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All Journal BALI MEDICAL JOURNAL (BMJ) journal of internal medicine Majalah Ilmiah Peternakan E-Jurnal Medika Udayana Jurnal Veteriner ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Bali Medika Jurnal Journal of Global Pharma Technology Biosaintifika: Journal of Biology & Biology Education

Anak Agung Ngurah Subawa

Bagian Patologi Klinik RSUP Sanglah Fakultas Kedokteran Universitas Udayana/Rumah Sakit Umum Pusat Sanglah Denpasar

Author-ID : 329904

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Transfusion Reactions as an Indicator of Service Quality of Blood Transfusion in Sanglah General Hospital Denpasar Bali-Indonesia Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah; Yasa, I Wayan Putu Sutirta
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: One of the fatal side effects of transfusion is transfusion reactions. The incidence of transfusion reaction in Sanglah Hospital is still relatively high and far from national target which is 0.01%. To achieve the target of quality, it is necessary to set up an active program so that the number of incidence of transfusion reactions can be decreased. Methods: Pre and post test interventional study was conducted for 6 months in Sanglah Hospital Bali. All nurses in wards which is blood product frequently used was involved in this study. The intervention in this study was in the form of education and training programs on the application of the closed system and cold chain in the distribution of blood products as well as improved service system. Results: The results showed a decline in the incidence of transfusion reactions occurred every month during the study. The incidence of transfusion reactions occurred each month was 0.77%, 0.56%, 0.5%, 0.49%, 0.45% and 0.38% respectively. The average reduction in the incidence of transfusion reactions was 0.08% every month. The type of transfusion reaction that occurred was 59% urticaria, 29% fever, 7% shortness of breath, 4% fever and chills, and 1% shock. Conclusion: Education and training programs on the application of the cold chain system and closed system in the distribution of blood products as well as the improvement of service system helped reduce the number of the incidence of transfusion reactions in Sanglah Hospital Bali.

Pre-Storage Leukoreduced Filtration (PLF) Decrease Soluble Human Leukocyte Antigen-I (sHLA-I) Level in Thrombocyte Concentrate Stored for Five Days Herawati, S.; Sutirta-Yasa, I. W. P.; Suega, K.; Subawa, A. A. N.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Thrombocyte concentrate is one of the important blood component to improve patient's clinical condition. In order to provide thrombocyte, concentrate with good therapeutic effect, the preparation process and storage condition should be maintained properly. One attempt to maintain good quality of thrombocyte concentrates is by doing Pre-storage Leukoreduced Filtration (PLF) method during preparation of thrombocyte concentrates. The purpose of this study was to determine the effect of PLF on sHLA-I level in thrombocyte concentrates stored for 1, 3 and 5 days. Methods: This is an experimental study with posttest only Control Group design, enrolling 34 thrombocyte concentrates and randomly assigned into PLF Group and Control Group. Results: It was obtained that PLF Group has lower mean sHLA-I level than Control Group stored for 1, 3 and 5 days and statistically significant. Mean sHLA-I level in PLF Group at day 1 is 2,75±0,82 µg/ml and Control Group is 3,66±0,87 µg/ml, which is statistically significant (p < 0,05). Mean sHLA-I level in PLF Group at day 3 is 3,07±0,75 µg/ml and Control Group is 4,05±1,29 µg/ml, which is statistically significant (p < 0,05). Mean sHLA-I level in PLF Group at day 5 is 3,81±0,97 µg/ml and Control Group is 5,61±3,26 µg/ml, which is statistically significant (p < 0,05). Conclusions: It can be concluded that PLF decrease sHLA-I level in thrombocyte concentrates stored for five days compared with Control Groups.

IMMUNOMODULATOR, GROWTH PERFORMANCE AND HEMATOLOGICAL PROFILES OF VIUSID VET SUPPLEMENTATION ON PIGLETS Ardana, Ida Bagus Komang; Soma, I Gede; Subawa, Anak Agung Ngurah; Putra, Dewa Ketut Harya
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

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Background: Immunity system plays important roles in maintaining health status in human as well as in animals.This work aims to study the effect of supplementation of food supplement Viusid vet 90 on growth performance, morbidity and mortality rates, hematological profile, and on antibody titer which may indicate its possible role as an immunomodulator. Methods: Sixty (60) piglets were used as the experimental animals divided into 2 groups, namely group without Viusid supplementation as the control group and that with Viusid supplementation starting from 3 days of age until 13 days of age (10 days of treatment). The dose of supplementation in the feed was 5 cc of Viusid given twice a day. At day 7 of age, the piglets were vaccinated intramuscularly with Hog cholera vaccine and it repeated at day 14 of age. The animals were weighed at the beginning of the experiment and again at Day 15 and then at the end the experiment at Day 30. At 20 days of age all animals were bled using vacuum tube containing anticoagulant EDTA. Subsequently the bloods were examined for hematological profiles using Manual ABC VET Automated blood counter. Finally, at 30 days of age they were all bled again for the assessment of their antibody titer against Hog cholera following ELISA method. Results: supplementation of Viusid vet 90 to piglets improves performance by reducing morbidity and mortality rates. As hematological profile and differential leucocyt count did not showed any abnormality then it may concluded that supplementation of Viusid is effective and safe for piglets. Moreover, the percentage Plate Count (PC) value for Hog cholera was seropositive (54.69%) and significantly higher than control (41.32%) and this could indicate that Viusid vet 90 act as a strong immunmodulator.

COMPARATIVE IMMUNE RESPONSES OF CHILDREN AFTER INTRADERMAL AND INTRAMUSCULAR RABIES VACCINATION Subawa, A. A. Ngurah; Sutirta Yasa, I Wayan Putu; Astawa, Nyoman Mantik
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
Publisher : BALI MEDICAL JOURNAL

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Background: Rabies is a cause of death to people within 100% of Case Fatality Rate. Approximately 55.000 people died because of rabies each year, the vast majority of these deaths happen in Asia and Africa. This study aims to find out comparative immune responses of intradermal (ID) and intramuscular (IM) vaccination in children. Method: This was an experimental study to determine antibody response of ID and IM rabies vaccines with randomized pre and posttest control group design. ID and IM vaccination were carried out in 4 replication for each group. A number of 16 children were recruited for each group. Enzyme Linked Immunosorbent Assay (ELISA) was applied to determine titers antibody on day 0, 7, 21, and 28 after vaccination. Results: This study found that titer antibody induced by ID vaccination was lower than IM vaccination. However, the different is not statistically significant in both groups (p > 0.05). Titers antibody on day 7 after vaccination were 3.08 ± 2.09 IU/ml intradermally and 4.22 ± 3.02 IU/ml intramuscularly. On day 21 and 28 after intradermal vaccination, titers antibody were 6.78 ± 3.52 IU/ml and 12.53 ± 5.92 IU/ml, respectively. Intramuscularly, antibody titers were 9.76 ± 4.86 IU/ml on day 21 and 14.98 ± 7.76 IU/ml on day 28. Conclusion: ID vaccination is safe and can be used as an alternative vaccination for rabies in human. In addition, 0, 7, 21 ID vaccination methods can be recommended for use to control rabies cases in Indonesia because that methods induce protective immune response.

PROFIL ANALISIS BATU SALURAN KENCING DI INSTALASI LABORATORIUM KLINIK RSUP SANGLAH DENPASAR Rasmika Dewi, Dewa Ayu Putu; Ngurah Subawa, Anak Agung
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Urolithiasis is a pathological condition that is caused by the formation of hard mass like stone along theurinary tract. Identification of the urinary stones can be done through chemical analysis or using of infraredspectroscopy. The semiquantitative methods used to analyze are titrimetric and colorimetric. This study wascross sectional whose results were descriptive. The data used in this study was 113 urinary stone analysisrecords taken from Routine Clinic of Laboratory Clinic Installation at Sanglah Hospital in period January untilDecember 2007 (one year). The prevalence of urolithiasis in males were more than females (4:1) and it wasmostly occur in age range 40-60 years old of both sexes. Generally, more than one kind of stone compositionswere found in a patient of urolithiasis, the dominant was calcium oxalate.

POLA JUMLAH TROMBOSIT PENDERITA DEMAM BERDARAH DENGUE (DBD) PADA ANAK-ANAK YANG PETANDA SEROLOGINYA POSITIF Ngurah Subawa, Anak Agung; Sutirta Yasa, I Wayan Putu
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Thrombocytopenia represent one of non specific laboratory criterion to uphold diagnosed DHF specifiedby WHO. Existence of trombositopenia on third or fourth days of disease, will be easily diagnosed of DHF. Toknow the pattern of the thrombocyte amount on children suffering from DHF based on IgG and IgM serologicmarker. This Research is retrospective study by seeing medical report of pediatric patient which is taken care byDHF in Sanglah Hospital Denpasar from July 2005 until June 2006. There are 42 pediatric patient sufferingfrom DHF with the positive serologi examination result, as much 17 child (40.5%) by IgG is positive, 9 child(21.4%) IgM positive and 16 child (38.1%) by IgG and IgM positive. At fourth days of disease development,the mean of the thrombocyte amount in serologi IgG are positive is the lowest (99.8 x 103/mm3). At fifth days,the mean of thrombocyte amount in serologic IgG and IgM are positive is the lowest (61.7 x 103/mm3). At sixthdays, the mean thrombocyte amount in serologic IgG are positive is the lowest (61.9 x 103/mm3). At seventhdays, the patient having positive IgG or positive IgG and IgM, the mean of the thrombocyte amount experienceof the improvement from previous day. At eighth days, patient having positive IgG and IgM were more oftenhave the thrombocyte amount more than the other (only IgG or IgM positive). The patient suffering from secondinfection (IgG positive or IgG and IgM positive) at the acute phase more often have the thrombocyte amount islower the than the primary infection (IgM Positive). Expected of continuation research with the sample amountand scope is more than before.

PREVALENSI PENYAKIT GINJAL KRONIK STADIUM 5 YANG MENJALANI HEMODIALISIS DI RSUD BADUNG PERIODE TAHUN 2017-2018 I.B.GDE ANANTA MAHESVARA; WAYAN PUTU SUTIRTA YASA; AAN. NGURAH SUBAWA
E-Jurnal Medika Udayana Vol 9 No 7 (2020): Vol 9 No 07(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i7.P06

ABSTRAK Penyakit ginjal kronik (PGK) merupakan masalah kesehatan masyarakat global dengan prevalensi daninsidensi gagal ginjal yang meningkat, prognosis yang buruk dan biaya terapi yang tinggi. Stadium PGK dibagi menjadi 5, berdasarkan laju filtrasi glomerulus (LFG) yang masih dapat dihasilkan ginjal, dimana halini mencerminkan fungsi ginjal. Untuk pasien dengan PGK stadium 5, terapi hemodialisis (HD) merupakansalah satu pilihan utama yang sering digunakan. Tujuan dilakukannya penelitian ini adalah untukmengetahui prevalensi dan karakteristik pasien dengan PGK stadium 5 yang menjalani HD di RSUDBadung periode tahun 2017-2018. Rancangan penelitian yang digunakan pada penelitian ini adalahpenelitian deskriptif dengan pendekatan retrospektif cross-sectional study. Sampel penelitian diambil daricatatan medis populasi terjangkau secara consecutive sampling. Penelitian dilaksanakan di Instalasi RekamMedis RSUD Badung dengan sumber data yang diambil selama 1 tahun, yaitu dari Januari tahun 2018sampai dengan Desember 2018. Pada penelitian ini didapatkan prevalensi PGK stadium 5 yang menjalaniHD di RSUD Badung sebesar 0,0003%. Pasien PGK stadium 5 yang paling banyak menjalani HD adalahsebagai berikut: pasien dengan jenis kelamin laki-laki, pasien berusia 50-59 tahun, pasien yang menjalaniHD selama <12 bulan, pasien dengan diagnosis etiologis pielonefritis kronik (PNC), pasien dengan aksesvaskular arteriovenous fistula (AVF), pasien dengan kadar hemoglobin (HB) 7-10 g/dL, pasien dengankadar kalsium (Ca) <8,4 mg/dL, pasien dengan kadar fosfat (PO4) >5,5 mg/dL, pasien dengan kadar produkCa x PO4 <55 mg2/dL2, dan pasien dengan kadar asam urat <7 mg/dL.Kata Kunci: PGK, stadium 5, hemodialisis, RSUD Badung ABSTRACTChronic kidney disease (CKD) is a global public health problem with increased prevalence and incidence of kidney failure, bad prognosis and high cost of therapy. CKD is divided into 5 stages, based onthe glomerular filtration rate (GFR) that the kidneys can still produce, which reflects to kidney function.For patients with stage 5 CKD, hemodialysis (HD) therapy is one of the main choices that are often used.The purpose of this study was to determine the prevalence and characteristics of patients with stage 5 CKDwho underwent HD on Badung General Hospital in the year of 2017-2018. The research design used in thisstudy was a descriptive study with a retrospective cross-sectional study approach. The study sample wastaken from population medical records by consecutive sampling. The study was carried out in the MedicalRecord Installation of Badung General Hospital with data sources taken for 1 year, from January 2018 toDecember 2018. In this study, the prevalence of stage 5 CKD which underwent HD in Badung GeneralHospital was 0.0003%. Stage 5 CKD patients who underwent the most HD were as follows: patients with male gender, patients aged 50-59 years, patients underwent HD for <12 months, patients with etiological diagnosis of chronic pyelonephritis (PNC), patients with AVF vascular access, patients with hemoglobin (HB) levels 7-10 g/dL, patients with calcium (Ca) <8.4 mg/dL, patients with phosphate levels (PO4) >5.5 mg/dL, patients with product levels Ca x PO4<55 mg2/dL2, and patients with uric acid level <7 mg/dL. Keywords: CKD, stadium 5, hemodialysis, Badung General Hospital

GAMBARAN KARAKTERISTIK ANEMIA DEFISIENSI BESI PADA IBU HAMIL DI RSUP SANGLAH TAHUN 2017 Putu Ayu Krisna Cahyaning Putri; A.A Ngurah Subawa; A.A Wiradewi Lestari
E-Jurnal Medika Udayana Vol 9 No 2 (2020): Vol 9 No 02(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Proporsi peningkatan volume plasma yang lebih besar dibandingkan dengan pembentukan eritrosit sering kali menyebabkan anemia pada ibu hamil. Dari berbagai jenis anemia, anemia defisiensi besi (ADB) paling sering terjadi pada ibu hamil. Tingginya morbiditas ibu hamil dengan anemia defisiensi besi di negara berkembang seperti Indonesia masih menjadi permasalahan kesehatan yang tergolong berat. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik anemia defisiensi besi pada ibu hamil di RSUP Sanglah tahun 2017 yang merupakan penelitian deskriptif-retrospektif dengan rancangan penelitian cross sectional. Subjek penelitian adalah 25 ibu hamil dengan ADB di RSUP Sanglah tahun 2017. Pengambilan data dari rekam medis pasien dilakukan bulan Mei sampai Juni 2018. Hasil penelitian menunjukan ibu hamil dengan anemia defisiensi besi paling banyak ditemukan pada trimester III sebanyak 21 (84%), dengan derajat anemia yang terbanyak adalah anemia ringan sebanyak 15 (60%). Ibu hamil paling banyak mengalami ADB pada umur 20-35 tahun dengan persentase 21 (84%). Tingkat pendidikan akhir terbanyak adalah SMA sebanyak 19 (76%) dan anemia paling sering terjadi pada kehamilan multigravida sebanyak 16 (64%). Sedangkan distribusi derajat anemia terhadap usia kehamilan, umur ibu, tingkat pendidikan dan paritas paling sering ditemukan pada derajat anemia ringan yaitu sebanyak 13 (65%) pada trimester III, 13 (61,9%) pada kelompok usia 20-35 tahun, 12 (63,1%) pada pendidikan akhir SMA dan 10 (62,5%) pada paritas kehamilan multigravida. Kata Kunci: Anemia, Defisiensi Besi, Ibu Hamil

GAMBARAN HASIL ANALISIS BATU SALURAN KEMIH DI LABORATORIUM PATOLOGI KLINIS RSUP SANGLAH DENPASAR PERIODE NOVEMBER 2013 – OKTOBER 2014 Felicia Suryanto; Anak Agung Ngurah Subawa
E-Jurnal Medika Udayana Vol 6 No 1 (2017): E-jurnal medika udayana
Publisher : Universitas Udayana

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Penyakit batu saluran kemih atau urolithiasis merupakan salah satu permasalahan yang paling sering terjadi pada saluran kemih. Peningkatan prevalensi batu saluran kemih menimbulkan peningkatan angka kesakitan (morbiditas) serta beban ekonomi. Batu saluran kemih juga memiliki rata- rata kekambuhan terjadi 50% dalam 5 tahun dan 70% dalam 10 tahun. Tujuan penelitian ini adalah untuk mengetahui bagaimana gambaran batu saluran kemih berdasarkan usia, jenis kelamin, lokasi dan komposisi batu. Penelitian ini menggunakan metode kuantitatif dan hasilnya merupakan survey deskriptif. Lokasi penelitian bertempat di laboratorium patologi klinis RSUP Sanglah Denpasar dengan total sampel sebesar 141. Data diolah secara manual, dilaporkan dalam bentuk table dan diberi narasi tanpa uji statistik. Dari 141 sampel yang dijadikan bahan penelitian didapatkan proporsi usia terbanyak adalah usia ? 50 tahun dengan jumlah 75 sampel (53, 2%). Batu saluran kemih lebih sering diderita oleh laki-laki dibandingkan perempuan dengan perbandingan 2,9 : 1. Proporsi lokasi batu saluran kemih terbanyak berasal dari ginjal yaitu sebanyak 84 sampel (59, 6%). Komposisi batu saluran kemih adalah sebagai berikut Kalsium Oksalat 72,3% , Kalsium Fosfat 42,5%, Asam Urat 17%, Sistin 34,7%, Struvit 67,4%, dan lain-lain 17%. Simpulan dari penelitian ini adalah proporsi batu saluran kemih meningkat seiring dengan pertambahan umur, lebih sering diderita oleh laki-laki dibandingkan perempuan, dengan lokasi terbanyak berasal dari ginjal, dan komposisi terbanyak adalah Kalsium Oksalat.

FAKTOR-FAKTOR YANG BERHUBUNGAN TERHADAP DERAJAT BERAT INFEKSI VIRUS DENGUE PADA PASIEN DEWASA YANG DIRAWAT DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR BALI Made Wulan Utami Dewi; Sianny Herawati; A.A. Ngurah Subawa
E-Jurnal Medika Udayana Vol 9 No 4 (2020): Vol 9 No 04(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Dengue virus belongs to the genus Flavivirus that can be transmitted to humans by the bite of the Aedes aegypti mosquito. Dengue virus infection has a mortality and morbidity rates are fairly high almost throughout the world. Diagnosis has been classified by degree of clinical manifestation according to WHO 1997, confirmed through clinical signs and symptoms and laboratory tests. The aim of this study is to examine the relationship leukocyte count, lymphocyte count, hematocrit and platelet count with a severity degree of dengue virus infections, according to WHO criteria in 1997 in adult patients admitted to the General Hospital Sanglah 2015. This study use cross-sectional analytic study on 90 patients with dengue infection using secondary data. Samples are adult patients with dengue infection aged > 12 years in the medical records contained the results of the leukocyte count, lymphocyte count, hematocrit and platelet count were treated at Sanglah Hospital in Bali on the period January 1 to December 31, 2015. Analysis using PASW Statistics 18 with the Kolmogorov-Smirnov normality then resumed with Pearson correlation test found no siginificant relationship between the number of leukocytes with the lowest degree of severe dengue infection (p = 0.354; r = -0.099), there is no significant relationship between hematocrit value with the highest degree of severe dengue infection (p = 0.293; r = 0.112), and obtained negative relationship weak significant between platelet counts with the lowest degree of severe dengue infection (p = 0.009; r = -, 0275). The results of analysis by Spearman correlation test found no significant relationship between low lymphocyte count with severity of dengue infection (p = 0.636, r = -0.051). Seeing the results, need to do prevention and detection of dengue infection early, so that morbidity and mortality can be reduced. Keywords: Leukocyte count, lymphocyte count, platelet count, hematocrit and severity of dengue infection.

Co-Authors Ali Djamhuri Anak Agung Wiradewi Lestari Anggraeni Suarsana Ardana I B K, Ardana Christian Nurtanto Putra Claudia Anastasia Desak Gde Diah Dharma Santhi Desak Laksmi Dewa Ayu Putu Rasmika Dewi Dewa Ngurah Suprapta Felicia Suryanto Gopi Krishnan I Dewa Ketut Harya Putra I Gede Soma I Gede Widhiantara I Gusti Kamasan Arijana I Made Bagus Cahya Wibawa I Made Dwikayana I Made Jawi I Made Kardana I NYOMAN MANTIK ASTAWA I Nyoman Wande I Wayan Agus Surya Pradnyana I Wayan Putu Sutirta Yasa I.B.GDE ANANTA MAHESVARA Ida Ayu Putri Wirawati Ida Bagus Komang Ardana Ida Bagus Ngurah Indira Pratiwi Kadek Pipin Rahina Soethama Ketut Suega Komang Agus Widhy Utama Putra Komang Vika Nariswari Ratna Kinasih Made Wulan Utami Dewi Made Yuliantari Dwi Astiti Mahardika, Ketut Indah Karina Naw, Sin War Ni Kadek Mulyantari Ni Kadek Nita Utami Ni Made Evitasari Dwitarini Ni Made Linawati Ni Nyoman Mahartini Ni Nyoman Yuliantini Nugraha, Ketut Yoga Wira Putra D K H, Putra Putu Angga Wiradana Putu Ayu Krisna Cahyaning Putri Putu Bihan Surya Kinanta Putu Devita Sucitawati Putu Purna Astika Utama Raka-Sudewi A. A. S. Herawati, S. Sari, Lia Cahya Sianny Herawati Sianny Herawati Stephanie Inge Wijanarko Sudewa Djelantik Tjokorda Gede Oka Wikananda, Made Argyanta

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