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All Journal Folia Medica Indonesiana Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Buletin Farmatera Biomolecular and Health Science Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology Vision Science and Eye Health Journal Hang Tuah Medical Journal

Rahmawati, Lita Diah

Bagian Penyakit Dalam Poliklinik Reumatologi FK Universitas Airlangga - RSUD Dr.Soetomo

Author-ID : 1252301

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Treatment of Lupus Nephritic with Severe Preeclampsia: A Case Report Asri Insanur Rahma; Lita Diah Rahmawati
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16805

A 25 years-old pregnant woman with history of Systemic Lupus Erythematosus (SLE) complained shortnessof breathing and swelling legs. Physical examination showed hypertension, tachycardia, tachypnea,anemic conjunctiva, and pitting edema in both legs. Workup examination found anemia, hypoglycemia,hypoalbuminemia, proteinuria, metabolic acidosis, strong positive dsDNA, trivial MR, mild TR, PR, dilatedLV, decrease of LV systolic function, hypokinetic global LV, eccentric LVH, and severe oligohydramnios.The patient was diagnosed with severe preeclampsia, severe oligohydramnios, SLE, Lupus Nephritic (LN),stage II JNC VII hypertension, and peripartum cardiomyopathy.An emergency caesarean section was planned as the main management to prevent infant and maternalmorbidity and mortality. MgSO4 was given to prevent eclampsia. Methylprednisolone and azathioprinewere given to control SLE and LN activity. Furosemide, spironolactone, ramipril, methyldopa and nifedipinewere given to control blood pressure, help normalizing heart function, and prevent organ failure. The patientwas suggested to postpone next pregnancy until 1 year after LV function turns to normal.

Deep Vein Thrombosis and Diabetes Mellitus Type 2 as Complications of Psoriatic Arthritis: A Case Report Hersih Srinowati; Lita Diah Rahmawati
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17561

A woman, 45 years old, complained of low back pain that improves with activity or analgesic andreoccurs when resting. The patient also complained of swollen joints, fever, shortness of breath, flakyskin and fragile nails. Physical examination found multiple inflamed joints, thickened and fragilenails, fever, limited range of movement of knee and ankle and positive Homan sign. Workup foundnegative anti-rheumatoid factor, increased blood sugar level, increased erythrocyte sedimentation rate,increased C-reactive protein, bacteria in urine, increased D-dimer, and imaging of lumbar spondylosisand sacroiliitis, and deep vein thrombosis in the left inferior limb using Doppler ultrasonography. Thepatient was diagnosed as psoriatic arthritis, deep vein thrombosis, type 2 diabetes mellitus, and urinarytract infection. The patient was given sulfasalazin, fondaparinux, warfarin, insulin, and antibiotic. Onthe 15th day of treatment, the patient experienced sudden shortness of breath and chest pain. The patientdied due to suspected cardiovascular event.

Demographic Profile, Clinical and Analysis of Osteoarthritis Patients in Surabaya Ilham Wildan Ahmad; Lita Diah Rahmawati; Teddy Heri Wardhana
Biomolecular and Health Science Journal Vol. 1 No. 1 (2018): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Introduction: Osteoarthritis is a degenerative joint disease which affects joint cartilage. As many as 80% patients movement are limited and 25% of them can not even perform daily activities. Osteoarthritis is one of the ten most disabling diseases in developed countries. Due to its chronic and progressive nature, socio-economic impacts in many developed and developing countries are enormous. The purpose of this study is to determine the profile of patients with osteoarthritis in the Orthopedic Department of RSUD Dr. Soetomo Surabaya (Dr. Soetomo General Hospital)Method: This is descriptive observasional research. Questionnaires data were obtained from all patients in the Department of Trauma and Orthopedic of RSUD Dr. Soetomo Surabaya during September 1, 2016 until October 31, 2016. Thirty five subjects with osteoarthritis were analyzed for the study. The variables observed in the patient profile include sex, age, body mass index, type of osteoarthritis, Kellgren-Lawrence scoring system, and knee osteoarthritis severity index.Result: The result shows that 43% of the samples were aged 60-69 years, 83% of the samples were female, 37% of the samples had an I BMI obesity, 60% of samples had bilateral osteoarthritis, and 77% of samples from primary osteoarthritis. A total of 15 of 53 knee samples had class III, and 15 of 53 knee samples also had class I, and as many as 21 of the 35 samples had a "very severe" clinical gradation. These results may be due to patients who have low grade gradation clinics and have received medical attention at the level I health facility or II.Conclusion: From the results of this study, it can be concluded that age, sex, BMI, Kellgren-Lawrence assessment system, index severity of patients Lequesne osteoarthritis in RSUD Dr. Soetomo Surabaya is in conformity with research that has been done in many places and theories that exist.Keywords: Knee osteoarthritis, age, gender, Kellgren-Lawrnce scoring system, knee osteoarthritis severity index

Profil ACR-EULAR 2010 Pasien Poliklinik Reumatologi IRJ RSUD DR.Soetomo Surabaya Tahun 2018 SUKACITA TEHUPURING; ARYATI; LITA DIAH RAHMAWATI
HANG TUAH MEDICAL JOURNAL Vol 19 No 2 (2022): Hang Tuah Medical Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/htmj.v19i2.174

Background: The 2010 ACR-EULAR criteria were established for the purpose of early diagnosis of Rheumatoid Arthritis (RA). It is hoped that the results of this study can provide evidence of RA patient profile data that can be used nationally to describe medical developments related to RA. The selected profiles are clinical and laboratory profiles to represent morbidity, prognosis, and disease course. Adult patients were selected to represent the socioeconomic impact and RSUD Dr. Soetomo was chosen as a data source to be able to represent RA cases in Eastern Indonesia. Objective: To determine the clinical and laboratory profile of RA patients based on the ACR-EULAR 20210 criteria at Rheumatology Outpatient Installation of RSUD Dr. Soetomo in 2018. Methods: Retrospective-descriptive research using medical record data of RA patients at RSUD Dr. Soetomo. Results: 100% of patients in this study were women. The highest age distribution was 45-64 years 47.83%, 35-44 years 30.43%, 15-24 years 13.04%, 25-34 years 8.70% with a median of 43 years. As many as 82.61% have high school education and 4.35% have junior high school education and 8.70% have less education. 56.52% of patients live outside Surabaya and 43.44% of patients live within the city of Surabaya. 52.17% of patients affected with RA symptoms in 4–10 small joints, 13.04% patients affected more than 10 joints (at least 1 small joint) and 17.39% patients affected 2–10 large joints and 1–3 small joints. 95.65% of patients had pain for 6 weeks or more and only 4.35% of patients had pain for less than 6 weeks. 65.22% of patients showed positive RF serology. 91.30% of patients were anti-MCV positive. 95.65% of patients had an ESR above the normal range with a median of 55 mm/hour. 30.34% of patients showed CRP above the normal limit, 26.09% of patients with CRP within normal limits, while 43,48% of patients had no data on CRP examination results. Evaluation based on the 2010 ACR-EULAR criteria showed 43.48% of patients with a score of 8; 26.09% of patients with a score of 6; 4.35% of patients with a score of 7; and, 13.04% of patients with a score of 9 and with a score of 10. Conclusion: Rheumatoid Arthritis Patients at Rheumatology Outpatient Installation of RSUD Dr. Soetomo Surabaya in 2018 had a demographic profile of more than 45 years old, with a high school education level, came from outside the city of Surabaya and all of them were female; with a clinical profile having involvement of 4–10 joints with a duration of pain more than 6 weeks; has a laboratory profile where most of the RF and Anti-MCV serological results are positive, with an above-normal ESR count in most of the samples; and has a 2010 ACR-EULAR profile at a score of 8 with the largest number of samples and at a score of 7 with the smallest number of samples. Keywords: Rheumatoid Arthritis, ACR-EULAR 2010, RSUD Dr. Soetomo

Psoriatic arthritis and Hashimoto's thyroiditis in a patient presenting with major depression and subclinical hyperthyroidism: A case report Lita Diah Rahmawati; Bagus Aulia Mahdi
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 8 No 01 (2024): Qanun Medika Vol 08 No 01 January 2024
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v8i01.17778

Psoriatic arthritis (PsA) is a chronic, deforming arthritis associated with psoriatic skin lesions. Numerous patients with PsA carry other co-existing chronic diseases, adding to their overall disease burden and affecting the patient’s quality of life. Depression is a common illness known to coexist in about 20% of patients with PsA. Long-term inflammation conditions can make patients more depressed and make the treatment more difficult. Cushing Syndrome (CS) is a complication of long-term treatment due to the exposure of glucocorticoids given to turn the hypothyroid condition into hyperthyroid because hypercortisolism in humans lowers TSH secretion and TSH pulse amplitude. When PsA combines with depression and CS, it will create complex conditions and treatments. The complexity is all about how we control the disease activity of PsA and the vicious circle of an inflammatory process that is difficult to control. Conventional treatment will fail, and targeted therapy with monoclonal antibodies such as anti-IL-17 Secukinumab, is needed. Secukinumab as an anti-IL-17 will block the inflammation pathway from interleukin-17, decrease the inflammation process, and improve the symptoms of PsA. We report a patient with psoriatic arthritis and Hashimoto's thyroiditis (HT) with a major depressive episode with CS and subclinical hyperthyroidism successfully treated with Secukinumab.

Clinical and Demographic Profiling of Patients with Spondyloarthritis and Its Association with Disease Activity in a Tertiary Hospital in Surabaya, Indonesia Yudha, Cahaya Prasta; Rahmawati, Lita Diah; Indrasari, Yulia Nadar; Yuliasih
Current Internal Medicine Research and Practice Surabaya Journal Vol. 5 No. 1 (2024): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v5i1.52842

Introduction: The assessment of disease activity is crucial for effectively managing chronic diseases like spondyloarthritis (SpA). Establishing the relationship between disease activity, demographic, and clinical factors is essential for better disease management. This study aimed to delve into the demographic and clinical characteristics of patients at Dr. Soetomo General Academic Hospital, a tertiary hospital in Surabaya, Indonesia, contributing to a comprehensive understanding of SpA occurrences in Surabaya.Methods: Data were obtained from 38 SpA patients' data classified using ASAS 2009 criteria at Dr. Soetomo General Academic Hospital, excluding individuals with SLE, gout, RA, and septic arthritis. Disease activity was measured using ASDAS-CRP. Association analysis between disease activity, clinical parameters, and demographics was conducted using Mann-Withney U test and Spearman correlation test.Results: Results indicated a male-to-female ratio of 8:30, with patients having a median age of 48 (95% CI: 41-53) and most of the patients had a senior high school education (42.11%). The patients exhibited a mean BMI of 25.19 ± 3.77, a median disease duration of 8.5 (95% CI: 5-10) years, and a median CRP value of 0.2 (95% CI: 0.1-0.5) mg/dL. The majority displayed moderate disease activity, with a median ASDAS-CRP score of 2 (95% CI: 1.5-2.7). Interestingly, no significant correlation was found between disease activity using ASDAS-CRP and the demographic or clinical parameters studied.Conclusion: Disease activities were found not to have correlations with the demography and clinical parameters of patients with SpA from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. This emphasizes the necessity for further research to comprehend the intricate relationship between disease activity and diverse influencing factors.

Perioperative Management of Systemic Lupus Erythematosus Patient with Perianal Abscess Complication due to Trauma Nasution, Huwainan Nisa; Rahmawati, Lita Diah
Buletin Farmatera Vol 6, No 3 (2021)
Publisher : Universitas Muhammadiyah Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30596/bf.v6i3.7059

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that can damage organs and cells due to autoantibodies and immune complexes bound to tissue. Infection is a major source of co-morbid in patients with SLE. The infection has been the second major cause of death in SLE, after disease activity itself. Perianal abscess is part of anorectal abscess which can occur in patients that have a risk factor of trauma on the anorectal region. Management of the patient consists of non-operative and operative procedures. In SLE patients that undergo the operative procedure, it is necessary to do perioperative preparation to prevent post-operative complications such as "flare-up" condition due to SLE. Evaluation of medicines and adjustment of glucocorticoid dosage based on the risk of surgery is important in perioperative preparation.

Correlation between Serum IL-6 Level and Th17/Treg Ratio with Systemic Lupus Erythematosus Disease Activity Familia, Adidia Carina; Yuliasih, Yuliasih; Rahmawati, Lita Diah
Biomolecular and Health Science Journal Vol. 2 No. 2 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Introduction: SLE pathophysiology shifted to a new paradigm which emphasizing the imbalance between Th17 and Treg. IL-6 is the main cytokine believed as the regulator of the balance between Th17 and Treg which play a big part in SLE pathophysiology and disease activity. The aim of this study was to determining the correlation between serum IL-6 level and Th17/Treg ratio with SLE disease activity on SLE inpatients of RSUD Dr. Soetomo Surabaya.Methods: This cross sectional study included newly diagnosed SLE patients based on American College of Rheumatology (ACR) 1997 revised criteria and confirmed by rheumatologist. All subjects underwent the same examination and assessment such as SLE disease activity was scored according to SLAM score, serum IL-6 level measured using ELISA, and Th17/Treg ratio where the expression Th17-Treg detected by flowcytometry method.Results: Thirty female subjects with active SLE had mean age 31,3 ± 10,46 years. The most frequent clinical manifestations were hematologic disorders and arthritis. Serum IL-6 level was significantly elevated in SLE patients compare to healthy subjects (200,61 pg/ml versus 45,9 pg/ml, p =0,028). Th17/Treg ratio were also significantly higher in SLE patients compared to healthy subjects (2,49 versus 1,20, p = 0,31). Th17/Treg ratio significantly correlated with SLE disease activity (r = 0,988; p<0,05). There were no significant correlation between serum IL-6 level with Th17/Treg ratio (r = -0,095; p>0,05) or even SLE disease activity (r = 0,066 ; p>0,05). Conclusion: Serum IL-6 level had no significant correlation with Th17/Treg ratio or SLE disease activity. We found significant correlation between Th17/Treg ratio with SLE disease activity.

Efficacy and Safety of Ozoralizumab vs. Moxibustion for Rheumatoid Arthritis Susanti, Luthfiana Rofhani; Mustika, Arifa; Rahmawati, Lita Diah; Wungu, Citrawati Dyah Kencono
Folia Medica Indonesiana Vol. 60 No. 4 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i4.64949

Rheumatoid arthritis is a chronic inflammatory disease that symmetrically damages the synovial membrane, affecting approximately 13% of the global population. Systemic complications and substantial declines in quality of life may result from untreated rheumatoid arthritis. This study investigated the safety and efficacy of moxibustion and ozoralizumab in reducing disease activity scores in rheumatoid arthritis patients. Between July 2023 and February 2025, we conducted a thorough search on four online databases (PubMed, Cochrane, Scopus, and ProQuest) using keywords, reference searches, and other methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The obtained randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias 2 (ROB2) tool. MetaInsight version 5.2.1 was utilized to perform the indirect network meta-analysis, using mean difference (MD) as the summary statistics. The measurement of the Disease Activity Score 28 (DAS28) indicated that ozoralizumab had a more significant effect on rheumatoid arthritis compared to placebo (MD=-1.88, 95% CI=-2.24-(-1.52)) and moxibustion (MD=-0.69, 95% CI=-1.07-0.31). Ozoralizumab demonstrated mild, moderate, and severe side effects, whereas moxibustion displayed modest side effects in comparison to placebo. In summary, both ozoralizumab and moxibustion reduced DAS28 in patients with rheumatoid arthritis, with ozoralizumab proving to be the more effective treatment. However, the adverse effects of ozoralizumab were more varied than those of moxibustion.

Bandage Contact Lens Associated Infection after Amnion Membrane Transplantation in Peripheral Ulcerative Keratitis Case with Spondyloarthritis Permatasari, Devi Sarah Intan; Zuhria, Ismi; Rahmawati, Lita Diah
Vision Science and Eye Health Journal Vol. 4 No. 1 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i1.2024.4-12

Introduction: Bacterial keratitis causes around 90% of all cases of microbial keratitis. The global rise in contact lens usage has contributed to an increased risk of microbial keratitis. Peripheral ulcerative keratitis (PUK) is essential to diagnose as it can be the first presenting feature of a sight-threatening and associated with rheumatic autoimmune disease. Case Presentation: The case presents a 35-year-old woman with redness, discharge, and tenderness in her right eye (RE) since the day before, along with light sensitivity and tearing. Three months prior, she underwent multilayer amniotic membrane transplantation (AMT) surgery for corneal thinning due to peripheral ulcerative keratitis (PUK) and wore a contact lens postoperatively as a bandage. She had a history of conjunctival resection related to the PUK a year ago. She received oral cyclosporin and methylprednisolone for spondyloarthritis. Initially, her visual acuity of the RE was limited to hand movement. Diagnosis included RE keratoconjunctivitis related to contact lens and PUK post-AMT surgery; treatment comprised intravenous and topical antibiotics, artificial tears, cycloplegics, analgesics, and oral ascorbic acid. After four days of treatment, clinical signs were improved, with visual acuity progressing from hand movement to counting fingers at one meter. Conclusions: Careful management is essential for PUK patients after AMT surgery, especially those using contact lenses as bandages due to the potential risk of infection. Early PUK identification is crucial, as it may indicate sight-threatening issues and underlying systemic diseases. Meticulous examination and multidisciplinary management are required to ensure patient safety.

Co-Authors Arifa Mustika Aryati Aryati Asri Insanur Rahma Bagus Aulia Mahdi Devi Sarah Intan Permatasari Elfrida Ratnawati Familia, Adidia Carina Fithriyah, Nathania Elma Hersih Srinowati Ilham Wildan Ahmad Nasution, Huwainan Nisa Rahmadhani, Khafiyah Hikmah SUKACITA TEHUPURING Susanti, Luthfiana Rofhani Wardhana, Teddy Heri Wungu, Citrawati Dyah Kencono Wungu, Citrawati Dyah Kencono Yudha, Cahaya Prasta Yulia Nadar Indrasari Zuhria, Ismi

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