Tjokorda Gde Dalem Pemayun
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Diponegoro/RSUP Dr. Kariadi, Jl. Dr. Sutomo 16-18 Semarang

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Homosistein Plasma dan Perubahan Skor Fungsi Kognitif pada Pasien Pasca Stroke Iskemik

MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 1 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

ABSTRACTPlasma homocysteine and cognitive function score change in post ischemic stroke patients Background: Increase of total homocysteine level is a strong risk factor for cerebrovascular disorder and is correlated with decrease of performance in sort of cognitive tests, including mini mental state examination (MMSE) and clock drawing test (CDT). The aim of this study was to prove the correlation between plasma homocysteine level and change in cognitive function score in postischemic stroke patients. Methods: The design was cross-sectional. The subjects were post-ischemic stroke patients, treated at B1-ward Dr. Kariadi Hospital Semarang from January-June 2010. Plasma homocysteine levels were measured on the first week post onset of ischemic stroke using venous blood at GAKI Laboratory Dr. Kariadi Hospital and cognitive function score was examined using MMSE and CDT on the first and 12th week post onset. Datas were analyzed using descriptive analysis and Spearman’s rho correlation test. Results: Of 30 patients, there were 13 patients with homocysteinemia (43.3%) and 17 with hyperhomocysteinemia (56.7%). There was significant difference of MMSE and CDT score decrease in the first and 12th post onset, with p=0.000 and p=0.001 respectively. Spearman’s rho showed correlation between plasma homocysteine level and cognitive function score based on MMSE with r=-0.837; p=0.000, and based on CDT with r=-0.655; p=0.000. Conclusions: There is strong negative correlation between plasma homocysteine level and change in cognitive function score on the first week post onset of ischemic stroke. Keywords: Homocysteine level, cognitive function score, post-ischemic stroke   ABSTRAK Latar belakang: Peningkatan kadar homosistein plasma merupakan faktor risiko kuat terjadinya penyakit  serebrovaskuler dan dihubungkan dengan penurunan performa sederet tes-tes kognitif, termasuk MMSE (mini mental state examination) dilengkapi oleh CDT (clock drawing test). Tujuan penelitian ini adalah membuktikan hubungan antara homosistein plasma dengan perubahan skor fungsi kognitif pada pasien pasca stroke iskemik. Metode: Desain penelitian adalah cross sectional, pasien pasca stroke iskemik dirawat di Bangsal B1 Saraf RSUP Dr. Kariadi Semarang mulai Januari 2010 sampai Juni 2010. Pemeriksaan homosistein plasma dilakukan pada I minggu pasca onset stroke iskemik menggunakan darah vena di Laboratorium GAKI RSUP Dr. Kariadi dan pemeriksaan skor fungsi kognitif dengan tes MMSE dan CDT dilakukan pada I dan XII minggu pasca onset stroke iskemik. Data di analisis dengan statistik deskriptif dan uji korelasi Spearman’s rho.  Hasil: Didapatkan homosisteinemia pada 13 orang (43,3%) dan hiperhomosisteinemia pada 17 orang (56,7%). Terdapat perbedaan bermakna penurunan skor MMSE dan CDT pada I dan XII minggu pasca onset stroke iskemik dengan nilai p=0,000 dan p=0,001. Uji korelasi Spearman’s rho, menunjukkan koefisien korelasi homosistein plasma dengan skor fungsi kognitif berdasarkan MMSE adalah r=-0,837; p=0,000, sedangkan berdasarkan skor CDT adalah r=-0,655; p=0,000. Simpulan: Didapatkan adanya hubungan kuat dan negatif antara homosistein plasma dengan perubahan skor fungsi kognitif pada I minggu pasca onset stroke iskemik.

CIRI-CIRI KARAKTERISTIK PENDERITA DIABETES MELITUS DENGAN OBESITAS DI POLIKLINIK ENDOKRIN RSUP DR KARIADI SEMARANG

MEDIA MEDIKA MUDA Vol 3, No 1 (2014): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Latar Belakang Prevalensi diabetes melitus (DM) di dunia semakin meningkat, DM yang memiliki indeks massa tubuh (IMT) ≥ 30 kg/m2 berisiko terjadinya komplikasi makro dan mikroangiopati diabetika.Tujuan Mengetahui ciri-ciri karakteristik penderita DM dengan obesitas.Metode Penelitian deskriptif menggunakan data sekunder dari catatan medik pasien DM dengan obesitas di Poliklinik Endokrin RSUP dr. Kariadi Semarang selama 2 bulan (Oktober – November 2013).Hasil Ciri-ciri karakteristik penderita DM dengan obesitas: perempuan (55,6%), usia 56-60 tahun (22,2% laki-laki dan 16,7% perempuan), berdomisili kota Semarang (88,9%), rata-rata lama menderita DM 5,1 ± 4,3 tahun, rata-rata lamamenderita obesitas 4,3 ± 3,1 tahun, kadar gula darah puasa > 126 mg/dL (66,7%), kadar gula darah 2 jam post prandial > 200 mg/dL (66,7%), rata-rata kadar kolesterol HDL 44,0 ± 9,2 mg/dL, rata-rata kadar kolesterol LDL 126,1 ± 25,3mg/dL, rata-rata kadar trigliserida 139,6 ± 58,5 mg/dL, rata-rata kadar kolesterol total 200,8 ± 28,0 mg/dL.Kesimpulan DM dengan obesitas terbanyak pada perempuan, usia 56-60 tahun, rata-rata lama menderita DM 5,1 ± 4,3 tahun, dan rata-rata lama menderita obesitas 4,3 ± 3,1 tahun

CIRI – CIRI KARAKTERISTIK PENDERITA NODUL TIROID DI POLIKLINIK ENDOKRIN DAN POLIKLINIK BEDAH RSUP DR. KARIADI SEMARANG

MEDIA MEDIKA MUDA Vol 3, No 1 (2014): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Latar Belakang Nodul tiroid merupakan jenis neoplasma yang paling sering ditemukan di klinik. Prevalensi nodul berkisar antara 5 – 50% dan meningkat sesuai pertambahan usia.Tujuan Mengetahui ciri - ciri karakteristik penderita nodul tiroidMetode Penelitian deskriptif menggunakan data sekunder dari catatan medik pasien nodul tiroid di Poliklinik Endokrin dan Poliklinik Bedah RSUP dr. Kariadi Semarang periode 2013.Hasil Ciri – ciri karakteristik penderita nodul tiroid : perempuan (91, 8%), usia 36 – 40 tahun (15%), riwayat keluarga (7,2%),domisili Semarang (36,1%). Nodul multipel (53,6%), lokasi bilateral (55,7%), dan ukuran ≤ 4,9 cm (61,0%). Pembesaran kelenjar limfe leher 25,8%) dan suara serak (3,1%) kasus.Kesimpulan Perempuan memiliki peluang lebih besar terkena nodul tiroid. Nodul soliter, pembesaran kelenjar limfe leher, atau suara serak perlu curiga keganasan. Penelitian tidak menemukan riwayat paparan radiasi dan obat amiodaron dalam terjangkitnya nodul tiroid.

Faktor-Faktor Risiko Kejadian Kaki Diabetik pada Penderita Diabetes Melitus Tipe 2 (Studi Kasus Kontrol di RSUP dr. M. Djamil Padang)

Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 2: Agustus 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

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Background : Diabetic foot is one of the chronic complications of diabetes mellitus and are the most feared by people who suffer of diabetes mellitus as it can lead to disability or even death. This more specific research on risk factors of the ethnic communities of the Minangkabau society. The purpose of this research is to prove the factors related to the incidence of diabetic foot in people with type 2 diabetes mellitus.Methods : The research applied with mix method were quantitative as the main approach (case control design) and qualitative as support (indepth interview). Target population is all people with a diagnosis of type 2 diabetes mellitus in Padang City, West Sumatera Province there were 172 respondent involved, consisting of 86 cases and 86 controls with concequtive sampling technique. Data analysis included univariat and bivariat analysis using the chi square test and mu ltivariate analysis using multiple logistic regression test.Results : Factors proven to correlate with the incidence of diabetic foot in patients with type 2diabetes mellitus are deformities in legs (p=<0,001), habit of smoking (p=<0,001), age ≥45 years (p=<0,001; OR=27,6; 95%CI=3,96-193,23), a series of ulceration on the legs (p=0,001;), and hypertension (p=0,001), with the probability of 95,88%. Protective factors on the incidence of diabetic foot in patients with type 2 diabetes mellitus is a gender (p=0,002).Conclusion : Risk factors to the incidence of diabetic foot are related of the deformities in the foot, smoking, age, leg ulceration and hypertension

Faktor Risiko Kejadian Stroke Iskemik pada Penderita Diabetes Mellitus Tipe 2 (Studi Kasus di RSUP Dr Kariadi Semarang)

Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 1: Februari 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

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Background : Stroke is the second leading cause of death and a major cause of long term disability. The prevalence of stroke in type 2 diabetes mellitus patients were increased. Diabetic patients have 3-4 times greater risk for ischemic stroke than non-diabetic. Information regarding risk factors for ischemic stroke in patients with type 2 diabetes mellitus is still limited. This study propose to determine risk factors of ischemic stroke in type 2 diabetes patients.Methods : Observational-analytic with case-control design study and qualitative data. Two groups of patients were include in this study, 48 ischemic stroke patient s with type 2 diabetes mellitus and 48 ischemic stroke without diabetes mellitus in Kariadi hospital, used by consecutive sampling. Data were collected by medical records and indepth interview. Data were analyzed by multiple logistic regression and content analysis.Results : Risk factors of ischemic stroke in patients with type 2 diabetes mellitus are hypertension (OR 5.42; 95% CI 1.40 to 20.93), fasting blood glucose levels ≥ 100 mg/dL(OR=2.72; 95%CI=1.13 to 6.56), and microalbuminuria (OR=10.92; 95%CI= 1.46 to 81.66). Age,sex, working status, cholesterol levels, triglycerid levels, HDL levels, LDL levels, total cholesterol/HDL ratio, triglyceride/HDL ratio, LDL/HDL ratio, and hyperuricemia are not statistically significant as a risk factors of ischemic stroke in type 2 diabetes mellitus patients. Conclusion: Hipertension, fasting blood glucose levels ≥ 100 mg/dL and microalbuminuria are significantly risk factors of ischemic stroke in type 2 diabetes mellitus patients. Microalbuminuria is the most dominant risk factor in stroke patients with type 2 diabetes mellitus.

Faktor Risiko yang Berpengaruh terhadap Terjadinya Hipertensi pada Penderita Diabetes Melitus Tipe II di Wilayah Puskesmas Kabupaten Pati

Jurnal Epidemiologi Kesehatan Komunitas Vol 2, No 2: Agustus 2017
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

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Background: The prevalence of hypertension in type 2 diabetic patients is 1,5-3 times higher than it is in nondiabetic individuals This chronic condition accelerates macrovascular complications. Research about risk factors of hypertension in type 2 diabetic patients is still rare because its causes multifactorial. The objectives of this research is to explain the risk factors affecting hypertension in type 2 diabetic patients.Methods: An observational studies with case-control study design in Primary Healthcare Centers patients in Pati District. Patients with hypertension in type 2 diabetes are the case, while the type 2 diabetes patients without hypertension are the control. There were 57 cases and 57 controls included. Data were obtained from medical records and qualitative interviews. Chi-square test in bivariate and multiple logistic regression in multivariate analysis.Results: Factors that influence hypertension in type 2 diabetic patients were physical activity (OR=6,4; 95% CI: 2,18 - 18,77; p=0,001), diabetes duration ≥ 5 years (OR=5,4; 95% CI: 1,97 - 14,704; p=0,001), and medication adherence (OR=3,6; 95% CI: 1,32 - 9,83; p=0,012). Other risk factors i.e age ≥45 years, male, diet compliance, history of hypertension, smoking, salt consumption, coffee consumption, and sleep duration were not significantly influenced.Conclusion: In this study, physical activity, diabetes duration, and DM medication adherence are risk factors that influence of hypertension in type 2 diabetic patients. 

DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia

Medical Journal of Indonesia Vol 28, No 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

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BACKGROUND Indonesia was a part of the most recent edition of DiabCare Asia held in 2008. DiabCare Asia 2012 is modeled after a similar project to provide the latest information to facilitate healthcare policymaking in this area.METHODS This was an observational, non-interventional, cross-sectional study of patients with type 2 diabetes mellitus from primary, secondary, and tertiary care centers in Indonesia. Patient data collected included demography, medical history complications, eye and foot examinations, diabetes management, and most recent laboratory investigations. Blood samples were collected from all patients for the analysis of glycated hemoglobin (HbA1c).RESULTS A total of 1,967 patients participated in the study, with a mean (SD) age of 58.4 (9.5) years and a median (range) duration of diabetes 6.0 (0.1−47.0) years. The percentage of patients with HbA1c <7.0% was 30.8% and the mean (SD) HbA1c level was 8.3 (2.2%). The proportion of patients using insulin was 34.7% with a mean (SD) total daily dose of 37.9 (24.1) IU. The most common diabetes-related complications were peripheral neuropathy (59.1%), erectile dysfunction (32.4%), and eye complications (29.1%).CONCLUSIONS Glycemic and metabolic control remain unsatisfactory in type 2 diabetes patients in Indonesia. Efforts are needed to optimize control and prevent complications in these patients.