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19 Years Old Male Patient with Cholelithiasis: A Case Report Semara, Putu Bagus Aditya Putra; Wirawan, I Made Suma
Indonesian Health Journal (IHJ) Vol. 3 No. 4 (2024): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v3i4.610

Cholelithiasis refers to the formation of hardened deposits of digestive fluid, known as gallstones, which can develop in the gallbladder, bile duct, or both. This study aims to analyze the factors contributing to the occurrence of cholelithiasis in young patients, specifically 19-year-old males, and identify the clinical symptoms and associated examination results. A 19-year-old male patient visited the Internal Medicine Polyclinic with the main complaint of right upper abdominal pain radiating to the back. He also experienced nausea and vomiting. The patient frequently consumed high-fat foods. On physical examination, the patient's height was 171 cm, weight 74 kg, and BMI 25.34 kg/m² (overweight). Abdominal examination revealed a positive Murphy's sign. Laboratory tests showed total cholesterol of 216 mg/dl, LDL 158 mg/dl, HDL 38 mg/dl, and triglycerides 86 mg/dl. An abdominal ultrasound indicated thickened gallbladder walls, a single stone measuring approximately 0.82 cm by 1.17 cm, accompanied by sludge, and calcification in the right lobe of the liver. The patient was treated with Ursodeoxycholic Acid (UDCA) 250 mg twice daily and Atorvastatin 10 mg once daily. Cholelithiasis is a multifactorial condition, influenced by several factors, commonly referred to as the "4F" factors: female gender, age over 40, fertility (being in the fertile period), and fat (obesity). Other contributing factors include age, genetics, and race. Children and adolescents may develop gallstones due to increased consumption of fat, refined carbohydrates, and low fiber intake. Overweight and obesity are significant risk factors because they increase the secretion of intrahepatic cholesterol, which promotes gallstone formation. The treatment of cholelithiasis can be classified into non-surgical and surgical approaches.

Therapeutic Strategy for Recurrent Ulcerative Colitis Pranata, Anak Agung Ngurah Satya; Wirawan, I Made Suma; Kumala Dewi, Anak Agung Istri Sri; ., Novitasari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202484-89

Ulcerative Colitis (UC) is a chronic idiopathic inflammation that appears from the rectum and can extend to colon causing diffuse friability and superficiality. In this case report, Woman, 44 years old, admitted to hospital because of bloody diarrhea, frequency of 4-6 times daily with mucous, malaise, and history of weight loss. Patient already had oral sulfasalazine and oral corticosteroid to maintain her condition, but she stopped the medication at will. On physical examination, showed anemic conjunctiva and increasing in bowel sound, fecal examination showed brown to red, porridge-like consistency, blood, mucous, and positive Benzidine test. Colonoscopy examination revealed, normal anus; in the sigmoid rectum, colon descendent found small swellings, an ulcer, and few bloody. On histopathology, epithelial surface with mucin depletiondistortion of crypt architecture, dilatation and elongation of crypt, as well as shortening of the crypt that does not reach muscular mucous and lamina propria contains solid aggregate inflammation cells, dominated by plasma cells. The patient was given combination of 5-aminosalicylates and glucocorticoids. On re-evaluation in week 8 of therapy, frequency of defecation becomes 1-2 times daily with no blood occurring and improvement on colonoscopy, rectal mucous, colon sigmoid improved, no bleeding and clean mucous. 5-aminosalicylates is the first treatment in UC, it also helps to achieve remission and prevent carcinoma development. UC is a disease that also causes extra-intestinal manifestation, so the treatment should be done holistically. Compliance and regular monitoring will help to improve the quality of life.

An Exploratory Study of the Prevalence and Risk Factors of Hypercholesterolemia Among the Elderly in Kelating Village, Tabanan Regency Pramesti, AA Intan; Sidemen, Premayani; Wirawan, I Made Suma; Adi Putra, Kadek Nova; R. P, Indry Agatha
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 2 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

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

Hypercholesterolemia, characterized by elevated levels of LDL, triglycerides, and total cholesterol, is a common but often undetected condition among the elderly. In Indonesia, the prevalence of hypercholesterolemia in individuals aged 65–74 is reported at 38.2%. Early detection is critical to prevent severe complications. Dietary habits and physical inactivity, particularly in populations such as the Segara Santhi elderly group in Kerambitan Village, Tabanan—who have a history of pork consumption and low physical activity—may increase vulnerability to this condition. This preliminary cross-sectional study aimed to explore the prevalence and potential risk factors associated with hypercholesterolemia among elderly individuals in the Segara Santhi group. Using purposive random sampling, 30 elderly participants were selected. Fasting total blood cholesterol levels were measured after an 8-hour fast. Data were analyzed and presented descriptively and in tabular form. A total of 16 participants (51.6%) had total cholesterol levels >200 mg/dL, with a higher proportion observed in elderly women. No statistically significant associations (P>0.05) were found between hypercholesterolemia and gender, age, blood pressure, or fasting blood glucose. However, a significant relationship was identified between hypercholesterolemia and uric acid levels (P<0.05). As a preliminary study, these findings suggest a high prevalence of hypercholesterolemia in this elderly population and indicate a possible link with uric acid levels. Further research with a larger sample size is needed to validate these results and better understand associated risk factors.

An Exploratory Study of the Prevalence and Risk Factors of Hypercholesterolemia Among the Elderly in Kelating Village, Tabanan Regency Pramesti, AA Intan; Sidemen, Premayani; Wirawan, I Made Suma; Adi Putra, Kadek Nova; R. P, Indry Agatha
Jurnal Sehat Indonesia (JUSINDO) Vol. 7 No. 2 (2025): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/.v7i2.368

Hypercholesterolemia, characterized by elevated levels of LDL, triglycerides, and total cholesterol, is a common but often undetected condition among the elderly. In Indonesia, the prevalence of hypercholesterolemia in individuals aged 65–74 is reported at 38.2%. Early detection is critical to prevent severe complications. Dietary habits and physical inactivity, particularly in populations such as the Segara Santhi elderly group in Kerambitan Village, Tabanan—who have a history of pork consumption and low physical activity—may increase vulnerability to this condition. This preliminary cross-sectional study aimed to explore the prevalence and potential risk factors associated with hypercholesterolemia among elderly individuals in the Segara Santhi group. Using purposive random sampling, 30 elderly participants were selected. Fasting total blood cholesterol levels were measured after an 8-hour fast. Data were analyzed and presented descriptively and in tabular form. A total of 16 participants (51.6%) had total cholesterol levels >200 mg/dL, with a higher proportion observed in elderly women. No statistically significant associations (P>0.05) were found between hypercholesterolemia and gender, age, blood pressure, or fasting blood glucose. However, a significant relationship was identified between hypercholesterolemia and uric acid levels (P<0.05). As a preliminary study, these findings suggest a high prevalence of hypercholesterolemia in this elderly population and indicate a possible link with uric acid levels. Further research with a larger sample size is needed to validate these results and better understand associated risk factors.

19 Years Old Male Patient with Cholelithiasis: A Case Report Semara, Putu Bagus Aditya Putra; Wirawan, I Made Suma
Indonesian Health Journal Vol. 3 No. 4 (2024): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v3i4.610

Cholelithiasis refers to the formation of hardened deposits of digestive fluid, known as gallstones, which can develop in the gallbladder, bile duct, or both. This study aims to analyze the factors contributing to the occurrence of cholelithiasis in young patients, specifically 19-year-old males, and identify the clinical symptoms and associated examination results. A 19-year-old male patient visited the Internal Medicine Polyclinic with the main complaint of right upper abdominal pain radiating to the back. He also experienced nausea and vomiting. The patient frequently consumed high-fat foods. On physical examination, the patient's height was 171 cm, weight 74 kg, and BMI 25.34 kg/m² (overweight). Abdominal examination revealed a positive Murphy's sign. Laboratory tests showed total cholesterol of 216 mg/dl, LDL 158 mg/dl, HDL 38 mg/dl, and triglycerides 86 mg/dl. An abdominal ultrasound indicated thickened gallbladder walls, a single stone measuring approximately 0.82 cm by 1.17 cm, accompanied by sludge, and calcification in the right lobe of the liver. The patient was treated with Ursodeoxycholic Acid (UDCA) 250 mg twice daily and Atorvastatin 10 mg once daily. Cholelithiasis is a multifactorial condition, influenced by several factors, commonly referred to as the "4F" factors: female gender, age over 40, fertility (being in the fertile period), and fat (obesity). Other contributing factors include age, genetics, and race. Children and adolescents may develop gallstones due to increased consumption of fat, refined carbohydrates, and low fiber intake. Overweight and obesity are significant risk factors because they increase the secretion of intrahepatic cholesterol, which promotes gallstone formation. The treatment of cholelithiasis can be classified into non-surgical and surgical approaches.

Determinant Factors of Type 2 Diabetes Mellitus Among Older Adults in Kelating Village Pake, Indry Agatha Rihi; Putra, I Made Gede Dwipayana; Adrya, Jessica; Jayaningrat, Dewa Ayu Tri; Wirawan, I Made Suma
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i2.57738

Type 2 diabetes mellitus (DM) increased in the elderly population due to metabolic changes and decreased function of pancreatic β cells. This study aims to determine the prevalence of type 2 diabetes mellitus in the elderly and examine the risk factors—such as age, gender, blood pressure, and uric acid levels—that influence the incidence of type 2 DM. This cross-sectional study involved 31 elderly people (≥60 years) in Segara Santhi, Kelating Village, Tabanan, who were selected using purposive random sampling. Fasting blood glucose and uric acid levels were checked using Accu-Chek after fasting for at least 8 hours. Data analysis used the Fisher's Exact Test with a significance of p<0.05. The results show prevalence of type 2 DM was 64.5% (20 of 31 respondents). Age and type 2 DM had no significant association (p= 0.262). However, there was a significant association between type 2 DM and gender (p = 0.012) and uric acid levels (p = 0.029), but not with blood pressure (p = 1,000). The prevalence of type 2 DM in the elderly in Segara Santhi is quite high, but age is not the main factor. Other factors such as diet, physical activity, and genetic predisposition may play a greater role. Further studies with larger sample sizes and multivariate analysis are needed to understand the risk factors for type 2 DM in the elderly more specifically.

Prevalensi Hiperurisemia pada Kelompok Lansia Segara Santhi di Desa Kelating, Kerambitan Tabanan: Studi Cross Sectional Aryani, Ni Made; Fahira, Cindy; Lestari, I Dewa Ayu Made Dian; Putra, Kadek Nova Adi; Wirawan, I Made Suma
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i3.57934

This study examines the design of a collaboration between SMEs producing goat milk soap and the Hilton hotel chain, aiming to identify an effective and sustainable partnership model. Using a qualitative approach with a case study design, the research involves in-depth interviews, observations, document analysis, and focus group discussions with various stakeholders. The results reveal that successful partnerships require knowledge and technology transfer, production capacity enhancement, quality standardization, and joint marketing strategies. The findings indicate significant potential for improving SME competitiveness, diversifying hotel products, and promoting local economic development. However, challenges such as differences in operational scale, investment needs, and regulatory adaptation need to be addressed. The proposed partnership model emphasizes the importance of long-term commitment, human resource development, and integration of sustainable practices. This research contributes to the understanding of SME-large enterprise partnership dynamics and offers practical implications for policymakers and business practitioners.

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