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All Journal Medicina E-Jurnal Medika Udayana Indonesian Journal of Urology Syntax Literate : Jurnal Ilmiah Indonesia JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico
Ida Bagus Putra Pramana
Departemen Urologi, Fakultas Kedokteran Universitas Udayana, Rumah Sakit Umum Pusat Sanglah Denpasar
Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health

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WOUND HEALING IN DIABETIC ULCER Putra Pramana, Ida Bagus; Yasa, Ketut Putu
Medicina Vol 43 No 1 (2012): Januari 2012
Publisher : Medicina

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Abstract

The mechanism of wound healing is a complex mechanism and involves a variety of cells. Injury is defined as a disruption of normal structure and function. Various types of growth factors and cytokines such as platelet derived growth factor and transforming growth factor beta involved in the mechanism of wound healing. There are four phases of wound healing mechanisms : hemostasis, inflammatory, proliferative, and remodeling. Diabetic ulcers is one major complication, occurring in 15% of patients with diabetes mellitus (DM) and as much as 84% of patients with diabetic ulcers require amputation action. In DM patients there is a failure in normal wound healing mechanisms. Various histopathological studies showed elongation phase of inflammation in patients with diabetes mellitus, thus inhibiting the formation of granulation tissue. Increased blood sugar levels will lower the expressin of perlecan, increased advanced glycation endproducts, decreased the formation of nitric oxide (by ± 67%), changes in the structure and function of fibroblasts and increased activity of matrix metalolproteinases, it will cause distruption of the normal wound healing mechanisms. (MEDICINA 2012;43:49-53).
THE EFFECTIVENESS OF TAMSULOSIN, SOLIFENACIN, AND COMBINATIONS THERAPY TAMSULOSIN ADDED SOLIFENACIN ON LOWER URINARY TRACT SYMPTOMS AFTER DOUBLE J STENT INSERTION Pramana, Ida Bagus Putra; Rizaldi, Fikri; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 26 No 2 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i2.503

Abstract

Objective: Insertion of DJ Stent is a procedure that is often done by urologist. Insertion of DJ Stent can cause LUTS complaints and greatly affect the physical and psychosocial health of patients. The aim of this study was to determine the effectiveness difference of tamsulosin therapy 0.4 mg/day, solifenacin 5 mg/day and the combination of tamsulosin therapy 0.4 mg/day added solifenacin 5 mg/day to manage LUTS complaint after DJ Stent insertion. Material & Methods: This study was a randomized placebo-controlled trial. There were 4 groups, group I received placebo, group II received tamsulosin 0.4 mg/day, group III received solifenacin 5 mg/day, and group IV received combination therapy of tamsulosin 0.4 mg/day added solifenacin 5 mg/day. Evaluation based on International Prostatic Symptom Score (IPSS) and Ureteral Stent Symptom Questioner (USSQ) score. Data were analyzed using SPSS 21.0. It is said to be significant if p<0.05. Results: There were a total of 32 samples consist of 19 (59.3%) men and 13 (40.6%) women. There were significant improvements in the score of total IPSS, IPSS storage and IPSS quality of life score in patients who received combination therapy (p<0.05) when compared with patients who received monotherapy. The highest decrease in USSQ scores 1, 2, 3, 4, 5 and 6 were in the group that received combination therapy when compared with the monotherapy group. Conclusion: The combination therapy is safe and effective to improve IPSS total, IPSS storage and IPSS Quality of Life scores compared with monotherapy.
FAKTOR PREDIKTOR KEGAGALAN KEMOTERAPI BLEOMYCIN, ETOPOSIDE DAN CISPLATIN PADA PASIEN DENGAN SEMINOMA TESTIS PENELITIAN KOHORT RETROSPEKTIF Ida Bagus Putra Pramana; Lukman Hakim; Wahjoe Djatisoesanto
E-Jurnal Medika Udayana Vol 8 No 6 (2019): Vol 8 No 6 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Di Amerika serikat sekitar 8400 orang mengalami kanker testis dan 280 orang meninggal karena penyakit ini. Germ cell tumor meningkat diseluruh dunia. Di Amerika angka prevalensinya pada pasien usia 15 – 49 tahun meningkat dari 2,9 per 100.000 pada tahun 1975 menjadi 5,1 per 100.000 pada tahun 2004. Prevalensinya meningkat dari 55 % pada tahun 1973 menjadi 73 % pada tahun 2001. Insiden kasus seminoma lebih tinggi dibandingkan dengan non-seminoma. Untuk mengetahui faktor – faktor prediktor kegagalan kemoterapi bleomycin, etoposide dan cisplatin (BEP) pada pasien dengan seminoma testis yang mendapat terapi di Rumah Sakit dr Soetomo Surabaya. Penelitian ini merupakan penelitian kohort retrospektif. Karakteristik pasien seperti umur, stadium, kadar serum tumor marker, adjuvant kemoterapi, efek samping dari kemoterapi dan respon kemoterapi didapatkan dari rekam medis pasien di RSUD dr Soetomo Surabaya pada Januari 2008 – Desember 2015. Data dianalisis dengan deskriptif analitik, faktor faktor yang mempengaruhi kegagalan kemoterapi seperti patologi staging tumor (pT), penyebaran regional lymph node (N), metastasis (M), dan level serum tumor marker preoperatif seperti Lactic Dehydrogenase (LDH), human chorionic gonadotrophin (hCG), dan Alpha-Fetoprotein (AFP) dianalisis dengan menggunakan Binary Logistic Regression.Terdapat 55 pasien dengan seminoma testis dengan rata rata umur 32,43±13,3 tahun. Dari 55 pasien hanya 41 pasien yang hanya mendapat adjuvant kemoterapi BEP. Faktor faktor seperti pT, N dan M yang signifikant secara statistik sebagai faktor prediktor kegagalan kemoterapi. Pasien dengan staging pT3 dan pT4 memiliki 8,25 kali faktor resiko yang lebih besar dibandingkan pT1 dan pT2 untuk terjadinya kegagalan kemoterapi (OR=8,250, p=0,005 dan IK95%=1,87 – 36,38). Pasien dengan N2 dan N3 memiliki resiko 4,812 kali lebih besar untuk mengalami kegagalan kemoterapi dibandingkan N0 dan N1 (OR = 4,812, p=0,036, IK95% = 1,105 – 20,95). Pasien dengan M1 (M1a atau M1b) memiliki resiko 6,4 kali lebih besar mengalami kegagalan kemoterapi jika dibandingkan dengan M0 (OR = 6,40, p = 0,015, CI = 1,44 – 28,443). Seminoma testis merupakan tumor yang kemo-sensitif. Staging tumor primer (pT), regional lymph nodes (N) dan Metastasis (M) dapat digunakan sebagai faktor prediktor kegagalan kemoterapi pada pasien dengan seminoma testis. Keywords : Germ Cell Tumors, Testicular Seminoma, Kemoterapi BEP.
Rekonstruksi Penis pada Entrapped Penis setelah Perbaikan Hipospadia: Laporan Dua Kasus Gede Wirya Diptanala Putra Duarsa; Pande Made Wisnu Tirtayasa; I. B. Putra Pramana; Gede Wirya Kusuma Duarsa
JBN (Jurnal Bedah Nasional) Vol 4 No 2 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (696.021 KB) | DOI: 10.24843/JBN.2020.v04.i02.p03

Abstract

Latar belakang: Entrapped penis adalah bentuk concealed penis yang didapat, disebabkan oleh jaringan sikatrik tebal yang terdapat pada penis. Jaringan sikatrik tersebut dapat disebabkan oleh sirkumsisi, operasi hipospadia atau trauma. Kasus: Kami melaporkan dua kasus entrapped penis yang muncul setelah operasi rekonstruksi pada hipospadia. Kasus pertama adalah laki-laki 13 tahun dan kasus kedua adalah anak laki-laki berusia 8 tahun, kedua pasien datang dengan keluhan entrapped penis. Kedua pasien lahir dengan kelainan hipospadia dan sudah menjalani beberapa kali operasi rekonstruksi untuk keluhan hipospadia yang dialami. Setelah operasi, kedua pasien mengeluhkan kondisi entrapped penis. Pada pemeriksaan fisik didapatkan kondisi entrapped penis, dengan ukuran penis yang normal saat diretraksi. Tidak terdapat keluhan kesulitan miksi, nyeri saat miksi maupun nyeri suprapubik. Pada pasien dilakukan operasi rekonstruksi untuk membebaskan jaringan ikat pada penis dan skin flap. Pada pasien dilakukan pemasangan kateter foley 12 Fr dan pembebatan penis selama 5 hari. Pasien juga diberikan antibiotika dan analgesik. Kedua pasien dipulangkan tanpa komplikasi. Simpulan: Entrapped penis merupakan suatu komplikasi yang sering terjadi pada operasi rekonstruksi hipospadia maupun sirkumsisi. Penanganan rekonstruksi terdiri dari pembebasan jaringan ikat pada penis, skin flap dan operasi lain yang diperlukan sesuai kondisi pasien.
Testicular Seminoma: Correlation Between Staging and Chemotherapy Response, Two Years Overall Survival Rate Ida Bagus Putra Pramana; Lukman Hakim; Wahjoe Djatisoesanto; Sunaryo Hardjowijoto
JBN (Jurnal Bedah Nasional) Vol 3 No 1 (2019): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (248.941 KB) | DOI: 10.24843/JBN.2019.v03.i01.p05

Abstract

Objective: to determine the patient’s characteristics, correlation between staging and chemotherapy response, furthermore two years overall survival rate. Methods: a retrospective analytic study was conducted. Data were obtained from medical records in January 2008 to December 2014 and analyzed using SPSS 17.0. All of correlation between staging and chemotherapy response, primary tumor staging (pT) and metastasis (M), regional lymph nodes staging (N) and metastasis (M), serum tumor marker and chemotherapy response were tested by Spearman correlation test. Two years overall survival rate was analyzed by Kaplan-Meier. Data ratio with normal distribution was tested by Paired T-test. Results: the mean age of patients were 31.03 ± 13.751 years, with seven patients (15.6%) had previous history of undescended testis. Based on TNM staging, we found that most patients had already develop into stage pT3 (46.7%), N3 (57.7%), and M0 (57.7%). A significant correlation between staging and chemotherapy response was shown with stage I of testicular seminoma had completely chemotherapy response (100%) and two years overall survival rate in stage I was 100%, whereas in metastatic seminoma (stage II and III) was 60%, with Hazard Ratio 0.63 (p=0.294; 95%CI 0.276-1.476). Conclusion: patients in early stage of testicular seminoma will give a better response to chemotherapy and will have better survival rate compared to those with metastatic seminoma.
Correlation of total ischemic time to creatinine serum level and resistive index value in kidney transplant Putu Astri Novianti; Gede Wirya Kusuma Duarsa; Gede Andi Aditya; Anak Agung Gde Oka; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Yenny Kandarini; Wayan Sudana; Djodi Sidartha; Raka Widiana
Neurologico Spinale Medico Chirurgico Vol 3 No 2 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i2.109

Abstract

Background: The transient period when the kidney donor was extracted until being anastomosed (total ischemic time) will aggravate many putative molecular ischemic-reperfusion injury mechanisms. Several studies have reported the risk of delayed graft function development, which can be reflected by creatinine serum (Cr) level and resistive index (RI) value. This study aims to determine the correlation of total ischemic time to Cr levels reduction in one-month post-transplantation and RI value. Methods: This was a cross-sectional retrospective study involving subjects who underwent kidney transplantation in Sanglah General Hospital. In this study, the primary parameters were total ischemic time, Cr level, and RI value. The total ischemic time is calculated using a stopwatch intraoperatively. Cr level was obtained from blood examination, and RI value was obtained from the ultrasonography test. Data analysis was analyzed statistically using SPSS 24.0, and p < 0.05 was considered significant. Results: About 17 kidney transplant subjects were included in this study. The mean total ischemic time was 105 minutes and 43 seconds. There was an insignificant negative correlation between Cr level reduction and total ischemia time (r = -0.36; p = 0.89). An analysis of the correlation of total ischemic time and RI value, there was a linear correlation, but statistically insignificant (r = 0.11; p = 0.66). Conclusion: Total ischemic time has a negative correlation with post-transplant creatinine serum level and a positive correlation with the post-transplant resistive index value, but these results are not statistically significant.
Treatment of panurethral strictures using one side dissection dorsal onlay buccal mucosal graft urethroplasty Gede Wirya Diptanala Putra Duarsa; Gede Wirya Kusuma Duarsa; Ida Bagus Putra Pramana; Paksi Satyagraha
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.133

Abstract

The management of panurethral stricture was still challenging and controversial. We presented a case of pan urethral strictures management by using a one-sided dissection of dorsal onlay buccal mucosal graft (BMG) urethroplasty (Kulkarni technique). A 53-years old man admitted with panurethral stricture who had previously undergone several procedures. Bipolar micturition cystourethrography procedure revealed 17 cm stricture length. One-sided dissection dorsal onlay buccal mucosal graft urethroplasty was performed. No drain was placed. The Foley catheter was removed four weeks after surgery, and the results of the micturition were favourable. No fistulae were found at a straight erection and meatus at a normal position. The postoperative flow rate (Qmax) was 24.9 ml/second. As a conclusion Kulkarni technique urethroplasty gained good outcome for panurethral stricture in our case.
Karakteristik pasien batu ginjal dengan tatalaksana retrograde intra-renal surgery di Rumah Sakit Umum Pusat Sanglah dan Rumah Sakit Surya Husada: initial report tahun 2017-2019 I Made Nugraha Gunamanta Sabudi; Gede Wirya Kusuma Duarsa; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Anak Agung Gde Oka
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (270.141 KB) | DOI: 10.15562/ism.v11i2.583

Abstract

Background: Renal stone is frequent cases that happened in the community. There are a lot of options to treat renal stone; one of them is RIRS. RIRS is an alternative procedure after ESWL and PNL for renal stone.Method: Twenty-seven samples as total sampling of all patients that were done with RIRS in Sanglah Hospital and Surya Husada Hospital from January 2017 until June 2019 retrospectively. Data were collected secondary from Medical Reports of the patients and showed a descriptive study depict how the RIRS patient characteristic in Sanglah Hospital and Surya Husada Hospital. All RIRS patients showed that the RIRS procedure is secondary due to history of ESWL, PNL, URS with insertion of DJ Stent, and or Nephrolithotomy.Results and Conclusion:Characteristic of age in this study was 52,41 years old in mean value, with male and female per cent, respectively 62,96% and 37,04%. Stone size of the study was classified to 4 cluster which are: (1) 37,04% cluster with stone size <1 cm, (2) 33,33% cluster with stone size ≥1cm to <2cm, (3) 3,70% cluster with stone size ≥2 cm, and (4) 25,93% cluster that with stone size unknown. This study also showed some similarity with two other studies about patient characteristic of RIRS treatment. Latar Belakang: Batu ginjal adalah kasus yang sering terjadi di masyarakat. Terdapat banyak pilihan tindakan untuk mengambil batu ginjal salah satunya adalah dengan tindakan RIRS. Tindakan RIRS masih menjadi alternatif tindakan setelah pilihan pertama PNL dan ESWL untuk batu ginjal.Metode: Penelitian ini mengambil 27 sampel pasien dari total sampling seluruh pasien yang dilakukan RIRS di Rumah Sakit Umum Pusat (RSUP) Sanglah dan Rumah Sakit (RS) Surya Husada selama Januari 2017 hingga Juni 2019 secara retrospektif. Data didapatkan dari data sekunder rekam medis pasien. Penelitian disajikan secara deskriptif memberikan gambaran karakteristik pasien yang mendapatkan tindakan RIRS. Seluruh pasien yang dilakukan RIRS di RSUP Sanglah dan RS Surya Husada merupakan pasien dengan mendapat RIRS Sekunder setelah sebelumnya memiliki riwayat pernah ESWL, PNL, URS dengan pemasangan DJ-stent, dan atau nefrolitotomi.Hasil dan Simpulan: Karakteristik usia rata-rata pada penelitian ini adalah 52,41 tahun dengan perbandingan persentase laki-laki perempuan berturut-turut 62,96% dan 37,04%. Ukuran batu pada penelitian dikelompokkan menjadi 4 kelompok dengan masing-masing kelompok: (1) 37,04% kelompok dengan ukuran batu <1 cm, (2) 33,33% kelompok dengan ukuran batu ≥1cm s/d <2cm, (3) 3,70% kelompok dengan ukuran batu ≥2 cm, (4) 25,93% kelompok yang ukuran batunya tidak tercantum.
The short-term disadvantageous of tension-suture and spica cast application in exstrophy-epispadias complex reconstruction: a case report Ida Bagus Putra Pramana; Anak Agung Gde Oka; Gede Wirya Kusuma Duarsa; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1139.414 KB) | DOI: 10.15562/ism.v10i3.605

Abstract

Background: Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC is a rare congenital disability. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. The decision to first approach is important for the next step. Herein, we reported a case of EEC with several anomalies. Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. The weight was 3300 grams, and the height was 48 centimetres. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. A complete dorsally opened urethral plate was seen from the bladder neck down to the glandular grove. The patient was diagnosed with Exstrophy-epispadias complex (EEC). A 2 stage repair was conducted in this patient. After 10 days post-operation, the wound became dehiscence and got sepsis postoperatively as well as lead to die in the day 20.Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC.
Studi Meta-analisis Hipertensi dan Diabetes Melitus Sebagai Faktor Risiko Penyakit Ginjal Kronis di Indonesia Maha Rani; Ida Bagus Putra Pramana; Anak Agung Gde Oka
E-Jurnal Medika Udayana Vol 11 No 9 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Indonesia is currently experiencing double burden of disease which Chronic Kidney Disease (CKD) is one of Indonesian disease burdens. Hypertension and Diabetes Mellitus are risk factors for CKD that have been widely studied, it is necessary to carry out a meta-analysis study in order to obtain stronger data and also could be used as a reference to prevent CKD. This study uses Systematic Review and Meta-analysis with RevMan 5.4.1. Estimated data using the Random Effect Model from 5 Case Control Studies with 781 case samples and 781 control samples. The OR for Hypertension for CKD was 5.28 (95% CI 1.46 - 19.09) while the OR for Diabetes Mellitus was 3.34 (95% CI 1.79 - 6.25). It can be interpreted that individuals with Hypertension have 5.28 times higher risk of experiencing CKD than non-Hypertensive individuals whereas individuals with Diabetes Mellitus have 3.34 times higher risk of developing CKD than individuals without Diabetes Mellitus.
Co-Authors Anak Agung Gde Oka Djodi Sidartha Gde Oka, A A Gede Andi Aditya Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gede Wirya Kusuma Duarsa I Gde Raka Widiana I Made Nugraha Gunamanta Sabudi I Wayan Yudiana Kadek Budi Santosa Ketut Putu Yasa Lukman Hakim Lukman Hakim Maha Rani Paksi Satyagraha Pande Made Wisnu Tirtayasa Putu Astri Novianti Rizaldi, Fikri Sunaryo Hardjowijoto Tarmono Djojodimedjo wahjoe djatisoesanto Wayan Sudana Yenny Kandarini