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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana JURNAL BIOMEDIK Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Journal of Applied Studies in Language ISM (Intisari Sains Medis) : Jurnal Kedokteran Bali Dermatology and Venereology Journal Journal of Global Pharma Technology Journal of General Procedural Dermatology and Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal
Made Wardhana
Dermatology And Venereology Departement, Faculty Of Medicine, Udayana University, Sanglah General Hospital Denpasar, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health

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High plasma dopamine level as a risk factor for atopic dermatitis Adiguna, Made Swastika; Wardhana, Made; Limbara, Ermon Naftali
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.169 KB) | DOI: 10.15562/bdv.v2i1.15

Abstract

Background: Dopamine is responsible for inflammatory response and plays a role in the skin immune system by modulating T-cells, dendritic cells, and keratinocytes which increases skin inflammatory response in atopic dermatitis (AD). Elevation of dopamine level will affect IL-6, IL-8, IL-23, Th-17, and TNF-α, which promotes keratinocyte proliferation and differentiation, infiltration of inflammatory cells, angiogenesis, vasodilation, and skin barrier disruption on AD.Objective: This study aimed to establish whether the increase of plasma dopamine level contributes to a risk factor for AD occurrence.Methods: This is a matched-pair case-control observational analytical study which involves patients with AD and without AD as control. Samples were taken using a consecutive sampling method which fulfilled inclusion and exclusion criteria, matched for gender and age. Plasma dopamine level was measured from venous blood and processed using enzyme-linked immunosorbent assay (ELISA) method. The collected data were then analysed using SPSS version 20.0 with Pearson chi-square test for the odds ratio.Results: A total of 30 samples with AD (case group) and 30 samples without AD (control group) involved in this study. This study proves that plasma dopamine levels in the case group were significantly higher than the control group (p<0.05). Odds ratio for plasma dopamine was 42.2 (95%CI: 9.5-187.2, p < 0.001).Conclusion: This study concludes that high plasma dopamine level is a risk factor for AD.
High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris Wiraguna, Anak Agung Gde Putra; Wardhana, Made; Maharani, Made Kusuma Dewi
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.566 KB) | DOI: 10.15562/bdv.v2i1.16

Abstract

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion.Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne.Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS.Results: H2O2 mean level in the case and control group, respectively 0.68 ± 0.03 and 0.42 ± 0.04 µmol/ml. High H2O2 level was determined from cut-off point >0.62 µmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p<0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 ± 0.06 and 0.74 ± 0.07 U/ml. Low catalase level was determined from the cut-off point <0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p<0.001; 95% CI: 5.18-77.21; OR: 20.00).Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.
Positive correlation between psoriasis vulgaris severity degree with HbA1C level Adiguna, Made Swastika; Wardhana, Made; Rahardjo, Fresa Nathania
Bali Dermatology and Venereology Journal Vol 1, No 2 (2018)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (348.961 KB) | DOI: 10.15562/bdv.v1i2.11

Abstract

Introduction: Psoriasis is a skin abnormality based on chronic inflammation immune mediated. Inflammatory mediator roles (Th-1, TNF-α, IL-6,IL-7, IL-8, IL-17, and IL-23) in its pathogenesis proven to inhibit insulin receptor and glucose uptake from fat tissue and causing insulin resistance, then blood glucose level increased. Mean blood glucose level within 3 months can be represented by HbA1c (glycosylated haemoglobin) level. HbA1c is a bond between glucose and hemoglobin.           Objective: The aim of this study is to understanding correlation between psoriasis vulgaris severity degree with HbA1c.Material and methods: This study is using cross sectional method. HbA1c level examination done by drawing venous blood, then analyzed with chromatography method. Samples were selected by using inclusion and exclusion criteria and consecutive sampling method.Result: Study result shows subject consist of total 51 subjects consists of 33 subjects with psoriasis vulgaris (22 males and 11 females with youngest age of 15 and oldest age of 65 years old), and 18 subjects without psoriasis vulgaris. Psoriasis vulgaris severity degree measured with Psoriasis Area Severity Index (PASI), then grouped to 3 categories: mild PASI score <6, moderate PASI score  6 – 12, and severe PASI score> 12. Mostly  (15 subjects) including mild category. HbA1c level on this study subjects resulted minimum level of 4.6%, maximum 12.1 %, and median 5.4%.  Based on Perkeni consensus, normal HbA1c level is <5,7%, prediabetes 5,7-6,4%, and diabetes >6,5%. HbA1c level of psoriasis vulgaris subjects are higher than non psoriasis vulgaris subjects significantly (p=0,019). Psoriasis vulgaris causing increase of HbA1c level with Prevalence Ratio (PR) 6,55. Thus, Psoriasis vulgaris subjects have increased risk 6,5 times to increase HbA1c level compared with non psoriasis vulgaris subjects. Correlation between severity degree and HbA1c level found in positive course significantly with moderate strength of correlation (Spearman correlation; r = 0.580, p<0,001).Conclusion: HbA1c level on psoriasis vulgaris subjects are higher than non psoriasis vulgaris, and psoriasis vulgaris severity degree positively correlated with HbA1c increasing level. Every increase of  psoriasis vulgaris severity degree will cause increase level of  HbA1c.
Positive correlation of psoriasis vulgaris severity and HOMA-IR Wardhana, Made; Adiguna, Made Swastika; Nareswari, Putu Ayu Diah
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.671 KB) | DOI: 10.15562/bdv.v2i1.18

Abstract

Background: Psoriasis vulgaris is a chronic inflammatory skin disease that its aetiology is still not completely known. A chronic inflammation in psoriasis can cause organ dysfunctions. Elevation of proinflammatory cytokines gives rise to insulin resistance by inhibiting insulin and glucose transport mechanism signals. Insulin resistance is the underlying pathogenesis of metabolic syndrome.Objective: This study aimed to undestand any correlation in the severity of psoriasis vulgaris with HOMA-IR.Methods: A cross sectional research involving 35 subjects with psoriasis vulgaris and 15 subjects without who met the selection criteria. HOMA-IR is a formula used to measure insulin resistance which calculates the fasting insulin value in μU/ml x fasting glucose in mg/DL/405 taken from the blood veins of subjects. PASI score was used to determine psoriasis vulgaris severity.Results: This study shows that the HOMA-IR median value was higher in psoriasis subject than the subjects without psoriasis (p<0.05). The correlaton analysis shows a moderate positive correlation between psoriasis vulgaris severity and HOMA-IR (r= 0.427; p<0.05). The prevalence ratio was 8.57, which means psoriasis vulgaris subjects were 8.57 times more likely to have HOMA-IR compared to those without psoriasis vulgaris (p<0.05; 95%CI: 1.26-58.1).Conclusion: This study concludes that there is a moderate positive correlation between severity of psoriasis vulgaris and HOMA-IR values.
ROLE OF ENVIRONMENTAL ALLERGENS ON ATOPIC DERMATITIS Wardhana, M.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (189.803 KB)

Abstract

Background: Atopic dermatitis (AD) is a chronic eczematous skin disease that develops in a patient with atopic diathesis, which is characterized by an increased liability to produce IgE antibodies for allergens mostly derived from environmental or inhalant allergens and food allergens. They are produced by cell-mediated allergic contact reactions, and recently contact sensitivity to various environmental allergens has been demonstrated in patients with AD. Atopic patients are recognized by their ability to produce large amounts of specific IgE antibodies to common substances as environmental allergens, i.e. house dust mites, grass pollens, animal danders, molds, food, etc. These antibodies can be detected by skin prick test. The aim of this study was to identify the sensitization against environmental or inhalants allergens through skin prick tests in the patients with atopic dermatitis. Material and Methods: This is a retrospective, descriptive study. We revised all medical records of patients with AD since January 2002 to December 2004 in the Out Patients Unit of Sanglah General Hospital, Bali-Indonesia. The variables studied were: gender, age, work related, diagnosis associates to AD, and prick test of environmental allergens. Results: In 3 years periods we had revised 46 of patients with AD that was done skin prick tests. The median age was 38 years (range 29-54 years), 34/46 (73.9 %) of these were male and 12 (26.1 %) female. Twenty nine patients presented pure AD, and 17 patients had AD with asthma and allergic rhinitis. Only 16 (34.7%) of patients had no history of allergic disease. Thirsty six of 46 (78.20%) of all tested AD patients had a positive skin prick tests against inhalant (aeroallergens) 16 patients and food allergens 21 patients. Sixteen patients with positive of skin test include; dust mite in 12 patients, animal dander in 10 patients, grass pollen in 9 patients and cockroach in 6 patients. Conclusion: We concluded that Environmental work related particularly dust-mite were significant that contributed to symptoms exacerbation and positive skin prick test. The skin prick tests are important methods to determine inhalant allergens in work related that exacerbation of AD patients.
PREVALENCE AND QUALITY OF LIFE OF PEMPHIGUS PATIENTS AT SANGLAH GENERAL HOSPITAL BALI-INDONESIA Wardhana, and, M.; Rusyati, L. M.
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (277.035 KB)

Abstract

Objectives: Pemphigus vulgaris (PV) is an autoimmune-blistering disease of the skin and mucous membranes caused by auto-antibodies against desmoglein-3 (Dsg-3) on the keratinocyte cell surface of squamous stratified epithelia. Pemphigus is a life-threatening autoimmune bullous disease resulting in the widespread denudation of skin and mucous membrane and severe impact of quality of life. The purpose of this study was to evaluate retrospectively the prevalence of pemphigus and to elucidate the clinical variants, clinical course, prognosis and quality of life (QOL) of pemphigus patients after discharge from hospitalized. Method: Observational non analytical retrospective study was conducted by observation of the medical records of all the newly registered patients with pemphigus at Sanglah General Hospital in Bali-Indonesia during the period of January 1995 and December 2002, and analyzed with regard to personal statistic, history of the diseases including onset, site of affected, symptoms, clinical diagnosis, severity, associated illness, therapy, and quality of life based on the Finlay’s methods. Results: During the 8-year periods studies, 33 pemphigus patients were admitted, represented 5.8 % of  all patients admitted in our in-patient ward during the periods. Our patients consist of female 20 patients (60.6 %) and male 13 patients (39.4 %). The most common of clinical type was pemphigus vulgaris 26 patients (78.78 %), followed by pemphigus foleaceous and pemphigus vegetans. Six patients (18.18 %) of 16 severe patients with severe condition at the clinical course of the diseases was death during the course of hospitalized. A number of 2 patients, in this study were observed with severe impact of quality of life. Conclusion: Our finding showed that pemphigus vulgaris is common type of our cases has a relatively high prevalence our hospital (5.8 %), and relatively high death rate (18.18 %). In our study, systemic corticosteroid was still applied until present for life saving drug for Pemphigus.
LYMPHANGIOMA CIRCUMSCRIPTUM YANG DITERAPI DENGAN BEDAH LISTRIK Medikawati, IGAA Ratna; Wardhana, Made; Darmaputra, IGN
Medicina Vol 45 No 3 (2014): September 2014
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (247.784 KB)

Abstract

Lymphangioma circumscriptum merupakan penyakit hamartoma, malformasi kongenital dari sistemlimfatik yang jarang dengan etiologi yang tidak diketahui, melibatkan saluran limfatik pada lapisandermis  dalam  dan  subkutaneus,  dapat  terjadi  pada  saat  lahir  atau muncul  pada masa  bayi  ataumasa kanak-kanak. Kasus adalah seorang perempuan berumur 13  tahun dengan keluhan munculbintik-bintik berair pada paha kanan sejak sepuluh tahun yang lalu. Pada pemeriksaan dermatologisditemukan  vesikel multipel  bergerombol  dengan  pola  zosteriform  pada  paha kanan. Berdasarkananamnesis,  pemeriksaan  fisik  dan  pemeriksaan  penunjang  berupa  dermoskopi  dan histopatologismendukung diagnosis lymphangioma circumscriptum. Pada kasus dilakukan tindakan bedah listrikdan respon terapi baik. [MEDICINA 2014;45:176-181].
ZINC SERUM LEVEL AND PERIPHERAL BLOOD MONOCYTE COUNT OF MULTIBACILAR LEPROSY PATIENT LOWER THAN PAUCIBACILAR LEPROSY IN RSUP SANGLAH Kurniawan Dhana, Putu; Darma Putra, IGN; Wardhana, Made
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

Zinc has been known to have important role in the immune system. Zinc deficiency can inhibit activation and production cytokine of Th1 and  may cause cellular immunity dysfunction. This conditon also may cause changes of lymphopoiesis and hematopoiesis also peripheral blood of mononuclear cell as mononuclear fagocyte. The Aim of this study is to know zinc serum status and peripheral blood monocyte count of leprosy patient in Dermato Venerologi policlinic Sanglah hospital Denpasar. This study use cross sectional design. Sample of study take by consecutive sampling with sample size contains 75 patient.  Mean of zinc serum status on multibacillary leprosy patient is 5.66  (SB 11.74 ) found lower compare to paucibacillary leprosy patient 19.38 (SB 18.21) and statistically significant with P < 0.05. Mean of peripheral blood monocyte count in multibacillary patient is 7.12 (SB 2.53) lower compare to paucibacillary leprosy patient with 7.88 (SB 3.08), but statistically not significant with P > 0.05. Binary logistic analysis show the influence of zinc serum status to probability to have leprosy. This study suggest correction of serum zinc level in leprosy patient through nutritional approach or the granting of a supplement of zinc
LOW PLASMA CORTISOL LEVEL IS A RISK FACTOR FOR ADULT ATOPIC DERMATITIS AND NEGATIVELY CORRELATED TO PLASMA LEVELS OF NOREPINEPHRINE AND INTERLEUKIN-4 Wardhana, Made; Suata, Ketut; Suastika, Ketut
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Atopic dermatitis is a skin inflammatory disease characterized by hyperactivity of the humoral immune system with a typical onset in infancy or early childhood. Many studies have focused on the patho-physiological role of the immune system in atopic dermatitis, but since the stress hormone receptor was recognized on the surface of immune cells, it appeared that cortisol was prominent stress hormones in regulating the immune system. Some studies have shown that individuals with atopic diseases such as atopic dermatitis, allergic rhinitis and bronchial asthma had lower concentration of saliva cortisol than those with non-atopic conditions. With this evidence, it can be assumed that lower concentration of cortisol as the result of hypo-response of hypothalamus-pituitary-adrenal to stressor can increase and interleukin (IL-4) concentrations. Both substances stimulate lymphocyte T helper 2 (Th2) cells to synthesize IL-4, which has an important role in atopic dermatitis pathogenesis to increase hypersensitivity to various environmental allergens. Until recently, few studies are available concerning the low concentration of plasma cortisol as a risk factor for atopic dermatitis, as well as its correlation with plasma levels of and IL-4. The purpose of this study was to show that low concentration of plasma cortisol is a risk factor for atopic dermatitis and it is negatively correlated with and plasma IL-4. Matched pair case control design, involving 36 cases and 36 controls, was used to show that low concentration of cortisol is a risk factor for atopic dermatitis, and cross sectional design was applied to find out the negative correlation between cortisol and IL-4 in 88 samples consisting of 52 patients with atopic dermatitis and 36 healthy person or persons without atopy. The result of the case-control study showed that plasma cortisol concentration of the case group was significantly lower (4.89 + 2.1 ug/dl; CI 95 %; p < 0.001) than in those of the control group (9.12 + 2.33 ug/dl) at confidence level of 95%; p < 0.001. Multiple logistic regression analysis showed odd ratio of cortisol 3.45, which was higher than the ratio of other parameters such as IL-4, history of atopy and skin moisture. Plasma and IL-4 concentrations of the patients with atopic dermatitis were significantly higher than in the subjects without atopy. The correlation test indicated that plasma cortisol was negatively correlated to norepinephrine (r = - 0.68; p < 0.05), and IL-4 (r = - 0.55; p = 0.05) levels in patients with atopic dermatitis. Based on the above findings, it can be deduced that low concentration of plasma cortisol, being correlated to increased plasma levels of norepinephrne and interleukin-4, is a risk factor for atopic dermatitis in adult
INTERAKSI ANTARA MAKROFAG DAN JARINGAN ADIPOSA PADA OBESITAS Wardhana, I Made W.; Wangko, Sunny
Jurnal Biomedik : JBM Vol 3, No 2 (2011): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.3.2.2011.866

Abstract

Abstract: In adipose tissues of obese people there is an activation of multiple signaling pathways towards hypertrophic adipocytes, associated with infiltration of macrophages.  These cells trigger inflammatory reactions in those tissues, that attract more macrophages from bone marrows; therefore, increasing the reactions. Moreover, there is a paracrine loop that consists of saturated fatty acids and TNF-α derived from macrophages and adipocytes. These two substances create an inflammatory/inflammation cycle, characterized by an up-regulation of pro-inflammatory adipokines and a down-regulation of anti-inflammatory adipokines. Disre-gulation of adipokines production in adipose tissues of obese people in vivo shows that there is a clear/strong interaction between adipocytes and macrophages in causing a chronic inflammation in the tissues. Key words: macrophages, adipose tissue, cytokines.   Abstrak: Pada jaringan adiposa orang obes terjadi aktivasi multiple signaling pathways terhadap adiposit yang hipertrofi, disertai adanya infiltrasi makrofag. Sel-sel ini memicu terjadinya reaksi inflamasi pada jaringan adiposa tersebut, yang selanjutnya menarik makrofag dari sumsum tulang, dengan akibat meningkatnya proses inflamasi. Selain itu terdapat lengkung parakrin yang meliputi asam lemak jenuh dan TNF-α yang berasal dari makrofag dan adiposit. Kedua bahan tersebut membentuk suatu siklus inflamasi yang ditandai oleh up-regulation dari adipokin pro-inflamasi dan down-regulation dari adipokin anti-inflamasi. Disregulasi produksi adipokin pada jaringan adiposa orang obes in vivo menunjukkan adanya hubungan erat antara adiposit dan makrofag sebagai mekanisme potensial yang menyebabkan inflamasi kronis pada jaringan adiposa. Kata kunci: makrofag, jaringan adiposa, sitokin.
Co-Authors Adeline Santoso Ana Rahmawati Anak Agung Gde Putra Wiraguna Anak Agung Gde Putra Wiraguna Ariana Ariana Ariana Ariana Batan, Putu Nila Wardhani Dewi Gotama Ermon Naftali Limbara Ermon Naftali Limbara Fresa Nathania Rahardjo Fresa Nathania Rahardjo Gde Ngurah Arya Ariwangsa Gde Somayana GK Darmaputra I Dewa Nyoman Wibawa I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman Sunyamurti Wirawan I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Nyoman Darmaputra I Ketut Mariadi I Ketut Suastika I.G.A. Karmila Ida Ayu Intan Pratiwi Ida Ayu Trisna Dewi IGAA Ratna Medikawati, IGAA Ratna IGN Darma Putra Ivana Sugiarto Ketut Suata Limbara, Ermon Naftali Luh Made Mas Rusyati Made Kusuma Dewi Maharani Made Kusuma Dewi Maharani Made Martina Windari Made Puspawati Made Swastika Adiguna Maharani, Made Kusuma Dewi Marrietta Sugiarti Sadeli Marrietta Sugiarti Sadeli Martima W Martina Windari Martina Windari Nareswari, Putu Ayu Diah Natih, Sintha Aprillia Gita Ni Luh Putu Ratih Vibriyanti Karna Ni Luh Putu Sri Widhiastuty Ni Made Dwi Puspawati Ni Putu Tiza Murtia Margha Nila Puspasari Nila Wardani Nila Wardhani Batan Nyoman Suryawati Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Pande Agung Mahariski Prima Sanjiwani Puspawati . Putu Ayu Diah Nareswari Putu Ayu Diah Nareswari Putu Kurniawan Dhana Rahardjo, Fresa Nathania Ratih Vebrianti Ricky Fernando Maharis Rikcy Fernando Maharis Sadeli, Marrietta Sugiarti Sissy Sissy Sunny Wangko Suryawati . Wiraguna, Swastika Adiguna