Putu Prathiwi Primadharsini
Division of Gastroentero-hepatology, Department of Internal Medicine Faculty of Medicine, University of Udayana/Sanglah Hospital, Denpasar

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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.
Upper Gastrointestinal Endoscopy as Diagnostic Test for Detection of Gastric Malignancy in Sanglah Hospital Denpasar Koncoro, Hendra; Primadharsini, Putu Prathiwi; Indrayani, Luh Putulin; Nyoman Wibawa, I Dewa
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (151.749 KB) | DOI: 10.24871/16120152-6

Abstract

Background: Gastric malignancy is the third most common cause of cancer-related death in the world. Upper gastrointestinal (UGI) endoscopy for detection of gastric malignancy has been used widely in Indonesia. This study aimed to determine the prevalence of gastric malignancy and diagnostic value of UGI endoscopy in detection of gastric malignancy in Sanglah Hospital, Denpasar.Method: A retrospective study on patients undergoing UGI endoscopy in Endoscopy Unit of Sanglah Hospital Denpasar between January 2012 and December 2014 was conducted. Endoscopical and histological diagnosis were documented. The diagnostic test of endoscopic diagnosis were conducted by showing its sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.Results: One thousand and sixty eight patients with upper gastrointestinal symptoms were subjected to endoscopy between January 2012 and December 2014. Of the 1068 cases, 39 patients were suspected for gastric malignant lesions on UGI endoscopy. During the study period, histopathologically-confirmed gastric malignancy was found in 2.72% patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of UGI endoscopic diagnosis for these neoplastic lesions were 100%, 99.04%, 74.36%, 100%, and 99.06%, respectively.Conclusion: The prevalence of gastric malignancy was higher compared to western countries. Endoscopy is important as diagnostic tool in patients with suspicion of gastric malignancy. Greater suspicion in clinical judgment and carefulness in excluding malignancy through one histopathology negative findings need to be done to reduce the number of misdiagnoses of gastric malignancy.
Correlation between Quantitative HBsAg and HBV-DNA in Chronic Hepatitis B Infection Primadharsini, Putu Prathiwi; Wibawa, I Dewa Nyoman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/14120139-12

Abstract

Background: Methods used to diagnose and monitor chronic hepatitis B (CHB) by quantitation of hepatitis B virus-deoxyribonucleic acid (HBV-DNA) levels is expensive. Cheaper laboratory test as an additional markeris needed, thus we studied serum quantitative HBsAg to be used as surrogate marker in CHB patients. This study was aimed to investigate correlation between serum quantitative HBsAg and HBV-DNA in CHB patients.Method: In this cross-sectional study, we enrolled 62 CHB patients between January 2010 and December 2012 who had quantitative HBsAg and HBV-DNA assays in a private laboratory at Denpasar. HBV-DNA was measured by real-time polymerase chain reaction and quantitative serum HBsAg was measured by chemiluminescent microparticle immunoassay (CMIA). Stastistical analysis was performed by Mann-Whitney and Spearman’s correlation.Results: Of 62 patients, most subjects were males (82.26%). Mean HBsAg titer of CHB in HBeAg positive and negative patients were 281,000 and 4,900 IU/mL, respectively; while mean HBV-DNA in HBeAg positiveand negative patients were 59,000,000 and 7,530,000 IU/mL, respectively. We found that quantitative HBsAg and HBV-DNA in HBeAg positive and HBeAg negative patients were statistically signi cant (p = 0.0001, p = 0.0001, respectively). Signi cant correlation was found between serum quantitative HBsAg and HBV-DNA (r = 0.737; p= 0.000). Quantitative HBsAg was signi cantly correlated with HBV-DNA in HBeAg-positive subgroup (r = 0.717; p = 0.0001); and signi cant correlation was also found in HBeAg-negative subgroup (r = 0.443; p = 0.006) although the correlation was weak. Conclusion: Quantitative HBsAg has signi cant correlation with HBV-DNA in CHB patients. Keywords: quantitative HBsAg Assay, HBV-DNA, HBeAg, chronic hepatitis B infection