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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina journal of internal medicine E-Jurnal Medika Udayana International Journal of Integrated Health Sciences Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Mutiara Medika: Jurnal Kedokteran dan Kesehatan INDONESIAN JOURNAL OF PHARMACY The Indonesian Biomedical Journal Paediatrica Indonesiana JBN (Jurnal Bedah Nasional) Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Patologi Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Ina Kidney Neurologico Spinale Medico Chirurgico Journal of Clinical and Cultural Psychiatry Bioscientia Medicina : Journal of Biomedicine and Translational Research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Eduvest - Journal of Universal Studies IJRETINA - International Journal of Retina Ophthalmologica Indonesiana International Journal of Psychology and Health Science
I Gde Raka Widiana
Departemen Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana, Denpasar, Indonesia
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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The relationship between urine specific gravity, urine pH, and blood uric acid levels to the type of urinary stones of patients with urolithiasis at Sanglah Hospital, Bali, Indonesia Jetty Kalembang; Anak Agung Gde Oka; I Gede Raka Widiana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (308.158 KB) | DOI: 10.15562/ism.v11i2.744

Abstract

Background: Urine specific gravity, urine pH, and blood uric acid levels are risk factors for urinary tract stones. The urinary tract stones are formed due to the concentration of a solute exceeds its ability to remain in solution, resulting in supersaturation and crystallization. This study aims to determine the relationship between urine specific gravity, urine pH, and blood uric acid levels to the urinary stone's types in patients with urolithiasis at Sanglah HospitalMethods: A retrospective cross-sectional study was conducted among 95 subjects by using secondary data from the medical records in the period June 2017-2018 at Sanglah Hospital. The urolithiasis patient who met the inclusion and exclusion criteria were enrolled in this study. Data were analyzed by the Mann-Whitney Test and Kruskal-Wallis Test using SPSS version 17 for Windows.Results: The average age was 55±11 years old. Most of respondents were male (70.5%), normal Body Mass Index (BMI) (89.5%), urine pH <7 (75.7%), and mixed type of urinary stones (48.4%). There was a statistically significant relationship between the type of uric acid stone (p=0.029), blood uric acid levels (p=0.003), phosphate stone type (p=0.026), and magnesium stone (p=0.010) with urine pH. Besides, there was a statistically significant relationship between ammonium stone and blood uric acid levels types (p=0.022). A statistically significant difference was also found between stone types based on urine pH (p=0.013) in multivariate analysis.Conclusion: There is a significant relationship between urine pH and stone type on the incidence of urolithiasis in Sanglah Hospital in June 2017-2018, thereby increasing the incidence of urolithiasis.
Faktor–faktor yang berhubungan dengan batu empedu pada Diabetes Melitus Tipe 2 (DMT2) di RSUP Sanglah, Bali, Indonesia I Dewa Agung Sutanjaya Giri Nugraha; Made Agus Dwianthara Sueta; I Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (330.868 KB) | DOI: 10.15562/ism.v11i3.809

Abstract

Background: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to impaired insulin secretion, insulin action, or both. The purpose of this study was to determine the risk factors for gallstones formation in patients with type 2 diabetes mellitus.Methods: This study was a cross-sectional retrospective study with analytic observational design. The study samples were taken using secondary data. The sample size was determined by consecutive non-probable sampling method. A total of 47 samples were included in this study. Data were analyzed using SPSS version 17 for Windows. Results: Sex (r=0.404; p=0.005), lipid profile (r=0.323; p=0.027), and HbA1c (r=0.431; p=0.002) had a moderate relationship with the incidence of gallstones. In addition, BMI had a strong relationship with the incidence of gallstones (r=0.528; p=0,000). However, the duration of DM (r=0.291; p=0.047) had a weak relationship with the incidence of gallstones. Multivariate results showed that patients with higher BMI were 10.9 times more likely to developed gallstones and it was the most dominant risk factor for gallstones.Conclusion: There were significant relationships between sex, BMI, lipid profile, HbA1c, duration of DM with the occurrence of gallstones. BMI was proved to be a dominant risk factor.  Latar Belakang: DM merupakan kelainan metabolik dengan ciri hiperglikemia akibat gangguan sekresi insulin, kerja insulin, atau keduanya. Tujuan penelitian untuk mengetahui faktor-faktor risiko terjadinya batu empedu pada pasien dengan diabetes melitus tipe 2.Metode: Penelitian ini menggunakan desain observasional analitik cross-sectional retrospektif dimana sampel penelitian diambil menggunakan data sekunder dalam satuan waktu tertentu. Sampel ditentukan secara consecutive non probable sampling yaitu setiap penderita DMT2 yang memiliki rekam medis dalam periode tahun 2018 di RSUP Sanglah pada periode penelitian diambil sebagai sampel. Sebanyak 47 sampel dilibatkan dalam penelitian ini. Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Jenis kelamin (r=0,404; p=0,005), profil lipid (r=0,323; p=0,027), dan HbA1c (r=0,431; p=0,002) memiliki hubungan sedang bermakna dengan kejadian batu empedu. Selain itu, IMT memiliki hubungan yang kuat dengan kejadian batu empedu (r=0,528; p=0,000). Namun lama waktu DM (r=0,291; p=0,047) memiliki hubungan yang lemah dengan kejadian batu empedu. Hasil multivariat menunjukkan bahwa pasien dengan BMI tinggi 10,9 kali lebih mungkin mengembangkan batu empedu dan hal tersebut merupakan faktor risiko paling dominan untuk batu empedu.Kesimpulan: ada hubungan jenis kelamin, IMT, profil lipid, Hba1c, durasi DM dengan terjadinya batu empedu. IMT merupakan faktor risiko dominan.
Rasio Neutrofil-Limfosit (RNL) dan nilai HbA1c sebagai prediktor amputasi pada pasien kaki diabetik di RSUP Sanglah, Bali, Indonesia Nyoman Maharmaya; Ketut Putu Yasa; I Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (434.079 KB) | DOI: 10.15562/ism.v11i3.813

Abstract

Background: Amputation is a management that is needed in cases of diabetic foot but is still challenging to predict. In diabetic foot infections, there can be a disturbance in the balance of inflammatory mediators as a cause of tissue damage. Inflammation is assessed by the Neutrophil Lymphocyte Ratio (NLR), and the HbA1c value is associated with an increased risk of amputation. Wagner's classification describes the extent and weight of diabetic foot ulcers.Methods: This study is a predictive diagnostic test on diabetic foot patients who meet the inclusion criteria. Consecutive sampling was conducted from medical records of Sanglah Hospital Denpasar patients from 2017 to 2019. NLR and HbA1c records were taken from the examination before receiving the medical intervention. An analysis using a 2x2 table is used to determine sensitivity and specificity, and a ROC curve analysis to determine the cut-off point with the best sensitivity and specificity. Data were analyzed using SPSS version 20 for Windows.Results: A total of 82 patients met the inclusion criteria with an average age of 57 (46-69) years. There was 43 (52.4%) male and 39 (47.6%) females enrolled in this study. Most diabetic foot samples with Wagner III degree 35 (42.7%) and Wagner IV 34 (41.5%). A total of 31 (37.8%) patients underwent amputation. The ROC analysis showed an NLR cut-off point of 13.67 (AUC=0.617; p=0.078) with a sensitivity of 54.8% and specificity of 66.7%. ROC HbA1c analysis showed a cut-off point of 9.5% (AUC=0.455) with a sensitivity of 45.2% and specificity of 47.1%. Secondary data and operating reliability are limitations in this study, and it makes a lower sensitivity.Conclusion: The results of this study indicate that the Neutrophil-Lymphocyte Ratio (RNL) and the HbA1c value can be used as predictors of amputation in diabetic foot patients at Sanglah General Hospital, Bali, Indonesia.  Latar Belakang: Amputasi merupakan penatalaksanaan yang diperlukan pada kasus kaki diabetik, namun masih sulit untuk diprediksi. Pada infeksi kaki diabetik dapat terjadi gangguan keseimbangan mediator inflamasi sebagai penyebab kerusakan jaringan. Inflamasi dinilai dari Rasio Neutrofil Limfosit (RNL) dan nilai HbA1c dihubungkan dengan meningkatnya resiko amputasi. Klasifikasi Wagner menggambarkan derajat luas dan berat ulkus kaki diabetik.Metode: Penelitian ini adalah uji diagnostik prediktif pada pasien kaki diabetik yang memenuhi kriteria inklusi. Pengambilan sampel dari rekam medis pasien RSUP Sanglah Denpasar secara konsekutif dari tahun 2017 sampai 2019. Pencatatan NLR dan HbA1c diambil dari pemeriksaan sebelum mendapatkan intervensi medis. Kemudian dilakukan analisa menggunakan tabel 2x2 untuk menentukan sensitivitas dan spesifisitas, serta analisa kurva ROC untuk menentukan cut-off point dengan sensitivitas dan spesifisitas terbaik. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Sebanyak 82 pasien memenuhi kriteria inklusi dengan rata-rata umur 57 (46-69) tahun. Terdapat 43 (52,4%) laki-laki dan 39 (47,6%) perempuan dalam penelitian ini. Sebagian besar sampel kaki diabetik dengan derajat wagner III 35 (42,7%) dan wagner IV 34 (41,5%). Sebanyak 31 (37,8%) pasien menjalani amputasi. Dari analisa ROC menunjukkan cut-off point RNL sebesar 13,67 (AUC=0,617; p=0,078) dengan sensitivitas 54,8% dan spesifisitas 66,7%. Analisa ROC HbA1c menunjukkan cut-off point sebesar 9,5% (AUC=0,455) dengan sensitivitas 45,2% dan spesifisitas 47,1%. Data sekunder dan reliabilitas operasi menjadi keterbatasan dalam penelitian ini, sehingga sensitivitasnya rendahKesimpulan: Hasil penelitian ini menunjukkan bahwa Rasio Neutrofil-Limfosit (RNL) dan nilai HbA1c dapat dipergunakan sebagai prediktor amputasi pada pasien kaki diabetik di RSUP Sanglah, Bali, Indonesia
Hubungan antara Platelet Lymphocyte Ratio (PLR) dan Neutrofil Lymphocyte Ratio (NLR) dengan amputasi pasca intervensi endovaskular pada pasien Peripheral Artery Disease (PAD) Rutherford 2–4 di RSUP Sanglah, Bali, Indonesia Ade Sinyo Aristantrisna; Ketut Putu Yasa; I Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (469.295 KB) | DOI: 10.15562/ism.v11i3.819

Abstract

Background: Endovascular intervention is an effort to reduce amputation number in Peripheral Artery Disease (PAD) patients. The latest studies show a correlation between platelet lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) to the prognosis of PAD. This study aims to evaluate if PLR and NLR can be used to determine the prognosis of PAD patients.Methods: An observational analytic study using a cross sectional approach has been conducted among 56 patients with PAD. The research was conducted in Sanglah Hospital Medical Report room Denpasar, using a patient medical report from January 2014 to December 2018. Variables assessed in this study include NLR, PLR, and ROC analysis to determine the cut-off point used in this study. Data were analyzed using SPSS version 23 for Windows.Results: The ROC analysis results showed that the cut-off point value of 140.5 on the PLR based on the Youden Index had a significant sensitivity level of 75% and a specificity of 64.3% (AUC = 0.739; p = 0.02). While the cut point was 3.14 for the NLR, which had a sensitivity level of 82% and a specificity of 75% (AUC = 0.844; p <0.001). PLR values ? 140.5 had a significant 2.4 times chance of occurrence of amputation after endovascular intervention compared to patients who had PLR values <140.5 (p <0.001; 95% CI = 1.233-4.746). Patients with an NLR ? 3.14 had a 3.9 times chance of having an amputation after the endovascular intervention than patients who had an NLR <3.14 (p <0.001; 95% CI = 1.770 -8.981).Conclusion: High PLR and NLR are associated with the risk of amputation after endovascular intervention in PAD Rutherford 2–4.  Latar Belakang: Salah satu usaha mengurangi angka amputasi pada pasien Periheral Artery Diseasse (PAD) adalah dengan intervensi endovascular. Beberapa studi terbaru menunjukkan adanya hubungan antara Platelet Lymphocyte Ratio (PLR) dan Neutrophil Lymphocyte Ratio (NLR) terhadap prognosis PAD. Penelitian ini bertujuan untuk mengetahui apakah PLR dan NLR dapat dipergunakan untuk menentukan prognosis pasien PAD.Metode: Penelitian observasional analitik dengan pendekatan potong-lintang dilakukan terhadap 56 pasien dengan GAD. Tempat penelitian dilakukan di rekam medik RSUP Sanglah Denpasar. Pengambilan data penelitian adalah rekam medis Januari tahun 2014 sampai dengan Desember 2018. Variabel yang dinilai pada penelitian ini meliputi NLR, PLR, dan analisis ROC untuk menentukan titik potong (cut-off) yang dipergunakan pada penelitian ini. Data dianalisis dengan SPSS versi 23 untuk Windows.Hasil: Hasil analisis ROC menunjukkan bahwa nilai titik potong 140,5 pada PLR berdasarkan Youden Indeks yang memiliki tingkat sensitivitas 75% dan spesifitas 64,3% secara bermakna (AUC=0,739; p=0,02). Sedangkan titik potong 3,14 pada NLR yang memiliki tingkat sensitivitas 82% dan spesifitas 75% (AUC=0,844; p<0,001). Nilai PLR ? 140,5 memiliki peluang 2,4 kali secara bermakna untuk terjadi amputasi pasca intervensi endovaskular dibandingkan dengan pasien yang memiliki nilai PLR < 140,5 (p<0,001; 95% IK=1,233-4,746). Pasien dengan NLR ? 3,14 memiliki  peluang 3,9 kali untuk  terjadi amputasi pasca intervensi endovaskular dibandingkan dengan pasien yang memiliki NLR  <3,14 (p < 0,001; 95% IK=1,770 -8,981).Kesimpulan: PLR dan NLR yang tinggi meningkatkan resiko amputasi pada pasien PAD Rutherford 2-4 yang sudah mendapatkan terapi intervensi endovascular
Hubungan antara densitas mikrovaskular dan limfoplasmasitik dengan metastasis kelenjar getah bening inguinal pada pasien karsinoma penis di RSUP Sanglah, Bali, Indonesia Silvester Kristian Taopan; Anak Agung Gde Oka; I Gde Raka Widiana; I Wayan Juli Sumadi
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (339.797 KB) | DOI: 10.15562/ism.v12i1.940

Abstract

Background: Carcinoma is the most common malignancy that occurs in penile tissue. Most of the metastasis of penile carcinoma is lymphogenic to the nearest lymph node. Metastasis is a significant prognosis factor in reflecting the outcome of penile carcinoma patients. To begin a process of metastasis requires the formation of new blood vessels (angiogenesis) and infiltration of mononuclear cells. Both of these can be assessed through micro vessel density and lymphoplasmacytic. This study aims to determine the relationship between microvascular and lymphoplasmic density with inguinal lymph node metastases in penile carcinoma patients at Sanglah General Hospital, Bali, Indonesia.Methods: This research is an analytic cross-sectional study. Data collection was carried out from the patient's Medical Record during January 2014 - December 2018. From 40 samples of penectomy surgery the micro vessel Density and lymphoplasmacytic readings were first stained with staining of hematoxylin eosin by anatomic pathologist. Cut-off point microvessel density and lymphoplasmacytic is taken by calculating the mean and standard deviation. Bivariate analysis with Chi Square Test and multivariate analysis using logistic regression tests were used for statistical analysis. Data were analyzed using SPSS version 20 for Windows.Results: From the Bivariate Analysis it was found that there was a significant relationship between Micro-vessel Density and Metastasis to the inguinal lymph node (P=0.019) and there was a significant relationship between lymphoplasmacytic and metastasis to the inguinal lymph node (P=0.005). The Multivariate Analysis confirms that microvessel density, lymphoplasmacytic and history of phimosis are significantly related to the occurrence of metastasis to inguinal lymph node in penile carcinoma patients (p=0.040).Conclusion: There were significant relationships between Micro vessel Density and Lymphoplasmacytic density with metastasis to inguinal lymph nodes in patients with penile SCC. A history of phimosis was proved to be a dominant risk factor.  Latar Belakang: Karsinoma merupakan keganasan tersering yang terjadi pada jaringan penis. Sebagian besar metastasis karsinoma penis bersifat limfogen menuju Kelenjar Getah Bening (KGB) terdekat. Untuk memulai suatu proses metastasis diperlukan pembentukan pembuluh darah baru (angiogenesis) dan infiltrasi sel mononuklear. Kedua hal tersebut bisa dinilai melalui densitas mikrovaskuler dan limfoplasmositik. Penelitian ini bertujuan untuk mengetahui hubungan antara densitas mikrovaskular dan limfoplasmositik dengan metastasis kelenjar getah bening inguinal pada pasien karsinoma penis   di RSUP Sanglah, Bali, Indonesia  Metode: Penelitian ini merupakan penelitian potong lintang analitik. Pengambilan data dilaksanakan dari Rekam Medis pasien selama Januari 2014 – Desember 2018. Dari 40 sampel Operasi Penektomi dilakukan pembacaan densitas mikrovaskuler dan limfoplasmositik yang telah lebih dulu diberikan pewarnaan Hematoxylin Eosin oleh ahli patologi anatomi. Titik potong densitas mikrovaskuler dan limfoplasmositik diambil dengan cara menghitung rerata dan standar deviasi. Analisis bivariat dengan Uji Chi-Square dan analisis multivariat dengan menggunakan uji regresi logistik digunakan untuk analisis statistik. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Analisis bivariat didapatkan hubungan yang bermakna antara Densitas Mikrovaskuler dengan metastasis ke KGB Inguinal (p=0,019) dan terdapat hubungan yang bermakna antara limfoplasmositik dengan metastasis ke KGB inguinal (p=0,005). Analisis multivariat menegaskan bahwa densitas mikrovaskuler, limfoplasmositik dan riwayat fimosis berhubungan secara bermakna dengan terjadinya metastasis ke KGB Inguinal pada pasien karsinoma penis (p=0,040).Simpulan: Adanya hubungan antara Densitas Mikrovaskular dan Limfoplasmositik dengan metastasis ke KGB inguinal pada pasien dengan KSS penis. Riwayat fimosis merupakan faktor resiko dominan.
The effect of Modified Radical Mastectomy (MRM) with and without latissimus dorsi flap on seroma of Locally Advanced Breast Cancer (LABC) in Sanglah Hospital Anak Agung Chris Tedy Pramana; I Ketut Widiana; I Gde Raka Widiana
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (253.975 KB) | DOI: 10.15562/ism.v12i2.1059

Abstract

Background: Locally Advanced Breast Cancer (LABC) is defined as breast cancer spread locoregionally and without any signs of metastasis. Stage IIIA breast cancer is one type of LABC that can be removed surgically, and Modified Radical Mastectomy (MRM) remains the first surgical option. Seroma production is one of the most common complications post MRM, with the hypothesis stating that the Latissimus Dorsi (LD) flap technique is responsible for resulting in higher seroma output. This study aims to compare seroma production in LABC patients post MRM with and without LD flap.Methods: This prospective cohort study was conducted in Sanglah General Hospital, Denpasar, between November 2018 and January 2020. The study sample was divided into 2 groups: LABC patients post MRM with and without LD flap reconstruction. Seroma was measured in milliliters (ml) and collected from the first to fifth day post-operation. Data were analyzed using SPSS version 21 for Windows.Results: Forty LABC patients were enrolled in this study. The mean age for the group without latissimus dorsi flap was 48.45±7.01 years and 49.40±10.77 years for the group with latissimus dorsi flap. The mean seroma production in LABC patients who underwent MRM without and with LD flap reconstruction was 696.45±66.37 ml and 490.10±62.11 ml. There was a significant difference in the total of seroma between the treatment group without-LD flap and compared to with-LD flap reconstruction (p<0.001).Conclusion: Seroma production is significantly higher in LABC patients post MRM without LD flap reconstruction than LABC patients with LD flap.
Efek ekstrak sambiloto (Andrographis paniculata) terhadap ekspresi matrix metalloproteinase-1 dan hipertrofi jantung pada mencit yang terpapar asap rokok I Made Agus Endra Permana; I Nyoman Wiryawan; Wayan Aryadana; I Gde Raka Widiana; I Gusti Kamasan Nyoman Arijana; I Made Satria Yudha Dewangga
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (566.204 KB) | DOI: 10.15562/ism.v12i2.1090

Abstract

Introduction: Sambiloto (Andrographis paniculata) is a plant that is often used in traditional medicine and is known to have antioxidant, anti-inflammatory and cardiovascular effects. There are many studies of sambiloto on inflammatory markers, but there is no study on the effect of sambiloto on MMP-1 expression. The purpose of this study was to determine the effect of sambiloto on MMP-1 expression and cardiac hypertrophy in mice exposed to cigarette smoke.Methods: This research is an experimental analytic study with a randomized post test only control group design. Thirty-two healthy male Swiss Webster mice aged 8-10 weeks weighing 20-30 grams were divided into 4 groups, namely: control group (standard feed + exposure to cigarette smoke), P1 (standard feed + exposure to cigarette smoke + sambiloto extract 18 mg/ kg BW), P2 (standard feed + exposure to cigarette smoke + sambiloto extract 29 mg/kg BW), P3 (standard feed + exposure to cigarette smoke + sambiloto extract 40 mg/kg BW). All groups were followed for 60 days.Results: There was a significant difference in MMP-1 expression between the control group and all treatment groups. There were significant differences in MMP-1 expression between groups P1 and P2, and between P1 and P3 groups. There was a significant difference in heart weight/weight ratio between the control group and all treatment groups. There was a significant difference in the heart weight/body weight ratio between the P1 and P3 groups.Conclusion: The administration of sambiloto extract decreased the expression of MMP-1 with a tendency for its effect to increase with increasing dose and the optimal dose was found in the sambiloto extract 29 mg/kg BW. The difference in the effect of sambiloto extract on cardiac hypertrophy only appeared after the dose was increased to 40 mg/kg BW Latar Belakang: Sambiloto (Andrographis paniculata) merupakan tanaman yang sering dipakai dalam pengobatan tradisional dan diketahui mempunyai efek antioksidan, anti inflamasi dan efek pada sistem kardiovaskular. Terdapat banyak penelitian sambiloto terhadap marker inflamasi, tetapi belum ada penelitian tentang efek ekstrak sambiloto terhadap ekspresi MMP-1. Tujuan dari penelitian ini untuk mengetahui efek ekstrak sambiloto terhadap ekspresi MMP-1 dan hipertrofi jantung pada mencit yang terpapar asap rokok.Metode: Penelitian ini adalah penelitian analitik eksperimental dengan rancangan randomized post test only control group design. Tiga puluh dua mencit Swiss Webster jantan sehat berumur 8-10 minggu dengan berat 20-30 gram dibagi menjadi 4 kelompok yaitu: kelompok kontrol (pakan standar + paparan asap rokok), P1 (pakan standar + paparan asap rokok + ekstrak sambiloto 18 mg/kg BB), P2 (pakan standar + paparan asap rokok + ekstrak sambiloto 29 mg/kg BB), P3 (pakan standar + paparan asap rokok + ekstrak sambiloto 40 mg/kg BB). Semua kelompok diikuti selama 60 hari.Hasil: Terdapat perbedaan signifikan ekspresi MMP-1 antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat perbedaan signifikan ekspresi MMP-1 antara kelompok P1 dengan P2, dan antara P1 dengan P3. Terdapat perbedaan signifikan rasio berat jantung/berat badan antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat perbedaan signifikan rasio berat jantung/berat badan antara kelompok P1 dengan P3. Simpulan: Pemberian ekstrak sambiloto menurunkan ekspresi MMP-1 dengan kecenderungan efeknya meningkat dengan peningkatan dosis dan dosis optimal terdapat pada ekstrak sambiloto 29 mg/kg BB. Perbedaan efek ekstrak sambiloto terhadap hipertrofi jantung baru muncul setelah dosis ditingkatkan menjadi 40 mg/kg BB.  
Efek ekstrak sambiloto (Andrographis paniculata) terhadap ekspresi vascular cell adhesion molecule-1 (VCAM-1) dan intimal media thickness (IMT) pada mencit yang terpapar asap rokok I Made Adi Satria Darma; Wayan Aryadana; I Nyoman Wiryawan; I Gede Raka Widiana; I Gusti Nyoman Kamasan Arijana; Made Satria Yudha Dewangga
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (943.858 KB) | DOI: 10.15562/ism.v12i3.1175

Abstract

Introduction: Sambiloto (Andrographis paniculata) is a plant that spread almost throughout the Indonesian archipelago and has been used for a long time as traditional medicine. Several previous literatures reported that sambiloto has anti-inflammatory and antioxidant effects, so its use is useful in cardiovascular disease, especially in reducing the process of atherosclerosis. The purpose of this study was to determine the effect of giving sambiloto extract on markers of inflammation and atherosclerosis in the form of VCAM-1 expression and IMT in mice exposed to cigarette smoke.Methods: This study used an experimental analytical method with a post-test-only group design. Using 32 healthy adult male mice weighing 20-30 grams were divided into four treatment groups, namely: control group (P0) only given exposure to cigarette smoke and treatment group 1 (P1), 2 (P2), and 3 (P3) given exposure cigarettes and sambiloto extract with doses of 18, 29, and 40 mg/kg/day. Exposure is given for 60 days, then the VCAM-1 expression and IMT in the aortic arch were examined histologically.Results: There were significant differences in VCAM-1 expression and IMT between the control group and all treatment groups. There was a significant decrease in VCAM-1 expression between P1 and P2 and P2 and P3. There was a significant decrease in IMT between P1 and P2 and P2 and P3.Conclusion: Sambiloto extract has effect in decreasing VCAM-1 expression and IMT. That effect strengthens with increasing dose. The maximum effect is obtained with the use of a dose of 40 mg/kg/day. Latar Belakang: Sambiloto (Andrographis paniculata) merupakan tanaman yang tersebar hampir di seluruh nusantara dan telah digunakan sejak lama oleh masyarakat Indonesia sebagai obat tradisional. Dari beberapa literatur sebelumnya melaporkan sambiloto memiliki efek antiinflamasi dan antioksidan sehingga bermaafaat dalam bidang penyakit kardiovaskular terutama mengurangi proses aterosklerosis. Tujuan dari penelitian ini untuk mengetahui efek pemberian ekstrak sambiloto terhadap petanda inflamasi dan atherosklerosis berupa ekspresi VCAM-1 dan IMT pada mencit yang terpapar asap rokok.    Metode: Penelitian ini menggunakan metode analitik eksperimental dengan rancangan post test only group design. Menggunakan 32 ekor mencit jantan dewasa kondisi sehat dengan berat 20-30 gram dibagi menjadi empat kelompok perlakuan yaitu kelompok kontrol (P0) hanya diberikan paparan asap rokok dan kelompok perlakuan 1 (P1), 2 (P2), dan 3 (P3) diberikan paparan rokok sigaret dan ekstrak sambiloto dengan dosis 18, 29, dan 40 mg/kg/hari. Paparan diberikan selama 60 hari, kemudian dilakukan pemeriksaan histologi ekspresi VCAM-1 dan IMT pada arkus aorta mencit.Hasil: Terdapat perbedaan yang bermakna ekspresi VCAM-1 dan IMT antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat penurunan bermakna ekspresi VCAM-1 antara P1 dengan P2 dan P2 dengan P3. Terdapat penurunan bermakna tebal IMT antara P1 dengan P2 dan P2 dengan P3.Simpulan: Ekstrak sambiloto memiliki efek menurunkan ekspresi VCAM-1 dan tebal IMT. Efek tersebut meningkat dengan peningkatan dosis. Efek maksimal diperoleh dengan penggunaan dosis 40 mg/kg/hari.
Korelasi nilai Homeostasis Model Assesment for Insulin Resistance (HOMA-IR) dan kadar vitamin D pada remaja dengan obesitas di Kota Denpasar, Bali, Indonesia Luh Gede Yuliadewi NS; I Made Arimbawa; Ketut Suarta; I Gde Raka Widiana; Made Kardana; Ni Putu Veny Kartika Yantie; Komang Ayu Witarini
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.024 KB) | DOI: 10.15562/ism.v12i3.1193

Abstract

Background: Obesity during adolescence can developed into obesity in adulthood and will increase the risk of metabolic dissease sush as insulin resistance. Recent years the role of vitamin D begin to be connection with insulin resistance. Vitamin D plays a role in regulation of synthesis dan insulin secretions from pancreatic beta cells, increase peripheral and hepatic glucose uptake. In obesity there is decrease in vitamin D bioavailability that causes low levels of vitamin D. This study aimed to proves a correlation between insulin resistance and vitamin D levels in adolescents with obesity.Methods: A observational analytic research with crossestional design has been done in junior and senior high school in Denpasar. Adolescennts performed anthropometric screening covers weight, height, body mass index (BMI), obesity if BMI  > 95th percentile of CDC 2000 curve. Examined vitamin D levels and insulin resistance through calculation of HOMA-IR levels. Sample size calculation with ? 0,05, correlation coefficient (r) set to 0,5 with minimum sampel size 50. Data were analyzed using SPSS versin 17 for Windows.Results: Anthropometric screening performed obtained 135 students (3,3%) with obesity. Mean of vitamin D levels was 18,9 ng/mL, 10 (20 %) classified as vitamin D insufficiency and 39 (78 %) vitamin D deficiencies. The average of HOMA-IR levels 3,84, 24 (48 %) with insulin resistance based on HOMA-IR levels. Correlation coefficient between HOMA-IR levels and vitamin D was obtained – 0,37 (p=0,007). There was significant difference of prevalence of insulin resistance between obese adolescent with vitamin D deficiency compared with insuficiency and suficiency group (OR=5.8; 95%CI=1.1-30.6; p=0.025).Conclusion: This study concluded that There is a moderate negative correlation between HOMA-IR levels and vitamin D in obese adolescents. Latar Belakang: Obesitas pada masa remaja berisiko menjadi obesitas pada masa dewasa dan meningkatkan risiko penyakit metabolik seperti resistensi insulin. Beberapa tahun terakhir peran vitamin D mulai dihubungkan dengan resistensi insulin. Vitamin D berperan dalam regulasi sintesis dan sekresi insulin oleh sel beta pankreas, meningkatkan uptake glukosa perifer dan hepatik. Pada obesitas terjadi penurunan bioavaibilitas vitamin D yang menyebabkan rendahnya kadar vitamin D. Penelitian ini bertujuan untuk membuktikan adanya korelasi antara kadar vitamin D dengan resistensi insulin pada remaja dengan obesitas.Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang pada remaja SMP dan SMA di kota Denpasar. Remaja dilakukan skrining antropometri meliputi berat badan, tinggi badan, Indeks Masa Tubuh (IMT). Diagnosis obesitas jika IMT > persentil 95 kurva CDC 2000. Dilakukan pemeriksaan kadar vitamin D darah dan resistensi insulin melalui perhitungan kadar HOMA-IR. Perhitungan besar sampel dengan ? 0,05 ( tingkat kemaknaan 0,95), koefesien korelasi (r) ditetapkan 0,5 dengan jumlah sampel minimal 50. Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Skrining antropometri dilakukan pada 135 subyek (3,3%) dengan obesitas. Rerata kadar vitamin D 18,9 ng/mL, dimana 10 ( 20 %) tergolong insufiseiensi vitamin D dan 39 (79%) defisiensi vitamin D. Rerata kadar HOMA-IR 3,84, 24 (48 %) mengalami resistensi insulin berdasarkan kadar HOMA-IR. Besar koefesien korelasi antara kadar HOMA-IR dan kadar vitamin D didapatkan – 0,37 (nilai p 0,007). Terdapat perbedaan bermakna kejadian resistensi insulin antara kelompok remaja obesitas dengan status defisiensi vitamin D dan kelompok dengan status vitamin D pada kelompok sufisien dan insufisien (OR=5,8; 95%IK=1,1-30,6; p=0,025).Kesimpulan: Penelitian ini menyimpulkan terdapat korelasi negatif sedang antara kadar HOMA-IR dan kadar vitamin D pada remaja dengan obesitas.
Anemia on Chronic Kidney Disease: The Role of Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitors Ni Wayan Anantika Riani; I Gde Raka Widiana
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1545

Abstract

Anemia is one of the homeostatic abnormalities caused by chronic kidney disease and also frequently problem encountered in end-stage renal disease patients, regardless of the hemodialysis treatment. Anemia in chronic kidney disease significantly impairs kidney function, increases morbidity and mortality risk, and deteriorates the quality of life. Chronic kidney disease’s patients with anemia conditions are affected by numerous factors, including decreased production of endogenous erythropoietin, functional and absolute iron deficiency, and elevated hepcidin levels due to inflammation, particularly in hemodialysis patients. Treatment options for anemia in chronic kidney disease include exogenous erythropoietin and iron supplementation. A new mechanism known as the "hypoxia-sensing system" termed a mediator of erythropoietin synthesis, has been proposed to boost endogenous erythropoietin synthesis. The hypoxia-inducible factor activates specific gene expression and contributes to a physiological response to lower tissue oxygen levels. Chronic kidney disease’s patients who are contraindicated or are hyporesponsive to therapy with erythropoiesis-stimulating drugs may utilize this mechanism as an alternative.
Co-Authors A. A. G. Oka, A. A. G. Ade Sinyo Aristantrisna Adnyani, Ni Made Dwi Agrasidi, Putu Anindya Ake, Anselmus Anak Agung Chris Tedy Pramana Anak Agung Gde Oka Anak Agung Wiradewi Lestari and N. Sutarka Anwar Santoso Ari Andayani Arlene Elizabeth Padang Aslesa Wangpathi Pagehgiri Ayu, Nyoman Paramita Bagus Ngurah Putu Arhana Bambang Purwanto Barimbing, Morris Lintong Budi Suprapti Christopher Ryalino Cokorda Bagus Jaya Lesmana Dedi Silakarma Desak Putu Puteri Diah Rahtini Desy Permatasari Dewa Nyoman Putra Adiwinata Dewi Catur Wulandari Dharmi Lestari, Ni Putu Djodi Sidartha E. Elyshanti Elizabeth Haryanti Elysanti Dwi Martadiani Erawan, I Gusti Ngurah Agung Tresna Feliciano Pinto, Feliciano Firman Parulian Sitanggang Firman Sitanggang Gede Andi Aditya Gede Sukma Pranata Darma Gede Wira Mahadita Gede Wirya Kusuma Duarsa Handayani, Putu Novi Hendra Koncoro Hendra S Hendra Salim Hizkia Robinson Junsen Lumban Gaol I Dewa Agung Sutanjaya Giri Nugraha I Dewa Nyoman Wibawa I G. N. Anom-Supradnya I G. N. M. Sugiana I Gede Aditya Krishna Santhi I Gede Hendra Sucipta I Gusti Agung Trisna Windiani I Gusti Ayu Made Juliari I Gusti Kamasan Arijana I Gusti Ngurah Ketut Budiarsa I Gusti Ngurah Made Suwarba I Gusti Rai Putra Wiguna I K. Sudartana I Kadek Agus Setiawan I Ketut Suwiyoga I Ketut Wiargitha I Ketut Widiana I Made Adi Satria Darma I Made Agus Endra Permana I Made Arimbawa I Made Ayusta I Made Gede Widnyana I Made Kardana I Nengah Wiadnyana Steven Christian I Nyoman Adi Putra I Nyoman Semadi I Nyoman Wiryawan I Putu Budhiastra, I Putu I Putu Gede Budiana, I Putu Gede I Putu Gede Eka Ariawan Suyasa, I Putu Gede Eka Ariawan I Wayan Eka Sutyawan I Wayan Gede Jayanegara I Wayan Juli Sumadi I Wayan Putu Sutirta Yasa I Wayan Sudhana I Wayan Wita I Wayan Yudiana IBN Mahendra Ida Bagus Gede Suparyatha Ida Bagus Putra Pramana Ida Safitri IKG Suandi Imam Effendi Indira Prawita Martani Inez Kartika Jetty Kalembang Jod Loekman Jodhi S Loekman Jodi Sidharta Loekman Jodi SL Juliari, I Gusti Ayu Made Juliari, IGAM K Suwitra K. Suwitra Kadek Budi Santosa Ketu Suwitra Ketut Mulyadi Ketut Putu Yasa Ketut Rina, Ketut Ketut Suarta Ketut Suega Ketut Suwitra Ketut Tuti Parwati Merati Komang Ayu Witarini Kristianto, Bobby Kumbara, Cokorde Istri Yuliandari Krisnawardani Luh Gede Yuliadewi NS Luh Yeni Laksmi Luh Yeni Laksmini Made Agus Dwianthara Sueta Made Agus Kusumadjaja Made Asih MADE RATNA SARASWATI . Made Satria Yudha Dewangga Made Widhi Asih Mahadita, Gede Wira Mahardani, Putu Nandika Tungga Yudanti Mahautama, I Gusti Agung Putra Maria, Dessy Marleen MOCHAMMAD THAHA Moestikaningsih ** Moestikaningsih . Monica Sampurna Ngakan Gede Dwija Hermawan Ni Ketut Putri Ariani Ni Kompyang Rahayu Ni Made Amelia R. Dewi Ni Made Ari Suryathi Ni Made Dharma Laksmi Ni Made Putri Suastari Ni Nyoman Margiani Ni Putu Sriwidyani Ni Wayan Anantika Riani Ni Wayan Winarti Noviantari, I Gusti Agung Ratna NP Veny Kartika Yantie Nyoman Maharmaya Nyoman Paramita Ayu Nyoman Srie Laksminingsih Nyoman Sutarka, Nyoman Oka Udrayana Ommy Agustriadi Pande Made Wisnu Tirtayasa Pande Putu Yuli Anandasari Pantjawati, Ni Luh Diah Patriawan, Putu Paulus Wiyono Pemayun, Cok Istri Dewiyani PITIKA ASPR Poerwono Rahardjo Pradnyana DS, Bagus Ari Prayuda, Prayuda Purnama Purnama Putra, I Made Rama Putrawati Triningrat, Anak Agung Mas Putu Astri Novianti Putu Ayu Saraswati Putu Junara Putra Putu Yuliawati Raka-Sudewi A. A. Reny Setya Pratiwi Duarsa Rully Roesli Sanyoto, Arundina Satrio Ryandi Semadhi, Putu Gitanjani Mahadewi Setiawan, I Gede Budhi Sianny Herawati Silvester Kristian Taopan Siska Sitanggang, Firman Parulian Soetjiningsih Soetjiningsih Sudaryat S Sudjana, Karismayusa Sukartini Djelantik, Anak Agung Ayu Sukmawati, Nurindah Sutyawan, I Wayan Eka Tianing - Trianto Trianto Triningrat, A.A. Mas Putrawati W Sudhana W. G. Jayanegara Wahyuningrum, Stefany Adi Wayan Aryadana Wayan Aryadana Wayan Sudana Wayan Sudhan Wayan Sudhana Wiradharma, Ketut Gede Y. Saskia-Javi Yenny Kandarini Yoga Putra Yuliawati, Putu Yuriawantini - Zulfariska, Nony