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All Journal Jurnal Agronomi Indonesia (Indonesian Journal of Agronomy) journal of internal medicine E-Jurnal Medika Udayana The Indonesian Biomedical Journal Jurnal Kesehatan Holistic ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran Journal of Global Pharma Technology Bali Medical and Wellness Journal Cermin Dunia Kedokteran
Ketut Suryana
Departemen/KSM Penyakit Dalam, Fakultas Kedokteran Universitas Udayana/RSUP Sanglah, Denpasar, Bali, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : journal of internal medicine

 1 
ASOSIASI CARA PEMBERIAN OBAT DENGAN ONSET DAN DERAJAT KLINIS REAKSI HIPERSENSITIFITAS AKUT/ANAFILAKSIS PADA PENDERITA YANG DIRAWAT DI RSUP SANGLAH DENPASAR BALI Eka Imbawan, I GN; Suryana, Ketut; Suardamana, Ketut
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Acute hypersensitivity reaction/anaphylaxis is a post exposure acute reaction involving dermatologic system/mucosal and subcutaneous tissue; while anaphylaxis is an acute systemic reaction involving two or more organ systems (the skin/mucosa and subcutaneous tissue, respiratory system, cardiovascular system, gastrointestinal system). Drugs as allergens can trigger these reactions orally, parenteral, or topically (contact). Different modes of drug administration are known to relate with onset and degree of the resulting clinical features. We conduct a cross sectional study to determine the association between modes of drugs administration with onset and clinical degree in patients hospitalized at Sanglah General Hospital Denpasar. This study involved 205 patients with acute hypersensitivity reactions/anaphylaxis (105 male and 100 female). Mean age was 33.12 (12 ! 80) years, 131 persons (63.9%) were triggered by drugs, while 57 patients (27.8%) were triggered by food, 13 patients (6.3%) by insect sting, and 3 patients (1.5% ) by other allergens. Of 131 patients with drugs as the trigger, 108 patients (82.4%) were given orally, 22 patients (16.8%) were given parenterally and 1 patient (0.8%) was triggered via contact. The mean onset of an acute hypersensitivity reaction/anaphylaxis triggered by oral and parenteral drugs were 4.2 hours and 0.6 hours respectively (p < 0.01). We conclude that modes of drug administration are associated with the onset of symptoms, but not with the degree of clinical manifestation of acute hypersensitivity reaction/anaphylaxi
ASPEK IMUNOLOGI SLE -, Yuriawantini; Suryana, Ketut
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Abstract

Systemic Lupus Erythematosus (SLE) is autoimmune disease characterised by the production ofautoantibodies to component of the cell nucleus in association with a diverse array of clinical manifestations.The patho-aetiology of systemic Lupus Erythematosus probably involves multifactorial interaction amongvarious genetic and environmental factors. Multiple genes contribute to disease susceptibility, including genesencoding complement and other components of the immune response. The interaction of sex, hormonal millieuand the hypothalamus-pituitary-adrenal axis modifies this susceptibility and the clinical expression of thedisease. Defective immune regulatory mechanism, such as the clearance of apoptotic cells and immunecomplexes, are important contributors to the development of SLE. The loss of immune tolerance, increaseantigenic load, excess T cells helper, defective B cell suppression, and the shifting of T helper 1 (Th1) to Th2immune responses leads to the B cell hyperactivity and the production of pathogenic autoantibodies. ANAs areantibodies against both functional and structural in the cell nucleus. ANA is early detection of autoantibodies forthe patient with clinical features that suggest SLE. Positive test for antinuclear antibodies may support thediagnosis, especially if more spesific autoantibodies are present, such as anti-double-stranded DNA, anti-Sm,anti-RNP or anti-Ro. Understanding the value of autoantibody testing in patient care requires clinical judgmentand experience.
ADVERSE DRUG REACTION Mariyono, Harbanu H; Suryana, Ketut
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

There are lots of new drugs that made for therapy, prevent and even as a diagnostic tools. Beside the desired effect therewere also undesired effect that can occur when managing patient with drugs which then we call adverse drugs reaction. Anadverse reaction to a drug has been defined as any noxious or unintended reaction to a drug that is administered in standard dosesby the proper route for the purpose of prophylaxis, diagnosis, or treatment. Adverse drug reaction can be devided in two groups,which is reactions than can occur on everyone and the ones that can only occur on susceptible ones. One of the adverse drugreaction is drug allergy. History taking is the most important thing on diagnosing drug allergy, one that can help was Naranjosscore. We can run few more test to defined the type of Adverse Drug Reaction. For managing patient with adverse drug reaction,we have to avoid drugs that induce the reaction, premedication and also desensitisation.
PREVALENSI ASMA BRONKIAL ATOPI PADA PELAJAR DI DESA TENGANAN Sastrawan, I Gede Pande; Suryana, Ketut; Ngurah Rai, I B
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Asthma as one of the allergic diseases continuos to be a major public health problem in developed anddeveloping countries. We carried out a population-based survey to search the prevalence of atopic asthma inschool children of Tenganan, Manggis-Karangasem. Asthma was diagnose by quisioner and bronchodilator test.Atopic asthma define as asthma patients with total IgE > 100 IU/ml and or skin prick test 3 mm. Five hundredfourteen (91.5%) students out of of 562 students were were invited, participated the study. Thirty six (7%)students were diagnosed asthma based on peak expiratory flow variability after brochodilator test, stratified bysex there were 13 (36.1%) boys and 23 (63.9%) girls and 9 (25.0%) primary school children, 14 (38.9%) juniorhigh, 13 (36.1%) high school, respectively. Mean of age, serum IgE total and wheal diameter was 13.42 ± 3.26year, 1551.83 ± 2008.19 IU/ml, 22.9±3.4% and 3.58 ± 0.99 mm, respectively. Out of 36 asthma patients, 35(97.2%) diagnosed atopic asthma consist of 12 (34.3%) boys and 23 (65.7%) girls, and 1 (2.8%) diagnosednonatopic asthma.
TES PROVOKASI (TP) SEBAGAI UPAYA PENDEKATAN DIAGNOSIS DUGAAN ALERGI OBAT PADA SEORANG PENDERITA TB PARU YANG DITERAPI DENGAN OBAT ANTI TUBERKULOSA KATEGORI I Duarsa, Reny S.P.; Suryana, Ketut
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Drug allergy is an unpredictable adverse reaction which is based on immunologic reaction. This event accounts foraround 5 to 10 % of the total number of adverse reaction to drug events. Diagnostic approaches to drug allergy are based ondetailed anamnestic questions, chronology of events, physical diagnostics and are also supported by other examinations such asskin prick test, skin patch test, radioallergosorbens test (RAST) and drug provocation test (DPT). DPT is still the gold standard fordrug allergy test and is done if other tests cannot confirm a significant conclusion. Nonetheless, this procedure is a dangerouscourse of action. Hence close coordination with intensive care unit and retaining informed consent should be done ahead of time.In this paper, we will examine a specific case in which DPT test is used to find out the drug which had caused an allergic reaction.It is shown in this paper, we are able to conduct a safe diagnostic procedure as long as we take into consideration the risk andbenefit for each patient. In this paper, we also point out about indication, contraindication, when to perform the test, test method,interval - dose, test preparation, and what kind of conclusion could be taken from the test.
SEORANG WANITA DENGAN URTIKARIA KRONIK IDIOPATIK Suryana, Ketut; Suastika Adiguna, Made
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Abstract

Urticaria is characterized by red edematous plaques surrounded by a clear or red halo. The lesions are round or oval andmay become polycyclic when confluent. They usually multiple and vary from 1 mm to several centimeters in diameter. They canoccur at any site of the body and are typically associated with itching and sometimes burning. Skin returns to its normalappearances usually within 1-24 hours. Urticaria is sometimes accompanied by angioedema, in which the edematous processextends into the deep dermis and / or subcutaneous tissues. While patient with urticaria usually have symptoms confined to theskin they may have concomitant systemic manifestations. Urticaria is termed acute when episode less than 6 weeks, it’s termedchronic when episode persist longer. Chronic urticaria / angioedema, the syndrome last and average of 3-5 years, with 20%patients still symptomatic at 40 years. The syndrome is frustrating to patient and clinician alike in death a search for an exogenouscause is futile in the majority of patients. However in recent year its has been demonstrated that many patients involved idiopathicchronic urticaria (80% of the chronic type urticaria). The incidence of idiopathic chronic urticaria was 3% population. Thediagnosis, there is no the specific approach. Mostly based on clinical history and several laboratory procedure and in certaincondition need skin biopsy. The management; allergen avoidance, medicamentosa symptomatically. The first line; non sedatingsecond-generation AH-1 and in a several case add by antihistamine AH-2. in severe case sometimes need the corticosteroids oranother immunosuppressive.
HUBUNGAN ANTARA KADAR HIGH SENSITIVE-C REACTIVE PROTEIN DENGAN DERAJAT ASMA BRONKIAL AKUT Jaya Santika, I Wayan Agus; Suryana, Ketut
journal of internal medicine Vol. 12, No. 3 September 2011
Publisher : journal of internal medicine

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Abstract

Bronchial asthma is a chronic inß ammation in the air way. There are some element of cell and cell also to interventionin the inß ammation process. Chronic inß ammation has caused hyper responsiveness in air way, which is episodic attacksign, like wheezing, cough, shortness of breath usually in the night. C-reactive protein is one of the protein which changesin acute infection and acute inß ammation. C-reactive protein is a acute phase response protein which responsibility todefense mechanism. Acute phase protein produced induction by injury or infection. Acute phase reactant synthesis byliver which induction by cytokine like IL-6. In acute asthma attack produced some cytokine pro inß ammatory like IL-1,IL-6 and TNF. All of that cytokine induced liver to produced CRP. Aim for this study, to know the level hs-CRP in asthmaattack patient and also to know correlation between the severity of asthma attack and level of hs-CRP in patient whotreated in Sanglah General Hospital. This study was enrolling 53 patient acute asthma attack, cross sectional study. Allthe data collected by interview, physical examination, blood examination which cbc, hs-CRP, also with peak ß ow meter.The data analyzed by SPSS. And the result is the median of level hs-CRP is 7.3 mg/l, and the correlation in odd ratio(OR) is 3.73; CI 95% (1.66 ! 8.41). Based on this study we have the conclusion there strong correlation between level ofhs-CRP and severity of asthma attack.
Co-Authors Anak Agung Yunda Prabundari Astari, Anak Agung Ayu Mita Bambang S. Purwoko Gotama, Yovita Harbanu H Mariyono I B Ngurah Rai I Dewa Made Sukrama I Gede Pande Sastrawan I GN Eka Imbawan I Ketut Agus Somia I Made Bakta I Made Sudarmaja I Wayan Agus Jaya Santika I Wayan Putu Sutirta Yasa I.B. Aditya Nugraha Ida Bagus Putra Manuaba Kadek Ena Septiani Surya Puspita Sari Kadek Surya Atmaja Ketut Suardamana Ketut Suardamana Ketut Tuti Parwati Merati Luh Nyoman Arya Wisma Ariani Made Cantika Kumara Dipa Made Swastika Adiguna Nugraha, I.B. Aditya Putu Dyah Ayu Saraswati Reny S.P. Duarsa Rudi Wisaksana Tjokorda Istri Anom Saturti Wayan Wahyu Semara Putra Wulansari Manuaba, Ida Ayu Ratih Yesicha Kurniawati Yuriawantini - Yusica Maylasari, Ni Putu