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All Journal Archives of The Medicine and Case Reports Aesculapius Medical Journal
I Gusti Ngurah Bayu Paramartha
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Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Hubungan antara Kadar Asam Urat dengan Profil Lipid pada Pasien Sindrom Koroner Akut di RSUD Sanjiwani Gianyar I Gusti Ngurah Bayu Paramartha; I Gede Bagus Gita Pranata Putra; Sri Ratna Dewi
AMJ (Aesculapius Medical Journal) Vol. 3 No. 3 (2023): October
Publisher : Fakultas Ilmu Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa

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AbstractThe Correlation Between Uric Acid and Lipid Profile in Acute Coronary Syndrome Patient of Sanjiwani Hospital GianyarSeveral studies show that high uric acid levels is linking to the incidence of acute coronary syndromes and dyslipidemia that leads to heart disease. The aim of this study is to determine the association between uric acid and lipid profile in acute coronary syndrome patients of Sanjiwani Hospital Gianyar. Cross-sectional analysis is the type of data analysis that is being used in this study and was conducted at the Sanjiwani Hospital, Gianyar, with a total of 45 subjects involved. Spearman correlation test showed that there was a significant positive correlation between uric acid levels and Total Cholesterol (TC) (r = 0.467 and p = 0.001). There was a significant positive correlation between uric acid levels and Low Density Lipoprotein (LDL) (r= 0.348 and p value = 0.019). There was a significant negative correlation between uric acid levels and High Density Lipoprotein (HDL) (r= -0.445 and p = 0.002). There was no significant correlation between uric acid levels and Triglycerides (TG) (r = 0.232 and p = 0.124). It was also found that more than 50% of subjects had uric acid levels in the high category (53.3%), optimal Total Cholesterol (TC) levels (80%), normal High Density Lipoprotein (HDL) levels (57.8%), and optimal Triglycerides (TG) levels (71.1%). Meanwhile, 46.7% of subjects had optimal Low Density Lipoprotein (LDL) levels.
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

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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 Desak Agung Indah Praharsini Dewi Dewa Gde Agung Wikananda Besang I Gede Bagus Gita Pranata Putra Sri Ratna Dewi