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ANALYSIS OF FACTORS ASSOCIATED WITH THE PRESENCE OF AEDES AEGYPTI LARVAE IN WORKING AREA OF COMMUNITY HEALTH CENTRE III, SOUTH DENPASAR Ekaputra, Ida Bagus; Seri Ani, Luh; Suastika, Ketut
Public Health and Preventive Medicine Archive Vol 1 No 2 (2013): Public Health and Preventive Medicine Archive
Publisher : Program Magister Ilmu Kesehatan Masyarakat Universitas Udayana

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The Community Health Center (CHC) III of South Denpasar is one of the endemic areas of Dengue Hemorrhagic Fever (DHF) in Denpasar, Bali Province. Dengue morbidity rate was high (>55 per 100,000 population), while the Percentage of Larvae Free Rate (PLFR) was low (<95%). This study was aimed at discovering the relationship between community's knowledge, attitude, behavior of Aedes aegypti (Ae. aegypti) larvae eradication and environmental health with the existence of Ae. aegypti larvae in the working area of CHC III of South Denpasar. A cross-sectional study was conducted with 147 households using systematic random sampling from a total of 5781 households. The respondents were the head of the family unit. The independent variables were knowledge, attitude, behavior and environmental health, while the dependent variable was the presence of Ae. aegypti mosquito larvae. The data were collected by using interview and observation in the respondent's house using instruments of questionnaire. The data were then analysed in stages covering the univariate, bivariate and multivariate analysis. Results indicated the PLFR was 87.1%. The variables related to the existence of larva were behavior (PR=17.89; 95%CI: 4.99-64.11) and environmental health (PR=7,08; 95%CI: 2.48-20.23). Multivariate analysis revealed that dominant variable was the behavior (PR=11,60, 95%CI: 2,98-45,13). Meanwhile, knowledge and attitude were not statistically associated with the existence of larvae. It can be concluded that the behavioral changes efforts that support of Ae. aegypti larvae eradication is still needed. It was recommended that the CHC needs to upscale health promotion efforts addressing the severity of DHF and prevention methods, cross-sector coordination, and involvement from healthcare providers as well as specially employed field workers in developing societies to eradicate mosquito breeding in order to increase the community's behavior of mosquito-larva eradication in order to increase the PLFR and to reduce the incidence rate of DHF.
HIGH PLASMA TNF-? LEVELS AND MONONUCLEAR CELLS INOS AND TNF-? EXPRESSION AS RISK FACTORS FOR PAINFUL DIABETIC NEUROPATHY Eko Purwata, Thomas; Suastika, Ketut; Raka Sudewi, A. A.; Widjaja, Djoenaidi
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 2 Juli 2010
Publisher : Udayana University

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Painful Diabetic Neuropathy (PDN) is one of the most common and annoyingcomplications of diabetes mellitus. The pathogenesis of PDN is complex and still unclear.Recently it has become clear that nitric oxide (NO) and proinflammatory cytokines playan important role in the pathogenesis and maintenance of pain in PDN. Based on thisphenomenon, this study was conducted to investigate whether the cytokine tumornecrosis factor-alpha (TNF-?) and NO, in this case inducible Nitric Oxide Synthase(iNOS), play a role in PDN pathogenesis.The study was carried in two steps. The first step was a cross sectional and thesecond step was a case-control study. The study was performed in 110 type-2 diabeticpatients. The plasma TNF-? levels were determined by ELISA while the expression ofTNF-? and iNOS in mononuclear cells were analyzed immunohistochemically.Of 110 subjects, 59 patients suffered from Painful DN (case) and the remaining51 patients were Painless DN (control). Cross sectionally, plasma TNF-? levels andimmunoreactivity for iNOS and TNF-? were higher in patients with more severe pain inthe Visual Analog Scale (VAS). There were statistically significant differences (p <0.05) between mild and severe pain in regard to TNF-? level (15.24 pg/ml ± 5.42 vs.20.44 pg/ml ± 10.34 ); to iNOS immunoreactivity (9.72 % ± 8.61 vs. 15.6% ± 11.84); andto TNF-? immunoreactivity (13.0 % ± 9. 48 vs. 20.44% ± 11.75).The case control study showed that TNF-? had an odd ratio of 5.053 [CI 95%(2.241-11.392); p < 0.001]. TNF-? immunoreactivity of 4.125 [CI 95% (1.805-9.425); p< 0.001]; and iNOS immunoreactivity of 3.546 [CI 95% (1.613-7.795); p = 0.002]. There were correlations between TNF-? level, TNF-? and iNOS immunoreactivity andVAS with coefficient correlation: 0.330; 0.285 and 0.275 (p < 0.05) respectively.It is concluded that Diabetic Neuropathy patients with high TNF-? levels, iNOSand TNF-? immunoreactivity of mononuclear cells have higher risk for painful DN thanpainless DN. The higher TNF-? level, iNOS and TNF-? immunoreactivity the moresevere was the pain. This supports the hypothesis that TNF-? and iNOS have role inPDN pathogenesis. The results of this research could be applied as a basic for furtherresearch in pursuit of better management of PDN.
HEALTH CARE-SEEKING FROM THE TRADITIONAL HERBAL HEALERS IN DENPASAR CITY Yuniari, Sri; Suastika, Ketut; Seri Ani, Luh
Public Health and Preventive Medicine Archive Vol 1 No 2 (2013): Public Health and Preventive Medicine Archive
Publisher : Program Magister Ilmu Kesehatan Masyarakat Universitas Udayana

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Traditional herbal treatment is one of treatment efforts beyond medical science which is currently quite popular among people in Denpasar. Seeking health care from traditional herbal healers is not only has a positive impact but also negative ones. Excessive promotion in various media causes people to be less rational in choosing health care services. This study was aimed to determine the relationship between knowledge, attitudes, beliefs and media information with the health care-seeking from traditional herbal healers. The study design was a analytic cross-sectional. Sample was consecutively selected from the population involving 129 people who have met the inclusion criteria. Data were collected by using questionnaire. Chi-square results showed that all variables examined were significantly associated with health care-seeking from the traditional herbal healers. Results from logistic regression indicated that only belief was significantly associated with the level of patient visits to traditional herbal healers (RP=6.57; 95%CI: 1.43-8.84, p=0.006 and R2=49.5%). Denpasar Department of Health should improved guidance and control the traditional herbal healers so as to provide a sense of security to the community.
RISK FACTORS OF TYPE 2 DIABETES MELLITUS OF OUTPATIENTS IN THE COMMUNITY HEALTH CENTRES OF SOUTH DENPASAR SUBDISTRICT Trisnawati, Sri; Widarsa, Tangking; Suastika, Ketut
Public Health and Preventive Medicine Archive Vol 1 No 1 (2013): Public Health and Preventive Medicine Archive
Publisher : Program Magister Ilmu Kesehatan Masyarakat Universitas Udayana

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Diabetes Mellitus (DM) adalah penyakit degeneratif yang terus meningkat prevalensinya di seluruh dunia dan sebagianbesar tergolong DM tipe 2. Peningkatan kasus DM tersebut sebagai akibat perubahan gaya hidup dan pola makan masyarakat. Padapenelitian ini diteliti hubungan antara obesitas berdasarkan lingkar pinggang, obesitas berdasarkan IMT, hipertensi, tidak melakukanaktivitas fisik, merokok dan umur ?50 tahun dengan kejadian DM tipe 2. Penelitian ini adalah kasus-kontrol berpasangan berdasarkanjenis kelamin dan riwayat keluarga dengan DM dimana kasus adalah pasien DM tipe 2 dan kontrol adalah pasien bukan DM. Kasusdan kontrol dipilih dari pasien rawat jalan di Puskesmas Kecamatan Denpasar Selatan secara consecutive sebanyak 136 orang denganperbandingan 1:1. Data dikumpulkan dengan wawancara, pemeriksaan fisik dan pemeriksaan laboratorium. Analisis datamenggunakan uji McNemar dan regresi logistik. Dari analisis didapatkan OR dari obesitas berdasarkan linggar pinggang sebesar 5,2[95%CI 2,31?11,68] dengan p=0,001 dan OR dari umur ?50 tahun sebesar 4 *95%CI 1,74?9,21] dengan p=0,001. Berdasarkanpenelitian ini dapat disimpulkan bahwa pasien dengan obesitas berdasarkan lingkar pinggang dan umur ?50 tahun dapatmeningkatkan risiko DM Tipe 2. Oleh karena itu kejadian obesitas di masyarakat perlu diturunkan dengan memperbaiki gaya hidupdan pola makan masyarakat.
SEORANG PENDERITA HIPOKALSEMIA BERAT OLEH KARENA HIPOPARATIROIDISME DIDAPAT Dharmawan Harjanto, David; Ratna Saraswati, Made; Suastika, Ketut
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Albeit rare, hypocalcemia might present an acute severe symptom as hypocalcemic seizure, which is documented in ourpatients. Failure in its diagnosis and management will lead to significant morbidity and mortality. Establishing the PTH status,anorganic-phosphate and magnesium level will enable investigation on possible etiology of hypocalcemia. The overall incidenceof post thyroidectomy hypoparathyroidism and hypocalcemia is about 0.5-3 % worldwide. The pathophysiology are multifactorial,it is not simply the glands extirpations, as well as its multiple risk factors although operator technique skill is still theprominent one. We have presented a case of 24 year old female with an acute generalized seizure (hypocalcemic seizure) andprolonged corrected QT interval due to a severe hypocalcemia secondary to hypoparathyroidism from a total thyroidectomy,accompanied by acquired hyperthyroidism and a cerebral cortex calcification. Clinical symptoms and total calcium were improvedafter intravenous calcium gluconate, followed by oral calcium and calcitriol administrations. However, the ideal therapyfor hypoparathyroidism is still the hormone substitution, either by auto/xeno-transplantations or injections, pending further studies.PTH level determinations immediately or several hours after surgery and thus oral calcium supplementations might predictand reduce the incidence of post thyroidectomy hypocalcemia and hypoparathyroidism.
HUBUNGAN ANTARA KONSENTRASI ASAM URAT SERUM DENGAN RESISTENSI INSULIN PADA PENDUDUK SUKU BALI ASLI DI DUSUN TENGANAN PEGRINGSINGAN KARANGASEM Ngurah Wises, Ida Bagus; Suastika, Ketut
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Elevated serum uric acid concentrations are commonly seen in association with individual cardiovascular risk factorsuch as hypertriglyseridemia, hypertension, obesity, and hyperglycemia, a cluster that, when found together in the same person,characterizes the so-called metabolic syndrome. The original conceptualization of this syndrome was on the basis of resistance tothe actions of insulin. The reduction of endothelial nitric oxide bioavailability and the production of reactive oxygen species byuric acid may be the mechanism for insulin resistance. Otherwise insulin has a physiological action on renal tubules by stimulatingreabsorption of sodium and urate, resulting an increase in serum uric acid levels. In this condition, HOMA-IR was the modelwhich is a convenient means of evaluating insulin resistance.To know the association between serum uric acid concentration and insulin resistance, a cross sectional analytic studywas conducted on Balinese in Tenganan region between Desember 2007 and January 2008. The study involved 80 participantsage of 18-65 years old, agree to participate by informed consent. Serum concentration of insulin was measured by immunoassaymethod, plasma glucosa, serum uric acid, HDL-cholesterol, trigycerides, serum creatinin, were determined by enzymatic procedureafter overnight fast. Descriptive statistic analysis on numeric data presented as mean ± SD, nominal and ordinal data inproportion. Inferential statistic analysis with bivariate KendallÕs tau correlation and simple logistic regression was performed andmultiple logistic regression was used to know the independency of its association.Of 80 eligible samples, 39 (49%) men, and 41 (51%) women, mean age was 41.73 ± 12.41 yo, mean of waist circumferencewas 77.99 ± 10.91 cm, mean of serum uric acid concentration was 5.49 ± 1.38 mg/dL, mean of plasma glucosa was 92.04± 8.79 mg/dL, median of insulin was 2.70 (2.00 Ð 17.90) mIU/mL, median of HOMA-IR was 0.685 (0.38-4.10), mean of HDLcholesterol was 59.19 ± 14.01 mg/dL, and median of triglycerides was 122.50 (48 Ð 369) mg/dL. In univariate analysis, theinsulin resistance were positively correlated with serum uric acid, waist circumference, and triglycerides (r= 0.234; P = 0.003),(r = 0.269; P = 0.001), and (r = 0.153; P = 0.046) respectively and negatively with HDL cholesterol (r = -0.297; P = 0.009). Inmultivariate analysis with multiple logistic regression both the 2nd tertile of uric acid (4,7 Ð 6,6 mg/dL) and waist circumferencewere independently associated with the insulin resistance (PR 3.97; IK 95% : 1.273 Ð 12.386; P = 0.018), and (PR 5.79; IK 95%: 1.417 Ð 23.650; P = 0.014) respectively. Conclusion: There is association between serum uric acid concentration and insulinresistance, and both the 2nd tertile of uric acid and waist circumference are independently and significantly associated with insulinresistance.
PREDIKTOR DISFUNGSI EREKSI PADA PENDERITA DIABETES TIPE 2 DI POLIKLINIK PENYAKIT DALAM RS SANGLAH DENPASAR Ratna Saraswat, Made; Sanjaya, Dwija; Suastika, Ketut
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Erectile dysfunction (ED) is a commonly reported condition among men with diabetes, however little is known aboutthe predictive factors associated with diabetic ED. To examine the predictors related to ED among type 2 diabetes outpatient, aconsecutive cross sectional study at Internal Medicine Outpatient Clinic, Sanglah Hospital was conducted, enrolled 137 type 2diabetes men aged between 35 ? 77 years old. We found 79.5% of type 2 diabetics with ED. Erectile function score was significantlycorrelated with other component of International Index of Erectile Function 15 (IIEF 15) including orgasmic function(r=0.622, p<0.001), sexual desire (r=0.782, p<0.001), intercourse satisfaction (r=0.911, p<0.001), and overall satisfaction (r=0.842,p<0.001). Erectile function was also correlated with age (r=0.315, p<0.001). Chi square analysis among diabetic complication,ED were significantly higher among patient with albuminuria/proteinuria (p=0.025, prevalence ratio 7.43 (95% IC 0.95 ? 58.15).Other factors such as duration of diabetes, central obesity, cigarette smoking, alcoholism, diabetic control (HbA1C and lipidprofile), diabetic complications, and hypertension were not significantly correlated with ED. ED were high among type 2 diabeticsand erectile function were correlated with orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.ED also correlated with age and albuminuri/proteinuria but not with other predictors.
HUBUNGAN KENDALI GLIKEMIK DENGAN ASYMMETRIC DIMETHYLARGININE PENDERITA DIABETES MELITUS TIPE 2 LANJUT USIA Ngurah Hariawa, Kadek; Suastika, Ketut
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Increasing life expectacy is usually in line with increasing prevalence of matabolic diseases, especially diabetes mellitus(DM). Old age and DM are risk factors for cardiovascular disease. Endothelial dysfunction is the early process of atherosclerosis.Asymmetric dimethylarginine (ADMA) is a marker for endothelial dysfunction. Until recently however, there is a lack of studyon the correlation of diabetes control and ADMA in elderly with DM.The objective of this study was to assess the correlation of diabetes control with ADMA in diabetes elderly. The designof the study was cross sectional analytic study. The study subects were diabetic patients aged 60 years or above without smokingand existance of end stage renal disease.The 80 study subjects consisted of 57 males and 43 females, ages ranging from 60 to 80 years. The majority of thesubjects were with other diseases i.e. hipertension 62 (77.5%), dyslipidemia 51 (63.8%), overweight 59 (73.9%), decreased renalfunction with creatinin clearence below 60 ml/mnt 58 (72.5%), hyperhomocysteinemia 35 (43.8%). The subjects with goodglicemic control were 25 (32%), moderate 31 (38.8%), and bad glicemic control 24 (30%). Pearson correlation showed there wasno correlation between glicemic control (fasting blood glucose, 2 hour after meal blood glucose, HbA1c) and ADMA. Analysis onother factors showed a correlation of ADMA with sistolic blood pressure (r=-0.222; p=0.024) and homocystein (r=0.333; p=0.001).Multiple liniar regression analysis constanly showed a correlation between homocystein and ADMA (B=0.473; p=0.003). Thenew construction model of this study was the formula ADMA (µmol/L)= 0.213+0.473 log homocystein µmol/L. Based on thecriteria used diabetes control, we found mean difference of ADMA at systolic blood pressure (p=0.031). There was no meandiffrence of ADMA found based on the treatment regimens given i.e. those given insulin or not (p=0.547) and those givenmetformin or not (p=0.219).In conclusion, blood glucose control has no correlation with ADMA in the elderly with DM, however homocystein haspositve correlation with ADMA in elderly with DM. The elderly with DM have several accompanying of diseases.
PELATIHAN GURU SD PEMBIMBING OLIMPIADE MATEMATIKA SE-GUGUS 7 KECAMATAN SUKUN KABUPATEN MALANG Suastika, Ketut; Suwanti, Vivi
Jurnal Pengabdian Masyarakat (JPM-IKP) Vol 2, No 02 (2019): Jurnal Pengabdian Masyarakat (JPM-IKP)
Publisher : Universitas Trilogi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31326/jmp-ikp.v2i02.442

Abstract

Tingkat kesulitan soal-soal olimpiade matematika yang berada jauh di atas soal-soal rutin. menutut guru pembimbing olimpiade matematika memiliki kemampuan yang lebih dari guru matematika Sekolah Dasar (SD) pada umumnya. Oleh karena itu, tujuan dari kegiatan ini adalah untuk membantu mengatasi kesulitan-kesulitan yang dihadapi para guru pembimbing olimpiade matematika terutama guru SD gugus 7 UPT Dinas pendidikan di kecamatan Sukun. Program pengabdian masyarakat ini dilaksanakan dengan 3 tahap yaitu a) tahap persiapan : identifikasi permasalahan mitra, diskusi solusi permasalahan, dan penyusunan materi workshop, b) tahap pelaksanaan : kegiatan 1 workshop dan kegiatan 2 latihan soal dan pembahasannya, c) tahap evaluasi. Berdasarkan hasil kegiatan pengabdian ini diketahui bahwa a) peserta lebih aktif dan paham ketika dilibatkan dan praktik secara langsung dalam pengerjaan soal daripada hanya materi dan teori, b) kesulitan paling sering dihadapi peserta saat mengerjakan soal yang membutuhkan kemampuan berpikir kreatif.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients?prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 ? 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.