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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

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Korelasi negatif kuat kadar prolaktin plasma yang rendah terhadap derajat keparahan melasma Angela Sandi Tagaroi Rahasia; Anak Agung Gde Putra Wiraguna; Luh Made Mas Rusyati
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Melasma is a chronic cutaneous hypermelanosis in areas exposed to sunlight. Hormonal factors are known to influence melanogenesis processes such as prolactin as a neuroendocrine modulator in skin epithelial growth and immune system. This study aims to prove the inverse relationship between plasma prolactin levels and the severity of melasma.Methods: A cross-sectional study was carried out on 59 patients in the skin and genital olyclinic at Sanglah Hospital in Denpasar involving 46 subjects of melasma and 13 subjects who were not melasma who met the inclusion and exclusion criteria. Plasma prolactin levels were assessed by the Chemiluminescent microparticle immunoassay (CMIA) method. Data analysis was performed using SPSS ver. 23 software with a P-value <0.05 was considered statistically significant.Results: Plasma prolactin levels in patients with melasma were significantly lower than non-melasma patients (p <0.05). Patients with moderate and severe degrees of melasma had significantly lower plasma prolactin levels compared with mild degree of melasma (p <0.05). Low plasma prolactin levels can increase the likelihood of melasma by 4.79 times (PR 4.79; 95% CI = 0.94-24.27; p <0.05). Low plasma prolactin levels were significantly strong negative correlated with melasma severity (r = -0.820; p <0.05).Conclusion: There is a strong negative correlation of low plasma prolactin levels with the severity of melasma in patients with skin disorders at Sanglah General Hospital

Korelasi jumlah sel CD4 dengan skor nugent pada wanita dengan infeksi human immunodeficiency virus Ni Made Dwi Puspawati; Anak Agung Gde Putra Wiraguna; I Gusti Ayu Agung Dwi Karmila; I Ketut Agus Somia
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: CD4 cell counts are still used to assess disease progression due to infection with Human Immunodeficiency Virus (HIV). The lower the number of CD4 cells, the more susceptible patients are to various kinds of opportunistic infections. Nugent Score is a rating system to determine the presence of Lactobacillus which is a normal microbiota in the vaginal ecosystem. The purpose of this study was to determine the relationship of CD4 cell counts with Nugent scores in HIV-infected women.Method: This study is an analytic study with a cross-sectional approach in women with HIV infection in Sanglah Hospital Denpasar. Sampling with consecutive sampling technique. For each sample, venous blood was taken to measure CD4 cell counts and gram stains were examined from a vaginal swab to measure Nugent's score.Results: The study found the average age of the study sample was 36.42 years. Most of the samples had a normal Nugent score (0-3) with a CD4 count> 500 or were not immunodeficient (34%). There was a significant difference in the Nugent score based on the number of partners owned (p<0.05). There was no significant difference in Nugent's score based on condom use, vaginal wash and smoking history (p>0.05). The majority of patients who experienced immunodeficiency, mild immunodeficiency, and moderate immunodeficiency had normal Nugent scores (47.1%, 80%, 54.5%, respectively). Only the group with the most severe immunodeficiency had bacterial vaginosis (57.1%).Conclusions: No significant differences were found between CD4 cell counts and Nugent scores. This can be caused because there is no relationship between the two or because of confounding factors that have not been controlled. Further research needs to be done by correcting confounding factors so that subsequent research can improve precision.Â Pendahuluan: Jumlah sel CD4 sampai saat ini masih digunakan untuk menilai perkembangan penyakit akibat infeksi Human Immunodeficiency Virus (HIV). Semakin rendah jumlah sel CD4 semakin rentan penderita terhadap berbagai macam infeksi oportunistik. Skor Nugent adalah sistem penilaian untuk mengetahui keberadaan Lactobacillus yang merupakan mikrobiota normal pada ekosistem vagina. Tujuan penelitian ini untuk mengetahui hubungan jumlah sel CD4 dengan skor Nugent pada wanita terinfeksi HIV.Metode: penelitian ini merupakan penilitian analitik dengan pendekatan cross-sectional pada wanita dengan infeksi HIV di RSUP Sanglah Denpasar. Pengambilan sampel dengan teknik consecutive sampling. Pada setiap sampel dilakukan pengambilan darah vena untuk pengukuran jumlah sel CD4 dan pemeriksaan pengecatan gram dari swab vagina untuk mengukur skor Nugent.Hasil: penelitian didapatkan rerata usia sampel penelitian adalah 36,42 tahun. Sebagian besar sampel memiliki skor Nugent normal (0-3) dengan jumlah CD4 >500 atau tidak imunodefisiensi (34%).Terdapat perbedaan signifikan pada skor Nugent berdasarkan jumlah pasangan yang dimiliki (p<0,05). Tidak ada perbedaan signifikan pada skor Nugent berdasarkan penggunaan kondom, pencuci vagina dan riwayat merokok (p>0,05). Mayoritas pasien yang mengalami imunodefisiensi, imunodefisiensi ringan, dan imunodefisiensi sedang memiliki skor Nugent yang normal (47,1%, 80%, 54,5%, secara berurutan). Hanya kelompok dengan imunodefisiensi berat yang mayoritas memiliki bakterial vaginosis (57,1%).Simpulan: tidak ditemukan perbedaan yang bermakna antara kadar CD4 dengan skor Nugent. Hal ini bisa disebabkan karena memang tidak ada hubungan antara keduanya atau karena faktor perancu yang belum dikontrol. Perlu dilakukan penelitian lanjutan dengan mengkoreksi faktor perancu sehingga penelitian berikutnya dapat meningkatkan presisi.

Gambaran karakteristik pasien kondiloma akuminata dengan infeksi HIV/AIDS di RSUP Sanglah, Denpasar, Indonesia tahun 2011-2015 Ida Bagus Gede Jayadharma; Anak Agung Gde Putra Wiraguna
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Condyloma acuminata, known as genital warts, is a sexually transmitted infection caused by a virus, namely Human Papilloma Virus (HPV). HPV infections are related to other sexually transmitted infections such as the Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). This study aims to know the patient characteristics of condyloma acuminata in patients with HIV infection in Sanglah General Hospital, Denpasar, from January 2011 to December 2015.Methods: This research is a retrospective descriptive study with a cross sectional method. This research analyzed 58 patients of condyloma acuminata with HIV infection in Sanglah Public Hospital from January 2011 to December 2015. Research variables were based on age, sex, level of education, marital status, and work level. Data were analyzed using SPSS version 17 for Windows.Results: This study found that the prevalence of condyloma acuminata with HIV infection based on age was 15-24 years old (17.2%), 25-44 years old (81.0%), and 45-64 years old (1.7%). The results based on sex were 91.4% for males and 8.6% for females. The results based on education level were elementary school (8.6%), high school (53.4%), higher education (37.9%). The results based on work level were government employee (3.4%), private employee (77.6%), entrepreneur (10.3%), and do not have a job (8.6%). And the results based on marital status were married (13.8%) and single (86.2%).Conclusion: The highest prevalence of condyloma acuminata with HIV infection based on age was 25-44 years old, males gender, high school level of education, and working in the private sector. Latar Belakang: Kondiloma akuminata atau dikenal sebagai genital wart (kutil kelamin) adalah infeksi menular seksual yang disebabkan oleh virus, yaitu Human papilloma virus (HPV). Infeksi HPV kerap dikaitkan dengan infeksi menular seksual lainnya seperti Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS). Tujuan penelitian ini untuk mengetahui karakteristik pasien kondiloma akuminata pada pasien yang terinfeksi HIV di Rumah Sakit Umum Pusat Sanglah Denpasar dari bulan Januari 2011 sampai dengan bulan Desember 2015.Metode: Penelitian ini merupakan penelitian deskriptif retrospektif, dengan metode cross sectional. Penelitian ini menganalisis 58 pasien dengan kondiloma akuminata dengan HIV di Poliklinik RSUP Sanglah pada periode Januari 2011 sampai dengan Desember 2015. Variable pada penelitian ini yaitu berdasarkan umur, jenis kelamin, tingkat pendidikan, status perkawinan, dan tingkat pekerjaan. Data dianalisis dengan SPSS versi 17 untuk Windows.Penelitian: Hasil dari penelitian ini didapatkan bahwa berdasarkan umur 15-24 tahun (17,2%), 25-44 tahun (81,0%), dan 45-64 tahun (1,7%). Berdasarkan jenis kelamin, yaitu laki-laki (91,4%) dan perempuan (8,6%). Hasil penelitian berdasarkan tingkat pendidikan, kelompok pendidikan dasar (8,6%), pendidikan menengah (53,4%), dan pendidikan tinggi (37,9%). Berdasarkan pekerjaan, yaitu kelompok PNS (3,4%), pegawai swasta (77,6%), wiraswasta (10,3%), dan kelompok tidak bekerja (8,6%). Dan berdasarkan status perkawinan didapatkan hasil yaitu kelompok menikah (13,8%) dan yang belum menikah (86,2%).Kesimpulan: Prevalensi kondiloma akuminata dengan HIV paling banyak berdasarkan kelompok umur yaitu kelompok usia 25-44 tahun, jenis kelamin laki-laki, kelompok pendidikan menengah, dan bekerja di sektor swasta.

Kondiloma akuminata perianal pada seorang laki-laki biseksual disertai infeksi HIV stadium III yang diterapi dengan kombinasi asam trikloroasetat 80% dan seng oral Rahel Lisana Debora Hutagalung; Anak Agung Gde Putra Wiraguna
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Condyloma acuminata in the homosexual population caused by anogenital sexual behavior causes more microabrasion to occur which increases the risk of infection with human papilloma virus (HPV) and HIV. This case report aims to provide an overview of the clinical outcome of condyloma acuminata in homosexual patients with HIV grade III.Case: Male, 26 years old with an itchy and painless lump around the genitals and anal canal since two months ago. The new patient was diagnosed with HIV since two weeks before the visit to the Sanglah Hospital polyclinic. It was found that the patient was a homosexual with a history of multiple partners and had been going on for five years. Physical examination of the perianal region revealed multiple skin-colored tumors, geographic shape, 3x5cm - 3x5.5cm in size, with a verrucous surface, and solid consistency with a positive acetowhite test that concluded as perianal condyloma acuminata. It was decided to give tricolor acetate (TCA) 80% spotted therapy and oral zinc sulfate 100mg/day. Up to 2 TCA session therapy and oral zinc administration in approximately three weeks, the lesion was getting better with efflorescence in the form of multiple papules, color of the mucosa that confluent to form a tumor, geographic shape, size 3x2cm - 3x3cm, smooth surface, solid consistency.Conclusion: The response to treatment with TCA 80% for 2 times and oral zinc for 3 weeks was quite good, the number of lesions was reduced and the size of the lesions was reduced. The prognosis of the patient is dubious because even if the condyloma acuminata lesion has been repaired, the presence of HIV infection can lead to the risk of recurrence and the risk of progression to malignancy. Latar belakang: Kondiloma akuminata pada populasi homoseksual diakibatkan oleh perilaku seksual secara anogenital menyebabkan lebih banyak mikroabrasi yang terjadi yang menyebabkan peningkatan risiko infeksi human papilloma virus (HPV) dan HIV. Laporan kasus ini bertujuan untuk memberikan suatu gambaran luaran klinis dari kondiloma akuminata pada pasien homoseksual dengan HIV derajat III.Kasus: Laki-laki, 26 tahun dengan benjolan risakan gatal dan tidak nyeri pada sekitar kelamin dan lubang anus sejak dua bulan yang lalu. Pasien baru terdiagnosa HIV sejak dua minggu sebelum kunjungan poliklinik RSUP Sanglah. Diketahui pasien merupakan seorang homoseksual dengan riwayat berganti-ganti pasangan dan sudah berlangsung selama lima tahun. Pemeriksaan fisik region perianal menunjukkan tumor sewarna kulit multipel, bentuk geografika, ukuran 3x5cm – 3x5,5cm, dengan permukaan verukosa, dan konsistensi padat dengan hasil tes acetowhite positif yang disimpulkan sebagai suatu kondiloma akuminata perianal. Diputuskan untuk memberikan terapi tutul tricolor acetat 80% dan seng sulfat oral 100mg/hari. Hingga terapi 2 kali tutul dan pemeberian seng oral dalam jangka waktu kurang lebih tiga minggu terjadi perbaikan lesi dengan efloresensi berupa papul multipel sewarna mukosa yang berkonfluen membentuk tumor, bentuk geografika, ukuran 3x2cm – 3x3cm, permukaan licin, konsistensi padat.Simpulan: Respon pengobatan dengan TCA 80% selama 2 kali dan seng oral selama 3 minggu cukup baik, jumlah lesi berkurang dan ukuran lesi mengecil. Prognosis dari pasien adalah dubius karena walaupun telah terjadi perbaikan lesi kondiloma akuminata, adanya infeksi HIV dapat menyebabkan risiko terjadinya rekurensi dan risiko perkembangan ke arah keganasan.

The prevalence between stress and acne vulgaris among medical students at Universitas Udayana in the 2019 period Somia Sri Subramaniam; Anak Agung Gde Putra Wiraguna; Ni Luh Putu Ratih Vibriyanti Karna
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Acne vulgaris is a common disease in medical students. One of the causes of acne vulgaris is stress. Acne vulgaris can affect the quality of life associated with one's self-confidence. But often, this disease is ignored and not treated properly. This study aims to know if acne vulgaris occurs in students at the Faculty of Medicine, Universitas Udayana, Bali, Indonesia, related to the stress that affects acne vulgaris.Methods: This research is a descriptive cross-sectional study. Data is collected using a data retrieval form. The inclusion criteria in this study were: 1) Participants selected must be from English class from semester 7 and aged 20 or above; 2) Participants can be from both genders; and 3) Participants that join the study willingly. Besides, the exclusion criteria were respondents who did not approve as a research sample and did not fill out informed consent. Data were analyzed using SPSS version 17 for Windows.Results: About 62 of 93 study participants were diagnosed with acne vulgaris in students at the Faculty of Medicine, Universitas Udayana. There were 31 of 62 study participants who were diagnosed with acne vulgaris due to stress. Women had more acne vulgaris than men and the number of students that had acne vulgaris the most are at the age of 21. The most common type of lesion is comedonal with a mild classification level. Most of the subject's cause of acne due to stress is before block exam. Most of the participants feel embarrassed due to acne. About 24.2% of the subjects had a habit of scratching/squeezing acne vulgaris.Conclusion: Most of the subjects diagnosed with acne were female and age 21 years old. Besides, comedones were the predominant type of lesion, followed by a mild degree of acne severity.

Peran sirkumsisi sebagai pencegahan infeksi herpes genetalis: suatu studi kohort retrospektif Made Wardhana; Martina Windari; Marrietta Sugiarti Sadeli; Anak Agung Gde Putra Wiraguna; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Pande Agung Mahariski
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Recurrent genital herpes (RGH) is a sexually transmitted infection that is a serious public health problem and is quite prominent in most countries worldwide. Management for this infection is antiviral and circumcision. Male circumcision significantly reduces human immunodeficiency virus (HIV) infection and other sexually transmitted infections. This research aims to evaluate circumcision efficacy as the prevention for herpes simplex virus type 2 (HSV-2) infection compared with oral acyclovir.Methods: This research is an experimental study with a retrospective cohort approach. We included 45 males, 24 subjects circumcised and 21 subjects without circumcision and took oral acyclovir as standard treatment. RGH was diagnosed based on typical clinical manifestation. Follow up treatment every two weeks and continued to 2 months after circumcised and given with oral acyclovir. Successful treatment was stated without recurrent genital herpes.Results: Of 24 circumcised subjects, 19 were cured, and five non-circumcised subjects suffered recurrent genital herpes (not cured). Among 21 subjects without circumcision was cured, and 12 subjects were not cured. Based on these results, the value of NNT= 2.7.Conclusion: Circumcision can be considered effective in reducing the incidence of HGR and prevent recurrence of HGR with the NNT value of 2.7. Latar Belakang: Herpes genetalis rekuren (HGR) merupakan infeksi menular seksual menjadi masalah kesehatan masyarakat yang serius dan cukup menonjol pada sebagian besar negara di dunia. Penanganannya adalah oral dengan antivirus dan tindakan sirkumsisi. Sirkumsisi pada pria secara signifikan mengurangi insiden infeksi human immunodeficiency virus (HIV) dan penyakit infeksi menular lainnya. Penelitian ini mengevaluasi efikasi sirkumsisi sebagai pencegahan infeksi virus herpes simpleks tipe 2 (HSV-2) dibandingkan dengan pemberian obat asiklovir.Metode: Studi ekperimental dengan pendekatan retrospektif kohort dengan mengikutsertakan 45 subjek pria dewasa, 24 subjek disirkumsisi dan 21 tanpa sirkumsisi dan hanya diberikan asiklovir sebagai obat standar. Diagnosis HGR dilakukan secara klinis dengan yang manifestasi klinis yang khas da pemeriksaan Tzanck. Setelah pemberian terapi dilakukan kontrol setiap 2 minggu sampai 2 bulan. Terapi dinyatakan berhasil bila tidak ada kekambuhan.Hasil: Dari 24 subjek disirkumsisi, 19 subjek dinyatakan sembuh dan 5 subjek mengalami kekambuhan (tidak sembuh). Dari 21 subjek tanpa sirkumsisi, 9 subjek dinyatakan sembuh dan 12 subjek dinyatakan tidak sembuh. Berdasarkan hasil ini didapatkan nilai NNT=2,7.Simpulan: Sirkumsisi dapat dinilai cukup efektif mengurangi angka kejadian HGR dan dapat mencegah kekambuhan HGR dengan nilai NNT 2.7.

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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Journal : ISM (Intisari Sains Medis) : Jurnal Kedokteran