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All Journal International Journal of Public Health Science (IJPHS) Jurnal Gizi dan Pangan BALI MEDICAL JOURNAL (BMJ) journal of internal medicine INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Jurnal Veteriner Journal of Biomedicine and Translational Research WMJ (Warmadewa Medical Journal) The Indonesian Biomedical Journal Public Health of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) JURNAL PENDIDIKAN JASMANI DAN OLAHRAGA Pharmasipha Jurnal Penyakit Dalam Udayana Jurnal Pendidikan dan Konseling Jurnal Cahaya Mandalika International Journal of Industrial Engineering and Engineering Management Indonesian Journal of Cancer Journal of Global Pharma Technology Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Jurnal Kedokteran Hewan Journal Pharmaceutical Science and Application (JPSA)

I Made Bakta

Universitas Bali Internasional

Author-ID : 240254

Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Languange, Linguistic, Communication & Media Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Neuroscience Public Health Social Sciences Veterinary Other

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Sistem Pengelolaan Limbah Padat di Fasilitas Layanan Kesehatan: Systematic Review Levi Anatolia; I Made Bakta
Jurnal Pendidikan dan Konseling (JPDK) Vol. 4 No. 5 (2022): Jurnal Pendidikan dan Konseling
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jpdk.v4i5.6705

Aktivitas layanan kesehatan di setiap fasilitas kesehatan menghasilkan berbagai macam limbah salah satunya adalah limbah padat. Hal ini mempunyai konsistensi perlunya pengelolaan limbah di fasilitas layanan kesehatan sebagai bagian dari kegiatan penyehatan lingkungan dan untuk melindungi masyarakat dari bahaya pencemaran lingkungan serta resiko infeski penyakit yang bersumber dari fasilitas layanan kesehatan. Oleh karena itu, tujuan utama dalam penulisan systematic review untuk mengetahui dan memahami sistem pengelolaan limbah non medis di fasilitas layanan kesehatan. Metode yang digunakan adalah menggunakan metode Systematic Review. Dari hasil pencarian literatur melalui publikasi yaitu Google, Google Scholar, PubMed, Emerald Insight, menggunakan kata kunci “pengelolaan limbah non medis”, menemukan 51 jurnal yang sesuai kata kunci tersebut dengan jenis jurnal seperti International Journal of GEOMATE, International Journal of Environment and Pollution Research, Journal of Community Health, Journal of solid waste technology and management, Journal of Environment and Waste Management, Int. J. Environment and Waste Management, Int. J. Environ. Res. Public Health, Global NEST Journal, International Journal of Environmental Research and Public Health. Selanjutnya melakukan screening sesuai kriteria Inklusi dan Eksklusi mendapatkan 7 Artikel yang sesuai Judul. Hasil pencarian Artikel dari tahun 2010-2020 dan hasil yang diperoleh dari 7 Artikel yang dianalisis ditemukan bahwa saat ini, masih ditemukan buruknya pengelolaan limbah dari fasilitas pelayanan kesehatan terlihat mulai dari limbah itu dihasilkan, dikelola hingga pada saat pembuangan. Permasalahan pengelolaan limbah khususnya limbah padat medis menjadi masalah dan tantangan bagi setiap fasilitas pelayanan kesehatan yang ada baik di perkotaan maupun di pedesaan. Hal ini karena pengelolaan limbah medis membutuhkan biaya yang cukup besar dan aturan yang wajib dipenuhi oleh penghasil limbah sebagai syarat dari upaya pengelolaan yang ada. Saat ini, sering ditemukan pengelolaan limbah medis dari fasilitas pelayanan kesehatan masih dibawah standar khususnya negara-negara berkembang. Fasilitas layanan kesehatan harus mengelola limbah non medis dengan baik dari mulai pemilihan, penampungan, pengangkutan, hingga pemusnahannya. Jika tidak, akan berdampak terhadap petugas kesehatan, petugas pengelola limbah dan pasien baik dari aspek kesehatan maupun keselamatannya, selain itu juga berdampak terhadap lingkungan hidup.

Inverse Correlation between Combination of Antiretroviral Therapy with the level of Serum Interleukin-6, Ferritin, and Hepcidin in HIV Patients with Anemia Chronic Disease I Ketut Agus Somia; Ketut Tuti Parwati Merati; I Made Bakta; Ida Bagus Putra Manuaba; Wayan Putu Sutirta Yasa; I Dewa Made Sukrama; Ketut Suryana; Rudi Wisaksana
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

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

Background: The purpose of this study was to determine whether the cARV therapy correlates with the serum level of IL-6, ferritin, and hepcidin in HIV infected patients with ACD.Methods: A cross-sectional study conducted in HIV patients with ACD, aged 15-65 years with exclusion criteria such as chronic renal disease, chronic liver disease, treated for anemia in the last 3 months, taking iron supplements in the last 3 months, history of blood transfusion in the last 1 year, suffering from acute infection, tuberculosis infection, malignancy, hepatitis C virus infection, acute hypersensitivity reaction and pregnancy. Blood specimen examined by high sensitivity human IL-6 In vitro ELISA, DRG Hepcidin- 25 ELISA, serum ferritin by agglutination method and CD4 cell count by flow cytometry. Results: A total of 86 HIV patients with ACD consist of 42 subjects with experienced cARV and 44 subjects with naive cARV. There are several differences between cARV naïve and experienced cARV including: Hb (g/dl) [ 10.8 ( 9.88 – 11.75) Vs. 11.60 (11.00 – 12.34) p: 0.058 ], serum iron (mg/dl) [ 50.00 (31 – 66.8) Vs. 71.40 (56.00 – 108.00) p: 0.121 ), serum ferritin (ug/dl) [ 630 ( 194 – 1101) Vs. 195.40 (128.25 – 589.47) p: 0.008 ], IL-6 (pg/mL) [7.20 (3.88 – 10.76) Vs. 4.03 (1.69 – 8.49) p: 0.009), serum hepcidin (ng/mL) [45.54 (16.74 – 95.31) Vs. 23.35 (6.58 – 49.99) p: 0.007] , CD4 cell count (cell/uL) [31.5 (14.25 – 90.75) Vs. 307 (168.5 – 458.75) p : < 0.001)] There is a significant inverse correlation between the cARV therapy with level of serum IL-6 ( r: - 0. 285, p: 0.008), ferritin (r: - 0.321, p: 0.007) and hepcidin (r: - 0.293, p: 0.006). While there was a significant positive correlation between the cARV therapy with CD4 cell count (r: 0.676, p: 0.001). There was no correlation between the cARV therapy with serum iron levels ( r: 0.176, p: 0.121).Conclusion: There is an inverse correlation between the cARV therapy with serum level of IL-6, ferritin, and hepcidin in HIV patients with ACD. Keywords: cARV, ACD, IL-6, Ferritin, Hepcidin.

Reticulocyte Hemoglobin Equivalent (RET-HE) As A Predictor and Early Marker for Oral Iron Response in Iron Deficiency Anemia Patients Ketut Suega; I Made Bakta
Journal of Global Pharma Technology Volume 10 Issue 06: (2018) June 2018
Publisher : Journal of Global Pharma Technology

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

This study was aimed to determine whether Ret-He has a role for early detection and as a predictor factor for treatment response in iron deficiency anemia patient after oral iron therapy in 4 weeks. Iron deficiency anemia (IDA) patient were diagnosed based on hypochromic microcytic anemia with ferritin level < 20 ng/ml. All patients were taking oral iron pill for 4 weeks. Hemoglobin serum, absolute reticulocyte count (ARC), Ret-He, MCV, MCH, MCHC, and hematocrit were measured. Responders are defined as patients who reach total changes of their hemoglobin level > 2 g/dl in 4 weeks. Data analysis was done by SPSS. There were 26 IDA patients consisted of 15 (57.7%) female and 11 (42.3%) male patients with mean of age was 47.31. Before treatment, level of Ret-He, absolute reticulocyte count, HB, HCT and MCV were 18.16 pg (SD 4.43), 0.67 (SD 3.02), 7.94 g/dl (0.74), 26.5 % (SD 2.48), 64.9 fl (SD 0.51) respectively. There was 18 (69.2%) patient considered as responders and 8 (30.8%) patients considered as non-responders. The evaluation showed all markers were increased except for absolute reticulocyte level. On adjusted multiple logistic regression, the only variable that found statistically significant was Ret-He at week 1 with p= 0.031; 95% CI 0.349-0.950. It is suggested that reticulocyte hemoglobin equivalent (Ret-He) proved to be an early and sensitive predictor for oral iron therapy response in patients with iron deficiency anemia. Keywords: Ret-He, Treatment response, Iron deficiency anemia.

PERAN OVISIDAL HERBAL SERBUK BIJI PEPAYA MATANG DAN ALBENDAZOL TERHADAP DAYA BEREMBRIO TELUR CACING Ascaris suum SECARA IN VIVO Ida Bagus Komang Ardana; I Made Bakta; I Made Damriyasa
Jurnal Kedokteran Hewan Vol 6, No 1 (2012): March
Publisher : Universitas Syiah Kuala

Telah dilakukan penelitian untuk mengetahui pemberian herbal serbuk biji pepaya matang secara oral pada babi ascariasis terhadap daya berembrio telur cacing pada tinja dan pada uterus cacing yang keluar dari babi yang diobati tersebut. Pada percobaan ini sebanyak 24 ekor babi Landrace betina dengan bobot badan ± 10-15 kg, umur ± 15 minggu yang terinfeksi cacing Ascaris suum (A. suum) secara alami, dengan egg per gram (EPG) berkisar 250-2500 butir. Babi tersebut dibagi menjadi empat kelompok perlakuan (P0, P1, P2, dan P3) masing-masing terdiri dari 6 ekor. Kelompok P1 dan kelompok P2 mendapat perlakuan dengan herbal serbuk biji pepaya matang per oral dengan dosis masing-masing 1 dan 3 g/kg bobot badan (P2) selama 3 hari berturut-turut. Kelompok P3 mendapat perlakuan dengan albendazol dosis 0,5 mg/kg bobot badan (Zodalben 0,04 ml/kg bobot badan) sedangkan kelompok P0 bertindak sebagai kontrol tanpa pengobatan. Hasil penelitian ini menunjukkan bahwa pengobatan dengan herbal serbuk biji pepaya matang pada babi ascariasis ternyata mampu menurunkan daya berembrio telur cacing dalam tinja babi dan dalam uterus cacing secara efektif sehingga dapat digunakan untuk pengendalian askariasis pada babi.

BALB/c Mice as Animal Model in Dengue Infection Research: Role of Endothelial Activation I Made Susila Utama; Tuti Parwati Merati; Made Bakta; Made Jawi
Journal of Biomedicine and Translational Research Vol 9, No 2 (2023): August 2023
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v9i2.17491

Introduction. There were various challenges in using experimental animals model for dengue infection studies aside from the fact that dengue infection only naturally affects humans and does not manifest clinical signs as in humans. Various experimental animals have been used in dengue research, but the mouse model is more widely used since it is easier to obtain although sometimes they do not show clinical symptoms but may still measure the immune response. BALB/c mice are immunocompetent mice that have the potential to be used in dengue infection research. Endothelial cell activation plays a role in the pathogenesis of dengue virus infection which contributes to plasma leakage. One of the biomarkers of endothelial cell activation is soluble intercellular adhesion molecule 1 (sICAM-1).Method. An analytic observational study was conducted using BALB/c mice aged 8 weeks and weighed 40 grams. Selected BALB/c mice were randomly assigned to serotype 2 dengue virus containing 2.1 x 106 pfu/ml intraperitoneally, given only once. A total of 11 mice were injected with dengue virus serotype 2 and 11 mice were not injected with dengue virus. On the second day of virus injection, non structural (NS) 1 antigen dengue examination was carried out to prove that the BALB/c mice were indeed infected with dengue virus. In BALB/c mice that were proven to be infected with dengue virus, sICAM-1 levels were examined in serum after 7 days of infection. Mice that were not injected with dengue virus also examined sICAM-1Results. All of BALB/c mice injected with dengue virus were proven to be infected, as indicated by the detection of NS1 antigen in their serum. The mean serum level of NS1 antigen was 88.35 ng/ml (mean 95.34 ng/ml and standard deviation 21.94). The level of sICAM-1 in BALB/c mice infected with dengue virus (mean = 1.34) was significantly higher than mice that were not infected (mean = Â 0.79), with a p-value 0.045Conclusions. BALB/c mice were proven to be infected with dengue virus by detecting ns1 dengue virus antigen in the serum. The sICAM-1 levels in the group of BALB/c mice infected with dengue serotype 2 were significantly higher than the BALB/c mice that were not infected with dengue virus.

A Predominant Physical Component Profile of Persipura Junior Football Athletes Daniel Womsiwor; N Adiputra; I Made Bakta; Ambrosius Purba; I Made Jawi; I Ketut Suyasa; Nita Fitria
JURNAL PENDIDIKAN JASMANI DAN OLAHRAGA Vol 5, No 1 (2020): Improving Physical Education to Promote Healthy Growth
Publisher : Universitas Pendidikan Indonesia

This study was aimed at determining the description of predominant physical component profile (physical fitness, fat thickness, agility, muscle endurance, flexibility, power, muscle strength and balance) of the Persipura Junior Football Athletes. This study used a survey of PERSIPURA Junior Football athletes involving 39 people. The inclusions of the athletes inculde male gender, aged 21 years, height 177 cm, an ideal body weight, a healthy body, and moderate to good categories of physical fitness. The instrument used in this study were dynamometer for muscle strength; crunches for muscular endurance, push-ups, squat jumps, beam side step for agility, flexometer for flexibility, vertical jump for power, and 2.4 km running test for physical fitness. The results showed that the Persipura Junior Football athletes had a good physical fitness, less triceps fat thickness, a normal sub scapular thickness, a normal supra iliaca thickness, lack of agility, a good endurance of arm and shoulder muscles, a good endurance of abdominal muscles, an adequate flexibility, a perfect vertical jump muscle power, a good medicine ball muscle explosive power, a good full muscle strength, lack push muscle strength, and a very good balance. It concludes that to gain an optimal predominant physical component, sports science with measurable and well-programmed exercises should be applied, so that the physical component of triceps fat thickness, agility, and push muscle strength could increase. Abstrak Penelitian ini bertujuan untuk mengidentifikasi Profil Komponen Fisik Predominan (Kebugaran Jasmani, Ketebalan Lemak, Kelincahan, Daya Tahan Otot, Kelentukan, Daya Ledak Otot, Kekuatan Otot dan Keseimbangan) Atlet Pemain Sepak Bola Persipura Junior. Penelitian ini menggunakan survei terhadap atlet Sepak Bola PERSIPURA Junior sebanyak 39 orang, yang memiliki inklusi: jenis kelamin laki-laki, umur 21 tahun, tinggi badan 177 cm, berat badan ideal, berbadan sehat dan kebugaran fisik dengan kategori sedang sampai kategori baik. Instrumen untuk mengukur kekuatan otot dengan dinamometer; daya tahan otot diukur dengan sit-up, push-up, squat jumps; kelincahan diukur dengan beam side step, kelentukan diukur dengan fleksometer, daya ledak otot diukur dengan vertical jump, dan kebugaran jasmani diukur dengan tes lari 2,4 km. Hasil Penelitian menunjukkan atlet Pemain Sepak Bola Persipura Junior memiliki kebugaran jasmani baik, ketebalan lemak triceps kurang, ketebalan sub scapula normal, ketebalan supra iliaca normal, kelincahan kurang, daya tahan otot lengan dan bahu baik sekali, daya tahan otot perut baik, kelentukan cukup, daya ledak otot vertical jump sempurna, daya ledak otot medicine ball baik, kekuatan otot full baik , kekuatan otot push kurang, keseimbangan baik sekali. Agar komponen fisik predominan optimal, hendaknya menerapkan sports science dengan latihan terukur dan terprogram dengan baik sehingga komponen fisik ketebalan lemak triceps, kelincahan dan kekuatan otot push meningkat.

Pengaruh puasa ramadhan terhadap kadar gula darah masyarakat diabetes mellitus tipe 2 di Denpasar Selatan Putri, Dhiancinantyan Windydaca Brata; Mirandinha Fortuna Sarmento Madeira, Angie; Adi Purwa Hita, I Putu Gede; Bakta, I Made
Pharmasipha : Pharmaceutical Journal of Islamic Pharmacy Vol. 8 No. 1 (2024): Maret
Publisher : University Of Darussalam Gontor

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21111/pharmasipha.v8i1.10711

Puasa diartikan sebagai ibadah menahan diri atau berpantang makan, minum, dan segala hal yang membatalkannya dengan waktu berpuasa berkisar antara 11 jam hingga 18 jam setiap hari. Manfaat yang didapat saat berpuasa salah satunya yaitu untuk mengontrol gula darah. Diabetes mellitus adalah penyakit yang ditandai dengan terjadinya hiperglikemia dan gangguan metabolisme karbohidrat, lemak, dan protein yang dihubungkan dengan kekurangan secara absolut atau relatif dari kerja dan atau sekresi insulin. Penelitian ini bertujuan untuk mengetahui adanya pengaruh puasa terhadap GDA dan GDP pada pasien DM tipe 2 di lingkungan Kepaon. Penelitian yang dilakukan merupakan penelitian Quasi Eksperiment dengan desain rancangan Pretest-Posttest Control Group Design. Pengambilan sampel menggunakan Teknik Purposive sampling. Penelitian ini dilakukan lingkungan Kepaon selama bulan puasa ramadhan 2023. Sampel pada penelitian ini merupakan pasien yang menderita DM tipe 2 di lingkungan Kepaon. Analisa data pada penelitian ini menggunakan uji paired t-test dan uji Mann-Whitney, dimana menunjukkan hasil GDA dan GDP kelompok intervensi sebelum berpuasa dan setelah berpuasa mengalami penurunan dibandingkan dengan kelompok kontrol dengan nilai p-value>0.001. Hal ini dapat disimpulkan bahwa puasa Ramadhan dapat menurunkan kadar GDA dan GDP pasien DM tipe 2 dibandingkan dengan kelompok yang tidak berpuasa.

Healthcare Professional’ Roles Educate Exclusive Breastfeeding: A Qualitative Exploratory Study of Strategies and Challenges Mertasari, Luh; Duarsa, Dyah Paramita; Ani, Luh Seri; Kusuma, Anak Agung Ngurah Jaya; Bakta, I Made
Public Health of Indonesia Vol. 10 No. 3 (2024): July - September
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v10i3.837

Background:The exclusive breastfeeding program has been in place for several years, but its implementation in various countries remains suboptimal. To reduce health risks for both mothers and children, exclusive breastfeeding education should begin as early as possible during pregnancy. Objective:This study aimed to explore models of exclusive breastfeeding education during pregnancy. Method:This study used a qualitative descriptive design with an exploratory approach. The sample included all parties involved in providing exclusive breastfeeding education within the Public Health Centers working areas of Buleleng I, Sukasada I, and II. The participants comprised 35 healthcare professionals, pregnant women, postpartum mothers, and hamlet heads. Data were collected through in-depth interviews using semi-structured interview guidelines until data saturation was reached. Interviews were conducted via video calls and private messages to confirm the transcription results. Results:Thematic analysis identified three main themes: Healthcare professionals’ roles, knowledge, attitudes, and support (including multiple roles, perceptions about exclusive breastfeeding education, and formal motivation and support); Education strategy and mechanisms (encompassing educational strategies, methods, preparation, location, schedule, time allocation, content, stages, media, and effectiveness evaluation); Challenges (such as lack of knowledge, maternal circumstances, and environmental conditions). Conclusion:Public health centers should provide structured education, with midwives playing a key role in promoting exclusive breastfeeding. The delivery of education should remain flexible to accommodate various conditions. Keywords:Breastfeeding; Child; Health knowledge; Midwifery; Postpartum period

Exploring Meditation Influence on Stem Cell: A Review of Current Evidence Santosa, I Gusti Ngurah Putra Eka; Jawi, I Made; Bakta, I Made; Yasa, I Wayan Putu Sutirta; Wirawan, I Made Ady; Lesmana, Cokorda Agung Bagus Jaya; Kandarini, Yenny; Purnamawati, Susy
Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Vol. 7 (2024): PROSIDING SINTESA
Publisher : LPPM Universitas Dhyana Pura

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36002/snts.v7i.3716

Endogenous stem cells play a critical role in maintaining tissue homeostasis, repair, and regeneration. The interconnectedness of mind and body has long been recognized as influencing physical health, with practices such as yoga and meditation demonstrating positive effects on overall well-being. This review aims to synthesize current evidence on the effects of meditation on stem cell function, focusing on both indirect (telomere-related) and direct pathways. Meditation appears to influence stem cell function through various mechanisms. Indirectly, meditation may impact stem cells by modulating telomere length and activity. This modulation is likely mediated through stress reduction, modulation of the hypothalamic-pituitary-adrenal (HPA) axis, melatonin elevation, immune system modulation, and reduction of oxidative stress. Directly, meditation may influence stem cell trafficking and differentiation. While studies suggest potential benefits of meditation on stem cell function, further research is needed to fully elucidate the underlying mechanisms. Emerging evidence suggests that meditation may positively influence stem cell function through both indirect and direct pathways. Future research should focus on clarifying the precise mechanisms, investigating the role of meditation parameters, and conducting clinical trials to assess the therapeutic potential of meditation in promoting stem cell-mediated tissue regeneration and repair. A multidisciplinary approach involving researchers from various fields is crucial for comprehensively understanding the complex interplay between meditation, stem cells, and overall health.

Slow 0.9% NaCl Bolus Administration Reduces ANP, MMP-2, and Syndecan-1 Shedding in Septic Shock Rabbit Models Hartawan, I Nyoman Budi; Wiryana, Made; Jawi, I Made; Astawa, I Nyoman Mantik; Bakta, I Made; Subanada, Ida Bagus; Suparyatha, Ida Bagus; Wati, Dyah Kanya
Molecular and Cellular Biomedical Sciences Vol 9, No 2 (2025)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v9i2.590

Background: The optimal rate for fluid bolus administration in septic shock remains a critical and unresolved question. Rapid bolus administration is commonly practiced but has been linked to elevated levels of atrial natriuretic peptide (ANP), matrix metalloproteinase-2 (MMP-2), and syndecan-1 shedding, potentially exacerbating endothelial glycocalyx damage and increasing vascular permeability. However, the physiological and clinical implications of slower bolus rates have not been thoroughly investigated. This study was conducted to identify safer fluid management practices and improve patient outcomes in septic shock.Materials and methods: A randomized post-test-only control group design was employed, involving 36 male New Zealand rabbits with lipopolysaccharide-induced septic shock. The treatment group received 0.9% NaCl boluses (20 mL/kg body weight) over 20 minutes per bolus (slow bolus), while the control group received the same volume over 5 minutes per bolus (rapid bolus). ANP, MMP-2, and syndecan-1 levels were measured using ELISA 10-15 minutes post-intervention.Results: The median ANP levels in the treatment group (92.86 ng/mL) were significantly lower (p<0.05) than those in the control group (367.32 ng/mL). The mean MMP-2 levels in the treatment group (10.26 ng/dL) were lower than those in the control group (11.43 ng/dL). The median levels of syndecan-1 were also lower in the treatment group (4.31 ng/mL) compared to the control group (5.94 ng/mL).Conclusion: Slow fluid boluses appear to mitigate endothelial damage by reducing ANP, MMP-2, and syndecan-1 shedding. These findings suggest that slower infusion rates may offer a protective advantage in fluid resuscitation, paving the way for updated clinical guidelines.Keywords: fluid bolus, ANP, MMP-2, syndecan-1

Co-Authors - Murtiananingsih, - - Saimi, - A. A. Mas-Putrawati AAG Sudewa D. Adi Purwa Hita, I Putu Gede Agustini, Made Priska Arya Alma Lystia Savitri Mahayasa Ambrosius Purba Anisa Hanum Annisa Hanum Anwar Santosa Ariati, N.N. Arundina Sanyoto Astawa N. M., Astawa N. Astawa P., Astawa Brad Otto Budha K. Claire Ryan Daniel Womsiwor Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dharmayuda, Tjokorda Gede Dhiancinantyan Windydaca Brata Putri Djoko Roeshadi Duarsa, Dyah Paramita Dwidjayanti, Ni Kadek Candra Dyah Kanya Wati Dyah Pradnya P.D., Dyah Pradnya Dyah Pradnya Paramitha Duarsa Dyah Pradnya Paramitha Duarsa, Dyah Pradnya Paramitha Dyah Pradnyaparamita D, Dyah Pradnyaparamita Ekaputra Ekaputra, Ekaputra Gusti Putu Surya H. S. Habiba Muhiddin, H. S. Habiba Hari Bagianto I Dewa Made Sukrama I Dewa Nyoman Wirawan I Dewa Putu Sutjana I Ketut Agus Somia I Ketut Suastika I Ketut Suyasa I Made Ady Wirawan I Made Damriyasa I Made Duwi Sumohadi I Made Jawi I Made Jawi I Made Sudarmaja I Made Susila Utama I N Agus Bagiada I NYOMAN ADI SURATMA I Nyoman Arhya I Nyoman Budi Hartawan I Nyoman Mangku Karmaya I NYOMAN MANTIK ASTAWA I Nyoman Sutarsa I P G. Adiatmika I Putu Budi Wibawa I Putu Suiraoka I Putu Wantera I Wayan Losen Adnyan I Wayan Losen Adnyana I Wayan Putu Sutirta Yasa I Wayan Suranadi I Wayan Wita Ida Bagus Gede Suparyatha Ida Bagus Komang Ardana Ida Bagus Putra Manuaba Ida Bagus Subanada IN Agus Bagiada IN Bagiada INT Suryadhi INT Suryadhi J. A. Pangkahila Karjono M, Karjono Ketut Siki Kawiyana Ketut Suata Ketut Suega Ketut Suega Ketut Suryana Ketut Tuti Parwati Merati Kusuma, Anak Agung Ngurah Jaya Lesmana, Cokorda Agung Bagus Jaya Levi Anatolia Losen Adnyan Ludirdja, Evan Pratama LUH MERTASARI . Luh Seri Ani Made Jawi Made Krisna Adi Jaya Made Wiryana Manuaba, I.B.P Mirandinha Fortuna Sarmento Madeira, Angie N Adiputra N. Adiputra N. K. Niti Susila, N. K. Ni Made Andrinia Ratih Sri Indarswari Ni Nyoman Yunita Kusuma Bakta Ni Putu Aryati Suryaningsih Nita Fitria P. Astawa Pratiwi, Made Sindy Astri Purnamawati, Susy R. A.T. Kuswardhani Rena, Ni Made Renny A Rena, Ni Made Renny Anggreni Renny A Rena Rudi Wisaksana Santosa, I Gusti Ngurah Putra Eka Satoto D., Satoto Sawitri, Anak Agung Sagung Shannon Turnbul Sri Maliawan Sumohadi, I Made Duwi Suryadi N. T., Suryadi N. Sutajaya, I.M. Sutema, Ida Ayu Manik Partha Tirtayasa, K. Tjok Darmayuda Tjok Gde Darmayuda Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Tjokorda Gde Dharmayuda Tjokorda Gde Dharmayuda Tuti Parwati Merati W. A., W. Winarto, Daniel Wiryana M., Wiryana Wulansari Manuaba, Ida Ayu Ratih Xavier Leverve Yenny Kandarini

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