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Dwitya Elvira
Allergy And Clinical Immunology Subdivision, Department Of Internal Medicine, Faculty Of Medicine, Universitas Andalas / M. Djamil Hospital, Padang, West Sumatera, Indonesia Andalas
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary Other

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HIGH-ALTITUDE ILLNESS Dwitya Elvira
Jurnal Kesehatan Andalas Vol 4, No 2 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i2.304

Abstract

AbstrakHigh-altitude illness (HAI) merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS), high-altitude cerebral edema (HACE) dan high-altitude pulmonary edema (HAPE). Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding) dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m), 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI) is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS), high-altitude cerebral edema (HACE) and high altitude pulmonary edema (HAPE). The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding) and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m), 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in Colorado ski resort, Honigman describe AMS incidence of 22% at an altitude of 1850 m to 2750 m, while Dean showed that 42% had symptoms at an altitude of 3000 m. Acclimatization is one of the prevention that can be done before the climbing, in the addition of several treatment such as acetazolamide, dexamethasone, phospodiestrase inhibitor and gingko biloba.Keywords: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema
Perbedaan Jumlah Leukosit pada Pasien Kanker Payudara Pasca Bedah Sebelum dan Sesudah Radioterapi Rizqy Auliya Lubis; Efrida Efrida; Dwitya Elvira
Jurnal Kesehatan Andalas Vol 6, No 2 (2017)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v6i2.691

Abstract

Radioterapi merupakan salah satu modalitas terapi kanker payudara. Radioterapi dapat menekan sistem hematopoetik pada sumsum tulang dengan efek akut berupa penurunan jumlah leukosit (leukopenia) yang memengaruhi prognosis pasien. Tujuan penelitian ini adalah menentukan perbedaan jumlah leukosit pasien kanker payudara pasca bedah sebelum dan sesudah radioterapi. Desain penelitian ini adalah analitik potong lintang. Populasi dalam penelitian ini merupakan seluruh data rekam mmedik pasien kanker payudara pasca bedah sebelum dan sesudah radioterapi di bagian Radioterapi RSUP Dr. M. Djamil Padang periode 2014-2016. Penelitian ini dilakukan dengan teknik total sampling pada 31 pasien kanker payudara dengan analisis statistik uji t berpasangan. Uji statistik bermakna jika p < 0,05. Subjek penelitian pasien kanker payudara memiliki rentang usia paling banyak 40-49 tahun (51,6%),  sedangkan  kanker  payudara  dominan  berlokasi  di  payudara  kiri  (51,6%)  dengan  stadium  terbanyak ditemukan yaitu stadium III (41,9%). Rerata jumlah leukosit sebelum radioterapi sebanyak 8015/mm3, sedangkan rerata jumlah leukosit sesudah radioterapi sebanyak 6256/mm3. Hasil penelitian menunjukkan bahwa terdapat perbedaan jumlah leukosit yang bermakna secara statistik pada pasien kanker payudara pasca bedah sebelum dan sesudah radioterapi.
Gambaran Hasil Pemeriksaan Urine pada Pasien dengan Pembesaran Prostat Jinak di RSUP DR. M. Djamil Padang Azia Putri Al Jamil; Dian Pertiwi; Dwitya Elvira
Jurnal Kesehatan Andalas Vol 7, No 1 (2018)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v7i1.792

Abstract

Pembesaran prostat jinak dapat menyebabkan terjadinya hambatan aliran urine, sehingga pasien akan merasakan keluhan pada saluran kemih bagian bawah atau Lower Urinary Tract Symptom (LUTS). Urinalisis merupakan salah satu pemeriksaan yang dapat dilakukan pada pasien dengan LUTS yang terdiri dari pemeriksaan fisik, mikroskopik dan kimia. Tujuan penelitian ini adalah untuk mengetahui gambaran hasil pemeriksaan urine pada pasien dengan pembesaran prostat jinak di RSUP Dr. M. Djamil Padang. Jenis penelitian adalah deskriptif observasional. Sampel diambil menggunakan teknik total sampling di bagian Bedah dan Rekam Medik RSUP. Dr. M. Djamil Padang. Penelitian dilaksanakan dari bulan Januari 2016 sampai Desember 2016 dengan jumlah sampel adalah 40 orang. Data yang digunakan adalah hasil pemeriksaan pH, protein, leukosit, eritrosit dan epitel urine pada rekam medik pasien pembesaran prostat jinak. Data yang sudah dikumpulkan kemudian dianalisis dengan program komputer. Hasil penelitian menunjukkan bahwa 100% pasien memiliki hasil pH urine 4.5 sampai 8. Sebanyak 42,5% memiliki hasil protein urine 1+, 60% pasien memiliki nilai leukosit >5/LPB, 80% pasien dengan nilai eritrosit >1/LPB serta 100% pasien dengan epitel gepeng positif satu (+). Simpulan penelitian ini adalah terdapat peningkatan leukosit, eritrosit dan protein urine pada pasien dengan pembesaran prostat jinak namun pH dan epitel urine pasien masih dalam nilai normal.
The Effect of Thionamide to TRH, TSH, IL-4, T-REG, and Anti-TPO in Graves’ Disease Eva Decroli; Dwitya Elvira; Dinda Aprilia
Indonesian Journal of Pharmacy Vol 30 No 2, 2019
Publisher : Faculty of Pharmacy Universitas Gadjah Mada, Yogyakarta, Skip Utara, 55281, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (774.604 KB) | DOI: 10.14499/indonesianjpharm30iss2pp122-127

Abstract

The most common cause of hyperthyroidism is Graves' disease. TRH and TSH are hormonal factors that modulate and control thyroid function in Graves' disease. In the immunological aspect, Graves' disease is played by the role of T-reg, IL-4, and anti-TPO. Graves' disease treatment goal is to inhibit thyroid hormone secretion by administering thionamide. The evaluation of this treatment is its hormonal and immunological aspects. To describe the effect of thionamide on serum TRH, TSH, IL-4, T-reg, and anti-TPO levels in Graves' disease. This study is a clinical trial study in 25 study participants. All study participants were given thionamide, namely PTU 300mg for three months and blood samples were taken for laboratory tests. Serum TRH, TSH, IL-4, T-reg FOXP3, and anti-TPO levels were examined by ELISA. The mean levels at the beginning and after three months of therapy are: serum TRH 92.589pg/mL and 115.944pg/mL; serum TSH 0.041mU/L and 0.223mU/L; serum IL-4 19.759pg/mL and 23.040pg/mL; T-reg FOXP3 gene polymorphism 0.621ng/mL and 0.518 ng/mL; serum anti-TPO 2697.539pg/mL and 2604.710pg/mL. Increased levels of serum TRH and TSH levels were statistically significant. The change in serum IL-4, T-reg FOXP3 gene polymorphism, and anti-TPO levels were not statistically significant. The administration of thionamide in Graves' disease for three months will significantly decrease Wayne index and serum FT4 levels, increase serum TRH and TSH levels.
Risk, Causality and Management of Severe Allergic Reactions of RNA Messenger SARS-CoV-2 Vaccine: A Mini Review Dwitya Elvira; Raveinal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i4.475

Abstract

SARS-CoV-2 infection has become a health problem throughout the world, including Indonesia with high rates of morbidity (more than 3 million confirmed case) and mortality (more than 80 thousand) due to COVID-19 since it was announced as pandemic in March 2020. Vaccination is one of the efforts to eliminate the pandemic, and just recently Food and Drug Monitoring Agency (BPOM) and Indonesian Government have granted approval for emergency use of messenger RNA (mRNA)-based vaccines. Allergic reactions after vaccination are rare adverse events, including severe allergic reactions and anaphylaxis. Polyethylene glycol (PEG) in mRNA vaccines is thought to be a hidden allergen that trigger allergies. Screening of individuals with a previous history of allergies is necessary to prevent reaction. Experienced health workers are also needed to provide adequate management in the event of a severe allergic reaction or anaphylaxis after COVID-19 vaccination. Aim of this review is to look at the risk of allergy of mRNA vaccine SARS CoV-2; possible causes of allergies and management of individuals with severe allergies/anaphylaxis.
HIV Drug Resistance Mutations Rizka Nadia; Dwitya Elvira; Raveinal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 7 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i7.547

Abstract

ART resistance, according to WHO, is the presence of one or more mutations in HIV that reduces the ability of certain drugs or drug groups to inhibit viral replication. According to the 2019 HIV Drug Resistance Report issued by the WHO, the prevalence of Antiretroviral Therapy (ART) drug resistance is 3%-29%. The prevalence of HIV drug resistance varies by country. In developed countries, the prevalence ranges from 6.6% to 11%. There are two types of resistance to ART: primary and secondary resistance. Primary resistance reflects the acquisition of drug-resistant strains in individuals who have recently been infected and have not received therapy. Secondary resistance occurs after treatment with ART. Resistance to antiretroviral therapy, mainly NRTIs, NNRTIs, and protease inhibitors, is caused by continuous inhibition of the HIV reverse transcriptase enzyme. World Health Organization (WHO) has recommended two NRTIs plus Lopinavir or Atazanavir as a second-line regimen for individuals who have failed treatment with efavirenz or dolutegravir; two NRTIs plus Darunavir and Lopinavir plus Raltegravir are recommended as an alternative due to cost constraints and the fact that Darunavir is unstable in moderately hot conditions.
EDUKASI COVID-19 DAN VAKSINASI BAGI MASYARAKAT DI KAMPUNG BATU BUSUAK KECAMATAN PAUH KOTA PADANG Saptino Miro; Roza Kurniati; Dwitya Elvira; Arina Widya Murni; Raveinal Raveinal; Alexander Kam
BULETIN ILMIAH NAGARI MEMBANGUN Vol 5 No 1 (2022)
Publisher : LPPM (Institute for Research and Community Services) Universitas Andalas Padang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/bina.v5i1.398

Abstract

Infectious diseases are still a major health issue that requires serious treatment. The covid-19 is now one of the significant infectious diseases worldwide marked by rapid contagion and global spread. The world health organization (who) has defined covid-19 as a global pandemic and the government has set public health emergencies in Indonesia, obliging countermeasures. The covid-19 countermeasures should continue massively with several strategies. In addition to promotive strategies and the application of health protocols, another effective strategy is needed to break off the chain of disease transmission through vaccination efforts. The purpose of the activity is to do the education about covid-19 and the covid-19 vaccination of the people in Kampung Batu Busuak, Kelurahan Limau Manis, Kecamatan Pauh, Padang. The implementation of this activity includes the counseling of covid-19 and the covid-19 vaccination on Saturday, November 13th, 2021. Before counseling, the Questionnaire was issued to assess a public knowledge level on covid-19 and a covid-19 vaccination. From a questionnaire on covid-19 and covid-19 vaccination, the total of people who have already been vaccinated twice is 22 people and 4 with the covid-19 vaccine once. Therefore, still needed counseling about covid-19 and covid-19 vaccination to enhance awareness of the society towards the importance of covid-19 vaccination.
POLIMORFISTIE GEN TNF-q G-238A DAN IL-4 T-34C SERTA HUBUNGAN DENGAN KADAR IL-4 DAN TNF-q PASIEN PENYAKIT GRAVES Raveinal Raveinal; Siti Nurhajjah; Dwitya Elvira; Suci Maulida
Majalah Kedokteran Andalas Vol 37 (2014): Supplement 2 | Published in December 2014
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4170.55 KB)

Abstract

Pendahuluan: Penyakit Graves adalah hipertiraidisme ditandai pembesaran tiroid difus dengan penyebab imunologi. Kondisi autoimun dengan adanya antibodi lmunoglobulin G (lgG) yang mengikat dan mengaktifkan reseptor tirotropin. Pemberian PTU dapat menurunkan hormon tiroid mencapai normal akan tetapi kadar lL-4 tidak pernah mencapai nilai normal. Penyakit Graves di Taiwan didapatkan polimorfisme gen promotor sitokin TNF-q G-238A, sedangkan gen IL-4 tidak berbeda dibanding kontrol sehat. Tujuan penelitian ini adalah mengetahui danmenganalis polimorfrsme TNF-o G-238A dan gen ll-i T-34C serta hubungannya dengan antibcCr tiroid, kadar lL-4 dan TNF-q pasien penyakit Graves. Metode: Penelitian ini merupakan penelitian deskriptif analitik, dengan jumlah sampel 35 orang pasien penyakit Graves di RSUP Dr. M. Djamil Padang. Darah vena diambil sebanyak 10 cc untuk isolasi DNA, kadar TNF-q dan lL-4. Pemeriksaan polimorfisme gen gen TNF-o G-238Adan IL-4 T-34C dengan teknik PCR-RFLP menggunakan enzym retriksi /'lzlsp/ dan Mnll serta dielektroporesis pada agarose 2%. Pemeriksaan TNF-q dan kadar IL-4 rnengunakan teknik ELISA. Analisis statistik untuk polimorfisme gen dengan uji Chi-Square dan untuk melihat hubungan antar variabel menggunakan uji ANOVA. Hasil: Didapatkan polimorfisme TNF-q G-238A dengan distribusi alel GG (91,4%), GA (8,6%) dan AA (0%). Frekuensi alel G adalah 95,99% dan alel A 4,3%.Rerata kadar TNF-q adalah 62,8+16,6 pg/ml. Polimorfisme gen lL-4 T-34C dengan distribusi alel TT t28,6 % ),TC ( 28,6 oA ), CC (42,9 %). Frekuensi alel T adalah 42,9 % dan alel C adalah 57,1 %. Rerata kadar lL-4 adalah sebesar 22,8 t9,4 pg/ml. Kesimpulan: penelitian ini dapat disimpulkan bahwa polimorfisme gen lL-4 T-34C lebih tinggi didapatkan pada penderita penyakit Graves dan terdapat kaiian antara polimorfisme gen inidengan peningkatan kadar IL-4. Kemungkinan adanya kaitan antara polimorfisme gen lL-4 T-34C dengan kejadian penyakit Graves.
DIAGNOSIS DAN TATALAKSANA HEPATOPULMONARY SYNDROME Dwitya Elvira
Majalah Kedokteran Andalas Vol 38, No 1 (2015): Published in May 2015
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (404.153 KB) | DOI: 10.22338/mka.v38.i1.p57-65.2015

Abstract

AbstrakSirosis hepatis dan penyakit hati kronik merupakan penyebab kematian terbanyak di seluruh dunia. Tingginya angka morbiditas dan mortalitas sirosis berhubungan dengan komplikasinya yang bersifat sistemik. Salah satu komplikasi sirosis dapat mengenai paru berupa sindrom hepatopulmonar atau hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) didefinisikan sebagai trias yang terdiri dari kegagalan hati stadium lanjut, hipoksemia arterial serta dilatasi intravaskular pulmonar tanpa disertai penyakit kardiopulmonar. Patogenesis HPS masih belum diketahui pasti, namun diduga terjadi gangguan metabolisme zat vasoaktif paru yang menimbulkan vasodilatasi vaskuler paru. Manifestasi klinis HPS berupa dispneu yang khas dengan tanda kegagalan hati dan hipertensi portal. Modalitas diagnostik HPS adalah radiologi thorax, analisa gas darah, contrast enhanced echocardiography (CEE), nuclear scanning dengan Tc-99m dan angiografi paru. Penatalaksanaan HPS terutama bertujuan menurunkan vasodilatasi intrapulmonar, meningkatkan oksigenasi arterial dan mengurangi keluhan. Deteksi dini terhadap komplikasi sirosis mutlak diperlukan dalam mencegah dan mengurangi angka morbiditas dan mortalitas.Abstract Liver cirrhosis and chronic liver disease are the leading cause of death worldwide. The high morbidity and mortality associated with their systemic complications. One of the complications of cirrhosis is hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) is defined as the triad of advanced-stage liver failure, arterial hypoxemia and pulmonary intravascular dilatation without cardiopulmonary disease. The pathogenesis of HPS is still not known for sure, but suspected metabolic disorder pulmonary vasoactive substances that cause pulmonary vascular vasodilatation. The clinical manifestations of HPS is typical dispneu with signs of liver failure and portal hypertension. HPS diagnostic modalities are radiology thorax, blood gas analysis, contrast enhanced echocardiography (CEE), nuclear scanning with Tc-99m and pulmonary angiography. HPS management aims primarily to lower intrapulmonar vasodilation, improving arterial oxygenation and reduce complaints. Early detection of complications of cirrhosis is absolutely necessary in preventing and reducing morbidity and mortality.
Human Immunodeficiency Virus (HIV) infection with Multiple Comorbidities in COVID-19 Pandemic Era: A Case Report Dwitya Elvira
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 15 (2021): Special Category COVID-19
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v15i0.3042

Abstract

Coronavirus disease-19 (COVID-19) and Human Immunodeficiency Virus (HIV) were pandemic diseases that affected the healthcare system worldwide. Decline immune system in HIV and accompanying opportunistic infection may worsen the outcome and prognosis of COVID-19 infection. Comprehensive diagnosis and treatment were crucial with HIV patients with a very low immune response. This is our first case report of 50 years old man recently known with HIV and confirmed COVID-19 from PCR swab at once. We found several comorbidities through a comprehensive examination of clinical and laboratory, such as bicytopenia (anemia and thrombocytopenia), acute renal failure, increased liver transaminase, and coagulation disorder (increased PT/APTT) D-dimer), hypoalbuminemia and extremely low CD4. Oral candidiasis, chronic B hepatitis, and lung tuberculosis also present as opportunistic infections in this patient. One dose of antiviral oseltamivir was given each day interval (considering the patient's renal function) accompanied with immediate resuscitation, multivitamins, fluconazole, and cotrimoxazole given. After resolving an acute condition, oral tuberculosis treatment was given, continued with antiretroviral therapy, and advised the patient to routine control in the outpatient department. Future research should address the significance of CD4 lymphocyte count or viral load to measure patients with HIV's immune system and clinical status, risk of opportunistic infection, and prognostic in this pandemic COVID-19 era.
Co-Authors Adrial Adrial Alexander Kam Arina Widya Murni Azia Putri Al Jamil Dian Pertiwi Dinda Aprilia Efrida Efrida Elvia Fataya Eva Decroli Fadrian Fadrian Gustia Anugrahwati Hendriati, Hendriati Ilmiawati, Ilmiawati Muhamad Delfin Muhammad Iqbal Andreas Mustafa Noer Netti Suharti Raveinal Raveinal Raveinal RAVEINAL RAVEINAL Rido Wandrivel Rizka Nadia Rizqy Auliya Lubis Roza Kurniati Roza Kurniati Saptino Miro Siti Nurhajjah Suci Maulida Yuliarni Syafrita Yulistini, Yulistini