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All Journal E-Jurnal Medika Udayana JURNAL BIOMEDIK Berkala Ilmu Kesehatan Kulit dan Kelamin Journal of General Procedural Dermatology and Venereology Indonesia ISM (Intisari Sains Medis) : Jurnal Kedokteran Bali Dermatology and Venereology Journal Neurologico Spinale Medico Chirurgico IJAAM (Indonesian Journal of Anti-Aging Medicine) Journal of Global Pharma Technology

Anak Agung Gde Putra Wiraguna

Department Of Dermatology Faculty Of Medicine, Udayana University

Author-ID : 351025

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 34 Documents Claim Missing Document

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The high homeostatic model assessment of insulin resistance as risk factor for acne vulgaris Praharsini, I Gusti Ayu Agung; Wiraguna, Anak Agung Gde Putra; Nurhadi, Stefani
Bali Dermatology and Venereology Journal Vol 1, No 2 (2018)
Publisher : DiscoverSys Inc

Background: Acne vulgaris (AV) is a common chronic skin disease involving blockage and or inflammation of pilosebaceous glands which usually affects teenagers and young adults. Elevated sebaceous gland secretion, Propionibacterium acne colonization and inflammation, high androgen effects, and follicular hyperproliferation are the main pathogenic factors of AV. IGF-1 and insulin were studied to stimulate sebaceous lipogenesis. In the skin, besides inducing lipid production in human sebocytes IGF-1 also induces keratinocyte proliferation in vitro and in vivo. HOMA-IR is an examination to determine insulin activity in the basal state.Objective: To prove that high HOMA-IR value is a risk factor for the occurrence of acne vulgaris.Methods: This study is a case control analytic study by comparing HOMA-IR in subjects with AV (case group) and non AV (control group). AV is diagnosed based on clinical predilection. Insulin testing was carried out by the immulite 2000 device through the immunochemiluminescent method.Results: Mean HOMA-IR of case group is 2.63 Ã‚Â± 0.29 meanwhile in the control group was 1.71 Ã‚Â± 0.26 (p <0.001). Subjects with high HOMA-IR had 4.8 times higher risk to experience AV compared to patients with normal HOMA-IR values (p <0.001; 95% IK 2,765-8,332). Conclusion: HOMA-IR values in acne patients were higher than controls. A high HOMA-IR value is an AV risk factor.

High plasma H2O2 level and low plasma catalase level as risk factors for acne vulgaris Wiraguna, Anak Agung Gde Putra; Wardhana, Made; Maharani, Made Kusuma Dewi
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Background: In this recent time, ROS and oxidative stress have been said to play an important role in the pathogenesis of inflamed acne lesions. One example of ROS produced by neutrophil through phagocytosis is H2O2. Nevertheless, there is an enzymatic antioxidant which catalyses H2O2 called catalase. Imbalance of free radicals and antioxidants due to excessive ROS formation promotes the state of oxidative stress and inflammation of the acne lesion.Objective: This study aimed to determine plasma H2O2 and catalase level as a risk factor for acne.Methods: This matched-pair case-control observational analytic study involving 38 patients with acne and 38 patients without acne. Sampling was done using consecutive sampling which fulfils the inclusion and exclusion criteria and followed by matching with age and gender. H2O2 and catalase level measured on both groups. The analysis was done using SPSS.Results: H2O2 mean level in the case and control group, respectively 0.68 Ã‚Â± 0.03 and 0.42 Ã‚Â± 0.04 Ã‚Âµmol/ml. High H2O2 level was determined from cut-off point >0.62 Ã‚Âµmol/ml. High H2O2 was a statistically significant risk factor for acne vulgaris (p<0.001; 95% CI: 4.59-40.62; OR: 13.67). The mean level of catalase in the case and control group respectively 0.48 Ã‚Â± 0.06 and 0.74 Ã‚Â± 0.07 U/ml. Low catalase level was determined from the cut-off point <0.58 U/ml. Catalase was significant risk factor for acne vulgaris (p<0.001; 95% CI: 5.18-77.21; OR: 20.00).Conclusion: High levels of H2O2 plasma and low levels of catalase plasma is a risk factor of acne vulgaris.

The positive correlation between serum malondialdehyde levels with vitiligo severity and activity Praharsini, I Gusti Ayu Agung; Wiraguna, Anak Agung Gde Putra; Batan, Putu Nila Wardhani
Bali Dermatology and Venereology Journal Vol 2, No 1 (2019)
Publisher : DiscoverSys Inc

Background: There are several theories that suggest melanocyte death in vitiligo, one example is oxidative stress theory. Oxidative stress primarily manifested by lipid peroxidation ultimately produce malondialdehyde. Malondialdehyde is a stable marker to assess an oxidative stress event. The correlation between serum malondialdehyde levels and vitiligo severity and activity remained controversial in previous studies.Objective: This study aimed to verify whether or not the serum MDA levels are positively correlated with vitiligo severity and activity.Methods: This study was an analytical cross-sectional study. which involved 64 subjects with vitiligo and 20 subjects without vitiligo. Serum MDA levels were measured to mark an oxidative stress event, whereas the severity and activity of vitiligo were clinically assessed with vitiligo area severity index (VASI) and vitiligo disease activity (VIDA) scoring system.Results: Total 64 subjects with vitiligo and 20 subjects without vitiligo participated in this study. Serum MDA mean levels of vitiligo subjects were significantly higher compared to subjects without vitiligo (p<0.05). Serum MDA levels had a strong positive correlation with VASI score (r=0.761; p<0.01). The strong positive correlation found between serum MDA levels with vitiligo activity assessed by VASI score in vitiligo subjects (r=0.609; p<0.01), and high serum MDA levels increased the risk for developing vitiligo (PR=7.62; 95% CI: 2.49-23.30; p<0.01). Serum MDA levels influenced vitiligo as much as 10.1%, meanwhile the remaining 89.9% were influenced by other variables apart from high serum MDA levels out of this study (R2=0.101; p<0.05).Conclusion: Serum MDA levels were positively correlated with vitiligo severity and activity, and high serum MDA levels increased the risk of developing vitiligo.

Bacterial vaginosis as a risk factor of preterm premature rupture of membrane (PPROM) Wiraguna, Aanak Agung Gde Putra; Rusyati, Luh Made Mas; Vijayamurthy, I Dewa Ayu Vanessa
Bali Dermatology and Venereology Journal Vol 1, No 2 (2018)
Publisher : DiscoverSys Inc

Introduction: The pathogenesis of PPROM is complex and not fully understood. Recent studies showed that such role of genital tract infection as bacterial vaginosis in the pathogenesis of PPROM turned out to be present. They produce lipase enzymes in which they can form compounds with the fibrous tissue of amniotic membrane resulting in increased risk of rupture of the membrane.Objective This study aims to prove that bacterial vaginosis is a risk factor for preterm premature rupture of membrane.Material and methods: This research used case control method. Sampling was using the consecutive sampling method and had fulfilled inclusion and exclusion criteria with age-based matching, then vaginal swab sampling was conducted, painted with gram staining in the Dermalotogy and Venereology Laboratory of Sanglah Hospital, and Nugent score.Result: Total of 76 pregnant women with 24-36 weeks of gestation were investigated, 38 mothers with PPROM and 38 mothers with normal pregnancy. Average score of Nugent at preterm PROM was 7.18 and in normal pregnancy was 2.37. Bacterial vaginosis risking for PPROM 7 times (OR= 7.0, 95% CI= 1.21-17.68, p= 0.001).Conclusion: Bacterial vaginosis as a risk factor for the occurrence of PPROM.

Pemberian tempoyak per oral dapat menghambat peningkatan ekspresi matriks metaloproteinase-1 pada tikus (Rattus norvegicus) betina dewasa galur Wistar yang dipajan sinar UVB Fiter, Joni; Wiraguna, AAG Putra; Pangkahila, Wimpie
Jurnal Biomedik : JBM Vol 9, No 2 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.2.2017.16357

Abstract: Ultraviolet B (UVB) is a source of free radicals that accelerate aging process, especially in the skin by increasing the expression of MMP-1. Tempoyak is rich in nutraceuticals and probiotics that may provide a protective effect against skin exposure to ultraviolet rays. This study was aimed to prove that oral tempoyak could inhibit the increase of matrix metalloproteinase-1 (MMP-1) in UVB-induced rats (Rattus norvegicus). This was a true experimental study with the posttest only control group design. Subjects were 36 female Wistar rats (Rattus norvegicus), aged 2.5-3 months, weighing180-200 g, divided into 2 groups. The control group (P0) exposed to UVB was given oral aquadest as placebo, while the treatment group (P1) exposed to UVB was given 1 g/200 g body weight of oral tempoyak. After 15 days of treatment, all rats were anesthetized and their skin tissues were taken for examination of MMP-1 expression. The analysis showed that the average of MMP-1 expression in the control group (P0) was 25.26Â±11.19% meanwhile the average of MMP-1 expression in the treatment group (P1) was 8.67Â±2.51%. There was a significant difference between the MMP-1 expression of the two groups (P = 0.000). Conclusion: Oral tempoyak could inhibit the increase of matrix metalloproteinase-1 (MMP-1) in UVB-induced rats (Rattus norvegicus).Keywords: tempoyak, MMP-1, UVBAbstrak: Ultraviolet B (UVB) merupakan salah satu sumber radikal bebas yang dapat mempercepat proses penuaan, khususnya penuaan kulit melalui peningkatan ekspresi MMP-1. Tempoyak yang kaya akan kandungan nutraseutikal dan probiotik dapat memberikan efek perlindungan kulit terhadap pajanan sinar ultraviolet. Penelitian ini bertujuan untuk membuktikan bahwa pemberian tempoyak per oral dapat menghambat peningkatan ekspresi MMP-1 tikus yang dipajan sinar ultraviolet-B (UVB). Jenis penelitian ialah eksperimental murni dengan menggunakan post test only control group design. Subjek penelitian ialah 36 ekor tikus putih (Rattus norvegicus), betina, galur Wistar, berumur 2,5-3 bulan, dengan berat badan 180-200 gr yang dibagi menjadi 2 (dua) kelompok masing-masing berjumlah 18 ekor tikus. Kelompok kontrol (P0) diberikan pajanan UVB dan akuades per oral sebagai plasebo sedangkan kelompok perlakuan (P1) diberikan pajanan UVB dan tempoyak dengan dosis 1 gr/ 200 gr BB. Setelah 15 hari perlakuan, seluruh tikus dianestesi kemudian diambil jaringan kulitnya untuk pemeriksaan ekspresi MMP-1 dermis. Hasil analisis menunjukkan bahwa rerata ekspresi MMP-1 pada kelompok kontrol (P0) ialah 25,26Â±11,19% sedangkan rerata ekspresi MMP-1 pada kelompok perlakuan (P1) ialah 8,67Â±2,51%. Terdapat perbedaan bermakna antara rerata ekspresi MMP-1 antara kedua kelompok (P = 0,000). Simpulan: Pemberian tempoyak per oral dapat menghambat peningkatan ekspresi MMP-1 tikus (Rattus norvegicus) yang dipajan sinar ultraviolet-B (UVB).Kata kunci: tempoyak, MMP-1, UVB

Elevated homeostatic model assessment of insulin resistance level increases the risk of acne Stefani Nurhadi; IGAA Praharsini; A. A. Gde Putra Wiraguna
Journal of General - Procedural Dermatology and Venereology Indonesia Vol 3, No 1 (2018): December 2018
Publisher : Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Insulin resistance and carbohydrate diets are currently considered to be influential in acne aetiology. Insulin is a hormone that does not only regulate the concentration of blood glucose but also affects the production of sebum and through the Insulin Growth Factor-1 (IGF-1) receptor stimulates androgen synthesis which will increase the proliferation of keratinocytes of the pilosebaceous duct and the production of sebum in acne. This is a cross sectional observational analytic study involving 38 acne patient and 38 non acne patients. This study aims to determine whether the increase in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value is a risk factor for acne. HOMA-IR formula was used to determine insulin activity in basal state. High HOMA-IR values are expressed from cut-off point ≥2. Sampling by consecutive sampling that meets inclusion and exclusion criteria. Fasting insulin and glucose levels is derived from venous blood examination. The average age of acne subjects was 23.71 years (10 men and 28 women). The mean value of HOMA-IR in the acne group was higher (2.63 ± 0.29) than those in the non acne group (1.71 ± 0.26) and statistically significant (p value <0.001). The prevalence ratio was 31.58, meaning that patients with high HOMA-IR were 31.6 times more likely to have acne than patients with normal HOMA-IR values. These results were statistically significant with p value <0.001. The conclusion was elevated HOMA-IR is one of the factors that increase the risk of someone developing acne.

GAMBARAN KARAKTERISTIK KASUS PSORIASIS VULGARIS DI POLIKLINIK PENYAKIT KULIT DAN KELAMIN RSUD KABUPATEN BULELENG TAHUN 2012-2013 Komang Aditya Yudistira; Anak Agung Gde Putra Wiraguna
E-Jurnal Medika Udayana vol 3 no 9 (2014):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.032 KB)

Psoriasis merupakan penyakit kulit kronis yang sering mengalami kekambuhan. Penyakit psoriasis tidak segera mengancam nyawa akan tetapi sangat mempengaruhi kualitas hidup penderitanya. Tujuan dari studi ini adalah untuk mengetahui profil dari pasien psoriasis vulgaris dan gambaran karakteristik pasien dengan psoriasis vulgaris. Penelitian ini adalah penelitian deskriptif dengan mengambil data sekunder pasien psoriasis vulgaris yang berobat ke poliklinik kulit dan kelamin RSUD Buleleng pada tahun 2012 sampai 2013. Sampel penelitian ini adalah pasien dengan psoriasis vulgaris yang berobat ke poliklinik kulit dan kelamin RSUD Buleleng. Dari hasil penelitian ini didapatkan sebanyak 54 pasien mengalami penyakit psoriasis vulgaris pada tahun 2012 dan sebanyak 50 pasien mengalami penyakit psoriasis vulgaris pada tahun 2013. Dari kedua tahun ini hampir sebagian besar merupakan kasus lama, persebaran kelompok usia hampir sama di semua kelompok usia dan jenis kelamin. Dari karakteristik pasien, sebanyak 74,1% dengan BMI normal pada tahun 2012 dan 54% pasien dengan BMI normal pada tahun 2013. 25,9% pasien yang memiliki kebiasaan merokok pada tahun 2012 dan 28% pasien di tahun 2013. Sebanyak 16,7% pasien memiliki kebiasaan minum alkohol pada tahun 2012 dan 24% pasien di tahun 2013. Untuk riwayat penyakit lain pada pasien psoriasis vulgaris, 24% pasien dengan diabetes mellitus di tahun 2012 dan 20% pasien di tahun 2013, 5% pasien dengan rheumatoid artritis di tahun 2012 dan 4% pasien di tahun 2013.

HUBUNGAN STRES TERHADAP TIMBULNYA AKNE VULGARIS PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA PROGRAM STUDI PENDIDIKAN DOKTER ANGKATAN 2017 Komang Saputra Yadnya; Anak Agung Gde Putra Wiraguna; Ni Putu Ratih Vibriyanti Karna; Prima Sanjiwani Sudarsa
E-Jurnal Medika Udayana Vol 9 No 12 (2020): Vol 9 No 12(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i12.P12

ABSTRAK Akne vulgaris dapat timbul karena beberapa faktor risiko, salah satunya adalah stres. Stres memicu peningkatan hormon androgen, dimana hormon androgen membuat kelenjar minyak membesar dan terjadilah peningkatan jumlah sebum. Penelitian ini dilaksanakan untuk mengetahui hubungan antara stres terhadap timbulnya akne vulgaris pada mahasiswa Program Studi Pendidikan Dokter angkatan 2017 FK UNUD. Desain penelitian yang digunakan metode cross-sectional dengan menggunakan data primer melalui kuisioner PSS-10 untuk mengetahui tingkat stres pada mahasiswa dan observasi untuk membuktikanada tidaknya akne vulgaris pada saat itu. Sampel penelitian ini terdiri dari 79 mahasiswa Program Studi Pendidikan Dokter angkatan 2017 FK UNUD yang diambil secara cluster sampling. Hasil penelitian didapatkan sampel yang menderita akne vulgaris sebanyak 28 orang (35,4%) sedangkan yang tidak mengalami adalah 51 orang (64,6%). Sampel yang mengalami stres adalah 60 orang (75,9%) sedangkan yang tidak 19 orang (24,1%). Setelah melakukan uji statistik terhadap akne vulgaris dan stres dengan uji chi-square diperoleh nilai p=0,02 (<0,05) yang membuktikan adanya hubungan antara stres dengan akne vulgaris pada Mahasiswa Fakultas Kedokteran Universitas Udayana Program Studi Pendidikan Dokter angkatan 2017. Kata Kunci: Akne Vulgaris, Sebum, Stres

Lipschutz Ulcer in A Virgin Woman: A Case Report I Gusti Ayu Agung Elis Indira; Vanessa Vijayamurthy; Made Dwi Puspawati; Anak Agung Gde Putra Wiraguna
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 32 No. 3 (2020): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V32.3.2020.244-249

Background: Lipschutz ulcer, also known as vulvae acutum ulcer, is an acute ulcer in the vulva. The aetiology and pathogenesis of Lipschutz ulcer are unclear, but it is known to be associated with infectious diseases such as Mycoplasma infection, paratyphoid fever, influenza A, and most infections with Epstein-Barr virus (EBV). This ulcer appears in adolescent females aged 14–20 years old, with 70% of cases occurring in virgin women. Purpose: To review the causes of non-Sexually Transmitted Diseases (STD) ulcers, so clinicians can establish an accurate diagnosis and rational therapy; therefore, minimizing the psychological impact on the patient due to possible misdiagnosis of STD-induced ulcer. Case: A painful wound in the genital area of a 20-year-old virgin woman. She was diagnosed with Lipshutz ulcer and vulvovaginal candidiasis based on the anamnesis, physical examination, and laboratory examination obtained from vaginal discharge using potassium hydroxide, Gram staining, and blood test to exclude genital ulcer caused by the sexually transmitted agent. A blood test was taken, including the serological tests for syphilis and genital herpes. Tests for EBV were also performed. The patient was treated only with single-dose fluconazole 150 mg orally and saline compress on the ulcer. Genital ulcer and vaginal discharge improved one week after treatment. Discussion: Lipshutz ulcer management is symptomatic, usually self-limiting, and disappears spontaneously within 1–2 weeks without recurrences. It can also occur as a single lesion with possible coinfection of other agents, for example, candidiasis, which in this case, requires treatment of comorbidities. Hygiene factors play an essential role in preventing occurrence of the secondary infection and further development of the disease. Conclusion: The diagnosis of Lipshutz ulcer is mainly based on clinical manifestation after excluding several possible ulcers that can affect the genital area, including sexually transmitted infections.

Gel of sandfish (Holothuria scabra) extract prevented melanin elevation in UVB-exposed guinea pig (Cavia porcellus) skin Dwindi Saptania; Wimpie Pangkahila; Anak Agung Gde Putra Wiraguna
IJAAM (Indonesian Journal of Anti-Aging Medicine) Vol 4 No 2 (2020): Indonesian Journal of Anti-Aging Medicine
Publisher : Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36675/ijaam.v4i2.95

Introduction: Hyperpigmentation is a condition of increasing melanin production in the skin due to UV light exposure. Sandfish (Holothuria scabra) contains phenol, quercetin, saponins, tannins, flavonoids and antioxidants such as vitamin C and others that have the potential anti-melanogenesis effects. The purpose of this study was to prove that topical administration of 40% sandfish (Holothuria scabra) extract gel prevented melanin elevation in UVB-exposed guinea pig (Cavia porcellus) skin. Methods: This study used a randomized post-test only group design by using of 36 guinea pigs. Guinea pigs were then divided into two groups. The control group were 18 guinea pigs exposed to UVB rays and treated with placebo gel base (P0). The treatment group were 18 guinea pigs exposed to UVB rays and treated with 40% sandfish extract gel. The back skin exposed to UVB rays, was cleaned from fur and swabbed with 70% alcohol. After that a punch-biopsy was carried out in the area and histopathological preparations were made. The amount of melanin was examined using Masson-Fontana staining. Results: The results showed that the average amount of melanin in the control group was 18.11± 1.11%, while the average amount of melanin in the treatment group was 1.82 ± 0.72%. Comparative analysis using independent T- test showed that the value of p was <0.001 means that there were significant differences between the control group and the treatment group. Conclusion: The administration of 40% sandfish (Holothuria scabra) extract gel prevented melanin elevation in UVB-exposed guinea pig (Cavia porcellus) skin.

Co-Authors Angela Sandi Tagaroi Rahasia Anne Carolina Kencanawati Astried Haryanto Balqis Wasliati Batan, Putu Nila Wardhani Bunge Dianmentari Chynthia Friama Diana Niti Santoso Dwindi Saptania Erwin Sugito Fatri Idana Fiter, Joni Gde Ngurah Idraguna Pinatih Golda Bernadet Lemewu I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Made Aman I Ketut Agus Somia Ida Bagus Gede Jayadharma Ida Sri Iswari Junivan Lindra Komang Aditya Yudistira Komang Saputra Yadnya Luh Made Mas Rusyati Made Wardhana Maharani, Made Kusuma Dewi Marrietta Sugiarti Sadeli Martina Windari Maya Cesarya Simangunsong Meiny Linda Setiawan Ni Luh Putu Ratih Vibriyanti Karna Ni Made Dwi Puspawati Ni Wayan Winarti Olivia Julita Pande Agung Mahariski Phery Candres Prima Saraswati Sanjiwani Sudarsa Priskila Ariana Rahel Lisana Debora Hutagalung Somia Sri Subramaniam Stefani Nurhadi Vanessa Vijayamurthy Vijayamurthy, I Dewa Ayu Vanessa Wimpie I Pangkahila Yuziana Yuziana

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