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Korelasi antara Jumlah Limfosit Total dan Limfosit Cd4+ pada Pasien HIV/AIDS di RSUD Provinsi NTB I Made Wikrama Resindra; Ilsa Hunaifi; I Gede Yasa Asmara
Jurnal Kedokteran Vol 8 No 2 (2019)
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v8i2.339

HIV (Human Immunodeficiency Virus) merupakan suatu jenis retrovirus yang berasal dari famili lentivirus. Virus ini memiliki kemampuan khusus yaitu merubah komponen RNA (Ribonucleic Acid) menjadi DNA (Deoxyribonucleic Acid). Virus HIV merupakan jenis virus yang menyerang sel limfosit CD (Cluster Differentiation) 4+ . Negara Indonesia merupakan negara kepulauan yang masih memiliki keterbatasan dalam melakukan pemeriksaan CD4+. Hitung jumlah limfosit total dapat dijadikan alternatif menggantikan pemeriksaan CD4+ dalam menentukan waktu terapi HAART (Highly Active Antiretroviral Therapy) atau melakukan monitoring. Secara umum tujuan penelitian ini adalah untuk mengetahui korelasi antara jumlah limfosit total dan limfosit CD4+ pada pasien HIV/AIDS di RSUD Provinsi NTB. Penelitian ini menggunakan metode kuantitatif dengan metode pengambilan data secara cross-sectional. Sampel penelitian yang telah memenuhi kriteria inklusi dan eksklusi dipilih berdasarkan teknik consecutive sampling. Pengambilan data menggunakan data rekam medis pasien HIV/AIDS pada klinik VCT (Voluntary Conseling and Testing). Analisis statistik yang digunakan yaitu analisis deskriptif dan bivariat dengan uji korelasi pearson. Sebanyak 52 sampel yang masuk kedalam kriteria inklusi didapatkan nilai korelasi positif lemah antara jumlah limfosit total dan CD4+ pada sampel pre-HAART (r = 0.396) dengan nilai sig 0.004 sedangkan pada sampel post-HAART didapatkan korelasi positif kuat (r = 0.665) dengan nilai sig 0.000. Terdapat korelasi yang signifikan antara TLC dan CD4+ pre-HAART dan post-HAART

Hubungan Diet Iritatif dan Ketidakteraturan Makan dengan Sindrom Dispepsia pada Remaja Santri Madrasah Aliyah Al-Aziziyah Putri Kapek Gunungsari Lombok Barat Nusa Tenggara Barat Ummul Khair Binti Amir; I gde Yasa Asmara; Rifana Cholidah
Jurnal Kedokteran Vol 8 No 2 (2019)
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v8i2.341

Dispepsia merupakan keluhan yang sering dijumpai dalam praktek klinis sehari-hari. Selain pada orang dewasa, dispepsia juga umum ditemui pada anak-anak dan remaja. Meskipun dispepsia jarang menimbulkan kematian, sebagian besar pasien mengalami nyeri perut signifikan yang mengganggu aktivitas mereka sehari-hari. Banyak pasien melaporkan gejala yang mereka alami terkait dengan konsumsi makanan. Selain itu, perilaku makan juga dikaitkan dengan dispepsia. Penelitian ini bertujuan untuk mengetahui hubungan antara diet iritatif dan ketidakteraturan makan dengan kejadian sindrom dispepsia pada remaja santri Madrasah Aliyah Al-Aziziyah Putri.Penelitian ini merupakan penelitian non eksperimental yang dirancang secara analitik menggunakan metode cross sectional. Responden penelitian adalah 202 orang remaja perempuan berusia 10-19 tahun yang bersekolah di Madrasah Aliyah Al-Aziziyah Putri dan tinggal di asrama Pondok Pesantren Al-Aziziyah. Responden diambil menggunakan teknik proportionate stratified sampling. Data diperoleh melalui kuesioner yang telah diisi oleh responden. Uji statistik yang digunakan adalah uji chi square. Responden yang memiliki kebiasaan mengonsumsi makanan dan minuman iritatif sebanyak 47%. Responden yang memiliki kebiasaan mengonsumsi makanan secara tidak teratur sebanyak 46%. Angka kejadian sindrom dispepsia yang didapatkan sebanyak 60%. Berdasarkan hasil uji chi square, tidak terdapat hubungan antara diet iritatif dengan kejadian sindrom dispepsia (p=0,239) dan tidak terdapat hubungan antara ketidakteraturan makan dengan kejadian sindrom dispepsia (p=0,216).Angka kejadian sindrom dispepsia yang didapatkan sebanyak 60%. Tidak terdapat hubungan antara diet iritatif dan ketidakteraturan makan dengan kejadian sindrom dispepsia pada remaja santri Madrasah Aliyah Al-Aziziyah Putri

Efektivitas Edukasi Cuci Tangan Pakai Sabun (CTPS) terhadap Upaya Pencegahan Diare di Kota Mataram Kumarayanti, Ni Komang Dessy; Asmara, I Gede Yasa; Artastra, I Ketut
Jurnal Kedokteran Vol 9 No 2 (2020): Jurnal Kedokteran Vol 9 No 2 2020 (Edisi Juni 2020)
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v9i2.392

Research Background: Diarrhea is an abnormal bowel movement with a liquid consistency and more frequent passage than normal. Diarrhea in Indonesia is still an endemic disease and potential to be an outbreak events which causing death. Diarrhea can be prevented by community-led total sanitation (CLTS) that consist of 5 programs, one of them is hand washing with soap. The purpose of this study was to determine the effectiveness of hand washing with soap education on the changes in knowledge and attitude of respondents to prevent diarrhea. Method:The design of the study was One Group Pre test Ã¢â‚¬â€œ Post test with purposive sampling.The subject of this study were 114 mothers who have children under five year of age at posyandu around Cakranegara Primary Health Care. Result:The result of the study found increasing in percentage of respondent who had high knowledge about 47,37% from 59 respondents (51,75%) before intervention to 113 respondents (99,12%). It was also found an increase in percentage of respondent who have good attitude about 7,9% from 102 respondents (89,47%) before intervention to 111 respondents (97,37%). Conclusion:Hand washing with soap education was effective to improve knowledge and attitude of respondent in order to prevent diarrhea with p < 0,001.

Tatalaksana Farmakologi Hipertensi pada Hiperaldosteronisme Primer Asmara, I Gede Yasa
Cermin Dunia Kedokteran Vol 46, No 7 (2019): CME - Continuing Medical Education
Publisher : PT. Kalbe Farma Tbk.

Hipertensi secara umum menurut etiologinya dibagi menjadi primer dan sekunder. Hiperaldosteronisme primer merupakan salah satu penyebab hipertensi sekunder yang memiliki terapi spesifik dan sangat mungkin disembuhkan. Hiperaldosteronisme primer memiliki efek multiorgan antara lain penurunan sensitivitas insulin pada otot dan jaringan lemak, gangguan fungsi sistolik dan hipertrofi otot jantung, inflamasi ginjal dan aterosklerosis. Diagnosis melalui tiga tahapan yaitu skrining, tes konfirmasi dan analisis subtipe. Tatalaksana meliputi non-farmakologi, medikamentosa dan pembedahan. Obat golongan antagonis mineralokortikoid seperti spirolonakton dan eplerenon merupakan pilihan utama untuk hiperaldosteronisme primer.Based on its etiology, hypertension can be subdivided into primary and secondary. Primary hyperaldosteronism is secondary hypertension with specific treatment and may be curable. The disease is associated with renal, metabolic, brain and cardiovascular complications. Primary hyperaldosteronism affects multi organs such as reduced insulin sensitivity on muscle and adipose tissue, systolic dysfunction, myocardial hypertrophy, inflammation in the kidney and atherosclerosis. Diagnosis of primary hyperaldosteronism consists of three steps i.e. case-finding, a confirmatory test, and subtype evaluation. The management comprises non-pharmacology, medication, and surgery. Mineralocorticoid antagonists such as spironolactone and eplerenone are the drug of choice for primary hyperaldosteronism.

Edukasi Deteksi Dini Stroke Pada Komunitas Diabetes Di Kota Mataram Ilsa Hunaifi; Herpan Syafii Harahap; Joko Anggoro; I Gede Yasa Asmara; Rina Lestari; Dewi Suryani
Jurnal Gema Ngabdi Vol. 1 No. 1 (2019): Jurnal Gema Ngabdi
Publisher : Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jgn.v1i1.10

Stroke remains one of the major causes of death and disability in Indonesia with a mortality and disability rate of 15% and 65%, respectively. Diabetes is known as a modifiable risk fator on stroke. Promptly identifying the symptoms of stroke is crucial as it leads to faster treatment and minimize brain damage. However, most patients are unaware of the early warning signs and symptoms of stroke. Therefore, providing education on early detection of stroke for patients with diabetes is essential as it may improve awareness on early signs of stroke hence allow patients to seek early treatment and later reduce the impact of the disease. The aim of this community education is to increase awareness of stroke and provide information on early signs and prevention of stroke among patients with diabetes.To achieve the aim of this community education include provide a talk/presentation on early sign of stroke and healthy life style for diabetes patient and evaluation of process. Evaluation of the community education was conducted through a pre and posttest to all participant on the related issue. Approximately 18 diabetes patients took part in this community education. The pre-test average score of participants was 73.33%. After providing education on stroke early detection, the participants' average score increased to 86.67 or increased by 18%. Education for early detection of stroke among Diabetes patients increased participants' understanding of the symptoms and early signs of stroke

Pola Penyakit Dan Terapi Dengan Pendekatan Empirik Simptomatik Di Desa Gunung Sari I Gede Yasa Asmara; Basuki Rahmat
Jurnal Gema Ngabdi Vol. 3 No. 3 (2021): JURNAL GEMA NGABDI
Publisher : Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jgn.v3i3.139

The recent global economic crisis has resulted in more expensive health care in which, poor families might not get access to proper health care. Furthermore, global warming and pollution could influence change of disease patterns in the world, includes the tropical island of Lombok. For those two factors, it is interesting to know the disease pattern among poor people and also to give positive contribution for free medical care and treatment to them. A survey of disease patterns and free medical care had been done in Gunung Sari village in August 2015. Patient histories were taken using fundamental four and basic seven techniques whereas physical examinations were done by two registered general practitioners. Soon after working diagnosis is confirmed, empiric antibiotic treatment and symptomatic drugs are prescribed to the patients. As a result, 54% of 136 patients are male and 51,4% of them aged from 16 to 59 years old. Upper respiratory tract infections, diarrhea, and skin problems were the three common diseases. As for the empiric antibiotic treatment, Amoxycillin is the common agent used (34%). Moreover, antipyretic and anti-diarrhoea serve as the common symptomatic treatment used (21,3%). In a summary, the disease pattern and type of treatment given to poor people in Gunung Sari village were the same as that in other areas.

Analysis of the Restriction of Vancomycin Use in Hospitals Before, During and After the Implementation of the Antimicrobial Resistance Control Program (ARCP) Eustachius Hagni Wardoyo; Didit Yudhanto; I Gede Yasa Asmara; Claresta Salsabila; Ajeng Retno
The Indonesian Journal of Infectious Diseases Vol 6, No 2 (2020): The Indonesian Journal of Infectious Disease
Publisher : Rumah Sakit Penyakit Infeksi Prof Dr. Sulianti Saroso

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32667/ijid.v6i2.109

Background: A policy restricting the use of vancomycin was a pilot project for the implementation of the Antimicrobial Resistance Control Program (ARCP) in RSUD Nusa Tenggara Barat in 2018. There were three phases of the ARCP in hospitals, namely preparation, execution, and monitoring. This research aimed to evaluate the quality of vancomycin prescribing before, during, and after the implementation of ARCP in 2017–2019. Method: Descriptive analysis was conducted of all the vancomycin prescriptions before, during, and after the implementation of ARCP in 2018. All medical records of cases requiring vancomycin prescriptions during the research period was evaluated: patient characteristics, culture test results, and clinical diagnoses. The quality of vancomycin prescriptions, which was expressed as follows: “Vancomycin prescriptions are intended only for infections caused by Gram-positive pathogens, particularly Staphylococcus aureus, that are resistant to methicillin (MRSA), Enterococcus sp (Vancomycin-sensitive enterococci)” was evaluated. Results: There were sixty-one cases of vancomycin prescribing; 21 female and 40 male patients, with a mean age of 23 years (0–82 years). Overall, there were 41 positive cultures, 5 negative cultures, and 15 no-cultures. The diagnoses were moderate to severe infections: sepsis, pneumonia, post-surgery infections, CNS infections, low birth weight, septic shocks, and chronic obstructive lung diseases. The urinary tract infection was present as a mild infection. The prescription quality indicators ‘vancomycin is prescribed only for moderate to severe infections’ and ‘prescribed only for Gram-positive pathogens’ altogether increased. Conclusion: There was improvement in the vancomycin prescription quality after the implementation of the vancomycin restriction policy.

HUBUNGAN ADEKUASI HEMODIALISIS DENGAN STATUS GIZI PASIEN PENYAKIT GINJAL KRONIS YANG MENJALANI HEMODIALISIS REGULER Ajeng Sulistianing Utami; I Gede Yasa Asmara; Deasy Irawati
Unram Medical Journal Vol 10 No 3 (2021): Jurnal Kedokteran volume 10 nomor 3 2021
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v10i3.472

Background: The quality of hemodialysis (HD) is one of the predictor factors of mortality and morbidity in patients with CKD 5. Increasing the adequacy of hemodialysis that can be evaluated from dosage’s sufficiency and effectivity, also can reduce the risk of having complications and side effects to certain organs. One of the complications that can be appeared is malnutrition. The aim of this research is to study the correlation between hemodialysis adequacy with CKD stage 5 patient’s nutritional status. Method: This research was held on August until September 2020 in Hemodialysis Unit of RSUD Kota Mataram. The research was a cross-sectional approach. There were 51 sample that are fit the inclusion and exclusion criterias. The data collection was done by recording the patients medical records. HD adequacy was assessed by patient's Kt/V and nutritional status was assessed by BMI parameter and patient's serum albumin level. The correlation test that was used in this research is Spearman correlation test to determine the correlation between variables. Result: In this research, sample’s mean age was 55,1 years old with 51% male and 49% female. The analysis correlation that was determined by using Spearman correlation test showed that, the correlation between HD adequacy and patient’s BMI was p=0.967 and r=0.006 and the correlation between HD adequacy and patient’s serum albumin level was p=0.662 and r=0.063. Conclusion: There was no significant correlation between HD adequacy and patient’s nutritional status. Key Words: Chronic Kidney Disease, Hemodialysis Adequacy, Nutritional Status, Body Mass Index, Serum Albumin Level

Hubungan Lama Menjalani Hemodialisis dengan Status Gizi Pada Pasien Penyakit Ginjal Tahap Akhir yang Menjalani Hemdialisis di RSUD Provinsi NTB Komang Adi Praja Semara Putra; I Gede Yasa Asmara; Rifana Cholidah
Unram Medical Journal Vol 10 No 4 (2021): Jurnal Kedokteran Volume 10 nomor 4 (Desember) 2021
Publisher : Faculty of Medicine Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jku.v10i4.633

Background: Chronic kidney disease is characterized by a decrease in kidney function for at least three months or more, a decrease in kidney function seen from a decrease in GFR < 60 ml/minute/1.73m2. The end stage of chronic kidney disease is known as end stage renal disease. Patients with end-stage renal disease require therapy to replace kidney function, one of the therapies that can be used is hemodialysis. Malnutrition is a condition that is often found in end-stage renal disease patients undergoing hemodialysis. Methods: This research is an observational analytic with a cross-sectional approach. Data were obtained from direct measurements and medical records of end stage kidney disease patients undergoing hemodialysis at the NTB Provincial Hospital with consecutive sampling technique. The analysis was carried out using the SPSS application. Results: In this study, there were 116 data that met the inclusion and exclusion criteria. Based on BMI, 13 of 116 samples were malnourished, 58 of 116 had normal BMI and 45 of 116 were overweight. Based on serum albumin, 33 of 116 had hypoalbuminemia and 83 of 116 had normal serum albumin. Conclusion: There was no relationship between duration of hemodialysis and body mass index of end-stage renal disease patients undergoing hemodialysis (p=1,000). There was a relationship between duration of hemodialysis and serum albumin in end-stage renal disease patients undergoing hemodialysis (p<0.00

Tatalaksana Farmakologi Hipertensi pada Hiperaldosteronisme Primer I Gede Yasa Asmara
Cermin Dunia Kedokteran Vol 46, No 7 (2019): CME - Continuing Medical Education
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i7.459

Hipertensi secara umum menurut etiologinya dibagi menjadi primer dan sekunder. Hiperaldosteronisme primer merupakan salah satu penyebab hipertensi sekunder yang memiliki terapi spesifik dan sangat mungkin disembuhkan. Hiperaldosteronisme primer memiliki efek multiorgan antara lain penurunan sensitivitas insulin pada otot dan jaringan lemak, gangguan fungsi sistolik dan hipertrofi otot jantung, inflamasi ginjal dan aterosklerosis. Diagnosis melalui tiga tahapan yaitu skrining, tes konfirmasi dan analisis subtipe. Tatalaksana meliputi non-farmakologi, medikamentosa dan pembedahan. Obat golongan antagonis mineralokortikoid seperti spirolonakton dan eplerenon merupakan pilihan utama untuk hiperaldosteronisme primer.Based on its etiology, hypertension can be subdivided into primary and secondary. Primary hyperaldosteronism is secondary hypertension with specific treatment and may be curable. The disease is associated with renal, metabolic, brain and cardiovascular complications. Primary hyperaldosteronism affects multi organs such as reduced insulin sensitivity on muscle and adipose tissue, systolic dysfunction, myocardial hypertrophy, inflammation in the kidney and atherosclerosis. Diagnosis of primary hyperaldosteronism consists of three steps i.e. case-finding, a confirmatory test, and subtype evaluation. The management comprises non-pharmacology, medication, and surgery. Mineralocorticoid antagonists such as spironolactone and eplerenone are the drug of choice for primary hyperaldosteronism.

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