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All Journal journal of internal medicine E-Jurnal Medika Udayana Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
I Ketut Mariadi
Division Of Gastroenterology And Hepatology, Department Of Internal Medicine, Udayana University/Sanglah General Hospital, Bali
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Kadar Resistin Serum Berhubungan Dengan Skor Child-Turcotte Pugh Pada Penderita Sirosis Hati Koncoro, Hendra; Primadharsini, Putu Prathiwi; Mariadi, I Ketut; Somayana, Gde; Suryadarma, I Gusti Agung; Purwadi, Nyoman; Wibawa, I Dewa Nyoman
Jurnal Penyakit Dalam Udayana Vol 1 No 1 (2017): JPD Vol. 1 No.1 2017
Publisher : PAPDI BALI

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Abstract

Latar Belakang: Sirosis hati (SH) sering disertai tingginya resistensi insulin dan kondisi proinflamasi. Resistin yang merupakan suatu adipokin, diketahui memiliki hubungan dengan resistensi insulin dan inflamasi. Studi-studi resistin pada SH memperlihatkan hasil yang bervariasi. Tujuan penelitian ini adalah untuk mencari hubungan kadar resistin serum dengan skor Child-Turcotte Pugh (CTP) pada penderita SH. Metode: Penelitian observasional, studi potong lintang ini dilaksanakan di RSUP Sanglah dari September 2014 sampai dengan Juni 2015 dengan menggunakan 75 pasien sirosis hati sebagai sampel. Kriteria inklusi mencakup pasien sirosis hati tanpa memandang etiologinya dan berusia 12 tahun atau lebih. Variabel yang diperiksa pada penelitian ini yaitu skor CTP (kadar albumin serum, kadar bilirubin total serum, nilai waktu protrombin, kadar international normalized ratio (INR), tanda ascites, tanda ensefalopati hepatikum), kadar C-reactive protein (CRP), dan kadar resistin serum. Hasil: Enam puluh lima persen dari 75 sampel adalah laki-laki dan sisanya perempuan. Sebelas diantaranya (14,7%) adalah kelas CTP A, 31 (41,3%) kelas CTP B, dan 33 (44%) kelas CTP C. Rerata kadar CRP adalah 15,05 ± 15,86 mg/L. Rerata kadar resistin adalah 23,39 ± 17,79 ng/mL. Hasil uji korelasi didapatkan korelasi positif yang sedang antara kadar resistin dan skor CTP (r = 0,438; p < 0,001). Korelasi positif sedang juga didapatkan antara CRP dan resistin (r = 0,478; p < 0,001). Simpulan: Kadar resistin memiliki korelasi sedang dengan skor CTP pada pasien SH. Kadar resistin didapatkan lebih tinggi kadarnya pada SH yang berat. Hal ini menunjukkan adanya kondisi inflamasi dan resistensi insulin seiring dengan peningkatan derajat beratnya SH.
INSUFISIENSI ADRENAL PADA PASIEN DENGAN PENYAKIT KRITIS Mariadi, I Ketu; Gotera, Wira
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Abstract

Stress from many sources, including pain, fever, and hypotension, activates the hypothalamic-pituitary-adrenal (HPA)axis with the sustained secretion of corticotropin and cortisol. Increased glucocorticoid action is an essential component of thestress response, and even minor degrees of adrenal insufficiency can be fatal in the stressed host. HPA dysfunction is a commonand underdiagnosed disorder in the critically ill. We review the risk factors, pathophysiology, diagnostic approach, and managementof HPA dysfunction in the critically ill
PERKEMBANGAN TERKINI DALAM DIAGNOSIS DAN PENATALAKSANAAN IRRITABEL BOWEL SYNDROME Mariadi, I Ketut; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Abstract

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) motility and sensory disorder that ischaracterized by abdominal pain/discomfort, bloating and altered bowel habit. The disease accounts for hugecosts for both patients and health-care systems and worsens significantly patients’ quality of life. Diagnosis isbased on the identification of symptoms according to Manning, Rome I and Rome II criteria and the most recentRome III criteria and exclusion of alarm indicators. The treatment of IBS is centred on an excellent doctor–patient relationship along with drugs targeting the predominant symptom, especially during exacerbations. Thisreview aim to explain new ctriteria to diagnose IBS and to conduct a systematic evidence-based review ofpharmacological therapies currently used, or in clinical development, for the treatment of IBS
HUBUNGAN ANTARA INTERLEUKIN- 6 DAN C-REACTIVE PROTEIN PADA SIROSIS HATI DENGAN PERDARAHAN SALURAN MAKANAN BAGIAN ATAS Mariadi, I Ketut; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Variceal bleeding is a frequent complication of liver cirrhosis. Upper gastrointestinal (GI) bleeding is a risk factor forinfection. The severity of liver cirrhosis was correlated with infection and GI bleeding. Bacterial infection and endotoxin promotecytokine proinflammation (IL-6) release from monocyte. IL-6 stimulates the liver to produce CRP. Does liver cirrhosisaffect the CRP production? Recently, there are no data about the correlation of IL-6 and CRP in liver cirrhosis with uppergastrointestinal bleeding. A cross-sectional analytic study was performed to describe the correlation between IL-6 and CRP inliver cirrhosis patient with upper gastrointestinal bleeding.We performed a cross-sectional analytic study in 52 liver cirrhosis patients. The liver cirrhosis patients with uppergastrointestinal bleeding in last 14 days, absence of steroid and statin treatment, without hepatoma, and GFR 15 ml/mnt/1.73m2, were collected consecutively. The correlation of IL-6 and CRP was analyzed with Pearson correlation test, mean differenceof CRP between Child Turcotte Pugh (CTP) group was analyzed by Ancova test continued with post hoc Tamhane test, the effectof CTP on CRP production was analyzed with Ancova test.Seventy-five percent out of 52 samples were male and the rest were female. Two of them (3.8%) with CTP score A, 20(38.5%) CTP score B and 30 (57.7%) CTP score C. Mean of IL-6 was 28.29 ± 34.60. Mean of CRP was 17.17 ± 28.80 mg/L. Wefound strong positive correlation between IL-6 and CRP (r = 0.610; p<0.001). CTP score didnt have significant independenteffect on correlation of IL-6 and CRP level (F=2.33; p=0.108). Significant mean difference of CRP was found between CTP scoregroup (F=4.27; p=0.02).In conclusion, Interleukin-6 has a strong correlation with CRP in liver cirrhosis with upper GI bleeding. CRP level issignificantly higher in severe liver cirrhosis. And the degree of liver damage doesnt have significant independent effect oncorrelation of IL-6 and CRP level. These results show us that hepatocyte in liver cirrhosis still adequately produce CRP.
INTERLEUKIN 8 BERHUBUNGAN DENGAN DERAJAT GASTRITIS PADA PASIEN TERINFEKSI HELICOBACTER PYLORI Mariadi, IK; Kurniari, PK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Helicobacter pylori infection induces a local pro-inflammatory cytokine response. The secretion of IL-8 by epithelialcells is probably a key factor in host defenses at mucosal sites, permitting a rapid polymorph response against infectious agents.Interleukin-8 is an important chemotactic and activating factor for neutrophils. If defense mechanisms fail and chronic infectionresults, continued up regulation of IL-8 and neutrophil activation could lead to mucosal damage and increased free radicalformation. Mucosal IL-8 production in Helicobacter pylori infection may be an important factor in the immunopathogenesisof gastritis and peptic ulcer disease. This study aim to investigate correlation between IL-8 and severity of gastritis in ourpopulation. We performed a cross-sectional analytic study in Helicobacter pylori infected patients. Severity of gastritis wasdetermined base on The Updated Sydney System. IL-8 level was analyzed from gastric mucosa biopsy using ELISA method.We included 65 samples. 31 (47.7%) men and the rest was women. Base on Kruskalwallis test we found significant associationbetween IL-8 gastric mucosa and severity of gastritis (x2 = 12.8; p = 0.002). We also found significant association between IL-8gastric mucosa and density of H pylori infection (x2 = 10.6; p = 0.01), severity of atrophy (x2 = 9.4; p = 0.02) and neutrophilscount (x2 = 11.0; p = 0.01). But notmethaplasia (x2 = 3.3; p = 0.18). Base on this study we concluded that IL-8 was associatedwith severity of gastritis in Helicobacter pylori infected patients.
HUBUNGAN C-REACTIVE PROTEIN DENGAN PEMANJANGAN PROTHROMBIN TIME PADA PASIEN SIROSIS HATI YANG MENGALAMI PERDARAHAN SALURAN MAKANAN BAGIAN ATAS Mariadi, IK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Bacterial infections are common complications in cirrhosis, and cause the systemic in! ammation process. The natureof the relationship between gastrointestinal bleeding and infection in cirrhosis has not been clari" ed. Infection is associatedwith failure to control variceal bleeding and early variceal rebleeding in these patients. Bacterial infections, and particularlyendotoxemia, have been shown to activate the coagulation system and generally to interfere with hemostasis. We performedcross-sectional analytic study in cirrhosis patients with upper gastrointestinal bleeding to assess whether there are any associationbetween in! ammation process (CRP) with defect in haemostatic system (prolongation in prothrombin time). Forty-nine patientswere evaluated, 37 (75.5%) out of these were male and the rest were female. Ninteen out of this with in! ammation process and30 without in! ammation process. Fourteen out of 19 patients (73.7%) in in! ammation group have prolongation on prothrombintime and 12 out of 30 patients (40%) in non in! ammation group have prolongation on prothrombin time. The difference of thisproportion statistically signi" cant (Chi-square test X2: 5.29; p = 0.021). The CRP also have positive correlation with prolongationin prothrombin time (Spearman correlation R = 0.390; p = 0.006). In conclusion there is signi" cant association between CRP andprothrombin time in cirrhosis patients with upper gastrointestinal bleeding.
FAKTOR RISIKO DAN GAMBARAN ESOFAGOGASTRODUODENOSKOPI PENGGUNA OBAT ANTI INFLAMASI NON-STEROID DI RSUP SANGLAH TAHUN 2016-2018 Renaldy Frederich Nathanael Magat; I Dewa Nyoman Wibawa; Gde Somayana; I Ketut Mariadi
E-Jurnal Medika Udayana Vol 11 No 1 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.v11.i01.p07

Abstract

The use of non-stereoidal anti-inflammatory drugs (NSAIDs) for a certain time and dose can cause abnormalities in the digestive tract ranging from asymptomatic, ulcers, bleeding to perforation. This study aims to determine the distribution of the proportion of patients with abnormality in gastric and duodenal due to NSAIDs based on esophagogastroduodenoscopy (EGD) results, age, gender, H. Pylori infection, type of NSAIDs, history of smoking, history of anticoagulants, history of corticosteroids and risk factors for EGD abnormalities in the gastric and duodenal due to NSAIDs use at Sanglah General Hospital in 2016-2018. This study is a retrospective cross-sectional study based on the medical records of patients who underwent endoscopy at Sanglah General Hospital in 2016-2018. The sampling technique was total sampling, then all data were analyzed using bivariate analysis of the chi-square test and multivariate logistic regression analysis. From 92 patients who met the criteria, men (54.3%) and women (45.7%) with the majority of the age group ³ 60 years (95.7%), EGD abnormalities were obtained in the form of superficial gastritis (33.7%), erosival gastritis (28.3%), gastric ulcer (28.3%), duodenal ulcer (5.4%). With ulcer characteristic are Forrest III (90.3%) and single (74.2%). The majority of patients used non-selective NSAIDs (94.5%), namely ketorolac 30 mg (40.2%). From the biopsy examination, the patient had H. pylori infection (20.5%). Based on medical records, the patients had a history of smoking (59.8%). Patients also found a history of use of anticoagulants (16.3%) and corticosteroids (35.9%). In this study, there was a significant relationship between H. pylori infection and severe EGD abnormalities in NSAID users (P = 0.012). In this study, there were no independent risk factors for severe EGD abnormalities in NSAID users, but there was a significant relationship between H. pylori infection and severe EGD abnormalities in NSAID users Keywords : NSAIDs, EGD, EGD abnormalities in NSAIDs user.
HUBUNGAN ANTARA KLASIFIKASI CHILD-TURCOTTE-PUGH DENGAN DERAJAT VARISES ESOFAGUS PADA PASIEN SIROSIS HATI DI RUMAH SAKIT UMUM PUSAT SANGLAH I Wayan Surya Ardiana; I Ketut Mariadi
E-Jurnal Medika Udayana Vol 8 No 11 (2019): Vol 8 No 11 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Varises esofagus (VE) merupakan komplikasi utama dari pasien sirosis hati. Sirosis hati diklasifikasikan menggunakan klasifikasi Child-Turcotte-Pugh (CTP) untuk menentukan prognosis dan mortalitasnya. Penelitian sebelumnya menemukan peningkatan prevalensi VE pada pasien dengan kelas CTP A, B, C secara berturut-turut. Namun, hubungan antara antara CTP dengan VE masih belum jelas. Tujuan penelitian ini untuk menentukan hubungan antara kelas CTP dengan kejadian VE dan derajat VE pada pasien sirosis hati. Penelitian ini merupakan studi cross-sectional yang diikuti oleh 90 pasien terdiagnosis sirosis hati di Rumah Sakit Sanglah dari April 2016 - Agustus 2017. Analisis statistik dikerjakan dengan uji chi-square, dan uji Kruskal-Wallis H non-parametric dengan nilai-p < 0,005 dianggap secara statistik signifikan. Hasil penelitian menunjukan dari 90 pasien, 71 (78,9%) laki-laki dan 19 (21,1%) perempuan. Rerata umur sampel 54±13 tahun, dengan rentangan 28-91 tahun. Kelas CTP teridentifikasi 20 (22,2%) kelas A, 45 (50%) kelas B, dan 25 (27,8%) kelas C. VE teridentifikasi 65 kasus(72,2%). prevalensi VE pada setiap kelas CTP ditemukan 10 (50%) pada kelas A, 34 (75,6%) pada kelas B, dan 21 (84%) pada kelas C. Uji Chi-square antara kelas CTP and kejadian VE ditemukan hasil signifikan (p=0,032) dengan OR=3,667 dan IK95% =1,288-10,437. Namun, uji Kruskal-Wallis H nonparametric tidak ditemukan hubungan yg signifikan antara kelas CTP dan derajat VE (p=0,168). Disimpulkan bahwa kelas CTP yang lebih tinggi pada pasien sirosis hati berhubungan dengan kejadian VE, namun tidak berhubungan dengan derajat VE Kata kunci: child-turcotte-pugh, varises esofagus, sirosis hati
GAMBARAN PERLEMAKAN HATI NON-ALKOHOLIK DI RSUP SANGLAH DENPASAR PERIODE TAHUN 2017-2018 Derryl Ravertio Timothy Subroto; I Ketut Mariadi
E-Jurnal Medika Udayana Vol 8 No 2 (2019): Vol 8 No 2 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Perlemakan hati (fatty liver, disingkat FL) merupakan penyakit yang paling sering terjadi di negara-negara barat. Diabetes Melitus (DM) adalah penyakit metabolik kronis yang terjadi akibat gangguan fungsi pankreas dalam menghasilkan insulin atau tubuh tidak dapat menggunakan insulin (resistensi insulin). Resistensi insulin yang disebabkan oleh T2DM juga dapat menjadi penyebab dari NAFLD ini. Selain itu, pasien T2DM juga berpotensi mengidap fibrosis dan sirosis, akibat perkembangan penyakit NAFLD. Studi ini adalah studi deskriptif potong lintang (cross-sectional). Sampel yang digunakan adalah seluruh populasi terjangkau yang diambil dari rekam medis. Data kemudian diolah menggunakan analisis deskriptif. Hasil penelitian diperoleh 13 sampel dengan reratausia 49,62 tahun (SD ± 9,57) dan penderita terbanyak pada kelompok umur 50-59 tahun. Didapatkan 8 penderita dengan indeks massa tubuh (IMT) berlebih (IMT ?23) (61,5%), dan 5 orang dengan IMT tidak berlebih (<23) (38,5%). Selain itu, hanya 2 penderita (15,4%) yang menderita diabetes melitus dan NAFLD, dan 11 orang sisanya (84,6%) tidak menderita diabetes melitus. Berdasarkan hasil penelitian yang sudah dilakukan disimpulkan bahwa jumlah penderita NAFLD pada RSUP Sanglah periode 2017-2018 sebanyak 13 kasus, dengan rerata usia 49,62 tahun ( ± SB 9,57), 61,5% dengan IMT berlebih (?23), dan 15,4% menderita diabetes melitus. Kata Kunci : Gambaran, Berat Badan Lebih, NAFLD, DM Tipe 2, RSUP Sanglah.
KARAKTERISTIK PENYAKIT GASTROENTERITIS AKUT PADA PASIEN DI RSUP SANGLAH DENPASAR TAHUN 2018 Wayan Arlis Saputra; I Ketut Mariadi; Gde Somayana
E-Jurnal Medika Udayana Vol 10 No 7 (2021): Vol 10 No 07(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i7.P17

Abstract

ABSTRAK Gastroenteritis Akut adalah peradangan pada lambung dan usus yang menimbulkan gejala berupa diare, mual dan muntah yang berlangsung kurang dari 14 hari. Penyakit ini masih menjadi masalah utama di masyarakat yang sulit untuk ditanggulangi baik pada negara berkembang maupun negara maju, dengan prevalensi yang masih cukup tinggi di Indonesia khususnya di Provinsi Bali. Penelitian ini bertujuan untuk mengetahui karakteristik penyakit gastroenteritis akut pada pasien di RSUP Sanglah Denpasar Tahun 2018 dengan karakteristik berdasarkan usia, jenis kelamin, etiologi dan status gizi. Penelitian ini menggunakan rancangan penelitian potong-lintang deskriptif, dengan melakukan pengambilan data melalui rekam medis, data tersebut akan diolah dan dianalisis dengan menggunakan program SPSS ver.25. Berdasarkan jumlah keseluruhan sampel yang memenuhi kriteria inklusi dan eksklusi yaitu sebanyak 71 kasus dan selanjutnya dianalisis secara deskriptif sehingga diperoleh karakteristik penyakit gastroenteritis akut paling banyak ditemukan pada kelompok umur dewasa (41-60 tahun) (36,6%), secara umum distribusi paling banyak juga ditemukan pada jenis kelamin perempuan (54,9%), etiologi infeksi bakteri (71,8%) dan status gizi overweight (39,4%). Jika dilakukan tabulasi silang antara etiologi dengan distribusi paling banyak, maka diperoleh kelompok umur dewasa yang infeksi bakteri (76,9%), perempuan yang infeksi bakteri (76,9%) dan status gizi overweight yang infeksi bakteri (71,4%). Kata Kunci : Gastroenteritis akut, karakteristik gastroenteritis akut, dewasa
Co-Authors Cokorda Agung Wahyu Purnamasidhi Derryl Ravertio Timothy Subroto Dewa Gde Agung Budiyasa Dewa Gde Agung Budiyasa Gde Somayana Godfried Erycesar Yeremia Saragih Hendra Koncoro Hendra Koncoro Hendra Koncoro I Dewa Nyoman Wibawa I Gusti Agung Suryadarma I Nyoman Astika I Wayan Surya Ardiana Ida Ayu T risha Kundalini Ida Bagus Nyoman Wibawa IDN Wibawa Itta Sandi Lesmana Dewi Jemi Tubung Jessica Raphaela Pranata Kadek Mercu Narapati Pamungkas Made Wardhana Mirdania, Yaditta N Purwadi Nyoman Purwadi Pande Ketut Kurniari Prasenah Subramaniam Putu Prathiwi Primadharsini Renaldy Frederich Nathanael Magat Tubung, Jemi Wayan Arlis Saputra Wibawa, Ida Bagus Nyoman Wira Gotera Yaditta Mirdania Yenny Kandarini Yuna Ariawan