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All Journal Buletin Udayana Mengabdi ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Andrology and Biomedical Journal

I Gusti Ngurah Pramesemara

Departemen Andrologi Dan Seksologi, Fakultas Kedokteran, Universitas Udayana, Bali, Indonesia

Author-ID : 4005809

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology

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Administration of sildenafil citrate not able to reduced hs-CRP on erectile dysfunction patient at Doctor Soetomo Hospital, Surabaya, Indonesia I Gusti Ngurah Pramesemara; Rossy Sintya Marthasari; Rezia Octarina; Ahmad Ricardo Syukur Silalahi; Judie Hartono; Tjahjo Djojo Tanojo
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Phosphodiesterase type-5 (PDE5) inhibitors was the first choice for the oral treatment of erectile dysfunction because of its ability to prevent endothelial dysfunction and restored erectile function properly. However, the inflammatory parameter such as hs-CRP can be used to assess the performance of PDE5 inhibitors as well as clinical questionnaires, IIEF-5, and EHS. So that, this study aims to determine the effect of PDE5 inhibitors administration such as sildenafil citrate 50 mg per day can decrease the value of hs-CRP, as well as increased the IIEF-5 and EHS at Dr. Soetomo General Hospital.Methods: A true clinical experimental studies used pretest and posttest control group design were carried out among 20 patients during 4 weeks. In the next 2 weeks, the crossover was conducted among respondents for the washout period whereas divided into 2 groups, control (K1 and K2) and treatment (P1 and P2). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software for Windows.Results: The average age of group K1 and P2 was 51 Â± 12.07 years old whereas 48.60 Â± 15.40 years old in group P1 and K2. The research was conducted in Andrology Clinic of Doctor Soetomo Hospital in Surabaya during June to November 2017. The research data were not normally distributed, then analyzed by two-tail T-group tests and Wilcoxon test at significance level Î±=0.05. The results showed that PDE5 inhibitors did not decrease the hs-CRP significantly (p>0.05), but increased EHS (p<0.05) and increased IIEF-5 (p<0.05) significantly.Conclusion: This study concluded that the administration of sildenafil citrate per day by oral increased the EHS and IIEF-5, but not able to reduced hs-CRP in patients with erectile dysfunction significantly.

Mobile Voluntary Counseling Testing (VCT) pada Perkumpulan Keluarga Berencana Indonesia (PKBI) Daerah Bali: studi empiris dalam upaya penanganan HIV-AIDS I Gusti Ngurah Pramesemara; Ninik Andrias; Dyah Pradnyaparamita Duarsa
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Nowadays, the transmission of HIV-AIDS is mostly due to risky sexual activity and found in the heterosexual group, around 76.5%. The high rate may be due to stigma and discrimination in society, so risk people are reluctant to come for a check-up or treatment. This study aims to evaluate the comprehensive approach from the upstream to downstream and culture based in dealing with HIV-AIDS in the form of Mobile Voluntary Counseling Testing (VCT) that has been carried out by the Indonesian Planned Parenthood Association (IPPA) Bali, Indonesia.Methods: This descriptive cross sectional study was conducted in the 2016-2018 period in all regions of Bali, Indonesia, by convenience sampling technique. There are differences in the total number of services that have been performed which include Post-Test (+) counselling, Post-Test Counseling (-), rapid test evaluation, HIV counselling and prevention measures, as well as VCT Pre-Test counselling. The medical team and counsellor came together to meet directly with groups at risk of HIV-AIDS infection called key populations, such as commercial sex workers, transvestites, drug users, and homosexuals. The data obtained were analyzed descriptively using Microsoft Excel for Windows.Results: The results of this descriptive empirical study show that the overall Post-Test (+) counselling was conducted 9 times in 2016 (2 times), 2017 (3 times), and 2018 (4 times). Whereas in Post-Test (-) counselling there were 161 examinations in 2016, 105 times (2017), and 125 (2018). In the last 3 years, 1,472 investigations have been carried out, of which 652 times were in 2016, 367 times in 2017, and 453 times in 2018.Conclusion: Mobile VCT of IPPA Bali may be one of the effective efforts in responding to the challenges of people who tend to be taboo and less concerned about sexual and reproductive health issues. Latar Belakang: Saat ini penularan HIV-AIDS sebagian besar disebabkan oleh aktivitas seksual yang berisiko dan ditemukan pada kelompok heteroseksual sekitar 76,5%. Tingginya angka tersebut mungkin disebabkan oleh stigma dan diskriminasi di masyarakat, sehingga orang yang berisiko enggan datang untuk melakukan pemeriksaan atau perawatan. Penelitian ini bertujuan untuk mengevaluasi pendekatan komprehensif dari hulu ke hilir dan budaya berbasis dalam berurusan dengan HIV-AIDS dalam bentuk Pengujian Konseling Sukarela Seluler (VCT) yang telah dilakukan oleh PKBI Bali, Indonesia.Metode: Penelitian deskriptif dengan pendekatan potong lintang ini dilakukan dalam rentang periode 2016-2018 di seluruh daerah Bali, Indonesia dengan menggunakan teknik convenience sampling. Terdapat perbedaan jumlah total layanan yang telah dilakukan dimana meliputi konseling Post-Test (+), Konseling Post-Test (-), evaluasi rapid test, konseling HIV dan tindakan pencegahan, maupun konseling VCT Pre-Test. Tim medis dan konselor datang bersama untuk bertemu langsung dengan kelompok yang berisiko terinfeksi HIV-AIDS yang disebut populasi kunci, seperti pekerja seks komersial, waria, pengguna narkoba, dan homoseksual. Data yang diperoleh dianalisis secara deskriptif menggunakan Microsoft Excel untuk Windows.Hasil: Hasil studi empiris deskriptif ini menunjukkan bahwa telah dilakukan 9 kali konseling Post-Test (+) baik pada tahun 2016 (2 kali), 2017 (3 kali), dan 2018 (4 kali). Sedangkan pada konseling Post-Test (-) terdapat 161 kali pemeriksaan pada tahun 2016, 105 kali (2017), dan 125 (2018). Secara keseluruhan dalam 3 tahun terakhir telah dilakukan sebanyak 1.472 pemeriksaan dimana sebanyak 652 kali pada tahun 2016, 367 kali pada tahun 2017, dan 453 kali pada tahun 2018.Kesimpulan: Mobile VCT PKBI Bali dapat menjadi salah satu upaya efektif dalam menanggapi tantangan orang-orang yang cenderung tabu dan kurang peduli tentang masalah kesehatan seksual dan reproduksi.

Hubungan andropause dengan skor IPSS pada pegawai di institusi pusat pemerintahan Kabupaten Badung-Bali Assuncao Caviota Da Silva Pinto; Yukhi Kurniawan; I Gusti Ngurah Pramesemara
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Andropause is a term which indicate reduced male testosterone levels. The mechanism of andropause is due to decreased male reproductive function which results in decreased levels of testosterone in the blood below normal levels. On the other hand, almost 50% of men aged 45-60 years experience complaints of urination due to Benign Prostate Hyperplasia (BPH). Until now, BPH is believed to be related to the aging process and decreased levels of the hormone testosterone or andropause. However, no clear evidence indicate a relathionship between andropause and severe micturition probelm. This study aims to determine the relathionship of andropause and the IPSS score.Methods: This study is an analytic observational study with a cross sectional method. Sampling in this study using purposive sampling with respondent taken from the Central Government Institution of Badung Regency, Bali. The total number of research respondents was 40 man. Symptoms and signs of andropause were evaluated using the Androgen Deficiency in the Aging Male (ADAM) questionnaire, while the degree of symptoms of micturition was determined by the International Prostate Symptom Score (IPSS). The data was analyze descriptively and analytically with Chi-square to determine the relationship between andropause status and the degree of micturition problem.Results: Complaints of moderate micturition problem were the most common complaint in andropause respondents (45.5%) while mild complaints were the most common among respondents who did not experience andropause (72.2%). The results showed a significant relationship between respondents who experienced andropause and the tendency to complain of symptoms of obstruction due to prostate enlargement as assessed by the IPSS score (p = 0.038).Conclusion: There is a significant relationship between respondents experiencing andropause and the tendency to complain of symptoms of obstruction due to prostate enlargement. Pendahuluan: Andropause merupakan suatu istilah yang berarti menurunnya kadar hormon testosteron pada laki-laki. Mekanisme terjadinya andropause adalah karena menurunnya fungsi reproduksi laki-laki yang berakibat menurunnya kadar testosteron dalam darah dibawah angka normal. Disisi lain, laki-laki usia 45-60 tahun hampir 50% mengalami keluhan miksi akibat Benign Prostate Hyperplasia (BPH). BPH hingga saat ini diyakini berhubungan dengan proses penuaan dan penuruan kadar hormon testosteron atau andropause. Akan tetapi belum banyak bukti menunjukan hubungan andropause dengan beratnya gangguan miksi akibat BPH. Penelitian ini bertujuan untuk mengetahui hubungan status andropause dengan skor IPSS.Metode: Penelitian ini merupakan penelitian observasional analitik dengan metode potong lintang. Pengambilan sampel pada penelitian ini menggunakan purposive sampling dengan responden diambil dari Institusi Pusat Pemerintah Kabupaten Badung, Bali. Keseluruhan responden penelitian berjumlah 40 orang. Gejala dan tanda andropause dievaluasi dengan kuisioner Androgen Deficiency in the Aging Male (ADAM) sedangkan derajat gejala gangguan miksi ditetukan dengan skor International Prostate Symptom Score (IPSS). Analisis data berupa deskriptif serta analitik dengan Chi-square untuk menentukan hubungan status andropause dengan derajat gangguan miksi.Hasil: Keluhan gangguan miksi derajat sedang merupakan tingkat keluhan paling umum pada responden andropause (45,5%) sedangkan keluhan ringan merupakan keluhan paling umum pada responden tidak mengalami andropause (72,2%). Hasil penelitian menunjukkan hubungan yang signifikan antara responden yang mengalami andropause dan kecenderungan mengeluhkan gejala obstruksi akibat pembesaran prostat yang dinilai melalui Skor IPSS (p=0,038).Simpulan: Terdapat hubungan yang signifikan antara responden yang mengalami andropause dan kecenderungan mengeluhkan gejala obstruksi akibat pembesaran prostat.

Hubungan disfungsi ereksi pada pasien dislipidemia dengan lama pengobatan statin di Puskesmas Denpasar Barat I Anak Agung Gde Ryantha Indra Pranamartha; I Gusti Ngurah Pramesemara; Yukhi Kurniawan Kurniawan
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: There has been change in people's lifestyles that affect disease patterns, and dyslipidemia is one of those disease. Statins are the main pharmacological therapy for dyslipidemia. Many studies have researched the relationship between statin therapy in dyslipidemia and erectile dysfunction. However, existing research has not specifically explained this relationship.Objective: This study aims to determine the relationship between erectile dysfunction in dyslipidemic patients and duration of statin treatment at Community Health Center I West Denpasar.Methods: This research is analytic observational with cross sectional design. The study was conducted on dyslipidemic patients who took statins and met inclusion and exclusion criteria at Community Health Center I West Denpasar in May-June 2021. The sample size was 35. Duration of statin consumption was obtained through medical records and reconfirmed through questionnaire. Erectile dysfunction was measured by IIEF-5 questionnaire. Data analysis using SPSS version 21 with chi square test and Cramer's V correlation test.Results: The prevalence of erectile dysfunction in dyslipidemic patients with statin treatment at Community Health Center I West Denpasar was 85.7% with majority of the patients experiencing mild erectile dysfunction (37.1%) and taking statins for less than 12 months (51.4%). Characteristics of the patients were mostly aged 45-60 years (74.2%), obesity I (42.8%), smoking (60%), and drinking alcohol (57%). Statistical tests showed significant relationship between erectile dysfunction in dyslipidemic patients and duration of statin treatment at Community Health Center I West Denpasar (p=0.031) with moderate correlation (r=0.552). Statins with treatment duration >12 months had protective effect against erectile dysfunction (RR = 0.81).Conclusion: There is a relationship between erectile dysfunction in dyslipidemic patients and duration of statin treatment with moderate correlation. Statins with duration of treatment >12 months have protective effect toward erectile dysfunction. Pendahuluan: Terdapat perubahan gaya hidup masyarakat yang dapat memengaruhi pola penyakit pada manusia, dimana dislipidemia adalah salah satu penyakit tersebut. Statin merupakan salah satu terapi utama untuk dislipidemia. Terdapat banyak penelitian yang telah meneliti hubungan antara terapi statin pada dislipidemia dan disfungsi ereksi. Namun, penelitian yang ada belum secara spesifik menjelaskan hubungan ini. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan disfungsi ereksi pada pasien dislipidemia dengan lama pengobatan statin di Puskesmas Denpasar Barat I.Metode: Penelitian ini adalah penelitian analitik observasional dengan desain cross-sectional. Penelitian dilakukan pada pasien dislipidemia yang mengonsumsu statin dan memenuhi kriteria inklusi dan eksklusi di Puskesmas Denpasar Barat I pada bulan Mei sampai Juni 2021. Sampel pada penelitian ini adalah 35 orang. Durasi konsumsi statin diperoleh melalui rekam medis dan dikonfirmasi ulang melalui kuisioner. Disfungsi ereksi diukur dengan kuisioner IIEF-5. Analisis data menggunakan SPSS versi 21 dengan uji chi-square dan uji korelasi Cramer’s V. Hasil: Prevalensi disfungsi ereksi pada pasien dislipidemia dengan pengobatan statin di Puskesmas Denpasar Barat I sebesar 85,7% dengan mayoritas pasien mengalami disfungsi ereksi ringan (37,1%) dan mengonsumsi statin kurang dari 12 bulan (51,4%). Karakteristik pasien sebagian besar berusia 45-60 tahun (74,2%), dengan obesitas I (42,8%), merokok (60%), dan minum alkohol (57%). Hasil uji statistic menunjukkan hubungan yang bermakna antara disfungsi ereksi pada pasien dislipidemia dengan lama pengobatan statin di Puskesmas Denpasar Barat I (p=0,031) dengan korelasi sedang (r=0,552). Statin dengan lama pengobatan lebih dari 12 bulan memiliki efek protektif terhadap disfungsi ereksi (RR = 0,81).Kesimpulan: Terdapat hubungan antara disfungsi ereksi pada pasien dislipidemia dan lama pengobatan statin dengan korelasi sedang. Pengobatan statin dengan lama pengobatan lebih dari 12 bulan memiliki efek protektif terhadap disfungsi ereksi.

Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka Ni Made Dian Hartaningsih; I Putu Yuda Prabawa; Benediktus Bosman Ariesta Gusti Putu; Dwijo Anargha Sindhughosa; Ida Bagus Amertha Putra Manuaba; I Gusti Ngurah Pramesemara
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1363

Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy. Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien.

Co-Authors Ahmad Ricardo Syukur Silalahi Albert Salim Alexander Petra Sihite Alexander Petra Sihite Alycia Madeleine Amelia Heryanto Anak Agung Ayu Dian Indah Lestari Anak Agung Gde Ryantha Indra Pranamartha Anak Agung Ngurah Perdana Anantadiva Anak Agung Sintya Padma Dewi Andhika Bhayangkara Putra Anak Agung Gde Assuncao Caviota Da Silva Pinto Benediktus Bosman Ariesta Gusti Putu Dwijo Anargha Sindhughosa Dyah Pradnyaparmita Duarsa G. Wirata I Gusti Ayu Pramitaresthi I Gusti Ayu Widianti I Putu Yuda Prabawa I Wayan Surudarma I Wayan Surudarma I. A. Sanjiwani I.A. Sanjiwani Ida Bagus Amertha Putra Manuaba Judie Hartono L.M. Puspita M. H. S. Nugraha N. A. J. Raya Ni Made Dian Hartaningsih Ni Made Dian Kurniasari Ninik Andrias Rezia Octarina Rossy Sintya Marthasari Tanojo, Tjahjo Djojo Yukhi Kurniawan Yukhi Kurniawan Yukhi Kurniawan Kurniawan

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