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Kadek Kristian Dwi Cahya

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Author-ID : 2937511

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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KARAKTERISTIK PENDERITA YANG MENJALANI PEMERIKSAAN PENDENGARAN DI POLIKLINIK THT-KL RSUP SANGLAH DENPASAR TAHUN 2018 Kadek Kristian Dwi Cahya; Komang Andi Dwi Saputra; Agus Rudi Asthuta; Sari Wulan Dwi Sutanegara
E-Jurnal Medika Udayana Vol 10 No 8 (2021): Vol 10 No 08(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i8.P10

Gangguan pendengaran ialah keadaan kurang mampu mendengarkan sebagian atau bisa juga keseluruhan pada salah satu atau kedua telinga. Kejadian gangguan pendengaran insidennya 40-45% pada lansia diatas 75 tahun. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik penderita yang menjalani pemeriksaan pendengaran di Poliklinik THT-KL RSUP Sanglah Denpasar tahun 2018. Deskriptif merupakan jenis pada penelitian ini dengan rancangan studi potong-lintang. Total sampling merupakan teknik pengambilan sampel pada penelitian ini dan terkumpul sebanyak 331 sampel terbanyak terjadi pada laki-laki sebanyak 208 orang (62,8%) kemudian paling sering pada golongan usia 0-5 tahun tercatat sebanyak 127 orang (38,4%), paling banyak melakukan tes pemeriksaan audiometri sebanyak 190 orang (57,4%) dengan diagnosis gangguan pendengaran yang lebih dominan tercatat sebanyak 118 orang (35,6%) dan hasil pemeriksaan paling sering adalah tuli sangat berat sebanyak 75 orang (22,7%) pada telinga kanan, sedangkan pada telinga kiri didominasi oleh hasil pemeriksaan normal sebanyak 88 orang (26,6%). Lebih dari 50% penderita gangguan pendengaran berjenis kelamin laki – laki dan dengan pemeriksaan audiometri sebanyak 57%. Untuk kelompok usia, diagnosis yang paling sering ditemukan serta hasil pemeriksaan berturut turut dengan kelompok usia 0-5 tahun tertinggi sebanyak 127 orang, diagnosis yang paling sering ditemukan pada telinga kanan adalah tuli derajat berat sedangkan pada telinga kiri ditemukan dominan dalam keadaan normal. Oleh karena itu, diperlukan penelitian lanjutan dengan jumlah sampel yang lebih banyak dan spesifik sehingga menjadi pengembangan bagi penelitian analitik selanjutnya. Kata Kunci: Gangguan Pendengaran, usia, jenis kelamin, diagnosis, jenis pemeriksaan, hasil pemeriksaan audiometri, RSUP Sanglah Denpasar

Divergent Inflammatory Trajectories: Independent Predictive Value of Admission Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratios for Acute Ischemic Stroke Severity in a Southeast Asian Cohort Kadek Kristian Dwi Cahya; I Ketut Sumada; Desie Yuliani; Ni Made Kurnia Dwi Jayanthi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1501

Background: Systemic sterile inflammation acts as a critical pathophysiological driver in the acute phase of ischemic stroke, mediating secondary brain injury through blood-brain barrier disruption and microvascular thrombosis. While the Neutrophil-to-Lymphocyte Ratio (NLR) and Lymphocyte-to-Monocyte Ratio (LMR) have emerged as potential biomarkers in Western populations, their independent prognostic utility and specific diagnostic thresholds within Southeast Asian populations remain under-explored. This region presents unique challenges due to potential variations in baseline hematological profiles driven by genetic polymorphisms and environmental factors. This study aims to elucidate the association between admission NLR and LMR levels and the severity of Acute Ischemic Stroke (AIS) and to determine optimal population-specific prognostic cut-offs. Methods: We conducted a retrospective cross-sectional comparative study involving 128 patients with confirmed AIS admitted to Wangaya Regional General Hospital, Indonesia, between January 2025 and August 2025. Patients were stratified based on admission National Institutes of Health Stroke Scale (NIHSS) scores into a Mild Group (NIHSS ≤ 6, n=64) and a Moderate-Severe Group (NIHSS > 6, n=64). Infection was strictly excluded using clinical and radiological criteria independent of admission leukograms to prevent circular bias. Receiver Operating Characteristic (ROC) curve analysis was performed to determine diagnostic accuracy and identify optimal cut-offs. To address potential multicollinearity between NLR and LMR, two separate multivariate binary logistic regression models were constructed to determine independent predictors of severity. Results: The study population had a mean age of 60.5 years. The Moderate-Severe Group exhibited significantly higher NLR (6.12 ± 3.41 vs. 2.85 ± 1.20; p < 0.001) and lower LMR (2.15 ± 0.92 vs. 4.22 ± 1.50; p < 0.001) compared to the Mild Group. ROC analysis identified optimal cut-offs of ≥ 4.82 for NLR (AUC: 0.782; Sensitivity: 76.6%) and ≤ 2.89 for LMR (AUC: 0.724; Sensitivity: 71.9%). In the multivariate analysis Model 1, NLR ≥ 4.82 remained an independent predictor of severity (Adjusted Odds Ratio [aOR]: 4.12; 95% CI: 1.78–9.54; p = 0.001). In the separate Model 2, LMR ≤ 2.89 was also confirmed as an independent predictor (aOR: 2.85; 95% CI: 1.24–6.55; p = 0.014). Conclusion: Elevated NLR and reduced LMR at admission are robust, independent indicators of stroke severity in this Indonesian cohort. These accessible hematological biomarkers reflect the divergent trajectories of post-ischemic neuroinflammation—innate immune hyperactivity and adaptive immune exhaustion. They provide a cost-effective method for risk stratification in resource-limited settings, warranting their integration into routine initial assessment protocols.

Divergent Inflammatory Trajectories: Independent Predictive Value of Admission Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratios for Acute Ischemic Stroke Severity in a Southeast Asian Cohort Kadek Kristian Dwi Cahya; I Ketut Sumada; Desie Yuliani; Ni Made Kurnia Dwi Jayanthi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1501

Background: Systemic sterile inflammation acts as a critical pathophysiological driver in the acute phase of ischemic stroke, mediating secondary brain injury through blood-brain barrier disruption and microvascular thrombosis. While the Neutrophil-to-Lymphocyte Ratio (NLR) and Lymphocyte-to-Monocyte Ratio (LMR) have emerged as potential biomarkers in Western populations, their independent prognostic utility and specific diagnostic thresholds within Southeast Asian populations remain under-explored. This region presents unique challenges due to potential variations in baseline hematological profiles driven by genetic polymorphisms and environmental factors. This study aims to elucidate the association between admission NLR and LMR levels and the severity of Acute Ischemic Stroke (AIS) and to determine optimal population-specific prognostic cut-offs. Methods: We conducted a retrospective cross-sectional comparative study involving 128 patients with confirmed AIS admitted to Wangaya Regional General Hospital, Indonesia, between January 2025 and August 2025. Patients were stratified based on admission National Institutes of Health Stroke Scale (NIHSS) scores into a Mild Group (NIHSS ≤ 6, n=64) and a Moderate-Severe Group (NIHSS > 6, n=64). Infection was strictly excluded using clinical and radiological criteria independent of admission leukograms to prevent circular bias. Receiver Operating Characteristic (ROC) curve analysis was performed to determine diagnostic accuracy and identify optimal cut-offs. To address potential multicollinearity between NLR and LMR, two separate multivariate binary logistic regression models were constructed to determine independent predictors of severity. Results: The study population had a mean age of 60.5 years. The Moderate-Severe Group exhibited significantly higher NLR (6.12 ± 3.41 vs. 2.85 ± 1.20; p < 0.001) and lower LMR (2.15 ± 0.92 vs. 4.22 ± 1.50; p < 0.001) compared to the Mild Group. ROC analysis identified optimal cut-offs of ≥ 4.82 for NLR (AUC: 0.782; Sensitivity: 76.6%) and ≤ 2.89 for LMR (AUC: 0.724; Sensitivity: 71.9%). In the multivariate analysis Model 1, NLR ≥ 4.82 remained an independent predictor of severity (Adjusted Odds Ratio [aOR]: 4.12; 95% CI: 1.78–9.54; p = 0.001). In the separate Model 2, LMR ≤ 2.89 was also confirmed as an independent predictor (aOR: 2.85; 95% CI: 1.24–6.55; p = 0.014). Conclusion: Elevated NLR and reduced LMR at admission are robust, independent indicators of stroke severity in this Indonesian cohort. These accessible hematological biomarkers reflect the divergent trajectories of post-ischemic neuroinflammation—innate immune hyperactivity and adaptive immune exhaustion. They provide a cost-effective method for risk stratification in resource-limited settings, warranting their integration into routine initial assessment protocols.

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