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All Journal journal of internal medicine E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Respirasi (JR) Health and Medical Journal Indian Journal of Forensic Medicine & Toxicology Respiratory Science Public Health and Preventive Medicine Archive

Ida Bagus Ngurah Rai

School Of Specialist In Pulmonary Disease Faculty Of Medicine Udayana University

Author-ID : 329901

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

Published : 17 Documents Claim Missing Document

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Prevalence and Onset of Hepatotoxicity Caused by Anti-Tuberculosis Drugs on Pulmonary TB Patients in Wangaya General Hospital Denpasar – Bali in 2016 Wayan Evie Frida Yustin; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; Ida Bagus Ngurah Rai
Health and Medical Journal Vol 4, No 3 (2022): HEME September 2022
Publisher : Universitas Baiturrahmah

Introduction: As tuberculosis (TB) endemic country, TB becomes a community health problem in Indonesia. Data from the Global TB Report in 2016 showed that Indonesia is the second most country with TB burden after India. WHO and the Ministry of Health issue a TB prevention program based on the End TB Strategy aimed to reduce morbidity, mortality, and disability due to TB. One of the challenges faced in the management of TB is the side effects of the anti-tuberculosis drug. Hepatotoxicity is the most common side effect. Aims: This study aims to determine the prevalence and onset of anti-TB drug-induced hepatotoxicity in TB patients after receiving the anti-TB drug in Wangaya Hospital Denpasar Bali. Method: This study used a cross-sectional method by obtaining secondary data of pulmonary TB patients visiting the pulmonary clinic in Wangaya General Hospital from January to December 2016. Result: Of 77 subjects, fifty-six percent of them were men. The highest prevalence was found in the 41-50 years age group (26.9%), while the lowest was found in the 81-90 years age group (1.2%). Anti-TB drug-induced hepatotoxicity occurred in 6.5% of subjects. The most frequent onset of hepatotoxicity occurred within the second week of medication. Anti-TB drug-induced hepatotoxicity occurred in 6.5% of subjects. The most frequent onset of hepatotoxicity occurred within the second week of medication. Conclusion: Based on this study, we suggest a liver function test before and after two weeks of an anti-TB drug.

Challenging Treatment of Drug-Resistant Tuberculosis during Pregnancy: A Case Report Ni Luh Putu Eka Arisanti; Ni Putu Ayu Widiasari; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ida Bagus Ngurah Rai; Made Ary Sarasmita
Jurnal Respirasi Vol. 8 No. 3 (2022): September 2022
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: Globally, drug-resistant tuberculosis (TB) still has a high number of cases. Pregnant women are one of the high-risk populations for TB infection, especially multidrug resistance (MDR)/Rifampicin resistance (RR) TB. Physiological differences in pregnant women and the safety of the fetus make drug resistance TB treatment challenging. Case: A 20-year-old woman was 22 weeks pregnant while undergoing the third month of the late phase for short-regimen. Thus, Kanamycin was one of her early phase treatment combinations during the first trimester of pregnancy. After we consulted with other departments, especially the obstetric department, we decided not to change her regimen. Her chief complaint before treatment was cough with white sputum and fluctuated shortness of breath for two months. The patient only experienced minor side effects in the early treatment phase. The patient was cured of MDR TB on 8 October 2020 at 34 weeks of gestation. Her baby was born on 10 November 2020 at 37 weeks without congenital abnormality. Observation for her baby continued by the pediatric department. The last follow-up of her baby in the middle of 2022 found no abnormality in the child’s growth and development. Conclusion: Drug-resistant TB therapy in pregnant women requires the collaboration of a multidisciplinary team to consider the benefits and risks of the therapy based on gestational age and disease severity.

Polusi udara terkait lalu lintas dan kesehatan respirasi I Gusti Ngurah Bagus Artana; Ida Bagus Ngurah Rai
Intisari Sains Medis Vol. 9 No. 3 (2018): (Available online: 1 December 2018)
Publisher : DiscoverSys Inc.

Polusi udara meningkatkan risiko menderita berbagai masalah kesehatan, terutama di bidang respirasi. Pajanan polusi udara terkait lalu lintas bersifat involunter dan mengenai manusia sejak dalam kandungan hingga kematian. Polutan udara mengandung bahan-bahan seperti nitrogen dioksida, sulfur dioksida, karbon monoksida, benzene, ozon, particulate matter 10 (PM10), timbal, arsenik, cadmium, nikel, benzopyrene, dan particulate matter 2,5 (PM2.5) yang dapat mempengaruhi kesehatan paru. Menentukan hubungan sebab akibat berbagai polutan utama dari jalan raya terhadap system respirasi manusia merupakan hal yang sangat rumit dilakukan. Secara umum dapat disimpulkan, polutan terkait lalu lintas akan mencetuskan reaksi inflamasi yang akan bergulir sesuai variasi individu manusia yang terpajan. Konsep stress oksidatif akibat polutan terkait lalu lintas juga mulai banyak diteliti. Hal ini memberikan harapan dalam membantu mekanisme anti-oksidan manusia dalam menghadapi ancaman polusi udara yang semakin sulit dihindari.

Pneumotoraks spontan primer berulang pada wanita hamil dengan hiperemesis gravidarum: laporan kasus Ni Putu Ayu Widiasari; Ni Luh Putu Eka Arisanti; Ida Bagus Ngurah Rai
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Spontaneous pneumothorax is a rare case during pregnancy. However, the condition of Hyperemesis Gravidarum during pregnancy is one of the risk factors for recurrent primary spontaneous pneumothorax.Case Description: A 28-year-old woman with G5P3013 gestational age 12-13 weeks with Hyperemesis Gravidarum had complaints of tightness and recurrent acute pleuritic chest pain. After a clinical and supporting examination using ultrasound, patients were diagnosed with recurrent primary spontaneous pneumothorax, and observational and symptomatic treatments were performed. The rupture of the bleb or the subpleura bulla is thought to be a pathological mechanism. Patients given birth vaginally without complications and complete resolution of the pneumothorax occurred.Conclusion: Recurrent pneumothorax in pregnant women with a history of hyperemesis gravidarum is rare. Observational and symptomatic treatment is the initial treatment that can be done.

Anosmia dan ageusia sebagai faktor prognosis baik pada pasien COVID-19 rawat inap di RSUP Sanglah Denpasar Senja Decy Ningrum; Ida Bagus Ngurah Rai; I Gede Ketut Sajinadiyasa; Anak Agung Raka Sudewi; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; Ni Luh Putu Eka Arisanti
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Anosmia and ageusia are early symptoms that are widely reported in COVID 19 patients and are associated with low rates of intensive care and mortality, so the hypothesis arises that anosmia and ageusia can be good prognostic factors in COVID-19 patients. This study aims to examine anosmia and ageusia as prognostic factors in COVID-19 patients. Methods: This study is an observational analytic study with a retrospective cohort design conducted at Sanglah General Hospital Denpasar from January to June 2022. Results: obtained a total of 1048 subjects with 344 subjects experiencing anosmia, 210 subjects experiencing ageusia, and 474 subjects experiencing a combination of anosmia and ageusia. Variable symptoms of anosmia and ageusia were statistically significant predictors for the recovery of COVID-19 patients (p<0.05). The cure rate in the group of patients with symptoms of anosmia was 1.8 times (RR = 1.783, 95% CI = 1.667-1.908) and the group of patients with symptoms of ageusia experienced 1.6 times higher recovery (RR = 1.564, 95% CI = 1.478 -1,655). After adjusting for other variables as confounders, the combination of symptoms of anosmia and ageusia in patients was a significant predictor of recovery for COVID-19 patients by 1.5 times compared to patients who did not experience the combination of symptoms of anosmia and ageusia (ARR = 1.523, 95% CI = 1.245- 1.864, p<0.05). Conclusion: Anosmia, ageusia and the combination of both, indicate protective factors against possible mortality and indicate a good prognosis in COVID-19 patients. Latar belakang: Anosmia dan ageusia merupakan gejala awal yang banyak dilaporkan pada pasien COVID-19 serta dikaitkan dengan tingkat rawat intensif dan mortalitas yang rendah sehingga muncul hipotesis bahwa anosmia dan ageusia dapat menjadi faktor prognosis yang baik pada pasien COVID-19. Penelitian ini bertujuan untuk meneliti anosmia dan ageusia sebagai faktor prognosis pada pasien COVID- 19. Metode: Penelitian ini merupakan studi analitik observasional dengan rancangan kohort retrospektif yang dilakukan di RSUP Sanglah Denpasar pada bulan Januari hingga Juni 2022. Hasil: Didapatkan total 1048 subjek dengan 344 subjek mengalami anosmia, 210 subjek mengalami ageusia, serta 474 subjek mengalami kombinasi anosmia dan ageusia. Variabel gejala anosmia maupun ageusia secara statistik merupakan prediktor signifikan untuk kesembuhan pasien COVID-19 (p<0,05). Tingkat kesembuhan pada kelompok pasien bergejala anosmia mencapai 1,8 kali (RR = 1,783, IK 95% = 1,667-1,908) lebih tinggi dan kelompok pasien bergejala ageusia mengalami kesembuhan 1,6 kali lebih tinggi (RR = 1,564, IK 95% = 1,478-1,655). Setelah disesuaikan dengan variabel lain sebagai perancu, kombinasi gejala anosmia dan ageusia pada pasien menjadi prediktor kesembuhan pasien COVID-19 secara signifikan sebesar 1,5 kali lipat dibandingkan pasien yang tidak mengalami kombinasi gejala anosmia dan ageusia (ARR = 1,523, IK95% = 1,245-1,864, p<0,05). Simpulan: Anosmia, ageusia, dan kombinasi keduanya menunjukkan adanya faktor protektif terhadap kemungkinan mortalitas serta menandakan adanya prognosis yang baik pada pasien COVID-19

Comparison between serum pleural effusion albumin gradient, total protein, lactate dehydrogenase, and erythrocyte count in malignant and non-malignant pleural effusion Victor Nugroho Wijaya; I Gede Ketut Sajinadiyasa; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Luh Putu Eka Arisanti; I Gusti Ngurah Bagus Artana; Ida Bagus Ngurah Rai
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.v13i3.1502

Background: Malignant pleural effusion carries a bad prognosis. Pathologic examination as the gold-standard diagnosis of malignant pleural effusion has sensitivity limitations and may cause delayed diagnosis. Several affordable examinations, such as serum pleural effusion albumin gradient, total protein, lactate dehydrogenase (LDH), and erythrocyte count, might be useful as malignant pleural effusion diagnostic tools. Methods: This is an observational analytic study with a cross-sectional design conducted at Sanglah Central General Hospital in Denpasar from December 2021 to July 2022. Pleural effusion fluid and blood were taken from subjects with malignant and non-malignant pleural effusion. Data were analyzed with SPSS version 25 software for Windows. Results: Total subjects were 47 persons consisting of 26 subjects with malignant pleural effusion and 21 subjects with non-malignant pleural effusion. Results from statistical analysis of malignant and non-malignant pleural effusion were serum pleural effusion albumin gradient median (IQR) 0.91 (0.65) g/dL vs. 1.22 (1.2) g/dL (p=0.129), total protein mean 3.92±0.95 g/dL vs. 3.52±1.67 g/dL (p=0.334), LDH median 535 (840) IU/L vs. 187 (1,016) IU/L (p=0.057), and erythrocyte count median 23,500 (109,250) cells/mm3 vs. 3,000 (11,000) cells/mm3 (p=0.004). The AUC of erythrocyte count from the ROC method was 0.745 (95%CI=0.599-0.890; p=0.004). Using a cut-off point ≥ 4,500 cells/mm3, it had a sensitivity of 80.8%, specificity of 61.9%, and Odds Ratio (OR) of 6.8 (95%CI=1.8-25.4). Conclusion: Erythrocyte count as routine examination showed good validity for diagnosing malignant pleural effusion and expected to reduce diagnosis delay. Meanwhile, albumin gradient, total protein, and LDH delivered no difference.

Risk Factors for Recurrences of Pulmonary TB among Patients in Denpasar: A Case-Control Study Ni Luh Putu Karminiasih; I Wayan Gede Artawan Eka Putra; Dyah Pradnyaparamita Duarsa; Ida Bagus Ngurah Rai; I Nyoman Mangku Karmaya
Public Health and Preventive Medicine Archive Vol. 4 No. 1 (2016)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2016.v4.i1.p04

Background and purpose: The incidence of recurrence in patients with pulmonary tuberculosis (TB) in Denpasar in 2014 was relatively high, around 3.5% of 1082 patients. This study aims to determine the risk factors for recurrence of pulmonary TB patients in Denpasar. Methods: The study design was a case control with 46 patients with pulmonary TB recurrence aged over 15 years as cases, and 92 patients who had recovered as control. Respondents were selected using systematic random sampling from the TB register from 2013 to 2015 in public health centers in Denpasar. Data were collected by a search of documents, observations, measurements and interviews conducted using questionnaires. Bivariate and multivariate analysis were conducted using chi square test and logistic regression respectively. Results: Risk factors that associated with recurrence of pulmonary TB were co-morbidity of diabetes mellitus (AOR=9.6; 95%CI: 2.17-43.08), adherence (AOR=7.6; 95%CI: 2.85-20.17), exposure to cigarette smoke during treatment (AOR=3.6; 95%CI: 1.41-9.16), home ventilation <10% (AOR=3.4; 95%CI: 1.27-9.47), house contact with pulmonary TB patients (AOR=3.1; 95%CI: 1.31-7.46) and malnutrition (AOR=2.8; 95%CI: 1.02-7.72). Conclusion: Risk factors for recurrence of pulmonary TB among patients were co-morbidity of diabetes mellitus adherence, cigarette smoke exposure during the treatment period, home ventilation <10%, house contact with pulmonary TB patients and malnutrition.

Co-Authors Dyah Pradnyaparmita Duarsa I Gede Ketut Sajinadiyasa I Made Agus Satrya Wibawa I Nyoman Mangku Karmaya I Wayan Dary I Wayan Gede Artawan Eka Putra Ida Ayu Jasminarti Dwi Kusumawardani Ida Bagus Putu Putrawan IGN Bagus Artana Kadek Widianiti Ketut Putu Yasa Kusmiati, Tutik Ni Luh Putu Eka Arisanti Ni Luh Putu Karminiasih Ni Made Ary Sarasmita Ni Putu Ayu Widiasari Ni Putu Ayu Widiasari Ni Putu Ayu Widiasari Ni Wayan Candrawati Raka-Sudewi A. A. Renny Irviana Eka Tantri Senja Decy Ningrum Venny Singgih Victor Nugroho Wijaya Wayan Evie Frida Yustin Wayan Rismayanti

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