I Nyoman Wande
Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

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KADAR IL-6 PLASMA PASIEN DIABETES MELITUS DENGAN DAN TANPA PENGIDAP RETINOPATI DIABETIKA (The Level of Interleukin-6 Plasma in Diabetes Mellitus Patients With and Without Diabetic Retinopathy) I Wayan Putu Sutirta Yasa; I Nyoman Wande; Ni Ketut Niti Susila; Putu Budhiastra; Cokorda Istri Dewiyani Pemayun; Sianny Herawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1249

Abstract

Diabetic retinopathy is a complication of diabetes mellitus in the form of microvascular (aneurysma) which can cause blindness.Interleukin-6 is a pro - inflammatory cytokine produced by monocyte macrophage in the early inflammation. Chronic inflammationplays the role on artherosclerosis event, because it is directly correlated with all phases of it and cardiovascular disease as well. Theaim of this study is to know the difference in plasma IL-6 levels among patients suffering from diabetes mellitus together with diabeticretinopathy and without diabetic retinopathy. This study is an observational analytical research with cross sectional design. The sampleswere taken randomly as many as 16 patients, divided in each group suffering from or without retinopathy. The diabetic mellitus patientswere established through their related history and were examined randomly for blood glucose and their fundus or retinal abnormality.The level of IL-6 was examined by ELISA method with double antibody sandwich streptavidin - biotin. Based on this study it was foundthat the mean plasma levels of interleukin 6 (IL-6) of the diabetic mellitus patients with retinopathy was 1.165 ± 0.296 pg/mL andthe mean plasma levels of IL-6 with diabetes mellitus without retinopathy was 0.879 ± 0.230 pg/mL. Based on the normality test withShapiro-Wilk the data showed a normal distribution (p>0.05), while the Levene’s homogenity test obtained homogeneous with p= 0.369(p>0,05). The statistical analysis with two independent samples t-test showed that there were significant differences between the groupsof patients who suffered diabetes mellitus with retinopathy and without retinopathy (p=0.005). It can be concluded so far that the meanlevels of interleukin-6 (IL-6) plasma in diabetic mellitus patients with retinopathy is higher compared to patients with the same diseasebut without retinopathy.
NEOPTERIN DAN PEROKSIDA SERUM SEBAGAI PETANDA MAKROFAG TERAKTIVASI PADA TUBERKULOSIS PARU AKTIF DAN INDIVIDU BERKEBAHAYAAN TINGGI (Serum Neopterin and Peroxide As Marker of Activated Macrophages on Active Pulmonary Tuberculosis and Individuals At High Risk) I Nyoman Wande; Ni Made Linawati; I Made Bagiada; IWP. Sutirta Yasa; AAN. Subawa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1227

Abstract

Failure of macrophages to phagocytize Mycobacterium tuberculosis causes the release of hydrogen peroxide/peroxide (H2O2) bythe activated macrophages. Neopterin is one of the most important markers in the activated macrophages. Neopterin is a pteridinederivative produced by the activated macrophages through the stimulation of interferon gamma. Increased levels of Neopterin has beenreported in lung tuberculosis. Activation of macrophages is essential to the development of tuberculosis infection that can lead to activepulmonary tuberculosis or latent tuberculosis, in this case is a high-risk for healthy individuals. To determine the differences in serumlevels of Neopterin and H2O2 between patients with active pulmonary tuberculosis and healthy individuals at high risk of pulmonarytuberculosis. A total of 15 patients with active pulmonary tuberculosis and 15 healthy individuals at high risk examination serumNeopterin levels and peroxide (H2O2). Active pulmonary tuberculosis patients when the results of sputum smear examination chest x-raysis obtained positive results. Healthy individuals at high risk when the results of smear examination and chest x-rays is negative. Thelevel of Neopterin was examined using a double antibody sandwich immunoassay with Human neopterin (NEOP) ELISA Kit ® BioassayTechnology Laboratory. The level of peroxide was examined using quantitative colorimetric peroxidedetermination with QuantiChromTMPeroxide Assay Kit (DIOX-250)®. Neopterin serum levels between patients with active pulmonary tuberculosis and healthy individualsat high-risk were analysed by independent samples t-test. H2O2 serum levels between patients with active pulmonary tuberculosis andhealthy individuals at high-risk were analysed with Mann Whitney Test. The confidence level is p <0.05. The mean Neopterin levelsin patients with active pulmonary tuberculosis was 5.17±4.64 nmol/L, the mean Neopterin levels in group of healthy individuals athigh risk was 3.97±1.79 nmol/L. Statistical analysis by the independent samples t-test found no significant differences between groupsin Neopterin serum levels of patients with active pulmonary tuberculosis and healthy individuals at high risk (p=0.357). The meanserum levels of H2O2 of group of patients with active pulmonary tuberculosis was 26.38±3.00 μM, the mean levels of H2O2of group ofhealthy individuals at high risk of 20.69±4.46 μM. Statistical analysis with non-parametric Mann-Whitney Test was found significantdifference in the peroxide (H2O2) levels between groups of patients with active pulmonary tuberculosis and group of healthy individualat high-risk (p=0.000). The levels of Neopterin in patients with active pulmonary tuberculosis was not significantly higher comparedto the healthy individuals of high risk. Levels of peroxide (H2O2) serum in patients with active pulmonary tuberculosis was significantlyhigher compared to the group of healthy individuals at high risk. This shows that there is increased activity of macrophages in patientswith active pulmonary tuberculosis, but not effective in eliminating of Mycobacterium tuberculosis.
SUHU PENYIMPANAN KREATININ DAN ASAM URAT DALAM AIR KEMIH SELAMA 24 JAM AAN. Subawa; Sianny Herawati; I Nyoman Wande; I Wayan Putu Sutirta Yasa; Tjokorda Gede Oka
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1107

Abstract

Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The examination of creatinine and uricacid in urine is done on 24-hour urine collection. During the storage of the urine, it is recommended to be stored in a refrigerator withthe grade temperatures ranging from 2–8°C and is not recommended to use any preservative for the examination of creatinine anduric acid in urine. To know the comparation of creatinine and uric acid concentrations in urine between the urine tested immediatelyafter the collection with urine that was stored at a temperature 2–8°C and those at room temperature for 24 hours. A total of 45 urinesamples from outpatient clinic that came to the laboratory, were collected in particular urine vacutainer. Each urine sample is divided intothree tubes. The first tube (P1) examined concentrations of creatinine and uric acid immediately after collection, was considered as thebaseline value. The second tube (P2) stored at 2–8°C and the third tube (P3) is stored at room temperature for 24 hours, then followedby the examination of creatinine and uric acid concentrations. The examination of creatinine in urine was using reagent CREP2 RocheDiagnostic and uric acid in urine was using reagent UA2 Roche diagnostics by Cobas Integra ® 400 plus ® instrument. The mean ofcreatinine in urine concentrations which immediately examined (P1) is (125.10±74.85 mg/dL), concentrations after storage at 2−8°C(P2) and at room temperature (P3) were (123.42±73.80 mg/dL) and (124.09±73.95 mg/dL) respectively. Based on the analysis ofone-way ANOVA, there were no significant differences between the concentrations of creatinine in urine immediately checked which werestored at 2–8°C and at room temperature (P>0.05). The mean of uric acid in urine concentrations which immediately examined (P1) is(52.61±35.48 mg/dL), where as after storage at 2–8°C (P2) and room temperature (P3) were (45.11±31.62 mg/dL) and (46.38±28.91mg/dL) respectively. Based on the analysis of one-way ANOVA, there were no significant differences between the concentrations of uricacid in urine immediately checked by those stored at 2–8°C and at room temperature (P>0.05). Based on this study, it can be concludedthat there were no effect of storage temperature on the concentrations of creatinine and uric acid in urine within 24 hours.
Correlation between Very Low-Density Lipoprotein and Trygliseride with Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients Sherly Karolina Simanjuntak; I Nyoman Wande; Ida Ayu Putri Wirawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1744

Abstract

Patients with Type 2 Diabetes Mellitus (T2DM) have an increased prevalence of dyslipidemia, which contributes to ahigher risk of dyslipidemia- related complications in T2DM such as cardiovascular disease and stroke. This study aimed todetermine the correlation between TG and VLDL-C towards HbA1c levels in a person with T2DM. A retrospective study of 74outpatients with T2DM at Sanglah General Hospital, Denpasar, who examined serum HbA1c and lipid profiles were tracedfor serum TG. From the obtained TG profile, a secondary calculation of VLDL was carried out using the Friedewald equation(TG/5). A correlation test was used to determine the relationship between TG and VLDL-C towards HbA1c levels. Serum TG(212.95±147.46 mg/dL) and VLDL (36.69±23.54 mg/dL) were found to be higher in the group with poor glycemic control(HbA1c > 7 mg/dL) compared to serum TG (111.00±39.56 mg/dL) and VLDL (21.05±6.13 mg/dL) in the group with goodglycemic control (HbA1c ≤ 7 mg/dL) (p < 0.05). A positive correlation between serum TG (r=0.512; p < 0.001) and VLDL(r=0.18; p <0.001) towards HbA1c levels in T2DM patient was found. Insulin resistance increases the production of VLDL andApoC-III in the liver and increased chylomicron absorption in the gastrointestinal tract, causing prolonged postprandiallipemia and disruption of VLDL and TG clearance, thereby resulting in increased TG and VLDL in circulation. There is asignificant positive correlation between serum TG and VLDL towards HbA1c levels in a patient with T2DM. 
Hubungan lingkar perut dengan kadar gula darah puasa pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2014 Alvin Wijaya; Nyoman Wande; Ida Ayu Putri Wirawati
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (205.618 KB) | DOI: 10.15562/ism.v10i2.191

Abstract

Introduction: Diabetes Mellitus is a metabolic disease characterized by elevated blood sugar levels, either caused by a disturbance of insulin secretion, insulin resistance or both. Obesity is one of the risk factors of diabetes mellitus. The incidence of diabetes mellitus increases from year to year, but the data that discusses the association of risk factors with diabetes mellitus itself, especially obesity is minimum. The purpose of this study is to determine the association of abdominal circumference with fasting blood sugar levels at students of Udayana University Faculty of Medicine class of 2014.Method: This research is an analytical research conducted at Udayana University Faculty of Medicine Campus, Denpasar. Data obtained in the form of primary data in the form of abdominal circumference to see the status of obesity and fasting blood sugar to see the status of diabetes mellitus. Data were analyzed using SPSS program.Result: The results showed that there was not significant negative association between abdominal circumference with fasting blood sugar levels at Udayana University, Faculty of Medicine students class of 2014. However, this association is not statistically significant because diabetes mellitus influenced by many factors other than obesity. In addition, it can be seen that the characteristics of the population did not describe the population of diabetes mellitus or obesity, thus affecting associations that have been described in some literature and the concept of author thinking. But indeed the association of anthropometric risk factors (abdominal circumference) has a greater value than other risk factors.Conclusion: There was a negative correlation between abdominal circumference and fasting blood sugar but not significant statistically
Gambaran proporsi dan faktor resiko anemia pada pasien diabetes melitus di RSUP Sanglah, Bali, Indonesia Komang Satvika Yogiswara; Sianny Herawati; I Nyoman Wande
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 (345.752 KB) | DOI: 10.15562/ism.v12i1.882

Abstract

Background: Patients with Type 2 Diabetes Mellitus (T2DM) are known to suffer from anemia as a direct or indirect result of their diabetes. In Indonesia, there are no studies that have looked at anemia in DM patients and the risk factors that influence it. Therefore, this study aims to determine the proportion and risk factors for anemia in T2DM patients at Sanglah General Hospital, Bali, Indonesia.Methods: This study is a descriptive study with a cross-sectional approach that uses secondary data from medical records determined by the Purposive Sampling technique. The data obtained according to the inclusion and exclusion criteria were 100 data which were then processed with SPSS version 23 for Windows.Results: In this study, it was found that 15.00% of T2DM patients in Sanglah General Hospital suffered from anemia. It was found that the risk factor that influenced the occurrence of anemia in T2DM patients was Chronic Kidney Disease (CKD) (r=0.581; p=0.000). Variable gender, HbA1c levels, BMI, type of drug, and the number of drugs were not associated with anemia in T2DM patients (p> 0.05).Conclusion: The CKD condition was known significantly as a factor affecting the occurrence of anemia in T2DM patients at Sanglah General Hospital. Latar belakang:  Pasien dengan Diabetes Melitus Tipe 2 (DMT2) diketahui dapat menderita anemia sebagai akibat langsung maupun tidak langsung dari diabetes yang mereka derita. Di Indonesia, belum ditemukan adanya penelitian yang melihat anemia pada pasien DM serta faktor resiko yang mempengaruhinya. Oleh karena itu penelitian ini bertujuan untuk mengetahui proporsi dan faktor risiko anemia pada pasien DMT2 di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian ini merupakan penelitian deskriptif dengan pendekatan potong lintang dimana menggunakan data sekunder rekam medis yang ditentukan dengan teknik Purposive Sampling. Data yang didapat sesuai kriteria inklusi dan eksklusi adalah 100 data yang kemudian diolah dengan SPSS versi 23 untuk Windows.Hasil: Pada studi ini ditemukan bahwa 15,00% pasien DMT2 di RSUP Sanglah menderita anemia, ditemukan bahwa faktor resiko yang mempengaruhi terjadinya anemia pada pasien DMT2 adalah kondisi Penyakit Ginjal Kronis (PGK) (r=0,581; p=0,000). Variabel jenis kelamin, kadar HbA1c, IMT, jenis obat, dan jumlah obat tidak berhubungan dengan kondisi anemia pada pasien DMT2 (p>0,05).Kesimpulan: Keadaan PGK diketahui secara bermakna sebagai faktor yang mempengaruhi terjadinya anemia pada pasien DMT2 di RSUP Sanglah.
Pancreatitis in Acute Lymphoblastic Leukemia Putu Yudi Adnyani; I Nyoman Wande; Sianny Herawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1828

Abstract

Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of heartburn accompanied by increased levels of pancreatic enzymes. Acute pancreatitis in acute lymphoblastic leukemia in addition to being caused by therapy can also be caused by other factors. 13-year-old female patient with a diagnosis of acute lymphoblastic leukemia complained of heartburn which was felt through to the back. Patients also experience nausea, vomiting, decreased appetite, difficulty in bowel movements, and fever. Physical examination found an increase in body temperature, anemic eyes, multiple neck gland enlargement, and enlargement of the liver. The results of complete blood tests showed leukocytosis, anemia, and thrombocytopenia. The results of examination of bone marrow aspiration show a picture of the bone marrow in accordance with acute lymphoblastic leukemia (ALL-L2). Clinical chemistry tests showed an increase in amylase, lipase, SGOT, BUN, creatinine, LDH, ferritin, calcium, and procalcitonin. The patient has never received chemotherapy for the ALL. Acute pancreatitis in ALL in addition to being caused by administration of leukemia can also be caused by sepsis conditions which are complications of the ALL. ALL patients who experience acute pancreatitis in this case show a poor prognosis.
Difference in Sodium and Potassium Reading by Blood Gas Analyzer and Electrolyte Analyzer at Sanglah Hospital Denpasar, Bali, Indonesia Anak Agung Wiradewi Lestari; I Putu Sidhi Rastu Karyana; I Nyoman Wande
Journal of Global Pharma Technology Volume 10 Issue 07: (2018) July 2018
Publisher : Journal of Global Pharma Technology

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

Abstract

Introduction: Electrolytes measurement is a standard procedure in medical practice to diagnose diseases or disease-related complication. Recently, there is a various device used to analyze blood electrolytes, but the difference accuracy between devices is a problematic issue for clinicians. Thus, we evaluate the differences of sodium and potassium concentration reading by Blood Gas Analyzer (BGA) and Electrolyte Analyzer at Sanglah Hospital to assess whether the difference could be accepted according to Clinical Laboratories Improvement Amendments (CLIA). Methods: A cross-sectional analytic study was conducted in May 2017 at Clinical Pathology Laboratory of  Sanglah Hospital, Denpasar. 30 subjects were enrolled consecutively during the study period and the blood samples were analyzed by both BGA and electrolyte analyzer. The data were analyzed using paired T-Test, Bland-Altman Plot, and Linear Regression. Result: The mean of sodium and potassium measured by BGA were 133.76 ± 5.68 mmol/L and 3.14 ± 0,86 mmol/L, respectively while electrolyte analyzer was 136,43 ± 6,48 mmol/L and 3,51 ± 0,9 mmol/L, respectively. Mean difference between sodium and potassium were 2.67 mmol/L (P=0,000) and 0.36 mmol/L (P=0,000), respectively. Bland-Altman plot analysis in sodium and potassium showed that the limit of the agreement was at -9.9 to 4.56 mmol/L and -1.28 to 0.56 mmol/L, respectively. Conclusion: There was a significant difference between BGA and electrolyte analyzer reading with BGA has higher acceptance level compared to electrolyte analyzer.Keywords: Natrium, Kalium, Blood Gas Analyzer, Electrolyte Analyzer.
KADAR INTERLEUKIN 10 (IL-10) MALARIA DAN ANEMIA I Nyoman Wande; Endang Retnowati; Juli Soemarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 18 No. 1 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i1.767

Abstract

Anaemia is an important complication of malaria, and its pathogenesis is not well understood. High level of the Th2 cytokine (such as IL-10), which counteract the Th1 cytokine, might prevent the development of severe malarial anaemia. The purpose of this study was to know the comparation between the plasma level of IL-10 in malaria patients with anaemia and without anaemia. The plasma level of IL-10 was examined in 16 malaria patients with anaemia and 16 malaria caused by P. falciparum patients without anaemia samplestaken from patients at the primary health centres in West Lombok and Centre Lombok during March until July 2008. The samples were measured using ELISA. The concentration of haemoglobin (Hb) was measured using hematological analyzer. The anaemia concentration of Hb is <11 g/dL. The results were analyzed using two (2) sample t test with SPSS ver.13.The plasma level of IL-10 in malaria patients caused by P. falciparum with anaemia was 8.81(3.04) [mean(SD)] pg/mL where as the plasma level of IL-10 in malaria patients without anaemia was 47.99(25.26) pg/mL. The mean of IL-10 level in malaria falciparum patients with anaemia was significantly lower than that of malaria patients caused by P. falciparum without anaemia (p=0.000).
Correlation between Very Low-Density Lipoprotein and Trygliseride with Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients Sherly Karolina Simanjuntak; I Nyoman Wande; Ida Ayu Putri Wirawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1744

Abstract

Patients with Type 2 Diabetes Mellitus (T2DM) have an increased prevalence of dyslipidemia, which contributes to a higher risk of dyslipidemia- related complications in T2DM such as cardiovascular disease and stroke. This study aimed to determine the correlation between TG and VLDL-C towards HbA1c levels in a person with T2DM. A retrospective study of 74 outpatients with T2DM at Sanglah General Hospital, Denpasar, who examined serum HbA1c and lipid profiles were traced for serum TG. From the obtained TG profile, a secondary calculation of VLDL was carried out using the Friedewald equation (TG/5). A correlation test was used to determine the relationship between TG and VLDL-C towards HbA1c levels. Serum TG (212.95±147.46 mg/dL) and VLDL (36.69±23.54 mg/dL) were found to be higher in the group with poor glycemic control (HbA1c > 7 mg/dL) compared to serum TG (111.00±39.56 mg/dL) and VLDL (21.05±6.13 mg/dL) in the group with good glycemic control (HbA1c ≤ 7 mg/dL) (p < 0.05). A positive correlation between serum TG (r=0.512; p < 0.001) and VLDL (r=0.18; p <0.001) towards HbA1c levels in T2DM patient was found. Insulin resistance increases the production of VLDL and ApoC-III in the liver and increased chylomicron absorption in the gastrointestinal tract, causing prolonged post-prandial lipemia and disruption of VLDL and TG clearance, thereby resulting in increased TG and VLDL in circulation. There is a significant positive correlation between serum TG and VLDL towards HbA1c levels in a patient with T2DM.