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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HUBUNGAN TEKANAN DARAH DENGAN KEJADIAN STROKE ISKEMIK PADA PENDERITA DIABETES MELLITUS TIPE 2 Muliawati, Ratna; Muliawati, Ratna; Pemayun, Tjokorda Gde Dalem; Hadisaputro, Suharyo
Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Vol 8 No 1 (2018): April
Publisher : LPPM STIKES KENDAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.333 KB) | DOI: 10.32583/pskm.8.1.2018.49-55

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ABSTRAK Stroke menempati urutan kedua penyebab kematian dan penyebab utama kecacatan jangka panjang. Prevalensi stroke pada penderita Diabetes Mellitus Tipe 2  (DMT2) mengalami peningkatan dan penderita diabetes berisiko 3-4 kali lebih besar menderita stroke iskemik dibandingkan non-diabetes. Penderita DMT2 seringkali disertai dengan tekanan darah tinggi. Informasi mengenai hubungan tekanan darah denganstroke iskemik pada penderita DMT2 masih terbatas. Penelitian ini bertujuan untuk mengetahui hubungan tekanan darah dengan stroke iskemik pada penderita DMT2. Penelitian ini merupakan penelitian observasional analitik dengan desain kasus-kontrol. Kelompok kasus adalah 48 orang penderita stroke iskemik dengan DMT2, dan kontrol adalah 48 orang penderita stroke iskemik non DM. Pengambilan sampel dengan consecutive sampling. Pengumpulan data melalui catatan rekam medis penderita stroke iskemik di RSUP dr. Kariadi Semarang. Data dianalisis secara bivariat dengan menggunakan chi square test. Hasil penelitian menunjukkan bahwa ada hubungan antara tekanan darah tinggi dengan kejadian stroke iskemik pada penderita DMT2 (nilai p 0,044, OR (95%CI) sebesar 2,88 (1,00 ? 8,30. Penderita DMT2 disarankan untuk mengontrol tekanan darah agar dapat meminimalkan risiko terjadinya stroke iskemik.   Kata kunci : Tekanan Darah, Stroke Iskemik, Diabetes Mellitus Tipe 2   THE RELATIONSHIP OF BLOOD PRESSURE WITH ISCHEMIC STROKE IN PATIENTS WITH DMT2   ABSTRACT Stroke is the second leading cause of death and the leading cause of long-term disability. The prevalence of stroke in patients with Diabetes Mellitus Type 2 (DMT2) has increased and diabetics are at 3-4 times greater risk of ischemic stroke than non-diabetics. People with DMT2 are often accompanied by high blood pressure. Information on the relationship of blood pressure with ischemic stroke in patients with DMT2 is still limited. This study aims to determine the relationship of blood pressure with ischemic stroke in patients with DMT2. This study is observational analytic study with case-control design. The case group was 48 ischemic stroke patients with DMT2, and control was 48 people with non-DM ischemic stroke patients. This study used consecutive sampling. Data collection through medical records of patients with ischemic stroke in dr. Kariadi Semarang. Data were analyzed by chi square test. The results showed that there was a correlation between high blood pressure and the incidence of ischemic stroke in patients with DMT2 (p value 0.044, OR (95% CI) of 2.88 (1.00 to 8.30). DMT2 patients were advised to control blood pressure in order to minimize the risk of ischemic stroke.   Keywords: Blood Pressure, Ischemic Stroke, Diabetes Mellitus Type 2
HUBUNGAN STATUS IODIUM IBU HAMIL TRIMESTER III DENGAN STATUS IODIUM DAN NILAI ANTROPOMETRI BAYI BARU LAHIR DI DAERAH GAKI Pibriyanti, Kartika; SS, Darmono; Pemayun, Tjokorda Gde Dalem
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 5, No 2 (2017)
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.208 KB) | DOI: 10.14710/jgi.5.2.75-81

Abstract

Background: Iodine essential for thyroid hormone synthesis. Women in their pregnancy are susceptible of Iodine Deficiency Disorder (IDD) since they are facing metabolism and hormonal alteration. IDD in pregnant women gave bad impact to the growth and development of the fetus. Determinant of the life continuity of the newborn babies and their life qualities could be seen through the newborn baby condition based on their body size proportions right after the birth. Objective : Explaining the impact of the iodine status of the pregnant women in their third trimester to the iodine status and anthropometric values of the newborn babies.Method : This research used non experimental study design cross sectional to 52 pregnant women in their third trimester with the babies. The Urinary Excretion of Iodine (UEI) for the examination of iodine status. To the newborn babies, UEI examination and anthropometric measurement, consists of weight birth (WB), length birth (LB), head circumference (HC) were done. Result : There is a significant correlation between the mothers? UEI and the LB of the newborn babies (p=0,018). There is no significant correlation between mothers? UEI and the babies? UEI (p=1,000), mothers? UEI and the WB of the newborn babies (p=0,548), mothers? UEI and the newborn babies? HC (p=0,885).Conclusion : There is a significant correlation iodine status of the pregnant women in their third trimester <150 µg/L with the LB of the newborn babies <48 cm, but there is no significant correlation with the UEI of the newborn babies <100 µg/L, WB <2500 gram, HC<34 cm.
Faktor-Faktor Risiko Kejadian Kaki Diabetik pada Penderita Diabetes Melitus Tipe 2 (Studi Kasus Kontrol di RSUP dr. M. Djamil Padang) Rina, Rina; Setyawan, Henry; Nugroho, Heri; Hadisaputro, Suharyo; Pemayun, Tjokorda Gde Dalem
Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 2: Agustus 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2396.077 KB) | DOI: 10.14710/j.e.k.k.v1i2.3943

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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) Muliawati, Ratna; Pemayun, Tjokorda Gde Dalem; Hadisaputro, Suharyo; Samekto, Widiastuti; Juliati, Hari Peni
Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 1: Februari 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (388.618 KB) | DOI: 10.14710/j.e.k.k.v1i1.3938

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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 Sari, Gracilaria Puspa; Chasani, Shofa; Pemayun, Tjokorda Gde Dalem; Hadisaputro, Suharyo; Nugroho, Heri
Jurnal Epidemiologi Kesehatan Komunitas Vol 2, No 2: Agustus 2017
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.003 KB) | DOI: 10.14710/jekk.v2i2.3996

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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. 
PENGARUH PEMBERIAN EKSTRAK KEDELAI HITAM (GLYCINE SOJA.) BERBAGAI DOSIS TERHADAP KADAR GLUKOSA DARAH, KADAR INSULIN, DAN HOMA-IR Kurniawati, Dewi M; Dharmana, Edi; Rachmawati, Banundari; Pemayun, Tjokorda Gde Dalem
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 6, No 1 (2017)
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (246.408 KB) | DOI: 10.14710/jgi.6.1.44-50

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Background: Obese is risk factor for abnormal glucose homeostasis and causes oxidative stress that can decrease insulin sensitivity resulting in hyperglycemia and hyperinsulinemia. Black soy bean contains anthocyanins and isoflavones, it is expected to reduce oxidative stress. Objective: Determine the effect of various dosage of black soybean extract (Glycine soja.) on blood glucose, insulin levels, and HOMA - IR in obese Sprague Dawley (SD) rats.Methods: True experimental study with randomized controlled pre test-post test design in male SD rats. Twenty four samples divided into 4 groups: control (K), 500 (P1), 750 (P2), and 1000 mg/kgBW (P3). Rats were induced to become obese with High Fat Sucrose Diet (HFSD) for 4 weeks then black soybean extracts were given for 2 weeks..Results: There was no difference in blood glucose before and after treatment (p> 0.05). There were differences on insulin levels in 500 (p = 0.012) and 750mg/kgBW (p = 0.020) doseges. There were differences on HOMA-IR in 500 (p = 0.043) and 750mg/kgBW (p = 0.028) dosages. There was difference in insulin levels?s difference (p = 0.009) between groups.Conclusion: There are differences on insulin levels and HOMA ? IR in 500 and 750 mg/kgBW dosages groups. However, there is no difference on blood glucose before and after black soybean extract treatment. The most decreased levels of blood glucose, insulin and HOMA- IR were in 750mg/kgBW dosage.
DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia Cholil, Achmad Rudijanto; Lindarto, Dharma; Pemayun, Tjokorda Gde Dalem; Wisnu, Wismandari; Kumala, Poppy; Puteri, Happy Helene Sulung
Medical Journal of Indonesia Vol 28, No 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (350.802 KB) | DOI: 10.13181/mji.v28i1.2931

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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 &lt;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.
HUBUNGAN STATUS BESI DAN IOIDUM IBU HAMIL TRIMESTER III TERHADAP BERAT BADAN DAN LINGKAR KEPALA BAYI LAHIR DIDAERAH ENDEMIK GAKI Novitasari, Sherly; Hadisaputro, Soeharyo; SS, Darmono; Rachmawati, Banundari; Pemayun, Tjokorda Gde Dalem
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 5, No 1 (2016)
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (257.266 KB) | DOI: 10.14710/jgi.5.1.1-6

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Background: Iodine and iron were micronutrient that highly related with formation of thyroid hormone. Iodine and iron deficiency during pregnancy, will affect fetal development. Weight and born baby?s head circumference were early indicator of infant development, because it describe the result of interaction of several factors for fetus during pregnancy. Objectives: To determine correlation between iodine and iron status of pregnant women in third trimester with born baby?s weight and head circumference. Methods: Cross sectional study with 49 pregnant women on third trimester and their baby born. Measurement of iron status used sTfR level by ELISA and iodine status used EIU. Meanwhile for the born baby, measurement was taken place on the baby?s weight and head circumference. Results: The average of iron status is 22,15 nmol/L, meanwhile average of iodine status is 168,63 ?g/L with urine median value 165 ?g/L. Statistical analysis with multiple correlation test showed no significant relationship between iron and iodine status of third trimester pregnant women to birth weight (r = 0,286; p = 0,141) as well as the babies head circumference (r = 0,195; p = 0,412).Conclusion: Iron and iodine status of third trimester pregnant women have low correlation to the born babies weight or head circumference in endemic area.
HOMOSISTEIN PLASMA DAN PERUBAHAN SKOR FUNGSI KOGNITIF PADA PASIEN PASCA STROKE ISKEMIK Yudawijaya, Agus; Kustiowati, Endang; Pemayun, Tjokorda Gde Dalem
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 1 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (119.104 KB)

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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.