Article Per Year (5 Year)
p-Index From 2021 - 2026
0.444
P-Index
This Author published in this journals
All Journal Archives of The Medicine and Case Reports Aesculapius Medical Journal
Dewa Gde Agung Wikananda Besang
Unknown Affiliation
Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

 1 
Hubungan Lama Menjalani Hemodialisis Dengan Status Gizi Pasien Gagal Ginjal Kronis yang Menjalani Hemodialisis Reguler di RSUD Sanjiwani Gianyar Dewa Gde Agung Wikananda Besang; Anak Agung Gede Budhitresna; Putu Arya Suryandhita
AMJ (Aesculapius Medical Journal) Vol. 3 No. 1 (2023): February
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Kondisi yang sering dialami pasien gagal ginjal kronis yang sedang melakukan hemodialisis yakni penurunan status gizi seiring dengan lamanya pasien tersebut menjalani terapi. Penelitian ini bertujuan untuk mengetahui hubungan lama menjalani hemodialisis dengan status gizi pasien gagal ginjal kronis yang menjalani hemodialisis reguler di RSUD Sanjiwani Gianyar. Metode penelitian yang dipakai merupakan analitik secara cross-sectional. Data diambil di RSUD Sanjiwani Gianyar dari pencatatan data rekam medis. Subjek penelitian yakni pasien yang tengah melaksanakan hemodialisis reguler di unit hemodialisis RSUD Sanjiwani, Gianyar berdasarkan kriteria pengambilan sampel yang sudah ditetapkan secara purposive sampling. Data yang telah diperoleh lallu diannalisis dengan Uji Chi-Square. Didapatkan hasil kebanyakan pasien gagal ginjal kronis yang menjalani hemodialisis reguler di RSUD Sanjiwani Gianyar melakukan terapi hemodialisis selama ≤3 tahun sejumlah 52,2%. Pasien gagal ginjal kronis yang menjalani hemodialisis reguler di RSUD Sanjiwani Gianyar memiliki status gizi normal sejumlah 40%, status gizi underweight sejumlah 26,7%, status gizi pre-obesity sejumlah 20%, status gizi obesity I sejumlah 11,1%, dan status gizi obesity II sejumlah 2,2%. Hasil uji Chi-Square menunjukan terdapat hubungan yang bermakna antara lama menjalani hemodialisis dengan status gizi pasien gagal ginjal kronis yang menjalani hemodialisis reguler di RSUD Sanjiwani Gianyar (p = 0,011).
Transfusion-Refractory Warm Autoimmune Hemolytic Anemia with Dual Direct Antiglobulin Test Positivity and Marked Monocytosis in an Elderly Patient: A Case Report I Gusti Ngurah Bayu Paramartha; Dewa Gde Agung Wikananda Besang; Desak Agung Indah Praharsini Dewi
Archives of The Medicine and Case Reports Vol. 7 No. 2 (2026): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v7i2.882

Abstract

Warm autoimmune hemolytic anemia represents a significant clinical challenge in adult hematology, with corticosteroid refractoriness occurring in approximately thirty to forty percent of cases. Management becomes substantially more complex in elderly patients with multiple comorbidities, where standard immunosuppressive therapy frequently fails and alternative therapeutic strategies become necessary. A sixty-three-year-old male with three months of documented warm autoimmune hemolytic anemia presented with acute hemolytic crisis manifested by severe anemia (hemoglobin declining from five point three to four point four grams per deciliter over four days) and accelerated hemolysis. Direct antiglobulin testing demonstrated dual positivity with immunoglobulin G one plus and complement component three-d two plus, indicating complement-mediated hemolysis. Notably, marked monocytosis ranged from seventy to seventy-four percent across serial complete blood counts. The patient demonstrated rapid immunosuppressive treatment failure with escalated triple therapy (methylprednisolone, mycophenolate mofetil, azathioprine) failing within four days of initiation. Transfusion refractoriness was evident despite premedication protocols. Concurrent medical conditions included hypertensive heart disease with documented coronary artery disease, newly diagnosed type two diabetes mellitus with suboptimal glycemic control, benign prostatic hyperplasia requiring catheterization, and clinical immunosuppression complications. The patient was referred to a tertiary academic medical center for advanced therapeutic decision-making. In conclusion, this case illustrates the diagnostic and therapeutic complexity of warm autoimmune hemolytic anemia with complement activation in an elderly population, highlighting the necessity for rapid escalation to advanced therapeutic modalities beyond conventional immunosuppression when clinical deterioration occurs despite maximal standard therapy.
Co-Authors Anak Agung Gede Budhitresna Desak Agung Indah Praharsini Dewi I Gusti Ngurah Bayu Paramartha Putu Arya Suryandhita