Ida Bagus Ngurah Rai
School Of Specialist In Pulmonary Disease Faculty Of Medicine Udayana University

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TERAPI 2-ADRENERGIK KERJA PANJANG PADA TATALAKSANA PENYAKIT PARU OBSTRUKTIF KRONIK Putrawan, Ida Bagus; Ngurah Rai, Ida Bagus
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease, characterized by airflow limitationthat is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory responseof the lung to noxious particle or gases. There is a chronic inflammation that leads to fixed narrowing of small airways andalveolar wall destruction (emphysema). This characterized by increased number of alveolar macrophages, neutrophils and cytotoxicT-lymphocytes, and the release of multiple inflammatory mediators. A high level of oxidative stress may amplify thisinflammation. There is also increased elastolysis and evidence for involvement of several elastolytic enzymes, including serineproteases, cathepsins and matrix metalloproteinasses. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelinesrecommend a stepwise approach to disease management, with bronchodilators being the mainstay of treatment. 2-Adrenergicagonists induce bronchodilatation through stimulation of 2-receptors, leading to an increase in cyclic adenosine monophosphate.In addition to prolonged bronchodilatation, long-acting 2-agonists (LABAs) exert other effects that may be of clinicalrelevance. These include inhibition of airway smooth-muscle cell proliferation and inflammatory mediator release, as well asnonsmooth-muscle effects, such as stimulation of mucociliary transport, cytoprotection of the respiratory mucosa, and attenuationof neutrophil recruitment and activation.
DIAGNOSIS DAN PENATALAKSANAAN PNEUMONITIS HIPERSENSITIVITAS Dary, I Wayan; Ngurah Rai, Ida Bagus
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Hypersensitivity pneumonitis (HP), or extrinsic allergic alveolitis, is a group of immunologically mediated lung diseasesin which the repeated inhalation of certain finely dispersed antigens of a wide variety, mainly including organic particles or lowmolecular weight chemicals, provokes a hypersensitivity reaction with granulomatous inflammation in the distal bronchioles andalveoli of susceptible subjects. HP can be classified as acute, subacute, and chronic form. Clinically its presented as fever, fatique,myalgia, cough and shortness of breath after exposured and physical finding with fever, takipneu, diffuse rhales bibasal. Chestradiograph showed diffuse micronodular pattern or ground-glass appearance on lower and mid field lung only found on tenperse10%n of cases. HRCT can show more specific abnormalities of the lung. Lung function test describe restrictive type.Hystopathologic features are noncaseating granulomas, giant cells with a lot of nucleus, and mononuclear cells infiltration. Themost diagnostic criteria used is made by Richerson et al. the history and physical findings and pulmonary function tests indicatean interstitial lung disease, the X-ray film is consistent, there is exposure to a recognized cause, and there is antibody to thatantigen. Being an immune reaction in the lung, the most obvious treatment of HP is avoidance of contact with the offendingantigen. Systemic corticosteroids represent the only reliable pharmacologic treatment of HP but do not alter the long-term outcome.On the acute HP, prednisone administrate 1 mg/kgBW/day or its equivalent dose for 7 ? 14 days than tapering off foe 2 ? 6 weeks.
Tuberculosiss Arthritis: A Case Report Anak Agung Gede Ocha Rama Kharisma Putra1 , Ni Wayan Candrawati2 , Ida Bagus Ngurah Rai2
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i1.13518

Abstract

Tuberculosis Arthritis of the knee joint is rare. A 25-year old female patient presented with pain andswelling of her left knee. The symptoms first appeared two months earlier; she was given glucocorticoidafter diagnosed with Rheumatoid Arthritis. The patient did not improve with the treatment. The patient wasdiagnosed with tuberculosis arthritis according to biopsy and PCR TB result. Biopsy excision of the left kneefound granulomatous appearance, which is consistent with tuberculosis, PCR TB examination also found apositive effect. Antituberculosis treatment was started and will be continued for nine months. Tuberculosisarthritis frequently mimics more common etiologies and can be difficult to diagnose. Tuberculosis arthritismay be suspected in a chronic case of joint pain, usually monoarticular, although pulmonary TB may absent.
HUBUNGAN LAMA KERJA DENGAN KELUHAN PENYAKIT RESPIRASI PADA ANGGOTA LALU LINTAS POLISI RESORT KOTA DENPASAR I Made Agus Satrya Wibawa; I Gede Ketut Sajinadiyasa; Ida Bagus Ngurah Rai; I G N Bagus Artana
E-Jurnal Medika Udayana Vol 9 No 6 (2020): Vol 9 No 06(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.245 KB) | DOI: 10.24843/MU.2020.V09.i6.P06

Abstract

ABSTRAK Pencemaran udara dapat ditimbulkan oleh kegiatan manusia maupun sumber-sumber alami. Gasbuang kendaraan bermotor dan gas buang pabrik merupakan sumber utama polusi udara. Gas pencemarudara yang paling dominan memengaruhi kesehatan manusia adalah nitrogen oksida (NOx), karbonmonoksida (CO), sulfur oksida (SOx), hidro karbon (HC), partikel debu, dan timbal / timah hitam (Pb).Polisi lalu lintas sering mengalami gangguan fungsi paru, hal diakibatkan oleh partikel debu dan gas sisapembuangan. Penelitian ini bertujuan untuk mengetahui apakah lama kerja berhubungan dengan keluhanpenyakit respirasi pada polisi lalu lintas di Denpasar. Penelitian ini berjenis analitik observasional,dengan rancang studi potong-lintang bertujuan mengetahui hubungan lama kerja dengan keluhan penyakitrespirasi pada anggota lalu lintas Polisi Resort Kota (POLRESTA) Denpasar. Pada hasil penelitian inilama kerja kategori tidak lama, didapatkan jumlah sampel 30 dengan kualitas hidup baik 22 responden(73,3%) dan kualitas hidup buruk 8 (26,7%) dibandingkan dengan kategori lama, didapatkan jumlahsampel 12 dengan kualitas hidup baik 7 responden (58,3%) dan 5 responden (41,7%). Berdasarkan hasiluji penelitian, diperoleh nilai p = 0,342. Tidak terdapat hubungan yang signifikan antara Lama Kerjadengan Keluhan Penyakit Respirasi. Selain itu, lama kerja tidak memiliki risiko terjadinya KeluhanPenyakit Respirasi. Kata kunci: Pencemaran udara, Lama Kerja, Keluhan Penyakit Respirasi
KARAKTERISTIK, KELUHAN RESPIRASI DAN KEJADIAN OBSTRUKSI JALAN NAPAS PADA PEKERJA RUMAH TRADISIONAL BALI DI DESA PENATIH Wayan Rismayanti; IGN Bagus Artana; I Gede Ketut Sajinadiyasa; Ida Bagus Ngurah Rai
E-Jurnal Medika Udayana Vol 10 No 5 (2021): Vol 10 No 05(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i5.P14

Abstract

ABSTRAK Pekerja rumah tradisional Bali sering terpapar debu batu bata dari kegiatan menempel dan memahat. Sehingga rentan terkena gangguan pernapasan berupa obstruksi jalan napas yang dapat ditunjukkan dari nilai APE. Tujuan penelitian ini yaitu untuk mengetahui karakteristik, keluhan respirasi dan kejadian obstruksi jalan napas pada pekerja rumah tradisional Bali di Desa Penatih. Metode penelitian adalah cross sectional. Sampel yang dipilih adalah yang memenuhi criteria dari penelitian ini. Didapatkan hasil yaitu pekerja paling banyak mengeluhkan batuk (42 %), terbanyak kedua adalah nyeri dada (22%), terbanyak ketiga adalah sesak napas dan batuk berdahak (12%) dan sedikit sekali yang mengeluh mengi (6%). Lebih dari 50 % pekerja sudah mengalami obstruksi jalan napas dan sebagian besar tergolong dalam kategori obstruksi ringan. Penelitian ini bermanfaat karena dapat memberikan gambaran karakteristik keluhan respirasi dan kejadian obstruksi jalan napas sehingga dapat dilakukan screening lebih lanjut untuk melindungi pekerja sebagai populasi yang berisiko. Kata kunci : Keluhan Respirasi, Obstruksi Jalan Napas, Pekerja Rumah Tradisional Bali
KARAKTERISTIK, KELUHAN RESPIRASI DAN KEJADIAN OBSTRUKSI JALAN NAPAS PADA PEKERJA RUMAH TRADISIONAL BALI DI DESA PENATIH Wayan Rismayanti; IGN Bagus Artana; I Gede Ketut Sajinadiyasa; Ida Bagus Ngurah Rai
E-Jurnal Medika Udayana Vol 10 No 6 (2021): Vol 10 No 06(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i6.P06

Abstract

Pekerja rumah tradisional Bali sering terpapar debu batu bata dari kegiatan menempel dan memahat. Sehingga rentan terkena gangguan pernapasan berupa obstruksi jalan napas yang dapat ditunjukkan dari nilai APE. Tujuan penelitian ini yaitu untuk mengetahui karakteristik, keluhan respirasi dan kejadian obstruksi jalan napas pada pekerja rumah tradisional Bali di Desa Penatih. Metode penelitian adalah cross sectional. Sampel yang dipilih adalah yang memenuhi criteria dari penelitian ini. Didapatkan hasil yaitu pekerja paling banyak mengeluhkan batuk (42 %), terbanyak kedua adalah nyeri dada (22%), terbanyak ketiga adalah sesak napas dan batuk berdahak (12%) dan sedikit sekali yang mengeluh mengi (6%). Lebih dari 50 % pekerja sudah mengalami obstruksi jalan napas dan sebagian besar tergolong dalam kategori obstruksi ringan. Penelitian ini bermanfaat karena dapat memberikan gambaran karakteristik keluhan respirasi dan kejadian obstruksi jalan napas sehingga dapat dilakukan screening lebih lanjut untuk melindungi pekerja sebagai populasi yang berisiko. Kata kunci : Keluhan Respirasi, Obstruksi Jalan Napas, Pekerja Rumah Tradisional Bali
Pin Point Trachea: A Case Report Ni Wayan Candrawati; Venny Singgih; Ketut Putu Yasa; Ida Bagus Ngurah Rai
Jurnal Respirasi Vol. 8 No. 1 (2022): January 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (702.187 KB) | DOI: 10.20473/jr.v8-I.1.2022.26-32

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Introduction: Pin point trachea is a rare case. It is caused by tuberculosis (TB) and trauma due to intubation procedure. Main complication of this abnormality is respiratory failure. It can be diagnosed through bronchoscopy. Managements of this abnormality are interventional bronchoscopy and treating the etiology. Surgery is considered if interventional bronchoscopy failed or cannot be performed.Case: A 29-year-old woman came to the emergency room complaining shortness of breath and hoarseness since two months before hospitalized. The patient also experienced cough, decreased body weight and appetite since 7 months earlier. The patient was diagnosed with bacteriologically confirmed TB and anti-TB drug was given. Cough symptom was decreasing but shortness of breath and hoarseness remained after treatment. Physical examination showed decreased vesicular sound and stridor. Bronchoscopy revealed narrow tracheal lumen (pin point) with fibrosis. Thoracic computed tomography (CT) scan showed severe narrowing of tracheal lumen at thoracic vertebrae 1-2. Surgery was performed to cut the fibrotic tissue and tracheostomy was placed at stenosis area.Conclusion: Pin point trachea is a rare case. One of the causes is tracheobronchial TB. The main managements are optimal administration of anti-TB drugs and interventional bronchoscopy or surgery.
Descriptive Study: Level of Communities Knowledge And Perception About Tuberculosis (TB) in Denpasar, Bali Ni Putu Ayu Widiasari; Ida Ayu Jasminarti Dwi Kusumawardani; Ida Bagus Ngurah Rai
Respiratory Science Vol. 1 No. 1 (2020): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i1.3

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Background: Success rate of Indonesia Tuberculosis (TB) treatment did not evenly distribute to every province in 2016, although various program had been carried out by Indonesia Government. Bali’s Case Notification Rate (CNR) and Success Rate (SR) of TB also did not reach target in 2017. Successful control of TB can be influenced by community’s level of knowledge and perception about TB. Our research objective was to know communities level of knowledge and perception about TB in Denpasar, Bali. Method: This was cross-sectional research. Our sample was Denpasar communities who visited Puputan Renon Field Car Free Day (CFD) at 25 March 2018. Sample was chosen by consecutive sampling. Results: Our research result was almost (62%) of respondent had poor knowledge about TB and 67% respondent had right perception about TB. Conclusion: We can conclude that Denpasar communities had poor level of knowledge and good perception about TB.
Tuberkulosis Serviks pada Penderita Tuberkulosis Paru: [Cervical Tuberculosis in Pulmonary Tuberculosis Patient] Renny Irviana Eka Tantri; Ida Bagus Ngurah Rai
Jurnal Respirasi Vol. 2 No. 2 (2016): Mei 2016
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (411.16 KB) | DOI: 10.20473/jr.v2-I.2.2016.41-44

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Background: Tuberculosis (TB) is a disease caused by infection of Mycobacterium tuberculosis complex. Global Tuberculosis Report 2011 stated the incidence of TB cases reached 8.7 million (1.1 million co-infected with HIV) and 990,000 people died because of TB. Twenty five percent of extrapulmonary TB occurs in cervix, which is 0.1 to 0.65% of all TB cases, and 5-24% of TB in urogenital tract. Case: We report the case of a woman, aged 28 years admitted with complaint hematuria since 6 months. With UTI treatment, Patient didn’t get improved. Gynecology examination within normal limit. The results of cervical biopsy were granulomatous chronic inflammation with suppuratif inflammatory process. Patient were diagnose with cervical TB. Patiens also complaint chronic cough with decrease of appetite and night sweating. Chest x-ray showed Lung TB with thickening of upper left pleural. AFB sputum examination with positive result, patient diagnosed with Lung TB. Patient got therapy ATD first chategory and after 2 weeks of therapy patient showed clinical improvement. Conclusion: Cervical TB is more common in women of childbearing age between 20-40 years. In this case, the possibility of Cervical TB occurs because through hematogenous dissemination of pulmonary tuberculosis.
Seorang Wanita Muda dengan Tuberkulosis Usus Menyerupai Apendiksitis Akut : [Pemphigus Paraneoplastic in Thymoma: A Rare Case] Kadek Widianiti; Tutik Kusmiati; Ida Bagus Ngurah Rai
Jurnal Respirasi Vol. 4 No. 1 (2018): Januari 2018
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1686.557 KB) | DOI: 10.20473/jr.v4-I.1.2018.12-18

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Background: Tuberculosis has become a global health problem, with increasing numbers of cases in line with the increasing number of immunocompromised patients. Intestinal of tuberculosis is believed to be a form of extrapulmonary tuberculosis which will occur most often in the future . Case: This case presents a young woman, 20 years old, suspected of acute appendicitis with suspected perforation, had right abdominal pain since 1 month and getting worse since 5 days PTA (prior to admission). The abdomen enlarges and feels hard on the right abdomen after being treated for 3 days. Fever,body weaknes,decreased of appetite, decreased of body weight approximately 7 kg since 2 months PTA. There are nausea, vomiting, diarea with runny mucus since 2 weeks PTA. The chest x-ray, abdominal ultrasound, endoscopy was normal result and plain abdominal radiograph showed that intestinal dilatation and step ladder features suspicious obstructive ileus. Discussion: After 2 months of therapy abdominal symptoms improved and weight began to gradually increase. Intestinal of tuberculosis is a challenge for clinicians to diagnose despite using modern medical techniques because the clinical and laboratory features are not specific especially when active pulmonary infection is absent and there are similarities with other abdominal diseases. The histological features will provide a diagnose. The delay in diagnosis will lead to more severe complications. Conclusion: At present a combination of clinical, radiological and pathological features continues to be the key to diagnosing intestinal tuberculosis. Medical management with antituberculosis drugs will produce a significant resolution of symptoms.