Ria Bandiara
Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran/ Rumah Sakit Hasan Sadikin Bandung

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Sclerostin Serum Concentration in Patients with Predialysis Ckd Stage 3-5 Pura, Lukman; Bandiara, Ria; Gondodiputro, Rubin S
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2018): September - December 2018
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (706.769 KB) | DOI: 10.32867/inakidney.v1i1.3

Abstract

Sclerostin is a glycoprotein expressed by osteocytes and plays a role in bone turnover in themetabolism of the bone. Sclerostin blocks the formation of a ligand with its receptor on theWnt/β-catenin pathway, and influences the activity of osteoblasts. Sclerostin also influencesmineral and bone disturbances in CKD via the interaction between kidney, bone and vascularaxis. The concentration of sclerostin will rise especially in patients with ESRD undergoingdialysis. Concentration of sclerostin has not been reported yet in non-dialysis CKD patientstage 3-5 and the aim of this study is to see sclerostin concentration on those population. Methods This is a descriptive and cross-sectional study designed to measure sclerostinconcentration in non dialysis patients with CKD stage 3-5. The sclerostin concentration ismeasured using an enzyme-linked immunosorbent assay kit. CKD stages are diagnosed usingthe KDIGO-2012 criteria which measures the estimated GFR (eGFR) with the formulation of EPICKD. Fifty six patients with CKD stage 3-5 were enrolled in this study and one way ANOVA comparative test followed with a post hoc analysis using Benferroni test to analysethe data. Results The mean concentration level of serum sclerostin in this population is (79.7+ 41.2) pmol/L, and in patients with CKD stage 3, CKD stage 4, and CKD stage 5 are (59.6 +28.5) pmol/L, (71.9 + 42.2) pmol/L and (96.7 + 39.8) pmol/L respectively. The comparativetest of mean concentrations of the serum sclerostin between stages of CKD are statisticallysignificant with a p=0.022. The post hoc analysis of serum sclerostin concentration betweenCKD stage 3 and CKD stage 5 have a significant difference with a mean of 37 pmol/L andp=0.037. Conclusion, The serum sclerostin concentration rise in accordance with the declineof kidney function in patients with pre-dialysis CKD stage 3-5.
Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak Putra, Ridwan A.; Zulqarnain, Iskandar; Azis, Zaimursyaf; Effendi, Jusuf S.; Permadi, Wiryawan; Bandiara, Ria
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.648 KB) | DOI: 10.32771/inajog.v7i3.1026

Abstract

Abstract Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section. Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia. Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used. Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group. Keywords : cesarean section, oxytocin, uterine atony.   Abstrak Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea. Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum. Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini. Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU. Kata kunci : atonia uteri, oksitosin, seksio sesarea.
Effects of Compression Stockings on the Risk of Obstructive Sleep Apnea (OSA) in Hemodialysis Patients Astilia, Astilia; Bandiara, Ria; Kosasih, Cecep Eli; Ibrahim, Kusman
Nurse Media Journal of Nursing Vol 10, No 2 (2020): (August 2020)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/nmjn.v10i2.24527

Abstract

Background: Obstruction Sleep Apnea (OSA) in hemodialysis patients is a sleep disorder that involves stopping or decreasing air flow to breathe during sleep due to excess fluid in the leg. Compression Stockings (CS) with 30-40 mmHg are high pressure elastic stockings that are assumed to reduce foot fluid accumulation during the day and to prevent overnight fluid shifting to the neck.Purpose: This study aimed to determine the effects of 30-40 mmHg CS on the risk of OSA in hemodialysis patients.Method: This research used a quasi-experimental pre-posttest with control group design. A purposive sampling was applied to recruit as many as 68 hemodialysis patients. The risk score of OSA was measured using STOP Bang questionnaire. High pressure CS were given for one week to the intervention group with two OSA measurements on the 4th and 7th days. The data then were analyzed using the Post Hoc Wilcoxon test and the Mann Whitney test.Results: There was a significant difference between the risk score for OSA before and after the use of 30-40 mmHg Compression Stocking in the intervention group on day 4 (p=0.000) and day 7 (p=0.000) compared to the control group.Conclusion:  High pressure CS decreased the risk of OSA in hemodialysis patients by avoiding fluid retention in the legs, thus preventing fluid shifting to the neck. CS should be recommended as an alternative to prevent the risk of OSA in hemodialysis patients.
HUBUNGAN LAJU FILTRASI GLOMERULUS DENGAN STATUS NUTRISI PADA PENDERITA PENYAKIT GINJAL KRONIK PREDIALISIS Pura, Lukman; Supriyadi, Rudi; Nugraha, Gaga Irawan; Bandiara, Ria; Soelaeman, Rachmat
Majalah Kedokteran Bandung Vol 41, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Malnutrisi banyak terjadi pada penderita penyakit ginjal kronik (PGK). Prevalensi malnutrisi pada penderita predialisis sekitar 44%. Penyebab malnutrisi pada penderita PGK predialisis bersifat multifaktorial. Hubungan laju filtrasi glomerulus (LFG) dengan status nutrisi gabungan menggunakan albumin serum, indeks massa tubuh (IMT) dan subjective global assessment (SGA) masih belum banyak diteliti. Penelitian ini bertujuan mencari hubungan LFG dengan parameter nutrisi gabungan pada subjek PGK predialisis yang berkunjung ke poliklinik ginjal hipertensi RS Hasan Sadikin Bandung dari bulan September sampai Oktober 2008. Data sekunder dan primer dikumpulkan secara konsekutif. Pemeriksaan meliputi penilaian klinis, laboratorium, dan LFG dengan metode in vivo. Analisis statistik menggunakan uji Mann-Whitney untuk melihat hubungan LFG dengan status nutrisi gabungan dengan multiple utility assessment criteria (MUAC). Tujuh puluh dua subjek terdiri dari 48 laki-laki dan 24 perempuan memenuhi kriteria penelitian. Sebanyak 79,2% subjek dengan usia di atas 50 tahun dan 54,2% dengan penyebab sakit hipertensi. Rata-rata LFG 32,62 mL/mnt, albumin serum 4,10 g/dL dan IMT 23,87 kg/m2 . Terdapat 80,6% subjek dengan status gizi buruk dan 19,4% dengan gizi baik. Menggunakan metode MUAC, 70 subjek dengan kategori gizi baik dan 2 subjek dengan gizi buruk. Hubungan LFG terhadap parameter nutrisi ditentukan dengan uji Rank-Spearman dan hasil tidak bermakna terhadap semua variabel nutrisi (p >0,05). Hubungan LFG terhadap parameter nutrisi gabungan memberikan hasil tidak bermakna (p> 0,05). Kesimpulan: terdapat hubungan yang sangat kecil antara LFG terhadap perubahan parameter nutrisi gabungan, dengan jumlah sampel 72 subjek tidak dapat mendeteksi adanya hubungan yang bermakna.Kata kunci: PGK, LFG, albumin serum, IMT, SGATHE CORRELATION BETWEEN GLOMERULAR FILTRATION RATE (GFR) AND NUTRITIONAL STATUS INPEDIALYTIC CHRONIC KIDNEY DISEASE PATIENTSProtein-energy malnutrition (PEM) is common in chronic kidney disease (CKD) patients. The prevalence of malnutrition in predialytic patients was approximately 44%. The causes of malnutrition in CKD patients are multifactorial. The correlation of glomerular filtration rate (GFR) and combined nutritional parameter such as serum albumin, body mass index (BMI) and subjective global assessment (SGA) is more need to study. The study aimed to find the correlation GFR and the combined nutritional parameter in predialytic CKD patients who attended the Nephrology-Hypertension Clinic of Hasan Sadikin Hospital between September and October 2008. The secondary and primary data were collected consecutively. The evaluation consisted of clinical assessment of nutritional status, laboratory values, and GFR by in vivo method. The combined nutritional parameter was classified into two groups using multiple utility assessment criteria (MUAC). Statistical analysis with Mann-Whitney test was used to find the correlation. Seventy two subjects (48 men and 24 women) fulfilled the criteria. The majority (79.2%) were older than 50 years old and 54.2% the causes of CKD were hypertension. The median GFR was 32.62 mL/mnt, serum albumin was 4.10 g/dL, and BMI was 23.87 kg/m2 . There were 80.6% subjects with malnourished status, 19.4% with normal status. Using MUAC assessment, 70 subjects with normal nutritional status and 2 with severe malnutrition.We found no significant correlation between GFR and any nutritional parameter (p>0.05). The correlation of GFR and combined nutritional parameter was not significant (p>0.05). Conclusion: There is minimal correlation of GFR and combined nutritional parameter, with 72 samples size the correlation cannot be detectedsignificantly.Key words: CKD, GFR, serum albumin, BMI, SGA DOI: http://dx.doi.org/10.15395/mkb.v41n1.180