Ketut Tuti Parwati Merati
Department Of Internal Medicine Faculty Of Medicine University Udayana/RSUP Sanglah

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Journal : journal of internal medicine

HUBUNGAN ANTARA DERAJAT BERAT INFEKSI VIRUS DENGUE DAN KADAR NATRIUM SERUM Agung Budiyasa, Dewa Gde; Parwati Merati, K Tuti
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Dengue Viral (DV) infection has been a big problem on the world (WHO, 2005). One of the factors that can inß uencesuccesfull of the DV infection treatment was correction for hyponatremia as one of the factors caused dengue encephalopathy.Hyponatremia cause by plasma leakage, the more severe plasma leakage the more severe hyponatremia. The aim of this study toknow association between degree of severity of DV infection and natrium serum concentration, correlation between two signsof plasma leakage (albumin concentration and hematocrit) with serum natrium concentration. Analytic cross sectional designbe applied for DV infection patients who admitted at Internal Medicine Department of Sanglah General Hospital on November! December 2010. Pearson correlation test showed signiÞ cant correlation between albumin and serum natrium (p = 0.018, r =0.254), no signiÞ cant correlation between hematocrit and natrium serum (p = 0.861, r = 0.019). Linear regression showed pvalue for albumin 0.495 and degree of severity of DV infection 0.000, so variable that can predict natrium serum concentrationwas degree of severity of DV infection, stated with formula y = 134,515 - 2,664x. The conclusion we found there was negativeassociation between degree of severity of DV infection and natrium serum concentration which signiÞ cant between DF and DHF.But among degree of DHF there were just tendention that the more severe degree of severity of DHF the lower serum natriumconcentration. There was signiÞ cant correlation between albumin and natrium serum concentration, but albumin can"t predictnatrium serum concentration. No signiÞ cant correlation between natrium serum concentration and hematocrit. We suggest tomeasure natrium serum concentration to antisipate worsening of DV infection, and better be performed for serial examination.
PAJANAN OKUPASI DARI PASIEN TERINFEKSI HIV DI RSUP SANGLAH DENPASAR Somia, Agus; Utama IM, Susila; Parwati Merati, Tuti
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Health care personnel who have occupational exposure to blood and some body ! uids or tissues are at risk for HIVinfection. Aim of this study to know about characteristics of occupational exposure to HIV who cares in VCT-CST OutpatientClinic Sanglah Hospital Denpasar. A retrospective descriptive study was done among exposed persons who care in VCT-CSTOutpatient Clinic Sanglah Hospital Denpasar during 1 January 2006 ? 31 December 2007.Total 11 cases occupational exposure occurred in health care places, 9 cases occurrence in Sanglah Hospital and 2 casesoutside Sanglah Hospital. The profession of exposed persons were doctor (45%), medical student (18.2%) and nurse (18.2%).The type of exposure were percutaneous injury (72.7%). Severity of exposures included, 36.4% KP1 (small volume in shorttime), 45.5 % KP2 (large volume and/or long time or percutaneous injury with solid needle, or superfesial laceration), and18.18% KP3 (percutaneous injury with hollow needle, deep injury, visible blood on the device which caused the injury, injurywith needle which had been placed in a source patients artery or vein). HIV-positive class I patients (asymptomatic HIV or alow viral load) was 27.3 % and HIV-positive class II (symptomatic HIV or AIDS, acute seroconversion, or high viral load) was27.3%. about 72% exposed person taken postexposure prophylaxis with combination zidovudine and lamivudine for 4 weeks.Anti HIV status exposed persons at " rst time exposure, 3 month after exposure and 6 month after exposure were negative.We conclude that the most type of exposure were percutaneous with source of exposure each included HIV positive classI dan HIV positive class II. About two third of exposed person taken postexposure prophylaxis with zidovudine and lamivudinecombination. Anti HIV status exposed person a " rst time exposure, 3 month after exposure and 6 month after exposure werenegative.
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN MAKROSITOSIS PADA PASIEN HIV/AIDS YANG MENDAPAT TERAPI ZIDOVUDIN DI RUMAH SAKIT SANGLAH DENPASAR Ridana Wibawa, Ketut; Parwati Merati, Tuti; Somia, Agus; Utama, Susila
journal of internal medicine Vol. 11, No. 1 Januari 2010
Publisher : journal of internal medicine

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Abstract

Zidovudine is a Þ rst line drug used for treating HIV/AIDS patients in Indonesia and has been associated with prolongedsurvival, a reduction in the frequecy and severity of opportunistic infections, transient increases in the number of CD4 Tlymphocytes, and decreases in serum HIV p24 antigen. However prolong use of zidovudine associated with bone marrowtoxicity manifested by macrocytosis until anemic condition which need the transfusion. Some factors has been identiÞ ed canincreasing the bone marrow toxicity like: age, sex, cotrimoxazole, anemic and neutropenia condition, CD4 count < 200 cells/ L,vit B12 and folic acid level.To determine the risk factors correlated with incident of macrocytosis on HIV/AIDS patients treated with zidovudine,an analytical retrospective cross sectional study was done. The patients were selected using WHO criteria and the antiretoviraltherapy as Depkes guideline which zidovudine base with dose 600 mg/day. The age, sex, cotrimoxazole use and CD4 count wereassesed from all the patients by review medical record when the macrocytosis exist.This study included 140 subyects, age arround 19 ! 65 years old, sex male 72 % and female 28%. Cotrimoxazole use as atreatment or prophylaxis for PCP infection is 90% and the median CD4 count is 24.5 cells/ L. The incidence of macrocytosis is54.3% which is 46.4% without anemia and 7.9% present with anemia. The mean MCV value before zidovudine therapy is 86.27fL and elevated to 110.11 fL after zidovudine therapy. The median time of macrocytosis is 5 month. With bivariat analysis wedidn"t Þ nd correlation betwen age, sex, cotrimoxazol use and CD4 count with incident of macrocytosis (age p = 0.935 95% CIOR = 0.963 sex p = 0.800 95% CI OR = 0.846 cotrimoxazol use p = 0.237 95% CI OR = 0.403 and CD4 count p= 0.646 95%CI = 0.997 respectively).This study concluded no correlation betwen age, sex, cotrimoxazol use and CD4 count with incident of macrocytosis onHIV/AIDS patients whom treated with zidovudine. We suggest to routinely monitoring the MCV value every a month in a year,be cause the incidence of macrocytosis cause by toxicity effect of zidovudine to bone marrow is high.
Co-Authors Abdul Azis Abdul Azis Agus Eka Darwinata Anak Agung Ayu Yuli Gayatri Artha Camellia Astiti, Cok Istri Sri Dharma Bagus Ngurah Putu Arhana Brad Otto Claire Ryan Cok Istri Sri Dharma Astiti Cokorda Agung Wahyu Purnamasidhi Dewa Gde Agung Budiyasa Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dian, Ni Made Dewi Diksha, I Gusti Ngurah Ariestha Satya Dyah Kanya Wati Elizabeth Haryanti Gayatri, Anak Agung Ayu Yuli Gusni Rahma Handayani, Putu Novi Haruko Akatsu Haryadi Haryadi - I Dewa Made Sukrama I Gde Raka Widiana I Gusti Ayu Agung Elis Indira I Gusti Ngurah Kade Mahardika I K. Suata I Ketut Agus Somia I Made Bakta I Made Susila Utama I Nyoman Sutarsa I Wayan Gede Artawan Eka Putra I Wayan Gede Artawan Eka Putra, I Wayan Gede Artawan Eka I Wayan Putu Sutirta Yasa Ida Bagus Nyoman Putra Dwija Ida Bagus Putra Manuaba Irwanto Irwanto Junior, Darren Ketut Dewi Kumara Wati Ketut Espana Giri Ketut Espana Giri Ketut Ridana Wibawa Ketut Suryana Komang Agus Trisna Amijaya, Komang Agus Trisna Kumbara, Cokorde Istri Yuliandari Krisnawardani Made Yogi Oktavian Prasetia Made Yogi Oktavian Prasetia, Made Yogi Oktavian Mahardani, Putu Nandika Tungga Yudanti N. Sri Budiyanti Ni Made Dewi Dian Sukmawati Ni Made Sri Nopiyani Ni Wayan Sri Rahayuni Ni Wayan Winarti Nittaya Phanuphak, Nittaya Plamularsih Swandari Rahayuni, Ni Wayan Sri Rudi Wisaksana Saktivi Harkitasari, Saktivi Sawitri, Anak Agung Sagung Semadhi, Putu Gitanjani Mahadewi Shannon Turnbul Siahaan, Katrin Wilentina Stefanie Juergens Suteja, Richard Christian Utama, I Made Susila Utarini, Gusti Ayu Eka Yundari, Yundari