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Kadar interleukin 6 serum sebagai prediktor luaran rawat inap pada lanjut usia di desa Pedawa Buleleng Bali Semaradana, Wayan Giri Putra; Suka Aryana, I Gusti Putu; Tuty Kuswardhani, RA; Astika, I Nyoman; Putrawan, Ida Bagus; Rai Purnami, Ni Ketut
Jurnal Penyakit Dalam Udayana Vol 2 No 1 (2018): Vol 2 No 1 (2018) January-June 2018
Publisher : PAPDI BALI

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Latar Belakang: Angka rawat inap semakin meningkat seiring pertambahan usia sehingga meningkatkan biaya kesehatan. Salah satu faktor risikonya adalah adanya immunosenescence. Inflamasi kronik merupakan penyebab dari immunosenescence dan dapat ditandai dengan peningkatan serum interleukin 6. Tujuan: Mengetahui apakah kadar interleukin 6 (IL-6) serum merupakan prediktor terjadinya luaran rawat inap pada lanjut usia. Metode: Penelitian ini merupakan studi prospektif analitik dengan jumlah sampel sebanyak 76 orang lanjut usia (usia â¥ 60 tahun) di Desa Pedawa Buleleng Bali yang diambil secara stratified random sampling. Pemeriksaan IL-6 kadar serum memakai reagen Quantikine HS Human IL-6 Immonoassay dengan satuan pg/mL. Luaran rawat inap diobservasi selama 6 bulan. Analisis data berupa deskriptif, bivariat (uji komparasi dan uji tabulasi silang) dan analisis multivariat yang menggunakan regresi logistik. Hasil: Rerata kadar IL-6 serum didapatkan 2,8 Â±4,09 pg/mL. Dari hasil observasi selama 6 bulan, didapatkan subyek yang mengalami luaran rawat inap sebanyak 12 orang (15,8%). Perbedaan rerata kadar IL-6 serum yang siginifikan didapatkan antara kelompok yang mengalami rawat inap (IK 95%; p <0,01) dibandingkan dengan yang tidak. Hasil regresi logistik menunjukkan bahwa kadar IL-6 serum tetap mempengaruhi terjadinya luaran rawat inap setelah mengendalikan variabel perancu (IK 95%; p <0,01). Uji chi-square menunjukkan subyek dengan kadar IL-6 serum tinggi mempunyai resiko relatif mengalami luaran rawat inap sebesar 18,8 (IK 95%; p <0,01). Simpulan: Kadar IL-6 serum yang tinggi merupakan prediktor luaran rawat inap lanjut usia.

HUBUNGAN ANTARA SUDUT KELENGKUNGAN THORAK DAN SELISIH TINGGI BADAN UKUR DAN TINGGI BADAN HITUNG BERDASARKAN TINGGI LUTUT PADA PASIEN USIA LANJUT DI POLIKLINIK GERIATRI RUMAH SAKIT SANGLAH DENPASAR Wiryani, Cilik; Kuswardhani, Tuty; Aryana, Suka; Astika, Nyoman; -, Yanson; Widana, K
journal of internal medicine Vol. 11, No. 1 Januari 2010
Publisher : journal of internal medicine

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Anthropometric measurements are part of the nutritional assessment which is an important component of health care.Measuring the individual!s stature with accuracy is very important because it is a basis for estimating basal energy expenditureand consequent nutrient needs and to calculate indices of nutrient status. However, common methods of nutritional anthropometricassessment are not entirely satisfactory for all elderly persons. Certain measurements such as stature may be difÞ cult to obtainbecause of postural changes, thinning of the disks of the spinal column, and diminution in the height of the vertebrae, all of whichare associated with aging.This study conducted to investigate the correlation between thoracic hyperkyposis with the difference of height calculatedwith WHO formula and actual height measurements in elderly patients among geriatric outpatient clinic, Sanglah hospital. Thisis a descriptive study at August 2008. Height was calculated with WHO formula. For men 59.01 + (2.08 x knee height) and forwomen 75 + (1.91 X knee height) - (0.17 X age) and compared with actual height measurements. Data analyzed with analyticdescriptive Spearman!s correlation.There were 91 elderly patients included, male 38 (41.8%), female 53 (58.2%). Mean of age was 70.61 years ± 5.75 SD,actual height measurements was 155.30 cm ± 9.37 SD, height calculated with formula was 160.35 cm ± 8.59 SD, knee heightwas 49.60 ± 3.39 SD, thoracic hyperkiposis was -17.210 ± -11.7 SD and the difference between height formula and actual heightmeasurements was 4.99 cm ± 5.84 SD.There were no correlation between thoracic hyperkyposis and the difference of heightcalculated with WHO formula and actual height measurement with r = 0.001, p = 0.993. There were no correlations betweenbetween thoracic hyperkyposis with the difference of height calculated with speciÞ c formula and actual height measurements inelderly patients among geriatric outpatient clinic, sanglah hospital

The The relationship between IL-6 and CRP with Sarcopenia in indigenous elderly population at Pedawa Village, Buleleng, Bali, Indonesia Suka Aryana; AA Wiradewi Lestari; I.B. Putrawan; Ni Ketut Rai Purnami; I Nyoman Astika; R.A. Tuty Kuswardhani
Health Science Journal of Indonesia Vol 9 No 1 (2018)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v9i1.467

Abstrak Latar belakang: Sarkopenia adalah sindrom yang ditandai dengan penurunan massa otot disertai penurunan kekuatan otot dan atau fungsi otot. Stres oksidatif dan proses inflamasi dikenal sebagai faktor pemicu untuk sarkopenia dengan melepaskan rangsangan katabolik interleukin-6 (IL-6) dan protein C-reaktif (CRP). Penelitian ini bertujuan untuk menentukan hubungan antara IL-6 dan kadar CRP terhadap parameter sarkopenia seperti massa otot, kekuatan pegangan, dan kecepatan berjalan. Metode: Penelitian ini menggunakan desain cross-sectional analitik yang dilakukan di Desa Pedawa, Kabupaten Buleleng, Bali pada bulan Agustus 2016. Sekitar 79 responden berusia ≥ 60 tahun menggunakan teknik sampling acak stratifikasi. Variabel yang dinilai yaitu parameter sarkopenia (massa otot, kekuatan pegangan, dan kecepatan berjalan) termasuk IMT, serta IL-6 dan pemeriksaan tingkat CRP. Uji korelasi spearman dan parsial digunakan untuk menilai korelasi antara parameter IL-6, CRP, dan sarkopenia. Hasil: Kadar IL-6 dan CRP tidak berkorelasi signifikan dengan tiga parameter sarkopenia. Kadar CRP berkorelasi dengan IL-6 (r = 0.37; p = 0.001) dan IMT (r = 0.29; p = 0.009). Pada kelompok pria, IL-6 hanya berkorelasi dengan CRP (r = 0.40; p = 0.011). Sedangkan pada kelompok wanita, IL-6 berkolerasi dengan CRP (r = 0.38; p = 0.017), kecepatan berjalan (r = 0.33; p = 0.037) serta CRP berkorelasi dengan IMT (r = 0.32; p = 0.049) dan massa otot total (r = -0.32; p = 0.043). Setelah penyesuaian untuk variabel IMT, IL-6 berkorelasi dengan CRP (r = 0.43; p = 0,001) dan massa otot total (r = -0.25; p = 0.026) serta secara signifikan berkorelasi pada kelompok kurus (IMT<18.5 kg/m2) (r = -0.50; p = 0.026). CRP tidak berkorelasi secara signifikan dengan tiga parameter sarkopenia pada uji spearman, korelasi parsial, dan uji korelasi spesifik spearman berdasarkan pada kelompok IMT. Kesimpulan: Kadar IL-6 berhubungan dengan penurunan massa otot total pada keseluruhan lansia desa Pedawa setelah penyesuaian variabel IMT. Kata kunci: IL-6, Protein C-Reaktif (CRP), Sarkopenia, Lanjut usia, Desa Pedawa. Abstract Background: Sarcopenia is a syndrome characterized by decreased muscle mass with decreased muscle strength and or muscle function. Oxidative stress and inflammatory processes are known as triggering factors for sarcopenia by releasing catabolic stimuli of interleukin-6 (IL-6) and C-reactive protein (CRP).This study aims to determine the relationship between IL-6 and CRP levels to sarcopenia parameter such as muscle mass, grip strength, and walking speed. Methods: This study was an analytic cross-sectional design conducted at Pedawa Village, Buleleng District, Bali in August 2016. About 79 respondents aged ≥ 60 years using stratified random sampling technique. The assessed variables were sarcopenia parameter (muscle mass, grip strength, and walking speed) including BMI, as well as IL-6 and CRP levels examination. Spearman and partial correlation test were used to assess the correlation among IL-6, CRP, and sarcopenia parameters. Results: IL-6 levels and CRP were not significantly correlated with the three parameters of sarcopenia. CRP levels correlated with IL-6 (r = 0.37; p = 0.001) and BMI (r = 0.29; p = 0.009). In the male group, IL-6 was only correlated with CRP (r = 0.40; p = 0.011). While in the women group, IL-6 correlated with CRP (r = 0.38; p = 0.017), walking speed (r = 0.33; p = 0.037) and CRP correlated with BMI (r = 0.32; p = 0.049) and total muscle mass (r = -0.32; p = 0.043). After adjustment to BMI variable, IL-6 was correlated with CRP (r = 0,43; p = 0,001) and total muscle mass (r = -0.25; p = 0.026) and significantly correlated in underweight groups (BMI<18.5 kg/m2) (r=-0.50; p=0.026). CRP was not significantly correlated with the three parameters of sarcopenia on Spearman, partial correlation, and Spearman's specific correlation test based on BMI group. Conclusion: IL-6 levels were associated with total muscle mass loss after BMI adjustmentin Pedawa village’s elderly as a whole. Keywords: IL-6, C-Reactive Protein (CRP), Sarcopenia, Elderly, Pedawa village.

High Myostatin Serum Related with High Prevalence of Sarcopenia Among Elderly Population in Pedawa Village, Bali, Indonesia I Gusti Putu Suka Aryana; I Nyoman Astika; Raden Ayu Tuty Kuswardhani; Ida Bagus Putu Putrawan; Ni Ketut Rai Purnami; Wayan Giri Putra; Anak Agung Wiradewi Lestari; I Nyoman Wande
The Indonesian Biomedical Journal Vol 11, No 3 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i3.822

BACKGROUND: Sarcopenia is defined as a decrease in muscle mass accompanied by a decrease in muscle strength and performance. Sarcopenia arises from the disruption of the complex balance between anabolic and catabolic factors. Myostatin strongly influences muscle growth inhibition. Deletion and function loss of myostatin causes hyperplasia and skeletal muscle hypertrophy.METHODS: This study was an analytical cross-sectional study. Seventy respondents aged ≥60 years in Pedawa Village, Bali, Indonesia were selected by using the stratified random sampling technique. Sarcopenia status was assessed according to Asian Working Group for Sarcopenia (AWGS) criteria, including muscle mass, grip strength, and walking speed. While the myostatin serum levels was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS: The incidence of sarcopenia in the elderly was 45 people (64.3%). Based on the analysis, there was a significant difference between myostatin levels in sarcopenia subjects (47.59 ng/mL) and non-sarcopenia subjects (39.7 ng/mL). Based on the statistical calculations, it was determined that the cut-off range of myostatin levels was 48.91 ng/mL. The prevalence ratio of sarcopenia incidence based on the myostatin levels in the elderly was 3.84, while based on the combination of age risk and myostatin levels was 9.75.CONCLUSION: Based of the data, there are significant differences of myostatin level between elderly people with and without sarcopenia. The prevalence of high myostatin levels in elderly is almost 4 times higher than low myostatin levels in the elderly.KEYWORDS: myostatin, sarcopenia, elderly

Comparison of Applications of Various Organic and Inorganic Fertilizers on the Growth and Yield of Cayenne Pepper I Nyoman Astika; I Gusti Nyoman Arthanawa; I Ketut Darmawan; Dewa Putu Semara Yana; Yohanes Parlindungan Situmeang; I Dewa Nyoman Sudita
Agriwar Journal Vol. 2 No. 1 (2022): Agriwar Journal
Publisher : Program Studi Magister Sains Pertanian Program Pascasarjana Universitas Warmadewa

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Cayenne pepper is one of the agricultural commodities that has high economic value and its demand continues to increase along with the development of the population. Efforts to increase the production and quality of various types of plants continue to be carried out, by utilizing various types of fertilizers. The purpose of this study was to determine the response of growth and yield of cayenne pepper using organic and inorganic fertilizers. This research was carried out at the Experimental Garden of the Local Waste Processing Site in Kusamba Village, Klungkung Regency, and the Laboratory of the Agrotechnology Study Program, Faculty of Agriculture, Warmadewa University, Denpasar from March to November 2021. The method used in this study was experimental, using a Randomized Block Design (RBD). ) with 1 factor and 4 replications. The variables observed were plant height, number of leaves, stem diameter, number of fruit, fruit weight per plant, and fruit weight per ha. The results showed that the application of various types of fertilizers can increase all observed variables. The best fertilizer for the growth and yield of cayenne pepper is NPK fertilizer.

The influence of light physical activity on scale of pain in elderly with knee osteoarthritis Prasenah Subramaniam; Nyoman Astika; Ketut Mariadi
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Osteoarthritis (OA) is a collection of mechanical variations of joint thinning, including the articular ligament and the subchondral bone.Aim: This study aims to find out how some light physical activity correlates with the pain scale among elderly with knee osteoarthritis and also to find out whether light physical activity in the elderly helps reduce pain in knee osteoarthritis.Method: This research is a descriptive cross sectional study. The sample in this study was elderly people aged 50 years and above with a total of 70 samples were selected using multistage random sampling technique located in Badung Market, Kumbasari Market, and Renon Field. Data were obtained by interviewing respondents who previously provided informed consent using structured questionnaires. The degree of pain caused by osteoarthritis was measured using The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the total score.Results: Distribution of sex within samples found that women (54.3%) and men (45.7%). Researchers found that the mean age of respondents was 61.2 (SD + 3.75) years. The total number of respondents who have exercise habits is 52.9%. The average WOMAC score was 23 (SD +2,319) with a minimum score of 18 and a maximum of 27. Respondents with WOMAC score <23 were 52.9% whereas respondents with WOMAC score> 23 were 47.1%. Cross-tabulation results showed 97.3% of respondents with a WOMAC score <23 had exercise habits.Conclusion: The exercise habits of the elderly with knee osteoarthritis can reduce pain when measured using a 0-4 scale and the WOMAC pain scale.

Prevalensi sarkopenia dan frailty di desa Pedawe, Mangupura, Serai dan Songan I Gusti Agung Wilaja Putra; I Gusti Putu Suka Aryana; I Nyoman Astika; RA Tuty Kuswardhani; Ida Bagus Putrawan; Ketut Rai Purnami
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Frailty is characterized by a decrease in multi-organ physiological functions. Sarcopenia and frailty have a significant impact on individuals and society so it is necessary to know the prevalence in the community. This study aimed to determine the prevalence of sarcopenia and frailty in rural areasMethod: The was a cross-sectional study in the elderly population in the villages of Pedawa, Mangupura, Serai and Songan. Measurement of muscle mass using bioelectrical impedance analysis (BIA) and categorized based on the recommendation of the Asian Working Group for Sarcopenia (AWGS). Frailty is established through a screening questionnaire based on the Cardiovascular Health Study. The study was chosen by simple random sampling and population register data.Results: The study involved 235 elderly people with 117 people in Pedawe village, 71 people in Mangupura village, 34 people in Serai village and 13 people in Songan village with a composition of 35.5% men and 64.5% women. In this study sarcopenia in women was 51% and men 49%, while frailty was experienced in 58.9% women and 41.02% men. The mean age is 67.7 years. The prevalence of total sarcopenia is 59% with the lowest percentage ranging from the villages of Mangupura (30%), Songan (53.8%), Pedawe (70.9%), and Serai (79.4%). The overall frailty prevalence in the four villages is 17% with the percentage starting from the lowest being Mangupura (1.4%), Serai (5.9%), Songan (22.2%) and Pedawe (29.1%).Conclusions: The prevalence of sarcopenia and frailty is most common among elderly women. The highest prevalence of sarcopenia was found in Serai village and frailty prevalence was highest in Pedawe village.Â Latar Belakang: Frailty ditandai dengan adanya penurunan fungsi fisiologis multi organ. Sarkopenia dan frailty memberikan dampak yang bermakna bagi individu dan bagi masyarakat sehingga perlu untuk mengetahui prevalensinya di masyarakat. Penelitian ini bertujuan untuk mengetahui prevalensi sarkopenia dan frailty di daerah pedesaanMetode: Penelitian menggunakan studi potong lintang pada populasi lansia di desa Pedawa, Mangupura, Serai dan Songan. Pengukuran massa otot menggunakan bioelectrical impedance analysis (BIA) dan dikategorikan berdasarkan rekomendasi Asian Working Group for Sarcopenia (AWGS). Frailty ditegakkan melalui kuesioner skrining berdasarkan Cardiovascular Health Study. Penelitian dipilih dengan cara simple random sampling dan data register penduduk.Hasil: Penelitian melibatkan 235 orang lanjut usia dengan jumlah 117 orang di desa Pedawe, 71 orang di desa Mangupura, 34 orang di desa Serai dan 13 orang di desa Songan dengan komposisi 35,5% laki-laki dan 64,5% perempuan. Pada penelitian ini sarkopenia pada perempuan adalah 51% dan laki-laki 49%, sedangkan frailty dialami 58,9% perempuan dan 41,02% laki-laki. Rerata usia adalah 67,7 tahun. Prevalensi sarkopenia total adalah 59% dengan persentase masing-masing mulai dari yang terendah adalah desa Mangupura (30%), Songan (53,8%), Pedawe (70,9%), dan Serai (79,4%).Â Prevalensi frailty keseluruhan di empat desa adalah 17% dengan persentase masing-masingÂ mulai dari yang terendah adalah desa Mangupura (1,4%), Serai (5,9%), Songan (22,2%) dan Pedawe (29,1%).Kesimpulan: Prevalensi sarkopenia dan frailty paling banyak ditemukan pada lansia perempuan. Prevalensi sarkopenia paling tinggi didapatkan di desa Serai dan prevalensi frailty didapatkan paling tinggi di desa Pedawe.

Evaluasi derajat delirium sebagai prediktor mortalitas pasien usia lanjut dengan delirium yang dirawat di RSUP Sanglah, Bali, Indonesia Dian Pritasari Jeger; Yosef Samon Sugi; I Gusti Putu Suka Aryana; RA Tuty Kuswardhani; I Nyoman Astika; Ida Bagus Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Delirium is an acute attention and cognitive disorder that occurs in elderly patients. The disorder is usually very serious, often goes unrecognized, and is usually fatal. Diagnosis requires a complete cognitive assessment and a history of acute symptoms. Despite the management of the cause, patients with delirium do not always recover. The aim of this study was to determine the correlation between the degree of delirium and the incidence of death in geriatric patients who were admitted to Sanglah General Hospital.Methods: A retrospective cohort study was conducted during November 2014-February 2015 of consecutive patients with delirium aged over 60 years. The degree of delirium was measured by the Memorial Delirium Assessment Scale (MDAS) and Charlson's-Age Comorbidity Index (CACI). These patients were followed periodically and then a bad outcome was determined, namely death while being treated. The association between the severity of delirium and clinical outcome was evaluated using the Pearson test. The results are said to be significant if the p value <0.05 on SPSS version 21 for Windows.Results: The prevalence of delirium in Sanglah General Hospital was mild delirium (48.4%), moderate delirium (28.1%), and severe delirium (23.4%). There was a significant difference in the prevalence of the degree of delirium based on age (p <0.05), but not on gender (p = 0.752). There was a significant difference in the incidence of death based on age (p = 0.045) and degree of delirium (p = 0.01). There was a moderate positive correlation between the degree of delirium and the incidence of death (p = 0.02; r = 0.373).Conclusion: There is a significant relationship between the degree of delirium and the incidence of death in geriatric patients hospitalized in Sanglah General Hospital. Latar belakang: Delirium merupakan gangguan perhatian dan kognitif akut yang terjadi pada pasien usia tua. Gangguan tersebut biasanya sangat serius, sering tidak dikenali, dan biasanya sangat fatal. Penegakan diagnosis memerlukan penilaian kognitif yang lengkap dan riwayat adanya gejala yang timbul secara akut. Meskipun diberikan penatalaksanaan terhadap penyebabnya, pasien dengan delirium tidak selalu pulih. Tujuan dari penelitian ini adalah untuk menentukan korelasi antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.Metode: Penelitian kohort retrospektif dilakukan selama bulan November 2014-Februari 2015 terhadap pasien dengan delirium yang berusia di atas 60 tahun secara konsekutif. Derajat delirium diukur dengan Memorial Delirium Assesment Scale (MDAS) dan Charlson’s-Age Comorbidity Index (CACI). Pasien tersebut diikuti secara berkala kemudian ditentukan luaran yang buruk yaitu kematian saat dirawat. Hubungan antara derajat keparahan delirium dengan luaran klinis dievaluasi menggunakan uji Pearson. Hasil dikatakan bermakna apabila nilai p<0.05 pada SPSS versi 21 untuk Windows.Hasil: Prevalensi delirium di RSUP Sanglah yakni delirium ringan (48,4%), delirium sedang (28,1%), dan delirium berat (23,4%). Terdapat perbedaan bermakna prevalensi derajat delirium berdasarkan umur (p<0,05), namun tidak pada jenis kelamin (p=0,752). Terdapat perbedaan bermakna pada insiden kematian berdasarkan umur (p=0,045) dan derajat delirium (p=0,01). Terdapat korelasi positif sedang antara derajat delirium dengan insiden kematian (p=0,02; r=0,373).Kesimpulan: Terdapat hubungan yang signifikan antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.

Correlation between albumin serum and frailty in geriatric inpatient and outpatient clinic at Sanglah Hospital Denpasar Putu Shely Prihastuti Rudy; RA Tuty Kuswardhani; I Gusti Putu Suka Aryana; Nyoman Astika; Ida Bagus Putu Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background. Frailty in the elderly has a bad impact on health, especially in the elderly with acute illness. Elderly with frailty has an increase susceptibility to falls, disability and death. Frailty is a common problem in elderly patients, and hypoalbuminemia suggested to increase the risk of death. This study aimed to determine the relationship between albumin and frailty.Method: A Cross-Sectional Study was conducted from February 2018 to January 2019 at Sanglah Hospital with total 60 patients. Patients were divided into two groups, patients with hypoalbuminemia (albumin < 3.5 g/dL) and patients with normal serum albumin levels (albumin ? 3.5 g/dL). The frailty status assessment was measured with Fried's Frailty Phenotype questionnaire. Chi-square test was used to find the relationship between serum albumin and frailty.Result: We evaluated 60 patients, 36 patients (60%) were male and 24 patients (40%) were female. The age of the study subjects ranged from 62 to 92 years. In this study 26 patients (43.3%) with hypoalbuminemia and 34 patients (56.7%) with normal serum albumin. There were 20 patients (76.9%) with frailty in the hypoalbuminemia group, compared to 11 patients (32.4%) in the group of patients with normal serum albumin. Hypoalbuminemia has a risk of 6.97 times greater frailty compared to normal albumin in elderly patients (p = 0.001).Conclusion: This study exhibited a significant relationship between serum albumin and frailty in elderly admitted to inpatient unit and outpatient clinic. The lower the serum albumin level, the higher the probability of the elderly to experience frailty.

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