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All Journal INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES WMJ (Warmadewa Medical Journal) JURNAL PENDIDIKAN TAMBUSAI Medical and Health Science Journal Jurnal Sewaka Bhakti Narra J Aesculapius Medical Journal Warmadewa Minesterium Medical Journal Dharma Bhakti
Anak Agung Gede Budhitresna
Universitas Warmadewa
Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Library & Information Science Medicine & Pharmacology Public Health Social Sciences Other

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Hubungan Antara Komorbiditas Dengan Derajat Keparahan Infeksi Covid-19 Di Rumah Sakit Sanjiwani Gianyar I Nyoman Arep Kusuma Negara; Anak Agung Gede Budhitresna; Ni Luh Putu Eka Kartika Sari
Aesculapius Medical Journal Vol 2 No 1 (2022): Juni
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/amj.2.1.2022.13-20

Abstract

COVID-19 is the leading cause of respiratory disease outbreaks worldwide. 30,949,804 cases of COVID19 have been confirmed since September 21, 2020, and 959,116 people have died worldwide. There are still differences of opinion regarding several diseases that underlie the worsening condition of COVID-19 patients. This study aims to determine the relationship between comorbidities and the severity of COVID-19 infection at the Sanjiwani Hospital. The research method used is analytic observational with a cross-sectional approach, by analyzing secondary data in the form of medical records. A sample of 164 people who have met the exclusion and inclusion criteria, were obtained using the Consecutive sampling technique. Data were analyzed by SPSS. The chi-square test and multiple logistic regression were used to determine the relationship among comorbidities and the severity of COVID-19 infection. Based on the results of multiple logistic regression, the comorbid factors for the severity of COVID-19 infection were hypertension, type 2 diabetes mellitus, COPD, pulmonary TB, chronic heart failure. The most dominant comorbid factor was pulmonary TB (Exp(B)=12,566 95% CI; 3,560 - 44,353).
Pemberdayaan Kader Posyandu Desa Bayung Gede: Langkah Proaktif Deteksi Dini Stunting dengan Pemahaman Milestone Perkembangan Bayi Erly Sintya Dewi; Sri Ratna Dewi; A.A.G. Budhitresna
Warmadewa Minesterium Medical Journal Vol. 4 No. 1 (2025): Januari 2025
Publisher : Warmadewa University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmmj.4.1.2025.61-66

Abstract

Kader Posyandu memiliki peran penting dalam mendukung perkembangan anak di masyarakat, terutama dalam mencegah stunting. Salah satu aspek penting yang menjadi fokus adalah pemahaman tentang milestone perkembangan bayi, yang berfungsi sebagai alat deteksi dini risiko stunting. Program ini bertujuan untuk meningkatkan keterampilan kader Posyandu di Desa Bayung Gede melalui pelatihan intensif, penggunaan aplikasi "Tentang Anak," serta pemberian paket gizi untuk anak stunting. Langkah pertama adalah memberikan pelatihan yang berfokus pada pengenalan milestone perkembangan bayi dan praktik pengolahan MPASI berbasis bahan lokal. Langkah selanjutnya adalah distribusi susu tinggi protein kepada anak-anak stunting, yang bertujuan memperbaiki status gizi mereka. Hasil evaluasi menunjukkan peningkatan signifikan dalam pengetahuan kader, dari rata-rata 55% pada pre-test menjadi 94,5% pada post-test. Selain itu, intervensi gizi memberikan dampak positif terhadap kesehatan anak. Program ini tidak hanya meningkatkan kompetensi kader Posyandu tetapi juga memperkuat pemberdayaan masyarakat melalui integrasi pengetahuan lokal.
Korelasi Kadar Angiopoietin-2 Plasma dan Petanda Inflamasi Dengan Resistensi Insulin Pada Penderita Obesitas Abdominal Anak Agung Gede Budhitresna
WMJ (Warmadewa Medical Journal) Vol 1 No 1 (2016): Mei 2016
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.1.1.5.10-16

Abstract

Obesitas abdominal (Ob-Ab) merupakan komponen utama resistensi insulin (RI) yaitu kekutan pendorong utama untuk terjadinya diabetes mellitus (DM)  tipe-2. Kadar angiopoietin-2  (Ang-2) plasma dilaporkan mengalami peningkatan pada  penderita Ob-Ab dan diduga bahwa Ang-2 berpengaruh untuk terjadinya RI. Tujuan penelitian ini adalah untuk mengetahui korelasi kadar Ang-2, Inflamasi dan RI pada penderita Ob-Ab. Dilakukan penelitian secara cross-sectional analitik pada 81 penderita dengan Ob-Ab. Kadar  TNF-α, sTNFR1 dan Ang-2 plasma diukur menggunakan metode ELISA. RI diukur menggunakan HOMA-IR. Analisis varian (ANOVA) dipergunakan untuk mengetahui persamaan variabel kontinyu. Analisis multivariat dipergunakan untuk mengetahui peran kadar TNF-α, s-TNFR-1, Ang-2 terhadap RI. Model analisis jalur (path analysis) dipergunakan untuk mengetahui pengaruh faktor risiko terjadinya RI. Hasil penelitian menunjukkan bahwa kadar TNF-α plasma tidak berkorelasi dengan HOMA-IR, sedangkan sTNFR-1 dan  Ang-2 plasma berkorelasi positif bermakna dengan HOMA-IR (masing-masing r=0,323; p=0,003 dan r=0,641; p=<0,001). Pada analisis multivariat ditemukan Ang-2 merupakan faktor bebas berhubungan dengan HOMA-IR (p=<0,001). Kadar Ang-2 plasma yang tinggi merupakan faktor dominan (64,1%, p=<0,001). Simpulan: pada penderita Ob-Ab kadar Ang-2 berkorelasi dengan terjadinya RI dan inflamasi.Kata kunci: Ang-2, resistensi insulin, inflamasi, obesitas abdominal. [Correlation of Plasma Angiopoietin-2 and Inflammation Marker with Insulin Resistence in Patients with Central Obesity]Abdominal obesity (Ab-Ob) is a central component of insulin resistance (IR) and it is suggested that IR is a driving factor in the development of type 2 diabetes mellitus (T2DM).  Plasma Ang-2 levels have been reported to increase in the Ab-Ob and it has been hypothesized that Ang-2 plays important role in the occurrence of IR. We assessed the relationship between plasma Ang-2 levels, Inflammation and IR in Ab-Ob. A cross-sectional analytic study on 81 abdominally obese subjects was performed. The concentrations of TNF-α, sTNFR1 and Ang-2 plasma were measured using ELISA method. IR was measured using HOMA-IR. Analysis of variance (ANOVA) was used to test the equality of continuous variables. Multivariate analyses were performed to examine the influence of TNF-α, s-TNFR-1, and Ang-2 on IR. Path analysis models were performed to assess the influence of risk factors on occurrence of IR. Plasma of TNF-α was not correlated with HOMA-IR (r=160; p=0.154) whereasTNFR-1 and Ang-2 were significantly positive correlated with HOMA-IR (r=0.323, p=0.003 and r=0.641, p=<0.001, respectively).  The multivariate analysis showed Ang-2 was independently associated with HOMA-IR (p <0.001). It was found that high Ang-2 level was a dominant risk factor (64.1%, p=<0.001) for influencing IR in the abdominally obese subjects. It is concluded that plasma Ang-2 level is correlated with occurrence of IR and inflammation in abdominally obese subjects.Keywords: Ang-2, insulin resistance, inflammation, abdominal-obesity.
Angiography Scores Can Predict Amputation in Diabetic Feet Anak Agung Gede Budhitresna; Anak Agung Gede Agung Budhi Kesuma; Ketut Putu Yasa
WMJ (Warmadewa Medical Journal) Vol 9 No 1 (2024): May 2024
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.9.1.8802.11-17

Abstract

Diabetic foot is a complication of diabetes mellitus, with a risk of amputation. One of the risk factors for amputation is peripheral arterial occlusive disease. Angiography is a diagnostic method used to visualize blood vessels, plan therapeutic actions, and predict prognosis, including the likelihood of amputation. The validity of angiography scores in predicting amputation in diabetic foot patients is assessed. This study is a diagnostic test to determine the validity of angiography scores in predicting amputation in 23 diabetic foot patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Data analysis used the Receiver Operator Curve (ROC) and diagnostic tests to obtain the Area Under the Curve (AUC), cutoff point, sensitivity and specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV), Positive Likelihood Ratio (PLR), and Negative Likelihood Ratio (NLR). The study results showed a cutoff point for angiography scores of 33% with an AUC of 0.9841 (>0.7) for the percent score and a cutoff point of 6 with an AUC of 0.9960 for the total score (>0.7). The sensitivity and specificity of the angiography scores were very good for predicting amputation in diabetic foot, at 92.9% and 88.9% (CI 95%), respectively. With PPV of 92.9% and NPV of 88.9%, the diagnostic value of angiography scores in predicting amputation in diabetic foot patients is supported. This study shows that angiography scores have good validity in predicting amputation in diabetic foot patients.
Hubungan Antara Status Gizi Dengan Menstruasi Dini Pada Siswi di SD Saraswati 3 Denpasar I Gusti Ayu Istri Pradnya Dewi; Anak Agung Gede Budhitresna; Desak Putu Citra Udiyani
Aesculapius Medical Journal Vol 4 No 1 (2024): February
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/amj.4.1.2024.22-28

Abstract

[Relationship Between Nutritional Status and Early Menstruation in Students at SD Saraswati 3 Denpasar] Early menstruation is increasingly showing an increase throughout the world, including in Indonesia. Bali Province ranks second after DKI Jakarta Province in cases of early menstruation, especially Denpasar City, which has a relatively high prevalence of early menstruation, reaching 26.7%. In the preliminary study that the researchers conducted at SD Saraswati 3 Denpasar, the majority of early menstruation was 40%. Excess nutritional status is often associated with earlier menstruation. This study aims to determine the relationship between nutritional status and early menstruation in female students at SD Saraswati 3 Denpasar. This research method is an observational analytic study with a cross-sectional design. The research subjects were SD Saraswati 3 Denpasar students who met the inclusion criteria with a total sample of 180 people using the total sampling method. The independent variable in this study was nutritional status, and the dependent variable was early menstruation. Research data were analyzed statistically in two stages: univariate and correlation tests with Spearmen-Rho. The P value is considered significant when P <0.05. This study found that age was obtained with an average of 9,56±1,13 years. The highest normal BMI was received by 80 female students (44,4%). Menstrual status was experienced by 77 female students (42,7%). The age of first menstruation was at the age of 11, with as many as 30 female students (16,7%). Based on the statistical test results, a moderate correlation was obtained with the results r = 0.462 and p = <0.001 (p < 0.05). This study's results indicate a significant relationship between nutritional status and early menstruation in female students at SD Saraswati 3 Denpasar.
Hubungan Status Gizi dan Tingkat Aktvitas Fisik dengan Siklus Menstruasi pada Remaja Perempuan di SMAN 7 Denpasar Komang Trinia Amanda Riadi; Anak Agung Gede Budhitresna; Putu Austin Widyasari Wijaya
Aesculapius Medical Journal Vol 4 No 3 (2024): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/amj.4.3.2024.344-350

Abstract

As many as 87% of women with menstrual cycle irregularities have a higher risk of experiencing (polycystic ovarian syndrome) due to impaired ovarian function. Irregular menstrual cycles also have a 2.01 times higher risk of developing diabetes mellitus. The prevalence of women who experience irregular menstrual cycles is more common in adolescent girls aged 16-18 years who are overweight and have a sedentary lifestyle. This study aims to determine the relationship between nutritional status and level of physical activity and the menstrual cycle in adolescent girls at SMA Negeri 7 Denpasar. The research subjects were class XI students of SMA Negeri 7 Denpasar who met the inclusion criteria and numbered 74 people. The sampling method uses simple random sampling. The research method is a quantitative method using a cross sectional design. Data regarding nutritional status was collected through measuring body weight and height, while data regarding physical activity and menstrual cycles were collected through filling out questionnaires by respondents. The research data were analyzed using the Pearson Chi Square test and multinomial logistic regression test. From the research results, it was found that the dominant respondents had normal nutritional status (68.9%), carried out moderate levels of physical activity (42.3%) and experienced normal menstrual cycles (60.8%). Based on the bivariate test, it shows that there is a relationship between nutritional status and physical activity level with a value of p = 0.000. Apart from that, there is a relationship between physical activity levels and the menstrual cycle (p= 0.014). The dominant independent variable that plays a role in the menstrual cycle is nutritional status.
Hubungan antara Kadar HbA1c dengan Dislipidemia pada Pasien Diabetes Melitus Tipe II di RSUD Sanjiwani Gianyar Kadek Kelnerin Pretty Sudirga; Anak Agung Gede Budhitresna; Sri Ratna Dewi
Aesculapius Medical Journal Vol 4 No 3 (2024): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/amj.4.3.2024.360-365

Abstract

Type 2 diabetes mellitus can cause complications including dyslipidemia. This study was conducted to determine the relationship between HbA1c levels and dyslipidemia in Type 2 Diabetes Mellitus Patients at Sanjiwani Gianyar Hospital. Cross sectional analytic research method was used using secondary data. A total of 81 patients who sought treatment at the Internal Medicine Polyclinic of Sanjiwani Hospital for the period 1 January 2021 - 31 December 2023 were sampled. The results of the analysis using the spearman test with a correlation coefficient value of 0.668 with p = 0.000 (p <0.05) have a strong relationship. The correlation coefficient is positive so that the relationship is unidirectional in both variables, so that if people with Type 2 Diabetes Mellitus have high HbA1c levels, the incidence rate of dyslipidaemia will increase. Based on these results, DM patients are advised to check their lipid profile to prevent dyslipidaemia which can increase the risk of cardiovascular complications and worsen overall health conditions.
Penyuluhan dan Skrining dalam Upaya Preventif Pre Diabetes pada Remaja di SMPN 9 Denpasar Budhitresna Anak Agung Gede
Warmadewa Minesterium Medical Journal Vol. 3 No. 3 (2024): September 2024
Publisher : Warmadewa University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmmj.3.3.2024.242-246

Abstract

Dalam beberapa tahun belakangan terjadi peningkatan dari kejadian penyakit tidak menular di Indonesia, salah satu yang paling banyak ditemui yaitu penyakit diabetes mellitus. Diabetes Mellitus (DM) merupakan penyakit metabolik yang terjadi oleh interaksi berbagai faktor: genetik, imunologik, lingkungan dan gaya hidup. Penyakit ini ditandai dengan keadaan hiperglikemia akibat disfungsi dari sekresi insulin, kerja insulin, ataupun keduanya. Penyakit diabetes pada umumnya akan dimulai dengan kondisi prediabetes Dalam jangka waktu 3 - 5 tahun, sekitar 25% prediabetes bisa berkembang menjadi diabetes mellitus tipe 2, 50% senantiasa dalam keadaan prediabetes, serta 25% kembali pada kadar glukosa darah normal. Dukungan pemahaman dan pemeriksaan secara dini melalui kegiatan Pengabdian kepada Masyarakat (PKM) ini bertujuan untuk memperkuat kader di SMPN 9 Denpasar dalam memberikan contoh positif dalam pola hidup sehat mencegah terjadinya diabetes mellitus pada remaja.Metode yang dipakai adalah dengan memberi penyuluhan, melakukan pemeriksaan glukosa darah pada kader siswa, serta memberikan pendampingan kader. Setelah pelaksanaan PKM diperoleh peningkatan pengetahuan kader sebanyak 73,3% (diikuti oleh 25 orang kader) mengenai diabetes mellitus dan pola hidup sehat. Selain itu dilakukan juga pemeriksaan glukosa darah kepada 25 kader dan hasil kadar glukosa darah secara keselurahan masih dalam kategori normal. Kata kunci: penyuluhan, diabetes mellitus, glukosa darah
Pemberdayaan Kelompok Ibu Desa Sebatu Sebagai Kader Sadar Gizi dan Tumbuh Kembang Balita Sri Ratna Dewi; Ni Putu Diah Witari; A.A.G. Budhitresna; Ni Luh Putu Eka Kartika Sari
Warmadewa Minesterium Medical Journal Vol. 3 No. 3 (2024): September 2024
Publisher : Warmadewa University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmmj.3.3.2024.224-229

Abstract

Abstrak Saat pandemi COVID-19 pemerintah memberlakukan pembatasan sosial untuk mengurangi penyebaran virus tersebut. Hal ini memberikan dampak signifikan pada banyak sektor, termasuk pelaksanaan posyandu yang juga harus membatasi aktivitas tatap muka. Pembatasan tatap muka ini berpotensi menyebabkan terbatasnya penyampaian informasi kepada ibu-ibu mengenai gizi dan tumbuh kembang balita, sehingga berpotensi meningkatkan risiko gangguan pertumbuhan dan perkembangan anak-anak. Untuk mengatasi permasalahan ini, kami mengadakan program pemberdayaan kelompok ibu sebagai kader sadar gizi dan tumbuh kembang balita. Mitra kami pada kegiatan ini adalah kelompok ibu di daerah Banjar Tegal Suci, Desa Sebatu, Kecamatan Tegallalang, Gianyar yang memiliki anak usia 0-5 tahun. Pada program ini kelompok ibu dan tenaga kesehatan terhubung dengan media sosial “WhatsApp” yang bertujuan untuk mempermudah penyampaian informasi mengenai gizi seimbang dan pemantauan tumbuh kembang anak. Metode yang digunakan adalah metode penyuluhan dan pendampingan yang dilakukan dengan perpaduan luring dan daring, serta dilakukan evaluasi melalui pre dan post test dengan rerata peningkatan pengetahuan sebanyak 73,81%. Selain itu mitra juga dapat mempertahankan tumbuh kembang balita mereka dalam rentang normal. Kata Kunci: komunikasi, tumbuh kembang, balita
Pemberdayaan Kelompok Ibu Desa Bayung Gede Sebagai Kader Bebas Stunting Sri Ratna Dewi; Ni Wayan Erly Sintya Dewi; A.A.G. Budhitresna; I Wayan Sudiarta
Warmadewa Minesterium Medical Journal Vol. 4 No. 3 (2025): September 2025
Publisher : Warmadewa University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmmj.4.3.2025.200-204

Abstract

Stunting pada anak merupakan dampak dari defisiensi nutrisi selama seribu hari pertama kehidupan yang menyebabkan gangguan pertumbuhan fisik, penurunan kecerdasan, dan masalah kesehatan lainnya. Berdasarkan data Riskesdas, masih dijumpai angka stunting yang cukup tinggi di Bangli, salah satunya di Desa Bayung Gede Permasalahan utama yang diidentifikasi adalah rendahnya asupan gizi dan kurangnya keterampilan pembuatan MPASI bergizi. Puskesmas Kintamani VI telah melakukan berbagai upaya, namun karena sifat masalah yang kompleks, Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warmadewa turut berperan dalam program pendampingan keluarga. Sasaran dari program ini adalah keluarga balita stunting dan berisiko stunting. Solusi yang diberikan berupa penyuluhan mengenai MPASI yang bergizi, pelatihan pembuatan MPASI dengan bahan pangan lokal, dan pemberian paket gizi (susu tinggi protein) serta alat dan bahan dalam pembuatan MPASI. Kegiatan dilaksanakan melalui koordinasi dan sosialisasi, penyuluhan menganai MPASI bergizi, pembuatan MPASI dengan bahan pangan lokal, serta penyerahan paket gizi. Hasil kegiatan menunjukkan peningkatan pengetahuan kader sebanyak 80,8%. Selain itu terdapat peningkatan keterampilan mitra dalam pengolahan MPASI. Program ini terbukti efektif meningkatkan keterampilan dan pemahaman keluarga dalam upaya pengentasan stunting.
Co-Authors Ali A. Rabaan Anak Agung Gede Agung Budhi Kesuma Anak Agung Gede Agung Budhi Kesuma Anwar Santoso Ayu Savitri Siskayani Dariraditya Pemayun, Tjokorda Gde Agung Desak i Putu Oki Lestar Dewa Gde Agung Wikananda Besang Dewa Gde Agung Wikananda Besang Dewa P. Surawan Duwi Sumohadi Haypheng Te I Gede Ari Purnama Putra I Gede Ari Purnama Putra I Gusti Ayu Istri Pradnya Dewi I Gusti Ayu Istri Pradnya Dewi I Ketut Suastika I Nyoman Arep Kusuma Negara I Nyoman Arep Kusuma Negara I NYOMAN MANTIK ASTAWA I Wayan Sudiarta Kadek Kelnerin Pretty Sudirga Kartika Dewi Kartika Dewi Ketut Putu Yasa Ketut Putu Yasa Komang Trinia Amanda Riadi Lestari, Putri P. Luh Made Ayu Pradnyadari Md. Rabiul Islam Md. Rabiul Islam Ni Luh Putu Eka Kartika Sari Ni Luh Putu Eka Kartika Sari Ni Putu Diah Witari, Ni Putu Ni Wayan Erly Sintya Dewi Ni Wayan Erly Sintya Dewi Pande Ayu Naya Kasih Permatananda Putri P. Lestari Putu Arya Suryandhita Putu Austin Widyasari Wijaya Rabaan, Ali A. Retenra P. Suwari Sri Masyeni, Dewa Ayu Putri Sri Ratna Dewi Suka Astini Suka Astini, Dewa Ayu Agung Alit Sumohadi, Duwi Surawan, Dewa P. Suwari, Retenra P. Te, Haypheng Tjahyadi, I Gede Ketut Deny Patmantha Putra Tjokorda Gde Agung Dariraditya Pemayun Udiyani, Desak Putu Citra Wasudewa Wikananda Wikananda, Wasudewa