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All Journal E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran MEDICINUS
Putu Andrika
Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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POLA KUMAN PENYEBAB COMMUNITY-ACQUIRED PNEUMONIA (CAP) DAN KEPEKAANNYA TERHADAP ANTIBIOTIKA DI RSUP SANGLAH DENPASAR TAHUN 2017 Ayu Agung Pradnya Paramitha Dwi Sutanega; I G N Bagus Artana; Putu Andrika
E-Jurnal Medika Udayana Vol 8 No 7 (2019): Vol 8 No 7 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (180.036 KB)

Abstract

Pneumonia komunitas atau community-acquired pneumoniae adalah pneumonia yang didapat di lingkungan masyarakat dan salah satu penyakit menular yang paling umumsehingga menjadi penyebab mortalitas dan morbiditas di seluruh dunia. Penyakit inimerupakan infeksi pada saluran pernafasan bagian bawah yang diakibatkan oleh bakteri,virus, jamur dan parasit. Tujuan dari penelitian ini adalah mengetahui pola kuman penyebabpneumonia komunitas dan mencari pola kepekaan terhadap antibiotika di Rumah SakitUmum Pusat Sanglah tahun 2017. Jenis penelitian ini merupakan deskriptif potong lintangdimana sumber data berasal dari data sekunder yaitu rekam medis pasien pneumoniakomunitas yang memiliki data hasil kultur sputum dan tes sensitivitas di RSUP Sanglah padatahun 2017. Pengambilan data dilakukan dengan metode Total Sampling. Didapatkan 36pasien pneumonia komunitas yang memiliki hasil kultur sputum dan tes sensitivitas. Kumantersering yang ditemukan adalah Streptococcus sp. Antibiotika yang memiliki tingkatsensitifitas paling tinggi adalah meropenem dan vankomisin. Sementara antibiotika yangmemiliki tingkat resistensi paling tinggi adalah cefazolin. Seluruh obat antifungal masihsensitif terhadap jamur yang didapat. Selanjutnya perlu dilakukan penelitian terkait faktoryang mempengaruhi terjadinya resistensi antibiotika pada bakteri. Kata Kunci: pneumonia komunitas, pola kuman, antibiotika, kultur sputum
GAMBARAN KARAKTERISTIK PASIEN TUBERCULOSIS DI POLIKLINIK PARU RSUP SANGLAH DENPASAR Anak Agung Istri Sarastriyani Dewi; Putu Andrika; IGN Bagus Artana
E-Jurnal Medika Udayana Vol 9 No 6 (2020): Vol 9 No 06(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (238.485 KB) | DOI: 10.24843/MU.2020.V09.i6.P02

Abstract

ABSTRAK Tuberkulosis (TB) adalah penyakit infeksi menular yang disebabkan oleh bakteri M. tuberculosis yangtermasuk dalam sepuluh besar penyebab kematian akibat infeksi tunggal. Sebagian besar kasus terjadi dinegara berkembang, dimana Indonesia merupakan negara yang menempati posisi ketiga dalam persentaseTB tertinggi di dunia. Tujuan penelitian ini adalah untuk melihat gambaran karakteristik sosiodemografi,laboratorium, dan klinis penderita TB di RSUP Sanglah Denpasar. Jenis penelitian ini adalah deskriptifdengan metode potong-lintang. Teknik purposive sampling digunakan dalam pengambilan sampel dari datarekam medis pasien TB yang tercatat di catatan register poli paru RSUP Sanglah Denpasar disesuaikandengan kriteria inklusi dan eksklusi data, mulai bulan Januari hingga Oktober 2018. Sebanyak 111 pasienTB (70,3% laki-laki dan 77,5% umur <60 tahun) diikutsertakan dalam penelitian ini. Penelitian inimengungkapkan bahwa terdapat 36% penderita TB dengan kultur basil tahan asam (BTA) positif dan 57%.Terdapat keluhan sistemik demam (36,9%), malaise (3,6%), keringat malam (11,7%), dan penurunan beratbadan (33,3%). Sementara batuk lebih dari tiga minggu (84,7%), sesak nafas (39,6%), nyeri dada (26,1%),dan batuk darah (27%). merupakan keluhan respiratorik. Ditemukan kasus TB baru sebanyak 92,8% danrelaps 7,2%. Kata Kunci: Tuberkulosis, Karakteristik
Karakteristik penderita tuberkulosis paru relapse yang berobat di poli paru RSUP Sanglah Denpasar Bali periode Mei 2017 hingga September 2018 Ni Nyoman Adi Widyastuti; I Made Bagiada; Putu Andrika
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 (230.605 KB) | DOI: 10.15562/ism.v10i2.386

Abstract

Introduction: Relapse pulmonary tuberculosis (TB) is a TB patient who has previously received TB treatment, and has been declared cured or complete treatment, was re-diagnosed with positive smear TB based on swab examination or culture. In Indonesia there are many cases of repeat treatment. 70% of them are relapse cases. So that research on the characteristics of pulmonary TB patients relapse is important. Method: This research is a cross sectional descriptive study where the source of the data comes from secondary data, namely medical records of patients with pulmonary TB patients relapse in pulmonary outpatient clinics at Sanglah General Hospital period May 2017 until September 2018.Result: The results of this study showed that there were 40 patients proven to have pulmonary TB relapse. Most of the patients have ages of 50 to 59 years (25.0%), male sex (55.0%), last education in high school (57.5%), as many as 27.5% of them work as entrepreneurs and 27.5% do not work , the range of BMI in relapse pulmonary TB patients is 13-31 kg / m2 to 28.04 kg / m2 with an average of 19.54 + 3.03 kg / m2, the most clinical complaints are cough (80%), the most common comorbidities are pneumonia (15%) and based on thorax X-ray results found that the most finding was a picture of pleural effusion (22.5%).Conclusion: Based on demographic characteristics, relapse pulmonary TB patients were dominated by age + 50 years with male sex, highschool education status, dominant in patients who did not work and had a low BMI. Based on clinical symptoms, coughing up phlegm, coughing up bleeding and chest tightness are common symptoms. Based on the accompanying comorbidities, pneumonia and heart failure that most often accompanying disease. The most common X-ray image found in relapse pulmonary TB patients is the presence of pleural effusion.
Diagnosis dan penatalaksanaan tuberkulosis sistem saraf pusat Prima Yogi; I Putu Andrika; I Gede Ketut Sajinadiyasa; I Made Bagiada
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 (373.864 KB) | DOI: 10.15562/ism.v12i3.1173

Abstract

Introduction: Central nervous system (CNS) tuberculous are the most dangerous form of extrapulmonary TB. CNS tuberculous can present as meningoencephalitis, intracranial tuberculomas, and vasculitis. CNS tuberculous accounts for about 1% of all TB cases and is associated with high mortality. Tuberculous meningoencephalitis commonly presents with classic symptoms of fever, headache, meningism (neck stiffness), seizures as well as focal neurologic deficits, and altered consciousness. The diagnosis and treatment of CNS tuberculosis is still a formidable clinical challenge.Case report: Patient presented with fever, headache, meningismus, convulsion, and decreased consciousness. CT scan showed cerebral tuberculoma in the left parietal lobe. Examination gene-Xpert of the cerebrospinal fluid showed Mycobacterium tuberculosis. The patient was given category 1 of anti-tuberculosis drugs.Conclusion: CNS tuberculosis has non-specific symptoms, difficult diagnosis, and high mortality. In this case report, the diagnosis of CNS tuberculosis was established based on the presence of Mycobacterium tuberculosis on the CSF molecular rapid test examination, and a CT scan of the head with contrast found cerebral tuberculoma.
Comprehensive Approach to Acute Pulmonary Embolism in a Patient with History of Cervical Cancer: Clinical Challenges and Therapeutic Strategies Arya Wiradarma; Putu Andrika
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/8nxexq93

Abstract

Pulmonary embolism (PE) is a life-threatening medical emergency that requires prompt diagnosis and treatment, particularly in patients with significant risk factors such as a history of cancer. This case report discusses a 45-year-old female with a history of stage IIIA cervical cancer who presented with acute onset dyspnea and hemodynamic instability. The patient’s prior cancer treatments, including chemotherapy and radiotherapy, increased the patient’s risk for venous thromboembolism (VTE), leading to acute pulmonary embolism. The diagnosis was confirmed by computed tomography pulmonary angiography (CTPA), which revealed a substantial thrombus obstructing the left pulmonary artery. Laboratoryfindings showed markedly elevated D-dimer levels. Further assessment with echocardiography (echo) revealed right ventricular (RV) dysfunction, a critical marker of hemodynamic stress caused by the embolism. The echo findings included RV hypokinesis, an increased right ventricle/left ventricle (RV/LV) ratio, and possible tricuspid regurgitation, all of which indicated severe right heart strain. These findings serve as key prognostic indicators in acute PE, correlating with a higher risk of mortality and guiding therapeutic decision-making. The comprehensive management approach for this patient highlights the importance of rapid diagnosis, risk stratification, and aggressive therapeutic interventions in highriskPE. Echocardiographic findings played a crucial role in determining the disease severity and informing the need for potential reperfusion therapies, such as thrombolysis or surgical embolectomy. This case emphasizes the importance of integrating clinical, imaging, and laboratory data to optimize patient outcomes. Echocardiography plays a pivotal role inmonitoring right ventricular function and adjusting treatment strategies in PE, particularly among oncology patients who are at increased risk.
Mortalitas Tuberkulosis Paru di RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar I Gede Ketut Sajinadiyasa; Gede Dilajaya Robin; Putu Andrika
MEDICINUS Vol. 39 No. 4 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/dw9ejg91

Abstract

Background: Pulmonary tuberculosis (TB) is the second leading cause of death from infectious disease worldwide. According to the World Health Organization (WHO) report in 2022, the global number of deaths due to TB reached 1.3million cases. In Indonesia, the mortality rate due to pulmonary TB in 2021 was 52 cases per 100,000 population. Methods: This is a descriptive study with cross-sectional approach to determine the mortality rate of TB. The subjects were ofpulmonary TB patients recorded at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, in 2023. The sampling technique used was total sampling. Results: Among the 84 subjects, 33 deaths were recorded. Based on sex, death occurred in 8 (9.5%) female subjects and 25 (29.8%) male subjects. Based on age, death occurred in 8 (9.5%) patients aged ≥60 years and 25 (29.8%) patients aged <60 years. Based on HIV status, death occurred in 20 (23.8%) patients with nonreactive HIV status and 13 (15.5%) patients with reactive HIV status. Based on diabetes status, death occurred in 4 (4.8%) diabetic patients and 29 (34.5%) nondiabetic patients. Based on the type of pulmonary TB, death occurred in 13 (15.5%) patients with clinically diagnosed pulmonary TB and 20 (23.8%) patients with bacteriologically confirmed pulmonary TB. Conclusion: Mortality due to pulmonary TB was more commonly observed among males, individuals under 60 years of age, those withnonreactive HIV status, nondiabetes, and those with bacteriologically confirmed pulmonary TB.
Co-Authors Anak Agung Istri Sarastriyani Dewi Arya Wiradarma Ayu Agung Pradnya Paramitha Dwi Sutanega Gede Dilajaya Robin I Gede Ketut Sajinadiyasa I M Bagiada IGN Bagus Artana Ni Nyoman Adi Widyastuti Prima Yogi