Anak Agung Ngurah Subawa
Bagian Patologi Klinik RSUP Sanglah Fakultas Kedokteran Universitas Udayana/Rumah Sakit Umum Pusat Sanglah Denpasar

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GAMBARAN KARAKTERISTIK PASIEN ACUTE MYELOID LEUKEMIA DI RSUP SANGLAH DENPASAR TAHUN 2018 I Made Bagus Cahya Wibawa; A. A. Ngurah Subawa; I Wayan Putu Sutirta Yasa; Ni Nyoman Mahartini
E-Jurnal Medika Udayana Vol 10 No 6 (2021): Vol 10 No 06(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i6.P08

Abstract

Acute Myeloid Leukemia (AML) merupakan salah satu keganasan hematologi dengan jumlah penderita terbanyak di dunia. Insiden AML meningkat setiap tahunnya secara global. Penelitian ini bertujuan mengetahui karakteristik pasien AML di Bagian Penyakit Dalam RSUP Sanglah Denpasar tahun 2018. Penelitian dilakukan dengan metode deskriptif menggunakan studi potong lintang. Penelitian dilaksanakan pada bulan Maret - September 2019. Sampel penelitian ini sebanyak 34 rekam medik pasien AML yang dirawat inap di RSUP Sanglah tahun 2018. Data dianalisis menggunakan perangkat lunak Microsoft Excel untuk mendapatkan karakteristik pasien AML berdasarkan usia, keluhan utama, jenis kelamin, kadar hemoglobin, jumlah leukosit, jumlah trombosit, persentase blast, dan diagnosis berdasarkan FAB. Hasil penelitian menunjukkan frekuensi tertinggi pasien AML diperoleh pada kelompok usia 41-60 tahun (35,29%) dan didominasi jenis kelamin laki-laki (58,82%). Keluhan utama tersering yang dialami adalah badan lemah (55,88%). Berdasarkan hasil pemeriksaan darah lengkap, kebanyakan pasien AML ditemukan mengalami anemia sedang dengan kadar hemoglobin 8-10 g/dL (58,82%), jumlah leukosit >50.000/mm3 atau hiperleukositosis (47,06%), dan trombositopenia grade IV dengan jumlah trombosit <25.000/mm3 (38,24%). Berdasarkan pemeriksaan sumsum tulang, frekuensi terbanyak ditemukan pada pasien AML dengan persentase sel blast 30-39% (38,24%) dan tipe AML M4 atau Acute Myelomonocytic Leukemia (44,12%). Hasil penelitian ini berguna untuk penelitian lanjutan karena dapat memberi gambaran tentang karakteristik pasien AML di RSUP Sanglah Bali tahun 2018. Perlu dilaksanakan penelitian lebih lanjut untuk mengetahui hubungan antar variabel. Kata Kunci: Acute Myeloid Leukemia, Gambaran Karakteristik
KARAKTERISTIK PENDERITA KETOASIDOSIS DIABETIK PADA PASIEN DENGAN DIABETES MELLITUS TIPE 2 DI RUMAH SAKIT UMUM DAERAH WANGAYA PERIODE?1 JANUARI 2017 – 31 DESEMBER 2019 Komang Vika Nariswari Ratna Kinasih; Anak Agung Ngurah Subawa; Sianny Herawati
E-Jurnal Medika Udayana Vol 10 No 12 (2021): Vol 10 No 12(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i12.P11

Abstract

Latar belakang : Diabetes Mellitus merupakan satu dari empat penyakit yang tidak menular yang menjadi target untuk ditangani dengan segera. Ketoasidosis Diabetik adalah komplikasi dari Diabetes Mellitus tipe 2 akibat penurunan kadar insulin dalam darah karena meningkatnya kadar glukosa. Penelitian bertujuan untuk mengetahui karakteristik penderita Ketoasidosis Diabetik pada Pasien dengan Diabetes Mellitus Tipe 2 di Rumah Sakit Umum Daerah Wangaya periode 1 Januari 2017 – 31 Desember 2019. Metode : Metoda deskriptif studi potong lintang digunakan pada penelitian ini. Sampel dikumpulkan dengan menggunakan data sekunder dari rekam medik RSUD Wangaya dengan sampel penelitian sebanyak 33 orang dengan teknik total sampling dan mempertimbangkan kriteria inklusi dan eksklusi. Hasil : Sebagian besar kejadian kasus ditemukan pada perempuan dan pada kelompok usia 46 – 55 tahun. Pada sebagian besar kasus kadar gula darah sewaktu berkisar antara 451 mg/dL hingga 550 mg/dL. Kadar keton urin 1+, 2+, dan 3+ memiliki frekuensi yang sama. Kadar pH darah pada kasus sebagian besar berkisar antara 7 hingga 7,24 dan kadar serum bikarbonat (HCO3) pada kasus sebagian besar adalah kurang dari 10 mEq/L. Sebagian besar kasus memiliki derajat berat Ketoasidosis Diabetik. Kesimpulan : Sebagian besar kasus Diabetes Mellitus tipe 2 dengan Ketoasidosis Diabetik mengalami Ketoasidosis Diabetik derajat berat. Kata kunci : Ketoasidosis Diabetik, Diabetes Mellitus Tipe 2, Karakteristik
HUBUNGAN KOMPARASI PENURUNAN GLUKOSA ANTARA TABUNG VACUTAINER NaF DAN TABUNG SST PADA PASIEN DIABETES MELITUS Christian Nurtanto Putra; A. A. Ngurah Subawa; Desak Gede Diah Dharma Santhi
E-Jurnal Medika Udayana Vol 8 No 8 (2019): Vol 8 No 8 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Pengukuran kadar glukosa darah adalah salah satu tes diagnostik yang paling umum digunakan. Pengukuran yang akurat dan tepat dari glukosa darah sangat penting dalam menentukan diagnosis dan penanganan terhadap penyakit Diabetes melitus (DM). Berbagai faktor dapat mempengaruhi hasil pemeriksaan, dimana salah satunya adalah penggunaan antikoagulan tambahan pada tabung penyimpanan darah itu sendiri. Tujuan penelitian ini adalah untuk mengetahui adanya perbedaan kadar glukosa pada penggunaan tabung vacutainer NaF Oksalat dibandingkan dengan tabung SST dengan metode pemeriksaan sebelum 2 jam pengambilan darah pertama dan sesudah penundaan 8 jam. Jenis penelitian yang digunakan adalah eksperimental analitik. Sampel penelitian diambil dari darah 15 orang pasien DM yang melakukan pemeriksaan kadar glukosa darah di Laboratorium Patologi Klinik RSUP Sanglah Denpasar. Dengan mengikuti metode yang sudah ada, sampel dimasukan kedalam 2 tabung yang berbeda dan dilakukan pemeriksaan sebelum 2 jam pengambilan darah pertama. Tabung disimpan selama 8 jam, kemudian dilakukan pemeriksaan kedua. Pada pemeriksaan sebelum 2 jam pengambilan darah pertama, didapatkan kadar glukosa yang lebih tiggi pada tabung NaF dengan nilai rerata sebesar 147,93 mg/dl, sedangkan tabung SST dengan nilai rerata sebesar 135,53±47,03 mg/dl. Sementara pada pemeriksaan dengan penundaan 8 jam, didapatkan nilai rerata kadar glukosa pada tabung NaF sebesar 145,67 mg/dl dan nilai rerata kadar glukosa pada tabung SST sebesar 137,87 mg/dl. Tidak terdapat perbedaan bermakna secara statistik pada perbandingan kedua tabung maupun korelasi antar tabung dengan lama penyimpanan setelah dianalisis menggunakan uji statistik independent t-test dan juga paired t-test. Kata kunci: glukosa darah, tabung vacutainer SST, tabung vacutainer NaF Oksalat
TINGGINYA KADAR LOW DENSITY LIPOPROTEIN (LDL) DAN TRIGLISERIDA PADA KEJADIAN DIABETIC FOOT ULCER (DFU) DI RUMAH SAKIT UMUM PUSAT SANGLAH PERIODE JANUARI-DESEMBER 2014 Ni Kadek Nita Utami; A.A. Ngurah Subawa; I W.P. Sutirta Yasa
E-Jurnal Medika Udayana Vol 6 No 2 (2017): E-jurnal medika udayana
Publisher : Universitas Udayana

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Abstract

Diabetes Melitus tipe 2 merupakan bentuk tersering dari DM yang memiliki karakteristik yaitu terjadinya gangguan pada sekresi insulin dan insulin resisten. Komplikasi tersering dari DM adalah diabetic foot ulcer (DFU) yang ditandai dengan munculnya ulkus pada ekstremitas bawah yang dapat berujung pada amputasi apabila tidak tertangani dengan baik. Penderita DFU biasanya memiliki kadar kolesterol yang tidak terkendali dalam jangka waktu yang lama, yang dapat menyebabkan kerusakan endotel pada sistem vaskuler. LDL dan trigliserida merupakan substansi organik yang berperan dalam metabolic factor dan vascular changes terbentuknya gangren pada pasien DFU. Tujuan dari penelitian ini adalah untuk mengetahui hubungan tingginya LDL dan trigliserida pada kejadian DFU di RSUP Sanglah periode Januari-Desember 2014. Penelitian ini merupakan penelitian observasional analitik dengan design study cross sectional dengan mengambil data rekam medis penderita DM tipe 2, kemudian data yang telah dikumpulkan tersebut dianalisis dengan program SPSS. Sebanyak 160 data subyek dianalisis dalam penelitian ini. dengan uji chi square didapatkan hasil yang signifikan pada kadar LDL dan trigliserida dengan nilai p 0,001 dan 0,011. Dapat disimpulkan bahwa tingginya  kadar LDL dan trigliserida memiliki hubungan pada kejadian DFU di Rumah Sakit Umum Pusat Sanglah periode Januari-Desember 2014
PENURUNAN JUMLAH LEUKOSIT PADA KASUS KANKER SERVIKS TIPE SQUAMOUS PASCA KEMOTERAPI PERTAMA DI RSUP SANGLAH DENPASAR Putu Purna Astika Utama; Sianny Herawati; A.A. Ngurah Subawa; Ida Ayu Putri Wirawati
E-Jurnal Medika Udayana Vol 10 No 6 (2021): Vol 10 No 06(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i6.P07

Abstract

Kanker ialah salah satu penyakit yang mematikan di dunia.Etiologi dari kanker serviks adalah infeksi Human Papilloma Virus (HPV).Salah satu penanganan kanker serviks adalah kemoterapi.Sebelum melakukan kemoterapi pasien diwajibkan untuk melakukan pemeriksaan darah lengkap yang salah satunya adalah Leukosit.Penelitian bersifat deskriptif retrospektif dengan pendekatan longitudinal dari data sekunder pasien yang terdiagnosis kanker serviks tipe squamous sebelum dan pasca kemoterapi pertama yang didapat di Ruang Rekam Medis Rumah Sakit Umum Provinsi Sanglah Denpasar. Data yangdidapatkansebesar 57 kasus yang telah terinklusi dan tereksklusi.Data tersebut dianalisis secara deskriptif dan didapat penurunan Leukosit sebesar 5,46 x 103/µL, Neutrofil sebesar 5,24 x 103/µL, Limfosit sebesar 0,36 x 103/µL, Eosinofil sebesar 0,10 x 103/µL dan Basofil sebesar 0,02 x 103/µL. Hasil penelitian ini menunjukan bahwa pasien kanker serviks tipe squamous setelah dilakukan kemoterapi pertama mengalami penurunan nilai dari Leukosit, Neutrofil, Limfosit, Eosinofil dan Basofil. Kata Kunci :Kankerserviks, kemoterapi, leukosit, neutrofil, limfosit, eosinofil, basofil, RSUP Sanglah Denpasar
THE EXTRACT OF PURPLE SWEET POTATO DECREASE BLOOD AND LIVER MDA OF MICE AFTER INTENSE PHYSICAL ACTIVITY I Made Jawi; Dewa Ngurah Suprapta; A.A. Ngurah Subawa
Jurnal Veteriner Vol 9 No 2 (2008)
Publisher : Faculty of Veterinary Medicine, Udayana University and Published in collaboration with the Indonesia Veterinarian Association

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Abstract

Oxidative stress as consequence of intense physical exercises cause tissue lesions. The objective of this study was to identify the comparable antioxidant effect of water extract and syrup of Balinese purple sweet potato to the liver tissue in mice after maximal exercise, through the quantification of blood and liver malondialdehyde (MDA), and the histologic feature of liver tissue. Subjects of this study were 60 adult male Swiss mice divided into 6 groups with control group post-test only design. Blood and liver were collected after exercise protocol of exhausting swimming in ten mice without water extract, ten mice with water extract and ten mice with syrup of Balinese purple sweet potato. The MDA was quantification with TBARS method. Samples were also collected from control group of ten mice without water extract, ten mice with water extract and ten mice with syrup of Balinese purple sweet potato as sedentary mice. The results show a significant increase of MDA in the blood and liver, after swimming with and without water extract or syrup of Balinese purple sweet potato respectively (p<0,05). The increase of MDA was slightly significant in the group with water extract or syrup of Balinese purple sweet potato (p<0,05). The increase of liver cell necrosis was slightly significant in the group with water extract of Balinese purple sweet potato (p<0,05). From this finding it can be concluded that water extract or syrup of Balinese purple sweet potato has antioxidant effect in exhausting exercise in mice. Water extract of Balinese purple sweet potato has protective effect to the liver cell in exhausting exercise in mice
INFEKSI VIRUS RABIES DI ANAK-ANAK A.A.N. Subawa; DGD. Dharma Santhi; A.A Raka Sudewi; IWP. Sutirta Yasa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 3 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (566.285 KB) | DOI: 10.24293/ijcpml.v17i3.1093

Abstract

Rabies has been known in ancient Egypt and China since the fifth century. The disease is caused by the Rhabdovirus of the genusLyssavirus spread from animals or bats to humans by saliva. A five-year-old kid was admitted to Sanglah General Hospital on February19. 2010 with fever complaints, before admitted to the hospital, since the morning he always stuck out his tongue, bit his lips, drinkinga little of water and hard to swallow. From the anamnesis, it is known that the patient has a history of bitten by a dog on February 4.2010 at the lower eyelid and had received wound treatment and VAR, after a while having the treatment the patient eventually died onFebruary 21. 2010. According to the post-mortem sample of the LCS it is showed a positive PCR result of rabies virus infection.
NEOPTERIN DAN PEROKSIDA SERUM SEBAGAI PETANDA MAKROFAG TERAKTIVASI PADA TUBERKULOSIS PARU AKTIF DAN INDIVIDU BERKEBAHAYAAN TINGGI (Serum Neopterin and Peroxide As Marker of Activated Macrophages on Active Pulmonary Tuberculosis and Individuals At High Risk) I Nyoman Wande; Ni Made Linawati; I Made Bagiada; IWP. Sutirta Yasa; AAN. Subawa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1227

Abstract

Failure of macrophages to phagocytize Mycobacterium tuberculosis causes the release of hydrogen peroxide/peroxide (H2O2) bythe activated macrophages. Neopterin is one of the most important markers in the activated macrophages. Neopterin is a pteridinederivative produced by the activated macrophages through the stimulation of interferon gamma. Increased levels of Neopterin has beenreported in lung tuberculosis. Activation of macrophages is essential to the development of tuberculosis infection that can lead to activepulmonary tuberculosis or latent tuberculosis, in this case is a high-risk for healthy individuals. To determine the differences in serumlevels of Neopterin and H2O2 between patients with active pulmonary tuberculosis and healthy individuals at high risk of pulmonarytuberculosis. A total of 15 patients with active pulmonary tuberculosis and 15 healthy individuals at high risk examination serumNeopterin levels and peroxide (H2O2). Active pulmonary tuberculosis patients when the results of sputum smear examination chest x-raysis obtained positive results. Healthy individuals at high risk when the results of smear examination and chest x-rays is negative. Thelevel of Neopterin was examined using a double antibody sandwich immunoassay with Human neopterin (NEOP) ELISA Kit ® BioassayTechnology Laboratory. The level of peroxide was examined using quantitative colorimetric peroxidedetermination with QuantiChromTMPeroxide Assay Kit (DIOX-250)®. Neopterin serum levels between patients with active pulmonary tuberculosis and healthy individualsat high-risk were analysed by independent samples t-test. H2O2 serum levels between patients with active pulmonary tuberculosis andhealthy individuals at high-risk were analysed with Mann Whitney Test. The confidence level is p <0.05. The mean Neopterin levelsin patients with active pulmonary tuberculosis was 5.17±4.64 nmol/L, the mean Neopterin levels in group of healthy individuals athigh risk was 3.97±1.79 nmol/L. Statistical analysis by the independent samples t-test found no significant differences between groupsin Neopterin serum levels of patients with active pulmonary tuberculosis and healthy individuals at high risk (p=0.357). The meanserum levels of H2O2 of group of patients with active pulmonary tuberculosis was 26.38±3.00 μM, the mean levels of H2O2of group ofhealthy individuals at high risk of 20.69±4.46 μM. Statistical analysis with non-parametric Mann-Whitney Test was found significantdifference in the peroxide (H2O2) levels between groups of patients with active pulmonary tuberculosis and group of healthy individualat high-risk (p=0.000). The levels of Neopterin in patients with active pulmonary tuberculosis was not significantly higher comparedto the healthy individuals of high risk. Levels of peroxide (H2O2) serum in patients with active pulmonary tuberculosis was significantlyhigher compared to the group of healthy individuals at high risk. This shows that there is increased activity of macrophages in patientswith active pulmonary tuberculosis, but not effective in eliminating of Mycobacterium tuberculosis.
SUHU PENYIMPANAN KREATININ DAN ASAM URAT DALAM AIR KEMIH SELAMA 24 JAM AAN. Subawa; Sianny Herawati; I Nyoman Wande; I Wayan Putu Sutirta Yasa; Tjokorda Gede Oka
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1107

Abstract

Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The examination of creatinine and uricacid in urine is done on 24-hour urine collection. During the storage of the urine, it is recommended to be stored in a refrigerator withthe grade temperatures ranging from 2–8°C and is not recommended to use any preservative for the examination of creatinine anduric acid in urine. To know the comparation of creatinine and uric acid concentrations in urine between the urine tested immediatelyafter the collection with urine that was stored at a temperature 2–8°C and those at room temperature for 24 hours. A total of 45 urinesamples from outpatient clinic that came to the laboratory, were collected in particular urine vacutainer. Each urine sample is divided intothree tubes. The first tube (P1) examined concentrations of creatinine and uric acid immediately after collection, was considered as thebaseline value. The second tube (P2) stored at 2–8°C and the third tube (P3) is stored at room temperature for 24 hours, then followedby the examination of creatinine and uric acid concentrations. The examination of creatinine in urine was using reagent CREP2 RocheDiagnostic and uric acid in urine was using reagent UA2 Roche diagnostics by Cobas Integra ® 400 plus ® instrument. The mean ofcreatinine in urine concentrations which immediately examined (P1) is (125.10±74.85 mg/dL), concentrations after storage at 2−8°C(P2) and at room temperature (P3) were (123.42±73.80 mg/dL) and (124.09±73.95 mg/dL) respectively. Based on the analysis ofone-way ANOVA, there were no significant differences between the concentrations of creatinine in urine immediately checked which werestored at 2–8°C and at room temperature (P>0.05). The mean of uric acid in urine concentrations which immediately examined (P1) is(52.61±35.48 mg/dL), where as after storage at 2–8°C (P2) and room temperature (P3) were (45.11±31.62 mg/dL) and (46.38±28.91mg/dL) respectively. Based on the analysis of one-way ANOVA, there were no significant differences between the concentrations of uricacid in urine immediately checked by those stored at 2–8°C and at room temperature (P>0.05). Based on this study, it can be concludedthat there were no effect of storage temperature on the concentrations of creatinine and uric acid in urine within 24 hours.
PENDERITA DENGAN HEMOKROMATOSIS PRIMER Kadek Mulyantari; A.A.Wiradewi Lestari; A.A.N. Subawa; Tjokorda Gede Oka; Sudewa Djelantik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 2 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i2.1014

Abstract

Primary Hemochromatosis is a hereditary disease that occurs predominantly in man. Among men, clinical signs and symptomsfrequently appears on 40 years until more than 60 years of age. Meanwhile, the signs and symptoms among women appear on 50 yearsof age or after menopause. It is a very rare case in children or young adult. Secondary hemochromatosis can be differentiated fromprimary hemochromatosis based on existence of other underlying disease and secondary hemochromatosis often occurs in patient withmultiple blood transfusions. The diagnosis of primary hemochromatosis is confirmed by chromosomal test and liver biopsy to confirmthe liver damage caused by excessive iron accumulation. The main treatment of primary hemochromatosis is phlebotomy. The purposeof this method is to remove overload iron in body. In this case, the patient was man, unmarried, 51 years old, Australian. Four yearsago, he had complained about arthropathies, chronic asthenia, depression, decreased of concentration and sexual desire. Laboratoryevaluation revealed Ferritin level 2126 ug/L and transferrin saturation always more than 99%. Liver function tests also increasedsignificantly. Some of his family’s members have the same disease as he has. He was diagnosed as primary hemochromatosis and hadperformed phlebotomy routinely. After phlebotomy has done, he recovered based on clinical and laboratorial findings.