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Manifestation of COVID-19 Mimicking Rheumatic Diseases : Review Article Laniyati Hamijoyo; Angkasa Ramatuan Hamdan
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.156

Abstract

Background: Diagnosing the newfound disease has been always the vital strategy of controlling and managing Corona Virus Disease (COVID)-19. Interestingly, patients with COVID-19 may also have features mimicking rheumatic diseases due to immunology responses and viral properties. Objective: In this systematic review, we aim to highlight features of COVID-19 that mimic those of rheumatic diseases, in hope to raise clinical awareness and prevention. Methods: We systematically searched both from MEDLINE (accessed from PubMed) and Google scholar from late of 2019 to June 2020 for related published articles. In both electronic databases, the used key words were “COVID-19” or “Corona virus”, “rheumatic diseases” and “clinical characteristics” Results: Through the search, we were able to conclude some characteristics that could be manifested both in COVID-19 infection and rheumatic diseases, including but not limited to constitutional manifestation, arthralgia and/or myalgia, myositis, hematologic manifestation, skin manifestation, acute interstitial pneumonia, myocarditis and gastrointestinal manifestation. Most studies were able to explain the possibility of immune dysregulation similar to what rheumatic diseases exhibit, include post mortem biopsy of a tissue damage similar to rheumatic complication in COVID-19 infection Conclusion: Since the possibility of overlap symptoms between COVID-19 infection and rheumatic diseases was able to be enucleated through our review, we believe that in the future clinical awareness to differentiate between autoimmune and infection origin of many rheumatic manifestations will hold pivotal role in prohibiting reemergence disease. Future study to assist clinicians to swiftly diagnose autoimmune diseases in the era of pandemic is essential.
Efektivitas Mediasi Dan Arbitrase Dalam Penyelesaian Sengketa Konsumen Kesehatan Yuyut Prayuti; Arman Lany; Davin Takaryanto; Angkasa Ramatuan Hamdan; Beni Ciptawan; Enggar Adi Nugroho
Syntax Idea 1533-1544
Publisher : Ridwan Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/syntax-idea.v6i3.3165

Abstract

Settlement of health consumer disputes is an important issue in the health system because it is directly related to consumer rights and the quality of health services. Mediation and arbitration are two alternative dispute resolution methods that can be used in cases like this. The aim of this research is to analyze the effectiveness of mediation and arbitration in resolving health consumer disputes. This study used qualitative research methods. The data collection technique in this research is literature study. The data that has been collected is then analyzed in three stages, namely data reduction, data presentation and drawing conclusions. The research results show that mediation is considered effective in resolving health consumer disputes, while the effectiveness of arbitration depends on the expertise of the arbitrators, especially in cases that require special technical knowledge. Mediation tends to be more effective and efficient in resolving disputes because it can help disputing parties to reach an agreement voluntarily with the help of a mediator. However, mediation results are not final and usually require agreement from both parties to be binding. On the other hand, arbitration offers higher legal certainty because the decision is final and binding. However, the arbitration process tends to be more formal, time consuming, and more expensive than mediation. Therefore, the choice between mediation and arbitration must consider the needs and preferences of each party to the dispute.
Juridical Analysis of Business Dispute Resolution in Strategic Technology and Services Procurement Contract Disputes through the Indonesian National Arbitration Board (BANI) Hamdan, Angkasa Ramatuan; Nugroho, Enggar Adi; Takaryanto, Davin; Ciptawan STP, Beni; Syahruddin, Syahruddin; Anggraeni, Happy Yulia
eScience Humanity Journal Vol 5 No 2 (2025): eSience Humanity vol 5.2. May 2025
Publisher : Asosiasi Ide Bahasa Kepri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37296/esci.v5i2.262

Abstract

This research examines legal issues arising from business disputes in contractual agreements, specifically focusing on the Availability Payment (AP) Service Level Agreement (SLA) between PT Palapa Ring Barat and the Ministry of Communication and Informatics of the Republic of Indonesia. Disputes emerged due to differing interpretations of tax clauses, where PT Palapa Ring Barat demanded additional VAT (10%) on AP payments, while Kemenkominfo argued the payments already included VAT. This study employs a normative juridical method, analyzing primary sources such as BANI Decision No. 45016/II/ARB-BANI/2022 and relevant legal frameworks, including Law No. 30 of 1999 on Arbitration and Alternative Dispute Resolution. Findings indicate that arbitration plays a critical role as an effective, binding dispute resolution mechanism, as demonstrated by BANI's decision, which affirmed the validity of the agreement and ordered Kemenkominfo to pay additional VAT. The case highlights the importance of clear contractual clauses, particularly regarding taxation, to prevent disputes. In comparison, other dispute resolutions, such as mediation, are evident in cases like the collaboration between RSUD Mataram and CV. Ijen Perkasa on hospital information system management. This research contributes to the field by emphasizing the need for clear, comprehensive contracts and effective dispute resolution mechanisms. The findings provide insights for businesses and policymakers to develop contracts that minimize potential conflicts while promoting adherence to legal frameworks
Undiagnosed Hypothyroidism as a Contributor to Cryptogenic Cirrhosis: A Case Report and Diagnostic Perspective Hamdan, Angkasa Ramatuan; Handayani, Indri
Jurnal sosial dan sains Vol. 5 No. 8 (2025): Jurnal Sosial dan Sains
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/jurnalsosains.v5i8.32429

Abstract

Cryptogenic cirrhosis poses a diagnostic dilemma because its underlying cause remains unidentified. Emerging research indicates a two-way association between thyroid disorders—especially hypothyroidism—and liver disease. On one hand, liver dysfunction can impair thyroid hormone metabolism; on the other, hypothyroidism may play a role in advancing non-alcoholic fatty liver disease (NAFLD) and the development of cirrhosis. We report a case of a 48-year-old woman presenting with chronic diarrhea, cold intolerance, fatigue, jaundice, and easy bruising. There was no history of alcohol use, viral hepatitis, or other known causes of liver disease. Physical examination revealed bradycardia, psychomotor slowing, dry skin, and signs of liver dysfunction. Laboratory findings showed pancytopenia, elevated liver enzymes, hypoalbuminemia, and a thyroid profile consistent with overt hypothyroidism (low fT4 and elevated TSH). Imaging supported diagnoses of hepatic cirrhosis and benign thyroid nodules. The patient was treated with levothyroxine 100 mcg/day alongside supportive care. Within a few days, notable clinical improvement occurred, including cessation of diarrhea and better hematologic findings.. This case demonstrates that hypothyroidism may be overlooked as contributor to liver dysfunction, especially in cryptogenic cases. Considering the shared clinical manifestations and biochemical interplay between the liver and thyroid, it is important for clinicians to assess thyroid function in patients presenting with unexplained liver disease. Treating hypothyroidism in such contexts may lead to significant clinical improvement and may alter the course of hepatic deterioration.
Systemic Immune-Inflammation Index as a Potential Indicator of COVID-19 Severity in a Tertiary Hospital in Indonesia Hamdan, Angkasa Ramatuan; Fianza, Pandji Irani; Hartantri, Yovita
Althea Medical Journal Vol 12, No 3 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v12n3.4238

Abstract

Background: The progression of coronavirus disease 2019 (COVID-19) to severe stages is strongly influenced by host immunity and inflammatory. The Systemic Immune-Inflammation Index (SII) is a novel biomarker reflecting both immunity and inflammation. This study aimed to analyze differences in SII according to COVID-19 severity.Methods: A cross-sectional study was conducted using medical records of COVID-19 patients hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between March 2020 and August 2021. SII was calculated as the absolute neutrophil count and platelet count divided by the absolute lymphocyte count obtained from peripheral blood samples. COVID-19 severity was classified based on oxygen saturation (SpO₂). Receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the discriminatory ability of SII. Results: Of the 1,192 patients included, 410 (34.3%) had severe symptoms and 782 (65.7%) had mild to moderate symptoms. The median SII at admission was significantly higher in severe symptoms [1779 x 109 /L (IQR 46-40416)] compared with mild to moderate symptoms [880 x 109 /L (IQR 14.5-23280)]; p<0.001. ROC analysis showed an SII cut-off of 1244 with an AUC of 0.695 (95% CI 0.668–0.721), sensitivity 65.9%, and specificity 66.2%.Conclusions: SII may serve as a potential biomarker for predicting COVID 19 severity. Its simplicity and availability from routine blood counts make it particularly valuable for early risk stratification, especially in resource-limited settings. Moreover, early recognition of elevated SII could support timely interventions, prevent disease progression, and improve clinical outcomes.
Remdesivir-Induced Hepatotoxicity: A Systematic Review of Clinical Evidence, Pharmacokinetics, and Safety Concerns Hamdan, Angkasa Ramatuan; Bestari, Muhamad Begawan; Girawan, Dolvy; Agustanti, Nenny; Husain, Okky; Hasan, Nadeem S.
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 3 (2025): VOLUME 26, NUMBER 3, December, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2632025228-236

Abstract

Background: Remdesivir is widely used for the treatment of COVID-19, with its potential benefits currently under investigation. Concerns remain regarding its potential hepatotoxic side effects. Drug-drug interactions, specifically with CYP3A4 and P-glycoprotein inhibitors, may worsen hepatotoxicity. In this context, dexamethasone has been suggested to mitigate liver injury, but the role remains unclear. Therefore, this study aimed to explore the characteristics, mechanisms, and risk factors of remdesivir-induced hepatotoxicity through a systematic review of case reports.Methods: A systematic review was conducted using databases such as PubMed, Scopus, EBSCO, and BMJ Case Reports for cases published from 2020 to 2024. The keywords used were “remdesivir,” “hepatotoxicity,” “COVID-19,” and “liver failure.” Relevant case reports were selected based on predefined inclusion and exclusion criteria. Furthermore, data were extracted following the Joanna Briggs Institute (JBI) checklist for case reports.Results: Among 46 individual articles screened after the removal of duplicates, five that detailed a total of six patients were eligible for inclusion. Hepatotoxicity was frequently reported in elderly patients and those with chronic liver disease. Drug-drug interactions that include remdesivir and CYP3A4 inhibitors increased the risk of liver injury. Based on observation, dexamethasone was associated with reduced hepatotoxicity, primarily due to its anti-inflammatory effects. In patients with ALT 5× ULN, remdesivir administration was controversial. Some cases showed improvement, and others required discontinuation due to severe liver dysfunction.Conclusion: This study emphasized the necessity for safety evaluations and standardized liver function monitoring in patients receiving remdesivir. Further investigation is essential to define clinical guidelines and improve patient safety in antiviral treatments.