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Journal : journal of internal medicine

PENGARUH VIRUS HEPATITIS C PADA RESPON CD4 SETELAH 6 BULAN PEMAKAIAN REGIMEN KOMBINASI ANTIRETROVIRUS LINI PERTAMA PADA PASIEN INFEKSI HIV Somia, Agus; Utama, Susila; Parwati, Tuti; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Hepatitis C Viral (HCV) and Human ImmunodeÞ ciency Virus (HIV) infection are global health problems. Co-infectionHIV-HCV in intravenous drug users about 53 99%. Despite very high prevalence of this co-infection, there were controversiesabout impact of hepatitis C virus in CD4 response of HIV patients receiving anti retroviral therapy. We conduct a retrospectivecohort to Þ nd out the impact of hepatitis C virus in CD4 response after 6 months of Þ rst line ART therapy. We collect data fromVCT-CST clinic patient!s record. Inclusion criteria for this study were HIV patients more than 12 years old, receiving Þ rst lineof ART treatment, and with anti HCV result.Sixty two patients enrolled for this study. Twenty eight patients found positive anti HCV and 34 negative anti HCV result.Mean of age was 29 ± 4.44 years old in anti HCV (+) group and 34 ± 7.335 in anti HCV (-) group, male dominant (92.9% and85.3% respectively). There were no signiÞ cant differences in total lymphocyte count, hemoglobine, and transaminases (AST andALT) between the two groups. The increasing of mean CD4 after 6 months ART treatment higher in anti HCV (-) group than inanti HCV (+) group, but statistically not signiÞ cant.
SEKRESI INTERLEUKIN-8 (IL-8) DAN HUBUNGANNYA DENGAN TINGKAT KEPARAHAN PENYAKIT INFEKSI DENGUE Wihandani, DM; Ayu Dewi, NN; Somia, Agus
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Elevation of IL-8 was found in many viral infection include dengue infection and related to the increases of illnessgradation. The aim of study is to know the secretion of IL-8 and the relation with the severity of the disease that caused by dengueviral infection that hospitalized at Sanglah hospital. There were 58 patients that diagnosed with dengue haemorrhagic fever basedon WHO criterion. Those samples consist of 38 patients of DHF grade I (mild) and 20 patients of DHF grade II, III and IV(severe). Serum was taken and then the level of IL-8 was examined by ELISA method with microplate reader in 450 nm wavelength (bioMerieux Reader 250). The data was analize statistically with non parametric measurement. The result showed thatthere were significant differences of IL-8 level between healthy people (control) and samples, and between mild and severepatients. We conclude that increase of IL-8 level related to severity of dengue viral infection
PAJANAN OKUPASI DARI PASIEN TERINFEKSI HIV DI RSUP SANGLAH DENPASAR Somia, Agus; Utama IM, Susila; Parwati Merati, Tuti
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Health care personnel who have occupational exposure to blood and some body ! uids or tissues are at risk for HIVinfection. Aim of this study to know about characteristics of occupational exposure to HIV who cares in VCT-CST OutpatientClinic Sanglah Hospital Denpasar. A retrospective descriptive study was done among exposed persons who care in VCT-CSTOutpatient Clinic Sanglah Hospital Denpasar during 1 January 2006 ? 31 December 2007.Total 11 cases occupational exposure occurred in health care places, 9 cases occurrence in Sanglah Hospital and 2 casesoutside Sanglah Hospital. The profession of exposed persons were doctor (45%), medical student (18.2%) and nurse (18.2%).The type of exposure were percutaneous injury (72.7%). Severity of exposures included, 36.4% KP1 (small volume in shorttime), 45.5 % KP2 (large volume and/or long time or percutaneous injury with solid needle, or superfesial laceration), and18.18% KP3 (percutaneous injury with hollow needle, deep injury, visible blood on the device which caused the injury, injurywith needle which had been placed in a source patients artery or vein). HIV-positive class I patients (asymptomatic HIV or alow viral load) was 27.3 % and HIV-positive class II (symptomatic HIV or AIDS, acute seroconversion, or high viral load) was27.3%. about 72% exposed person taken postexposure prophylaxis with combination zidovudine and lamivudine for 4 weeks.Anti HIV status exposed persons at " rst time exposure, 3 month after exposure and 6 month after exposure were negative.We conclude that the most type of exposure were percutaneous with source of exposure each included HIV positive classI dan HIV positive class II. About two third of exposed person taken postexposure prophylaxis with zidovudine and lamivudinecombination. Anti HIV status exposed person a " rst time exposure, 3 month after exposure and 6 month after exposure werenegative.
KARAKTERISTIK PASIEN KO-INFEKSI HIV-HCV DI RSUP SANGLAH DENPASAR Somia, Agus; Utama, Susila; Parwati, Tuti; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Human Immunode! ciency Virus (HIV) and Hepatitis C Virus (HCV) are similar in many respects. Both viruses have asingle stranded RNA genome, both share similar routes of transmission and both cause chronic infection. However, HIV andHCV are also different in the pathogenesis, clinical manifestation and treatment. The aim of this study is to know characteristicof HIV-HCV coinfection patients in Sanglah Hospital. This study was descriptive study. Data based on patients medical recordduring from 1 januari 2004 sampai 31 Desember 2007 at VCT-CST. There were 48 cases HIV-HCV coinfected. 81.6% was male,mean of age of the ! rst anti HIV positive was 29.19 ± 4.63 years old. The risk factor was 75% IVDU. Baseline data showed71.4% suffered from HIV infection stage IV (WHO). The mean of body mass index was 18.78 ± 2.965 kg/m2, the mean of CD4was median of CD 4 was 222.56 ± 155.4 cell/ul, mean WBC was 4.38 ± 7.06 K/ul, mean of TLC was 1.134 ± 0.689 k/ul, meanof Hb was 12.53 ± 2.29 g/dl, Mean of PLT was 247.9 ± 90.11 k/ul, mean of SGOT 62.29 ± 71.91 IU, mean of SGPT was 77.34 ±109.83 IU. HbsAg positif 8.3% and 79.6% with HAART. The mortality rate was 10.8%. Most of HIV-HCV coinfected was male,productive age and the risk factor were IVDU.
PENALAKSANAAN SINDROMA RENJATAN DENGUE DENGAN EDEMA PARU Somia, Agus; Parwati, Tuti
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Dengue Hemorrhagic Fever (DHF) is a systemic disease caused by one of the four types Dengue Viruses. DHF transmittedby a mosquito called Aedes aegyptii. Clinical spectrums of dengue infection widely vary from asymptomatic, undifferentiatedfever, dengue fever, dengue hemorrhagic fever, and dengue shock syndrome grade III and IV. Dengue infections remain on thetop list of infectious disease found in our country and several South-East Asia Nations. Pathognomonic clue differing denguehemorrhagic fever with dengue fever is the presence of plasma leakage due to the increasing of vascular permeability. Dengueshock syndrome is a medical emergency needing direct and correct ß uid resuscitation to deal with hemodynamic disturbance andplasma leakages without causing ß uid overload or further complication. We report an 18 years old male with chief complain offever for 6 days and newly lung edema after 12 hours of admission. Patient diagnosed with 3rd grade of dengue hemorrhagic feverwith lung edema. Patient then undergone ß uid resuscitation with crystalloid and colloid ß uid and given furosemide as diureticagent simultaneously. Finally getting better after Þ ve days of treatment in hospital
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN MAKROSITOSIS PADA PASIEN HIV/AIDS YANG MENDAPAT TERAPI ZIDOVUDIN DI RUMAH SAKIT SANGLAH DENPASAR Ridana Wibawa, Ketut; Parwati Merati, Tuti; Somia, Agus; Utama, Susila
journal of internal medicine Vol. 11, No. 1 Januari 2010
Publisher : journal of internal medicine

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Abstract

Zidovudine is a Þ rst line drug used for treating HIV/AIDS patients in Indonesia and has been associated with prolongedsurvival, a reduction in the frequecy and severity of opportunistic infections, transient increases in the number of CD4 Tlymphocytes, and decreases in serum HIV p24 antigen. However prolong use of zidovudine associated with bone marrowtoxicity manifested by macrocytosis until anemic condition which need the transfusion. Some factors has been identiÞ ed canincreasing the bone marrow toxicity like: age, sex, cotrimoxazole, anemic and neutropenia condition, CD4 count < 200 cells/ L,vit B12 and folic acid level.To determine the risk factors correlated with incident of macrocytosis on HIV/AIDS patients treated with zidovudine,an analytical retrospective cross sectional study was done. The patients were selected using WHO criteria and the antiretoviraltherapy as Depkes guideline which zidovudine base with dose 600 mg/day. The age, sex, cotrimoxazole use and CD4 count wereassesed from all the patients by review medical record when the macrocytosis exist.This study included 140 subyects, age arround 19 ! 65 years old, sex male 72 % and female 28%. Cotrimoxazole use as atreatment or prophylaxis for PCP infection is 90% and the median CD4 count is 24.5 cells/ L. The incidence of macrocytosis is54.3% which is 46.4% without anemia and 7.9% present with anemia. The mean MCV value before zidovudine therapy is 86.27fL and elevated to 110.11 fL after zidovudine therapy. The median time of macrocytosis is 5 month. With bivariat analysis wedidn"t Þ nd correlation betwen age, sex, cotrimoxazol use and CD4 count with incident of macrocytosis (age p = 0.935 95% CIOR = 0.963 sex p = 0.800 95% CI OR = 0.846 cotrimoxazol use p = 0.237 95% CI OR = 0.403 and CD4 count p= 0.646 95%CI = 0.997 respectively).This study concluded no correlation betwen age, sex, cotrimoxazol use and CD4 count with incident of macrocytosis onHIV/AIDS patients whom treated with zidovudine. We suggest to routinely monitoring the MCV value every a month in a year,be cause the incidence of macrocytosis cause by toxicity effect of zidovudine to bone marrow is high.
Co-Authors Adhyatma, I Gede Raka Adiputra, I Komang Hotra Aditya Darmika Amanda Trisliana Dwi Putri Anak Agung Ayu Yuli Gayatri Anak Agung Gde Putra Wiraguna Anbiya Umam Anthony Widyanata Lebuan Chintya Cahyarini, I Gusti Agung Ayu Cindy Gracia Trisina Cokorda Agung Wahyu Purnamasidhi Derian Adiguna Sutanto Desak Made Wihandani Dian, Ni Made Dewi Diksha, I Gusti Ngurah Ariestha Satya Gayatri, Anak Agung Ayu Yuli Gede Wira Mahadita Haruko Akatsu I Dewa Made Sukrama I Dewa Nyoman Wibawa I G A Gita Dewi Rahmautami I Gede Gita Sastrawan I Gede Gita Sastrawan I Gede Gita Sastrawan Sastrawan I Gede Raka Adhyatma I Gusti Agung Ayu Chintya Cahyarini I Gusti Agung Bagus Arya Wiradarma I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ngurah Bagus Jayanta Ananda I Komang Gede Triana Adiputra I Made Bakta I Made Siswadi Semadi I Made Susila Utama I Nyoman Bayu Andika Wiguna I Putu Pande Agus Asmara Widhiana Saputra I Wayan Putu Sutirta Yasa Ida Ayu Santhi Pertiwi Manuaba Ida Bagus Nyoman Putra Dwija Ida Bagus Putra Manuaba IGA Putri Purwanthi Jerry Junior, Darren Kadek Aprilia Sukma Dewi Ketut Ridana Wibawa Ketut Suryana Ketut Tuti Parwati Merati Komang Adya Data Agrasidi Komang Agus Trisna Amijaya, Komang Agus Trisna Komang Andjani Putri Komang Vika Nariswari Ratna Kinasih Made Yogi Oktavian Prasetia Made Yogi Oktavian Prasetia, Made Yogi Oktavian Merry Merry Merry Ni Made Dewi Dian Sukmawati Ni Made Dwi Puspawati Ni Putu Kostarika Melia Daradila Ni Wayan Winarti Nittaya Phanuphak, Nittaya NN Ayu Dewi Purnama, Giovanca Verentzia Putri, Amanda Trisliana Dwi Putu Ardy Hartadi Putu Herdita Sudiantara Putu Novi Handayani Putu SAtherogenic Index Of Plasma iatyakumara Upadhana Putu Satyakumara Upadhana Putu Sudarmika Robertus Brian Junarli Rudi Wisaksana Sastrawan, I Gede Gita Sastrawan Sawitri, Anak Agung Sagung Setiawan, Gerry Shanti, Dewa Ayu Fony Prema Siahaan, Katrin Wilentina Suteja, Richard Christian Tika Rizki Nur Laela Tuti Parwati Umam, Anbiya Khairul Upadhana, Putu Satyakumara Utama, I Made Susila Weisnawa, I Gede Purna Wulandari, Putu Kintan Yundari, Yundari