dr. I Nyoman Wande, Sp.PK (original) (raw)

Papers by dr. I Nyoman Wande, Sp.PK

Jurnal Penyakit Dalam Udayana

Background: Many elder peoples in the community suffering from frailty syndrome and sarcopenia. O... more Background: Many elder peoples in the community suffering from frailty syndrome and sarcopenia. One of the important components in the occurrence of frailty and sarcopenia is the decrease in muscle strength that can withstand grip strength. Various factors influence, one of which is the level of testosterone hormone. There are still some controversial results regarding the relationship between testosterone levels and hand grip strength. Objective: This study aimed to prove that testosterone levels are associated with grip strength in elderly men. Methods: This study is an analytic cross-sectional study in an urban area in Bali. The study was started by giving informed consent to the research subjects, then examination using a handgrip dynamometer, and taking blood samples to check testosterone levels. The relationship between testosterone levels and grip strength was analyzed using the Spearman test using SPSS edition 24 software. Results: A total of 62 elderly men in urban areas in...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY

Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of hear... more Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of heartburn accompanied by increased levels of pancreatic enzymes. Acute pancreatitis in acute lymphoblastic leukemia in addition to being caused by therapy can also be caused by other factors. 13-year-old female patient with a diagnosis of acute lymphoblastic leukemia complained of heartburn which was felt through to the back. Patients also experience nausea, vomiting, decreased appetite, difficulty in bowel movements, and fever. Physical examination found an increase in body temperature, anemic eyes, multiple neck gland enlargement, and enlargement of the liver. The results of complete blood tests showed leukocytosis, anemia, and thrombocytopenia. The results of examination of bone marrow aspiration show a picture of the bone marrow in accordance with acute lymphoblastic leukemia (ALL-L2). Clinical chemistry tests showed an increase in amylase, lipase, SGOT, BUN, creatinine, LDH, ferritin, c...

Journal of Hunan University Natural Sciences, Oct 30, 2022

Bali Medical Journal

Backgrounds: Chronic kidney disease (CKD) is an abnormality in the kidney that lasts for more tha... more Backgrounds: Chronic kidney disease (CKD) is an abnormality in the kidney that lasts for more than 3 months. Increased phosphate levels in the blood due to CKD will stimulate the secretion of Fibroblast Growth Factor 23 (FGF-23). Increased secretion of FGF-23 happens to maintain phosphate balance because the capacity of excretion of phosphorus in the kidneys decreases and leads to the incidence of secondary hyperparathyroidism due to Parathyroid Hormone (PTH). This study aims to evaluate the relationship between serum levels of FGF-23 and PTH in predialysis CKD patients.Methods: An analytical observational study with a cross-sectional approach has been conducted in this study from August until October 2020. Analysis of the relationship between serum levels of Fibroblast Growth Factor (FGF-23) and intact parathyroid hormone using the Spearman correlation test with a significance level of =0.05. Data were analyzed using SPSS version 17 for Windows.Results: A total of 75 people consist...

Bali Medical Journal

Background: Based on the onset of events, the most common neonatal sepsis is early-onset neonatal... more Background: Based on the onset of events, the most common neonatal sepsis is early-onset neonatal sepsis (EONS), which occurs within the first 72 hours of life. Blood culture is the gold standard for EONS, but this examination takes a long time to provide the results. However, the latest method is obtained to determine the shift to the left granulocytic image by counting Immature Granulocyte (IG). This study aims to evaluate the accuracy of the IG Ratio for diagnosing EONS in neonates suspected of having sepsis. Methods: A cross-sectional observational study was conducted among 60 EONS patients consecutively, who met the inclusion criteria from January to June 2022 at Prof. dr. I.G.N.G Ngoerah Hospital, Bali. Variables assessed in this study included age, gender, delivery methods, birth status, birthweight, blood culture, complete blood count (CBC), I/T ratio, and IG ratio. Data were analyzed using SPSS version 23 for Windows. Results: The cut-off point of the IG Ratio was 2.21 (AUC...

International Journal of Pharmaceutical Research

Hepcidin levels increased significantly with increased of iron stores in early phase of acute leu... more Hepcidin levels increased significantly with increased of iron stores in early phase of acute leukemia patients when erithropoisis pressed by blast cells in bone marrow, then decreased significantly with acute leukemia remission. The study aimed to determine role of hepcidin in activity of erythropoisis and serum iron reserves in acute lymphoblastic leukemia (ALL) patients during phase of therapy. This study used an observational analytic design. Serum hepcidin examination used ELISA methods. Erythropoisis activity was determined by complete blood and reticulocyte percentage. Iron reserves was determined by serum iron and ferritin levels by ECLIA. Result shows a total of 48 patient subjects were divided into groups of induction, consolidation and maintenance phase with an average age of 6.81 years (induction), 9.7 years (consolidation) and 7.8 years (maintenance). In the normality test with Shapiro-Wilk data showed abnormal distribution (p <0.05). Analysis by the Kruskal-Wallis test showed there were differences between the three treatment phases in the examination of hemoglobin, reticulocytes, serum iron, ferritin and hepcidin (p <0.05). In statistical analysis with Spearman's rank correlation shows there is a significant correlation between hemoglobin with ferritin (r =-0.416, p = 0.003), hemoglobin with hepcidin (r =-0.305, p = 0.035), reticulocytes with hepcidin (r =-0.496), p = 0.000) and serum iron with hepcidin (r =-0.302, p = 0.037). We concluded that the higher levels of hepcidin indicate lower levels of hemoglobin, reticulocytes and serum iron in patients with acute lymphoblastic leukemia during treatment phase.

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: Insulinoma is a functional neuroendocrine tumor in the pancreas that can cause hypogl... more BACKGROUND: Insulinoma is a functional neuroendocrine tumor in the pancreas that can cause hypoglycemia due to endogenic hyperinsulinism. Insulinoma is a rare case with an incidence of 1–4 cases per million people each year. Insulinoma can occur at various ages and mostly occurs in adults with a predominance in women. CASE REPORT: A baby boy aged 1 month 23 days was referred from Prof. Dr. W. Z. Johannes Hospital with the chief complaint was seizures. The results of the examination of blood glucose levels at Sanglah Hospital were 28 mg/dl. There were some episodes of normal blood glucose level in the patient after having some doses of glucose infusion therapy. However, it was only for a while, the blood glucose level came back low and induced the symptoms of the seizure (neuroglycopenia). The seizures stopped after having anticonvulsant therapy and blood glucose levels within normal limits. These symptoms were consistent with the Whipple triad in insulinoma. The patient has an eleva...

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: Human immunodeficiency virus (HIV) infection is an infectious disease caused by the H... more BACKGROUND: Human immunodeficiency virus (HIV) infection is an infectious disease caused by the HIV-1 or HIV-2 virus. Cluster of differentiation 4+ (CD4+) T lymphocytes have an important role in the immune process. Chemokine Ligand 13 (CXCL13) is chemotactic for receptor-expressing cells (CXCR5), including B cells and follicular helper (Tfh) T cells. CXCL13 examination can be used to detect HIV antibodies and as a marker of disease progression and monitoring anti-retrovirus therapy (ART) in HIV-infected patients. Giving ART will reduce CXCL13 levels and show B cell activation, so CXCL13 can be used as a new marker of immune or antibody formation during acute or chronic HIV infection. CXCL13 examination can be used to detect HIV antibodies and as a marker of disease progression and monitoring ART in HIV-infected patients. Giving ART will reduce CXCL13 levels and show B cell activation, so CXCL13 can be used as a new marker of immune or antibody formation during acute or chronic HIV i...

Open Access Macedonian Journal of Medical Sciences, Feb 23, 2022

INTRODUCTION: Insulinoma is congenital hyperinsulinism of infancy (CHI). It is a type of function... more INTRODUCTION: Insulinoma is congenital hyperinsulinism of infancy (CHI). It is a type of functional neuroendocrine tumor (NET) in the pancreas that manifests with persistent hypoglycemia caused by inappropriately high secretion of insulin (hyperinsulinemia). Comprehensive and multidisciplinary management is required for a better outcome. CASE PRESENTATION: A 2-months-old girl came to the Emergency unit Sanglah Hospital, with a chief complaint of seizure. The patient had a low blood glucose level, high fasting insulin, high LDH, computed tomography of the abdomen result showed isodense heterogeneous lesions border in the cauda pancreas with size 1.32 × 1.24 × 1.35 cm. The anatomy-pathological result showed pancreatic neuroendocrine tumor WHO Grade II, functional, consistent, and clinically to insulinoma on the tail of the pancreas. The patient was treated with hydrocortisone, nifedipine, and octreotide. The patient underwent laparotomy partial pancreatectomy. In post-surgery condition, she had good drink tolerance, no episode of recurrent seizure, and blood glucose was controlled. CONCLUSION: Insulinoma is a rare disease. The diagnosis was challenging. This case report presents the diagnostic work-up and management of a patient with a persistent hypoglycemia condition that was diagnosed as insulinoma.

Malaysian Journal of Medicine and Health Sciences, 2021

Bali Journal of Anesthesiology, 2022

Background: New biomarkers are urgently needed to predict the severity of patients infected with ... more Background: New biomarkers are urgently needed to predict the severity of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eosinophil count and neutrophil-to-lymphocyte ratio (NLR) are new biomarkers for the severity of viral infection. Pentraxin 3 (PTX3) is a natural humoral immune mediator that can bind to viruses, complement, and apoptotic cells, and can trigger T-helper type 1 (Th1) to produce pro-inflammatory cytokines and their levels increase depending on the severity of the disease. Materials and Methods: This was a case-control study consisting of 66 patients infected with SARS-CoV-2 who were divided into critical patients (Group C) and noncritical patients (Group N). We obtained lab samples from the subjects upon admission. We then analyzed the data using the Mann–Whitney U test, receiving operator characteristic (ROC) analysis, and chi-square test with odds ratio (OR) to test the hypothesis. Results: Median eosinophil count, NLR, and PT...

Indonesia Journal of Biomedical Science, 2021

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2021

Patients with Type 2 Diabetes Mellitus (T2DM) have an increased prevalence of dyslipidemia, which... more Patients with Type 2 Diabetes Mellitus (T2DM) have an increased prevalence of dyslipidemia, which contributes to ahigher risk of dyslipidemia- related complications in T2DM such as cardiovascular disease and stroke. This study aimed todetermine the correlation between TG and VLDL-C towards HbA1c levels in a person with T2DM. A retrospective study of 74outpatients with T2DM at Sanglah General Hospital, Denpasar, who examined serum HbA1c and lipid profiles were tracedfor serum TG. From the obtained TG profile, a secondary calculation of VLDL was carried out using the Friedewald equation(TG/5). A correlation test was used to determine the relationship between TG and VLDL-C towards HbA1c levels. Serum TG(212.95Â±147.46 mg/dL) and VLDL (36.69Â±23.54 mg/dL) were found to be higher in the group with poor glycemic control(HbA1c > 7 mg/dL) compared to serum TG (111.00Â±39.56 mg/dL) and VLDL (21.05Â±6.13 mg/dL) in the group with goodglycemic control (HbA1c â‰¤ 7 mg/dL) (p < 0.05). A pos...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2018

Diabetic retinopathy is a complication of diabetes mellitus in the form of microvascular (aneurys... more 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...

Indonesian Journal of Clinical Pathology and Medical Laboratory, 2011

Anaemia is an important complication of malaria, and its pathogenesis is not well understood. Hig... more Anaemia is an important complication of malaria, and its pathogenesis is not well understood. High level of the Th2 cytokine (such as IL-10), which counteract the Th1 cytokine, might prevent the development of severe malarial anaemia. The purpose of this study was to know the comparation between the plasma level of IL-10 in malaria falciparum patients with anaemia and without anaemia. The plasma level of IL-10 was examined in 16 malaria falciparum patients with anaemia and 16 malaria caused by P. falciparum patients without anaemia samples taken from patients at the primary health centres in West Lombok and Centre Lombok during March until July 2008. The samples were measured using ELISA. The concentration of haemoglobin (Hb) was measured using hematological analyzer. The anaemia concentration of Hb is < 11 g/dL. The results were analyzed using two (2) sample t test with SPSS ver.13.The plasma level of IL-10 in malaria patients caused by P. falciparum with anaemia was 8.81(3.04) ...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2018

Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The ... more Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The examination of creatinine and uricacid in urine is done on 24-hour urine collection. During the storage of the urine, it is recommended to be stored in a refrigerator withthe grade temperatures ranging from 2â€“8Â°C and is not recommended to use any preservative for the examination of creatinine anduric acid in urine. To know the comparation of creatinine and uric acid concentrations in urine between the urine tested immediatelyafter the collection with urine that was stored at a temperature 2â€“8Â°C and those at room temperature for 24 hours. A total of 45 urinesamples from outpatient clinic that came to the laboratory, were collected in particular urine vacutainer. Each urine sample is divided intothree tubes. The first tube (P1) examined concentrations of creatinine and uric acid immediately after collection, was considered as thebaseline value. The second tube (P2) stored at 2â€“8Â°C...

Indonesian Journal of Clinical Pathology and Medical Laboratory, 2015

Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The ... more Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The examination of creatinine and uric acid in urine is done on 24-hour urine collection. During the storage of the urine, it is recommended to be stored in a refrigerator with the grade temperatures ranging from 2–8°C and is not recommended to use any preservative for the examination of creatinine and uric acid in urine. To know the comparation of creatinine and uric acid concentrations in urine between the urine tested immediately after the collection with urine that was stored at a temperature 2–8°C and those at room temperature for 24 hours. A total of 45 urine samples from outpatient clinic that came to the laboratory, were collected in particular urine vacutainer. Each urine sample is divided into three tubes. The first tube (P1) examined concentrations of creatinine and uric acid immediately after collection, was considered as the baseline value. The second tube (P2) stored at 2–8°C a...

Indonesian Journal of Clinical Pathology and Medical Laboratory, 2014

Diabetic retinopathy is a complication of diabetes mellitus in the form of microvascular (aneurys... more 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 inflammation plays the role on artherosclerosis event, because it is directly correlated with all phases of it and cardiovascular disease as well. The aim of this study is to know the difference in plasma IL-6 levels among patients suffering from diabetes mellitus together with diabetic retinopathy and without diabetic retinopathy. This study is an observational analytical research with cross sectional design. The samples were taken randomly as many as 16 patients, divided in each group suffering from or without retinopathy. The diabetic mellitus patients were 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 a...

Journal of Global Pharma Technology, 2018

Introduction: Electrolytes measurement is a standard procedure in medical practice to diagnose di... more Introduction: Electrolytes measurement is a standard procedure in medical practice to diagnose diseases or disease-related complication. Recently, there is a various device used to analyze blood electrolytes, but the difference accuracy between devices is a problematic issue for clinicians. Thus, we evaluate the differences of sodium and potassium concentration reading by Blood Gas Analyzer (BGA) and Electrolyte Analyzer at Sanglah Hospital to assess whether the difference could be accepted according to Clinical Laboratories Improvement Amendments (CLIA). Methods: A cross-sectional analytic study was conducted in May 2017 at Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. 30 subjects were enrolled consecutively during the study period and the blood samples were analyzed by both BGA and electrolyte analyzer. The data were analyzed using paired T-Test, Bland-Altman Plot, and Linear Regression. Result: The mean of sodium and potassium measured by BGA were 133.76 ± 5.68 mm...

e-Jurnal Medika Udayana, 2016

DBD merupakan penyakit yang masih menjadi masalah kesehatan masyarakat. Dalam menegakkan diagnosi... more DBD merupakan penyakit yang masih menjadi masalah kesehatan masyarakat. Dalam menegakkan diagnosis DBD dapat ditentukan dari gambaran klinis dan pemeriksaan penunjang. Salah satu pemeriksaan penunjang yang dapat dilakukan yaitu pemeriksaan serologi. Dalam pemeriksaan serologi akan didapatkan respon imun tubuh terhadap virus dengue. Yang mana akan menyebabkan tubuh membentuk antibodi IgM dan IgG. Dari antibodi tersebut dapat ditentukan jenis infeksi, berupa infeksi primer dan infeksi sekunder. Penelitian ini merupakan penelitian cross sectional dengan metode deskriptif. Data penelitian diperoleh dengan mengkaji secara langsung data pasien dilaboratorium Rumah Sakit Umum Pusat Sanglah yang dirawat inap bulan Agustus sampai September 2014. Subjek penelitian berjumlah 36 pasien. Data yang diperoleh kemudian dipresentasikan dalam bentuk tabel dan narasi. Data serologi IgM dan IgG kemudian dikelompokkan sesuai dengan pola infeksi dengue. Dari 36 sampel didapatkan jumlah laki-laki 17 (47%...