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Analisis Hubungan Polimorfisme Gen Matrix Metalloproteinase-9 (MMP-9) dengan Penyakit Ulkus Diabetik pada Penderita Diabetes Mellitus Tipe 2 di RSCM Pratama, Dedy; Wibawa, IGAB Krisna; Patrianef, Patrianef
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.20

Latar Belakang: Ulkus kaki diabetik (UKD) adalah salah satu komplikasi dari diabetes melitus (DM) yang insidennya cenderung meningkat. Beberapa penelitian mengindikasikan polimorfisme gen matrix metalloproteinase-9 (MMP-9) pada titik -1562C/T dan +632A/G memiliki peranan penting dalam perkembangan dan patofisiologi ulkus kaki diabetik, yakni sebagai penanda inflamasi. Penelitian ini bertujuan untuk mengetahui hubungan polimorfisme gen MMP-9 dengan penyakit ulkus diabetik pada penderita DM tipe 2. Metode: Evaluasi menggunakan case control study, subjek penelitian adalah semua penderita DM tipe 2 dengan atau tanpa UKD yang memenuhi kriteria inklusi di RSUPN Dr. Cipto Mangunkusumo pada bulan Juli 2016 hingga Desember 2016. Hasil: Terdapat 197 pasien DM tipe 2 (laki-laki 49,2% dan perempuan 50,8%). Faktor yang berpengaruh dan bermakna secara statistik yakni penyakit arteri perifer (p=0,001), nyeri istirahat (p=0,001), neuropati (p=0,001), merokok (p=0,001), hipertensi (p=0,001), klaudikasio (p=0,001), anemia (p=0,001), dan leukositosis (p=0,001). Distribusi polimorfisme alel dari gen -1562C/T pada seluruh populasi, pada alel C = 74,6%, alel T = 25,4%. Distribusi polimorfisme alel dari gen +836A/G, pada alel A = 41,4%, dan alel G = 58,6% pada seluruh populasi. Simpulan: Pada MMP-9 -1562 C>T, genotipe TC secara statistik memiliki perbedaan secara signifikan terhadap insiden dan merupakan faktor pencegah dalam terjadinya UKD (p=0,001).

Comparison of Mortality and Glasgow Outcome Scale Extended (GOSE) between Craniotomy and Decompressive Craniectomy in Patients with Traumatic Acute Subdural Hematoma at Sanglah General Hospital, Bali Ni Luh Putu Julita Yanti; I Wayan Niryana; Sri Maliawan; I Nyoman Semadi; Tjokorda G. B. Mahadewa; I G. A. B. Krisna Wibawa
JBN (Jurnal Bedah Nasional) Vol 6 No 1 (2022): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2022.v06.i01.p03

Background: Craniotomy and decompressive craniectomy and are surgical modalities for the evacuation of acute subdural hematoma (SDH). These two techniques show different outcomes in various existing studies. The superiority between either techniques remains controversial. Objective: To determine the outcome comparison of mortality and Glasgow Outcome Scale Extended (GOSE) craniotomy with decompressive craniectomy in patients with traumatic acute SDH. Methods: This is a historical cohort study. Samples of the study were collected from January 2018 to March 2020 at Sanglah General Hospital. All patients with acute traumatic SDH who underwent SDH evacuation with craniotomy and decompressive craniectomy were assessed for mortality status at discharge and GOSE 3 months after surgery. Independent T-test will be carried out if the numerical variable were all normally distributed, while Mann-Whitney U test will be performed if otherwise. A Chi-square test will be performed on all unpaired categorical variables. Statistical analysis was performed with SPSS 25 with 95% confidence intervals. Results: As many as 40 subjects with traumatic acute SDH who underwent craniotomy and 40 subjects with traumatic acute SDH who underwent decompressive craniectomy were included in this study. There was no significant difference in mortality (RR: 1; 95% CI 0.67-1.87; p=0.651) and GOSE score (p=0.718) in traumatic acute SDH who underwent craniotomy or decompressive craniectomy. Conclusion: There was no difference in mortality and GOSE outcomes between a craniotomy and decompressive craniectomy for management of traumatic acute SDH.

Analisis Hubungan Polimorfisme Gen Matrix Metalloproteinase-9 (MMP-9) dengan Penyakit Ulkus Diabetik pada Penderita Diabetes Mellitus Tipe 2 di RSCM Dedy Pratama; IGAB Krisna Wibawa; Patrianef Patrianef
Jurnal llmu Bedah Indonesia Vol. 47 No. 1 (2019): Maret 2019
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.20

Latar Belakang: Ulkus kaki diabetik (UKD) adalah salah satu komplikasi dari diabetes melitus (DM) yang insidennya cenderung meningkat. Beberapa penelitian mengindikasikan polimorfisme gen matrix metalloproteinase-9 (MMP-9) pada titik -1562C/T dan +632A/G memiliki peranan penting dalam perkembangan dan patofisiologi ulkus kaki diabetik, yakni sebagai penanda inflamasi. Penelitian ini bertujuan untuk mengetahui hubungan polimorfisme gen MMP-9 dengan penyakit ulkus diabetik pada penderita DM tipe 2. Metode: Evaluasi menggunakan case control study, subjek penelitian adalah semua penderita DM tipe 2 dengan atau tanpa UKD yang memenuhi kriteria inklusi di RSUPN Dr. Cipto Mangunkusumo pada bulan Juli 2016 hingga Desember 2016. Hasil: Terdapat 197 pasien DM tipe 2 (laki-laki 49,2% dan perempuan 50,8%). Faktor yang berpengaruh dan bermakna secara statistik yakni penyakit arteri perifer (p=0,001), nyeri istirahat (p=0,001), neuropati (p=0,001), merokok (p=0,001), hipertensi (p=0,001), klaudikasio (p=0,001), anemia (p=0,001), dan leukositosis (p=0,001). Distribusi polimorfisme alel dari gen -1562C/T pada seluruh populasi, pada alel C = 74,6%, alel T = 25,4%. Distribusi polimorfisme alel dari gen +836A/G, pada alel A = 41,4%, dan alel G = 58,6% pada seluruh populasi. Simpulan: Pada MMP-9 -1562 C>T, genotipe TC secara statistik memiliki perbedaan secara signifikan terhadap insiden dan merupakan faktor pencegah dalam terjadinya UKD (p=0,001).

Neutrophil-Lymphocyte Ratio (NLR) as an output-outcome predictor in moderate-severe head injury at Sanglah General Hospital, Denpasar, Indonesia Melissa Krisanty; Tjokorda Gde Bagus Mahadewa; I Wayan Niryana; I Nyoman Semadi; I Gede Suwedagatha; I Gusti Agung Bagus Krisna Wibawa
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: This prospective cohort study aims to determine the best cut point value and the ability to predict Neutrophil Lymphocyte Ratio (NLR), analyze the most dominant factors, and the direct influence of the NLR to output and outcome in moderate and severe trauma to the head injury at Sanglah General Hospital, Denpasar, Indonesia.Methods: This study was an observational analytic with a prospective cohort design. The subjects of this study were head injury patients over 16 years old with Glasgow Coma Scale (GCS) ? 12 who visited and were treated at Sanglah General Hospital, Denpasar, Indonesia. Patients less than 16 years old, history of alcohol intoxication, stroke, metabolic disease, and multiple traumas were not included as research subjects. Data were analyzed using SPSS version 20 for Windows.Results: The research conducted on 49 respondents found that the best cut-off point of NLR was 6.05 has the most significant predictor (OR=7.6; p=0.001) and dominant (OR=64.97; p=0.002) factors to the output-outcome predictor in moderate-severe head injury. In addition, this cut-off value (6.05) also has a direct influence (x-value=0.523) in the occurrence of output and outcome unfavorable in moderate-severe head injury.Conclusion: the cut-off NLR values of 6.05 became the dominant predictor that directly affected the output and outcome unfavorable in moderate-severe head injury.

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