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Sarkoma Kaposi pada ODHA Kadek Ena Septiani Surya Puspita Sari; Putu Dyah Ayu Saraswati; I Ketut Suryana
Cermin Dunia Kedokteran Vol 44, No 6 (2017): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v44i6.770

Abstract

Dilaporkan satu kasus Sarkoma Kaposi (SK) yang berkaitan dengan HIV pada seorang laki-laki Suku Bali berumur 46 tahun. Gambaran klinis berupa bentol-bentol pada wajah, kelopak mata, rongga mulut, punggung dan dada. Pasien diketahui menderita HIV stadium IV berdasarkan kriteria WHO. Diagnosis sarkoma Kaposi ditegakkan dengan pemeriksaan klinis dan pemeriksaan histopatologis. Penderita mendapatkan pengobatan ARV lini kedua dengan respon terapi yang baik yang terlihat dari perbaikan secara klinis. Prognosis penderita cenderung buruk.A case of HIV-associated Kaposi sarcoma in a male, 46 years-old was reported. The patient was diagnosed with HIV stage IV according to WHO criteria. Physical examination found multiple purple papules and nodules in face, left eyelid, oral cavity, trunk and back. The definitive Kaposi Sarcoma diagnosis was made by clinical and histopathology examination. Antiretroviral treatment gave good clinical improvements. The patient prognoses was bad. 
Peranan Antibodi Anti-Imunoglobulin E dalam Tatalaksana Asma Bronkial I.B. Aditya Nugraha; Ketut Suryana
Cermin Dunia Kedokteran Vol 43, No 8 (2016): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i8.97

Abstract

Asma merupakan penyakit inflamasi kronis yang menyerang saluran pernapasan. Pada asma bronkiale atopi, terdapat keterlibatan imunoglobulin E (IgE), di mana salah satu terapi yang dapat digunakan adalah pemberian antibodi anti-IgE. Sesuai penatalaksanaan asma menurut GINA tahun 2013, penggunaan antibodi anti-IgE merupakan penatalaksanaan step 5 (tipe controller asma) apabila terapi dengan controller lain tidak adekuat. Penggunaan antibodi anti-IgE hanya saat serangan asma tidak dapat terkontrol dengan inhalasi kortikosteroid, mengingat efek samping, yaitu nyeri, kemerahan di tempat injeksi (reaksi alergi lokal), hingga syok anafilaktik.
Hubungan antara peningkatan kadar immunoglobulin-e (IgE) dengan matrix metalloproteinase-9 (MMP-9) pada pasien sindrom koroner akut (SKA) di RSUP Sanglah, Denpasar, Bali Anak Agung Yunda Prabundari; Ketut Suardamana; Ketut Suryana; Tjok Istri Anom Saturti
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (246.355 KB) | DOI: 10.15562/ism.v11i3.641

Abstract

Introduction. Acute Coronary Syndrome (ACS) is a cardiovascular disease that has a high mortality rate. One of the markers which play a role in the pathophysiology of ACS is Immunoglobulin E (Ig E), one of the antibodies released by B lymphocytes as the result of complex interactions that can activate mast cells. Mast cells will activate Metalloproteinase-9 (MMP-9) then facilitate pathogenesis of acute myocardial infarction or acute coronary syndrome phase. This study aimed to determine the relationship between increasing levels of IgE and MMP-9 in ACS patients at Sanglah Hospital, Denpasar, Bali.Method. This was a cross-sectional analytic study, and the samples were collected from ACS patients at Sanglah Hospital, Denpasar, Bali, using a consecutive sampling method. A total of 73 samples were included in this study, then statistical tests and Pearson correlation test was conducted.Results. Seventy-three samples included in this study contain 59 men (80.8%) and 14 women (19.2%). The IgE level is between 0.5-1000 and MMP-9 levels between 6.91-29.56. There is a statistically significant correlation between IgE levels and MMP-9 levels in Acute Coronary Syndrome patients (p = 0.018: r = 0.277).Conclusion. We found a significant association between increased IgE and MMP-9 in patients with Acute Coronary Syndrome at RSUP Sanglah, Denpasar, Bali. Pendahuluan. Sindrom Koroner Akut (SKA) merupakan penyakit kardiovaskular dengan angka kematian yang sangat tinggi. Salah satu marker yang berperan dalam patofisiologi SKA adalah Immunoglobulin E (IgE). IgE merupakan salah satu antibodi yang dilepaskan oleh limfosit B sebagai interaksi kompleks yang dapat mengaktivasi sel mast. Sel mast yang sudah aktif akan mengaktivasi Metallopriteinase-9 (MMP-9) yang ikut berperan dalam patogenesis miokard infark akut atau sindrom koroner akut. Penelitian ini bertujuan unuk mengetahui hubungan peningkatan kadar IgE dan MMP-9 pasien SKA di RSUP Sanglah, Denpasar, Bali.Metode. Penelitian ini merupakan penelitian potong lintang analitik yang dilakukan pada populasi SKA di RSUP Sanglah, Denpasar, Bali. Sampel keseluruhan berjumlah 73 orang pasien SKA secara konsekutif diikutsertakan dalam penelitian ini, kemudian dilakukan uji statistik dan uji korelasi Pearson.Hasil. Dari hasil penelitian pada 73 sampel tersebut, didapatkan jumlah sampel 59 orang laki-laki (80,8%) dan 14 orang perempuan (19,2%). Adapun kadar IgE dalam rentang antara 0,5-1000 dan kadar MMP-9 antara 6,91-29,56. Terdapat korelasi yang bermakna antara kadar IgE dengan kadar MMP-9 pada pasien Sindrom Koroner Akut (p=0,018; r=0,277).Kesimpulan. Terdapat hubungan yang signifikan antara peningkatan kadar IgE dengan peningkatan kadar MMP-9 pada pasien Sindrom Koroner Akut di RSUP Sanglah, Denpasar, Bali.
Dramatic improvement in severe-critical COVID-19 patient after tocilizumab administration: a clinical experience Yesicha Kurniawati; Kadek Surya Atmaja; Ketut Suryana; Wayan Wahyu Semara Putra
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (321.573 KB) | DOI: 10.15562/ism.v12i1.951

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in coronavirus disease 2019 (COVID-19) involve so many inflammatory cytokines, especially Interleukin-6 (IL-6). The usage of tocilizumab as an anti-IL-6 receptor antibody had been approved as COVID-19 medication.Case Presentation: This article reports a 51-year-old woman diagnosed with severe-critical COVID-19. The patient made significant progress after tocilizumab administration. The patient was hospitalized for 14 days before being discharged.Conclusion: Tocilizumab administration showed a significant improvement in COVID-19 patients.  However, further investigations are needed to explain this further.
Inverse Correlation between Combination of Antiretroviral Therapy with the level of Serum Interleukin-6, Ferritin, and Hepcidin in HIV Patients with Anemia Chronic Disease I Ketut Agus Somia; Ketut Tuti Parwati Merati; I Made Bakta; Ida Bagus Putra Manuaba; Wayan Putu Sutirta Yasa; I Dewa Made Sukrama; Ketut Suryana; Rudi Wisaksana
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: The purpose of this study was to determine whether the cARV therapy correlates with the serum level of IL-6, ferritin, and hepcidin in HIV infected patients with ACD.Methods: A cross-sectional study conducted in HIV patients with ACD, aged 15-65 years with exclusion criteria such as chronic renal disease, chronic liver disease, treated for anemia in the last 3 months, taking iron supplements in the last 3 months, history of blood transfusion in the last 1 year, suffering from acute infection, tuberculosis infection, malignancy, hepatitis C virus infection, acute hypersensitivity reaction and pregnancy. Blood specimen examined by high sensitivity human IL-6 In vitro ELISA, DRG Hepcidin- 25 ELISA, serum ferritin by agglutination method and CD4 cell count by flow cytometry. Results: A total of 86 HIV patients with ACD consist of 42 subjects with experienced cARV and 44 subjects with naive cARV. There are several differences between cARV naïve and experienced cARV including: Hb (g/dl) [ 10.8 ( 9.88 – 11.75) Vs. 11.60 (11.00 – 12.34) p: 0.058 ], serum iron (mg/dl) [ 50.00 (31 – 66.8) Vs. 71.40 (56.00 – 108.00) p: 0.121 ), serum ferritin (ug/dl) [ 630 ( 194 – 1101) Vs. 195.40 (128.25 – 589.47) p: 0.008 ], IL-6 (pg/mL) [7.20 (3.88 – 10.76) Vs. 4.03 (1.69 – 8.49) p: 0.009), serum hepcidin (ng/mL) [45.54 (16.74 – 95.31) Vs. 23.35 (6.58 – 49.99) p: 0.007] , CD4 cell count (cell/uL) [31.5 (14.25 – 90.75) Vs. 307 (168.5 – 458.75) p : < 0.001)] There is a significant inverse correlation between the cARV therapy with level of serum IL-6 ( r: - 0. 285, p: 0.008), ferritin (r: - 0.321, p: 0.007) and hepcidin (r: - 0.293, p: 0.006). While there was a significant positive correlation between the cARV therapy with CD4 cell count (r: 0.676, p: 0.001). There was no correlation between the cARV therapy with serum iron levels ( r: 0.176, p: 0.121).Conclusion: There is an inverse correlation between the cARV therapy with serum level of IL-6, ferritin, and hepcidin in HIV patients with ACD.  Keywords: cARV, ACD, IL-6, Ferritin, Hepcidin.
A Rare Case of Systemic Lupus Erythematosus with Concomitant Inflammatory Bowel Disease: A Diagnostic and Therapeutic Challenge Made Cantika Kumara Dipa; Ketut Suryana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1248

Abstract

Background: Systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD) are chronic conditions with complex pathophysiologies. While both diseases can affect the gastrointestinal tract, their co-occurrence is rare and presents unique diagnostic and therapeutic challenges. This case report describes a patient with SLE who developed IBD, highlighting the complexities of managing such cases. Case presentation: A 27-year-old female with a history of SLE presented with hematochezia, abdominal pain, and weight loss. A colonoscopy revealed findings consistent with IBD. The patient's SLE was well-controlled on immunosuppressive therapy, but the addition of IBD required careful medication adjustments to manage both conditions effectively. Conclusion: The coexistence of SLE and IBD is an uncommon but significant clinical scenario. This case underscores the importance of a thorough evaluation of IBD in SLE patients presenting with gastrointestinal symptoms. Furthermore, it emphasizes the need for a multidisciplinary approach to optimize treatment strategies and improve patient outcomes.
Analysis of Prevalence and Contributing Factors for Advanced HIV Disease at Wangaya Denpasar General Hospital: January 2022 to December 2023 Astari, Anak Agung Ayu Mita; Suryana, Ketut
Bali Medical and Wellness Journal Vol. 1 No. 1 (2024): Bali Medical and Wellness Journal
Publisher : PT BMW Journal Sejahtera

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71341/bmwj.v1i1.8

Abstract

Background: Advanced HIV disease (AHD) remains a significant health concern and a leading cause of mortality among individuals living with HIV/AIDS. Understanding the psychosocial factors influencing AHD, such as social support, access to healthcare resources, and mental health conditions like depression, is vital for effective intervention. Aim: This study aimed to determine the prevalence of AHD and identify the factors associated with it at Wangaya Denpasar General Hospital from January 2022 to December 2023. Methods: A cross-sectional study was conducted involving all newly diagnosed AHD patients at the Merpati clinic, Wangaya General Hospital, during the specified period. Participants were selected based on inclusion and exclusion criteria, and data were collected through a comprehensive review of patients' medical records. Results: Out of 128 newly diagnosed individuals living with HIV/AIDS (PLWHA), 84 (65.6%) were classified as having AHD. The majority of PLWHA with AHD were male (73.8%), under 50 years of age (82.1%), without a college education (94.0%), unemployed (83.3%), married (54.8%), had medical insurance (90.5%), contracted HIV through heterosexual contact (90.5%), were referred from other medical facilities (82.1%), and reported having social support (98.8%). Significant factors associated with AHD included lack of college education (p=0.000), unemployment (p=0.000), marital status (p=0.037), and referral source (p=0.010). Conclusion: The findings indicate that lack of college education, unemployment, marital status, and being referred from other medical facilities are significant factors associated with AHD. To mitigate AHD-related morbidity and mortality, it is essential to enhance education and training programs focused on HIV/AIDS and to promote provider-initiated HIV testing and counseling. This approach could facilitate earlier prevention and diagnosis of HIV.
Diagnosis dan Penanganan TB-IRIS Paradoksikal: Tinjauan Pustaka Gotama, Yovita; Suryana, Ketut
Cermin Dunia Kedokteran Vol 52 No 10 (2025): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i10.1544

Abstract

Tuberculosis (TB) is the most common opportunistic infection in patients with human immunodeficiency virus (HIV). TB-HIV is a global burden, especially in TB endemic countries, such as Indonesia, and increased mortality. Patients with HIV need antiretroviral drugs treatment as early as possible but comorbidity with TB carries a high-risk of immune reconstitution inflammatory syndrome (IRIS), which can worsen clinical condition and increase the mortality rate. TB-IRIS is divided into 2 categories, namely paradoxical TB-IRIS in patients who have previously received TB therapy and unmasking TB-IRIS in patients newly diagnosed with TB after initiation of ARV. Clinical manifestations of TB-IRIS include worsening respiratory and constitutional symptoms, as well as the appearance of new lesions in other organs. The diagnosis of TB-IRIS requires the exclusion of other conditions such as opportunistic infections or TB treatment failure. Prevention strategies include TB screening before ARV initiation, selection of the appropriate timing for ARV administration, and the use of corticosteroids such as prednisone to reduce the risk of worsening. Management of TB-IRIS focuses on supportive therapy, inflammation control, and continuation of ARV and OAT treatment. With early detection, prevention, and appropriate management, morbidity and mortality rates due to TB-IRIS can be significantly reduced.
Serum DNase1, sTNFR1 and sTNFR2 as Risk Factors for Lupus Nephritis in Systemic Lupus Erythematosus Patients Manuaba, Ida Ayu Ratih Wulansari; Suryana, Ketut; Bakta, I Made; Sudarmaja, I Made
The Indonesian Biomedical Journal Vol 16, No 3 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i3.3052

Abstract

BACKGROUND: Early detection and management of lupus nephritis (LN) in systemic lupus erythematosus (SLE) are essential to prevent irreversible kidney damage and improve patient outcomes; therefore, identifying reliable biomarkers to predict LN is paramount. However, there are still relatively few studies examining the potential biomarkers for LN in SLE patients. This study was conducted to investigate serum deoxyribonuclease I (DNase), soluble tumor necrosing factor 1 (sTNFR1) and soluble tumor necrosing factor 2 (sTNFR2) as a risk factor for LN in SLE patients.METHODS: A case-control study involving SLE patients aged 20-60 years was conducted. Blood was withdrawn from each subject for the measurement of serum level of DNase1, sTNFR1, and sTNFR2 that was performed using enzyme-linked immunoassay (ELISA) methods. Data was then analyzed using Chi-Square test and logistic regression tests.RESULTS: A total of 22 patients with LN and 22 without LN were included. The cut-off value for DNase1, sTNFR1, and sTNFR2 were 5.05 ng/mL, 6.52 ng/mL, and 7.02 ng/mL, respectively. The risk factors of LN in SLE patients were the low level of serum DNase1 (aOR=6.64; 95%CI: 1.25-35.29; p=0.026), low level of serum sTNFR1 (aOR=8.12; 95% CI: 1.56-42.10; p=0.013), and low level of serum sTNFR2 (aOR=5.57; 95%CI: 1.03-30.11; p=0.046).CONCLUSION: Serum DNase1 lower than 5.05 ng/mL, sTNFR1 lower than 6.52 ng/mL, and sTNFR2 lower than 7.02 ng/mL were risk factors for lupus nephritis in SLE patients. Hence, serum DNase1, sTNFR1 and sTNFR2 could be used as risk factors predictors for LN in SLE patients.KEYWORDS: DNase1, sTNFR1, sTNFR2, SLE, lupus nephritis
Efek Suhu Simpan dan Pelapis terhadap Perubahan Kualitas Buah Pisang Cavendish Purwoko, Bambang S.; Suryana, K.
Jurnal Agronomi Indonesia (Indonesian Journal of Agronomy) Vol. 28 No. 3 (2000): Buletin Agronomi
Publisher : Indonesia Society of Agronomy (PERAGI) and Department of Agronomy and Horticulture, Faculty of Agriculture, IPB University, Bogor, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1620.499 KB) | DOI: 10.24831/jai.v28i3.1557

Abstract

The objective of the experiment was to determine the effect of coating materials and storage temperatures in inhibiting the ripening process of banana fruits. The experiment consisted of two factors namely storage temperatures (ambient and cool) and coating materials (control, Carnauba wax, bee wax, and Sempefresh). One experimental unit consisted of two fingers of banana. The experiment was replicated three times. Observation was conducted on the following variables: peel color development, weight loss, fruit softening, ratio of flesh and peel weight, sugar content, and titratable acidity. Result of the experiment showed that carnauba wax 6 % inhibited weight loss, fruit softening, and the increase of flesh and peel weight ratio. Bee wax inhibited fruit softening, peel color development and sugar content. Fruit treated with carnauba wax 6 % could be stored at cool temperature for 25.9 days, 10.5 days longer than untreated fruit stored at ambient temperature. Among the three coating materials, Sempefresh had the lowest effectiveness in inhibiting bananaf ruit ripening process.   Key words: Coating, Ripening, Banana, Shelf life