rudy R. A.T. Kuswardhani RA Tuty Kusumawardhani Richard Samsudin Semaradana, Wayan Giri Putra Sri Kayati Widyastuti Surya Rini, Sandra Tuty Kuswardani Wayan Giri Putra Wirawan, I Made Budi Yanson - Yosef Samon Sugi Yulan Permatasari

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