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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Ophthalmologica Indonesiana

N. K. Niti Susila, N. K.

Bagian SMF Mata Fakultas Kedokteran Universitas Udayana

Author-ID : 588483

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

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Articles

POLYMORPHISM OF VASCULAR ENDOTHELIAL GROWTH FACTOR REGIO PROMOTER C(-634)G AS A RISK FACTOR OF BALINESE TYPE-2 DIABETIC RETINOPATHY Mas-Putrawati, A. A.; Bakta, M.; Suastika, K.; Muhiddin, H. S. Habiba; Niti Susila, N. K.
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
Publisher : BALI MEDICAL JOURNAL

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Background: Diabetic retinopathy (DR) is one of the complications on diabetic mellitus (DM) patient as a micro vascular retina disorder which caused by a long term of hyperglycemia. This is one of the blindness causes in the world. This research aims to find out Polymorphism of VEGFC(-634)G gene as a risk factor of DR on the Balinese with DM type-2 (DMT2). Method: This study is applying two designs, analytical cross sectional and case control. The case is DMT2 patient with DR(+), DMT2 without DR as control. The sequencing technique was performed to evaluate polymorphism and plasma VEGF levels were determined by ELISA. Results: Cross sectional study (hospital based) came out with quite high number of DR, 57 people of 97 study samples. This study shows the existence of genetic variation on Gen VEGF C(-634)G, with most often genotype of CG (51.5%). Polymorphism C(-634)G as the risk factor of DR (OR=1.815 CI-95%= 1.077-3.057, p=0.025), and high level of VEGF were also significant (QR=3.75 , CI-95% 1.34-10.20, p=0.008). VEGF level with genotype of CG, CC and GG, not found any difference (p=0.245). Logistic regression shows that the most influential variable as the risk factor of DR is VEGF level (p= 0.007), polymorphism gen VEGF C(-634)G (p=0.022) and systolic blood pressure (p=0.023). Conclusions: Polymorphism of VEGF C(-634)G gene and high level of VEGF as the risk factor of DR, and can be used as a reference in handling early stage of DR patient to prevent blindness.

CRYOTHERAPY PADA DESCEMETOCELE REKUREN POST-PERIOSTEAL GRAFT : LAPORAN KASUS PADA KERATOKONJUNGTIVITIS GONOKOKUS Yenny K, Nyoman; Susila, NK Niti; Budayanti, Nyoman Sri
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Keratokonjungtivitis gonokokus disebabkan oleh Neisseria gonorrhoeae, kokus gram negatif yangmenginvasi epitel kornea intak menyebabkan keratolisis stroma kornea hingga perforasi. Membrandescemet merupakan barrier terhadap mikroorganisme, namun ketika ditembus oleh mikroorganisme,akan menonjol ke depan membentuk descemetocele. Dilaporkan satu kasus descemetocele padakeratokonjungtivitis gonokokus pada wanita usia 45 tahun di Rumah Sakit Umum Pusat SanglahDenpasar. Penderita mengeluh pandangan buram, kotoran mata kekuningan, kental sejak 6 hari,kelopak mata bengkak dan bintik hitam di mata kanan. Tajam penglihatan mata kanan 5/60.Pemeriksaan oftalmologi pada mata kanan didapat udem palpebra , konjungtiva sekret mukopurulenmasif, conjunctival vascular injection dan pericorneal vascular injection, udemkornea dan descemetoceledi jam 1, ukuran 3x2 mm, bilik mata depan dangkal dan fibrin, iris retraksi, pupil ireguler dan reflekpupil negatif, lensa tertutup fibrin, vitreus sulit dievaluasi, reflek fundus positif. Pada penderita telahdilakukan periosteal graft namun flap bergeser sehingga dilakukan tindakan ulangan cryotherapy yangmemberikan hasil baik. [MEDICINA 2015;46:184-8]Gonococcus keratoconjunctivitis caused by Neisseria gonorrhoeae, a gram-negative coccus thatinvading intact corneal epithel causing keratolysis until perforation. Descemet membrane is a barrierfor microorganism, but when penetrated by microorganism, it will bulging forming descemetocele.Wereported a case descemetoceleon gonococcus keratoconjunctivitis of a 45 years old woman in SanglahHospital-Denpasar.Patient complained blurry vision, white-yellowish secrete, purulent since 6 days,palpebra edema, and black dot on right eye. Right eye visual acuity was 5/60. Ophthalmologyexamination of palpebra was edema, massive conjunctival mucopurulene secrete, conjunctival vascularinjection, pericorneal vascular injection, corneal edema, and descemetocele at 1o’clock hour, size 3x2mm, shallow anterior chamber and fibrin, iris retracted, irregular pupil, negative pupil reflex, fibrincovered by lens, can not evaluated vitreous, funduscopy reflex positive.Patient had been treated withgraft periosteal but then the flap was sliding, so we treated patient with cryotherapy and gave goodresult. [MEDICINA 2015;46:184-8].

KARAKTERISTIK PASIEN UVEITIS DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR PERIODE MARET 2016 SAMPAI DESEMBER 2016 Kadek Ayu Dorinda Sari; Ni Ketut Niti Susila; Putu Budhiastra
E-Jurnal Medika Udayana Vol 8 No 8 (2019): Vol 8 No 8 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Uveitis merupakan inflamasi pada uvea, dapat juga disertai dengan inflamasi pada jaringansekitar. Uveitis diperkirakan sekitar 10% sebagai penyebab kebutaan di dunia. Angka kejadianuveitis di Rumah Sakit Umum Pusat Sanglah tahun 2016 ditemukan sebanyak 28 kasus.Penelitian ini bertujuan untuk mengetahui karakteristik pasien uveitis di Rumah Sakit UmumPusat (RSUP) Sanglah Denpasar periode Maret 2016 sampai Desember 2016.Penelitian inimerupakan penelitian deskriptif cross sectional yang dilakukan di RSUP Sanglah Denpasar.Data yang diperoleh berupa data sekunder rekam medis pasien periode Maret 2016 sampaiDesember 2016. Data diolah dengan menggunakan program SPSS. Hasil penelitianmenunjukkan bahwa dari 22 pasien, rata-rata usia penderita uveitis yaitu 43,8 tahun denganproporsi penderita terbanyak yaitu usia 45 – 64 tahun. Jenis kelamin terbanyak pada pasienuveitis yaitu laki-laki sebanyak 54,5%. Pasien yang tinggal di Denpasar paling banyakmenderita uveitis sebanyak 6 orang (27,3%) pasien. Keluhan utama terbanyak yaitu mata kabursebanyak 77% mata dengan beberapa pasien uveitis memiliki keluhan utama lebih dari satu.Jenis uveitis berdasarkan anatomi menunjukkan bahwa pasien uveitis paling banyak mengalamiuveitis anterior sebanyak 80%. Sebanyak 18 orang (81,8%) pasien uveitis mengalami uveitisunilateral. Pada penelitian ini dapat disimpulkan pasien uveitis di RSUP Sanglah periode Maret2016 – Desember 2016 lebih banyak pada usia 45 – 64 tahun, jenis kelamin laki-laki, bertempattinggal di Denpasar, keluhan utama pengelihatan kabur, jenis uveitis terbanyak adalah uveitisanterior, dan keterlibatan mata yaitu unilateral. Kata kunci: Uveitis, Penglihatan Kabur, Unilateral

Juvenile rheumatoid arthritis associated with uveitis in a 4-year-old girl Made Sukmawati; Hendra Santoso; Niti Susila
Paediatrica Indonesiana Vol 46 No 2 (2006): March 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.2.2006.87-92

The variability of the disease may explain mis-conceptions that JRA is usually a benign disease. Acohort study in which 506 subjects during the periodof 1970-1999 found that approximately one-third ofJRA patients achieve disease remission. The visualcomplications are also important in determining theoutcome. Functional disability is common and can belong-lasting. Recognizing JRA symptoms earlier areimportant to prevent mortality, disability, and long-term complications. Although JRA is the most com-mon rheumatic disease in children, many doctors arenot familiar with this disease. The purpose of thispaper is to report a case of juvenile rheumatoid ar-thritis associated with uveitis in a 4-year, 8-month-old girl.

KADAR IL-6 PLASMA PASIEN DIABETES MELITUS DENGAN DAN TANPA PENGIDAP RETINOPATI DIABETIKA (The Level of Interleukin-6 Plasma in Diabetes Mellitus Patients With and Without Diabetic Retinopathy) I Wayan Putu Sutirta Yasa; I Nyoman Wande; Ni Ketut Niti Susila; Putu Budhiastra; Cokorda Istri Dewiyani Pemayun; Sianny Herawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1249

Diabetic retinopathy is a complication of diabetes mellitus in the form of microvascular (aneurysma) which can cause blindness.Interleukin-6 is a pro - inflammatory cytokine produced by monocyte macrophage in the early inflammation. Chronic inflammationplays the role on artherosclerosis event, because it is directly correlated with all phases of it and cardiovascular disease as well. Theaim of this study is to know the difference in plasma IL-6 levels among patients suffering from diabetes mellitus together with diabeticretinopathy and without diabetic retinopathy. This study is an observational analytical research with cross sectional design. The sampleswere taken randomly as many as 16 patients, divided in each group suffering from or without retinopathy. The diabetic mellitus patientswere established through their related history and were examined randomly for blood glucose and their fundus or retinal abnormality.The level of IL-6 was examined by ELISA method with double antibody sandwich streptavidin - biotin. Based on this study it was foundthat the mean plasma levels of interleukin 6 (IL-6) of the diabetic mellitus patients with retinopathy was 1.165 ± 0.296 pg/mL andthe mean plasma levels of IL-6 with diabetes mellitus without retinopathy was 0.879 ± 0.230 pg/mL. Based on the normality test withShapiro-Wilk the data showed a normal distribution (p>0.05), while the Levene’s homogenity test obtained homogeneous with p= 0.369(p>0,05). The statistical analysis with two independent samples t-test showed that there were significant differences between the groupsof patients who suffered diabetes mellitus with retinopathy and without retinopathy (p=0.005). It can be concluded so far that the meanlevels of interleukin-6 (IL-6) plasma in diabetic mellitus patients with retinopathy is higher compared to patients with the same diseasebut without retinopathy.

Hasil tajam pengelihatan pasca operasi katarak senilis di RSUP Sanglah Denpasar periode Oktober 2016 - Juni 2017 Anak Agung Gde Arisena Asmara; Putu Budhiastra; Ni Ketut Niti Susila
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Introduction: Cataract is a type of eye disease that occurs in the lens of the eye. Cataract occurs not only due to the age factor, but also can occur in children born with these conditions or congenital factors. This study aimed to find out visual acuity outcome after senile cataract surgery at RSUP Sanglah Denpasar on October 2016 - June 2017 period.Method: The type of this research was descriptive cross-sectional conducted at RSUP of Sanglah Denpasar using the medical records of the period of October 2016 - June 2017. The sampling technique used the total sampling, with the number of samples of 32 subjects. The result of this research was processed by using a computer software.Result: The postoperative patients with poor outcome tended to be experienced by the senile cataract of mature group compared to the immature that was around 9.1%, borderline outcome tended to be experienced by group with immature senile cataract of 23.8% while the dominant senile cataract outcome was 81.8%. Patients undergoing SICS procedures tended to have a poor outcome compared to those undergoing a phacoemulsification procedure of 16.7%. Borderline outcome tended to the group undergoing phacoemulsification procedures, and 83.3% of the good outcome tended to be experienced by the group undergoing SICS procedures.Conclusion: This research concludes that good outcome come from cataract senile mature group (81.8%) and the group that doing SICS procedure (83.3%)

Tingkat pengetahuan mahasiswa semester VI, Pogram Studi Pendidikan Dokter, Fakultas Kedokteran, Universitas Udayana terhadap konjungtivitis bakteri tahun 2017 I Made Gede Dwipayana Putra; Putu Budhiastra; Ni Ketut Niti Susila
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Bacterial conjunctivitis is an infection of the eye caused by bacteria, such as Staphylococcus, Streptococcus, or Haemophilus. Based on 30% of visits in the Department of Eye Disease in the United States, 15% are conjunctivitis complaints caused by bacteria and virus, and 15% are conjunctivitis complaints caused by allergy. A common complication of conjunctivitis is the decreased visual acuity that greatly affects the patient in performing daily activities.Aim: This study aimed to determine the knowledge level of semester VI students of Doctor Education Study Program, Faculty of Medicine, Udayana University, toward conjunctivitis.Method: The samples were 70 people with 10% relative accuracy. Sampling was done by random sampling technique. The data were collected by using questionnaire technique. Data analysis was performed using descriptive statistics.Result: The result of the students' knowledge level on bacterial conjunctivitis was 62 respondents (89%) were in good category, 8 respondents (11%) were in moderate category, and none for poor category (0) as well. The knowledge level of the respondent toward bacterial conjunctivitis at the age of 21 years was quite good, that were 31 people (44.5%). Respondents with moderate knowledge level at the age of 21 years were 5 people.Conclusion: The result of the test shows that the level of students' knowledge on bacterial conjunctivitis is that 62 respondents (89%) are in good category. Therefore, to the management of Faculty of Medicine, Udayana University, this research is expected to be used as a reference in formulating various learning strategies, so the learning achievement can be improved.

Nodular anterior scleritis in systemic sclerosis: a case report Komang Putra Tridiyoga; Ida Ayu Ary Pramita; I Gusti Ayu Made Juliari; A. A Mas Putrawati Triningrat; I Made Agus Kusumadjaja; N.K Niti Susila
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: Scleritis is an inflammation of the sclera’s lining, characterized by cellular infiltration, collagen damage, and vascular changes. The incidence rate of scleritis accompanied by systemic disease generally is around 39% to 50%. Scleritis can be divided into two, namely anterior and posterior scleritis. Anterior scleritis can be divided into four, diffuse anterior scleritis, nodular anterior scleritis, necrotizing anterior scleritis with inflammation and without inflammation. One of the causes of nodular anterior scleritis is systemic sclerosis which is an autoimmune disease. Nodular anterior scleritis in systemic sclerosis is very rare, with an estimated prevalence rate of 4.4%.Case Description: A man, 46 years old, complaining of red, watery, painful, and visible white membrane on his right eye since two weeks ago and was referred from an ophthalmologist with scleritis on his right eye. The patient had a history of asthma and cataract surgery. Physical examination showed right eye VA was 6/45 pinhole (PH) 6/18, conjunctival and scleral injection, nodule on superior conjunctiva with yellowish-white in color. Laboratory examination showed a clinical representation of autoimmune disease, consulted to the rheumatology division, and was diagnosed with systemic sclerosis. The patient has been prescribed corticosteroids and immunosuppressant’s for the therapy, the patient's eye condition improves after.Conclusion: Systemic sclerosis with a presenting ophthalmologic complaint is a rare disease. This case illustrates that nodular anterior scleritis needs comprehensive intervention to seek the etiology and provide the treatment. This case has shown that nodular anterior scleritis with systemic sclerosis improved with corticosteroids and immunosuppressants, a typical treatment for autoimmune disease.

Case report: a rare case of ocular leptospirosis I Made Surya Dinajaya; Ida Ayu Ary Pramita; I Gusti Ayu Made Juliari; Ni Ketut Niti Susila; I Made Agus Kusumadjaja
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1320

Background: Ocular leptospirosis is a rare condition. Transmission of leptospirosis is caused by the bacterium leptospira interrogans transmitted directly or indirectly from animals to humans (zoonosis). Ocular manifestations often caused by leptospirosis are conjunctivitis, keratitis, uveitis (anterior, intermediate, posterior, and panuveitis), complicated cataracts, choroiditis, papillitis, and macular edema. Uveitis is a latent manifestation of leptospirosis. Proper management can lead to a good prognosis of visual.Case Presentation: Male patient, 55 years old, with complaints of both red and blurry eyes since 5 days. Blurring comes slowly with pain, glare, and seeing shadows like spider webs. The patient's previous medical history was hospitalized because of Weil's disease. Examination of the anterior segment of both eyes revealed eyelid spasm, conjunctival injection, corneal infiltrate, keratic precipitate, and posterior synechiae on both eyes. While in the posterior segment found cells 4+ in the vitreous. The patient was treated with antibiotics and topical steroids, and visual acuity was improved.Conclusion: Leptospirosis uveitis can have various presentations during the acute and chronic phases of the disease. Even when ocular involvement is extensive and severe, most patients have a good visual prognosis with appropriate therapy. Timely diagnosis is essential to maximize the potential for visual acuity improvement and appropriate systemic monitoring and treatment of extraocular involvement in this potentially fatal condition. Good sanitation in the community plays an important role in preventing exposure to leptospirosis.

Management Ocular Syphilis in Human Immunodeficiency Virus (HIV) Patients Alexander Theodore Samosir; N. K. Niti Susila; I Gutsi Ayu Made Juliari; Ida Ayu Ary Paramita; I Made Agus Kusumadjaja
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v48i1.100455

Introduction: Ocular syphilis is a rare manifestation of syphilis. Ocular syphilis manifestations vary and can occur at all stages of the disease. Syphilis can affect all eye structures, the main complaint is blurred vision, accompanied by non-specific symptoms such as pain in the eye, and does not respond to steroids. Case: The male patient, 54 years old, presents with complaints of both eyes slowly getting worse with a history of sexual multi-partners. Visual acuity in both eyes were light perception bad projection, ophthalmological examination showed cloudy lens, cloudy vitreous, cell (+) flare (+) right eye optic nerve, hyperemia, and left eye optic nerve, pale at temporal. VDRL results: reactive> 1: 512 and TPHA: reactive> 1: 5120. The patient was diagnosed with late latent syphilis and neurosyphilis observation from the Dermatology and Venereology Department and received benzathine penicillin injection therapy. From the Neurology Department the patient was diagnosed with neuro-syphilis and was consulted to VCT department with pre-HAART Stage IV HIV infection (WHO). After receiving penicillin therapy and topical steroids, the patient was experienced improvement in visual acuity. Conclusion: In HIV patients without antiretroviral therapy, Treponema pallidum infection is more common and has manifestations such as ocular syphilis and neurosyphilis. Treatment of ocular syphilis using topical steroids to reduce inflammation and penicillin as the main antibiotic.

Co-Authors A. A. Mas-Putrawati Alexander Theodore Samosir Anak Agung Gde Arisena Asmara Anak Agung Mas Putrawati Triningrat Cokorda Istri Dewiyani Pemayun H. S. Habiba Muhiddin, H. S. Habiba Hendra Santoso I Gusti Ayu Made Juliari I Ketut Suastika I Made Bakta I Made Gede Dwipayana Putra I Made Surya Dinajaya I Nyoman Wande I Wayan Putu Sutirta Yasa Ida Ayu Ary Paramita Ida Ayu Ary Pramita Kadek Ayu Dorinda Sari Komang Putra Tridiyoga Made Agus Kusumadjaja Made Sukmawati Ni Nyoman Sri Budayanti Nyoman Yenny K, Nyoman Putu Budhiastra Putu Budhiastra Putu Budhiastra Sianny Herawati

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